Featured Publications
Peripheral Artery Disease Screening in the Community and 1-Year Mortality, Cardiovascular Events, and Adverse Limb Events
Smolderen K, Ameli O, Chaisson C, Heath K, Mena-Hurtado C. Peripheral Artery Disease Screening in the Community and 1-Year Mortality, Cardiovascular Events, and Adverse Limb Events. AJPM Focus 2022, 1: 100016. PMID: 37791014, PMCID: PMC10546509, DOI: 10.1016/j.focus.2022.100016.Peer-Reviewed Original ResearchMajor adverse limb eventsPeripheral artery diseaseAdverse limb eventsMajor cardiovascular eventsPeripheral artery disease (PAD) screeningArtery diseaseCardiovascular eventsLimb eventsCause mortalityOne-yearDisease screeningPeripheral vascular interventionsCardiovascular risk managementCause mortality ratesHome health visitsMedicare Advantage beneficiariesCardiovascular medicationsHealth visitsRevascularization proceduresHealthcare utilizationLandmark analysisSimilar riskVascular interventionsClaims dataMortality rateRisk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease
Luna P, Harris K, Castro-Dominguez Y, Algara M, Severiche-Mena C, Smolderen KG, Mena-Hurtado C. Risk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease. Journal Of Vascular Surgery 2022, 77: 216-224.e15. PMID: 36037965, DOI: 10.1016/j.jvs.2022.08.021.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseLower extremity peripheral artery diseaseNon-Hispanic whitesEmergency departmentPAD careArtery diseaseRisk factorsSevere peripheral artery diseaseChronic limb-threatening ischemiaRisk profileNational Inpatient Sample dataCardiovascular risk factorsLimb-threatening ischemiaPatients' sociodemographic characteristicsWorse clinical outcomesMultivariable logistic regressionAssociation of ethnicityLength of stayHealth care consumptionHealth care coveragePAD hospitalizationsPrior amputationEndovascular revascularizationED admissionRenal failureFrailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI)
Al-Damluji MS, Smolderen KG, Meng C, Dai F, Nanna MG, Sumpio B, Henke P, Mena-Hurtado C. Frailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI). Vascular Medicine 2022, 27: 251-257. PMID: 35485400, DOI: 10.1177/1358863x221083701.Peer-Reviewed Original ResearchConceptsRisk Analysis IndexVascular Quality InitiativeLower extremity revascularizationFrailty screening toolsMFI-5Lower extremity peripheral artery diseaseScreening toolFrailty detectionAddition of frailtyPAD risk factorsPeripheral artery diseasePAD populationRevascularization typeVascular cohortMajor amputationPerioperative outcomesArtery diseaseFrailty indexFrailty toolsAdjusted analysisUnplanned amputationRisk factorsHigher oddsPredictive valuePatientsThe Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk
Smolderen K, Heath K, Scherr T, Bauzon S, Howell A, Mena-Hurtado C. The Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk. European Journal Of Vascular And Endovascular Surgery 2022, 63: e98. DOI: 10.1016/j.ejvs.2022.06.013.Peer-Reviewed Original ResearchHealth status and cognitive function for risk stratification in chronic coronary and peripheral artery disease.
Smolderen K, Mena-Hurtado C, Eikelboom J, Bosch J, Xie F, Ramasundarahettige C, Bhatt D, Anand S. Health status and cognitive function for risk stratification in chronic coronary and peripheral artery disease. European Journal Of Preventive Cardiology 2022, 30: 535-545. PMID: 36444513, DOI: 10.1093/eurjpc/zwac282.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseDigit Symbol Substitution TestVisual analog scaleEQ visual analogue scaleHealth statusLimb eventsCAD cohortCognitive functionArtery diseaseEQ-5DHierarchical Cox regression modelsMajor adverse cardiovascular eventsStable coronary artery diseaseAdverse cardiovascular eventsPeripheral artery diseasePopulation attributable riskCox regression modelOverall health statusCognitive function assessmentCOMPASS trialPAD cohortCardiovascular eventsPAD patientsRisk stratificationAnalog scaleLongitudinal Pathways Between Physical Activity, Depression, and Perceived Stress in Peripheral Artery Disease.
