2024
Racial/Ethnic Disparities in Aortic Valve Replacement Among Medicare Beneficiaries in the United States, 2012-2019
Gupta A, Mori M, Wang Y, Pawar S, Vahl T, Nazif T, Onuma O, Yong C, Sharma R, Kirtane A, Forrest J, George I, Kodali S, Chikwe J, Geirsson A, Makkar R, Leon M, Krumholz H. Racial/Ethnic Disparities in Aortic Valve Replacement Among Medicare Beneficiaries in the United States, 2012-2019. The American Journal Of Medicine 2024, 137: 321-330.e7. PMID: 38190959, PMCID: PMC11019903, DOI: 10.1016/j.amjmed.2023.12.026.Peer-Reviewed Original ResearchAortic valve replacementRace/ethnicityValve replacementAortic stenosisWhite patientsMedicare beneficiariesSurgical aortic valve replacement (SAVR) proceduresCross-sectional cohort studyAortic valve replacement proceduresAortic stenosis treatmentRacial/Ethnic DisparitiesValve replacement proceduresSelf-reported race/ethnicityRace-related differencesIndex admissionIndex hospitalizationCohort studyAsian patientsPrincipal diagnosisProcedural outcomesStenosis treatmentCare spectrumPatientsEthnic disparitiesStenosis
2023
Race and Ethnicity and Emergency Department Discharge Against Medical Advice
Tsai J, Janke A, Krumholz H, Khidir H, Venkatesh A. Race and Ethnicity and Emergency Department Discharge Against Medical Advice. JAMA Network Open 2023, 6: e2345437. PMID: 38015503, PMCID: PMC10685883, DOI: 10.1001/jamanetworkopen.2023.45437.Peer-Reviewed Original ResearchConceptsWhite patientsHispanic patientsEmergency departmentCross-sectional studyED visitsBlack patientsDAMA rateMedical adviceMAIN OUTCOMEEthnic disparitiesNationwide Emergency Department SampleNational cross-sectional studyHospital ED visitsEmergency department dischargeHospital-level variationEmergency Department SampleMetropolitan teaching hospitalHealth care resourcesMedian ageGreater morbidityHospital variationUnadjusted analysesTeaching hospitalAdditional adjustmentLower odds
2022
Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissions
2020
Evaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities
Hsia RY, Krumholz H, Shen YC. Evaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities. JAMA Network Open 2020, 3: e2025874. PMID: 33196809, PMCID: PMC7670311, DOI: 10.1001/jamanetworkopen.2020.25874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBlack or African AmericanCaliforniaCause of DeathCohort StudiesFemaleHealth Services AccessibilityHealthcare DisparitiesHispanic or LatinoHospitalizationHumansMaleMiddle AgedMinority GroupsMortalityNon-Randomized Controlled Trials as TopicPercutaneous Coronary InterventionRegional Medical ProgramsResidence CharacteristicsST Elevation Myocardial InfarctionTime-to-TreatmentWhite PeopleConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionPercutaneous coronary interventionPCI-capable hospitalsZip codesNon-Hispanic whitesPatient's countyCause mortalityCohort studyCoronary interventionPCI hospitalsPCI treatmentWhite patientsCapable hospitalsMyocardial infarctionTop tertileInpatient dataMAIN OUTCOMEPatientsSTEMI regionalizationSmall improvementHospitalPotential mechanismsSame dayHispanic population
2018
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Graham GN, Jones PG, Chan PS, Arnold SV, Krumholz HM, Spertus JA. Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e184240. PMID: 30646346, PMCID: PMC6324589, DOI: 10.1001/jamanetworkopen.2018.4240.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsMortality rate differencesMortality ratePatient characteristicsMyocardial infarctionPropensity scoreAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registrySelf-identified black patientsObserved survival differencesNational Death IndexTime of admissionLower propensity scoreProspective registryClinical characteristicsCohort studyDeath IndexHighest quintileBlack raceC-statisticSurvival differencesWorse outcomesMAIN OUTCOMEPatientsSex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSex
2015
Life Expectancy and Years of Potential Life Lost After Acute Myocardial Infarction by Sex and Race A Cohort-Based Study of Medicare Beneficiaries
Bucholz EM, Normand SL, Wang Y, Ma S, Lin H, Krumholz HM. Life Expectancy and Years of Potential Life Lost After Acute Myocardial Infarction by Sex and Race A Cohort-Based Study of Medicare Beneficiaries. Journal Of The American College Of Cardiology 2015, 66: 645-655. PMID: 26248991, PMCID: PMC5459400, DOI: 10.1016/j.jacc.2015.06.022.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsLife expectancyMyocardial infarctionMedicare beneficiariesCox proportional hazards regressionPotential lifeProspective cohort studyCohort-based studyProportional hazards regressionCooperative Cardiovascular ProjectBurden of diseaseLong-term survivalCohort studyClinical presentationHazards regressionBlack raceSurvival advantageGeneral populationPatientsAverage ageRace differencesLife expectancy estimatesYPLLRacial Differences in Heart Failure Outcomes Evidence From the Tele-HF Trial (Telemonitoring to Improve Heart Failure Outcomes)
