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Cindy Westerhout, PhD

Associate Director (Research and Strategy), Faculty of Medicine & Dentistry - Medicine Dept
Contact Overview Publications

Contact

Associate Director (Research and Strategy), Faculty of Medicine & Dentistry - Medicine Dept
Email
cynthiaw@ualberta.ca

Overview

About

Dr. Cindy Westerhout is currently appointed as the Associate Director (Research & Strategy) at the Canadian VIGOUR Centre, an academic research organization and official University Centre. Dr. Westerhout oversees the CVC Clinical Trial Statistics team, and provides consultation on the design and analysis of clinical trials and observational studies. Her research interests include therapeutic treatment effects (e.g., weighted composite endpoints) in randomized clinical trials. She also advises the directors, faculty and management team on the strategic directions of the CVC, and leads strategy implementation. She is also an Adjunct Assistant Professor in the Division of Cardiology in the Department of Medicine.

Dr. Westerhout completed a MSc in epidemiology at the University of Alberta in 2001 and a PhD in clinical cardiovascular epidemiology at Erasmus University (Rotterdam, the Netherlands) in 2007. She is currently a member of the editorial board of the American Heart Journal, and is a co-founder of the BALSAM (Biomedical AnaLytics Studio And Methods unit) at the University of Alberta.

Featured Publications

Rescue percutaneous coronary intervention in the pharmaco-invasive era of ST-elevation myocardial infarction: insights from the STREAM-2 trial

Kevin R Bainey, Robert C Welsh, Yinggan Zheng, Kris Bogaerts, Arsen D Ristić, Oleg V Averkov, Alexandra Arias-Mendoza, Yves Lambert, Peter Sinnaeve, Cynthia M Westerhout, Frans Van de Werf, Paul W Armstrong

European Heart Journal: Acute Cardiovascular Care. 2026 April; 10.1093/ehjacc/zuaf158

Geographic Region Variation in Patient Characteristics, Clinical Outcomes and Treatment of HFrEF in the VICTORIA Trial

Cynthia M. Westerhout, Wendimagegn Alemayehu, Alain Cohen-Solal, Carolyn S. P. Lam, Justin A. Ezekowitz, Stefano Corda, Ciaran J. McMullan, Christopher M. O'Connor, Paul W. Armstrong

ESC Heart Failure. 2025 December; 10.1002/ehf2.15416

Proteomics Identify Clinical Phenotypes and Predict Functional Outcomes in Heart Failure With Preserved Ejection Fraction: Insights From VITALITY-HFpEF

Christopher R. deFilippi, Palak Shah, Sanjiv J. Shah, Wendimagegn Alemayehu, Carolyn S.P. Lam, Javed Butler, Lothar Roessig, Christopher M. O’Connor, Cynthia M. Westerhout, Paul W. Armstrong

Circulation: Heart Failure. 2024 September; 10.1161/CIRCHEARTFAILURE.124.011792

Background Medical Therapy and Clinical Outcomes From the VICTORIA Trial

Justin A. Ezekowitz, Ciaran J. McMullan, Cynthia M. Westerhout, Ileana L. Piña, Jose Lopez-Sendon, Kevin J. Anstrom, Adrian F. Hernandez, Carolyn S.P. Lam, Christopher M. O’Connor, Burkert Pieske, Piotr Ponikowski, Lothar Roessig, Adriaan A. Voors, Joerg Koglin, Paul W. Armstrong, Javed Butler

Circulation: Heart Failure. 2023 September; 10.1161/CIRCHEARTFAILURE.123.010599

Is There Any Interaction Between Sex and Renal Function Change During Hospital Stay in Patients Hospitalized With Acute Heart Failure?

FLORINE E.C. Julius, MARGJE R. VAN NOREL, ARIETJE J.L. ZANDIJK, SARAH RATHWELL, CYNTHIA WESTERHOUT, FINLAY A. MCALISTER, NARIMAN SEPEHRVAND, ADRIAAN A. VOORS, JUSTIN A. EZEKOWITZ

Journal of Cardiac Failure. 2021 September; 10.1016/j.cardfail.2021.05.005

Participation in a Heart Failure Clinical Trial

Justin Ezekowitz, Robert J. Mentz, Cynthia M. Westerhout, Nancy K. Sweitzer, Michael M. Givertz, Ileana L. Piña, Christopher M. O’Connor, Stephen J. Greene, Ciaran McMullan, Lothar Roessig, Adrian F. Hernandez, Paul W. Armstrong

