2024
Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study
Oikonomou E, Aminorroaya A, Dhingra L, Partridge C, Velazquez E, Desai N, Krumholz H, Miller E, Khera R. Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study. European Heart Journal - Digital Health 2024, 5: 303-313. PMID: 38774380, PMCID: PMC11104476, DOI: 10.1093/ehjdh/ztae023.Peer-Reviewed Original ResearchRisk of acute myocardial infarctionAssociated with lower oddsHospital health systemCoronary artery diseaseCardiac testingRisk of adverse outcomesUK BiobankHealth systemProvider-drivenLower oddsAssociated with better outcomesAcute myocardial infarctionBlack raceStable chest painFemale sexReal world evaluationDiabetes historyMulticohort studyFunction testsSuspected coronary artery diseaseYounger ageRisk profileAdverse outcomesMultinational cohortPost hoc analysisFactors Associated With Long COVID: Insights From Two Nationwide Surveys
Wu Y, Sawano M, Wu Y, Shah R, Bishop P, Iwasaki A, Krumholz H. Factors Associated With Long COVID: Insights From Two Nationwide Surveys. The American Journal Of Medicine 2024, 137: 515-519. PMID: 38490304, DOI: 10.1016/j.amjmed.2024.02.032.Peer-Reviewed Original ResearchBehavioral Risk Factor Surveillance SystemNational Health Interview SurveyAssociated with long COVIDNational Health Interview Survey cohortRisk Factor Surveillance SystemNon-Hispanic White individualsLong COVIDFactors associated with Long COVIDHealth Interview SurveyCross-sectional studyPositive COVID-19 testNon-HispanicInterview SurveyDoctor's diagnosisWhite individualsCOVID-19 testingCollege degreeCOVID-19 infectionFemale sexSurveillance systemBlack AmericansNationwide surveySeverity of acute COVID-19 infectionAcute COVID-19 infectionCohort
2023
Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction
Swat S, Xu H, Allen L, Greene S, DeVore A, Matsouaka R, Goyal P, Peterson P, Hernandez A, Krumholz H, Yancy C, Fonarow G, Hess P, Program A. Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 11: 918-929. PMID: 37318420, DOI: 10.1016/j.jchf.2023.04.015.Peer-Reviewed Original ResearchConceptsEvidence-based medicationsMedication initiationReduced ejection fractionNumber of medicationsMultivariable logistic regressionNumber of patientsPre-existing conditionsReduced ejectionEjection fractionHeart failureMultivariable analysisFemale sexLower oddsMedicationsMean net gainPatientsRural hospitalsAdmissionOlder ageLogistic regressionStudy periodMean numberOddsInitiationRural locations
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospitalPrevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China
Lu Y, Zhang H, Lu J, Ding Q, Li X, Wang X, Sun D, Tan L, Mu L, Liu J, Feng F, Yang H, Zhao H, Schulz WL, Krumholz HM, Pan X, Li J, Huang C, Dong Z, Jiang B, Guo Z, Zhang Y, Sun J, Liu Y, Ren Z, Meng Y, Wang Z, Xi Y, Xing L, Tian Y, Liu J, Fu Y, Liu T, Sun W, Yan S, Jin L, Zheng Y, Wang J, Yan J, Xu X, Chen Y, Xing X, Zhang L, Zhong W, Fang X, Zhu L, Xu Y, Guo X, Xu C, Zhou G, Fan L, Qi M, Zhu S, Qi J, Li J, Yin L, Liu Q, Geng Q, Feng Y, Wang J, Wen H, Han X, Liu P, Ding X, Xu J, Deng Y, He J, Liu G, Jiang C, Zha S, Yang C, Bai G, Yu Y, Tashi Z, Qiu L, Hu Z, He H, Zhang J, Zhou M, Li X, Zhao J, Ma S, Ma Y, Huang Y, Zhang Y, Li F, Shen J. Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China. JAMA Network Open 2021, 4: e2127573. PMID: 34586366, PMCID: PMC8482054, DOI: 10.1001/jamanetworkopen.2021.27573.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseLipid-lowering medicationsPrimary care institutionsPrevalence of dyslipidemiaControl of dyslipidemiaLipoprotein cholesterolCare institutionsControl rateFemale sexCardiovascular diseaseMAIN OUTCOMEHigh riskNonstatin lipid-lowering drugsHigh-density lipoprotein cholesterolLow-density lipoprotein cholesterolPrimary health care settingsMajor public health problemLipid lowering medicationsMillion Persons ProjectOverall control rateLDL-C levelsLipid-lowering drugsCross-sectional studyPublic health problemHealth care settings
