2023
Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression modelsSex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study
Bikdeli B, Muriel A, Wang Y, Piazza G, Khairani C, Rosovsky R, Mehdipoor G, O'Donoghue M, Madridano O, Lopez-Saez J, Mellado M, Brasero A, Grandone E, Spagnolo P, Lu Y, Bertoletti L, López-Jiménez L, Núñez M, Blanco-Molina Á, Gerhard-Herman M, Goldhaber S, Bates S, Jimenez D, Krumholz H, Monreal M. Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study. Seminars In Thrombosis And Hemostasis 2023, 49: 725-735. PMID: 36868268, DOI: 10.1055/s-0043-1764231.Peer-Reviewed Original ResearchConceptsOlder adultsClinical characteristicsRisk factorsElderly womenPE risk stratificationTransient provoking factorsRelevant clinical characteristicsSex differencesWarrants further investigationSex-related differencesSex-specific factorsClot burdenPE presentationChest painHormonal therapyHormone therapyPatient characteristicsPulmonary embolismYounger patientsAtherosclerotic diseaseRisk stratificationLung diseaseMedicare databaseProvoking factorsCardiovascular disease
2022
Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissions
2021
Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a cross-sectional study
Huang X, Dhruva SS, Yuan X, Bai X, Lu Y, Yan X, Liu J, Li W, Hu D, Ji R, Gao M, Miao F, Li J, Ge J, Krumholz HM, Li J. Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a cross-sectional study. BMJ Open 2021, 11: e052946. PMID: 34732492, PMCID: PMC8572400, DOI: 10.1136/bmjopen-2021-052946.Peer-Reviewed Original ResearchConceptsSevere valvular heart diseaseValvular heart diseaseHigh operative riskRheumatic originValve interventionHospital outcomesOperative riskCommon etiologyPrimary diagnosisHeart diseaseSeverity of VHDTypes of VHDCommon valvular heart diseaseMultivariable logistic regression analysisDegenerative valvular heart diseaseOutcomes of patientsCross-sectional studyLogistic regression analysisTwo-stage random sampling designClinical characteristicsFrequent etiologyPredominant etiologyTricuspid regurgitationAdult patientsPatient characteristicsChanges in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
Zhou T, Li X, Lu Y, Murugiah K, Bai X, Hu S, Gao Y, Masoudi FA, Krumholz HM, Li J, . Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015. Open Heart 2021, 8: e001666. PMID: 34599073, PMCID: PMC8488733, DOI: 10.1136/openhrt-2021-001666.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionPrehospital delayMyocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionAcute cardiovascular careAcute myocardial infarctionWeighted national estimateHealth service capacityRisk-adjusted ratesAcute reperfusionEligible patientsHospital deathReperfusion therapyMedical chartsPatient characteristicsHospital treatmentPatient outcomesRandom cohortCardiovascular diseaseCardiovascular carePatientsNational estimatesStandardised definitions
2020
Geographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015
Zhong Q, Gao Y, Zheng X, Chen J, Masoudi FA, Lu Y, Feng Y, Hu S, Zhang Q, Huang C, Wang Y, Krumholz HM, Li X, Zhou Y. Geographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015. JAMA Network Open 2020, 3: e2021182. PMID: 33095248, PMCID: PMC7584924, DOI: 10.1001/jamanetworkopen.2020.21182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionProcess of careHospital mortalityMyocardial infarctionOdds ratioAngiotensin receptor blockersCross-sectional studyOutcomes of careReceptor blockersReperfusion therapyPatient characteristicsTherapy useCare measuresPatient hospitalizationIdeal patientOutcome measuresMAIN OUTCOMEΒ-blockersAMI managementPatientsEnzyme inhibitorsSignificant geographic variationMortalityCareHospitalizationEvaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System
Mori M, Wilson L, Ali A, Ahmad T, Anwer M, Jacoby D, Geirsson A, Krumholz HM. Evaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System. JAMA Network Open 2020, 3: e2017513. PMID: 32945877, PMCID: PMC7501535, DOI: 10.1001/jamanetworkopen.2020.17513.Peer-Reviewed Original ResearchConceptsYale-New Haven HospitalHeart transplant programShort-term outcomesHeart transplantHeart transplant volumeNew Haven HospitalDonor heartsPatient selectionRecipient selectionTransplant programsTransplant volumeWaiting listCase volumeDonor heart allocation systemPre-post cohort studyConservative patient selectionUnused donor heartsHeart allocation systemHigher median numberCirculatory assist devicesCohort studyPatient characteristicsMore patientsSingle centerCenter volumeStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsRates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction
Caraballo C, Khera R, Jones PG, Decker C, Schulz W, Spertus JA, Krumholz HM. Rates and Predictors of Patient Underreporting of Hospitalizations During Follow-Up After Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006231. PMID: 32552061, PMCID: PMC9465954, DOI: 10.1161/circoutcomes.119.006231.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHospitalization eventsMedical recordsLongitudinal multicenter cohort studyMulticenter cohort studyMedical record abstractionDifferent patient characteristicsHealth care eventsPatients' underreportingTRIUMPH registryAccuracy of reportingCohort studyPatient characteristicsRecord abstractionProspective studyClinical studiesClinical investigationHospitalizationPatientsCare eventsInfarctionEvent ratesParticipantsPredictorsAssociation Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Rodrick D, Fine JM, Eckenrode S, Galusha DH, Tasimi A, Hunt DR, Bernheim SM, Normand ST, Krumholz HM. Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States. JAMA Network Open 2020, 3: e202142. PMID: 32259263, PMCID: PMC7139276, DOI: 10.1001/jamanetworkopen.2020.2142.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMedicare Patient Safety Monitoring SystemAdverse event ratesAdverse eventsHeart failureMedicare expendituresService patientsMyocardial infarctionMedicare feeEvent ratesHigher adverse event ratesCare expendituresRisk-standardized ratesPatients 65 yearsAdverse event dataAcute care hospitalsCross-sectional studyFinal study sampleInpatient care expendituresRate of occurrenceDates of analysisPatient characteristicsCare hospitalMean ageInpatient careAssociation Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction
Wang Y, Leifheit E, Normand S, Krumholz HM. Association Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction. Journal Of The American Heart Association 2020, 9: e014907. PMID: 32172654, PMCID: PMC7335517, DOI: 10.1161/jaha.119.014907.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionIndex acute myocardial infarctionClinical Classification SoftwareMyocardial infarctionDisease categoriesRisk of deathCox regression modelPost-acute careAcute care hospitalsOccurrence of hospitalizationLow recurrence riskUnplanned rehospitalizationSubsequent hospitalizationBackground PatientsHazard ratioPatient characteristicsSecondary preventionMedian timeService patientsChronic diseasesPatient riskOutcome measuresRehospitalizationHigh risk
2019
Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia
Krumholz HM, Wang Y, Wang K, Lin Z, Bernheim SM, Xu X, Desai NR, Normand ST. Association of Hospital Payment Profiles With Variation in 30-Day Medicare Cost for Inpatients With Heart Failure or Pneumonia. JAMA Network Open 2019, 2: e1915604. PMID: 31730185, PMCID: PMC6902811, DOI: 10.1001/jamanetworkopen.2019.15604.Peer-Reviewed Original ResearchConceptsHeart failureSame patientSame diagnosisMortality rateRisk-standardized mortality ratesHighest quartile hospitalsObservational cohort studyMedian hospitalQuartile hospitalsIndex hospitalizationCohort studyCritical access hospitalsPatient characteristicsHospital variationAcute careEpisode paymentsPrincipal diagnosisMAIN OUTCOMEMedicare feePneumoniaMedicare beneficiariesPatientsCase mixService Part ADifferent hospitalsP415330-Day readmission after hospitalization for heart failure in china
Li J, Bai X, Zhang L, Masoudi F, Spertus J, Krumholz H. P415330-Day readmission after hospitalization for heart failure in china. European Heart Journal 2019, 40: ehz745.0725. DOI: 10.1093/eurheartj/ehz745.0725.Peer-Reviewed Original ResearchDays of dischargeHeart failurePatient characteristicsMedian odds ratioOdds ratioChronic obstructive pulmonary diseaseIndex hospital stayObstructive pulmonary diseaseWeeks of dischargeValvular heart diseaseTransitions of careHF hospitalizationRandom hospitalsCause readmissionEligible patientsHospital stayHospitalization stayReadmission diagnosesReadmission ratesConsecutive patientsHospital readmissionMedian agePulmonary diseasePatient factorsC-statisticCharacteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study
Yu Y, Gupta A, Wu C, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J, Group T. Characteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2019, 8: e012884. PMID: 31431117, PMCID: PMC6755852, DOI: 10.1161/jaha.119.012884.Peer-Reviewed Original ResearchConceptsHeart failureHF careSignificant healthcare resource utilizationBackground Heart failureGuideline-recommended medicationsLower inpatient mortalityAcute heart failureOutcomes of patientsHealthcare resource utilizationLower prescription ratesMedical record abstractionHeart Failure StudyTraditional Chinese medicineHospital mortalityConclusions PatientsInpatient mortalityPatient characteristicsTreatment withdrawalEjection fractionMedian agePrescription ratesRecord abstractionMedian lengthBiomarker testingInpatient settingTraditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study
