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  1. Article ; Online: Aspirin for Primary Prevention-Time to Rethink Our Approach.

    Berger, Jeffrey S

    JAMA network open

    2022  Volume 5, Issue 4, Page(s) e2210144

    MeSH term(s) Aspirin/therapeutic use ; Humans ; Platelet Aggregation Inhibitors/therapeutic use ; Primary Prevention
    Chemical Substances Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2022-04-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.10144
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  2. Article ; Online: Bleeding Outcomes after Noncardiac Surgery - Are We POISEd to Do Better?

    Berger, Jeffrey S

    The New England journal of medicine

    2022  Volume 386, Issue 21, Page(s) 2052–2053

    MeSH term(s) Hemorrhage/etiology ; Humans ; Postoperative Complications ; Postoperative Hemorrhage/etiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgical Procedures, Operative/adverse effects
    Language English
    Publishing date 2022-05-25
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMe2204599
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  3. Article ; Online: Psoriasis and Cardiovascular Disease-An Ounce of Prevention Is Worth a Pound of Cure.

    Garshick, Michael S / Berger, Jeffrey S

    JAMA dermatology

    2022  Volume 158, Issue 3, Page(s) 239–241

    MeSH term(s) Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Humans ; Psoriasis/prevention & control
    Language English
    Publishing date 2022-01-14
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2701761-8
    ISSN 2168-6084 ; 2168-6068
    ISSN (online) 2168-6084
    ISSN 2168-6068
    DOI 10.1001/jamadermatol.2021.4723
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  4. Article: Platelet-monocyte aggregates: molecular mediators of thromboinflammation.

    Rolling, Christina C / Barrett, Tessa J / Berger, Jeffrey S

    Frontiers in cardiovascular medicine

    2023  Volume 10, Page(s) 960398

    Abstract: Platelets, key facilitators of primary hemostasis and thrombosis, have emerged as crucial cellular mediators of innate immunity and inflammation. Exemplified by their ability to alter the phenotype and function of monocytes, activated platelets bind to ... ...

    Abstract Platelets, key facilitators of primary hemostasis and thrombosis, have emerged as crucial cellular mediators of innate immunity and inflammation. Exemplified by their ability to alter the phenotype and function of monocytes, activated platelets bind to circulating monocytes to form monocyte-platelet aggregates (MPA). The platelet-monocyte axis has emerged as a key mechanism connecting thrombosis and inflammation. MPA are elevated across the spectrum of inflammatory and autoimmune disorders, including cardiovascular disease, systemic lupus erythematosus (SLE), and COVID-19, and are positively associated with disease severity. These clinical disorders are all characterized by an increased risk of thromboembolic complications. Intriguingly, monocytes in contact with platelets become proinflammatory and procoagulant, highlighting that this interaction is a central element of thromboinflammation.
    Language English
    Publishing date 2023-05-15
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2023.960398
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  5. Article ; Online: Perioperative bleeding and outcomes after noncardiac surgery.

    Smilowitz, Nathaniel R / Ruetzler, Kurt / Berger, Jeffrey S

    American heart journal

    2023  Volume 260, Page(s) 26–33

    Abstract: Background: Perioperative bleeding is a common and potentially life-threatening complication after surgery. We sought to identify the frequency, patient characteristics, causes, and outcomes of perioperative bleeding in patients undergoing noncardiac ... ...

    Abstract Background: Perioperative bleeding is a common and potentially life-threatening complication after surgery. We sought to identify the frequency, patient characteristics, causes, and outcomes of perioperative bleeding in patients undergoing noncardiac surgery.
    Methods: In a retrospective cohort study of a large administrative database, adults aged ≥45 years hospitalized for noncardiac surgery in 2018 were identified. Perioperative bleeding was defined using ICD-10 diagnosis and procedure codes. Clinical characteristics, in-hospital outcomes, and first hospital readmission within 6 months were assessed by perioperative bleeding status.
    Results: We identified 2,298,757 individuals undergoing noncardiac surgery, among which 35,429 (1.54%) had perioperative bleeding. Patients with bleeding were older, less likely to be female, and more likely to have renal and cardiovascular disease. All-cause, in-hospital mortality was higher in patients with vs without perioperative bleeding (6.0% vs 1.3%; adjusted OR [aOR] 2.38, 95% CI 2.26-2.50). Patients with vs without bleeding had a prolonged inpatient length of stay (6 [IQR 3-13] vs 3 [IQR 2-6] days, P < .001). Among those who were discharged alive, hospital readmission was more common within 6 months among patients with bleeding (36.0% vs 23.6%; adjusted HR 1.21, 95% CI 1.18-1.24). The risk of in-hospital death or readmission was greater in patients with vs without bleeding (39.8% vs 24.5%; aOR 1.33, 95% CI 1.29-1.38). When stratified by revised cardiac risk index , there was a stepwise increase in surgical bleeding risk with increasing perioperative cardiovascular risks.
    Conclusions: Perioperative bleeding is reported in 1 out of every 65 noncardiac surgeries, with a higher incidence in patients at elevated cardiovascular risk. Among postsurgical inpatients with perioperative bleeding, approximately 1 of every 3 patients died during hospitalization or were readmitted within 6-months. Strategies to reduce perioperative bleeding are warranted to improve outcomes following non-cardiac surgery.
    MeSH term(s) Adult ; Humans ; Female ; Male ; Retrospective Studies ; Hospital Mortality ; Hemorrhage/etiology ; Cardiovascular Diseases/epidemiology ; Hospitalization ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Risk Factors ; Surgical Procedures, Operative/adverse effects
    Language English
    Publishing date 2023-02-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80026-0
    ISSN 1097-6744 ; 0002-8703
    ISSN (online) 1097-6744
    ISSN 0002-8703
    DOI 10.1016/j.ahj.2023.02.008
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  6. Article ; Online: Oral Antiplatelet Therapy for Secondary Prevention of Acute Coronary Syndrome.

