Featured Publications
Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials
Oikonomou EK, Spatz ES, Suchard MA, Khera R. Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials. The Lancet Digital Health 2022, 4: e796-e805. PMID: 36307193, PMCID: PMC9768739, DOI: 10.1016/s2589-7500(22)00170-4.Peer-Reviewed Original ResearchConceptsSystolic blood pressure controlBlood pressure controlIntensive systolic blood pressure controlType 2 diabetesPressure controlCardiovascular benefitsClinical trialsMajor adverse cardiovascular eventsFirst major adverse cardiovascular eventLarge randomised clinical trialsACCORD-BP trialAdverse cardiovascular eventsRandomised clinical trialsSystolic blood pressureCox regression analysisTreatment effectsHazard ratio estimatesACCORD-BPBP trialCardiovascular eventsBlood pressurePrimary outcomeStandard treatmentBaseline variablesIndex patients
2024
Comparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM
Khera R, Aminorroaya A, Dhingra L, Thangaraj P, Pedroso Camargos A, Bu F, Ding X, Nishimura A, Anand T, Arshad F, Blacketer C, Chai Y, Chattopadhyay S, Cook M, Dorr D, Duarte-Salles T, DuVall S, Falconer T, French T, Hanchrow E, Kaur G, Lau W, Li J, Li K, Liu Y, Lu Y, Man K, Matheny M, Mathioudakis N, McLeggon J, McLemore M, Minty E, Morales D, Nagy P, Ostropolets A, Pistillo A, Phan T, Pratt N, Reyes C, Richter L, Ross J, Ruan E, Seager S, Simon K, Viernes B, Yang J, Yin C, You S, Zhou J, Ryan P, Schuemie M, Krumholz H, Hripcsak G, Suchard M. Comparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM. Journal Of The American College Of Cardiology 2024, 84: 904-917. PMID: 39197980, DOI: 10.1016/j.jacc.2024.05.069.Peer-Reviewed Original ResearchConceptsGLP-1 RAsSecond-line agentsGLP-1Antihyperglycemic agentsCardiovascular diseaseMACE riskGlucagon-like peptide-1 receptor agonistsSodium-glucose cotransporter 2 inhibitorsPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsEffects of SGLT2isType 2 diabetes mellitusPeptidase-4 inhibitorsAdverse cardiovascular eventsCox proportional hazards modelsRandom-effects meta-analysisCardiovascular risk reductionTarget trial emulationProportional hazards modelTransforming Cardiovascular Care With Artificial Intelligence: From Discovery to Practice JACC State-of-the-Art Review
Khera R, Oikonomou E, Nadkarni G, Morley J, Wiens J, Butte A, Topol E. Transforming Cardiovascular Care With Artificial Intelligence: From Discovery to Practice JACC State-of-the-Art Review. Journal Of The American College Of Cardiology 2024, 84: 97-114. PMID: 38925729, DOI: 10.1016/j.jacc.2024.05.003.Peer-Reviewed Original ResearchPerformance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study
Camargos A, Barreto S, Brant L, Ribeiro A, Dhingra L, Aminorroaya A, Bittencourt M, Figueiredo R, Khera R. Performance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study. Open Heart 2024, 11: e002762. PMID: 38862252, PMCID: PMC11168182, DOI: 10.1136/openhrt-2024-002762.Peer-Reviewed Original ResearchConceptsPooled Cohort EquationsELSA-BrasilRisk scoreCardiovascular diseaseCVD eventsCommunity-based cohort studyArea under the receiver operating characteristic curveCVD risk scoreELSA-Brasil studyIncident CVD eventsMiddle-income countriesAdjudicated CVD eventsCardiovascular disease riskCVD scoreCohort EquationsNational guidelinesRisk stratification scoresWhite womenAge/sex groupsCohort studyProspective cohortLMICsSex/race groupsHigher incomeRisk discriminationArtificial intelligence-enhanced exposomics: novel insights into cardiovascular health
