2024
Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputation
2023
National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020
Lu Y, Liu Y, Dhingra L, Caraballo C, Mahajan S, Massey D, Spatz E, Sharma R, Rodriguez F, Watson K, Masoudi F, Krumholz H. National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020. JAMA Network Open 2023, 6: e2345964. PMID: 38039001, PMCID: PMC10692850, DOI: 10.1001/jamanetworkopen.2023.45964.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHistory of ASCVDCross-sectional studyLifestyle modificationPharmacological medicationsOptimal careCurrent careUS adultsEthnic differencesWhite individualsGuideline-recommended therapiesTotal cholesterol controlNon-Hispanic white individualsNutrition Examination SurveyLatino individualsQuality of careSelf-reported raceStatin useRecommended TherapiesSecondary preventionCholesterol controlOptimal regimensSmoking cessationEligible participantsExamination SurveySex‐Specific Associations of Obstructive Sleep Apnea Risk With Patient Characteristics and Functional Outcomes After Acute Myocardial Infarction: Evidence From the VIRGO Study
Gupta A, Barthel A, Mahajan S, Dreyer R, Yaggi H, Bueno H, Lichtman J, Krumholz H. Sex‐Specific Associations of Obstructive Sleep Apnea Risk With Patient Characteristics and Functional Outcomes After Acute Myocardial Infarction: Evidence From the VIRGO Study. Journal Of The American Heart Association 2023, 12: e027225. PMID: 37702090, PMCID: PMC10547292, DOI: 10.1161/jaha.122.027225.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaAcute myocardial infarctionHigh OSA riskOSA riskSex-specific associationsFunctional outcomeHealth statusHigh riskVIRGO StudyMyocardial infarctionDepressive symptomsHistory of OSATime of AMIImpact of OSAObstructive sleep apnea riskLow-risk patientsSleep apnea riskMajority of patientsTime of presentationSex-specific outcomesWorse health statusHigh-risk menPoor health statusMental health statusPoor health outcomesImpact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2023, 12: e030031. PMID: 37589125, PMCID: PMC10547344, DOI: 10.1161/jaha.123.030031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac-specific qualityGeneric health statusMyocardial infarctionBaseline healthMarital stressHealth outcomesHealth statusWorse patient-reported outcomesMental healthYoung adultsObservational cohort studyPatient-reported outcomesSocioeconomic factorsWorse mental healthReadmission 1Cause readmissionCohort studyYounger patientsRoutine screeningDepressive symptomsGreater oddsAnginaMale participantsOutcomesSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesDeveloping Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study
Bikdeli B, Lo Y, Khairani C, Bejjani A, Jimenez D, Barco S, Mahajan S, Caraballo C, Secemsky E, Klok F, Hunsaker A, Aghayev A, Muriel A, Wang Y, Hussain M, Appah-Sampong A, Lu Y, Lin Z, Aneja S, Khera R, Goldhaber S, Zhou L, Monreal M, Krumholz H, Piazza G. Developing Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study. Thrombosis And Haemostasis 2023, 123: 649-662. PMID: 36809777, PMCID: PMC11200175, DOI: 10.1055/a-2039-3222.Peer-Reviewed Original ResearchConceptsElectronic health recordsNLP algorithmNatural language processing toolsLanguage processing toolsPrincipal discharge diagnosisICD-10 codesDischarge diagnosisNLP toolsChart reviewHealth systemProcessing toolsYale New Haven Health SystemPatient identificationElectronic databasesHealth recordsData validationHigh-risk PEPulmonary Embolism ResearchSecondary discharge diagnosisIdentification of patientsManual chart reviewNegative predictive valueCodeRadiology reportsAlgorithmQuantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression modelsDeveloping 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 notesTiming of Blood Draws Among Patients Hospitalized in a Large Academic Medical Center
Caraballo C, Mahajan S, Murugiah K, Mortazavi B, Lu Y, Khera R, Krumholz H. Timing of Blood Draws Among Patients Hospitalized in a Large Academic Medical Center. JAMA 2023, 329: 255-257. PMID: 36648476, PMCID: PMC9856620, DOI: 10.1001/jama.2022.21509.Commentaries, Editorials and Letters
2022
