2024
Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities
Katz M, Mszar R, Grimshaw A, Gunderson C, Onuma O, Lu Y, Spatz E. Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities. JAMA Network Open 2024, 7: e2356070. PMID: 38353950, PMCID: PMC10867699, DOI: 10.1001/jamanetworkopen.2023.56070.Peer-Reviewed Original ResearchConceptsDigital health interventionsHealth disparitiesHealth interventionsSystematic reviewSystolic BPSocial determinants of healthHypertension managementCommunity health workersFactors associated with cardiovascular diseaseDeterminants of healthLeveraging digital healthRemote BP monitoringDigital health technologiesStandard care groupMeta-analysisBlood pressureDiastolic BPPreferred Reporting ItemsControl groupSystolic BP changeBaseline to 6Random-effects modelSkilled nursingCultural tailoringSocial determinantsAssociation 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
Illness Perception and the Impact of a Definitive Diagnosis on Women With Ischemia and No Obstructive Coronary Artery Disease: A Qualitative Study.
Tseng L, Göç N, Schwann A, Cherlin E, Kunnirickal S, Odanovic N, Curry L, Shah S, Spatz E. Illness Perception and the Impact of a Definitive Diagnosis on Women With Ischemia and No Obstructive Coronary Artery Disease: A Qualitative Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: 521-529. PMID: 37476997, DOI: 10.1161/circoutcomes.122.009834.Peer-Reviewed Original ResearchMeSH KeywordsCoronary Artery DiseaseFemaleHumansIschemiaMiddle AgedMyocardial IschemiaPerceptionQuality of LifeConceptsObstructive coronary artery diseaseCoronary function testingCoronary artery diseaseInvasive coronary angiographyArtery diseaseCoronary angiographyFunction testingDefinitive diagnosisYale-New Haven HospitalNon-Hispanic blacksMore patient-centered careNew Haven HospitalPatient-centered careStructured telephone interviewQuality of lifeHealth care experiencesNon-Hispanic whitesGroup of womenCoronary functionIllness perceptionsMean ageINOCAUncertain causeMultidisciplinary teamPatient careAssociation of Population Well-Being With Cardiovascular Outcomes
Spatz E, Roy B, Riley C, Witters D, Herrin J. Association of Population Well-Being With Cardiovascular Outcomes. JAMA Network Open 2023, 6: e2321740. PMID: 37405774, PMCID: PMC10323707, DOI: 10.1001/jamanetworkopen.2023.21740.Peer-Reviewed Original ResearchConceptsPopulation health factorsCVD mortalityCoronary heart diseaseCross-sectional studyHeart diseaseCardiovascular diseaseSecondary outcomesHealth factorsCardiovascular outcomesHeart failureCardiovascular healthMortality rateCounty-level ratesLower CVD mortalityTotal CVD mortalityCardiovascular death ratesAcute myocardial infarctionTotal heart diseaseEffect sizePrimary outcomeHighest quintileLowest quintileMyocardial infarctionNational HealthMAIN OUTCOMEAtorvastatin 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 ResearchConceptsExtracorporeal 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 scalesPlaceboPatientsQuantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression modelsDeveloping an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Lu Y, Du C, Khidir H, Caraballo C, Mahajan S, Spatz E, Curry L, Krumholz H. Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009453. PMID: 36727515, DOI: 10.1161/circoutcomes.122.009453.