Featured Publications
Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials
Oikonomou EK, Spatz ES, Suchard MA, Khera R. Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials. The Lancet Digital Health 2022, 4: e796-e805. PMID: 36307193, PMCID: PMC9768739, DOI: 10.1016/s2589-7500(22)00170-4.Peer-Reviewed Original ResearchConceptsSystolic blood pressure controlBlood pressure controlIntensive systolic blood pressure controlType 2 diabetesPressure controlCardiovascular benefitsClinical trialsMajor adverse cardiovascular eventsFirst major adverse cardiovascular eventLarge randomised clinical trialsACCORD-BP trialAdverse cardiovascular eventsRandomised clinical trialsSystolic blood pressureCox regression analysisTreatment effectsHazard ratio estimatesACCORD-BPBP trialCardiovascular eventsBlood pressurePrimary outcomeStandard treatmentBaseline variablesIndex patients
2024
Comparative 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, 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 model
2023
Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes
Chui P, Lan Z, Freeman J, Enriquez A, Khera R, Akar J, Masoudi F, Ong E, Curtis J. Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes. Heart Rhythm 2023, 20: 1000-1008. PMID: 36963741, DOI: 10.1016/j.hrthm.2023.03.022.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiac Resynchronization TherapyDefibrillators, ImplantableHeart FailureHospitalsHumansMedicareTreatment OutcomeUnited StatesConceptsEligible patientsICD RegistryCardiac resynchronizationNational Cardiovascular Data Registry ICD RegistryCRT-D implantationCRT-D useHospital-level outcomesStrong guideline recommendationsHospital-level variationPatient-level outcomesIntraclass correlation coefficientQuality improvement effortsHospital mortalityGuideline indicationsReadmission ratesSelect patientsClinical outcomesGuideline recommendationsHospital variationHospital ratesUse of CRTHospital levelHospital usePatientsCase mix
2022
Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest
Wheelock K, Chan P, Chen L, de Lemos J, Miller P, Nallamothu B, Girotra S, Khera R. Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest. Resuscitation 2022, 182: 109650. PMID: 36442596, PMCID: PMC9885789, DOI: 10.1016/j.resuscitation.2022.11.016.Peer-Reviewed Original ResearchConceptsFavorable neurologic outcomeHospital cardiac arrestTherapeutic rangeNeurologic outcomeOverall survivalTemperature managementCardiac arrestFavorable neurologic survivalFavorable neurological outcomeRetrospective cohort studyTargeted temperature managementHigh therapeutic rangeRisk-adjusted analysisComatose survivorsNeurologic survivalNeurological outcomeCohort studyHospital dischargeMedian durationMedian timeCurrent guidelinesCompression trialTreatment targetsSignificant associationGoal temperatureIdentifying quality of life outcome patterns to inform treatment choices in ischemic cardiomyopathy
Mori M, Mark DB, Khera R, Lin H, Jones P, Huang C, Lu Y, Geirsson A, Velazquez EJ, Spertus JA, Krumholz HM. Identifying quality of life outcome patterns to inform treatment choices in ischemic cardiomyopathy. American Heart Journal 2022, 254: 12-22. PMID: 35932911, DOI: 10.1016/j.ahj.2022.07.007.Peer-Reviewed Original ResearchMeSH KeywordsCardiomyopathiesClinical Trials as TopicCoronary Artery BypassHumansMyocardial IschemiaQuality of LifeTreatment OutcomeConceptsCoronary artery bypass surgeryGuideline-directed medical therapyTreatment choiceBetter outcomesIschemic cardiomyopathyQOL outcomesQoL dataKansas City Cardiomyopathy Questionnaire overall summary scoreQOL trajectoriesOutcome patternsIschemic Heart Failure (STICH) trialHeart Failure TrialMain baseline predictorsArtery bypass surgeryOverall summary scoreDifferent treatment choicesLogistic regression modelsBypass surgeryMedical therapySurgical treatmentFailure TrialLife scoresQOL scoresPatient's probabilityBaseline predictors
2021
Comparative Outcomes of Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction Among Medicare Beneficiaries With Multivessel Coronary Artery Disease
Secemsky EA, Butala N, Raja A, Khera R, Wang Y, Curtis JP, Maddox TM, Virani SS, Armstrong EJ, Shunk KA, Brindis RG, Bhatt D, Yeh RW. Comparative Outcomes of Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction Among Medicare Beneficiaries With Multivessel Coronary Artery Disease. Circulation Cardiovascular Interventions 2021, 14: e010323. PMID: 34372676, PMCID: PMC8485756, DOI: 10.1161/circinterventions.120.010323.Peer-Reviewed Original ResearchContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican CollegeFinancial burden, distress, and toxicity in cardiovascular disease
Slavin SD, Khera R, Zafar SY, Nasir K, Warraich HJ. Financial burden, distress, and toxicity in cardiovascular disease. American Heart Journal 2021, 238: 75-84. PMID: 33961830, DOI: 10.1016/j.ahj.2021.04.011.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseFinancial burdenCommunity Health Worker IntegrationHigh-risk individualsComparative effectiveness studiesNon-medical needsHigh-cost interventionsHigh-cost treatmentsCVD managementEffectiveness studiesHealth systemPsychological distressInsurance coverageHealthcare policyBurdenDistressDiseaseSystem navigationInterventionCommunity-based initiativesPatientsPhysiciansElectronic 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 discriminationPatientsAdmissionScores
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 practiceCharacteristics of cardiac catheterization laboratory directors at the 2017 U.S. News & World Report top 100 U.S. cardiovascular hospitals
Murugiah K, Annapureddy AR, Khera R, Lansky A, Curtis JP. Characteristics of cardiac catheterization laboratory directors at the 2017 U.S. News & World Report top 100 U.S. cardiovascular hospitals. Catheterization And Cardiovascular Interventions 2020, 97: e624-e626. PMID: 32833350, DOI: 10.1002/ccd.29217.Peer-Reviewed Original ResearchConceptsCardiac catheterization laboratoryCardiovascular HospitalFellowship trainingPercutaneous coronary interventionCardiac catheterization laboratory directorsStructural interventionsCoronary interventionMedian agePeripheral interventionsMedical school graduationCardiovascular programCatheterization laboratoryMedicare dataMedicare Provider UtilizationHospitalClinical focusMedian yearsProvider Utilization
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
Hospital Variation in the Utilization and Implementation of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
Khera R, Humbert A, Leroux B, Nichol G, Kudenchuk P, Scales D, Baker A, Austin M, Newgard CD, Radecki R, Vilke GM, Sawyer KN, Sopko G, Idris AH, Wang H, Chan PS, Kurz MC. Hospital Variation in the Utilization and Implementation of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004829. PMID: 30571336, DOI: 10.1161/circoutcomes.118.004829.Peer-Reviewed Original ResearchConceptsTargeted temperature managementHospital cardiac arrestCardiac arrestMedian rateResuscitation Outcomes Consortium sitesHospital cardiac arrest patientsImproved functional survivalMedian hospital rateClass I recommendationPotential survival benefitResuscitation Outcomes ConsortiumNon-traumatic outCardiac arrest patientsTemperature managementPatterns of utilizationConsecutive adultsHospital arrivalProspective cohortSurvival benefitArrest patientsHospital variationI recommendationMean ageOutcomes ConsortiumResuscitation guidelinesSex 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 declineOutcomesPatientsSexEffects of Weight-Loss Medications on Cardiometabolic Risk Profiles: A Systematic Review and Network Meta-analysis
Khera R, Pandey A, Chandar AK, Murad MH, Prokop LJ, Neeland IJ, Berry JD, Camilleri M, Singh S. Effects of Weight-Loss Medications on Cardiometabolic Risk Profiles: A Systematic Review and Network Meta-analysis. Gastroenterology 2018, 154: 1309-1319.e7. PMID: 29305933, PMCID: PMC5880739, DOI: 10.1053/j.gastro.2017.12.024.Peer-Reviewed Original ResearchConceptsWeight loss medicationsCardiometabolic risk profileHigh-density lipoprotein cholesterolWaist circumferenceDrug AdministrationSystematic reviewRisk profileLipoprotein cholesterolHemoglobin A1cObese adultsCholesterol profileSystolic/diastolic BPCardiometabolic risk factorsNetwork Meta-AnalysisRandomized clinical trialsQuality of evidenceLow-density lipoproteinModest decreaseOutcomes of interestEffect of foodLong-term useMinimal effectLiraglutide useOrlistat useBlood pressure
2017
Comparison 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
Racial 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 diagnosisHospitalizationStroke
2015
Use 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 SampleRacial Disparities in Outcomes After Cardiac Surgery: the Role of Hospital Quality
Khera R, Vaughan-Sarrazin M, Rosenthal GE, Girotra S. Racial Disparities in Outcomes After Cardiac Surgery: the Role of Hospital Quality. Current Cardiology Reports 2015, 17: 29. PMID: 25894800, PMCID: PMC4780328, DOI: 10.1007/s11886-015-0587-7.Peer-Reviewed Original ResearchConceptsCardiac surgeryHospital qualityRacial disparitiesEarly postoperative phaseLow-quality hospitalsWhite patientsPostoperative phasePoor outcomeWorse outcomesExcess mortalityHospital careMinority patientsHigh mortalityPatientsSurgeryHealth conditionsRecent evidenceOutcomesMortalityLong termSocioeconomic backgroundEthnic minoritiesHospitalDisparitiesFactors