Qian F, Parzynski CS, Chaudhry SI, Hannan EL, Shaw BA, Spertus JA, Krumholz HM. Racial Differences in Heart Failure Outcomes Evidence From the Tele-HF Trial (Telemonitoring to Improve Heart Failure Outcomes). JACC Heart Failure 2015, 3: 531-538. PMID: 26160368, PMCID: PMC8635169, DOI: 10.1016/j.jchf.2015.03.005.Peer-Reviewed Original ResearchConceptsPatient-reported health statusKansas City Cardiomyopathy QuestionnaireHeart failureBlack patientsHealth statusHF hospitalizationRacial differencesBaseline KCCQ scoresClinical laboratory valuesPatient-reported outcomesSignificant racial differencesKCCQ scoresHF admissionsPatient demographicsWhite patientsLaboratory valuesPropensity score methodsPatientsHospitalizationOutcome evidenceMonthsLinear mixed modelsBaselineTrialsStatus
2013
Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race
Leifheit-Limson EC, Spertus JA, Reid KJ, Jones SB, Vaccarino V, Krumholz HM, Lichtman JH. Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race. Journal Of Women's Health 2013, 22: 659-666. PMID: 23841468, DOI: 10.1089/jwh.2012.3962.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overBlack or African AmericanBody Mass IndexCounselingDiabetes Mellitus, Type 2FemaleHospitalizationHumansHypercholesterolemiaHypertensionLife StyleMaleMiddle AgedMyocardial InfarctionObesityPrevalenceProspective StudiesRisk FactorsSecondary PreventionSex FactorsSmokingSmoking CessationSocioeconomic FactorsWhite PeopleConceptsCardiac risk factorsAcute myocardial infarctionSecondary prevention effortsTraditional cardiac risk factorsLipid-lowering medicationsRisk factorsWhite patientsAMI patientsMyocardial infarctionPrevention effortsGreater risk factor burdenMultiple cardiac risk factorsRisk factor burdenYoung black patientsYoung white patientsSecondary prevention strategiesRisk factor prevalenceHigh-risk subgroupsMultiple risk factorsBlack womenAge-sex groupsOlder patientsSecondary preventionYounger patientsFactor prevalenceLong-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest
Chan PS, Nallamothu BK, Krumholz HM, Spertus JA, Li Y, Hammill BG, Curtis LH. Long-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest. New England Journal Of Medicine 2013, 368: 1019-1026. PMID: 23484828, PMCID: PMC3652256, DOI: 10.1056/nejmoa1200657.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestCardiac arrestNeurologic disabilityReadmission ratesElderly survivorsRisk-adjusted ratesNeurologic statusHeart failureIn-Hospital Cardiac ArrestInpatient cardiac arrestsSevere neurologic disabilityDemographic characteristicsLong-term outcomesLong-term survivalYears of ageRate of survivalHospital dischargeOlder patientsYounger patientsWhite patientsBlack patientsTerm outcomesNational registryMedicare filesPatients
2011
Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH)
Arnold SV, Chan PS, Jones PG, Decker C, Buchanan DM, Krumholz HM, Ho PM, Spertus JA. Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH). Circulation Cardiovascular Quality And Outcomes 2011, 4: 467-476. PMID: 21772003, PMCID: PMC3376532, DOI: 10.1161/circoutcomes.110.960468.Peer-Reviewed Original ResearchConceptsHealth status studiesMyocardial infarctionHealth statusPostdischarge careAcute Myocardial Infarction Patients' Health StatusSubset of patientsTranslational researchPost-MI outcomesRacial differencesHigh mortality ratePatients' health statusMI registryChart abstractionHospital dischargeWhite patientsBlack patientsVital statusMedical historyWorse outcomesTreatment characteristicsInpatient careBaseline interviewUS CentersBlood samplesPatients
2009
Racial Differences in Survival After In-Hospital Cardiac Arrest
Chan PS, Nichol G, Krumholz HM, Spertus JA, Jones PG, Peterson ED, Rathore SS, Nallamothu BK, Investigators F. Racial Differences in Survival After In-Hospital Cardiac Arrest. JAMA 2009, 302: 1195-1201. PMID: 19755698, PMCID: PMC2795316, DOI: 10.1001/jama.2009.1340.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestCardiac arrestBlack patientsWhite patientsSuccessful resuscitationPostresuscitation survivalRacial differencesHospital sitesIn-Hospital Cardiac ArrestLower ratesPulseless ventricular tachycardiaRate of survivalCohort studyHospital dischargePatient characteristicsClinical factorsImmediate resuscitationPostresuscitation periodNational registryVentricular tachycardiaHospital CenterVentricular fibrillationCardiopulmonary resuscitationAdditional adjustmentPatientsFactors associated with racial differences in myocardial infarction outcomes.
