Featured Publications
Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group
Shimokawa H, Suda A, Takahashi J, Berry C, Camici PG, Crea F, Escaned J, Ford T, Yii E, Kaski JC, Kiyooka T, Mehta PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yasuda S, Beltrame JF, Merz CNB, Group O. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group. European Heart Journal 2021, 42: 4592-4600. PMID: 34038937, PMCID: PMC8633728, DOI: 10.1093/eurheartj/ehab282.Peer-Reviewed Original ResearchConceptsMajor cardiovascular eventsCoronary artery diseaseMicrovascular anginaPrognosis of patientsInternational Study GroupClinical characteristicsStudy groupPrevious historyMultivariable Cox proportional hazards analysisNon-fatal myocardial infarctionCox proportional hazards analysisSeattle Angina Questionnaire scoresNon-fatal strokeAcute coronary syndromeProspective cohort studyStable angina pectorisProportional hazards analysisImportant health problemComparable prognosisCardiovascular deathCardiovascular eventsCoronary syndromePrimary endpointCohort studyUnstable anginaInstitutional solutions addressing disparities in compensation and advancement of emergency medicine physicians: A critical appraisal of gaps and associated recommendations
Madsen TE, Heron S, Lall MD, Blomkalns A, Arbelaez C, Lopez B, Lin M, Rounds K, Sethuraman KN, Safdar B. Institutional solutions addressing disparities in compensation and advancement of emergency medicine physicians: A critical appraisal of gaps and associated recommendations. Academic Emergency Medicine 2022, 29: 710-718. PMID: 35064998, DOI: 10.1111/acem.14452.Peer-Reviewed Original ResearchEffect 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 menSurvival of the Fittest: Impact of Cardiorespiratory Fitness on Outcomes in Men and Women with Cardiovascular Disease
Safdar B, Mangi AA. Survival of the Fittest: Impact of Cardiorespiratory Fitness on Outcomes in Men and Women with Cardiovascular Disease. Clinical Therapeutics 2020, 42: 385-392. PMID: 32088022, DOI: 10.1016/j.clinthera.2020.01.014.Peer-Reviewed Original ResearchConceptsPeak cardiorespiratory fitnessCardiorespiratory fitnessCardiovascular diseaseCardiac rehabilitationPhysical inactivityMyocardial infarctionImpact of CRFOnset of CVDPeak exercise capacityCardiac rehabilitation programModifiable risk factorsRecurrent myocardial infarctionPoor functional outcomeCause of mortalitySex differencesImpact of sexCVD outcomesExercise capacityImproved survivalLow referralMale patientsFemale patientsExercise prescriptionFunctional outcomeRisk factorsChapter 6 Cardiovascular disease: Sex and gender evidence in acute ischemic syndrome and heart failure
Safdar B. Chapter 6 Cardiovascular disease: Sex and gender evidence in acute ischemic syndrome and heart failure. 2021, 101-127. DOI: 10.1016/b978-0-12-816569-0.00006-1.Peer-Reviewed Original ResearchCardiovascular diseaseHeart failureManagement of CVDAcute cardiovascular conditionsAcute ischemic syndromesCongestive heart failureIschemic heart diseasePrimary care practicesCause of mortalityIschemic syndromeCardiac remodelingHeart diseaseCardiovascular conditionsAutonomic regulationCare practicesClinical perspectiveGender evidenceSex differencesDiseaseSexHypertensionGenderObesityDiabetesFailureRenalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19
Safdar B, Sobiesk M, Bertsimas D, Nowroozpoor A, Deng Y, D’Onofrio G, Dziura J, El-Khoury J, Guo X, Simonov M, Taylor R, Wang M, Desir G. Renalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19. Journal Of Biotechnology And Biomedicine 2024, 07 DOI: 10.26502/jbb.2642-91280139.Peer-Reviewed Original ResearchAssociation 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 levelsIs microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review
