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4. Association of Medication Adherence and Health Status in Heart Failure With Reduced Ejection Fraction: Insights From the CHAMP-HF Registry.

Author

El-Zein, Rayan S., Mohammed, Moghniuddin, Nguyen, Daniel D., Hill Jr, C. Larry, Thomas, Laine, Nassif, Michael, DeVore, Adam D., Albert, Nancy M., Butler, Javed, Patterson, J. Herbert, Williams, Fredonia B., Hernandez, Adrian, Fonarow, Gregg C., and Spertus, John A.

Abstract

BACKGROUND: The foundation for managing heart failure with reduced ejection fraction (HFrEF) is adherence to guidelinedirected medical therapy. Finding an association between medication adherence and patients' health status (their symptoms, function, and quality of life) can be used to underscore its importance to patients. METHODS: The association of self-reported medication adherence in US outpatients with HFrEF enrolled in the Change the Management of Patients with Heart Failure registry from 2015 to 2017 was compared with their health status at baseline and 12 months later. A secondary analysis of changes in adherence between baseline and 6 months with 6-month health status was also performed. Medication adherence was assessed with the self-reported 4-item Morisky-Green-Levine Medication Adherence Scale, with scores ≥1 classified as nonadherent. The primary health status outcome was the diseasespecific 12-item Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OS; range, 0-100; higher is better). Robust linear regression models adjusted for confounders were used. RESULTS: After excluding those who died (n=316) or did not provide 12-month KCCQ (n=1285), 3495 outpatients with HFrEF were included, of whom 1108 (31.7%) reported being nonadherent. Nonadherent participants were younger, had significantly worse baseline health status (-5.83-point difference; P<0.001), and showed less improvement at 12 months (-1.7-point difference in mean change; P=0.017) than adherent participants. Among nonadherent patients at baseline, those whose adherence improved trended toward greater 6-month health status improvements than those remaining nonadherent (fully adjusted difference of 2.52 points; P=0.054). CONCLUSIONS: In HFrEF, medication nonadherence was associated with worse health status and less improvement over the following year. Improvements in adherence were associated with better health status than remaining nonadherent, underscoring the importance of supporting adherence with guideline-directed medical therapy in patients with HFrEF. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Multicenter assessment of the outcomes of subcutaneous ICD implantation in patients with prior or future sternotomy

Author

Al‐Kofahi, Mejalli, primary, Adeola, Oluwaseun G., additional, Payne, Jason, additional, Mohammed, Moghniuddin, additional, Reddy, Y. Madhu, additional, Dendi, Raghuveer, additional, Pimentel, Rhea, additional, Berenbom, Loren, additional, Emert, Martin, additional, Ramirez, Rigoberto, additional, Noheria, Amit, additional, Montgomery, Jay A., additional, and Sheldon, Seth H., additional

Published
2022
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21. Poor Medication Adherence Is Associated With Worse Health Status In Heart Failure With Reduced Ejection Fraction

Author

Mohammed, Moghniuddin, primary, Hill, C. Larry, additional, Thomas, Laine, additional, Nassif, Michael, additional, DeVore, Adam D., additional, Albert, Nancy M., additional, Butler, Javed, additional, Patterson, J. Herbert, additional, Williams, Fredonia B., additional, Hernandez, Adrian, additional, Fonarow, Gregg C., additional, and Spertus, John A., additional

Published
2022
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27. Electromagnetic interference from left ventricular assist devices detected in patients with implantable cardioverter‐defibrillators

Author

Sheldon, Seth H., primary, Jazayeri, Mohammad‐Ali, additional, Pierpoline, Michael, additional, Mohammed, Moghniuddin, additional, Parikh, Valay, additional, Robinson, Alexander, additional, Noheria, Amit, additional, Haglund, Nicholas, additional, Sauer, Andrew J., additional, and Reddy, Y. Madhu, additional

Published
2021
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28. Multicenter assessment of the outcomes of subcutaneous ICD implantation in patients with prior or future sternotomy.

