Featured Publications
Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians
Solnick RE, Peyton K, Kraft-Todd G, Safdar B. Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians. JAMA Network Open 2020, 3: e1920511. PMID: 32083686, PMCID: PMC7043197, DOI: 10.1001/jamanetworkopen.2019.20511.Peer-Reviewed Original ResearchConceptsWhite male physiciansPatient satisfactionPhysician genderMale physiciansHistory of cancerAbdominal surgical proceduresEmergency department physiciansLower patient satisfactionSignificant differencesOnline symptom checkersBlack physiciansComposite outcomeControl physiciansPhysician diagnosisPatient evaluationDepartment physiciansPatient ratingsSurgical proceduresMAIN OUTCOMEPhysician confidenceClinical diagnosisPhysiciansWhite womenDiagnosisWhite menAssociation of renalase with clinical outcomes in hospitalized patients with COVID-19
Safdar B, Wang M, Guo X, Cha C, Chun HJ, Deng Y, Dziura J, El-Khoury JM, Gorelick F, Ko AI, Lee AI, Safirstein R, Simonov M, Zhou B, Desir GV. Association of renalase with clinical outcomes in hospitalized patients with COVID-19. PLOS ONE 2022, 17: e0264178. PMID: 35259186, PMCID: PMC8903289, DOI: 10.1371/journal.pone.0264178.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsRenalase levelsIntensive care unit admissionHospitalized COVID-19 patientsMean age 64 yearsCOVID-19Cox proportional hazards modelCare unit admissionPrimary composite outcomeRetrospective cohort studyUse of vasopressorsSevere COVID-19IL-6 levelsAge 64 yearsRisk of deathCOVID-19 subjectsInitial disease severityProportional hazards modelCOVID-19 diseasePlasma renalaseUnit admissionICU admissionCohort studyComposite outcomeCytokine levelsElevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia
Safdar B, Guo X, Johnson C, D'Onofrio G, Dziura J, Sinusas AJ, Testani J, Rao V, Desir G. Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia. International Journal Of Cardiology 2019, 279: 155-161. PMID: 30630613, PMCID: PMC6482834, DOI: 10.1016/j.ijcard.2018.12.061.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionFramingham risk scorePET/CTChest painInflammatory markersMicrovascular dysfunctionEmergency departmentRisk scoreRb-82 PET/CTElevated renalase levelsAcute chest painCoronary artery diseaseC-reactive proteinVascular endothelial growth factorAnti-inflammatory proteinTumor necrosis factorEndothelial growth factorAngina historyCMD diagnosisRenalase levelsHypertensive crisisED presentationsHemodynamic instabilityArtery diseaseHeart failurePrevalence 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 population
2024
Effectiveness of Original Monovalent and Bivalent COVID‐19 Vaccines Against COVID‐19‐Associated Hospitalization and Severe In‐Hospital Outcomes Among Adults in the United States, September 2022–August 2023
DeCuir J, Surie D, Zhu Y, Lauring A, Gaglani M, McNeal T, Ghamande S, Peltan I, Brown S, Ginde A, Steinwand A, Mohr N, Gibbs K, Hager D, Ali H, Frosch A, Gong M, Mohamed A, Johnson N, Srinivasan V, Steingrub J, Khan A, Busse L, Duggal A, Wilson J, Qadir N, Chang S, Mallow C, Kwon J, Exline M, Shapiro N, Columbus C, Vaughn I, Ramesh M, Safdar B, Mosier J, Casey J, Talbot H, Rice T, Halasa N, Chappell J, Grijalva C, Baughman A, Womack K, Rhoads J, Swan S, Johnson C, Lewis N, Ellington S, Dawood F, McMorrow M, Self W, Network F. Effectiveness of Original Monovalent and Bivalent COVID‐19 Vaccines Against COVID‐19‐Associated Hospitalization and Severe In‐Hospital Outcomes Among Adults in the United States, September 2022–August 2023. Influenza And Other Respiratory Viruses 2024, 18: e70027. PMID: 39496339, PMCID: PMC11534416, DOI: 10.1111/irv.70027.Peer-Reviewed