Journal articleContemp Clin Trials · March 2026
As the availability of real-world data has expanded in recent years, studies leveraging external controls (ECs) have emerged as potential alternatives to conventional randomized controlled trials (RCTs). While RCTs remain the gold standard for estimating t ...
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Journal articleStat Methods Med Res · October 2023
Evaluating causal effects of an intervention in pre-specified subgroups is a standard goal in comparative effectiveness research. Despite recent advancements in causal subgroup analysis, research on time-to-event outcomes has been lacking. This article inv ...
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Journal articleAm J Obstet Gynecol · September 2023
BACKGROUND: Few studies have directly compared different surgical procedures for uterine fibroids with respect to long-term health-related quality of life outcomes and symptom improvement. OBJECTIVE: We examined differences in change from baseline to 1-, 2 ...
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Journal articleJAMA Netw Open · April 3, 2023
IMPORTANCE: Limited effective therapeutics are available to hospitalized patients with COVID-19. Clinical trials and observational studies have shown varying effects of systemic corticosteroids, including dexamethasone, in hospitalized patients with COVID- ...
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Journal articleJ Womens Health (Larchmt) · April 2023
Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or u ...
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Journal articlePLoS One · 2023
IMPORTANCE: The COVID-19 pandemic stressed the healthcare field, resulting in a worker exodus at the onset and throughout the pandemic and straining healthcare systems. Female healthcare workers face unique challenges that may impact job satisfaction and r ...
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Journal articlePLoS One · 2023
Little is known about the mental health consequences of the COVID-19 pandemic in healthcare workers (HCWs). Past literature has shown that chronic strain caused by pandemics can adversely impact a variety of mental health outcomes in HCWs. There is growing ...
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Journal articleEpidemiol Methods · January 2023
OBJECTIVES: Propensity score (PS) weighting methods are commonly used to adjust for confounding in observational treatment comparisons. However, in the setting of substantial covariate imbalance, PS values may approach 0 and 1, yielding extreme weights and ...
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Journal articleNurs Res · November 2022
BACKGROUND: Nursing professional organizations and media sources indicated early in the pandemic that the physical and psychological effects of COVID-19 might be distinct and possibly greater in nurses than in other types of healthcare workers (HCWs). OBJE ...
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Journal articleHeart Rhythm · August 2022
BACKGROUND: The etiology of atrial fibrillation (AF) is multifactorial and incompletely understood. OBJECTIVE: The purpose of this study was to evaluate the association between coronary artery disease (CAD) affecting atrial tissue and AF. METHODS: Patients ...
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Journal articleJAMA Cardiol · July 1, 2022
IMPORTANCE: Data are limited regarding the risk of cerebrovascular ischemic events and major bleeding in patients with atrial fibrillation (AF) and recent acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). OBJECTIVE: Determine t ...
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Journal articleJ Am Heart Assoc · June 21, 2022
BACKGROUND: There are limited data on the use of angiotensin receptor neprilysin inhibitors (ARNIs) in minority populations with heart failure (HF) with reduced ejection fraction. We used data from the CHAMP-HF (Change the Management of Patients With Heart ...
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Journal articlePediatrics · June 1, 2022
OBJECTIVES: Over 6 million pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have occurred in the United States, but risk factors for infection remain poorly defined. We sought to evaluate the association between asthma and ...
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Journal articleAm J Epidemiol · May 20, 2022
The inverse probability of treatment weighting (IPTW) approach is popular for evaluating causal effects in observational studies, but extreme propensity scores could bias the estimator and induce excessive variance. Recently, the overlap weighting approach ...
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Journal articleFertil Steril · May 2022
OBJECTIVE: To assess prospectively the association between the myomectomy route and fertility. DESIGN: Prospective cohort study. SETTING: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight cli ...
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Journal articleEur J Heart Fail · May 2022
AIMS: We assessed for an association between improvements in left ventricular ejection fraction (LVEF) and future outcomes, including health status, in routine clinical practice. METHODS AND RESULTS: CHAMP-HF was a registry of outpatients with heart failur ...
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Journal articleJ Card Fail · March 2022
BACKGROUND: The comparative effectiveness of differing dosages of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) on clinical and patient-reported outcomes in clinical practice in the United States is unkn ...
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Journal articleEClinicalMedicine · March 2022
BACKGROUND: The extent to which healthcare worker (HCWs) experiences during the COVID-19 pandemic vary by race or ethnicity after adjustment for confounding factors is not currently known. METHODS: We performed an observational prospective cohort study of ...
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Journal articleR Journal · March 1, 2022
Propensity score weighting is an important tool for comparative effectiveness research. Besides the inverse probability of treatment weights (IPW), recent development has introduced a general class of balancing weights, corresponding to alternative target ...
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Journal articleJ Am Coll Cardiol · February 8, 2022
BACKGROUND: The use of apixaban instead of vitamin K antagonists (VKA) as well as dropping aspirin results in less bleeding and comparable ischemic events in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary interve ...
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Journal articleJ Card Fail · February 2022
BACKGROUND: Clinical practice guidelines support sustained use of renin-angiotensin-aldosterone-system (RAAS) inhibitors over time in heart failure with reduced ejection fraction, yet few data are available regarding the frequency, timing or predictors of ...
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Journal articleESC Heart Fail · February 2022
AIMS: We aimed to develop a risk prediction tool that incorporated both clinical events and worsening health status for patients with heart failure (HF) with reduced ejection fraction (HFrEF). Identifying patients with HFrEF at increased risk of a poor out ...
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Journal articleAm Heart J · January 2022
Randomized controlled trials (RCTs) are considered the gold standard for estimating the effectiveness of a treatment. However, in many instances they are impractical to conduct because of time limitations, cost restrictions, or ethical reasons. As a conseq ...
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Journal articleCirc Cardiovasc Interv · January 2022
BACKGROUND: Due to increased risks of contrast nephropathy, chronic kidney disease (CKD) can deter consideration of invasive management for patients with myocardial infarction (MI). Black patients have a higher prevalence of CKD. Whether racial disparities ...
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Journal articleCirc Heart Fail · November 2021
BACKGROUND: Diuretics are a mainstay therapy for the symptomatic treatment of heart failure. However, in contemporary US outpatient practice, the degree to which diuretic dosing changes over time and the associations with clinical outcomes and health care ...
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Journal articleClin Trials · October 2021
BACKGROUND: Subgroup analyses are frequently conducted in randomized clinical trials to assess evidence of heterogeneous treatment effect across patient subpopulations. Although randomization balances covariates within subgroups in expectation, chance imba ...
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Journal articleCirc Cardiovasc Qual Outcomes · October 2021
BACKGROUND: Health status outcomes are increasingly being promoted as measures of health care quality, given their importance to patients. In heart failure (HF), an American College of Cardiology/American Heart Association Task Force proposed using the pro ...
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Journal articleStroke Vasc Neurol · September 2021
BACKGROUND AND PURPOSE: Depression is common after stroke and is often treated with antidepressant medications (AD). ADs have also been hypothesised to improve stroke recovery, although recent randomised trials were neutral. We investigated the patterns of ...
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Journal articleAm J Cardiovasc Drugs · September 2021
INTRODUCTION: Direct oral anticoagulants (DOACs) have partial renal clearance and generally require dosage adjustments based on renal function. While current US and European guidance recommends dose adjustments in patients with moderate chronic kidney dise ...
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Journal articleStat Med · August 30, 2021
A common goal in comparative effectiveness research is to estimate treatment effects on prespecified subpopulations of patients. Though widely used in medical research, causal inference methods for such subgroup analysis (SGA) remain underdeveloped, partic ...
