Featured Publications
Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials
Oikonomou EK, Spatz ES, Suchard MA, Khera R. Individualising intensive systolic blood pressure reduction in hypertension using computational trial phenomaps and machine learning: a post-hoc analysis of randomised clinical trials. The Lancet Digital Health 2022, 4: e796-e805. PMID: 36307193, PMCID: PMC9768739, DOI: 10.1016/s2589-7500(22)00170-4.Peer-Reviewed Original ResearchConceptsSystolic blood pressure controlBlood pressure controlIntensive systolic blood pressure controlType 2 diabetesPressure controlCardiovascular benefitsClinical trialsMajor adverse cardiovascular eventsFirst major adverse cardiovascular eventLarge randomised clinical trialsACCORD-BP trialAdverse cardiovascular eventsRandomised clinical trialsSystolic blood pressureCox regression analysisTreatment effectsHazard ratio estimatesACCORD-BPBP trialCardiovascular eventsBlood pressurePrimary outcomeStandard treatmentBaseline variablesIndex patients
2024
Comparative 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, 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 temperatureMeasures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US
Wang SY, Valero-Elizondo J, Cainzos-Achirica M, Desai NR, Nasir K, Khera R. Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US. JAMA Health Forum 2022, 3: e221962. PMID: 35977226, PMCID: PMC9308060, DOI: 10.1001/jamahealthforum.2022.1962.Peer-Reviewed Original ResearchConceptsFinancial hardshipFinancial burdenPocket medical expensesMedical Expenditure Panel SurveyHealth care expensesHigher incomePanel SurveyHealth careCare expensesFinancial consequencesHealth care costsForgone carePublic insuranceMedical billsSubstantial financial burdenMedical expensesIncomeDisparate measuresHardshipCare costsRepresentative surveySubjective measuresComprehensive frameworkExpenseInsuranceSex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults
Lu Y, Li SX, Liu Y, Rodriguez F, Watson KE, Dreyer RP, Khera R, Murugiah K, D’Onofrio G, Spatz ES, Nasir K, Masoudi FA, Krumholz HM. Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Network Open 2022, 5: e229953. PMID: 35503221, PMCID: PMC9066284, DOI: 10.1001/jamanetworkopen.2022.9953.Peer-Reviewed Original ResearchConceptsFirst acute myocardial infarctionAcute myocardial infarctionPsychosocial risk factorsRisk factor profilePopulation attributable fractionRisk factor associationsRisk factorsOdds ratioYoung womenAMI subtypesMyocardial infarctionPrevention of AMIType 1 acute myocardial infarctionFactor profileRisk of AMITraditional cardiovascular risk factorsSex-specific risk factorsFactor associationsYoung adultsRisk factor modificationCardiovascular risk factorsStrong associationNutrition Examination SurveyCase-control studyPopulation-based controlsDepression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience)
Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Lu Y, Spatz ES, Gupta A, Khera R, Ng VG, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Depression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience). The American Journal Of Cardiology 2022, 173: 33-38. PMID: 35365290, PMCID: PMC9133198, DOI: 10.1016/j.amjcard.2022.03.005.Peer-Reviewed Original ResearchConceptsSpontaneous coronary artery dissectionPatient Health Questionnaire-9Coronary artery dissectionPSS-14 scoreArtery dissectionBaseline PHQ-9 scoreAcute myocardial infarction patientsCardiovascular risk factorsPHQ-9 scoresAcute myocardial infarctionMyocardial infarction patientsYears of agePerceived Stress Scale scoresStress Scale scoresLinear mixed-effects analysisSCAD casesVIRGO StudyQuestionnaire-9Infarction patientsMixed-effects analysisMyocardial infarctionSubgroup analysisRisk factorsRoutine screeningClinical acuityHealth status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience
Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Khera R, Lu Y, Spatz ES, Ng VG, Gupta A, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Health status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience. PLOS ONE 2022, 17: e0265624. PMID: 35320296, PMCID: PMC8942215, DOI: 10.1371/journal.pone.0265624.Peer-Reviewed Original ResearchConceptsSpontaneous coronary artery dissectionAcute myocardial infarctionAMI patientsCoronary artery dissectionYoung AMI patientsHealth status outcomesHealth status instrumentsSCAD patientsArtery dissectionMyocardial infarctionStatus outcomesPatientsOutcomesHousehold incomeCollege educationInfarctionPhenomapping-Derived Tool to Individualize the Effect of Canagliflozin on Cardiovascular Risk in Type 2 Diabetes.