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureElectronic Health RecordsFemaleHumansHypertensionMaleMiddle AgedConceptsPersistent hypertensionElectronic health recordsBlood pressureHealth recordsPharmacologic agentsPrescribed treatmentYale New Haven Health SystemTreatment planAdditional pharmacologic agentsAntihypertensive treatment intensificationConsecutive outpatient visitsElevated blood pressurePersistence of hypertensionElectronic health record dataHealth record dataEligible patientsTreatment intensificationChart reviewHispanic patientsOutpatient visitsMean agePharmacological treatmentConventional content analysisHypertensionClinician notes
2022
Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes
INVESTIGATORS I, Sadeghipour P, Talasaz A, Barco S, Bakhshandeh H, Rashidi F, Rafiee F, Rezaeifar P, Jamalkhani S, Matin S, Baghizadeh E, Tahamtan O, Sharif-Kashani B, Beigmohammadi M, Farrokhpour M, Sezavar S, Payandemehr P, Dabbagh A, Moghadam K, Jimenez D, Monreal M, Maleki M, Siegerink B, Spatz E, Piazza G, Parikh S, Kirtane A, Van Tassell B, Lip G, Goldhaber S, Klok F, Krumholz H, Bikdeli B. Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes. European Journal Of Internal Medicine 2022, 103: 76-83. PMID: 35879217, PMCID: PMC9212871, DOI: 10.1016/j.ejim.2022.06.014.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsCOVID-19Critical CareFemaleHospitalizationHumansMaleMiddle AgedSARS-CoV-2ConceptsStandard-dose prophylactic anticoagulationPatient Health Questionnaire-2Proportion of patientsProphylactic anticoagulationIntermediate doseFunctional limitationsDepressive symptomsFunctional outcomeCOVID-19Intensive care unit hospitalizationCritically Ill PatientsMultiple organ failureSevere functional limitationsFunctional Status ScaleCoronavirus disease 2019Open labelExercise limitationAirway diseaseICU patientsOrgan failureIntensive careStatus ScaleClinical trialsGrade 3Anticoagulation
2019
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states
Roy B, Riley C, Herrin J, Spatz E, Hamar B, Kell KP, Rula EY, Krumholz H. Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states. BMJ Open 2019, 9: e030017. PMID: 31780588, PMCID: PMC6886944, DOI: 10.1136/bmjopen-2019-030017.Peer-Reviewed Original ResearchConceptsHospitalisation ratesZip codesPrimary care physician densityCross-sectional study SETTINGCancer-related admissionsRespiratory-related admissionsCross-sectional studyQuality of lifeRace/ethnicityCause hospitalisationSecondary outcomesPrimary outcomeHighest quintileUnnecessary hospitalisationAdmission ratesSD increaseHospitalisationLife benefitsPhysician densityStudy settingMain independent variableBeing IndexHospital bedsAdmissionGallup-Sharecare WellIdeal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis
Osibogun O, Ogunmoroti O, Spatz ES, Fashanu OE, Michos ED. Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis. Preventive Medicine 2019, 130: 105890. PMID: 31715219, PMCID: PMC6930349, DOI: 10.1016/j.ypmed.2019.105890.Peer-Reviewed Original ResearchConceptsIdeal cardiovascular healthFavorable cardiovascular healthOptimal cardiovascular healthSimple 7 (LS7) metricsCardiovascular healthRace/ethnicityMulti-Ethnic StudyElevated RHRHeart rateLife's Simple 7 (LS7) metricsIncreased cardiovascular disease riskAtrioventricular nodal blockersCardiovascular disease riskCross-sectional analysisClinical CVDLS7 metricsCVH scoreHigher RHRAtherosclerosis participantsMean ageRisk factorsOdds ratioStratified analysisLower oddsMultinomial logistic regressionPhenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study.
Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethnicity & Disease 2019, 29: 535-544. PMID: 31641320, PMCID: PMC6802166, DOI: 10.18865/ed.29.4.535.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure measurementsABPM patternsBP patternAmbulatory blood pressure patternsMore precision-based approachesAmbulatory BP patternsDiagnosis of HTNTreatment of HTNBlood pressure patternWave 2High-risk populationBlood pressure measurementsCommunity-residing adultsPrecision-based approachesAntihypertensive medicationsBlood pressureProspective studyHypertension StudyHypertensive phenotypeCardiovascular diseaseParent studyHTNEcological momentary assessmentSelf-report surveyHigh rateFinancial barriers in accessing medical care for peripheral artery disease are associated with delay of presentation and adverse health status outcomes in the United States
Jelani QU, Jhamnani S, Spatz ES, Spertus J, Smolderen KG, Wang J, Desai NR, Jones P, Gosch K, Shah S, Attaran R, Mena-Hurtado C. Financial barriers in accessing medical care for peripheral artery disease are associated with delay of presentation and adverse health status outcomes in the United States. Vascular Medicine 2019, 25: 13-24. PMID: 31603393, DOI: 10.1177/1358863x19872542.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHealth Care CostsHealth Services AccessibilityHealth Status DisparitiesHealthcare DisparitiesHumansInsurance, HealthMaleMedically UninsuredMiddle AgedPatient Reported Outcome MeasuresPeripheral Arterial DiseaseProspective StudiesQuality of LifeRisk FactorsTime FactorsTime-to-TreatmentUnited StatesConceptsPeripheral artery diseasePeripheral Artery QuestionnaireHealth status outcomesHealth statusArtery diseaseStatus outcomesFinancial barriersGeneral health-related qualityDisease-specific health statusPatient-reported health statusDelay of presentationPatient-reported difficultyVascular specialty clinicsPeripheral arterial diseaseEuroQol-5 DimensionsHealth-related qualityPoor health statusUnited States patientsMulticenter registryMultivariable adjustmentPAD symptomsArterial diseaseTreatment patternsUS patientsLate presentationPrevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project
Mahajan S, Zhang D, He S, Lu Y, Gupta A, Spatz ES, Lu J, Huang C, Herrin J, Liu S, Yang J, Wu C, Cui J, Zhang Q, Li X, Nasir K, Zheng X, Krumholz HM, Li J, Dong Z, Jiang B, Zhang Y, Liu Y, Meng Y, Xi Y, Tian Y, Fu Y, Liu T, Yan S, Jin L, Wang J, Xu X, Xing X, Zhang L, Fang X, Xu Y, Xu C, Fan L, Qi M, Qi J, Li J, Liu Q, Feng Y, Wang J, Wen H, Xu J, He J, Jiang C, Yang C, Yu Y, Tashi Z, Hu Z, Zhang J, Li X, Ma S, Ma Y, Huang Y, Zhang Y, Shen J. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. Journal Of The American Heart Association 2019, 8: e012954. PMID: 31566101, PMCID: PMC6806046, DOI: 10.1161/jaha.119.012954.Peer-Reviewed Original ResearchConceptsMillion Persons ProjectPrior cardiovascular eventsBody mass indexAntihypertensive medicationsDiastolic hypertensionCardiovascular eventsDiabetes mellitusMass indexIsolated diastolic hypertensionDiastolic blood pressureSelf-reported diagnosisTreatment of peoplePersons ProjectBlood pressureTreatment patternsHypertensionLeast collegeHigher likelihoodMellitusMedicationsPrevalenceTreatmentDiagnosisSubstantial numberCurrent useHemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance
Mahajan S, Gu J, Lu Y, Khera R, Spatz ES, Zhang M, Sun N, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance. The American Journal Of Medicine 2019, 133: e127-e139. PMID: 31525336, DOI: 10.1016/j.amjmed.2019.08.042.Peer-Reviewed Original ResearchConceptsSystemic vascular resistance indexVascular resistance indexSystemic vascular resistanceCardiac indexBlood pressure categoriesResistance index ratioResistance indexVascular resistanceCardiac outputBlood pressureHemodynamic phenotypesPressure categoriesHigh systemic vascular resistance indexNormal systemic vascular resistance indexSystolic blood pressure 140Systolic blood pressure categoriesBlood pressure 140Health checkup centerNormal cardiac indexLow cardiac indexStroke volume indexHigher cardiac indexSystolic blood pressureBody mass indexSubtypes of hypertensionEffects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus
Huo X, Krumholz HM, Bai X, Spatz ES, Ding Q, Horak P, Zhao W, Gong Q, Zhang H, Yan X, Sun Y, Liu J, Wu X, Guan W, Wang X, Li J, Li X, Spertus JA, Masoudi FA, Zheng X. Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005805. PMID: 31474119, DOI: 10.1161/circoutcomes.119.005805.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBiomarkersBlood GlucoseChinaCoronary DiseaseCulturally Competent CareDiabetes MellitusExerciseFemaleGlycated HemoglobinHealth CommunicationHealthy LifestyleHumansHypoglycemic AgentsMaleMedication AdherenceMiddle AgedMotivationPatient Education as TopicRisk Reduction BehaviorSelf CareSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseHeart diseaseGlycemic controlIntervention groupUsual careDiabetes mellitusBlood glucosePhysical activityControl groupText message-based interventionBlood pressure controlProportion of patientsRisk factor managementGood glycemic controlSystolic blood pressureBody mass indexText messaging programsText message interventionMobile health interventionsSecondary outcomesBlood pressurePrimary outcomeLDL cholesterolMass indexMedication adherenceAssociation of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study
Ding Q, Funk M, Spatz ES, Whittemore R, Lin H, Lipska KJ, Dreyer RP, Spertus JA, Krumholz HM. Association of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2019, 8: e010988. PMID: 31441351, PMCID: PMC6755841, DOI: 10.1161/jaha.118.010988.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsDiabetes MellitusFemaleHealth StatusHealth Status IndicatorsHumansMaleMental HealthMiddle AgedMyocardial InfarctionPatient Reported Outcome MeasuresPredictive Value of TestsPrevalencePrognosisQuality of LifeRecovery of FunctionRisk AssessmentRisk FactorsSex FactorsSpainTime FactorsUnited StatesYoung AdultConceptsAcute myocardial infarctionEuroQol visual analogue scaleSeattle Angina QuestionnaireDiabetes mellitusForm Health SurveyHealth status outcomesHealth statusVIRGO StudyAnalog scaleMyocardial infarctionHealth SurveyStatus outcomesYoung adultsSAQ angina frequencyCardiovascular risk factorsHealth status scoresRisk of mortalityWorse health statusPoor health statusQuality of lifeWorse anginaAngina QuestionnaireClinical characteristicsHealthcare useStatus scoreDisparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT
Shahu A, Herrin J, Dhruva SS, Desai NR, Davis BR, Krumholz HM, Spatz ES. Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT. Journal Of The American Heart Association 2019, 8: e012277. PMID: 31362591, PMCID: PMC6761647, DOI: 10.1161/jaha.119.012277.Peer-Reviewed Original ResearchConceptsBlood pressure controlLow-income sitesCardiovascular outcomesPressure controlALLHAT participantsPoor blood pressure controlEnd-stage renal diseaseHospitalization/mortalityAdverse cardiovascular eventsCardiovascular risk factorsWorse cardiovascular outcomesHigh blood pressureStandardized treatment protocolRandomized clinical trialsBackground Observational studiesLow socioeconomic statusHighest income quintileAngina hospitalizationCardiovascular eventsCause mortalityCoronary revascularizationClinical characteristicsBlood pressureRenal diseaseClinical outcomesEffect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease
Zheng X, Spatz ES, Bai X, Huo X, Ding Q, Horak P, Wu X, Guan W, Chow CK, Yan X, Sun Y, Wang X, Zhang H, Liu J, Li J, Li X, Spertus JA, Masoudi FA, Krumholz HM. Effect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005616. PMID: 30998400, DOI: 10.1161/circoutcomes.119.005616.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBlood PressureChinaCoronary DiseaseCulturally Competent CareFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPatient Education as TopicRisk AssessmentRisk FactorsSecondary PreventionSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseSystolic blood pressureBody mass indexBlood pressureHeart diseaseSecondary preventionIntervention groupPhysical activityEnd pointSmoking statusMass indexControl groupPrimary end pointRisk factor controlSecondary end pointsRisk factor managementLDL-C levelsDisease-specific knowledgeMobile phone textMobile health technologyUsual careDiabetes mellitusMedication adherenceRisk factorsFactor managementApplication of the VIRGO taxonomy to differentiate acute myocardial infarction in young women
Sciria CT, Dreyer RP, D'Onofrio G, Safdar B, Krumholz HM, Spatz ES. Application of the VIRGO taxonomy to differentiate acute myocardial infarction in young women. International Journal Of Cardiology 2019, 288: 5-11. PMID: 31031078, DOI: 10.1016/j.ijcard.2019.03.054.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseCardiac catheterizationYoung womenNon-obstructive coronary artery diseaseSingle-center retrospective chart reviewYoung AMI Patients (VIRGO) studyObstructive coronary artery diseaseRetrospective chart reviewAcute myocardial infarctionProportion of womenUniversal definitionIndex admissionChart reviewArtery diseaseConsecutive womenMyocardial infarctionTreatment strategiesCatheterizationMore young womenType 2Type 1Class IType 4BWomenPatient studiesTrends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular function