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 reductionsIdentification of hypertrophic cardiomyopathy on electrocardiographic images with deep learning
Sangha V, Dhingra L, Aminorroaya A, Croon P, Sikand N, Sen S, Martinez M, Maron M, Krumholz H, Asselbergs F, Oikonomou E, Khera R. Identification of hypertrophic cardiomyopathy on electrocardiographic images with deep learning. Nature Cardiovascular Research 2025, 4: 991-1000. PMID: 40696040, DOI: 10.1038/s44161-025-00685-3.Peer-Reviewed Original ResearchHypertension Prevalence, Awareness, and Control in US Adults Before and After the COVID‐19 Pandemic
Essa M, Malik D, Lu Y, Yang H, Spatz E, Krumholz H, Faridi K. Hypertension Prevalence, Awareness, and Control in US Adults Before and After the COVID‐19 Pandemic. Journal Of Clinical Hypertension 2025, 27: e70093. PMID: 40685707, PMCID: PMC12277530, DOI: 10.1111/jch.70093.Peer-Reviewed Original ResearchConceptsHypertension prevalencePrevalence ratiosUS adultsAge-standardized prevalence estimatesAggressive public health effortsPublic health effortsPre-pandemicControl of hypertensionCOVID-19 pandemicHypertension awarenessHealth effortsPoisson regressionImpact of hypertensionPost-pandemicPrevalence estimatesNHANES dataNationwide prevalenceCause of deathUnited StatesBlood pressure controlNational trendsPrevalenceCOVID-19AdultsHypertensionDelayed 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 characteristicsImprovements in Cardiometabolic Risk Factors by Weight Reduction: A Post Hoc Analysis of Adults With Obesity Randomly Assigned to Tirzepatide.
Linetzky B, Sattar N, Verma S, Krumholz H, Xie C, Hoffmann H, Zimner-Rapuch S, Torcello-Gómez A, Stefanski A. Improvements in Cardiometabolic Risk Factors by Weight Reduction: A Post Hoc Analysis of Adults With Obesity Randomly Assigned to Tirzepatide. Annals Of Internal Medicine 2025, 178: 1095-1105. PMID: 40550133, DOI: 10.7326/annals-24-02623.Peer-Reviewed Original ResearchConceptsCardiometabolic risk factorsBaseline to weekHemoglobin A1cHomeostatic model assessmentDiastolic blood pressureRisk factorsBlood pressureHemoglobin AWaist circumferenceHOMA-IRHigh-density lipoprotein (HDL) cholesterolMean body mass indexHomeostatic model assessment of insulin resistanceModel assessment of insulin resistanceWeight reductionAssessment of insulin resistanceLow-density lipoprotein cholesterolWeight-related complicationsDegree of weight reductionEvaluation of cardiovascular outcomesNon-HDL cholesterolBody mass indexLevels of triglyceridesSystolic blood pressurePost Hoc AnalysisTrends and Key Factors Associated With Racial and Ethnic Differences in Life’s Essential 8 Scores
Yang H, Huang C, Sawano M, Herrin J, Faridi K, Li Z, Spatz E, Krumholz H, Lu Y. Trends and Key Factors Associated With Racial and Ethnic Differences in Life’s Essential 8 Scores. JAMA Network Open 2025, 8: e2516663. PMID: 40531529, PMCID: PMC12177675, DOI: 10.1001/jamanetworkopen.2025.16663.Peer-Reviewed Original ResearchConceptsLife's Essential 8 scoreLife's Essential 8Cross-sectional studyWhite differencesEthnic differencesNational Health and Nutrition Examination SurveyHealth and Nutrition Examination SurveySleep health scoreNutrition Examination SurveyGroup-specific interventionsPrimary positive factorPhysical activityExamination SurveyHealth scoresBlack adultsWhite adultsMain OutcomesAsian adultsOverall scoreEvaluate trendsNicotine exposureEssential 8Blood lipidsAdultsEthnic groups10-Year and 30-Year Risks of Cardiovascular Disease in the U.S. Population
Faridi K, Malik D, Essa M, Yang H, Spatz E, Krumholz H, Lu Y. 10-Year and 30-Year Risks of Cardiovascular Disease in the U.S. Population. Journal Of The American College Of Cardiology 2025, 85: 2239-2249. PMID: 40499978, DOI: 10.1016/j.jacc.2025.03.546.Peer-Reviewed Original ResearchConceptsRisk of cardiovascular diseaseAtherosclerotic CVDU.S. adultsU.S. populationHispanic adultsCardiovascular diseaseCVD riskLong-term riskNational Health and Nutrition Examination SurveyHealth and Nutrition Examination SurveyRisk of atherosclerotic CVDElevated 10-year riskLong-term risk of cardiovascular diseaseAdults aged >Nutrition Examination SurveyTotal cardiovascular diseaseRisk factor profileRisk of total cardiovascular diseaseSurvey-weighted prevalenceMiddle-aged adultsPrevent Cardiovascular DiseaseHeart failureExamination SurveyAge-standardizedBlack adultsEnsemble Deep Learning Algorithm for Structural Heart Disease Screening Using Electrocardiographic Images PRESENT SHD