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Journal articleAm J Cardiol · June 1, 2021
To address literature gaps on treatment with real-world evidence, this study compared effectiveness, safety, and cost outcomes in NVAF patients with coronary or peripheral artery disease (CAD, PAD) prescribed apixaban versus other oral anticoagulants. NVAF ...
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Journal articleJ Gen Intern Med · May 2021
BACKGROUND: The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers. OBJECTIVE: Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry. DESIG ...
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Journal articleJAMA Cardiol · May 1, 2021
IMPORTANCE: It is unclear how New York Heart Association (NYHA) functional class compares with patient-reported outcomes among patients with heart failure (HF) in contemporary US clinical practice. OBJECTIVE: To characterize longitudinal changes and concor ...
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Journal articleCoron Artery Dis · March 1, 2021
BACKGROUND: The best timing for early invasive therapy in non-ST-segment elevation myocardial infarction (NSTEMI) patients remains controversial. We sought to determine the optimal timing of early catheterization in order to improve long-term outcomes in e ...
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Journal articleJ Womens Health (Larchmt) · March 2021
Background: To evaluate differences in the proportion of uterine fibroid (UF) treatments that are uterine-sparing between Black women and White women and identify factors that could explain disparities. Methods: Women at age 18-54 years who were enrolled f ...
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Journal articleESC Heart Fail · February 2021
AIMS: The aim of our study was to investigate heterogeneity of health status treatment response of sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). METHODS AND RESULTS: We leveraged data from CHAMP-HF, an observat ...
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Journal articleAm Heart J · January 2021
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought about abrupt changes in the way health care is delivered, and the impact of transitioning outpatient clinic visits to telehealth visits on processes of care and outcomes is unclear. METHO ...
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Journal articleJACC Heart Fail · January 2021
OBJECTIVES: The authors sought to evaluate the association of heart failure hospitalization (HFH) with guideline-directed medical therapy (GDMT) prescribing patterns among patients with heart failure with reduced ejection fraction (HFrEF). BACKGROUND: HFH ...
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Journal articleAm Heart J · December 2020
BACKGROUND: In PARADIGM-HF, sacubitril/valsartan improved quality of life (QOL) versus enalapril in heart failure with reduced ejection fraction (HFrEF), yet limited data are available regarding QOL changes after sacubitril/valsartan initiation in routine ...
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Journal articleStat Methods Med Res · December 2020
Propensity score weighting methods are often used in non-randomized studies to adjust for confounding and assess treatment effects. The most popular among them, the inverse probability weighting, assigns weights that are proportional to the inverse of the ...
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Journal articleAm Heart J · August 2020
UNLABELLED: While oral anticoagulation is a cornerstone of stroke prevention therapy in atrial fibrillation (AF), few studies have evaluated comparative discontinuation rates in clinical practice. The objective of this study is to evaluate discontinuation ...
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Journal articleStat Med · July 30, 2020
Observational studies of treatment effects attempt to mimic a randomized experiment by balancing the covariate distribution in treated and control groups, thus removing biases related to measured confounders. Methods such as weighting, matching, and strati ...
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Journal articleCirc Heart Fail · July 2020
BACKGROUND: Among patients with heart failure (HF) with reduced ejection fraction (EF), improvements in left ventricular EF (LVEF) are associated with better outcomes and remain an important treatment goal. Patient factors associated with LVEF improvement ...
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Journal articleJACC Heart Fail · June 2020
OBJECTIVES: The purpose of this study was to characterize the clinical profile, treatment patterns, and clinical outcomes of patients with comorbid diabetes mellitus (DM) and heart failure with reduced ejection fraction (HFrEF) in a contemporary, real-worl ...
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Journal articleCirculation · May 19, 2020
BACKGROUND: In AUGUSTUS (Open-Label, 2×2 Factorial, Randomized, Controlled Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Perc ...
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Journal articleAm J Obstet Gynecol · April 2020
BACKGROUND: Uterine fibroids may decrease quality of life in a significant proportion of affected women. Myomectomy offers a uterine-sparing treatment option for patients with uterine fibroids that can be performed abdominally, laparoscopically (with or wi ...
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Journal articleJ Am Coll Cardiol · March 24, 2020
BACKGROUND: Atrial fibrillation (AF) is common in patients with end-stage renal disease (ESRD). The impact of oral anticoagulation (OAC) in ESRD patients is uncertain. OBJECTIVES: The purpose of this study was to describe patterns of OAC use in ESRD patien ...
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Journal articleFertil Steril · March 2020
OBJECTIVE: To compare long-term health-related quality of life (HRQOL) 1 year after hysterectomy or myomectomy for treatment of uterine fibroids (UFs) and to determine whether route of procedure, race, or age affected improvements in HRQOL. DESIGN: Prospec ...
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Journal articleAm Heart J · February 2020
BACKGROUND: Amiodarone is the most effective antiarrhythmic drug (AAD) for atrial fibrillation (AF), but it has a high incidence of adverse effects. METHODS: Using the ORBIT AF registry, patients with AF on amiodarone at enrollment, prescribed amiodarone d ...
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Journal articleAm Heart J · January 2020
BACKGROUND: Comorbidities are common in patients with atrial fibrillation (AF) and affect prognosis, yet are often undertreated. However, contemporary rates of use of guideline-directed therapies (GDT) for non-AF comorbidities and their association with ou ...
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Journal articleAm J Cardiol · December 15, 2019
Underuse of hydralazine/nitrate (HYD/NIT) in black patients with heart failure and reduced ejection fraction (HFrEF) has been previously described, but whether this important treatment gap persists in contemporary practice is unknown. Sacubitril/valsartan ...
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Journal articleHealth Serv Res · December 2019
OBJECTIVE: To compare predictive analytic approaches to characterize medication nonadherence and determine under which circumstances each method may be best applied. DATA SOURCES/STUDY SETTING: Medicare Parts A, B, and D claims from 2007 to 2013. STUDY DES ...
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Journal articleJACC Heart Fail · November 2019
OBJECTIVES: This study sought to describe the short-term health status benefits of angiotensin-neprilysin inhibitor (ARNI) therapy in patients with heart failure and reduced ejection fraction (HFrEF). BACKGROUND: Although therapy with sacubitril/valsartan, ...
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Journal articleJAMA Neurol · October 1, 2019
IMPORTANCE: Current guidelines recommend direct oral anticoagulants (DOACs) over warfarin for stroke prevention in patients with atrial fibrillation (AF) who are at high risk. Despite demonstrated efficacy in clinical trials, real-world data of DOACs vs wa ...
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Journal articleJ Am Heart Assoc · October 2019
Background When patients require readmission after a recent myocardial infarction (MI), returning to the discharging (index) hospital may be associated with better outcomes as a result of greater continuity in care. However, little evidence exists to answe ...
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Journal articleAm Heart J · August 2019
BACKGROUND: Little is known about the proportion of hospitals in the United States that offer clinical trial enrollment opportunities and how patient outcomes differ between hospitals that do and do not participate in clinical trials. METHODS: In the natio ...
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Journal articleJAMA Cardiol · August 1, 2019
IMPORTANCE: Bleeding and thrombotic events (eg, stroke and systemic embolism) are common in patients with atrial fibrillation (AF) taking warfarin sodium despite a well-established therapeutic range. OBJECTIVE: To evaluate whether history of therapeutic wa ...
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Journal articleObstet Gynecol · August 2019
OBJECTIVE: To compare short-term health-related quality of life (HRQOL) 6-12 weeks after hysterectomy or myomectomy for the treatment of symptomatic leiomyomas. METHODS: We conducted a prospective comparative effectiveness analysis of data. In an existing ...