Khera R. Artificial intelligence-enhanced exposomics: novel insights into cardiovascular health. European Heart Journal 2024, 45: 1550-1552. PMID: 38544282, DOI: 10.1093/eurheartj/ehae159.Peer-Reviewed Original ResearchConceptsCardiovascular health
2023
Machine learning in precision diabetes care and cardiovascular risk prediction
Oikonomou E, Khera R. Machine learning in precision diabetes care and cardiovascular risk prediction. Cardiovascular Diabetology 2023, 22: 259. PMID: 37749579, PMCID: PMC10521578, DOI: 10.1186/s12933-023-01985-3.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsArtificial IntelligenceCardiovascular DiseasesDiabetes MellitusHeart Disease Risk FactorsHumansMachine LearningRisk FactorsConceptsArtificial intelligence solutionsArtificial intelligence productsData-driven methodIntelligence solutionsArtificial intelligenceMachine learningPersonalized solutionsIntelligence productsBias mitigationMachineKey issuesPredictive modelSuch modelsSuccessful applicationRisk predictionParadigm shiftIntelligenceKey propertiesApplicationsLearningPersonalized careFrameworkSolutionCurrent regulatory frameworkHealthcareUse of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020
Dhingra L, Aminorroaya A, Oikonomou E, Nargesi A, Wilson F, Krumholz H, Khera R. Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020. JAMA Network Open 2023, 6: e2316634. PMID: 37285157, PMCID: PMC10248745, DOI: 10.1001/jamanetworkopen.2023.16634.Peer-Reviewed Original ResearchMeSH KeywordsAdultCardiovascular DiseasesCross-Sectional StudiesFemaleHumansHypertensionMaleMiddle AgedObesityRisk FactorsConceptsHealth Information National Trends SurveyUS adultsExacerbate disparitiesWearable device usersCardiovascular diseaseCardiovascular healthPopulation-based cross-sectional studySelf-reported cardiovascular diseaseCardiovascular disease risk factorsNational Trends SurveyOverall US adult populationCardiovascular risk factor profileSelf-reported accessAssociated with lower useUse of wearable devicesImprove cardiovascular healthLower household incomeLower educational attainmentUS adult populationRisk factor profileNationally representative sampleCross-sectional studyProportion of adultsTrends SurveyWearable device data
2022
Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US
Wang SY, Valero-Elizondo J, Cainzos-Achirica M, Desai NR, Nasir K, Khera R. Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US. JAMA Health Forum 2022, 3: e221962. PMID: 35977226, PMCID: PMC9308060, DOI: 10.1001/jamahealthforum.2022.1962.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAtherosclerosisCardiovascular DiseasesCross-Sectional StudiesFemaleFinancial StressHealth ExpendituresHumansIncomeMaleYoung AdultConceptsFinancial hardshipFinancial burdenPocket medical expensesMedical Expenditure Panel SurveyHealth care expensesHigher incomePanel SurveyHealth careCare expensesFinancial consequencesHealth care costsForgone carePublic insuranceMedical billsSubstantial financial burdenMedical expensesIncomeDisparate measuresHardshipCare costsRepresentative surveySubjective measuresComprehensive frameworkExpenseInsurancePhenomapping-Derived Tool to Individualize the Effect of Canagliflozin on Cardiovascular Risk in Type 2 Diabetes.