Yu Y, Spatz ES, Tan Q, Liu S, Lu Y, Masoudi FA, Schulz WL, Krumholz HM, Li J, Group T. Traditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2019, 8: e012776. PMID: 31364457, PMCID: PMC6761625, DOI: 10.1161/jaha.119.012776.Peer-Reviewed Original ResearchConceptsTraditional Chinese medicineAcute heart failureHeart failureEvidence-based therapiesWestern Medicine HospitalTCM useMedicine HospitalEvidence-based therapy useTraditional Chinese medicine useChinese medicine useCoronary artery diseaseHeart Failure StudyHierarchical logistic regression modelsLogistic regression modelsSalvia miltiorrhizaRandom sampleHospital bleedingPatient's bleedingPatient characteristicsArtery diseaseTherapy useMedicine useHospital characteristicsRetrospective analysisHospital use
2018
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Graham GN, Jones PG, Chan PS, Arnold SV, Krumholz HM, Spertus JA. Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e184240. PMID: 30646346, PMCID: PMC6324589, DOI: 10.1001/jamanetworkopen.2018.4240.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsMortality rate differencesMortality ratePatient characteristicsMyocardial infarctionPropensity scoreAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registrySelf-identified black patientsObserved survival differencesNational Death IndexTime of admissionLower propensity scoreProspective registryClinical characteristicsCohort studyDeath IndexHighest quintileBlack raceC-statisticSurvival differencesWorse outcomesMAIN OUTCOMEPatientsThe China Patient-centered Evaluative Assessment of Cardiac Events (China PEACE) retrospective heart failure study design
Yu Y, Zhang H, Li X, Lu Y, Masoudi FA, Krumholz HM, Li J. The China Patient-centered Evaluative Assessment of Cardiac Events (China PEACE) retrospective heart failure study design. BMJ Open 2018, 8: e020918. PMID: 29748344, PMCID: PMC5950642, DOI: 10.1136/bmjopen-2017-020918.Peer-Reviewed Original ResearchConceptsHeart failureChina PatientEthics CommitteeRetrospective cohort studyHeart Failure StudyCardiovascular disease prevalenceEthics committee approvalQuality of careHospital outcomesCohort studyPatient characteristicsLeading causeMedical recordsCardiovascular diseaseCase ascertainmentTreatment outcomesCurrent burdenCommittee approvalData abstractionDiagnostic testingPatient recordsCentral Ethics CommitteeLocal approvalPatientsStudy designSex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction. Circulation 2018, 137: 781-790. PMID: 29459463, PMCID: PMC5822747, DOI: 10.1161/circulationaha.117.031650.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPerception of symptomsChest painCare-seeking behaviorSymptom presentationYounger patientsMyocardial infarctionST-segment elevation acute myocardial infarctionMultivariable hierarchical logistic regressionIndex AMI hospitalizationMajority of womenHierarchical logistic regressionStress/anxietyVIRGO StudyMuscle painPatient characteristicsPredominant symptomAMI symptomsPerceive symptomsProdromal symptomsPatient interviewsHeart diseasePainAMI hospitalizationUS hospitals
2017
Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013
Yuan X, Zhang H, Zheng Z, Rao C, Zhao Y, Wang Y, Krumholz HM, Hu S. Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013. European Heart Journal - Quality Of Care And Clinical Outcomes 2017, 3: 312-318. PMID: 29044398, PMCID: PMC5805118, DOI: 10.1093/ehjqcco/qcx021.Peer-Reviewed Original ResearchConceptsMajor complication rateUrban teaching hospitalCoronary artery bypassComplication rateHospital mortalityTeaching hospitalArtery bypassMean ageChinese Cardiac Surgery RegistryAge groupsAnnual CABG volumePost-operative LOSPatients' mean ageCardiac Surgery RegistryPatient characteristicsCardiac surgeryMajor complicationsNumber of hospitalsCABG volumeTotal LOSHospitalMortalityPatientsRegistry systemMixed effects modelsSex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction
Lu Y, Zhou S, Dreyer RP, Spatz ES, Geda M, Lorenze NP, D'Onofrio G, Lichtman JH, Spertus JA, Ridker PM, Krumholz HM. Sex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003470. PMID: 28228461, PMCID: PMC5459381, DOI: 10.1161/circoutcomes.116.003470.Peer-Reviewed Original ResearchMeSH Keywords1-Alkyl-2-acetylglycerophosphocholine EsteraseAdolescentAdultAge of OnsetBiomarkersChi-Square DistributionComorbidityC-Reactive ProteinFemaleHealth Status DisparitiesHumansInflammation MediatorsLinear ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocioeconomic FactorsUnited StatesUp-RegulationYoung AdultConceptsHigh-sensitivity C-reactive proteinAcute myocardial infarctionHigher inflammatory levelsInflammatory markersPoor health statusHealth statusYoung womenMyocardial infarctionInflammatory levelsTargeted anti-inflammatory treatmentsElevated inflammatory markersResidual cholesterol riskResidual inflammatory riskSex differencesAnti-inflammatory treatmentAnti-inflammatory therapyC-reactive proteinHigher mortality riskYoung menPhospholipase A2Years of ageCardiovascular outcomesMultivariable adjustmentPatient characteristicsSecondary prevention