2024
Variability in short-term mortality following repair of ruptured abdominal aortic aneurysms across centers and physicians
Romain G, Wang K, Scierka L, Cleman J, Callegari S, Aboian E, Smolderen K, Mena-Hurtado C. Variability in short-term mortality following repair of ruptured abdominal aortic aneurysms across centers and physicians. Journal Of Vascular Surgery 2024, 80: 737-745.e14. PMID: 38729585, DOI: 10.1016/j.jvs.2024.05.004.Peer-Reviewed Original ResearchPhysician variablesPhysician volumeRuptured infrarenal abdominal aortic aneurysmMortality riskPhysician levelAbdominal aortic aneurysmShort-term mortalityProcedure volumeMortality outcomesQuality of careAortic aneurysmMedian odds ratioShort-term mortality outcomesRepair of ruptured abdominal aortic aneurysmMedicare claims dataInfrarenal abdominal aortic aneurysmRuptured abdominal aortic aneurysmVascular Quality Initiative databaseAssociated with short-term mortalityLogistic regression modelsMortality rateCenter-level factorsCare managementClaims dataOdds ratioVariability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions
Smolderen K, Romain G, Cleman J, Scierka L, Mena-Hurtado C. Variability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions. American Heart Journal 2024, 270: 75-85. PMID: 38307364, DOI: 10.1016/j.ahj.2024.01.008.Peer-Reviewed Original ResearchMedian odds ratioGuideline-directed medical therapy prescriptionGuideline-directed medical therapy ratesPeripheral vascular interventionsGuideline-directed medical therapyIntraclass correlationHealth system levelDecrease hospital readmissionsPatient-level factorsGuideline-directed medical therapy useAssociated with higher riskAngiotensin-converting enzyme inhibitor/angiotensin receptor blockerRisk of deathParametric survival modelsInhibitor/angiotensin receptor blockerProportion of riskHospital readmissionVascular Quality Initiative registryLong-term mortalityOdds ratioReadmission riskVascular interventionsLogistic regressionDose-response relationshipAmputation
2023
Predictors of Revascularization in Lower-Extremity Peripheral Artery Disease: Insights From the PORTRAIT Study.
Pokharel Y, Kokkinidis D, Wang J, Gosch K, Safley D, Spertus J, Mena-Hurtado C, Smolderen K. Predictors of Revascularization in Lower-Extremity Peripheral Artery Disease: Insights From the PORTRAIT Study. Journal Of Endovascular Therapy 2023, 15266028231179574. PMID: 37309164, DOI: 10.1177/15266028231179574.Peer-Reviewed Original ResearchPredictors of revascularizationEarly revascularizationPeripheral artery diseaseExtensive diseasePAD symptomsSymptom burdenArtery diseaseOdds ratioLower Extremity Peripheral Artery DiseaseAnkle-brachial index scoreGoal-directed medical therapyEarly revascularization proceduresKnee arterial segmentsLifestyle-limiting claudicationRutherford class 3Peripheral arterial diseaseMonths of presentationPatient-level predictorsLower extremity PADMain predictorsMedian odds ratioHierarchical logistic regressionSymptomatic PADDisease guidelinesMedical therapyObesity prevalence and variability in management practices for patients with symptomatic peripheral artery disease
Scierka L, Peri-Okonny P, Romain G, Mena-Hurtado C, Smolderen K. Obesity prevalence and variability in management practices for patients with symptomatic peripheral artery disease. Obesity Research & Clinical Practice 2023, 17: 264-268. PMID: 37225553, DOI: 10.1016/j.orcp.2023.05.002.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseaseWeight loss medicationsObesity management strategiesMedian odds ratioDietary counselingLower extremity peripheral arterial diseaseSymptomatic peripheral artery diseaseDietary management strategiesSymptomatic PAD patientsPeripheral artery diseaseObesity prevalence ratesPrevalence of obesityPoor disease outcomeModifiable comorbiditiesPORTRAIT registryPAD patientsArtery diseaseArterial diseaseTreatment modalitiesObesity prevalenceOdds ratioDisease outcomePrevalence ratesPAD managementObesity
