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253. Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction

Author

Khera, Rohan, primary, Haimovich, Julian, additional, Hurley, Nathan C., additional, McNamara, Robert, additional, Spertus, John A., additional, Desai, Nihar, additional, Rumsfeld, John S., additional, Masoudi, Frederick A., additional, Huang, Chenxi, additional, Normand, Sharon-Lise, additional, Mortazavi, Bobak J., additional, and Krumholz, Harlan M., additional

Published
2021
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256. REVeAL-HF

Author

Ahmad, Tariq, primary, Yamamoto, Yu, additional, Biswas, Aditya, additional, Ghazi, Lama, additional, Martin, Melissa, additional, Simonov, Michael, additional, Hsiao, Allen, additional, Kashyap, Nitu, additional, Velazquez, Eric J., additional, Desai, Nihar R., additional, and Wilson, F. Perry, additional

Published
2021
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259. Serum Potassium and Mortality in High-Risk Patients:SPRINT

Author

Byrne, Christina, Pareek, Manan, Vaduganathan, Muthiah, Biering-Sørensen, Tor, Krogager, Maria Lukács, Kragholm, Kristian Hay, Steensig, Kamilla, Mortensen, Martin Bødtker, Mishra, Shiva Raj, McCullough, Megan J., Desai, Nihar R., Torp-Pedersen, Christian, Olsen, Michael Hecht, Bhatt, Deepak L., Byrne, Christina, Pareek, Manan, Vaduganathan, Muthiah, Biering-Sørensen, Tor, Krogager, Maria Lukács, Kragholm, Kristian Hay, Steensig, Kamilla, Mortensen, Martin Bødtker, Mishra, Shiva Raj, McCullough, Megan J., Desai, Nihar R., Torp-Pedersen, Christian, Olsen, Michael Hecht, and Bhatt, Deepak L.

Abstract

A U-shaped association between serum potassium (s-potassium) and short-term mortality has been reported for patients with hypertension. Less is known about the long-term prognostic implications of s-potassium and whether this relationship is modified by intensive blood pressure (BP) control. SPRINT (Systolic Blood Pressure Intervention Trial) was a randomized, controlled trial of 9361 high-risk patients aged ≥50 years without diabetes, who were allocated to intensive versus standard BP control. We investigated associations between baseline and on-treatment s-potassium and death, using Cox proportional hazards regression (including s-potassium as a time-dependent covariate) and restricted cubic splines. We further explored the effects of intensive BP control across the s-potassium spectrum. Baseline s-potassium was available in 9336 individuals, and 8473 had a measurement at 12 months. Mean baseline s-potassium was similar between the 2 treatment groups (intensive 4.21 mmol/L versus standard 4.20 mmol/L; P=0.74), but on-treatment s-potassium was lower in the intensive group (4.14 mmol/L versus 4.18 mmol/L; P=0.001). Median follow-up was 3.3 years, with 365 all-cause deaths (3.9%) and 102 cardiovascular deaths (1.1%). Baseline s-potassium had a linear association with both types of death events (P<0.05). On-treatment potassium also had a linear association with all-cause death (P=0.04) but not with cardiovascular death (P=0.13). None of the associations remained significant after multivariable adjustment (P≥0.05). S-potassium did not modify the effect of intensive BP control (P≥0.05). In SPRINT, neither baseline nor on-treatment s-potassium levels were independently associated with death, and the effect of intensive BP control was not modified by s-potassium. Careful monitoring of patients on antihypertensive medications may eliminate the risks associated with abnormal s-potassium. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062

Published
2021

260. The GLAMM1 Study - Global Access to Myeloma Medications: Potential Barriers to Chimeric Antigen Receptors (CART) and T-Cell-Engaging Bispecific Antibodies (TCE) Globally

Author

Atallah, Rawan, Shatnawi, Yara, Mammadzadeh, Aytaj, Hashmi, Shahrukh K, Rana, Shabeeha K, Mushtaq, Muhammad Umair, Mohamed, Benlazar, Desai, Nihar, Xavier Carneiro, Thiago, Popat, Rakesh, McGuirk, Joseph P, Atrash, Shebli, Mahmoudjafari, Zahra, Abdallah, Al-Ola, and Ahmed, Nausheen

Published
2023
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263. When past is prologue

Author

Desai, Nihar R., Cheng, Susan, Nohria, Anju, Halperin, Florencia, and Giugliano, Robert P.

