2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryElectronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial
Ghazi L, Yamamoto Y, Riello RJ, Coronel-Moreno C, Martin M, O'Connor KD, Simonov M, Huang J, Olufade T, McDermott J, Dhar R, Inzucchi SE, Velazquez EJ, Wilson FP, Desai NR, Ahmad T. Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial. Journal Of The American College Of Cardiology 2022, 79: 2203-2213. PMID: 35385798, DOI: 10.1016/j.jacc.2022.03.338.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyUsual careEjection fractionHeart failureMedical therapyPrimary outcomeCluster-randomized comparative effectiveness trialSodium-glucose cotransporter 2 inhibitorsElectronic health record alertsAldosterone system inhibitorsReduced ejection fractionUsual care armCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsVentricular ejection fractionComparative effectiveness trialNumber of patientsKnowledge of guidelinesLow-cost interventionCare armDays postrandomizationEligible patientsGDMT useFailure therapyPatient characteristicsHeart Failure Spending Function: An Investment Framework for Sequencing and Intensification of Guideline-Directed Medical Therapies
Allen LA, Teerlink JR, Gottlieb SS, Ahmad T, Lam CSP, Psotka MA. Heart Failure Spending Function: An Investment Framework for Sequencing and Intensification of Guideline-Directed Medical Therapies. Circulation Heart Failure 2022, 15: e008594. PMID: 35000432, DOI: 10.1161/circheartfailure.121.008594.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyMedical therapyReduced ejection fractionHealth care delivery researchAdverse eventsCardiac benefitsSerum creatinineBlood pressureEjection fractionHeart failureRoutine carePatient burdenHeart rateNew therapiesPatient harmHigh dosesPatientsPsychosocial domainsPocket costsTherapeutic opportunitiesClinical useTherapyNew drugsPhysiological domainsSpending function
2021
Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)
Ghazi L, Desai NR, Simonov M, Yamamoto Y, O'Connor KD, Riello RJ, Huang J, Olufade T, McDermott J, Inzucchi SE, Velazquez EJ, Wilson FP, Ahmad T. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF). American Heart Journal 2021, 244: 107-115. PMID: 34808104, DOI: 10.1016/j.ahj.2021.11.010.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyBest practice alertLeft ventricular ejection fractionHeart failureUsual careMedical therapyPragmatic trialElectronic health recordsEjection fractionCluster-randomized pragmatic trialLarge integrated healthcare systemDays post randomizationAppropriate medical therapyHeart Failure TrialReduced ejection fractionUsual care groupCommon chronic illnessGlomerular filtration rateVentricular ejection fractionRecent blood pressureIntegrated healthcare systemUse of guidelinesLow-cost interventionCreatinine levelsReal-world practiceThe Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial
Chouairi F, Fuery MA, Mullan CW, Caraballo C, Sen S, Maulion C, Wilkinson ST, Surti T, McCullough M, Miller PE, Pacor J, Leifer ES, Felker GM, Velazquez EJ, Fiuzat M, O'Connor CM, Januzzi JL, Desai NR, Ahmad T. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial. Journal Of Cardiac Failure 2021, 27: 1359-1366. PMID: 34166799, DOI: 10.1016/j.cardfail.2021.06.008.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyReduced ejection fractionAmino-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsGUIDE-IT trialNatriuretic peptide levelsHeart failureEjection fractionClinical outcomesPeptide levelsOptimal guideline-directed medical therapyCox proportional hazards regression modelingProportional hazards regression modelingImpact of depressionHistory of depressionCardiovascular deathCause hospitalizationCause mortalityOverall cohortMedical therapyAdverse outcomesTarget dosesPatientsMental healthTime pointsIntercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure
Fuery MA, Chouairi F, Januzzi JL, Moe GW, Caraballo C, McCullough M, Miller PE, Reinhardt SW, Clark K, Oseran A, Milner A, Pacor J, Kahn PA, Singh A, Ravindra N, Guha A, Vadlamani L, Kulkarni NS, Fiuzat M, Felker GM, O'Connor CM, Ahmad T, Ezekowitz J, Desai NR. Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure. JACC Heart Failure 2021, 9: 497-505. PMID: 33992564, DOI: 10.1016/j.jchf.2021.02.011.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyGDMT useCountry of enrollmentHeart failureMedical therapyHigher body mass indexKaplan-Meier survival estimatesGUIDE-IT trialHeart failure hospitalizationReduced ejection fractionLog-rank testingMineralocorticoid receptor antagonistsPrimary study endpointBody mass indexPatterns of careCare delivery structuresGUIDE-ITHF hospitalizationFailure hospitalizationUsual careEjection fractionStudy endpointBlack patientsClinical outcomesMass indexDifferences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction
Daubert MA, Yow E, Barnhart HX, Piña IL, Ahmad T, Leifer E, Cooper L, Desvigne‐Nickens P, Fiuzat M, Adams K, Ezekowitz J, Whellan DJ, Januzzi JL, O’Connor C, Felker GM. Differences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction. Journal Of The American Heart Association 2021, 10: e019712. PMID: 33955231, PMCID: PMC8200692, DOI: 10.1161/jaha.120.019712.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiomarkersCanadaCause of DeathFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPrognosisProtein PrecursorsRetrospective StudiesSex DistributionSex FactorsStroke VolumeUnited StatesConceptsReduced ejection fractionNT-proBNP responseGuideline-directed medical therapyGUIDE-IT trialHeart failureEjection fractionNT-proBNPPrognostic valuePg/mLHF hospitalizationMedical therapyEquivalent prognostic valueNT-proBNP reductionNT-proBNP valuesGreater prognostic valueNonischemic causesClinical characteristicsClinical outcomesImproved outcomesLandmark analysisPrognostic biomarkerTherapeutic goalsConclusions MenSecondary analysisWomenEffects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial
Chouairi F, Pacor J, Miller PE, Fuery MA, Caraballo C, Sen S, Leifer ES, Felker GM, Fiuzat M, O’Connor C, Januzzi JL, Friedman DJ, Desai NR, Ahmad T, Freeman JV. Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial. Mayo Clinic Proceedings Innovations Quality & Outcomes 2021, 5: 447-455. PMID: 33997640, PMCID: PMC8105522, DOI: 10.1016/j.mayocpiqo.2021.02.005.Peer-Reviewed Original ResearchNT-proBNP levelsReduced ejection fractionAtrial fibrillationHF hospitalizationHeart failureEjection fractionMedical therapyN-terminal pro-B-type natriuretic peptideOptimal guideline-directed medical therapyPro-B-type natriuretic peptideGuideline-directed medical therapyHigher NT-proBNP concentrationsHigher NT-proBNP levelsGUIDE-IT trialMedical therapy useHeart failure outcomesHeart Failure TrialPrevalent atrial fibrillationNT-proBNP concentrationsType natriuretic peptideEvidence-based therapiesCardiovascular deathAF patientsTherapy useFailure Trial
2019
Optimal Medical Therapy in Heart Failure: Reasons for Lack of Medication Titration in the GUIDE IT Trial
Fiuzat M, Alemayehu W, Ezekowitz J, Westerhout C, Whellan D, Mulder H, Ahmad T, Adams K, Pina I, Anstrom K, Cooper L, Alhanti B, Sbolli M, Mark D, Leifer E, Felker M, O'Connor C, Januzzi J. Optimal Medical Therapy in Heart Failure: Reasons for Lack of Medication Titration in the GUIDE IT Trial. Journal Of Cardiac Failure 2019, 25: s78. DOI: 10.1016/j.cardfail.2019.07.221.Peer-Reviewed Original ResearchHeart failureMedication titrationMedical therapyMedication adjustmentsClinical outcomesTarget dosesGUIDE-IT trialOptimal medical therapyReduced ejection fractionWeeks of enrollmentEnd of studyProtocol-driven approachUse of guidelinesFree-text reasonsGDMT groupGUIDE-ITHF medicationsB-blockersNT-proBNPEjection fractionNatriuretic peptideStudy visitClinicians' decisionsIT trialSerial measurements