2025
Coronary Artery Disease–Based Polygenic Risk Score in Early-Onset Acute Myocardial Infarction Subtypes
Dong W, Lu Y, Li S, Sawano M, Caraballo C, Liu Y, Khera A, Philippakis A, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Herrington D, Post W, Rich S, Rotter J, Krumholz H. Coronary Artery Disease–Based Polygenic Risk Score in Early-Onset Acute Myocardial Infarction Subtypes. JACC Advances 2025, 4: 101994. PMID: 40712269, PMCID: PMC12311502, DOI: 10.1016/j.jacadv.2025.101994.Peer-Reviewed Original ResearchAcute myocardial infarction subtypePolygenic risk scoresAcute myocardial infarctionRisk of acute myocardial infarctionRisk scoreCoronary artery diseaseAssociated with acute myocardial infarctionEstimated riskAssociated with higher riskAssociated with MIAcute myocardial infarction patientsMultinomial logistic regressionArtery diseaseNonobstructive coronary artery diseaseLogistic regressionFemale-to-male ratioYoung adultsCox regressionHigh riskInfarction subtypesYoung individualsMyocardial infarctionEarly-onsetScoresSexJoint Exposure to Ozone and Temperature and Acute Myocardial Infarction Among Adults Aged 18 to 64 Years in the United States
Chu L, Wang R, Gross C, Wei J, Lu Y, Krumholz H, Ma X, Chen K. Joint Exposure to Ozone and Temperature and Acute Myocardial Infarction Among Adults Aged 18 to 64 Years in the United States. Circulation 2025, 152: 246-256. PMID: 40458867, PMCID: PMC12303734, DOI: 10.1161/circulationaha.124.073614.Peer-Reviewed Original ResearchIncident acute myocardial infarctionAcute myocardial infarctionIncreased oddsRisk of acute myocardial infarctionHigher risk of acute myocardial infarctionProbability of acute myocardial infarctionOccurrence of acute myocardial infarctionRandom-effects meta-analysisCase-crossover studyMultivariate random-effects meta-analysisExposure to ozoneRegion-specific estimatesMyocardial infarctionStatistical interaction termsAmbient ozone pollutionPrevention strategiesUnited StatesJoint exposureMeta-analysisAdult ageYoung adultsHigh riskAdultsOddsInteraction termsFloods and cause-specific mortality in the United States applying a triply robust approach
Chu L, Warren J, Spatz E, Lowe S, Lu Y, Ma X, Ross J, Krumholz H, Chen K. Floods and cause-specific mortality in the United States applying a triply robust approach. Nature Communications 2025, 16: 2853. PMID: 40122917, PMCID: PMC11930965, DOI: 10.1038/s41467-025-58236-0.Peer-Reviewed Original ResearchConceptsCDC's National Center for Health StatisticsNational Center for Health StatisticsCause-specific mortality ratesCenter for Health StatisticsCause-specific mortalityHealth impacts of floodingExcess all-cause deathsLong-term health risksFlood daysLong-term associationDeath recordsHealth StatisticsConfounder adjustmentExternal causesStorm Events DatabaseAll-cause deathHealth impactsImpact of floodsPropensity scorePost‐flood yearMortality rateMyocardial infarctionPost-floodContiguous U.S.Respiratory diseaseDepression and Low Social Support Mediate the Association of Marital Stress and 12-Month Cardiac-Specific Quality of Life in Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D’Onofrio G, Pilote L, Lichtman J. Depression and Low Social Support Mediate the Association of Marital Stress and 12-Month Cardiac-Specific Quality of Life in Young Adults With Acute Myocardial Infarction. Biopsychosocial Science And Medicine 2025, 87: 129-137. PMID: 39909011, DOI: 10.1097/psy.0000000000001363.Peer-Reviewed Original ResearchConceptsLow social supportCardiac-specific quality of lifeNatural direct effectSocial supportMonths post-AMIQuality of lifeAcute myocardial infarctionMarital stressComprehensive secondary preventive strategySignificant depressive symptomsPost-AMISecondary prevention strategiesYoung adultsMyocardial infarctionSociodemographic factorsDepressive symptomsAMI survivorsCovariate adjustmentPrevention strategiesSelf-ReportContinuous scoresQoLBaseline QOLCategorical depressionDepressionDirect oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.
