2023
Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Lu Y, Du C, Khidir H, Caraballo C, Mahajan S, Spatz E, Curry L, Krumholz H. Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009453. PMID: 36727515, DOI: 10.1161/circoutcomes.122.009453.Peer-Reviewed Original ResearchConceptsPersistent hypertensionElectronic health recordsBlood pressureHealth recordsPharmacologic agentsPrescribed treatmentYale New Haven Health SystemTreatment planAdditional pharmacologic agentsAntihypertensive treatment intensificationConsecutive outpatient visitsElevated blood pressurePersistence of hypertensionElectronic health record dataHealth record dataEligible patientsTreatment intensificationChart reviewHispanic patientsOutpatient visitsMean agePharmacological treatmentConventional content analysisHypertensionClinician notes
2022
Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissions
2020
Assessment of Prevalence, Awareness, and Characteristics of Isolated Systolic Hypertension Among Younger and Middle-Aged Adults in China
Mahajan S, Feng F, Hu S, Lu Y, Gupta A, Murugiah K, Gao Y, Lu J, Liu J, Zheng X, Spatz ES, Zhang H, Krumholz HM, Li J. Assessment of Prevalence, Awareness, and Characteristics of Isolated Systolic Hypertension Among Younger and Middle-Aged Adults in China. JAMA Network Open 2020, 3: e209743. PMID: 33289843, PMCID: PMC7724558, DOI: 10.1001/jamanetworkopen.2020.9743.Peer-Reviewed Original ResearchConceptsMiddle-aged adultsSystolic hypertensionCardiac Events Million Persons ProjectOlder individualsIsolated systolic hypertensionManagement of ISHMillion Persons ProjectPrevalence of ISHPrevious cardiovascular eventsSystolic blood pressureTypes of hypertensionAssessment of prevalenceCross-sectional studyHypertension subtypesCardiovascular eventsBlood pressureChina PatientMean ageHypertensionMAIN OUTCOMEAwareness ratePrevalenceAged adultsYoung adultsAdultsIncidence, predictors, and prognostic impact of recurrent acute myocardial infarction in China
Song J, Murugiah K, Hu S, Gao Y, Li X, Krumholz HM, Zheng X, . Incidence, predictors, and prognostic impact of recurrent acute myocardial infarction in China. Heart 2020, 107: 313-318. PMID: 32938773, PMCID: PMC7873426, DOI: 10.1136/heartjnl-2020-317165.Peer-Reviewed Original ResearchRecurrent acute myocardial infarctionAcute myocardial infarctionPrognostic impactMyocardial infarctionAMI eventsHospital percutaneous coronary interventionInitial acute myocardial infarctionTime-dependent Cox regressionGuideline-based medicationsKaplan-Meier methodologyPercutaneous coronary interventionLog-rank testRenal dysfunctionCardiac eventsCoronary interventionDischarge medicationsInitial admissionChina PatientCox regressionMean ageAge 75AMI ratesHeart rateMortality rateMultivariable modellingAssociation Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Rodrick D, Fine JM, Eckenrode S, Galusha DH, Tasimi A, Hunt DR, Bernheim SM, Normand ST, Krumholz HM. Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States. JAMA Network Open 2020, 3: e202142. PMID: 32259263, PMCID: PMC7139276, DOI: 10.1001/jamanetworkopen.2020.2142.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMedicare Patient Safety Monitoring SystemAdverse event ratesAdverse eventsHeart failureMedicare expendituresService patientsMyocardial infarctionMedicare feeEvent ratesHigher adverse event ratesCare expendituresRisk-standardized ratesPatients 65 yearsAdverse event dataAcute care hospitalsCross-sectional studyFinal study sampleInpatient care expendituresRate of occurrenceDates of analysisPatient characteristicsCare hospitalMean ageInpatient careRelationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure
Mahajan S, Gu J, Caraballo C, Lu Y, Spatz ES, Zhao H, Zhang M, Sun N, Zheng X, Lu H, Yuan H, J. Z, Krumholz HM. Relationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure. Journal Of The American Geriatrics Society 2020, 68: 1520-1528. PMID: 32212398, DOI: 10.1111/jgs.16411.Peer-Reviewed Original ResearchConceptsElevated blood pressureBlood pressureCardiac indexHemodynamic profileHemodynamic parametersHealth checkup centerFinal study populationPathophysiology of hypertensionSelection of therapyCross-sectional studyMin/Relationship of ageDifferent age groupsHemodynamic assessmentMean ageStudy populationMAIN OUTCOMEAge strataAge groupsLarger studyImpedance cardiographyAgeSVRIWomenMenBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.