Dhingra L, Aminorroaya A, Sangha V, Pedroso A, Shankar S, Coppi A, Foppa M, Brant L, Barreto S, Ribeiro A, Krumholz H, Oikonomou E, Khera R. Ensemble Deep Learning Algorithm for Structural Heart Disease Screening Using Electrocardiographic Images PRESENT SHD. Journal Of The American College Of Cardiology 2025, 85: 1302-1313. PMID: 40139886, PMCID: PMC12199746, DOI: 10.1016/j.jacc.2025.01.030.Peer-Reviewed Original ResearchConceptsStructural heart diseaseYale-New Haven HospitalTransthoracic echocardiogramRisk stratificationHeart failureLeft-sided valvular diseaseSevere left ventricular hypertrophyLeft ventricular ejection fractionReceiver-operating characteristic curveVentricular ejection fractionLeft ventricular hypertrophyHeart disease screeningELSA-BrasilEnsemble deep learning algorithmRisk of deathConvolutional neural network modelEjection fractionEnsemble deep learning approachVentricular hypertrophyDeep learning algorithmsNew Haven HospitalDeep learning approachValvular diseaseNeural network modelClinical cohortFloods 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 diseaseArtificial 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 approachDepression 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 depressionDepressionA failure to launch: blood pressure control after stroke in a regional health system
Forman R, Xin X, Kim C, Kernan W, Sheth K, Krumholz H, de Havenon A, Spatz E, Lu Y. A failure to launch: blood pressure control after stroke in a regional health system. Journal Of Hypertension 2025, 43: 715-718. PMID: 39995224, PMCID: PMC12046530, DOI: 10.1097/hjh.0000000000003961.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemRegional health systemHealth systemSystolic blood pressureDiastolic blood pressureMonths post strokeAverage proportion of patientsBP controlPost strokeBlood pressureProfessional visitsPrimary outcomeBlood pressure controlProportion of patientsAverage proportionVisitsSBP valuesEpic systemPressure controlStrokePatientsGlobal budgetDirect 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
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 cholesterolHospital COVID-19 Burden and Adverse Event Rates
Metersky M, Rodrick D, Ho S, Galusha D, Timashenka A, Grace E, Marshall D, Eckenrode S, Krumholz H. Hospital COVID-19 Burden and Adverse Event Rates. JAMA Network Open 2024, 7: e2442936. PMID: 39495512, PMCID: PMC11581512, DOI: 10.1001/jamanetworkopen.2024.42936.Peer-Reviewed Original ResearchConceptsCOVID-19 burdenHospital admissionPatient safetyRelative riskCohort studyStudy of hospital admissionsAcute care hospitalsRisk-adjustment variablesRisk-adjusted ratesMedicare hospital admissionsCOVID-19 pandemicStaffing shortagesHospital characteristicsMain OutcomesHospital resilienceSurge capacityMedicare patientsCare hospitalHighest burdenPrevent declinesPatient admissionsStudy sampleElixhauser comorbiditiesCOVID-19Low burdenNatural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure
Adejumo P, Thangaraj P, Dhingra L, Aminorroaya A, Zhou X, Brandt C, Xu H, Krumholz H, Khera R. Natural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure. JAMA Network Open 2024, 7: e2443925. PMID: 39509128, PMCID: PMC11544492, DOI: 10.1001/jamanetworkopen.2024.43925.Peer-Reviewed Original ResearchConceptsFunctional status assessmentArea under the receiver operating characteristic curveClinical documentationElectronic health record dataHF symptomsOptimal care deliveryHealth record dataAssess functional statusStatus assessmentClinical trial participationProcessing of clinical documentsFunctional status groupCare deliveryOutpatient careMain OutcomesMedical notesTrial participantsNew York Heart AssociationFunctional statusQuality improvementRecord dataHeart failureClinical notesDiagnostic studiesStatus groupsEarly 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 curveNEWS2Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-Cause MortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageLong-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States
Ma Y, Zang E, Liu Y, Wei J, Lu Y, Krumholz H, Bell M, Chen K. Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States. Proceedings Of The National Academy Of Sciences Of The United States Of America 2024, 121: e2403960121. PMID: 39316057, PMCID: PMC11459178, DOI: 10.1073/pnas.2403960121.Peer-Reviewed Original ResearchConceptsWildland firesContiguous United StatesNonaccidental mortalityExposure to ambient fine particlesSmoke PMWildland fire smokeMoving average concentrationsAmbient fine particlesLong-term exposureAverage concentrationSmoke PMHealth risksFine particlesFire smokeTemporal confoundingHealth effectsKidney disease mortalityChronic kidney disease mortalityPublic health actionFireMortality rateUnited StatesDisease mortalityHealth actionsMortality outcomes
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