2024
Pragmatic Trial of Messaging to Providers About Treatment of Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial
Shah N, Ghazi L, Yamamoto Y, Kumar S, Martin M, Simonov M, Riello Iii R, Faridi K, Ahmad T, Wilson F, Desai N. Pragmatic Trial of Messaging to Providers About Treatment of Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial. Circulation Cardiovascular Quality And Outcomes 2024, 17: e010335. PMID: 38634282, DOI: 10.1161/circoutcomes.123.010335.Peer-Reviewed Original ResearchElectronic health recordsElectronic health record alertsHigh-risk atherosclerotic cardiovascular diseaseLipid lowering therapyAtherosclerotic cardiovascular diseasePragmatic trialCardiovascular diseaseProportion of patientsYale New Haven HealthLDL-CSecondary outcomesPrimary outcomeInternal medicine cliniciansEHR alertUsual careHealth recordsProvider levelCluster-randomizedLDL-C managementLDL-C levelsAdverse cardiovascular eventsRandomized clinical trialsTreatment of hyperlipidemiaCliniciansCardiovascular events
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 visitsImpact of Digital Health Technology on Quality of Life in Patients With Heart Failure
Victoria-Castro A, Martin M, Yamamoto Y, Melchinger H, Weinstein J, Nguyen A, Lee K, Gerber B, Calderon F, Subair L, Lee V, Williams A, Shaw M, Arora T, Garcez A, Desai N, Ahmad T, Wilson F. Impact of Digital Health Technology on Quality of Life in Patients With Heart Failure. JACC Heart Failure 2023, 12: 336-348. PMID: 37943227, DOI: 10.1016/j.jchf.2023.09.022.Peer-Reviewed Original ResearchOverall summary scoreClinical summary scoreTotal symptom scoreKCCQ overall summary scoreUsual careHeart failureQuality of lifeMedian changeKansas City Cardiomyopathy Questionnaire overall summary scoreSummary scoresMedian agePrimary outcomeSymptom scoresPhysical functionLongitudinal carePatientsDigital health toolsLarger studyDigital health technologiesHealth toolsQoLCareDigital interventionsIndependent effectsHealth technologiesElectronic 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 ageImpact 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
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalRationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID)
Shah NN, Ghazi L, Yamamoto Y, Martin M, Simonov M, Riello RJ, Faridi KF, Ahmad T, Wilson FP, Desai NR. Rationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID). American Heart Journal 2022, 253: 76-85. PMID: 35841944, PMCID: PMC9936562, DOI: 10.1016/j.ahj.2022.07.002.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyAtherosclerotic cardiovascular diseaseTreatment of hyperlipidemiaProportion of patientsElectronic health recordsPragmatic trialHigh riskCardiovascular diseaseProprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitorsHigh-risk atherosclerotic cardiovascular diseaseSubtilisin/kexin type 9 inhibitorsLow-density lipoprotein cholesterol reductionImportant public health implicationsEnrollment of patientsPublic health implicationsUsual careSecondary outcomesPrimary outcomeGuideline recommendationsCholesterol reductionPatientsLDLHyperlipidemiaScalable interventionsOutpatientsPragmatic 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 systemElectronic 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
2021
Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes
Gevaert AB, Tibebu S, Mamas MA, Ravindra NG, Lee SF, Ahmad T, Ko DT, Januzzi JL, Van Spall HGC. Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes. ESC Heart Failure 2021, 8: 2741-2754. PMID: 33934542, PMCID: PMC8318507, DOI: 10.1002/ehf2.13344.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionChronic obstructive pulmonary diseaseHazard ratioComposite outcomePrimary outcomeAtrial fibrillationHeart diseaseComposite cardiovascular deathEjection fraction categoriesSecondary composite outcomeHeart failure outcomesPrimary composite outcomeObstructive pulmonary diseaseVentricular ejection fractionValvular heart diseaseCoronary heart diseaseGreater prognostic informationDifferent risk categoriesCause deathHF rehospitalizationPredominant comorbiditiesCardiovascular deathHF trialsBaseline characteristicsSecondary outcomesTransition 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