Oikonomou EK, Suchard MA, McGuire DK, Khera R. Phenomapping-Derived Tool to Individualize the Effect of Canagliflozin on Cardiovascular Risk in Type 2 Diabetes. Diabetes Care 2022, 45: 965-974. PMID: 35120199, PMCID: PMC9016734, DOI: 10.2337/dc21-1765.Peer-Reviewed Original ResearchMeSH KeywordsCanagliflozinCardiovascular DiseasesDiabetes Mellitus, Type 2FemaleHeart Disease Risk FactorsHumansMaleRisk FactorsConceptsCanagliflozin Cardiovascular Assessment StudyMajor adverse cardiovascular eventsType 2 diabetesHazard ratioSodium-glucose cotransporter 2 inhibitorsCardiovascular disease benefitAdverse cardiovascular eventsCotransporter 2 inhibitorsEffects of canagliflozinCanagliflozin dosesCanagliflozin's effectsCardiovascular eventsCardiovascular riskPatients 5Cardioprotective effectsSGLT2 inhibitorsDisease benefitBaseline variablesOriginal trialCanagliflozinType 2DiabetesPatientsRisk estimatesEffect estimates
2021
Digital Cardiovascular Epidemiology—Ushering in a New Era Through Computational Phenotyping of Cardiovascular Disease
Khera R. Digital Cardiovascular Epidemiology—Ushering in a New Era Through Computational Phenotyping of Cardiovascular Disease. JAMA Network Open 2021, 4: e2135561. PMID: 34807263, DOI: 10.1001/jamanetworkopen.2021.35561.Commentaries, Editorials and LettersConceptsCardiovascular diseaseRepeated cross-sectional analysis of hydroxychloroquine deimplementation in the AHA COVID-19 CVD Registry
Bradley SM, Emmons-Bell S, Mutharasan RK, Rodriguez F, Gupta D, Roth G, Gluckman TJ, Shah RU, Wang TY, Khera R, Peterson PN, Das S. Repeated cross-sectional analysis of hydroxychloroquine deimplementation in the AHA COVID-19 CVD Registry. Scientific Reports 2021, 11: 15097. PMID: 34302004, PMCID: PMC8302649, DOI: 10.1038/s41598-021-94203-7.Peer-Reviewed Original ResearchConceptsCOVID-19Use of hydroxychloroquineActive COVID-19Cross-sectional analysisRandomized trialsIneffective therapyNational registryMedian useClinical careClinical informationDeimplementationU.S. hospitalsOverall proportionLittle dataHydroxychloroquineFurther studiesPatientsRegistryTherapyHospitalTrialsCareAssociation of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry
Rao A, Ranka S, Ayers C, Hendren N, Rosenblatt A, Alger HM, Rutan C, Omar W, Khera R, Gupta K, Mody P, DeFilippi C, Das SR, Hedayati SS, de Lemos JA. Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry. Journal Of The American Heart Association 2021, 10: e020910. PMID: 34107743, PMCID: PMC8477855, DOI: 10.1161/jaha.121.020910.Peer-Reviewed Original ResearchConceptsAcute kidney injuryMajor adverse cardiac eventsAdverse cardiac eventsChronic kidney diseaseCardiac eventsKidney diseaseCause mortalityAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCOVID-19Major adverse cardiovascular eventsEnd-stage kidney diseaseCardiovascular Disease RegistryLarge multicenter registryNonfatal heart failureSerial laboratory dataAdverse cardiovascular eventsNonfatal myocardial infarctionKey secondary outcomesCardiovascular disease outcomesPrimary exposure variableNonfatal strokeCardiogenic shockCardiovascular deathCardiovascular eventsCardiovascular outcomesContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican CollegeFinancial burden, distress, and toxicity in cardiovascular disease
Slavin SD, Khera R, Zafar SY, Nasir K, Warraich HJ. Financial burden, distress, and toxicity in cardiovascular disease. American Heart Journal 2021, 238: 75-84. PMID: 33961830, DOI: 10.1016/j.ahj.2021.04.011.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseFinancial burdenCommunity Health Worker IntegrationHigh-risk individualsComparative effectiveness studiesNon-medical needsHigh-cost interventionsHigh-cost treatmentsCVD managementEffectiveness studiesHealth systemPsychological distressInsurance coverageHealthcare policyBurdenDistressDiseaseSystem navigationInterventionCommunity-based initiativesPatientsPhysicians
2020
Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index
