Featured Publications
Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia
Safdar B, Guo X, Johnson C, D'Onofrio G, Dziura J, Sinusas AJ, Testani J, Rao V, Desir G. Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia. International Journal Of Cardiology 2019, 279: 155-161. PMID: 30630613, PMCID: PMC6482834, DOI: 10.1016/j.ijcard.2018.12.061.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionFramingham risk scorePET/CTChest painInflammatory markersMicrovascular dysfunctionEmergency departmentRisk scoreRb-82 PET/CTElevated renalase levelsAcute chest painCoronary artery diseaseC-reactive proteinVascular endothelial growth factorAnti-inflammatory proteinTumor necrosis factorEndothelial growth factorAngina historyCMD diagnosisRenalase levelsHypertensive crisisED presentationsHemodynamic instabilityArtery diseaseHeart failureCurrent Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians
Madsen TE, Linden JA, Rounds K, Hsieh Y, Lopez BL, Boatright D, Garg N, Heron SL, Jameson A, Kass D, Lall MD, Melendez AM, Scheulen JJ, Sethuraman KN, Westafer LM, Safdar B. Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians. Academic Emergency Medicine 2017, 24: 1182-1192. PMID: 28779488, DOI: 10.1111/acem.13269.Peer-Reviewed Original ResearchConceptsClinical hoursRacial/Ethnic DisparitiesAcademic emergency departmentEmergency medicine physiciansAcademy of AdministratorsEmergency medicine workforceEmergency departmentWhite raceMedicine physiciansResponse rateUnknown raceEthnic disparitiesAsian IndiansAcademic Emergency Medicine PhysiciansFellowship trainingClinical commitmentsWomenYears of experienceMenBoard certificationCurrent statusMean salaryGenderNonwhitesHoursPrevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Prevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department. European Heart Journal Acute Cardiovascular Care 2018, 9: 5-13. PMID: 29543037, DOI: 10.1177/2048872618764418.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary artery diseaseCardiac positron emission tomography/Positron emission tomography/Chest pain patientsArtery diseaseAcute myocardial infarctionEmission tomography/Chest painMyocardial infarctionMicrovascular dysfunctionPain patientsEmergency departmentTomography/General emergency department populationLower coronary flow reserveNon-obstructive coronary arteriesPrior emergency department visitsTraditional cardiac risk factorsCardiac risk factorsModerate-risk patientsEmergency department visitsEmergency department patientsCoronary flow reserveEmergency department populationIdentifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation
Safdar B, Ong P, Camici PG. Identifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation. Clinical Therapeutics 2018, 40: 1920-1930. PMID: 30458932, DOI: 10.1016/j.clinthera.2018.09.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent chest painCoronary microvascular dysfunctionChest painEmergency departmentHs-TnTMicrovascular dysfunctionMyocardial ischemiaAcute chest pain evaluationHigh-sensitivity troponin TDiagnosis of AMIType 2 acute myocardial infarctionElevated hs-TnTIschemia/necrosisChest pain evaluationGroup of patientsAssessment of symptomsIdentification of patientsAppropriate medical treatmentSex-specific thresholdsPulmonary embolismVasomotor disordersAortic dissectionPain evaluationEpicardial coronaries
2024
Interim Effectiveness of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years — VISION and IVY Networks, September 2023–January 2024
