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JOURNAL ARTICLE
Sarah Krumholz, Molly Hurd, Wendy Memishian
No abstract text is available yet for this article.
February 21, 2024: Medical Education
#22
JOURNAL ARTICLE
Thomas A Pearson, Debbie Vitalis, Charlotte Pratt, Rebecca Campo, Antonis A Armoundas, David Au, Bettina Beech, Olga Brazhnik, Christopher G Chute, Karina W Davidson, Ana V Diez-Roux, Lawrence J Fine, Davera Gabriel, Peter Groenveld, Jaclyn Hall, Alison B Hamilton, Hui Hu, Heng Ji, Amy Kind, William E Kraus, Harlan Krumholz, George A Mensah, Raina M Merchant, Dariush Mozaffarian, David M Murray, Dianne Neumark-Sztainer, Maya Petersen, David Goff
Precision prevention embraces personalized prevention but includes broader factors such as social determinants of health to improve cardiovascular health. The quality, quantity, precision, and diversity of data relatable to individuals and communities continue to expand. New analytical methods can be applied to these data to create tools to attribute risk, which may allow a better understanding of cardiovascular health disparities. Interventions using these analytic tools should be evaluated to establish feasibility and efficacy for addressing cardiovascular disease disparities in diverse individuals and communities...
January 2024: JACC Adv
#23
Rohan Khera, Arya Aminorroaya, Lovedeep Singh Dhingra, Phyllis M Thangaraj, Aline Pedroso Camargos, Fan Bu, Xiyu Ding, Akihiko Nishimura, Tara V Anand, Faaizah Arshad, Clair Blacketer, Yi Chai, Shounak Chattopadhyay, Michael Cook, David A Dorr, Talita Duarte-Salles, Scott L DuVall, Thomas Falconer, Tina E French, Elizabeth E Hanchrow, Guneet Kaur, Wallis Cy Lau, Jing Li, Kelly Li, Yuntian Liu, Yuan Lu, Kenneth Kc Man, Michael E Matheny, Nestoras Mathioudakis, Jody-Ann McLeggon, Michael F McLemore, Evan Minty, Daniel R Morales, Paul Nagy, Anna Ostropolets, Andrea Pistillo, Thanh-Phuc Phan, Nicole Pratt, Carlen Reyes, Lauren Richter, Joseph Ross, Elise Ruan, Sarah L Seager, Katherine R Simon, Benjamin Viernes, Jianxiao Yang, Can Yin, Seng Chan You, Jin J Zhou, Patrick B Ryan, Martijn J Schuemie, Harlan M Krumholz, George Hripcsak, Marc A Suchard
BACKGROUND: SGLT2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1-RAs) reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM). However, their effectiveness relative to each other and other second-line antihyperglycemic agents is unknown, without any major ongoing head-to-head trials. METHODS: Across the LEGEND-T2DM network, we included ten federated international data sources, spanning 1992-2021. We identified 1,492,855 patients with T2DM and established cardiovascular disease (CVD) on metformin monotherapy who initiated one of four second-line agents (SGLT2is, GLP1-RAs, dipeptidyl peptidase 4 inhibitor [DPP4is], sulfonylureas [SUs])...
February 8, 2024: medRxiv
#24
REVIEW
Alexander W Carter, Sahan Jayawardana, Joan Costa-Font, Khurram Nasir, Harlan M Krumholz, Elias Mossialos
BACKGROUND: Quasi-experimental methods (QEMs) are a family of techniques used to estimate causal relationships when randomized controlled trials are unfeasible or unethical. They offer a powerful alternative to observational studies by introducing random assignment of individuals or groups into their design, thereby offering stronger means of establishing causation. The use of QEMs in cardiovascular research has not been systematically examined to determine steps toward improving and expanding their use...
February 2024: Circulation. Cardiovascular Quality and Outcomes
#25
Lovedeep S Dhingra, Veer Sangha, Arya Aminorroaya, Robyn Bryde, Andrew Gaballa, Adel H Ali, Nandini Mehra, Harlan M Krumholz, Sounok Sen, Christopher M Kramer, Matthew W Martinez, Milind Y Desai, Evangelos K Oikonomou, Rohan Khera
Artificial intelligence-enhanced electrocardiography (AI-ECG) interpretation can identify hypertrophic cardiomyopathy (HCM) on 12-lead ECGs and is a novel way to monitor response to treatment. While initial therapies were procedural - i.e. the surgical or percutaneous reduction of the interventricular septum (SRT), medical therapy with mavacamten offers an oral alternative. To evaluate biological response to SRT, we applied an AI-ECG model for HCM detection to ECG images obtained from the same patients before and after SRT across three sites: Yale New Haven Health System (YNHHS), Cleveland Clinic Foundation (CCF), and Atlantic Health System (AHS)...
