2025
Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide
Lu Y, Liu Y, Totojani T, Kim C, Khera R, Xu H, Brush J, Krumholz H, Abaluck J. Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide. JAMA Network Open 2025, 8: e2526013. PMID: 40779264, PMCID: PMC12334959, DOI: 10.1001/jamanetworkopen.2025.26013.Peer-Reviewed Original ResearchConceptsHealth care expendituresCardiovascular risk factorsCare expendituresCohort studyRisk factorsYale New Haven Health SystemCohort study of adultsType 2 diabetes statusLong-term impactStudy of adultsHealth systemRetrospective cohort studyBlood pressureHemoglobin A1c reductionMain OutcomesTotal cholesterolSentara HealthcareInpatient staySecondary outcomesGlucagon-like peptide-1 receptor agonistsPrimary outcomeHealthPeptide-1 receptor agonistsAssociated with clinical outcomesAssociated with reductionsDelayed Hypertension Diagnosis and Its Association With Cardiovascular Treatment and Outcomes
Lu Y, Brush J, Kim C, Liu Y, Xin X, Huang C, Sawano M, Young P, McPadden J, Anderson M, Burrows J, Asher J, Krumholz H. Delayed Hypertension Diagnosis and Its Association With Cardiovascular Treatment and Outcomes. JAMA Network Open 2025, 8: e2520498. PMID: 40658418, PMCID: PMC12261005, DOI: 10.1001/jamanetworkopen.2025.20498.Peer-Reviewed Original ResearchConceptsElectronic health recordsHypertension diagnosisIntegrated health care systemHazard ratioNon-Hispanic black raceAntihypertensive medication prescribingMedication prescription ratesClinical diagnosis of hypertensionHealth care systemCardiovascular outcomesRisk of myocardial infarctionCox proportional hazards regression modelsAssociated with younger ageOutpatient blood pressureBlood pressureCardiovascular riskProportional hazards regression modelsAntihypertensive medication prescriptionsDiagnosis of hypertensionMultivariate Cox proportional hazards regression modelsAssociated with delayHazards regression modelsMedication prescribingHealth recordsNon-HispanicMarginalized Neighborhoods and Health Outcomes in Younger Myocardial Infarction Survivors
Akioyamen L, Sivaswamy A, Haldenby O, Abdel-Qadir H, Sud M, Alter D, Atzema C, Austin P, Jackevicius C, Kapral M, Krumholz H, Tu K, Wijeysundera H, Ko D. Marginalized Neighborhoods and Health Outcomes in Younger Myocardial Infarction Survivors. JAMA Network Open 2025, 8: e2518826. PMID: 40601315, PMCID: PMC12223890, DOI: 10.1001/jamanetworkopen.2025.18826.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionAMI survivorsUniversal health care systemCohort studyMarginalized neighborhoodsHealth service utilizationPopulation-based retrospective cohortPrimary care physiciansHealth care systemUniversal health careNeighbourhood marginalizationAdjusted hazard ratiosMyocardial infarction survivorsProportional hazards regression modelsAcute myocardial infarction patientsYears of follow-upNeighbourhood quintilesHazards regression modelsCare physiciansService utilizationHealth outcomesHealth careCare systemAdministrative databasesNeighborhood characteristicsArtificial intelligence-guided detection of under-recognised cardiomyopathies on point-of-care cardiac ultrasonography: a multicentre study
Oikonomou E, Vaid A, Holste G, Coppi A, McNamara R, Baloescu C, Krumholz H, Wang Z, Apakama D, Nadkarni G, Khera R. Artificial intelligence-guided detection of under-recognised cardiomyopathies on point-of-care cardiac ultrasonography: a multicentre study. The Lancet Digital Health 2025, 7: e113-e123. PMID: 39890242, PMCID: PMC12084816, DOI: 10.1016/s2589-7500(24)00249-8.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemPoint-of-care ultrasonographyMount Sinai Health SystemTransthyretin amyloid cardiomyopathyArtificial intelligenceHealth systemAmyloid cardiomyopathyHypertrophic cardiomyopathyRetrospective cohort of individualsCardiomyopathy casesTesting artificial intelligenceConvolutional neural networkSinai Health SystemCohort of individualsOpportunistic screeningHypertrophic cardiomyopathy casesMulti-labelPositive screenAI frameworkEmergency departmentMortality riskNeural networkLoss functionCardiac ultrasonographyAugmentation approach
2024
Lipid‐Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity
Gordon-Kundu B, Peyravi R, Garg A, Baker A, Salas S, Levien M, Faridi K, de Havenon A, Krumholz H, Sheth K, Forman R, Sharma R. Lipid‐Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity. Journal Of The American Heart Association 2024, 14: e033365. PMID: 39699007, PMCID: PMC12054410, DOI: 10.1161/jaha.123.033365.Peer-Reviewed Original ResearchConceptsPrescribed lipid-lowering therapyNational Institutes of Health Stroke Scale scoreAcute ischemic strokeLipid-Lowering TherapyStroke Scale scoreStroke severityGuidelines-Stroke registryAtherosclerotic cardiovascular disease eventsCardiovascular disease eventsScale scoreGuideline-recommended criteriaSevere stroke symptomsStudy assessed usePropensity score subclassificationLipid-lowering therapy useNational InstituteLogistic regression modelsCholesterol management guidelinesPoststroke disabilityElevated low-density lipoprotein cholesterolInstitutional GetSmall vessel diseaseTime of acute ischemic strokeLarge-artery atherosclerosisLow-density lipoprotein cholesterolEarly Warning Scores With and Without Artificial Intelligence
