2024
Residual Ultrasound-Enhancing Agents Mimicking Portal Venous Gas
Bitar R, Langdon J, Kaur M, Crandall I, McNamara R, Revzin M. Residual Ultrasound-Enhancing Agents Mimicking Portal Venous Gas. Ultrasound Quarterly 2024, 40: e00694. PMID: 39466239, DOI: 10.1097/ruq.0000000000000694.Peer-Reviewed Original ResearchConceptsUltrasound enhancing agentsPortal venous gasBowel ischemiaAbdominal ultrasoundVenous gasEchogenic fociContrast-enhanced echocardiographyEvaluation of cardiac functionPortal venous systemSeries of casesSonographic detectionCardiac functionDifferential diagnosisPortal veinVenous systemObservational studyLiver parenchymaPortal triadsVascular patencyBowelIschemiaEchocardiographyLiverUltrasound
2019
Patient, clinician and logistic barriers to blood pressure control among adult hypertensives in rural district hospitals in Rwanda: a cross-sectional study
Sibomana J, McNamara R, Walker T. Patient, clinician and logistic barriers to blood pressure control among adult hypertensives in rural district hospitals in Rwanda: a cross-sectional study. BMC Cardiovascular Disorders 2019, 19: 231. PMID: 31638907, PMCID: PMC6805529, DOI: 10.1186/s12872-019-1203-3.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntihypertensive AgentsBlood PressureClinical CompetenceCross-Sectional StudiesFemaleGuideline AdherenceHospitals, RuralHumansHypertensionMaleMedication AdherenceMiddle AgedPhysician's RolePractice Guidelines as TopicPractice Patterns, Physicians'RwandaTime FactorsTreatment OutcomeYoung AdultConceptsRural district hospitalDistrict hospitalsBlood pressure controlBarriers to effective blood pressure controlRural Rwandan district hospitalsAssociated with poor blood pressure controlRwandan district hospitalsBarriers to blood pressure controlPoor blood pressure controlMethodsThis cross-sectionalCross-sectional studyLogistical factorsMedication side effectsPressure controlAnti-hypertensive medicationsHypertensive patientsSociodemographic factorsBlood pressureBlood pressure dataPrescribed medicationsEffective blood pressure controlJNC 8 recommendationsGoal blood pressurePatient factorsMedical costs
2017
Contemporary risk model for inhospital major bleeding for patients with acute myocardial infarction: The acute coronary treatment and intervention outcomes network (ACTION) registry®–Get With The Guidelines (GWTG)®
Desai NR, Kennedy KF, Cohen DJ, Connolly T, Diercks DB, Moscucci M, Ramee S, Spertus J, Wang TY, McNamara RL. Contemporary risk model for inhospital major bleeding for patients with acute myocardial infarction: The acute coronary treatment and intervention outcomes network (ACTION) registry®–Get With The Guidelines (GWTG)®. American Heart Journal 2017, 194: 16-24. PMID: 29223432, DOI: 10.1016/j.ahj.2017.08.004.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionIntervention Outcomes Network RegistryAcute Coronary TreatmentInhospital major bleedingMajor bleedingRisk scoreCoronary TreatmentValidation cohortMyocardial infarctionHigh riskLower riskContemporary risk modelsProspective risk stratificationSimplified risk scoreHospital quality assessmentRisk adjustment methodsBaseline hemoglobinCardiogenic shockCreatinine clearanceFrequent complicationDerivation cohortHeart failureRisk stratificationSignificant morbidityCardiac arrest
2015
Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records
McNamara RL, Wang Y, Partovian C, Montague J, Mody P, Eddy E, Krumholz HM, Bernheim SM. Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records. Medical Care 2015, 53: 818-826. PMID: 26225445, DOI: 10.1097/mlr.0000000000000402.Peer-Reviewed Original ResearchConceptsElectronic health recordsOutcome measuresClinical dataMortality rateClinical practiceFuture quality improvement measuresRisk-standardized mortality ratesHospital risk-standardized mortality ratesLow-mortality hospitalsHealth recordsSystolic blood pressureOdds of mortalityClinical registry dataAcute myocardial infarctionHigh-mortality hospitalsHospital outcome measuresEHR dataFinal risk modelCurrent clinical practiceStandard clinical practiceFirst outcome measureNational Quality ForumCurrent electronic health recordsQuality improvement measuresChart abstractionStandardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM)
