2023
Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction
Brush J, Chaudhry S, Dreyer R, D'Onofrio G, Greene E, Hajduk A, Lu Y, Krumholz H. Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2023, 197: 101-107. PMID: 37062667, PMCID: PMC10198892, DOI: 10.1016/j.amjcard.2023.03.009.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionD2B timeSymptom complexityYoung womenChest painBalloon timeST-elevation myocardial infarctionSILVER-AMI StudySymptom phenotypeSex differencesPain symptomsCoronary interventionOlder patientsMyocardial infarctionOlder womenSTEMIOlder menSymptom patternsPresentation delayPatientsSymptom clustersLogistic regressionSymptomsWomenMean number
2021
Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction
Brush JE, Hajduk AM, Greene EJ, Dreyer RP, Krumholz HM, Chaudhry SI. Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction. The American Journal Of Medicine 2021, 135: 342-349. PMID: 34715061, PMCID: PMC8901454, DOI: 10.1016/j.amjmed.2021.09.022.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionSymptom combinationsOlder patientsAcute myocardial infarction subgroupsAcute myocardial infarction admissionsMyocardial infarction subgroupsPatients 75 yearsMyocardial infarction admissionsSILVER-AMI StudySymptom phenotypeClinical studiesIndividual patientsMore symptomsPatientsInfarctionDiagnostic possibilitiesSymptomsWomenPerson interviewsMenCommon phenotypeSex differencesCliniciansPhenotypeFalls in older adults after hospitalization for acute myocardial infarction
Goldstein DW, Hajduk AM, Song X, Tsang S, Geda M, McClurken JB, Tinetti ME, Krumholz HM, Chaudhry SI. Falls in older adults after hospitalization for acute myocardial infarction. Journal Of The American Geriatrics Society 2021, 69: 3476-3485. PMID: 34383963, PMCID: PMC8882265, DOI: 10.1111/jgs.17398.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionSerious fallsOlder patientsMyocardial infarctionRisk factorsAge 75Older adultsMedical record adjudicationLonger hospital stayMonths of dischargeProspective cohort studyMedical record reviewSelf-reported fallsAdults age 75Logistic regression analysisAcademic medical centerHospital stayCohort studyClinical factorsRecord reviewFunctional mobilityNew medicationsFall riskMedical CenterImpaired mobility
2020
Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017
Mori M, Wang Y, Murugiah K, Khera R, Gupta A, Vallabhajosyula P, Masoudi FA, Geirsson A, Krumholz HM. Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017. Journal Of The American Heart Association 2020, 9: e016980. PMID: 33045889, PMCID: PMC7763387, DOI: 10.1161/jaha.120.016980.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryFirst-time coronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryGraft surgeryMedicare feeOlder adultsPatient baseline characteristicsData of adultsYear of dischargeProportion of womenService inpatientsIndex surgeryBaseline characteristicsHospital dischargeOlder patientsMedian agePrimary outcomeCox regressionService patientsUnique patientsPatientsSurgeryAnnual declineDemographic subgroupsPresentation, 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 statusChanges in Functional Status and Health-Related Quality of Life in Older Adults After Surgical, Interventional, or Medical Management of Acute Myocardial Infarction
Mori M, Djulbegovic M, Hajduk A, Holland ML, Krumholz HM, Chaudhry SI. Changes in Functional Status and Health-Related Quality of Life in Older Adults After Surgical, Interventional, or Medical Management of Acute Myocardial Infarction. Seminars In Thoracic And Cardiovascular Surgery 2020, 33: 72-81. PMID: 32439546, PMCID: PMC7983308, DOI: 10.1053/j.semtcvs.2020.05.001.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graftPercutaneous coronary interventionAcute myocardial infarctionPhysical component scaleMedical managementFunctional statusOlder patientsMyocardial infarctionArtery bypass graftHealth-related qualityAge 75 yearsPatient-centered outcomesRisk of declinePredictors of declineQuality of lifeUnadjusted incidenceCoronary interventionADL declineCardiac surgeryMedical therapyBypass graftSF-12Multivariable modelHRQoLPatients