Dodson JA, Hajduk AM, Geda M, Krumholz HM, Murphy TE, Tsang S, Tinetti ME, Nanna MG, McNamara R, Gill TM, Chaudhry SI. Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study. Annals Of Internal Medicine 2019, 172: 12-21. PMID: 31816630, PMCID: PMC7695040, DOI: 10.7326/m19-0974.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI mortalityFunctional impairmentOlder adultsCohort studyMean ageMyocardial infarctionPatient-reported health statusNet reclassification improvement indexProspective cohort studyParticipants' mean ageFinal risk modelMobility impairmentsGood discriminatory abilityRisk modelChart reviewHospital dischargePrognostic utilityBlood InstituteClinical variablesNational HeartHigh prevalenceHealth statusMortalityYounger counterpartsUsefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study)
Green YS, Hajduk AM, Song X, Krumholz HM, Sinha SK, Chaudhry SI. Usefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study). The American Journal Of Cardiology 2019, 125: 313-319. PMID: 31787249, PMCID: PMC7003680, DOI: 10.1016/j.amjcard.2019.10.038.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI outcomesMyocardial infarctionIndependent associationMedical Outcomes Study Social Support SurveySocial supportOlder AMI patientsSocial Support SurveyParticipants 75 yearsLow emotional supportLow social supportImportant social determinantInitial hospitalizationOlder patientsDevelopment of interventionsAMI patientsMultivariable analysisMean ageMultivariable regressionHealth outcomesSupport SurveyInformational supportReadmissionSocial determinantsOlder adultsDevelopment and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention
Huang C, Li SX, Mahajan S, Testani JM, Wilson FP, Mena CI, Masoudi FA, Rumsfeld JS, Spertus JA, Mortazavi BJ, Krumholz HM. Development and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention. JAMA Network Open 2019, 2: e1916021. PMID: 31755952, PMCID: PMC6902830, DOI: 10.1001/jamanetworkopen.2019.16021.Peer-Reviewed Original ResearchConceptsCreatinine level increaseAcute kidney injuryPercutaneous coronary interventionContrast volumeAKI riskKidney injuryCoronary interventionBaseline riskCardiology National Cardiovascular Data Registry's CathPCI RegistryNational Cardiovascular Data Registry CathPCI RegistryRisk of AKIAcute Kidney Injury AssociatedDifferent baseline risksPCI safetyCathPCI RegistryInjury AssociatedMean ageDerivation setPreprocedural riskMAIN OUTCOMEAmerican CollegePrognostic studiesUS hospitalsCalibration slopeValidation setAcute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study
Dodson JA, Hajduk A, Curtis J, Geda M, Krumholz HM, Song X, Tsang S, Blaum C, Miller P, Parikh CR, Chaudhry SI. Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2019, 132: e817-e826. PMID: 31170374, PMCID: PMC6891160, DOI: 10.1016/j.amjmed.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAcute Kidney InjuryAge FactorsAgedAged, 80 and overCohort StudiesCoronary AngiographyDatabases, FactualFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansKaplan-Meier EstimateLogistic ModelsMaleMyocardial InfarctionOdds RatioPrognosisProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSurvival AnalysisConceptsAcute kidney injuryAcute myocardial infarctionAge-related conditionsKidney injuryBody mass indexCoronary angiographyRisk factorsMyocardial infarctionOlder patientsMean ageAcute kidney injury risk factorsAcute Myocardial Infarction StudyAcute myocardial infarction cohortOlder adultsGlobal Outcomes criteriaMyocardial Infarction StudyInjury risk factorsParticipants' mean ageSILVER-AMI StudyMultivariable adjustmentComorbid diseasesHeart failureIndependent predictorsGeriatric conditionsMass index
2018
Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study
Huang C, Murugiah K, Mahajan S, Li SX, Dhruva SS, Haimovich JS, Wang Y, Schulz WL, Testani JM, Wilson FP, Mena CI, Masoudi FA, Rumsfeld JS, Spertus JA, Mortazavi BJ, Krumholz HM. Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study. PLOS Medicine 2018, 15: e1002703. PMID: 30481186, PMCID: PMC6258473, DOI: 10.1371/journal.pmed.1002703.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedClinical Decision-MakingData MiningDecision Support TechniquesFemaleHumansMachine LearningMaleMiddle AgedPercutaneous Coronary InterventionProtective FactorsRegistriesReproducibility of ResultsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsPercutaneous coronary interventionNational Cardiovascular Data RegistryRisk prediction modelAKI eventsAKI riskCoronary interventionAKI modelMean ageCardiology-National Cardiovascular Data RegistryAcute kidney injury riskAKI risk predictionRetrospective cohort studyIdentification of patientsCandidate variablesAvailable candidate variablesCohort studyPCI proceduresPoint of careBrier scoreAmerican CollegeData registryPatientsCalibration slopeInjury riskSame cohortRisk Factors Associated With Major Cardiovascular Events 1 Year After Acute Myocardial Infarction