The Impact of the Affordable Care Act on Disparities in Utilization of Cardiovascular Preventive Services by Socioeconomic Status
Verma H, Javed Z, Hong JC, Mahajan S, Mszar R, Grandhi GR, Desai NR, Virani SS, Javed U, Valero-Elizondo J, Nasir K. The Impact of the Affordable Care Act on Disparities in Utilization of Cardiovascular Preventive Services by Socioeconomic Status. Population Health Management 2022, 25: 669-676. PMID: 36067118, DOI: 10.1089/pop.2021.0337.Peer-Reviewed Original ResearchConceptsPreventive servicesSocioeconomic statusAffordable Care ActNational Health Interview SurveyBlood pressure checkSmoking cessation adviceCare ActHealth Interview SurveyVulnerable population subgroupsCardiovascular preventive servicesCessation adviceGlycemic screeningCardiovascular outcomesCholesterol checkBlood pressurePressure checkStudy populationUS adultsCare disparitiesSES disparitiesSES groupStudy periodInterview SurveyPopulation subgroupsSignificant decreaseHemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography
Caraballo C, Mahajan S, Gu J, Lu Y, Spatz ES, Dreyer RP, Zhang M, Sun N, Ren Y, Zheng X, Zhao H, Lu H, J. Z, Krumholz HM. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLOS ONE 2022, 17: e0269777. PMID: 35700163, PMCID: PMC9197037, DOI: 10.1371/journal.pone.0269777.Peer-Reviewed Original ResearchConceptsElevated blood pressureSystemic vascular resistance indexVascular resistance indexBlood pressureCardiac indexResistance indexHigh systemic vascular resistance indexLower systemic vascular resistance indexHigher mean systolic blood pressureMean diastolic blood pressureMean systolic blood pressureImpedance cardiographyLow cardiac indexHigher cardiac indexDiastolic blood pressureSystolic blood pressureBody mass indexYear old womanPersonalization of treatmentSame age groupNon-invasive assessmentSex differencesHemodynamic profileMass indexHemodynamic differencesCardiac Status Among Heart Failure Patients With Implantable Cardioverter Defibrillators Before, During, and After COVID-19 Lockdown
Lu Y, Jones PW, Murugiah K, Caraballo C, Mahajan S, Massey D, Ahmed R, Bader E, Krumholz H. Cardiac Status Among Heart Failure Patients With Implantable Cardioverter Defibrillators Before, During, and After COVID-19 Lockdown. Journal Of Cardiac Failure 2022, 28: 1372-1374. PMID: 35690314, PMCID: PMC9187866, DOI: 10.1016/j.cardfail.2022.05.012.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillatorHeart failure patientsCRT-D devicesCardiac statusFailure patientsHeart failureCardioverter defibrillatorCardiac resynchronization therapy defibrillatorAcute cardiac conditionsMedical care deliveryInpatient careCardiac conditionsPhysiologic markersInpatient servicesPatientsCardiac healthCare deliveryMarked restrictionImplanted ICDsMinneapolis/Saint PaulSex subgroupsDefibrillatorCOVID-19Telemedicine servicesCOVID-19 lockdownTemporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018
Caraballo C, Herrin J, Mahajan S, Massey D, Lu Y, Ndumele CD, Drye EE, Krumholz HM. Temporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018. The American Journal Of Medicine 2022, 135: 1083-1092.e14. PMID: 35472394, DOI: 10.1016/j.amjmed.2022.04.010.Peer-Reviewed Original ResearchConceptsMultimorbidity prevalenceRace/ethnicityWhite individualsChronic conditionsBlack individualsSerial cross-sectional analysisCommon chronic conditionsRisk of morbidityPrevalence of multimorbidityPublic health interventionsCross-sectional analysisSelf-reported presenceSelf-reported raceLatino/HispanicMAIN OUTCOMEHealth interventionsEthnic disparitiesPrevalenceHealth inequalitiesStudy periodEarly lifeHispanic individualsTemporal trendsStudy sampleAsian individualsEvaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018
Caraballo C, Mahajan S, Valero-Elizondo J, Massey D, Lu Y, Roy B, Riley C, Annapureddy AR, Murugiah K, Elumn J, Nasir K, Nunez-Smith M, Forman HP, Jackson CL, Herrin J, Krumholz HM. Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. JAMA Network Open 2022, 5: e226385. PMID: 35389500, PMCID: PMC8990329, DOI: 10.1001/jamanetworkopen.2022.6385.Peer-Reviewed Original ResearchConceptsCross-sectional studyLong sleep durationSleep durationWhite individualsBlack individualsLatino individualsEthnic differencesSerial cross-sectional studyNational Health Interview Survey dataHealth Interview Survey dataSelf-reported sleep durationShort sleep durationInterview Survey dataMiddle-aged adultsSelf-reported raceEstimated prevalenceMAIN OUTCOMELong sleepSleep deficiencyHigher household incomeEthnic disparitiesAge groupsHealth disparitiesPrevalenceSleep disparitiesSocial determinants of health and obesity: Findings from a national study of US adults
Javed Z, Valero‐Elizondo J, Maqsood MH, Mahajan S, Taha MB, Patel KV, Sharma G, Hagan K, Blaha MJ, Blankstein R, Mossialos E, Virani SS, Cainzos‐Achirica M, Nasir K. Social determinants of health and obesity: Findings from a national study of US adults. Obesity 2022, 30: 491-502. PMID: 35088551, DOI: 10.1002/oby.23336.Peer-Reviewed Original ResearchConceptsOverweight/obesitySocial determinantsNon-Hispanic black adultsNational Health Interview SurveyObesity class 1Prevalence of overweightObesity class 3Odds of obesityHealth Interview SurveyHigher relative prevalenceCumulative social disadvantageLogistic regression modelsRace/ethnicityMultinomial logistic regression modelsObesity prevalenceHealth burdenUS adultsObesityObesity ratesBlack adultsOverweightRelevant covariatesInterview SurveyQuartilePrevalencePhysical Activity Among Patients With Intracardiac Remote Monitoring Devices Before, During, and After COVID-19–Related Restrictions
Lu Y, Jones PW, Murugiah K, Caraballo C, Massey DS, Mahajan S, Ahmed R, Bader EM, Krumholz HM. Physical Activity Among Patients With Intracardiac Remote Monitoring Devices Before, During, and After COVID-19–Related Restrictions. Journal Of The American College Of Cardiology 2022, 79: 309-310. PMID: 35057917, PMCID: PMC8763290, DOI: 10.1016/j.jacc.2021.11.010.Peer-Reviewed Original ResearchSocial Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States
Sharma G, Grandhi GR, Acquah I, Mszar R, Mahajan S, Khan SU, Javed Z, Mehta LS, Gulati M, Cainzos‐Achirica M, Blumenthal RS, Nasir K. Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States. Journal Of The American Heart Association 2022, 11: e022837. PMID: 35014862, PMCID: PMC9238529, DOI: 10.1161/jaha.121.022837.Peer-Reviewed Original ResearchConceptsSuboptimal cardiovascular healthInsufficient physical activityPregnant womenCardiovascular healthAssociation of SDOHRisk factorsPhysical activitySocial determinantsNational Health Interview SurveyModifiable risk factorsPublic health urgencyHealth Interview SurveyDisadvantaged pregnant womenPoisson regression modelsMaternal morbidityRisk ratioFirst quartileSDOHInterview SurveyCross-sectional dataWomenQuartileRegression modelsHealthUnited States
2021
Delayed medical care due to transportation barriers among adults with atherosclerotic cardiovascular disease
Acquah I, Hagan K, Valero-Elizondo J, Javed Z, Butt SA, Mahajan S, Taha MB, Hyder AA, Mossialos E, Cainzos-Achirica M, Nasir K. Delayed medical care due to transportation barriers among adults with atherosclerotic cardiovascular disease. American Heart Journal 2021, 245: 60-69. PMID: 34902312, DOI: 10.1016/j.ahj.2021.11.019.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseTransportation barriersCardiovascular diseaseMedical careSociodemographic characteristicsNon-Hispanic black adultsNational Health Interview SurveyHealth Interview SurveySelf-reported prevalenceUse of telehealthMedicaid insuranceU.S. patientsHigher oddsProvision of transportationMobile clinicsPatientsBlack adultsLogistic regressionYoung adultsInterview SurveyCareYoung individualsAdultsVulnerable groupsDiseaseNational Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlTracking Self-reported Symptoms and Medical Conditions on Social Media During the COVID-19 Pandemic: Infodemiological Study
Ding Q, Massey D, Huang C, Grady CB, Lu Y, Cohen A, Matzner P, Mahajan S, Caraballo C, Kumar N, Xue Y, Dreyer R, Roy B, Krumholz HM. Tracking Self-reported Symptoms and Medical Conditions on Social Media During the COVID-19 Pandemic: Infodemiological Study. JMIR Public Health And Surveillance 2021, 7: e29413. PMID: 34517338, PMCID: PMC8480398, DOI: 10.2196/29413.Peer-Reviewed Original Research