Jenab Y, Sadeghipour P, Mohseni-Badalabadi R, Kaviani R, Hosseini K, Pasebani Y, Khederlou H, Rafati A, Mohammadi Z, Jamalkhani S, Talasaz A, Firouzi A, Ariannejad H, Alemzadeh-Ansari M, Ahmadi-Renani S, Maadani M, Farrashi M, Bakhshandeh H, Piazza G, Krumholz H, Mehran R, Lip G, Bikdeli B. Direct oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials. EuroIntervention 2025, 21: 82-92. PMID: 39773831, PMCID: PMC11684328, DOI: 10.4244/eij-d-24-00527.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionLeft ventricular thrombusLeft ventricular thrombus resolutionRandomised clinical trialsPooled analysisVentricular thrombusTreatment of left ventricular thrombusTwo-dimensional transthoracic echocardiographyMyocardial infarctionDirect oral anticoagulantsImaging core laboratoryWarfarin-based anticoagulationMeta-analysis of randomised trialsTransthoracic echocardiographyOpen-labelOral anticoagulantsBleeding eventsAdult patientsDOACsCore laboratoryWarfarinClinical trialsRandomised trialsPatientsBleeding
2024
Health status outcomes after acute myocardial infarction in patients without standard modifiable risk factors
Ikemura N, Chan P, Gosch K, Nguyen D, Iv C, Khan M, Lu Y, Sawano M, Krumholz H, Spertus J. Health status outcomes after acute myocardial infarction in patients without standard modifiable risk factors. American Heart Journal 2024, 281: 123-132. PMID: 39638274, PMCID: PMC11810589, DOI: 10.1016/j.ahj.2024.11.018.Peer-Reviewed Original ResearchSeattle Angina QuestionnaireModifiable risk factorsHealth status outcomesBaseline SAQ scoresAcute myocardial infarctionStatus outcomesHealth statusRisk factorsSequential adjustmentSAQ scoresModifiable cardiovascular risk factorsHistory of coronary diseaseSAQ Summary ScoreHierarchical linear mixed modelsAcute myocardial infarction patientsCardiovascular risk factorsMyocardial infarctionSummary scoreSociodemographic characteristicsAngina QuestionnaireLinear mixed modelsDepressive symptomsU.S. hospitalsLong-term mortalitySecondary preventionFibrinolytic Agents in Thromboembolic Diseases: Historical Perspectives and Approved Indications
Rashedi S, Greason C, Sadeghipour P, Talasaz A, O'Donoghue M, Jimenez D, Monreal M, Anderson C, Elkind M, Kreuziger L, Lang I, Goldhaber S, Konstantinides S, Piazza G, Krumholz H, Braunwald E, Bikdeli B. Fibrinolytic Agents in Thromboembolic Diseases: Historical Perspectives and Approved Indications. Seminars In Thrombosis And Hemostasis 2024, 50: 773-789. PMID: 38428841, DOI: 10.1055/s-0044-1781451.Peer-Reviewed Original ResearchST-segment elevation myocardial infarctionTissue plasminogen activatorFood and Drug AdministrationFibrinolytic agentsThromboembolic diseasePlasminogen activatorFood and Drug Administration approvalArterial thromboembolic eventsElevation myocardial infarctionCentral venous access device occlusionPlasma half-lifeU.S. Food and Drug AdministrationAcute ischemic strokePulmonary embolismThromboembolic eventsHemodynamic compromiseDevice occlusionTreated patientsRecanalize occluded vesselsActive protease plasminDrug AdministrationMyocardial infarctionApproved indicationsOccluded vesselIschemic strokeAssociation of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputation
2023
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System
Akioyamen L, Abdel-Qadir H, Han L, Sud M, Mistry N, Alter D, Atzema C, Austin P, Bhatia R, Booth G, Dhalla I, Ha A, Jackevicius C, Kapral M, Krumholz H, Lee D, McNaughton C, Roifman I, Schull M, Sivaswamy A, Tu K, Udell J, Wijeysundera H, Ko D. Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System. Circulation Cardiovascular Quality And Outcomes 2023, 16: e010063. PMID: 38050754, DOI: 10.1161/circoutcomes.123.010063.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHealth care systemHospital dischargeClinical outcomesSocioeconomic statusFirst acute myocardial infarctionProportional hazards regression modelsCare systemSecondary prevention medicationsWorse clinical outcomesHealth service usePopulation-based studyPrimary care physiciansHealth care useHazards regression modelsGreater long-term riskPrescription medication useSingle-payer health care systemUniversal health care systemLong-term riskLow socioeconomic statusCause mortalityDays postdischargePrevention medicationsClinical Phenotyping with an Outcomes-driven Mixture of Experts for Patient Matching and Risk Estimation
Hurley N, Dhruva S, Desai N, Ross J, Ngufor C, Masoudi F, Krumholz H, Mortazavi B. Clinical Phenotyping with an Outcomes-driven Mixture of Experts for Patient Matching and Risk Estimation. ACM Transactions On Computing For Healthcare 2023, 4: 1-18. PMID: 37908872, PMCID: PMC10613929, DOI: 10.1145/3616021.Peer-Reviewed Original ResearchSex‐Specific Associations of Obstructive Sleep Apnea Risk With Patient Characteristics and Functional Outcomes After Acute Myocardial Infarction: Evidence From the VIRGO Study
