Acute Coronary Syndromes

Overview

Research by faculty affiliated with the Acute Cardiac Care Unit focuses on clinical trials that provide the evidence base for quality care.

Cardiovascular medicine faculty led the SYNERGY trial, which enrolled 10,027 patients at 457 sites in 12 countries. In comparing rates of death or non-fatal heart attack after 30 days, the trial found that treatment with enoxaparin is at least as effective as with unfractionated heparin.

Other research examples include:

  • Leadership of a study showing that hospital adherence to national guidelines for treating patients with potential heart attacks saves lives. It is one of the few studies to correlate individual hospitals' combined use of recommended treatments with how patients actually fare.
  • Analysis of a large clinical trial shows that adherence to medical therapy, even if the medication is an inert placebo, relates to better outcomes for heart failure patients. The finding suggests that adherence itself is a marker for other unmeasured variables that can determine outcome.
  • A substudy of GUSTO-IIa shows that the cardiac troponin level is a strong, independent predictor of short-term outcome in acute coronary syndromes, and that adding subsequent samples to a baseline level is useful to evaluate the risk of serious cardiac events.
  • Comparison of prognostic markers among 29,357 patients in the CRUSADE initiative showed that an elevated cardiac troponin (cTn) level identifies patients at increased acute risk regardless of Creatinine kinase-MB (CK-MB) status, but an isolated CK-MB+ status has limited prognostic value. Recognition of these risk differences may contribute to more appropriate early use of antithrombotic therapy and invasive management for all cTn+ patients.

Faculty

Christopher B. Granger, MD
Director

L. Kristin Newby, MD
Co-director

John H. Alexander, MD
Richard C. Becker, MD 
Robert M. Califf, MD
Pamela S. Douglas, MD
Robert A. Harrington, MD
James G. Jollis, MD
Kenneth W. Mahaffey, MD
Daniel B. Mark, MD
E. Magnus Ohman, MD
Eric D. Peterson, MD
Matthew T. Roe, MD

Contact Information

Office: 7005 North Pavilion, Durham, NC, 27710 
Campus mail: DUMC Box 3409, Durham, NC 27710 
Phone: 919-668-8900 
Fax: 919-668-7056