2023
Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Clark K, Victoria-Castro A, Ghazi L, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use. JACC Heart Failure 2023, 12: 322-332. PMID: 37943221, DOI: 10.1016/j.jchf.2023.08.025.Peer-Reviewed Original ResearchBest practice alertMineralocorticoid receptor antagonistsNovel potassium bindersPotassium bindersEligible patientsUsual careEjection fractionSerum potassiumHistory of hyperkalemiaIncidence of hyperkalemiaStrong guideline recommendationsHeart failure hospitalizationReduced ejection fractionLaboratory test valuesPopulation health outcomesHyperkalemia treatmentMRA prescriptionAntagonist useFailure hospitalizationPatient characteristicsSecondary outcomesHeart failurePrimary outcomeGuideline recommendationsOutpatient visitsElectronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageFrequency and clinicoeconomic impact of delays to definitive diagnosis of obstructive hypertrophic cardiomyopathy in the United States
Naidu S, Sutton M, Gao W, Fine J, Xie J, Desai N, Owens A. Frequency and clinicoeconomic impact of delays to definitive diagnosis of obstructive hypertrophic cardiomyopathy in the United States. Journal Of Medical Economics 2023, 26: 682-690. PMID: 37170479, DOI: 10.1080/13696998.2023.2208966.Peer-Reviewed Original ResearchConceptsObstructive hypertrophic cardiomyopathyDefinitive diagnosisHypertrophic cardiomyopathyHCM diagnosisMedicare Supplemental databasesIBM MarketScan CommercialEmergency room visitsAdministrative claims dataMisclassification of patientsEligible patientsMarketScan CommercialMost patientsRoom visitsAlternative diagnosesPotential misdiagnosesCardiovascular conditionsInappropriate treatmentDatabase studyClaims dataHealthcare costsDiagnostic journeyPatientsEconomic burdenCurrent studyDiagnostic historyClinical Outcomes, Resource Utilization, and Treatment Over the Disease Course of Symptomatic Obstructive Hypertrophic Cardiomyopathy in the United States
Desai N, Sutton M, Xie J, Fine J, Gao W, Owens A, Naidu S. Clinical Outcomes, Resource Utilization, and Treatment Over the Disease Course of Symptomatic Obstructive Hypertrophic Cardiomyopathy in the United States. The American Journal Of Cardiology 2023, 192: 16-23. PMID: 36709525, DOI: 10.1016/j.amjcard.2022.12.030.Peer-Reviewed Original ResearchConceptsObstructive hypertrophic cardiomyopathyHypertrophic cardiomyopathyIndex dateCardiovascular eventsIncidence rateSymptomatic obstructive hypertrophic cardiomyopathyAtrial fibrillation/flutterCommon cardiovascular eventMonths continuous eligibilityHealthcare resource utilizationMedicare Supplemental databasesIBM MarketScan CommercialEligible patientsDiagnosis dateMarketScan CommercialClinical outcomesContinuous eligibilityTreatment optionsCumulative riskPatientsResource utilizationPharmacotherapyCardiomyopathyDisease
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisory
2015
National assessment of statin therapy for patients with acute myocardial infarction, 2001–11: insight from the China PEACE-Retrospective Acute Myocardial Infarction study
Zhang L, Li J, Li X, Nasir K, Zhang H, Wu Y, Hu S, Wang Q, Downing N, Desai N, Masoudi F, Spertus J, Krumholz H, Jiang L, Group O. National assessment of statin therapy for patients with acute myocardial infarction, 2001–11: insight from the China PEACE-Retrospective Acute Myocardial Infarction study. The Lancet 2015, 386: s42. DOI: 10.1016/s0140-6736(15)00623-6.Peer-Reviewed Original ResearchIntensive statin therapyAcute myocardial infarctionAcute Myocardial Infarction StudyStatin therapyMyocardial Infarction StudyMyocardial infarctionStatin useCardiovascular diseaseLow-density lipoprotein cholesterolStatin therapy useLong-term mortalityUse of statinsNumber of patientsTwo-stage random sampling designMultilevel logistic regression modelsCochran-Armitage testLogistic regression modelsWestern rural regionStatin regimensEligible patientsHospital mortalityLipoprotein cholesterolFamily Planning CommissionIntensive therapyTherapy use