2024
Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks
Lu Y, Keeley E, Barrette E, Cooper-DeHoff R, Dhruva S, Gaffney J, Gamble G, Handke B, Huang C, Krumholz H, McDonough C, Schulz W, Shaw K, Smith M, Woodard J, Young P, Ervin K, Ross J. Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks. BMC Cardiovascular Disorders 2024, 24: 497. PMID: 39289597, PMCID: PMC11409735, DOI: 10.1186/s12872-024-04161-x.Peer-Reviewed Original ResearchConceptsElectronic health recordsHealth recordsHealth systemUncontrolled hypertensionUse of electronic health recordsHypertension managementElectronic health record systemsOneFlorida Clinical Research ConsortiumElectronic health record dataYale New Haven Health SystemBP measurementsICD-10-CM codesHealth system networkPublic health priorityICD-10-CMIncidence rate of deathElevated BP measurementsElevated blood pressure measurementsHealthcare visitsAmbulatory careHealth priorityRetrospective cohort studyEHR dataOneFloridaBlood pressure measurementsHypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records
Brush J, Lu Y, Liu Y, Asher J, Li S, Sawano M, Young P, Schulz W, Anderson M, Burrows J, Krumholz H. Hypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records. Journal Of The American Heart Association 2024, 13: e033253. PMID: 38686864, PMCID: PMC11179912, DOI: 10.1161/jaha.123.033253.Peer-Reviewed Original ResearchConceptsElectronic health recordsRegional health systemImprove hypertension careHealth systemHealth recordsHypertension careDiastolic blood pressureAge-adjusted prevalence ratesNon-Hispanic Black patientsPrevalence ratesLarger health systemCross-sectional analysisTransformation of medical dataLeveraging real-world dataHigh prevalence rateHypertension trendsHypertension prevalenceBlood pressureBlood pressure measurementsHypertension diagnosisPrimary outcomeNational trendsProportion of patientsAntihypertensive medicationsBlack patients
2023
Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction
Brush J, Chaudhry S, Dreyer R, D'Onofrio G, Greene E, Hajduk A, Lu Y, Krumholz H. Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2023, 197: 101-107. PMID: 37062667, PMCID: PMC10198892, DOI: 10.1016/j.amjcard.2023.03.009.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionD2B timeSymptom complexityYoung womenChest painBalloon timeST-elevation myocardial infarctionSILVER-AMI StudySymptom phenotypeSex differencesPain symptomsCoronary interventionOlder patientsMyocardial infarctionOlder womenSTEMIOlder menSymptom patternsPresentation delayPatientsSymptom clustersLogistic regressionSymptomsWomenMean numberTiming of Blood Draws Among Patients Hospitalized in a Large Academic Medical Center
Caraballo C, Mahajan S, Murugiah K, Mortazavi B, Lu Y, Khera R, Krumholz H. Timing of Blood Draws Among Patients Hospitalized in a Large Academic Medical Center. JAMA 2023, 329: 255-257. PMID: 36648476, PMCID: PMC9856620, DOI: 10.1001/jama.2022.21509.Peer-Reviewed Original Research
2022
Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomenStudy protocol for the Innovative Support for Patients with SARS-COV-2 Infections Registry (INSPIRE): A longitudinal study of the medium and long-term sequelae of SARS-CoV-2 infection
O’Laughlin K, Thompson M, Hota B, Gottlieb M, Plumb ID, Chang AM, Wisk LE, Hall AJ, Wang RC, Spatz ES, Stephens KA, Huebinger RM, McDonald SA, Venkatesh A, Gentile N, Slovis BH, Hill M, Saydah S, Idris AH, Rodriguez R, Krumholz HM, Elmore JG, Weinstein RA, Nichol G, . Study protocol for the Innovative Support for Patients with SARS-COV-2 Infections Registry (INSPIRE): A longitudinal study of the medium and long-term sequelae of SARS-CoV-2 infection. PLOS ONE 2022, 17: e0264260. PMID: 35239680, PMCID: PMC8893622, DOI: 10.1371/journal.pone.0264260.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionLong-term sequelaePatient-reported outcomesRelative riskAcute SARS-CoV-2 infectionSARS-CoV-2 negative participantsHealth system encountersPredictors of sequelaeHealth recordsInstitutional review board approvalLongitudinal studyDigital health recordsReview board approvalSARS-CoV-2Secure online platformClinical outcomesStudy protocolNegative participantsViral testsSimilar symptomatologyNew diagnosisBoard approvalSequelaeSelf-administered surveyInfection
2021
Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries
Wheelock KM, Ross JS, Murugiah K, Lin Z, Krumholz HM, Khera R. Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries. JAMA Network Open 2021, 4: e2137288. PMID: 34870678, PMCID: PMC8649845, DOI: 10.1001/jamanetworkopen.2021.37288.Peer-Reviewed Original ResearchConceptsDOAC useAnticoagulant prescriptionOral anticoagulantsUS cliniciansMedicare beneficiariesNational clinical practice guidelinesElevated bleeding riskOral anticoagulant prescriptionsRetrospective cohort studyDirect oral anticoagulantsClinical practice guidelinesUS Medicare beneficiariesInternal medicine physiciansNumber of cliniciansAnticoagulant prescribingDOAC prescriptionsUnique cliniciansBleeding riskCohort studyAnticoagulant strategiesPrescription claimsPractice guidelinesMAIN OUTCOMEMost indicationsMedicare populationTrends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States
Mori M, Gupta A, Wang Y, Vahl T, Nazif T, Kirtane AJ, George I, Yong CM, Onuma O, Kodali S, Geirsson A, Leon MB, Krumholz HM. Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. Journal Of The American College Of Cardiology 2021, 78: 2161-2172. PMID: 34823659, DOI: 10.1016/j.jacc.2021.09.855.Peer-Reviewed Original ResearchEffectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial
Wang L, Lu Y, Wang H, Gu J, J Z, Lian Z, Zhang Z, Krumholz H, Sun N. Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial. Open Heart 2021, 8: e001719. PMID: 34580169, PMCID: PMC8477318, DOI: 10.1136/openhrt-2021-001719.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAntihypertensive AgentsBlood PressureCardiography, ImpedanceChinaClinical Decision-MakingFemaleFollow-Up StudiesHumansHypertensionIncidenceMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTherapy, Computer-AssistedTime FactorsTreatment OutcomeYoung AdultConceptsBody mass indexPeking University People's HospitalStandard care groupBlood pressure controlSystolic BPHaemodynamic groupsTreatment strategiesImpedance cardiographyBaseline BPBP goalHypertension clinicHaemodynamic profileBP levelsCare groupPeople's HospitalMean baseline systolic BPPressure controlReal-world clinical practiceBaseline systolic BPMean systolic BPDiastolic BP levelsProportion of patientsPragmatic clinical trialsReal-world populationBaseline DBPChanges in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
Zhou T, Li X, Lu Y, Murugiah K, Bai X, Hu S, Gao Y, Masoudi FA, Krumholz HM, Li J, . Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015. Open Heart 2021, 8: e001666. PMID: 34599073, PMCID: PMC8488733, DOI: 10.1136/openhrt-2021-001666.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionPrehospital delayMyocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionAcute cardiovascular careAcute myocardial infarctionWeighted national estimateHealth service capacityRisk-adjusted ratesAcute reperfusionEligible patientsHospital deathReperfusion therapyMedical chartsPatient characteristicsHospital treatmentPatient outcomesRandom cohortCardiovascular diseaseCardiovascular carePatientsNational estimatesStandardised definitionsContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican CollegeAssociation of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction
Shen YC, Krumholz H, Hsia RY. Association of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007195. PMID: 33641339, PMCID: PMC7969448, DOI: 10.1161/circoutcomes.120.007195.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionST-segment elevation myocardial infarction (STEMI) systemsSame-day percutaneous coronary interventionST-segment elevation myocardial infarctionSTEMI regionalizationLong-term mortalityOutcomes of patientsElevation myocardial infarctionPCI-capable hospitalsEmergency medical services agenciesMyocardial infarction systemLocal emergency medical services agenciesPoints greater reductionPercentage point decreasePCI capabilityCoronary interventionMyocardial infarctionAdministrative databasesPatientsSTEMIPoint decreaseMortalityTimely accessReadmissionGreater reduction180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart 2021, 8: e001442. PMID: 33452007, PMCID: PMC7813425, DOI: 10.1136/openhrt-2020-001442.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission risk modelSelf-reported health statusMyocardial infarctionFunctional mobilityOlder adultsHealth statusDays of AMIFirst diastolic blood pressureChronic obstructive pulmonary diseaseIschemic ECG changesProspective cohort studyDiastolic blood pressureObstructive pulmonary diseaseLength of stayInitial heart rateFinal risk modelSILVER-AMI StudyRisk modelInitial hemoglobinCohort studyReadmission ratesBlood pressureEjection fractionHeart failure
2020
Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceIntermediate versus standard-dose prophylactic anticoagulation and statin therapy versus placebo in critically-ill patients with COVID-19: Rationale and design of the INSPIRATION/INSPIRATION-S studies