2019
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017
Khera R, Valero-Elizondo J, Das SR, Virani SS, Kash BA, de Lemos JA, Krumholz HM, Nasir K. Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017. Circulation 2019, 140: 2067-2075. PMID: 31760784, DOI: 10.1161/circulationaha.119.041974.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseCost-related nonadherenceMedication nonadherenceCardiovascular diseaseHigher oddsHistory of ASCVDNational Health Interview SurveyCost-related medication nonadherenceHigher comorbidity burdenLong-term therapyLow-cost medicationsVulnerable patient groupHealth Interview SurveyLow family incomeASCVD morbidityComorbidity burdenEssential therapySecondary preventionLess medicationPatient groupFemale sexMedication fillsWorse outcomesPrescribed dosesDrug costs
2018
Factors Associated With Return to Work After Acute Myocardial Infarction in China
Jiang Z, Dreyer RP, Spertus JA, Masoudi FA, Li J, Zheng X, Li X, Wu C, Bai X, Hu S, Wang Y, Krumholz HM, Chen H. Factors Associated With Return to Work After Acute Myocardial Infarction in China. JAMA Network Open 2018, 1: e184831. PMID: 30646375, PMCID: PMC6324382, DOI: 10.1001/jamanetworkopen.2018.4831.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionIndex acute myocardial infarctionHistory of smokingMyocardial infarctionHospital complicationsBaseline characteristicsFemale sexPatient baseline characteristicsProspective cohort studyLower likelihoodAcute myocardial infarction hospitalizationsLogistic regression modelsMyocardial infarction hospitalizationsCohort studyPatient factorsChina PatientProspective studyChinese patientsMAIN OUTCOMEInfarctionPatientsMonthsHospitalizationComplicationsSmokingSex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study
Dreyer RP, Zheng X, Xu X, Liu S, Li J, Ding Q, Du X, Li X, Zhang H, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study. European Heart Journal Acute Cardiovascular Care 2018, 8: 273-282. PMID: 30270637, DOI: 10.1177/2048872618803726.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsDisease-specific health statusAdverse cardiac eventsAcute myocardial infarctionGeneric health statusMyocardial infarctionCardiac eventsFemale sexHealth statusWeekly anginaChina PatientHealth outcomesAcute Myocardial Infarction StudyPost-acute myocardial infarctionAcute myocardial infarction patientsLong-term health outcomesCardiac Events (PEACE) studyMyocardial Infarction StudyMyocardial infarction patientsSpecific health statusHigher crude ratesSex differencesCardiovascular deathMultivariable analysisInfarction patientsSex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics
Gupta A, Barrabes JA, Strait K, Bueno H, Porta‐Sánchez A, Acosta‐Vélez J, Lidón R, Spatz E, Geda M, Dreyer RP, Lorenze N, Lichtman J, D'Onofrio G, Krumholz HM. Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics. Journal Of The American Heart Association 2018, 7: e007021. PMID: 29514807, PMCID: PMC5907538, DOI: 10.1161/jaha.117.007021.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetElectrocardiographyFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial ReperfusionPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsST-segment elevation myocardial infarctionElectrocardiographic characteristicsMyocardial infarctionReperfusion delayYounger patientsVentricular hypertrophyST elevationPrehospital ECGLateral leadsMultivariable logistic regression modelTimeliness of reperfusionVoltage criteriaElevation myocardial infarctionLeft ventricular hypertrophyAcute myocardial infarctionYears of ageLogistic regression modelsSex differencesClinical characteristicsCohort studyElectrocardiographic correlatesMultivariable analysisFemale sexSpanish hospitalsReperfusion guidelines
2016
Long-Term Risk for Device-Related Complications and Reoperations After Implantable Cardioverter-Defibrillator Implantation: An Observational Cohort Study.
