2023
Timing 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.Peer-Reviewed Original Research
2021
Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries
Wheelock KM, Ross JS, Murugiah K, Lin Z, Krumholz HM, Khera R. Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries. JAMA Network Open 2021, 4: e2137288. PMID: 34870678, PMCID: PMC8649845, DOI: 10.1001/jamanetworkopen.2021.37288.Peer-Reviewed Original ResearchConceptsDOAC useAnticoagulant prescriptionOral anticoagulantsUS cliniciansMedicare beneficiariesNational clinical practice guidelinesElevated bleeding riskOral anticoagulant prescriptionsRetrospective cohort studyDirect oral anticoagulantsClinical practice guidelinesUS Medicare beneficiariesInternal medicine physiciansNumber of cliniciansAnticoagulant prescribingDOAC prescriptionsUnique cliniciansBleeding riskCohort studyAnticoagulant strategiesPrescription claimsPractice guidelinesMAIN OUTCOMEMost indicationsMedicare populationScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsComparative Outcomes of Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction Among Medicare Beneficiaries With Multivessel Coronary Artery Disease
Secemsky EA, Butala N, Raja A, Khera R, Wang Y, Curtis JP, Maddox TM, Virani SS, Armstrong EJ, Shunk KA, Brindis RG, Bhatt D, Yeh RW. Comparative Outcomes of Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction Among Medicare Beneficiaries With Multivessel Coronary Artery Disease. Circulation Cardiovascular Interventions 2021, 14: e010323. PMID: 34372676, PMCID: PMC8485756, DOI: 10.1161/circinterventions.120.010323.Peer-Reviewed Original ResearchAssociation of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry
Rao A, Ranka S, Ayers C, Hendren N, Rosenblatt A, Alger HM, Rutan C, Omar W, Khera R, Gupta K, Mody P, DeFilippi C, Das SR, Hedayati SS, de Lemos JA. Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry. Journal Of The American Heart Association 2021, 10: e020910. PMID: 34107743, PMCID: PMC8477855, DOI: 10.1161/jaha.121.020910.Peer-Reviewed Original ResearchConceptsAcute kidney injuryMajor adverse cardiac eventsAdverse cardiac eventsChronic kidney diseaseCardiac eventsKidney diseaseCause mortalityAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCOVID-19Major adverse cardiovascular eventsEnd-stage kidney diseaseCardiovascular Disease RegistryLarge multicenter registryNonfatal heart failureSerial laboratory dataAdverse cardiovascular eventsNonfatal myocardial infarctionKey secondary outcomesCardiovascular disease outcomesPrimary exposure variableNonfatal strokeCardiogenic shockCardiovascular deathCardiovascular eventsCardiovascular outcomesContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican CollegeElectronic 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 discriminationPatientsAdmissionScores
2020
Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceTemporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016
Khera R, Kondamudi N, Zhong L, Vaduganathan M, Parker J, Das SR, Grodin JL, Halm EA, Berry JD, Pandey A. Temporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016. JAMA Network Open 2020, 3: e2022190. PMID: 33095250, PMCID: PMC7584929, DOI: 10.1001/jamanetworkopen.2020.22190.Peer-Reviewed Original ResearchConceptsHeart failure incidenceHF risk factorsHF incidenceClinical Modification codesRisk factorsAcute MIMedicare beneficiariesFailure incidenceHF prevention strategiesRisk factor strataNational cohort studyService Medicare beneficiariesUnique Medicare beneficiariesInternational Statistical ClassificationRace/ethnicityPrior HFPrevalent hypertensionCohort studyIncident HFNinth RevisionPrevious diagnosisCardiovascular conditionsTenth RevisionMAIN OUTCOMEInternational ClassificationThe Upcoming Epidemic of Heart Failure in South Asia
