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  1. Article ; Online: Vascular Disease Patient Information Page: COVID-19-related thrombosis.

    Schmaier, Alec A / Schmaier, Alvin H

    Vascular medicine (London, England)

    2020  Volume 25, Issue 6, Page(s) 604–607

    MeSH term(s) Anticoagulants/therapeutic use ; Blood Coagulation/drug effects ; COVID-19/blood ; COVID-19/diagnosis ; COVID-19/drug therapy ; COVID-19/virology ; Host-Pathogen Interactions ; Humans ; Risk Factors ; SARS-CoV-2/pathogenicity ; Thrombosis/blood ; Thrombosis/diagnosis ; Thrombosis/prevention & control ; Thrombosis/virology
    Chemical Substances Anticoagulants
    Keywords covid19
    Language English
    Publishing date 2020-10-12
    Publishing country England
    Document type Journal Article ; Patient Education Handout
    ZDB-ID 1311628-9
    ISSN 1477-0377 ; 1358-863X
    ISSN (online) 1477-0377
    ISSN 1358-863X
    DOI 10.1177/1358863X20963804
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  2. Article ; Online: Trends in Discharge Rates for Acute Pulmonary Embolism in U.S. Emergency Departments.

    Watson, Nathan W / Carroll, Brett J / Krawisz, Anna / Schmaier, Alec / Secemsky, Eric A

    Annals of internal medicine

    2024  Volume 177, Issue 2, Page(s) 134–143

    Abstract: Background: Outpatient management of select patients with low-risk acute pulmonary embolism (PE) has been proven to be safe and effective, yet recent evidence suggests that patients are still managed with hospitalization. Few studies have assessed ... ...

    Abstract Background: Outpatient management of select patients with low-risk acute pulmonary embolism (PE) has been proven to be safe and effective, yet recent evidence suggests that patients are still managed with hospitalization. Few studies have assessed contemporary real-world trends in discharge rates from U.S. emergency departments (EDs) for acute PE.
    Objective: To evaluate whether the proportion of discharges from EDs for acute PE changed between 2012 and 2020 and which baseline characteristics are associated with ED discharge.
    Design: Serial cross-sectional analysis.
    Setting: U.S. EDs participating in the National Hospital Ambulatory Medical Care Survey.
    Patients: Patients with ED visits for acute PE between 2012 and 2020.
    Measurements: National trends in the proportion of discharges for acute PE and factors associated with ED discharge.
    Results: Between 2012 and 2020, there were approximately 1 635 300 visits for acute PE. Overall, ED discharge rates remained constant over time, with rates of 38.2% (95% CI, 17.9% to 64.0%) between 2012 and 2014 and 33.4% (CI, 21.0% to 49.0%) between 2018 and 2020 (adjusted risk ratio, 1.01 per year [CI, 0.89 to 1.14]). No baseline characteristics, including established risk stratification scores, were predictive of an increased likelihood of ED discharge; however, patients at teaching hospitals and those with private insurance were more likely to receive oral anticoagulation at discharge. Only 35.9% (CI, 23.9% to 50.0%) of patients who were considered low-risk according to their Pulmonary Embolism Severity Index (PESI) class, 33.1% (CI, 21.6% to 47.0%) according to simplified PESI score, and 34.8% (CI, 23.3% to 48.0%) according to hemodynamic stability were discharged from the ED setting.
    Limitations: Cross-sectional survey design and inability to adjudicate diagnoses.
    Conclusion: In a representative nationwide sample, rates of discharge from the ED for acute PE appear to have remained constant between 2012 and 2020. Only one third of low-risk patients were discharged for outpatient management, and rates seem to have stabilized. Outpatient management of low-risk acute PE may still be largely underutilized in the United States.
    Primary funding source: None.
    MeSH term(s) Humans ; United States/epidemiology ; Patient Discharge ; Cross-Sectional Studies ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/therapy ; Pulmonary Embolism/diagnosis ; Emergency Service, Hospital ; Risk Factors
    Language English
    Publishing date 2024-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M23-2442
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  4. Article ; Online: Predictors of Thrombus Resolution Among Patients Who Undergo Anticoagulation for a Right Heart Thrombus.

    Watson, Nathan W / Dicks, Andrew B / Carroll, Brett J / Schmaier, Alec / Secemsky, Eric A

    Chest

    2023  Volume 164, Issue 5, Page(s) 1298–1301

    MeSH term(s) Humans ; Thrombosis/drug therapy ; Anticoagulants/therapeutic use ; Heart Diseases/drug therapy
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Letter
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2023.06.017
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  5. Article ; Online: Vasculopathy in COVID-19.

    Flaumenhaft, Robert / Enjyoji, Keiichi / Schmaier, Alec A

    Blood

    2022  Volume 140, Issue 3, Page(s) 222–235

    Abstract: COVID-19 is a primary respiratory illness that is frequently complicated by systemic involvement of the vasculature. Vascular involvement leads to an array of complications ranging from thrombosis to pulmonary edema secondary to loss of barrier function. ...

