Division of Cardiovascular Diseases and Hypertension

The Center for Disease Management and Clinical Outcomes is a collaborative effort of the Department of Medicine of UMDNJ-Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, and Rutgers University College of Pharmacy. Established in July 1994, the Center carries out research, educational, and clinical activities in the broad areas of disease management and clinical outcomes.

In the research area, it conducts and supports research on disease management and clinical outcomes in the inpatient, outpatient, and community settings. Research activities involve:

• Methodological issues
• Individual disease entities
• Pharmacoeconomics
• Factors affecting the application of medical knowledge
• Physician education
• Protocol implementation across hospital systems

Clinical activities involve coordination of Robert Wood Johnson University Hospital physician-related initiatives including:

• Disease management and clinical outcomes
• Medical “best practices”
• Practice protocols
• Clinical resource management
• Clinical benchmarking.

Activities in the outpatient area are coordinated with the University Medical Group and the Robert Wood Johnson University Hospital.

Educational activities target healthcare professionals and persons involved in the broad fields of disease management and clinical outcomes. Activities include:

• Continuing medical education conferences addressed to local and national audiences,
• Seminars and publication of relevant material.

A fellowship in disease management and clinical outcomes will be inaugurated in the next academic year.
In the current academic year, the center has received external funding of over $100,000 for its research and educational activities.

The Center has developed a new journal, Disease Management and Clinical Outcomes, first published by Elsevier Science Inc. in 1997. The journal boasts a distinguished multidisciplinary editorial board of internationally and nationally renowned experts in the fields of epidemiology, disease management, clinical outcomes, and health economics and health services research.

The publication publishes peer-reviewed articles on all aspects of disease management, clinical outcomes, and health economics including original studies, review articles, and commentary regarding theoretical, methodological, implementation, ethical, legal, and regulatory issues.

Directors: Clifton R. Lacy, MD, and John B. Kostis, MD

The Advanced Heart Failure and Transplant Cardiology Research Program is a collaborative effort of the Department of Medicine of UMDNJ-Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital. Established in 2002, the Program carries out research, educational, and clinical activities in the area of heart failure and transplant research.

In the research area, it conducts and supports research on heart failure management and clinical outcomes in the inpatient, outpatient, and community settings. Research activities involve:

• Decision analysis
• New drug development
• Pharmacoeconomics
• Cardiac support devices
• Outcomes research