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Journal articleJ Thromb Thrombolysis · July 2019
We explored associations between INR measures and clinical outcomes in patients with AF using warfarin, and whether INR history predicted future INR measurements. We included patients in ARISTOTLE who were randomized to and received warfarin. Among patient ...
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Journal articleJACC Heart Fail · July 2019
OBJECTIVES: The aim of this study was to use a multicenter, observational outpatient registry of patients with heart failure with reduced ejection fraction (HFrEF) to describe the association between changes in patients' medications with changes in health ...
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Journal articleCirc Cardiovasc Qual Outcomes · July 2019
BACKGROUND: The benefit of β-blocker use beyond 3 years after a myocardial infarction (MI) has not been clearly determined. METHODS AND RESULTS: Using data from the CRUSADE Registry (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Advers ...
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Journal articleEur Heart J · June 14, 2019
Much of medical risk prediction involves externally derived prediction equations, nomograms, and point-based risk scores. These settings are vulnerable to misleading findings of incremental value based on versions of the net reclassification index (NRI) in ...
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Journal articleJ Am Coll Cardiol · May 21, 2019
BACKGROUND: Guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF) have medical therapy titrated to target doses derived from clinical trials, as tolerated. The degree to which titration occurs in contemporary U.S. pra ...
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Journal articleAm J Cardiol · May 15, 2019
Systolic blood pressure (SBP) and its association with clinical outcomes in atrial fibrillation (AF) patients in community practice are poorly characterized. In patients with AF, we sought to (1) examine the prevalence of baseline uncontrolled hypertension ...
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Journal articleJ Am Heart Assoc · May 7, 2019
Background Patient satisfaction with therapy is an important metric of care quality and has been associated with greater medication persistence. We evaluated the association of patient satisfaction with warfarin therapy to other metrics of anticoagulation ...
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Journal articleAm Heart J · May 2019
BACKGROUND: The incidence of cognitive impairment and frailty increase with age and may impact both therapy and outcomes in atrial fibrillation (AF). METHODS: We examined the prevalence of clinically recognized cognitive impairment and frailty (as defined ...
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Journal articleCirc Cardiovasc Qual Outcomes · May 2019
Background The Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire has recently been validated to measure the impact of atrial fibrillation on quality of life, but a clinically important difference in AFEQT score has not been well defined. ...
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Journal articleStat Methods Med Res · April 2019
Improving the quality of care that patients receive is a major focus of clinical research, particularly in the setting of cardiovascular hospitalization. Quality improvement studies seek to estimate and visualize the degree of variability in dichotomous tr ...
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Journal articleJACC Heart Fail · April 2019
OBJECTIVES: This study sought to determine the rate of use of target doses of foundational guideline-directed medical therapy (GDMT) in a contemporary cohort of patients with heart failure with reduced ejection fraction (HFrEF) across systolic blood pressu ...
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Journal articleAm Heart J · February 2019
BACKGROUND: Nonadherence to optimal medical therapy following myocardial infarction (MI) is associated with adverse clinical outcomes such as stent thrombosis, recurrent cardiovascular events, and death. Whether adherence to medications prior to MI predict ...
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Journal articleInt J Cardiol · January 1, 2019
BACKGROUND: Renal function has been associated with an increased stroke risk in patients with atrial fibrillation (AF). However, whether renal function incrementally adds to risk prediction in both anticoagulated and non-anticoagulated patients with AF is ...
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Journal articleAm J Epidemiol · January 1, 2019
The popular inverse probability weighting method in causal inference is often hampered by extreme propensity scores, resulting in biased estimates and excessive variance. A common remedy is to trim patients with extreme scores (i.e., remove them from the w ...
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Journal articleJ Thromb Thrombolysis · November 2018
Anticoagulation is highly effective for the prevention of stroke in patients with atrial fibrillation (AF) but it is dependent on patients continuing therapy. While studies have demonstrated suboptimal therapeutic persistence on warfarin, few have studied ...
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Journal articleCirc Cardiovasc Qual Outcomes · October 2018
Background Among clinical trial patients at high surgical risk, a model has been developed and externally validated to estimate patient risk for poor outcomes after transcatheter aortic valve replacement (TAVR). How this model performs in lower risk and un ...
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Journal articleJ Am Heart Assoc · September 18, 2018
Background Chronic kidney disease ( CKD ) is a common comorbidity in patients with atrial fibrillation. The presence of CKD complicates drug selection for stroke prevention and rhythm control. Methods and Results Patients enrolled in ORBIT AF (Outcomes Reg ...
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Journal articleJ Am Heart Assoc · September 4, 2018
Background Physician shortages and reimbursement changes have led to greater use of advanced practice providers ( APP s). Prevalence of and outcomes associated with APP care following myocardial infarction are unknown. Methods and Results We examined outpa ...
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Journal articleClin Cardiol · September 2018
BACKGROUND: Comorbid condition and hospital risk-adjusted outcomes prevalence were compared based on clinical registry vs administrative claims data. HYPOTHESIS: Risk-adjusted outcomes will vary depending on the source of comorbidity data used. METHODS: Cl ...
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Journal articleCirc Heart Fail · September 2018
Background Current guidelines recommend sacubitril/valsartan for patients with heart failure with reduced ejection fraction, but the rate of adoption in the United States has been slow. Methods and Results Using data from CHAMP-HF (Change the Management of ...
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Journal articleCirculation · August 28, 2018
BACKGROUND: Bleeding is commonly cited as a reason for stopping oral anticoagulants (OACs). Whether minor bleeding events (nuisance bleeding, NB) in patients with atrial fibrillation on OACs are associated with OAC discontinuation, major bleeding, and stro ...
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Journal articleJ Am Heart Assoc · August 21, 2018
Background Current American College of Cardiology/American Heart Association guidelines suggest that for patients with atrial fibrillation who are at low risk for stroke (CHA2DS2VASc=1) (or women with CHA2DS2VASc=2) a variety of treatment strategies may be ...
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Journal articleJ Am Coll Cardiol · July 24, 2018
BACKGROUND: Guidelines strongly recommend patients with heart failure with reduced ejection fraction (HFrEF) be treated with multiple medications proven to improve clinical outcomes, as tolerated. The degree to which gaps in medication use and dosing persi ...
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Journal articleAm J Obstet Gynecol · July 2018
BACKGROUND: Uterine fibroids are common in premenopausal women, yet comparative effectiveness research on uterine fibroid treatments is rare. OBJECTIVE: The purpose of this study was to design and establish a uterine fibroid registry based in the United St ...
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Journal articleJ Am Heart Assoc · June 12, 2018
BACKGROUND: The US Food and Drug Administration approved sacubitril/valsartan for patients with chronic heart failure (HF) with reduced ejection fraction in 2015 on the basis of the results of the PARADIGM-HF (Prospective Comparison of ARNI [Angiotensin Re ...
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Journal articleJ Am Heart Assoc · June 9, 2018
BACKGROUND: Oral anticoagulation (OAC) reduces stroke risk in atrial fibrillation, but bleeding is a frequent side effect. The decision to discontinue or modify medication regimens in response to a bleeding event may differ according to bleeding site and s ...
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Journal articleJACC Heart Fail · June 2018
OBJECTIVES: This study sought to describe the health status of outpatients with heart failure and reduced ejection fraction (HFrEF) by sex, race/ethnicity, and socioeconomic status (SES). BACKGROUND: Although a primary goal in treating patients with HFrEF ...
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Journal articleCirc Cardiovasc Qual Outcomes · June 2018
BACKGROUND: Patients living in disadvantaged neighborhoods are at high risk for adverse outcomes after acute myocardial infarction (MI). Whether residential socioeconomic status (SES) is associated with quality of in-hospital care among patients presenting ...
