2023
Rationale, 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 visitsElectronic 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 age
2022
Electronic 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
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 outcomesEvaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System
Mori M, Wilson L, Ali A, Ahmad T, Anwer M, Jacoby D, Geirsson A, Krumholz HM. Evaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System. JAMA Network Open 2020, 3: e2017513. PMID: 32945877, PMCID: PMC7501535, DOI: 10.1001/jamanetworkopen.2020.17513.Peer-Reviewed Original ResearchConceptsYale-New Haven HospitalHeart transplant programShort-term outcomesHeart transplantHeart transplant volumeNew Haven HospitalDonor heartsPatient selectionRecipient selectionTransplant programsTransplant volumeWaiting listCase volumeDonor heart allocation systemPre-post cohort studyConservative patient selectionUnused donor heartsHeart allocation systemHigher median numberCirculatory assist devicesCohort studyPatient characteristicsMore patientsSingle centerCenter volume
2015
Use of outcome measures in pulmonary hypertension clinical trials
Parikh KS, Rajagopal S, Arges K, Ahmad T, Sivak J, Kaul P, Shah SH, Tapson V, Velazquez EJ, Douglas PS, Samad Z. Use of outcome measures in pulmonary hypertension clinical trials. American Heart Journal 2015, 170: 419-429.e3. PMID: 26385024, DOI: 10.1016/j.ahj.2015.06.010.Peer-Reviewed Original ResearchConceptsHypertension clinical trialsPulmonary arterial hypertensionPAH trialsClinical practiceInvasive hemodynamicsPrimary endpointClinical trialsOutcome measuresInvasive measuresSurrogate measureDuke University Medical CenterPatient-centered endpointsSecondary outcome measuresClinical treatment trialsMEDLINE/EMBASEUniversity Medical CenterSmall patient populationQuality of lifeContemporary clinical practicePAH therapyPH medicationsArterial hypertensionSerial echocardiographyPatient characteristicsSecondary outcomes