2024
Illusory generalizability of clinical prediction models
Chekroud A, Hawrilenko M, Loho H, Bondar J, Gueorguieva R, Hasan A, Kambeitz J, Corlett P, Koutsouleris N, Krumholz H, Krystal J, Paulus M. Illusory generalizability of clinical prediction models. Science 2024, 383: 164-167. PMID: 38207039, DOI: 10.1126/science.adg8538.Peer-Reviewed Original Research
2023
Atorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial
Talasaz A, Sadeghipour P, Bakhshandeh H, Sharif-Kashani B, Rashidi F, Beigmohammadi M, Moghadam K, Rezaian S, Dabbagh A, Sezavar S, Farrokhpour M, Abedini A, Aliannejad R, Riahi T, Yadollahzadeh M, Lookzadeh S, Rezaeifar P, Matin S, Tahamtan O, Mohammadi K, Zoghi E, Rahmani H, Hosseini S, Mousavian S, Abri H, Sadeghipour P, Baghizadeh E, Rafiee F, Jamalkhani S, Amin A, Mohebbi B, Parhizgar S, Soleimanzadeh M, Aghakouchakzadeh M, Eslami V, Payandemehr P, Khalili H, Talakoob H, Tojari T, Shafaghi S, Tabrizi S, Kakavand H, Kashefizadeh A, Najafi A, Jimenez D, Gupta A, Madhavan M, Sethi S, Parikh S, Monreal M, Hadavand N, Hajighasemi A, Ansarin K, Maleki M, Sadeghian S, Barco S, Siegerink B, Spatz E, Piazza G, Kirtane A, Tassell B, Lip G, Klok F, Goldhaber S, Stone G, Krumholz H, Bikdeli B. Atorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial. Thrombosis And Haemostasis 2023, 123: 723-733. PMID: 36944357, DOI: 10.1055/a-2059-4844.Peer-Reviewed Original ResearchMeSH KeywordsAdultAtorvastatinCOVID-19Double-Blind MethodFemaleHumansIntensive Care UnitsMaleMiddle AgedThrombosisTreatment OutcomeConceptsExtracorporeal membrane oxygenationArterial thrombosisMAIN OUTCOMEAtorvastatin 20Symptom onsetICU patientsFunctional statusIntensive care unit patientsCOVID-19Double-blind multicenterAdult ICU patientsCare unit patientsThrombo-inflammatory responseCoronavirus disease 2019Meaningful treatment effectPrespecified studyCause mortalityAtorvastatin useUnit patientsMembrane oxygenationFunctional outcomeDisease 2019Functional scalesPlaceboPatientsDo PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets?
Shen Y, Krumholz H, Hsia R. Do PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets? JACC Cardiovascular Interventions 2023, 16: 1129-1140. PMID: 37225284, PMCID: PMC10229059, DOI: 10.1016/j.jcin.2023.02.010.Peer-Reviewed Original ResearchMeSH KeywordsHospitalizationHospitals, High-VolumeHumansPercutaneous Coronary InterventionRetrospective StudiesTreatment OutcomeConceptsPercutaneous coronary interventionPCI hospitalsSame-day percutaneous coronary interventionHealth outcomesHigh-volume PCI hospitalsHospital PCI volumeRetrospective cohort studyAcute myocardial infarctionPercentage point decreasePatient health outcomesHospital revascularizationCohort studyCoronary interventionAMI outcomesPCI volumePoint decreasePoor outcomePCI facilitiesMyocardial infarctionRelative increaseHospital openingPatientsHospital availabilityHospitalHospital closuresReclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression
Cho I, Kim W, Kim S, Ko K, Seong Y, Kim D, Seo J, Shim C, Ha J, Mori M, Gupta A, You S, Hong G, Krumholz H. Reclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression. Scientific Reports 2023, 13: 6694. PMID: 37095171, PMCID: PMC10125992, DOI: 10.1038/s41598-023-33683-1.Peer-Reviewed Original ResearchConceptsRapid progression groupModerate aortic stenosisAortic valve replacementSlow progression groupAortic stenosisProgression groupHemodynamic progressionRapid progressionMore rapid progressionLatent class trajectory modelingTransthoracic echocardiography studyBetween-group differencesData-driven phenotypingPressure gradient measurementAVR ratesModerate ASCause mortalityValve replacementEchocardiography studyAtrial fibrillationTTE studiesEchocardiographic dataRisk factorsPredictive valuePatientsEffect of the New Glomerular Filtration Rate Estimation Equation on Risk Predicting Models for Acute Kidney Injury After Percutaneous Coronary Intervention
Huang C, Murugiah K, Li X, Masoudi F, Messenger J, Williams K, Mortazavi B, Krumholz H. Effect of the New Glomerular Filtration Rate Estimation Equation on Risk Predicting Models for Acute Kidney Injury After Percutaneous Coronary Intervention. Circulation Cardiovascular Interventions 2023, 16: e012831. PMID: 37009734, PMCID: PMC10622038, DOI: 10.1161/circinterventions.122.012831.Peer-Reviewed Original ResearchIn-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility
Ivey-Miranda J, Rao V, Cox Z, Moreno-Villagomez J, Mahoney D, Maulion C, Bellumkonda L, Turner J, Collins S, Wilson F, Krumholz H, Testani J. In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility. Circulation Heart Failure 2023, 16: e010206. PMID: 36896716, PMCID: PMC10186250, DOI: 10.1161/circheartfailure.122.010206.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureDiuretic responseDiuretic dosingOral diureticsHeart failureMulticenter cohortHospital observationLower readmission ratesNet fluid balanceDays postdischargeReadmission ratesHospital readmissionUrine outputReadmission riskFluid statusFluid balanceHospital measuresDose selectionCohortProvider decisionsWeight changeReadmissionDiureticsPatients
2022
Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High–risk Pulmonary Embolism
Sadeghipour P, Jenab Y, Moosavi J, Hosseini K, Mohebbi B, Hosseinsabet A, Chatterjee S, Pouraliakbar H, Shirani S, Shishehbor MH, Alizadehasl A, Farrashi M, Rezvani MA, Rafiee F, Jalali A, Rashedi S, Shafe O, Giri J, Monreal M, Jimenez D, Lang I, Maleki M, Goldhaber SZ, Krumholz HM, Piazza G, Bikdeli B. Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High–risk Pulmonary Embolism. JAMA Cardiology 2022, 7: 1189-1197. PMID: 36260302, PMCID: PMC9582964, DOI: 10.1001/jamacardio.2022.3591.Peer-Reviewed Original ResearchConceptsConventional catheter-directed thrombolysisRV/LV ratioRisk pulmonary embolismCatheter-directed thrombolysisProportion of patientsPulmonary embolismLV ratioMajor bleedingPrimary outcomeRight ventricleClinical trialsIntermediate-high risk pulmonary embolismDefinitive clinical outcome trialsMain safety outcomeMajor gastrointestinal bleedingRV/LVClinical events committeeClinical outcome trialsLarge cardiovascular centresCause mortalityEfficacy outcomesGastrointestinal bleedingMonotherapy groupOutcome trialsSecondary outcomesPercutaneous Left Atrial Appendage Occlusion in Comparison to Non‐Vitamin K Antagonist Oral Anticoagulant Among Patients With Atrial Fibrillation
Noseworthy PA, Van Houten HK, Krumholz HM, Kent DM, Abraham NS, Graff‐Radford J, Alkhouli M, Henk HJ, Shah ND, Gersh BJ, Friedman PA, Holmes DR, Yao X. Percutaneous Left Atrial Appendage Occlusion in Comparison to Non‐Vitamin K Antagonist Oral Anticoagulant Among Patients With Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e027001. PMID: 36172961, PMCID: PMC9673739, DOI: 10.1161/jaha.121.027001.Peer-Reviewed Original ResearchConceptsComposite end pointAtrial appendage occlusionOral anticoagulantsAtrial fibrillationLower riskMajor bleedingSystemic embolismIntracranial bleedingAppendage occlusionNon-Vitamin K Antagonist Oral AnticoagulantsIschemic stroke/systemic embolismK Antagonist Oral AnticoagulantsPrimary composite end pointPropensity score overlap weightingStroke/systemic embolismEnd pointHigh bleeding riskSignificant differencesAntithrombotic regimensBleeding riskCause mortalityBaseline characteristicsComposite outcomeIschemic strokeSecondary outcomesHospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study
Yu Y, Guan W, Masoudi FA, Wang B, He G, Spertus JA, Lu Y, Krumholz HM, Li J. Hospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2022, 11: e026300. PMID: 36172964, PMCID: PMC9673705, DOI: 10.1161/jaha.122.026300.Peer-Reviewed Original ResearchConceptsSpironolactone prescriptionSpironolactone useHeart failureMedian odds ratioIdeal patientAldosterone antagonistsHospital variationMedian rateReduced ejection fractionUse of spironolactoneMultivariable linear regression modelsHeart Failure StudyEjection fractionHospital characteristicsOdds ratioRepresentative cohortPatientsHospitalChinese hospitalsInappropriate usePrescriptionSpironolactoneSelect individualsAntagonistHigh rateIdentifying quality of life outcome patterns to inform treatment choices in ischemic cardiomyopathy
