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 ResearchCardiac magnetic resonance markers of pre-clinical hypertrophic and dilated cardiomyopathy in genetic variant carriers
Croon P, van Vugt M, Allaart C, Ruijsink B, Elliott P, Asselbergs F, Khera R, Bezzina C, Winter M, Schmidt A. Cardiac magnetic resonance markers of pre-clinical hypertrophic and dilated cardiomyopathy in genetic variant carriers. BMC Medicine 2025, 23: 421. PMID: 40660250, PMCID: PMC12261545, DOI: 10.1186/s12916-025-04226-4.Peer-Reviewed Original ResearchConceptsCardiac magnetic resonance imagingCardiac magnetic resonance imaging measuresCardiac magnetic resonance markersDilated CardiomyopathyHypertrophic cardiomyopathyHeart failureUK Biobank participantsAtrial fibrillationLeft ventricular (LV) ejection fractionMitral annular plane systolic excursionAnnular plane systolic excursionLV) ejection fractionFunctional cardiac abnormalitiesEnd-systolic volumeCardiac risk factorsCardiomyopathy-associated variantsAssociated with incident AFAssociated with TTNIncident atrial fibrillationLV-ESVIMagnetic resonance imagingRV-ESVRV EFGenetic variant carriersSystolic excursionComputational Phenomapping of Randomized Clinical Trial Participants to Enable Assessment of Their Real-World Representativeness and Personalized Inference
Thangaraj P, Oikonomou E, Dhingra L, Aminorroaya A, Jayaram R, Suchard M, Khera R. Computational Phenomapping of Randomized Clinical Trial Participants to Enable Assessment of Their Real-World Representativeness and Personalized Inference. Circulation Cardiovascular Quality And Outcomes 2025, 18: e011306. PMID: 40261065, PMCID: PMC12203226, DOI: 10.1161/circoutcomes.124.011306.Peer-Reviewed Original ResearchConceptsElectronic health record patientElectronic health recordsDistance metricRandomized clinical trialsElectronic health record dataMachine learning methodsYale New Haven Health SystemElectronic health record cohortRandomized clinical trial participantsLearning methodsHeart failureClinical trial participationTOPCAT participantsReal worldMultidimensional metricRCT participantsHealth recordsTreatment effectsHealth systemCharacteristics of patientsRandomized clinical trial cohortsTrial participantsMetricsUnited StatesNovel statisticEnsemble 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 cohortUso da Inteligência Artificial Aplicada ao Eletrocardiograma para Diagnóstico de Disfunção Sistólica Ventricular Esquerda
de Santana W, Pinto M, Barreto S, Foppa M, Giatti L, Khera R, Ribeiro A. Uso da Inteligência Artificial Aplicada ao Eletrocardiograma para Diagnóstico de Disfunção Sistólica Ventricular Esquerda. Arquivos Brasileiros De Cardiologia 2025, 122: e20240740. PMID: 40396866, PMCID: PMC12108124, DOI: 10.36660/abc.20240740.Peer-Reviewed Original ResearchConceptsLeft ventricular systolic dysfunctionLeft ventricular ejection fractionNegative predictive valueDiagnostic odds ratioPositive predictive valueHeart failureDetect left-ventricular systolic dysfunctionPredictive valueVentricular systolic dysfunctionVentricular ejection fractionNegative likelihood ratioPositive likelihood ratioDiagnostic accuracy cross-sectional studyLikelihood ratioCross-sectional studySystolic dysfunctionEjection fractionEvaluating HFAUC-ROCElectrocardiographic alterationsOdds ratioEchocardiogramROC curveScreening toolElectrocardiogramEffects of Tirzepatide in Type 2 Diabetes Individual Variation and Relationship to Cardiometabolic Outcomes
