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 riskComparative Analysis of PCI Strategies in Aortic Stenosis Patients Undergoing TAVI: A Systematic Review and Network Meta‐Analysis
Fallahtafti P, Soleimani H, Ebrahimi P, Ghaseminejad‐Raeini A, Karimi E, Shirinezhad A, Sabri M, Mehrani M, Taheri H, Siegel R, Shah N, Nanna M, Hakim D, Hosseini K. Comparative Analysis of PCI Strategies in Aortic Stenosis Patients Undergoing TAVI: A Systematic Review and Network Meta‐Analysis. Clinical Cardiology 2024, 47: e24324. PMID: 39054901, PMCID: PMC11272956, DOI: 10.1002/clc.24324.Peer-Reviewed Original ResearchConceptsTranscatheter aortic valve implantationCoronary artery diseasePercutaneous coronary interventionIn-hospital mortalityNetwork meta-analysisMyocardial infarctionAortic stenosisAssociated with worse 30-day outcomeMeta-analysisIncreased risk of 1-year mortalityAssociated with higher 1-year mortalityRisk of 1-year mortalitySevere aortic stenosisFrequentist network meta-analysisRates of myocardial infarctionPercutaneous coronary intervention timeTime of revascularizationAortic valve implantationSevere ASNo significant differencePacemaker implantationPost-TAVIValve implantationPatient characteristicsArtery diseaseChronological 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 patientsIntravascular Imaging–Guided Versus Angiography‐Guided Percutaneous Coronary Intervention: A Systematic Review and Meta‐Analysis of Randomized Trials
Sreenivasan J, Reddy R, Jamil Y, Malik A, Chamie D, Howard J, Nanna M, Mintz G, Maehara A, Ali Z, Moses J, Chen S, Chieffo A, Colombo A, Leon M, Lansky A, Ahmad Y. Intravascular Imaging–Guided Versus Angiography‐Guided Percutaneous Coronary Intervention: A Systematic Review and Meta‐Analysis of Randomized Trials. Journal Of The American Heart Association 2024, 13: e031111. PMID: 38214263, PMCID: PMC10926835, DOI: 10.1161/jaha.123.031111.Peer-Reviewed Original ResearchConceptsAdverse cardiac eventsPercutaneous coronary interventionAngiography-guided percutaneous coronary interventionTarget vessel revascularizationTarget-lesion revascularizationCardiac eventsCardiac deathImaging-guided percutaneous coronary interventionWeighted mean follow-up durationMeta-analysisPrimary outcomeMean follow-up durationStent thrombosisMeta-analysis of randomized trialsStudy-level meta-analysisComplex lesion subsetsIntravascular imagingAll-cause deathRandom-effects meta-analysisStandard of careIntention-to-treat principleUpdates of clinical guidelinesMixed-effects meta-regressionComplex percutaneous coronary interventionIntravascular imaging-guided percutaneous coronary intervention
2023
Complex Percutaneous Coronary Intervention Outcomes in Older Adults
Hanna J, Wang S, Kochar A, Park D, Damluji A, Henry G, Ahmad Y, Curtis J, Nanna M. Complex Percutaneous Coronary Intervention Outcomes in Older Adults. Journal Of The American Heart Association 2023, 12: e029057. PMID: 37776222, PMCID: PMC10727245, DOI: 10.1161/jaha.122.029057.Peer-Reviewed Original ResearchConceptsNoncomplex percutaneous coronary interventionsComplex percutaneous coronary interventionStable ischemic heart diseasePercutaneous coronary interventionIschemic heart diseaseTarget lesion revascularizationEvent-free survivalHeart diseaseOlder adultsCause deathLesion revascularizationClinical characteristicsElective percutaneous coronary interventionPercutaneous coronary intervention outcomesWorse event-free survivalMedical therapy useCox regression modelLarge health systemNoncardiac comorbiditiesRevascularization riskCoronary interventionTherapy useClinical outcomesDisease featuresLower riskComparison of intravascular ultrasound, optical coherence tomography, and conventional angiography‐guided percutaneous coronary interventions: A systematic review, network meta‐analysis, and meta‐regression
Park D, An S, Jolly N, Attanasio S, Yadav N, Gutierrez J, Nanna M, Rao S, Vij A. Comparison of intravascular ultrasound, optical coherence tomography, and conventional angiography‐guided percutaneous coronary interventions: A systematic review, network meta‐analysis, and meta‐regression. Catheterization And Cardiovascular Interventions 2023, 102: 440-450. PMID: 37483068, PMCID: PMC10908343, DOI: 10.1002/ccd.30784.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsPercutaneous coronary interventionOptical coherence tomographyCoronary angiographyIntravascular ultrasoundCoronary interventionCardiac deathClinical outcomesClinical efficacyConventional angiography-guided PCIAngiography-guided percutaneous coronary interventionCoherence tomographyUse of IVUSSuperiority of OCTAdverse cardiovascular eventsRandomized clinical trialsConventional coronary angiographyImaging modalitiesComparative clinical efficacyBest imaging modalityIntracoronary imaging modalityLesion revascularizationPCI guidanceCardiovascular eventsCause mortalityDelirium in older adults after percutaneous coronary intervention: Prevalence, risks, and clinical phenotypes
