2024
Cost-effectiveness of iptacopan in paroxysmal nocturnal hemoglobinuria
Ito S, Chetlapalli K, Wang D, Potnis K, Richmond R, Krumholz H, Lee A, Cuker A, Goshua G. Cost-effectiveness of iptacopan in paroxysmal nocturnal hemoglobinuria. Blood 2024 PMID: 39374533, DOI: 10.1182/blood.2024025176.Peer-Reviewed Original ResearchStandard-of-careParoxysmal nocturnal hemoglobinuriaIncremental net monetary benefitNocturnal hemoglobinuriaComplement-mediated hemolytic anemiaTreating paroxysmal nocturnal hemoglobinuriaComplement C5 inhibitor eculizumabPhase 3 studyQuality-adjusted life expectancyRare blood disorderComprehensive cost-effectiveness analysisProbabilistic sensitivity analysesCost-saving thresholdsC5 inhibitor eculizumabNet monetary benefitPersistent anemiaIptacopanExtravascular hemolysisIntravenous infusionMonotherapyHemolytic anemiaAnemia resolutionC5 inhibitionFDA approvalPrimary outcomeCost-effectiveness of rapid vs in-house vs send-out ADAMTS13 testing for immune thrombotic thrombocytopenic purpura
Allen C, Ito S, Butt A, Purcell A, Richmond R, Tormey C, Krumholz H, Cuker A, Goshua G. Cost-effectiveness of rapid vs in-house vs send-out ADAMTS13 testing for immune thrombotic thrombocytopenic purpura. Blood Advances 2024, 8: 2279-2289. PMID: 38502197, PMCID: PMC11116991, DOI: 10.1182/bloodadvances.2024012608.Peer-Reviewed Original ResearchImmune thrombotic thrombocytopenic purpuraPLASMIC scoreThrombotic thrombocytopenic purpuraThrombocytopenic purpuraADAMTS13 testingIncremental net monetary benefitPer-patient cost savingsTherapeutic plasma exchangeBase-case analysisMarkov cohort simulationProbabilistic sensitivity analysesAmount of QALYEmpirical therapyADAMTS13 assaysPlasma exchangeEmpirical treatmentCaplacizumabFRET-based assayPrimary outcomePatientsNet monetary benefitCohort simulationCost-effectiveness evaluationPurpuraTesting strategiesHypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records
Brush J, Lu Y, Liu Y, Asher J, Li S, Sawano M, Young P, Schulz W, Anderson M, Burrows J, Krumholz H. Hypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records. Journal Of The American Heart Association 2024, 13: e033253. PMID: 38686864, PMCID: PMC11179912, DOI: 10.1161/jaha.123.033253.Peer-Reviewed Original ResearchConceptsElectronic health recordsRegional health systemImprove hypertension careHealth systemHealth recordsHypertension careDiastolic blood pressureAge-adjusted prevalence ratesNon-Hispanic Black patientsPrevalence ratesLarger health systemCross-sectional analysisTransformation of medical dataLeveraging real-world dataHigh prevalence rateHypertension trendsHypertension prevalenceBlood pressureBlood pressure measurementsHypertension diagnosisPrimary outcomeNational trendsProportion of patientsAntihypertensive medicationsBlack patients
2023
Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease
Godoy L, Farkouh M, Austin P, Shah B, Qiu F, Jackevicius C, Wijeysundera H, Krumholz H, Ko D. Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease. Journal Of The American College Of Cardiology 2023, 81: 2299-2311. PMID: 37316110, DOI: 10.1016/j.jacc.2023.04.021.Peer-Reviewed Original ResearchConceptsStable coronary artery diseaseCoronary artery diseaseBeta-blocker groupRecent myocardial infarctionHeart failureMyocardial infarctionCardiovascular eventsCoronary angiographyPrescription claimsObstructive coronary artery diseaseIndex coronary angiographyBeta-blocker therapyBeta-blocker useHeart failure hospitalizationElective coronary angiographyNew-user designMyocardial infarction hospitalizationsCause deathCardiovascular outcomesCause mortalityFailure hospitalizationCardioprotective benefitsArtery diseasePrimary outcomeIschemic heartTrends in the likelihood of receiving percutaneous coronary intervention in a low-volume hospital and disparities by sociodemographic communities
