2024
Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Rout A, Moumneh M, Kalra K, Singh S, Garg A, Kunadian V, Biscaglia S, Alkhouli M, Rymer J, Batchelor W, Nanna M, Damluji A. Invasive Versus Conservative Strategy in Older Adults ≥75 Years of Age With Non-ST-segment-Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal Of The American Heart Association 2024, 13: e036151. PMID: 39494560, DOI: 10.1161/jaha.124.036151.Peer-Reviewed Original ResearchConceptsNon-ST segment elevation acute coronary syndromeAcute coronary syndromeComposite of deathBurden of geriatric conditionsRandomized controlled trialsCoronary syndromeMyocardial infarctionYears of ageInvasive strategyOlder adultsControlled trialsGeriatric conditionsOlder patientsCardiovascular deathOdds ratioMeta-analysis of randomized controlled trialsNon-ST segment elevationSecondary end pointsMeta-analysisFixed effects meta-analysisAll-cause deathEffects meta-analysisYounger patientsFollow-upDecreased riskValidating the PREVENT Equations—A Contemporary Update to Cardiovascular Risk Assessment
Mangalesh S, Nanna M. Validating the PREVENT Equations—A Contemporary Update to Cardiovascular Risk Assessment. JAMA Network Open 2024, 7: e2438284. PMID: 39392636, DOI: 10.1001/jamanetworkopen.2024.38284.Peer-Reviewed Original ResearchRepresentation of Older Adults in the ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
Jamil Y, Sibindi C, Park D, Frampton J, Damluji A, Nanna M. Representation of Older Adults in the ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. JAMA Network Open 2024, 7: e2421547. PMID: 38995647, PMCID: PMC11245718, DOI: 10.1001/jamanetworkopen.2024.21547.Peer-Reviewed Original ResearchMachine learning prediction of one-year mortality after percutaneous coronary intervention in acute coronary syndrome patients
Hosseini K, Behnoush A, Khalaji A, Etemadi A, Soleimani H, Pasebani Y, Jenab Y, Masoudkabir F, Tajdini M, Mehrani M, Nanna M. Machine learning prediction of one-year mortality after percutaneous coronary intervention in acute coronary syndrome patients. International Journal Of Cardiology 2024, 409: 132191. PMID: 38777044, DOI: 10.1016/j.ijcard.2024.132191.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionLogistic regressionPost-PCI mortalityPrediction of one-year mortalityCoronary interventionPrediction of 1-year mortalityBody mass indexAcute coronary syndrome patientsOne-year mortalityIndividual-level assessmentsReceiver operating characteristic curveAcute coronary syndromeCoronary syndrome patientsTehran Heart CenterRates of comorbiditiesMass indexHigher ageSyndrome patientsCoronary syndromeHeart CenterFollow-upLipid profileU-shaped correlationPatientsCharacteristic curveCase Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States
Rymer J, Narcisse D, Chen A, Wojdyla D, Ashley S, Damluji A, Shah B, Nanna M, Swaminathan R, Gutierrez J, Uzendu A, Nelson A, Bethel G, Kearney K, Jones W, Rao S, Doll J. Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States. Journal Of The American College Of Cardiology 2024, 83: 1990-1998. PMID: 38749617, PMCID: PMC11173360, DOI: 10.1016/j.jacc.2024.03.395.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionAnnual case volumeNational Cardiovascular Data Registry CathPCI RegistryCase volumeIncreased risk of mortalityBleeding riskRisk of mortalityST-segment elevation myocardial infarctionMedian annual case volumeEarly-careerCertificate databaseCathPCI RegistryInterventional cardiologistsMortality riskElevation myocardial infarctionAmerican BoardIncreased riskSystem databasePredicted riskBleeding outcomesAcute presentationTreated patientsMortality rateProcedural characteristicsCareer statusChronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series