Park D, Jamil Y, Hu J, Lowenstern A, Frampton J, Abdullah A, Damluji A, Ahmad Y, Soufer R, Nanna M. Delirium in older adults after percutaneous coronary intervention: Prevalence, risks, and clinical phenotypes. Cardiovascular Revascularization Medicine 2023, 57: 60-67. PMID: 37414611, PMCID: PMC10730763, DOI: 10.1016/j.carrev.2023.06.010.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionHospital mortalityHigher oddsOlder adultsHospital deliriumCoronary interventionAdverse health-related outcomesInpatient percutaneous coronary interventionNon-home dischargePeri-procedural settingAcute kidney injuryImpact of deliriumPost-procedural complicationsNational Inpatient SampleHealth-related outcomesDelirium preventionHospital complicationsMore comorbiditiesGastrointestinal hemorrhageKidney injuryAdverse eventsSecondary outcomesBlood transfusionPrimary outcomeIntracranial hemorrhageManagement 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 ResearchMeSH KeywordsAgedAngina, StableComorbidityHumansMyocardial IschemiaRandomized Controlled Trials as TopicTreatment OutcomeConceptsStable 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 pointThe Heterogeneity of Old Age Healthy Aging in Older Adults Undergoing TAVR ∗
Damluji A, Rymer J, Nanna M. The Heterogeneity of Old Age Healthy Aging in Older Adults Undergoing TAVR ∗. JACC Cardiovascular Interventions 2023, 16: 189-192. PMID: 36697155, PMCID: PMC9945654, DOI: 10.1016/j.jcin.2022.12.008.Peer-Reviewed Original Research
2022
Network 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 trialsReadmission rates and risk factors for readmission after transcatheter aortic valve replacement in patients with end-stage renal disease
Park DY, An S, Hanna JM, Wang SY, Cruz-Solbes AS, Kochar A, Lowenstern AM, Forrest JK, Ahmad Y, Cleman M, Al Damluji A, Nanna MG. Readmission rates and risk factors for readmission after transcatheter aortic valve replacement in patients with end-stage renal disease. PLOS ONE 2022, 17: e0276394. PMID: 36264931, PMCID: PMC9584363, DOI: 10.1371/journal.pone.0276394.Peer-Reviewed Original ResearchConceptsEnd-stage renal diseaseTranscatheter aortic valve replacementLength of stayAortic valve replacementIndex hospitalizationHospital mortalityReadmission ratesValve replacementRenal diseaseLonger LOSNational Readmission DatabaseRisk of readmissionChronic pulmonary diseaseMultivariable logistic regressionCardiovascular causesCardiovascular readmissionCause readmissionHospital readmissionPulmonary diseaseHospital chargesPoor outcomeRisk factorsHospital costsReadmissionHigher oddsReadmission and In-Hospital Outcomes After Transcatheter Aortic Valve Replacement in Patients With Dementia
Park DY, Sana MK, Shoura S, Hammo H, Hu JR, Forrest JK, Lowenstern A, Cleman M, Ahmad Y, Nanna MG. Readmission and In-Hospital Outcomes After Transcatheter Aortic Valve Replacement in Patients With Dementia. Cardiovascular Revascularization Medicine 2022, 46: 70-77. PMID: 35973922, PMCID: PMC10940024, DOI: 10.1016/j.carrev.2022.08.016.Peer-Reviewed Original ResearchConceptsTranscatheter aortic valve replacementAortic valve replacementAortic stenosisValve replacementSecondary diagnosisHospital adverse outcomesAcute kidney injuryIn-Hospital OutcomesNational Readmission DatabasePresence of dementiaPrevalence of dementiaProportional hazards modelDecade of ageHigher hazardIndex hospitalizationInpatient outcomesKidney injuryDefinitive treatmentPacemaker placementReadmission riskAdverse outcomesReadmissionHigher oddsDecision-making discussionsHigh riskChoice of antihypertensive agent in isolated systolic hypertension and isolated diastolic hypertension: A secondary analysis of the ALLHAT trial