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Journal articleJ Am Heart Assoc · May 25, 2018
BACKGROUND: Intensive care unit (ICU) use for initially stable patients presenting with non-ST-segment-elevation myocardial infarction (NSTEMI) varies widely across hospitals and minimally correlates with severity of illness. We aimed to develop a bedside ...
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Journal articleCirculation · May 15, 2018
BACKGROUND: Medication adherence is important to improve the long-term outcomes after acute myocardial infarction (MI). We hypothesized that there is significant variation among US hospitals in terms of medication adherence after MI, and that patients trea ...
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Journal articleJ Am Heart Assoc · April 13, 2018
BACKGROUND: Mineralocorticoid receptor antagonist (MRA) therapy may be beneficial to patients with atrial fibrillation (AF), but little is known about their use in patients with AF and subsequent outcomes. METHODS AND RESULTS: In order to better understand ...
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Journal articleHeart Rhythm · April 2018
BACKGROUND: Compared with men, women have longer corrected QT (QTc) intervals, lower clearance of dofetilide, and higher rates of drug-induced torsades de pointes, but the dofetilide dosing algorithm is the same for men and women. OBJECTIVE: The purpose of ...
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Journal articleCirc Cardiovasc Qual Outcomes · April 2018
BACKGROUND: Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal ...
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Journal articleJ Am Coll Cardiol · March 13, 2018
BACKGROUND: Digoxin is widely used in patients with atrial fibrillation (AF). OBJECTIVES: The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modifie ...
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Journal articleAm Heart J · March 2018
BACKGROUND: Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagn ...
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Journal articleJ Am Heart Assoc · February 16, 2018
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for stroke prevention in atrial fibrillation (AF) but require lower doses in certain patients. We sought to describe the frequency, appropriateness (according to Food and Drug A ...
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Journal articleJ Am Heart Assoc · January 25, 2018
BACKGROUND: The 2013 American College of Cardiology/American Heart Association cholesterol guidelines recommend high-intensity statins for patients after myocardial infarction (MI) rather than treating to a low-density lipoprotein cholesterol goal, as the ...
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Journal articleJAMA Cardiol · January 1, 2018
IMPORTANCE: Atrial fibrillation (AF) is usually classified on the basis of the disease subtype. However, this characterization does not capture the full heterogeneity of AF, and a data-driven cluster analysis reveals different possible classifications of p ...
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Journal articleBMJ Open Diabetes Res Care · 2018
OBJECTIVE: Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. RESEARCH DESIGN AND METHODS: We conducted an observational analysis of data from the Nateglinide and Val ...
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Journal articleJ Am Heart Assoc · December 22, 2017
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. M ...
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Journal articleAm Heart J · December 2017
UNLABELLED: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment. METHODS: Demographics, comorbidities, and stroke risk of the patien ...
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Journal articleCirculation. Arrhythmia and electrophysiology · November 2017
BackgroundIt is unclear how frequently patients with atrial fibrillation receive guideline-concordant (GC) care and whether guideline concordance is associated with improved outcomes.Methods and resultsUsing data from ORBIT-AF (Outcomes R ...
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Journal articleStroke · October 2017
BACKGROUND AND PURPOSE: Rehabilitation is recommended after a stroke to enhance recovery and improve outcomes, but hospital's use of inpatient rehabilitation facilities (IRFs) or skilled nursing facility (SNF) and the factors associated with referral are u ...
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Journal articleJ Am Coll Cardiol · September 12, 2017
BACKGROUND: Diabetes is a well-established risk factor for thromboembolism in patients with atrial fibrillation (AF), but less is known about how diabetes influences outcomes among AF patients. OBJECTIVES: This study assessed whether symptoms, health statu ...
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Journal articleJAMA Cardiol · September 1, 2017
This population-based study uses the Acute Coronary Treatment and Intervention Outcomes Network Registry to evaluate the prevalence of smoking cessation medication use among patients following myocardial infarction. ...
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Journal articleJ Am Coll Cardiol · July 25, 2017
BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. ...
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Journal articleAm Heart J · July 2017
BACKGROUND: Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients ...
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Journal articleAm Heart J · July 2017
Heart failure (HF) with reduced ejection fraction (HFrEF) is a common and costly condition that diminishes patients' health status and confers a poor prognosis. Despite the availability of multiple guideline-recommended pharmacologic and cardiac device the ...
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Journal articleEur Heart J Qual Care Clin Outcomes · July 1, 2017
AIMS: The presence of cancer can complicate treatment choices for patients with atrial fibrillation (AF) increasing both the risk of thrombotic and bleeding events. METHODS AND RESULTS: Using data from Outcomes Registry for Better Informed Treatment of Atr ...
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Journal articleBlood · June 1, 2017
We investigated the frequency and characteristics of intracranial hemorrhage (ICH), the factors associated with the risk of ICH, and outcomes post-ICH overall and by randomized treatment. We identified patients with ICH from the overall trial population en ...
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Journal articleAm J Cardiol · June 1, 2017
The degree to which clinical outcomes are worsened in patients with atrial fibrillation (AF) with heart failure (HF) compared with those without HF is not well described. This study aimed to determine the impact of HF on clinical outcomes in patients with ...
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Journal articleAm J Cardiol · May 15, 2017
Non-vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed to assess the freq ...
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Journal articleJ Diabetes Complications · May 2017
AIMS: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Im ...
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Journal articleAm J Med · April 2017
BACKGROUND: Prior studies have shown a treatment gap in oral anticoagulation (OAC) use among patients with atrial fibrillation yet have incompletely characterized factors associated with failure to treat and subsequent outcomes in contemporary practice. ME ...
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Journal articleAm Heart J · April 2017
BACKGROUND: Patients with impaired glucose tolerance have an elevated risk of cardiovascular (CV) death; however, the causes and risk factors associated with non-CV deaths are poorly understood. METHODS: The NAVIGATOR trial enrolled 9,306 participants with ...
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Journal articleAm Heart J · March 2017
UNLABELLED: Cardioversion is a class I procedure for patients with symptomatic atrial fibrillation (AF) pursuing rhythm control. There are few contemporary reports on quality of life and outcomes after cardioversion. METHODS: Using the nationwide prospecti ...
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Journal articleAm Heart J · March 2017
BACKGROUND: Patients with atrial fibrillation (AF) are prone to cardiovascular events and anticoagulation-related bleeding complications. We hypothesized that patients with anemia are at increased risk for these outcomes. METHODS: We performed a post hoc a ...
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Journal articleJ Am Heart Assoc · January 17, 2017
BACKGROUND: We studied (1) the rates of stroke or systemic embolism and bleeding in patients with atrial fibrillation and peripheral artery disease (PAD) and (2) the efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation with ...
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Journal articleInt J Cardiol · January 15, 2017
BACKGROUND: Evidence supporting use of antithrombotic therapy in atrial fibrillation (AF) is based mainly on data from patients with permanent, persistent, or paroxysmal AF. Less is known about the risk following a new diagnosis of AF and the efficacy and ...
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Journal articleCirculation · January 3, 2017
BACKGROUND: Guidelines recommend that patients with low ejection fraction (EF) after myocardial infarction (MI) have their EF reassessed 40 days after MI for implantable cardioverter-defibrillator (ICD) candidacy. This study examines rates of EF reassessme ...
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Journal articleJAMA Cardiol · January 1, 2017
IMPORTANCE: Intensive care unit (ICU) utilization may have important implications for the care and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI). OBJECTIVES: To examine interhospital variation in ICU utilization in the U ...
