2023
Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study
Bikdeli B, Muriel A, Wang Y, Piazza G, Khairani C, Rosovsky R, Mehdipoor G, O'Donoghue M, Madridano O, Lopez-Saez J, Mellado M, Brasero A, Grandone E, Spagnolo P, Lu Y, Bertoletti L, López-Jiménez L, Núñez M, Blanco-Molina Á, Gerhard-Herman M, Goldhaber S, Bates S, Jimenez D, Krumholz H, Monreal M. Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study. Seminars In Thrombosis And Hemostasis 2023, 49: 725-735. PMID: 36868268, DOI: 10.1055/s-0043-1764231.Peer-Reviewed Original ResearchConceptsOlder adultsClinical characteristicsRisk factorsElderly womenPE risk stratificationTransient provoking factorsRelevant clinical characteristicsSex differencesWarrants further investigationSex-related differencesSex-specific factorsClot burdenPE presentationChest painHormonal therapyHormone therapyPatient characteristicsPulmonary embolismYounger patientsAtherosclerotic diseaseRisk stratificationLung diseaseMedicare databaseProvoking factorsCardiovascular disease
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 hospitalsMortalityWomen
2021
Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a cross-sectional study
Huang X, Dhruva SS, Yuan X, Bai X, Lu Y, Yan X, Liu J, Li W, Hu D, Ji R, Gao M, Miao F, Li J, Ge J, Krumholz HM, Li J. Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a cross-sectional study. BMJ Open 2021, 11: e052946. PMID: 34732492, PMCID: PMC8572400, DOI: 10.1136/bmjopen-2021-052946.Peer-Reviewed Original ResearchConceptsSevere valvular heart diseaseValvular heart diseaseHigh operative riskRheumatic originValve interventionHospital outcomesOperative riskCommon etiologyPrimary diagnosisHeart diseaseSeverity of VHDTypes of VHDCommon valvular heart diseaseMultivariable logistic regression analysisDegenerative valvular heart diseaseOutcomes of patientsCross-sectional studyLogistic regression analysisTwo-stage random sampling designClinical characteristicsFrequent etiologyPredominant etiologyTricuspid regurgitationAdult patientsPatient characteristicsClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
McPadden J, Warner F, Young HP, Hurley NC, Pulk RA, Singh A, Durant TJS, Gong G, Desai N, Haimovich A, Taylor RA, Gunel M, Dela Cruz CS, Farhadian SF, Siner J, Villanueva M, Churchwell K, Hsiao A, Torre CJ, Velazquez EJ, Herbst RS, Iwasaki A, Ko AI, Mortazavi BJ, Krumholz HM, Schulz WL. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection. PLOS ONE 2021, 16: e0243291. PMID: 33788846, PMCID: PMC8011821, DOI: 10.1371/journal.pone.0243291.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionYale New Haven HealthSARS-CoV-2Hospital mortalityRisk of admissionMale sexRisk factorsSARS-CoV-2 testingInvasive mechanical ventilationSevere acute respiratory syndrome virusBurden of diseaseRT-PCR testingAcademic health systemDiverse patient populationsRespiratory syndrome virusEthnic groupsAdult patientsClinical characteristicsDischarge dispositionRespiratory supportPrimary outcomeTreatment guidelinesMechanical ventilationRetrospective studyPatient populationAssociation between antecedent statin use and decreased mortality in hospitalized patients with COVID-19
Gupta A, Madhavan MV, Poterucha TJ, DeFilippis EM, Hennessey JA, Redfors B, Eckhardt C, Bikdeli B, Platt J, Nalbandian A, Elias P, Cummings MJ, Nouri SN, Lawlor M, Ranard LS, Li J, Boyle C, Givens R, Brodie D, Krumholz HM, Stone GW, Sethi SS, Burkhoff D, Uriel N, Schwartz A, Leon MB, Kirtane AJ, Wan EY, Parikh SA. Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19. Nature Communications 2021, 12: 1325. PMID: 33637713, PMCID: PMC7910606, DOI: 10.1038/s41467-021-21553-1.Peer-Reviewed Original ResearchConceptsAcute respiratory distress syndromeStatin usePrimary endpointCOVID-19Multivariable logistic regression modelStudy periodLower inpatient mortalityPropensity-matched cohortRespiratory distress syndromeCoronavirus disease 2019Electronic medical recordsLogistic regression modelsPropensity-score matchingHospital mortalityHyperinflammatory stateOutpatient medicationsClinical characteristicsInpatient mortalityStatin usersThrombotic complicationsDistress syndromeHospitalized patientsMyocardial injuryMedical recordsRetrospective analysis
2019
Association of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study
