Featured Publications
Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images
Sangha V, Nargesi A, Dhingra L, Khunte A, Mortazavi B, Ribeiro A, Banina E, Adeola O, Garg N, Brandt C, Miller E, Ribeiro A, Velazquez E, Giatti L, Barreto S, Foppa M, Yuan N, Ouyang D, Krumholz H, Khera R. Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images. Circulation 2023, 148: 765-777. PMID: 37489538, PMCID: PMC10982757, DOI: 10.1161/circulationaha.122.062646.Peer-Reviewed Original ResearchConceptsLV systolic dysfunctionYale-New Haven HospitalVentricular systolic dysfunctionSystolic dysfunctionLV ejection fractionBrazilian Longitudinal StudyNew Haven HospitalEjection fractionCardiology clinicRegional hospitalLeft ventricular systolic dysfunctionCedars-Sinai Medical CenterAdult Health (ELSA-Brasil) cohort
2024
Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study
McIntyre D, Quintans D, Kazi S, Min H, He W, Marschner S, Khera R, Nassar N, Chow C. Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study. BMC Health Services Research 2024, 24: 1364. PMID: 39516863, PMCID: PMC11545568, DOI: 10.1186/s12913-024-11840-0.Peer-Reviewed Original ResearchConceptsHeart failure careNew South WalesHospital admissionHealth service utilisationAdministrative health recordsPrimary diagnosis of heart failureData cohort studyRate of admissionPre-pandemicHealth of patientsSouth WalesCOVID-19 pandemicHospital utilisationService utilisationHealth recordsED presentationsMortality dataDiagnosis of heart failureCOVID-19 burdenEmergency departmentCohort studyPrimary diagnosisData collectionCareAustralian dataRacial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageCause-Specific Mortality Rates Among the US Black Population
Arun A, Caraballo C, Sawano M, Lu Y, Khera R, Yancy C, Krumholz H. Cause-Specific Mortality Rates Among the US Black Population. JAMA Network Open 2024, 7: e2436402. PMID: 39348122, PMCID: PMC11443349, DOI: 10.1001/jamanetworkopen.2024.36402.Commentaries, Editorials and LettersPerformance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study
Camargos A, Barreto S, Brant L, Ribeiro A, Dhingra L, Aminorroaya A, Bittencourt M, Figueiredo R, Khera R. Performance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study. Open Heart 2024, 11: e002762. PMID: 38862252, PMCID: PMC11168182, DOI: 10.1136/openhrt-2024-002762.Peer-Reviewed Original ResearchConceptsPooled Cohort EquationsELSA-BrasilRisk scoreCardiovascular diseaseCVD eventsCommunity-based cohort studyArea under the receiver operating characteristic curveCVD risk scoreELSA-Brasil studyIncident CVD eventsMiddle-income countriesAdjudicated CVD eventsCardiovascular disease riskCVD scoreCohort EquationsNational guidelinesRisk stratification scoresWhite womenAge/sex groupsCohort studyProspective cohortLMICsSex/race groupsHigher incomeRisk discrimination
2023
Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020
Dhingra L, Aminorroaya A, Oikonomou E, Nargesi A, Wilson F, Krumholz H, Khera R. Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020. JAMA Network Open 2023, 6: e2316634. PMID: 37285157, PMCID: PMC10248745, DOI: 10.1001/jamanetworkopen.2023.16634.Peer-Reviewed Original ResearchConceptsHealth Information National Trends SurveyUS adultsExacerbate disparitiesWearable device usersCardiovascular diseaseCardiovascular healthPopulation-based cross-sectional studySelf-reported cardiovascular diseaseCardiovascular disease risk factorsNational Trends SurveyOverall US adult populationCardiovascular risk factor profileSelf-reported accessAssociated with lower useUse of wearable devicesImprove cardiovascular healthLower household incomeLower educational attainmentUS adult populationRisk factor profileNationally representative sampleCross-sectional studyProportion of adultsTrends SurveyWearable device dataNonexercise machine learning models for maximal oxygen uptake prediction in national population surveys.
