2024
Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Rout A, Moumneh M, Kalra K, Singh S, Garg A, Kunadian V, Biscaglia S, Alkhouli M, Rymer J, Batchelor W, Nanna M, Damluji A. Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal Of The American Heart Association 2024, 13: e036151. PMID: 39494560, DOI: 10.1161/jaha.124.036151.Peer-Reviewed Original ResearchConceptsNon-ST segment elevation acute coronary syndromeAcute coronary syndromeComposite of deathBurden of geriatric conditionsRandomized controlled trialsCoronary syndromeMyocardial infarctionYears of ageInvasive strategyOlder adultsControlled trialsGeriatric conditionsOlder patientsCardiovascular deathOdds ratioMeta-analysis of randomized controlled trialsNon-ST segment elevationSecondary end pointsMeta-analysisFixed effects meta-analysisAll-cause deathEffects meta-analysisYounger patientsFollow-upDecreased riskQuality of Life in Older Adults With Stable Ischemic Heart Disease and Diabetes Mellitus: A Post Hoc Analysis of the BARI 2D Trial
Park D, Jamil Y, Moumneh M, Batchelor B W, Nanna M, Damluji A. Quality of Life in Older Adults With Stable Ischemic Heart Disease and Diabetes Mellitus: A Post Hoc Analysis of the BARI 2D Trial. The American Journal Of Cardiology 2024, 223: 58-69. PMID: 38797195, PMCID: PMC11214881, DOI: 10.1016/j.amjcard.2024.05.016.Peer-Reviewed Original ResearchDuke Activity Status IndexOlder adultsYears of follow-upStable ischemic heart diseaseIntensive medical therapyQoL measuresStatus indexIschemic heart diseaseDistress ratingsOlder adult populationOlder adult patientsBARI 2D trialDiabetes mellitusQuality of lifeQuality-of-lifeHeart diseaseMultivariate linear regressionFollow-upMedical therapyAdult populationQoLCognitive impairmentOlder patientsPost hoc analysisChronic total occlusionChronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series
Damluji A, Nanna M, Rymer J, Kochar A, Lowenstern A, Baron S, Narins C, Alkhouli M. Chronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series. JACC Cardiovascular Interventions 2024, 17: 961-978. PMID: 38597844, PMCID: PMC11097960, DOI: 10.1016/j.jcin.2024.01.284.Peer-Reviewed Original ResearchConceptsCardiovascular careImprove health outcomesOlder adult populationPatient-centered outcomesBiological ageAge-associated riskAging global populationAge-related riskFamily seriesComplex careHealth outcomesJACC State-of-the-Art ReviewOlder AdultsChronic illnessInfluence eligibilityProcedural adverse eventsStructural heart diseaseClinical focusCareOlder individualsInvasive careAdult populationInterventionCardiovascular diseaseOlder patientsRole of Cognitive Frailty in Older Adults With Cardiovascular Disease
Ijaz N, Jamil Y, Brown C, Krishnaswami A, Orkaby A, Stimmel M, Gerstenblith G, Nanna M, Damluji A. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. Journal Of The American Heart Association 2024, 13: e033594. PMID: 38353229, PMCID: PMC11010094, DOI: 10.1161/jaha.123.033594.Peer-Reviewed Original ResearchConceptsCognitive frailtyCardiovascular diseaseDecreased cognitive reserveOlder adult populationCognitive impairmentEvidence of dementiaPresence of cognitive impairmentTargeted intervention studiesSedentary behaviorTobacco usePhysical frailtyOlder adultsGeriatric syndromesIntervention studiesCardiovascular cliniciansFrailtyAdult populationAssociated with poor outcomesCognitive reserveRisk factorsOlder patientsCliniciansPoor outcomeTherapeutic strategiesPathophysiological underpinnings
2023
A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II A JACC: Advances Expert Panel
Nanna M, Sutton N, Kochar A, Rymer J, Lowenstern A, Gackenbach G, Hummel S, Goyal P, Rich M, Kirkpatrick J, Krishnaswami A, Alexander K, Forman D, Bortnick A, Batchelor W, Damluji A. A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II A JACC: Advances Expert Panel. JACC Advances 2023, 2: 100421. PMID: 37575202, PMCID: PMC10419335, DOI: 10.1016/j.jacadv.2023.100421.Peer-Reviewed Original ResearchPercutaneous coronary interventionCoronary interventionOlder adultsPreprocedural risk assessmentGoals of carePatient-centered outcomesInterventional cardiology practiceOlder adult populationHeart team membersGeriatric approachOlder patientsHeart teamGeriatric syndromesPharmacotherapeutic considerationsGeriatric specialistsCardiology practiceGeriatric principlesGeriatric risksAdult populationExpert panelAdultsRisk assessmentInterventionFacilitate uptakeCurrent knowledgeManagement of Stable Angina in the Older Adult Population
Nanna M, Wang S, Damluji A. Management of Stable Angina in the Older Adult Population. Circulation Cardiovascular Interventions 2023, 16: e012438. PMID: 36916288, PMCID: PMC10121835, DOI: 10.1161/circinterventions.122.012438.Peer-Reviewed Original ResearchConceptsStable ischemic heart diseaseIschemic heart diseaseStable anginaHeart diseaseOlder adultsOlder patientsGuideline-recommended treatment optionsGoals of careComplex treatment decisionsOlder Adult PopulationAdverse eventsYounger patientsMedical therapyClinical presentationGreater morbidityTreatment optionsSubgroup analysisOverall burdenHigh burdenObservational studyTreatment decisionsPatient prioritiesAnginaAdult populationEnd point
2022
Lipid‐lowering treatment among older patients with atherosclerotic cardiovascular disease