    Berger, Jeffrey S

    American journal of cardiovascular drugs : drugs, devices, and other interventions

    2018  Volume 18, Issue 6, Page(s) 457–472

    Abstract: Patients surviving an acute coronary syndrome (ACS) remain at increased risk of ischemic events long term. This paper reviews current evidence and guidelines for oral antiplatelet therapy for secondary prevention following ACS, with respect to decreased ... ...

    Abstract Patients surviving an acute coronary syndrome (ACS) remain at increased risk of ischemic events long term. This paper reviews current evidence and guidelines for oral antiplatelet therapy for secondary prevention following ACS, with respect to decreased risk of ischemic events versus bleeding risk according to individual patient characteristics and risk factors. Specifically, data are reviewed from clinical studies of clopidogrel, prasugrel, ticagrelor and vorapaxar, as well as the results of systematic reviews and meta-analyses looking at the benefits and risks of oral antiplatelet therapy, and the relative merits of shorter versus longer duration of dual antiplatelet therapy, in different patient groups.
    MeSH term(s) Acute Coronary Syndrome/epidemiology ; Acute Coronary Syndrome/prevention & control ; Adenosine Diphosphate/metabolism ; Administration, Oral ; Aging ; Blood Platelets/metabolism ; Cyclooxygenase 1/biosynthesis ; Diabetes Mellitus/epidemiology ; Drug Administration Schedule ; Hemorrhage/chemically induced ; Humans ; Platelet Aggregation Inhibitors/administration & dosage ; Platelet Aggregation Inhibitors/adverse effects ; Practice Guidelines as Topic ; Purinergic P2Y Receptor Antagonists/administration & dosage ; Purinergic P2Y Receptor Antagonists/adverse effects ; Receptor, PAR-1/biosynthesis ; Receptors, Purinergic P2Y12/biosynthesis ; Renal Insufficiency/epidemiology ; Risk Factors ; Secondary Prevention/methods ; Thrombin/metabolism ; Thromboxane A2/biosynthesis ; Time Factors ; Vascular Diseases/epidemiology
    Chemical Substances Platelet Aggregation Inhibitors ; Purinergic P2Y Receptor Antagonists ; Receptor, PAR-1 ; Receptors, Purinergic P2Y12 ; Thromboxane A2 (57576-52-0) ; Adenosine Diphosphate (61D2G4IYVH) ; Cyclooxygenase 1 (EC 1.14.99.1) ; Thrombin (EC 3.4.21.5)
    Language English
    Publishing date 2018-09-27
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2052547-3
    ISSN 1179-187X ; 1175-3277
    ISSN (online) 1179-187X
    ISSN 1175-3277
    DOI 10.1007/s40256-018-0291-2
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  7. Article ; Online: Anticoagulation in COVID-19: reaction to the ACTION trial.

    Berger, Jeffrey S / Connors, Jean Marie

    Lancet (London, England)

    2021  Volume 397, Issue 10291, Page(s) 2226–2228

    MeSH term(s) Anticoagulants/adverse effects ; COVID-19 ; Fibrin Fibrinogen Degradation Products ; Hospitals ; Humans ; SARS-CoV-2
    Chemical Substances Anticoagulants ; Fibrin Fibrinogen Degradation Products ; fibrin fragment D
    Language English
    Publishing date 2021-06-10
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)01291-5
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  8. Article ; Online: Acute myocardial infarction in von Willebrand disease: characteristics and outcomes.