Damluji A, Nanna M, Rymer J, Kochar A, Lowenstern A, Baron S, Narins C, Alkhouli M. Chronological vs Biological Age in Interventional Cardiology A Comprehensive Approach to Care for Older Adults: JACC Family Series. JACC Cardiovascular Interventions 2024, 17: 961-978. PMID: 38597844, PMCID: PMC11097960, DOI: 10.1016/j.jcin.2024.01.284.Peer-Reviewed Original ResearchConceptsCardiovascular careImprove health outcomesOlder adult populationPatient-centered outcomesBiological ageAge-associated riskAging global populationAge-related riskFamily seriesComplex careHealth outcomesJACC State-of-the-Art ReviewOlder AdultsChronic illnessInfluence eligibilityProcedural adverse eventsStructural heart diseaseClinical focusCareOlder individualsInvasive careAdult populationInterventionCardiovascular diseaseOlder patientsRisk Prediction for Atherosclerotic Cardiovascular Disease With and Without Race Stratification
Ghosh A, Venkatraman S, Nanna M, Safford M, Colantonio L, Brown T, Pinheiro L, Peterson E, Navar A, Sterling M, Soroka O, Nahid M, Banerjee S, Goyal P. Risk Prediction for Atherosclerotic Cardiovascular Disease With and Without Race Stratification. JAMA Cardiology 2024, 9: 55-62. PMID: 38055247, PMCID: PMC10701663, DOI: 10.1001/jamacardio.2023.4520.Peer-Reviewed Original ResearchConceptsLipoprotein cholesterol levelsAtherosclerotic cardiovascular diseaseCohort studyREGARDS cohortCholesterol levelsCardiovascular diseaseLow-density lipoprotein cholesterol levelsCoronary heart disease deathDensity lipoprotein cholesterol levelsRace-sex stratumHeart disease deathProspective cohort studyCohort risk equationsRisk predictionRace stratificationIncident ASCVDNonfatal strokeDisease deathsC-statisticMyocardial infarctionHigh riskRisk equationsSocial determinantsPercentage declineIncremental value
2022
Lipid‐lowering treatment among older patients with atherosclerotic cardiovascular disease
Nanna M, Nelson A, Haynes K, Shambhu S, Eapen Z, Cziraky M, Calvert S, Pagidipati N, Granger C. Lipid‐lowering treatment among older patients with atherosclerotic cardiovascular disease. Journal Of The American Geriatrics Society 2022, 71: 1243-1249. PMID: 36538393, PMCID: PMC10089944, DOI: 10.1111/jgs.18172.Peer-Reviewed Original ResearchConceptsHigh-intensity statinsLipid-lowering therapyModerate-intensity statinsU.S. older adultsOlder adultsPCSK9 inhibitorsNon-statin lipid-lowering therapyMulticenter retrospective cohort studyRetrospective cohort studyMinority of patientsAtherosclerotic cardiovascular diseaseCoronary artery diseaseEligible older adultsCohort studyOlder patientsOverall cohortArtery diseaseIntensive treatmentCardiovascular diseaseASCVDSecondary measuresStatinsUntreated individualsPatientsTherapyCost-effectiveness of Pulmonary Rehabilitation Among US Adults With Chronic Obstructive Pulmonary Disease
Mosher CL, Nanna MG, Jawitz OK, Raman V, Farrow NE, Aleem S, Casaburi R, MacIntyre NR, Palmer SM, Myers ER. Cost-effectiveness of Pulmonary Rehabilitation Among US Adults With Chronic Obstructive Pulmonary Disease. JAMA Network Open 2022, 5: e2218189. PMID: 35731514, PMCID: PMC9218844, DOI: 10.1001/jamanetworkopen.2022.18189.Peer-Reviewed Original ResearchConceptsQuality-adjusted life expectancyNet cost savingsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness ratioEconomic evaluationSocietal perspective analysisCost savingsSensitivity analysisChronic obstructive pulmonary diseaseMarkov microsimulation modelUS dollarsMicrosimulation modelNet costDominant strategySocietal perspectiveLifetime horizonUS health care systemPulmonary rehabilitationObstructive pulmonary diseaseCOPD hospitalizationsHypothetical cohortQALYSavingsMicrosimulationHigh-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.
