Featured Publications
Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group
Shimokawa H, Suda A, Takahashi J, Berry C, Camici PG, Crea F, Escaned J, Ford T, Yii E, Kaski JC, Kiyooka T, Mehta PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yasuda S, Beltrame JF, Merz CNB, Group O. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group. European Heart Journal 2021, 42: 4592-4600. PMID: 34038937, PMCID: PMC8633728, DOI: 10.1093/eurheartj/ehab282.Peer-Reviewed Original ResearchConceptsMajor cardiovascular eventsCoronary artery diseaseMicrovascular anginaPrognosis of patientsInternational Study GroupClinical characteristicsStudy groupPrevious historyMultivariable Cox proportional hazards analysisNon-fatal myocardial infarctionCox proportional hazards analysisSeattle Angina Questionnaire scoresNon-fatal strokeAcute coronary syndromeProspective cohort studyStable angina pectorisProportional hazards analysisImportant health problemComparable prognosisCardiovascular deathCardiovascular eventsCoronary syndromePrimary endpointCohort studyUnstable anginaEffect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians
Solnick RE, Peyton K, Kraft-Todd G, Safdar B. Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians. JAMA Network Open 2020, 3: e1920511. PMID: 32083686, PMCID: PMC7043197, DOI: 10.1001/jamanetworkopen.2019.20511.Peer-Reviewed Original ResearchConceptsWhite male physiciansPatient satisfactionPhysician genderMale physiciansHistory of cancerAbdominal surgical proceduresEmergency department physiciansLower patient satisfactionSignificant differencesOnline symptom checkersBlack physiciansComposite outcomeControl physiciansPhysician diagnosisPatient evaluationDepartment physiciansPatient ratingsSurgical proceduresMAIN OUTCOMEPhysician confidenceClinical diagnosisPhysiciansWhite womenDiagnosisWhite menSurvival of the Fittest: Impact of Cardiorespiratory Fitness on Outcomes in Men and Women with Cardiovascular Disease
Safdar B, Mangi AA. Survival of the Fittest: Impact of Cardiorespiratory Fitness on Outcomes in Men and Women with Cardiovascular Disease. Clinical Therapeutics 2020, 42: 385-392. PMID: 32088022, DOI: 10.1016/j.clinthera.2020.01.014.Peer-Reviewed Original ResearchConceptsPeak cardiorespiratory fitnessCardiorespiratory fitnessCardiovascular diseaseCardiac rehabilitationPhysical inactivityMyocardial infarctionImpact of CRFOnset of CVDPeak exercise capacityCardiac rehabilitation programModifiable risk factorsRecurrent myocardial infarctionPoor functional outcomeCause of mortalitySex differencesImpact of sexCVD outcomesExercise capacityImproved survivalLow referralMale patientsFemale patientsExercise prescriptionFunctional outcomeRisk factorsAssociation of renalase with clinical outcomes in hospitalized patients with COVID-19
Safdar B, Wang M, Guo X, Cha C, Chun HJ, Deng Y, Dziura J, El-Khoury JM, Gorelick F, Ko AI, Lee AI, Safirstein R, Simonov M, Zhou B, Desir GV. Association of renalase with clinical outcomes in hospitalized patients with COVID-19. PLOS ONE 2022, 17: e0264178. PMID: 35259186, PMCID: PMC8903289, DOI: 10.1371/journal.pone.0264178.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsRenalase levelsIntensive care unit admissionHospitalized COVID-19 patientsMean age 64 yearsCOVID-19Cox proportional hazards modelCare unit admissionPrimary composite outcomeRetrospective cohort studyUse of vasopressorsSevere COVID-19IL-6 levelsAge 64 yearsRisk of deathCOVID-19 subjectsInitial disease severityProportional hazards modelCOVID-19 diseasePlasma renalaseUnit admissionICU admissionCohort studyComposite outcomeCytokine levelsIs microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review
Nowroozpoor A, Gutterman D, Safdar B. Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review. Microvascular Research 2020, 134: 104123. PMID: 33333140, DOI: 10.1016/j.mvr.2020.104123.Peer-Reviewed Original ResearchConceptsMicrovascular dysfunctionUnderlying systemic processC-reactive proteinLow-density cholesterolMulti-system involvementUric acidDifferent disease entitiesMulti-system manifestationsVon Willebrand factorNT-proBNPEndothelial dysfunctionTotal cholesterolClinical evidenceImmune activationSystemic disordersVitamin DIL-6Asymmetric dimethylarginineBlood biomarkersInforms cliniciansDisease entityCystatin CVital organsDysfunctionCommon biomarkersElevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia
Safdar B, Guo X, Johnson C, D'Onofrio G, Dziura J, Sinusas AJ, Testani J, Rao V, Desir G. Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia. International Journal Of Cardiology 2019, 279: 155-161. PMID: 30630613, PMCID: PMC6482834, DOI: 10.1016/j.ijcard.2018.12.061.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionFramingham risk scorePET/CTChest painInflammatory markersMicrovascular dysfunctionEmergency departmentRisk scoreRb-82 PET/CTElevated renalase levelsAcute chest painCoronary artery diseaseC-reactive proteinVascular endothelial growth factorAnti-inflammatory proteinTumor necrosis factorEndothelial growth factorAngina historyCMD diagnosisRenalase levelsHypertensive crisisED presentationsHemodynamic instabilityArtery diseaseHeart failureCurrent Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians
Madsen TE, Linden JA, Rounds K, Hsieh Y, Lopez BL, Boatright D, Garg N, Heron SL, Jameson A, Kass D, Lall MD, Melendez AM, Scheulen JJ, Sethuraman KN, Westafer LM, Safdar B. Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians. Academic Emergency Medicine 2017, 24: 1182-1192. PMID: 28779488, DOI: 10.1111/acem.13269.Peer-Reviewed Original ResearchConceptsClinical hoursRacial/Ethnic DisparitiesAcademic emergency departmentEmergency medicine physiciansAcademy of AdministratorsEmergency medicine workforceEmergency departmentWhite raceMedicine physiciansResponse rateUnknown raceEthnic disparitiesAsian IndiansAcademic Emergency Medicine PhysiciansFellowship trainingClinical commitmentsWomenYears of experienceMenBoard certificationCurrent statusMean salaryGenderNonwhitesHoursSex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction. Circulation 2018, 137: 781-790. PMID: 29459463, PMCID: PMC5822747, DOI: 10.1161/circulationaha.117.031650.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPerception of symptomsChest painCare-seeking behaviorSymptom presentationYounger patientsMyocardial infarctionST-segment elevation acute myocardial infarctionMultivariable hierarchical logistic regressionIndex AMI hospitalizationMajority of womenHierarchical logistic regressionStress/anxietyVIRGO StudyMuscle painPatient characteristicsPredominant symptomAMI symptomsPerceive symptomsProdromal symptomsPatient interviewsHeart diseasePainAMI hospitalizationUS hospitalsPrevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Prevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department. European Heart Journal Acute Cardiovascular Care 2018, 9: 5-13. PMID: 29543037, DOI: 10.1177/2048872618764418.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary artery diseaseCardiac positron emission tomography/Positron emission tomography/Chest pain patientsArtery diseaseAcute myocardial infarctionEmission tomography/Chest painMyocardial infarctionMicrovascular dysfunctionPain patientsEmergency departmentTomography/General emergency department populationLower coronary flow reserveNon-obstructive coronary arteriesPrior emergency department visitsTraditional cardiac risk factorsCardiac risk factorsModerate-risk patientsEmergency department visitsEmergency department patientsCoronary flow reserveEmergency department populationPresentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusIdentifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation
Safdar B, Ong P, Camici PG. Identifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation. Clinical Therapeutics 2018, 40: 1920-1930. PMID: 30458932, DOI: 10.1016/j.clinthera.2018.09.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent chest painCoronary microvascular dysfunctionChest painEmergency departmentHs-TnTMicrovascular dysfunctionMyocardial ischemiaAcute chest pain evaluationHigh-sensitivity troponin TDiagnosis of AMIType 2 acute myocardial infarctionElevated hs-TnTIschemia/necrosisChest pain evaluationGroup of patientsAssessment of symptomsIdentification of patientsAppropriate medical treatmentSex-specific thresholdsPulmonary embolismVasomotor disordersAortic dissectionPain evaluationEpicardial coronaries