DeCuir J, Payne A, Self W, Rowley E, Dascomb K, DeSilva M, Irving S, Grannis S, Ong T, Klein N, Weber Z, Reese S, Ball S, Barron M, Naleway A, Dixon B, Essien I, Bride D, Natarajan K, Fireman B, Shah A, Okwuazi E, Wiegand R, Zhu Y, Lauring A, Martin E, Gaglani M, Peltan I, Brown S, Ginde A, Mohr N, Gibbs K, Hager D, Prekker M, Mohamed A, Srinivasan V, Steingrub J, Khan A, Busse L, Duggal A, Wilson J, Chang S, Mallow C, Kwon J, Exline M, Columbus C, Vaughn I, Safdar B, Mosier J, Harris E, Casey J, Chappell J, Grijalva C, Swan S, Johnson C, Lewis N, Ellington S, Adams K, Tenforde M, Paden C, Dawood F, Fleming-Dutra K, Surie D, Link-Gelles R, Collaborators C, Collaborators C, Ghamande S, Gottlieb R, McNeal T, Raver C, Bender W, Fletcher L, Heaton P, Kane S, McEvoy C, Thapa S, Vazquez-Benitez G, Frosch A, Lamerato L, Ramesh M, Arnofer J, Ali H, Hopkins J, Crane B, Dandamudi P, Goddard K, Hansen J, Timbol J, Zerbo O, Allen K, Duszynski T, Fadel W, Rogerson C, Qadir N, Chavez C, Doyle B, Mayer D, Rao S, Rivas C, Johnson N, Baughman A, Lwin C, Rhoads J, Womack K, Dunne M, Ciesla A, Mak J, Najdowski M, Ray C. Interim Effectiveness of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years — VISION and IVY Networks, September 2023–January 2024. MMWR Morbidity And Mortality Weekly Report 2024, 73: 180-188. PMID: 38421945, PMCID: PMC10907041, DOI: 10.15585/mmwr.mm7308a5.Peer-Reviewed Original ResearchConceptsVaccine effectivenessEmergency departmentCOVID-19 vaccineCDC's Advisory CommitteeCOVID-19-associated hospitalizationUrgent careCOVID-19 vaccine dosesImmunocompetent adultsMedian intervalCase-control designVE estimatesVaccine doseImmunization PracticesTest-negativeSevere diseaseCDC recommendationsDoseVaccineHospitalVE networkCOVID-19CDCMonthsAdvisory CommitteeDays
2023
Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation index
2022
Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain
Banco D, Chang J, Talmor N, Wadhera P, Mukhopadhyay A, Lu X, Dong S, Lu Y, Betensky RA, Blecker S, Safdar B, Reynolds HR. Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain. Journal Of The American Heart Association 2022, 11: e024199. PMID: 35506534, PMCID: PMC9238573, DOI: 10.1161/jaha.121.024199.Peer-Reviewed Original ResearchConceptsChest painAcute myocardial infarctionEmergency departmentMultivariable adjustmentYoung adultsMyocardial infarctionBackground Acute myocardial infarctionRacial differencesCardiac biomarker testingHospital admissionClinical featuresConclusions WomenPhysician evaluationTriage levelBiomarker testingCardiac biomarkersWhite adultsNational estimatesObservation unitCP managementAdultsSurvey 2014WomenPainInfarction
2020
National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare Survey
2017
Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial. Clinical Therapeutics 2017, 39: 55-63. PMID: 28081848, PMCID: PMC10345862, DOI: 10.1016/j.clinthera.2016.12.002.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveCoronary artery diseaseChest painSymptomatic patientsArtery diseasePrimary outcomeEmergency departmentNonobstructive coronary artery diseaseRb-82 positron emission tomographyEffect of ranolazineRate-pressure productEmergency department patientsQTc-prolonging drugsRobust clinical trialsPositron emission tomographyHypertensive urgencyMicrovascular anginaMicrovascular dysfunctionUnderdiagnosed causeControlled TrialsDepartment patientsHeart failureAcute symptomsPressure product
2016
Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department.
