2024
Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities
Katz M, Mszar R, Grimshaw A, Gunderson C, Onuma O, Lu Y, Spatz E. Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities. JAMA Network Open 2024, 7: e2356070. PMID: 38353950, PMCID: PMC10867699, DOI: 10.1001/jamanetworkopen.2023.56070.Peer-Reviewed Original ResearchConceptsDigital health interventionsHealth disparitiesHealth interventionsSystematic reviewSystolic BPSocial determinants of healthHypertension managementCommunity health workersFactors associated with cardiovascular diseaseDeterminants of healthLeveraging digital healthRemote BP monitoringDigital health technologiesStandard care groupMeta-analysisBlood pressureDiastolic BPPreferred Reporting ItemsControl groupSystolic BP changeBaseline to 6Random-effects modelSkilled nursingCultural tailoringSocial determinantsAssociation of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputationPsychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan
Gaffey A, Spatz E. Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan. Current Atherosclerosis Reports 2024, 26: 45-58. PMID: 38240928, PMCID: PMC11219074, DOI: 10.1007/s11883-023-01185-0.Peer-Reviewed Original ResearchConceptsIschemic heart disease riskPsychological healthIschemic heart diseasePsychosocial stressRisk of ischemic heart diseaseIschemic heart disease diagnosisPsychological factorsStudy of psychological factorsPositive psychological factorsOptimal psychological healthHeart diseaseSignificant life eventsIHD riskPsychosocial factorsSense of purposeWoman's riskPsychological screeningPsychological assessmentPsychological interventionsLife eventsSex-specific factorsSocial isolationHealthVulnerable groupsNarrative review
2023
National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020
Lu Y, Liu Y, Dhingra L, Caraballo C, Mahajan S, Massey D, Spatz E, Sharma R, Rodriguez F, Watson K, Masoudi F, Krumholz H. National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020. JAMA Network Open 2023, 6: e2345964. PMID: 38039001, PMCID: PMC10692850, DOI: 10.1001/jamanetworkopen.2023.45964.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHistory of ASCVDCross-sectional studyLifestyle modificationPharmacological medicationsOptimal careCurrent careUS adultsEthnic differencesWhite individualsGuideline-recommended therapiesTotal cholesterol controlNon-Hispanic white individualsNutrition Examination SurveyLatino individualsQuality of careSelf-reported raceStatin useRecommended TherapiesSecondary preventionCholesterol controlOptimal regimensSmoking cessationEligible participantsExamination SurveyAssociation of SGLT‐2 Inhibitors With Treatment Satisfaction and Diabetes‐Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes
Ding Q, Spatz E, Bena J, Morrison S, Levay M, Lin H, Grey M, Edwards N, Isaacs D, West L, Combs P, Albert N. Association of SGLT‐2 Inhibitors With Treatment Satisfaction and Diabetes‐Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes. Journal Of The American Heart Association 2023, 12: e029058. PMID: 37655510, PMCID: PMC10547320, DOI: 10.1161/jaha.122.029058.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsGeneral health statusCardiovascular disease typesType 2 diabetesTreatment satisfactionDiabetes-specific qualityCardiovascular diseaseHealth statusDisease typeProspective observational study designPatient-reported health statusInverse probabilityNoninsulin antidiabetic medicationsSGLT-2i useSGLT-2i usersTreatment-weighted analysisCotransporter 2 inhibitorsSGLT-2 inhibitorsDiabetes treatment satisfactionObservational study designGreater reductionAntidiabetic medicationsDiabetes medicationsSecondary outcomesSymptom burdenImpact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2023, 12: e030031. PMID: 37589125, PMCID: PMC10547344, DOI: 10.1161/jaha.123.030031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac-specific qualityGeneric health statusMyocardial infarctionBaseline healthMarital stressHealth outcomesHealth statusWorse patient-reported outcomesMental healthYoung adultsObservational cohort studyPatient-reported outcomesSocioeconomic factorsWorse mental healthReadmission 1Cause readmissionCohort studyYounger patientsRoutine screeningDepressive symptomsGreater oddsAnginaMale participantsOutcomesPrevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults — United States, December 2020–March 2023
Montoy J, Ford J, Yu H, Gottlieb M, Morse D, Santangelo M, O’Laughlin K, Schaeffer K, Logan P, Rising K, Hill M, Wisk L, Salah W, Idris A, Huebinger R, Spatz E, Rodriguez R, Klabbers R, Gatling K, Wang R, Elmore J, McDonald S, Stephens K, Weinstein R, Venkatesh A, Saydah S, Group I, Group I, Ahmed Z, Choi M, Derden A, Gottlieb M, Guzman D, Hassaballa M, Jerger R, Kaadan M, Koo K, Yang G, Dorney J, Kinsman J, Li S, Lin Z, Mannan I, Pierce S, Puente X, Ulrich A, Yang Z, Yu H, Adams K, Anderson J, Chang G, Gentile N, Geyer R, Maat Z, Malone K, Nichol G, Park J, Ruiz L, Schiffgens M, Stober T, Willis M, Zhang Z, Amadio G, Charlton A, Cheng D, Grau D, Hannikainen P, Kean E, Kelly M, Miao J, Renzi N, Shughart H, Shughart L, Shutty C, Watts P, Kane A, Nikonowicz P, Sapp S, Gallegos D, Martin R, Chandler C, Eguchi M, L’Hommedieu M, Moreno R, Roldan K, Arreguin M, Chan V, Chavez C, Kemball R, Wong A, Briggs-Hagen M, Hall A, Plumb I. Prevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults — United States, December 2020–March 2023. MMWR Morbidity And Mortality Weekly Report 2023, 72: 859-865. PMID: 37561663, PMCID: PMC10415002, DOI: 10.15585/mmwr.mm7232a2.Peer-Reviewed Original ResearchConceptsCOVID-like illnessSARS-CoV-2 test resultsPost-COVID conditionsNegative SARS-CoV-2 test resultsPositive SARS-CoV-2 test resultProspective multicenter cohort studySARS-CoV-2 infectionMulticenter cohort studyPrevalence of symptomsTime of enrollmentCOVID-19 testing statusHealth care providersSARS-CoV-2Self-reported symptomsCohort studyPersistent symptomsAcute illnessAntigen testPolymerase chain reactionClinical signsSymptom progressionCare providersDrug AdministrationTesting statusSymptomsIllness Perception and the Impact of a Definitive Diagnosis on Women With Ischemia and No Obstructive Coronary Artery Disease: A Qualitative Study.
Tseng L, Göç N, Schwann A, Cherlin E, Kunnirickal S, Odanovic N, Curry L, Shah S, Spatz E. Illness Perception and the Impact of a Definitive Diagnosis on Women With Ischemia and No Obstructive Coronary Artery Disease: A Qualitative Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: 521-529. PMID: 37476997, DOI: 10.1161/circoutcomes.122.009834.Peer-Reviewed Original ResearchConceptsObstructive coronary artery diseaseCoronary function testingCoronary artery diseaseInvasive coronary angiographyArtery diseaseCoronary angiographyFunction testingDefinitive diagnosisYale-New Haven HospitalNon-Hispanic blacksMore patient-centered careNew Haven HospitalPatient-centered careStructured telephone interviewQuality of lifeHealth care experiencesNon-Hispanic whitesGroup of womenCoronary functionIllness perceptionsMean ageINOCAUncertain causeMultidisciplinary teamPatient careAssociation of Population Well-Being With Cardiovascular Outcomes
Spatz E, Roy B, Riley C, Witters D, Herrin J. Association of Population Well-Being With Cardiovascular Outcomes. JAMA Network Open 2023, 6: e2321740. PMID: 37405774, PMCID: PMC10323707, DOI: 10.1001/jamanetworkopen.2023.21740.Peer-Reviewed Original ResearchConceptsPopulation health factorsCVD mortalityCoronary heart diseaseCross-sectional studyHeart diseaseCardiovascular diseaseSecondary outcomesHealth factorsCardiovascular outcomesHeart failureCardiovascular healthMortality rateCounty-level ratesLower CVD mortalityTotal CVD mortalityCardiovascular death ratesAcute myocardial infarctionTotal heart diseaseEffect sizePrimary outcomeHighest quintileLowest quintileMyocardial infarctionNational HealthMAIN OUTCOMEVariation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement
Chuzi S, Lindenauer P, Faridi K, Priya A, Pekow P, D'Aunno T, Mazor K, Stefan M, Spatz E, Gilstrap L, Werner R, Lagu T. Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement. Journal Of The American Heart Association 2023, 12: e029758. PMID: 37345796, PMCID: PMC10356066, DOI: 10.1161/jaha.122.029758.Peer-Reviewed Original ResearchConceptsAcute admission ratesHeart failureMedicare Shared Savings Program Accountable Care OrganizationsAccountable care organizationsAdmission ratesMost ACOsPrimary care providersPerformance categoriesCare organizationsACO characteristicsHealth care qualityAdmission riskBlack beneficiariesCare providersMedicare feeService beneficiariesConclusions AdmissionCare qualityPatientsAdmissionHospital affiliationACO structureFuture studiesLower proportionFailureAtorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial
Talasaz A, Sadeghipour P, Bakhshandeh H, Sharif-Kashani B, Rashidi F, Beigmohammadi M, Moghadam K, Rezaian S, Dabbagh A, Sezavar S, Farrokhpour M, Abedini A, Aliannejad R, Riahi T, Yadollahzadeh M, Lookzadeh S, Rezaeifar P, Matin S, Tahamtan O, Mohammadi K, Zoghi E, Rahmani H, Hosseini S, Mousavian S, Abri H, Sadeghipour P, Baghizadeh E, Rafiee F, Jamalkhani S, Amin A, Mohebbi B, Parhizgar S, Soleimanzadeh M, Aghakouchakzadeh M, Eslami V, Payandemehr P, Khalili H, Talakoob H, Tojari T, Shafaghi S, Tabrizi S, Kakavand H, Kashefizadeh A, Najafi A, Jimenez D, Gupta A, Madhavan M, Sethi S, Parikh S, Monreal M, Hadavand N, Hajighasemi A, Ansarin K, Maleki M, Sadeghian S, Barco S, Siegerink B, Spatz E, Piazza G, Kirtane A, Tassell B, Lip G, Klok F, Goldhaber S, Stone G, Krumholz H, Bikdeli B. Atorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial. Thrombosis And Haemostasis 2023, 123: 723-733. PMID: 36944357, DOI: 10.1055/a-2059-4844.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationArterial thrombosisMAIN OUTCOMEAtorvastatin 20Symptom onsetICU patientsFunctional statusIntensive care unit patientsCOVID-19Double-blind multicenterAdult ICU patientsCare unit patientsThrombo-inflammatory responseCoronavirus disease 2019Meaningful treatment effectPrespecified studyCause mortalityAtorvastatin useUnit patientsMembrane oxygenationFunctional outcomeDisease 2019Functional scalesPlaceboPatientsSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesPhysician responses to apple watch-detected irregular rhythm alerts
Demkowicz P, Dhruva S, Spatz E, Beatty A, Ross J, Khera R. Physician responses to apple watch-detected irregular rhythm alerts. American Heart Journal 2023, 262: 29-37. PMID: 37084933, PMCID: PMC10988207, DOI: 10.1016/j.ahj.2023.04.008.Peer-Reviewed Original ResearchConceptsAtrial fibrillationPrimary careEmergency medicinePhysician responsesDiagnostic testingUse of antiarrhythmicsClinical practice guidelinesMeasurement of BNPFurther diagnostic testingCase-based surveyLarge academic centerAF alertsAsymptomatic patientsPatient demographicsClinical symptomsTreatment optionsMedical historyPatient referralPhysician specialtyPractice guidelinesPhysician differencesRhythm monitoringAcademic centersUS FoodClinical complexityQuantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression modelsAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOMERoutine saliva testing for SARS-CoV-2 in children: Methods for partnering with community childcare centers
