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 ResearchConceptsCoronary 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
Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation
Chouairi F, Mullan C, Ahmed A, Bhinder J, Guha A, Miller P, Jastreboff A, Fuery M, Chiravuri M, Geirsson A, Desai N, Maulion C, Sen S, Ahmad T, Anwer M. Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation. PLOS ONE 2022, 17: e0273111. PMID: 36516178, PMCID: PMC9750001, DOI: 10.1371/journal.pone.0273111.Peer-Reviewed Original ResearchConceptsPost-transplant mortalityType 2 diabetesAllocation system changeOld allocation systemsHeart transplant recipientsOutcomes of patientsOrgan Sharing databaseProportion of patientsHeart transplantation outcomesLower likelihoodLikelihood of transplantationHigher likelihoodNew allocation systemCardiac transplantationHeart transplantationTransplant recipientsT2D patientsHeart failureSharing databaseCox regressionTransplantation outcomesUnited NetworkWorse outcomesT2DPatientsAlerting 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 hospitalMachine 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 ResearchConceptsASCEND-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 womenRationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID)
Shah NN, Ghazi L, Yamamoto Y, Martin M, Simonov M, Riello RJ, Faridi KF, Ahmad T, Wilson FP, Desai NR. Rationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID). American Heart Journal 2022, 253: 76-85. PMID: 35841944, PMCID: PMC9936562, DOI: 10.1016/j.ahj.2022.07.002.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyAtherosclerotic cardiovascular diseaseTreatment of hyperlipidemiaProportion of patientsElectronic health recordsPragmatic trialHigh riskCardiovascular diseaseProprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitorsHigh-risk atherosclerotic cardiovascular diseaseSubtilisin/kexin type 9 inhibitorsLow-density lipoprotein cholesterol reductionImportant public health implicationsEnrollment of patientsPublic health implicationsUsual careSecondary outcomesPrimary outcomeGuideline recommendationsCholesterol reductionPatientsLDLHyperlipidemiaScalable interventionsOutpatientsElectronic 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 characteristics
2021
Trends and Outcomes of Cardiac Transplantation in the Lowest Urgency Candidates
Fuery MA, Chouairi F, Natov P, Bhinder J, Rose Chiravuri M, Wilson L, Clark KA, Reinhardt SW, Mullan C, Miller PE, Davis RP, Rogers JG, Patel CB, Sen S, Geirsson A, Anwer M, Desai N, Ahmad T. Trends and Outcomes of Cardiac Transplantation in the Lowest Urgency Candidates. Journal Of The American Heart Association 2021, 10: e023662. PMID: 34743559, PMCID: PMC9075266, DOI: 10.1161/jaha.121.023662.Peer-Reviewed Original ResearchConceptsLow-urgency patientsHigh-urgency patientsUrgency patientsCardiac transplantationAllocation system changeLonger waitlist timesOrgan Sharing databaseTime of transplantationCardiac transplantation candidatesNew allocation systemBaseline recipientPosttransplantation outcomesPosttransplantation survivalAdditional comorbiditiesClinical characteristicsConclusions PatientsHepatitis CIschemic timeTransplantation candidatesSharing databaseWaitlist timeWaitlist survivalUnited NetworkRetrospective analysisPatientsBrief 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 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 dataCUDCannabisEvaluation 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 periodComparison of Transcatheter and Open Mitral Valve Repair Among Patients With Mitral Regurgitation
Kay B, Chouairi F, Clark KAA, Reinhardt SW, Fuery M, Guha A, Ahmad T, Kaple RK, Desai NR. Comparison of Transcatheter and Open Mitral Valve Repair Among Patients With Mitral Regurgitation. Mayo Clinic Proceedings 2021, 96: 1522-1529. PMID: 34088415, DOI: 10.1016/j.mayocp.2021.01.029.Peer-Reviewed Original ResearchConceptsMitral valve repairMitral regurgitationValve repairInternational ClassificationPatient underwent mitral valve repairOpen mitral valve repairUnderwent mitral valve repairTranscatheter mitral valve repairStudy periodComparison of transcatheterProhibitive surgical riskTenth Revision codesTotal hospital chargesDegenerative mitral regurgitationNational Inpatient SampleLength of stayTranscatheter mitral valve repair deviceDischarge homeHospital mortalityDischarge dispositionPatient comorbiditiesSurgical riskHospital chargesMedian lengthNinth RevisionNational 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 diseaseHospitalizationPatientsMortalityDifferences 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 ResearchConceptsHospital 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 analysisImpact 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
2020
Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure
Mezzacappa C, Ravindra NG, Caraballo C, Chouairi F, Miller PE, Clarke JD, Gruen J, Mori M, McCullough M, Mullan C, Geirsson A, Rogers JG, Anwer M, Desai N, Ahmad T. Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure. PLOS ONE 2020, 15: e0242928. PMID: 33270648, PMCID: PMC7714148, DOI: 10.1371/journal.pone.0242928.Peer-Reviewed Original ResearchConceptsClinical trialsVentricular assist deviceExclusion criteriaLVAD recipientsAssist deviceReal-world settingClinical implicationsClinical trial exclusion criteriaHeart failure clinical trialsEnd-stage renal diseaseEnd-stage heart failureReal-world registryRetrospective cohort studyLandmark clinical trialsStage renal diseaseTrial exclusion criteriaRisk of deathStage heart failureRespiratory failureCohort studyPatient characteristicsHeart failurePatient factorsRenal diseaseClinical outcomesImpact of Preoperative Lymphopenia on Survival Following Left Ventricular Assist Device Placement
Stawiarski K, Agboola O, Park J, Geirsson A, Jacoby D, Bellumkonda L, Ahmad T, Chou J, Lee F, Mangi A, Bonde P. Impact of Preoperative Lymphopenia on Survival Following Left Ventricular Assist Device Placement. ASAIO Journal 2020, 67: 650-657. PMID: 33074860, DOI: 10.1097/mat.0000000000001289.Peer-Reviewed Original ResearchConceptsAbsolute lymphocyte countCause mortalityLymphopenia groupLeft ventricular assist device patientsVentricular assist device patientsVentricular assist device placementCox proportional hazards modelImpact of lymphopeniaHeart failure populationKaplan-Meier plotsFurther clinical investigationProportional hazards modelLog-rank statisticsDurable LVADPreoperative lymphopeniaLVAD placementLymphocyte countLymphopenic patientsDevice patientsSingle centerPoor outcomePrognostic implicationsALC levelsFailure populationStudy population