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 practiceTemporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016
Khera R, Kondamudi N, Zhong L, Vaduganathan M, Parker J, Das SR, Grodin JL, Halm EA, Berry JD, Pandey A. Temporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016. JAMA Network Open 2020, 3: e2022190. PMID: 33095250, PMCID: PMC7584929, DOI: 10.1001/jamanetworkopen.2020.22190.Peer-Reviewed Original ResearchConceptsHeart failure incidenceHF risk factorsHF incidenceClinical Modification codesRisk factorsAcute MIMedicare beneficiariesFailure incidenceHF prevention strategiesRisk factor strataNational cohort studyService Medicare beneficiariesUnique Medicare beneficiariesInternational Statistical ClassificationRace/ethnicityPrior HFPrevalent hypertensionCohort studyIncident HFNinth RevisionPrevious diagnosisCardiovascular conditionsTenth RevisionMAIN OUTCOMEInternational ClassificationPerformance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index
Khera R, Pandey A, Ayers CR, Carnethon MR, Greenland P, Ndumele CE, Nambi V, Seliger SL, Chaves PHM, Safford MM, Cushman M, Xanthakis V, Ramachandran V, Mentz RJ, Correa A, Lloyd-Jones DM, Berry JD, de Lemos JA, Neeland IJ. Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index. JAMA Network Open 2020, 3: e2023242. PMID: 33119108, PMCID: PMC7596579, DOI: 10.1001/jamanetworkopen.2020.23242.Peer-Reviewed Original ResearchConceptsHigh-sensitivity C-reactive proteinPooled Cohort EquationsASCVD riskAtherosclerotic cardiovascular diseaseBody mass indexBMI categoriesCohort EquationsObesity categoriesCohort studySevere obesityWaist circumferenceBMI groupsMass indexUnderweight categoryAtherosclerotic cardiovascular disease riskMean baseline BMIRisk of ASCVDUsual clinical measuresCardiovascular disease riskC-reactive proteinPooled individual-level dataSevere obesity groupLongitudinal cohort studyNormal weight categoryAdults ages 40Temporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries
Pandey A, Keshvani N, Khera R, Lu D, Vaduganathan M, Maddox K, Das SR, Kumbhani DJ, Goyal A, Girotra S, Chan P, Fonarow GC, Matsouaka R, Wang TY, de Lemos JA. Temporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries. JAMA Cardiology 2020, 5: 136-145. PMID: 31913411, PMCID: PMC6990949, DOI: 10.1001/jamacardio.2019.4845.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionNonblack patientsMyocardial infarctionReadmission ratesMortality rateBlack patientsChest Pain-MI RegistryThirty-day readmission ratesRacial disparitiesExcess readmission ratiosPenalty statusObservational cohort analysisPatient-level factorsRacial differencesReadmissions Reduction ProgramHigher unadjusted oddsHRRP implementationCause readmissionPatient characteristicsUnadjusted oddsBlack raceThirty-dayAdjusted associationsReadmission ratios
2019
Hemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance
Mahajan S, Gu J, Lu Y, Khera R, Spatz ES, Zhang M, Sun N, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance. The American Journal Of Medicine 2019, 133: e127-e139. PMID: 31525336, DOI: 10.1016/j.amjmed.2019.08.042.Peer-Reviewed Original ResearchConceptsSystemic vascular resistance indexVascular resistance indexSystemic vascular resistanceCardiac indexBlood pressure categoriesResistance index ratioResistance indexVascular resistanceCardiac outputBlood pressureHemodynamic phenotypesPressure categoriesHigh systemic vascular resistance indexNormal systemic vascular resistance indexSystolic blood pressure 140Systolic blood pressure categoriesBlood pressure 140Health checkup centerNormal cardiac indexLow cardiac indexStroke volume indexHigher cardiac indexSystolic blood pressureBody mass indexSubtypes of hypertensionNational 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
Intraosseous versus intravenous access in patients with out-of-hospital cardiac arrest: Insights from the resuscitation outcomes consortium continuous chest compression trial
Mody P, Brown SP, Kudenchuk PJ, Chan PS, Khera R, Ayers C, Pandey A, Kern K, de Lemos JA, Link MS, Idris AH. Intraosseous versus intravenous access in patients with out-of-hospital cardiac arrest: Insights from the resuscitation outcomes consortium continuous chest compression trial. Resuscitation 2018, 134: 69-75. PMID: 30391366, DOI: 10.1016/j.resuscitation.2018.10.031.Peer-Reviewed Original ResearchConceptsFavorable neurological functionIntravenous accessNeurological functionIntraosseous accessCompression trialHospital cardiac arrest resuscitationInitial drug administrationHospital cardiac arrestCardiac arrest resuscitationOptimal access routeDelivery of medicationsBystander cardiopulmonary resuscitationRate of survivalSustained ROSCHospital survivalInitial rhythmHospital dischargeOHCA patientsROSC rateSpontaneous circulationUnadjusted outcomesSustained returnCardiac arrestCardiopulmonary resuscitationPatientsAssociation 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
2016
Use of Pulmonary Artery Catheterization in US Patients With Heart Failure, 2001-2012
Pandey A, Khera R, Kumar N, Golwala H, Girotra S, Fonarow GC. Use of Pulmonary Artery Catheterization in US Patients With Heart Failure, 2001-2012. JAMA Internal Medicine 2016, 176: 1-4. PMID: 26618346, PMCID: PMC4780342, DOI: 10.1001/jamainternmed.2015.6190.Peer-Reviewed Original Research