2024
Validating the PREVENT Equations—A Contemporary Update to Cardiovascular Risk Assessment
Mangalesh S, Nanna M. Validating the PREVENT Equations—A Contemporary Update to Cardiovascular Risk Assessment. JAMA Network Open 2024, 7: e2438284. PMID: 39392636, DOI: 10.1001/jamanetworkopen.2024.38284.Peer-Reviewed Original ResearchRepresentation of Older Adults in the ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
Jamil Y, Sibindi C, Park D, Frampton J, Damluji A, Nanna M. Representation of Older Adults in the ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. JAMA Network Open 2024, 7: e2421547. PMID: 38995647, PMCID: PMC11245718, DOI: 10.1001/jamanetworkopen.2024.21547.Peer-Reviewed Original ResearchMachine learning prediction of one-year mortality after percutaneous coronary intervention in acute coronary syndrome patients
Hosseini K, Behnoush A, Khalaji A, Etemadi A, Soleimani H, Pasebani Y, Jenab Y, Masoudkabir F, Tajdini M, Mehrani M, Nanna M. Machine learning prediction of one-year mortality after percutaneous coronary intervention in acute coronary syndrome patients. International Journal Of Cardiology 2024, 409: 132191. PMID: 38777044, DOI: 10.1016/j.ijcard.2024.132191.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionLogistic regressionPost-PCI mortalityPrediction of one-year mortalityCoronary interventionPrediction of 1-year mortalityBody mass indexAcute coronary syndrome patientsOne-year mortalityIndividual-level assessmentsReceiver operating characteristic curveAcute coronary syndromeCoronary syndrome patientsTehran Heart CenterRates of comorbiditiesMass indexHigher ageSyndrome patientsCoronary syndromeHeart CenterFollow-upLipid profileU-shaped correlationPatientsCharacteristic curveCase Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States
Rymer J, Narcisse D, Chen A, Wojdyla D, Ashley S, Damluji A, Shah B, Nanna M, Swaminathan R, Gutierrez J, Uzendu A, Nelson A, Bethel G, Kearney K, Jones W, Rao S, Doll J. Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States. Journal Of The American College Of Cardiology 2024, 83: 1990-1998. PMID: 38749617, PMCID: PMC11173360, DOI: 10.1016/j.jacc.2024.03.395.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionAnnual case volumeNational Cardiovascular Data Registry CathPCI RegistryCase volumeIncreased risk of mortalityBleeding riskRisk of mortalityST-segment elevation myocardial infarctionMedian annual case volumeEarly-careerCertificate databaseCathPCI RegistryInterventional cardiologistsMortality riskElevation myocardial infarctionAmerican BoardIncreased riskSystem databasePredicted riskBleeding outcomesAcute presentationTreated patientsMortality rateProcedural characteristicsCareer statusChronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series
Damluji A, Nanna M, Rymer J, Kochar A, Lowenstern A, Baron S, Narins C, Alkhouli M. Chronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series. JACC Cardiovascular Interventions 2024, 17: 961-978. PMID: 38597844, PMCID: PMC11097960, DOI: 10.1016/j.jcin.2024.01.284.Peer-Reviewed Original ResearchConceptsCardiovascular careImprove health outcomesOlder adult populationPatient-centered outcomesBiological ageAge-associated riskAging global populationAge-related riskFamily seriesComplex careHealth outcomesJACC State-of-the-Art ReviewOlder AdultsChronic illnessInfluence eligibilityProcedural adverse eventsStructural heart diseaseClinical focusCareOlder individualsInvasive careAdult populationInterventionCardiovascular diseaseOlder patientsRisk Prediction for Atherosclerotic Cardiovascular Disease With and Without Race Stratification
Ghosh A, Venkatraman S, Nanna M, Safford M, Colantonio L, Brown T, Pinheiro L, Peterson E, Navar A, Sterling M, Soroka O, Nahid M, Banerjee S, Goyal P. Risk Prediction for Atherosclerotic Cardiovascular Disease With and Without Race Stratification. JAMA Cardiology 2024, 9: 55-62. PMID: 38055247, PMCID: PMC10701663, DOI: 10.1001/jamacardio.2023.4520.Peer-Reviewed Original ResearchConceptsLipoprotein cholesterol levelsAtherosclerotic cardiovascular diseaseCohort studyREGARDS cohortCholesterol levelsCardiovascular diseaseLow-density lipoprotein cholesterol levelsCoronary heart disease deathDensity lipoprotein cholesterol levelsRace-sex stratumHeart disease deathProspective cohort studyCohort risk equationsRisk predictionRace stratificationIncident ASCVDNonfatal strokeDisease deathsC-statisticMyocardial infarctionHigh riskRisk equationsSocial determinantsPercentage declineIncremental value
2022
Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding
Li D, Ong S, Hughes M, Hung K, Agarwal R, Alexis J, Damianos J, Sharma S, Pires J, Nanna M, Laine L. Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2022, 57: 94-102. PMID: 36394111, DOI: 10.1111/apt.17278.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsGastrointestinal bleedingPrimary preventionCardiovascular eventsRisk of MACEYale-New Haven HospitalPrimary cardiovascular preventionAdverse cardiovascular eventsKaplan-Meier curvesLong-term outcomesRisk-benefit ratioLog-rank testAspirin 81Hospitalised patientsPrimary endpointSecondary endpointsCardiovascular preventionSubsequent hospitalisationMedian ageDeprescriptionHigh riskAspirinHospitalisationPatientsPreventionCost-effectiveness of Pulmonary Rehabilitation Among US Adults With Chronic Obstructive Pulmonary Disease
Mosher CL, Nanna MG, Jawitz OK, Raman V, Farrow NE, Aleem S, Casaburi R, MacIntyre NR, Palmer SM, Myers ER. Cost-effectiveness of Pulmonary Rehabilitation Among US Adults With Chronic Obstructive Pulmonary Disease. JAMA Network Open 2022, 5: e2218189. PMID: 35731514, PMCID: PMC9218844, DOI: 10.1001/jamanetworkopen.2022.18189.Peer-Reviewed Original ResearchConceptsQuality-adjusted life expectancyNet cost savingsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness ratioEconomic evaluationSocietal perspective analysisCost savingsSensitivity analysisChronic obstructive pulmonary diseaseMarkov microsimulation modelUS dollarsMicrosimulation modelNet costDominant strategySocietal perspectiveLifetime horizonUS health care systemPulmonary rehabilitationObstructive pulmonary diseaseCOPD hospitalizationsHypothetical cohortQALYSavingsMicrosimulationHigh-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.
Nelson AJ, Haynes K, Shambhu S, Eapen Z, Cziraky MJ, Nanna MG, Calvert SB, Gallagher K, Pagidipati NJ, Granger CB. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. Journal Of The American College Of Cardiology 2022, 79: 1802-1813. PMID: 35512860, PMCID: PMC9344279, DOI: 10.1016/j.jacc.2022.02.048.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHigh-intensity statinsStatin useYounger patientsFemale patientsHigh-intensity statin useHigher Charlson comorbidity scoreAppropriate statin useNew guideline recommendationsCharlson comorbidity scoreRetrospective cohort studyPeripheral artery diseaseModerate-intensity statinsMultivariable logistic regressionCommercial health plansMedical claims dataComorbidity scoreIndex dateCohort studyOlder patientsPreventive therapyStatin usersArtery diseaseContemporary cohortGuideline recommendations
2021
Estimating the real-world performance of the PROMISE minimal-risk tool
Nanna MG, Wang TY, Chiswell K, Sun JL, Vemulapalli S, Hoffmann U, Patel MR, Udelson JE, Fordyce CB, Douglas PS. Estimating the real-world performance of the PROMISE minimal-risk tool. American Heart Journal 2021, 239: 100-109. PMID: 34077743, DOI: 10.1016/j.ahj.2021.05.016.Peer-Reviewed Original ResearchMeSH KeywordsAngina, StableComputed Tomography AngiographyCoronary AngiographyCoronary StenosisCoronary VesselsFemaleHeart Disease Risk FactorsHumansMaleMedical OveruseMiddle AgedMyocardial InfarctionMyocardial RevascularizationOutcome and Process Assessment, Health CarePrognosisRisk AssessmentUnited StatesConceptsObstructive coronary artery diseaseNon-low risk patientsLow-risk patientsCoronary artery diseaseStable chest painRisk patientsCardiac catheterizationArtery diseaseChest painMyocardial infarctionLower riskProspective Multicenter Imaging StudyStable chest pain patientsCardiovascular adverse outcomesMI-free survivalChest pain patientsObstructive coronary diseaseElective cardiac catheterizationLikelihood of freedomLogistic regression modelingOutcomes of interestPositive predictive valueAlternative cut pointsIndex angiographyIndex catheterization
2020
Performance of Guideline Recommendations for Prevention of Myocardial Infarction in Young Adults
Zeitouni M, Nanna MG, Sun JL, Chiswell K, Peterson ED, Navar AM. Performance of Guideline Recommendations for Prevention of Myocardial Infarction in Young Adults. Journal Of The American College Of Cardiology 2020, 76: 653-664. PMID: 32762899, PMCID: PMC7444655, DOI: 10.1016/j.jacc.2020.06.030.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyYears of agePremature myocardial infarctionIntensive lipid-lowering therapyHigh-risk criteriaMyocardial infarctionYoung adultsYounger patientsHigh low-density lipoprotein cholesterolAHA/ACC guidelinesMajor adverse cardiovascular eventsLow-density lipoprotein cholesterolDuke University Medical CenterACC/AHAAdverse cardiovascular eventsRecurrent myocardial infarctionMost young patientsReductase inhibitor therapyFirst myocardial infarctionAmerican Heart AssociationUniversity Medical CenterOlder age groupsCause deathCholesterol guidelinesStatin candidatesAge-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease
Lowenstern A, Alexander KP, Hill CL, Alhanti B, Pellikka PA, Nanna MG, Mehta RH, Cooper LS, Bullock-Palmer RP, Hoffmann U, Douglas PS. Age-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease. JAMA Cardiology 2020, 5: 193-201. PMID: 31738382, PMCID: PMC6865842, DOI: 10.1001/jamacardio.2019.4973.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseOlder patientsMyocardial infarctionCV deathNoninvasive testsArtery diseaseNoninvasive evaluationElevated coronary artery calcium scoresDeath/myocardial infarctionPositive noninvasive test resultsPossible coronary artery diseaseProspective Multicenter Imaging StudyCoronary artery calcium scoreNonwhite race/ethnicityComparative effectiveness designArtery calcium scoreCoronary artery calciumMinority of patientsCause of morbidityNoninvasive test resultsFunctional test resultsAge-specific approachesBest noninvasive testPositive test resultsOlder age groups
2019
The Accuracy of Cardiovascular Pooled Cohort Risk Estimates in U.S. Older Adults
Nanna MG, Peterson ED, Wojdyla D, Navar AM. The Accuracy of Cardiovascular Pooled Cohort Risk Estimates in U.S. Older Adults. Journal Of General Internal Medicine 2019, 35: 1701-1708. PMID: 31667745, PMCID: PMC7280419, DOI: 10.1007/s11606-019-05361-4.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseOlder adultsACC/AHA guidelinesAge groupsLarge prospective cohort studyRisk estimatesYoung adultsASCVD risk estimationProspective cohort studyCardiovascular Health StudyHigh-risk groupU.S. older adultsDifferent age groupsCHD deathFramingham OriginalASCVD riskCardiovascular eventsAHA guidelinesCohort studyPrimary preventionCardiovascular diseaseRisk groupsTreatment decisionsFramingham OffspringHealth StudyAge, knowledge, preferences, and risk tolerance for invasive cardiac care
Nanna MG, Peterson ED, Wu A, Harding T, Galanos AN, Wruck L, Alexander KP. Age, knowledge, preferences, and risk tolerance for invasive cardiac care. American Heart Journal 2019, 219: 99-108. PMID: 31733450, PMCID: PMC6944066, DOI: 10.1016/j.ahj.2019.09.008.Peer-Reviewed Original ResearchConceptsInvasive cardiac careAcute coronary syndromeInvasive cardiovascular proceduresCardiac careCardiovascular proceduresSingle academic medical centerCoronary artery bypassProspective cohort studyPercutaneous coronary interventionGroup of patientsConfidence intervalsSubstantial inter-individual variabilityAcademic medical centerArtery bypassCABG surgeryCoronary syndromeBaseline characteristicsCohort studyCoronary interventionYounger patientsCardiac catheterizationInvasive careInter-individual variabilityCare teamCardiovascular careSex Differences in the Use of Statins in Community Practice
Nanna MG, Wang TY, Xiang Q, Goldberg AC, Robinson JG, Roger VL, Virani SS, Wilson PWF, Louie MJ, Koren A, Li Z, Peterson ED, Navar AM. Sex Differences in the Use of Statins in Community Practice. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005562. PMID: 31416347, PMCID: PMC6903404, DOI: 10.1161/circoutcomes.118.005562.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiovascular DiseasesCommunity Health ServicesDyslipidemiasFemaleGuideline AdherenceHealth Knowledge, Attitudes, PracticeHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMedication AdherenceMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'Primary PreventionRegistriesRisk AssessmentRisk FactorsSecondary PreventionSex FactorsTime FactorsTreatment OutcomeTreatment RefusalUnited StatesConceptsStatin therapyStatin treatmentStatin useCardiology/American Heart Association cholesterol guidelinesAmerican Heart Association cholesterol guidelinesGuideline-recommended statin intensityHeart Association cholesterol guidelinesSex differencesAggressive lipid managementGuideline-recommended intensityLipid Management (PALM) registrySecondary prevention indicationUse of statinsAtherosclerotic cardiovascular diseaseMultivariable logistic regressionCholesterol guidelinesStatin dosingStatin intensityLipid managementClinical characteristicsNationwide registryPrevention indicationMale patientsManagement RegistryFemale patients
2018
Association of Patient Perceptions of Cardiovascular Risk and Beliefs on Statin Drugs With Racial Differences in Statin Use: Insights From the Patient and Provider Assessment of Lipid Management Registry
Nanna MG, Navar AM, Zakroysky P, Xiang Q, Goldberg AC, Robinson J, Roger VL, Virani SS, Wilson PWF, Elassal J, Lee LV, Wang TY, Peterson ED. Association of Patient Perceptions of Cardiovascular Risk and Beliefs on Statin Drugs With Racial Differences in Statin Use: Insights From the Patient and Provider Assessment of Lipid Management Registry. JAMA Cardiology 2018, 3: 739-748. PMID: 29898219, PMCID: PMC6656582, DOI: 10.1001/jamacardio.2018.1511.