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Jason H Cole

Publications and source records attributed to Jason H Cole.

7 recordsLinked to original sources
PubMed2007

Clues to cardiovascular risk: an office-based approach.

Current tools for predicting coronary heart disease risk in the asymptomatic patient fall into 2 major categories: traditional population-based models and noninvasive imaging techniques. Population-based models that estimate cardiovascular risk are powerful clinical tools but do not utilize a large volume of patient-specific data that are readily available to the clinician and may help to identify at-risk patients. The use of high-technology noninvasive imaging has not been consistently validated and clinicians or patients often lack the resources for such testing. This paper reviews several commonly encountered historical, physical, radiologic, laboratory, and electrocardiographic markers of increased cardiovascular risk that may enhance clinicians' ability to identify individual patients at increased risk for coronary heart disease.

Atherosclerosis↗
PubMed2004

Risk factors and outcomes in patients with coronary artery aneurysms.

Previous small series have provided conflicting data on the association between coronary artery aneurysms and traditional cardiac risk factors, as well as limited information on patient outcomes. This investigation sought to determine whether the presence of coronary artery aneurysms has an adverse affect on patient outcomes. The results show that coronary aneurysms were an independent predictor of mortality, and overall 5-year survival in patients with aneurysms was only 71%. We believe that clinicians should aggressively monitor and modify coronary risk factors in patients with coronary aneurysms.

Adult↗
PubMed2004

Premature coronary artery disease: clinical risk factors and prognosis.

Coronary artery disease (CAD) that becomes manifest in young adults can have devastating consequences. Additionally, the study of young patients with CAD may provide insight into the genetic basis of coronary disease. Over the past few years, our understanding of risk factors in this population has been expanded to include social, environmental, and emotional factors. The identification of genetic markers for disease is just beginning. Also, it has recently been shown that CAD in young adults has a poor long-term prognosis, meaning that clinicians caring for these patients must be aggressive in risk factor control.

Age Factors↗
PubMed2003

Long-term follow-up of coronary artery disease presenting in young adults.

OBJECTIVES: This study evaluated long-term survival and predictors of elevated risk for young adults diagnosed with coronary artery disease (CAD). BACKGROUND: Coronary artery disease is rarely seen in young adults. Traditional cardiac risk factors have been studied in small series; however, many questions exist. METHODS: We identified 843 patients under age 40 with CAD diagnosed by coronary angiography from 1975 to 1985. Death, hypertension, gender, family history, prior myocardial infarction (MI), diabetes, heart failure, angina class, number of diseased vessels, ejection fraction (EF), Q-wave infarction, in-hospital death, and initial therapy were studied. Patients were followed for 15 years. RESULTS: The mean age was 35 for women (n = 94) and 36 for men (n = 729). The average EF was 55%. Fifty-eight percent of the subjects had single-vessel disease, and 10% were diabetic. The strongest predictors of long-term mortality were a prior MI (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.00 to 1.73), New York Heart Association class II heart failure (HR 1.75, 95% CI 1.03 to 2.97), and active tobacco use (HR 1.59, 95% CI 1.14 to 2.21). Revascularization, rather than medical therapy, was associated with lower mortality (coronary angioplasty: HR 0.51, 95% CI 0.32 to 0.81; coronary artery bypass graft: HR 0.68, 95% CI 0.50 to 0.94). Overall mortality was 30% at 15 years. Patients with diabetes had 15-year mortality of 65%. Those with prior MI had 15-year mortality of 45%, and patients with an EF <30% a mortality of 83% at 15 years. CONCLUSIONS: Coronary disease in young adults can carry a poor long-term prognosis. A prior MI, diabetes, active tobacco abuse, and lower EF predict a significantly higher mortality.

Adult↗
PubMed2002

Outcomes of repeat revascularization in diabetic patients with prior coronary surgery.

OBJECTIVES: This study evaluated both short- and long-term outcomes of diabetic patients who underwent repeat coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI) after initial CABG. BACKGROUND: Although diabetic patients who have multivessel coronary disease and require initial revascularization may benefit from CABG as compared with PCI, the uncertainty concerning the choice of revascularization may be greater for diabetic patients who have had previous CABG. METHODS: Data were obtained over 15 years for diabetic patients undergoing PCI procedures or repeat CABG after previous coronary surgery. Baseline characteristics were compared between groups, and in-hospital, 5-year, and 10-year mortality rates were calculated. Multivariate correlates of in-hospital and long-term mortality were determined. RESULTS: Both PCI (n = 1,123) and CABG (n = 598) patients were similar in age, gender, years of diabetes, and insulin dependence, but they varied in presence of hypertension, prior myocardial infarction, angina severity, heart failure, ejection fraction, and left main disease. In-hospital mortality was greater for CABG, but differences in long-term mortality were not significant (10 year mortality, 68% PCI vs. 74% CABG, p = 0.14). Multivariate correlates of long-term mortality were older age, hypertension, low ejection fraction, and an interaction between heart failure and choice of PCI. The PCI itself did not correlate with mortality. CONCLUSIONS: The increased initial risk of redo CABG in diabetic patients and the comparable high long-term mortality regardless of type of intervention suggest that, except for patients with severe heart failure, PCI be strongly considered in all patients for whom there is a percutaneous alternative.

Aged↗