Liu Y, Herrin J, Huang C, Khera R, Dhingra L, Dong W, Mortazavi B, Krumholz H, Lu Y. Nonexercise machine learning models for maximal oxygen uptake prediction in national population surveys. Journal Of The American Medical Informatics Association 2023, 30: 943-952. PMID: 36905605, PMCID: PMC10114129, DOI: 10.1093/jamia/ocad035.Peer-Reviewed Original ResearchQuantifying 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 models
2022
Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest
Wheelock K, Chan P, Chen L, de Lemos J, Miller P, Nallamothu B, Girotra S, Khera R. Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest. Resuscitation 2022, 182: 109650. PMID: 36442596, PMCID: PMC9885789, DOI: 10.1016/j.resuscitation.2022.11.016.Peer-Reviewed Original ResearchConceptsFavorable neurologic outcomeHospital cardiac arrestTherapeutic rangeNeurologic outcomeOverall survivalTemperature managementCardiac arrestFavorable neurologic survivalFavorable neurological outcomeRetrospective cohort studyTargeted temperature managementHigh therapeutic rangeRisk-adjusted analysisComatose survivorsNeurologic survivalNeurological outcomeCohort studyHospital dischargeMedian durationMedian timeCurrent guidelinesCompression trialTreatment targetsSignificant associationGoal temperatureContemporary National Patterns of Eligibility and Use of Novel Lipid‐Lowering Therapies in the United States
Shen M, Nargesi A, Nasir K, Bhatt DL, Khera R. Contemporary National Patterns of Eligibility and Use of Novel Lipid‐Lowering Therapies in the United States. Journal Of The American Heart Association 2022, 11: e026075. PMID: 36102276, PMCID: PMC9683659, DOI: 10.1161/jaha.122.026075.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyIcosapent ethylCardiology/American Heart Association (ACC/AHA) guideline recommendationsNutrition Examination Survey dataAddition of ezetimibeUse of statinsClinical practice guidelinesCurrent statin usePopulation health outcomesConclusions SixCardiovascular outcomesStatin useClinical profileGuideline recommendationsLipid profileNational HealthPCSK9iNovel therapiesNovel agentsPractice guidelinesUS adultsAmerican CollegeStatinsHealth outcomesTherapyMeasures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US
Wang SY, Valero-Elizondo J, Cainzos-Achirica M, Desai NR, Nasir K, Khera R. Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US. JAMA Health Forum 2022, 3: e221962. PMID: 35977226, PMCID: PMC9308060, DOI: 10.1001/jamahealthforum.2022.1962.Peer-Reviewed Original ResearchConceptsFinancial hardshipFinancial burdenPocket medical expensesMedical Expenditure Panel SurveyHealth care expensesHigher incomePanel SurveyHealth careCare expensesFinancial consequencesHealth care costsForgone carePublic insuranceMedical billsSubstantial financial burdenMedical expensesIncomeDisparate measuresHardshipCare costsRepresentative surveySubjective measuresComprehensive frameworkExpenseInsuranceLarge-scale evidence generation and evaluation across a network of databases for type 2 diabetes mellitus (LEGEND-T2DM): a protocol for a series of multinational, real-world comparative cardiovascular effectiveness and safety studies
Khera R, Schuemie MJ, Lu Y, Ostropolets A, Chen R, Hripcsak G, Ryan PB, Krumholz HM, Suchard MA. Large-scale evidence generation and evaluation across a network of databases for type 2 diabetes mellitus (LEGEND-T2DM): a protocol for a series of multinational, real-world comparative cardiovascular effectiveness and safety studies. BMJ Open 2022, 12: e057977. PMID: 35680274, PMCID: PMC9185490, DOI: 10.1136/bmjopen-2021-057977.Peer-Reviewed Original ResearchConceptsLarge-scale Evidence GenerationType 2 diabetes mellitusCardiovascular effectivenessDiabetes mellitusSafety outcomesGlucagon-like peptide-1 receptor agonistsSodium-glucose co-transporter-2 inhibitorsMajor adverse cardiovascular eventsNew-user cohort designPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsSafety studiesAdverse cardiovascular eventsPrimary cardiovascular outcomePeptidase-4 inhibitorsAnti-hyperglycaemic agentsElectronic health record data sourcesEvidence generationCardiovascular eventsCardiovascular outcomesCardiovascular riskActive comparatorTherapeutic optionsReceptor agonistDrug comparisonsRural-Urban Disparities in Heart Failure and Acute Myocardial Infarction Hospitalizations
Minhas AMK, Sheikh AB, Ijaz SH, Mostafa A, Nazir S, Khera R, Loccoh EC, Warraich HJ. Rural-Urban Disparities in Heart Failure and Acute Myocardial Infarction Hospitalizations. The American Journal Of Cardiology 2022, 175: 164-169. PMID: 35577603, DOI: 10.1016/j.amjcard.2022.04.014.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospital mortalityUrban hospitalRural hospitalsInflation-adjusted costStudy periodAMI hospitalizationMortality gapNational Inpatient SampleLength of stayAcute myocardial infarction hospitalizationsShorter mean lengthMyocardial infarction hospitalizationsHF hospitalizationCardiovascular outcomesClinical outcomesConsistent decreaseMyocardial infarctionInpatient SampleRural-urban disparitiesCardiovascular careHospitalizationHospitalMean lengthCost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018.