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Journal articleJACC Heart Fail · January 2017
OBJECTIVES: The purpose of this study was to determine the significant clinical predictors of incident heart failure (HF) and its prognostic effect on long-term outcomes among community-based patients with established atrial fibrillation (AF). BACKGROUND: ...
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Journal articleCirc Cardiovasc Qual Outcomes · January 2017
BACKGROUND: Functional status is a key patient-centric outcome, but there are little data on whether functional recovery post-stroke varies among hospitals. This study examined the distribution of functional status 3 months after stroke, determined whether ...
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Journal articleJ Am Coll Cardiol · December 20, 2016
BACKGROUND: Although non-vitamin K antagonist oral anticoagulants (NOACs) do not require frequent laboratory monitoring, each compound requires dose adjustments on the basis of certain clinical criteria. OBJECTIVES: This study assessed the frequency of off ...
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Journal articleAm Heart J · December 2016
BACKGROUND: As treatment options for atrial fibrillation (AF) increase, more attention is focused on patients' experiences and quality of life (QoL). However, little is known about the factors associated with these outcomes. METHODS: The Atrial Fibrillatio ...
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Journal articleAm Heart J · November 2016
BACKGROUND: Assessments of stroke and bleeding risks are essential to selecting oral anticoagulation in patients with atrial fibrillation (AF). We aimed to assess outcomes according to physician assessed risk, with comparison to empirical risk scores. METH ...
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Journal articleAm Heart J · October 2016
BACKGROUND: Hospital mortality is an important quality measure for acute myocardial infarction care. There is a concern that despite risk adjustment, percutaneous coronary intervention hospitals accepting a greater volume of high-risk ST elevation myocardi ...
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Journal articleClin Cardiol · October 2016
BACKGROUND: Race and sex have been shown to affect management of myocardial infarction (MI); however, it is unclear if such disparities exist in contemporary care of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial ...
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Journal articleCirc Cardiovasc Qual Outcomes · September 2016
BACKGROUND: Among older patients with acute myocardial infarction (MI), it remains uncertain whether there is a time-dependent difference in the risk of recurrent mortality and nonfatal cardiovascular and cerebrovascular events for those with ST-segment-el ...
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Journal articleAm Heart J · August 2016
BACKGROUND: Little is known about the relationship between ejection fraction (EF) and clinical outcomes among older patients with myocardial infarction in contemporary clinical practice. METHODS: Data on 82,558 patients 65 years or older with ST-elevation ...
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Journal articleEpidemiology · July 2016
BACKGROUND: Over the past two decades, there have been increasingly long waiting times for heart transplantation. We studied the relationship between heart transplant waiting time and transplant failure (removal from the waitlist, pretransplant death, or d ...
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Journal articleBMJ · June 15, 2016
OBJECTIVE: To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. DESIGN: Post hoc analysis performed in 2015 of results from ARISTOTLE (apixab ...
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Journal articleAm J Med · June 2016
BACKGROUND: The role of triple antithrombotic therapy vs dual antithrombotic therapy in patients with both atrial fibrillation and coronary artery disease remains unclear. This study explores the differences in treatment practices and outcomes between trip ...
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Journal articleJAMA Cardiol · June 1, 2016
IMPORTANCE: Despite the frequency of atrial fibrillation (AF) in clinical practice, relatively little is known about sex differences in symptoms and quality of life and how they may affect treatment and outcomes. OBJECTIVE: To determine whether symptoms, q ...
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Journal articleJACC Clin Electrophysiol · June 2016
OBJECTIVES: This study sought to determine the association between body mass index (BMI) and clinical outcomes among patients with prevalent atrial fibrillation (AF). BACKGROUND: Higher BMI is an independent risk factor for incident AF. However, its impact ...
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Journal articleJ Am Heart Assoc · May 4, 2016
BACKGROUND: Whereas insurance status has been previously associated with care patterns, little is currently known about the association between Medicaid insurance and the clinical characteristics, treatment, or outcomes of patients with atrial fibrillation ...
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Journal articleJ Am Coll Cardiol · May 3, 2016
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) associated with acute myocardial infarction (MI) confers high in-hospital mortality; however, among those patients who survive, little is known regarding their post-discharge mortality and health care use r ...
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Journal articleAm Heart J · May 2016
BACKGROUND: We addressed whether patients with a family history of atrial fibrillation (AF) were diagnosed as having AF earlier in life, were more symptomatic, and had worse outcomes compared with those without a family history of AF. METHODS: Using the OR ...
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Journal articleJAMA Cardiol · May 1, 2016
IMPORTANCE: The use of evidence-based medication therapy in patients after acute myocardial infarction (AMI) improves long-term prognosis, yet the current rates of adherence are poor. OBJECTIVE: To determine whether earlier outpatient follow-up after AMI i ...
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Journal articleAm Heart J · April 2016
BACKGROUND: Significant racial/ethnic differences exist in the incidence of atrial fibrillation (AF). However, less is known about racial/ethnic differences in quality of life (QoL), treatment, and outcomes associated with AF. METHODS: Using data from the ...
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Journal articleJACC Clin Electrophysiol · April 2016
OBJECTIVES: The study sought to evaluate clinical outcomes in clinical practice with rhythm control versus rate control strategy for management of atrial fibrillation (AF). BACKGROUND: Randomized trials have not demonstrated significant differences in stro ...
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Journal articleJAMA Cardiol · April 1, 2016
IMPORTANCE: Survival rates after in-hospital cardiac arrest (IHCA) vary significantly among US centers; whether this variation is owing to differences in IHCA care quality is unknown. OBJECTIVE: To evaluate hospital-level variation to determine whether hos ...
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Journal articleBraz J Cardiovasc Surg · April 2016
INTRODUCTION: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. OBJECTIVE: Identify predictors of clopidogrel following CABG. METHODS: We evaluat ...
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Journal articleJ Am Heart Assoc · March 14, 2016
BACKGROUND: While use of P2Y12 receptor inhibitor is recommended by guidelines, few studies have examined its effectiveness among older non-ST-segment elevation myocardial infarction patients who did not undergo coronary revascularization. METHODS AND RESU ...
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Journal articleCirc Cardiovasc Qual Outcomes · March 2016
BACKGROUND: Many patients in the United States require transfer from one hospital to another for acute myocardial infarction (MI) care. How well these transferred-in patients are transitioned back to their local community is unknown. METHODS AND RESULTS: W ...
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Journal articleStroke · March 2016
BACKGROUND AND PURPOSE: Stroke survivors have identified home-time as a meaningful outcome. We evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days ...
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Journal articleJ Am Coll Cardiol · February 23, 2016
BACKGROUND: Many patients with acute myocardial infarction (AMI) and cardiogenic shock survive hospitalization; little is known about their subsequent prognosis. OBJECTIVES: This study sought to evaluate the associations between cardiogenic shock and post- ...
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Journal articleClin Cardiol · February 2016
BACKGROUND: Patients with sinus node dysfunction (SND) have increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). To date, treatment patterns and outcomes of patients with SND and AF have not been well described. HYPOTHESIS: Patien ...
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Journal articleInt J Cardiol · January 1, 2016
BACKGROUND: Comorbid chronic obstructive pulmonary disease (COPD) is associated with poor outcomes among patients with cardiovascular disease. The risks of stroke and mortality associated with COPD among patients with atrial fibrillation are not well under ...
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Journal articleJAMA Neurol · January 2016
IMPORTANCE: Intravenous tissue plasminogen activator (tPA) is known to improve outcomes in ischemic stroke; however, many patients may have been receiving antiplatelet therapy before acute ischemic stroke and could face an increased risk for bleeding when ...
