2022
Performance of current risk stratification models for predicting mortality in patients with heart failure: a systematic review and meta-analysis
Siddiqi TJ, Ahmed A, Greene SJ, Shahid I, Usman MS, Oshunbade A, Alkhouli M, Hall ME, Murad MH, Khera R, Jain V, Van Spall HGC, Khan MS. Performance of current risk stratification models for predicting mortality in patients with heart failure: a systematic review and meta-analysis. European Journal Of Preventive Cardiology 2022, 29: 2027-2048. PMID: 35919956, DOI: 10.1093/eurjpc/zwac148.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic heart failureLong-term mortalityMid-term mortalityAcute HFHeart failureRisk scoreGeneric inverse variance random effects modelInverse variance random-effects modelCurrent risk stratification modelsExcellent discriminationAcute heart failureRisk stratification modelShort-term mortalityLack of headRandom-effects modelGood discriminationAHF mortalityCause mortalityC-statisticNineteen studiesPatientsMortality predictionSystematic reviewHead comparisonMortalityRural-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 ResearchMeSH KeywordsAdultHeart FailureHospital MortalityHospitalizationHospitals, RuralHumansMyocardial InfarctionUnited StatesConceptsAcute 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 length
2021
Association of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes
Khera R, Liu Y, de Lemos JA, Das SR, Pandey A, Omar W, Kumbhani DJ, Girotra S, Yeh RW, Rutan C, Walchok J, Lin Z, Bradley SM, Velazquez EJ, Churchwell KB, Nallamothu BK, Krumholz HM, Curtis JP. Association of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes. The American Journal Of Medicine 2021, 134: 1380-1388.e3. PMID: 34343515, PMCID: PMC8325555, DOI: 10.1016/j.amjmed.2021.06.034.Peer-Reviewed Original ResearchConceptsCOVID-19 hospitalizationHospitalization volumeAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCase volumeUS hospitalsCoronavirus disease 2019 (COVID-19) hospitalizationIntensive care unit therapyHospital case fatality ratePoor COVID-19 outcomesCardiovascular Disease RegistryHospital case volumeCase fatality rateCOVID-19 outcomesHospital bed capacityLowest quartilePatient outcomesHospital careHigher oddsTriage strategiesFuture health challengesDisease RegistryMedical treatmentEarly identificationHospitalSignificant associationUse of Machine Learning Models to Predict Death After Acute Myocardial Infarction
Khera R, Haimovich J, Hurley NC, McNamara R, Spertus JA, Desai N, Rumsfeld JS, Masoudi FA, Huang C, Normand SL, Mortazavi BJ, Krumholz HM. Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction. JAMA Cardiology 2021, 6: 633-641. PMID: 33688915, PMCID: PMC7948114, DOI: 10.1001/jamacardio.2021.0122.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesFemaleHospital MortalityHumansMachine LearningMaleMyocardial InfarctionRegistriesRisk AssessmentUnited StatesConceptsMachine learning modelsMeta-classifier modelLearning modelNeural networkGradient descent boostingAcute myocardial infarctionContemporary machineGradient descentXGBoost modelXGBoostHospital mortalityCohort studyLogistic regressionMyocardial infarctionNetworkChest Pain-MI RegistryPrecise classificationIndependent validation dataInitial laboratory valuesNovel methodLarge national registryHigh-risk individualsData analysisValidation dataResolution of riskElectronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit
Kunitomo Y, Thomas A, Chouairi F, Canavan ME, Kochar A, Khera R, Katz JN, Murphy C, Jentzer J, Ahmad T, Desai NR, Brennan J, Miller PE. Electronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit. American Heart Journal 2021, 238: 85-88. PMID: 33891906, DOI: 10.1016/j.ahj.2021.04.004.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitRothman IndexCare unitRisk scoreModern cardiac intensive care unitSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreElectronic health recordsCICU mortalityCICU patientsSOFA scoreCICU admissionClinical outcomesEarly prognosticationObservational studyPrognostic abilityAssessment scoresOutcome predictionHealth recordsGood calibrationSuperior discriminationPatientsAdmissionScoresAssociation 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
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 practice
2019
Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak association
2018
Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014
