Featured Publications
Severe aortic stenosis detection by deep learning applied to echocardiography
Holste G, Oikonomou E, Mortazavi B, Coppi A, Faridi K, Miller E, Forrest J, McNamara R, Ohno-Machado L, Yuan N, Gupta A, Ouyang D, Krumholz H, Wang Z, Khera R. Severe aortic stenosis detection by deep learning applied to echocardiography. European Heart Journal 2023, 44: 4592-4604. PMID: 37611002, PMCID: PMC11004929, DOI: 10.1093/eurheartj/ehad456.Peer-Reviewed Original ResearchMultinational patterns of second line antihyperglycaemic drug initiation across cardiovascular risk groups: federated pharmacoepidemiological evaluation in LEGEND-T2DM
Khera R, Dhingra L, Aminorroaya A, Li K, Zhou J, Arshad F, Blacketer C, Bowring M, Bu F, Cook M, Dorr D, Duarte-Salles T, DuVall S, Falconer T, French T, Hanchrow E, Horban S, Lau W, Li J, Liu Y, Lu Y, Man K, Matheny M, Mathioudakis N, McLemore M, Minty E, Morales D, Nagy P, Nishimura A, Ostropolets A, Pistillo A, Posada J, Pratt N, Reyes C, Ross J, Seager S, Shah N, Simon K, Wan E, Yang J, Yin C, You S, Schuemie M, Ryan P, Hripcsak G, Krumholz H, Suchard M. Multinational patterns of second line antihyperglycaemic drug initiation across cardiovascular risk groups: federated pharmacoepidemiological evaluation in LEGEND-T2DM. BMJ Medicine 2023, 2: e000651. PMID: 37829182, PMCID: PMC10565313, DOI: 10.1136/bmjmed-2023-000651.Peer-Reviewed Original ResearchType 2 diabetes mellitusSecond-line treatmentCardiovascular risk groupsDiabetes mellitusCardiovascular diseaseAntihyperglycaemic drugsLine treatmentRisk groupsObservational Health Data SciencesGlucagon-like peptide-1 receptor agonistsElectronic health recordsSodium-glucose cotransporter 2 inhibitorsCalendar year trendsPeptide-1 receptor agonistsUS databaseOutcomes of patientsCotransporter 2 inhibitorsAdministrative claims databaseSecond-line drugsHealth recordsSodium-glucose cotransporter-2 inhibitorsMedication useMetformin monotherapyGuideline recommendationsOutcome measuresDetection of left ventricular systolic dysfunction from single-lead electrocardiography adapted for portable and wearable devices
Khunte A, Sangha V, Oikonomou E, Dhingra L, Aminorroaya A, Mortazavi B, Coppi A, Brandt C, Krumholz H, Khera R. Detection of left ventricular systolic dysfunction from single-lead electrocardiography adapted for portable and wearable devices. Npj Digital Medicine 2023, 6: 124. PMID: 37433874, PMCID: PMC10336107, DOI: 10.1038/s41746-023-00869-w.Peer-Reviewed Original ResearchArtificial intelligenceRandom Gaussian noiseNoisy electrocardiogramGaussian noiseElectrocardiogram (ECGWearable devicesSingle-lead electrocardiogramPortable devicesSNRWearableNoiseDevice noiseRepositoryAI-based screeningIntelligenceDetectionDevicesNoise sourcesVentricular systolic dysfunctionModelElectrocardiogramSingle-lead electrocardiographyTrainingDetection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images
Sangha V, Nargesi A, Dhingra L, Khunte A, Mortazavi B, Ribeiro A, Banina E, Adeola O, Garg N, Brandt C, Miller E, Ribeiro A, Velazquez E, Giatti L, Barreto S, Foppa M, Yuan N, Ouyang D, Krumholz H, Khera R. Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images. Circulation 2023, 148: 765-777. PMID: 37489538, PMCID: PMC10982757, DOI: 10.1161/circulationaha.122.062646.Peer-Reviewed Original ResearchConceptsLV systolic dysfunctionYale-New Haven HospitalVentricular systolic dysfunctionSystolic dysfunctionLV ejection fractionBrazilian Longitudinal StudyNew Haven HospitalEjection fractionCardiology clinicRegional hospitalLeft ventricular systolic dysfunctionCedars-Sinai Medical CenterAdult Health (ELSA-Brasil) cohortIndividualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials
Oikonomou EK, Spatz ES, Suchard MA, Khera R. Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials. The Lancet Digital Health 2022, 4: e796-e805. PMID: 36307193, PMCID: PMC9768739, DOI: 10.1016/s2589-7500(22)00170-4.Peer-Reviewed Original ResearchConceptsSystolic blood pressure controlBlood pressure controlIntensive systolic blood pressure controlType 2 diabetesPressure controlCardiovascular benefitsClinical trialsMajor adverse cardiovascular eventsFirst major adverse cardiovascular eventLarge randomised clinical trialsACCORD-BP trialAdverse cardiovascular eventsRandomised clinical trialsSystolic blood pressureCox regression analysisTreatment effectsHazard ratio estimatesACCORD-BPBP trialCardiovascular eventsBlood pressurePrimary outcomeStandard treatmentBaseline variablesIndex patients
2024
Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report.