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Journal articleJACC Cardiovasc Interv · December 28, 2015
OBJECTIVES: The aim of this study was to compare outcomes of ST-segment elevation myocardial infarction (STEMI) patients with a history of coronary artery bypass graft surgery (CABG), previous percutaneous coronary intervention (PCI), or no previous revasc ...
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Journal articleEur Heart J · December 7, 2015
BACKGROUND: Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. OBJECTIVES: We sought to develop and validate a novel bleeding risk score using rout ...
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Journal articleEuropean heart journal · December 7, 2015
BACKGROUND: Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. ...
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Journal articleClin Cardiol · December 2015
BACKGROUND: Interhospital transfer invasive management patterns and implications for older non-ST-segment elevation myocardial infarction (NSTEMI) patients initially presenting to non-revascularization-capable hospitals have not been explored. HYPOTHESIS: ...
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Journal articleJ Am Heart Assoc · December 1, 2015
BACKGROUND: Patients with atrial fibrillation (AF) and hypertension are at high risk for stroke. Previous studies have shown elevated risk of stroke in patients with AF who have a history of hypertension (regardless of blood pressure [BP] control) and in p ...
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Journal articleCirc Cardiovasc Qual Outcomes · November 2015
BACKGROUND: In 2009, national legislation promoted wide-spread adoption of electronic health records (EHRs) across US hospitals; however, the association of EHR use with quality of care and outcomes after acute myocardial infarction (AMI) remains unclear. ...
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Journal articleAm Heart J · November 2015
BACKGROUND: Guidelines recommend cardiac rehabilitation after acute myocardial infarction, yet little is known about the impact of cardiac rehabilitation on medication adherence and clinical outcomes among contemporary older adults. The optimal number of c ...
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Journal articleCirc Cardiovasc Qual Outcomes · November 2015
BACKGROUND: Little is known about whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). METHODS AND RESULTS: Using Medicare records linked to Acute ...
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Journal articleJ Am Heart Assoc · September 14, 2015
BACKGROUND: Most patients with atrial fibrillation (AF) require rate control; however, the optimal target heart rate remains under debate. We aimed to assess rate control and subsequent outcomes among patients with permanent AF. METHODS AND RESULTS: We stu ...
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Journal articleBMJ Open · August 14, 2015
OBJECTIVES: While bidirectional relationships exist between body weight and physical activity, direction of causality remains uncertain and previous studies have been limited by self-reported activity or weight and small sample size. We investigated the pr ...
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Journal articleJ Am Coll Cardiol · August 11, 2015
BACKGROUND: Antithrombotic therapy for acute myocardial infarction (MI) with atrial fibrillation (AF) among higher risk older patients treated with percutaneous coronary intervention (PCI) remains unclear. OBJECTIVES: This study sought to determine appropr ...
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Journal articleDiabet Med · August 2015
AIM: To investigate whether previous physical activity levels are associated with blood glucose levels in individuals with impaired glucose tolerance in the context of an international pharmaceutical trial. METHODS: Data were analysed from the NAVIGATOR tr ...
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Journal articleCirc Cardiovasc Qual Outcomes · July 2015
BACKGROUND: Instruments to assess symptom burden and quality of life among patients with atrial fibrillation (AF) have not been well evaluated in community practice or associated with patient outcomes. METHODS AND RESULTS: Using data from 10 087 AF patient ...
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Journal articleAm Heart J · July 2015
BACKGROUND: Time in therapeutic range (TTR) of international normalized ratio (INR) of 2.0 to 3.0 is important for the safety and effectiveness of warfarin anticoagulation. There are few data on TTR among patients with atrial fibrillation (AF) in community ...
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Journal articleAm Heart J · July 2015
BACKGROUND: Statins reduce mortality after acute myocardial infarction, but up to half of patients discontinue statin use within 1 year of therapy initiation. Although cost may influence medication adherence, it is unknown whether use of generic versus bra ...
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Journal articleJ Am Coll Cardiol · June 30, 2015
BACKGROUND: Although digoxin has long been used to treat atrial fibrillation (AF) and heart failure (HF), its safety remains controversial. OBJECTIVES: This study sought to describe digoxin use over time in patients with AF who were stratified by the prese ...
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Journal articleJAMA · June 23, 2015
IMPORTANCE: Implantable cardioverter-defibrillators (ICDs) are not recommended within 40 days of myocardial infarction (MI); thus, ICD implantation might not be considered during the post-MI care transition. OBJECTIVE: To examine ICD implantation rates and ...
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Journal articleAm J Med · June 2015
BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in thi ...
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Journal articleHeart · June 2015
OBJECTIVE: Atrial fibrillation (AF) often progresses from paroxysmal or persistent to more sustained forms, but the rate and predictors of AF progression in clinical practice are not well described. METHODS: Using the Outcomes Registry for Better Informed ...
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Journal articleEur Heart J · May 21, 2015
AIM: In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced the risk of stroke, major bleed, and death in patients with atrial fibrillation. In this ancillar ...
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Journal articleCirc Cardiovasc Qual Outcomes · May 2015
BACKGROUND: Antiarrhythmic drugs (AADs) are used to reduce the frequency, severity, and duration of atrial fibrillation (AF) events, which should reduce hospitalizations; however, little is known about the associations between different AADs and hospitaliz ...
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Journal articleAm Heart J · April 2015
BACKGROUND: Cardiac arrest (CA) is a major complication of patients with ST-elevation myocardial infarction (STEMI). Its prevalence and prognostic impact in contemporary US practice has not been well assessed. METHODS: We evaluated STEMI patients included ...
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Journal articleAm J Med · March 2015
BACKGROUND: Contemporary studies suggest an association between venous thromboembolism and a higher incidence of major cardiovascular events, mostly attributed to arterial atherothrombosis. Using data from the Nateglinide and Valsartan in Impaired Glucose ...
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Journal articleCirculation · February 3, 2015
BACKGROUND: Temporary interruption of oral anticoagulation for procedures is often required, and some propose using bridging anticoagulation. However, the use and outcomes of bridging during oral anticoagulation interruptions in clinical practice are unkno ...
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Journal articleAm J Cardiol · February 1, 2015
Little is known in clinical practice about antiarrhythmic drug (AAD) use in patients with atrial fibrillation (AF) (particularly younger ones) who do not have structural heart disease. Using the MarketScan database, we identified patients <65 years without ...
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Journal articleJAMA Intern Med · February 2015
IMPORTANCE: Guidelines for patients with ST-segment elevation myocardial infarction (STEMI) recommend timely reperfusion with primary percutaneous coronary intervention (pPCI) or fibrinolysis. Among patients with STEMI who require interhospital transfer, i ...
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Journal articleHeart · February 2015
OBJECTIVES: Acute management of ST elevation myocardial infarction (STEMI) patients on chronic vitamin K antagonist (VKA) therapy is uncertain. This study aims to estimate in-hospital major bleeding risk among STEMI patients on chronic VKA treated with pri ...
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Journal articleAm Heart J · January 2015
BACKGROUND: We sought to assess the occurrence of events after blinded study drug discontinuation and transition to open-label vitamin K antagonist (VKA) in ARISTOTLE. METHODS: At the end of ARISTOTLE, blinded study drug was stopped, and open-label VKA was ...
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Journal articleAm Heart J · January 2015
BACKGROUND: Quality improvement is central to improving the care of patients with cardiovascular disease; however, the optimum type of data feedback to support such efforts is unknown. METHODS: Over 26 months, 149 eligible Acute Coronary Treatment and Inte ...
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Journal articlePLoS One · 2015
BACKGROUND: Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the prevalence of AF and its antithrombotic management in a cont ...
