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Judith Hochman, M.D.

Dr. Hochman directs the Cardiovascular Clinical Research Center at the New York University School of Medicine. Her particular areas of interest include the management of acute coronary syndromes and the pathophysiology and management of cardiogenic shock.

She is Study Chair of the NHLBI funded Occluded Artery Trial (OAT) which tested the hypothesis that late opening of the infarct related artery (PCI\stent) will reduce the 3 year risk of death, MI and Class IV HF.  Dr Hochman previously demonstrated in an experimental model of myocardial infarction that late reperfusion reduced infarct expansion and adverse LV remodeling.

She tested this hypothesis in a large clinical trial. 2166 stable patients with persistent total occlusion of the IRA were randomized to either routine PCI plus stenting and optimal medical therapy or optimal medical therapy alone, three to 28 days after their MI. 

The results presented at the American Heart Association 2006 Scientific Sessions and published in NEJM demonstrated that in stable MI survivors late recanalization of an occluded infarct-related vessel in the subacute phase does not improve outcome compared to optimal medical therapy alone.

In a subset of patients in the NHLBI funded angiographic ancillary study (TOSCA 2) less LV remodeling was seen with PCI.

Despite this, there is no net clinical benefit to PCI and an adverse trend toward excess reinfarction in the PCI group. As noted by many experts in the extensive press coverage, the findings should change medical practice.

She is also leading other NHLBI funded OAT ancillary studies (OAT-EP, OAT-NUC, TOSCA-2) that are assessing the effect of late PCI on electrical stability and interaction with viability.

She was the Study Chair of the NHLBI funded SHOCK Trial which demonstrated a one year survival benefit for emergency PCI or CABG and led to a change in the national guidelines. She has investigated the role of systemic inflammation and excess nitric oxide in the genesis and persistence of cardiogenic shock and is Study Chair for phase 2 and phase 3 studies of nitric oxide synthase inhibition in refractory cardiogenic shock- SHOCK 2 and TRIUMPH.

Dr. Hochman is on several steering committees for multi-center ACS trials including SYNERGY, MERLIN-TIMI 36, EARLY ACS and SHINE and the quality improvement CRUSADE project.