Rubens M, Saxena A, Ramamoorthy V, Das S, Khera R, Hong J, Armaignac D, Veledar E, Nasir K, Gidel L. Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014. Journal Of Intensive Care Medicine 2018, 35: 858-868. PMID: 30175649, DOI: 10.1177/0885066618794136.Peer-Reviewed Original ResearchComparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation
Kumar N, Khera R, Fonarow GC, Bhatt DL. Comparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation. The American Journal Of Cardiology 2018, 122: 1520-1526. PMID: 30190074, DOI: 10.1016/j.amjcard.2018.07.025.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAge DistributionAged, 80 and overBlood TransfusionCohort StudiesDatabases, FactualFemaleHeart FailureHospital MortalityHumansLength of StayMalePacemaker, ArtificialPeripheral Vascular DiseasesPrevalencePropensity ScoreStrokeTranscatheter Aortic Valve ReplacementUnited StatesConceptsTranscatheter aortic valve implantationAcute kidney injuryTA-TAVI proceduresAortic valve implantationTF-TAVIHospital mortalityTA-TAVIPostoperative strokeTransapical approachValve implantationTAVI procedureTA TAVIReal-world patient populationTA-TAVI groupTF-TAVI groupPropensity-matched cohortPeripheral vascular diseasePropensity-matched pairsComparison of outcomesTF approachICD-9 procedureLower ratesTA approachKidney injuryBaseline characteristicsSex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSex
2017
Role of Hospital Volumes in Identifying Low-Performing and High-Performing Aortic and Mitral Valve Surgical Centers in the United States
Khera R, Pandey A, Koshy T, Ayers C, Nallamothu BK, Das SR, Drazner MH, Jessen ME, Kirtane AJ, Gardner TJ, de Lemos JA, Bhatt DL, Kumbhani DJ. Role of Hospital Volumes in Identifying Low-Performing and High-Performing Aortic and Mitral Valve Surgical Centers in the United States. JAMA Cardiology 2017, 2: 1322-1331. PMID: 29117319, PMCID: PMC5815001, DOI: 10.1001/jamacardio.2017.4003.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAortic ValveBayes TheoremCoronary Artery BypassDatabases, FactualFemaleHeart Valve Prosthesis ImplantationHospital Bed CapacityHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHospitals, TeachingHumansMaleMiddle AgedMitral ValveMitral Valve AnnuloplastyQuality of Health CareUnited StatesConceptsSurgical aortic valve replacementRisk-standardized mortality ratesMV replacementHospital procedure volumeMV repair proceduresHospital volumeSurgical proceduresProcedure volumeMitral Valve Surgical ProceduresHospital risk-standardized mortality ratesHigh-volume tertilesHospital surgical volumeMV surgical proceduresRisk-standardized outcomesAortic valve replacementCoronary artery bypassLow-volume hospitalsGood surgical outcomeMedian annual volumeRisk-adjusted outcomesLowest volume tertileHospital performanceRepair proceduresSAVR proceduresArtery bypassComparison of Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Chronic Kidney Disease
Kumar N, Khera R, Garg N, Echouffo-Tcheugui JB, Venkatraman A, Pandey A, Bhatt DL. Comparison of Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Chronic Kidney Disease. The American Journal Of Cardiology 2017, 121: 343-348. PMID: 29268936, DOI: 10.1016/j.amjcard.2017.10.029.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementTranscatheter aortic valve implantationDialysis-requiring acute kidney injuryAcute kidney injuryChronic kidney diseaseAortic valve replacementPostoperative strokeSAVR proceduresKidney diseaseHospital mortalityValve replacementTranscatheter Versus Surgical Aortic Valve ReplacementRate of AKIRetrospective cohort studySevere aortic stenosisCo-primary outcomesPropensity-matched pairsAortic valve implantationComparison of outcomesKidney injuryCohort studyValve implantationAortic stenosisMultivariate analysisPatients
2016
Variation in Hospital Use and Outcomes Associated With Pulmonary Artery Catheterization in Heart Failure in the United States
