Featured Publications
Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction. Circulation 2018, 137: 781-790. PMID: 29459463, PMCID: PMC5822747, DOI: 10.1161/circulationaha.117.031650.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPerception of symptomsChest painCare-seeking behaviorSymptom presentationYounger patientsMyocardial infarctionST-segment elevation acute myocardial infarctionMultivariable hierarchical logistic regressionIndex AMI hospitalizationMajority of womenHierarchical logistic regressionStress/anxietyVIRGO StudyMuscle painPatient characteristicsPredominant symptomAMI symptomsPerceive symptomsProdromal symptomsPatient interviewsHeart diseasePainAMI hospitalizationUS hospitalsPrevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Prevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department. European Heart Journal Acute Cardiovascular Care 2018, 9: 5-13. PMID: 29543037, DOI: 10.1177/2048872618764418.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary artery diseaseCardiac positron emission tomography/Positron emission tomography/Chest pain patientsArtery diseaseAcute myocardial infarctionEmission tomography/Chest painMyocardial infarctionMicrovascular dysfunctionPain patientsEmergency departmentTomography/General emergency department populationLower coronary flow reserveNon-obstructive coronary arteriesPrior emergency department visitsTraditional cardiac risk factorsCardiac risk factorsModerate-risk patientsEmergency department visitsEmergency department patientsCoronary flow reserveEmergency department populationIdentifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation
Safdar B, Ong P, Camici PG. Identifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation. Clinical Therapeutics 2018, 40: 1920-1930. PMID: 30458932, DOI: 10.1016/j.clinthera.2018.09.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent chest painCoronary microvascular dysfunctionChest painEmergency departmentHs-TnTMicrovascular dysfunctionMyocardial ischemiaAcute chest pain evaluationHigh-sensitivity troponin TDiagnosis of AMIType 2 acute myocardial infarctionElevated hs-TnTIschemia/necrosisChest pain evaluationGroup of patientsAssessment of symptomsIdentification of patientsAppropriate medical treatmentSex-specific thresholdsPulmonary embolismVasomotor disordersAortic dissectionPain evaluationEpicardial coronaries
2022
Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain
Banco D, Chang J, Talmor N, Wadhera P, Mukhopadhyay A, Lu X, Dong S, Lu Y, Betensky RA, Blecker S, Safdar B, Reynolds HR. Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain. Journal Of The American Heart Association 2022, 11: e024199. PMID: 35506534, PMCID: PMC9238573, DOI: 10.1161/jaha.121.024199.Peer-Reviewed Original ResearchConceptsChest painAcute myocardial infarctionEmergency departmentMultivariable adjustmentYoung adultsMyocardial infarctionBackground Acute myocardial infarctionRacial differencesCardiac biomarker testingHospital admissionClinical featuresConclusions WomenPhysician evaluationTriage levelBiomarker testingCardiac biomarkersWhite adultsNational estimatesObservation unitCP managementAdultsSurvey 2014WomenPainInfarctionDepression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience)
Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Lu Y, Spatz ES, Gupta A, Khera R, Ng VG, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Depression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience). The American Journal Of Cardiology 2022, 173: 33-38. PMID: 35365290, PMCID: PMC9133198, DOI: 10.1016/j.amjcard.2022.03.005.Peer-Reviewed Original ResearchConceptsSpontaneous coronary artery dissectionPatient Health Questionnaire-9Coronary artery dissectionPSS-14 scoreArtery dissectionBaseline PHQ-9 scoreAcute myocardial infarction patientsCardiovascular risk factorsPHQ-9 scoresAcute myocardial infarctionMyocardial infarction patientsYears of agePerceived Stress Scale scoresStress Scale scoresLinear mixed-effects analysisSCAD casesVIRGO StudyQuestionnaire-9Infarction patientsMixed-effects analysisMyocardial infarctionSubgroup analysisRisk factorsRoutine screeningClinical acuityHealth status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience
Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Khera R, Lu Y, Spatz ES, Ng VG, Gupta A, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Health status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience. PLOS ONE 2022, 17: e0265624. PMID: 35320296, PMCID: PMC8942215, DOI: 10.1371/journal.pone.0265624.Peer-Reviewed Original ResearchConceptsSpontaneous coronary artery dissectionAcute myocardial infarctionAMI patientsCoronary artery dissectionYoung AMI patientsHealth status outcomesHealth status instrumentsSCAD patientsArtery dissectionMyocardial infarctionStatus outcomesPatientsOutcomesHousehold incomeCollege educationInfarction
2020
National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare SurveyUtility of discovery approach using proteomics to create a biomarker profile for coronary microvascular dysfunction
Nowroozpoor A, Gutterman D, Safdar B. Utility of discovery approach using proteomics to create a biomarker profile for coronary microvascular dysfunction. Microvascular Research 2020, 129: 103985. PMID: 32007502, PMCID: PMC10291513, DOI: 10.1016/j.mvr.2020.103985.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveMicrovascular dysfunctionNormal coronary flow reservePositron emission tomography/Beta-blocker useAcute myocardial infarctionEmission tomography/Regional perfusion defectsSerum proteinsBaseline characteristicsCoronary calcificationMyocardial infarctionTomography/Perfusion defectsCMD patientsFlow reserveSerial measurementsBiomarker profilesAdvanced imagingPatientsPotential biomarkersPotential protein biomarkersSerum samplesObservation unit
2013
Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women
Diercks DB, Mumma BE, Peacock W, Hollander JE, Safdar B, Mahler SA, Miller CD, Counselman FL, Birkhahn R, Schrock J, Singer AJ, Nagurney JT. Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women. Academic Emergency Medicine 2013, 20: 265-270. PMID: 23517258, PMCID: PMC3725334, DOI: 10.1111/acem.12092.Peer-Reviewed Original ResearchConceptsObjective cardiac testingPhysician risk assessmentAcute myocardial infarctionAcute coronary syndromeCardiac testingNon-high riskNet reclassification indexChest painTroponin IEmergency departmentReclassification indexPresence of ACSAcute coronary syndrome studyMedian age 58 yearsNegative troponin ISerial cardiac markersSerial troponin IAge 58 yearsIncremental valueReceiver operator characteristic curveContemporary troponin assaysClinician risk assessmentOperator characteristic curveReclassified patientsCoronary syndrome
2012
Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain
Diercks DB, Peacock WF, Hollander JE, Singer AJ, Birkhahn R, Shapiro N, Glynn T, Nowack R, Safdar B, Miller CD, Lewandrowski E, Nagurney JT. Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain. American Heart Journal 2012, 163: 74-80.e4. PMID: 22172439, DOI: 10.1016/j.ahj.2011.09.028.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCare troponin IAcute coronary syndromeSymptom onsetMyocardial infarctionDiagnostic accuracyCoronary syndromeEmergency departmentSerial testingAmerican Heart Association/American CollegeTroponin ICriterion standard diagnosisInitial blood drawAvailable medical recordsCardiac marker testingPositive likelihood ratioSimilar diagnostic accuracyNegative likelihood ratioInvestigational markersIschemia evaluationCardiology criteriaChest painLikelihood ratioMedian ageMedian time