Ding Q, Funk M, Spatz ES, Whittemore R, Lin H, Lipska KJ, Dreyer RP, Spertus JA, Krumholz HM. Association of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2019, 8: e010988. PMID: 31441351, PMCID: PMC6755841, DOI: 10.1161/jaha.118.010988.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsDiabetes MellitusFemaleHealth StatusHealth Status IndicatorsHumansMaleMental HealthMiddle AgedMyocardial InfarctionPatient Reported Outcome MeasuresPredictive Value of TestsPrevalencePrognosisQuality of LifeRecovery of FunctionRisk AssessmentRisk FactorsSex FactorsSpainTime FactorsUnited StatesYoung AdultConceptsAcute myocardial infarctionEuroQol visual analogue scaleSeattle Angina QuestionnaireDiabetes mellitusForm Health SurveyHealth status outcomesHealth statusVIRGO StudyAnalog scaleMyocardial infarctionHealth SurveyStatus outcomesYoung adultsSAQ angina frequencyCardiovascular risk factorsHealth status scoresRisk of mortalityWorse health statusPoor health statusQuality of lifeWorse anginaAngina QuestionnaireClinical characteristicsHealthcare useStatus scoreDisparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT
Shahu A, Herrin J, Dhruva SS, Desai NR, Davis BR, Krumholz HM, Spatz ES. Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT. Journal Of The American Heart Association 2019, 8: e012277. PMID: 31362591, PMCID: PMC6761647, DOI: 10.1161/jaha.119.012277.Peer-Reviewed Original ResearchConceptsBlood pressure controlLow-income sitesCardiovascular outcomesPressure controlALLHAT participantsPoor blood pressure controlEnd-stage renal diseaseHospitalization/mortalityAdverse cardiovascular eventsCardiovascular risk factorsWorse cardiovascular outcomesHigh blood pressureStandardized treatment protocolRandomized clinical trialsBackground Observational studiesLow socioeconomic statusHighest income quintileAngina hospitalizationCardiovascular eventsCause mortalityCoronary revascularizationClinical characteristicsBlood pressureRenal diseaseClinical outcomes
2018
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Graham GN, Jones PG, Chan PS, Arnold SV, Krumholz HM, Spertus JA. Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e184240. PMID: 30646346, PMCID: PMC6324589, DOI: 10.1001/jamanetworkopen.2018.4240.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsMortality rate differencesMortality ratePatient characteristicsMyocardial infarctionPropensity scoreAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registrySelf-identified black patientsObserved survival differencesNational Death IndexTime of admissionLower propensity scoreProspective registryClinical characteristicsCohort studyDeath IndexHighest quintileBlack raceC-statisticSurvival differencesWorse outcomesMAIN OUTCOMEPatientsPresentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusSex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study
Lu Y, Ding Q, Xu X, Spatz ES, Dreyer RP, D'Onofrio G, Caulfield M, Nasir K, Spertus JA, Krumholz HM. Sex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e008189. PMID: 29848494, PMCID: PMC6015388, DOI: 10.1161/jaha.117.008189.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status scoresArachidonic acidVIRGO StudyStatus scoreMyocardial infarctionHealth statusPoorer health status outcomesYoung menPatient-reported health statusYoung womenOmega-3 fatty acidsSex differencesPatient-reported outcomesFatty acidsHealth status outcomesCardiovascular outcomesClinical characteristicsAdjusted analysisAMI patientsRisk factorsUS adultsStatus outcomesOmega-3Women 1Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics
Gupta A, Barrabes JA, Strait K, Bueno H, Porta‐Sánchez A, Acosta‐Vélez J, Lidón R, Spatz E, Geda M, Dreyer RP, Lorenze N, Lichtman J, D'Onofrio G, Krumholz HM. Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics. Journal Of The American Heart Association 2018, 7: e007021. PMID: 29514807, PMCID: PMC5907538, DOI: 10.1161/jaha.117.007021.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetElectrocardiographyFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial ReperfusionPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsST-segment elevation myocardial infarctionElectrocardiographic characteristicsMyocardial infarctionReperfusion delayYounger patientsVentricular hypertrophyST elevationPrehospital ECGLateral leadsMultivariable logistic regression modelTimeliness of reperfusionVoltage criteriaElevation myocardial infarctionLeft ventricular hypertrophyAcute myocardial infarctionYears of ageLogistic regression modelsSex differencesClinical characteristicsCohort studyElectrocardiographic correlatesMultivariable analysisFemale sexSpanish hospitalsReperfusion guidelines
