2024
Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputation
2023
Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2023, 12: e030031. PMID: 37589125, PMCID: PMC10547344, DOI: 10.1161/jaha.123.030031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac-specific qualityGeneric health statusMyocardial infarctionBaseline healthMarital stressHealth outcomesHealth statusWorse patient-reported outcomesMental healthYoung adultsObservational cohort studyPatient-reported outcomesSocioeconomic factorsWorse mental healthReadmission 1Cause readmissionCohort studyYounger patientsRoutine screeningDepressive symptomsGreater oddsAnginaMale participantsOutcomesSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesSex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction
Brush J, Chaudhry S, Dreyer R, D'Onofrio G, Greene E, Hajduk A, Lu Y, Krumholz H. Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2023, 197: 101-107. PMID: 37062667, PMCID: PMC10198892, DOI: 10.1016/j.amjcard.2023.03.009.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionD2B timeSymptom complexityYoung womenChest painBalloon timeST-elevation myocardial infarctionSILVER-AMI StudySymptom phenotypeSex differencesPain symptomsCoronary interventionOlder patientsMyocardial infarctionOlder womenSTEMIOlder menSymptom patternsPresentation delayPatientsSymptom clustersLogistic regressionSymptomsWomenMean number
2022
Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults
Lu Y, Li SX, Liu Y, Rodriguez F, Watson KE, Dreyer RP, Khera R, Murugiah K, D’Onofrio G, Spatz ES, Nasir K, Masoudi FA, Krumholz HM. Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Network Open 2022, 5: e229953. PMID: 35503221, PMCID: PMC9066284, DOI: 10.1001/jamanetworkopen.2022.9953.Peer-Reviewed Original ResearchConceptsFirst acute myocardial infarctionAcute myocardial infarctionPsychosocial risk factorsRisk factor profilePopulation attributable fractionRisk factor associationsRisk factorsOdds ratioYoung womenAMI subtypesMyocardial infarctionPrevention of AMIType 1 acute myocardial infarctionFactor profileRisk of AMITraditional cardiovascular risk factorsSex-specific risk factorsFactor associationsYoung adultsRisk factor modificationCardiovascular risk factorsStrong associationNutrition Examination SurveyCase-control studyPopulation-based controls
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospital
2020
The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction
Raparelli V, Pilote L, Behlouli H, Dziura J, Bueno H, D'Onofrio G, Krumholz H, Dreyer R. The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction. European Heart Journal 2020, 41: ehaa946.3175. DOI: 10.1093/ehjci/ehaa946.3175.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careYoung adultsMyocardial infarctionHealthcare systemHigher risk factor burdenRisk factor burdenPost-discharge carePhases of careMultipayer systemImpact of sexSystem-level factorsHospital phaseAMI careCare scoresSingle-payer systemCareWomenCanadian InstituteSexAdultsMenInfarctionHospitalLinear regression modelsWhere Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionCross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries
Venkatesh AK, Mei H, Shuling L, D’Onofrio G, Rothenberg C, Lin Z, Krumholz HM. Cross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries. Academic Emergency Medicine 2020, 27: 570-579. PMID: 32302034, DOI: 10.1111/acem.13971.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsEmergency departmentUnscheduled careMedicare beneficiariesCross-sectional analysisVisit ratesCare servicesHighest ED visit ratesNumber of EDVulnerable subpopulationsSkilled nursing facility useAmbulatory office settingNon-ED settingsUnscheduled care servicesAcute care utilizationED visit ratesOffice-based visitsAcute care servicesClaims-based definitionNursing facility useMedicare beneficiaries age 65Dual-eligible beneficiariesOlder adult populationBeneficiaries age 65Care visits
2019
Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition
Venkatesh AK, Chou SC, Li SX, Choi J, Ross JS, D’Onofrio G, Krumholz HM, Dharmarajan K. Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition. JAMA Internal Medicine 2019, 179: 686-693. PMID: 30933243, PMCID: PMC6503571, DOI: 10.1001/jamainternmed.2019.0037.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsthmaCritical CareCross-Sectional StudiesDatabases, FactualEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalizationHumansInsurance CoverageInsurance, HealthLung DiseasesMaleMedicaidMedically UninsuredMiddle AgedPatient DischargePatient TransferPneumoniaPulmonary Disease, Chronic ObstructiveUnited StatesConceptsNational Emergency Department SampleEmergency Department SampleCommon medical conditionsUninsured patientsCritical care capabilitiesED dischargeED visitsED transfersPulmonary diseaseCare capabilitiesInsurance statusHigher oddsMedicaid beneficiariesMedical conditionsChronic obstructive pulmonary diseaseAcute pulmonary diseaseEmergency department transfersAdult ED visitsHospital admission ratesObstructive pulmonary diseaseEmergency department dispositionPatient insurance statusPatient case mixHospital ownership statusIntensive care capabilities
2018
Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusSex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction. Circulation 2018, 137: 781-790. PMID: 29459463, PMCID: PMC5822747, DOI: 10.1161/circulationaha.117.031650.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPerception of symptomsChest painCare-seeking behaviorSymptom presentationYounger patientsMyocardial infarctionST-segment elevation acute myocardial infarctionMultivariable hierarchical logistic regressionIndex AMI hospitalizationMajority of womenHierarchical logistic regressionStress/anxietyVIRGO StudyMuscle painPatient characteristicsPredominant symptomAMI symptomsPerceive symptomsProdromal symptomsPatient interviewsHeart diseasePainAMI hospitalizationUS hospitals
2017
Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain
Lindau S, Abramsohn E, Bueno H, D’Onofrio G, Lichtman J, Lorenze N, Sanghani R, Spatz E, Spertus J, Strait K, Wroblewski K, Zhou S, Krumholz H. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. Obstetrical & Gynecological Survey 2017, 72: 334-335. DOI: 10.1097/01.ogx.0000516136.75506.a3.Peer-Reviewed Original ResearchMECHANISMS OF ACUTE MYOCARDIAL INFARCTION IN YOUNG WOMEN AND DISCHARGE MEDICATION PATTERNS
Sciria C, Dreyer R, Safdar B, D'Onofrio G, Krumholz H, Spatz E. MECHANISMS OF ACUTE MYOCARDIAL INFARCTION IN YOUNG WOMEN AND DISCHARGE MEDICATION PATTERNS. Journal Of The American College Of Cardiology 2017, 69: 195. DOI: 10.1016/s0735-1097(17)33584-2.Peer-Reviewed Original ResearchPerceived Stress After Acute Myocardial Infarction
Xu X, Bao H, Strait KM, Edmondson DE, Davidson KW, Beltrame JF, Bueno H, Lin H, Dreyer RP, Brush JE, Spertus JA, Lichtman JH, D'Onofrio G, Krumholz HM. Perceived Stress After Acute Myocardial Infarction. Psychosomatic Medicine 2017, 79: 50-58. PMID: 27984507, PMCID: PMC5459399, DOI: 10.1097/psy.0000000000000429.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPSS-14 scoreMiddle-aged patientsPatient characteristicsMyocardial infarctionSex differencesMonths of recoveryAMI anginaInitial hospitalizationPerceived Stress ScalePatientsAnginaLess improvementLinear mixed-effects modelsFirst monthPsychological stressMixed-effects modelsWomenMonthsHigh levelsMenInfarctionStress ScalePerceived stress
2016
Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain
Lindau ST, Abramsohn E, Bueno H, D’Onofrio G, Lichtman JH, Lorenze NP, Sanghani RM, Spatz ES, Spertus JA, Strait KM, Wroblewski K, Zhou S, Krumholz HM. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. JAMA Cardiology 2016, 1: 754-764. PMID: 27579897, PMCID: PMC5459405, DOI: 10.1001/jamacardio.2016.2362.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionSexual function problemsSexual activityMyocardial infarctionYoung AMI Patients (VIRGO) studyYoung womenSexual problemsModifiable risk factorsLogistic regression analysisMultinomial logistic regression analysisPrevalent sexual problemPhysician counselingMedian ageMost young adultsSexual functionRisk factorsSpanish hospitalsMAIN OUTCOMEErectile difficultiesFirst monthYoung adultsTime pointsWomenMore womenPatient studiesEditor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis
Bucholz EM, Strait KM, Dreyer RP, Lindau ST, D’Onofrio G, Geda M, Spatz ES, Beltrame JF, Lichtman JH, Lorenze NP, Bueno H, Krumholz HM. Editor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis. European Heart Journal Acute Cardiovascular Care 2016, 6: 610-622. PMID: 27485141, PMCID: PMC5459677, DOI: 10.1177/2048872616661847.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionYoung womenTime of AMIST-segment elevation myocardial infarctionHigh clinical risk scoreSegment elevation myocardial infarctionChronic obstructive pulmonary diseaseYoung AMI patientsCardiovascular risk factorsClinical risk scorePre-hospital delayProspective cohort studyCongestive heart failureElevation myocardial infarctionObstructive pulmonary diseaseHigh-risk populationYoung menMental health statusElectrocardiogram findingsMorbid obesityCardiovascular riskCohort studyRenal failureYounger patients
2015
Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction The VIRGO Study
Leifheit-Limson EC, D’Onofrio G, Daneshvar M, Geda M, Bueno H, Spertus JA, Krumholz HM, Lichtman JH. Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction The VIRGO Study. Journal Of The American College Of Cardiology 2015, 66: 1949-1957. PMID: 26515996, PMCID: PMC4628727, DOI: 10.1016/j.jacc.2015.08.859.Peer-Reviewed Original ResearchConceptsCardiac risk factorsAcute myocardial infarctionHealth care provider discussionsRisk modificationRisk factorsHeart diseaseHealth care providersProvider discussionsVIRGO StudyYounger patientsMyocardial infarctionCare providersSignificant cardiac risk factorsYoung AMI patientsPatients age 18Heart disease riskRisk factor prevalenceSelf-perceived riskModified Poisson regressionSex differencesFactor prevalenceAMI patientsCardiac riskSpanish hospitalsProvider feedbackSex 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 disparitiesSEX DIFFERENCES IN 12-MONTH HEALTH STATUS IN YOUNG PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION: RESULTS FROM THE VIRGO STUDY (VARIATION IN RECOVERY: ROLE OF GENDER ON OUTCOMES OF YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS)
Dreyer R, Wang Y, Strait K, Lorenze N, D’Onofrio G, Bueno H, Lichtman J, Spertus J, Krumholz H. SEX DIFFERENCES IN 12-MONTH HEALTH STATUS IN YOUNG PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION: RESULTS FROM THE VIRGO STUDY (VARIATION IN RECOVERY: ROLE OF GENDER ON OUTCOMES OF YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS). Journal Of The American College Of Cardiology 2015, 65: a6. DOI: 10.1016/s0735-1097(15)60006-7.Peer-Reviewed Original Research