2024
Representation 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 ResearchChronological 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 patients
2023
Complex Percutaneous Coronary Intervention Outcomes in Older Adults
Hanna J, Wang S, Kochar A, Park D, Damluji A, Henry G, Ahmad Y, Curtis J, Nanna M. Complex Percutaneous Coronary Intervention Outcomes in Older Adults. Journal Of The American Heart Association 2023, 12: e029057. PMID: 37776222, PMCID: PMC10727245, DOI: 10.1161/jaha.122.029057.Peer-Reviewed Original ResearchConceptsNoncomplex percutaneous coronary interventionsComplex percutaneous coronary interventionStable ischemic heart diseasePercutaneous coronary interventionIschemic heart diseaseTarget lesion revascularizationEvent-free survivalHeart diseaseOlder adultsCause deathLesion revascularizationClinical characteristicsElective percutaneous coronary interventionPercutaneous coronary intervention outcomesWorse event-free survivalMedical therapy useCox regression modelLarge health systemNoncardiac comorbiditiesRevascularization riskCoronary interventionTherapy useClinical outcomesDisease featuresLower risk
2022
Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding
Li D, Ong S, Hughes M, Hung K, Agarwal R, Alexis J, Damianos J, Sharma S, Pires J, Nanna M, Laine L. Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2022, 57: 94-102. PMID: 36394111, DOI: 10.1111/apt.17278.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsGastrointestinal bleedingPrimary preventionCardiovascular eventsRisk of MACEYale-New Haven HospitalPrimary cardiovascular preventionAdverse cardiovascular eventsKaplan-Meier curvesLong-term outcomesRisk-benefit ratioLog-rank testAspirin 81Hospitalised patientsPrimary endpointSecondary endpointsCardiovascular preventionSubsequent hospitalisationMedian ageDeprescriptionHigh riskAspirinHospitalisationPatientsPreventionCost-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 recommendations
2021
180-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 statusAge-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 counterpartsThe Accuracy of Cardiovascular Pooled Cohort Risk Estimates in U.S. Older Adults
Nanna MG, Peterson ED, Wojdyla D, Navar AM. The Accuracy of Cardiovascular Pooled Cohort Risk Estimates in U.S. Older Adults. Journal Of General Internal Medicine 2019, 35: 1701-1708. PMID: 31667745, PMCID: PMC7280419, DOI: 10.1007/s11606-019-05361-4.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseOlder adultsACC/AHA guidelinesAge groupsLarge prospective cohort studyRisk estimatesYoung adultsASCVD risk estimationProspective cohort studyCardiovascular Health StudyHigh-risk groupU.S. older adultsDifferent age groupsCHD deathFramingham OriginalASCVD riskCardiovascular eventsAHA guidelinesCohort studyPrimary preventionCardiovascular diseaseRisk groupsTreatment decisionsFramingham OffspringHealth StudyAge, knowledge, preferences, and risk tolerance for invasive cardiac care
Nanna MG, Peterson ED, Wu A, Harding T, Galanos AN, Wruck L, Alexander KP. Age, knowledge, preferences, and risk tolerance for invasive cardiac care. American Heart Journal 2019, 219: 99-108. PMID: 31733450, PMCID: PMC6944066, DOI: 10.1016/j.ahj.2019.09.008.Peer-Reviewed Original ResearchConceptsInvasive cardiac careAcute coronary syndromeInvasive cardiovascular proceduresCardiac careCardiovascular proceduresSingle academic medical centerCoronary artery bypassProspective cohort studyPercutaneous coronary interventionGroup of patientsConfidence intervalsSubstantial inter-individual variabilityAcademic medical centerArtery bypassCABG surgeryCoronary syndromeBaseline characteristicsCohort studyCoronary interventionYounger patientsCardiac catheterizationInvasive careInter-individual variabilityCare teamCardiovascular careSex-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 prevalenceThirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Goldstein D, Forman DE, Alexander KP, Gill TM, Chaudhry SI. Thirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005320. PMID: 31010300, PMCID: PMC6481309, DOI: 10.1161/circoutcomes.118.005320.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overFemaleGeriatric AssessmentHealth Status IndicatorsHumansMaleMyocardial InfarctionPatient AdmissionPatient ReadmissionPredictive Value of TestsProspective StudiesReproducibility of ResultsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionReadmission risk modelFinal risk modelFunctional mobilityFunctional impairmentMyocardial infarctionOlder adultsFirst diastolic blood pressureChronic obstructive pulmonary diseaseAge-related functional impairmentsP2Y12 inhibitor useAcute kidney injuryDaily living (ADL) disabilityPatient-level factorsProspective cohort studyDiastolic blood pressureObstructive pulmonary diseasePatients of ageGeneral health statusStrongest predictorRisk modelMore comorbiditiesCause readmissionKidney injuryCohort study
2018
Statin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry
Nanna MG, Navar AM, Wang TY, Mi X, Virani SS, Louie MJ, Lee LV, Goldberg AC, Roger VL, Robinson J, Peterson ED. Statin Use and Adverse Effects Among Adults >75 Years of Age: Insights From the Patient and Provider Assessment of Lipid Management (PALM) Registry. Journal Of The American Heart Association 2018, 7: e008546. PMID: 29739801, PMCID: PMC6015311, DOI: 10.1161/jaha.118.008546.Peer-Reviewed Original ResearchConceptsLipid Management (PALM) registryHigh-dose statinsHigh-intensity statinsStatin useOlder patientsSecondary preventionManagement RegistryPrimary preventionProvider assessmentCardiology/American Heart Association guidelinesAmerican Heart Association guidelinesMultivariable logistic regression modelRoutine community practiceHeart Association guidelinesCurrent statin usersCurrent statin useYears of ageLogistic regression modelsStatin usersYounger patientsPatient surveyAssociation guidelinesAmerican CollegeStatinsPatientsLong-Term Cognitive Decline After Newly Diagnosed Heart Failure
Hammond CA, Blades NJ, Chaudhry SI, Dodson JA, Longstreth WT, Heckbert SR, Psaty BM, Arnold AM, Dublin S, Sitlani CM, Gardin JM, Thielke SM, Nanna MG, Gottesman RF, Newman AB, Thacker EL. Long-Term Cognitive Decline After Newly Diagnosed Heart Failure. Circulation Heart Failure 2018, 11: e004476. PMID: 29523517, PMCID: PMC6072263, DOI: 10.1161/circheartfailure.117.004476.Peer-Reviewed Original ResearchConceptsIncident heart failureHeart failureYears of ageEjection fractionHF diagnosisAtrial fibrillationModified Mini-Mental State Examination scoresCommunity-based prospective cohort studyCognitive declineHistory of HFMini-Mental State Examination scoreLong-term cognitive declineModified Mini-Mental State ExaminationAtrial fibrillation statusComorbid atrial fibrillationMini-Mental State ExaminationProspective cohort studyGlobal cognitive abilityState Examination scoreHospital discharge summariesPublic health implicationsCohort studyClinical strokeCardiovascular healthAdjusted model