Nanna M, Nelson A, Haynes K, Shambhu S, Eapen Z, Cziraky M, Calvert S, Pagidipati N, Granger C. Lipid‐lowering treatment among older patients with atherosclerotic cardiovascular disease. Journal Of The American Geriatrics Society 2022, 71: 1243-1249. PMID: 36538393, PMCID: PMC10089944, DOI: 10.1111/jgs.18172.Peer-Reviewed Original ResearchConceptsHigh-intensity statinsLipid-lowering therapyModerate-intensity statinsU.S. older adultsOlder adultsPCSK9 inhibitorsNon-statin lipid-lowering therapyMulticenter retrospective cohort studyRetrospective cohort studyMinority of patientsAtherosclerotic cardiovascular diseaseCoronary artery diseaseEligible older adultsCohort studyOlder patientsOverall cohortArtery diseaseIntensive treatmentCardiovascular diseaseASCVDSecondary measuresStatinsUntreated individualsPatientsTherapyPrimary prevention statin therapy in older adults
Nanna M, Abdullah A, Mortensen M, Navar A. Primary prevention statin therapy in older adults. Current Opinion In Cardiology 2022, 38: 11-20. PMID: 36598445, PMCID: PMC9830552, DOI: 10.1097/hco.0000000000001003.Peer-Reviewed Original ResearchConceptsAge 75Older adult populationStatin treatmentRandomized trialsAdult populationPrimary prevention statin therapyOlder adultsAverage lifespan increasesRecent guideline recommendationsACC/AHAOngoing randomized trialsPrevention of morbidityPaucity of evidenceStatin therapyStatin useUSPSTF recommendationsOlder patientsGuideline recommendationsOngoing trialsTreatment recommendationsCardiovascular diseaseTreatment benefitTreatment decisionsGuidelines conflictTrialsHigh-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.
Nelson AJ, Haynes K, Shambhu S, Eapen Z, Cziraky MJ, Nanna MG, Calvert SB, Gallagher K, Pagidipati NJ, Granger CB. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. Journal Of The American College Of Cardiology 2022, 79: 1802-1813. PMID: 35512860, PMCID: PMC9344279, DOI: 10.1016/j.jacc.2022.02.048.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHigh-intensity statinsStatin useYounger patientsFemale patientsHigh-intensity statin useHigher Charlson comorbidity scoreAppropriate statin useNew guideline recommendationsCharlson comorbidity scoreRetrospective cohort studyPeripheral artery diseaseModerate-intensity statinsMultivariable logistic regressionCommercial health plansMedical claims dataComorbidity scoreIndex dateCohort studyOlder patientsPreventive therapyStatin usersArtery diseaseContemporary cohortGuideline recommendations
2020
Presentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study
Gupta A, Tsang S, Hajduk A, Krumholz HM, Nanna MG, Green P, Dodson JA, Chaudhry SI. Presentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2020, 134: 95-103. PMID: 32805225, PMCID: PMC7752813, DOI: 10.1016/j.amjmed.2020.07.020.Peer-Reviewed Original ResearchConceptsOldest-old patientsMyocardial infarctionFunctional impairmentOlder patientsMobility impairmentsCox proportional hazards regressionMiddle-old patientsProportional hazards regressionAcute myocardial infarctionCase fatality rateAcute myocardial infarction hospitalizationsSILVER-AMI StudyYears of ageMyocardial infarction hospitalizationsChest painCoronary revascularizationAtypical presentationHazards regressionClinical variablesRisk factorsAdvanced agePrimary symptomsPatientsFatality rateHealth statusAge-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease
Lowenstern A, Alexander KP, Hill CL, Alhanti B, Pellikka PA, Nanna MG, Mehta RH, Cooper LS, Bullock-Palmer RP, Hoffmann U, Douglas PS. Age-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease. JAMA Cardiology 2020, 5: 193-201. PMID: 31738382, PMCID: PMC6865842, DOI: 10.1001/jamacardio.2019.4973.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseOlder patientsMyocardial infarctionCV deathNoninvasive testsArtery diseaseNoninvasive evaluationElevated coronary artery calcium scoresDeath/myocardial infarctionPositive noninvasive test resultsPossible coronary artery diseaseProspective Multicenter Imaging StudyCoronary artery calcium scoreNonwhite race/ethnicityComparative effectiveness designArtery calcium scoreCoronary artery calciumMinority of patientsCause of morbidityNoninvasive test resultsFunctional test resultsAge-specific approachesBest noninvasive testPositive test resultsOlder age groups
2019
Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalence
2018
Statin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry
Nanna MG, Navar AM, Wang TY, Mi X, Virani SS, Louie MJ, Lee LV, Goldberg AC, Roger VL, Robinson J, Peterson ED. Statin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry. Journal Of The American Heart Association 2018, 7: e008546. PMID: 29739801, PMCID: PMC6015311, DOI: 10.1161/jaha.118.008546.Peer-Reviewed Original ResearchConceptsLipid Management (PALM) registryHigh-dose statinsHigh-intensity statinsStatin useOlder patientsSecondary preventionManagement RegistryPrimary preventionProvider assessmentCardiology/American Heart Association guidelinesAmerican Heart Association guidelinesMultivariable logistic regression modelRoutine community practiceHeart Association guidelinesCurrent statin usersCurrent statin useYears of ageLogistic regression modelsStatin usersYounger patientsPatient surveyAssociation guidelinesAmerican CollegeStatinsPatients