2025
Trends and Key Factors Associated With Racial and Ethnic Differences in Life’s Essential 8 Scores
Yang H, Huang C, Sawano M, Herrin J, Faridi K, Li Z, Spatz E, Krumholz H, Lu Y. Trends and Key Factors Associated With Racial and Ethnic Differences in Life’s Essential 8 Scores. JAMA Network Open 2025, 8: e2516663. PMID: 40531529, PMCID: PMC12177675, DOI: 10.1001/jamanetworkopen.2025.16663.Peer-Reviewed Original ResearchConceptsLife's Essential 8 scoreLife's Essential 8Cross-sectional studyWhite differencesEthnic differencesNational Health and Nutrition Examination SurveyHealth and Nutrition Examination SurveySleep health scoreNutrition Examination SurveyGroup-specific interventionsPrimary positive factorPhysical activityExamination SurveyHealth scoresBlack adultsWhite adultsMain OutcomesAsian adultsOverall scoreEvaluate trendsNicotine exposureEssential 8Blood lipidsAdultsEthnic groups10-Year and 30-Year Risks of Cardiovascular Disease in the U.S. Population
Faridi K, Malik D, Essa M, Yang H, Spatz E, Krumholz H, Lu Y. 10-Year and 30-Year Risks of Cardiovascular Disease in the U.S. Population. Journal Of The American College Of Cardiology 2025, 85: 2239-2249. PMID: 40499978, DOI: 10.1016/j.jacc.2025.03.546.Peer-Reviewed Original ResearchConceptsRisk of cardiovascular diseaseAtherosclerotic CVDU.S. adultsU.S. populationHispanic adultsCardiovascular diseaseCVD riskLong-term riskNational Health and Nutrition Examination SurveyHealth and Nutrition Examination SurveyRisk of atherosclerotic CVDElevated 10-year riskLong-term risk of cardiovascular diseaseAdults aged >Nutrition Examination SurveyTotal cardiovascular diseaseRisk factor profileRisk of total cardiovascular diseaseSurvey-weighted prevalenceMiddle-aged adultsPrevent cardiovascular diseaseHeart failureExamination SurveyAge-standardizedBlack adultsEnsemble Deep Learning Algorithm for Structural Heart Disease Screening Using Electrocardiographic Images PRESENT SHD
Dhingra L, Aminorroaya A, Sangha V, Pedroso A, Shankar S, Coppi A, Foppa M, Brant L, Barreto S, Ribeiro A, Krumholz H, Oikonomou E, Khera R. Ensemble Deep Learning Algorithm for Structural Heart Disease Screening Using Electrocardiographic Images PRESENT SHD. Journal Of The American College Of Cardiology 2025, 85: 1302-1313. PMID: 40139886, PMCID: PMC12199746, DOI: 10.1016/j.jacc.2025.01.030.Peer-Reviewed Original ResearchConceptsStructural heart diseaseYale-New Haven HospitalTransthoracic echocardiogramRisk stratificationHeart failureLeft-sided valvular diseaseSevere left ventricular hypertrophyLeft ventricular ejection fractionReceiver-operating characteristic curveVentricular ejection fractionLeft ventricular hypertrophyHeart disease screeningELSA-BrasilEnsemble deep learning algorithmRisk of deathConvolutional neural network modelEjection fractionEnsemble deep learning approachVentricular hypertrophyDeep learning algorithmsNew Haven HospitalDeep learning approachValvular diseaseNeural network modelClinical cohortFloods and cause-specific mortality in the United States applying a triply robust approach
Chu L, Warren J, Spatz E, Lowe S, Lu Y, Ma X, Ross J, Krumholz H, Chen K. Floods and cause-specific mortality in the United States applying a triply robust approach. Nature Communications 2025, 16: 2853. PMID: 40122917, PMCID: PMC11930965, DOI: 10.1038/s41467-025-58236-0.Peer-Reviewed Original ResearchConceptsCDC's National Center for Health StatisticsNational Center for Health StatisticsCause-specific mortality ratesCenter for Health StatisticsCause-specific mortalityHealth impacts of floodingExcess all-cause deathsLong-term health risksFlood daysLong-term associationDeath recordsHealth StatisticsConfounder adjustmentExternal causesStorm Events DatabaseAll-cause deathHealth impactsImpact of floodsPropensity scorePost‐flood yearMortality rateMyocardial infarctionPost-floodContiguous U.S.Respiratory diseaseArtificial intelligence-guided detection of under-recognised cardiomyopathies on point-of-care cardiac ultrasonography: a multicentre study
Oikonomou E, Vaid A, Holste G, Coppi A, McNamara R, Baloescu C, Krumholz H, Wang Z, Apakama D, Nadkarni G, Khera R. Artificial intelligence-guided detection of under-recognised cardiomyopathies on point-of-care cardiac ultrasonography: a multicentre study. The Lancet Digital Health 2025, 7: e113-e123. PMID: 39890242, PMCID: PMC12084816, DOI: 10.1016/s2589-7500(24)00249-8.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemPoint-of-care ultrasonographyMount Sinai Health SystemTransthyretin amyloid cardiomyopathyArtificial intelligenceHealth systemAmyloid cardiomyopathyHypertrophic cardiomyopathyRetrospective cohort of individualsCardiomyopathy casesTesting artificial intelligenceConvolutional neural networkSinai Health SystemCohort of individualsOpportunistic screeningHypertrophic cardiomyopathy casesMulti-labelPositive screenAI frameworkEmergency departmentMortality riskNeural networkLoss functionCardiac ultrasonographyAugmentation approachA failure to launch: blood pressure control after stroke in a regional health system
Forman R, Xin X, Kim C, Kernan W, Sheth K, Krumholz H, de Havenon A, Spatz E, Lu Y. A failure to launch: blood pressure control after stroke in a regional health system. Journal Of Hypertension 2025, 43: 715-718. PMID: 39995224, PMCID: PMC12046530, DOI: 10.1097/hjh.0000000000003961.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemRegional health systemHealth systemSystolic blood pressureDiastolic blood pressureMonths post strokeAverage proportion of patientsBP controlPost strokeBlood pressureProfessional visitsPrimary outcomeBlood pressure controlProportion of patientsAverage proportionVisitsSBP valuesEpic systemPressure controlStrokePatientsGlobal budgetDirect oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.
Jenab Y, Sadeghipour P, Mohseni-Badalabadi R, Kaviani R, Hosseini K, Pasebani Y, Khederlou H, Rafati A, Mohammadi Z, Jamalkhani S, Talasaz A, Firouzi A, Ariannejad H, Alemzadeh-Ansari M, Ahmadi-Renani S, Maadani M, Farrashi M, Bakhshandeh H, Piazza G, Krumholz H, Mehran R, Lip G, Bikdeli B. Direct oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials. EuroIntervention 2025, 21: 82-92. PMID: 39773831, PMCID: PMC11684328, DOI: 10.4244/eij-d-24-00527.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionLeft ventricular thrombusLeft ventricular thrombus resolutionRandomised clinical trialsPooled analysisVentricular thrombusTreatment of left ventricular thrombusTwo-dimensional transthoracic echocardiographyMyocardial infarctionDirect oral anticoagulantsImaging core laboratoryWarfarin-based anticoagulationMeta-analysis of randomised trialsTransthoracic echocardiographyOpen-labelOral anticoagulantsBleeding eventsAdult patientsDOACsCore laboratoryWarfarinClinical trialsRandomised trialsPatientsBleeding
2024
Lipid‐Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity
Gordon-Kundu B, Peyravi R, Garg A, Baker A, Salas S, Levien M, Faridi K, de Havenon A, Krumholz H, Sheth K, Forman R, Sharma R. Lipid‐Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity. Journal Of The American Heart Association 2024, 14: e033365. PMID: 39699007, PMCID: PMC12054410, DOI: 10.1161/jaha.123.033365.Peer-Reviewed Original ResearchConceptsPrescribed lipid-lowering therapyNational Institutes of Health Stroke Scale scoreAcute ischemic strokeLipid-lowering therapyStroke Scale scoreStroke severityGuidelines-Stroke registryAtherosclerotic cardiovascular disease eventsCardiovascular disease eventsScale scoreGuideline-recommended criteriaSevere stroke symptomsStudy assessed usePropensity score subclassificationLipid-lowering therapy useNational InstituteLogistic regression modelsCholesterol management guidelinesPoststroke disabilityElevated low-density lipoprotein cholesterolInstitutional GetSmall vessel diseaseTime of acute ischemic strokeLarge-artery atherosclerosisLow-density lipoprotein cholesterolHospital COVID-19 Burden and Adverse Event Rates
Metersky M, Rodrick D, Ho S, Galusha D, Timashenka A, Grace E, Marshall D, Eckenrode S, Krumholz H. Hospital COVID-19 Burden and Adverse Event Rates. JAMA Network Open 2024, 7: e2442936. PMID: 39495512, PMCID: PMC11581512, DOI: 10.1001/jamanetworkopen.2024.42936.Peer-Reviewed Original ResearchConceptsCOVID-19 burdenHospital admissionPatient safetyRelative riskCohort studyStudy of hospital admissionsAcute care hospitalsRisk-adjustment variablesRisk-adjusted ratesMedicare hospital admissionsCOVID-19 pandemicStaffing shortagesHospital characteristicsMain OutcomesHospital resilienceSurge capacityMedicare patientsCare hospitalHighest burdenPrevent declinesPatient admissionsStudy sampleElixhauser comorbiditiesCOVID-19Low burdenNatural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure
Adejumo P, Thangaraj P, Dhingra L, Aminorroaya A, Zhou X, Brandt C, Xu H, Krumholz H, Khera R. Natural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure. JAMA Network Open 2024, 7: e2443925. PMID: 39509128, PMCID: PMC11544492, DOI: 10.1001/jamanetworkopen.2024.43925.Peer-Reviewed Original ResearchConceptsFunctional status assessmentArea under the receiver operating characteristic curveClinical documentationElectronic health record dataHF symptomsOptimal care deliveryHealth record dataAssess functional statusStatus assessmentClinical trial participationProcessing of clinical documentsFunctional status groupCare deliveryOutpatient careMain OutcomesMedical notesTrial participantsNew York Heart AssociationFunctional statusQuality improvementRecord dataHeart failureClinical notesDiagnostic studiesStatus groupsRacial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageEarly Warning Scores With and Without Artificial Intelligence
Edelson D, Churpek M, Carey K, Lin Z, Huang C, Siner J, Johnson J, Krumholz H, Rhodes D. Early Warning Scores With and Without Artificial Intelligence. JAMA Network Open 2024, 7: e2438986. PMID: 39405061, PMCID: PMC11544488, DOI: 10.1001/jamanetworkopen.2024.38986.Peer-Reviewed Original ResearchConceptsEarly Warning ScoreWarning ScoreCohort studyYale New Haven Health SystemClinical deterioration eventsHigh-risk thresholdHealth systemRetrospective cohort studyPatient encountersDeteriorating patientsOverall PPVMain OutcomesInpatient encountersEDI scoresHospital encountersDeterioration eventsClinical deteriorationIntensive care unitEarly warning toolCare unitDecision support toolArtificial intelligenceScoresReceiver operating characteristic curveNEWS2Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States
Ma Y, Zang E, Liu Y, Wei J, Lu Y, Krumholz H, Bell M, Chen K. Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States. Proceedings Of The National Academy Of Sciences Of The United States Of America 2024, 121: e2403960121. PMID: 39316057, PMCID: PMC11459178, DOI: 10.1073/pnas.2403960121.Peer-Reviewed Original ResearchConceptsWildland firesContiguous United StatesNonaccidental mortalityExposure to ambient fine particlesSmoke PM<sWildland fire smokeMoving average concentrationsAmbient fine particlesLong-term exposureAverage concentrationSmoke PMHealth risksFine particlesFire smokeTemporal confoundingHealth effectsKidney disease mortalityChronic kidney disease mortalityPublic health actionFireMortality rateUnited StatesDisease mortalityHealth actionsMortality outcomesUse of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks
Lu Y, Keeley E, Barrette E, Cooper-DeHoff R, Dhruva S, Gaffney J, Gamble G, Handke B, Huang C, Krumholz H, McDonough C, Schulz W, Shaw K, Smith M, Woodard J, Young P, Ervin K, Ross J. Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks. BMC Cardiovascular Disorders 2024, 24: 497. PMID: 39289597, PMCID: PMC11409735, DOI: 10.1186/s12872-024-04161-x.Peer-Reviewed Original ResearchConceptsElectronic health recordsHealth recordsHealth systemUncontrolled hypertensionUse of electronic health recordsHypertension managementElectronic health record systemsOneFlorida Clinical Research ConsortiumElectronic health record dataYale New Haven Health SystemBP measurementsICD-10-CM codesHealth system networkPublic health priorityICD-10-CMIncidence rate of deathElevated BP measurementsElevated blood pressure measurementsHealthcare visitsAmbulatory careHealth priorityRetrospective cohort studyEHR dataOneFloridaBlood pressure measurementsCause-Specific Mortality Rates Among the US Black Population
Arun A, Caraballo C, Sawano M, Lu Y, Khera R, Yancy C, Krumholz H. Cause-Specific Mortality Rates Among the US Black Population. JAMA Network Open 2024, 7: e2436402. PMID: 39348122, PMCID: PMC11443349, DOI: 10.1001/jamanetworkopen.2024.36402.Commentaries, Editorials and LettersComparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM
Khera R, Aminorroaya A, Dhingra L, Thangaraj P, Pedroso Camargos A, Bu F, Ding X, Nishimura A, Anand T, Arshad F, Blacketer C, Chai Y, Chattopadhyay S, Cook M, Dorr D, Duarte-Salles T, DuVall S, Falconer T, French T, Hanchrow E, Kaur G, Lau W, Li J, Li K, Liu Y, Lu Y, Man K, Matheny M, Mathioudakis N, McLeggon J, McLemore M, Minty E, Morales D, Nagy P, Ostropolets A, Pistillo A, Phan T, Pratt N, Reyes C, Richter L, Ross J, Ruan E, Seager S, Simon K, Viernes B, Yang J, Yin C, You S, Zhou J, Ryan P, Schuemie M, Krumholz H, Hripcsak G, Suchard M. Comparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM. Journal Of The American College Of Cardiology 2024, 84: 904-917. PMID: 39197980, PMCID: PMC12045554, DOI: 10.1016/j.jacc.2024.05.069.Peer-Reviewed Original ResearchConceptsGLP-1 RAsSecond-line agentsGLP-1Antihyperglycemic agentsCardiovascular diseaseMACE riskGlucagon-like peptide-1 receptor agonistsSodium-glucose cotransporter 2 inhibitorsPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsEffects of SGLT2isType 2 diabetes mellitusPeptidase-4 inhibitorsAdverse cardiovascular eventsCox proportional hazards modelsRandom-effects meta-analysisCardiovascular risk reductionTarget trial emulationProportional hazards modelBarriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure
Lu Y, Arowojolu O, Qiu X, Liu Y, Curry L, Krumholz H. Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure. JAMA Network Open 2024, 7: e2426135. PMID: 39106065, PMCID: PMC11304113, DOI: 10.1001/jamanetworkopen.2024.26135.Peer-Reviewed Original ResearchConceptsBarriers to guideline adherenceElectronic health recordsGuideline adherenceClinician adherenceEHR dataElevated blood pressureHypertension managementAnalysis of EHR dataYale New Haven Health SystemSevere hypertensionClinical practice guidelinesAdherence scenariosQualitative content analysisPublic health challengeThematic saturationHealth recordsHealth systemBlood pressureThematic analysisTargeted interventionsManagement of severe hypertensionQualitative studyHealth challengesPractice guidelinesPatient outcomesBenchmarking Emergency Physician EHR Time per Encounter Based on Patient and Clinical Factors
Iscoe M, Venkatesh A, Holland M, Krumholz H, Sheares K, Melnick E. Benchmarking Emergency Physician EHR Time per Encounter Based on Patient and Clinical Factors. JAMA Network Open 2024, 7: e2427389. PMID: 39136949, PMCID: PMC11322841, DOI: 10.1001/jamanetworkopen.2024.27389.Peer-Reviewed Original ResearchLearning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial
Song J, Wang X, Wang B, Ge Y, Bi L, Jing F, Jin H, Li T, Gu B, Wang L, Hao J, Zhao Y, Liu J, Zhang H, Li X, Li J, Ma W, Wang J, Normand S, Herrin J, Armitage J, Krumholz H, Zheng X. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. The BMJ 2024, 386: e079143. PMID: 39043397, PMCID: PMC11265211, DOI: 10.1136/bmj-2023-079143.Peer-Reviewed Original ResearchConceptsClinical decision support systemsPrimary care practicesElectronic health recordsIntervention groupSystolic blood pressurePrimary careCare practicesBlood pressure <Health recordsPragmatic cluster randomised controlled trialCluster randomised controlled trialImproving hypertension treatmentPrimary care settingBlood pressure control ratesBlood pressureProportion of visitsProportion of participantsRandomised controlled trialsSystolic blood pressure <Control groupInjurious fallsRelated visitsCare settingsDiastolic blood pressure <Follow-upIncorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure
Kyanko K, Sahay K, Wang Y, Li S, Schreiber M, Hager M, Myers R, Johnson W, Zhang J, Krumholz H, Suter L, Triche E. Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure. JAMA Network Open 2024, 7: e2414431. PMID: 38829614, PMCID: PMC11148674, DOI: 10.1001/jamanetworkopen.2024.14431.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesSpecialty subgroupsPerformance quintileMedicare AdvantageReadmission ratesRisk-standardized readmission ratesHospital-wide readmission measureHospital outcome measuresTest-retest reliabilityRisk-adjustment variablesMeasurement reliabilityAdministrative claims dataReadmission measuresImprove measurement reliabilityIntegrated data repositoryMA beneficiariesQuintile rankingsMedicare beneficiariesMedicaid ServicesAll-causePublic reportingStudy assessed differencesClaims dataOutcome measuresMA cohort
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