2024
Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention
Callegari S, Romain G, Cleman J, Scierka L, Jacque F, Smolderen K, Mena‐Hurtado C. Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention. Journal Of The American Heart Association 2024, 13: e034477. PMID: 38761075, PMCID: PMC11179837, DOI: 10.1161/jaha.124.034477.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaPeripheral vascular interventionsHealth careLimb-threatening ischemiaMortality predictorsLong-term mortality riskMultidimensional risk factorsBody mass indexLong-term mortality predictorsImprove individualized careVascular interventionsIndividualized careAssisted careBiopsychosocial modelMortality riskCareMass indexRisk factorsMedical comorbiditiesRisk profileInterventionMortality rateChronic kidney diseaseMortalityPredictive variables
2023
Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease JACC Scientific Statement
McDermott M, Ho K, Alabi O, Criqui M, Goodney P, Hamburg N, McNeal D, Pollak A, Smolderen K, Bonaca M. Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease JACC Scientific Statement. Journal Of The American College Of Cardiology 2023, 82: 2312-2328. PMID: 38057074, DOI: 10.1016/j.jacc.2023.09.830.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseaseRate of amputationAmputation ratePeripheral arterial disease prevalencePrevalence of peripheral arterial diseaseLower extremity peripheral arterial diseasePeripheral arterial disease outcomesHealth policy changesCulturally appropriate messagesHigher amputation rateOptimal medical careHealth carePatient educationDisparity eliminationMobility lossSocioeconomic statusClinician educationMedical careImprove accessLower extremity revascularizationUnited StatesAtypical symptomsOlder ageDisparitiesAmputationRepresentativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines
Castro-Dominguez Y, Mena-Hurtado C, Algara M, Obas V, Ahmed Z, Romain G, Solaru K, Smolderen K. Representativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines. The American Journal Of Cardiology 2023, 201: 166-169. PMID: 37385170, DOI: 10.1016/j.amjcard.2023.05.053.Peer-Reviewed Original ResearchConceptsPeripheral artery diseasePAD guidelinesArtery diseaseRecent American Heart Association/American CollegeAmerican Heart Association/American CollegeLower extremity peripheral artery diseaseOlder adult patientsRace/ethnicity distributionAdult patientsPooled proportionMean ageClinical trialsCurrent guidelinesEpidemiologic studiesAmerican CollegeTrial participantsRCTsEthnicity distributionOlder adultsTrialsWomenPatientsDiseaseGuidelinesEthnic groupsComparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative
Cleman J, Romain G, Grubman S, Guzman R, Smolderen K, Mena-Hurtado C. Comparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative. Journal Of Vascular Surgery 2023, 78: 745-753.e6. PMID: 37207790, PMCID: PMC10964324, DOI: 10.1016/j.jvs.2023.05.015.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaLower extremity bypassPeripheral vascular interventionsVascular Quality InitiativeLimb-threatening ischemiaCause mortalityRisk of deathExtremity bypassVascular interventionsQuality InitiativeCox proportional hazards regressionKaplan-Meier survival curvesProportional hazards regressionOverall mean ageLogistic regression modelsComparative effectiveness researchKnee poplitealMedicare registryInfrapopliteal arteriesHazards regressionMean ageThirty-dayHispanic ethnicityOutcome dataTreatment groupsIn-home Visits and Subsequent Health Outcomes in Medicare Advantage Beneficiaries With Coronary Artery Disease, Diabetes, Hypertension, and Depression
Smolderen K, Heath K, Ameli O, Spencer D, Natwick T, Musich S, Miedico T, Mena-Hurtado C. In-home Visits and Subsequent Health Outcomes in Medicare Advantage Beneficiaries With Coronary Artery Disease, Diabetes, Hypertension, and Depression. Medical Care 2023, 61: 366-376. PMID: 37167558, DOI: 10.1097/mlr.0000000000001850.Peer-Reviewed Original ResearchConceptsPrimary care visitsCoronary artery diseaseMajor adverse cardiovascular eventsFirst primary care visitAdverse cardiovascular eventsCare visitsWait-list control groupHome visitsArtery diseaseList control groupControl groupCardiovascular eventsCare metricsOptum Labs Data WarehouseHigh-morbidity conditionsMedicare Advantage populationInpatient care episodesMedicare Advantage beneficiariesRetrospective data analysisSubsequent health outcomesIndex dateSecondary outcomesEmergency visitsPrimary outcomeInpatient stayDrug‐Coated Balloon and Drug‐Eluting Stent Safety in Patients With Femoropopliteal and Severe Chronic Kidney Disease