Circulation: Heart Failure. 2021 September; 10.1161/CIRCHEARTFAILURE.120.008242

Sitagliptin and risk of fractures in type 2 diabetes: Results from the TECOS trial

Diabetes, Obesity and Metabolism. 2017 January; 10.1111/dom.12786

Characterization of hemodynamically stable acute heart failure patients requiring a critical care unit admission: Derivation, validation, and refinement of a risk score

American Heart Journal. 2017 January; 10.1016/j.ahj.2017.03.014

Composite End Points in Clinical Research: A Time for Reappraisal

Circulation. 2017 January; 10.1161/CIRCULATIONAHA.117.026229

Hospital variation in treatment and outcomes in acute coronary syndromes: Insights from the Alberta Contemporary Acute Coronary Syndrome Patients Invasive Treatment Strategies (COAPT) study

International Journal of Cardiology. 2017 January; 10.1016/j.ijcard.2017.04.109

Implications of ischaemic area at risk and mode of reperfusion in ST-elevation myocardial infarction

Heart. 2016 January; 10.1136/heartjnl-2015-308075

Arterial access site and outcomes in patients undergoing percutaneous coronary intervention with and without vorapaxar

Catheterization and Cardiovascular Interventions. 2016 January; 10.1002/ccd.26335

Frailty is associated with worse outcomes in non-ST-segment elevation acute coronary syndromes: Insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS) trial

European heart journal. Acute cardiovascular care. 2016 January; 10.1177/2048872615581502

Applying novel methods to assess clinical outcomes: Insights from the TRILOGY ACS trial

European Heart Journal. 2015 January; 10.1093/eurheartj/ehu262

Relationship between time to invasive assessment and clinical outcomes of patients undergoing an early invasive strategy after fibrinolysis for ST-segment elevation myocardial infarction: A patient-level analysis of the randomized early routine invasive clinical trials

JACC: Cardiovascular Interventions. 2015 January; 10.1016/j.jcin.2014.09.005

Reduced dose tenecteplase and outcomes in elderly ST-segment elevation myocardial infarction patients: Insights from the STrategic Reperfusion Early after Myocardial infarction trial

American Heart Journal. 2015 January; 10.1016/j.ahj.2015.03.011

Outcomes of a pharmacoinvasive strategy for successful versus failed fibrinolysis and primary percutaneous intervention in acute myocardial infarction (from the strategic reperfusion early after myocardial infarction [STREAM] study)

American Journal of Cardiology. 2015 January; 10.1016/j.amjcard.2014.06.011

Impact of weighted composite compared to traditional composite endpoints for the design of randomized controlled trials

Statistical Methods in Medical Research. 2015 January; 10.1177/0962280211436004

Baseline Q Waves and Time from Symptom Onset to ST-segment Elevation Myocardial Infarction: Insights from PLATO on the Influence of Sex

American Journal of Medicine. 2015 January; 10.1016/j.amjmed.2015.03.005

Consistency of benefit from an early invasive strategy after fibrinolysis: A patient-level meta-analysis

Heart. 2015 January; 10.1136/heartjnl-2015-307815

Efficacy and safety of vorapaxar in non-ST-segment elevation acute coronary syndrome patients undergoing noncardiac surgery

Journal of the American Heart Association. 2015 January; 10.1161/JAHA.115.002546

Novel approaches to composite endpoints in clinical trials

EuroIntervention. 2015 January; 10.4244/EIJV11I1A22

Impact of a pharmacoinvasive strategy when delays to primary PCI are prolonged

Heart. 2015 January; 10.1136/heartjnl-2014-306686

An assessment of ST-segment measurement variability between two core electrocardiogram laboratories

Journal of Electrocardiology. 2014 January; 10.1016/j.jelectrocard.2013.10.005

Aborted myocardial infarction in ST-elevation myocardial infarction: Insights from the STrategic Reperfusion Early after Myocardial infarction trial

Heart. 2014 January; 10.1136/heartjnl-2014-306023

The prognostic relationship of qt interval and dispersion in patients with acute st elevation myocardial infarction

Experimental and Clinical Cardiology. 2014 January;

The association between meteorological events and acute heart failure: New insights from ASCEND-HF

International Journal of Cardiology. 2014 January; 10.1016/j.ijcard.2014.11.066

Routine invasive management early after fibrinolysis: Relationship between baseline risk and treatment effects in a pooled patient-level analysis of 7 randomized controlled trials