2016
Sex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction
Beckman AL, Bucholz EM, Zhang W, Xu X, Dreyer RP, Strait KM, Spertus JA, Krumholz HM, Spatz ES. Sex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction. Journal Of The American Heart Association 2016, 5: e003923. PMID: 27742618, PMCID: PMC5121496, DOI: 10.1161/jaha.116.003923.Peer-Reviewed Original ResearchMeSH KeywordsAdultAftercareDepressionDrug CostsFemaleHealth Services AccessibilityHumansIncomeLinear ModelsMaleMedication AdherenceMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient Health QuestionnaireProspective StudiesRecovery of FunctionSex FactorsSocioeconomic FactorsSpainUnited StatesConceptsAcute myocardial infarctionMyocardial infarctionFinancial barriersHealth status 12 monthsYoung adultsPost-AMI outcomesYear post-AMIYoung AMI patientsMultivariable linear regression modelsGreater depressive symptomatologyMental functional statusSex differencesClinical characteristicsYounger patientsAMI patientsPost-AMIFunctional statusWorse outcomesBaseline healthPsychosocial statusOutcomes 1Depressive symptomatologyPatientsMore womenHealth careHospital Phenotypes in the Management of Patients Admitted for Acute Myocardial Infarction
Xu X, Li SX, Lin H, Normand SL, Lagu T, Desai N, Duan M, Kroch EA, Krumholz HM. Hospital Phenotypes in the Management of Patients Admitted for Acute Myocardial Infarction. Medical Care 2016, 54: 929-936. PMID: 27261637, PMCID: PMC5305177, DOI: 10.1097/mlr.0000000000000571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPercutaneous coronary interventionICU admission rateICU admissionMyocardial infarctionAdmission ratesProcedure ratesIntensive care unit admissionHigher ICU admissionLower ICU admissionCare unit admissionCoronary artery bypassPatients' clinical characteristicsManagement of patientsOpen heart surgeryRisk-standardized mortalityArtery bypassUnit admissionClinical characteristicsCoronary interventionReadmission ratesGroup of hospitalsHospital costsPractice patternsCABG
2015
The Variation in Recovery
Spatz ES, Curry LA, Masoudi FA, Zhou S, Strait KM, Gross CP, Curtis JP, Lansky AJ, Soares Barreto-Filho JA, Lampropulos JF, Bueno H, Chaudhry SI, D'Onofrio G, Safdar B, Dreyer RP, Murugiah K, Spertus JA, Krumholz HM. The Variation in Recovery. Circulation 2015, 132: 1710-1718. PMID: 26350057, PMCID: PMC4858327, DOI: 10.1161/circulationaha.115.016502.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetAlgorithmsAortic DissectionClassificationCoronary DiseaseDiagnostic Techniques, CardiovascularFemaleHumansMaleMedical RecordsMiddle AgedMyocardial InfarctionMyocardiumOxygen ConsumptionPhenotypePlaque, AtheroscleroticProspective StudiesReproducibility of ResultsRisk FactorsSex FactorsTreatment OutcomeYoung AdultConceptsAcute myocardial infarctionCoronary artery diseaseArtery diseaseClinical phenotypeNonobstructive coronary artery diseaseYoung AMI Patients (VIRGO) studyObstructive coronary artery diseaseYoung womenType 2 acute myocardial infarctionBiological disease mechanismsSubset of patientsThird universal definitionUnique clinical phenotypeCulprit lesionClinical characteristicsMyocardial infarctionTherapeutic efficacyUniversal definitionStudy participantsPatientsSupply-demand mismatchYoung adultsDisease mechanismsPatient studiesCurrent classification schemesSex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction
Xu X, Bao H, Strait K, Spertus JA, Lichtman JH, D'Onofrio G, Spatz E, Bucholz EM, Geda M, Lorenze NP, Bueno H, Beltrame JF, Krumholz HM. Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction. Circulation 2015, 131: 614-623. PMID: 25679303, PMCID: PMC4652932, DOI: 10.1161/circulationaha.114.012826.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMiddle-aged patientsMyocardial infarctionMental health statusWorse recoveryHealth statusSex differencesBaseline stressSex-based disparitiesYears of ageMultiple health outcomesQuality of lifeGreater mental stressSex-based differencesClinical characteristicsFemale sexEarly recoveryPerceived Stress ScaleGeneral populationGreater psychological stressHealth outcomesImprovement scoresInfarctionPatientsYounger age
2014
Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities
Ben-Josef G, Ott LS, Spivack SB, Wang C, Ross JS, Shah SJ, Curtis JP, Kim N, Krumholz HM, Bernheim SM. Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities. Circulation Cardiovascular Quality And Outcomes 2014, 7: 882-888. PMID: 25387777, DOI: 10.1161/circoutcomes.114.000927.Peer-Reviewed Original ResearchConceptsNon-PCI hospitalsCoronary artery bypass graft ratesPCI hospitalsAcute myocardial infarctionMyocardial infarctionPercutaneous coronary intervention capabilityAcute myocardial infarction admissionsLower revascularization ratesPrincipal discharge diagnosisTreatment of patientsMyocardial infarction admissionsHigh rateMyocardial infarction episodeGraft ratePCI capabilityPCI useIndex admissionRevascularization ratesClinical characteristicsPatient demographicsDays postadmissionDischarge diagnosisMedicare patientsCare proceduresMedicare feeDesign and rationale of the comprehensive evaluation of risk factors in older patients with AMI (SILVER-AMI) study
Dodson JA, Geda M, Krumholz HM, Lorenze N, Murphy TE, Allore HG, Charpentier P, Tsang SW, Acampora D, Tinetti ME, Gill TM, Chaudhry SI. Design and rationale of the comprehensive evaluation of risk factors in older patients with AMI (SILVER-AMI) study. BMC Health Services Research 2014, 14: 506. PMID: 25370536, PMCID: PMC4239317, DOI: 10.1186/s12913-014-0506-4.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status declineOlder patientsRisk factorsGeriatric impairmentsHospital readmissionOlder adultsDetailed medical record abstractionStatus declineDiagnostic study resultsPost-AMI outcomesProportion of patientsProspective cohort studyMedical record abstractionAMI studyHealth status measuresClinical characteristicsCohort studyRecord abstractionAdverse outcomesMyocardial infarctionAcademic hospitalHospital assessmentMultivariable regressionStatus measuresTrends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, D'Onofrio G, Lichtman JH, Krumholz HM. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. Journal Of The American College Of Cardiology 2014, 64: 337-345. PMID: 25060366, PMCID: PMC4415523, DOI: 10.1016/j.jacc.2014.04.054.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLength of stayHospital mortalityHospitalization ratesClinical characteristicsAge groupsAMI hospitalization ratesYounger patientsMyocardial infarctionLonger LOSNationwide Inpatient Sample dataYoung womenU.S. hospital dischargesPrevalence of comorbiditiesPrincipal discharge diagnosisNational Inpatient SampleSex differencesContemporary longitudinal dataLarge national datasetMore comorbiditiesHospital dischargeDischarge diagnosisInpatient SampleMortality rateAge 30Hospital variation in risk-standardized hospital admission rates from US EDs among adults
Capp R, Ross JS, Fox JP, Wang Y, Desai MM, Venkatesh AK, Krumholz HM. Hospital variation in risk-standardized hospital admission rates from US EDs among adults. The American Journal Of Emergency Medicine 2014, 32: 837-843. PMID: 24881514, DOI: 10.1016/j.ajem.2014.03.033.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency departmentAdmission ratesClinical characteristicsED visitsHospital factorsClinical factorsAdult ED visitsUS emergency departmentsHospital teaching statusCross-sectional analysisPatient characteristicsHospital admissionHospital variationPatientsTeaching statusHospitalED dataVisitsRepresentative sampleAdultsRural locationsAdmissionFactorsNational variationsHospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure
Allen LA, Fonarow GC, Grau-Sepulveda MV, Hernandez AF, Peterson PN, Partovian C, Li SX, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Hospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure. Circulation Heart Failure 2014, 7: 251-260. PMID: 24488983, PMCID: PMC5459367, DOI: 10.1161/circheartfailure.113.000761.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiotonic AgentsCross-Sectional StudiesDose-Response Relationship, DrugFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHospital MortalityHospitalsHumansInfusions, IntravenousInpatientsLength of StayMaleOutcome Assessment, Health CarePractice Patterns, Physicians'RegistriesRetrospective StudiesSurvival RateUnited StatesConceptsInotrope useHeart failureInotropic therapyInotropic agentsGuidelines-Heart Failure registryIntravenous inotropic agentsIntravenous inotropic therapyRisk-standardized ratesUse of inotropesHeart failure hospitalizationHospital-level ratesRandom hospital effectsFailure hospitalizationClinical characteristicsHospital factorsInpatient mortalityClinical factorsClinical outcomesHospital variationHospital characteristicsHospital effectsPatientsUS hospitalsHospitalStudy period