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 advisoryFunctional and Symptomatic Clinical Trial Endpoints The HFC-ARC Scientific Expert Panel
Psotka M, Abraham W, Fiuzat M, Filippatos G, Lindenfeld J, Ahmad T, Felker G, Jacob R, Kitzman D, Leifer E, Lewis E, Mentz R, Nkulikiyinka R, Ni W, Schaber D, Sharma A, Solomon S, Stockbridge N, Teerlink J, Unger E, Whellan D, Wittes J, Anker S, O'Connor C. Functional and Symptomatic Clinical Trial Endpoints The HFC-ARC Scientific Expert Panel. JACC Heart Failure 2022, 10: 889-901. PMID: 36456063, DOI: 10.1016/j.jchf.2022.09.012.Peer-Reviewed Original ResearchConceptsAcademic Research ConsortiumHeart failureSubmaximal exercise tolerancePatient-reported outcomesCardiovascular clinical researchResearch ConsortiumExercise toleranceScientific Expert PanelPatients' qualityFunctional statusClinical trialsLife endpointsConsensus recommendationsClinical utilityDrug AdministrationCardiovascular therapeuticsClinical researchU.S. FoodExpert panelPotential endpointsNational InstituteEvidence generationTrialsEndpointAcademic investigatorsThirty-Day and 90-Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries
Reinhardt SW, Clark KAA, Xin X, Parzynski CS, Riello R, Sarocco P, Ahmad T, Desai NR. Thirty-Day and 90-Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008069. PMID: 35861780, DOI: 10.1161/circoutcomes.121.008069.Peer-Reviewed Original ResearchConceptsHypertensive heart diseaseIndex hospitalizationMedicare beneficiariesPost-acute care spendingService administrative claims dataMedicare Bundled PaymentsHeart failure admissionsHeart failure hospitalizationPrimary discharge diagnosisChronic kidney diseaseAdministrative claims dataCare spendingPostacute care spendingSkilled nursing facilitiesCare Improvement ProgramDrivers of costDiastolic HFHF careHF hospitalizationSystolic HFFailure hospitalizationDischarge diagnosisKidney diseaseObservation staysPostacute careMedicare 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 pricesPatterns of care and outcomes of outpatient percutaneous coronary intervention in the United States: Insights from Nationwide Ambulatory Surgery Sample
Milioglou I, Guha A, Chouari F, Chaturvedi A, Clark KAA, Kochar A, Sung JG, Velazquez EJ, Ahmad T, Desai NR. Patterns of care and outcomes of outpatient percutaneous coronary intervention in the United States: Insights from Nationwide Ambulatory Surgery Sample. Hellenic Journal Of Cardiology 2022, 65: 51-52. PMID: 35272018, DOI: 10.1016/j.hjc.2022.03.001.Peer-Reviewed Original Research
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 practiceBrief report: Cannabis and opioid use disorder among heart failure admissions, 2008–2018
Chouairi F, Mullan CW, Ravindra N, Clark KAA, Jaffe EM, Bhinder J, Fuery M, Guha A, Ahmad T, Desai NR. Brief report: Cannabis and opioid use disorder among heart failure admissions, 2008–2018. PLOS ONE 2021, 16: e0255514. PMID: 34591847, PMCID: PMC8483306, DOI: 10.1371/journal.pone.0255514.Peer-Reviewed Original ResearchTrends in transcatheter and surgical aortic valve replacement in the United States, 2008-2018
Clark KA, Chouairi F, Kay B, Reinhardt SW, Miller PE, Fuery M, Mullan CW, Guha A, Ahmad T, Desai NR. Trends in transcatheter and surgical aortic valve replacement in the United States, 2008-2018. American Heart Journal 2021, 243: 87-91. PMID: 34571040, DOI: 10.1016/j.ahj.2021.03.017.Peer-Reviewed Original ResearchCannabis use disorder among atrial fibrillation admissions, 2008–2018
Chouairi F, Miller PE, Guha A, Clarke J, Reinhardt SW, Ahmad T, Freeman JV, Desai NR, Friedman DJ. Cannabis use disorder among atrial fibrillation admissions, 2008–2018. Pacing And Clinical Electrophysiology 2021, 44: 1934-1938. PMID: 34506639, DOI: 10.1111/pace.14356.Peer-Reviewed Original ResearchConceptsAtrial fibrillation hospitalizationsAF hospitalizationsImpact of CUDNational Inpatient SampleProportion of admissionsDiseases diagnosis codesPrevalence of cannabisHistory of CUDHospital dischargeYounger patientsHigher proportionUnderserved patientsBlack raceDiagnosis codesInpatient SampleInternational ClassificationHospitalizationLegality of cannabisCannabis usePatientsAdmissionCodiagnosisLittle dataCUDCannabisTrends 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 rateEvaluation of Racial and Ethnic Disparities in Cardiac Transplantation
Chouairi F, Fuery M, Clark KA, Mullan CW, Stewart J, Caraballo C, Clarke J, Sen S, Guha A, Ibrahim NE, Cole RT, Holaday L, Anwer M, Geirsson A, Rogers JG, Velazquez EJ, Desai NR, Ahmad T, Miller PE. Evaluation of Racial and Ethnic Disparities in Cardiac Transplantation. Journal Of The American Heart Association 2021, 10: e021067. PMID: 34431324, PMCID: PMC8649228, DOI: 10.1161/jaha.120.021067.Peer-Reviewed Original ResearchConceptsWhite patientsHispanic patientsBlack patientsCardiac transplantationHeart transplantationHigh riskEthnic disparitiesAdult heart recipientsAllocation system changePost-transplant deathPost-transplant mortalityOrgan Sharing databasePost-transplantation deathNew allocation systemHeart recipientsDiabetes mellitusRenal diseaseSharing databaseTransplantation ratesUnited NetworkContemporary outcomesPatientsTransplantationDonor characteristicsStudy periodNational 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 analysisWomenElectronic 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 discriminationPatientsAdmissionScoresTrends in 30- and 90-Day Readmission Rates for Heart Failure
Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, Anker SD, Fonarow GC, Butler J. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circulation Heart Failure 2021, 14: e008335. PMID: 33866827, DOI: 10.1161/circheartfailure.121.008335.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHeart FailureHumansMaleMedicarePatient ReadmissionQuality of Health CareRetrospective StudiesUnited StatesConceptsHospital Readmissions Reduction ProgramHF readmission ratesIndex HF hospitalizationLow-volume hospitalsReadmission ratesHF hospitalizationPayer sourceHeart failure outcomesNational Readmission DatabaseReadmissions Reduction ProgramNon-Medicare insuranceCause 30Cause readmissionEjection fractionHeart failureSubgroup analysisReadmissionLinear regression analysisPrimary analysisSecondary analysisHospitalizationFailure outcomesHF volumeLimited dataRegression analysisChanges in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy
Mullan CW, Chouairi F, Sen S, Mori M, Clark KAA, Reinhardt SW, Miller PE, Fuery MA, Jacoby D, Maulion C, Anwer M, Geirsson A, Mulligan D, Formica R, Rogers JG, Desai NR, Ahmad T. Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy. JACC Heart Failure 2021, 9: 420-429. PMID: 33714748, DOI: 10.1016/j.jchf.2021.01.010.Peer-Reviewed Original ResearchConceptsDonor heart allocation systemNumber of patientsHeart allocation systemVentricular assist deviceWaitlist survivalAssist deviceNew heart allocation policyLeft ventricular assist deviceAllocation system changePost-transplant mortalityOrgan Sharing databaseOutcomes of patientsPost-transplantation outcomesProportion of patientsTime of transplantContinuous-flow LVADPost-transplantation survivalHeart allocation policyNew allocation systemBaseline recipientStatus 1AHeart transplantationIschemic timeLVAD implantationTransplant listImpact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies
Chouairi F, Mullan CW, Sen S, Mori M, Fuery M, Elder RW, Lesse J, Norton K, Clark KA, Miller PE, Mulligan D, Formica R, Rogers JG, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T. Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies. PLOS ONE 2021, 16: e0247789. PMID: 33651802, PMCID: PMC7924739, DOI: 10.1371/journal.pone.0247789.Peer-Reviewed Original ResearchConceptsCongenital heart diseaseAllocation system changeHeart allocation systemNew heart allocation policyNew heart allocation systemTransplantation of patientsOrgan Sharing databasePost-transplantation outcomesPost-transplant survivalTime of transplantationMechanical circulatory supportRate of transplantationNumber of patientsHeart allocation policyNew allocation systemStatus 1ACardiac transplantAdult patientsSharing databaseWaitlist survivalCirculatory supportClinical benefitCongenital cardiomyopathyUnited NetworkCHD patientsRelation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry)
Pareek M, Singh A, Vadlamani L, Eder M, Pacor J, Park J, Ghazizadeh Z, Heard A, Cruz-Solbes AS, Nikooie R, Gier C, Ahmed ZV, Freeman JV, Meadows J, Smolderen KGE, Lampert R, Velazquez EJ, Ahmad T, Desai NR. Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry). The American Journal Of Cardiology 2021, 146: 99-106. PMID: 33539857, PMCID: PMC7849530, DOI: 10.1016/j.amjcard.2021.01.029.Peer-Reviewed Original ResearchConceptsCardiovascular risk factorsCoronavirus disease 2019Risk factorsHigher troponin TCardiovascular diseaseCardiovascular eventsHospitalized patientsLaboratory findingsMental statusDisease 2019Multivariable binary logistic regression analysisTroponin TMajor adverse cardiovascular eventsPre-existing cardiovascular diseaseHigher C-reactive proteinCOVID-19 positive patientsPredictors of MACEPrevious ventricular arrhythmiaUse of P2YAdverse cardiovascular eventsProspective cohort studyTertiary care centerC-reactive proteinBinary logistic regression analysisPoor prognostic markerTransition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes
Miller PE, Chouairi F, Thomas A, Kunitomo Y, Aslam F, Canavan ME, Murphy C, Daggula K, Metkus T, Vallabhajosyula S, Carnicelli A, Katz JN, Desai NR, Ahmad T, Velazquez EJ, Brennan J. Transition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes. Journal Of The American Heart Association 2021, 10: e018182. PMID: 33412899, PMCID: PMC7955420, DOI: 10.1161/jaha.120.018182.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitHospital mortalityCare unitCICU mortalityClinical outcomesModern cardiac intensive care unitSurgical intensive care unitTotal hospital chargesSeverity of illnessMultivariable logistic regressionCICU lengthMultivariable adjustmentRespiratory insufficiencyPrimary outcomeUnique admissionsHospital chargesCardiac arrestSubgroup analysisImproved outcomesMortalityLogistic regressionAdmissionClosed unitStaffing models