Edelson D, Churpek M, Carey K, Lin Z, Huang C, Siner J, Johnson J, Krumholz H, Rhodes D. Early Warning Scores With and Without Artificial Intelligence. JAMA Network Open 2024, 7: e2438986. PMID: 39405061, PMCID: PMC11544488, DOI: 10.1001/jamanetworkopen.2024.38986.Peer-Reviewed Original ResearchConceptsEarly Warning ScoreWarning ScoreCohort studyYale New Haven Health SystemClinical deterioration eventsHigh-risk thresholdHealth systemRetrospective cohort studyPatient encountersDeteriorating patientsOverall PPVMain OutcomesInpatient encountersEDI scoresHospital encountersDeterioration eventsClinical deteriorationIntensive care unitEarly warning toolCare unitDecision support toolArtificial intelligenceScoresReceiver operating characteristic curveNEWS2Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks
Lu Y, Keeley E, Barrette E, Cooper-DeHoff R, Dhruva S, Gaffney J, Gamble G, Handke B, Huang C, Krumholz H, McDonough C, Schulz W, Shaw K, Smith M, Woodard J, Young P, Ervin K, Ross J. Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks. BMC Cardiovascular Disorders 2024, 24: 497. PMID: 39289597, PMCID: PMC11409735, DOI: 10.1186/s12872-024-04161-x.Peer-Reviewed Original ResearchConceptsElectronic health recordsHealth recordsHealth systemUncontrolled hypertensionUse of electronic health recordsHypertension managementElectronic health record systemsOneFlorida Clinical Research ConsortiumElectronic health record dataYale New Haven Health SystemBP measurementsICD-10-CM codesHealth system networkPublic health priorityICD-10-CMIncidence rate of deathElevated BP measurementsElevated blood pressure measurementsHealthcare visitsAmbulatory careHealth priorityRetrospective cohort studyEHR dataOneFloridaBlood pressure measurements
2023
Prevalence of covid-19 and long covid in collegiate student athletes from spring 2020 to fall 2021: a retrospective survey
Massey D, Saydah S, Adamson B, Lincoln A, Aukerman D, Berke E, Sikka R, Krumholz H. Prevalence of covid-19 and long covid in collegiate student athletes from spring 2020 to fall 2021: a retrospective survey. BMC Infectious Diseases 2023, 23: 876. PMID: 38093182, PMCID: PMC10717379, DOI: 10.1186/s12879-023-08801-z.Peer-Reviewed Original ResearchMeSH KeywordsAthletesCOVID-19HumansPost-Acute COVID-19 SyndromePrevalenceRetrospective StudiesSARS-CoV-2StudentsUnited StatesConceptsLong COVIDCOVID-19SARS-CoV-2 infectionPost-acute sequelaeSymptomatic COVID-19SARS-CoV-2Student athletesPost-COVID conditionsMental health consequencesHealthy athletesCollegiate Student-AthletesHealthy peopleRetrospective surveyMore weeksHealth consequencesPrevalenceConclusionsThis studyConvenience sampleFall 2020College athletesFurther studiesAthletesCOVIDSpring 2020Relevant time periodShort- and longer-term all-cause mortality among SARS-CoV-2- infected individuals and the pull-forward phenomenon in Qatar: a national cohort study
Chemaitelly H, Faust J, Krumholz H, Ayoub H, Tang P, Coyle P, Yassine H, Al Thani A, Al-Khatib H, Hasan M, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal A, Latif A, Shaik R, Abdul-Rahim H, Nasrallah G, Al-Kuwari M, Butt A, Al-Romaihi H, Al-Thani M, Al-Khal A, Bertollini R, Abu-Raddad L. Short- and longer-term all-cause mortality among SARS-CoV-2- infected individuals and the pull-forward phenomenon in Qatar: a national cohort study. International Journal Of Infectious Diseases 2023, 136: 81-90. PMID: 37717648, DOI: 10.1016/j.ijid.2023.09.005.Peer-Reviewed Original ResearchConceptsAdjusted hazard ratioPrimary infection cohortCause mortalityCohort studyPrimary infectionMortality incidencePrimary SARS-CoV-2 infectionSARS-CoV-2-infected individualsCox proportional hazards regression modelSARS-CoV-2 infectionProportional hazards regression modelsRetrospective cohort studySevere COVID-19Cause mortality riskNational cohort studyCOVID-19 mortalityInfection cohortHazard ratioUnvaccinated personsVaccination statusVaccinated personsMortality riskVulnerable personsAccelerated onsetCohortDo 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 ResearchMeSH KeywordsHospitalizationHospitals, High-VolumeHumansPercutaneous Coronary InterventionRetrospective StudiesTreatment OutcomeConceptsPercutaneous 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 closuresReclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression
Cho I, Kim W, Kim S, Ko K, Seong Y, Kim D, Seo J, Shim C, Ha J, Mori M, Gupta A, You S, Hong G, Krumholz H. Reclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression. Scientific Reports 2023, 13: 6694. PMID: 37095171, PMCID: PMC10125992, DOI: 10.1038/s41598-023-33683-1.Peer-Reviewed Original ResearchConceptsRapid progression groupModerate aortic stenosisAortic valve replacementSlow progression groupAortic stenosisProgression groupHemodynamic progressionRapid progressionMore rapid progressionLatent class trajectory modelingTransthoracic echocardiography studyBetween-group differencesData-driven phenotypingPressure gradient measurementAVR ratesModerate ASCause mortalityValve replacementEchocardiography studyAtrial fibrillationTTE studiesEchocardiographic dataRisk factorsPredictive valuePatientsQuantifying 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 ResearchMeSH KeywordsAdolescentAdultBlood PressureBlood Pressure DeterminationFemaleHumansHypertensionMaleMiddle AgedRetrospective StudiesRisk FactorsConceptsRetrospective 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 modelsTrends 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 ResearchMeSH KeywordsEthnicityHospitals, Low-VolumeHumansMedicaidPercutaneous Coronary InterventionRetrospective StudiesUnited StatesConceptsLow-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
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 ResearchMeSH KeywordsAgedHeart FailureHumansMedicareMyocardial InfarctionPneumoniaPneumonia, Ventilator-AssociatedRetrospective StudiesUnited StatesConceptsVentilator-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 trendsFailureHospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study
Yu Y, Guan W, Masoudi FA, Wang B, He G, Spertus JA, Lu Y, Krumholz HM, Li J. Hospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2022, 11: e026300. PMID: 36172964, PMCID: PMC9673705, DOI: 10.1161/jaha.122.026300.Peer-Reviewed Original ResearchConceptsSpironolactone prescriptionSpironolactone useHeart failureMedian odds ratioIdeal patientAldosterone antagonistsHospital variationMedian rateReduced ejection fractionUse of spironolactoneMultivariable linear regression modelsHeart Failure StudyEjection fractionHospital characteristicsOdds ratioRepresentative cohortPatientsHospitalChinese hospitalsInappropriate usePrescriptionSpironolactoneSelect individualsAntagonistHigh rateSex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535-e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchMeSH KeywordsAspirinChinaFemaleHealthcare DisparitiesHumansMaleNon-ST Elevated Myocardial InfarctionRetrospective StudiesSex CharacteristicsTime FactorsTreatment OutcomeConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomenPhysical Activity Among Patients With Intracardiac Remote Monitoring Devices Before, During, and After COVID-19–Related Restrictions
Lu Y, Jones PW, Murugiah K, Caraballo C, Massey DS, Mahajan S, Ahmed R, Bader EM, Krumholz HM. Physical Activity Among Patients With Intracardiac Remote Monitoring Devices Before, During, and After COVID-19–Related Restrictions. Journal Of The American College Of Cardiology 2022, 79: 309-310. PMID: 35057917, PMCID: PMC8763290, DOI: 10.1016/j.jacc.2021.11.010.Peer-Reviewed Original Research
2021
Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries
Wheelock KM, Ross JS, Murugiah K, Lin Z, Krumholz HM, Khera R. Clinician Trends in Prescribing Direct Oral Anticoagulants for US Medicare Beneficiaries. JAMA Network Open 2021, 4: e2137288. PMID: 34870678, PMCID: PMC8649845, DOI: 10.1001/jamanetworkopen.2021.37288.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAtrial FibrillationFactor Xa InhibitorsHumansMedicarePractice Patterns, Physicians'Retrospective StudiesTime FactorsUnited StatesWarfarinConceptsDOAC useAnticoagulant prescriptionOral anticoagulantsUS cliniciansMedicare beneficiariesNational clinical practice guidelinesElevated bleeding riskOral anticoagulant prescriptionsRetrospective cohort studyDirect oral anticoagulantsClinical practice guidelinesUS Medicare beneficiariesInternal medicine physiciansNumber of cliniciansAnticoagulant prescribingDOAC prescriptionsUnique cliniciansBleeding riskCohort studyAnticoagulant strategiesPrescription claimsPractice guidelinesMAIN OUTCOMEMost indicationsMedicare populationTrends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States
Mori M, Gupta A, Wang Y, Vahl T, Nazif T, Kirtane AJ, George I, Yong CM, Onuma O, Kodali S, Geirsson A, Leon MB, Krumholz HM. Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. Journal Of The American College Of Cardiology 2021, 78: 2161-2172. PMID: 34823659, DOI: 10.1016/j.jacc.2021.09.855.Peer-Reviewed Original ResearchVariations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospital
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