Spertus JA, Jones PG, Masoudi FA, Rumsfeld JS, Krumholz HM. Factors associated with racial differences in myocardial infarction outcomes. Annals Of Internal Medicine 2009, 150: 314-24. PMID: 19258559, PMCID: PMC3387537, DOI: 10.7326/0003-4819-150-5-200903030-00007.Peer-Reviewed Original ResearchConceptsQuality of lifeMyocardial infarction outcomesSite of careBlack patientsMyocardial infarctionRacial differencesPost-myocardial infarction outcomesBaseline cardiac riskHigher unadjusted mortalityProspective cohort studySeattle Angina QuestionnaireAngina QuestionnaireCardiovascular outcomesCause mortalityRehospitalization ratesUnadjusted mortalityCohort studyHospital factorsPatient characteristicsWhite patientsCardiac dysfunctionCardiac riskPatient factorsPatient's symptomsNational Heart
2005
Racial differences in reperfusion therapy use in patients hospitalized with myocardial infarction: A regional phenomenon
Rathore SS, Frederick PD, Every NR, Barron HV, Krumholz HM. Racial differences in reperfusion therapy use in patients hospitalized with myocardial infarction: A regional phenomenon. American Heart Journal 2005, 149: 1074-1081. PMID: 15976791, PMCID: PMC2790272, DOI: 10.1016/j.ahj.2004.08.018.Peer-Reviewed Original ResearchConceptsTherapy useMyocardial infarctionBlack patientsReperfusion therapyWhite patientsRacial differencesLower crude ratesMyocardial Infarction 2Reperfusion therapy ratesCohort of patientsTherapy ratesMultivariable adjustmentClinical contraindicationsNational registryPractice patternsCrude ratePatientsInfarctionGeographic regionsTherapyLower ratesTreatmentNational patternsContraindicationsDifferencesRace and Renal Impairment in Heart Failure
Smith GL, Shlipak MG, Havranek EP, Masoudi FA, McClellan WM, Foody JM, Rathore SS, Krumholz HM. Race and Renal Impairment in Heart Failure. Circulation 2005, 111: 1270-1277. PMID: 15769768, DOI: 10.1161/01.cir.0000158131.78881.d5.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBiomarkersBlack or African AmericanCohort StudiesComorbidityCreatinineDiabetes MellitusFemaleGlomerular Filtration RateHeart FailureHumansHypertensionInpatientsKidney DiseasesMaleMedicareMortalityMyocardial InfarctionPrognosisRetrospective StudiesRisk FactorsTreatment OutcomeWhite PeopleConceptsRenal impairmentHF patientsWhite patientsMortality riskRacial differencesElderly HF patientsSimilar racial differencesGlomerular filtration rateHeart failure patientsStriking racial disparitiesMagnitude of riskDistinct morbidityElevated creatinineFailure patientsRenal functionHeart failureHigher creatinineRenal diseaseBlack patientsOptimal therapyPrognostic indicatorFiltration rateMedicare patientsMortality burdenRepresentative cohortThe impact of socioeconomic status and race on trial participation for older women with breast cancer
Gross CP, Filardo G, Mayne ST, Krumholz HM. The impact of socioeconomic status and race on trial participation for older women with breast cancer. Cancer 2005, 103: 483-491. PMID: 15597407, DOI: 10.1002/cncr.20792.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsianBlack or African AmericanBreast NeoplasmsCase-Control StudiesClinical Trials as TopicFemaleHispanic or LatinoHumansLogistic ModelsMedicaidMultivariate AnalysisNational Institutes of Health (U.S.)Odds RatioPatient SelectionPovertySEER ProgramUnemploymentUnited StatesWhite PeopleConceptsBreast cancer trialsTrial participationOlder womenBreast cancerSocioeconomic statusMedicaid insuranceTrial enrollmentCancer patientsCancer trialsMultivariable logistic regression modelBreast cancer patientsMedicaid insurance coverageAssociation of SESHigh-poverty zip codesCase-control studyPopulation-based sampleLow socioeconomic statusLogistic regression modelsImpact of SESWhite patientsBlack patientsSEER areasBlack raceElderly womenTrial participants
2004
Regional variations in racial differences in the treatment of elderly patients hospitalized with acute myocardial infarction