American Heart Journal. 2014 January; 10.1016/j.ahj.2014.07.027

Prognostic implications of quantitative evaluation of baseline Q-wave width in ST-segment elevation myocardial infarction

Journal of Electrocardiology. 2014 January; 10.1016/j.jelectrocard.2014.04.013

Acute decompensated heart failure patients admitted to critical care units: Insights from ASCEND-HF

International Journal of Cardiology. 2014 January; 10.1016/j.ijcard.2014.11.007

Association of metabolic syndrome and its individual components with outcomes among patients with high-risk non-ST-segment elevation acute coronary syndromes

American Heart Journal. 2014 January; 10.1016/j.ahj.2014.04.009

Dietary fatty acids intake and mortality in patients with heart failure

Nutrition. 2014 January; 10.1016/j.nut.2014.04.006

Providing rapid out of hospital acute cardiovascular treatment 3 (PROACT-3)

Canadian Journal of Cardiology. 2014 January; 10.1016/j.cjca.2014.04.012

Practice patterns and clinical outcomes among non-ST-Segment elevation acute coronary syndrome (NSTE-ACS) patients presenting to primary and tertiary hospitals: Insights from the EARLY glycoprotein IIb/IIIa inhibition in NSTE-ACS (EARLY-ACS) trial

Catheterization and Cardiovascular Interventions. 2014 January; 10.1002/ccd.25590

Outcomes of a pharmacoinvasive strategy for successful versus failed fibrinolysis and primary percutaneous intervention in acute myocardial infarction (from the STrategic Reperfusion Early After Myocardial Infarction [STREAM] study).

The American journal of cardiology. 2014 January;

Association between bleeding and mortality among women and men with high-risk acute coronary syndromes: Insights from the Early versus Delayed, Provisional Eptifibatide in Acute Coronary Syndromes (EARLY ACS) trial

American Heart Journal. 2013 January; 10.1016/j.ahj.2013.07.014

The relationship between meteorological conditions and index acute coronary events in a global clinical trial

International Journal of Cardiology. 2013 January; 10.1016/j.ijcard.2013.01.061

The power of more than one

Circulation. 2013 January; 10.1161/CIRCULATIONAHA.112.000627

The forgotten lead: Does aVR ST-deviation add insight into the outcomes of ST-elevation myocardial infarction patients?

American Heart Journal. 2013 January; 10.1016/j.ahj.2013.05.018

Quantitative ST-depression in acute coronary syndromes: The plato electrocardiographic substudy

American Journal of Medicine. 2013 January; 10.1016/j.amjmed.2013.01.038

Aborted myocardial infarction after primary percutaneous coronary intervention: Magnetic resonance imaging insights from the assessment of pexelizumab in acute myocardial infarction (APEX-AMI) trial

American Heart Journal. 2013 January; 10.1016/j.ahj.2012.10.028

Association of global weather changes with acute coronary syndromes: Gaining insights from clinical trials data

International Journal of Biometeorology. 2013 January; 10.1007/s00484-012-0565-3

Dynamic modeling of 90-day mortality in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

American Heart Journal. 2013 January; 10.1016/j.ahj.2012.12.001

Radial versus femoral access, bleeding and ischemic events in patients with non-ST-segment elevation acute coronary syndrome managed with an invasive strategy

American Heart Journal. 2013 January; 10.1016/j.ahj.2013.01.009

Evaluation of early percutaneous coronary intervention vs. standard therapy after fibrinolysis for ST-segment elevation myocardial infarction: Contribution of weighting the composite endpoint

European Heart Journal. 2013 January; 10.1093/eurheartj/ehs438

Baseline Q waves as a prognostic modulator in patients with ST-segment elevation: Insights from the PLATO trial

CMAJ. 2012 January; 10.1503/cmaj.111683

Acute heart failure perspectives from a randomized trial and a simultaneous registry

Circulation: Heart Failure. 2012 January; 10.1161/CIRCHEARTFAILURE.112.968974

Anticoagulation after subcutaneous enoxaparin is time sensitive in STEMI patients treated with tenecteplase

Journal of Thrombosis and Thrombolysis. 2012 January; 10.1007/s11239-012-0697-7

Relative prognostic value of baseline q wave and time from symptom onset among men and women with ST-elevation myocardial infarction undergoing percutaneous coronary intervention