Shimbo D, Shah R, Abdalla M, Agarwal R, Ahmad F, Anaya G, Attia Z, Bull S, Chang A, Commodore-Mensah Y, Ferdinand K, Kawamoto K, Khera R, Leopold J, Luo J, Makhni S, Mortazavi B, Oh Y, Savage L, Spatz E, Stergiou G, Turakhia M, Whelton P, Yancy C, Iturriaga E. Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report. Hypertension 2024 PMID: 39011653, DOI: 10.1161/hypertensionaha.124.22095.Peer-Reviewed Original ResearchMachine learning toolsManagement of hypertensionNational HeartArtificial intelligenceBlood InstitutePredictive of incident hypertensionHealth care systemImplementation challengesDiverse group of stakeholdersAI toolsPopulation healthMeasurement of blood pressureCare systemHealth careIncident hypertensionHypertension riskEra of artificial intelligenceHypertension diagnosisLearning toolsManaging hypertensionHypertension-related complicationsAntihypertensive medicationsHealthPublic healthGroups of stakeholdersArtificial intelligence-enhanced patient evaluation: bridging art and science
Oikonomou E, Khera R. Artificial intelligence-enhanced patient evaluation: bridging art and science. European Heart Journal 2024, ehae415. PMID: 38976371, DOI: 10.1093/eurheartj/ehae415.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsEfficient deep learning-based automated diagnosis from echocardiography with contrastive self-supervised learning
Holste G, Oikonomou E, Mortazavi B, Wang Z, Khera R. Efficient deep learning-based automated diagnosis from echocardiography with contrastive self-supervised learning. Communications Medicine 2024, 4: 133. PMID: 38971887, PMCID: PMC11227494, DOI: 10.1038/s43856-024-00538-3.Peer-Reviewed Original ResearchSelf-supervised learningTransfer learningTraining dataEchocardiogram videosPortion of labelled dataStandard transfer learning approachContrastive self-supervised learningSelf-supervised learning approachLearning approachImage recognition tasksState-of-the-artContrastive learning approachFine-tuningTransfer learning approachMedical image diagnosisCardiac disease diagnosisContrastive learningVideo framesLabeled datasetLabeled dataExpert labelsClassification performanceMedical imagesRecognition taskVideoTransforming Cardiovascular Care With Artificial Intelligence: From Discovery to Practice JACC State-of-the-Art Review
Khera R, Oikonomou E, Nadkarni G, Morley J, Wiens J, Butte A, Topol E. Transforming Cardiovascular Care With Artificial Intelligence: From Discovery to Practice JACC State-of-the-Art Review. Journal Of The American College Of Cardiology 2024, 84: 97-114. PMID: 38925729, DOI: 10.1016/j.jacc.2024.05.003.Peer-Reviewed Original ResearchExcess Cardiovascular Mortality Among Black Americans 2000-2022
Arun A, Sawano M, Lu Y, Warner F, Caraballo C, Khera R, Echols M, Yancy C, Krumholz H. Excess Cardiovascular Mortality Among Black Americans 2000-2022. Journal Of The American College Of Cardiology 2024, 84: 581-588. PMID: 38901531, DOI: 10.1016/j.jacc.2024.06.004.Peer-Reviewed Original ResearchPerformance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study
Camargos A, Barreto S, Brant L, Ribeiro A, Dhingra L, Aminorroaya A, Bittencourt M, Figueiredo R, Khera R. Performance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study. Open Heart 2024, 11: e002762. PMID: 38862252, PMCID: PMC11168182, DOI: 10.1136/openhrt-2024-002762.Peer-Reviewed Original ResearchConceptsPooled Cohort EquationsELSA-BrasilRisk scoreCardiovascular diseaseCVD eventsCommunity-based cohort studyArea under the receiver operating characteristic curveCVD risk scoreELSA-Brasil studyIncident CVD eventsMiddle-income countriesAdjudicated CVD eventsCardiovascular disease riskCVD scoreCohort EquationsNational guidelinesRisk stratification scoresWhite womenAge/sex groupsCohort studyProspective cohortLMICsSex/race groupsHigher incomeRisk discriminationA Multimodal Video-Based AI Biomarker for Aortic Stenosis Development and Progression
