2024
Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report.
Shimbo D, Shah R, Abdalla M, Agarwal R, Ahmad F, Anaya G, Attia Z, Bull S, Chang A, Commodore-Mensah Y, Ferdinand K, Kawamoto K, Khera R, Leopold J, Luo J, Makhni S, Mortazavi B, Oh Y, Savage L, Spatz E, Stergiou G, Turakhia M, Whelton P, Yancy C, Iturriaga E. Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report. Hypertension 2024 PMID: 39011653, DOI: 10.1161/hypertensionaha.124.22095.Peer-Reviewed Original ResearchMachine learning toolsManagement of hypertensionNational HeartArtificial intelligenceBlood InstitutePredictive of incident hypertensionHealth care systemImplementation challengesDiverse group of stakeholdersAI toolsPopulation healthMeasurement of blood pressureCare systemHealth careIncident hypertensionHypertension riskEra of artificial intelligenceHypertension diagnosisLearning toolsManaging hypertensionHypertension-related complicationsAntihypertensive medicationsHealthPublic healthGroups of stakeholdersEvaluating Ischemic Heart Disease in Women: Focus on Angina With Nonobstructive Coronary Arteries (ANOCA)
Maayah M, Latif N, Vijay A, Gallegos C, Cigarroa N, Martinez E, Mazure C, Miller E, Spatz E, Shah S. Evaluating Ischemic Heart Disease in Women: Focus on Angina With Nonobstructive Coronary Arteries (ANOCA). Journal Of The Society For Cardiovascular Angiography & Interventions 2024, 102195. DOI: 10.1016/j.jscai.2024.102195.Peer-Reviewed Original ResearchIschemic heart diseaseNonobstructive coronary arteriesCoronary artery diseaseArtery diseaseObstructive coronary artery diseaseCoronary arteryLong-term cardiovascular prognosisHeart diseaseSuspected ischemic heart diseaseAtherosclerotic coronary artery diseaseCoronary vasomotor disordersPretest probability of diseasePragmatic diagnostic algorithmExpert consensus documentEvaluating ischemic heart diseaseImpact quality of lifeQuality of lifeSymptomatic patientsPretest probabilityANOCACardiovascular prognosisVasomotor disordersDiagnostic evaluationPersistent symptomsDiagnostic strategiesGlobal considerations for informed consent with shared decision-making in the digital age
St John E, Moore C, Pillarisetti R, Spatz E. Global considerations for informed consent with shared decision-making in the digital age. BMJ Evidence-Based Medicine 2024, bmjebm-2023-112740. PMID: 38697783, DOI: 10.1136/bmjebm-2023-112740.Peer-Reviewed Original ResearchDevelopment and multinational validation of an algorithmic strategy for high Lp(a) screening
Aminorroaya A, Dhingra L, Oikonomou E, Saadatagah S, Thangaraj P, Vasisht Shankar S, Spatz E, Khera R. Development and multinational validation of an algorithmic strategy for high Lp(a) screening. Nature Cardiovascular Research 2024, 3: 558-566. DOI: 10.1038/s44161-024-00469-1.Peer-Reviewed Original ResearchElectronic health recordsAssociated with premature atherosclerotic cardiovascular diseaseElevated Lp(aHealth recordsUK BiobankPremature atherosclerotic cardiovascular diseaseMachine learning modelsAtherosclerotic cardiovascular diseaseCohort studyReal-world settingsTargeted screeningCardiovascular diseaseLearning modelsNovel targeted therapeuticsAlgorithmic strategiesCohortProbability thresholdScreeningClinical featuresValidation cohortElevated lipoproteinRisk inspectionARICLp(aDigital 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 determinantsPrioritizing the Exposome to Reduce Cardiovascular Disease Burden
Spatz E, Chen K, Krumholz H. Prioritizing the Exposome to Reduce Cardiovascular Disease Burden. JAMA Cardiology 2024, 9: 163-164. PMID: 37955872, DOI: 10.1001/jamacardio.2023.4722.Peer-Reviewed Original ResearchAssociation 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 imputationPsychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan
Gaffey A, Spatz E. Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan. Current Atherosclerosis Reports 2024, 26: 45-58. PMID: 38240928, PMCID: PMC11219074, DOI: 10.1007/s11883-023-01185-0.Peer-Reviewed Original ResearchConceptsIschemic heart disease riskPsychological healthIschemic heart diseasePsychosocial stressRisk of ischemic heart diseaseIschemic heart disease diagnosisPsychological factorsStudy of psychological factorsPositive psychological factorsOptimal psychological healthHeart diseaseSignificant life eventsIHD riskPsychosocial factorsSense of purposeWoman's riskPsychological screeningPsychological assessmentPsychological interventionsLife eventsSex-specific factorsSocial isolationHealthVulnerable groupsNarrative review
2023
National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020
Lu Y, Liu Y, Dhingra L, Caraballo C, Mahajan S, Massey D, Spatz E, Sharma R, Rodriguez F, Watson K, Masoudi F, Krumholz H. National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020. JAMA Network Open 2023, 6: e2345964. PMID: 38039001, PMCID: PMC10692850, DOI: 10.1001/jamanetworkopen.2023.45964.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHistory of ASCVDCross-sectional studyLifestyle modificationPharmacological medicationsOptimal careCurrent careUS adultsEthnic differencesWhite individualsGuideline-recommended therapiesTotal cholesterol controlNon-Hispanic white individualsNutrition Examination SurveyLatino individualsQuality of careSelf-reported raceStatin useRecommended TherapiesSecondary preventionCholesterol controlOptimal regimensSmoking cessationEligible participantsExamination SurveyAssociation of SGLT‐2 Inhibitors With Treatment Satisfaction and Diabetes‐Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes
Ding Q, Spatz E, Bena J, Morrison S, Levay M, Lin H, Grey M, Edwards N, Isaacs D, West L, Combs P, Albert N. Association of SGLT‐2 Inhibitors With Treatment Satisfaction and Diabetes‐Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes. Journal Of The American Heart Association 2023, 12: e029058. PMID: 37655510, PMCID: PMC10547320, DOI: 10.1161/jaha.122.029058.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsGeneral health statusCardiovascular disease typesType 2 diabetesTreatment satisfactionDiabetes-specific qualityCardiovascular diseaseHealth statusDisease typeProspective observational study designPatient-reported health statusInverse probabilityNoninsulin antidiabetic medicationsSGLT-2i useSGLT-2i usersTreatment-weighted analysisCotransporter 2 inhibitorsSGLT-2 inhibitorsDiabetes treatment satisfactionObservational study designGreater reductionAntidiabetic medicationsDiabetes medicationsSecondary outcomesSymptom burdenImpact 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 participantsOutcomesPrevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults — United States, December 2020–March 2023
Montoy J, Ford J, Yu H, Gottlieb M, Morse D, Santangelo M, O’Laughlin K, Schaeffer K, Logan P, Rising K, Hill M, Wisk L, Salah W, Idris A, Huebinger R, Spatz E, Rodriguez R, Klabbers R, Gatling K, Wang R, Elmore J, McDonald S, Stephens K, Weinstein R, Venkatesh A, Saydah S, Group I, Group I, Ahmed Z, Choi M, Derden A, Gottlieb M, Guzman D, Hassaballa M, Jerger R, Kaadan M, Koo K, Yang G, Dorney J, Kinsman J, Li S, Lin Z, Mannan I, Pierce S, Puente X, Ulrich A, Yang Z, Yu H, Adams K, Anderson J, Chang G, Gentile N, Geyer R, Maat Z, Malone K, Nichol G, Park J, Ruiz L, Schiffgens M, Stober T, Willis M, Zhang Z, Amadio G, Charlton A, Cheng D, Grau D, Hannikainen P, Kean E, Kelly M, Miao J, Renzi N, Shughart H, Shughart L, Shutty C, Watts P, Kane A, Nikonowicz P, Sapp S, Gallegos D, Martin R, Chandler C, Eguchi M, L’Hommedieu M, Moreno R, Roldan K, Arreguin M, Chan V, Chavez C, Kemball R, Wong A, Briggs-Hagen M, Hall A, Plumb I. Prevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults — United States, December 2020–March 2023. MMWR Morbidity And Mortality Weekly Report 2023, 72: 859-865. PMID: 37561663, PMCID: PMC10415002, DOI: 10.15585/mmwr.mm7232a2.Peer-Reviewed Original ResearchConceptsCOVID-like illnessSARS-CoV-2 test resultsPost-COVID conditionsNegative SARS-CoV-2 test resultsPositive SARS-CoV-2 test resultProspective multicenter cohort studySARS-CoV-2 infectionMulticenter cohort studyPrevalence of symptomsTime of enrollmentCOVID-19 testing statusHealth care providersSARS-CoV-2Self-reported symptomsCohort studyPersistent symptomsAcute illnessAntigen testPolymerase chain reactionClinical signsSymptom progressionCare providersDrug AdministrationTesting statusSymptomsHealthcare Market-Level and Hospital-Level Disparities in Access to and Utilization of High-Quality Hip and Knee Replacement Hospitals Among Medicare Beneficiaries
