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111. A Prognostic Tool for COVID-19 Decision Support: The Intermountain Risk Score Predicts Major Adverse Health Events in Patients Positive for COVID-19

Author

Horne, Benjamin D., primary, Bledsoe, Joseph R., additional, Muhlestein, Joseph B., additional, May, Heidi T., additional, Peltan, Ithan D., additional, Webb, Brandon J., additional, Carlquist, John F., additional, Bennett, Sterling T., additional, Rea, Susan, additional, Bair, Tami L., additional, Grissom, Colin K., additional, Knight, Stacey, additional, Ronnow, Brianna S., additional, Le, Viet T., additional, Stenehjem, Edward A., additional, Woller, Scott C., additional, Knowlton, Kirk U., additional, and Anderson, Jeffrey L., additional

Published
2021
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112. The Summit Score Stratifies Mortality and Morbidity in Chronic Obstructive Pulmonary Disease

Author

Horne, Benjamin D, Hegewald, Matthew J, Crim, Courtney, Rea, Susan, Bair, Tami L, and Blagev, Denitza P

Subjects
Adult, Aged, 80 and over, Intermountain risk score, clinical decision tool, risk score, International Journal of Chronic Obstructive Pulmonary Disease, Middle Aged, Chlorobenzenes, Androstadienes, Drug Combinations, Pulmonary Disease, Chronic Obstructive, Double-Blind Method, Forced Expiratory Volume, randomized controlled trial, Administration, Inhalation, Humans, IMRS, Morbidity, Original Research, Aged
Abstract

Benjamin D Horne,1,2 Matthew J Hegewald,3 Courtney Crim,4 Susan Rea,5 Tami L Bair,1 Denitza P Blagev3 1Intermountain Medical Center Heart Institute, Salt Lake City, UT, USA; 2Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA; 3Division of Pulmonary Medicine, Department of Internal Medicine, Intermountain Medical Center, Salt Lake City, UT, USA; 4Research and Development, GlaxoSmithKline, Research Triangle Park, NC, USA; 5Care Transformation, Intermountain Healthcare, Salt Lake City, UT, USACorrespondence: Benjamin D HorneIntermountain Medical Center Heart Institute, 5121 S. Cottonwood Street, Salt Lake City, UT 84107, USATel +1801-507-4701Email benjamin.horne@imail.org Twitter@DrBenjaminHorneIntroduction: Tobacco use and other cardiovascular risk factors often accompany chronic obstructive pulmonary disease (COPD). This study derived and validated the Summit Score to predict mortality in people with COPD and cardiovascular risks.Methods: SUMMIT trial subjects (N=16,485) ages 40– 80 years with COPD were randomly assigned 50%/50% to derivation (N=8181) and internal validation (N=8304). Three external COPD validations from Intermountain Healthcare included outpatients with cardiovascular risks (N=9251), outpatients without cardiovascular risks (N=8551), and inpatients (N=26,170). Cox regression evaluated 40 predictors of all-cause mortality. SUMMIT treatments including combined fluticasone furoate (FF) 100μg/vilanterol 25μg (VI) were not included in the score.Results: Mortality predictors were FEV1, heart rate, systolic blood pressure, body mass index, age, smoking pack-years, prior COPD hospitalizations, myocardial infarction, heart failure, diabetes, anti-thrombotics, anti-arrhythmics, and xanthines. Combined in the Summit Score (derivation: c=0.668), quartile 4 vs 1 had HR=4.43 in SUMMIT validation (p< 0.001, 95% CI=3.27, 6.01, c=0.662) and HR=8.15 in Intermountain cardiovascular risk COPD outpatients (p< 0.001, 95% CI=5.86, 11.34, c=0.736), and strongly predicted mortality in the other Intermountain COPD populations. Among all SUMMIT subjects with scores 14– 19, FF 100μg/VI 25μg vs placebo had HR=0.76 (p=0.0158, 95% CI=0.61, 0.95), but FF 100μg/VI 25μg was not different from placebo for scores < 14 or > 19.Conclusion: In this post hoc analysis of SUMMIT trial data, the Summit Score was derived and validated in multiple Intermountain COPD populations. The score was used to identify a subpopulation in which mortality risk was lower for FF 100μg/VI 25μg treatment.Trial Registration: The SUMMIT trial is registered at ClinicalTrials.gov as number NCT01313676.Keywords: clinical decision tool, risk score, randomized controlled trial, Intermountain risk score, IMRS

Published
2020

115. Lipoprotein-associated phospholipase A(sub 2) independently predicts the angiographic diagnosis of coronary artery disease and coronary death

Author

May, Heidi T., Horne, Benjamin D., Anderson, Jeffrey L., Wolfert, Robert L., Muhlestein, Joseph B., Renlund, Dale G., Clarke, Jessica L., Kolck, Matthew J., Bair, Tami L., Pearson, Robert R., Sudhir, Krishnankutty, and Carlqluist, John F.

