Bio

Bio


Eleanor Levin completed her undergraduate degree at Stanford, Phi Beta Kappa in Human Biology with Distinction, and her MD at UCSF as a Phi Beta Kappa Scholar. Her first internship was at Children's Hospital of San Francisco in pediatrics and her second at the Cleveland Clinic in internal medicine. She completed internal medicine training at Georgetown University and cardiology fellowship at George Washington University in Washington, D.C. At GW she undertook an advanced fellowship in echocardiography and lipids following her general cardiology fellowship. After fellowship training, Dr. Levin joined the GW faculty as an assistant professor of medicine in the Lipid Research Clinic. Subsequently she joined The Permanente Medical Group in northern California as a non-invasive cardiologist. She directed the Echocardiography Lab at Kaiser Santa Clara and introduced TEE and stress echo during her 25-year tenure. She introduced CT angiography of the heart at Santa Clara and coordinated joint readings between Radiology and Cardiology for 15 years. She created the Cholesterol Management and Heart Failure Programs initially at Santa Clara and eventually at more than 20 medical centers in Northern California. She was Kaiser's regional expert in lipidology as well as in cardiac disease in pregnancy in a patient population of 4 million. Dr. Levin served as Chief of Cardiology at Santa Clara for 16 years and as Chair of the Chiefs of Cardiology (120 cardiologists) for Northern California Kaiser for 8 years. She directed the Regional Cardiac Rehabilitation Program using home-based comprehensive rehabilitation across 18 medical centers for nearly three decades. During this time, she led teams developing cardiac guidelines embedded in order sets and electronic medical records throughout Kaiser medical centers to improve quality. She has spoken about and presented her work on population management and quality improvement nationally and internationally. Her awards include the national NCQA (National Committee of Quality Assurance) Award for Excellence in Cardiac Care, the Exceptional Contribution Award from The Permanente Medical Group for “exceptional work in care management programs” for heart failure and cholesterol management, the Santa Clara County Medical Association Outstanding Achievement Award for cardiac care management, and the Silicon Business Journal Award as one of the "Top 100 Influential Women in Silicon Valley." She is a fellow of the American College of Cardiology and the American Heart Association. She is board certified in both Internal Medicine and in Cardiovascular Diseases by the American Board of Internal Medicine.
Dr. Levin is a member of the Preventive Cardiology group. She participates in the Women’s Heart Health group and consults on pregnant patients with heart disease as requested. She sees general cardiology patients with lipid disorders and cardiovascular diseases of all types.

Clinical Focus


  • Cardiovascular Disease
  • Lipid management
  • Women’s Heart Health
  • Heart disease in pregnancy

Academic Appointments


Honors & Awards


  • Top Doctors as Chosen by Their Peers, Bay Area Consumer’s Checkbook
  • Women of Influence Award, Silicon Valley Business Journal (2013)
  • Achievement in Medicine for improving cardiac outcomes in a large population, Santa Clara County Medical Society (2012)
  • Scientific Excellence Oral Presentation, Preventive Medicine Society (2008)
  • Plenary Speaker, Coronary Heart Disease, National Conference to Improve Cardiac Care, National Health Service, United Kingdom (2004)
  • AHA Excellence Award for Chronic Conditions Programs, American Heart Association (2003)
  • Exceptional Contribution Award for regional cholesterol and heart failure management programs., The Permanente Medical Group (2003)
  • National Award for Innovations in Health Care, Adaptive Business Leaders (2003)
  • National Award for Quality Improvement for population management programs in CAD and Heart Failure, National Committee for Quality Assurance (2002)
  • Phi Beta Kappa, Stanford University (1974)

Boards, Advisory Committees, Professional Organizations


  • Fellow, American College of Cardiology (1990 - Present)
  • Fellow, American Heart Association (1990 - Present)
  • Invited Participant, LDL Think Tank, American College of Cardiology (2016 - 2017)
  • Home-based Cardiac Rehab Group member, Million Hearts Initiative:U.S. Department of Health and Human Services initiative co-led by CDC &CMS (2018 - Present)
  • Representative from Stanford, California Medical Leadership Forum for Prevention and Public Health (2018 - Present)
  • Scientific Advisory Board, Moving Analytics, Inc. (2018 - Present)