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Journal articleBlood · December 11, 2014
Using data from ARISTOTLE, we describe the periprocedural management of anticoagulation and rates of subsequent clinical outcomes among patients chronically anticoagulated with warfarin or apixaban. We recorded whether (and for how long) anticoagulant ther ...
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Journal articleDiabetes Obes Metab · December 2014
Increased physical activity is known to be beneficial in people with type 2 diabetes mellitus (T2DM), but it is not known whether individuals change their activity levels after T2DM diagnosis. The present Nateglinide and Valsartan in Impaired Glucose Toler ...
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Journal articleAm J Cardiol · November 15, 2014
There is increasing emphasis on optimizing evidence-based medication (EBM) persistence as a means to improve longitudinal patient outcomes after acute myocardial infarction (MI); yet it is unknown whether differences in medication persistence exist between ...
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Journal articleCirc Cardiovasc Qual Outcomes · November 2014
BACKGROUND: Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web- ...
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Journal articleJ Am Coll Cardiol · October 14, 2014
BACKGROUND: Amiodarone is an effective medication in preventing atrial fibrillation (AF), but it interferes with the metabolism of warfarin. OBJECTIVES: This study sought to examine the association of major thrombotic clinical events and bleeding with the ...
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Journal articleAm Heart J · October 2014
BACKGROUND: Warfarin reduces thromboembolic risks in atrial fibrillation (AF), but therapeutic durability remains a concern. METHODS: We used clinical data from ORBIT-AF, a nationwide outpatient AF registry conducted at 176 sites with follow-up data at 6 a ...
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Journal articleCirculation · August 19, 2014
BACKGROUND: Blacks are less likely than whites to receive coronary revascularization and evidence-based therapies after acute myocardial infarction, yet the impact of these differences on long-term outcomes is unknown. METHODS AND RESULTS: We linked Can Ra ...
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Journal articleAm Heart J · August 2014
BACKGROUND: Recent clinical trials have demonstrated the safety and efficacy of several non-vitamin K oral anticoagulants (NOACs) for the treatment of atrial fibrillation (AF). However, there are limited data on their use and outcomes in routine clinical p ...
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Journal articleEur Heart J · July 21, 2014
AIMS: The risk of stroke in patients with atrial fibrillation (AF) increases with age. In the ARISTOTLE trial, apixaban when compared with warfarin reduced the rate of stroke, death, and bleeding. We evaluated these outcomes in relation to patient age. MET ...
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Journal articleJ Am Coll Cardiol · May 27, 2014
OBJECTIVES: This study sought to characterize major bleeding on the basis of the components of the major bleeding definition, to explore major bleeding by location, to define 30-day mortality after a major bleeding event, and to identify factors associated ...
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Journal articleCirculation · May 20, 2014
BACKGROUND: Physicians treating patients with atrial fibrillation (AF) must weigh the benefits of anticoagulation in preventing stroke versus the risk of bleeding. Although empirical models have been developed to predict such risks, the degree to which the ...
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Journal articleAm Heart J · May 2014
BACKGROUND: Prior studies have found that academic hospitals provide more consistent use of guideline-recommended therapies in patients with non-ST-segment myocardial infarction (NSTEMI) compared with nonacademic centers, yet it is unclear whether these ca ...
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Journal articleAm Heart J · May 2014
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac dysrhythmia and contributes significantly to health care expenditures. We sought to assess the frequency and predictors of hospitalization in patients with AF. METHODS: The ORBIT-AF registry i ...
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Journal articleMetabolism · April 2014
OBJECTIVE: The cardiometabolic risk cluster metabolic syndrome (MS) includes ≥3 of elevated fasting glucose, hypertension, elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-c), and increased waist circumference. Each can be affected ...
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Journal articleLancet · March 22, 2014
BACKGROUND: The extent to which change in physical activity can modify the risk of cardiovascular disease in individuals at high cardiovascular risk is uncertain. We investigated whether baseline and change in objectively-assessed ambulatory activity is as ...
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Journal articleAm Heart J · March 2014
BACKGROUND: Patients with non-ST-elevation myocardial infarction (NSTEMI) and three-vessel or left main coronary disease (3VD/LMD) have a high risk of long-term mortality when treated with a medical management strategy (MMS) compared with revascularization ...
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Journal articleCirc Cardiovasc Qual Outcomes · March 2014
BACKGROUND: Major bleeding has received increasing attention as a target for quality improvement in care of patients with acute myocardial infarction. However, little is known about variation in bleeding across hospitals and whether variation is attributab ...
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Journal articleEur Heart J · January 2014
AIMS: We assessed the effect of concomitant aspirin use on the efficacy and safety of apixaban compared with warfarin in patients with atrial fibrillation (AF). METHODS AND RESULTS: In ARISTOTLE, 18 201 patients were randomized to apixaban 5 mg twice daily ...
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Journal articleBMJ · December 9, 2013
OBJECTIVE: To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. DESIGN: Reanalysis of data from the Nateglinide and ...
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Journal articleAm Heart J · December 2013
BACKGROUND: Prior studies have observed that smokers have paradoxically favorable 1-year mortality rates after acute coronary syndromes, but it is unknown whether this association extends to long-term outcomes and to older patients. METHODS: We identified ...
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Journal articleJ Am Heart Assoc · November 25, 2013
BACKGROUND: Dabigatran is a novel oral anticoagulant approved for thromboprophylaxis in atrial fibrillation. Adoption patterns of this new agent in community practice are unknown. METHODS AND RESULTS: We studied patterns of dabigatran use among patients en ...
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Journal articleComput Stat Data Anal · November 1, 2013
In clinical studies, covariates are often measured with error due to biological fluctuations, device error and other sources. Summary statistics and regression models that are based on mismeasured data will differ from the corresponding analysis based on t ...
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Journal articleAm Heart J · November 2013
BACKGROUND: The role of dysglycemia as an additional risk factor for atrial fibrillation (AF) is controversial. Therefore, it was of interest to assess risk factors for incident AF in a large, representative population of patients with cardiovascular risk ...
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Journal articleAm Heart J · November 2013
BACKGROUND: We sought to determine the risk of readmission for bleeding and major cardiac events in stented non-ST-segment elevation myocardial infarction (NSTEMI) atrial fibrillation (AF) patients. METHODS: For this patient population, selection of an ant ...
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Journal articleCirc Cardiovasc Qual Outcomes · November 2013
BACKGROUND: Despite the widespread availability of effective and affordable therapies, hypertension remains this country's most significant modifiable cardiovascular risk factor. Approximately 30% to 50% of individuals with hypertension currently fail to r ...
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Journal articleCirculation · September 10, 2013
BACKGROUND: Hospital readmission rates within 30 days after acute myocardial infarction are a national performance metric. Previous data suggest that early physician follow-up after heart failure hospitalizations can reduce readmissions; whether these resu ...
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Journal articleStroke · September 2013
BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance ...
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Journal articleAm Heart J · September 2013
BACKGROUND: Patients with atrial fibrillation who are vitamin K antagonist (VKA)-naive may have a higher risk of thrombosis and/or bleeding than VKA-experienced patients. METHODS AND RESULTS: Using data from ARISTOTLE, we assessed baseline characteristics ...
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Journal articleCirculation · August 13, 2013
BACKGROUND: The role of concomitant aspirin (ASA) therapy in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) is unclear. We assessed concomitant ASA use and its association with clinical outcomes among AF patients treated with O ...
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Journal articleEur Heart J · August 2013
AIMS: It is uncertain whether the benefit from apixaban varies by type and duration of atrial fibrillation (AF). METHODS AND RESULTS: A total of 18 201 patients with AF [2786 (15.3%) with paroxysmal and 15 412 (84.7%) with persistent or permanent] were ran ...