Taha MB, Valero-Elizondo J, Yahya T, Caraballo C, Khera R, Patel KV, Ali HJR, Sharma G, Mossialos E, Cainzos-Achirica M, Nasir K. Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018. Diabetes Care 2022, 45: 594-603. PMID: 35015860, DOI: 10.2337/dc21-1757.Peer-Reviewed Original ResearchConceptsCost-related medication nonadherenceNational Health Interview SurveyLack of insuranceMedication nonadherenceNational Health Interview Survey 2013Duration of diabetesHigher comorbidity burdenSelf-reported diabetesHealth Interview SurveyWorse health outcomesHealth-related expendituresComorbidity burdenInsulin useCurrent smokingLess medicationMedication adherenceFemale sexWeighted prevalenceHigher oddsAge subgroupsSkipping dosesDiabetesHealth outcomesElderly adultsNHIS participants
2021
Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States
Lago‐Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States. Hepatology 2021, 74: 1509-1522. PMID: 33772833, DOI: 10.1002/hep.31835.Peer-Reviewed Original ResearchConceptsChronic liver diseaseScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsFinancial Hardship Among Nonelderly Adults With CKD in the United States
Acquah I, Valero-Elizondo J, Javed Z, Ibrahim HN, Patel KV, Ryoo Ali HJ, Menser T, Khera R, Cainzos-Achirica M, Nasir K. Financial Hardship Among Nonelderly Adults With CKD in the United States. American Journal Of Kidney Diseases 2021, 78: 658-668. PMID: 34144103, DOI: 10.1053/j.ajkd.2021.04.011.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseLack of insuranceMedical billsDiagnosis of CKDMultivariable logistic regression modelNational Health Interview SurveyHealth Interview SurveyFinancial hardshipLogistic regression modelsClinical characteristicsClinical factorsCKD diagnosisKidney diseaseUS populationAbstractTextStudy designInterview SurveyRepresentative estimatesDiagnosisRegression modelsRepresentative sampleAdultsOutcomesStrong determinantAMPCost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases
Lago-Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Cost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases. Mayo Clinic Proceedings 2021, 96: 2639-2650. PMID: 34120754, PMCID: PMC8492496, DOI: 10.1016/j.mayocp.2021.02.026.Peer-Reviewed Original ResearchAssociation of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19
Khera R, Clark C, Lu Y, Guo Y, Ren S, Truax B, Spatz ES, Murugiah K, Lin Z, Omer SB, Vojta D, Krumholz HM. Association of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19. Journal Of The American Heart Association 2021, 10: e018086. PMID: 33624516, PMCID: PMC8403305, DOI: 10.1161/jaha.120.018086.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersLower hospitalization riskACE inhibitorsCOVID-19 hospitalizationHospitalization riskHospital mortalityReceptor blockersValidation cohortAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionEnzyme inhibitorsSyndrome coronavirus 2 infectionAngiotensin converting enzyme (ACE) inhibitorsCoronavirus 2 infectionRisk of hospitalizationCoronavirus disease-19SARS-CoV-2COVID-19 preventionHypertensive patientsInpatient cohortOutpatient cohortContemporary cohortStudy cohortOutpatient studyMedicare group
2020
Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults
Mszar R, Mahajan S, Valero-Elizondo J, Yahya T, Sharma R, Grandhi GR, Khera R, Virani SS, Lichtman J, Khan SU, Cainzos-Achirica M, Vahidy FS, Krumholz HM, Nasir K. Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults. Stroke 2020, 51: 3552-3561. PMID: 33100188, DOI: 10.1161/strokeaha.120.031137.Peer-Reviewed Original ResearchConceptsNational Health Interview SurveyCommon stroke symptomsStroke symptomsHealth Interview SurveyYoung adultsUS young adultsSymptom awarenessFocused public health interventionsInterview SurveyStroke symptom awarenessHigh-risk characteristicsPublic health interventionsArms/legsCertain sociodemographic subgroupsLow education levelStroke incidenceSevere headacheSingle symptomStudy populationTimely diagnosisHigher oddsStroke rateHispanic ethnicityGeneral populationSociodemographic determinants