2019
Usefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study)
Green YS, Hajduk AM, Song X, Krumholz HM, Sinha SK, Chaudhry SI. Usefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study). The American Journal Of Cardiology 2019, 125: 313-319. PMID: 31787249, PMCID: PMC7003680, DOI: 10.1016/j.amjcard.2019.10.038.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI outcomesMyocardial infarctionIndependent associationMedical Outcomes Study Social Support SurveySocial supportOlder AMI patientsSocial Support SurveyParticipants 75 yearsLow emotional supportLow social supportImportant social determinantInitial hospitalizationOlder patientsDevelopment of interventionsAMI patientsMultivariable analysisMean ageMultivariable regressionHealth outcomesSupport SurveyInformational supportReadmissionSocial determinantsOlder adultsPatient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study
Richards BG, Hajduk AM, Perry J, Krumholz HM, Khan AM, Chaudhry SI. Patient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study. Journal Of General Internal Medicine 2019, 35: 808-814. PMID: 31654359, PMCID: PMC7080904, DOI: 10.1007/s11606-019-05414-8.Peer-Reviewed Original ResearchConceptsDays of dischargeEmergency department utilizationAcute myocardial infarctionPatient-reported qualityHospital discharge processOlder patientsAcute Myocardial Infarction StudyMyocardial Infarction StudyProspective cohort studyMedical record reviewEmergency room utilizationAdults age 75Key ResultsA totalHospital Consumer AssessmentSILVER-AMI StudyHospital discharge transitionsHigh-risk periodDesignMulti-centerCohort studyHospital dischargeMedian ageClinical outcomesRecord reviewAdverse outcomesResultsA totalSex-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 prevalenceAcute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study
Dodson JA, Hajduk A, Curtis J, Geda M, Krumholz HM, Song X, Tsang S, Blaum C, Miller P, Parikh CR, Chaudhry SI. Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2019, 132: e817-e826. PMID: 31170374, PMCID: PMC6891160, DOI: 10.1016/j.amjmed.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAcute Kidney InjuryAge FactorsAgedAged, 80 and overCohort StudiesCoronary AngiographyDatabases, FactualFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansKaplan-Meier EstimateLogistic ModelsMaleMyocardial InfarctionOdds RatioPrognosisProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSurvival AnalysisConceptsAcute kidney injuryAcute myocardial infarctionAge-related conditionsKidney injuryBody mass indexCoronary angiographyRisk factorsMyocardial infarctionOlder patientsMean ageAcute kidney injury risk factorsAcute Myocardial Infarction StudyAcute myocardial infarction cohortOlder adultsGlobal Outcomes criteriaMyocardial Infarction StudyInjury risk factorsParticipants' mean ageSILVER-AMI StudyMultivariable adjustmentComorbid diseasesHeart failureIndependent predictorsGeriatric conditionsMass indexTrends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular function
2016
Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006–2013
Lipska KJ, Yao X, Herrin J, McCoy RG, Ross JS, Steinman MA, Inzucchi SE, Gill TM, Krumholz HM, Shah ND. Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006–2013. Diabetes Care 2016, 40: 468-475. PMID: 27659408, PMCID: PMC5360291, DOI: 10.2337/dc16-0985.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBlood GlucoseComorbidityDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsDrug UtilizationFemaleGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsInsulinLogistic ModelsMaleMetforminMiddle AgedRetrospective StudiesSulfonylurea CompoundsThiazolidinedionesYoung AdultConceptsGlycemic controlSevere hypoglycemiaOlder patientsDipeptidyl peptidase-4 inhibitorsGlucose-lowering drugsGlucose-lowering medicationsProportion of patientsOverall glycemic controlPeptidase-4 inhibitorsMedicare Advantage patientsSex-standardized ratesType 2 diabetesOverall rateClass of agentsMore comorbiditiesChronic comorbiditiesYounger patientsAdvantage patientsDrug utilizationClaims dataPatientsHypoglycemiaHemoglobin AT2DMComorbidities