Bikdeli B, Talasaz AH, Rashidi F, Sharif-Kashani B, Farrokhpour M, Bakhshandeh H, Sezavar H, Dabbagh A, Beigmohammadi MT, Payandemehr P, Yadollahzadeh M, Riahi T, Khalili H, Jamalkhani S, Rezaeifar P, Abedini A, Lookzadeh S, Shahmirzaei S, Tahamtan O, Matin S, Amin A, Parhizgar SE, Jimenez D, Gupta A, Madhavan MV, Parikh SA, Monreal M, Hadavand N, Hajighasemi A, Maleki M, Sadeghian S, Mohebbi B, Piazza G, Kirtane AJ, Lip GYH, Krumholz HM, Goldhaber SZ, Sadeghipour P. Intermediate versus standard-dose prophylactic anticoagulation and statin therapy versus placebo in critically-ill patients with COVID-19: Rationale and design of the INSPIRATION/INSPIRATION-S studies. Thrombosis Research 2020, 196: 382-394. PMID: 32992075, PMCID: PMC7513771, DOI: 10.1016/j.thromres.2020.09.027.Peer-Reviewed Original ResearchConceptsStandard-dose prophylactic anticoagulationKey safety endpointIll patientsProphylactic anticoagulationVenous thromboembolismMajor bleedingSafety endpointCOVID-19Bleeding Academic Research Consortium definitionAcademic Research Consortium definitionsTimes upper normal limitAcute arterial thrombosisExuberant immune responseMacrovascular thrombotic eventsPrespecified secondary analysisCritically Ill PatientsKey secondary endpointVentilator-free daysExtracorporeal membrane oxygenationUpper normal limitNon-inferiority marginReverse transcription-polymerase chain reactionCoronavirus disease 2019Transcription-polymerase chain reactionAtorvastatin 20Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
Li SX, Wang Y, Lama SD, Schwartz J, Herrin J, Mei H, Lin Z, Bernheim SM, Spivack S, Krumholz HM, Suter LG. Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data. BMC Health Services Research 2020, 20: 733. PMID: 32778098, PMCID: PMC7416804, DOI: 10.1186/s12913-020-05611-w.Peer-Reviewed Original ResearchRates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction
Caraballo C, Khera R, Jones PG, Decker C, Schulz W, Spertus JA, Krumholz HM. Rates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006231. PMID: 32552061, PMCID: PMC9465954, DOI: 10.1161/circoutcomes.119.006231.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHospitalization eventsMedical recordsLongitudinal multicenter cohort studyMulticenter cohort studyMedical record abstractionDifferent patient characteristicsHealth care eventsPatients' underreportingTRIUMPH registryAccuracy of reportingCohort studyPatient characteristicsRecord abstractionProspective studyClinical studiesClinical investigationHospitalizationPatientsCare eventsInfarctionEvent ratesParticipantsPredictorsAgile Health Care Analytics: Enabling Real-Time Disease Surveillance With a Computational Health Platform
Schulz WL, Durant T, Torre CJ, Hsiao AL, Krumholz HM. Agile Health Care Analytics: Enabling Real-Time Disease Surveillance With a Computational Health Platform. Journal Of Medical Internet Research 2020, 22: e18707. PMID: 32442130, PMCID: PMC7257473, DOI: 10.2196/18707.Peer-Reviewed Original ResearchConceptsReal-time dataHealth information technologyReal-world dataHealth platformInformation technologyCombination of technologiesReal timeSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Timely informationRespiratory syndrome coronavirus 2PlatformRespiratory tract infectionsSyndrome coronavirus 2Health care systemTract infectionsCoronavirus disease (COVID-19) outbreakIncident casesCoronavirus 2Novel applicationTechnologyAnalyticsHealth systemCare systemSpecific pathogensRelevance of Cardiac Surgery Outcome Reporting 3 Years Later in a New York and California Statewide Analysis
Mori M, Shahian DM, Suter LG, Geirsson A, Lin Z, Krumholz HM. Relevance of Cardiac Surgery Outcome Reporting 3 Years Later in a New York and California Statewide Analysis. JAMA Surgery 2020, 155: 442-444. PMID: 32129801, PMCID: PMC7057169, DOI: 10.1001/jamasurg.2019.6367.Peer-Reviewed Original ResearchLeveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
Lu Y, Huang C, Mahajan S, Schulz WL, Nasir K, Spatz ES, Krumholz HM. Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure. Journal Of The American Heart Association 2020, 9: e015033. PMID: 32200730, PMCID: PMC7428633, DOI: 10.1161/jaha.119.015033.Peer-Reviewed Original ResearchConceptsDiastolic blood pressureSystolic blood pressureElevated blood pressureBlood pressureElectronic health recordsPopulation health surveillanceHealth recordsYale New Haven Health SystemHealth surveillanceHealth systemPatterns of patientsLarge health systemUsual careOutpatient encountersControl ratePatientsCare patternsPopulation healthMonthsHgSurveillancePrevalenceRecordsVisitsCare