Featured Publications
Clues to Diagnose Myocardial Infarction in the Young No Longer a Needle in the Haystack ∗
Safdar B. Clues to Diagnose Myocardial Infarction in the Young No Longer a Needle in the Haystack ∗. Journal Of The American College Of Cardiology 2019, 73: 585-588. PMID: 30732712, DOI: 10.1016/j.jacc.2018.11.034.Peer-Reviewed Original ResearchPrevalence 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 ResearchMeSH KeywordsAcute DiseaseAlgorithmsBiomarkersChest PainCoronary Artery DiseaseEmergency Service, HospitalEuropeFemaleHumansMaleMyocardial InfarctionMyocardial IschemiaConceptsAcute 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
Clinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery
Safdar B, Mori M, Nowroozpoor A, Geirsson A, D'Onofrio G, Mangi AA. Clinical Profile and Sex-Specific Recovery With Cardiac Rehabilitation After Coronary Artery Bypass Grafting Surgery. Clinical Therapeutics 2022, 44: 846-858. PMID: 35570056, DOI: 10.1016/j.clinthera.2022.04.002.Peer-Reviewed Original ResearchConceptsCardiac rehabilitationElectronic health recordsComposite outcomeEndothelial functionClinical profileCoronary Artery Bypass Grafting SurgeryMajor adverse cardiac outcomesPostoperative blood transfusionTwelve-month mortalityCardiac risk factorsCoronary artery bypassPrimary composite outcomeRetrospective cohort studyHealth recordsAdverse cardiac outcomesCardiac risk profileKaplan-Meier analysisBody mass indexSex-specific outcomesKaplan-Meier plotsThoracic Surgeons registryAerobic exercise durationHigher hemoglobin AHealth care systemUrgent CABGSex 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 ResearchMeSH KeywordsChest PainEmergency Service, HospitalFemaleHumansMaleMyocardial InfarctionRace FactorsTriageYoung AdultConceptsChest 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 ResearchMeSH KeywordsCoronary AngiographyCoronary Vessel AnomaliesCoronary VesselsDepressionFemaleHumansMyocardial InfarctionRisk FactorsStress, PsychologicalVascular DiseasesConceptsSpontaneous 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 ResearchMeSH KeywordsCoronary Vessel AnomaliesCoronary VesselsFemaleHealth StatusHumansMiddle AgedMyocardial InfarctionQuality of LifeVascular DiseasesConceptsSpontaneous coronary artery dissectionAcute myocardial infarctionAMI patientsCoronary artery dissectionYoung AMI patientsHealth status outcomesHealth status instrumentsSCAD patientsArtery dissectionMyocardial infarctionStatus outcomesPatientsOutcomesHousehold incomeCollege educationInfarction
2015
Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction
D'Onofrio G, Safdar B, Lichtman JH, Strait KM, Dreyer RP, Geda M, Spertus JA, Krumholz HM. Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction. Circulation 2015, 131: 1324-1332. PMID: 25792558, PMCID: PMC4652789, DOI: 10.1161/circulationaha.114.012293.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionMyocardial infarctionReperfusion therapyAcute ST-segment elevation myocardial infarctionProspective observational cohort studyYoung AMI Patients (VIRGO) studyTime guidelinesYoung womenObservational cohort studyProportion of patientsElevation myocardial infarctionPercutaneous coronary interventionYears of ageSex differencesPatients 18Reperfusion strategyCohort studyCoronary interventionFibrinolytic therapyNeedle timeYounger patientsReperfusion delayRatio of womenReperfusion guidelinesSex disparities
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
2009
Improvements in Time to Reperfusion
Rao V, Safdar B, Parkosewich J, Lee LV, D'Onofrio G, Foody JM. Improvements in Time to Reperfusion. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2009, 8: 38-42. PMID: 19258837, DOI: 10.1097/hpc.0b013e318194e443.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngioplasty, Balloon, CoronaryCohort StudiesElectrocardiographyEmergency Service, HospitalEmergency TreatmentFemaleHospitals, TeachingHumansIncidenceMaleMiddle AgedMyocardial InfarctionPrognosisRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsSurvival AnalysisTime FactorsTreatment OutcomeUrban HealthConceptsPrimary percutaneous coronary interventionST-elevation myocardial infarctionYale-New Haven HospitalPrimary PCIChart-abstracted dataPercutaneous coronary interventionUrban teaching hospitalQuality of carePhysician-level interventionsSingle-site studyChest painCoronary interventionHospital-wide systemPhysician awarenessEmergency departmentMyocardial infarctionHeart diseaseSTEMI careImproved outcomesTeaching hospitalEarly presentationReperfusionTimely managementClinical initiativesWomen