Nowroozpoor A, Gutterman D, Safdar B. Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review. Microvascular Research 2020, 134: 104123. PMID: 33333140, DOI: 10.1016/j.mvr.2020.104123.Peer-Reviewed Original ResearchConceptsMicrovascular dysfunctionUnderlying systemic processC-reactive proteinLow-density cholesterolMulti-system involvementUric acidDifferent disease entitiesMulti-system manifestationsVon Willebrand factorNT-proBNPEndothelial dysfunctionTotal cholesterolClinical evidenceImmune activationSystemic disordersVitamin DIL-6Asymmetric dimethylarginineBlood biomarkersInforms cliniciansDisease entityCystatin CVital organsDysfunctionCommon biomarkersDiagnosis of coronary microvascular dysfunction in the clinic
Ong P, Safdar B, Seitz A, Hubert A, Beltrame J, Prescott E. Diagnosis of coronary microvascular dysfunction in the clinic. Cardiovascular Research 2020, 116: 841-855. PMID: 31904824, DOI: 10.1093/cvr/cvz339.Peer-Reviewed Original ResearchConceptsInterventional diagnostic proceduresCoronary microvascular dysfunctionCoronary microcirculationMicrovascular dysfunctionIntracoronary acetylcholine testingCoronary microvascular functionCoronary blood flowIndividual patient characteristicsChronic pathologic conditionsAcetylcholine testingCoronary spasmRecurrent symptomsCoronary vasoconstrictorPatient characteristicsCoronary thrombosisMicrovascular functionInvasive assessmentClinical conditionsEffective treatmentRespective patientsBlood flowCardiac metabolismClinical importancePathologic conditionsInvasive methodElevated 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 failureClues to Diagnose Myocardial Infarction in the Young No Longer a Needle in the Haystack ∗
Safdar B. Clues to Diagnose Myocardial Infarction in the Young No Longer a Needle in the Haystack ∗. Journal Of The American College Of Cardiology 2019, 73: 585-588. PMID: 30732712, DOI: 10.1016/j.jacc.2018.11.034.Peer-Reviewed Original ResearchMaking Promotion Count: The Gender Perspective
Madsen TE, Heron SL, Rounds K, Kass D, Lall M, Sethuraman KN, Arbelaez C, Blomkalns A, Safdar B, Taskforce T. Making Promotion Count: The Gender Perspective. Academic Emergency Medicine 2019, 26: 335-338. PMID: 30628138, DOI: 10.1111/acem.13680.Peer-Reviewed Original ResearchCurrent Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians
Madsen TE, Linden JA, Rounds K, Hsieh Y, Lopez BL, Boatright D, Garg N, Heron SL, Jameson A, Kass D, Lall MD, Melendez AM, Scheulen JJ, Sethuraman KN, Westafer LM, Safdar B. Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians. Academic Emergency Medicine 2017, 24: 1182-1192. PMID: 28779488, DOI: 10.1111/acem.13269.Peer-Reviewed Original ResearchConceptsClinical hoursRacial/Ethnic DisparitiesAcademic emergency departmentEmergency medicine physiciansAcademy of AdministratorsEmergency medicine workforceEmergency departmentWhite raceMedicine physiciansResponse rateUnknown raceEthnic disparitiesAsian IndiansAcademic Emergency Medicine PhysiciansFellowship trainingClinical commitmentsWomenYears of experienceMenBoard certificationCurrent statusMean salaryGenderNonwhitesHoursSex 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 hospitalsPrevalence 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 populationPresentation, 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 statusIdentifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation
Safdar B, Ong P, Camici PG. Identifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation. Clinical Therapeutics 2018, 40: 1920-1930. PMID: 30458932, DOI: 10.1016/j.clinthera.2018.09.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent chest painCoronary microvascular dysfunctionChest painEmergency departmentHs-TnTMicrovascular dysfunctionMyocardial ischemiaAcute chest pain evaluationHigh-sensitivity troponin TDiagnosis of AMIType 2 acute myocardial infarctionElevated hs-TnTIschemia/necrosisChest pain evaluationGroup of patientsAssessment of symptomsIdentification of patientsAppropriate medical treatmentSex-specific thresholdsPulmonary embolismVasomotor disordersAortic dissectionPain evaluationEpicardial coronaries
2024
Shock prediction with dipeptidyl peptidase-3 and renin (SPiDeR) in hypoxemic patients with COVID-19
Busse L, Teixeira J, Schaich C, Lohuis C, Nielsen N, Sturek J, Merck L, Self W, Puskarich M, Khan A, Semler M, Moskowitz A, Hager D, Duggal A, Rice T, Ginde A, Tiffany B, Iovine N, Chen P, Safdar B, Gibbs K, Javaheri A, de Wit M, Harkins M, Joly M, Collins S, Investigators F. Shock prediction with dipeptidyl peptidase-3 and renin (SPiDeR) in hypoxemic patients with COVID-19. Journal Of Critical Care 2024, 85: 154950. PMID: 39546997, DOI: 10.1016/j.jcrc.2024.154950.Peer-Reviewed Original ResearchRenin levelsVasopressor initiationAssociated with organ dysfunctionHigher 28-day mortalityVasopressor-free daysAssociated with increased riskBaseline plasma levelsAt-risk patientsOnset of shockAccelerating COVID-19 Therapeutic InterventionsVasopressor requirementsHypoxemic patientsAcute hypoxemiaOrgan dysfunctionBaseline hypotensionOdds ratioHypotensive eventsReninPlasma samplesPatientsTherapeutic interventionsHypoxemiaMortalityPlatform trialsBaselineThe Role of Sex and Gender in Precision Emergency Medicine: A Scoping Review and Proposed Hierarchy
Jarman A, Wolfe M, Mumma B, Madsen T, Safdar B, Greenberg M, Wolfe J, Gunn B, Walter L, Maughan B, McGregor A. The Role of Sex and Gender in Precision Emergency Medicine: A Scoping Review and Proposed Hierarchy. Clinical Therapeutics 2024 PMID: 39542745, DOI: 10.1016/j.clinthera.2024.10.007.Peer-Reviewed Original ResearchEmergency medicineStandardized data extraction formClinical topic areasImplementation of guidelinesScreened eligible studiesData extraction formPreferred Reporting ItemsAcute care medicineDeterminants of diseaseGender medicineGender-based medicineScoping reviewPrecision medicine researchReporting ItemsExtraction formIndividual patient dataClinical topicsStudy characteristicsSystematic reviewInclusion criteriaEligible studiesWorkgroup membersCare medicineEM researchPrecision medicine conceptAssessment and mitigation of bias in influenza and COVID-19 vaccine effectiveness analyses — IVY Network, September 1, 2022–March 30, 2023
Lewis N, Harker E, Leis A, Zhu Y, Talbot H, Grijalva C, Halasa N, Chappell J, Johnson C, Rice T, Casey J, Lauring A, Gaglani M, Ghamande S, Columbus C, Steingrub J, Shapiro N, Duggal A, Felzer J, Prekker M, Peltan I, Brown S, Hager D, Gong M, Mohamed A, Exline M, Khan A, Wilson J, Mosier J, Qadir N, Chang S, Ginde A, Mohr N, Mallow C, Harris E, Johnson N, Srinivasan V, Gibbs K, Kwon J, Vaughn I, Ramesh M, Safdar B, DeCuir J, Surie D, Dawood F, Ellington S, Self W, Martin E. Assessment and mitigation of bias in influenza and COVID-19 vaccine effectiveness analyses — IVY Network, September 1, 2022–March 30, 2023. Vaccine 2024, 43: 126492. PMID: 39515195, DOI: 10.1016/j.vaccine.2024.126492.Peer-Reviewed Original ResearchCo-circulating virusesRespiratory syncytial virusCOVID-19-associated hospitalizationVaccine effectivenessControl groupRespiratory pathogensInfluenza-associated hospitalizationsExclusion of patientsStudies of vaccine effectivenessAcute respiratory illnessTest-negative studySentinel Surveillance NetworkEstimates of VEInfluenza VEInfluenza-associatedVE controlsReal-world analysisSyncytial virusVE estimatesOverall VEVE analysisPatientsInfluenzaRespiratory illnessVaccine-preventable