Professional Education


  • Board certification, American Board of Internal Medicine, Cardiovascular Disease (1989)
  • Board Certification, American Board of Internal Medicine, Internal Medicine (1985)
  • Fellowship, George Washington University, Lipidology and Echocardiography (1988)
  • Fellowship, George Washington University, Cardiovascular Disease (1987)
  • Residency, Georgetown University, Internal Medicine (1985)
  • Internship, Cleveland Clinic, Internal Medicine (1983)
  • Internship, Children’s Hospital of San Francisco, Pediatrics (1980)
  • M.D., University of California, San Francisco, Medicine (1979)
  • B.A. with Distinction, Stanford University, Human Biology (1975)

Teaching

2018-19 Courses


Publications

All Publications


  • Outcomes of Chest Pain Calls to an Advice and Appointment Call Center Bhargava, R., Temkin, T. L., Fireman, B., Levin, E., Amaral, D. LIPPINCOTT WILLIAMS & WILKINS. 2012
  • Improving Cardiac Rehabilitation Referral Rate in a Post-PCI Population: Using NCDR CathPCI® Registry and Integrated Electronic Medical Record, ACC NCDR 11, April 1, 2011 Chen, S., Lee, A., Levin, E., Jackson, J., Ford, T. 2011
  • Standardized Discharge Orders after Stroke Results of the Quality Improvement in Stroke Prevention (QUISP) Cluster Randomized Trial ANNALS OF NEUROLOGY Johnston, S., Sidney, S., Hills, N. K., Grosvenor, D., Klingman, J. G., Bernstein, A., Levin, E. 2010; 67 (5): 579–89

    Abstract

    Proven strategies to reduce risk of stroke recurrence are under-utilized. We sought to evaluate the impact of standardized stroke discharge orders on treatment practices in a cluster-randomized trial.The Quality Improvement in Stroke Prevention (QUISP) trial randomized 12 hospitals to continue usual care or to receive assistance in the development and implementation of standardized stroke discharge orders. All patients with ischemic stroke were identified during a 12-month period prior to implementation and for 12 months afterward, and were followed for 6 months after discharge. The primary outcome was optimal treatment at 6 months, defined as taking a statin, having blood pressure <140/90mmHg, and receiving anticoagulation if atrial fibrillation was diagnosed. The primary analysis treated the hospital as the unit of analysis, comparing optimal treatment rates-adjusted for race, age, dementia, atrial fibrillation, and history of bleeding-between intervention and non-intervention hospitals using a paired t test.In the primary analysis with hospital as the unit of analysis, the odds of optimal treatment was not significantly increased at intervention compared to non-intervention hospitals (odds ratio, 1.39; 95% confidence interval, 0.71-2.76; p = 0.27). However, in analyses conducted at the level of the individual patients (N = 3,361), rates of optimal treatment increased from 37% to 45% in the intervention hospitals (p = 0.001) and did not change significantly in the non-intervention hospitals (39% to 40%; p = 0.27).Implementation of standardized discharge orders after stroke was associated with increased rates of optimal secondary prevention; this improvement was not significant in the primary analysis at the hospital level.

    View details for DOI 10.1002/ana.22019

    View details for Web of Science ID 000277190000004

    View details for PubMedID 20437555

  • Standardized Discharge Orders After Stroke: Results of the Quality Improvement in Stroke Prevention (QUISP) Trial Johnston, S., Sidney, S., Hills, N. K., Grosvenor, D., Klingman, J. G., Bernstein, A., Levin, E. LIPPINCOTT WILLIAMS & WILKINS. 2010: E289
  • Blood pressure control among women six months after ischemic stroke Hills, N., Grosvenor, D., Sidney, S., Klingman, J., Bernstein, A., Levin, E., Johnston, S. LIPPINCOTT WILLIAMS & WILKINS. 2008: A232
  • Race and blood pressure control six months after ischemic stroke Hills, N. K., Nguyen-Huynh, M., Grosvenor, D., Sidney, S., Klingman, J., Bernstein, A., Levin, E., Johnston, S. C. LIPPINCOTT WILLIAMS & WILKINS. 2008: 622–23
  • Comparison of Screening Outcomes Among Different Healthcare Delivery Systems for Three Major Diseases: February 2008, Oral Presentation Preventive Medicine Society Annual Scientific Meeting Levin, E., Loftus, B., Pearl, R. 2008
  • Successful clinical guidelines implementation in a large integrated healthcare system Levin, E., Emerson, L., Whippy, A., Steimle, A. E., Pearl, R. LIPPINCOTT WILLIAMS & WILKINS. 2007: 785
  • Acute Coronary Syndromes Clinical Practice Guidelines. Critical pathways in cardiology Brindis, R. G., Fischer, E., Besinque, G., Gjedsted, A., Lee, P. C., Padgett, T., Petru, M., Raley, J., Levin, E., Strohmeier, A. 2006; 5 (2): 69-102