Subjects
Phospholipases -- Analysis, Biological markers -- Analysis, Coronary heart disease -- Diagnosis, Coronary heart disease -- Patient outcomes, Coronary heart disease -- Research, Stroke (Disease) -- Diagnosis, Stroke (Disease) -- Patient outcomes, Stroke (Disease) -- Research, Health
Published
2006

117. Improved long-term survival associated with stent deployment during percutaneous coronary interventions: results from a registry of 3399 patients

Author

Muhlestein, Joseph B., Anderson, Jeffrey L., Cui, ChangZong, Lan, YanPing, Bair, Tami L., Bunch, T. Jared, Pearson, Robert R., Sorensen, Sherman G., Renlund, Dale G., Zhang, Li, Horne, Benjamin D., and Vincent, G. Michael

Subjects
Stent (Surgery) -- Patient outcomes, Stenosis -- Prevention, Angioplasty -- Patient outcomes, Health
Published
2005

123. Effect of fasting glucose levels on mortality rate in patients with and without diabetes mellitus and coronary artery disease undergoing percutaneous coronary intervention

Author

Muhlestein, Joseph B., Anderson, Jeffrey L., Horne, Benjamin D., Lavasani, Farangis, Maycock, Chloe A. Allen, Bair, Tami L., Pearson, Robert R., and Carlquist, John F.

Subjects
Cardiac patients -- Research, Coronary heart disease -- Research, Coronary heart disease -- Care and treatment, Diabetes -- Research, Diabetes -- Care and treatment, Health
Published
2003

124. Bete-Blockers reduce the incidence of clinical restenosis: Prospective study of 4840 patients undergoing percutaneous coronary revascularization

Author

Jackson, Jeffrey D., Muhlestein, Joseph B., Bunch, T. Jared, Bair, Tami L., Horne, Benjamin D., Madsen, Troy E., Lappe, Jason M., and Anderson, Jeffrey L.

Subjects
Coronary heart disease -- Research, Coronary heart disease -- Care and treatment, Adrenergic beta blockers -- Research, Coronary restenosis -- Research, Coronary restenosis -- Care and treatment, Health
Published
2003

130. Risk score–guided multidisciplinary team-based Care for Heart Failure Inpatients is associated with lower 30-day readmission and lower 30-day mortality

Author

Horne, Benjamin D., primary, Roberts, Colleen A., additional, Rasmusson, Kismet D., additional, Buckway, Jason, additional, Alharethi, Rami, additional, Cruz, Jalisa, additional, Evans, R. Scott, additional, Lloyd, James F., additional, Bair, Tami L., additional, Kfoury, Abdallah G., additional, and Lappé, Donald L., additional

Published
2020
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150. E valuation of T R eatment With A ngiotensin C onverting E nzyme Inhibitors and the R isk of Lung Cancer: ERACER—An Observational Cohort Study.

Author

Anderson, Jeffrey L., Knowlton, Kirk U., Muhlestein, J. Brent, Bair, Tami L., Le, Viet T., and Horne, Benjamin D.

Subjects
LUNG cancer, ACE inhibitors, DISEASE risk factors, ANGIOTENSIN receptors, MORTALITY
Abstract

Introduction: Angiotensin converting enzyme inhibitors (ACEIs) are widely prescribed medications. A recent British study reported a 14% increased risk of lung cancer with ACEI versus angiotensin receptor blocker (ARB) prescriptions, and risk increased with longer use. We sought to validate this observation. Methods: We searched the Intermountain Enterprise Data Warehouse from 1996 to 2018 for patients newly treated with an ACEI or an ARB and with ≥1 year's follow-up or to incident lung cancer or death. Unadjusted and adjusted hazard ratios (HRs) for lung cancer and for lung cancer or all-cause mortality were calculated for ACEIs compared to ARBs. Results: A total of 187,060 patients met entry criteria (age 60.2 ± 15.1 y; 51% women). During a mean of 7.1 years follow-up (max: 20.0 years), 3,039 lung cancers and 43,505 deaths occurred. Absolute lung cancer rates were 2.16 and 2.31 per 1000 patient-years in the ARB and ACEI groups, respectively. The HR of lung cancer was modestly increased with ACEIs (unadjusted HR = 1.11, CI: 1.02, 1.22, P =.014; adjusted HR = 1.18, CI: 1.06, 1.31, P =.002; number needed to harm [NNH] 6,667). Rates of the composite of lung cancer or death over time also favored ARBs. Lung cancer event curves separated gradually over longitudinal follow-up beginning at 10-12 years. Conclusions: We noted a small long-term increase in lung cancer risk with ACEIs compared with ARBs. Separation of survival curves was delayed until 10-12 years after treatment initiation. Although the observed increases in lung cancer risk are small, implications are potentially important because of the broad use of ACEIs. Thus, additional work to validate these findings is needed. [ABSTRACT FROM AUTHOR]

Published
2021
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