Oddleifson D, Xu X, Wiznia D, Gibson D, Spatz E, Desai N. Healthcare Market-Level and Hospital-Level Disparities in Access to and Utilization of High-Quality Hip and Knee Replacement Hospitals Among Medicare Beneficiaries. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: e961-e973. PMID: 37543752, DOI: 10.5435/jaaos-d-23-00183.Peer-Reviewed Original ResearchUtilization of hospitalKnee replacementMedicaid ServicesHospital-level disparitiesLow-income patientsCross-sectional studyHospital-level analysisHospital referral regionsHigh-quality hospitalsReplacement hospitalNational averageCare measuresHospital's percentageReferral regionsMedicare beneficiariesHospitalLevel IIIPatient accessHipSocioeconomic disparitiesSurgical processQuartileLogit linkHigh social vulnerabilityAssociationIllness 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 ResearchConceptsObstructive 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 OUTCOMEVariation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement
Chuzi S, Lindenauer P, Faridi K, Priya A, Pekow P, D'Aunno T, Mazor K, Stefan M, Spatz E, Gilstrap L, Werner R, Lagu T. Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement. Journal Of The American Heart Association 2023, 12: e029758. PMID: 37345796, PMCID: PMC10356066, DOI: 10.1161/jaha.122.029758.Peer-Reviewed Original ResearchConceptsAcute admission ratesHeart failureMedicare Shared Savings Program Accountable Care OrganizationsAccountable care organizationsAdmission ratesMost ACOsPrimary care providersPerformance categoriesCare organizationsACO characteristicsHealth care qualityAdmission riskBlack beneficiariesCare providersMedicare feeService beneficiariesConclusions AdmissionCare qualityPatientsAdmissionHospital affiliationACO structureFuture studiesLower proportionFailureClassification of blood pressure during sleep impacts designation of nocturnal nondipping
Mortazavi B, Martinez-Brockman J, Tessier-Sherman B, Burg M, Miller M, Nowroozilarki Z, Adams O, Maharaj R, Nazario C, Nunez M, Nunez-Smith M, Spatz E. Classification of blood pressure during sleep impacts designation of nocturnal nondipping. PLOS Digital Health 2023, 2: e0000267. PMID: 37310958, PMCID: PMC10263317, DOI: 10.1371/journal.pdig.0000267.Peer-Reviewed Original ResearchAmbulatory blood pressure monitorBlood pressure monitorNocturnal nondippingBlood pressurePressure monitorAmbulatory blood pressure monitoringClinic blood pressure measurementsAmbulatory blood pressureFuture cardiovascular riskBlood pressure monitoringSleep periodBlood pressure measurementsCardiovascular riskHypertension StudyTotal sleep lengthCardiovascular diseaseNondippingSleep qualitySleep efficiencyPressure monitoringSleep patternsSecondary analysisSleep onsetSleep lengthFleiss' kappaAtorvastatin 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 scalesPlaceboPatientsSex 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. hospitalsWomenInfarctionOutcomesPhysician responses to apple watch-detected irregular rhythm alerts
Demkowicz P, Dhruva S, Spatz E, Beatty A, Ross J, Khera R. Physician responses to apple watch-detected irregular rhythm alerts. American Heart Journal 2023, 262: 29-37. PMID: 37084933, PMCID: PMC10988207, DOI: 10.1016/j.ahj.2023.04.008.Peer-Reviewed Original ResearchConceptsAtrial fibrillationPrimary careEmergency medicinePhysician responsesDiagnostic testingUse of antiarrhythmicsClinical practice guidelinesMeasurement of BNPFurther diagnostic testingCase-based surveyLarge academic centerAF alertsAsymptomatic patientsPatient demographicsClinical symptomsTreatment optionsMedical historyPatient referralPhysician specialtyPractice guidelinesPhysician differencesRhythm monitoringAcademic centersUS FoodClinical complexity