Martinez-Amezcua P, Haque W, Khera R, Kanaya AM, Sattar N, Lam CSP, Harikrishnan S, Shah SJ, Kandula NR, Jose PO, Narayan KMV, Agyemang C, Misra A, Jenum AK, Bilal U, Nasir K, Cainzos-Achirica M. The Upcoming Epidemic of Heart Failure in South Asia. Circulation Heart Failure 2020, 13: e007218. PMID: 32962410, DOI: 10.1161/circheartfailure.120.007218.Peer-Reviewed Original ResearchConceptsType 2 diabetes mellitusHeart failureCoronary heart diseaseHeart diseaseHF epidemicDiabetes mellitusEarly type 2 diabetes mellitusLifestyle-related risk factorsPrognosis of HFPremature coronary heart diseasePremature heart failurePrevalent heart failureRheumatic heart diseaseSouth AsiansAbdominal obesityGeneral obesitySouth Asian populationRisk factorsDramatic healthGlobal burdenRecent studiesUrgent interventionUnderrecognized threatTobacco productsUpcoming epidemicRates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction
Caraballo C, Khera R, Jones PG, Decker C, Schulz W, Spertus JA, Krumholz HM. Rates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006231. PMID: 32552061, PMCID: PMC9465954, DOI: 10.1161/circoutcomes.119.006231.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHospitalization eventsMedical recordsLongitudinal multicenter cohort studyMulticenter cohort studyMedical record abstractionDifferent patient characteristicsHealth care eventsPatients' underreportingTRIUMPH registryAccuracy of reportingCohort studyPatient characteristicsRecord abstractionProspective studyClinical studiesClinical investigationHospitalizationPatientsCare eventsInfarctionEvent ratesParticipantsPredictorsTemporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries
Pandey A, Keshvani N, Khera R, Lu D, Vaduganathan M, Maddox K, Das SR, Kumbhani DJ, Goyal A, Girotra S, Chan P, Fonarow GC, Matsouaka R, Wang TY, de Lemos JA. Temporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries. JAMA Cardiology 2020, 5: 136-145. PMID: 31913411, PMCID: PMC6990949, DOI: 10.1001/jamacardio.2019.4845.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionNonblack patientsMyocardial infarctionReadmission ratesMortality rateBlack patientsChest Pain-MI RegistryThirty-day readmission ratesRacial disparitiesExcess readmission ratiosPenalty statusObservational cohort analysisPatient-level factorsRacial differencesReadmissions Reduction ProgramHigher unadjusted oddsHRRP implementationCause readmissionPatient characteristicsUnadjusted oddsBlack raceThirty-dayAdjusted associationsReadmission ratios
2019
Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak association
2018
Effects of the Hospital Readmissions Reduction Program
Khera R, Krumholz HM. Effects of the Hospital Readmissions Reduction Program. Circulation Cardiovascular Quality And Outcomes 2018, 11: e005083. PMID: 30562071, DOI: 10.1161/circoutcomes.118.005083.Peer-Reviewed Original Research
2017
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002–2013
Valero-Elizondo J, Hong JC, Spatz ES, Salami JA, Desai NR, Rana JS, Khera R, Virani SS, Blankstein R, Blaha MJ, Nasir K. Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002–2013. Atherosclerosis 2017, 269: 301-305. PMID: 29254694, DOI: 10.1016/j.atherosclerosis.2017.12.014.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseSocioeconomic statusWorse cardiovascular risk factor profileCardiovascular risk factor profileHighest prevalence increasePrevalence of CRFCardiovascular risk factorsRisk factor profileHealthy lifestyle behaviorsMedical Expenditure Panel Survey 2002Medical Expenditure Panel SurveyHealth disparity gapRelative percent increasePhysical inactivityLifestyle behaviorsRisk factorsPrevalence increasesHigh burdenHigh prevalenceLow-income groupsProportion of individualsUS adultsFactor profileDisparity gapSocioeconomic disparitiesBurden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States