McNamara RL, Spatz ES, Kelley TA, Stowell CJ, Beltrame J, Heidenreich P, Tresserras R, Jernberg T, Chua T, Morgan L, Panigrahi B, Rosas Ruiz A, Rumsfeld JS, Sadwin L, Schoeberl M, Shahian D, Weston C, Yeh R, Lewin J. Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM). Journal Of The American Heart Association 2015, 4: e001767. PMID: 25991011, PMCID: PMC4599409, DOI: 10.1161/jaha.115.001767.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth Outcomes MeasurementOutcome measurementsMyocardial infarctionCoronary artery disease outcomesPatient-reported health statusCoronary artery bypassPercutaneous coronary interventionCoronary artery diseasePatient-centered outcomesStandardized outcome measurementsLongitudinal outcomesCardiovascular hospital admissionsAsymptomatic CADAcute complicationsArtery bypassCoronary interventionRenal failureArtery diseaseHospital admissionInternational Working GroupRisk factorsCardiovascular diseaseDisease outcomeOutcome measures
2014
International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries
McNamara RL, Chung SC, Jernberg T, Holmes D, Roe M, Timmis A, James S, Deanfield J, Fonarow GC, Peterson ED, Jeppsson A, Hemingway H. International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries. International Journal Of Cardiology 2014, 175: 240-247. PMID: 24882696, PMCID: PMC4112832, DOI: 10.1016/j.ijcard.2014.04.270.Peer-Reviewed Original ResearchConceptsNon-ST segment elevation myocardial infarctionPercutaneous coronary interventionManagement of patientsMyocardial infarctionRIKS-HIAAcute non-ST segment elevation myocardial infarctionNon-ST segment elevation acute myocardial infarctionEnzyme inhibitors/angiotensin receptor blockersSegment elevation acute myocardial infarctionElevation acute myocardial infarctionSegment elevation myocardial infarctionFuture comparative effectiveness researchAngiotensin receptor blockersPrior heart failureDual antiplatelet agentsElevation myocardial infarctionAcute myocardial infarctionComparative effectiveness researchCoronary interventionDischarge medicationsOngoing registryReceptor blockersHeart failureAntiplatelet agentsClinical registry
2008
Systolic Function as a Predictor of Mortality and Quality of Life in Long‐term Survivors with Heart Failure
McNamara R, Austin B, Wang Y, Smith G, Vaccarine V, Krumholz H. Systolic Function as a Predictor of Mortality and Quality of Life in Long‐term Survivors with Heart Failure. Clinical Cardiology 2008, 31: 119-124. PMID: 18383045, PMCID: PMC6653267, DOI: 10.1002/clc.20118.Peer-Reviewed Original ResearchConceptsQuality of lifeEjection fractionHeart failureLong-term survivorsFunctional declineSystolic functionKansas City Cardiomyopathy Questionnaire scoreModest survival advantageReduced ejection fractionDaily living scoreDisease-related qualityPredictors of mortalityHeart failure patientsClinical summary scoreLong-term survivalHigh mortality rateKCCQ scoresRenal insufficiencyFailure patientsLiving scoreDiabetes mellitusOverall mortalityPrimary outcomeLimitation scoresQOL scores
2007
Impact of Delay in Door-to-Needle Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction
McNamara RL, Herrin J, Wang Y, Curtis JP, Bradley EH, Magid DJ, Rathore SS, Nallamothu BK, Peterson ED, Blaney ME, Frederick P, Krumholz HM. Impact of Delay in Door-to-Needle Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction. The American Journal Of Cardiology 2007, 100: 1227-1232. PMID: 17920362, PMCID: PMC2715362, DOI: 10.1016/j.amjcard.2007.05.043.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArrhythmias, CardiacCaliforniaCohort StudiesEmergency Service, HospitalEmergency TreatmentFemaleFibrinolytic AgentsHospital MortalityHumansMaleMedical RecordsMyocardial InfarctionOutcome Assessment, Health CareRegistriesRetrospective StudiesThrombolytic TherapyTime and Motion StudiesTime FactorsConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionNeedle timeFibrinolytic therapyMyocardial infarctionHospital mortalitySymptom onsetOdds ratioReperfusion strategyAdjunctive medicationsHospital arrivalShorter doorTimely administrationNational registryRepresentative cohortPatientsMortalityInfarctionTherapyIndependent effectsCohortMinutesSmaller centersOnsetImpact of delay
2003
Predictors of cause‐specific hospital readmission in patients with heart failure
Babayan Z, McNamara R, Nagajothi N, Kasper E, Armenian H, Powe N, Baughman K, Lima J. Predictors of cause‐specific hospital readmission in patients with heart failure. Clinical Cardiology 2003, 26: 411-418. PMID: 14524597, PMCID: PMC6654034, DOI: 10.1002/clc.4960260906.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryCohort StudiesCoronary Artery BypassFemaleFollow-Up StudiesHeart FailureHumansLength of StayMaleMarylandMiddle AgedMyocardial IschemiaPatient ReadmissionPredictive Value of TestsPrevalenceRecurrenceRegression AnalysisSex FactorsStroke VolumeTime FactorsVentricular Dysfunction, LeftConceptsCause-specific readmissionsCoronary artery bypass graftPercutaneous transluminal coronary angioplastyIschemic etiologyRecurrent heart failureHeart failureCardiovascular diseaseHospital readmissionLV dysfunctionVentricular functionMyocardial infarctionAnnual readmission ratesTotal hospital readmissionsArtery bypass graftRisk of readmissionTransluminal coronary angioplastyLeft ventricular functionCox hazard ratiosAvailable clinical dataCause readmissionHF etiologyHazard ratioReadmission ratesRetrospective cohortConsecutive patients
2001
Specialty of principal care physician and Medicare expenditures in patients with coronary artery disease: impact of comorbidity and severity.
McNamara R, Powe N, Thiemann D, Shaffer T, Weller W, Anderson G. Specialty of principal care physician and Medicare expenditures in patients with coronary artery disease: impact of comorbidity and severity. The American Journal Of Managed Care 2001, 7: 261-6. PMID: 11258143.Peer-Reviewed Original ResearchConceptsPrincipal care physicianCoronary artery diseaseAcute myocardial infarctionArtery diseaseCare physiciansUnstable anginaMean expenditureMyocardial infarctionChronic coronary artery diseaseMedicare expendituresProportion of patientsImpact of comorbiditiesLevel of comorbiditySeverity of diagnosisCharlson indexElderly patientsLow comorbidityPhysician typeAcute diagnosisChronic conditionsAcute diseaseChronic diseasesRetrospective analysisComorbiditiesPatients
2000
Efficacy of agents for pharmacologic conversion of atrial fibrillation and subsequent maintenance of sinus rhythm: a meta-analysis of clinical trials.
Miller M, McNamara R, Segal J, Kim N, Robinson K, Goodman S, Powe N, Bass E. Efficacy of agents for pharmacologic conversion of atrial fibrillation and subsequent maintenance of sinus rhythm: a meta-analysis of clinical trials. The Journal Of Family Practice 2000, 49: 1033-46. PMID: 11093570.Peer-Reviewed Original ResearchConceptsAF conversionAtrial fibrillationSinus rhythmOdds ratioModerate evidenceMultiple antiarrhythmic agentsAdverse event ratesClinical trials databasesEfficacy of agentsAdverse event dataPharmacologic conversionAdverse eventsRandomized trialsTrials databasesCochrane CollaborationAntiarrhythmic agentsClinical trialsStudy qualityAgent efficacySuggestive evidenceEvent ratesFlecainideDisopyramideRelative efficacyStrong evidenceManagement of new onset atrial fibrillation.