Director: Luis H. Arroyo, MD

Peer-Reviewed Articles

• Ciaccio EJ, Biviano AB, Whang W, Wit AL, Garan H, Coromilas J: New methods for estimating local electrical activation rate during atrial fibrillation. Heart Rhythm 6: 21-32, 2009.  
• Tung R, Sklyar E, Josephson M. An unusual form of preexcitation: fasciculoventricular bypass tract. Heart Rhythm. 2008 Dec;5(12):1767-8
• Sabnani I, Zucker MJ, Rosenstein ED, Baran DA, Arroyo LH, Tsang P, Zubair M, Rivera V. A novel therapeutic approach to the treatment of scleroderma-associated pulmonary complications: safety and efficacy o combination therapy with imatinib and cyclophosphamide. Rheumatology (Oxford). 2009 Jan; 48(1):49-52, PMID:18815156
• Tinker LF, Bonds DE, Margolis, et al (JB Kostis Collaborator); Women’s Health Initiative. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women:  the Women’s Health Initiative randomized controlled dietary modification trial. Arch Intern 168(14):1500-1511, 2008.
• Brunner RL, Cochrane B, Jackson RD, et al (JB Kostis Collaborator); Women’s Health Initiative Investigators. Calcium, vitamin D supplementation, and physical function in the Women’s Health Initiative. J Am Diet Assoc 108(9):1472-1479, 2008.
• Sharma R, Kostis WJ, Wilson AC, Cosgrove NM, Hassett AL, Moreyra AE, Delnevo CD, Kostis JB. Questionable hospital chart documentation practices by physicians. J Gen Intern Med 23(11):1865-1870, 2008.
• Ritenbaugh C, Stanford JL, Wu L, Shikany JM, Schoen RE, Stefanick ML, Taylor V, Garland C, Frank G, Lane D, Mason E, McNeeley SG, Ascensao J, Chlebowski RT:  The Women’s Health Initiative randomized clinical trial.  (JB Kostis Collaborator). Conjugated equine estrogens and colorectal cancer incidence and survival:  The Women’s Health Initiative randomized clinical trial. Cancer Epidemiol Biomarkers Prev 17;(10):2609-2618, 2008.
• Turnbull F, Woodward M, Neal B, Barzi F, Ninomiya T, Chalmers J, Perkovic V, Li N, MacMahon S. for the Blood Pressure Lowering Treatment Trialists’ Collaboration  (JB Kostis, member). Do men and women respond differently to blood pressure-lowering treatment?  Results of prospectively-designed overviews of randomized trials.  European Heart J 29(21):2669-2680, 2008.
• Davis BR, Kostis JB, Simpson LM, et al. for the ALLHAT Collaborative Research Group.  Heart failure with preserved and reduced left ventricular ejection fraction in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Circulation 118:2259-2267, 2008.
• Chlebowski RT, Johnson KC, Kooperberg C, Pettinger M, Wactawski-Wende J, Rohan T, Rossouw J, Lane D, O’Sullivan MJ, Yasmeen S, Hiatt RA, Shikany JM, Vitolins M, Khandekar J, Hubbell FA; Women’s Health Initiative Investigators (JB Kostis Collaborator). Calcium plus vitamin D supplementation and the risk of breast cancer. J Natl Cancer Inst 100(22):1581-1591, 2008.
• Chlebowski RT, Kuller LH, Prentice RL, Stefanick ML, Manson JE, Gass M, Aragaki AK, Ockene JK, Lane DS, Sarto GE, Rajkovic A, Schenken R, Hendrix SL, Ravdin PM, Rohan TE, Yasmeen S, Anderson G; WHI Investigators (JB Kostis Collaborator). Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med 360(6):573-587, 2009.
• The Fibrinogen Studies Collaboration (JB Kostis, member). Measures to assess the prognostic ability of the stratified Cox proportional hazards model. Statistics in Medicine 28(3):389-411, 2009.
• The Fibrinogen Studies Collaboration (JB Kostis, member). Correcting for multivariate measurement error by regression calibration in meta-analyses of epidemiological studies. Statistics in Medicine 28(7):1067-1092, 2009. (PMID: 19222086)
• The Fibrinogen Studies Collaboration (JB Kostis, member). Systematically missing confounders in individual participant data meta-analysis of observational cohort studies. Statistics in Medicine 28(8); 1218-1237, 2009. (PMID: 19222087)
• Berger JS, Brown DL, Burke GL, Oberman A, Kostis JB, Langer RD, Wong ND, Wassertheil-Smoller S. Aspirin use, dose, and clinical outcomes in postmenopausal women with stable cardiovascular disease. Circulation:  Cardiovascular Quality and Outcomes 2;78-87, 2009.
• James E Skinner, Michael Meyer, William C. Dalsey, Brian A. Nester, George Ramalanjaona, Brian J O’Neil, Antoinette Mangione, Carol Terregino, Abel Moreyra, Daniel N Weiss, Jerry M Anchin, Una Geary, Pamela Taggart.  “Risk Stratification for Arrhythmic Death in an Emergency Department Cohort: a new Oct;156(4):776-82.method of nonlinear PD2i analysis of the ECG” Therapeutics and Clinical Risk Management 2008 4(4) 689-697.
• Rudnick MR, Davidson C, Laskey W, Stafford JL, Sherwin PF; VALOR Trial Investigators. (Collaborators (38) Bottner R, Cambier P, Clark V, Davidson C, DeGent G, Douglas J, Eways E, Farrell P, Fenves A, Fung A, Gellman J, Hanks WE, Hillegas W, Khosla S, Kingsley E, LaMarche N, Mann T, Markarian M, McFalls E, McGeehin F, Moreyra A, Nader R, O’Bryan J, O’Meallie L, Papadakos S, Piana R, Puildo J, Rohrbeck S, Rudnick M, Rusterholtz L, Schaer G, Shunk K, Stafford JL, Tobis J, Vernace M, Weiland F, Weinstein I, Williams D. Am Heart J. 2008 Oct;156(4):776-82.  Nephrotoxicity of iodixanol versus ioversol in patients with chronic kidney disease: the Visipaque Angiography/Interventions with Laboratory Outcomes in Renal Insufficiency (VALOR) Trial.