Subjects
Dropsy -- Case studies, Dropsy -- Diagnosis, Dropsy -- Care and treatment, Edema -- Case studies, Edema -- Diagnosis, Edema -- Care and treatment, Electromyography -- Health aspects
Abstract

The article discusses how important it is for a physician to make the correct diagnosis, which should be based on the fact that what is past is prologue. A case study of a 36-year-old man with edema is highlighted to better understand past diagnosis and what kind of treatment the present circumstances require.

Published
2009

265. Outcomes in patients with anthracycline‐induced cardiomyopathy undergoing left ventricular assist devices implantation

Author

Guha, Avirup, primary, Caraballo, Cesar, additional, Jain, Prantesh, additional, Miller, P. Elliott, additional, Owusu‐Guha, Jocelyn, additional, Clark, Katherine A.A., additional, Velazquez, Eric J., additional, Ahmad, Tariq, additional, Baldassarre, Lauren A., additional, Addison, Daniel, additional, Weintraub, Neal L., additional, and Desai, Nihar R., additional

Published
2021
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267. OUTCOMES OF CONTEMPORARY NON-INFERIORITY VERSUS SUPERIORITY CARDIOVASCULAR TRIALS

Author

Dreyfus, Isaac, primary, Varunok, Nicholas, additional, Madhavan, Mahesh, additional, Burton, John, additional, Redfors, Bjorn, additional, Collier, Timothy, additional, Rossello, Xavier, additional, Owen, Ruth, additional, Francese, Dominic, additional, Desai, Nihar, additional, Ross, Joseph, additional, Kaul, Sanjay, additional, Pocock, Stuart, additional, Stone, Gregg, additional, Krumholz, Harlan, additional, and Bikdeli, Behnood, additional

Published
2021
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273. INTRAOPERATIVE MORTALITY AND DISPOSITION OF ELECTIVE PCI: INSIGHTS FROM THE NATIONAL AMBULATORY SURGERY SAMPLE

Author

Milioglou, Ioannis, primary, Chouairi, Fouad, additional, Miller, Paul, additional, Ahmad, Tariq, additional, Reinhardt, Samuel, additional, Kay, Bradley, additional, Clark, Katherine, additional, Milner, Aidan, additional, Pacor, Justin, additional, Caraballo, Cesar, additional, Ravindra, Neal, additional, Friedman, Daniel, additional, Desai, Nihar, additional, and Guha, Avirup, additional

Published
2021
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274. Diabetes Care Among Older Adults Enrolled in Medicare Advantage Versus Traditional Medicare Fee-For-Service Plans: The Diabetes Collaborative Registry.

Author

Essien, Utibe R., Tang, Yuanyuan, Figueroa, Jose F., Litam, Terrence Michael A., Tang, Fengming, Jones, Philip G., Patel, Ravi, Wadhera, Rishi K., Desai, Nihar R., Mehta, Sanjeev N., Kosiborod, Mikhail N., and Vaduganathan, Muthiah

Subjects
FEE for service (Medical fees), HYPOGLYCEMIC agents, ACQUISITION of data, RETROSPECTIVE studies, TYPE 2 diabetes, RESEARCH funding, MEDICARE
Abstract

