Bio

Clinical Focus


  • Cardiovascular Disease
  • Cardiology (Heart)

Academic Appointments


Administrative Appointments


  • Chief, Cardiology Section, VA Palo Alto Health Care System (1983 - Present)
  • Associate Chief (Veterans Affairs), Division of Cardiovascular Medicine (1995 - Present)

Professional Education


  • Fellowship:SUNY Medical School - Buffalo (1978) NY
  • Residency:SUNY Medical School - Buffalo (1977) NY
  • Board Certification: Cardiovascular Disease, American Board of Internal Medicine (1989)
  • Board Certification: Cardiology, American Board of Internal Medicine (1978)
  • Fellowship:Stanford University Medical Center (1978) CA
  • Internship:SUNY Medical School - Buffalo (1975) NY
  • Medical Education:Baylor College of Medicine (1973) TX

Research & Scholarship

Current Research and Scholarly Interests


Calcium channel blockers; membrane pharmacology;, coronary physiology; antiarrhythmic drugs; cardiac hemodynamics;, cellular mechanisms of myocyte hypertrophy.

Teaching

2013-14 Courses


Publications

Journal Articles


  • Successful lysis of an aortic prosthetic valve thrombosis with a dosing regimen for peripheral artery and bypass graft occlusions JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Nguyen, P. K., Wasserman, S. M., Fann, J. I., Giacomini, J. 2008; 135 (3): 691-693

    View details for DOI 10.1016/j.jtcvs.2007.11.012

    View details for Web of Science ID 000253860300043

    View details for PubMedID 18329497

  • Same-day discharge after elective percutaneous coronary intervention was noninferior for safety to staying overnight in hospital. ACP journal club Hlatky, M., Giacomini, J. 2007; 147 (2): 35-?

    View details for PubMedID 17764126

  • Statin therapy in heart failure CURRENT OPINION IN LIPIDOLOGY Pham, M., Oka, R. K., Giacomini, J. C. 2005; 16 (6): 630-634

    Abstract

    The 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors, or statins, have been shown to reduce cardiovascular morbidity and mortality among a wide spectrum of patients with established atherosclerotic vascular disease. Mounting experimental and clinical evidence also suggest a potential benefit as well as theoretical harm of statin therapy in patients with heart failure.This article briefly summarizes the therapeutic properties of statins that may be of benefit to patients with heart failure and the theoretical adverse effects of cholesterol reduction in this group of patients. A number of nonrandomized clinical studies over the past several years have shown an association between statin use and reduced overall mortality. Several large-scale randomized studies designed to confirm these findings are currently under way.Statin therapy appears to improve clinical outcomes in patients with both ischemic and nonischemic cardiomyopathy independently of their cholesterol-lowering properties. The theoretical adverse properties of statins in heart failure patients have not been substantiated in small to medium-sized clinical trials. Although the encouraging results of these preliminary studies suggest a role for statin therapy in heart failure, larger studies are needed to validate these findings. Several ongoing randomized trials are currently under way to evaluate the effect of statin therapy on cardiovascular outcomes in heart failure patients. The results of these studies, expected in the next several years, should provide scientific evidence for the role of statins in the treatment of failure.

    View details for Web of Science ID 000233795300006

    View details for PubMedID 16276240

  • ANTIARRHYTHMIC AGENT AMIODARONE POSSESSES CALCIUM-CHANNEL BLOCKER PROPERTIES JOURNAL OF CARDIOVASCULAR PHARMACOLOGY Lubic, S. P., NGUYEN, K. P., Dave, B., Giacomini, J. C. 1994; 24 (5): 707-714

    Abstract

    Amiodarone possesses multiple pharmacologic properties, including peripheral and coronary vasodilatation, negative inotropy, and negative chronotropic and dromotropic effects. These properties are shared by the group of drugs termed calcium channel blockers. We examined the interaction of amiodarone with receptors for the 1,4-dihydropyridine (DHP) calcium blockers in rat and rabbit myocardial membrane particulates. Amiodarone displaced specifically bound [3H]nitrendipine in both rat and rabbit preparations in a competitive, concentration-dependent manner at a single class of binding sites (Ki approximately 0.27 micxroM). Calcium channel activity was determined pharmacologically in a tissue bath with electrically stimulated rabbit right ventricular strips, KCl-induced aortic ring contraction, and 45Ca2+ uptake in K(+)-depolarized cultured rat cardiomyocytes. Amiodarone completely inhibited myocardial contraction (EC50 = 1.7 microM), completely antagonized depolarization-induced aortic ring contraction (EC50 = 24 nM), and significantly reduced (29% vs. control) 45Ca2+ uptake into cultured cells. The calcium channel blocking effects of amiodarone may contribute significantly to its pharmacologic profile.

    View details for Web of Science ID A1994PP29500004

    View details for PubMedID 7532747

  • ANGER REPORT PREDICTS CORONARY-ARTERY VASOMOTOR RESPONSE TO MENTAL STRESS IN ATHEROSCLEROTIC SEGMENTS AMERICAN JOURNAL OF CARDIOLOGY BOLTWOOD, M. D., Taylor, C. B., Burke, M. B., GROGIN, H., Giacomini, J. 1993; 72 (18): 1361-1365

    Abstract

    To determine the effects of anger on coronary artery vasoconstriction, 12 patients with symptomatic myocardial ischemia were studied during cardiac catheterization. During catheterization, the patients were asked to recall a recent event that had produced anger. One narrowed and 2 non-narrowed arterial segments were selected using predetermined criteria. Patients also completed various self-report measurements upon entering the catheterization laboratory before any procedures, after completion of the clinical angiogram and after the anger recall stressor. There was a significant increase in subject reports of anger (F[1,6] = 21.94, p < 0.01) and arousal (F [2,6] = 5.49, p < 0.05) during the anger stressor. There were no significant changes in heart rate, systolic or diastolic blood pressure, or heart rate x systolic blood pressure product during the anger stressor. A total of 27 arterial segments (9 narrowed and 18 non-narrowed) were selected and analyzed using quantitative angiographic techniques. Repeated-measures analysis of variance (baseline vs anger stressor) found no significant group differences with regard to changes in arterial diameter between conditions or among segments. Reported anger was significantly correlated with a decrease in both mean (r = -0.76, p < 0.05) and minimal (r = -0.82, p < 0.05) diameter changes in narrowed arteries. Vasoconstriction only occurred with high levels of anger. There were no significant correlations between anger report and diameter change in non-narrowed arteries. Thus, anger may produce coronary vasoconstriction in previously narrowed coronary arteries.

    View details for Web of Science ID A1993ML96800005

    View details for PubMedID 8256727

  • CORONARY-OCCLUSION FOLLOWING DIAGNOSTIC ANGIOGRAPHY - SALVAGE BY INTRACORONARY STENTING CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS STGOAR, F. G., Giacomini, J. C., Fischell, T. A. 1991; 23 (4): 294-296

    Abstract

    Catheter-induced coronary artery dissection and occlusion is a rare but serious complication of diagnostic cardiac angiography. This report describes the successful management of this complication with an intracoronary stent after prolonged balloon inflations and intracoronary thrombolytic therapy were unsuccessful.

    View details for Web of Science ID A1991FX14300012

    View details for PubMedID 1909604

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