Aminorroaya A, Oikonomou E, Biswas D, Jastreboff A, Khera R. Effects of Tirzepatide in Type 2 Diabetes Individual Variation and Relationship to Cardiometabolic Outcomes. Journal Of The American College Of Cardiology 2025, 85: 1858-1872. PMID: 40368575, PMCID: PMC12186526, DOI: 10.1016/j.jacc.2025.03.516.Peer-Reviewed Original ResearchConceptsElevated body mass indexCardiometabolic abnormalitiesBody mass indexOdds of elevated body mass indexType 2 diabetesIndividual Participant Data Meta-AnalysisMass indexParticipant data meta-analysisOdds of MetSCardiometabolic risk factorsComponents of metabolic syndromeData Meta-AnalysisHigh-density lipoprotein cholesterolCardiometabolic healthStudy design differencesMixed-effects modelsBaseline usePhase 3 randomized clinical trialSodium-glucose cotransporter 2 inhibitorsOddsStudy outcomesEffects of tirzepatideMeta-analysisRisk factorsClinical subpopulationsArtificial 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 approachEvaluation of a Machine Learning-Guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems
Aminorroaya A, Dhingra L, Oikonomou E, Khera R. Evaluation of a Machine Learning-Guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems. Circulation Genomic And Precision Medicine 2025, 18: e004632. PMID: 39846171, PMCID: PMC11835527, DOI: 10.1161/circgen.124.004632.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemHealth systemVanderbilt University Medical CenterHealth system electronic health recordUniversity Medical CenterCoronary Artery Risk DevelopmentMulti-Ethnic Study of AtherosclerosisElectronic health recordsMedical CenterUS health systemHealth system patientsAssociated with significantly higher oddsMulti-Ethnic StudyUS-based cohortStudy of atherosclerosisSignificantly higher oddsHealth recordsUK BiobankAtherosclerosis RiskRisk DevelopmentHigher oddsElevated Lp(aUniversal screeningSystem patientsStudy cohort
2024
Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study
McIntyre D, Quintans D, Kazi S, Min H, He W, Marschner S, Khera R, Nassar N, Chow C. Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study. BMC Health Services Research 2024, 24: 1364. PMID: 39516863, PMCID: PMC11545568, DOI: 10.1186/s12913-024-11840-0.Peer-Reviewed Original ResearchConceptsHeart failure careNew South WalesHospital admissionHealth service utilisationAdministrative health recordsPrimary diagnosis of heart failureData cohort studyRate of admissionPre-pandemicHealth of patientsSouth WalesCOVID-19 pandemicHospital utilisationService utilisationHealth recordsED presentationsMortality dataDiagnosis of heart failureCOVID-19 burdenEmergency departmentCohort studyPrimary diagnosisData collectionCareAustralian dataNatural 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 groupsRacial 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 ageCause-Specific Mortality Rates Among the US Black Population
Arun A, Caraballo C, Sawano M, Lu Y, Khera R, Yancy C, Krumholz H. Cause-Specific Mortality Rates Among the US Black Population. JAMA Network Open 2024, 7: e2436402. PMID: 39348122, PMCID: PMC11443349, DOI: 10.1001/jamanetworkopen.2024.36402.Commentaries, Editorials and LettersComparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM
Khera R, Aminorroaya A, Dhingra L, Thangaraj P, Pedroso Camargos A, Bu F, Ding X, Nishimura A, Anand T, Arshad F, Blacketer C, Chai Y, Chattopadhyay S, Cook M, Dorr D, Duarte-Salles T, DuVall S, Falconer T, French T, Hanchrow E, Kaur G, Lau W, Li J, Li K, Liu Y, Lu Y, Man K, Matheny M, Mathioudakis N, McLeggon J, McLemore M, Minty E, Morales D, Nagy P, Ostropolets A, Pistillo A, Phan T, Pratt N, Reyes C, Richter L, Ross J, Ruan E, Seager S, Simon K, Viernes B, Yang J, Yin C, You S, Zhou J, Ryan P, Schuemie M, Krumholz H, Hripcsak G, Suchard M. Comparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes A Multinational, Federated Analysis of LEGEND-T2DM. Journal Of The American College Of Cardiology 2024, 84: 904-917. PMID: 39197980, PMCID: PMC12045554, DOI: 10.1016/j.jacc.2024.05.069.Peer-Reviewed Original ResearchConceptsGLP-1 RAsSecond-line agentsGLP-1Antihyperglycemic agentsCardiovascular diseaseMACE riskGlucagon-like peptide-1 receptor agonistsSodium-glucose cotransporter 2 inhibitorsPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsEffects of SGLT2isType 2 diabetes mellitusPeptidase-4 inhibitorsAdverse cardiovascular eventsCox proportional hazards modelsRandom-effects meta-analysisCardiovascular risk reductionTarget trial emulationProportional hazards modelPerformance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study
