Michael Harrington: An ``Other American\u27\u27

This talk was presented at Sacred Heart University on February 17, 1993 as part of a lecture series in memory of Max Dickstein, Daniel Friedman Gottlieb, and Ned Gottlieb. It will be included in Prof. Isserman\u27s forth-coming biography of Michael Harrington

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)

On the Hill: A Bicentennial History of Hamilton College, 1812-2012

In 1812, the Regents of the State of New York issued a charter to the third college launched in the state, and the 31st to be established in the United States — a college named for Alexander Hamilton and tracing its origins to a school established by the Reverend Samuel Kirkland in 1793 for the children of Indians and white settlers. On the Hill: A Bicentennial History of Hamilton College marks the occasion of that college’s 200th anniversary in 2012. It is the first official and full-scale history of Hamilton to be published since 1962, the year of the College’s sesquicentennial. The half-century between 1962 and 2012 brought great changes to the institution, as Hamilton more than doubled in size, dramatically revised its curriculum, reshaped campus social life, became coeducational, attracted a more diverse student body and rose in national prominence. At the same time, much stayed the same. In 2012, as in 1962 — and, for that matter, as in 1812 — Hamilton remains a small, selective, residential liberal arts college with a dedicated faculty of teacher-scholars. This book is thus a history of change and continuity played out over two centuries on a hilltop overlooking the village of Clinton, New York. It is also a consideration of the myriad ways in which the evolution of the college was bound up with a much larger history — local, regional and national. And, finally and throughout, it is the story of the men and women who taught and studied at Hamilton College over the course of two centuries, and in doing so created a legacy of a vibrant, if not always harmonious, learning community, a legacy that they have passed on to their successors in the years to come.https://digitalcommons.hamilton.edu/books/1088/thumbnail.jp

The Other American: The Life of Michael Harrington

https://digitalcommons.hamilton.edu/books/1075/thumbnail.jp

Journey to Freedom: The African-American Great Migration

https://digitalcommons.hamilton.edu/books/1084/thumbnail.jp

Continental Divide: A History of American Mountaineering

In Continental Divide, Maurice Isserman tells the history of American mountaineering through four centuries of landmark climbs and first ascents. Mountains were originally seen as obstacles to civilization; over time they came to be viewed as places of redemption and renewal. The White Mountains stirred the transcendentalists; the Rockies and Sierras pulled explorers westward toward Manifest Destiny; Yosemite inspired the early environmental conservationists. Climbing began in North America as a pursuit for lone eccentrics but grew to become a mass-participation sport. Beginning with Darby Field in 1642, the first person to climb a mountain in North America, Isserman describes the exploration and first ascents of the major American mountain ranges, from the Appalachians to Alaska. He also profiles the most important American mountaineers, including such figures as John C. Frémont, John Muir, Annie Peck, Bradford Washburn, Charlie Houston, and Bob Bates, relating their exploits both at home and abroad. Isserman traces the evolving social, cultural, and political roles mountains played in shaping the country. He describes how American mountaineers forged a brotherhood of the rope, modeled on America’s unique democratic self-image that characterized climbing in the years leading up to and immediately following World War II. And he underscores the impact of the postwar rucksack revolution, including the advances in technique and style made by pioneering dirtbag rock climbers. A magnificent, deeply researched history, Continental Divide tells a story of adventure and aspiration in the high peaks that makes a vivid case for the importance of mountains to American national identity.https://digitalcommons.hamilton.edu/books/1090/thumbnail.jp

Which Side Were You On?: The American Communist Party during the Second World War

https://digitalcommons.hamilton.edu/books/1077/thumbnail.jp

If I Had a Hammer: The Death of the Old Left and the Birth of the New Left

https://digitalcommons.hamilton.edu/books/1076/thumbnail.jp