Oikonomou E, Holste G, Yuan N, Coppi A, McNamara R, Haynes N, Vora A, Velazquez E, Li F, Menon V, Kapadia S, Gill T, Nadkarni G, Krumholz H, Wang Z, Ouyang D, Khera R. A Multimodal Video-Based AI Biomarker for Aortic Stenosis Development and Progression. JAMA Cardiology 2024, 9: 534-544. PMID: 38581644, PMCID: PMC10999005, DOI: 10.1001/jamacardio.2024.0595.Peer-Reviewed Original ResearchCardiac magnetic resonanceAortic valve replacementCardiac magnetic resonance imagingAV VmaxSevere ASAortic stenosisCohort studyPeak aortic valve velocityCohort study of patientsAortic valve velocityCohort of patientsTraditional cardiovascular risk factorsAssociated with faster progressionStudy of patientsCedars-Sinai Medical CenterAssociated with AS developmentCardiovascular risk factorsCardiovascular imaging modalitiesIndependent of ageModerate ASEjection fractionEchocardiographic studiesValve replacementRisk stratificationCardiac structureVideo-Based Kinematic Analysis of Movement Quality in a Phase 3 Clinical Trial of Troriluzole in Adults with Spinocerebellar Ataxia: A Post Hoc Analysis
L’Italien G, Oikonomou E, Khera R, Potashman M, Beiner M, Maclaine G, Schmahmann J, Perlman S, Coric V. Video-Based Kinematic Analysis of Movement Quality in a Phase 3 Clinical Trial of Troriluzole in Adults with Spinocerebellar Ataxia: A Post Hoc Analysis. Neurology And Therapy 2024, 13: 1287-1301. PMID: 38814532, PMCID: PMC11263303, DOI: 10.1007/s40120-024-00625-6.Peer-Reviewed Original ResearchMovement qualityVideo-based kinematic analysisGait stability measuresTandem walking taskRating of AtaxiaGait qualityGait assessmentGait parametersTandem walkingWalking assessmentsWalking taskSpinocerebellar ataxiaVideo-based assessmentClinical expertiseNatural walkingRandomized participantsGaitHigh riskPost hoc analysisStandardized scalesAdultsWalkingParticipantsHoc analysisPhase 3The PAX LC Trial: A Decentralized, Phase 2, Randomized, Double-blind Study of Nirmatrelvir/Ritonavir Compared with Placebo/Ritonavir for Long COVID
Krumholz H, Sawano M, Bhattacharjee B, Caraballo C, Khera R, Li S, Herrin J, Coppi A, Holub J, Henriquez Y, Johnson M, Goddard T, Rocco E, Hummel A, Al Mouslmani M, Putrino D, Carr K, Carvajal-Gonzalez S, Charnas L, De Jesus M, Ziegler F, Iwasaki A. The PAX LC Trial: A Decentralized, Phase 2, Randomized, Double-blind Study of Nirmatrelvir/Ritonavir Compared with Placebo/Ritonavir for Long COVID. The American Journal Of Medicine 2024 PMID: 38735354, DOI: 10.1016/j.amjmed.2024.04.030.Peer-Reviewed Original ResearchLC trialPROMIS-29Participants' homesTargeting viral persistencePlacebo-controlled trialDouble-blind studyElectronic health recordsCore Outcome MeasuresLong COVIDEQ-5D-5LRepeated measures analysisEvidence-based treatmentsPhase 2Double-blindParticipant-centred approachStudy drugPrimary endpointSecondary endpointsCommunity-dwellingHealth recordsHealthcare utilizationContiguous US statesViral persistencePatient groupDrug treatmentIntroducing the JAMA Summit
Bibbins-Domingo K, Angus D, Park H, Lewis R, Khera R, Zeis J, Flanagin A, Curfman G. Introducing the JAMA Summit. JAMA 2024, 331: 1451-1451. PMID: 38573798, DOI: 10.1001/jama.2024.5570.Peer-Reviewed Original ResearchDevelopment and multinational validation of an algorithmic strategy for high Lp(a) screening
Aminorroaya A, Dhingra L, Oikonomou E, Saadatagah S, Thangaraj P, Vasisht Shankar S, Spatz E, Khera R. Development and multinational validation of an algorithmic strategy for high Lp(a) screening. Nature Cardiovascular Research 2024, 3: 558-566. DOI: 10.1038/s44161-024-00469-1.Peer-Reviewed Original ResearchElectronic health recordsAssociated with premature atherosclerotic cardiovascular diseaseElevated Lp(aHealth recordsUK BiobankPremature atherosclerotic cardiovascular diseaseMachine learning modelsAtherosclerotic cardiovascular diseaseCohort studyReal-world settingsTargeted screeningCardiovascular diseaseLearning modelsNovel targeted therapeuticsAlgorithmic strategiesCohortProbability thresholdScreeningClinical featuresValidation cohortElevated lipoproteinRisk inspectionARICLp(aLocal large language models for privacy-preserving accelerated review of historic echocardiogram reports
Vaid A, Duong S, Lampert J, Kovatch P, Freeman R, Argulian E, Croft L, Lerakis S, Goldman M, Khera R, Nadkarni G. Local large language models for privacy-preserving accelerated review of historic echocardiogram reports. Journal Of The American Medical Informatics Association 2024, ocae085. PMID: 38687616, DOI: 10.1093/jamia/ocae085.Peer-Reviewed Original ResearchLanguage modelEchocardiogram reportsGround-truth answersText similarity measuresMount Sinai Health SystemQuestion-answer pairsEnhancing clinical decision-makingSinai Health SystemIntervention identificationClinical decision-makingHealth systemPatient careComplex patient dataRelevant snippetsSimilarity measureComplex cardiac diseaseGround truthReal-World Experience and Outcomes With Percutaneous Coronary Intervention for Protected Versus Unprotected Left Main Coronary Artery Disease: Insights from the Veteran Affairs Clinical Assessment Reporting and Tracking Program
Gonzalez P, Hebbe A, Hussain Y, Khera R, Banerjee S, Plomondon M, Waldo S, Pfau S, Curtis J, Shah S. Real-World Experience and Outcomes With Percutaneous Coronary Intervention for Protected Versus Unprotected Left Main Coronary Artery Disease: Insights from the Veteran Affairs Clinical Assessment Reporting and Tracking Program. The American Journal Of Cardiology 2024, 222: 39-50. PMID: 38677666, DOI: 10.1016/j.amjcard.2024.04.039.Peer-Reviewed Original ResearchULM percutaneous coronary interventionPercutaneous coronary interventionPropensity-matched cohortMyocardial infarctionCoronary interventionAll-cause mortalityTracking programUS clinical practiceOne-year MACEOne-year outcomesIncidence of rehospitalizationAdverse cardiovascular eventsUnprotected left main coronary artery diseaseAcute coronary syndromeCoronary artery diseaseRates of MIMechanical circulatory supportLeft main percutaneous coronary interventionPCI patientsUrgent revascularizationPractice patternsCart programLeft main bifurcationPrimary outcomeMatched cohortAutomated Video-based Characterization of Movement Quality in a Phase III Clinical Trial of Troriluzole in Subjects with Spinocerebellar Ataxia (P6-3.014)
Beiner M, Oikonomou E, L’Italien G, Khera R, Potashman M, Schmahmann J, Perlman S, Coric V. Automated Video-based Characterization of Movement Quality in a Phase III Clinical Trial of Troriluzole in Subjects with Spinocerebellar Ataxia (P6-3.014). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205170.Peer-Reviewed Original ResearchReal-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study
Oikonomou E, Aminorroaya A, Dhingra L, Partridge C, Velazquez E, Desai N, Krumholz H, Miller E, Khera R. Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study. European Heart Journal - Digital Health 2024, 5: 303-313. PMID: 38774380, PMCID: PMC11104476, DOI: 10.1093/ehjdh/ztae023.Peer-Reviewed Original ResearchRisk of acute myocardial infarctionAssociated with lower oddsHospital health systemCoronary artery diseaseCardiac testingRisk of adverse outcomesUK BiobankHealth systemProvider-drivenLower oddsAssociated with better outcomesAcute myocardial infarctionBlack raceStable chest painFemale sexReal world evaluationDiabetes historyMulticohort studyFunction testsSuspected coronary artery diseaseYounger ageRisk profileAdverse outcomesMultinational cohortPost hoc analysis