2024
Implications of Atrial Fibrillation for Guideline-Directed Therapy in Patients With Heart Failure JACC State-of-the-Art Review
Newman J, O'Meara E, Böhm M, Savarese G, Kelly P, Vardeny O, Allen L, Lancellotti P, Gottlieb S, Samad Z, Morris A, Desai N, Rosano G, Teerlink J, Giraldo C, Lindenfeld J. Implications of Atrial Fibrillation for Guideline-Directed Therapy in Patients With Heart Failure JACC State-of-the-Art Review. Journal Of The American College Of Cardiology 2024, 83: 932-950. PMID: 38418008, DOI: 10.1016/j.jacc.2023.12.033.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAtrial fibrillationHeart failureAssociated with significant morbiditySpectrum of ejection fractionPrevention of AFIncidence of AFGuideline-directed therapyDiagnosis of AFEjection fractionSignificant morbidityMedical therapyJACC State-of-the-Art ReviewPatientsFrequent hospitalizationsIncreased life expectancyAssociated with greater symptom burdenCardiovascular conditionsGreater symptom burdenTherapySymptom burdenLife expectancyFibrillationHeartPrognosis
2023
Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction
Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Piña I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 12: 479-487. PMID: 38127049, DOI: 10.1016/j.jchf.2023.11.007.Peer-Reviewed Original ResearchNT-proBNP measurementsPrimary trial endpointChronic heart failureNT-proBNP levelsReduced ejection fractionTrial endpointsHeart failureEjection fractionN-terminal pro-B-type natriuretic peptide (NT-proBNP) measurementBaseline NT-proBNP levelsChronic heart failure patientsNT-proBNP monitoringSecondary trial endpointsHeart failure hospitalizationNatriuretic peptide measurementHeart failure patientsCardiovascular deathFailure hospitalizationNT-proBNPFailure patientsPrognostic impactClinical outcomesPrognostic valueOutpatient sitesClinical studiesRationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Clark K, Victoria-Castro A, Ghazi L, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use. JACC Heart Failure 2023, 12: 322-332. PMID: 37943221, DOI: 10.1016/j.jchf.2023.08.025.Peer-Reviewed Original ResearchBest practice alertMineralocorticoid receptor antagonistsNovel potassium bindersPotassium bindersEligible patientsUsual careEjection fractionSerum potassiumHistory of hyperkalemiaIncidence of hyperkalemiaStrong guideline recommendationsHeart failure hospitalizationReduced ejection fractionLaboratory test valuesPopulation health outcomesHyperkalemia treatmentMRA prescriptionAntagonist useFailure hospitalizationPatient characteristicsSecondary outcomesHeart failurePrimary outcomeGuideline recommendationsOutpatient visitsElectronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageImpact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial
Castro A, Martin M, Desai N, Ahmad T, Yamamoto Y, Melchinger H, Lee K, Gerber B, Nguyen A, Weinstein J, Subair L, Lee V, Williams A, Shaw M, Arora T, Wilson F. Impact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial. Journal Of Cardiac Failure 2023, 29: 662. DOI: 10.1016/j.cardfail.2022.10.284.Peer-Reviewed Original ResearchQuality of lifeUsual careClinical summary scoreTotal symptom scoreHeart failureSymptom scoresSummary scoresKansas City Cardiomyopathy Questionnaire overall scoreYale New Haven Health SystemDigital health toolsHealth toolsReduced ejection fractionResults One hundred fiftyUsual care groupMethods One hundred eightyNon-Hispanic blacksDigital health interventionsHF clinicSecondary outcomesEjection fractionEmergency visitsMedian agePrimary outcomeClinical outcomesRandomization groupPrevalence And Excess Risk Of Hospitalization In Heart Failure With Reduced Ejection Fraction
Desai N, Butler J, Binder G, Greene S. Prevalence And Excess Risk Of Hospitalization In Heart Failure With Reduced Ejection Fraction. Journal Of Cardiac Failure 2023, 29: 641. DOI: 10.1016/j.cardfail.2022.10.232.Peer-Reviewed Original ResearchHF hospitalizationReduced ejection fractionHeart failureEjection fractionHF populationExcess riskRisk factorsAverage patientAdult HF patientsHF hospitalization ratesPrevalence of HFHeart failure hospitalizationHigh-risk subgroupsHigh-risk groupNew treatment optionsFailure hospitalizationHF patientsCardiovascular deathAdult patientsConclusions PatientsHospitalization riskHospitalization ratesHF eventsTreatment optionsUS prevalenceWHAT IS THE VALUE OF REPEATED NT-PROBNP MEASUREMENTS IN CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION?
Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Pina I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. WHAT IS THE VALUE OF REPEATED NT-PROBNP MEASUREMENTS IN CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION? Journal Of The American College Of Cardiology 2023, 81: 624. DOI: 10.1016/s0735-1097(23)01068-9.Peer-Reviewed Original Research
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryMedicare Coverage and Out-of-Pocket Costs of Quadruple Drug Therapy for Heart Failure
Faridi K, Dayoub E, Ross J, Dhruva S, Ahmad T, Desai N. Medicare Coverage and Out-of-Pocket Costs of Quadruple Drug Therapy for Heart Failure. Journal Of The American College Of Cardiology 2022, 79: 2516-2525. PMID: 35738713, DOI: 10.1016/j.jacc.2022.04.031.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorQuadruple therapyOOP costsMedicare coveragePocket costsAngiotensin-converting enzyme inhibitorPrior authorizationAngiotensin receptor blockersQuadruple drug therapyCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsReduced ejection fractionDrug plansReceptor blockersEjection fractionHeart failureDrug therapyReceptor antagonistPrescription drug plansMedicare patientsEnzyme inhibitorsTherapyRegimensMedication pricesTrends In US Heart Failure Hospitalizations: Increased Volume And Patient Diversity With Decreased Total Costs, 2008-2018
Reinhardt S, Clark K, Chouairi F, Miller E, Kay B, Fuery M, Guha A, Ahmad T, Desai N. Trends In US Heart Failure Hospitalizations: Increased Volume And Patient Diversity With Decreased Total Costs, 2008-2018. Journal Of Cardiac Failure 2022, 28: s109-s110. DOI: 10.1016/j.cardfail.2022.03.280.Peer-Reviewed Original ResearchOverall heart failureHeart failureInpatient mortalityDiagnosis codesHospital costsChronic obstructive pulmonary diseaseIntroduction Heart failureHeart failure hospitalizationPeripheral arterial diseaseObstructive pulmonary diseaseCoronary artery diseaseNational Inpatient SampleLength of stayUS healthcare costsComorbid diabetesHF hospitalizationHospitalization volumeFailure hospitalizationHF cohortArtery diseaseEjection fractionMedian agePulmonary diseaseArterial diseaseHispanic patientsHEALTHCARE RESOURCE USE, INTENSITY AND COSTS AMONG PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION TREATED WITH OMECAMTIV MECARBIL IN GALACTIC-HF
Desai N, Diaz R, Felker M, Metra M, Solomon S, Binder G, Divanji P, Gomes D, Kociol R, Meng L, Teerlink J. HEALTHCARE RESOURCE USE, INTENSITY AND COSTS AMONG PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION TREATED WITH OMECAMTIV MECARBIL IN GALACTIC-HF. Journal Of The American College Of Cardiology 2022, 79: 309. DOI: 10.1016/s0735-1097(22)01300-6.Peer-Reviewed Original Research
2020
Mortality and readmission in non-ischemic compared with ischemic cardiomyopathies after implantable cardioverter-defibrillator implantation
Freeman J, Bjerre J, Parzynski C, Minges K, Ahmad T, Desai N, Enriquez A, Spatz E, Friedman D, Curtis J, Hlatky M, Higgins A. Mortality and readmission in non-ischemic compared with ischemic cardiomyopathies after implantable cardioverter-defibrillator implantation. European Heart Journal 2020, 41: ehaa946.0788. DOI: 10.1093/ehjci/ehaa946.0788.Peer-Reviewed Original ResearchNon-ischemic cardiomyopathyImplantable cardioverter defibrillator implantationPrimary prevention ICDsCardioverter-defibrillator implantationIschemic cardiomyopathyICM patientsNational Cardiovascular Data Registry ICD RegistryCox proportional hazards regression modelPrimary prevention ICD implantationLeft ventricular ejection fractionProportional hazards regression modelsOne-year mortalityHeart failure readmissionVentricular ejection fractionKaplan-Meier curvesHazards regression modelsRisk of mortalityMedian followCause readmissionICD implantationEjection fractionHeart failureHospital readmissionICD RegistryPatient subgroups