Wang SY, Hanna JM, Gongal P, Onuma O, Nanna MG. Choice of antihypertensive agent in isolated systolic hypertension and isolated diastolic hypertension: A secondary analysis of the ALLHAT trial. American Heart Journal 2022, 254: 30-34. PMID: 35932912, PMCID: PMC10908340, DOI: 10.1016/j.ahj.2022.07.006.Peer-Reviewed Original ResearchMeSH KeywordsAmlodipineAntihypertensive AgentsChlorthalidoneHumansHypertensionIsolated Systolic HypertensionLisinoprilTreatment OutcomeConceptsDiastolic hypertensionSystolic hypertensionAntihypertensive agentsSecondary analysisPrevent Heart Attack TrialBroad treatment recommendationsDifferent antihypertensive agentsUse of chlorthalidoneLipid-Lowering TreatmentHeart Attack TrialCoronary heart diseaseCause mortalityPrimary outcomeAttack TrialALLHAT trialHeart diseaseTreatment recommendationsHypertensionPatientsTrialsAntihypertensivesAmlodipineLisinoprilStrokeAgentsShortening the duration of dual antiplatelet therapy after percutaneous coronary intervention for acute coronary syndrome: A systematic review and meta-analysis
Park DY, Wang P, An S, Grimshaw AA, Frampton J, Ohman EM, Rao SV, Nanna MG. Shortening the duration of dual antiplatelet therapy after percutaneous coronary intervention for acute coronary syndrome: A systematic review and meta-analysis. American Heart Journal 2022, 251: 101-114. PMID: 35654162, PMCID: PMC10904033, DOI: 10.1016/j.ahj.2022.05.019.Peer-Reviewed Original ResearchConceptsMonths of DAPTHazard ratioIschemic eventsDuration of DAPTSelect patient characteristicsDual antiplatelet therapyAcute coronary syndromeCoronary artery lesionsPercutaneous coronary interventionConfidence intervalsAssociation of outcomesRandom-effects modelComprehensive literature searchMeta-regression analysisMajor bleedingAntiplatelet therapyCoronary syndromeArtery lesionsCoronary interventionControlled TrialsPatient characteristicsPrespecified outcomesGreater proportionSimilar efficacySystematic reviewAn age‐old dilemma: Defining the optimal revascularization approach in older adults
Hanna JM, Nanna MG. An age‐old dilemma: Defining the optimal revascularization approach in older adults. Journal Of The American Geriatrics Society 2022, 70: 2205-2208. PMID: 35596677, PMCID: PMC9378558, DOI: 10.1111/jgs.17831.Peer-Reviewed Original ResearchFrailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI)
Al-Damluji MS, Smolderen KG, Meng C, Dai F, Nanna MG, Sumpio B, Henke P, Mena-Hurtado C. Frailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI). Vascular Medicine 2022, 27: 251-257. PMID: 35485400, DOI: 10.1177/1358863x221083701.Peer-Reviewed Original ResearchConceptsRisk Analysis IndexVascular Quality InitiativeLower extremity revascularizationFrailty screening toolsMFI-5Lower extremity peripheral artery diseaseScreening toolFrailty detectionAddition of frailtyPAD risk factorsPeripheral artery diseasePAD populationRevascularization typeVascular cohortMajor amputationPerioperative outcomesArtery diseaseFrailty indexFrailty toolsAdjusted analysisUnplanned amputationRisk factorsHigher oddsPredictive valuePatients
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 statusRacial Differences in Long-Term Cardiovascular Outcomes The Need to Move From Description to Action ∗
Nanna MG, Peterson ED. Racial Differences in Long-Term Cardiovascular Outcomes The Need to Move From Description to Action ∗. JACC Cardiovascular Interventions 2020, 13: 1596-1598. PMID: 32646702, PMCID: PMC7338011, DOI: 10.1016/j.jcin.2020.05.043.Peer-Reviewed Original Research
2019
A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention
Sullivan AE, Nanna MG, Rao SV, Cantrell S, Gibson CM, Verheugt FWA, Peterson ED, Lopes RD, Alexander JH, Granger CB, Yee MK, Kong DF. A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention. Catheterization And Cardiovascular Interventions 2019, 96: e102-e109. PMID: 31713326, PMCID: PMC7211549, DOI: 10.1002/ccd.28535.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAnticoagulantsAtrial FibrillationCoronary ThrombosisDual Anti-Platelet TherapyFemaleFibrinolytic AgentsHemorrhageHumansMalePercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeConceptsPercutaneous coronary interventionAcute coronary syndromeDouble therapyOral anticoagulationAtrial fibrillationTriple therapyAntithrombotic therapyCoronary syndromeCoronary interventionStent thrombosisMajor adverse cardiovascular eventsTriple antithrombotic therapyAdverse cardiovascular eventsDual antiplatelet therapyOptimal antithrombotic therapyGood safety profileRandom-effects modelIschemic outcomesAntiplatelet therapyCardiovascular eventsP2Y12 inhibitorsMedical managementRandomized trialsIntracranial hemorrhageSafety profileSex-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