    View details for DOI 10.1097/01.hpc.0000221568.67190.df

    View details for PubMedID 18340221

  • Myocardial infarction in Asian Indians (MIAI) study: The Kaiser Permanente Northern California experience Rau, J., Johnsen, N., Lee, P., Chandra, M., Go, A., Levin, E. LIPPINCOTT WILLIAMS & WILKINS. 2006: E378
  • Gender bias in the use of lipid-lowering therapy Bhargava, R., Sandhu, G., Armstrong, M., Nasiri, H., Sah, A., Levin, E. LIPPINCOTT WILLIAMS & WILKINS. 2005: U893
  • Differential association between statin exposure and elevated levels of creatine kinase ANNALS OF PHARMACOTHERAPY Chan, J., Hui, R. L., Levin, E. 2005; 39 (10): 1611–16

    Abstract

    Although hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) are generally well tolerated, myopathy can be a serious adverse event. The association among different statins, doses, and related risk factors is not well understood.To determine the prevalence of elevated creatine kinase (CK) levels in patients taking statins, specific doses of these drugs, and other factors. Simvastatin and lovastatin were the drugs of primary interest.In a modified prevalence (cross-sectional) study, prescriptions and laboratory data for 215,191 patients exposed to a statin in 2002 were reviewed. A log-linear Poisson regression model was used to determine the statistical relationship of an elevated CK level to other independent variables.Prevalence of high elevation of CK levels (ie, n of cases/1000 pts. exposed to statins) was 1.6; prevalence of mild to moderate elevation of CK levels was 6.4. For high elevations, the prevalence ratios were lower for low doses of lovastatin than for high doses of simvastatin. A higher prevalence ratio was associated with elevated serum creatinine (SCr) levels (2.44), exposure to interacting drugs (1.62), male gender (1.48), and evidence of diabetes (1.34). For mild to moderate elevation, a higher prevalence ratio was associated with elevated SCr (1.45), exposure to interacting drugs (1.21), male gender (3.19), age < or =65 years (1.35), and evidence of diabetes (1.34). Lower prevalence ratios were associated with all doses of lovastatin compared with those of high doses of simvastatin.Compared with simvastatin, lovastatin was generally associated with a lower prevalence of high elevation and mild to moderate elevation of CK levels. An elevated SCr level, exposure to interacting drugs, male gender, evidence of diabetes, and age < or =65 years were associated with higher prevalence ratios.

    View details for PubMedID 16160000

  • Successful conversion of patients with hypercholesterolemia from a brand name to a generic cholesterol-lowering drug Cheetham, T. C., Chan, J., Benson, Richmond, C., Levin, E., Campen, D. AMER MED PUBLISHING, M W C COMPANY. 2005: 546–52