Hanna J, Smolderen K, Castro‐Dominguez Y, Romain G, Lee M, Turner J, Mena‐Hurtado C. Drug‐Coated Balloon and Drug‐Eluting Stent Safety in Patients With Femoropopliteal and Severe Chronic Kidney Disease. Journal Of The American Heart Association 2023, 12: e028622. PMID: 36974774, PMCID: PMC10122876, DOI: 10.1161/jaha.122.028622.Peer-Reviewed Original ResearchConceptsEarly-stage chronic kidney diseaseChronic kidney diseaseBare metal stentsDrug-eluting stentsDrug-coated balloonsMortality riskAmputation riskKidney diseaseSevere chronic kidney diseaseMajor amputation riskPlain balloon angioplastyDrug-Coated BalloonAmputation outcomesCKD statusAmputation rateCause mortalityBackground PatientsAdjusted analysisBalloon angioplastyFemoropopliteal interventionsDES useBMS useRegistry dataDisease trialsPatientsCommunity distress and risk of adverse outcomes after peripheral vascular intervention
Schenck C, Strand E, Smolderen K, Romain G, Nagpal S, Cleman J, Blume P, Mena-Hurtado C. Community distress and risk of adverse outcomes after peripheral vascular intervention. Journal Of Vascular Surgery 2023, 78: 166-174.e3. PMID: 36944389, PMCID: PMC11146282, DOI: 10.1016/j.jvs.2023.03.027.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsDistressed Communities IndexMajor amputationRisk of mortalityAdverse outcomesVascular interventionsVascular Quality Initiative databaseDCI scoresCommunity distressCox regression modelTime-dependent receiverCharacteristic curve analysisClinical characteristicsFinal cohortPrimary outcomeClinical outcomesCardiovascular diseasePatientsAmputationZip code dataMortalityRisk categoriesCurve analysisInitiative databaseOutcomesGuideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions
Smolderen K, Romain G, Provance J, Scierka L, Mao J, Goodney P, Henke P, Sedrakyan A, Mena-Hurtado C. Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions. JACC Cardiovascular Interventions 2023, 16: 332-343. PMID: 36792257, PMCID: PMC10359106, DOI: 10.1016/j.jcin.2022.09.022.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyPeripheral vascular interventionsMedical therapyVascular interventionsEnzyme inhibitors/angiotensin receptor blockersVascular Quality Initiative registryAngiotensin receptor blockersLong-term mortalityRisk of amputationRisk of mortalityNational quality registryQuality improvement effortsAmputation outcomesAmputation riskMajor amputationAntiplatelet therapyCause mortalityReceptor blockersMean ageVascular careQuality registryObservational studyMortality riskHigh riskAmputation data
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 sitesAdvancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association
Smolderen KG, Alabi O, Collins TC, Dennis B, Goodney PP, Mena-Hurtado C, Spertus JA, Decker C, Health O. Advancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association. Circulation 2022, 146: e286-e297. PMID: 36252117, DOI: 10.1161/cir.0000000000001105.Peer-Reviewed Original ResearchConceptsPAD carePeripheral artery diseasePatient-reported outcomesClinical practiceAmerican Heart AssociationChronic disease managementHealth system perspectiveClinical trial contextPatient engagement strategiesScientific statementHealth status assessmentDisease QualityArtery diseaseHeart AssociationPRO measuresClinical phenotypeBiomedical variablesHealth equityTrial contextRisk adjustmentCareDisease managementStatus assessmentOutcomesPotential benefitsPatient-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 classificationThe Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk
Smolderen KG, Heath K, Scherr T, Bauzon SR, Howell AN, Mena-Hurtado C. The Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk. Journal Of Vascular Surgery 2022, 75: 2054-2064.e3. PMID: 35181520, DOI: 10.1016/j.jvs.2022.01.134.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsPeripheral artery diseaseUnadjusted hazard ratioLower extremity peripheral artery diseaseHazard ratioMedicare Advantage beneficiariesCause mortalityElectronic medical recordsArtery diseaseMajor adverse cardiovascular event riskAdverse cardiovascular eventsAtherosclerotic risk factorsMedicare Advantage populationCardiovascular event riskAnnual health assessmentPrimary care providersPatients' electronic medical recordsRisk of mortalityScreening resultsPositive screening resultsMACE ratePAD screeningCardiovascular eventsMultivariable adjustmentScreening status
2021
Association of sleep apnea with outcomes in peripheral artery disease: Insights from the PORTRAIT study