Ranasinghe I, Parzynski CS, Freeman JV, Dreyer RP, Ross JS, Akar JG, Krumholz HM, Curtis JP. Long-Term Risk for Device-Related Complications and Reoperations After Implantable Cardioverter-Defibrillator Implantation: An Observational Cohort Study. Annals Of Internal Medicine 2016, 165: 20-29. PMID: 27135392, DOI: 10.7326/m15-2732.Peer-Reviewed Original ResearchICD-related complicationsNational Cardiovascular Data RegistryObservational cohort studyDevice-related complicationsICD implantationLong-term riskCohort studyMedicare feeNational Cardiovascular Data Registry ICD RegistryImplantable cardioverter defibrillator implantationImplantable cardioverter-defibrillator placementCardioverter-defibrillator implantationService claims dataCRT-D devicesSingle-chamber devicesCumulative incidenceNonfatal outcomesICD RegistryService patientsBlack raceFemale sexReoperationAmerican CollegeClaims dataComplications
2015
Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction
Dreyer RP, Ranasinghe I, Wang Y, Dharmarajan K, Murugiah K, Nuti SV, Hsieh AF, Spertus JA, Krumholz HM. Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction. Circulation 2015, 132: 158-166. PMID: 26085455, PMCID: PMC5322973, DOI: 10.1161/circulationaha.114.014776.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionPrincipal diagnosisYounger patientsHigh riskUtilization Project State Inpatient DatabasesYoung womenCause readmission rateGreater mortality riskSex differencesNoncardiac diagnosesReadmission diagnosesReadmission timingReadmission ratesInpatient DatabaseReadmission riskFemale sexCondition categoriesReadmissionMortality riskHealthcare costsDay 2InfarctionPatientsDiagnosisSex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction
Xu X, Bao H, Strait K, Spertus JA, Lichtman JH, D'Onofrio G, Spatz E, Bucholz EM, Geda M, Lorenze NP, Bueno H, Beltrame JF, Krumholz HM. Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction. Circulation 2015, 131: 614-623. PMID: 25679303, PMCID: PMC4652932, DOI: 10.1161/circulationaha.114.012826.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMiddle-aged patientsMyocardial infarctionMental health statusWorse recoveryHealth statusSex differencesBaseline stressSex-based disparitiesYears of ageMultiple health outcomesQuality of lifeGreater mental stressSex-based differencesClinical characteristicsFemale sexEarly recoveryPerceived Stress ScaleGeneral populationGreater psychological stressHealth outcomesImprovement scoresInfarctionPatientsYounger age
2012
Physical function and independence 1 year after myocardial infarction: Observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry
Dodson JA, Arnold SV, Reid KJ, Gill TM, Rich MW, Masoudi FA, Spertus JA, Krumholz HM, Alexander KP. Physical function and independence 1 year after myocardial infarction: Observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry. American Heart Journal 2012, 163: 790-796. PMID: 22607856, PMCID: PMC3359897, DOI: 10.1016/j.ahj.2012.02.024.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAge FactorsAgedAngioplasty, Balloon, CoronaryAttitude to HealthCardiac CatheterizationCoronary AngiographyDepressionElectrocardiographyFemaleFollow-Up StudiesHealth SurveysHumansIncidenceIndependent LivingMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionPhysical FitnessPoisson DistributionPredictive Value of TestsQuality of LifeRegistriesRisk AssessmentSickness Impact ProfileSurveys and QuestionnairesSurvivorsTime FactorsTranslational Research, BiomedicalConceptsAcute myocardial infarctionPhysical function declineFunction declinePhysical functionMyocardial infarctionHealth statusEuroQol-5DUninsured statusTime of AMIShort Form-12 Physical Component ScoreIndependence lossEnd-stage renal diseasePost-acute myocardial infarctionCardiac rehabilitation referralPhysical component scorePatients' health statusQuality of lifePoisson regression modelsTRIUMPH registryRehabilitation referralRenal diseaseNonwhite raceFemale sexRisk factorsUnmarried status