Nelson AJ, Haynes K, Shambhu S, Eapen Z, Cziraky MJ, Nanna MG, Calvert SB, Gallagher K, Pagidipati NJ, Granger CB. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. Journal Of The American College Of Cardiology 2022, 79: 1802-1813. PMID: 35512860, PMCID: PMC9344279, DOI: 10.1016/j.jacc.2022.02.048.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHigh-intensity statinsStatin useYounger patientsFemale patientsHigh-intensity statin useHigher Charlson comorbidity scoreAppropriate statin useNew guideline recommendationsCharlson comorbidity scoreRetrospective cohort studyPeripheral artery diseaseModerate-intensity statinsMultivariable logistic regressionCommercial health plansMedical claims dataComorbidity scoreIndex dateCohort studyOlder patientsPreventive therapyStatin usersArtery diseaseContemporary cohortGuideline recommendationsAre risk factors necessary for pretest probability assessment of coronary artery disease? A patient similarity network analysis of the PROMISE trial
Kolossváry M, Mayrhofer T, Ferencik M, Karády J, Pagidipati NJ, Shah SH, Nanna MG, Foldyna B, Douglas PS, Hoffmann U, Lu MT. Are risk factors necessary for pretest probability assessment of coronary artery disease? A patient similarity network analysis of the PROMISE trial. Journal Of Cardiovascular Computed Tomography 2022, 16: 397-403. PMID: 35393245, PMCID: PMC9452442, DOI: 10.1016/j.jcct.2022.03.006.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseCoronary CT angiographyCalcium scoreRisk factorsLuminal narrowingPTP scoreArtery diseasePatient characteristicsPROMISE trialStable chest pain patientsObstructive coronary artery diseasePretest probability assessmentChest pain patientsSimilar risk profilesCT angiographyImaging markerRisk profileDiagnostic accuracyCAD predictionSex groupsProbability calculatorScoresSubanalysesDiseaseGroup individuals
2021
Estimating the real-world performance of the PROMISE minimal-risk tool
Nanna MG, Wang TY, Chiswell K, Sun JL, Vemulapalli S, Hoffmann U, Patel MR, Udelson JE, Fordyce CB, Douglas PS. Estimating the real-world performance of the PROMISE minimal-risk tool. American Heart Journal 2021, 239: 100-109. PMID: 34077743, DOI: 10.1016/j.ahj.2021.05.016.Peer-Reviewed Original ResearchMeSH KeywordsAngina, StableComputed Tomography AngiographyCoronary AngiographyCoronary StenosisCoronary VesselsFemaleHeart Disease Risk FactorsHumansMaleMedical OveruseMiddle AgedMyocardial InfarctionMyocardial RevascularizationOutcome and Process Assessment, Health CarePrognosisRisk AssessmentUnited StatesConceptsObstructive coronary artery diseaseNon-low risk patientsLow-risk patientsCoronary artery diseaseStable chest painRisk patientsCardiac catheterizationArtery diseaseChest painMyocardial infarctionLower riskProspective Multicenter Imaging StudyStable chest pain patientsCardiovascular adverse outcomesMI-free survivalChest pain patientsObstructive coronary diseaseElective cardiac catheterizationLikelihood of freedomLogistic regression modelingOutcomes of interestPositive predictive valueAlternative cut pointsIndex angiographyIndex catheterization180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart 2021, 8: e001442. PMID: 33452007, PMCID: PMC7813425, DOI: 10.1136/openhrt-2020-001442.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission risk modelSelf-reported health statusMyocardial infarctionFunctional mobilityOlder adultsHealth statusDays of AMIFirst diastolic blood pressureChronic obstructive pulmonary diseaseIschemic ECG changesProspective cohort studyDiastolic blood pressureObstructive pulmonary diseaseLength of stayInitial heart rateFinal risk modelSILVER-AMI StudyRisk modelInitial hemoglobinCohort studyReadmission ratesBlood pressureEjection fractionHeart failure
2020
Can the Absence of Hypertension Refine the Risk Assessment of Older Adults for Future Cardiovascular Events?
Nanna MG, Navar AM, Wojdyla D, Nelson AJ, Sullivan AE, Peterson ED. Can the Absence of Hypertension Refine the Risk Assessment of Older Adults for Future Cardiovascular Events? The American Journal Of Cardiology 2020, 142: 83-90. PMID: 33279483, PMCID: PMC8221431, DOI: 10.1016/j.amjcard.2020.11.027.Peer-Reviewed Original ResearchConceptsSystolic blood pressureAtherosclerotic cardiovascular diseaseAbsence of hypertensionBlood pressureCardiovascular diseaseCardiovascular eventsEvent ratesOlder adultsLower CVD event ratesLower systolic blood pressureASCVD event ratesCVD event ratesDiastolic blood pressureFuture cardiovascular eventsASCVD riskRisk stratificationPooled cohortMultivariable modelingHypertensionRisk scoreLower riskRisk estimatesNational InstituteObserved event ratesAdultsPresentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study