2024
Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults
Surie D, Yuengling K, DeCuir J, Zhu Y, Lauring A, Gaglani M, Ghamande S, Peltan I, Brown S, Ginde A, Martinez A, Mohr N, Gibbs K, Hager D, Ali H, Prekker M, Gong M, Mohamed A, Johnson N, Srinivasan V, Steingrub J, Leis A, Khan A, Hough C, Bender W, Duggal A, Bendall E, Wilson J, Qadir N, Chang S, Mallow C, Kwon J, Exline M, Shapiro N, Columbus C, Vaughn I, Ramesh M, Mosier J, Safdar B, Casey J, Talbot H, Rice T, Halasa N, Chappell J, Grijalva C, Baughman A, Womack K, Swan S, Johnson C, Lwin C, Lewis N, Ellington S, McMorrow M, Martin E, Self W. Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults. JAMA Network Open 2024, 7: e244954. PMID: 38573635, PMCID: PMC11192181, DOI: 10.1001/jamanetworkopen.2024.4954.Peer-Reviewed Original ResearchConceptsInvasive mechanical ventilationRespiratory syncytial virusSeverity of RSV diseaseInfluenza diseaseVaccinated patientsIn-hospital deathUnvaccinated patientsRSV diseaseSyncytial virusClinical decision-makingComposite of invasive mechanical ventilationOutcome of invasive mechanical ventilationSeverity of respiratory syncytial virusLaboratory-confirmed respiratory syncytial virusHospitalized US adultsInfluenza vaccination statusVaccination statusAcute respiratory illnessMultivariate logistic regressionCenters for Disease Control and PreventionSeverity of COVID-19Disease Control and PreventionInfluenza infectionInfluenza severityClinical outcomes
2023
Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation indexRenin-Angiotensin System Modulation With Synthetic Angiotensin (1-7) and Angiotensin II Type 1 Receptor–Biased Ligand in Adults With COVID-19
Self W, Shotwell M, Gibbs K, de Wit M, Files D, Harkins M, Hudock K, Merck L, Moskowitz A, Apodaca K, Barksdale A, Safdar B, Javaheri A, Sturek J, Schrager H, Iovine N, Tiffany B, Douglas I, Levitt J, Busse L, Ginde A, Brown S, Hager D, Boyle K, Duggal A, Khan A, Lanspa M, Chen P, Puskarich M, Vonderhaar D, Venkateshaiah L, Gentile N, Rosenberg Y, Troendle J, Bistran-Hall A, DeClercq J, Lavieri R, Joly M, Orr M, Pulley J, Rice T, Schildcrout J, Semler M, Wang L, Bernard G, Collins S, Becker R, del Zoppo G, Henke P, Holubkov R, Johnson M, Kerr K, Lipman H, Lurie F, Pitt B, Vesely S, Fleg J, Aamodt D, Ayers J, Clark D, Collins J, Cook M, Dixon S, Graves J, Jordan C, Lindsell C, Lopez I, McKeel D, Orozco D, Prato N, Qi A, Qutab M, Stoughton C, Vermillion K, Walsh K, Winchell S, Young T, Franklin R, Wagner E, Walther T, Demitrack M, Johnson J, Walsh R, Bales B, Miller K, Torr D, Barot H, Landreth L, LaRose M, Parks L, Teixeira J, Cardenas S, Ceniceros J, Cunningham A, Kunkel S, Lovato D, Zimmerman B, Nguyen T, Zeger W, Nichols H, Wiedel N, Javaheri A, Stilinovic S, Brokowski C, Lu J, Solberg M, Lee D, Roach K, Tiffany B, Tanner C, Taylor A, Zumbahl J, Syed A, Mason J, Jackson P, Coleman R, Haughey H, Cherabuddi K, James N, Wakeman R, Duncan C, Montero C, Rogers A, Wilson J, Vojnik R, Perez C, Wyles D, Hiller T, Oakes J, Garcia A, Gong M, Mohamed A, Andrea L, Nair R, Nkemdirim W, Lopez B, Boujid S, Torres M, Garcia O, Martinez F, Baduashvili A, Bastman J, Chauhan L, Douin D, Finck L, Licursi A, ten Lohuis C, Zhang S, Bender W, Tovar S, Hayes S, Kurtzman N, Rosseto E, Scaffidi D, Shapiro N, Pak J, Allada G, Briceno G, Peña J, Oh M, Ali H, Beselman S, Eby Y, Klimov V, Hite R, Tanzeem H, Droege C, Winter J, Jackman S, Caudill A, Bayoumi E, Pascual E, Chen P, Mucha S, Thiruchelvam N, Siuba M, Mehkri O, Driver B, Hendrickson A, Kaus O, Ontiveros C, Riehm A, Laudun S, Hudock D, Ensley C, Shaner V, Gentile N, Isenberg D, Reimer H, Cincola P, Harris E, Callahan S, Yamane M, Barrios M, Desai N, Bharara A, Keller M, Majumder P, Dohe C, D’Armiento J, Goldklang M, Wagener G, Fonseca L, Valezquez-Sanchez I, Johnson N, Petersen E, Fuentes M, Newton M, Gundel S, Srinivasan V, Steel T, Robinson B. Renin-Angiotensin System Modulation With Synthetic Angiotensin (1-7) and Angiotensin II Type 1 Receptor–Biased Ligand in Adults With COVID-19. JAMA 2023, 329: 1170-1182. PMID: 37039791, PMCID: PMC10091180, DOI: 10.1001/jama.2023.3546.Peer-Reviewed Original ResearchConceptsAngiotensin II type 1 receptorII type 1 receptorRenin-angiotensin systemSevere COVID-19Type 1 receptorCause mortalityRAS agentsRAS modulationPlacebo groupAngiotensin IIIntravenous infusionOdds ratioSafety outcomesCOVID-19Renin-angiotensin system modulationSARS-CoV-2 infectionAcute COVID-19Key secondary outcomesAction of angiotensinKidney replacement therapySupplemental oxygen useCOVID-19 pathophysiologyContinuous intravenous infusionLast followSecondary outcomes
2022
Clinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery
Safdar B, Mori M, Nowroozpoor A, Geirsson A, D'Onofrio G, Mangi AA. Clinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery. Clinical Therapeutics 2022, 44: 846-858. PMID: 35570056, DOI: 10.1016/j.clinthera.2022.04.002.Peer-Reviewed Original ResearchConceptsCardiac rehabilitationElectronic health recordsComposite outcomeEndothelial functionClinical profileCoronary Artery Bypass Grafting SurgeryMajor adverse cardiac outcomesPostoperative blood transfusionTwelve-month mortalityCardiac risk factorsCoronary artery bypassPrimary composite outcomeRetrospective cohort studyHealth recordsAdverse cardiac outcomesCardiac risk profileKaplan-Meier analysisBody mass indexSex-specific outcomesKaplan-Meier plotsThoracic Surgeons registryAerobic exercise durationHigher hemoglobin AHealth care systemUrgent CABGSex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain
Banco D, Chang J, Talmor N, Wadhera P, Mukhopadhyay A, Lu X, Dong S, Lu Y, Betensky RA, Blecker S, Safdar B, Reynolds HR. Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain. Journal Of The American Heart Association 2022, 11: e024199. PMID: 35506534, PMCID: PMC9238573, DOI: 10.1161/jaha.121.024199.Peer-Reviewed Original ResearchConceptsChest painAcute myocardial infarctionEmergency departmentMultivariable adjustmentYoung adultsMyocardial infarctionBackground Acute myocardial infarctionRacial differencesCardiac biomarker testingHospital admissionClinical featuresConclusions WomenPhysician evaluationTriage levelBiomarker testingCardiac biomarkersWhite adultsNational estimatesObservation unitCP managementAdultsSurvey 2014WomenPainInfarction
2021
Influence of Sex and Gender on Lifestyle Interventions for Cardiovascular Disease
Safdar B. Influence of Sex and Gender on Lifestyle Interventions for Cardiovascular Disease. Clinical Therapeutics 2021, 44: 8-10. PMID: 34973826, DOI: 10.1016/j.clinthera.2021.12.004.Peer-Reviewed Original ResearchUse of peripheral arterial tonometry in detection of abnormal coronary flow reserve
Gaeta M, Nowroozpoor A, Dziura J, D'Onofrio G, Sinusas AJ, Safdar B. Use of peripheral arterial tonometry in detection of abnormal coronary flow reserve. Microvascular Research 2021, 138: 104223. PMID: 34256085, PMCID: PMC10227886, DOI: 10.1016/j.mvr.2021.104223.Peer-Reviewed Original ResearchConceptsLower coronary flow reserveCoronary flow reserveCoronary microvascular dysfunctionCoronary artery diseaseClinical screening toolPET/CTFlow reserveRubidium-82 positron emission tomography/Large vessel coronary artery diseaseNormal coronary flow reserveTraditional CAD risk factorsVessel coronary artery diseaseAbnormal coronary flow reservePositron emission tomography/Screening toolPeripheral arterial tonometryCAD risk factorsEmission tomography/Presence of calcificationLower RHIHyperemia indexArterial tonometryMicrovascular dysfunctionArtery diseaseAugmentation indexSex- or Gender-specific Differences in the Clinical Presentation, Outcome, and Treatment of SARS-CoV-2
Wolfe J, Safdar B, Madsen TE, Sethuraman KN, Becker B, Greenberg MR, McGregor AJ. Sex- or Gender-specific Differences in the Clinical Presentation, Outcome, and Treatment of SARS-CoV-2. Clinical Therapeutics 2021, 43: 557-571.e1. PMID: 33583576, PMCID: PMC7833665, DOI: 10.1016/j.clinthera.2021.01.015.Peer-Reviewed Original ResearchConceptsImmunologic responseBody's immunologic responseCOVID-19 presentationComplications of infectionSARS-CoV-2Influence of hormonesGender-specific differencesClinical presentationLaboratory presentationOutcomesSex differencesSexBody responseInfectionTreatmentPresentationGender differencesResponseComplicationsDifferencesHormonePrevention
2020
National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare Survey