Search

Your search keyword '"Lappe, Donald L"' showing total 203 results
Start Over Author "Lappe, Donald L"
203 results on '"Lappe, Donald L"'

5. Comparison of Three Atherosclerotic Cardiovascular Disease Risk Scores With and Without Coronary Calcium for Predicting Revascularization and Major Adverse Coronary Events in Symptomatic Patients Undergoing Positron Emission Tomography-Stress Testing

Author

Anderson, Jeffrey L., Le, Viet T., Min, David B., Biswas, Santanu, Minder, C. Michael, McCubrey, Raymond O., Knight, Stacey, Horne, Benjamin D., Mason, Steve, Lappe, Donald L., Muhlestein, Joseph B., and Knowlton, Kirk U.

Published
2020
Full Text
View/download PDF

28. Vitamin D supplementation protects against reductions in plasma 25‐hydroxyvitamin D induced by open‐heart surgery: Assess‐d trial

Author

Barker, Tyler, primary, May, Heidi T., additional, Doty, John R., additional, Lappe, Donald L., additional, Knowlton, Kirk U., additional, Carlquist, John, additional, Konery, Kristin, additional, Inglet, Shannon, additional, Chisum, Ben, additional, Galenko, Oxana, additional, Anderson, Jeffrey L., additional, and Muhlestein, Joseph B., additional

Published
2021
Full Text
View/download PDF

44. Improvements in 1-year cardiovascular clinical outcomes associated with a hospital-based discharge medication program

Author

Lappe, Jason M., Muhlestein, Joseph B., Lappe, Donald L., Badger, Rodney S., Bair, Tami L., Brockman, Ruth, French, Thomas K., Hofmann, Linda C., Horne, Benjamin D., Kralick-Goldberg, Susan, Nicponski, Nan, Orton, Janette A., Pearson, Robert R., Renlund, Dale G., Rimmasch, Holly, Roberts, Colleen, and Anderson, Jeffrey L.

Subjects
Enzyme inhibitors -- Dosage and administration, Cardiovascular diseases -- Research, Cardiovascular diseases -- Care and treatment, Company business management, Health
Abstract

Background: Despite recent advances in the treatment and prevention of cardiovascular disease, a treatment gap for secondary prevention medications still exists. Objective: To develop and implement a program ensuring appropriate prescription of aspirin, statins, [beta]-blockers, angiotensin-converting enzyme inhibitors, and warfarin at hospital discharge. Design: A nonrandomized before-after study comparing patients hospitalized before (1996-1998) and after (1999-2002) implementation of a discharge medication program (DMP). Patients were followed for up to 1 year. Setting: The 10 largest hospitals in the Utah-based Intermountain Health Care system. Patients: In the pre-DMP and DMP time periods, 26 000 and 31 465 patients, respectively, were admitted to cardiovascular services (n = 57 465). Measurements: Prescription of indicated medications at hospital discharge; postdischarge death or readmission. Results: By 1 year, the rate of prescription of each medication increased significantly to more than 90% (P < 0.001); this rate was sustained. At 1 year, unadjusted absolute event rates for readmission and death, respectively, were 210 per 1000 person-years and 96 per 1000 person-years before DMP implementation and 191 per 1000 person-years and 70 per 1000 person-years afterward. Relative risk for death and readmission at 30 days decreased after DMP implementation; hazard ratios (HRs) for death and readmission were 0.81 (95% CI, 0.73 to 0.89) and 0.92 (CI, 0.87 to 0.99) (P < 0.001 and P = 0.017, respectively). At 1 year, risk for death continued to decrease (hazard ratio, 0.79 [CI, 0.75 to 0.84]; P< 0.001) while risk for readmission stabilized (hazard ratio, 0.94 [CI, 0.90 to 0.98]; P = 0.002), probably because survivors had more opportunities to be readmitted. Limitations: The study design was observational and nonrandomized, and the authors could not control for potential con-founders or determine the extent to which secular trends accounted for the observed improvements. Conclusions: A relatively simple quality improvement program aimed at enhancing the prescription of appropriate discharge medications among cardiovascular patients is feasible and can be sustained within an integrated multihospital system. Such a program may be associated with improvements in cardiovascular readmission rates and mortality.

