In This Section      
 

Wendy S. Post, MD, MS

Ciccarone Center Research

Published By

Wendy S. Post, MD, MS

Wendy S. Post, MD, MS
Post, Wendy S., MD, MS

Wendy S. Post, MD, MS is a Professor of Medicine at the Johns Hopkins University, School of Medicine. She is also a Professor of Epidemiology at Johns Hopkins Bloomberg School of Public Health. Additionally she is part of the associate faculty at the Welch Center for Prevention and Clinical Research and Epidemiology divisions of Johns Hopkins University.

View my Johns Hopkins Medicine profile for more information and to request an appointment.

 

Landmark Articles

Adverse outcome analyses of observational data: assessing cardiovascular risk in HIV disease.

By: Triant VA, Josephson F, Rochester CG, Althoff KN, Marcus K, Munk R, Cooper C, D’Agostino RB, Costagliola D, Sabin CA, Williams PL, Hughes S, Post WS, Chandra-Strobos N, Guaraldi G, Young SS, Obenchain R, Bedimo R, Miller V, Strobos J.

Clinical decisions are ideally based on randomized trials but must often rely on observational data analyses, which are less straightforward and more influenced by methodology. The authors, from a series of expert roundtables convened by the Forum for Collaborative HIV Research on the use of observational studies to assess cardiovascular disease risk in human immunodeficiency virus infection, recommend that clinicians who review or interpret epidemiological publications consider 7 key statistical issues: (1) clear explanation of confounding and adjustment; (2) handling and impact of missing data; (3) consistency and clinical relevance of outcome measurements and covariate risk factors; (4) multivariate modeling techniques including time-dependent variables; (5) how multiple testing is addressed; (6) distinction between statistical and clinical significance; and (7) need for confirmation from independent databases. Recommendations to permit better understanding of potential methodological limitations include both responsible public access to de-identified source data, where permitted, and exploration of novel statistical methods.

Genome-wide association study for coronary artery calcification with follow-up in myocardial infarction.

By: O’Donnell CJ, Kavousi M, Smith AV, Kardia SL, Feitosa MF, Hwang SJ, Sun YV, Province MA, Aspelund T, Dehghan A, Hoffmann U, Bielak LF, Zhang Q, Eiriksdottir G, van Duijn CM, Fox CS, de Andrade M, Kraja AT, Sigurdsson S, Elias-Smale SE, Murabito JM, Launer LJ, van der Lugt A, Kathiresan S; CARDIoGRAM Consortium, Krestin GP, Herrington DM, Howard TD, Liu Y, Post W, et al.

Coronary artery calcification (CAC) detected by computed tomography is a noninvasive measure of coronary atherosclerosis, which underlies most cases of myocardial infarction (MI). We sought to identify common genetic variants associated with CAC and further investigate their associations with MI. SNPs in the 9p21 and PHACTR1 gene loci were strongly associated with CAC and MI, and there are suggestive associations with both CAC and MI of SNPs in additional loci. Multiple genetic loci are associated with development of both underlying coronary atherosclerosis and clinical events.

Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.

By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high levels of coronary artery calcium are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, as compared to high CAC.

Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.

By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC scores.

Predicting and preventing cardiovascular disease in HIV-infected patients.

By: Post WS.
In the absence of specific randomized trials in the HIV-infected population, HIV-infected persons should be treated for cardiovascular risk factors according to current national guidelines for reducing risk, including those for aspirin use and for treatment of dyslipidemia, hypertension, and metabolic syndrome.

Longitudinal predictors of progression of carotid atherosclerosis in rheumatoid arthritis.

By: Giles JT, Post WS, Blumenthal RS, Polak J, Petri M, Gelber AC, Szklo M, Bathon JM.
These prospective data provide evidence that inflammation is a contributor to the progression of subclinical atherosclerosis in rheumatoid arthritis and that it is potentially modified favorably by tumor necrosis factor inhibitors and detrimentally by glucocorticoids.

Electrocardiographic and clinical predictors separating atherosclerotic sudden cardiac death from incident coronary heart disease.

By: Soliman EZ, Prineas RJ, Case LD, Russell G, Rosamond W, Rea T, Sotoodehnia N, Post WS, Siscovick D, Psaty BM, Burke GL.
Sudden cardiac death and coronary heart disease have many risk factors in common, including hypertension, race/ethnicity, BMI, and heart rate, that have the potential to separate between the risks of both diseases. These results need to be validated in another cohort.

QT-interval duration and mortality rate: results from the Third National Health and Nutrition Examination Survey.

By: Zhang Y, Post WS, Dalal D, Blasco-Colmenares E, Tomaselli GF, Guallar E.

Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.

Electrocardiographic QT interval and mortality: A meta-analysis.

By: Zhang Y, Post WS, Blasco-Colmenares E, Dalal D, Tomaselli GF, Guallar E.
Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population have been unclear. We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population.

Meta-analysis of genome-wide association studies from CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque.

By: Bis JC, Kavousi M, Francheschini N, Isaacs A, Abecasis GR, Schminke U, Post WS, Smith AV, et al.

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10(-8)). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events.