Gupta A, Tsang S, Hajduk A, Krumholz HM, Nanna MG, Green P, Dodson JA, Chaudhry SI. Presentation, Treatment, and Outcomes of the Oldest-Old Patients with Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2020, 134: 95-103. PMID: 32805225, PMCID: PMC7752813, DOI: 10.1016/j.amjmed.2020.07.020.Peer-Reviewed Original ResearchConceptsOldest-old patientsMyocardial infarctionFunctional impairmentOlder patientsMobility impairmentsCox proportional hazards regressionMiddle-old patientsProportional hazards regressionAcute myocardial infarctionCase fatality rateAcute myocardial infarction hospitalizationsSILVER-AMI StudyYears of ageMyocardial infarction hospitalizationsChest painCoronary revascularizationAtypical presentationHazards regressionClinical variablesRisk factorsAdvanced agePrimary symptomsPatientsFatality rateHealth statusPerformance of Guideline Recommendations for Prevention of Myocardial Infarction in Young Adults
Zeitouni M, Nanna MG, Sun JL, Chiswell K, Peterson ED, Navar AM. Performance of Guideline Recommendations for Prevention of Myocardial Infarction in Young Adults. Journal Of The American College Of Cardiology 2020, 76: 653-664. PMID: 32762899, PMCID: PMC7444655, DOI: 10.1016/j.jacc.2020.06.030.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyYears of agePremature myocardial infarctionIntensive lipid-lowering therapyHigh-risk criteriaMyocardial infarctionYoung adultsYounger patientsHigh low-density lipoprotein cholesterolAHA/ACC guidelinesMajor adverse cardiovascular eventsLow-density lipoprotein cholesterolDuke University Medical CenterACC/AHAAdverse cardiovascular eventsRecurrent myocardial infarctionMost young patientsReductase inhibitor therapyFirst myocardial infarctionAmerican Heart AssociationUniversity Medical CenterOlder age groupsCause deathCholesterol guidelinesStatin candidatesAge-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease
Lowenstern A, Alexander KP, Hill CL, Alhanti B, Pellikka PA, Nanna MG, Mehta RH, Cooper LS, Bullock-Palmer RP, Hoffmann U, Douglas PS. Age-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease. JAMA Cardiology 2020, 5: 193-201. PMID: 31738382, PMCID: PMC6865842, DOI: 10.1001/jamacardio.2019.4973.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseOlder patientsMyocardial infarctionCV deathNoninvasive testsArtery diseaseNoninvasive evaluationElevated coronary artery calcium scoresDeath/myocardial infarctionPositive noninvasive test resultsPossible coronary artery diseaseProspective Multicenter Imaging StudyCoronary artery calcium scoreNonwhite race/ethnicityComparative effectiveness designArtery calcium scoreCoronary artery calciumMinority of patientsCause of morbidityNoninvasive test resultsFunctional test resultsAge-specific approachesBest noninvasive testPositive test resultsOlder age groups
2019
Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.
Dodson JA, Hajduk AM, Geda M, Krumholz HM, Murphy TE, Tsang S, Tinetti ME, Nanna MG, McNamara R, Gill TM, Chaudhry SI. Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study. Annals Of Internal Medicine 2019, 172: 12-21. PMID: 31816630, PMCID: PMC7695040, DOI: 10.7326/m19-0974.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI mortalityFunctional impairmentOlder adultsCohort studyMean ageMyocardial infarctionPatient-reported health statusNet reclassification improvement indexProspective cohort studyParticipants' mean ageFinal risk modelMobility impairmentsGood discriminatory abilityRisk modelChart reviewHospital dischargePrognostic utilityBlood InstituteClinical variablesNational HeartHigh prevalenceHealth statusMortalityYounger counterpartsA systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention
Sullivan AE, Nanna MG, Rao SV, Cantrell S, Gibson CM, Verheugt FWA, Peterson ED, Lopes RD, Alexander JH, Granger CB, Yee MK, Kong DF. A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention. Catheterization And Cardiovascular Interventions 2019, 96: e102-e109. PMID: 31713326, PMCID: PMC7211549, DOI: 10.1002/ccd.28535.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAnticoagulantsAtrial FibrillationCoronary ThrombosisDual Anti-Platelet TherapyFemaleFibrinolytic AgentsHemorrhageHumansMalePercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeConceptsPercutaneous coronary interventionAcute coronary syndromeDouble therapyOral anticoagulationAtrial fibrillationTriple therapyAntithrombotic therapyCoronary syndromeCoronary interventionStent thrombosisMajor adverse cardiovascular eventsTriple antithrombotic therapyAdverse cardiovascular eventsDual antiplatelet therapyOptimal antithrombotic therapyGood safety profileRandom-effects modelIschemic outcomesAntiplatelet therapyCardiovascular eventsP2Y12 inhibitorsMedical managementRandomized trialsIntracranial hemorrhageSafety profileSex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalence