2022
Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study
Abdel-Qadir H, Akioyamen LE, Fang J, Pang A, Ha ACT, Jackevicius CA, Alter DA, Austin PC, Atzema CL, Bhatia RS, Booth GL, Johnston S, Dhalla I, Kapral MK, Krumholz HM, McNaughton CD, Roifman I, Tu K, Udell JA, Wijeysundera HC, Ko DT, Schull MJ, Lee DS. Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study. Circulation 2022, 146: 159-171. PMID: 35678171, PMCID: PMC9287095, DOI: 10.1161/circulationaha.122.058949.Peer-Reviewed Original ResearchConceptsYears of ageCohort studyUniversal health careAF-related adverse eventsNeighbourhood-level material deprivationPopulation-based cohort studyPrimary care physician visitsCause-specific hazards regressionRhythm control interventionsHigh cardiovascular disease burdenCardiovascular disease burdenHealth careAtrial fibrillation careNeighborhood material deprivationSingle-payer health care systemMaterial deprivation quintileAtrial fibrillation diagnosisHealth care systemNoncardiovascular comorbiditiesAdverse eventsHeart failurePhysician visitsHazards regressionAdverse outcomesDeprivation quintileDepression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience)
Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Lu Y, Spatz ES, Gupta A, Khera R, Ng VG, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Depression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience). The American Journal Of Cardiology 2022, 173: 33-38. PMID: 35365290, PMCID: PMC9133198, DOI: 10.1016/j.amjcard.2022.03.005.Peer-Reviewed Original ResearchConceptsSpontaneous coronary artery dissectionPatient Health Questionnaire-9Coronary artery dissectionPSS-14 scoreArtery dissectionBaseline PHQ-9 scoreAcute myocardial infarction patientsCardiovascular risk factorsPHQ-9 scoresAcute myocardial infarctionMyocardial infarction patientsYears of agePerceived Stress Scale scoresStress Scale scoresLinear mixed-effects analysisSCAD casesVIRGO StudyQuestionnaire-9Infarction patientsMixed-effects analysisMyocardial infarctionSubgroup analysisRisk factorsRoutine screeningClinical acuity
2020
Presentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study
Gupta A, Tsang S, Hajduk A, Krumholz HM, Nanna MG, Green P, Dodson JA, Chaudhry SI. Presentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2020, 134: 95-103. PMID: 32805225, PMCID: PMC7752813, DOI: 10.1016/j.amjmed.2020.07.020.Peer-Reviewed Original ResearchConceptsOldest-old patientsMyocardial infarctionFunctional impairmentOlder patientsMobility impairmentsCox proportional hazards regressionMiddle-old patientsProportional hazards regressionAcute myocardial infarctionCase fatality rateAcute myocardial infarction hospitalizationsSILVER-AMI StudyYears of ageMyocardial infarction hospitalizationsChest painCoronary revascularizationAtypical presentationHazards regressionClinical variablesRisk factorsAdvanced agePrimary symptomsPatientsFatality rateHealth statusClinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction
Jackevicius CA, Krumholz HM, Ross JS, Koh M, Chong A, Austin PC, Stukel TA, Azizi P, Ko DT. Clinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction. Canadian Journal Of Cardiology 2020, 36: 1633-1640. PMID: 32416066, DOI: 10.1016/j.cjca.2020.01.024.Peer-Reviewed Original ResearchConceptsPrior myocardial infarctionMyocardial infarctionStable patientsPopulation-based observational studyAngina 1 yearDeath/hospitalizationHistory of revascularisationBeta-blocker useMajor cardiovascular eventsHospital discharge diagnosisUse of BBsIndividual end pointsContemporary clinical trialsYears of ageCardiovascular eventsIndex dateCohort studyComposite outcomeBB useHeart failureMedian agePrimary outcomeClinical outcomesAtrial fibrillationDischarge diagnosis
2018
Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics
Gupta A, Barrabes JA, Strait K, Bueno H, Porta‐Sánchez A, Acosta‐Vélez J, Lidón R, Spatz E, Geda M, Dreyer RP, Lorenze N, Lichtman J, D'Onofrio G, Krumholz HM. Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics. Journal Of The American Heart Association 2018, 7: e007021. PMID: 29514807, PMCID: PMC5907538, DOI: 10.1161/jaha.117.007021.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetElectrocardiographyFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial ReperfusionPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsST-segment elevation myocardial infarctionElectrocardiographic characteristicsMyocardial infarctionReperfusion delayYounger patientsVentricular hypertrophyST elevationPrehospital ECGLateral leadsMultivariable logistic regression modelTimeliness of reperfusionVoltage criteriaElevation myocardial infarctionLeft ventricular hypertrophyAcute myocardial infarctionYears of ageLogistic regression modelsSex differencesClinical characteristicsCohort studyElectrocardiographic correlatesMultivariable analysisFemale sexSpanish hospitalsReperfusion guidelines
2017
Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects
Krumholz HM, Wang K, Lin Z, Dharmarajan K, Horwitz LI, Ross JS, Drye EE, Bernheim SM, Normand ST. Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects. New England Journal Of Medicine 2017, 377: 1055-1064. PMID: 28902587, PMCID: PMC5671772, DOI: 10.1056/nejmsa1702321.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesReadmission ratesObserved readmission ratesSimilar diagnosesHospital effectsDifferent hospitalsHospital readmission performanceRate of readmissionHospital readmission ratesLower readmission ratesStudy sampleYears of ageSignificant differencesMultiple admissionsReadmission outcomesOnly significant differencePatient effectsSame patientMedicare recipientsPatientsReadmission performanceRisk-standardized hospital readmission ratesHospitalHospital qualityQuartileHospital Readmissions among Commercially Insured and Medicare Advantage Beneficiaries with Diabetes and the Impact of Severe Hypoglycemic and Hyperglycemic Events
McCoy RG, Lipska KJ, Herrin J, Jeffery MM, Krumholz HM, Shah ND. Hospital Readmissions among Commercially Insured and Medicare Advantage Beneficiaries with Diabetes and the Impact of Severe Hypoglycemic and Hyperglycemic Events. Journal Of General Internal Medicine 2017, 32: 1097-1105. PMID: 28685482, PMCID: PMC5602759, DOI: 10.1007/s11606-017-4095-x.Peer-Reviewed Original ResearchConceptsDiabetes Complications Severity IndexSevere dysglycemiaIndex hospitalizationMedicare Advantage beneficiariesRisk factorsBetter care transitionsComplications Severity IndexPost-discharge managementIndependent risk factorYounger patient ageOptumLabs Data WarehouseStrong risk factorYears of ageBackgroundHospital readmissionsDesignRetrospective analysisCause readmissionUnplanned readmissionPatient agePrior hospitalizationReadmission ratesYounger patientsHeart failureHospital readmissionSevere hypoglycemiaDiabetes complicationsSex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction
Lu Y, Zhou S, Dreyer RP, Spatz ES, Geda M, Lorenze NP, D'Onofrio G, Lichtman JH, Spertus JA, Ridker PM, Krumholz HM. Sex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003470. PMID: 28228461, PMCID: PMC5459381, DOI: 10.1161/circoutcomes.116.003470.Peer-Reviewed Original ResearchMeSH Keywords1-Alkyl-2-acetylglycerophosphocholine EsteraseAdolescentAdultAge of OnsetBiomarkersChi-Square DistributionComorbidityC-Reactive ProteinFemaleHealth Status DisparitiesHumansInflammation MediatorsLinear ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocioeconomic FactorsUnited StatesUp-RegulationYoung AdultConceptsHigh-sensitivity C-reactive proteinAcute myocardial infarctionHigher inflammatory levelsInflammatory markersPoor health statusHealth statusYoung womenMyocardial infarctionInflammatory levelsTargeted anti-inflammatory treatmentsElevated inflammatory markersResidual cholesterol riskResidual inflammatory riskSex differencesAnti-inflammatory treatmentAnti-inflammatory therapyC-reactive proteinHigher mortality riskYoung menPhospholipase A2Years of ageCardiovascular outcomesMultivariable adjustmentPatient characteristicsSecondary preventionSex Differences in 1-Year All-Cause Rehospitalization in Patients After Acute Myocardial Infarction
Dreyer RP, Dharmarajan K, Kennedy KF, Jones PG, Vaccarino V, Murugiah K, Nuti SV, Smolderen KG, Buchanan DM, Spertus JA, Krumholz HM. Sex Differences in 1-Year All-Cause Rehospitalization in Patients After Acute Myocardial Infarction. Circulation 2017, 135: 521-531. PMID: 28153989, PMCID: PMC5312975, DOI: 10.1161/circulationaha.116.024993.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionAge-sex interactionHigh riskRehospitalization ratesClinical factorsMyocardial infarctionCox proportional hazards modelSignificant age-sex interactionCause rehospitalization rateSex differencesMedical record abstractionProportional hazards modelYears of ageFirst yearTRIUMPH studyCause rehospitalizationRecord abstractionPatient interviewsRehospitalizationUS CentersHazards modelPsychosocial factorsPhysician panelHealth statusPsychosocial state
2016
Participation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals
Downing NS, Shah ND, Neiman JH, Aminawung JA, Krumholz HM, Ross JS. Participation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals. Trials 2016, 17: 199. PMID: 27079511, PMCID: PMC4832528, DOI: 10.1186/s13063-016-1322-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedClinical Trials as TopicCross-Sectional StudiesDatabases, FactualDrug ApprovalEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHumansMaleMiddle AgedMinority GroupsPatient SelectionSex FactorsTime FactorsUnited StatesUnited States Food and Drug AdministrationConceptsSubgroup efficacy analysesPivotal trialsEfficacy analysisNovel therapeuticsSubgroup analysisTrial participantsU.S. FoodMean proportionAvailable FDA documentsCross-sectional studyDrug Administration approvalBasis of approvalYears of ageTrial patientsElderly patientsMedian ageBlack patientsAsian patientsAdministration approvalClinical studiesFDA reviewersPatientsHispanic participantsTrialsDemographic characteristics
2015
Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012
Murugiah K, Wang Y, Desai NR, Spatz ES, Nuti SV, Dreyer RP, Krumholz HM. Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012. JACC Heart Failure 2015, 4: 197-205. PMID: 26746377, PMCID: PMC5323042, DOI: 10.1016/j.jchf.2015.09.013.Peer-Reviewed Original ResearchConceptsLong-term outcomesReadmission ratesNonwhite patientsHospitalization ratesSecondary diagnosisMedicare feeYears of ageTakotsubo cardiomyopathyWorse outcomesWhite racePatientsService beneficiariesHospitalMortalityTime pointsOutcomesHospitalizationCohortDiagnosisRepresentative dataTakotsuboTTCReadmissionCardiomyopathyYearsExcess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined
Bucholz EM, Beckman AL, Krumholz HA, Krumholz HM, conducted. B. Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined. American Heart Journal 2015, 172: 173-181. PMID: 26856230, PMCID: PMC5097250, DOI: 10.1016/j.ahj.2015.10.024.Peer-Reviewed Original ResearchConceptsNormal weight patientsAcute myocardial infarctionBody mass indexHigher body mass indexLong-term survivalObese patientsOverweight patientsObesity paradoxExcess weightMyocardial infarctionLife expectancyTime of AMIHigher crude mortalityTime pointsShort-term mortalityCooperative Cardiovascular ProjectMedical record studyProportional hazards modelYears of ageMorbid obesityOlder patientsSurvival benefitYounger patientsCrude mortalityBMI groupsImplications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis)
Nasir K, Bittencourt MS, Blaha MJ, Blankstein R, Agatson AS, Rivera JJ, Miedema MD, Sibley CT, Shaw LJ, Blumenthal RS, Budoff MJ, Krumholz HM. Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis). Journal Of The American College Of Cardiology 2015, 66: 1657-1668. PMID: 26449135, DOI: 10.1016/j.jacc.2015.07.066.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationAtherosclerosisCalciumCoronary AngiographyCoronary Artery DiseaseCoronary VesselsEthnicityFemaleFollow-Up StudiesGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProspective StudiesRisk AssessmentRisk FactorsUnited StatesConceptsCoronary artery calciumASCVD event ratesYears of ageStatin therapyAmerican CollegeAbsence of CACHard coronary heart disease eventsNew ACC/AHA guidelinesCoronary Artery Calcium TestingACC/AHA guidelinesAtherosclerotic cardiovascular disease riskCoronary heart disease eventsLow-density lipoprotein levelsEvent ratesCholesterol management guidelinesHigh-intensity statinsHeart disease eventsLipid-lowering medicationsModerate-intensity statinsCardiovascular disease riskLow-density lipoproteinStatin candidatesASCVD riskAHA guidelinesArtery calciumNational Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010
Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM. National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010. PLOS ONE 2015, 10: e0132470. PMID: 26147225, PMCID: PMC4493110, DOI: 10.1371/journal.pone.0132470.Peer-Reviewed Original ResearchConceptsMitral valve surgeryLength of stayHospital LOSReadmission ratesHospital readmission ratesOlder patientsHospital readmissionMedicare feeMean hospital LOSSurvival rateProportional hazards regressionYears of ageValve surgeryHazards regressionService patientsWorse outcomesAge subgroupsPatientsOlder adultsSurvivorsNational trendsReadmissionModest declineWomenSubgroupsGender Differences in the Trajectory of Recovery in Health Status Among Young Patients With Acute Myocardial Infarction
Dreyer RP, Wang Y, Strait KM, Lorenze NP, D'Onofrio G, Bueno H, Lichtman JH, Spertus JA, Krumholz HM. Gender Differences in the Trajectory of Recovery in Health Status Among Young Patients With Acute Myocardial Infarction. Circulation 2015, 131: 1971-1980. PMID: 25862743, PMCID: PMC4657729, DOI: 10.1161/circulationaha.114.014503.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status scoresHealth statusMyocardial infarctionStatus scoreMedical record abstractionMental summary scoresShort Form-12Disease-specific measuresHealth status measuresWomen's health statusYears of ageLower health status scoresLinear mixed-effects analysisPatients 18Younger patientsRecord abstractionForm-12Excess riskMixed-effects analysisPatient interviewsSpanish hospitalsBaseline hospitalizationSummary scoresGender differencesSex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction
D'Onofrio G, Safdar B, Lichtman JH, Strait KM, Dreyer RP, Geda M, Spertus JA, Krumholz HM. Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction. Circulation 2015, 131: 1324-1332. PMID: 25792558, PMCID: PMC4652789, DOI: 10.1161/circulationaha.114.012293.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionMyocardial infarctionReperfusion therapyAcute ST-segment elevation myocardial infarctionProspective observational cohort studyYoung AMI Patients (VIRGO) studyTime guidelinesYoung womenObservational cohort studyProportion of patientsElevation myocardial infarctionPercutaneous coronary interventionYears of ageSex differencesPatients 18Reperfusion strategyCohort studyCoronary interventionFibrinolytic therapyNeedle timeYounger patientsReperfusion delayRatio of womenReperfusion guidelinesSex disparitiesSex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction
Xu X, Bao H, Strait K, Spertus JA, Lichtman JH, D'Onofrio G, Spatz E, Bucholz EM, Geda M, Lorenze NP, Bueno H, Beltrame JF, Krumholz HM. Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction. Circulation 2015, 131: 614-623. PMID: 25679303, PMCID: PMC4652932, DOI: 10.1161/circulationaha.114.012826.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMiddle-aged patientsMyocardial infarctionMental health statusWorse recoveryHealth statusSex differencesBaseline stressSex-based disparitiesYears of ageMultiple health outcomesQuality of lifeGreater mental stressSex-based differencesClinical characteristicsFemale sexEarly recoveryPerceived Stress ScaleGeneral populationGreater psychological stressHealth outcomesImprovement scoresInfarctionPatientsYounger age
2014
Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China
Zheng X, Dreyer RP, Hu S, Spatz ES, Masoudi FA, Spertus JA, Nasir K, Li X, Li J, Wang S, Krumholz HM, Jiang L. Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China. Heart 2014, 101: 349. PMID: 25510395, PMCID: PMC4453015, DOI: 10.1136/heartjnl-2014-306456.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge FactorsAgedAged, 80 and overChinaDrug UtilizationFemaleHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsRetrospective StudiesRural PopulationSex FactorsUrban PopulationConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionGender-age interactionHospital mortalityEarly mortalityMyocardial infarctionChina PEACE-Retrospective AMI StudyHospital mortality rateYears of ageAge-specific gender differencesPatient characteristicsHospital characteristicsMultivariable modelMortality rateGender differencesChinese populationMortalityYounger groupChinese hospitalsWomenAMI studyMenInfarctionAgeRepresentative sampleTrends in Hospitalizations and Outcomes for Acute Cardiovascular Disease and Stroke, 1999–2011
Krumholz HM, Normand SL, Wang Y. Trends in Hospitalizations and Outcomes for Acute Cardiovascular Disease and Stroke, 1999–2011. Circulation 2014, 130: 966-975. PMID: 25135276, PMCID: PMC4171056, DOI: 10.1161/circulationaha.113.007787.Peer-Reviewed Original ResearchConceptsAcute cardiovascular diseaseCardiovascular diseaseIschemic strokeUnstable anginaHeart failureMyocardial infarctionNational Medicare dataYears of ageQuality of careDemographic subgroupsReadmission outcomesHospitalization ratesMortality overallService patientsCardiovascular conditionsAdjusted ratesHospitalizationMedicare dataMortality rateStrokeMortalityDiseaseAnginaReadmissionInfarction
2013
For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery
Sen S, Soulos PR, Herrin J, Roberts KB, Yu JB, Lesnikoski BA, Ross JS, Krumholz HM, Gross CP. For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery. Surgery 2013, 155: 776-788. PMID: 24787104, PMCID: PMC4008843, DOI: 10.1016/j.surg.2013.12.009.Peer-Reviewed Original ResearchConceptsHospital ownership statusBreast-conserving operationsBreast-conserving surgeryUse of brachytherapyRadiation therapyOperative careBreast cancerMedicare beneficiariesOverall useReceipt of brachytherapyAdjuvant radiation therapyInvasive breast cancerFemale Medicare beneficiariesGreater overall useYears of ageShort life expectancyRetrospective studyRT modalityProfit hospitalsExpensive modalityOlder womenBrachytherapy useBreast brachytherapyHospitalBrachytherapy