    Abstract

    To evaluate the safety and effectiveness of a simvastatin-to-lovastatin therapeutic conversion program.Observational database study of a therapeutic conversion in members of the Northern and Southern California regions of Kaiser Permanente, using a pretest/posttest design.All patients actively converted from simvastatin to lovastatin between April 1, 2002, and March 31, 2003, were identified for inclusion in the analysis. The conversion from simvastatin to lovastatin was based on an equipotent dose ratio of 1 mg of simvastatin to 2 mg of lovastatin. Electronic prescription record and laboratory data were collected for converted patients beginning 365 days before changing therapy through June 30, 2003. The primary effectiveness end point was a comparison of the preconversion and postconversion low-density lipoprotein cholesterol (LDL-C) levels. Safety end points included an analysis of preconversion and postconversion alanine aminotransferase (ALT) tests and creatine kinase values.A total of 33,318 converted patients met criteria for inclusion in the analysis. The mean LDL-C was lowered from 110.9 to 108.4 mg/dL (P < .001) following the conversion to lovastatin. The percentage of patients with serum ALT levels greater than 3 times the upper limit of normal (ULN) was similar before (0.7%) and after (0.6%) conversion from simvastatin to lovastatin. Creatine kinase elevations greater then 10 times the ULN occurred at similar rates before and after the conversion.Overall, patients had an improvement in their lipid profile without evidence of hepatic or muscle enzyme elevations. Appropriately selected patients can be safely and effectively converted from simvastatin to lovastatin.

    View details for PubMedID 16159044

  • Women at Risk for Coronary Heart Disease: How Research is Translated Into Innovation and Quality Outcomes at Kaiser Permanente. The Permanente journal Levin, E., Arango, J. 2005; 9 (1): 48-51

    View details for PubMedID 21687483

    View details for PubMedCentralID PMC3108413

  • Chronic Kidney Disease and Lipid Control in Patients with Coronary Artery Disease American Society of Nephrology Nasiri, H., Armstrong, M., Sandhu, G., Levin, E., Bhargava, R., Hung, Y. 2005
  • Successful conversion of 33,318 patients with hypercholesterolernia from a brand-name to a generic cholesterol-lowering drug Levin, E., Cheetham, C. T., Chan, J., Richmond, C., Benson, V. M., Campen, D. LIPPINCOTT WILLIAMS & WILKINS. 2004: 819
  • Putting Heart Disease Guidelines into Practice: Kaiser Permanente Leads the Way The Permanente Journal L, P., Ralph, B., Levin, E. 2003; 7 (1)
  • Population-based approach to heart failure management is associated with improved outcomes Steimle, A., Levin, E., Arango, J., Kim, E., Stone, B. LIPPINCOTT WILLIAMS & WILKINS. 2002: 568
  • Myocardial infarction mortality in patients administered thrombolytic therapy versus primary percutaneous coronary intervention: A two-county comparison in northern California Levin, E., Brindis, R., Petru, M., Lee, P. LIPPINCOTT WILLIAMS & WILKINS. 2002: 761
  • Innovative approach to guidelines implementation is associated with declining cardiovascular mortality in a population of three million Levin, E. G., Arango, J., Steimle, A. E., Lee, P. C., Fireman, B. LIPPINCOTT WILLIAMS & WILKINS. 2001: 789
  • Home-based cardiac rehabilitation program is associated with excellent outcomes Krowley, J., Levin, E. G. LIPPINCOTT WILLIAMS & WILKINS. 2001: 800
  • COMPARISON OF PSYLLIUM HYDROPHILIC MUCILLOID AND CELLULOSE AS ADJUNCTS TO A PRUDENT DIET IN THE TREATMENT OF MILD TO MODERATE HYPERCHOLESTEROLEMIA ARCHIVES OF INTERNAL MEDICINE LEVIN, E. G., MILLER, V. T., MUESING, R. A., STOY, D. B., BALM, T. K., LAROSA, J. C. 1990; 150 (9): 1822–27

    Abstract

    The effects of the administration of 5.1 g of psyllium or placebo (cellulose) twice daily for 16 weeks were compared as adjuncts to a prudent diet in the management of moderate hypercholesterolemia in a parallel, double-blind study. Psyllium decreased the total cholesterol level by 5.6% and the low-density lipoprotein cholesterol level by 8.6%, whereas the levels were unchanged in the placebo group. The high-density lipoprotein cholesterol level decreased during the diet stabilization period in both groups and returned to near-baseline values by week 16. Plasma triglyceride levels did not change substantially in either group. Subject compliance to treatment was greater than 95%. These data suggest that psyllium hydrophilic mucilloid in a twice-daily regimen may be a useful and safe adjunct to a prudent diet in the treatment of moderate hypercholesterolemia.

    View details for DOI 10.1001/archinte.150.9.1822

    View details for Web of Science ID A1990DY36400007

    View details for PubMedID 2203322