Jelani QU, Mena-Hurtado C, Gosch K, Mohammed M, Labrosciano C, Regan C, Scierka LE, Spertus JA, Nagpal S, Smolderen KG. Association of sleep apnea with outcomes in peripheral artery disease: Insights from the PORTRAIT study. PLOS ONE 2021, 16: e0256933. PMID: 34506511, PMCID: PMC8432750, DOI: 10.1371/journal.pone.0256933.Peer-Reviewed Original ResearchConceptsPeripheral artery diseasePeripheral Artery QuestionnaireSleep apneaHealth statusArtery diseaseSummary scoresDisease-specific Peripheral Artery QuestionnaireFive-year survival curvesHigh ankle-brachial indexPAQ summary scoreVascular specialty clinicsAnkle-brachial indexLog-rank testSleep apnea statusHealth status outcomesWorse health statusQuality of lifeBetter health statusCause mortalityMultivariable adjustmentPAD symptomsCoronary diseasePeripheral interventionsUS patientsMean ageRelation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry)
Pareek M, Singh A, Vadlamani L, Eder M, Pacor J, Park J, Ghazizadeh Z, Heard A, Cruz-Solbes AS, Nikooie R, Gier C, Ahmed ZV, Freeman JV, Meadows J, Smolderen KGE, Lampert R, Velazquez EJ, Ahmad T, Desai NR. Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry). The American Journal Of Cardiology 2021, 146: 99-106. PMID: 33539857, PMCID: PMC7849530, DOI: 10.1016/j.amjcard.2021.01.029.Peer-Reviewed Original ResearchConceptsCardiovascular risk factorsCoronavirus disease 2019Risk factorsHigher troponin TCardiovascular diseaseCardiovascular eventsHospitalized patientsLaboratory findingsMental statusDisease 2019Multivariable binary logistic regression analysisTroponin TMajor adverse cardiovascular eventsPre-existing cardiovascular diseaseHigher C-reactive proteinCOVID-19 positive patientsPredictors of MACEPrevious ventricular arrhythmiaUse of P2YAdverse cardiovascular eventsProspective cohort studyTertiary care centerC-reactive proteinBinary logistic regression analysisPoor prognostic marker
2020
Physical Activity in Patients with Symptomatic Peripheral Artery Disease: Insights from the PORTRAIT Registry
Peri-Okonny PA, Gosch K, Patel S, Heyligers JMM, Mena-Hurtado C, Shishebor M, Malik A, Provance J, Hejjaji V, Spertus JA, Smolderen KG. Physical Activity in Patients with Symptomatic Peripheral Artery Disease: Insights from the PORTRAIT Registry. European Journal Of Vascular And Endovascular Surgery 2020, 60: 889-895. PMID: 32709469, PMCID: PMC7749016, DOI: 10.1016/j.ejvs.2020.06.010.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseSupervised exercisePhysical activityArtery diseaseSedentary behaviorSedentary participantsSymptomatic peripheral artery diseasePeripheral arterial diseasePhysical activity levelsPoisson regression analysisPORTRAIT registryCardiovascular eventsCurrent smokersArterial diseaseLifestyle factorsExercise referralFunctional impairmentPatientsNetherlands cohortActive lifestyleTreatment practicesReferralDiseaseActivity levelsMonthsAdherence 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
2019
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
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 presentationAssessing Patient Preferences for Shared Decision-Making in Peripheral Artery Disease
Provance JB, Spertus JA, Decker C, Jones PG, Smolderen KG. Assessing Patient Preferences for Shared Decision-Making in Peripheral Artery Disease. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005730. PMID: 31412733, DOI: 10.1161/circoutcomes.119.005730.Peer-Reviewed Original ResearchAnkle-brachial index in patients with intermittent claudication is a poor indicator of patient-centered and clinician-based evaluations of functional status
Johnston AL, Vemulapalli S, Gosch KL, Aronow HD, Abbott JD, Patel MR, Smolderen KG, Shishebor M, Spertus JA, Jones WS. Ankle-brachial index in patients with intermittent claudication is a poor indicator of patient-centered and clinician-based evaluations of functional status. Journal Of Vascular Surgery 2019, 69: 906-912. PMID: 30626552, DOI: 10.1016/j.jvs.2018.07.039.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnkle Brachial IndexAustraliaCost of IllnessFemaleHealth StatusHemodynamicsHumansIntermittent ClaudicationMaleMiddle AgedNetherlandsPatient Reported Outcome MeasuresPeripheral Arterial DiseasePredictive Value of TestsProspective StudiesQuality of LifeRegistriesSeverity of Illness IndexUnited StatesConceptsAnkle-brachial indexPeripheral artery diseasePeripheral Artery QuestionnaireIntermittent claudicationRutherford classificationABI valuesPAQ scoresArtery diseaseImpact of PADHealth statusMean ankle-brachial indexPAD-specific health statusSevere peripheral artery diseasePAQ summary scoreStudy of patientsQuality of lifeHealth status assessmentRutherford classNew onsetPatient's symptomsHemodynamic assessmentLife scoresFunctional statusPatients' perceptionsInternational cohort
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