2024
Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing
Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.Peer-Reviewed Original ResearchReduced ejection fractionEjection fractionHeart failureLeft ventricular ejection fractionVentricular ejection fractionYale-New Haven HospitalIdentification of patientsCommunity hospitalIdentification of heart failureLanguage modelNorthwestern MedicineMeasure care qualityQuality of careNew Haven HospitalDeep learning-based natural language processingHFrEFGuideline-directed careDeep learning language modelsMIMIC-IIIDetect HFrEFNatural language processingReclassification improvementHospital dischargePatientsCare qualityELECTRONIC ALERTS TO IMPROVE MINERALOCORTICOID RECEPTOR ANTAGONIST USE AND HYPERKALEMIA MANAGEMENT IN AMBULATORY PATIENTS WITH HEART FAILURE: A CLUSTER RANDOMIZED TRIAL
Clark K, Victoria-Castro A, Ghazi, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. ELECTRONIC ALERTS TO IMPROVE MINERALOCORTICOID RECEPTOR ANTAGONIST USE AND HYPERKALEMIA MANAGEMENT IN AMBULATORY PATIENTS WITH HEART FAILURE: A CLUSTER RANDOMIZED TRIAL. Journal Of The American College Of Cardiology 2024, 83: 2395. DOI: 10.1016/s0735-1097(24)04385-7.Peer-Reviewed Original Research
2023
Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction
Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Piña I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 12: 479-487. PMID: 38127049, DOI: 10.1016/j.jchf.2023.11.007.Peer-Reviewed Original ResearchNT-proBNP measurementsPrimary trial endpointChronic heart failureNT-proBNP levelsReduced ejection fractionTrial endpointsHeart failureEjection fractionN-terminal pro-B-type natriuretic peptide (NT-proBNP) measurementBaseline NT-proBNP levelsChronic heart failure patientsNT-proBNP monitoringSecondary trial endpointsHeart failure hospitalizationNatriuretic peptide measurementHeart failure patientsCardiovascular deathFailure hospitalizationNT-proBNPFailure patientsPrognostic impactClinical outcomesPrognostic valueOutpatient sitesClinical studiesLeft Ventricular Ejection Fraction and the Future of Heart Failure Phenotyping
Dimond M, Ibrahim N, Fiuzat M, McMurray J, Lindenfeld J, Ahmad T, Bozkurt B, Bristow M, Butler J, Carson P, Felker G, Jessup M, Murillo J, Kondo T, Solomon S, Abraham W, O'Connor C, Psotka M. Left Ventricular Ejection Fraction and the Future of Heart Failure Phenotyping. JACC Heart Failure 2023, 12: 451-460. PMID: 38099892, DOI: 10.1016/j.jchf.2023.11.005.Peer-Reviewed Original ResearchRationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Clark K, Victoria-Castro A, Ghazi L, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use. JACC Heart Failure 2023, 12: 322-332. PMID: 37943221, DOI: 10.1016/j.jchf.2023.08.025.Peer-Reviewed Original ResearchBest practice alertMineralocorticoid receptor antagonistsNovel potassium bindersPotassium bindersEligible patientsUsual careEjection fractionSerum potassiumHistory of hyperkalemiaIncidence of hyperkalemiaStrong guideline recommendationsHeart failure hospitalizationReduced ejection fractionLaboratory test valuesPopulation health outcomesHyperkalemia treatmentMRA prescriptionAntagonist useFailure hospitalizationPatient characteristicsSecondary outcomesHeart failurePrimary outcomeGuideline recommendationsOutpatient visitsImpact of Digital Health Technology on Quality of Life in Patients With Heart Failure
Victoria-Castro A, Martin M, Yamamoto Y, Melchinger H, Weinstein J, Nguyen A, Lee K, Gerber B, Calderon F, Subair L, Lee V, Williams A, Shaw M, Arora T, Garcez A, Desai N, Ahmad T, Wilson F. Impact of Digital Health Technology on Quality of Life in Patients With Heart Failure. JACC Heart Failure 2023, 12: 336-348. PMID: 37943227, DOI: 10.1016/j.jchf.2023.09.022.Peer-Reviewed Original ResearchOverall summary scoreClinical summary scoreTotal symptom scoreKCCQ overall summary scoreUsual careHeart failureQuality of lifeMedian changeKansas City Cardiomyopathy Questionnaire overall summary scoreSummary scoresMedian agePrimary outcomeSymptom scoresPhysical functionLongitudinal carePatientsDigital health toolsLarger studyDigital health technologiesHealth toolsQoLCareDigital interventionsIndependent effectsHealth technologiesElectronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageElectronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure
Fuery M, Kadhim B, Samsky M, Freeman J, Clark K, Desai N, Wilson F, Ahmed T, Ahmad T. Electronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure. Current Heart Failure Reports 2023, 20: 280-286. PMID: 37552356, DOI: 10.1007/s11897-023-00614-0.Peer-Reviewed Original ResearchConceptsHeart failure patientsFailure patientsElectronic health recordsEHR alertClinical trialsRandomized clinical trialsCare of patientsQuality of careHeart failureClinician satisfactionRandomized fashionRecent FindingsTherePatientsUnmet needPatient careClinical decisionEvidence-based decisionsFuture interventionsCareHealth recordsTrialsCliniciansInterventionFindingsThereImpact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial
Castro A, Martin M, Desai N, Ahmad T, Yamamoto Y, Melchinger H, Lee K, Gerber B, Nguyen A, Weinstein J, Subair L, Lee V, Williams A, Shaw M, Arora T, Wilson F. Impact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial. Journal Of Cardiac Failure 2023, 29: 662. DOI: 10.1016/j.cardfail.2022.10.284.Peer-Reviewed Original ResearchQuality of lifeUsual careClinical summary scoreTotal symptom scoreHeart failureSymptom scoresSummary scoresKansas City Cardiomyopathy Questionnaire overall scoreYale New Haven Health SystemDigital health toolsHealth toolsReduced ejection fractionResults One hundred fiftyUsual care groupMethods One hundred eightyNon-Hispanic blacksDigital health interventionsHF clinicSecondary outcomesEjection fractionEmergency visitsMedian agePrimary outcomeClinical outcomesRandomization groupTrends and Outcomes in Cardiac Arrest Among Heart Failure Admissions
Chouairi F, Miller P, Loriaux D, Katz J, Sen S, Ahmad T, Fudim M. Trends and Outcomes in Cardiac Arrest Among Heart Failure Admissions. The American Journal Of Cardiology 2023, 194: 93-101. PMID: 36889986, DOI: 10.1016/j.amjcard.2023.01.012.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseCardiac arrestHospital cardiac arrestHF admissionsHF hospitalizationArtery diseaseHeart failureRenal diseasePrimary HF admissionsHeart failure admissionsHigher inpatient mortalityClinical Modification codesLong-term outcomesNational Inpatient SampleMultivariate logistic regressionHF patientsInpatient mortalityMultivariate adjustmentInpatient SampleFemale genderTenth RevisionHigher oddsLower oddsInternational ClassificationSerious eventsUse of patient‐reported outcomes in heart failure: from clinical trials to routine practice
Savarese G, Lindenfeld J, Stolfo D, Adams K, Ahmad T, Desai N, Ammirati E, Gottlieb S, Psotka M, Rosano G, Allen L. Use of patient‐reported outcomes in heart failure: from clinical trials to routine practice. European Journal Of Heart Failure 2023, 25: 139-151. PMID: 36644876, DOI: 10.1002/ejhf.2778.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesHeart failureHF careApplication of PROsClinical practiceDisease statusMortality/morbidityPatient-centered approachQuality of lifeDaily clinical routinePerception of diseasePhysician assessmentClinical trialsTraditional careComplex syndromeOwn carePatient experiencePatient's lifeRoutine practiceSymptom severityClinical routineModalities of usePatient's standpointCareTrials
2022
Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation
Chouairi F, Mullan C, Ahmed A, Bhinder J, Guha A, Miller P, Jastreboff A, Fuery M, Chiravuri M, Geirsson A, Desai N, Maulion C, Sen S, Ahmad T, Anwer M. Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation. PLOS ONE 2022, 17: e0273111. PMID: 36516178, PMCID: PMC9750001, DOI: 10.1371/journal.pone.0273111.Peer-Reviewed Original ResearchConceptsPost-transplant mortalityType 2 diabetesAllocation system changeOld allocation systemsHeart transplant recipientsOutcomes of patientsOrgan Sharing databaseProportion of patientsHeart transplantation outcomesLower likelihoodLikelihood of transplantationHigher likelihoodNew allocation systemCardiac transplantationHeart transplantationTransplant recipientsT2D patientsHeart failureSharing databaseCox regressionTransplantation outcomesUnited NetworkWorse outcomesT2DPatientsPragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryNetwork Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction
Park D, An S, Attanasio S, Jolly N, Malhotra S, Doukky R, Samsky M, Sen S, Ahmad T, Nanna M, Vij A. Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction. The American Journal Of Cardiology 2022, 187: 84-92. PMID: 36459752, PMCID: PMC10958453, DOI: 10.1016/j.amjcard.2022.10.026.Peer-Reviewed Original ResearchMeSH KeywordsAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBayes TheoremDeathHeart FailureHumansHypotensionNeprilysinNetwork Meta-AnalysisRandomized Controlled Trials as TopicReceptors, AngiotensinStroke VolumeTreatment OutcomeVentricular Dysfunction, LeftConceptsAngiotensin receptor neprilysin inhibitorAngiotensin receptor blockersReduced ejection fractionHeart failureEjection fractionHigh riskCause mortalityReceptor blockersCardiac deathLower riskEnzyme inhibitorsMajor adverse cardiac eventsAngiotensin converting enzyme (ACE) inhibitorsAdverse cardiac eventsEfficacy end pointNetwork meta-analysis approachImproved clinical outcomesRandomized clinical trialsP scoreCardiac eventsAngiotensin receptorsClinical outcomesNeprilysin inhibitorClinical benefitRecent trialsFunctional and Symptomatic Clinical Trial Endpoints The HFC-ARC Scientific Expert Panel