Mori M, Mark DB, Khera R, Lin H, Jones P, Huang C, Lu Y, Geirsson A, Velazquez EJ, Spertus JA, Krumholz HM. Identifying quality of life outcome patterns to inform treatment choices in ischemic cardiomyopathy. American Heart Journal 2022, 254: 12-22. PMID: 35932911, DOI: 10.1016/j.ahj.2022.07.007.Peer-Reviewed Original ResearchMeSH KeywordsCardiomyopathiesClinical Trials as TopicCoronary Artery BypassHumansMyocardial IschemiaQuality of LifeTreatment OutcomeConceptsCoronary artery bypass surgeryGuideline-directed medical therapyTreatment choiceBetter outcomesIschemic cardiomyopathyQOL outcomesQoL dataKansas City Cardiomyopathy Questionnaire overall summary scoreQOL trajectoriesOutcome patternsIschemic Heart Failure (STICH) trialHeart Failure TrialMain baseline predictorsArtery bypass surgeryOverall summary scoreDifferent treatment choicesLogistic regression modelsBypass surgeryMedical therapySurgical treatmentFailure TrialLife scoresQOL scoresPatient's probabilityBaseline predictorsSex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomenInstitutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Ngo L, Ali A, Ganesan A, Woodman R, Krumholz HM, Adams R, Ranasinghe I. Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e022009. PMID: 35156395, PMCID: PMC9245833, DOI: 10.1161/jaha.121.022009.Peer-Reviewed Original ResearchConceptsProcedure-related complicationsComplication rateAF ablationAtrial fibrillationCatheter ablationStroke/transient ischemic attackCare qualityTransient ischemic attackRisk of complicationsIschemic attackHospital stayCohort studyCommon complicationHospital dischargePericardial effusionCardiorespiratory failurePrimary outcomeProcedural characteristicsComplicationsPatientsHospitalStudy periodBackground ComplicationsPotential disparitiesFibrillation
2021
Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial
Wang L, Lu Y, Wang H, Gu J, J Z, Lian Z, Zhang Z, Krumholz H, Sun N. Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial. Open Heart 2021, 8: e001719. PMID: 34580169, PMCID: PMC8477318, DOI: 10.1136/openhrt-2021-001719.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAntihypertensive AgentsBlood PressureCardiography, ImpedanceChinaClinical Decision-MakingFemaleFollow-Up StudiesHumansHypertensionIncidenceMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTherapy, Computer-AssistedTime FactorsTreatment OutcomeYoung AdultConceptsBody mass indexPeking University People's HospitalStandard care groupBlood pressure controlSystolic BPHaemodynamic groupsTreatment strategiesImpedance cardiographyBaseline BPBP goalHypertension clinicHaemodynamic profileBP levelsCare groupPeople's HospitalMean baseline systolic BPPressure controlReal-world clinical practiceBaseline systolic BPMean systolic BPDiastolic BP levelsProportion of patientsPragmatic clinical trialsReal-world populationBaseline DBPNational Trends in the Use of Sacubitril/Valsartan
Ozaki AF, Krumholz HM, Mody FV, Jackevicius CA. National Trends in the Use of Sacubitril/Valsartan. Journal Of Cardiac Failure 2021, 27: 839-847. PMID: 34364661, DOI: 10.1016/j.cardfail.2021.05.015.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanSacubitril/valsartan useReduced ejection fractionValsartan useEjection fractionHeart failurePopulation-level cohort studyNational Prescription AuditEligible patientsCohort studyPrescription patternsYounger patientsPrescription auditDosage patternClinical implicationsFurther evaluationValsartanPatientsSubstantial proportionNational trendsPrescriptionGreater increaseRecent useGreater proportionUnited StatesComparative First-Line Effectiveness and Safety of ACE (Angiotensin-Converting Enzyme) Inhibitors and Angiotensin Receptor Blockers
Chen R, Suchard MA, Krumholz HM, Schuemie MJ, Shea S, Duke J, Pratt N, Reich CG, Madigan D, You SC, Ryan PB, Hripcsak G. Comparative First-Line Effectiveness and Safety of ACE (Angiotensin-Converting Enzyme) Inhibitors and Angiotensin Receptor Blockers. Hypertension 2021, 78: 591-603. PMID: 34304580, PMCID: PMC8363588, DOI: 10.1161/hypertensionaha.120.16667.Peer-Reviewed Original ResearchContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican CollegeEffect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit
Mazloomzadeh S, Khaleghparast S, Ghadrdoost B, Mousavizadeh M, Baay M, Noohi F, Sharifnia H, Ahmadi A, Tavan S, Malekpour Alamdari N, Fathi M, Soleimanzadeh M, Mostafa M, Davoody N, Zarinsadaf M, Tayyebi S, Farrokhzadeh F, Nezamabadi F, Soomari E, Sadeghipour P, Talasaz A, Rashidi F, Sharif-Kashani B, Beigmohammadi M, Farrokhpour M, Sezavar S, Payandemehr P, Dabbagh A, Moghadam K, Jamalkhani S, Khalili H, Yadollahzadeh M, Riahi T, Rezaeifar P, Tahamtan O, Matin S, Abedini A, Lookzadeh S, Rahmani H, Zoghi E, Mohammadi K, Sadeghipour P, Abri H, Tabrizi S, Mousavian S, Shahmirzaei S, Bakhshandeh H, Amin A, Rafiee F, Baghizadeh E, Mohebbi B, Parhizgar S, Aliannejad R, Eslami V, Kashefizadeh A, Kakavand H, Hosseini S, Shafaghi S, Ghazi S, Najafi A, Jimenez D, Gupta A, Madhavan M, Sethi S, Parikh S, Monreal M, Hadavand N, Hajighasemi A, Maleki M, Sadeghian S, Piazza G, Kirtane A, Van Tassell B, Dobesh P, Stone G, Lip G, Krumholz H, Goldhaber S, Bikdeli B. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit. JAMA 2021, 325: 1620-1630. PMID: 33734299, PMCID: PMC7974835, DOI: 10.1001/jama.2021.4152.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsCOVID-19Drug Administration ScheduleEnoxaparinExtracorporeal Membrane OxygenationFemaleHemorrhageHospitalizationHumansIntensive Care UnitsIranLength of StayMaleMiddle AgedOdds RatioOutcome Assessment, Health CareOxygen Inhalation TherapyPulmonary EmbolismThrombocytopeniaThrombosisTreatment OutcomeVenous ThrombosisConceptsStandard-dose prophylactic anticoagulationIntensive care unitIntermediate-dose groupProphylactic anticoagulationPrimary efficacy outcomeExtracorporeal membrane oxygenationIntermediate doseMajor bleedingProphylaxis groupEfficacy outcomesMembrane oxygenationPrimary outcomeThrombotic eventsArterial thrombosisCare unitSevere thrombocytopeniaCOVID-19Bleeding Academic Research ConsortiumExtracorporeal membrane oxygenation treatmentPrespecified safety outcomesRoutine empirical useStandard prophylactic anticoagulationAcademic Research ConsortiumMembrane oxygenation treatmentAntithrombotic prophylaxisClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
McPadden J, Warner F, Young HP, Hurley NC, Pulk RA, Singh A, Durant TJS, Gong G, Desai N, Haimovich A, Taylor RA, Gunel M, Dela Cruz CS, Farhadian SF, Siner J, Villanueva M, Churchwell K, Hsiao A, Torre CJ, Velazquez EJ, Herbst RS, Iwasaki A, Ko AI, Mortazavi BJ, Krumholz HM, Schulz WL. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection. PLOS ONE 2021, 16: e0243291. PMID: 33788846, PMCID: PMC8011821, DOI: 10.1371/journal.pone.0243291.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionYale New Haven HealthSARS-CoV-2Hospital mortalityRisk of admissionMale sexRisk factorsSARS-CoV-2 testingInvasive mechanical ventilationSevere acute respiratory syndrome virusBurden of diseaseRT-PCR testingAcademic health systemDiverse patient populationsRespiratory syndrome virusEthnic groupsAdult patientsClinical characteristicsDischarge dispositionRespiratory supportPrimary outcomeTreatment guidelinesMechanical ventilationRetrospective studyPatient populationComprehensive Comparative Effectiveness and Safety of First-Line β-Blocker Monotherapy in Hypertensive Patients
You S, Krumholz HM, Suchard MA, Schuemie MJ, Hripcsak G, Chen R, Shea S, Duke J, Pratt N, Reich CG, Madigan D, Ryan PB, Park R, Park S. Comprehensive Comparative Effectiveness and Safety of First-Line β-Blocker Monotherapy in Hypertensive Patients. Hypertension 2021, 77: 1528-1538. PMID: 33775125, PMCID: PMC8035236, DOI: 10.1161/hypertensionaha.120.16402.Peer-Reviewed Original ResearchAssociation of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction
Shen YC, Krumholz H, Hsia RY. Association of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007195. PMID: 33641339, PMCID: PMC7969448, DOI: 10.1161/circoutcomes.120.007195.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionST-segment elevation myocardial infarction (STEMI) systemsSame-day percutaneous coronary interventionST-segment elevation myocardial infarctionSTEMI regionalizationLong-term mortalityOutcomes of patientsElevation myocardial infarctionPCI-capable hospitalsEmergency medical services agenciesMyocardial infarction systemLocal emergency medical services agenciesPoints greater reductionPercentage point decreasePCI capabilityCoronary interventionMyocardial infarctionAdministrative databasesPatientsSTEMIPoint decreaseMortalityTimely accessReadmissionGreater reduction