Khera R, Pandey A, Kumar N, Singh R, Bano S, Golwala H, Kumbhani DJ, Girotra S, Fonarow GC. Variation in Hospital Use and Outcomes Associated With Pulmonary Artery Catheterization in Heart Failure in the United States. Circulation Heart Failure 2016, 9: e003226. PMID: 27780836, PMCID: PMC5123800, DOI: 10.1161/circheartfailure.116.003226.Peer-Reviewed Original ResearchMeSH KeywordsAgedArrhythmias, CardiacCase-Control StudiesCatheterization, Swan-GanzCerebrovascular DisordersCoronary Artery DiseaseDatabases, FactualDisease ManagementFemaleHeart ArrestHeart FailureHospital MortalityHospitalsHumansLength of StayLogistic ModelsMaleMiddle AgedMyocardial InfarctionOdds RatioPractice Patterns, Physicians'Propensity ScoreShock, CardiogenicUnited StatesConceptsPA catheterizationHeart failureCatheter useHospital useDiseases-Ninth Revision codesPropensity-matched analysisPulmonary artery catheterPulmonary artery catheterizationHospital-level variabilityHF hospitalizationHospital mortalityArtery catheterArtery catheterizationNumber of hospitalsPA catheterRevision codesPatient outcomesAcademic hospitalExcess mortalityOdds ratioOutcomes AssociatedCatheterizationInternational ClassificationHospitalMortalityRacial Differences in Outcomes after Acute Ischemic Stroke Hospitalization in the United States
Kumar N, Khera R, Pandey A, Garg N. Racial Differences in Outcomes after Acute Ischemic Stroke Hospitalization in the United States. Journal Of Stroke And Cerebrovascular Diseases 2016, 25: 1970-1977. PMID: 27212273, DOI: 10.1016/j.jstrokecerebrovasdis.2016.03.049.Peer-Reviewed Original ResearchConceptsEndovascular mechanical thrombectomyLength of stayAcute ischemic stroke hospitalizationsIschemic stroke hospitalizationsInflation-adjusted chargesHospital mortalityIschemic strokeStroke hospitalizationsRacial differencesAverage LOSUtilization of thrombolysisAcute ischemic strokeNational Inpatient SampleHealth policy implicationsReperfusion therapyMechanical thrombectomySecondary outcomesStroke outcomePrimary outcomeClinical outcomesMean ageInpatient SamplePrimary diagnosisHospitalizationStrokeWeekend hospitalizations for acute aortic dissection have a higher risk of in-hospital mortality compared to weekday hospitalizations
Kumar N, Venkatraman A, Pandey A, Khera R, Garg N. Weekend hospitalizations for acute aortic dissection have a higher risk of in-hospital mortality compared to weekday hospitalizations. International Journal Of Cardiology 2016, 214: 448-450. PMID: 27093682, DOI: 10.1016/j.ijcard.2016.03.187.Peer-Reviewed Original ResearchResponse to “Higher mortality among males in takotsubo cardiomyopathy”
Khera R, Girotra S. Response to “Higher mortality among males in takotsubo cardiomyopathy”. American Heart Journal 2016, 176: e3. PMID: 27264234, DOI: 10.1016/j.ahj.2016.03.010.Commentaries, Editorials and Letters
2015
Trends in hospitalization for takotsubo cardiomyopathy in the United States
Khera R, Light-McGroary K, Zahr F, Horwitz PA, Girotra S. Trends in hospitalization for takotsubo cardiomyopathy in the United States. American Heart Journal 2015, 172: 53-63. PMID: 26856216, PMCID: PMC4748175, DOI: 10.1016/j.ahj.2015.10.022.Peer-Reviewed Original ResearchConceptsTakotsubo cardiomyopathyPrimary diagnosis groupCardiac arrestDiagnosis groupsHigh incidenceCardiogenic shockRespiratory failurePsychiatric disordersTransient left ventricular systolic dysfunctionLeft ventricular systolic dysfunctionNational Inpatient Sample dataCardiovascular risk factorsDiagnostic coronary angiographyVentricular systolic dysfunctionSecondary discharge diagnosisRisk of mortalityCost of careHospital mortalitySystolic dysfunctionCritical illnessCoronary angiographyDischarge diagnosisRisk factorsExcess mortalitySecondary groupUse of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States
Khera R, Cram P, Vaughan-Sarrazin M, Horwitz PA, Girotra S. Use of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States. The American Journal Of Cardiology 2015, 117: 10-16. PMID: 26547292, PMCID: PMC4690753, DOI: 10.1016/j.amjcard.2015.10.005.Peer-Reviewed Original ResearchConceptsPercutaneous ventricular assist devicePercutaneous coronary interventionIntraaortic balloon pumpMechanical circulatory supportHigh-risk percutaneous coronary interventionHospital mortalityIABP recipientsCoronary interventionCirculatory supportPropensity-matched analysisChronic kidney diseaseNinth Edition codesNational Inpatient SampleAcute myocardial infarctionVentricular assist deviceCardiogenic shockUnadjusted mortalityBalloon pumpHeart failureRandomized trialsEdition codesMechanical ventilationKidney diseaseMyocardial infarctionInpatient SampleLetter by Khera et al Regarding Article, “Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes
Khera R, Cram P, Girotra S. Letter by Khera et al Regarding Article, “Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes. Circulation 2015, 132: e35. PMID: 26240269, PMCID: PMC4617823, DOI: 10.1161/circulationaha.114.013342.Commentaries, Editorials and Letters