2023
Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes
Chui P, Lan Z, Freeman J, Enriquez A, Khera R, Akar J, Masoudi F, Ong E, Curtis J. Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes. Heart Rhythm 2023, 20: 1000-1008. PMID: 36963741, DOI: 10.1016/j.hrthm.2023.03.022.Peer-Reviewed Original ResearchConceptsEligible patientsICD RegistryCardiac resynchronizationNational Cardiovascular Data Registry ICD RegistryCRT-D implantationCRT-D useHospital-level outcomesStrong guideline recommendationsHospital-level variationPatient-level outcomesIntraclass correlation coefficientQuality improvement effortsHospital mortalityGuideline indicationsReadmission ratesSelect patientsClinical outcomesGuideline recommendationsHospital variationHospital ratesUse of CRTHospital levelHospital usePatientsCase mix
2022
Rural-Urban Disparities in Heart Failure and Acute Myocardial Infarction Hospitalizations
Minhas AMK, Sheikh AB, Ijaz SH, Mostafa A, Nazir S, Khera R, Loccoh EC, Warraich HJ. Rural-Urban Disparities in Heart Failure and Acute Myocardial Infarction Hospitalizations. The American Journal Of Cardiology 2022, 175: 164-169. PMID: 35577603, DOI: 10.1016/j.amjcard.2022.04.014.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospital mortalityUrban hospitalRural hospitalsInflation-adjusted costStudy periodAMI hospitalizationMortality gapNational Inpatient SampleLength of stayAcute myocardial infarction hospitalizationsShorter mean lengthMyocardial infarction hospitalizationsHF hospitalizationCardiovascular outcomesClinical outcomesConsistent decreaseMyocardial infarctionInpatient SampleRural-urban disparitiesCardiovascular careHospitalizationHospitalMean length
2021
Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction
Khera R, Haimovich J, Hurley NC, McNamara R, Spertus JA, Desai N, Rumsfeld JS, Masoudi FA, Huang C, Normand SL, Mortazavi BJ, Krumholz HM. Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction. JAMA Cardiology 2021, 6: 633-641. PMID: 33688915, PMCID: PMC7948114, DOI: 10.1001/jamacardio.2021.0122.Peer-Reviewed Original ResearchConceptsMachine learning modelsMeta-classifier modelLearning modelNeural networkGradient descent boostingAcute myocardial infarctionContemporary machineGradient descentXGBoost modelXGBoostHospital mortalityCohort studyLogistic regressionMyocardial infarctionNetworkChest Pain-MI RegistryPrecise classificationIndependent validation dataInitial laboratory valuesNovel methodLarge national registryHigh-risk individualsData analysisValidation dataResolution of riskAssociation of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19
Khera R, Clark C, Lu Y, Guo Y, Ren S, Truax B, Spatz ES, Murugiah K, Lin Z, Omer SB, Vojta D, Krumholz HM. Association of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19. Journal Of The American Heart Association 2021, 10: e018086. PMID: 33624516, PMCID: PMC8403305, DOI: 10.1161/jaha.120.018086.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersLower hospitalization riskACE inhibitorsCOVID-19 hospitalizationHospitalization riskHospital mortalityReceptor blockersValidation cohortAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionEnzyme inhibitorsSyndrome coronavirus 2 infectionAngiotensin converting enzyme (ACE) inhibitorsCoronavirus 2 infectionRisk of hospitalizationCoronavirus disease-19SARS-CoV-2COVID-19 preventionHypertensive patientsInpatient cohortOutpatient cohortContemporary cohortStudy cohortOutpatient studyMedicare group
2020
Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceReadmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure
Ko DT, Khera R, Lau G, Qiu F, Wang Y, Austin PC, Koh M, Lin Z, Lee DS, Wijeysundera HC, Krumholz HM. Readmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure. Journal Of The American College Of Cardiology 2020, 75: 736-746. PMID: 32081282, DOI: 10.1016/j.jacc.2019.12.026.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-discharge mortalityHospital mortalityReadmission ratesHospitalization ratesMyocardial infarctionMortality rateRisk-adjusted mortality ratesHospital Readmissions Reduction ProgramHF hospitalization ratesHeart failure hospitalizationPatients 65 yearsReadmissions Reduction ProgramFailure hospitalizationHF patientsSecondary outcomesHospital readmissionPrimary outcomeReadmissionMortalityAMI hospitalization ratesStudy periodPattern of outcomesHospitalizationOutcomes
2019
National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions
Miller PE, Guha A, Khera R, Chouairi F, Ahmad T, Nasir K, Addison D, Desai NR. National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions. The American Journal Of Cardiology 2019, 124: 1140-1148. PMID: 31371062, PMCID: PMC7883647, DOI: 10.1016/j.amjcard.2019.06.029.Peer-Reviewed Original ResearchConceptsLength of stayCommon cardiovascular conditionCentral line-associated bloodstream infectionsCatheter-associated urinary tract infectionsLine-associated bloodstream infectionsUrinary tract infectionVentilator-associated pneumoniaClostridium difficile infectionCardiovascular conditionsTract infectionsBloodstream infectionsDifficile infectionOutcome of HAICoronary artery bypassTotal hospital chargesAcute myocardial infarctionSkilled care facilityHealthcare-Associated InfectionsValue-based careHospital mortalityArtery bypassCardiogenic shockHeart failurePropensity matchingAtrial fibrillation
2018
Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia
Khera R, Dharmarajan K, Wang Y, Lin Z, Bernheim SM, Wang Y, Normand ST, Krumholz HM. Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182777. PMID: 30646181, PMCID: PMC6324473, DOI: 10.1001/jamanetworkopen.2018.2777.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionPostdischarge mortalityHeart failureHRRP announcementReadmissions Reduction ProgramMedicare beneficiariesRisk-adjusted ratesMyocardial infarctionService Medicare beneficiariesReduction programsInterrupted time series frameworkHospital mortalityReduced readmissionsCohort studyPneumonia hospitalizationsReadmission ratesMAIN OUTCOMEPneumoniaMedicare dataHospitalizationHospitalMortalityReadmissionConcomitant harmComparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation
Kumar N, Khera R, Fonarow GC, Bhatt DL. Comparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation. The American Journal Of Cardiology 2018, 122: 1520-1526. PMID: 30190074, DOI: 10.1016/j.amjcard.2018.07.025.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAge DistributionAged, 80 and overBlood TransfusionCohort StudiesDatabases, FactualFemaleHeart FailureHospital MortalityHumansLength of StayMalePacemaker, ArtificialPeripheral Vascular DiseasesPrevalencePropensity ScoreStrokeTranscatheter Aortic Valve ReplacementUnited StatesConceptsTranscatheter aortic valve implantationAcute kidney injuryTA-TAVI proceduresAortic valve implantationTF-TAVIHospital mortalityTA-TAVIPostoperative strokeTransapical approachValve implantationTAVI procedureTA TAVIReal-world patient populationTA-TAVI groupTF-TAVI groupPropensity-matched cohortPeripheral vascular diseasePropensity-matched pairsComparison of outcomesTF approachICD-9 procedureLower ratesTA approachKidney injuryBaseline characteristics
2017
Comparison of Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Chronic Kidney Disease
Kumar N, Khera R, Garg N, Echouffo-Tcheugui JB, Venkatraman A, Pandey A, Bhatt DL. Comparison of Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Chronic Kidney Disease. The American Journal Of Cardiology 2017, 121: 343-348. PMID: 29268936, DOI: 10.1016/j.amjcard.2017.10.029.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementTranscatheter aortic valve implantationDialysis-requiring acute kidney injuryAcute kidney injuryChronic kidney diseaseAortic valve replacementPostoperative strokeSAVR proceduresKidney diseaseHospital mortalityValve replacementTranscatheter Versus Surgical Aortic Valve ReplacementRate of AKIRetrospective cohort studySevere aortic stenosisCo-primary outcomesPropensity-matched pairsAortic valve implantationComparison of outcomesKidney injuryCohort studyValve implantationAortic stenosisMultivariate analysisPatients
2016
Variation in Hospital Use and Outcomes Associated With Pulmonary Artery Catheterization in Heart Failure in the United States
Khera R, Pandey A, Kumar N, Singh R, Bano S, Golwala H, Kumbhani DJ, Girotra S, Fonarow GC. Variation in Hospital Use and Outcomes Associated With Pulmonary Artery Catheterization in Heart Failure in the United States. Circulation Heart Failure 2016, 9: e003226. PMID: 27780836, PMCID: PMC5123800, DOI: 10.1161/circheartfailure.116.003226.Peer-Reviewed Original ResearchMeSH KeywordsAgedArrhythmias, CardiacCase-Control StudiesCatheterization, Swan-GanzCerebrovascular DisordersCoronary Artery DiseaseDatabases, FactualDisease ManagementFemaleHeart ArrestHeart FailureHospital MortalityHospitalsHumansLength of StayLogistic ModelsMaleMiddle AgedMyocardial InfarctionOdds RatioPractice Patterns, Physicians'Propensity ScoreShock, CardiogenicUnited StatesConceptsPA catheterizationHeart failureCatheter useHospital useDiseases-Ninth Revision codesPropensity-matched analysisPulmonary artery catheterPulmonary artery catheterizationHospital-level variabilityHF hospitalizationHospital mortalityArtery catheterArtery catheterizationNumber of hospitalsPA catheterRevision codesPatient outcomesAcademic hospitalExcess mortalityOdds ratioOutcomes AssociatedCatheterizationInternational ClassificationHospitalMortalityRacial Differences in Outcomes after Acute Ischemic Stroke Hospitalization in the United States
Kumar N, Khera R, Pandey A, Garg N. Racial Differences in Outcomes after Acute Ischemic Stroke Hospitalization in the United States. Journal Of Stroke And Cerebrovascular Diseases 2016, 25: 1970-1977. PMID: 27212273, DOI: 10.1016/j.jstrokecerebrovasdis.2016.03.049.Peer-Reviewed Original ResearchConceptsEndovascular mechanical thrombectomyLength of stayAcute ischemic stroke hospitalizationsIschemic stroke hospitalizationsInflation-adjusted chargesHospital mortalityIschemic strokeStroke hospitalizationsRacial differencesAverage LOSUtilization of thrombolysisAcute ischemic strokeNational Inpatient SampleHealth policy implicationsReperfusion therapyMechanical thrombectomySecondary outcomesStroke outcomePrimary outcomeClinical outcomesMean ageInpatient SamplePrimary diagnosisHospitalizationStrokeWeekend hospitalizations for acute aortic dissection have a higher risk of in-hospital mortality compared to weekday hospitalizations
Kumar N, Venkatraman A, Pandey A, Khera R, Garg N. Weekend hospitalizations for acute aortic dissection have a higher risk of in-hospital mortality compared to weekday hospitalizations. International Journal Of Cardiology 2016, 214: 448-450. PMID: 27093682, DOI: 10.1016/j.ijcard.2016.03.187.Peer-Reviewed Original Research
2015
Trends in hospitalization for takotsubo cardiomyopathy in the United States
Khera R, Light-McGroary K, Zahr F, Horwitz PA, Girotra S. Trends in hospitalization for takotsubo cardiomyopathy in the United States. American Heart Journal 2015, 172: 53-63. PMID: 26856216, PMCID: PMC4748175, DOI: 10.1016/j.ahj.2015.10.022.Peer-Reviewed Original ResearchConceptsTakotsubo cardiomyopathyPrimary diagnosis groupCardiac arrestDiagnosis groupsHigh incidenceCardiogenic shockRespiratory failurePsychiatric disordersTransient left ventricular systolic dysfunctionLeft ventricular systolic dysfunctionNational Inpatient Sample dataCardiovascular risk factorsDiagnostic coronary angiographyVentricular systolic dysfunctionSecondary discharge diagnosisRisk of mortalityCost of careHospital mortalitySystolic dysfunctionCritical illnessCoronary angiographyDischarge diagnosisRisk factorsExcess mortalitySecondary groupUse of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States
Khera R, Cram P, Vaughan-Sarrazin M, Horwitz PA, Girotra S. Use of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States. The American Journal Of Cardiology 2015, 117: 10-16. PMID: 26547292, PMCID: PMC4690753, DOI: 10.1016/j.amjcard.2015.10.005.Peer-Reviewed Original ResearchConceptsPercutaneous ventricular assist devicePercutaneous coronary interventionIntraaortic balloon pumpMechanical circulatory supportHigh-risk percutaneous coronary interventionHospital mortalityIABP recipientsCoronary interventionCirculatory supportPropensity-matched analysisChronic kidney diseaseNinth Edition codesNational Inpatient SampleAcute myocardial infarctionVentricular assist deviceCardiogenic shockUnadjusted mortalityBalloon pumpHeart failureRandomized trialsEdition codesMechanical ventilationKidney diseaseMyocardial infarctionInpatient SampleTrends in the Use of Percutaneous Ventricular Assist Devices: Analysis of National Inpatient Sample Data, 2007 Through 2012
Khera R, Cram P, Lu X, Vyas A, Gerke A, Rosenthal GE, Horwitz PA, Girotra S. Trends in the Use of Percutaneous Ventricular Assist Devices: Analysis of National Inpatient Sample Data, 2007 Through 2012. JAMA Internal Medicine 2015, 175: 941-950. PMID: 25822170, PMCID: PMC4780323, DOI: 10.1001/jamainternmed.2014.7856.Peer-Reviewed Original ResearchConceptsPercutaneous ventricular assist deviceIntra-aortic balloon pumpUse of PVADsAcute myocardial infarctionUse of IABPCardiogenic shockVentricular assist devicePVAD useCoronary artery bypass graft surgeryAssist deviceHigh mortalityArtery bypass graft surgeryBypass graft surgeryPropensity-matched analysisChronic kidney diseasePercutaneous coronary interventionHospital mortalityIABP recipientsGraft surgeryCoronary interventionHemodynamic supportOlder patientsBalloon pumpDiabetes mellitusNumber of hospitals