Published
2004

46. Free thyroxine within the normal reference range predicts risk of atrial fibrillation.

Author

Anderson, Jeffrey L., Jacobs, Victoria, May, Heidi T., Bair, Tami L., Benowitz, Barry A., Lappe, Donald L., Muhlestein, Joseph B., Knowlton, Kirk U., and Bunch, T. Jared

Subjects
ATRIAL fibrillation risk factors, HEALTH facilities, MEDICAL records, REFERENCE values, THYROTROPIN, THYROXINE, TRIIODOTHYRONINE, MULTIPLE regression analysis, DESCRIPTIVE statistics
Abstract

Introduction: Hyperthyroidism is a known precipitating factor for atrial fibrillation (AF). However, recent reports have suggested an increased risk of AF with free thyroxine (fT4) levels even within the upper reference (normal) range. We sought to test whether higher fT4 levels within the reference range are associated with an increased risk of AF. Methods and Results: All patients in the Intermountain Healthcare electronic medical record database with an fT4 level not on thyroid medication were included. The reference range of fT4 was divided into quartiles (Q), and associations with prevalent and incident AF were assessed by multivariable regression. Similar analyses were performed for thyroid stimulating hormone (TSH) and total and free T3. A total of 174 914 patients were included and followed for 7.0 ± 4.9 years. Of these, 7.4%, 88.4%, and 4.2% had fT4 levels below, within, and above the reference range. As expected, prevalent AF was greater with elevated fT4. However, gradients also were noted within the reference range, comparing Q4 to Q1, for prevalent AF (adjusted odds ratio 1.4, P <.0001) and incident AF (adjusted hazard ratio 1.16, P <.0001). In contrast, no relationship with AF prevalence and incidence was noted for total and free T3 within their reference ranges, and the pattern for TSH was uninformative. Conclusion: Higher fT4 levels within the reference range were associated with an increased prevalence and incidence of AF. These findings in a large dataset prospectively validate earlier reports and may have important implications, including a redefinition of the normal range and fT4 targets for replacement therapy. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

48. Implementation of a cardiac PET stress program: comparison of outcomes to the preceding SPECT era

Author

Knight, Stacey, primary, Min, David B., additional, Le, Viet T., additional, Meredith, Kent G., additional, Dhar, Ritesh, additional, Biswas, Santanu, additional, Jensen, Kurt R., additional, Mason, Steven M., additional, Ethington, Jon-David, additional, Lappe, Donald L., additional, Muhlestein, Joseph B., additional, Anderson, Jeffrey L., additional, and Knowlton, Kirk U., additional

Published
2018
Full Text
View/download PDF

49. CHA2DS2-VASc scores and Intermountain Mortality Risk Scores for the joint risk stratification of dementia among patients with atrial fibrillation.

Author

Graves, Kevin G, May, Heidi T, Jacobs, Victoria, Knowlton, Kirk U, Muhlestein, Joseph B, Lappe, Donald L, Anderson, Jeffrey L, Horne, Benjamin D, and Bunch, T Jared

Abstract

Background: High CHA2DS2-VASc scores in atrial fibrillation (AF) patients are generally associated with increased risks of stroke and dementia. At lower CHA2DS2-VASc scores, there remains an unquantifiable cranial injury risk, necessitating an improved risk assessment method within these lower-risk groups.Objective: The purpose of this study was to determine whether sex-specific Intermountain Mortality Risk Scores (IMRS), a dynamic measures of systemic health that comprises commonly performed blood tests, can stratify dementia risk overall and among CHA2DS2-VASc score strata in AF patients.Methods: Female (n = 34,083) and male (n = 39,998) AF patients with no history of dementia were studied. CHA2DS2-VASc scores were assessed at the time of AF diagnosis and were stratified into scores of 0-1, 2, and ≥3. Within each CHA2DS2-VASc score stratum, patients were further stratified by IMRS categories of low, moderate, and high. Multivariable Cox hazard regression was used to determine dementia risk.Results: High-risk IMRS patients were generally older and had higher rates of hypertension, diabetes, heart failure, and prior stroke. Higher CHA2DS2-VASc score strata (≥3 vs ≤1: women, hazard ratio [HR] 7.77, 95% confidence interval [CI] 5.94-10.17, P < .001; men: HR 4.75, 95% CI 4.15-5.44, P < .001) and IMRS categories (high vs low: women, HR 3.09, 95% CI 2.71-3.51, P < .001; men, HR 2.70, 95% CI 2.39-3.06, P < .001) were predictive of dementia. When stratified by CHA2DS2-VASc scores, IMRS further identified risk in each stratum.Conclusion: Both CHA2DS2-VASc scores and IMRS were independently associated with dementia incidence among AF patients. IMRS further stratified dementia risk among CHA2DS2-VASc score strata, particularly among those with lower CHA2DS2-VASc scores. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results