Safdar B, D'Onofrio G. Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department. The Yale Journal Of Biology And Medicine 2016, 89: 227-38. PMID: 27354848, PMCID: PMC4918863.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseAcute coronary syndromeChest painEmergency departmentMicrovascular dysfunctionED patientsCoronary artery endothelial dysfunctionCause of anginaCoronary artery dissectionCoronary artery spasmPersistent chest painRecurrent chest painSex-specific causesQuality of lifeArtery spasmArtery dissectionCoronary syndromeEndothelial dysfunctionMyocardial bridgingArtery diseasePoor functionCardinal symptomsAnginaPainPatients
2013
Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women
Diercks DB, Mumma BE, Peacock W, Hollander JE, Safdar B, Mahler SA, Miller CD, Counselman FL, Birkhahn R, Schrock J, Singer AJ, Nagurney JT. Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women. Academic Emergency Medicine 2013, 20: 265-270. PMID: 23517258, PMCID: PMC3725334, DOI: 10.1111/acem.12092.Peer-Reviewed Original ResearchConceptsObjective cardiac testingPhysician risk assessmentAcute myocardial infarctionAcute coronary syndromeCardiac testingNon-high riskNet reclassification indexChest painTroponin IEmergency departmentReclassification indexPresence of ACSAcute coronary syndrome studyMedian age 58 yearsNegative troponin ISerial cardiac markersSerial troponin IAge 58 yearsIncremental valueReceiver operator characteristic curveContemporary troponin assaysClinician risk assessmentOperator characteristic curveReclassified patientsCoronary syndrome
2012
Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain
Diercks DB, Peacock WF, Hollander JE, Singer AJ, Birkhahn R, Shapiro N, Glynn T, Nowack R, Safdar B, Miller CD, Lewandrowski E, Nagurney JT. Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain. American Heart Journal 2012, 163: 74-80.e4. PMID: 22172439, DOI: 10.1016/j.ahj.2011.09.028.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCare troponin IAcute coronary syndromeSymptom onsetMyocardial infarctionDiagnostic accuracyCoronary syndromeEmergency departmentSerial testingAmerican Heart Association/American CollegeTroponin ICriterion standard diagnosisInitial blood drawAvailable medical recordsCardiac marker testingPositive likelihood ratioSimilar diagnostic accuracyNegative likelihood ratioInvestigational markersIschemia evaluationCardiology criteriaChest painLikelihood ratioMedian ageMedian time
2011
Inclusion of Gender in Emergency Medicine Research
Safdar B, McGregor AJ, McKee SA, Ali A, Radulescu R, Himelfarb NT, Klein MR, Mazure CM. Inclusion of Gender in Emergency Medicine Research. Academic Emergency Medicine 2011, 18: e1-e4. PMID: 21314767, DOI: 10.1111/j.1553-2712.2010.00978.x.Peer-Reviewed Original ResearchConceptsHealth outcomesEmergency departmentOdds ratioEmergency medicineConfidence intervalsEffect of genderPrimary hypothesisEmergency medical servicesGender-specific approachEmergency medicine researchAcute settingAdult human subjectsCardiovascular diseaseEmergency physiciansEmergency careManagement of diseasesStudy subjectsClinical specialistsPatient careStudy designStudy periodChi-squareMedical servicesOutcomesHuman subjects
2009
Improvements in Time to Reperfusion
Rao V, Safdar B, Parkosewich J, Lee LV, D'Onofrio G, Foody JM. Improvements in Time to Reperfusion. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2009, 8: 38-42. PMID: 19258837, DOI: 10.1097/hpc.0b013e318194e443.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngioplasty, Balloon, CoronaryCohort StudiesElectrocardiographyEmergency Service, HospitalEmergency TreatmentFemaleHospitals, TeachingHumansIncidenceMaleMiddle AgedMyocardial InfarctionPrognosisRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsSurvival AnalysisTime FactorsTreatment OutcomeUrban HealthConceptsPrimary percutaneous coronary interventionST-elevation myocardial infarctionYale-New Haven HospitalPrimary PCIChart-abstracted dataPercutaneous coronary interventionUrban teaching hospitalQuality of carePhysician-level interventionsSingle-site studyChest painCoronary interventionHospital-wide systemPhysician awarenessEmergency departmentMyocardial infarctionHeart diseaseSTEMI careImproved outcomesTeaching hospitalEarly presentationReperfusionTimely managementClinical initiativesWomen
2006
405 Impact of Patient Gender on Pain Management Practices in the Emergency Department: A Multi-Center Study
Safdar B, Choiniere M, Crandall C, Ducharme J, Fosnocht D, Homel P, Tanabe P, Todd K. 405 Impact of Patient Gender on Pain Management Practices in the Emergency Department: A Multi-Center Study. Annals Of Emergency Medicine 2006, 48: 121. DOI: 10.1016/j.annemergmed.2006.07.874.Peer-Reviewed Original Research