Wang C, Lindquist K, Krumholz H, Hsia R. Trends in the likelihood of receiving percutaneous coronary intervention in a low-volume hospital and disparities by sociodemographic communities. PLOS ONE 2023, 18: e0279905. PMID: 36652416, PMCID: PMC9847957, DOI: 10.1371/journal.pone.0279905.Peer-Reviewed Original ResearchConceptsLow-volume hospitalsNon-Latinx WhitesRelative riskSociodemographic groupsLow-income zip codesHospital PCI volumeRetrospective cohort studyPercutaneous coronary interventionCoronary artery diseaseLow-volume centersFavorable patient outcomesLow-volume facilitiesZip code median incomeLow incomeRace/ethnicityCohort studyCoronary interventionLatinx patientsSecondary outcomesArtery diseasePCI centerPrimary outcomePCI volumeAsian patientsCertain socioeconomic factors
2022
Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High–risk Pulmonary Embolism
Sadeghipour P, Jenab Y, Moosavi J, Hosseini K, Mohebbi B, Hosseinsabet A, Chatterjee S, Pouraliakbar H, Shirani S, Shishehbor MH, Alizadehasl A, Farrashi M, Rezvani MA, Rafiee F, Jalali A, Rashedi S, Shafe O, Giri J, Monreal M, Jimenez D, Lang I, Maleki M, Goldhaber SZ, Krumholz HM, Piazza G, Bikdeli B. Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High–risk Pulmonary Embolism. JAMA Cardiology 2022, 7: 1189-1197. PMID: 36260302, PMCID: PMC9582964, DOI: 10.1001/jamacardio.2022.3591.Peer-Reviewed Original ResearchConceptsConventional catheter-directed thrombolysisRV/LV ratioRisk pulmonary embolismCatheter-directed thrombolysisProportion of patientsPulmonary embolismLV ratioMajor bleedingPrimary outcomeRight ventricleClinical trialsIntermediate-high risk pulmonary embolismDefinitive clinical outcome trialsMain safety outcomeMajor gastrointestinal bleedingRV/LVClinical events committeeClinical outcome trialsLarge cardiovascular centresCause mortalityEfficacy outcomesGastrointestinal bleedingMonotherapy groupOutcome trialsSecondary outcomesEffectiveness of a clinical decision support system for hypertension management in primary care: study protocol for a pragmatic cluster-randomized controlled trial
Song J, Wang X, Wang B, Gao Y, Liu J, Zhang H, Li X, Li J, Wang JG, Cai J, Herrin J, Armitage J, Krumholz HM, Zheng X. Effectiveness of a clinical decision support system for hypertension management in primary care: study protocol for a pragmatic cluster-randomized controlled trial. Trials 2022, 23: 412. PMID: 35578345, PMCID: PMC9109449, DOI: 10.1186/s13063-022-06374-x.Peer-Reviewed Original ResearchConceptsHypertension managementPrimary carePrimary outcomeDual antihypertensive therapyHypertension Treatment TrialBlood pressure managementGuideline-based treatmentPrimary care sitesCluster-randomized trialUnit of randomizationGuideline-based decision support systemClinical decision support systemAntihypertensive regimensAntihypertensive treatmentUsual careGuideline adherenceBlood pressureMiddle-income countriesTreatment trialsManagement visitsStudy protocolCare sitesPatientsTrialsPressure managementInstitutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Ngo L, Ali A, Ganesan A, Woodman R, Krumholz HM, Adams R, Ranasinghe I. Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e022009. PMID: 35156395, PMCID: PMC9245833, DOI: 10.1161/jaha.121.022009.Peer-Reviewed Original ResearchConceptsProcedure-related complicationsComplication rateAF ablationAtrial fibrillationCatheter ablationStroke/transient ischemic attackCare qualityTransient ischemic attackRisk of complicationsIschemic attackHospital stayCohort studyCommon complicationHospital dischargePericardial effusionCardiorespiratory failurePrimary outcomeProcedural characteristicsComplicationsPatientsHospitalStudy periodBackground ComplicationsPotential disparitiesFibrillation