Objective: Medicare Advantage (MA), Medicare's managed care program, is quickly expanding, yet little is known about diabetes care quality delivered under MA compared with traditional fee-for-service (FFS) Medicare.Research Design and Methods: This was a retrospective cohort study of Medicare beneficiaries ≥65 years old enrolled in the Diabetes Collaborative Registry from 2014 to 2019 with type 2 diabetes treated with one or more antihyperglycemic therapies. Quality measures, cardiometabolic risk factor control, and antihyperglycemic prescription patterns were compared between Medicare plan groups, adjusted for sociodemographic and clinical factors.Results: Among 345,911 Medicare beneficiaries, 229,598 (66%) were enrolled in FFS and 116,313 (34%) in MA plans (for ≥1 month). MA beneficiaries were more likely to receive ACE inhibitors/angiotensin receptor blockers for coronary artery disease, tobacco cessation counseling, and screening for retinopathy, foot care, and kidney disease (adjusted P ≤ 0.001 for all). MA beneficiaries had modestly but significantly higher systolic blood pressure (+0.2 mmHg), LDL cholesterol (+2.6 mg/dL), and HbA1c (+0.1%) (adjusted P < 0.01 for all). MA beneficiaries were independently less likely to receive glucagon-like peptide 1 receptor agonists (6.9% vs. 9.0%; adjusted odds ratio 0.80, 95% CI 0.77-0.84) and sodium-glucose cotransporter 2 inhibitors (5.4% vs. 6.7%; adjusted odds ratio 0.91, 95% CI 0.87-0.95). When integrating Centers for Medicare and Medicaid Services-linked data from 2014 to 2017 and more recent unlinked data from the Diabetes Collaborative Registry through 2019 (total N = 411,465), these therapeutic differences persisted, including among subgroups with established cardiovascular and kidney disease.Conclusions: While MA plans enable greater access to preventive care, this may not translate to improved intermediate health outcomes. MA beneficiaries are also less likely to receive newer antihyperglycemic therapies with proven outcome benefits in high-risk individuals. Long-term health outcomes under various Medicare plans requires surveillance. [ABSTRACT FROM AUTHOR]

Published
2022
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276. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection

Author

McPadden, Jacob, primary, Warner, Frederick, additional, Young, H. Patrick, additional, Hurley, Nathan C., additional, Pulk, Rebecca A., additional, Singh, Avinainder, additional, Durant, Thomas J. S., additional, Gong, Guannan, additional, Desai, Nihar, additional, Haimovich, Adrian, additional, Taylor, Richard Andrew, additional, Gunel, Murat, additional, Dela Cruz, Charles S., additional, Farhadian, Shelli F., additional, Siner, Jonathan, additional, Villanueva, Merceditas, additional, Churchwell, Keith, additional, Hsiao, Allen, additional, Torre, Charles J., additional, Velazquez, Eric J., additional, Herbst, Roy S., additional, Iwasaki, Akiko, additional, Ko, Albert I., additional, Mortazavi, Bobak J., additional, Krumholz, Harlan M., additional, and Schulz, Wade L., additional

Published
2021
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280. Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies

Author

Chouairi, Fouad, primary, Mullan, Clancy W., additional, Sen, Sounok, additional, Mori, Makoto, additional, Fuery, Michael, additional, Elder, Robert W., additional, Lesse, Joshua, additional, Norton, Kelsey, additional, Clark, Katherine A., additional, Miller, P. Elliott, additional, Mulligan, David, additional, Formica, Richard, additional, Rogers, Joseph G., additional, Jacoby, Daniel, additional, Maulion, Christopher, additional, Anwer, Muhammad, additional, Geirsson, Arnar, additional, Desai, Nihar R., additional, and Ahmad, Tariq, additional

Published
2021
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285. Assessment of Market-Level Information on Quality Using Hospital Care Compare.

Author

Oddleifson, D. August, Xu, Xiao, Ross, Joseph S., Spatz, Erica S., and Desai, Nihar R.

Subjects
HOSPITAL care quality, MEDICAID beneficiaries, CHILDREN'S hospitals, HOSPITAL size, RATINGS of hospitals, TOTAL knee replacement
Abstract

The Hospital Care Compare online tool was developed by the Centers for Medicare & Medicaid Services (CMS) to help Medicare beneficiaries make informed quality-based choices about where to receive care and to support hospital quality improvement efforts. RESULTS The majority of HRRs contained only average-rated hospitals for all five performance measures - 94.8% (290/306) for AMI readmission, 91.8% (281/306) for AMI mortality, 96.1% (292/304) for CABG readmission, 92.1% (280/304) for CABG mortality, and 76.5% (234/306) for hip/knee complication. Although many public and private hospital quality-comparison tools exist, each has its own limitations.[4],[5] For CMS's Hospital Care Compare, the tool identifies performance outliers but does not distinguish between hospitals in the middle majority. [Extracted from the article]