Gupta A, Barthel A, Mahajan S, Dreyer R, Yaggi H, Bueno H, Lichtman J, Krumholz H. Sex‐Specific Associations of Obstructive Sleep Apnea Risk With Patient Characteristics and Functional Outcomes After Acute Myocardial Infarction: Evidence From the VIRGO Study. Journal Of The American Heart Association 2023, 12: e027225. PMID: 37702090, PMCID: PMC10547292, DOI: 10.1161/jaha.122.027225.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaAcute myocardial infarctionHigh OSA riskOSA riskSex-specific associationsFunctional outcomeHealth statusHigh riskVIRGO StudyMyocardial infarctionDepressive symptomsHistory of OSATime of AMIImpact of OSAObstructive sleep apnea riskLow-risk patientsSleep apnea riskMajority of patientsTime of presentationSex-specific outcomesWorse health statusHigh-risk menPoor health statusMental health statusPoor health outcomesImpact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Impact of Marital Stress on 1‐Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2023, 12: e030031. PMID: 37589125, PMCID: PMC10547344, DOI: 10.1161/jaha.123.030031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac-specific qualityGeneric health statusMyocardial infarctionBaseline healthMarital stressHealth outcomesHealth statusWorse patient-reported outcomesMental healthYoung adultsObservational cohort studyPatient-reported outcomesSocioeconomic factorsWorse mental healthReadmission 1Cause readmissionCohort studyYounger patientsRoutine screeningDepressive symptomsGreater oddsAnginaMale participantsOutcomesImpact of Sex‐ and Gender‐Related Factors on Length of Stay Following Non–ST‐Segment–Elevation Myocardial Infarction: A Multicountry Analysis
Bender U, Norris C, Dreyer R, Krumholz H, Raparelli V, Pilote L. Impact of Sex‐ and Gender‐Related Factors on Length of Stay Following Non–ST‐Segment–Elevation Myocardial Infarction: A Multicountry Analysis. Journal Of The American Heart Association 2023, 12: e028553. PMID: 37489737, PMCID: PMC10492965, DOI: 10.1161/jaha.122.028553.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionMyocardial infarctionGender-related factorsLonger LOSSegment elevation myocardial infarction diagnosisConclusions Older ageObservational cohort studyAdverse clinical outcomesAdjusted multivariable modelAcute myocardial infarctionLength of stayImpact of sexHealth care expendituresGENESIS-PRAXYHospital lengthNon–STCause mortalityCohort studyIndependent predictorsMyocardial infarction diagnosisClinical outcomesShorter LOSMedical historyMultivariable modelUnivariate associationsAssociation 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 heartDo PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets?
Shen Y, Krumholz H, Hsia R. Do PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets? JACC Cardiovascular Interventions 2023, 16: 1129-1140. PMID: 37225284, PMCID: PMC10229059, DOI: 10.1016/j.jcin.2023.02.010.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionPCI hospitalsSame-day percutaneous coronary interventionHealth outcomesHigh-volume PCI hospitalsHospital PCI volumeRetrospective cohort studyAcute myocardial infarctionPercentage point decreasePatient health outcomesHospital revascularizationCohort studyCoronary interventionAMI outcomesPCI volumePoint decreasePoor outcomePCI facilitiesMyocardial infarctionRelative increaseHospital openingPatientsHospital availabilityHospitalHospital closuresSex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesSex 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
2022
Temporal trends in postoperative and ventilator-associated pneumonia in the United States
Metersky M, Wang Y, Klompas M, Eckenrode S, Mathew J, Krumholz H. Temporal trends in postoperative and ventilator-associated pneumonia in the United States. Infection Control And Hospital Epidemiology 2022, 44: 1247-1254. PMID: 36326283, DOI: 10.1017/ice.2022.264.Peer-Reviewed Original ResearchConceptsVentilator-associated pneumoniaMajor surgical proceduresPostoperative pneumoniaAcute myocardial infarctionSurgical proceduresHeart failureMyocardial infarctionMedicare Patient Safety Monitoring SystemAnnual riskRetrospective cohort studyPrior yearRisk-adjusted ratesAdverse event measuresCohort studyRetrospective reviewPneumoniaPatientsInfarctionUnited StatesRiskSignificant changesYearsTemporal trendsFailureTrends in Adverse Event Rates in Hospitalized Patients, 2010-2019
Eldridge N, Wang Y, Metersky M, Eckenrode S, Mathew J, Sonnenfeld N, Perdue-Puli J, Hunt D, Brady PJ, McGann P, Grace E, Rodrick D, Drye E, Krumholz HM. Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019. JAMA 2022, 328: 173-183. PMID: 35819424, PMCID: PMC9277501, DOI: 10.1001/jama.2022.9600.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAdultAgedAged, 80 and overCross InfectionCross-Sectional StudiesDrug-Related Side Effects and Adverse ReactionsFemaleHeart FailureHospitalizationHumansMaleMedicareMiddle AgedMyocardial InfarctionPatient SafetyPneumoniaPostoperative ComplicationsPressure UlcerRisk AssessmentSurgical Procedures, OperativeUnited StatesConceptsMajor surgical proceduresAcute myocardial infarctionAdverse event ratesGeneral adverse eventsAdverse eventsHeart failureAdverse drug eventsAcute care hospitalsMyocardial infarctionHospital-acquired infectionsSurgical proceduresEvent ratesHospital dischargeCare hospitalDrug eventsMedicare Patient Safety Monitoring SystemSerial cross-sectional studyPatient safetyUS acute care hospitalsHospital adverse eventsSignificant decreaseSurgical procedure groupsCross-sectional studyRisk-adjusted ratesAdult patientsTrends 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
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