2023
Reclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression
Cho I, Kim W, Kim S, Ko K, Seong Y, Kim D, Seo J, Shim C, Ha J, Mori M, Gupta A, You S, Hong G, Krumholz H. Reclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression. Scientific Reports 2023, 13: 6694. PMID: 37095171, PMCID: PMC10125992, DOI: 10.1038/s41598-023-33683-1.Peer-Reviewed Original ResearchConceptsRapid progression groupModerate aortic stenosisAortic valve replacementSlow progression groupAortic stenosisProgression groupHemodynamic progressionRapid progressionMore rapid progressionLatent class trajectory modelingTransthoracic echocardiography studyBetween-group differencesData-driven phenotypingPressure gradient measurementAVR ratesModerate ASCause mortalityValve replacementEchocardiography studyAtrial fibrillationTTE studiesEchocardiographic dataRisk factorsPredictive valuePatients
2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2019
Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study
Dodson JA, Hajduk A, Curtis J, Geda M, Krumholz HM, Song X, Tsang S, Blaum C, Miller P, Parikh CR, Chaudhry SI. Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2019, 132: e817-e826. PMID: 31170374, PMCID: PMC6891160, DOI: 10.1016/j.amjmed.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAcute Kidney InjuryAge FactorsAgedAged, 80 and overCohort StudiesCoronary AngiographyDatabases, FactualFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansKaplan-Meier EstimateLogistic ModelsMaleMyocardial InfarctionOdds RatioPrognosisProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSurvival AnalysisConceptsAcute kidney injuryAcute myocardial infarctionAge-related conditionsKidney injuryBody mass indexCoronary angiographyRisk factorsMyocardial infarctionOlder patientsMean ageAcute kidney injury risk factorsAcute Myocardial Infarction StudyAcute myocardial infarction cohortOlder adultsGlobal Outcomes criteriaMyocardial Infarction StudyInjury risk factorsParticipants' mean ageSILVER-AMI StudyMultivariable adjustmentComorbid diseasesHeart failureIndependent predictorsGeriatric conditionsMass index
2018
Risk Factors Associated With Major Cardiovascular Events 1 Year After Acute Myocardial Infarction
Wang Y, Li J, Zheng X, Jiang Z, Hu S, Wadhera RK, Bai X, Lu J, Wang Q, Li Y, Wu C, Xing C, Normand SL, Krumholz HM, Jiang L. Risk Factors Associated With Major Cardiovascular Events 1 Year After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e181079-e181079. PMID: 30646102, PMCID: PMC6324290, DOI: 10.1001/jamanetworkopen.2018.1079.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiovascular DiseasesFemaleHumansMaleMiddle AgedMyocardial InfarctionProspective StudiesRisk FactorsSeverity of Illness IndexTime FactorsConceptsAcute myocardial infarctionMajor cardiovascular eventsCardiovascular eventsRisk factorsC-statisticMyocardial infarctionAggressive risk factor reductionOne-year event ratesSubsequent major cardiovascular eventsRecurrent acute myocardial infarctionIndex AMI hospitalizationRisk factor reductionHigh-risk patientsProspective cohort studyCoronary heart diseaseLow-risk groupAcute care hospitalsCohort studyCommon comorbiditiesHeart failureMean ageRisk modelHeart diseaseMAIN OUTCOMEHigh riskComparison of Physician Visual Assessment With Quantitative Coronary Angiography in Assessment of Stenosis Severity in China
Zhang H, Mu L, Hu S, Nallamothu BK, Lansky AJ, Xu B, Bouras G, Cohen DJ, Spertus JA, Masoudi FA, Curtis JP, Gao R, Ge J, Yang Y, Li J, Li X, Zheng X, Li Y, Krumholz HM, Jiang L. Comparison of Physician Visual Assessment With Quantitative Coronary Angiography in Assessment of Stenosis Severity in China. JAMA Internal Medicine 2018, 178: 239-247. PMID: 29340571, PMCID: PMC5838612, DOI: 10.1001/jamainternmed.2017.7821.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChinaCoronary AngiographyCoronary StenosisCoronary VesselsCross-Sectional StudiesFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPercutaneous Coronary InterventionPractice Patterns, Physicians'Predictive Value of TestsProspective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsConceptsPhysician visual assessmentPercutaneous coronary interventionAcute myocardial infarctionQuantitative coronary angiographyStenosis severityCoronary angiographyMean agePCI studiesMean percent diameter stenosisIndependent core laboratoryPercent diameter stenosisCross-sectional studyNon-AMI patientsStandard clinical practiceFractional flow reserveSubset of participantsQCA assessmentCoronary revascularizationMore stenosisCoronary interventionCoronary lesionsChina PatientCoronary angiogramDiameter stenosisMyocardial infarction