2021
Prior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction
Ozaki AF, Krumholz HM, Mody FV, Tran TT, Le QT, Yokota M, Jackevicius CA. Prior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007665. PMID: 34465124, DOI: 10.1161/circoutcomes.120.007665.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanSacubitril/valsartan useInsurance plan typeReduced ejection fractionHeart failureEjection fractionValsartan useCommercial plansNew York Heart Association classPA criteriaReduced ejection fraction patientsReduced ejection fraction populationPlan typeEjection fraction patientsMedicare plansEjection fraction populationCross-sectional studyProportion of plansPrescription copaymentsAssociation classCopayment amountPrimary outcomeClinical outcomesPlan populationMore prescriptionsThe association of neighborhood walkability with health outcomes in older adults after acute myocardial infarction: The SILVER-AMI study
Roy B, Hajduk AM, Tsang S, Geda M, Riley C, Krumholz HM, Chaudhry SI. The association of neighborhood walkability with health outcomes in older adults after acute myocardial infarction: The SILVER-AMI study. Preventive Medicine Reports 2021, 23: 101391. PMID: 34040930, PMCID: PMC8141908, DOI: 10.1016/j.pmedr.2021.101391.Peer-Reviewed Original ResearchAcute myocardial infarctionSILVER-AMI StudyPhysical activityMental healthMyocardial infarctionNeighborhood walkabilityOlder adultsHealth outcomesSocial supportCommunity-Living AdultsSecondary outcomesCoronary diseasePrimary outcomeSF-12Longitudinal cohortPhysical therapyAdjusted modelSurvival timeBetter outcomesGreater walkabilitySurvival analysisMobility limitationsPhysical healthOutcomesAdultsEffect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit
Mazloomzadeh S, Khaleghparast S, Ghadrdoost B, Mousavizadeh M, Baay M, Noohi F, Sharifnia H, Ahmadi A, Tavan S, Malekpour Alamdari N, Fathi M, Soleimanzadeh M, Mostafa M, Davoody N, Zarinsadaf M, Tayyebi S, Farrokhzadeh F, Nezamabadi F, Soomari E, Sadeghipour P, Talasaz A, Rashidi F, Sharif-Kashani B, Beigmohammadi M, Farrokhpour M, Sezavar S, Payandemehr P, Dabbagh A, Moghadam K, Jamalkhani S, Khalili H, Yadollahzadeh M, Riahi T, Rezaeifar P, Tahamtan O, Matin S, Abedini A, Lookzadeh S, Rahmani H, Zoghi E, Mohammadi K, Sadeghipour P, Abri H, Tabrizi S, Mousavian S, Shahmirzaei S, Bakhshandeh H, Amin A, Rafiee F, Baghizadeh E, Mohebbi B, Parhizgar S, Aliannejad R, Eslami V, Kashefizadeh A, Kakavand H, Hosseini S, Shafaghi S, Ghazi S, Najafi A, Jimenez D, Gupta A, Madhavan M, Sethi S, Parikh S, Monreal M, Hadavand N, Hajighasemi A, Maleki M, Sadeghian S, Piazza G, Kirtane A, Van Tassell B, Dobesh P, Stone G, Lip G, Krumholz H, Goldhaber S, Bikdeli B. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit. JAMA 2021, 325: 1620-1630. PMID: 33734299, PMCID: PMC7974835, DOI: 10.1001/jama.2021.4152.