2024
Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention
Callegari S, Romain G, Cleman J, Scierka L, Jacque F, Smolderen K, Mena‐Hurtado C. Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention. Journal Of The American Heart Association 2024, 13: e034477. PMID: 38761075, PMCID: PMC11179837, DOI: 10.1161/jaha.124.034477.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaPeripheral vascular interventionsHealth careLimb-threatening ischemiaMortality predictorsLong-term mortality riskMultidimensional risk factorsBody mass indexLong-term mortality predictorsImprove individualized careVascular interventionsIndividualized careAssisted careBiopsychosocial modelMortality riskCareMass indexRisk factorsMedical comorbiditiesRisk profileInterventionMortality rateChronic kidney diseaseMortalityPredictive variablesClinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach.
Regan C, Scierka L, Dardik A, Tonnessen B, Iyad Ochoa Chaar C, Ionescu C, Aboian E, Cardella J, Nassiri N, Guzman R, Attaran R, Nagpal S, Shah S, Smolderen K, Mena-Hurtado C. Clinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach. Vascular 2024, 17085381241246318. PMID: 38669051, DOI: 10.1177/17085381241246318.Peer-Reviewed Original ResearchDual antiplatelet therapyPeripheral arterial diseaseCYP2C19 testingCYP2C19 mutationsHeterogeneity of treatment effectsPeripheral vascular interventionsConsensus statementKnowledge questionsAntiplatelet therapyGenetic testingVascular surgeryAcademic health systemBarriers to implementationInterquartile rangeCYP2C19 genotype testingVascular diseaseInterventional cardiologyModified Delphi methodPatient's metabolic statusManagement of patientsCritical limb ischemiaPerceived barriersPeripheral vascular diseaseArterial vascular diseaseClinician perspectivesComparison of mortality and amputation after lower extremity bypass versus peripheral vascular intervention in patients with chronic limb-threatening ischemia and comorbid chronic kidney disease
Cleman J, Sierra J, Romain G, Capuano B, Scierka L, Callegari S, Jacque F, Peri-Okonny P, Nagpal S, Smolderen K, Mena-Hurtado C. Comparison of mortality and amputation after lower extremity bypass versus peripheral vascular intervention in patients with chronic limb-threatening ischemia and comorbid chronic kidney disease. Journal Of Vascular Surgery 2024, 80: 480-489.e5. PMID: 38608966, DOI: 10.1016/j.jvs.2024.04.016.Peer-Reviewed Original ResearchChronic limb-threatening ischemiaAll-cause mortalityLower extremity bypassPeripheral vascular interventionsComorbid chronic kidney diseaseLimb-threatening ischemiaComparison of mortalityPreference-sensitive treatment decisionsCox proportional hazards modelsRisk of deathInteraction termsProportional hazards modelLower-extremity bypassChronic kidney diseaseFine-Gray modelMortality riskVascular interventionsAmputationHazards modelOutcome dataFine-GrayAssociated with worse outcomesHigh riskKidney diseasePropensity scoreEvaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia
Cleman J, Romain G, Callegari S, Scierka L, Jacque F, Smolderen K, Mena-Hurtado C. Evaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia. Vascular Medicine 2024, 29: 172-181. PMID: 38334045, DOI: 10.1177/1358863x231224335.Peer-Reviewed Original ResearchChronic limb-threatening ischemiaPeripheral vascular interventionsAssisted careLimb-threatening ischemiaCongestive heart failureFunctional status variablesCrude mortality ratePredictive variablesMortality rateStatus variablesRandom survival forest modelShort-term mortalityStage 5 chronic kidney diseaseQuality InitiativeRandom survival forestTreatment conversionMedical comorbiditiesShort-term outcomesHarrell's C-indexVascular Quality InitiativeCareDementiaInterventionMortalityRisk stratificationVariability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions
Smolderen K, Romain G, Cleman J, Scierka L, Mena-Hurtado C. Variability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions. American Heart Journal 2024, 270: 75-85. PMID: 38307364, DOI: 10.1016/j.ahj.2024.01.008.Peer-Reviewed Original ResearchMedian odds ratioGuideline-directed medical therapy prescriptionGuideline-directed medical therapy ratesPeripheral vascular interventionsGuideline-directed medical therapyIntraclass correlationHealth system levelDecrease hospital readmissionsPatient-level factorsGuideline-directed medical therapy useAssociated with higher riskAngiotensin-converting enzyme inhibitor/angiotensin receptor blockerRisk of deathParametric survival modelsInhibitor/angiotensin receptor blockerProportion of riskHospital readmissionVascular Quality Initiative registryLong-term mortalityOdds ratioReadmission riskVascular interventionsLogistic regressionDose-response relationshipAmputation
2023
Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions
Smolderen K, Romain G, Provance J, Scierka L, Mao J, Goodney P, Henke P, Sedrakyan A, Mena-Hurtado C. Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions. JACC Cardiovascular Interventions 2023, 16: 332-343. PMID: 36792257, PMCID: PMC10359106, DOI: 10.1016/j.jcin.2022.09.022.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyPeripheral vascular interventionsMedical therapyVascular interventionsEnzyme inhibitors/angiotensin receptor blockersVascular Quality Initiative registryAngiotensin receptor blockersLong-term mortalityRisk of amputationRisk of mortalityNational quality registryQuality improvement effortsAmputation outcomesAmputation riskMajor amputationAntiplatelet therapyCause mortalityReceptor blockersMean ageVascular careQuality registryObservational studyMortality riskHigh riskAmputation data
2022
Real‐world VASCADE closure device versus manual compression use and outcomes in patients with severe common femoral artery disease
Nagpal S, Scierka LE, Castro‐Dominguez Y, Kansal D, Kunnirickal S, Hussain Y, Love K, Aboian E, Smolderen KG, Mena‐Hurtado C. Real‐world VASCADE closure device versus manual compression use and outcomes in patients with severe common femoral artery disease. Catheterization And Cardiovascular Interventions 2022, 100: 776-784. PMID: 36129818, DOI: 10.1002/ccd.30405.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsManual compressionClosure deviceCommon femoral artery diseaseVascular Quality Initiative databaseFemoral artery diseasePropensity-matched cohortPseudoaneurysm rateRetroperitoneal bleedingArtery diseaseRetrospective reviewMean ageBaseline variablesInstitutional databaseNonsignificant reductionNonsignificant decreaseVascular interventionsMortality ratePatientsCompression useCollagen plugDiseaseInitiative databaseProcedural metricsDevice use