Wang Y, Li J, Zheng X, Jiang Z, Hu S, Wadhera RK, Bai X, Lu J, Wang Q, Li Y, Wu C, Xing C, Normand SL, Krumholz HM, Jiang L. Risk Factors Associated With Major Cardiovascular Events 1 Year After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e181079-e181079. PMID: 30646102, PMCID: PMC6324290, DOI: 10.1001/jamanetworkopen.2018.1079.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMajor cardiovascular eventsCardiovascular eventsRisk factorsC-statisticMyocardial infarctionAggressive risk factor reductionOne-year event ratesSubsequent major cardiovascular eventsRecurrent acute myocardial infarctionIndex AMI hospitalizationRisk factor reductionHigh-risk patientsProspective cohort studyCoronary heart diseaseLow-risk groupAcute care hospitalsCohort studyCommon comorbiditiesHeart failureMean ageRisk modelHeart diseaseMAIN OUTCOMEHigh riskClinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome
Ko DT, Krumholz HM, Tu JV, Austin PC, Stukel TA, Koh M, Chong A, de Melo JF, Jackevicius CA. Clinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004194. PMID: 29535091, DOI: 10.1161/circoutcomes.117.004194.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAged, 80 and overClopidogrelCost SavingsCost-Benefit AnalysisDatabases, FactualDrug CostsDrug SubstitutionDrugs, GenericFemaleHemorrhageHumansMaleOntarioPatient AdmissionPatient ReadmissionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsRecurrenceRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsAcute coronary syndromeGeneric clopidogrelClinical outcomesCoronary syndromePrimary outcomeRecurrent acute coronary syndromeSubstantial healthcare cost savingsPopulation-based observational studyPropensity-weighted cohortsComposite of deathTransient ischemic attackComposite end pointEffect of clopidogrelElevation myocardial infarctionHealthcare cost savingsCox proportional hazardsRate of deathIschemic attackACS hospitalizationCause readmissionBaseline characteristicsHospital dischargeRecurrent hospitalizationsMean ageMyocardial infarctionComparison of Physician Visual Assessment With Quantitative Coronary Angiography in Assessment of Stenosis Severity in China
Zhang H, Mu L, Hu S, Nallamothu BK, Lansky AJ, Xu B, Bouras G, Cohen DJ, Spertus JA, Masoudi FA, Curtis JP, Gao R, Ge J, Yang Y, Li J, Li X, Zheng X, Li Y, Krumholz HM, Jiang L. Comparison of Physician Visual Assessment With Quantitative Coronary Angiography in Assessment of Stenosis Severity in China. JAMA Internal Medicine 2018, 178: 239-247. PMID: 29340571, PMCID: PMC5838612, DOI: 10.1001/jamainternmed.2017.7821.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChinaCoronary AngiographyCoronary StenosisCoronary VesselsCross-Sectional StudiesFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPercutaneous Coronary InterventionPractice Patterns, Physicians'Predictive Value of TestsProspective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsConceptsPhysician visual assessmentPercutaneous coronary interventionAcute myocardial infarctionQuantitative coronary angiographyStenosis severityCoronary angiographyMean agePCI studiesMean percent diameter stenosisIndependent core laboratoryPercent diameter stenosisCross-sectional studyNon-AMI patientsStandard clinical practiceFractional flow reserveSubset of participantsQCA assessmentCoronary revascularizationMore stenosisCoronary interventionCoronary lesionsChina PatientCoronary angiogramDiameter stenosisMyocardial infarction
2017
Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013
Yuan X, Zhang H, Zheng Z, Rao C, Zhao Y, Wang Y, Krumholz HM, Hu S. Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013. European Heart Journal - Quality Of Care And Clinical Outcomes 2017, 3: 312-318. PMID: 29044398, PMCID: PMC5805118, DOI: 10.1093/ehjqcco/qcx021.Peer-Reviewed Original ResearchConceptsMajor complication rateUrban teaching hospitalCoronary artery bypassComplication rateHospital mortalityTeaching hospitalArtery bypassMean ageChinese Cardiac Surgery RegistryAge groupsAnnual CABG volumePost-operative LOSPatients' mean ageCardiac Surgery RegistryPatient characteristicsCardiac surgeryMajor complicationsNumber of hospitalsCABG volumeTotal LOSHospitalMortalityPatientsRegistry systemMixed effects models