Rathore SS, Masoudi FA, Havranek EP, Krumholz HM. Regional variations in racial differences in the treatment of elderly patients hospitalized with acute myocardial infarction. The American Journal Of Medicine 2004, 117: 811-822. PMID: 15589484, PMCID: PMC2790535, DOI: 10.1016/j.amjmed.2004.06.034.Peer-Reviewed Original ResearchConceptsBeta-blocker useMyocardial infarctionWhite patientsCoronary revascularizationBlack patientsRacial differencesCardiac catheterization useLower crude ratesUse of aspirinDay of admissionHealth care useTreatment of patientsAcute myocardial infarctionService Medicare beneficiariesMedical record dataQuality of careElderly feeRevascularization useAspirin useMultivariable adjustmentElderly patientsCardiac catheterizationCardiac proceduresCare useCrude rateRacial and Ethnic Differences in Time to Acute Reperfusion Therapy for Patients Hospitalized With Myocardial Infarction
Bradley EH, Herrin J, Wang Y, McNamara RL, Webster TR, Magid DJ, Blaney M, Peterson ED, Canto JG, Pollack CV, Krumholz HM. Racial and Ethnic Differences in Time to Acute Reperfusion Therapy for Patients Hospitalized With Myocardial Infarction. JAMA 2004, 292: 1563-1572. PMID: 15467058, DOI: 10.1001/jama.292.13.1563.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngioplasty, Balloon, CoronaryAsian PeopleBlack PeopleFemaleHispanic or LatinoHospitalsHumansInsurance, HospitalizationMaleMiddle AgedMyocardial InfarctionOutcome Assessment, Health CarePatient AdmissionRetrospective StudiesSocioeconomic FactorsThrombolytic TherapyTime and Motion StudiesTime FactorsUnited StatesWhite PeopleConceptsST-segment elevation myocardial infarctionAcute reperfusion therapyElevation myocardial infarctionMyocardial infarctionReperfusion therapyAfrican American/BlackBalloon timeInsurance statusAmerican/BlackEthnic differencesPercutaneous coronary interventionBundle branch blockAsian/Pacific IslandersHealth care disparitiesRace/ethnicity differencesRace/ethnicityClinical characteristicsCoronary interventionFibrinolytic therapyHospital arrivalNonwhite patientsPrimary reperfusionWhite patientsUS cohortHospital characteristicsParticipation in Cancer Clinical Trials: Race-, Sex-, and Age-Based Disparities
Murthy VH, Krumholz HM, Gross CP. Participation in Cancer Clinical Trials: Race-, Sex-, and Age-Based Disparities. JAMA 2004, 291: 2720-2726. PMID: 15187053, DOI: 10.1001/jama.291.22.2720.Peer-Reviewed Original ResearchConceptsCancer trialsCancer clinical trialsClinical trialsTrial participantsEnrollment fractionWhite patientsAge groupsCross-sectional population-based analysisProstate cancer clinical trialsCancer research participationCancer trial participantsColorectal cancer trialsPatients 75 yearsIncident cancer patientsLung cancer trialsPopulation-based analysisRelative risk ratiosAge-based disparitiesYears of ageNational Cancer InstituteLogistic regression modelsLittle recent informationTrial enrolleesYounger patientsPatient group
2003
Race, Quality of Care, and Outcomes of Elderly Patients Hospitalized With Heart Failure
Rathore SS, Foody JM, Wang Y, Smith GL, Herrin J, Masoudi FA, Wolfe P, Havranek EP, Ordin DL, Krumholz HM. Race, Quality of Care, and Outcomes of Elderly Patients Hospitalized With Heart Failure. JAMA 2003, 289: 2517-2524. PMID: 12759323, DOI: 10.1001/jama.289.19.2517.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngiotensin-Converting Enzyme InhibitorsBlack or African AmericanFee-for-Service PlansFemaleHeart FailureHospitalsHumansMaleMedicareMultivariate AnalysisOutcome Assessment, Health CarePatient ReadmissionQuality of Health CareRetrospective StudiesSurvival AnalysisUnited StatesVentricular Function, LeftWhite PeopleConceptsLeft ventricular ejection fractionQuality of careACE inhibitor useWhite patientsBlack patientsHeart failureYear of dischargeACE inhibitorsMultivariable adjustmentInhibitor useLVEF assessmentCrude rateMedicare beneficiariesMortality rateAngiotensin receptor blocker useNational Heart Failure ProjectBlack Medicare patientsHeart Failure ProjectPrescription of angiotensinReceptor blocker useHigh rateVentricular ejection fractionYear of admissionHigher crude ratesService Medicare beneficiaries