Author

Al‐Kofahi, Mejalli, Adeola, Oluwaseun G., Payne, Jason, Mohammed, Moghniuddin, Reddy, Y. Madhu, Dendi, Raghuveer, Pimentel, Rhea, Berenbom, Loren, Emert, Martin, Ramirez, Rigoberto, Noheria, Amit, Montgomery, Jay A., and Sheldon, Seth H.

Subjects
STERNUM surgery, IMPLANTABLE cardioverter-defibrillators, RETROSPECTIVE studies, ACQUISITION of data, TREATMENT effectiveness, MEDICAL records, DILATED cardiomyopathy, DESCRIPTIVE statistics, BODY mass index, LONGITUDINAL method
Abstract

Background: The subcutaneous ICD (S‐ICD) is a viable alternative to transvenous ICD and avoids intravascular complications in patients without a pacing indication. The outcomes of S‐ICD implantation are uncertain in patients with prior sternotomy. Objective: We aim to compare the implant techniques and outcomes with S‐ICD implantation in patients with and without prior sternotomy. Methods: Multicenter retrospective cohort study including adult patients with an S‐ICD implanted between January 2014 and June 2020. Outcomes were compared between patients with and without prior sternotomy. Results: Among the 212 patients (49 ± 15 years old, 43% women, BMI 30 ± 8 kg/m2, 68% primary prevention, 30% ischemic cardiomyopathy, LVEF median 30% IQR 25%–45%) who underwent S‐ICD implantation, 47 (22%) had a prior sternotomy. There was no difference in the sensing vector (57% vs. 53% primary, p = 0.55), laterality of the S‐ICD lead to the sternum (94% vs. 96% leftward, p = 0.54), or the defibrillation threshold (65 ± 1.4 J vs. 65 ± 0.8 J, p = 0.76) with versus without prior sternotomy. The frequency of 30‐day complications was similar with and without prior sternotomy (n = 3/47 vs. n = 15/165, 6% vs. 9%, p = 0.56). Over a median follow‐up of 28 months (IQR 10–49 months), the frequency of inappropriate shocks was similar between those with and without prior sternotomy (n = 3/47 and n = 16/165, 6% vs. 10%, p = 0.58). Conclusion: Implantation of an S‐ICD in patients with prior sternotomy is safe with a similar risk of 30‐day complications and inappropriate ICD shocks as patients without prior sternotomy. [ABSTRACT FROM AUTHOR]

Published
2023
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30. B-PO04-049 MULTICENTER OUTCOMES WITH SUBCUTANEOUS ICD IMPLANTATION IN PATIENTS WITH PRIOR STERNOTOMY

Author

Al-Kofahi, Mejalli, primary, Adeola, Oluwaseun G., additional, Payne, Jason J., additional, Mohammed, Moghniuddin, additional, Reddy, Madhu, additional, Dendi, Raghuveer, additional, Pimentel, Rhea, additional, Berenbom, Loren D., additional, Emert, Martin, additional, Rigoberto, Ramirez, additional, Noheria, Amit, additional, Montgomery, Jay A., additional, and Sheldon, Seth H., additional

Published
2021
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32. EFFECT OF SACUBITRIL/VALSARTAN ON ELECTRICAL AND STRUCTURAL REVERSE REMODELING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION

Author

Abudan, Anas, primary, Sami, Farhad, additional, Mahmood, Uzair, additional, Parimi, Nikhil, additional, Schwarz, Colton, additional, Pierpoline, Michael, additional, Mohammed, Moghniuddin, additional, Dendi, Raghuveer, additional, Pimentel, Rhea, additional, Berenbom, Loren, additional, Emert, Martin, additional, Ramirez, Rigoberto, additional, Noheria, Amit, additional, Reddy, Madhu, additional, Sauer, Andrew, additional, Gupta, Bhanu, additional, and Sheldon, Seth, additional

Published
2021
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33. SAFETY AND EFFICACY OF ATRIAL FIBRILLATION ABLATION IN PATIENTS WITH LIVER CIRRHOSIS: A PROPENSITY-SCORE MATCHED ANALYSIS