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Journal articleAm Heart J · August 2013
BACKGROUND: Cardiogenic shock complicating acute myocardial infarction (MI) in older patients is associated with a high risk of inhospital mortality; however, the long-term prognosis among these patients who survive the index hospitalization is uncertain. ...
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Journal articleJ Am Heart Assoc · July 18, 2013
BACKGROUND: The prevalence of atrial fibrillation (AF) continues to increase; however, there are limited data describing the division of care among practitioners in the community and whether care differs depending on provider specialty. METHODS AND RESULTS ...
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Journal articleAm J Cardiol · July 15, 2013
We used baseline data from the NAVIGATOR trial to (1) identify risk factors for diabetes progression in those with impaired glucose tolerance and high cardiovascular risk, (2) create models predicting 5-year incident diabetes, and (3) provide risk classifi ...
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Journal articleAm J Med · July 2013
BACKGROUND: Patients with atrial fibrillation often have cardiovascular risk factors or known comorbid disease, yet the use of evidence-based primary and secondary prevention cardiac therapy among atrial fibrillation outpatients is unknown. METHODS: Using ...
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Journal articleCirc Cardiovasc Qual Outcomes · July 2013
BACKGROUND: Patients with atrial fibrillation (AF) at the highest stroke risk derive the largest benefit from oral anticoagulation (OAC). Those with the highest stroke risk have been paradoxically less likely to receive OAC. This study assessed the associa ...
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Journal articleCirculation · June 4, 2013
BACKGROUND: In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced stroke and systemic embolism, major bleeding, and mortality. We evaluated treatment effect ...
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Journal articleAm J Hypertens · June 2013
BACKGROUND: Low and low-normal serum potassium is associated with an increased risk of diabetes. We hypothesized that the protective effect of valsartan on diabetes risk could be mediated by its effect of raising serum potassium. METHODS: We analyzed data ...
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Journal articleCirc Cardiovasc Qual Outcomes · May 1, 2013
BACKGROUND: Early invasive management is recommended for patients with non-ST-segment elevation myocardial infarction (MI), but the incidence of long-term outcomes after early catheterization among older patients and the relationship of revascularization p ...
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Journal articleCirc Arrhythm Electrophysiol · April 2013
BACKGROUND: Although cardiac resynchronization therapy (CRT) can improve left ventricular ejection fraction (LVEF), it is not known whether a specific level of improvement will predict future implantable cardioverter defibrillator (ICD) therapy. METHODS AN ...
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Journal articleEur Heart J · March 2013
AIMS: Death of a spouse from acute myocardial infarction (AMI) presents hardship, yet few studies have investigated the psychological consequences of fatal and non-fatal AMI on spouses. METHODS AND RESULTS: Several Danish national registries were linked to ...
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Journal articleCirc Heart Fail · March 2013
BACKGROUND: Impaired glucose tolerance and metabolic syndrome are associated with increased risk of heart failure (HF). However, predictors associated with the increased risk of incident HF have not been well characterized. We aimed to identify independent ...
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Journal articleJ Am Coll Cardiol · December 4, 2012
OBJECTIVES: This study compared prognoses of myocardial infarction related to percutaneous coronary intervention (PCI, procedural MI) using increasing creatine kinase-myocardial band (CK-MB) thresholds with spontaneous MI. BACKGROUND: Procedural MI usually ...
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Journal articleEur Heart J · November 2012
AIMS: Atrial fibrillation (AF) is common among patients with impaired renal function. Apixaban, a novel oral anticoagulant with partial renal excretion, was compared with warfarin and reduced the rate stroke, death and bleeding in the ARISTOTLE trial. We e ...
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Journal articleEur Heart J · August 2012
AIMS: Bleeding complications have been associated with short-term mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Their association with long-term outcomes is less clear. This study examines mortality associated with in- ...
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Journal articleCirc Cardiovasc Qual Outcomes · July 1, 2012
BACKGROUND: The impact of polyvascular disease (peripheral arterial disease [PAD] and cerebrovascular disease [CVD]) on long-term cardiovascular outcomes among older patients with acute myocardial infarction has not been well studied. METHODS AND RESULTS: ...
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Journal articleJ Am Coll Cardiol · May 22, 2012
OBJECTIVES: The purpose of this study was to examine temporal trends in post-percutaneous coronary intervention (PCI) bleeding among patients with elective PCI, unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment el ...
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Journal articleAm Heart J · April 2012
BACKGROUND: We aimed to study the comparative safety and effectiveness of various antithrombotic treatment strategies among older adults with non-ST elevation myocardial infarction (NSTEMI) and atrial fibrillation (AF). METHODS: Using the CRUSADE registry ...
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Journal articleJAMA · January 4, 2012
CONTEXT: ST-segment elevation myocardial infarction (STEMI) treatment has improved outcomes and shortened hospital stay. Recently, 30-day readmission rates have been proposed as a metric for care of patients with STEMI. However, international rates and pre ...
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Journal articleBMJ Open · 2012
OBJECTIVES: Risk factors for cardiovascular events are well established in general populations and those with diabetes but have been sparsely studied in impaired glucose tolerance (IGT). We sought to identify predictors of (1) a composite cardiovascular ou ...
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Journal articleJournal of Statistics Education · January 1, 2012
Clinicians have characteristics - high scientific maturity, low tolerance for symbol manipulation and programming, limited time outside of class - that limit the effectiveness of traditional methods for teaching multi-predictor modeling. We describe an act ...
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Journal articleBiometrics · December 2011
Studies of clinical characteristics frequently measure covariates with a single observation. This may be a mismeasured version of the "true" phenomenon due to sources of variability like biological fluctuations and device error. Descriptive analyses and ou ...
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Journal articleAm Heart J · November 2011
OBJECTIVES: We sought to develop a long-term mortality risk prediction model and a simplified risk score for use in older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Limited data are available regarding long-term mort ...
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Journal articleAm Heart J · October 2011
BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of stroke, heart failure, and death. Data on contemporary treatment patterns and outcomes associated with AF in clinical practice ...
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Journal articleAm Heart J · April 2011
BACKGROUND: Patients with diabetes have increased in-hospital mortality following acute myocardial infarction (AMI), with studies suggesting higher risk with both hypoglycemia and hyperglycemia. We assessed whether a J-shaped relation exists between hemogl ...
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Journal articleAm J Cardiol · December 1, 2010
We sought to examine the relation between the United States economic decrease in 2008 and cardiovascular events as measured by local acute myocardial infarction (AMI) rates. Mental stress and traumatic events have been shown to be associated with increased ...
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Journal articleJAMA · August 26, 2009
CONTEXT: Conflicting information exists about whether sex differences modulate short-term mortality following acute coronary syndromes (ACS). OBJECTIVES: To investigate the relationship between sex and 30-day mortality in ACS, and to determine whether this ...
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Journal articleBlood · June 15, 2008
Up to 30% of adult patients with sickle cell disease (SCD) will develop pulmonary hypertension (pHTN), a complication associated with significant morbidity and mortality. To identify genetic factors that contribute to risk for pHTN in SCD, we performed ass ...
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Journal articleDiabetes Care · May 2008
OBJECTIVE: Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and re ...
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Journal articleBr J Haematol · May 2007
Priapism occurs in 30-45% of male patients with sickle cell disease (SCD), but the possible influence of genetic risk factors on the incidence of priapism is not well understood. We examined genetic polymorphisms in 199 unrelated, adult (>18 years), male p ...
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Journal articleN Engl J Med · October 12, 2006
BACKGROUND: Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. METHODS: In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we r ...
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