Khera R, Pandey A, Ayers CR, Carnethon MR, Greenland P, Ndumele CE, Nambi V, Seliger SL, Chaves PHM, Safford MM, Cushman M, Xanthakis V, Ramachandran V, Mentz RJ, Correa A, Lloyd-Jones DM, Berry JD, de Lemos JA, Neeland IJ. Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index. JAMA Network Open 2020, 3: e2023242. PMID: 33119108, PMCID: PMC7596579, DOI: 10.1001/jamanetworkopen.2020.23242.Peer-Reviewed Original ResearchConceptsHigh-sensitivity C-reactive proteinPooled Cohort EquationsASCVD riskAtherosclerotic cardiovascular diseaseBody mass indexBMI categoriesCohort EquationsObesity categoriesCohort studySevere obesityWaist circumferenceBMI groupsMass indexUnderweight categoryAtherosclerotic cardiovascular disease riskMean baseline BMIRisk of ASCVDUsual clinical measuresCardiovascular disease riskC-reactive proteinPooled individual-level dataSevere obesity groupLongitudinal cohort studyNormal weight categoryAdults ages 40Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions
Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. Journal Of The American Heart Association 2020, 9: e017793. PMID: 32924728, PMCID: PMC7792407, DOI: 10.1161/jaha.120.017793.Peer-Reviewed Original ResearchMeSH KeywordsAtherosclerosisCardiovascular DiseasesCost of IllnessFinancial StressHealth ExpendituresHumansQuality of LifeUnited StatesConceptsAtherosclerotic cardiovascular diseaseFinancial toxicitySubstantial economic impactCost sharingHigh deductiblesNational expenditureEconomic impactPolicy circlesPocket costsFinancial impactHealthcare expendituresHealth careASCVD patientsWell tradeoffCardiovascular diseaseExpenditureNecessary medical care
2019
National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions
Miller PE, Guha A, Khera R, Chouairi F, Ahmad T, Nasir K, Addison D, Desai NR. National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions. The American Journal Of Cardiology 2019, 124: 1140-1148. PMID: 31371062, PMCID: PMC7883647, DOI: 10.1016/j.amjcard.2019.06.029.Peer-Reviewed Original ResearchConceptsLength of stayCommon cardiovascular conditionCentral line-associated bloodstream infectionsCatheter-associated urinary tract infectionsLine-associated bloodstream infectionsUrinary tract infectionVentilator-associated pneumoniaClostridium difficile infectionCardiovascular conditionsTract infectionsBloodstream infectionsDifficile infectionOutcome of HAICoronary artery bypassTotal hospital chargesAcute myocardial infarctionSkilled care facilityHealthcare-Associated InfectionsValue-based careHospital mortalityArtery bypassCardiogenic shockHeart failurePropensity matchingAtrial fibrillationFinancial Toxicity of Acute Cardiovascular Disease in India
Nasir K, Khera R. Financial Toxicity of Acute Cardiovascular Disease in India. JAMA Network Open 2019, 2: e193839. PMID: 31099855, DOI: 10.1001/jamanetworkopen.2019.3839.Commentaries, Editorials and LettersAssociation of access to exercise opportunities and cardiovascular mortality
Angraal S, Gupta A, Khera R, Nasir K, Desai NR. Association of access to exercise opportunities and cardiovascular mortality. American Heart Journal 2019, 212: 152-156. PMID: 31051426, DOI: 10.1016/j.ahj.2019.02.010.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCardiovascular DiseasesExerciseExercise TherapyFemaleHealth BehaviorHumansMaleMiddle AgedMotor ActivityRetrospective StudiesSurvival RateUnited StatesConceptsCVD mortalityLower CVD mortalityCardiovascular disease mortalityLeisure physical activityExercise opportunitiesAssociation of accessCardiovascular mortalityDisease mortalityHigh prevalencePhysical activityExercise facilitiesMortalityHigh accessHigh percentageLow accessObesityDiabetesPrevalenceFinancial Hardship From Medical Bills Among Nonelderly U.S. Adults With Atherosclerotic Cardiovascular Disease
Valero-Elizondo J, Khera R, Saxena A, Grandhi GR, Virani SS, Butler J, Samad Z, Desai NR, Krumholz HM, Nasir K. Financial Hardship From Medical Bills Among Nonelderly U.S. Adults With Atherosclerotic Cardiovascular Disease. Journal Of The American College Of Cardiology 2019, 73: 727-732. PMID: 30765039, DOI: 10.1016/j.jacc.2018.12.004.Peer-Reviewed Original Research