2015
Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined
Bucholz EM, Beckman AL, Krumholz HA, Krumholz HM, conducted. B. Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined. American Heart Journal 2015, 172: 173-181. PMID: 26856230, PMCID: PMC5097250, DOI: 10.1016/j.ahj.2015.10.024.Peer-Reviewed Original ResearchConceptsNormal weight patientsAcute myocardial infarctionBody mass indexHigher body mass indexLong-term survivalObese patientsOverweight patientsObesity paradoxExcess weightMyocardial infarctionLife expectancyTime of AMIHigher crude mortalityTime pointsShort-term mortalityCooperative Cardiovascular ProjectMedical record studyProportional hazards modelYears of ageMorbid obesityOlder patientsSurvival benefitYounger patientsCrude mortalityBMI groupsNational Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010
Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM. National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010. PLOS ONE 2015, 10: e0132470. PMID: 26147225, PMCID: PMC4493110, DOI: 10.1371/journal.pone.0132470.Peer-Reviewed Original ResearchConceptsMitral valve surgeryLength of stayHospital LOSReadmission ratesHospital readmission ratesOlder patientsHospital readmissionMedicare feeMean hospital LOSSurvival rateProportional hazards regressionYears of ageValve surgeryHazards regressionService patientsWorse outcomesAge subgroupsPatientsOlder adultsSurvivorsNational trendsReadmissionModest declineWomenSubgroupsFrequency and Effects of Excess Dosing of Anticoagulants in Patients ≤55 Years With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention (from the VIRGO Study)
Gupta A, Chui P, Zhou S, Spertus JA, Geda M, Lorenze N, Lee I, Onofrio G, Lichtman JH, Alexander KP, Krumholz HM, Curtis JP. Frequency and Effects of Excess Dosing of Anticoagulants in Patients ≤55 Years With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention (from the VIRGO Study). The American Journal Of Cardiology 2015, 116: 1-7. PMID: 25937348, PMCID: PMC4466069, DOI: 10.1016/j.amjcard.2015.03.032.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAngioplasty, Balloon, CoronaryAnticoagulantsAntithrombinsBody Mass IndexCohort StudiesFemaleHemorrhageHeparinHirudinsHumansMaleMiddle AgedMyocardial InfarctionPeptide FragmentsPercutaneous Coronary InterventionPlatelet Glycoprotein GPIIb-IIIa ComplexPrevalenceRecombinant ProteinsRisk AssessmentRisk FactorsSex DistributionTreatment OutcomeUnited StatesConceptsPercutaneous coronary interventionGlycoprotein IIb/IIIa inhibitorsIIb/IIIa inhibitorsExcess dosingAcute myocardial infarctionCoronary interventionMultivariable analysisMyocardial infarctionUnderwent Percutaneous Coronary InterventionLower body weightOlder patientsYounger patientsUnfractionated heparinMedical recordsUnivariate analysisAnticoagulant agentsAnticoagulant drugsBody weightPatientsDosingYounger ageLogistic regressionYoung womenAnticoagulantsGender-based differencesTrajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study
Dharmarajan K, Hsieh AF, Kulkarni VT, Lin Z, Ross JS, Horwitz LI, Kim N, Suter LG, Lin H, Normand SL, Krumholz HM. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. The BMJ 2015, 350: h411. PMID: 25656852, PMCID: PMC4353309, DOI: 10.1136/bmj.h411.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyHeart failureRisk of deathMyocardial infarctionFirst readmissionAbsolute riskOlder patientsCohort studyRelative riskMedicare feeService beneficiariesRisk of readmissionGeneral elderly populationGeneral older populationRisk trajectoriesHigh-risk periodHospital dischargeHospital admissionDischarge diagnosisAdverse outcomesReadmissionHospitalizationTrajectories of riskElderly population
2014
Design and rationale of the comprehensive evaluation of risk factors in older patients with AMI (SILVER-AMI) study