Original ResearchConceptsCOVID-19-associated hospitalizationIn-hospital outcomesVaccine effectivenessMonovalent dosesAbsolute VETest-negative case-control designInvasive mechanical ventilationCOVID-19 vaccineMultivariate logistic regressionSevere COVID-19Case patientsCase-control designControl patientsMechanical ventilationUnvaccinated patientsPatientsMonovalent vaccineCOVID-19-like illnessDoseCOVID-19 vaccine effectivenessBivalent vaccineLogistic regressionAdmission dateVaccineHospitalSeverity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults
Surie D, Yuengling K, DeCuir J, Zhu Y, Lauring A, Gaglani M, Ghamande S, Peltan I, Brown S, Ginde A, Martinez A, Mohr N, Gibbs K, Hager D, Ali H, Prekker M, Gong M, Mohamed A, Johnson N, Srinivasan V, Steingrub J, Leis A, Khan A, Hough C, Bender W, Duggal A, Bendall E, Wilson J, Qadir N, Chang S, Mallow C, Kwon J, Exline M, Shapiro N, Columbus C, Vaughn I, Ramesh M, Mosier J, Safdar B, Casey J, Talbot H, Rice T, Halasa N, Chappell J, Grijalva C, Baughman A, Womack K, Swan S, Johnson C, Lwin C, Lewis N, Ellington S, McMorrow M, Martin E, Self W. Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults. JAMA Network Open 2024, 7: e244954. PMID: 38573635, PMCID: PMC11192181, DOI: 10.1001/jamanetworkopen.2024.4954.Peer-Reviewed Original ResearchConceptsInvasive mechanical ventilationRespiratory syncytial virusSeverity of RSV diseaseInfluenza diseaseVaccinated patientsIn-hospital deathUnvaccinated patientsRSV diseaseSyncytial virusClinical decision-makingComposite of invasive mechanical ventilationOutcome of invasive mechanical ventilationSeverity of respiratory syncytial virusLaboratory-confirmed respiratory syncytial virusHospitalized US adultsInfluenza vaccination statusVaccination statusAcute respiratory illnessMultivariate logistic regressionCenters for Disease Control and PreventionSeverity of COVID-19Disease Control and PreventionInfluenza infectionInfluenza severityClinical outcomes
2023
Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60 Years — IVY Network, 20 U.S. States, February 2022–May 2023
Surie D, Yuengling K, DeCuir J, Zhu Y, Gaglani M, Ginde A, Talbot H, Casey J, Mohr N, Ghamande S, Gibbs K, Files D, Hager D, Ali H, Prekker M, Gong M, Mohamed A, Johnson N, Steingrub J, Peltan I, Brown S, Leis A, Khan A, Hough C, Bender W, Duggal A, Wilson J, Qadir N, Chang S, Mallow C, Kwon J, Exline M, Lauring A, Shapiro N, Columbus C, Vaughn I, Ramesh M, Safdar B, Halasa N, Chappell J, Grijalva C, Baughman A, Rice T, Womack K, Han J, Swan S, Mukherjee I, Lewis N, Ellington S, McMorrow M, Martin E, Self W, Network I. Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60 Years — IVY Network, 20 U.S. States, February 2022–May 2023. MMWR Morbidity And Mortality Weekly Report 2023, 72: 1083-1088. PMID: 37796753, PMCID: PMC10564326, DOI: 10.15585/mmwr.mm7240a2.Peer-Reviewed Original ResearchConceptsHigh-flow nasal cannulaInvasive mechanical ventilationRSV disease severityNoninvasive ventilationDisease severityCOVID-19Intensive care unit admissionRespiratory syncytial virus vaccinationOlder adultsLaboratory-confirmed RSVCare unit admissionAcute respiratory illnessFlow oxygen therapyMultivariable logistic regressionCDC's Advisory CommitteeRespiratory syncytial virusSARS-CoV-2Advisory CommitteeUnit admissionICU admissionImmunization PracticesRSV vaccinationVirus vaccinationAdults AgedInfluenza severity
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 CABG
2021
Use of peripheral arterial tonometry in detection of abnormal coronary flow reserve
Gaeta M, Nowroozpoor A, Dziura J, D'Onofrio G, Sinusas AJ, Safdar B. Use of peripheral arterial tonometry in detection of abnormal coronary flow reserve. Microvascular Research 2021, 138: 104223. PMID: 34256085, PMCID: PMC10227886, DOI: 10.1016/j.mvr.2021.104223.Peer-Reviewed Original ResearchConceptsLower coronary flow reserveCoronary flow reserveCoronary microvascular dysfunctionCoronary artery diseaseClinical screening toolPET/CTFlow reserveRubidium-82 positron emission tomography/Large vessel coronary artery diseaseNormal coronary flow reserveTraditional CAD risk factorsVessel coronary artery diseaseAbnormal coronary flow reservePositron emission tomography/Screening toolPeripheral arterial tonometryCAD risk factorsEmission tomography/Presence of calcificationLower RHIHyperemia indexArterial tonometryMicrovascular dysfunctionArtery diseaseAugmentation index
2020
Relationship Between Depressive Symptoms and Health Status in Peripheral Artery Disease: Role of Sex Differences
Jelani Q, Mena‐Hurtado C, Burg M, Soufer R, Gosch K, Jones PG, Spertus JA, Safdar B, Smolderen KG. Relationship Between Depressive Symptoms and Health Status in Peripheral Artery Disease: Role of Sex Differences. Journal Of The American Heart Association 2020, 9: e014583. PMID: 32781883, PMCID: PMC7660812, DOI: 10.1161/jaha.119.014583.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseDepressive symptomsHealth statusArtery diseaseEQ-5D visual analog scale scoresEQ-5D visual analog scaleVisual analog scale scoreGeneric health statusPeripheral Artery QuestionnaireVascular specialty clinicsAnalog scale scoreHealth status scoresPatient Health QuestionnaireSevere depressive symptomsVisual analog scaleHealth status outcomesWorse health statusAdjusted general linear modelSex differencesPORTRAIT registryPAD diagnosisPAD symptomsAnalog scaleConclusions WomenMean age
2016
Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department.
Safdar B, D'Onofrio G. Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department. The Yale Journal Of Biology And Medicine 2016, 89: 227-38. PMID: 27354848, PMCID: PMC4918863.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseAcute coronary syndromeChest painEmergency departmentMicrovascular dysfunctionED patientsCoronary artery endothelial dysfunctionCause of anginaCoronary artery dissectionCoronary artery spasmPersistent chest painRecurrent chest painSex-specific causesQuality of lifeArtery spasmArtery dissectionCoronary syndromeEndothelial dysfunctionMyocardial bridgingArtery diseasePoor functionCardinal symptomsAnginaPainPatients
2014
Differential Survival for Men and Women from Out‐of‐hospital Cardiac Arrest Varies by Age: Results from the OPALS Study
Safdar B, Stolz U, Stiell IG, Cone DC, Bobrow BJ, deBoehr M, Dreyer J, Maloney J, Spaite DW. Differential Survival for Men and Women from Out‐of‐hospital Cardiac Arrest Varies by Age: Results from the OPALS Study. Academic Emergency Medicine 2014, 21: 1503-1511. PMID: 25491713, DOI: 10.1111/acem.12540.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overArrhythmias, CardiacCardiopulmonary ResuscitationElectric CountershockEmergency Medical ServicesFemaleGender IdentityHumansMaleMiddle AgedOdds RatioOntarioOut-of-Hospital Cardiac ArrestRegression AnalysisRisk FactorsSex CharacteristicsSex FactorsSurvival AnalysisSurvival RateTime FactorsConceptsHospital dischargeEmergency medical servicesProbability of survivalOHCA patientsOPAL studyInitial ventricular fibrillation/ventricular tachycardia rhythmMultivariable logistic regression modelAge 47 yearsAge 65 yearsHospital cardiac arrestSex-stratified regression modelsPrimary risk factorRegression modelsLogistic regression modelsFractional polynomialsOHCA populationHospital admissionSpontaneous circulationAdult OHCACardiac arrestRapid defibrillationLife Support ProgramRisk factorsFavorable outcomeOHCA survivalElevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients
Safdar B, Bezek SK, Sinusas AJ, Russell RR, Klein MR, Dziura JD, D’onofrio G. Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2014, 13: 14-19. PMID: 24526146, DOI: 10.1097/hpc.0000000000000001.Peer-Reviewed Original ResearchConceptsAdverse cardiac eventsCPU patientsNormal troponinAdverse eventsCardiac eventsMultiple logistic regression modelComposite adverse eventsElevated creatinine kinaseObservation unit patientsSerial troponin testingStandardized chart reviewRetrospective cohort studyAcute coronary syndromeNational Death RegistryCoronary artery diseaseLogistic regression modelsPositive troponinPrior CADRenal insufficientCoronary syndromeHemodynamic instabilityChart reviewCohort studyDeath RegistryIschemic electrocardiogram
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
2011
Myeloperoxidase in the diagnosis of acute coronary syndromes: The importance of spectrum
Peacock WF, Nagurney J, Birkhahn R, Singer A, Shapiro N, Hollander J, Glynn T, Nowak R, Safdar B, Miller C, Peberdy M, Counselman F, Chandra A, Kosowsky J, Neuenschwander J, Schrock J, Plantholt S, Lewandrowski E, Wong V, Kupfer K, Diercks D. Myeloperoxidase in the diagnosis of acute coronary syndromes: The importance of spectrum. American Heart Journal 2011, 162: 893-899. PMID: 22093206, DOI: 10.1016/j.ahj.2011.08.017.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeNoncardiac chest painCoronary syndromeMyocardial infarctionPredictive valueTroponin ISerial cardiac markersEmergency department patientsNegative predictive valuePositive predictive valuePositive likelihood ratioNegative likelihood ratioChest painLikelihood ratioSymptom onsetUnstable anginaDepartment patientsProspective studyRisk stratificationMean agePerfusion testingC-statisticFinal diagnosisPatientsCardiac markers
2010
Depression as Modifiable Coronary Risk Factor in the Emergency Department Chest Pain Observation Unit
Safdar B, Foody JM, D'Onofrio G. Depression as Modifiable Coronary Risk Factor in the Emergency Department Chest Pain Observation Unit. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2010, 9: 82-87. PMID: 20520215, DOI: 10.1097/hpc.0b013e3181db06ef.Peer-Reviewed Original ResearchConceptsCoronary risk factorsModifiable coronary risk factorsRisk factorsUrban tertiary care hospital EDChest pain observation unitTertiary care hospital EDEmergency department observation unitFramingham risk scoreObservation unitProspective observational studyHealth service utilizationSeverity of depressionBehavioral health referralsCPC patientsChest painNonprivate insuranceED visitsStudy nursesCardiac symptomsHigher obesityHospital EDSpecialty referralsFuture trialsHealth referralsQuick Inventory
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
2001
S UBCUTANEOUS E PINEPHRINE IN THE P REHOSPITAL S ETTING
Safdar B, Cone D, Pham K. S UBCUTANEOUS E PINEPHRINE IN THE P REHOSPITAL S ETTING. Prehospital Emergency Care 2001, 5: 200-207. PMID: 11339733, DOI: 10.1080/10903120190940137.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseSubcutaneous epinephrineOlder patientsArtery diseaseAmerican Heart Association Emergency Cardiovascular Care CommitteeAdverse effectsCardiovascular side effectsTreatment of asthmaLife-threatening conditionHealth care personnelStrength of evidenceRelative contraindicationP REHOSPITAL S ETTINGCase reportAdverse reactionsPrehospital settingAllergic reactionsPrehospital useCare personnelSytematic reviewSide effectsAsthmaCare CommitteeLevel IIIEpinephrine