Abstracts Published

• Vagaonescu T, Hussain A, Mehra A, Wilson AC, Moreyra AE. ST-Segment Elevation Acute Myocardial Infarction Diagnosed By The Emergency Room:  How Often Are They True?  Cath and Cardiovasc Interv 2009, 74:159
• Vagaonescu T, Moreyra AE, Wilson AC, Cosgrove NM, Kostis JB. Transfusions After Percutaneous Coronary Intervention For ST-T Segment Elevation Acute Myocardial Infarction Patients Are Associated With Increased Long Term Mortality:  A Statewide Registry Study.  Cath and Cardiovasc Interv 2009, 74:160
• Vagaonescu T, Wilson AC, Kostis JB. Electrocardiographic Left Ventricular Hypertrophy Predicts Long Term Fatal Outcomes in Elderly Hypertensives Despite Diuretic-Based Antihypertensive Treatment:  14-Year Follow-Up of the Systolic Hypertension in the Elderly Program (SHEP).  Circulation Suppl. 2008
• Yingzi Deng, William J Kostis, Alan Wilson, Nora Cosgrove, Yu-Hsuan Shao, Abel Moreyra, John B Kostis. The Impact of Atrial Fibrillation on the outcomes of patients suffering a second Myocardial Infarction: AHA Scientific Sessions. Circulation 2008;118:S_818.
• J.B. Kostis, Y.-H. Shao, A.E. Moreyra, G.G. Rhoads. Increasing long-term mortality of acute myocardial infarction patients. European Heart Journal (2008)29 (Abstract Supplement), 70
• T. Vagaonescu, A.E. Moreyra, A.C. Wilson, N. Cosgrove, J.B. Kostis. Drug-eluting stents are associated with better survival and outcomes than bare metal stents after percutaneous coronary intervention for acute myocardial patients: a state-wide registry analysis. Presented at the ESC Congress, Munich, Germany. European Heart Journal (2008)29 (Abstract Supplement), 577
• Abel E. Moreyra, Alan C. Wilson, Yingzi Deng, Nora M. Cosgrove,  John B. Kostis, For the Myocardial Infarction Data Acquisition System (MIDAS) Study Group. Lack of Change in Occurrence Rate and Long-Term Outcome of Patients with Post-Infarction Ventricular Septal Rupture: A 21-year Study. Presented at 58th Annual Scientific Session, Orlando, FL (2009).
• Tudor D Vagaonescu, Alan C Wilson, Abel E Moreyra. Transfusions after Percutaneous Coronary Intervention for Acute Myocardial Infarction Patients are Associated with Increased Long Term Mortality: A Statewide Registry Study. Presented at the i2 Summit American College of Cardiology 58th Annual Scientific Session, Orlando, FL (2009).
• Syed A. Hussain, Alan C. Wilson, Abel E. Moreyra.  Improved Outcomes Post Coronary Revascularization with Drug-Eluting Stents Compared to Coronary Artery Bypass Surgery in Patients with End Stage Renal Disease on Hemodialysis. Presented at the i2 Summit American College of Cardiology 58th Annual Scientific Session, Orlando, Florida (2009).
• Abel E. Moreyra, Cezar S. Staniloae, Samin K. Sharma, Richard J. Solomon, Brendan Barrett.  Contrast-Induced Nephropathy in Angiography Patients: Insights from the Care Trial.  XXII InterAmerican Congress of Cardiology, 12 AL 16 DE Junio DE 2009; June 12-16, 2009. Farjardo, Puerto Rico
• Fyfe BS, Iyer DB, Jaworski JM, Wood DM, Butchy GT, Arroyo LH. Pattern and evolution of C4d staining in perioperative ischemic myocyte injury post-transplantation. J Heart Lung Transp. 2009 Feb;28:S77
• Kostis WJ, Kostis JB, Staessen JA. Persistence of Beneficial Effects of Cardiovascular  Preventive Pharmacotherapy After Discontinuation of Blinded Therapy. JACC  53;10(Suppl 1)A381, 2008.
• Bangalore S, Messerli FH, Wun C-C, Zuckerman AL, DeMicco D, Kostis JB, LaRosa JC. J-Curve Revisited:  An Analysis of the Treatment to New Targets (TNT) Trial. JACC 53;10(Suppl 1)A217, 2008. Presented at the 58th Annual Scientific Session of the American College of Cardiology in Orlando, FL, Mar 2009.
• Bangalore S, Messerli FH, Wun C-C, Zuckerman AL, DeMicco D, Kostis JB, LaRosa JC. J-Curve Revisited:  An Analysis of the Treating to New Targets (TNT) Trial. J of Clin Hypertens 11(4):A88, 2009.
• Rich DQ, Kipen HM, Zhang J, Kamat L, Wilson A, Kostis J. Triggering of myocardial infarction by ambient fine particle concentration, differences in response by MI type and presence of chronic obstructive pulmonary disease. Circulation 119(10):e365, 2009.
• Rich DQ, Kipen HM, Zhang J, Kamat L, Turpin B, Wilson A, Kostis J. Triggering of myocardial infarction by ambient fine particles and fine particle species.  Amer J of Respiratory and Crit Care Med 179(1): A1176, 2009.
• H. Khanova, C. Doyle, I. Korichneva.  Interaction of Protein Kinase C with Zinc Transporters.  Circulation Research Vol 103, No 5 August 29, 2008 P52 (AHA Council on Basic Cardiovascular Sciences Annual Meeting, Keystone CO).