Dodson JA, Geda M, Krumholz HM, Lorenze N, Murphy TE, Allore HG, Charpentier P, Tsang SW, Acampora D, Tinetti ME, Gill TM, Chaudhry SI. Design and rationale of the comprehensive evaluation of risk factors in older patients with AMI (SILVER-AMI) study. BMC Health Services Research 2014, 14: 506. PMID: 25370536, PMCID: PMC4239317, DOI: 10.1186/s12913-014-0506-4.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status declineOlder patientsRisk factorsGeriatric impairmentsHospital readmissionOlder adultsDetailed medical record abstractionStatus declineDiagnostic study resultsPost-AMI outcomesProportion of patientsProspective cohort studyMedical record abstractionAMI studyHealth status measuresClinical characteristicsCohort studyRecord abstractionAdverse outcomesMyocardial infarctionAcademic hospitalHospital assessmentMultivariable regressionStatus measures
2013
Trends in Aortic Valve Replacement for Elderly Patients in the United States, 1999-2011
Barreto-Filho JA, Wang Y, Dodson JA, Desai MM, Sugeng L, Geirsson A, Krumholz HM. Trends in Aortic Valve Replacement for Elderly Patients in the United States, 1999-2011. JAMA 2013, 310: 2078-2084. PMID: 24240935, PMCID: PMC4089974, DOI: 10.1001/jama.2013.282437.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAortic ValveBicuspid Aortic Valve DiseaseBlack PeopleCohort StudiesCoronary Artery BypassCross-Sectional StudiesFee-for-Service PlansFemaleHeart Defects, CongenitalHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHumansLength of StayMaleMedicarePatient ReadmissionTreatment OutcomeUnited StatesConceptsSurgical aortic valve replacementAortic valve replacementValve replacementProcedure ratesElderly patientsCoronary artery bypass graft surgeryArtery bypass graft surgeryCross-sectional cohort studyPatients 85 yearsBypass graft surgeryHigh mortality rateCause readmissionCABG surgeryGraft surgeryOlder patientsCohort studyReadmission ratesTranscatheter optionsBlack patientsTranscatheter treatmentMechanical prosthesesThirty-dayContemporary outcomesMAIN OUTCOMEMedicare feePrevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race
Leifheit-Limson EC, Spertus JA, Reid KJ, Jones SB, Vaccarino V, Krumholz HM, Lichtman JH. Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race. Journal Of Women's Health 2013, 22: 659-666. PMID: 23841468, DOI: 10.1089/jwh.2012.3962.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overBlack or African AmericanBody Mass IndexCounselingDiabetes Mellitus, Type 2FemaleHospitalizationHumansHypercholesterolemiaHypertensionLife StyleMaleMiddle AgedMyocardial InfarctionObesityPrevalenceProspective StudiesRisk FactorsSecondary PreventionSex FactorsSmokingSmoking CessationSocioeconomic FactorsWhite PeopleConceptsCardiac risk factorsAcute myocardial infarctionSecondary prevention effortsTraditional cardiac risk factorsLipid-lowering medicationsRisk factorsWhite patientsAMI patientsMyocardial infarctionPrevention effortsGreater risk factor burdenMultiple cardiac risk factorsRisk factor burdenYoung black patientsYoung white patientsSecondary prevention strategiesRisk factor prevalenceHigh-risk subgroupsMultiple risk factorsBlack womenAge-sex groupsOlder patientsSecondary preventionYounger patientsFactor prevalenceLong-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest
Chan PS, Nallamothu BK, Krumholz HM, Spertus JA, Li Y, Hammill BG, Curtis LH. Long-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest. New England Journal Of Medicine 2013, 368: 1019-1026. PMID: 23484828, PMCID: PMC3652256, DOI: 10.1056/nejmoa1200657.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestCardiac arrestNeurologic disabilityReadmission ratesElderly survivorsRisk-adjusted ratesNeurologic statusHeart failureIn-Hospital Cardiac ArrestInpatient cardiac arrestsSevere neurologic disabilityDemographic characteristicsLong-term outcomesLong-term survivalYears of ageRate of survivalHospital dischargeOlder patientsYounger patientsWhite patientsBlack patientsTerm outcomesNational registryMedicare filesPatients