2023
Trends and Outcomes in Cardiac Arrest Among Heart Failure Admissions
Chouairi F, Miller P, Loriaux D, Katz J, Sen S, Ahmad T, Fudim M. Trends and Outcomes in Cardiac Arrest Among Heart Failure Admissions. The American Journal Of Cardiology 2023, 194: 93-101. PMID: 36889986, DOI: 10.1016/j.amjcard.2023.01.012.Peer-Reviewed Original ResearchMeSH KeywordsCoronary Artery DiseaseFemaleHeart ArrestHeart FailureHospital MortalityHospitalizationHumansMaleStroke VolumeConceptsCoronary artery diseaseCardiac arrestHospital cardiac arrestHF admissionsHF hospitalizationArtery diseaseHeart failureRenal diseasePrimary HF admissionsHeart failure admissionsHigher inpatient mortalityClinical Modification codesLong-term outcomesNational Inpatient SampleMultivariate logistic regressionHF patientsInpatient mortalityMultivariate adjustmentInpatient SampleFemale genderTenth RevisionHigher oddsLower oddsInternational ClassificationSerious events
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 advisoryNetwork Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction
Park D, An S, Attanasio S, Jolly N, Malhotra S, Doukky R, Samsky M, Sen S, Ahmad T, Nanna M, Vij A. Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction. The American Journal Of Cardiology 2022, 187: 84-92. PMID: 36459752, PMCID: PMC10958453, DOI: 10.1016/j.amjcard.2022.10.026.Peer-Reviewed Original ResearchMeSH KeywordsAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBayes TheoremDeathHeart FailureHumansHypotensionNeprilysinNetwork Meta-AnalysisRandomized Controlled Trials as TopicReceptors, AngiotensinStroke VolumeTreatment OutcomeVentricular Dysfunction, LeftConceptsAngiotensin receptor neprilysin inhibitorAngiotensin receptor blockersReduced ejection fractionHeart failureEjection fractionHigh riskCause mortalityReceptor blockersCardiac deathLower riskEnzyme inhibitorsMajor adverse cardiac eventsAngiotensin converting enzyme (ACE) inhibitorsAdverse cardiac eventsEfficacy end pointNetwork meta-analysis approachImproved clinical outcomesRandomized clinical trialsP scoreCardiac eventsAngiotensin receptorsClinical outcomesNeprilysin inhibitorClinical benefitRecent trialsAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalSGLT2 Inhibitors Should Be Considered for All Patients With Heart Failure ∗
Ahmad T, Desai NR, Velazquez EJ. SGLT2 Inhibitors Should Be Considered for All Patients With Heart Failure ∗. Journal Of The American College Of Cardiology 2022, 80: 1311-1313. PMID: 36041913, DOI: 10.1016/j.jacc.2022.08.005.Peer-Reviewed Original ResearchMachine learning to define phenotypes and outcomes of patients hospitalized for heart failure with preserved ejection fraction: Findings from ASCEND-HF
Murray EM, Greene SJ, Rao VN, Sun JL, Alhanti BA, Blumer V, Butler J, Ahmad T, Mentz RJ. Machine learning to define phenotypes and outcomes of patients hospitalized for heart failure with preserved ejection fraction: Findings from ASCEND-HF. American Heart Journal 2022, 254: 112-121. PMID: 36007566, DOI: 10.1016/j.ahj.2022.08.009.Peer-Reviewed Original ResearchMeSH KeywordsAtrial FibrillationClinical Trials as TopicFemaleHeart FailureHumansMachine LearningMaleObesityPrognosisStroke VolumeConceptsASCEND-HF trialAtrial fibrillationBlood pressureEjection fractionHeart failureLatent class analysisOutcomes of patientsLong-term outcomesYoung menFour-hour urine outputDistinct phenotypesAcute HFRenal impairmentClinical profileUrine outputASCEND-HFClinical benefitHeterogenous diseaseClinical dataOlder womenHFpEFPatientsOlder individualsCluster 3Asian womenMedicare 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 pricesElectronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial
Ghazi L, Yamamoto Y, Riello RJ, Coronel-Moreno C, Martin M, O'Connor KD, Simonov M, Huang J, Olufade T, McDermott J, Dhar R, Inzucchi SE, Velazquez EJ, Wilson FP, Desai NR, Ahmad T. Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial. Journal Of The American College Of Cardiology 2022, 79: 2203-2213. PMID: 35385798, DOI: 10.1016/j.jacc.2022.03.338.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyUsual careEjection fractionHeart failureMedical therapyPrimary outcomeCluster-randomized comparative effectiveness trialSodium-glucose cotransporter 2 inhibitorsElectronic health record alertsAldosterone system inhibitorsReduced ejection fractionUsual care armCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsVentricular ejection fractionComparative effectiveness trialNumber of patientsKnowledge of guidelinesLow-cost interventionCare armDays postrandomizationEligible patientsGDMT useFailure therapyPatient characteristicsReimagining Evidence Generation for Heart Failure and the Role of Integrated Health Care Systems
Ahmad T, Desai NR. Reimagining Evidence Generation for Heart Failure and the Role of Integrated Health Care Systems. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008292. PMID: 35272506, DOI: 10.1161/circoutcomes.121.008292.Peer-Reviewed Original ResearchAssessing race and ethnicity differences in outcomes based on GDMT and target NT-proBNP in patients with heart failure with reduced ejection fraction: An analysis of the GUIDE-IT study
Pahuja M, Leifer ES, Clarke JD, Ahmad T, Daubert MA, Mark DB, Cooper L, Desvigne-Nickens P, Fiuzat M, Adams K, Ezekowitz J, Whellan DJ, Januzzi JL, O'Connor CM, Felker GM, Piña IL. Assessing race and ethnicity differences in outcomes based on GDMT and target NT-proBNP in patients with heart failure with reduced ejection fraction: An analysis of the GUIDE-IT study. Progress In Cardiovascular Diseases 2022, 71: 79-85. PMID: 35490873, DOI: 10.1016/j.pcad.2022.04.010.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkersEthnicityHeart FailureHumansNatriuretic Peptide, BrainPeptide FragmentsQuality of LifeStroke VolumeConceptsHeart failure hospitalizationNon-black patientsNT-proBNPBlack patientsFailure hospitalizationHigh riskKansas City Cardiomyopathy Questionnaire overall scorePre-specified subgroup analysisGUIDE-IT trialHigher NYHA classReduced ejection fractionNT-proBNP concentrationsHeart failure therapyNon-Hispanic patientsUsual clinical careImportant baseline covariatesQuality of lifeEthnicity-based differencesHF hospitalizationMore comorbiditiesNYHA classCause mortalityTriple therapyFailure therapyEjection fractionHeart Failure Spending Function: An Investment Framework for Sequencing and Intensification of Guideline-Directed Medical Therapies
Allen LA, Teerlink JR, Gottlieb SS, Ahmad T, Lam CSP, Psotka MA. Heart Failure Spending Function: An Investment Framework for Sequencing and Intensification of Guideline-Directed Medical Therapies. Circulation Heart Failure 2022, 15: e008594. PMID: 35000432, DOI: 10.1161/circheartfailure.121.008594.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyMedical therapyReduced ejection fractionHealth care delivery researchAdverse eventsCardiac benefitsSerum creatinineBlood pressureEjection fractionHeart failureRoutine carePatient burdenHeart rateNew therapiesPatient harmHigh dosesPatientsPsychosocial domainsPocket costsTherapeutic opportunitiesClinical useTherapyNew drugsPhysiological domainsSpending function
2021
Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)
Ghazi L, Desai NR, Simonov M, Yamamoto Y, O'Connor KD, Riello RJ, Huang J, Olufade T, McDermott J, Inzucchi SE, Velazquez EJ, Wilson FP, Ahmad T. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF). American Heart Journal 2021, 244: 107-115. PMID: 34808104, DOI: 10.1016/j.ahj.2021.11.010.Peer-Reviewed Original ResearchMeSH KeywordsHeart FailureHumansOutpatientsStroke VolumeUnited StatesVentricular Dysfunction, LeftVentricular Function, LeftConceptsGuideline-directed medical therapyBest practice alertLeft ventricular ejection fractionHeart failureUsual careMedical therapyPragmatic trialElectronic health recordsEjection fractionCluster-randomized pragmatic trialLarge integrated healthcare systemDays post randomizationAppropriate medical therapyHeart Failure TrialReduced ejection fractionUsual care groupCommon chronic illnessGlomerular filtration rateVentricular ejection fractionRecent blood pressureIntegrated healthcare systemUse of guidelinesLow-cost interventionCreatinine levelsReal-world practiceTrends in Heart Failure Hospitalizations in the US from 2008 to 2018
Clark KAA, Reinhardt SW, Chouairi F, Miller PE, Kay B, Fuery M, Guha A, Ahmad T, Desai NR. Trends in Heart Failure Hospitalizations in the US from 2008 to 2018. Journal Of Cardiac Failure 2021, 28: 171-180. PMID: 34534665, DOI: 10.1016/j.cardfail.2021.08.020.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityHeart FailureHospitalizationHumansPrognosisStroke VolumeUnited StatesVentricular Function, LeftConceptsOverall heart failureHeart failureEjection fractionStudy periodHeart failure hospitalizationInpatient mortality rateNational Inpatient SampleLength of stayHospital inpatient costsVolume of patientsHealth care costsHFpEF subgroupsComorbid diabetesFailure hospitalizationInpatient mortalityMedian ageBlack patientsHispanic patientsSleep apneaEntire cohortInpatient costsInpatient SampleHF typeHospital costsMortality rateThe Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial
Chouairi F, Fuery MA, Mullan CW, Caraballo C, Sen S, Maulion C, Wilkinson ST, Surti T, McCullough M, Miller PE, Pacor J, Leifer ES, Felker GM, Velazquez EJ, Fiuzat M, O'Connor CM, Januzzi JL, Desai NR, Ahmad T. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial. Journal Of Cardiac Failure 2021, 27: 1359-1366. PMID: 34166799, DOI: 10.1016/j.cardfail.2021.06.008.Peer-Reviewed Original ResearchMeSH KeywordsDepressionFemaleHeart FailureHospitalizationHumansProportional Hazards ModelsStroke VolumeConceptsGuideline-directed medical therapyReduced ejection fractionAmino-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsGUIDE-IT trialNatriuretic peptide levelsHeart failureEjection fractionClinical outcomesPeptide levelsOptimal guideline-directed medical therapyCox proportional hazards regression modelingProportional hazards regression modelingImpact of depressionHistory of depressionCardiovascular deathCause hospitalizationCause mortalityOverall cohortMedical therapyAdverse outcomesTarget dosesPatientsMental healthTime pointsNational Trends in the Burden of Atrial Fibrillation During Hospital Admissions for Heart Failure
Reinhardt SW, Chouairi F, Miller PE, Clark KAA, Kay B, Fuery M, Guha A, Freeman JV, Ahmad T, Desai NR, Friedman DJ. National Trends in the Burden of Atrial Fibrillation During Hospital Admissions for Heart Failure. Journal Of The American Heart Association 2021, 10: e019412. PMID: 34013736, PMCID: PMC8483517, DOI: 10.1161/jaha.120.019412.Peer-Reviewed Original ResearchConceptsReduced ejection fractionComorbid atrial fibrillationHeart failureAtrial fibrillationEjection fractionHospital mortalityHF hospitalizationBackground Heart failureConclusion Atrial fibrillationWhite individualsNational Inpatient SampleMedian hospital chargesMore comorbiditiesComorbid hypertensionHF admissionsHF outcomesPatient demographicsDiabetes mellitusHospital admissionHospital chargesInpatient SampleVascular diseaseHospitalizationPatientsMortalityIntercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure
Fuery MA, Chouairi F, Januzzi JL, Moe GW, Caraballo C, McCullough M, Miller PE, Reinhardt SW, Clark K, Oseran A, Milner A, Pacor J, Kahn PA, Singh A, Ravindra N, Guha A, Vadlamani L, Kulkarni NS, Fiuzat M, Felker GM, O'Connor CM, Ahmad T, Ezekowitz J, Desai NR. Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure. JACC Heart Failure 2021, 9: 497-505. PMID: 33992564, DOI: 10.1016/j.jchf.2021.02.011.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyGDMT useCountry of enrollmentHeart failureMedical therapyHigher body mass indexKaplan-Meier survival estimatesGUIDE-IT trialHeart failure hospitalizationReduced ejection fractionLog-rank testingMineralocorticoid receptor antagonistsPrimary study endpointBody mass indexPatterns of careCare delivery structuresGUIDE-ITHF hospitalizationFailure hospitalizationUsual careEjection fractionStudy endpointBlack patientsClinical outcomesMass indexDifferences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction
Daubert MA, Yow E, Barnhart HX, Piña IL, Ahmad T, Leifer E, Cooper L, Desvigne‐Nickens P, Fiuzat M, Adams K, Ezekowitz J, Whellan DJ, Januzzi JL, O’Connor C, Felker GM. Differences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction. Journal Of The American Heart Association 2021, 10: e019712. PMID: 33955231, PMCID: PMC8200692, DOI: 10.1161/jaha.120.019712.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiomarkersCanadaCause of DeathFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPrognosisProtein PrecursorsRetrospective StudiesSex DistributionSex FactorsStroke VolumeUnited StatesConceptsReduced ejection fractionNT-proBNP responseGuideline-directed medical therapyGUIDE-IT trialHeart failureEjection fractionNT-proBNPPrognostic valuePg/mLHF hospitalizationMedical therapyEquivalent prognostic valueNT-proBNP reductionNT-proBNP valuesGreater prognostic valueNonischemic causesClinical characteristicsClinical outcomesImproved outcomesLandmark analysisPrognostic biomarkerTherapeutic goalsConclusions MenSecondary analysisWomenClinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes
Gevaert AB, Tibebu S, Mamas MA, Ravindra NG, Lee SF, Ahmad T, Ko DT, Januzzi JL, Van Spall HGC. Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes. ESC Heart Failure 2021, 8: 2741-2754. PMID: 33934542, PMCID: PMC8318507, DOI: 10.1002/ehf2.13344.Peer-Reviewed Original ResearchMeSH KeywordsHeart FailureHumansPrognosisPulmonary Disease, Chronic ObstructiveStroke VolumeVentricular Function, LeftConceptsLeft ventricular ejection fractionChronic obstructive pulmonary diseaseHazard ratioComposite outcomePrimary outcomeAtrial fibrillationHeart diseaseComposite cardiovascular deathEjection fraction categoriesSecondary composite outcomeHeart failure outcomesPrimary composite outcomeObstructive pulmonary diseaseVentricular ejection fractionValvular heart diseaseCoronary heart diseaseGreater prognostic informationDifferent risk categoriesCause deathHF rehospitalizationPredominant comorbiditiesCardiovascular deathHF trialsBaseline characteristicsSecondary outcomesEffect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure
Clarke JD, Riello R, Allen LA, Psotka MA, Teerlink JR, Lindenfeld J, Desai NR, Ahmad T. Effect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure. Circulation Heart Failure 2021, 14: e007759. PMID: 33530705, DOI: 10.1161/circheartfailure.120.007759.Peer-Reviewed Original ResearchConceptsEnd-stage heart failureReduced ejection fractionHealth-related qualityPatient-reported health statusEffect of inotropesHeart failureHealth status domainsEjection fractionHealth statusFunctional statusPositive inotropesStatus domainsAvailable clinical trial dataMorbidity/mortalityPopulation of patientsPatient-centered outcomesHealth status outcomesClinical trial dataFunctional capacity changesQuantity of lifeWeb of ScienceInotrope therapyInotrope useCalcium sensitizerSurvival benefit
2020
Quadruple Therapy Is the New Standard of Care for HFrEF ∗
Ahmad T, Desai NR. Quadruple Therapy Is the New Standard of Care for HFrEF ∗. JACC Heart Failure 2020, 8: 819-821. PMID: 32800506, DOI: 10.1016/j.jchf.2020.06.004.Peer-Reviewed Original Research