Published
2023
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289. Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock

Author

Dhruva, Sanket S., primary, Ross, Joseph S., additional, Mortazavi, Bobak J., additional, Hurley, Nathan C., additional, Krumholz, Harlan M., additional, Curtis, Jeptha P., additional, Berkowitz, Alyssa P., additional, Masoudi, Frederick A., additional, Messenger, John C., additional, Parzynski, Craig S., additional, Ngufor, Che G., additional, Girotra, Saket, additional, Amin, Amit P., additional, Shah, Nilay D., additional, and Desai, Nihar R., additional

Published
2021
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292. Transition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes

Author

Miller, P. Elliott, primary, Chouairi, Fouad, additional, Thomas, Alexander, additional, Kunitomo, Yukiko, additional, Aslam, Faisal, additional, Canavan, Maureen E., additional, Murphy, Christa, additional, Daggula, Krishna, additional, Metkus, Thomas, additional, Vallabhajosyula, Saraschandra, additional, Carnicelli, Anthony, additional, Katz, Jason N., additional, Desai, Nihar R., additional, Ahmad, Tariq, additional, Velazquez, Eric J., additional, and Brennan, Joseph, additional

Published
2021
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293. Socio-Economic Burden of Myocardial Infarction Among Cancer Patients

Author

Guha, Avirup, primary, Dey, Amit Kumar, additional, Al-Kindi, Sadeer, additional, Miller, P. Elliott, additional, Ghosh, Arjun K., additional, Banerjee, Amitava, additional, Lopez-Mattei, Juan, additional, Desai, Nihar R., additional, Patel, Brijesh, additional, Oliveira, Guilherme H., additional, de Lima, Marcos, additional, Fradley, Michael, additional, and Addison, Daniel, additional

Published
2021
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295. Medical Student Patient Outreach to Ensure Continuity of Care During the COVID-19 Pandemic

Author

Belzer, Annika, primary, Yeagle, Erin M., additional, Kohlenberg, Lucille K., additional, Solberg, Muriel, additional, Gudbranson, Emily, additional, Budge, Mariana, additional, Batchelor, Hannah M., additional, Fitzpatrick, Sarah E., additional, Zhao, Anna, additional, Armengol, V. Diego, additional, Hassan, Samer F., additional, Shum, May, additional, Bia, Margaret, additional, Bia, Frank, additional, Desai, Nihar R., additional, and Kahn, Peter A., additional

Published
2021
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298. Myopericarditis after Covid-19 Vaccination – a Case Series

Author

Pareek, Manan, primary, Asnes, Jeremy, additional, Baldassarre, Lauren, additional, Casale, Linda, additional, Desai, Nihar, additional, Elder, Robert, additional, Faherty, Erin, additional, Ferguson, Ian, additional, Fishman, Robert, additional, Ghazizadeh, Zaniar, additional, Glick, Laura, additional, Hall, Kevin, additional, Khera, Rohan, additional, Kokkinidis, Damianos, additional, Kwan, Jennifer, additional, O'Marr, Jamieson, additional, Schussheim, Adam, additional, Steele, Jeremy, additional, Tuohy, Edward, additional, Wang, Yanting, additional, Spatz, Erica, additional, Jacoby, Daniel, additional, and Miller, Edward, additional

Published
2021
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300. Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure

Author

Mezzacappa, Catherine, primary, Ravindra, Neal G., additional, Caraballo, Cesar, additional, Chouairi, Fouad, additional, Miller, P. Elliott, additional, Clarke, John-Ross D., additional, Gruen, Jadry, additional, Mori, Makoto, additional, McCullough, Megan, additional, Mullan, Clancy, additional, Geirsson, Arnar, additional, Rogers, Joseph G., additional, Anwer, Mohammad, additional, Desai, Nihar, additional, and Ahmad, Tariq, additional

Published
2020
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