2016
Comparative Effectiveness of Generic Atorvastatin and Lipitor® in Patients Hospitalized with an Acute Coronary Syndrome
Jackevicius CA, Tu JV, Krumholz HM, Austin PC, Ross JS, Stukel TA, Koh M, Chong A, Ko DT. Comparative Effectiveness of Generic Atorvastatin and Lipitor® in Patients Hospitalized with an Acute Coronary Syndrome. Journal Of The American Heart Association 2016, 5: e003350. PMID: 27098970, PMCID: PMC4859299, DOI: 10.1161/jaha.116.003350.Peer-Reviewed Original ResearchConceptsGeneric atorvastatinACS hospitalizationSecondary outcomesClinical effectivenessAcute coronary syndrome hospitalizationPopulation-based cohort studyNew-onset diabetesAcute coronary syndromeDays of dischargePrespecified subgroup analysisPropensity-matched pairsInfrequent side effectsBrand-name medicationsSignificant differencesHealth care plansRecurrent ACSAdmission diagnosisAtorvastatin doseCardiovascular outcomesCoronary syndromeCohort studyRenal failureHeart failurePrimary outcomeMean ageCoronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study
Zheng X, Curtis JP, Hu S, Wang Y, Yang Y, Masoudi FA, Spertus JA, Li X, Li J, Dharmarajan K, Downing NS, Krumholz HM, Jiang L. Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study. JAMA Internal Medicine 2016, 176: 512. PMID: 26974883, PMCID: PMC5459379, DOI: 10.1001/jamainternmed.2016.0166.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngina, UnstableCardiac CatheterizationChinaCoronary Artery DiseaseDrug-Eluting StentsFemaleHospital MortalityHospitals, UrbanHumansLength of StayMaleMedical RecordsMiddle AgedMyocardial InfarctionOdds RatioOutcome Assessment, Health CarePercutaneous Coronary InterventionPostoperative ComplicationsPostoperative HemorrhageQuality of Health CareRetrospective StudiesStentsTime-to-TreatmentConceptsPercutaneous coronary interventionDrug-eluting stentsQuality of careCoronary catheterizationCoronary interventionNonobstructive coronary artery diseasePrimary percutaneous coronary interventionFuture quality improvement initiativesEvidence-based medicationsOutcomes of patientsCoronary artery diseaseClinical observational studyUse of catheterizationQuality improvement initiativesCalendar year 2001Hospital mortalityArtery diseasePatient characteristicsStable patientsTreatment patternsMedian lengthMean agePCI proceduresMedical recordsObservational study
2015
Qingdao Port Cardiovascular Health Study: a prospective cohort study
Spatz ES, Jiang X, Lu J, Masoudi FA, Spertus JA, Wang Y, Li X, Downing NS, Nasir K, Du X, Li J, Krumholz HM, Liu X, Jiang L. Qingdao Port Cardiovascular Health Study: a prospective cohort study. BMJ Open 2015, 5: e008403. PMID: 26656011, PMCID: PMC4679897, DOI: 10.1136/bmjopen-2015-008403.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsian PeopleBody Mass IndexCardiovascular DiseasesChinaCohort StudiesCost of IllnessDiabetes Mellitus, Type 2Early DiagnosisEnvironmental ExposureFemaleHealth BehaviorHealth SurveysHumansHyperlipidemiasHypertensionIncidenceMaleMiddle AgedOccupational ExposurePhysical ExaminationPreventive Health ServicesProspective StudiesRisk FactorsSelf ReportSocioeconomic FactorsWorkplaceConceptsAnnual health assessmentCardiovascular diseaseRisk factorsUnique risk factor profileCardiovascular risk factorsClinical risk factorsProspective cohort studyRisk factor profileHospital medical recordsCardiovascular Health StudyPopulation-based studyPopulation-based strategiesHealth assessmentCardiovascular outcomesCohort studyCarotid ultrasoundMean agePhysical examinationCardiovascular healthHeart diseaseMedical recordsDisease onsetMedical insurance claimsHealth StudyUrine analysis
2014
Readmission Rates and Long-Term Hospital Costs Among Survivors of an In-Hospital Cardiac Arrest
Chan PS, Nallamothu BK, Krumholz HM, Curtis LH, Li Y, Hammill BG, Spertus JA. Readmission Rates and Long-Term Hospital Costs Among Survivors of an In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2014, 7: 889-895. PMID: 25351479, PMCID: PMC4241155, DOI: 10.1161/circoutcomes.114.000925.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestCardiac arrestInpatient costsMean inpatient costsLarge national registryInpatient resource useNeurological statusReadmission patternsHospital dispositionPatient demographicsReadmission ratesMean ageInpatient useNational registryYounger ageReadmissionArrestAgeYearsDaysPatientsRegistryResource useSurvivors