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtherosclerosisAttitude to HealthBlack or African AmericanCholesterol, LDLFemaleGuideline AdherenceHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHyperlipidemiasMaleMiddle AgedPerceptionPrimary PreventionRegistriesRiskSecondary PreventionSocial ClassUnited StatesWhite PeopleConceptsAfrican American patientsAfrican American individualsStatin therapyStatin useWhite individualsAmerican patientsPatients' beliefsProvider assessmentCardiology/American Heart Association guidelinesMedian low-density lipoprotein (LDL) cholesterol levelLow-density lipoprotein cholesterol levelsGuideline-recommended statin therapyAtherosclerotic cardiovascular disease riskAmerican Heart Association guidelinesGuideline-recommended intensityLipid Management (PALM) registryHeart Association guidelinesLipoprotein cholesterol levelsCardiovascular disease riskAmerican individualsCommunity health care practicesClinician differencesHealth care practicesPALM registryCardiovascular riskStatin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry
Nanna MG, Navar AM, Wang TY, Mi X, Virani SS, Louie MJ, Lee LV, Goldberg AC, Roger VL, Robinson J, Peterson ED. Statin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry. Journal Of The American Heart Association 2018, 7: e008546. PMID: 29739801, PMCID: PMC6015311, DOI: 10.1161/jaha.118.008546.Peer-Reviewed Original ResearchConceptsLipid Management (PALM) registryHigh-dose statinsHigh-intensity statinsStatin useOlder patientsSecondary preventionManagement RegistryPrimary preventionProvider assessmentCardiology/American Heart Association guidelinesAmerican Heart Association guidelinesMultivariable logistic regression modelRoutine community practiceHeart Association guidelinesCurrent statin usersCurrent statin useYears of ageLogistic regression modelsStatin usersYounger patientsPatient surveyAssociation guidelinesAmerican CollegeStatinsPatientsLong-Term Cognitive Decline After Newly Diagnosed Heart Failure
Hammond CA, Blades NJ, Chaudhry SI, Dodson JA, Longstreth WT, Heckbert SR, Psaty BM, Arnold AM, Dublin S, Sitlani CM, Gardin JM, Thielke SM, Nanna MG, Gottesman RF, Newman AB, Thacker EL. Long-Term Cognitive Decline After Newly Diagnosed Heart Failure. Circulation Heart Failure 2018, 11: e004476. PMID: 29523517, PMCID: PMC6072263, DOI: 10.1161/circheartfailure.117.004476.Peer-Reviewed Original ResearchConceptsIncident heart failureHeart failureYears of ageEjection fractionHF diagnosisAtrial fibrillationModified Mini-Mental State Examination scoresCommunity-based prospective cohort studyCognitive declineHistory of HFMini-Mental State Examination scoreLong-term cognitive declineModified Mini-Mental State ExaminationAtrial fibrillation statusComorbid atrial fibrillationMini-Mental State ExaminationProspective cohort studyGlobal cognitive abilityState Examination scoreHospital discharge summariesPublic health implicationsCohort studyClinical strokeCardiovascular healthAdjusted modelPrevalence and Management of Symptoms Associated With Statin Therapy in Community Practice
Navar AM, Peterson ED, Li S, Robinson JG, Roger VL, Goldberg AC, Virani S, Wilson PWF, Nanna MG, Lee LV, Elassal J, Wang TY. Prevalence and Management of Symptoms Associated With Statin Therapy in Community Practice. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004249. PMID: 29545393, PMCID: PMC5858190, DOI: 10.1161/circoutcomes.117.004249.Peer-Reviewed Original Research
2015
Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction
Feder SL, Schulman-Green D, Geda M, Williams K, Dodson JA, Nanna MG, Allore HG, Murphy TE, Tinetti ME, Gill TM, Chaudhry SI. Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction. Heart & Lung 2015, 44: 376-381. PMID: 26164651, PMCID: PMC4567390, DOI: 10.1016/j.hrtlng.2015.05.005.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial Infarction (TIMI) risk scoreRisk scoreOlder adultsMyocardial infarctionMedian sample ageTIMI risk scoreRisk stratification modelSemi-structured telephone interviewsRisk factorsNew risk modelAMI treatmentPhysicians' perceptionsMortality riskClinical experienceClinical practiceStratification modelTelephone interviewsAdultsThrombolysisInfarctionConstant comparative methodPhysiciansScoresQualitative study