American Journal of Cardiology. 2012 January; 10.1016/j.amjcard.2012.07.020

ST-elevation acute coronary syndromes in the platelet inhibition and patient outcomes (PLATO) trial: Insights from the ECG substudy

Circulation. 2012 January; 10.1161/CIRCULATIONAHA.111.047530

Mode of hospital presentation in patients with non-ST-elevation myocardial infarction: Implications for strategic management

American Heart Journal. 2011 January; 10.1016/j.ahj.2011.06.011

The influence of time from symptom onset and reperfusion strategy on 1-year survival in ST-elevation myocardial infarction: A pooled analysis of an early fibrinolytic strategy versus primary percutaneous coronary intervention from CAPTIM and WEST

American Heart Journal. 2011 January; 10.1016/j.ahj.2010.10.033

ST elevation acute coronary syndromes in PLATO: Insights from the ECG substudy

Circulation. 2011 January; 10.1161/CIRCULATIONAHA.111.CIRCULATIONAHA.111.047530

High-risk patients with ST-elevation myocardial infarction derive greatest absolute benefit from primary percutaneous coronary intervention: Results from the Primary Coronary Angioplasty Trialist versus Thrombolysis (PCAT)-2 Collaboration

American Heart Journal. 2011 January; 10.1016/j.ahj.2010.11.022

Refining clinical trial composite outcomes: An application to the assessment of the safety and efficacy of a new thrombolytic-3 (ASSENT-3) trial

American Heart Journal. 2011 January; 10.1016/j.ahj.2010.12.026

Reprinted Article "a combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery"

European Journal of Vascular and Endovascular Surgery. 2011 January; 10.1016/j.ejvs.2011.06.016

Do baseline atrial electrocardiographic and infarction patterns predict new-onset atrial fibrillation after ST-elevation myocardial infarction? Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction Trial

Journal of Electrocardiology. 2010 January; 10.1016/j.jelectrocard.2010.04.001

Usefulness of the QRS score as a strong prognostic marker in patients discharged after undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

American Journal of Cardiology. 2010 January; 10.1016/j.amjcard.2010.04.013

Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: Insights from the APEX-AMI trial

European Heart Journal. 2010 January; 10.1093/eurheartj/ehq143

ST-Segment Resolution and Outcome in Myocardial Infarction

Journal of the American College of Cardiology. 2010 January; 10.1016/j.jacc.2009.12.033

Prior Coronary Artery Bypass Graft Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

JACC: Cardiovascular Interventions. 2010 January; 10.1016/j.jcin.2009.12.008

Does silent myocardial infarction add prognostic value in ST-elevation myocardial infarction patients without a history of prior myocardial infarction? Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) Trial

American Heart Journal. 2010 January; 10.1016/j.ahj.2010.06.054

Is visual interpretation of coronary epicardial flow reliable in patients with ST-elevation myocardial infarction undergoing primary angioplasty? Insights from the angiographic substudy of the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial

American Heart Journal. 2010 January; 10.1016/j.ahj.2010.02.028

Mortality and Morbidity Reduction by Primary Percutaneous Coronary Intervention Is Independent of the Patient's Age

JACC: Cardiovascular Interventions. 2010 January; 10.1016/j.jcin.2009.11.022

Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: Insights from the APEX-AMI trial

European Heart Journal. 2010 January; 10.1093/eurheartj/ehq129

Resolution of ST-segment depression: A new prognostic marker in ST-segment elevation myocardial infarction

European Heart Journal. 2010 January; 10.1093/eurheartj/ehp494

Is duration of symptoms is the key modulator of the choice of reperfusion for ST-elevation myocardial infarction

Circulation. 2009 January; 10.1161/CIRCULATIONAHA.108.796383

Contribution of angiographic and electrocardiographic parameters of reperfusion to prediction of mortality and morbidity after acute ST-elevation myocardial infarction: Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction trial

American Heart Journal. 2009 January; 10.1016/j.ahj.2009.09.009

Time from first medical contact to reperfusion in ST elevation myocardial infarction: A Which Early ST Elevation Myocardial Infarction Therapy (WEST) substudy

Canadian Journal of Cardiology. 2009 January;

Baseline Q-Wave Surpasses Time From Symptom Onset as a Prognostic Marker in ST-Segment Elevation Myocardial Infarction Patients Treated With Primary Percutaneous Coronary Intervention

