2024
Development and multinational validation of an algorithmic strategy for high Lp(a) screening
Aminorroaya A, Dhingra L, Oikonomou E, Saadatagah S, Thangaraj P, Vasisht Shankar S, Spatz E, Khera R. Development and multinational validation of an algorithmic strategy for high Lp(a) screening. Nature Cardiovascular Research 2024, 3: 558-566. PMID: 39195936, DOI: 10.1038/s44161-024-00469-1.Peer-Reviewed Original ResearchElectronic health recordsAssociated with premature atherosclerotic cardiovascular diseaseElevated Lp(aHealth recordsUK BiobankPremature atherosclerotic cardiovascular diseaseMachine learning modelsAtherosclerotic cardiovascular diseaseCohort studyReal-world settingsTargeted screeningCardiovascular diseaseLearning modelsNovel targeted therapeuticsAlgorithmic strategiesCohortProbability thresholdScreeningClinical featuresValidation cohortElevated lipoproteinRisk inspectionARICLp(a
2023
Validation of the European SCORE2 models in a Canadian primary care cohort
Sud M, Sivaswamy A, Austin P, Abdel-Qadir H, Anderson T, Khera R, Naimark D, Lee D, Roifman I, Thanassoulis G, Tu K, Wijeysundera H, Ko D. Validation of the European SCORE2 models in a Canadian primary care cohort. European Journal Of Preventive Cardiology 2023, 31: 668-676. PMID: 37946603, PMCID: PMC11025037, DOI: 10.1093/eurjpc/zwad352.Peer-Reviewed Original ResearchPrimary care cohortAtherosclerotic cardiovascular diseaseLow-risk regionsCare cohortC-statisticOlder personsElectronic medical record dataLarge Canadian cohortMedical record dataYears of ageYoung personASCVD riskCanadian cohortCardiovascular diseaseOlder womenIndividuals 70Age groupsSCORE2CohortRecord dataWomenMenRiskPersonsDisease
2022
Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey
Valero-Elizondo J, Javed Z, Khera R, Tano M, Dudum R, Acquah I, Hyder A, Andrieni J, Sharma G, Blaha M, Virani S, Blankstein R, Cainzos-Achirica M, Nasir K. Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey. Archives Of Public Health 2022, 80: 248. PMID: 36474300, PMCID: PMC9727868, DOI: 10.1186/s13690-022-00987-z.Peer-Reviewed Original ResearchFinancial toxicityEconomic stabilityNational Health Interview SurveyFood povertyCost-effective interventionHealth Interview SurveyCumulative social disadvantageMedical billsForegone careCost-related medicationComprehensive measureCardiovascular diseaseFinancial strainSocial determinantsInterview SurveyAtherosclerotic cardiovascular diseaseAge-stratified analysisNeighborhood conditionsDeterminantsSpecific social determinantsVulnerable groupsIncomeSDOH domainsHigh burdenHigher odds
2021
Patterns of Prescribing Sodium-Glucose Cotransporter-2 Inhibitors for Medicare Beneficiaries in the United States
Sangha V, Lipska K, Lin Z, Inzucchi SE, McGuire DK, Krumholz HM, Khera R. Patterns of Prescribing Sodium-Glucose Cotransporter-2 Inhibitors for Medicare Beneficiaries in the United States. Circulation Cardiovascular Quality And Outcomes 2021, 14: e008381. PMID: 34779654, PMCID: PMC9022137, DOI: 10.1161/circoutcomes.121.008381.Peer-Reviewed Original ResearchConceptsType 2 diabetesMedicare beneficiariesSodium-glucose cotransporter 2 inhibitorsLarge randomized clinical trialsMedicare Part D prescriber dataChronic kidney diseaseCotransporter 2 inhibitorsAtherosclerotic cardiovascular diseasePercent of cliniciansRandomized clinical trialsUS Medicare beneficiariesAdvanced practice providersCross-sectional studyKidney outcomesSGLT2i useSulfonylurea prescriptionUnique cliniciansCardiovascular deathMedication classesKidney diseaseLabel indicationsClinical trialsSGLT2iCardiovascular diseasePractice providersScope 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 subgroupsAtherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States
Valero-Elizondo J, Chouairi F, Khera R, Grandhi GR, Saxena A, Warraich HJ, Virani SS, Desai NR, Sasangohar F, Krumholz HM, Esnaola NF, Nasir K. Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States. JACC CardioOncology 2021, 3: 236-246. PMID: 34396329, PMCID: PMC8352280, DOI: 10.1016/j.jaccao.2021.02.006.Peer-Reviewed Original ResearchCost-related medication nonadherenceFinancial toxicityMedication nonadherenceNational Health Interview SurveyAtherosclerotic cardiovascular diseaseMedical billsHealth Interview SurveyCancer careASCVDCardiovascular diseaseHigh burdenHigher oddsElderly populationCancerInterview SurveyFood insecurityCareNonadherenceSignificant proportionAdultsToxicityHigh financial distressPatientsPrevalenceDiseaseContemporary 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 College
2020
Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index
Khera R, Pandey A, Ayers CR, Carnethon MR, Greenland P, Ndumele CE, Nambi V, Seliger SL, Chaves PHM, Safford MM, Cushman M, Xanthakis V, Ramachandran V, Mentz RJ, Correa A, Lloyd-Jones DM, Berry JD, de Lemos JA, Neeland IJ. Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index. JAMA Network Open 2020, 3: e2023242. PMID: 33119108, PMCID: PMC7596579, DOI: 10.1001/jamanetworkopen.2020.23242.Peer-Reviewed Original ResearchConceptsHigh-sensitivity C-reactive proteinPooled Cohort EquationsASCVD riskAtherosclerotic cardiovascular diseaseBody mass indexBMI categoriesCohort EquationsObesity categoriesCohort studySevere obesityWaist circumferenceBMI groupsMass indexUnderweight categoryAtherosclerotic cardiovascular disease riskMean baseline BMIRisk of ASCVDUsual clinical measuresCardiovascular disease riskC-reactive proteinPooled individual-level dataSevere obesity groupLongitudinal cohort studyNormal weight categoryAdults ages 40Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions
Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. Journal Of The American Heart Association 2020, 9: e017793. PMID: 32924728, PMCID: PMC7792407, DOI: 10.1161/jaha.120.017793.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAtherosclerotic cardiovascular diseaseFinancial toxicitySubstantial economic impactCost sharingHigh deductiblesNational expenditureEconomic impactPolicy circlesPocket costsFinancial impactHealthcare expendituresHealth careASCVD patientsWell tradeoffCardiovascular diseaseExpenditureNecessary medical careAssociation of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States
Grandhi GR, Valero-Elizondo J, Mszar R, Brandt EJ, Annapureddy A, Khera R, Saxena A, Virani SS, Blankstein R, Desai NR, Blaha MJ, Cheema FH, Vahidy FS, Nasir K. Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States. American Journal Of Preventive Cardiology 2020, 2: 100034. PMID: 34327457, PMCID: PMC8315456, DOI: 10.1016/j.ajpc.2020.100034.Peer-Reviewed Original ResearchAtherosclerotic cardiovascular diseaseCardiovascular risk factor profileCost-related barriersRisk factor profileNon-elderly adultsCRF profileLow prevalenceMedical billsFactor profileNational Health Interview SurveyHealth Interview SurveyLack of insuranceFinancial hardshipLogistic regression modelsLow incomeASCVD statusRisk factorsCardiovascular diseaseStudy populationLower oddsLower mortalityUninsured individualsLow burdenHealthcare expendituresPrevalenceCumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States
Mszar R, Grandhi GR, Valero‐Elizondo J, Caraballo C, Khera R, Desai N, Virani SS, Blankstein R, Blaha MJ, Nasir K. Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States. Journal Of The American Heart Association 2020, 9: e015523. PMID: 32394783, PMCID: PMC7660844, DOI: 10.1161/jaha.119.015523.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseDiabetes mellitusNon-elderly adultsMedical billsCardiovascular diseaseBackground Atherosclerotic cardiovascular diseaseNational Health Interview SurveyEffective public health policiesThird of deathsTreatment-related expensesHealth Interview SurveyHigher relative oddsLogistic regression analysisFinancial hardshipPublic health policyASCVD statusPatient populationStudy populationHigh riskRelative oddsWeighted populationCumulative burdenHealth policyInterview SurveyStrong association
2019
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017
Khera R, Valero-Elizondo J, Das SR, Virani SS, Kash BA, de Lemos JA, Krumholz HM, Nasir K. Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017. Circulation 2019, 140: 2067-2075. PMID: 31760784, DOI: 10.1161/circulationaha.119.041974.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseCost-related nonadherenceMedication nonadherenceCardiovascular diseaseHigher oddsHistory of ASCVDNational Health Interview SurveyCost-related medication nonadherenceHigher comorbidity burdenLong-term therapyLow-cost medicationsVulnerable patient groupHealth Interview SurveyLow family incomeASCVD morbidityComorbidity burdenEssential therapySecondary preventionLess medicationPatient groupFemale sexMedication fillsWorse outcomesPrescribed dosesDrug costs
2018
Association Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States
Annapureddy A, Valero-Elizondo J, Khera R, Grandhi GR, Spatz ES, Dreyer RP, Desai NR, Krumholz HM, Nasir K. Association Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e005180. PMID: 30571331, DOI: 10.1161/circoutcomes.118.005180.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseQuality of lifeCardiovascular diseaseMental healthFinancial burdenAssociation of Out-of-Pocket Annual Health Expenditures With Financial Hardship in Low-Income Adults With Atherosclerotic Cardiovascular Disease in the United States
Khera R, Valero-Elizondo J, Okunrintemi V, Saxena A, Das SR, de Lemos JA, Krumholz HM, Nasir K. Association of Out-of-Pocket Annual Health Expenditures With Financial Hardship in Low-Income Adults With Atherosclerotic Cardiovascular Disease in the United States. JAMA Cardiology 2018, 3: 729-738. PMID: 29971325, PMCID: PMC6143078, DOI: 10.1001/jamacardio.2018.1813.Peer-Reviewed Original ResearchConceptsCatastrophic financial burdenLow-income familiesPocket health care expensesHigh financial burdenMedical Expenditure Panel SurveyHealth care expensesFamily incomeFinancial burdenPanel SurveyHealth expensesMean annual family incomePocket expensesCare expensesFinancial hardshipAtherosclerotic cardiovascular diseaseLow incomePocket health expensesAssociation of OutAnnual family incomeFederal poverty limitHigh-income familiesAnnual health expenditureLow-income adultsInsurance premiumsHealth expenditure