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsCOVID-19Drug Administration ScheduleEnoxaparinExtracorporeal Membrane OxygenationFemaleHemorrhageHospitalizationHumansIntensive Care UnitsIranLength of StayMaleMiddle AgedOdds RatioOutcome Assessment, Health CareOxygen Inhalation TherapyPulmonary EmbolismThrombocytopeniaThrombosisTreatment OutcomeVenous ThrombosisConceptsStandard-dose prophylactic anticoagulationIntensive care unitIntermediate-dose groupProphylactic anticoagulationPrimary efficacy outcomeExtracorporeal membrane oxygenationIntermediate doseMajor bleedingProphylaxis groupEfficacy outcomesMembrane oxygenationPrimary outcomeThrombotic eventsArterial thrombosisCare unitSevere thrombocytopeniaCOVID-19Bleeding Academic Research ConsortiumExtracorporeal membrane oxygenation treatmentPrespecified safety outcomesRoutine empirical useStandard prophylactic anticoagulationAcademic Research ConsortiumMembrane oxygenation treatmentAntithrombotic prophylaxisClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
McPadden J, Warner F, Young HP, Hurley NC, Pulk RA, Singh A, Durant TJS, Gong G, Desai N, Haimovich A, Taylor RA, Gunel M, Dela Cruz CS, Farhadian SF, Siner J, Villanueva M, Churchwell K, Hsiao A, Torre CJ, Velazquez EJ, Herbst RS, Iwasaki A, Ko AI, Mortazavi BJ, Krumholz HM, Schulz WL. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection. PLOS ONE 2021, 16: e0243291. PMID: 33788846, PMCID: PMC8011821, DOI: 10.1371/journal.pone.0243291.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionYale New Haven HealthSARS-CoV-2Hospital mortalityRisk of admissionMale sexRisk factorsSARS-CoV-2 testingInvasive mechanical ventilationSevere acute respiratory syndrome virusBurden of diseaseRT-PCR testingAcademic health systemDiverse patient populationsRespiratory syndrome virusEthnic groupsAdult patientsClinical characteristicsDischarge dispositionRespiratory supportPrimary outcomeTreatment guidelinesMechanical ventilationRetrospective studyPatient population
2020
Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand
Labrosciano C, Horton D, Air T, Tavella R, Beltrame JF, Zeitz CJ, Krumholz HM, Adams R, Scott IA, Gallagher M, Hossain S, Hariharaputhiran S, Ranasinghe I. Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand. European Journal Of Heart Failure 2020, 23: 31-40. PMID: 33094886, DOI: 10.1002/ejhf.2030.Peer-Reviewed Original ResearchConceptsHF hospitalisationUnplanned readmissionReadmission ratesHeart failure hospitalisationUnplanned readmission rateMortality cohortReadmission cohortCause mortalityHeart failurePrimary outcomeHospitalisationReadmissionSeparate cohortMortality rateHospitalPatientsMortalityCare qualityPrivate hospitalsStudy periodCohortModest declineNational averageOutcomesDaysTrends 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 subgroupsRevascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceClinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction
Jackevicius CA, Krumholz HM, Ross JS, Koh M, Chong A, Austin PC, Stukel TA, Azizi P, Ko DT. Clinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction. Canadian Journal Of Cardiology 2020, 36: 1633-1640. PMID: 32416066, DOI: 10.1016/j.cjca.2020.01.024.Peer-Reviewed Original ResearchConceptsPrior myocardial infarctionMyocardial infarctionStable patientsPopulation-based observational studyAngina 1 yearDeath/hospitalizationHistory of revascularisationBeta-blocker useMajor cardiovascular eventsHospital discharge diagnosisUse of BBsIndividual end pointsContemporary clinical trialsYears of ageCardiovascular eventsIndex dateCohort studyComposite outcomeBB useHeart failureMedian agePrimary outcomeClinical outcomesAtrial fibrillationDischarge diagnosisReadmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure
Ko DT, Khera R, Lau G, Qiu F, Wang Y, Austin PC, Koh M, Lin Z, Lee DS, Wijeysundera HC, Krumholz HM. Readmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure. Journal Of The American College Of Cardiology 2020, 75: 736-746. PMID: 32081282, DOI: 10.1016/j.jacc.2019.12.026.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-discharge mortalityHospital mortalityReadmission ratesHospitalization ratesMyocardial infarctionMortality rateRisk-adjusted mortality ratesHospital Readmissions Reduction ProgramHF hospitalization ratesHeart failure hospitalizationPatients 65 yearsReadmissions Reduction ProgramFailure hospitalizationHF patientsSecondary outcomesHospital readmissionPrimary outcomeReadmissionMortalityAMI hospitalization ratesStudy periodPattern of outcomesHospitalizationOutcomes
2019
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states
Roy B, Riley C, Herrin J, Spatz E, Hamar B, Kell KP, Rula EY, Krumholz H. Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states. BMJ Open 2019, 9: e030017. PMID: 31780588, PMCID: PMC6886944, DOI: 10.1136/bmjopen-2019-030017.Peer-Reviewed Original ResearchConceptsHospitalisation ratesZip codesPrimary care physician densityCross-sectional study SETTINGCancer-related admissionsRespiratory-related admissionsCross-sectional studyQuality of lifeRace/ethnicityCause hospitalisationSecondary outcomesPrimary outcomeHighest quintileUnnecessary hospitalisationAdmission ratesSD increaseHospitalisationLife benefitsPhysician densityStudy settingMain independent variableBeing IndexHospital bedsAdmissionGallup-Sharecare WellP573Effects of mobile text messaging on glycemic control in patients with coronary heart disease and diabetes mellitus: a randomized controlled trial
Huo X, Krumholz H, Bai X, Spatz E, Ding Q, Horak P, Zhao W, Gong Q, Yan X, Wu X, Li J, Li X, Spertus J, Masoudi F, Zheng X. P573Effects of mobile text messaging on glycemic control in patients with coronary heart disease and diabetes mellitus: a randomized controlled trial. European Heart Journal 2019, 40: ehz747.0184. DOI: 10.1093/eurheartj/ehz747.0184.Peer-Reviewed Original ResearchCoronary heart diseaseIntervention groupPhysical activityControl groupGlycemic controlHeart diseaseBaseline 6 monthsHigh-risk patientsText messaging programsSecondary outcome analysisMobile health interventionsText message programMean change differenceBP controlGlycemic hemoglobinHbA1c levelsLifestyle modificationUsual careDiabetes mellitusFamily Planning CommissionPrimary outcomeLifestyle recommendationsMonth followRisk factorsClinical trialsEffects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus
Huo X, Krumholz HM, Bai X, Spatz ES, Ding Q, Horak P, Zhao W, Gong Q, Zhang H, Yan X, Sun Y, Liu J, Wu X, Guan W, Wang X, Li J, Li X, Spertus JA, Masoudi FA, Zheng X. Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005805. PMID: 31474119, DOI: 10.1161/circoutcomes.119.005805.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBiomarkersBlood GlucoseChinaCoronary DiseaseCulturally Competent CareDiabetes MellitusExerciseFemaleGlycated HemoglobinHealth CommunicationHealthy LifestyleHumansHypoglycemic AgentsMaleMedication AdherenceMiddle AgedMotivationPatient Education as TopicRisk Reduction BehaviorSelf CareSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseHeart diseaseGlycemic controlIntervention groupUsual careDiabetes mellitusBlood glucosePhysical activityControl groupText message-based interventionBlood pressure controlProportion of patientsRisk factor managementGood glycemic controlSystolic blood pressureBody mass indexText messaging programsText message interventionMobile health interventionsSecondary outcomesBlood pressurePrimary outcomeLDL cholesterolMass indexMedication adherence