2017
Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization
Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM. Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke 2017, 48: 3101-3107. PMID: 28954922, DOI: 10.1161/strokeaha.117.017960.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesElectronic health record dataHealth record dataStroke severityClaims dataMortality rateAmerican Heart Association/American Stroke AssociationHealth Stroke Scale scoreRisk variablesMedicaid ServicesRisk adjustmentMedian risk-standardized mortality rateGuidelines-Stroke registryLow-mortality hospitalsStroke Scale scoreAcute ischemic strokeAmerican Stroke AssociationOdds of mortalityMortality measuresRecord dataIschemic stroke hospitalizationsHigh-mortality hospitalsService claims dataRisk-adjustment variablesHospital admissionHospital Readmissions among Commercially Insured and Medicare Advantage Beneficiaries with Diabetes and the Impact of Severe Hypoglycemic and Hyperglycemic Events
McCoy RG, Lipska KJ, Herrin J, Jeffery MM, Krumholz HM, Shah ND. Hospital Readmissions among Commercially Insured and Medicare Advantage Beneficiaries with Diabetes and the Impact of Severe Hypoglycemic and Hyperglycemic Events. Journal Of General Internal Medicine 2017, 32: 1097-1105. PMID: 28685482, PMCID: PMC5602759, DOI: 10.1007/s11606-017-4095-x.Peer-Reviewed Original ResearchConceptsDiabetes Complications Severity IndexSevere dysglycemiaIndex hospitalizationMedicare Advantage beneficiariesRisk factorsBetter care transitionsComplications Severity IndexPost-discharge managementIndependent risk factorYounger patient ageOptumLabs Data WarehouseStrong risk factorYears of ageBackgroundHospital readmissionsDesignRetrospective analysisCause readmissionUnplanned readmissionPatient agePrior hospitalizationReadmission ratesYounger patientsHeart failureHospital readmissionSevere hypoglycemiaDiabetes complications
2016
Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time
Dharmarajan K, Qin L, Lin Z, Horwitz LI, Ross JS, Drye EE, Keshawarz A, Altaf F, Normand SL, Krumholz HM, Bernheim SM. Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time. Health Affairs 2016, 35: 1294-1302. PMID: 27385247, DOI: 10.1377/hlthaff.2015.1614.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCenters for Medicare and Medicaid Services, U.S.Chronic DiseaseDatabases, FactualDisease ProgressionFemaleGeriatric AssessmentHospital MortalityHumansIncidenceLength of StayMaleOutcome Assessment, Health CarePatient AdmissionPatient ReadmissionRetrospective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsUnited StatesRisk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Spatz ES, Lipska KJ, Dai Y, Bao H, Lin Z, Parzynski CS, Altaf FK, Joyce EK, Montague JA, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations. Medical Care 2016, 54: 528-537. PMID: 26918404, PMCID: PMC5356461, DOI: 10.1097/mlr.0000000000000518.Peer-Reviewed Original ResearchConceptsHeart failure measuresAccountable care organizationsAcute admission ratesHeart failureAdmission ratesNational ratesUnplanned hospital admissionsHeart failure cohortRisk-adjustment variablesPopulation-based measuresCare organizationsOutcome measure developmentIntraclass correlation coefficientHospital admissionDiabetes measuresFailure cohortChronic conditionsMedicare feeDiabetesService beneficiariesPatientsMeet criteriaMeasures of qualitySocioeconomic statusPerformance categories
2015
Appropriate Use Criteria for Coronary Revascularization and Trends in Utilization, Patient Selection, and Appropriateness of Percutaneous Coronary Intervention
Desai NR, Bradley SM, Parzynski CS, Nallamothu BK, Chan PS, Spertus JA, Patel MR, Ader J, Soufer A, Krumholz HM, Curtis JP. Appropriate Use Criteria for Coronary Revascularization and Trends in Utilization, Patient Selection, and Appropriateness of Percutaneous Coronary Intervention. JAMA 2015, 314: 2045-2053. PMID: 26551163, PMCID: PMC5459470, DOI: 10.1001/jama.2015.13764.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngina PectorisCross-Sectional StudiesFemaleHumansMaleMyocardial RevascularizationPatient SelectionPercutaneous Coronary InterventionSeverity of Illness IndexConceptsNonacute percutaneous coronary interventionPercutaneous coronary interventionAppropriate use criteriaInappropriate percutaneous coronary interventionHospital-level variationCoronary revascularizationPatient selectionUse criteriaCoronary interventionStudy periodAppropriateness of PCINational Cardiovascular Data Registry CathPCI RegistryProportion of PCIsMultivessel coronary artery diseaseHigh-risk findingsCoronary artery diseaseAnnual PCI volumesCross-sectional analysisAngina severityAntianginal medicationsAcute indicationsCathPCI RegistryArtery diseasePCI volumePCI procedures
2013
Response to Letters Regarding Article, “Comparison of Clinical Interpretation With Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice
Nallamothu BK, Spertus JA, Lansky AJ, Cohen DJ, Jones PG, Kureshi F, Dehmer GJ, Drozda JP, Walsh MN, Brush JE, Koenig GC, Waites TF, Gantt DS, Kichura G, Chazal RA, O’Brien P, Valentine CM, Rumsfeld JS, Reiber JH, Elmore JG, Krumholz RA, Weaver WD, Krumholz HM. Response to Letters Regarding Article, “Comparison of Clinical Interpretation With Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice. Circulation 2013, 128: e463-e464. PMID: 24344070, PMCID: PMC8698215, DOI: 10.1161/circulationaha.113.005507.Peer-Reviewed Original ResearchMeSH KeywordsCoronary AngiographyCoronary StenosisFemaleHumansMalePercutaneous Coronary InterventionSeverity of Illness IndexDominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives?
Bikdeli B, Strait KM, Dharmarajan K, Partovian C, Coca SG, Kim N, Li SX, Testani JM, Khan U, Krumholz HM. Dominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives? Journal Of The American College Of Cardiology 2013, 61: 1549-1550. PMID: 23500272, PMCID: PMC4038646, DOI: 10.1016/j.jacc.2012.12.043.Peer-Reviewed Original ResearchComparison of Clinical Interpretation With Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice
Nallamothu BK, Spertus JA, Lansky AJ, Cohen DJ, Jones PG, Kureshi F, Dehmer GJ, Drozda JP, Walsh MN, Brush JE, Koenig GC, Waites TF, Gantt DS, Kichura G, Chazal RA, O’Brien P, Valentine CM, Rumsfeld JS, Reiber JH, Elmore JG, Krumholz RA, Weaver WD, Krumholz HM. Comparison of Clinical Interpretation With Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice. Circulation 2013, 127: 1793-1800. PMID: 23470859, PMCID: PMC3908681, DOI: 10.1161/circulationaha.113.001952.Peer-Reviewed Original ResearchMeSH KeywordsAgedCoronary AngiographyCoronary StenosisFemaleHumansMaleMiddle AgedPercutaneous Coronary InterventionSeverity of Illness IndexConceptsQuantitative coronary angiographyPercent diameter stenosisPercutaneous coronary interventionDiameter stenosisCoronary interventionCoronary angiographyCoronary lesionsClinical interpretationAngiographic interpretationStenosis severityHigher percent diameter stenosisMedian percent diameter stenosisElective percutaneous coronary interventionMean differenceCoronary stenosis severityIntermediate lesionsUS hospitalsStenosisLesionsAngiographyPatientsInterventionSeverityVisual assessmentSuch findingsRisk Factors for Hospital Admission Among Older Persons With Newly Diagnosed Heart Failure Findings From the Cardiovascular Health Study
Chaudhry SI, McAvay G, Chen S, Whitson H, Newman AB, Krumholz HM, Gill TM. Risk Factors for Hospital Admission Among Older Persons With Newly Diagnosed Heart Failure Findings From the Cardiovascular Health Study. Journal Of The American College Of Cardiology 2013, 61: 635-642. PMID: 23391194, PMCID: PMC3576871, DOI: 10.1016/j.jacc.2012.11.027.Peer-Reviewed Original ResearchConceptsHeart failure diagnosisIndependent risk factorHospital admissionCardiovascular Health StudyHeart failureGeriatric conditionsRisk factorsMuscle weaknessSlow gaitOlder personsHealth StudyNew diagnosisNew York Heart Association functional class IIICommunity-living older personsDepressed ejection fractionHeart Failure FindingsFunctional class IIIChronic kidney diseaseCause hospital admissionsMedical record reviewRelevant clinical dataLong-term riskDiabetes mellitusEjection fractionKidney disease
2012
Role of Intensive Glucose Control in Development of Renal End Points in Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis
Coca SG, Ismail-Beigi F, Haq N, Krumholz HM, Parikh CR. Role of Intensive Glucose Control in Development of Renal End Points in Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis. JAMA Internal Medicine 2012, 172: 761-769. PMID: 22636820, PMCID: PMC3688081, DOI: 10.1001/archinternmed.2011.2230.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlood GlucoseDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionFemaleGlycated HemoglobinHumansHypoglycemic AgentsKidney Failure, ChronicKidney Function TestsMaleMiddle AgedMonitoring, PhysiologicPrognosisRandomized Controlled Trials as TopicRenal DialysisRisk AssessmentSeverity of Illness IndexConceptsIntensive glucose controlRenal end pointsSerum creatinine levelsConventional glucose controlGlucose controlType 2 diabetesRenal diseaseCreatinine levelsEnd pointGlycemic controlSystematic reviewType 2 diabetes mellitusAggressive glycemic controlClinical renal outcomesKidney-related outcomesIntensive glycemic controlRenal outcomesCumulative incidenceDiabetes mellitusRandomized trialsConventional therapyLanguage restrictionsMacroalbuminuriaMicroalbuminuriaType 2
2011
Cognitive impairment and outcomes in older adult survivors of acute myocardial infarction: Findings from the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients' Health Status registry
Gharacholou SM, Reid KJ, Arnold SV, Spertus J, Rich MW, Pellikka PA, Singh M, Holsinger T, Krumholz HM, Peterson ED, Alexander KP. Cognitive impairment and outcomes in older adult survivors of acute myocardial infarction: Findings from the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients' Health Status registry. American Heart Journal 2011, 162: 860-869.e1. PMID: 22093202, PMCID: PMC3410733, DOI: 10.1016/j.ahj.2011.08.005.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of lifeMyocardial infarctionCognitive statusCognitive impairmentAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registryCardiac catheterization ratesCardiac rehabilitation referralRates of hypertensionMost older patientsSurvival 1 yearNormal cognitive functionCognitive function assessmentOlder adult survivorsLess referralCatheterization ratesMulticenter registryOlder patientsCardiac rehabilitationCerebrovascular accidentRehabilitation referralInvasive careMean ageHospital treatmentAMI care
2010
Telemonitoring in Patients with Heart Failure
Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z, Phillips CO, Hodshon BV, Cooper LS, Krumholz HM. Telemonitoring in Patients with Heart Failure. New England Journal Of Medicine 2010, 363: 2301-2309. PMID: 21080835, PMCID: PMC3237394, DOI: 10.1056/nejmoa1010029.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHeart FailureHome Care ServicesHospitalizationHumansKaplan-Meier EstimateMaleMiddle AgedMonitoring, PhysiologicPatient ReadmissionSeverity of Illness IndexTelemedicineConceptsPrimary end pointUsual care groupSecondary end pointsHeart failureEnd pointHeart failure outcomesNumber of hospitalizationsTelephone-based interactive voice response systemUsual careAdverse eventsPatient's clinicianMedian ageCare groupLarge trialsInteractive voice response systemPatientsSmall studyVoice response systemNumber of daysHospitalizationReadmissionTelemonitoringSignificant differencesCliniciansDeathDo Self- or Parent-Reported Dietary, Physical Activity, and Sedentary Behaviors Predict Worsening Obesity in Children?