    Abstract COVID-19 is a primary respiratory illness that is frequently complicated by systemic involvement of the vasculature. Vascular involvement leads to an array of complications ranging from thrombosis to pulmonary edema secondary to loss of barrier function. This review will address the vasculopathy of COVID-19 with a focus on the role of the endothelium in orchestrating the systemic response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The endothelial receptor systems and molecular pathways activated in the setting of COVID-19 and the consequences of these inflammatory and prothrombotic changes on endothelial cell function will be discussed. The sequelae of COVID-19 vascular involvement at the level of organ systems will also be addressed, with an emphasis on the pulmonary vasculature but with consideration of effects on other vascular beds. The dramatic changes in endothelial phenotypes associated with COVID-19 has enabled the identification of biomarkers that could help guide therapy and predict outcomes. Knowledge of vascular pathogenesis in COVID-19 has also informed therapeutic approaches that may control its systemic sequelae. Because our understanding of vascular response in COVID-19 continues to evolve, we will consider areas of controversy, such as the extent to which SARS-CoV-2 directly infects endothelium and the degree to which vascular responses to SARS-CoV-2 are unique or common to those of other viruses capable of causing severe respiratory disease. This conceptual framework describing how SARS-CoV-2 infection affects endothelial inflammation, prothrombotic transformation, and barrier dysfunction will provide a context for interpreting new information as it arises addressing the vascular complications of COVID-19.
    MeSH term(s) COVID-19/complications ; Humans ; Inflammation ; SARS-CoV-2 ; Thrombosis/etiology ; Vascular Diseases/etiology
    Language English
    Publishing date 2022-01-04
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2021012250
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  6. Article ; Online: Vascular Disease Patient Information Page

    Schmaier, Alec A / Schmaier, Alvin H

    Vascular Medicine

    COVID–19-related thrombosis

    2020  , Page(s) 1358863X2096380

    Keywords Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1311628-9
    ISSN 1477-0377 ; 1358-863X
    ISSN (online) 1477-0377
    ISSN 1358-863X
    DOI 10.1177/1358863x20963804
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  7. Article ; Online: Venous Thromboembolism for the Practicing Cardiologist.

    Pribish, Abby M / Secemsky, Eric A / Schmaier, Alec A

    Cardiology clinics

    2021  Volume 39, Issue 4, Page(s) 551–566

    Abstract: Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep vein thrombosis (DVT), is encountered commonly. Acute PE may present as a high-risk cardiovascular emergency, and acute DVT can cause acute and chronic vascular complications. ... ...

    Abstract Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep vein thrombosis (DVT), is encountered commonly. Acute PE may present as a high-risk cardiovascular emergency, and acute DVT can cause acute and chronic vascular complications. The goal of this review is to ensure that cardiologists are comfortable managing VTE-including risk stratification, anticoagulation therapy, and familiarity with primary reperfusion therapy. Clinical assessment and determination of degree of right ventricular dysfunction are critical in initial risk stratification of PE and determination of parenteral versus oral anticoagulation therapy. Direct oral anticoagulants have emerged as preferred first-line oral anticoagulation strategy in VTE scenarios.
    MeSH term(s) Anticoagulants/therapeutic use ; Cardiologists ; Humans ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/therapy ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thrombosis
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-10-22
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 1196385-2
    ISSN 1558-2264 ; 0733-8651
    ISSN (online) 1558-2264
    ISSN 0733-8651
    DOI 10.1016/j.ccl.2021.06.008
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  8. Article ; Online: 2019 Fellows Course and Advanced Practice Provider Course.

    Weinberg, Ido / Weinberg, Mitchell / Secemsky, Eric / Schmaier, Alec

    Vascular medicine (London, England)

    2020  Volume 25, Issue 2, Page(s) 200–201

    Language English
    Publishing date 2020-03-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1311628-9
    ISSN 1477-0377 ; 1358-863X
    ISSN (online) 1477-0377
    ISSN 1358-863X
    DOI 10.1177/1358863X20906861
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  9. Article ; Online: Are Patients Getting Their Aspirin's Worth in Ischemic Stroke?

    Schmaier, Alec A / Bhatt, Deepak L

    Journal of the American Heart Association

    2018  Volume 7, Issue 11

    MeSH term(s) Aspirin ; Brain Ischemia ; Humans ; Platelet Aggregation Inhibitors ; Platelet Function Tests ; Stroke
    Chemical Substances Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2018-06-01
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.118.009564
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  10. Article ; Online: A Lack of Reserve: Recognizing the Large Impact of Small Vessels in the Heart.

    Schmaier, Alec A / Taqueti, Viviany R

    Circulation

    2018  Volume 138, Issue 4, Page(s) 424–428

    MeSH term(s) Aged ; Angina Pectoris/diagnostic imaging ; Angina Pectoris/physiopathology ; Angina Pectoris/therapy ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/physiopathology ; Coronary Artery Disease/therapy ; Coronary Restenosis/etiology ; Coronary Restenosis/physiopathology ; Coronary Stenosis/diagnostic imaging ; Coronary Stenosis/physiopathology ; Coronary Stenosis/therapy ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/physiopathology ; Drug-Eluting Stents ; Electrocardiography ; Female ; Fractional Flow Reserve, Myocardial ; Humans ; Microcirculation ; Myocardial Perfusion Imaging/methods ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation ; Positron-Emission Tomography ; Treatment Outcome
    Language English
    Publishing date 2018-07-23
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.117.031602
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