2011
Association of Door-In to Door-Out Time With Reperfusion Delays and Outcomes Among Patients Transferred for Primary Percutaneous Coronary Intervention
Wang TY, Nallamothu BK, Krumholz HM, Li S, Roe MT, Jollis JG, Jacobs AK, Holmes DR, Peterson ED, Ting HH. Association of Door-In to Door-Out Time With Reperfusion Delays and Outcomes Among Patients Transferred for Primary Percutaneous Coronary Intervention. JAMA 2011, 305: 2540-2547. PMID: 21693742, DOI: 10.1001/jama.2011.862.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryCohort StudiesFemaleHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionOdds RatioPatient AdmissionPatient DischargePatient TransferQuality Indicators, Health CareReferral and ConsultationRetrospective StudiesTime FactorsTreatment OutcomeUnited StatesConceptsPrimary percutaneous coronary interventionST-elevation myocardial infarctionPrimary PCIPercutaneous coronary interventionDIDO timeHospital mortalityDTB timeCoronary interventionReperfusion delayFirst hospital presentationMedian DIDO timeOff-hour presentationSTEMI referral hospitalsClinical performance measuresHospital presentationAbsolute contraindicationBalloon timeRetrospective cohortReferral hospitalInterhospital transferACTION RegistryFemale sexMyocardial infarctionFirst HospitalPatient outcomes
2010
Delay From Symptom Onset to Hospital Presentation for Patients With Non–ST-Segment Elevation Myocardial Infarction
Ting HH, Chen AY, Roe MT, Chan PS, Spertus JA, Nallamothu BK, Sullivan MD, DeLong ER, Bradley EH, Krumholz HM, Peterson ED. Delay From Symptom Onset to Hospital Presentation for Patients With Non–ST-Segment Elevation Myocardial Infarction. JAMA Internal Medicine 2010, 170: 1834-1841. PMID: 21059977, DOI: 10.1001/archinternmed.2010.385.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionHospital presentationSymptom onsetHospital mortalityMultivariable adjustmentMyocardial infarctionUnstable Angina Patients Suppress Adverse OutcomesCan Rapid Risk StratificationSegment elevation myocardial infarctionNational quality improvement initiativeRapid Risk StratificationQuality improvement initiativesMedian delay timeSecular trendsNon–STCurrent smokingRisk stratificationNonwhite raceAdverse outcomesFemale sexOdds ratioEarly presentationAmerican CollegePatients
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 feePatientsCatheterization
1995
Sex differences in mortality after myocardial infarction. Is there evidence for an increased risk for women?
Vaccarino V, Krumholz H, Berkman L, Horwitz R. Sex differences in mortality after myocardial infarction. Is there evidence for an increased risk for women? Circulation 1995, 91: 1861-71. PMID: 7882498, DOI: 10.1161/01.cir.91.6.1861.Peer-Reviewed Original ResearchConceptsMyocardial infarctionMortality rateIncreased early mortalitySex differencesUnadjusted mortality ratesHigh mortality rateEnglish-language literatureEarly phaseImproved survivalPatient seriesEarly mortalityFemale sexRisk factorsOutcome eventsCrude rateMEDLINE searchInfarctionSurvival rateOlder ageMortalityWomenAgeMenNumber of studiesLower survival