Dorsey KB, Mauldon M, Magraw R, Yu S, Krumholz HM. Do Self- or Parent-Reported Dietary, Physical Activity, and Sedentary Behaviors Predict Worsening Obesity in Children? The Journal Of Pediatrics 2010, 157: 566-571. PMID: 20542293, PMCID: PMC2936814, DOI: 10.1016/j.jpeds.2010.04.062.Peer-Reviewed Original ResearchConceptsBMI z-scoreRisk factorsZ-scoreFamily historySedentary behaviorPhysical activityRisk behaviorsRoutine healthcare visitsPhysical activity behaviorHealthcare visitsObese patientsDiabetes mellitusObese childrenAcanthosis nigricansMedical recordsPediatric cliniciansBMI valuesObesityRandom effects regression analysisGreater riskActivity behaviorOverweightPatientsRegression analysisVisits
2009
Determinants of Cardiac Catheterization Use in Older Medicare Patients With Acute Myocardial Infarction
Ko DT, Ross JS, Wang Y, Krumholz HM. Determinants of Cardiac Catheterization Use in Older Medicare Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2009, 3: 54-62. PMID: 20123672, PMCID: PMC3024143, DOI: 10.1161/circoutcomes.109.858456.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overCardiac CatheterizationChi-Square DistributionComorbidityFemaleHemorrhageHospitalizationHumansLikelihood FunctionsLogistic ModelsMaleMedicareMyocardial InfarctionPatient SelectionPractice Patterns, Physicians'Risk AssessmentRisk FactorsSeverity of Illness IndexSex FactorsTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionCardiac catheterization useCardiac catheterizationInappropriate indicationsAMI patientsAppropriate indicationsMyocardial infarctionRisk scoreCardiology/American Heart Association class IBaseline cardiovascular riskOlder Medicare patientsHigh-risk patientsDemographic factorsMore comorbiditiesCardiovascular riskOlder patientsMale sexProcedure indicationFemale sexMedicare patientsAmerican CollegeAMI admissionsMedicare feePatientsCatheterizationIncreased Mortality among Survivors of Myocardial Infarction with Kidney Dysfunction: the Contribution of Gaps in the use of Guideline-Based Therapies
Peterson PN, Ambardekar AV, Jones PG, Krumholz HM, Schelbert E, Spertus JA, Rumsfeld JS, Masoudi FA. Increased Mortality among Survivors of Myocardial Infarction with Kidney Dysfunction: the Contribution of Gaps in the use of Guideline-Based Therapies. BMC Cardiovascular Disorders 2009, 9: 29. PMID: 19586550, PMCID: PMC2716301, DOI: 10.1186/1471-2261-9-29.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedFemaleGlomerular Filtration RateHumansKaplan-Meier EstimateKidney DiseasesMaleMiddle AgedMyocardial InfarctionPractice Guidelines as TopicProportional Hazards ModelsProspective StudiesRegistriesRisk AssessmentSeverity of Illness IndexSurvivorsTime FactorsTreatment OutcomeUnited StatesConceptsGlomerular filtration rateAcute myocardial infarctionGuideline-based medical therapyGuideline-based therapyMedical therapyKidney dysfunctionMyocardial infarctionUse of guidelinesEligible patientsRenal dysfunctionHazard ratioCox regressionPathophysiological abnormalitiesClinical variablesKidney diseaseFiltration rateNovel therapiesUS CentersHigh mortalityPatientsTherapyFurther adjustmentMortalityDysfunctionTreatment factors