Selected publications  

  1. Hochman, J.S. and Choo, H: Limitation of Myocardial Infarct Expansion by Reperfusion Independent of Myocardial Salvage. Circulation 1987; 75:299-306.
  2. Hochman JS, Tamis JE, Thompson TD, Weaver WD, White HD, Van de Werf F, Aylward P, Topol EJ, Califf RM. Sex, Clinical Presentation, and Outcome in Patients with Acute Coronary Syndromes. New Engl. J. Med. 1999 341 4: 226-232
  3. Hochman J, Sleeper L, Webb J, Sanborn T, White H, Talley J, Buller C, Jacobs A, Slater J, Col J, McKinlay S, LeJemtel, T. Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock. New Engl. J. Med 1999; 341: 625-34.
  4. Sadanandan S, Buller C, Menon V, Dzavik V. Terrin M, Knatterud G, Lamas G, Hochman JS. The Late Open Artery Hypothesis – a decade later. Am Heart J 2001;142(3):411-21
  5. Hochman JS, Sleeper LA, White HD, Dzavik V, Wong SC, Menon V, Webb JG, Steingart R, Picard MH, Menegus MA, Boland J, Sanborn T, Buller CE, Modur S, Forman R, Desvigne-Nickens P, Jacobs AK, Slater JN, LeJemtel TH, for the SHOCK Investigators. One Year Survival Following Early Revascularization for Acute Myocardial Infarction Complicated by Cardiogenic Shock. J Am Med Assoc 2001; 285: 190-192.
  6. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW, Smith EE 3rd, Steward DE, Theroux P, Gibbons RJ, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Smith SC Jr; American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--2002: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). Circulation. 2002 Oct 1;106(14):1893-900
  7. Hochman JS. Cardiogenic Shock Complicating Acute Myocardial Infarction: Expanding the Paradigm. Circulation . 2003;107(24):2998-3002
  8. Picard MH, Davidoff R, Sleeper L, Mendes L, Thompson C, Dzavik V, Steingart R, Gin K, White Harvey, Hochman JS for the SHOCK Trial. Echocardiographic Predictors of Survival and Response to Early Revascularization in Cardiogenic Shock. Circulation 2003; 107:279-284
  9. Sanborn TA, Sleeper LA, Webb JG, French JK, Bergman G, Parikh M, Wong SC, Boland J, Pfisterer M, Slater JN, Sharma S, and Hochman JS, for the SHOCK Investigators. Correlates of One-Year Survival in Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction: Angiographic Findings from the SHOCK Trial. J Am Coll Cardiol 2003; 42; 1373-9.
  10. Webb JG, Lowe AM, Sanborn TA, White HD, Sleeper LA, Carere RG, Buller CE, Wong SC, Boland J, Dzavik V, Porway M, Pate G, Bergman G, Hochman JS, for the SHOCK Investigators. Percutaneous Coronary Intervention For Cardiogenic Shock In The SHOCK Trial. J Am Coll Cardiol 2003; 42:1380-6
  11. Hochman JS and Ingbar D. Chapter: Pulmonary Edema and Cardiogenic Shock in Harrison’s Textbook of Internal Medicine (2004) 16 th edition
  12. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; Canadian Cardiovascular Society. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). Circulation. 2004 Aug 31;110(9):e82-292
  13. Kohsaka S, Menon V, Lowe AM, Lange M, DzavikV, Sleeper LA, Hochman JS. Systemic Inflammatory Response Syndrome After Acute Myocardial Infarction Complicated by Cardiogenic Shock. Arch Intern Med. 2005;165:1643-1650
  14. Babae v A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS for the NRMI Investigators. National Guidelines and Trends in Management of Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock: Observations from the National Registry of Myocardial Infarction. J Am Med Assoc 2005;294:448-454
  15. Sleeper LA, Ramanathan K, Picard MH, LeJemtel TH, White HD, Dzavik V, Tormey D, Avis NE, Hochman JS. Functional Status and Quality of Life After Emergency Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction. J Am Coll Cardiol 2005;46:266-73
  16. Hochman JS. Chapter 20: “Acute Myocardial Infarction/Complications” in Textbook of Cardiovascular Medicine 3rd Edition. Editor Eric Topol. (Publisher: Lippincott - Williams & Wilkens), 2006.
  17. Lansky AJ, Hochman JS, Ward PA, Mintz GS, Fabunmi R, Berger PB, New G, Grines CL, Pietras CG, Kern MJ, Ferrell M, Leon MB, Mehran R, White C, Mieres JH, Moses JW, Stone GW, Jacobs AK; American College of Cardiology Foundation; American Heart Association.  Percutaneous coronary intervention and adjunctive pharmacotherapy in women: a statement for healthcare professionals from the American Heart Association. Circulation. 2005;111(7):940-53
  18. White HD, Assmann SF, Sanborn TA, Jacobs AK, Webb JG, Sleeper LA, Wong CK, Stewart JT, Aylward PE, Wong SC, Hochman JS.   Comparison of percutaneous coronary intervention and coronary artery bypass grafting after acute myocardial infarction complicated by cardiogenic shock: results from the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial. Circulation. 2005;112(13):1992-2001.
  19. Hochman JS, Sleeper LA, Webb JG, Dzavik V, Buller CE, Aylward P, Col J, White HD, for the SHOCK Investigators.  Early Revascularization Improves Long-Term Survival for Cardiogenic Shock Complicating Acute Myocardial Infarction. JAMA 2006:295;2511-2515
  20. Hochman JS and Shah NR. What price pain relief? Circulation 2006;113:2868-2870
  21. Dzavik  V, Buller CE, Lamas GA, Rankin JM, Mancini GB, Cantor WJ, Carere RJ, Ross JR, Atchison D, Forman S, Thomas B, Buszman P, Vozzi C, Glanz A, Cohen EA, Meciar P, Devlin G, Mascette A, Sopko G, Knatterud GL, Hochman JS.  Randomized Trial of Percutaneous Coronary Intervention for Subacute Infarct-Related Coronary Artery Occlusion to Achieve Long-Term Patency and Improve Ventricular Function. The Total Occlusion Study of Canada (TOSCA)-2 Trial. Circulation 2006 Nov 14
  22. Hochman JS, Lamas GA, Buller CE, Dzavik V, Reynolds HR, Abramsky SJ, Forman S, Ruzyllo W, Maggioni AP, White H, Sadowski Z, Carvalho AC, Rankin JM, Renkin JP, Steg PG, Mascette AM, Sopko G, Pfisterer ME, Leor J, Fridrich V, Mark DB, Knatterud GL.  Coronary Intervention for Persistent Occlusion after Myocardial Infarction. N Engl J Med. 2006; 355(23):2395-2407
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