    Leiva, Orly / Connors, Jean M / Connell, Nathan T / Berger, Jeffrey S

    Research and practice in thrombosis and haemostasis

    2023  Volume 7, Issue 7, Page(s) 102198

    Abstract: Background: Von Willebrand disease (VWD) is the most common inherited bleeding disorder. As treatments have improved prognosis of VWD, age-related diseases, including acute myocardial infarction (AMI), have become more prevalent. The treatment of AMI ... ...

    Abstract Background: Von Willebrand disease (VWD) is the most common inherited bleeding disorder. As treatments have improved prognosis of VWD, age-related diseases, including acute myocardial infarction (AMI), have become more prevalent. The treatment of AMI includes antithrombotic therapies, which increase the risk of bleeding. Current guidelines suggest weighing risks/benefits of antithrombotic therapy in patients with VWD. However, data to inform these discussions are lacking.
    Objective: To characterize outcomes of patients with VWD after AMI.
    Methods: We conducted a retrospective cohort study utilizing the National Readmissions Database of patients with and without VWD admitted with AMI in 2017 and 2018. Primary outcomes were 90-day any-cause, bleeding-related, and arterial thrombosis-related readmissions. Case-control matching was performed for age, sex (male or female), ST-elevation myocardial infarction, percutaneous coronary intervention, diabetes, and chronic kidney disease. Time-to-event analysis was performed after matching using Cox proportional hazards regression.
    Results: A total of 136 patients with VWD were matched with 3400 controls without VWD. At 90 days, there were no differences in all-cause (10.7% vs 11.5%;
    Conclusion: Among patients admitted with AMI, VWD was associated with higher risk of 90-day readmission for bleeding but not any-cause and arterial thrombosis-related readmissions. Further studies are needed to balance bleeding and thrombotic risks post-AMI in patients with VWD.
    Language English
    Publishing date 2023-09-09
    Publishing country United States
    Document type Journal Article
    ISSN 2475-0379
    ISSN (online) 2475-0379
    DOI 10.1016/j.rpth.2023.102198
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  9. Article ; Online: Frailty Assessment and Perioperative Major Adverse Cardiovascular Events After Noncardiac Surgery.

    Siddiqui, Emaad / Banco, Darcy / Berger, Jeffrey S / Smilowitz, Nathaniel R

    The American journal of medicine

    2023  Volume 136, Issue 4, Page(s) 372–379.e5

    Abstract: Objective: Frailty is an emerging risk factor for adverse outcomes. However, perioperative frailty assessments derived from electronic health records have not been studied on a large scale. We aim to estimate the prevalence of frailty and the associated ...

    Abstract Objective: Frailty is an emerging risk factor for adverse outcomes. However, perioperative frailty assessments derived from electronic health records have not been studied on a large scale. We aim to estimate the prevalence of frailty and the associated incidence of major adverse cardiovascular events (MACE) among adults hospitalized for noncardiac surgery.
    Methods: Adults aged ≥45 years hospitalized for noncardiac surgery from 2004-2014 were identified from the National Inpatient Sample. The validated Hospital Frailty Risk Score (HFRS) derived from International Classification of Diseases codes was used to classify patients as low (HFRS <5), medium (5-10), or high (>10) frailty risk. The primary outcome was MACE, defined as myocardial infarction, cardiac arrest, and in-hospital mortality. Multivariable logistic regression was used to estimate the adjusted odds of MACE stratified by age and HFRS.
    Results: A total of 55,349,978 hospitalizations were identified, of which 81.0%, 14.4%, and 4.6% had low, medium, and high HFRS, respectively. Patients with higher HFRS had more cardiovascular risk factors and comorbidities. MACE occurred during 2.5% of surgical hospitalizations and was common among patients with high frailty scores (high HFRS: 9.1%, medium: 6.9%, low: 1.3%, P < .001). Medium (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI], 2.02-2.08) and high (aOR 2.75; 95% CI, 2.70-2.79) HFRS were associated with greater odds of MACE vs low HFRS, with the greatest odds of MACE observed in younger individuals 45-64 years (interaction P value < .001).
    Conclusions: The HFRS may identify frail surgical inpatients at risk for adverse perioperative cardiovascular outcomes.
    MeSH term(s) Adult ; Humans ; Frailty/epidemiology ; Frailty/complications ; Retrospective Studies ; Myocardial Infarction/epidemiology ; Myocardial Infarction/etiology ; Hospitalization ; Risk Factors
    Language English
    Publishing date 2023-01-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2022.12.033
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  10. Article ; Online: Antithrombotic therapy in peripheral artery disease.

    Berger, Jeffrey S

    Lancet (London, England)

    2017  Volume 391, Issue 10117, Page(s) 183–184

    MeSH term(s) Anticoagulants ; Fibrinolytic Agents ; Humans ; Peripheral Arterial Disease ; Platelet Aggregation Inhibitors
    Chemical Substances Anticoagulants ; Fibrinolytic Agents ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2017-11-10
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(17)32847-7
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