Yazgan I, Bartlett V, Romain G, Cleman J, Petersen-Crair P, Spertus J, Hardt M, Mena-Hurtado C, Smolderen K. Longitudinal Pathways Between Physical Activity, Depression, and Perceived Stress in Peripheral Artery Disease. Circulation Cardiovascular Quality And Outcomes 2023, 16: 544-553. PMID: 37470195, PMCID: PMC10561081, DOI: 10.1161/circoutcomes.122.009840.Peer-Reviewed Original ResearchConceptsPhysical activityPAD diagnosisDepressive symptomsLower physical activity scoresPerceived stressVascular specialty clinicsPeripheral artery diseasePhysical activity scoreSignificant depressive symptomsPatient Health QuestionnaireBehavioral health approachesSubsequent depressive symptomsINTERHEART studySymptomatic PADCardiovascular eventsPAD symptomsArtery diseaseInitial presentationActivity scoreSpecialty clinicHealth QuestionnairePatient's abilityTreatment goalsPAD managementPerceived Stress ScaleExamining Outcomes in Patients Admitted With Comorbid Peripheral Artery Disease and Microvascular Disease
Grubman S, Algara M, Smolderen K, Luna P, Walenczyk K, Scierka L, Cleman J, Siddiqui W, Romain G, Mena‐Hurtado C. Examining Outcomes in Patients Admitted With Comorbid Peripheral Artery Disease and Microvascular Disease. Journal Of The American Heart Association 2024, 13: e030710. PMID: 38166496, PMCID: PMC10863818, DOI: 10.1161/jaha.123.030710.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseMajor adverse cardiac eventsAdverse cardiac eventsMicrovascular diseaseMinor amputationHospital mortalityCardiac eventsArtery diseaseNational Readmission DatabaseFurther prospective researchNumber of patientsCommon risk factorsMultiple logistic regressionMajor amputationBaseline factorsFinal cohortCox regressionAdverse outcomesPAD groupSecondary diagnosisRisk factorsAnnual admissionsObservational studyPrevalent conditionHigh risk
2023
Association Between Mental Health Burden, Clinical Presentation, and Outcomes in Individuals With Symptomatic Peripheral Artery Disease: A Scientific Statement From the American Heart Association
Smolderen K, Samaan Z, Decker C, Collins T, Lazar R, Itoga N, Mena-Hurtado C, Research O. Association Between Mental Health Burden, Clinical Presentation, and Outcomes in Individuals With Symptomatic Peripheral Artery Disease: A Scientific Statement From the American Heart Association. Circulation 2023, 148: 1511-1528. PMID: 37781785, DOI: 10.1161/cir.0000000000001178.Peer-Reviewed Original ResearchConceptsPsychological interventionsPeripheral artery diseaseMental healthStress reduction interventionsSymptomatic peripheral artery diseaseComorbid mental health conditionsMental health concernsRole of painMental health conditionsMental health burdenPAD careCognitive declineBehavioral health needsArtery diseaseCognitive dysfunctionPsychotropic interventionScientific statementPAD treatmentBehavior changeUse of opioidsAmerican Heart AssociationUse of benzodiazepinesChronic disease managementHealth behaviorsFragmentation of carePatient knowledge and preferences for peripheral artery disease treatment
Smolderen K, Romain G, Gosch K, Arham A, Provance J, Spertus J, Poosala A, Shishehbor M, Safley D, Scott K, Stone N, Mena-Hurtado C. Patient knowledge and preferences for peripheral artery disease treatment. Vascular Medicine 2023, 28: 397-403. PMID: 37638882, PMCID: PMC10591804, DOI: 10.1177/1358863x231181613.Peer-Reviewed Original ResearchPeripheral artery diseaseTreatment goalsPatient knowledgeTreatment optionsTreatment preferencesHeart attack/strokeSymptomatic peripheral artery diseasePeripheral artery disease treatmentImportant treatment goalQuality of lifeCost of treatmentSpecific treatment goalsMulticenter registryPAD symptomsPain reliefSecondary preventionArtery diseaseTreatment choiceTreatment benefitPatient understandingPatientsMedical decision makingDisease managementClaudicationDisease treatmentRepresentativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines
Castro-Dominguez Y, Mena-Hurtado C, Algara M, Obas V, Ahmed Z, Romain G, Solaru K, Smolderen K. Representativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines. The American Journal Of Cardiology 2023, 201: 166-169. PMID: 37385170, DOI: 10.1016/j.amjcard.2023.05.053.Peer-Reviewed Original ResearchConceptsPeripheral artery diseasePAD guidelinesArtery diseaseRecent American Heart Association/American CollegeAmerican Heart Association/American CollegeLower extremity peripheral artery diseaseOlder adult patientsRace/ethnicity distributionAdult patientsPooled proportionMean ageClinical trialsCurrent guidelinesEpidemiologic studiesAmerican CollegeTrial participantsRCTsEthnicity distributionOlder adultsTrialsWomenPatientsDiseaseGuidelinesEthnic groupsHealth Disparities in Peripheral Artery Disease: A Scientific Statement From the American Heart Association
Allison M, Armstrong D, Goodney P, Hamburg N, Kirksey L, Lancaster K, Mena-Hurtado C, Misra S, Treat-Jacobson D, Solaru K, Health O. Health Disparities in Peripheral Artery Disease: A Scientific Statement From the American Heart Association. Circulation 2023, 148: 286-296. PMID: 37317860, PMCID: PMC11520198, DOI: 10.1161/cir.0000000000001153.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseArtery diseaseClinical effectsAmerican Heart AssociationMajor limb amputationCerebrovascular eventsHeart AssociationHigh prevalenceLimb amputationHealth disparitiesInequitable deliveryInequitable burdenScientific statementHigh rateCertain demographic groupsDiseasePotential novel solutionIndividual disabilityOverview statementDemographic groupsAmputationDisparitiesPrevalenceCareStructural inequitiesPredictors of Revascularization in Lower-Extremity Peripheral Artery Disease: Insights From the PORTRAIT Study.
Pokharel Y, Kokkinidis D, Wang J, Gosch K, Safley D, Spertus J, Mena-Hurtado C, Smolderen K. Predictors of Revascularization in Lower-Extremity Peripheral Artery Disease: Insights From the PORTRAIT Study. Journal Of Endovascular Therapy 2023, 15266028231179574. PMID: 37309164, DOI: 10.1177/15266028231179574.Peer-Reviewed Original ResearchPredictors of revascularizationEarly revascularizationPeripheral artery diseaseExtensive diseasePAD symptomsSymptom burdenArtery diseaseOdds ratioLower Extremity Peripheral Artery DiseaseAnkle-brachial index scoreGoal-directed medical therapyEarly revascularization proceduresKnee arterial segmentsLifestyle-limiting claudicationRutherford class 3Peripheral arterial diseaseMonths of presentationPatient-level predictorsLower extremity PADMain predictorsMedian odds ratioHierarchical logistic regressionSymptomatic PADDisease guidelinesMedical therapyObesity prevalence and variability in management practices for patients with symptomatic peripheral artery disease
Scierka L, Peri-Okonny P, Romain G, Mena-Hurtado C, Smolderen K. Obesity prevalence and variability in management practices for patients with symptomatic peripheral artery disease. Obesity Research & Clinical Practice 2023, 17: 264-268. PMID: 37225553, DOI: 10.1016/j.orcp.2023.05.002.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseaseWeight loss medicationsObesity management strategiesMedian odds ratioDietary counselingLower extremity peripheral arterial diseaseSymptomatic peripheral artery diseaseDietary management strategiesSymptomatic PAD patientsPeripheral artery diseaseObesity prevalence ratesPrevalence of obesityPoor disease outcomeModifiable comorbiditiesPORTRAIT registryPAD patientsArtery diseaseArterial diseaseTreatment modalitiesObesity prevalenceOdds ratioDisease outcomePrevalence ratesPAD managementObesityLower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults
Lee M, Smolderen K, Ionescu C, Hillegass W, Romain G, Mena-Hurtado C. Lower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults. Vascular Medicine 2023, 28: 197-204. PMID: 37293738, DOI: 10.1177/1358863x231151729.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseAbnormal ABILower extremity symptomsNormal ABILeg symptomsHigh riskBlack adultsExtremity symptomsStepwise Cox proportional hazards modelKaplan-Meier survival curvesCox proportional hazards modelAnkle-brachial indexFramingham risk factorsJackson Heart StudyProportional hazards modelCardiovascular outcomesCause mortalityArtery diseaseAsymptomatic diseaseAdverse outcomesMean ageSymptom assessmentAsymptomatic participantsRisk factorsSymptomatic participants
2022
Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease
Lee M, Pichert M, Tran A, Farooq A, Heyligers J, de Vries J, Spertus J, Guzman R, Thomas M, Mena-Hurtado C, Smolderen K. Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease. International Journal Of Cardiology 2022, 375: 94-97. PMID: 36577485, PMCID: PMC10371801, DOI: 10.1016/j.ijcard.2022.12.042.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseAbdominal aortic aneurysmScreening ratesArtery diseaseSpecialty centersAdjusted median odds ratioSymptomatic peripheral artery diseaseInternational prospective registryHigh-risk populationMedian odds ratioAbdominal aorta aneurysmAAA positivityMulticenter registryPAD symptomsProspective registryGuideline implementationAortic aneurysmAAA screeningAorta aneurysmOdds ratioPAD managementDisease RegistryPatientsMedian oddsClinical sitesPredictors of Major Adverse Limb Events After Infrainguinal Bypass in Patients with Diabetes
Alameddine D, Satam K, Slade M, Wang H, Mena-Hurtado C, Turner J, Inzucchi S, Chaar C. Predictors of Major Adverse Limb Events After Infrainguinal Bypass in Patients with Diabetes. American Heart Journal 2022, 254: 241. DOI: 10.1016/j.ahj.2022.10.026.Peer-Reviewed Original ResearchMajor adverse limb eventsLower extremity revascularizationPeripheral artery diseaseAdverse limb eventsInfrainguinal bypassInsulin useDiabetes mellitusLimb eventsVascular Quality Initiative databaseHigher major amputationObjective Diabetes mellitusOutcomes of patientsAssociation of diabetesLower primary patencyMajor risk factorMajor amputationPrimary patencyExtremity revascularizationInsulin therapyKidney transplantArtery diseaseGlucose controlA1c controlRisk factorsHigh riskSurgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia
Farber A, Menard M, Conte M, Kaufman J, Powell R, Choudhry N, Hamza T, Assmann S, Creager M, Cziraky M, Dake M, Jaff M, Reid D, Siami F, Sopko G, White C, van Over M, Strong M, Villarreal M, McKean M, Azene E, Azarbal A, Barleben A, Chew D, Clavijo L, Douville Y, Findeiss L, Garg N, Gasper W, Giles K, Goodney P, Hawkins B, Herman C, Kalish J, Koopmann M, Laskowski I, Mena-Hurtado C, Motaganahalli R, Rowe V, Schanzer A, Schneider P, Siracuse J, Venermo M, Rosenfield K. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. New England Journal Of Medicine 2022, 387: 2305-2316. PMID: 36342173, DOI: 10.1056/nejmoa2207899.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaMajor adverse limb eventsAdverse limb eventsPrimary outcome eventGreat saphenous veinEndovascular groupSurgical groupSurgical revascularizationEndovascular therapySaphenous veinLimb eventsAdequate greater saphenous veinInfrainguinal peripheral artery diseaseChronic limb threatening ischemiaAlternative bypass conduitLimb threatening ischemiaLimb-threatening ischemiaPeripheral artery diseaseSaphenous vein conduitsRisk of amputationAdverse eventsLimb outcomesArtery diseasePrimary outcomeBypass conduitDerivation and validation of a predictive model for chronic stress in patients with cardiovascular disease
Malik AO, Jones PG, Mena-Hurtado C, Burg MM, Shishehbor MH, Hejjaji V, Tran A, Spertus JA, Smolderen KG. Derivation and validation of a predictive model for chronic stress in patients with cardiovascular disease. PLOS ONE 2022, 17: e0275729. PMID: 36256655, PMCID: PMC9578618, DOI: 10.1371/journal.pone.0275729.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseCardiovascular diseaseChronic stressWorse outcomesSymptomatic peripheral artery diseaseMyocardial Infarction RegistryLogistic regression modelsPAD patientsProspective registryCurrent smokingArtery diseaseClinical factorsDerivation cohortValidation cohortC-statisticFemale sexPerceived Stress ScalePatientsEconomic burdenMedical careInstrument scoresSocioeconomic statusPotential targetDiseasePSS-4 scoresAdvancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association
Smolderen KG, Alabi O, Collins TC, Dennis B, Goodney PP, Mena-Hurtado C, Spertus JA, Decker C, Health O. Advancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association. Circulation 2022, 146: e286-e297. PMID: 36252117, DOI: 10.1161/cir.0000000000001105.Peer-Reviewed Original ResearchConceptsPAD carePeripheral artery diseasePatient-reported outcomesClinical practiceAmerican Heart AssociationChronic disease managementHealth system perspectiveClinical trial contextPatient engagement strategiesScientific statementHealth status assessmentDisease QualityArtery diseaseHeart AssociationPRO measuresClinical phenotypeBiomedical variablesHealth equityTrial contextRisk adjustmentCareDisease managementStatus assessmentOutcomesPotential benefitsThe association of depression with mortality and major adverse limb event outcomes in patients with peripheral artery disease: A systematic review and meta-analysis
Scierka LE, Mena-Hurtado C, Ahmed ZV, Yousef S, Arham A, Grimshaw AA, Harris KM, Burg M, Vriens PW, Heyligers J, Lee M, Yazgan I, Smolderen KG. The association of depression with mortality and major adverse limb event outcomes in patients with peripheral artery disease: A systematic review and meta-analysis. Journal Of Affective Disorders 2022, 320: 169-177. PMID: 36179780, DOI: 10.1016/j.jad.2022.09.098.Peer-Reviewed Original ResearchConceptsMajor adverse limb eventsPeripheral artery diseaseAssociation of depressionCause mortalityArtery diseaseDepressive symptomsSystematic reviewAdverse limb eventsAdverse prognostic outcomeCoronary artery diseaseRisk of biasImportant comorbidityPoor outcomeAdverse outcomesPrognostic outcomesPooled resultsRisk factorsObservational studyTreatment statusLimb eventsDepression severityPatientsLarger sample sizeMortalityRisk estimates