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 studiesEarly Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US
Jang S, Webber F, Alam M, Bae J, Aggarwal A, Thomas A, Zarich S, Ahmad T, Miller P, Davila C. Early Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 101185. PMID: 39131072, PMCID: PMC11308019, DOI: 10.1016/j.jscai.2023.101185.Peer-Reviewed Original ResearchAcute mechanical circulatory supportStress-induced cardiomyopathyRenal replacement therapyCardiogenic shockIndex hospitalizationReplacement therapyIntra-aortic balloon pumpAggressive hemodynamic supportHospital mortality rateNationwide Readmissions DatabaseMechanical circulatory supportFuture prospective studiesLarge national databaseObserved mortality differencesHospital mortalityMore comorbiditiesHospital deathHemodynamic supportBalloon pumpMembrane oxygenationClinical outcomesCirculatory supportProspective studyAdministrative databasesImpellaImpact 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 group
2022
Network 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 trialsPragmatic 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 system
2021
Mechanical ventilation at the time of heart transplantation and associations with clinical outcomes
Miller PE, Mullan CW, Chouairi F, Sen S, Clark KA, Reinhardt S, Fuery M, Anwer M, Geirsson A, Formica R, Rogers JG, Desai NR, Ahmad T. Mechanical ventilation at the time of heart transplantation and associations with clinical outcomes. European Heart Journal Acute Cardiovascular Care 2021, 10: 843-851. PMID: 34389855, PMCID: PMC8557439, DOI: 10.1093/ehjacc/zuab063.Peer-Reviewed Original ResearchConceptsHeart transplantationMechanical ventilationSingle-organ heart transplantationMedian waitlist timeOrgan Sharing databaseTime of transplantationMultivariable logistic regressionMultivariable adjustmentWaitlist timeClinical outcomesSharing databasePoor outcomeVentilated patientsUnited NetworkTemporary mechanical supportClinical acuityTransplantationPatientsPrevious dialysisLogistic regressionMortalityStrong associationReasonable outcomesOutcomesAssociationThe Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial
Chouairi F, Fuery MA, Mullan CW, Caraballo C, Sen S, Maulion C, Wilkinson ST, Surti T, McCullough M, Miller PE, Pacor J, Leifer ES, Felker GM, Velazquez EJ, Fiuzat M, O'Connor CM, Januzzi JL, Desai NR, Ahmad T. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial. Journal Of Cardiac Failure 2021, 27: 1359-1366. PMID: 34166799, DOI: 10.1016/j.cardfail.2021.06.008.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyReduced ejection fractionAmino-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsGUIDE-IT trialNatriuretic peptide levelsHeart failureEjection fractionClinical outcomesPeptide levelsOptimal guideline-directed medical therapyCox proportional hazards regression modelingProportional hazards regression modelingImpact of depressionHistory of depressionCardiovascular deathCause hospitalizationCause mortalityOverall cohortMedical therapyAdverse outcomesTarget dosesPatientsMental healthTime pointsIntercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure
Fuery MA, Chouairi F, Januzzi JL, Moe GW, Caraballo C, McCullough M, Miller PE, Reinhardt SW, Clark K, Oseran A, Milner A, Pacor J, Kahn PA, Singh A, Ravindra N, Guha A, Vadlamani L, Kulkarni NS, Fiuzat M, Felker GM, O'Connor CM, Ahmad T, Ezekowitz J, Desai NR. Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure. JACC Heart Failure 2021, 9: 497-505. PMID: 33992564, DOI: 10.1016/j.jchf.2021.02.011.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyGDMT useCountry of enrollmentHeart failureMedical therapyHigher body mass indexKaplan-Meier survival estimatesGUIDE-IT trialHeart failure hospitalizationReduced ejection fractionLog-rank testingMineralocorticoid receptor antagonistsPrimary study endpointBody mass indexPatterns of careCare delivery structuresGUIDE-ITHF hospitalizationFailure hospitalizationUsual careEjection fractionStudy endpointBlack patientsClinical outcomesMass indexDifferences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction
Daubert MA, Yow E, Barnhart HX, Piña IL, Ahmad T, Leifer E, Cooper L, Desvigne‐Nickens P, Fiuzat M, Adams K, Ezekowitz J, Whellan DJ, Januzzi JL, O’Connor C, Felker GM. Differences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction. Journal Of The American Heart Association 2021, 10: e019712. PMID: 33955231, PMCID: PMC8200692, DOI: 10.1161/jaha.120.019712.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiomarkersCanadaCause of DeathFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPrognosisProtein PrecursorsRetrospective StudiesSex DistributionSex FactorsStroke VolumeUnited StatesConceptsReduced ejection fractionNT-proBNP responseGuideline-directed medical therapyGUIDE-IT trialHeart failureEjection fractionNT-proBNPPrognostic valuePg/mLHF hospitalizationMedical therapyEquivalent prognostic valueNT-proBNP reductionNT-proBNP valuesGreater prognostic valueNonischemic causesClinical characteristicsClinical outcomesImproved outcomesLandmark analysisPrognostic biomarkerTherapeutic goalsConclusions MenSecondary analysisWomenElectronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit
Kunitomo Y, Thomas A, Chouairi F, Canavan ME, Kochar A, Khera R, Katz JN, Murphy C, Jentzer J, Ahmad T, Desai NR, Brennan J, Miller PE. Electronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit. American Heart Journal 2021, 238: 85-88. PMID: 33891906, DOI: 10.1016/j.ahj.2021.04.004.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitRothman IndexCare unitRisk scoreModern cardiac intensive care unitSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreElectronic health recordsCICU mortalityCICU patientsSOFA scoreCICU admissionClinical outcomesEarly prognosticationObservational studyPrognostic abilityAssessment scoresOutcome predictionHealth recordsGood calibrationSuperior discriminationPatientsAdmissionScoresAssociation between Respiratory Failure and Clinical Outcomes in Patients with Acute Heart Failure: Analysis of 5 Pooled Clinical Trials
Miller PE, Van Diepen S, Metkus TS, Alviar CL, Rayner-Hartley E, Rathwell S, Katz JN, Ezekowitz J, Desai NR, Ahmad T. Association between Respiratory Failure and Clinical Outcomes in Patients with Acute Heart Failure: Analysis of 5 Pooled Clinical Trials. Journal Of Cardiac Failure 2021, 27: 602-606. PMID: 33556546, PMCID: PMC8527461, DOI: 10.1016/j.cardfail.2021.01.018.Peer-Reviewed Original ResearchConceptsAcute heart failureBaseline ejection fractionMechanical ventilationRespiratory failureHeart failureClinical trialsClinical outcomesHF etiologyHF rehospitalizationEjection fractionAcute HF admissionBaseline diabetes mellitusHF clinical trialsMechanical ventilation groupMechanical ventilation useProportion of patientsChronic lung diseaseMultivariable logistic regressionOriginal clinical trialsCause mortalityHF admissionsIndex hospitalizationMultivariable adjustmentSmoking historyVentilation groupTransition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes
Miller PE, Chouairi F, Thomas A, Kunitomo Y, Aslam F, Canavan ME, Murphy C, Daggula K, Metkus T, Vallabhajosyula S, Carnicelli A, Katz JN, Desai NR, Ahmad T, Velazquez EJ, Brennan J. Transition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes. Journal Of The American Heart Association 2021, 10: e018182. PMID: 33412899, PMCID: PMC7955420, DOI: 10.1161/jaha.120.018182.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitHospital mortalityCare unitCICU mortalityClinical outcomesModern cardiac intensive care unitSurgical intensive care unitTotal hospital chargesSeverity of illnessMultivariable logistic regressionCICU lengthMultivariable adjustmentRespiratory insufficiencyPrimary outcomeUnique admissionsHospital chargesCardiac arrestSubgroup analysisImproved outcomesMortalityLogistic regressionAdmissionClosed unitStaffing models
2020
Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure
Mezzacappa C, Ravindra NG, Caraballo C, Chouairi F, Miller PE, Clarke JD, Gruen J, Mori M, McCullough M, Mullan C, Geirsson A, Rogers JG, Anwer M, Desai N, Ahmad T. Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure. PLOS ONE 2020, 15: e0242928. PMID: 33270648, PMCID: PMC7714148, DOI: 10.1371/journal.pone.0242928.Peer-Reviewed Original ResearchConceptsClinical trialsVentricular assist deviceExclusion criteriaLVAD recipientsAssist deviceReal-world settingClinical implicationsClinical trial exclusion criteriaHeart failure clinical trialsEnd-stage renal diseaseEnd-stage heart failureReal-world registryRetrospective cohort studyLandmark clinical trialsStage renal diseaseTrial exclusion criteriaRisk of deathStage heart failureRespiratory failureCohort studyPatient characteristicsHeart failurePatient factorsRenal diseaseClinical outcomes
2019
Optimal Medical Therapy in Heart Failure: Reasons for Lack of Medication Titration in the GUIDE IT Trial
Fiuzat M, Alemayehu W, Ezekowitz J, Westerhout C, Whellan D, Mulder H, Ahmad T, Adams K, Pina I, Anstrom K, Cooper L, Alhanti B, Sbolli M, Mark D, Leifer E, Felker M, O'Connor C, Januzzi J. Optimal Medical Therapy in Heart Failure: Reasons for Lack of Medication Titration in the GUIDE IT Trial. Journal Of Cardiac Failure 2019, 25: s78. DOI: 10.1016/j.cardfail.2019.07.221.Peer-Reviewed Original ResearchHeart failureMedication titrationMedical therapyMedication adjustmentsClinical outcomesTarget dosesGUIDE-IT trialOptimal medical therapyReduced ejection fractionWeeks of enrollmentEnd of studyProtocol-driven approachUse of guidelinesFree-text reasonsGDMT groupGUIDE-ITHF medicationsB-blockersNT-proBNPEjection fractionNatriuretic peptideStudy visitClinicians' decisionsIT trialSerial measurements