Author

Dalia, Tarun, primary, Mohammed, Moghniuddin, additional, Pierpoline, Michael, additional, Ranka, Sagar, additional, Chandler, Jonathan, additional, Hacker, Ethan, additional, Sami, Farhad, additional, Robinson, Alexander, additional, Dendi, Raghuveer, additional, Pimentel, Rhea Linette, additional, Berenbom, Loren, additional, Emert, Martin, additional, Ramirez, Rigoberto, additional, Noheria, Amit, additional, Reddy, Madhu, additional, and Sheldon, Seth, additional

Published
2021
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40. In-Hospital Outcomes and Trends of Tricuspid Valve Surgery in Heart Transplant Patients

Author

Mohammed, Moghniuddin, primary, Rali, Aniket S., additional, Buechler, Tyler, additional, Vuddanda, Venkat, additional, Arshi, Juwairiya, additional, Hosseini Dehkordi, Seyed Hamed, additional, Chandler, Jonathan, additional, Weidling, Robert, additional, Abicht, Travis, additional, Haglund, Nicholas, additional, Sauer, Andrew, additional, and Shah, Zubair, additional

Published
2020
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41. Electromagnetic interference from left ventricular assist devices detected in patients with implantable cardioverter‐defibrillators.

Author

Sheldon, Seth H., Jazayeri, Mohammad‐Ali, Pierpoline, Michael, Mohammed, Moghniuddin, Parikh, Valay, Robinson, Alexander, Noheria, Amit, Haglund, Nicholas, Sauer, Andrew J., and Reddy, Y. Madhu

Subjects
LEFT heart ventricle, PATIENT aftercare, IMPLANTABLE cardioverter-defibrillators, HEART assist devices, SHOCK (Pathology), ELECTROMAGNETIC fields, DESCRIPTIVE statistics
Abstract

Introduction: Electromagnetic interference (EMI) from left ventricular assist devices (LVADs) can cause implantable cardioverter‐defibrillator (ICD) oversensing. We sought to assess the frequency of inappropriate shocks/oversensing due to LVAD‐related EMI and prospectively compare integrated (IB) versus dedicated bipolar (DB) sensing in patients with LVADs. Methods: Single‐center study in LVAD patients with Medtronic or Abbott ICDs between September 2017 and March 2020. We excluded patients that were pacemaker dependent. Measurements were obtained of IB and DB sensing and noise to calculate a signal‐to‐noise ratio (SNR). Device checks were reviewed to assess appropriate and inappropriate sensing events. Results: Forty patients (age 52 ± 14 years, 75% men, 38% ischemic cardiomyopathy) were included with the median time between LVAD implantation and enrollment of 6.7 months (2.3, 11.4 months). LVAD subtypes included: HeartWare (n = 22, 55%), Heartmate II (n = 10, 25%), and Heartmate III (n = 8, 20%). Over a follow‐up duration of 21.6 ± 12.9 months after LVAD implantation, 5% of patients (n = 2) had oversensing of EMI from the LVAD (both with HeartWare LVADs and Abbott ICDs) at 4 days and 10.8 months after LVAD implantation. Both patients underwent adjustment of ventricular sensing with resolution of oversensing and no further events over 5 and 15 months of further follow‐up. The SNR was similar between IB and DB sensing (50 [29–67] and 57 [41–69], p = 0.89). Conclusion: ICD oversensing of EMI from LVADs is infrequent and can be managed with reprogramming the sensitivity. There was no significant difference in the R‐wave SNR with IB versus DB ICD leads. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Abstract 16275: Cardiac Sarcoidosis: A United States National Study of In-Hospital Outcomes and 30-Day Readmissions

Author

Jazayeri, Mohammad-Ali, Umale, Nikita A, Vuddanda, Venkat, Mohammed, Moghniuddin, Hosseini Dehkordi, Seyed Hamed, Mastoris, Ioannis, Taduru, Siva Sagar, Sheldon, Seth H, Reddy, Madhu, Haglund, Nicholas, Sauer, Andrew J, and Shah, Zubair I