2022
Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease
Lee M, Pichert M, Tran A, Farooq A, Heyligers J, de Vries J, Spertus J, Guzman R, Thomas M, Mena-Hurtado C, Smolderen K. Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease. International Journal Of Cardiology 2022, 375: 94-97. PMID: 36577485, PMCID: PMC10371801, DOI: 10.1016/j.ijcard.2022.12.042.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseAbdominal aortic aneurysmScreening ratesArtery diseaseSpecialty centersAdjusted median odds ratioSymptomatic peripheral artery diseaseInternational prospective registryHigh-risk populationMedian odds ratioAbdominal aorta aneurysmAAA positivityMulticenter registryPAD symptomsProspective registryGuideline implementationAortic aneurysmAAA screeningAorta aneurysmOdds ratioPAD managementDisease RegistryPatientsMedian oddsClinical sitesVariability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass
Brahmandam A, Lee M, Bellamkonda K, Provance JB, Sumpio B, Ochoa Chaar CI, Smolderen KG, Mena-Hurtado C, Guzman RJ. Variability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass. Annals Of Vascular Surgery 2022, 88: 51-62. PMID: 36245106, DOI: 10.1016/j.avsg.2022.08.016.Peer-Reviewed Original ResearchConceptsInfrainguinal lower extremity bypassLower extremity bypassDual antiplatelet therapySingle antiplatelet therapyAntithrombotic therapyCombination therapyAntiplatelet therapyMedian odds ratioExtremity bypassDistal targetsHierarchical multivariable logistic regressionCenter-level variabilityCommon combination therapyPatient-level factorsPercutaneous coronary interventionPeripheral vascular interventionsMultivariable logistic regressionMultivariable regression modelsAntiplatelet monotherapyBypass targetAntithrombotic regimensPostoperative bleedingTriple therapyCoronary interventionAntithrombotic strategiesPatient-level and external factors in the use of drug-coated balloons and drug-eluting stents in femoropopliteal endovascular interventions
Castro-Dominguez Y, Smolderen KG, Pichert M, Alabi O, Romain G, Huang J, Lee M, Ahmed Z, Peri-Okonny PA, Arham A, Brice A, Chaar CO, Stacy MR, Mena-Hurtado C. Patient-level and external factors in the use of drug-coated balloons and drug-eluting stents in femoropopliteal endovascular interventions. Journal Of Vascular Surgery 2022, 76: 1675-1680. PMID: 35868423, DOI: 10.1016/j.jvs.2022.06.093.Peer-Reviewed Original ResearchConceptsDrug-coated balloonsDrug-eluting stentsBare metal stentsDES useFemoropopliteal endovascular interventionEndovascular interventionMedian odds ratioFemoropopliteal diseaseLesion characteristicsPrimary treatmentChronic kidney disease stage 4Adjusted median odds ratioVascular Quality Initiative registryAppropriate use guidelinesPrior anticoagulant usePatient-level factorsPoor functional statusTrans-Atlantic InterPlain balloon angioplastyPatient-level characteristicsFavorable patency ratesHierarchical logistic regression modelsLogistic regression modelsMeta-analysis publicationsRutherford classification
2021
Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention
Jelani QU, Llanos-Chea F, Bogra P, Trejo-Paredes C, Huang J, Provance JB, Turner J, Anantha-Narayanan M, Sheikh AB, Smolderen KG, Mena-Hurtado C. Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention. American Journal Of Nephrology 2021, 52: 845-853. PMID: 34706363, DOI: 10.1159/000519484.Peer-Reviewed Original ResearchConceptsComorbid chronic kidney diseaseGuideline-directed medical therapyPeripheral vascular interventionsCritical limb ischemiaMedian odds ratioMedical therapyPrescription ratesVascular interventionsHigh riskUse of GDMTAdjusted median odds ratioVascular Quality Initiative databaseAngiotensin-converting enzyme inhibitorAngiotensin receptor blockersChronic kidney diseaseLower prescription ratesPoor clinical outcomeCKD groupCKD statusAntiplatelet therapyReceptor blockersLimb ischemiaLimb outcomesClinical outcomesMedical managementVariability in utilization of diagnostic imaging tests in patients with symptomatic peripheral artery disease