Journal of the American College of Cardiology. 2009 January; 10.1016/j.jacc.2009.01.046

Reperfusion after primary angioplasty for ST-elevation myocardial infarction: Predictors of success and relationship to clinical outcomes in the APEX-AMI Angiographic Study

European Heart Journal. 2008 January; 10.1093/eurheartj/ehn125

ST-segment recovery and outcome after primary percutaneous coronary intervention for ST-elevation myocardial infarction: Insights from the assessment of pexelizumab in acute myocardial infarction (APEX-AMI) trial

Circulation. 2008 January; 10.1161/CIRCULATIONAHA.108.767772

Sex differences in patients seeking medical attention for prodromal symptoms before an acute coronary event

American Heart Journal. 2008 January; 10.1016/j.ahj.2008.07.016

Dihydropiridine calcium-channel blockers and perioperative mortality in aortic aneurysm surgery

British Journal of Anaesthesia. 2008 January; 10.1093/bja/aen173

Guideline adjudicated fibrinolytic failure: Incidence, findings, and management in a contemporary clinical trial

American Heart Journal. 2008 January; 10.1016/j.ahj.2007.08.027

Acute heart failure in the emergency department: Short and long-term outcomes of elderly patients with heart failure

European Journal of Heart Failure. 2008 January; 10.1016/j.ejheart.2008.01.014

Integrating ancillary studies in a large clinical trial: The design and rationale of the APEX library

Contemporary Clinical Trials. 2008 January; 10.1016/j.cct.2008.06.003

No prognostic significance of chronic infection with Chlamydia pneumoniae in acute coronary syndromes: Insights from the Global Utilization of Strategies to Open Occluded Arteries IV Acute Coronary Syndromes trial

American Heart Journal. 2007 January; 10.1016/j.ahj.2007.04.010

Primary percutaneous coronary intervention compared with fibrinolysis for myocardial infarction in diabetes mellitus: Results from the primary coronary angioplasty vs thrombolysis-2 trial

Archives of Internal Medicine. 2007 January; 10.1001/archinte.167.13.1353

A novel enoxaparin regime for st elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A WEST sub-study

Catheterization and Cardiovascular Interventions. 2007 January; 10.1002/ccd.21062

Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes

CMAJ. 2007 January; 10.1503/cmaj.060711

Effects of Socioeconomic Status on Mortality after Acute Myocardial Infarction

American Journal of Medicine. 2007 January; 10.1016/j.amjmed.2006.05.056

Effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST segment elevation acute coronary syndromes: Benefit and harm in different age subgroups

Heart. 2007 January; 10.1136/hrt.2006.098657

Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: An important risk marker of mortality in women

European Heart Journal. 2007 January; 10.1093/eurheartj/ehm223

Forecasting mortality: Dynamic assessment of risk in ST-segment elevation acute myocardial infarction

European Heart Journal. 2006 January; 10.1093/eurheartj/ehi700

Predictors of stroke within 30 days in patients with non-ST-segment elevation acute coronary syndromes

European Heart Journal. 2006 January; 10.1093/eurheartj/ehl356

Short- and Long-Term Risk Stratification in Acute Coronary Syndromes. The Added Value of Quantitative ST-Segment Depression and Multiple Biomarkers

Journal of the American College of Cardiology. 2006 January; 10.1016/j.jacc.2006.04.085

Are international differences in the outcomes of acute coronary syndromes apparent or real? A multilevel analysis

Journal of Epidemiology and Community Health. 2005 January; 10.1136/jech.2004.024984

A combination of satins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery

European Journal of Vascular and Endovascular Surgery. 2004 January; 10.1016/j.ejvs.2004.07.008

Association between long-term statin use and mortality after successful abdominal aortic aneurysm surgery

American Journal of Medicine. 2004 January; 10.1016/j.amjmed.2003.08.029

Interinstitutional variation in the use of abciximab for percutaneous coronary intervention

Canadian Journal of Cardiology. 2004 January;

Intravenous glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: Lessons from recently conducted randomized clinical trials

Current Opinion in Investigational Drugs. 2004 January;

Impact of Sex on Long-term Mortality From Acute Myocardial Infarction vs Unstable Angina

Archives of Internal Medicine. 2003 January; 10.1001/archinte.163.20.2476

Risk-benefit analysis of platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes

Expert Opinion on Drug Safety. 2003 January; 10.1517/14740338.2.1.49

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