Abstract

Introduction:Cardiac sarcoidosis (CS) is clinically manifest in 5% of sarcoidosis patients, though up to 25% have subclinical cardiac involvement. Diagnostic advances have improved detection of CS, but much is unknown regarding its optimal management and outcomes.Objective:Using a large national database, we characterized in-hospital outcomes and 30-day readmissions in CS patients.Methods:The 2016 Nationwide Readmissions Database (NRD), accounting for ~36 million discharges in 27 US states with ~58% of the US population, was queried using International Classification of Diseases, 10threvision codes to isolate adult inpatients admitted with CS. Patient characteristics, reasons for hospitalization, diagnostic and therapeutic procedures, in-hospital outcomes, and 30-day readmission causes were collected. Values of interest were counted and their frequencies computed.Results:A total of 1120 patients were included, of whom 1113 had 30-day follow-up data. Mean age was 56 +11 years with 59% male and 51% white subjects. Nearly 77% had a history of heart failure (HF), 46% had ICDs, 8% had PPMs, and 37% had prior chronic kidney disease. The most common causes for hospitalization were arrhythmias (22%) and HF (19%). Sudden cardiac arrest occurred in 1%. While inpatient, ICDs and PPMs were implanted in 6% and 3%, respectively, while 4% underwent catheter ablation and 4% received advanced HF therapies. In 3% of inpatients, CPR was performed, and in-hospital mortality was 1%. In 30-day follow up, unplanned readmission occurred in 28%, with the most common reasons being ventricular tachycardia (16%) and acute heart failure (12%). Nearly 9% had infectious or hematologic causes of readmission.Conclusions:CS hospitalizations are primarily driven by arrhythmic and HF etiologies with an associated high rate of 30-day readmission for similar reasons. Further study is needed to determine if enhanced risk stratification and timely intervention can improve outcomes.

Published
2019
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49. Abstract 16274: Cilostazol is Not Associated With Improved Health Status in Patients With Symptomatic Peripheral Arterial Disease

Author

Mohammed, Moghniuddin, Gosch, Kensey, and Smolderen, Kim

Abstract

Introduction:Cilostazol is the only FDA approved medication recommended by AHA/ACC guidelines for the treatment of claudication symptoms. There is a paucity of data on the use of cilostazol in the real world and its association with peripheral arterial disease (PAD) specific health status outcomes.Methods:Participants in the US cohort of PORTRAIT registry who presented with new or worsening symptoms, did not have a history of heart failure and were not on Cilostazol at the time of enrollment were assessed. Health status was measured by the disease specific Peripheral Artery Questionnaire (PAQ). The summary score, symptoms and physical functioning scores were assessed at baseline, 3, 6 and 12-months follow up, in which higher scores indicate better health status. Health status over time was assessed using a hierarchical linear mixed model, which included time and cilostazol as categorical effects, as well as a time-by-cilostazol interaction and a random effect for the site. The models were additionally adjusted for age, race, socioeconomic status, bilateral disease, treatment strategy, and sleep apnea history.Results:Of the 567 cilostazol na?ve patients, only 65 (11%) were started on cilostazol. Figure 1 shows the unadjusted mean summary, symptoms and physical functioning PAQ scores for both the groups over time. There was no significant difference in adjusted scores between the groups at follow up, with a 12-month difference of -0.56 [CI (-7.1, 6.0), p = 0.2] for summary scores, -0.12 [CI (-7.8, 7.6), p = 0.97] for symptoms score and -2.6 [CI (-12.2, 7.0), p = 0.6] for physical functioning score.Conclusions:In conclusion, we found a low rate of Cilostazol use among patients with new or worsening symptoms of claudication. We did not find a significant difference in health status outcomes, including patients? overall health status, their symptoms and physical functioning between Cilostazol and non-Cilostazol group.

Published
2019
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