Oikonomou EK, Suchard MA, McGuire DK, Khera R. Phenomapping-Derived Tool to Individualize the Effect of Canagliflozin on Cardiovascular Risk in Type 2 Diabetes. Diabetes Care 2022, 45: 965-974. PMID: 35120199, PMCID: PMC9016734, DOI: 10.2337/dc21-1765.Peer-Reviewed Original ResearchConceptsCanagliflozin Cardiovascular Assessment StudyMajor adverse cardiovascular eventsType 2 diabetesHazard ratioSodium-glucose cotransporter 2 inhibitorsCardiovascular disease benefitAdverse cardiovascular eventsCotransporter 2 inhibitorsEffects of canagliflozinCanagliflozin dosesCanagliflozin's effectsCardiovascular eventsCardiovascular riskPatients 5Cardioprotective effectsSGLT2 inhibitorsDisease benefitBaseline variablesOriginal trialCanagliflozinType 2DiabetesPatientsRisk estimatesEffect estimatesCost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018.
Taha MB, Valero-Elizondo J, Yahya T, Caraballo C, Khera R, Patel KV, Ali HJR, Sharma G, Mossialos E, Cainzos-Achirica M, Nasir K. Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018. Diabetes Care 2022, 45: 594-603. PMID: 35015860, DOI: 10.2337/dc21-1757.Peer-Reviewed Original ResearchConceptsCost-related medication nonadherenceNational Health Interview SurveyLack of insuranceMedication nonadherenceNational Health Interview Survey 2013Duration of diabetesHigher comorbidity burdenSelf-reported diabetesHealth Interview SurveyWorse health outcomesHealth-related expendituresComorbidity burdenInsulin useCurrent smokingLess medicationMedication adherenceFemale sexWeighted prevalenceHigher oddsAge subgroupsSkipping dosesDiabetesHealth outcomesElderly adultsNHIS participants
2021
Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries
Fudim M, Zhong L, Patel KV, Khera R, Abdelmalek MF, Diehl AM, McGarrah RW, Molinger J, Moylan CA, Rao VN, Wegermann K, Neeland IJ, Halm EA, Das SR, Pandey A. Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries. Journal Of The American Heart Association 2021, 10: e021654. PMID: 34755544, PMCID: PMC8751938, DOI: 10.1161/jaha.121.021654.Peer-Reviewed Original ResearchConceptsNonalcoholic fatty liver diseaseIncident heart failureReduced ejection fractionFatty liver diseaseHeart failureEjection fractionMedicare beneficiariesHF subtypesLiver diseaseHigh riskBackground Nonalcoholic fatty liver diseaseBaseline NAFLDAssociation of NAFLDNew-onset heart failureConclusions PatientsCohort studyPrior diagnosisBlack patientsNinth RevisionKidney diseaseOutpatient claimsRisk factorsIndependent associationHigh burdenMedicare patientsScope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data
Murugiah K, Chen L, Castro-Dominguez Y, Khera R, Krumholz HM. Scope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data. The American Journal Of Cardiology 2021, 160: 40-45. PMID: 34610872, DOI: 10.1016/j.amjcard.2021.08.041.Peer-Reviewed Original ResearchFinancial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States
Lago‐Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States. Hepatology 2021, 74: 1509-1522. PMID: 33772833, DOI: 10.1002/hep.31835.Peer-Reviewed Original ResearchConceptsChronic liver diseaseScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsRepeated cross-sectional analysis of hydroxychloroquine deimplementation in the AHA COVID-19 CVD Registry
Bradley SM, Emmons-Bell S, Mutharasan RK, Rodriguez F, Gupta D, Roth G, Gluckman TJ, Shah RU, Wang TY, Khera R, Peterson PN, Das S. Repeated cross-sectional analysis of hydroxychloroquine deimplementation in the AHA COVID-19 CVD Registry. Scientific Reports 2021, 11: 15097. PMID: 34302004, PMCID: PMC8302649, DOI: 10.1038/s41598-021-94203-7.Peer-Reviewed Original ResearchConceptsCOVID-19Use of hydroxychloroquineActive COVID-19Cross-sectional analysisRandomized trialsIneffective therapyNational registryMedian useClinical careClinical informationDeimplementationU.S. hospitalsOverall proportionLittle dataHydroxychloroquineFurther studiesPatientsRegistryTherapyHospitalTrialsCareCost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases
Lago-Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Cost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases. Mayo Clinic Proceedings 2021, 96: 2639-2650. PMID: 34120754, PMCID: PMC8492496, DOI: 10.1016/j.mayocp.2021.02.026.Peer-Reviewed Original Research