McNamara R, Bass E, Miller M, Segal J, Goodman S, Kim N, Robinson K, Powe N. Management of new onset atrial fibrillation. Evidence Report Technology Assessment 2000, 1-7. PMID: 11471248, PMCID: PMC4781222.Peer-Reviewed Original ResearchAdultAge DistributionAgedAged, 80 and overAmbulatory CareAnti-Arrhythmia AgentsAnticoagulantsAspirinAtrial FibrillationClinical Trials as TopicComorbidityDecision Support TechniquesEchocardiographyElectric CountershockEvidence-Based MedicineFemaleHumansIncidenceMaleMiddle AgedPrognosisRisk FactorsSex DistributionSurvival RateThromboembolismTreatment OutcomeDistribution, Severity and Risk Factors for Aortic Atherosclerosis in Cerebral Ischemia
Sen S, Wu K, McNamara R, Lima J, Piantadosi S, Oppenheimer S. Distribution, Severity and Risk Factors for Aortic Atherosclerosis in Cerebral Ischemia. Cerebrovascular Diseases 2000, 10: 102-109. PMID: 10686448, DOI: 10.1159/000016038.Peer-Reviewed Original ResearchConceptsRisk factorsAortic atheromaAortic plaquesCarotid stenosisStroke/TIA patientsSymptomatic coronary artery diseaseAortic plaque thicknessThoracic aortic plaqueTransesophageal echocardiography assessmentIndependent risk factorCoronary artery diseaseIschemic heart diseaseExtracranial carotid stenosisTIA patientsAortic atherosclerosisAsymptomatic patientsIschemic strokeArtery diseaseCerebral ischemiaConsecutive patientsEchocardiography assessmentMultivariable analysisProximal aortaCardiac screeningHeart disease
1998
Capitation for cardiologists: Accepting risk for coronary artery disease under managed care
McNamara R, Powe N, Shaffer T, Thiemann D, Weller W, Anderson G. Capitation for cardiologists: Accepting risk for coronary artery disease under managed care. The American Journal Of Cardiology 1998, 82: 1178-1182. PMID: 9832090, DOI: 10.1016/s0002-9149(98)00602-x.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMean annual expenditureArtery diseaseMedicare populationDemographic factorsGeneral Medicare populationCapitation ratesCertain chronic illnessesHigher mean expendituresMeasures of severityAnnual expenditureCharlson indexClinical factorsChronic diseasesChronic illnessDiseases codesClinical measuresCare plansInternational ClassificationPatientsNational random sampleMean expenditureDiseaseHigher expendituresComorbiditiesUsefulness of Transesophageal Echocardiography in Predicting Mortality and Morbidity in Stroke Patients Without Clinically Known Cardiac Sources of Embolus 11The views expressed in this article are those of the authors and do not reflect the official policy of the United States Navy, Department of Defense, or the United States Government.
O’Brien P, Thiemann D, McNamara R, Roberts J, Raska K, Oppenheimer S, Lima J. Usefulness of Transesophageal Echocardiography in Predicting Mortality and Morbidity in Stroke Patients Without Clinically Known Cardiac Sources of Embolus 11The views expressed in this article are those of the authors and do not reflect the official policy of the United States Navy, Department of Defense, or the United States Government. The American Journal Of Cardiology 1998, 81: 1144-1151. PMID: 9605057, DOI: 10.1016/s0002-9149(98)00132-5.Peer-Reviewed Original ResearchConceptsSpontaneous echo contrastRecurrent strokeTransesophageal echocardiographyMyocardial infarctionEcho contrastAtrial spontaneous echo contrastMitral valve strandsNonfatal myocardial infarctionTransient ischemic attackIschemic stroke patientsMitral annular calcificationMitral valve thickeningRecent myocardial infarctionAtrial septal defectMultiplane transesophageal echocardiographyAscending aorticCardiovascular survivalHeart thrombusIschemic attackPeripheral embolismAortic atherosclerosisCardiac causesFatal strokeVascular causesAnnular calcification
1997
Echocardiographic identification of cardiovascular sources of emboli to guide clinical management of stroke: a cost-effectiveness analysis.
McNamara R, Lima J, Whelton P, Powe N. Echocardiographic identification of cardiovascular sources of emboli to guide clinical management of stroke: a cost-effectiveness analysis. Annals Of Internal Medicine 1997, 127: 775-87. PMID: 9382398, DOI: 10.7326/0003-4819-127-9-199711010-00001.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsCardiovascular DiseasesCerebrovascular DisordersCohort StudiesCost-Benefit AnalysisDecision Support TechniquesEchocardiographyEchocardiography, TransesophagealHealth Care CostsHumansMarkov ChainsQuality-Adjusted Life YearsRecurrenceSensitivity and SpecificityThromboembolismConceptsTransesophageal echocardiographyAtrial thrombusRecurrent strokeTransthoracic echocardiographyCardiovascular sourcesNew-onset strokePotential cardiovascular sourcesRisks of anticoagulationEfficacy of anticoagulationNormal sinus rhythmQuality of lifeCost-effectiveness analysisIntracranial bleedingEchocardiographic identificationSinus rhythmAnticoagulation effectClinical managementCardiac problemsEchocardiographyAnticoagulationMedicare dataMortality ratePatientsHypothetical patientsClinical practice