Derbas LA, Patel KK, Muskula PR, Wang J, Gosch K, Fitridge R, Spertus JA, Smolderen KG. Variability in utilization of diagnostic imaging tests in patients with symptomatic peripheral artery disease. International Journal Of Cardiology 2021, 330: 200-206. PMID: 33581177, DOI: 10.1016/j.ijcard.2021.02.014.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseaseMedian odds ratioImaging testsSymptomatic peripheral artery diseaseSymptomatic peripheral arterial diseaseInvasive imaging testsPAQ summary scoreVascular specialty clinicsPatient-level factorsPeripheral artery diseaseDiagnostic imaging testsHierarchical logistic regression modelsLogistic regression modelsMean ABIPAD diagnosisNew onsetPAD symptomsPatient demographicsArtery diseasePatient characteristicsVascular clinicArterial diseaseDisease characteristicsRecent exacerbationReferral rates
2020
Adherence to Guideline‐Recommended Therapy—Including Supervised Exercise Therapy Referral—Across Peripheral Artery Disease Specialty Clinics: Insights From the International PORTRAIT Registry
Saxon JT, Safley DM, Mena‐Hurtado C, Heyligers J, Fitridge R, Shishehbor M, Spertus JA, Gosch K, Patel MR, Smolderen KG. Adherence to Guideline‐Recommended Therapy—Including Supervised Exercise Therapy Referral—Across Peripheral Artery Disease Specialty Clinics: Insights From the International PORTRAIT Registry. Journal Of The American Heart Association 2020, 9: e012541. PMID: 31973609, PMCID: PMC7033887, DOI: 10.1161/jaha.119.012541.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulatory Care FacilitiesAustraliaCardiovascular AgentsExercise TherapyFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedNetherlandsPeripheral Arterial DiseasePractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesQuality Indicators, Health CareReferral and ConsultationRegistriesUnited StatesConceptsSupervised exercise therapyPeripheral artery diseaseGuideline-recommended therapiesMedian odds ratioPORTRAIT registryAntiplatelet medicationsPAD symptomsOdds ratioSpecialty clinicSpecialty care facilityEvidence-based careCessation counselingExercise therapyCurrent smokersArtery diseaseCare facilitiesPatientsTherapy/counselingUS sitesReferralTherapyStatinsProcedural databaseQuality measuresMedications
2018
Guideline‐directed statin intensification in patients with new or worsening symptoms of peripheral artery disease
Khariton Y, Patel KK, Chan PS, Pokharel Y, Wang J, Spertus JA, Safley DM, Hiatt WR, Smolderen KG. Guideline‐directed statin intensification in patients with new or worsening symptoms of peripheral artery disease. Clinical Cardiology 2018, 41: 1414-1422. PMID: 30284297, PMCID: PMC6489902, DOI: 10.1002/clc.23087.Peer-Reviewed Original ResearchMeSH KeywordsAgedAustraliaDisease ProgressionDyslipidemiasFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntermittent ClaudicationMaleMiddle AgedNetherlandsPeripheral Arterial DiseasePractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesRegistriesTime FactorsTreatment OutcomeUnited StatesConceptsPeripheral artery diseaseAdjusted median odds ratioStatin intensificationClaudication symptomsStatin therapyGuideline therapyArtery diseaseSpecialty clinicACC/AHA cholesterol guidelinesHigh-intensity statin treatmentHigh-intensity statinsLow-intensity statinsProvider-level variationMedian odds ratioCholesterol guidelinesPORTRAIT registryMost patientsOlder patientsPAD symptomsStatin treatmentMedical therapyPatient factorsAppropriate therapyOdds ratioLower odds