Psotka M, Abraham W, Fiuzat M, Filippatos G, Lindenfeld J, Ahmad T, Felker G, Jacob R, Kitzman D, Leifer E, Lewis E, Mentz R, Nkulikiyinka R, Ni W, Schaber D, Sharma A, Solomon S, Stockbridge N, Teerlink J, Unger E, Whellan D, Wittes J, Anker S, O'Connor C. Functional and Symptomatic Clinical Trial Endpoints The HFC-ARC Scientific Expert Panel. JACC Heart Failure 2022, 10: 889-901. PMID: 36456063, DOI: 10.1016/j.jchf.2022.09.012.Peer-Reviewed Original ResearchConceptsAcademic Research ConsortiumHeart failureSubmaximal exercise tolerancePatient-reported outcomesCardiovascular clinical researchResearch ConsortiumExercise toleranceScientific Expert PanelPatients' qualityFunctional statusClinical trialsLife endpointsConsensus recommendationsClinical utilityDrug AdministrationCardiovascular therapeuticsClinical researchU.S. FoodExpert panelPotential endpointsNational InstituteEvidence generationTrialsEndpointAcademic investigatorsAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalMachine learning to define phenotypes and outcomes of patients hospitalized for heart failure with preserved ejection fraction: Findings from ASCEND-HF
Murray EM, Greene SJ, Rao VN, Sun JL, Alhanti BA, Blumer V, Butler J, Ahmad T, Mentz RJ. Machine learning to define phenotypes and outcomes of patients hospitalized for heart failure with preserved ejection fraction: Findings from ASCEND-HF. American Heart Journal 2022, 254: 112-121. PMID: 36007566, DOI: 10.1016/j.ahj.2022.08.009.Peer-Reviewed Original ResearchConceptsASCEND-HF trialAtrial fibrillationBlood pressureEjection fractionHeart failureLatent class analysisOutcomes of patientsLong-term outcomesYoung menFour-hour urine outputDistinct phenotypesAcute HFRenal impairmentClinical profileUrine outputASCEND-HFClinical benefitHeterogenous diseaseClinical dataOlder womenHFpEFPatientsOlder individualsCluster 3Asian womenPragmatic randomized trial assessing the impact of digital health technology on quality of life in patients with heart failure: Design, rationale and implementation
Victoria‐Castro A, Martin M, Yamamoto Y, Ahmad T, Arora T, Calderon F, Desai N, Gerber B, Lee KA, Jacoby D, Melchinger H, Nguyen A, Shaw M, Simonov M, Williams A, Weinstein J, Wilson FP. Pragmatic randomized trial assessing the impact of digital health technology on quality of life in patients with heart failure: Design, rationale and implementation. Clinical Cardiology 2022, 45: 839-849. PMID: 35822275, PMCID: PMC9346973, DOI: 10.1002/clc.23848.Peer-Reviewed Original ResearchConceptsQuality of lifeHF patientsYale New Haven Health SystemKansas City Cardiomyopathy QuestionnaireDigital health technologiesHeart failure careHealth technologiesDigital health interventionsDisease exacerbationHF clinicUsual carePrimary outcomeClinical outcomesHeart failurePatient engagementPatientsHealth interventionsDigital health toolsPatient empowermentHealth systemPatient usabilityHealth toolsEarly detectionFirst enrollmentHealthcare systemMedicare Coverage and Out-of-Pocket Costs of Quadruple Drug Therapy for Heart Failure
Faridi K, Dayoub E, Ross J, Dhruva S, Ahmad T, Desai N. Medicare Coverage and Out-of-Pocket Costs of Quadruple Drug Therapy for Heart Failure. Journal Of The American College Of Cardiology 2022, 79: 2516-2525. PMID: 35738713, DOI: 10.1016/j.jacc.2022.04.031.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorQuadruple therapyOOP costsMedicare coveragePocket costsAngiotensin-converting enzyme inhibitorPrior authorizationAngiotensin receptor blockersQuadruple drug therapyCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsReduced ejection fractionDrug plansReceptor blockersEjection fractionHeart failureDrug therapyReceptor antagonistPrescription drug plansMedicare patientsEnzyme inhibitorsTherapyRegimensMedication pricesElectronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial
Ghazi L, Yamamoto Y, Riello RJ, Coronel-Moreno C, Martin M, O'Connor KD, Simonov M, Huang J, Olufade T, McDermott J, Dhar R, Inzucchi SE, Velazquez EJ, Wilson FP, Desai NR, Ahmad T. Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial. Journal Of The American College Of Cardiology 2022, 79: 2203-2213. PMID: 35385798, DOI: 10.1016/j.jacc.2022.03.338.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyUsual careEjection fractionHeart failureMedical therapyPrimary outcomeCluster-randomized comparative effectiveness trialSodium-glucose cotransporter 2 inhibitorsElectronic health record alertsAldosterone system inhibitorsReduced ejection fractionUsual care armCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsVentricular ejection fractionComparative effectiveness trialNumber of patientsKnowledge of guidelinesLow-cost interventionCare armDays postrandomizationEligible patientsGDMT useFailure therapyPatient characteristics