Khera R, Hong JC, Saxena A, Arrieta A, Virani SS, Blankstein R, de Lemos JA, Krumholz HM, Nasir K. Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States. Circulation 2017, 137: 408-410. PMID: 29133601, PMCID: PMC5780190, DOI: 10.1161/circulationaha.117.030128.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleHealth Care CostsHealth ExpendituresHealth Services AccessibilityHospital ChargesHospital CostsHumansIncomeMaleMedically UninsuredMiddle AgedMyocardial InfarctionPatient Protection and Affordable Care ActProcess Assessment, Health CareStrokeTime FactorsUnited StatesYoung AdultContemporary Epidemiology of Heart Failure in Fee-For-Service Medicare Beneficiaries Across Healthcare Settings
Khera R, Pandey A, Ayers CR, Agusala V, Pruitt SL, Halm EA, Drazner MH, Das SR, de Lemos JA, Berry JD. Contemporary Epidemiology of Heart Failure in Fee-For-Service Medicare Beneficiaries Across Healthcare Settings. Circulation Heart Failure 2017, 10: e004402. PMID: 29129828, PMCID: PMC6057614, DOI: 10.1161/circheartfailure.117.004402.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overAmbulatory CareCardiology Service, HospitalDatabases, FactualFee-for-Service PlansFemaleHealth Services Needs and DemandHeart FailureHumansIncidenceInsurance BenefitsMaleMedicareNeeds AssessmentPrevalencePrognosisTime FactorsUnited StatesConceptsIncident HFService Medicare beneficiariesMedicare beneficiariesStudy periodEpidemiology of HFHeart failure epidemicOutpatient care settingsHealth policy interventionsHF mortalityPrevalent HFHeart failureMean ageOutpatient settingOverall burdenCare settingsContemporary epidemiologyNew diagnosisInpatientsHealthcare settingsCohortEpidemiologyPatientsMortalityFirst yearPronounced decreasePredictors of Death in Adults With Duchenne Muscular Dystrophy–Associated Cardiomyopathy
Cheeran D, Khan S, Khera R, Bhatt A, Garg S, Grodin JL, Morlend R, Araj FG, Amin AA, Thibodeau JT, Das S, Drazner MH, Mammen PPA. Predictors of Death in Adults With Duchenne Muscular Dystrophy–Associated Cardiomyopathy. Journal Of The American Heart Association 2017, 6: e006340. PMID: 29042427, PMCID: PMC5721845, DOI: 10.1161/jaha.117.006340.Peer-Reviewed Original ResearchConceptsDuchenne muscular dystrophyDMD patientsPrognostic factorsDMD populationCardiac biomarkersHigh-risk cardiovascular populationLower body mass indexAdult DMD patientsHeart failure medicationsPredictors of deathAlanine aminotransferase levelsElevated cardiac biomarkersPoor prognostic factorMaximum inspiratory pressureBody mass indexElectronic medical recordsCardiomyopathy clinicMedian followAminotransferase levelsBaseline characteristicsCardiovascular populationRetrospective cohortConsecutive patientsMass indexWorse prognosisComparison of Readmission Rates After Acute Myocardial Infarction in 3 Patient Age Groups (18 to 44, 45 to 64, and ≥65 Years) in the United States
Khera R, Jain S, Pandey A, Agusala V, Kumbhani DJ, Das SR, Berry JD, de Lemos JA, Girotra S. Comparison of Readmission Rates After Acute Myocardial Infarction in 3 Patient Age Groups (18 to 44, 45 to 64, and ≥65 Years) in the United States. The American Journal Of Cardiology 2017, 120: 1761-1767. PMID: 28865892, PMCID: PMC5825232, DOI: 10.1016/j.amjcard.2017.07.081.Peer-Reviewed Original ResearchConceptsYounger age groupsLow-income patientsReadmission ratesAge groupsHigh hospitalization burdenIndex AMI hospitalizationNationwide Readmissions DatabaseRisk of readmissionPatient age groupsAcute myocardial infarctionVulnerable patient groupSignificant resource utilizationMultivariable hierarchical modelsYears of ageHealth care resourcesHealth care systemReadmission periodHospitalization burdenPayer databaseAMI survivorsPost-AMIPatient groupInpatient hospitalizationMyocardial infarctionReadmissionWith Great Power Comes Great Responsibility
Khera R, Krumholz HM. With Great Power Comes Great Responsibility. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003846. PMID: 28705865, PMCID: PMC5728376, DOI: 10.1161/circoutcomes.117.003846.Peer-Reviewed Original Research