Camargos A, Barreto S, Brant L, Ribeiro A, Dhingra L, Aminorroaya A, Bittencourt M, Figueiredo R, Khera R. Performance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study. Open Heart 2024, 11: e002762. PMID: 38862252, PMCID: PMC11168182, DOI: 10.1136/openhrt-2024-002762.Peer-Reviewed Original ResearchConceptsPooled Cohort EquationsELSA-BrasilRisk scoreCardiovascular diseaseCVD eventsCommunity-based cohort studyArea under the receiver operating characteristic curveCVD risk scoreELSA-Brasil studyIncident CVD eventsMiddle-income countriesAdjudicated CVD eventsCardiovascular disease riskCVD scoreCohort EquationsNational guidelinesRisk stratification scoresWhite womenAge/sex groupsCohort studyProspective cohortLMICsSex/race groupsHigher incomeRisk discrimination
2023
Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020
Dhingra L, Aminorroaya A, Oikonomou E, Nargesi A, Wilson F, Krumholz H, Khera R. Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020. JAMA Network Open 2023, 6: e2316634. PMID: 37285157, PMCID: PMC10248745, DOI: 10.1001/jamanetworkopen.2023.16634.Peer-Reviewed Original ResearchConceptsHealth Information National Trends SurveyUS adultsExacerbate disparitiesWearable device usersCardiovascular diseaseCardiovascular healthPopulation-based cross-sectional studySelf-reported cardiovascular diseaseCardiovascular disease risk factorsNational Trends SurveyOverall US adult populationCardiovascular risk factor profileSelf-reported accessAssociated with lower useUse of wearable devicesImprove cardiovascular healthLower household incomeLower educational attainmentUS adult populationRisk factor profileNationally Representative SampleCross-sectional studyProportion of adultsTrends SurveyWearable device dataSex 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. hospitalsWomenInfarctionOutcomesNonexercise machine learning models for maximal oxygen uptake prediction in national population surveys.
Liu Y, Herrin J, Huang C, Khera R, Dhingra L, Dong W, Mortazavi B, Krumholz H, Lu Y. Nonexercise machine learning models for maximal oxygen uptake prediction in national population surveys. Journal Of The American Medical Informatics Association 2023, 30: 943-952. PMID: 36905605, PMCID: PMC10114129, DOI: 10.1093/jamia/ocad035.Peer-Reviewed Original ResearchQuantifying 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 models
2022
Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest
Wheelock K, Chan P, Chen L, de Lemos J, Miller P, Nallamothu B, Girotra S, Khera R. Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest. Resuscitation 2022, 182: 109650. PMID: 36442596, PMCID: PMC9885789, DOI: 10.1016/j.resuscitation.2022.11.016.Peer-Reviewed Original ResearchConceptsFavorable neurologic outcomeHospital cardiac arrestTherapeutic rangeNeurologic outcomeOverall survivalTemperature managementCardiac arrestFavorable neurologic survivalFavorable neurological outcomeRetrospective cohort studyTargeted temperature managementHigh therapeutic rangeRisk-adjusted analysisComatose survivorsNeurologic survivalNeurological outcomeCohort studyHospital dischargeMedian durationMedian timeCurrent guidelinesCompression trialTreatment targetsSignificant associationGoal temperature
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