Rayack E, Askari H, Zirinsky E, Lapidus S, Sheikha H, Peno C, Kazemi Y, Yolda-Carr D, Liu C, Grubaugh N, Ko A, Wyllie A, Spatz E, Oliveira C, Bei A. Routine saliva testing for SARS-CoV-2 in children: Methods for partnering with community childcare centers. Frontiers In Public Health 2023, 11: 1003158. PMID: 36817891, PMCID: PMC9936085, DOI: 10.3389/fpubh.2023.1003158.Peer-Reviewed Original ResearchConceptsParents/guardiansOnline patient portalYounger age groupsSARS-CoV-2Age groupsSurveillance programSaliva collectionSARS-CoV-2 testingSARS-CoV-2 screeningWeekly saliva samplesRT-PCR testingChildcare centre staffCritical age groupRoutine surveillance toolRoutine testing programsChildcare centersCOVID-19 transmissionAsymptomatic screeningSaliva collection methodNasal swabsPatient portalsSymptomatic testingPublic health dataSaliva samplesChildcare facilitiesDeveloping an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Lu Y, Du C, Khidir H, Caraballo C, Mahajan S, Spatz E, Curry L, Krumholz H. Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009453. PMID: 36727515, DOI: 10.1161/circoutcomes.122.009453.Peer-Reviewed Original ResearchConceptsPersistent hypertensionElectronic health recordsBlood pressureHealth recordsPharmacologic agentsPrescribed treatmentYale New Haven Health SystemTreatment planAdditional pharmacologic agentsAntihypertensive treatment intensificationConsecutive outpatient visitsElevated blood pressurePersistence of hypertensionElectronic health record dataHealth record dataEligible patientsTreatment intensificationChart reviewHispanic patientsOutpatient visitsMean agePharmacological treatmentConventional content analysisHypertensionClinician notesPrimary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study
Group C, Zhou T, Wang Y, Zhang H, Wu C, Tian N, Cui J, Bai X, Yang Y, Zhang X, Lu Y, Spatz E, Ross J, Krumholz H, Lu J, Li X, Hu S. Primary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study. The Lancet Global Health 2023, 11: e83-e94. PMID: 36521957, DOI: 10.1016/s2214-109x(22)00428-4.Peer-Reviewed Original ResearchConceptsProportion of participantsPrimary care institutionsHypertension awarenessPrimary care systemBlood pressureCare institutionsCardiac Events Million Persons ProjectAverage diastolic blood pressureMedical Sciences (CAMS) Innovation FundAverage systolic blood pressureCare systemMillion Persons ProjectHistory of hypertensionDiastolic blood pressurePrimary care surveySystolic blood pressureCardiovascular disease riskBlood pressure measurementsCross-sectional studyParticipant-level dataProportion of physiciansRoutine service deliveryPrimary care roleHealth Care SurveyPublic health services
2022
Three-Month Symptom Profiles Among Symptomatic Adults With Positive and Negative Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Prospective Cohort Study From the INSPIRE Group
Spatz E, Gottlieb M, Wisk L, Anderson J, Chang A, Gentile N, Hill M, Huebinger R, Idris A, Kinsman J, Koo K, Li S, McDonald S, Plumb I, Rodriguez R, Saydah S, Slovis B, Stephens K, Unger E, Wang R, Yu H, Hota B, Elmore J, Weinstein R, Venkatesh A. Three-Month Symptom Profiles Among Symptomatic Adults With Positive and Negative Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Prospective Cohort Study From the INSPIRE Group. Clinical Infectious Diseases 2022, 76: 1559-1566. PMID: 36573005, DOI: 10.1093/cid/ciac966.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 symptomsSARS-CoV-2 infectionPost-infectious syndromesProspective cohort studyCohort studyCOVID groupAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionSARS-CoV-2 test resultsSyndrome coronavirus 2 infectionEar/nose/throatSevere acute respiratory syndrome coronavirus 2 testsCoronavirus 2 infectionLong-term symptomsNose/throatLong COVIDSymptomatic adultsMean ageActive symptomsSymptom profilesDrug AdministrationSociodemographic characteristicsSymptomsInfectionMonthsScreening for atrial fibrillation to prevent stroke: increasing enthusiasm but outcomes still lag
Spatz E, Herrin J. Screening for atrial fibrillation to prevent stroke: increasing enthusiasm but outcomes still lag. European Heart Journal 2022, 44: 205-207. PMID: 36458879, DOI: 10.1093/eurheartj/ehac696.Peer-Reviewed Original Research