January 17, 2024: medRxiv
#26
JOURNAL ARTICLE
Richa Sharma, Adam de Havenon, Cyprien Rivier, Seyedmehdi Payabvash, Rachel Forman, Harlan Krumholz, Guido J Falcone, Kevin N Sheth, Walter N Kernan
BACKGROUND: Vascular brain injury (VBI) may be an under-recognised contributor to mobility impairment. We examined associations between MRI VBI biomarkers and impaired mobility. METHODS: We separately analysed Atherosclerosis Risk in Communities (ARIC) and UK Biobank (UKB) study cohorts. Inclusion criteria were no prevalent clinical stroke, and available brain MRI and balance and gait data. MRI VBI biomarkers were (ARIC: ventricular and white matter hyperintensity (WMH) volumes, non-lacunar and lacunar infarctions, microhaemorrhage; UKB: ventricular, brain and WMH volumes, fractional anisotropy (FA), mean diffusivity (MD), intracellular and isotropic free water volume fractions)...
2024: BMJ neurology open
#27
JOURNAL ARTICLE
Satoko Ito, Ankur Pandya, Ronald G Hauser, Lakshmanan Krishnamurti, Edward Stites, Chris Tormey, Harlan M Krumholz, Jeanne E Hendrickson, George Goshua
Red blood cell alloimmunization and consequent delayed hemolytic transfusion reaction (DHTR) incidence and mortality in patients with sickle cell disease (SCD) are high. A shared transfusion resource has decreased both in other countries, while in the United States cost concerns persist. We conducted a Markov cohort simulation of a birth cohort of alloimmunized patients with SCD to estimate lifetime DHTR incidence, DHTR-specific mortality, quality-adjusted life expectancy (QALE), and costs with the implementation of a shared transfusion resource to identify antibody history versus without (i...
April 2024: American Journal of Hematology
#28
JOURNAL ARTICLE
Cenjing Zhu, Rachel P Dreyer, Fan Li, Erica S Spatz, César Caraballo, Shiwani Mahajan, Valeria Raparelli, Erica C Leifheit, Yuan Lu, Harlan M Krumholz, John A Spertus, Gail D'Onofrio, Louise Pilote, Judith H Lichtman
INTRODUCTION: Despite evidence supporting the benefits of marriage on cardiovascular health, the impact of marital/partner status on the long-term readmission of young acute myocardial infarction (AMI) survivors is less clear. We examined the association between marital/partner status and 1-year all-cause readmission and explored sex differences among young AMI survivors. METHODS: Data were from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which enrolled young adults aged 18-55 years with AMI (2008-2012)...
2024: PloS One
#29
Yuan Lu, Oreoluwa Arowojolu, Xiaoliang Qiu, Yuntian Liu, Leslie Curry, Harlan M Krumholz
IMPORTANCE: Hypertension poses a significant public health challenge. Despite clinical practice guidelines for hypertension management, clinician adherence to these guidelines remains suboptimal. OBJECTIVE: This study aims to develop a taxonomy of suboptimal adherence scenarios for severe hypertension and identify barriers to guideline adherence. DESIGN: We conducted a qualitative content analysis using electronic health records (EHRs) of Yale New Haven Health System who had at least two consecutive visits between January 1, 2013, and October 31, 2018...
January 13, 2024: medRxiv
#30
Connor B Grady, Bornali Bhattacharjee, Julio Silva, Jillian Jaycox, Lik Wee Lee, Valter Silva Monteiro, Mitsuaki Sawano, Daisy Massey, César Caraballo, Jeff R Gehlhausen, Alexandra Tabachnikova, Tianyang Mao, Carolina Lucas, Mario A Peña-Hernandez, Lan Xu, Tiffany J Tzeng, Takehiro Takahashi, Jeph Herrin, Diana Berrent Güthe, Athena Akrami, Gina Assaf, Hannah Davis, Karen Harris, Lisa McCorkell, Wade L Schulz, Daniel Grffin, Hannah Wei, Aaron M Ring, Leying Guan, Charles Dela Cruz, Akiko Iwasaki, Harlan M Krumholz
BACKGROUND: Long COVID contributes to the global burden of disease. Proposed root cause hypotheses include the persistence of SARS-CoV-2 viral reservoir, autoimmunity, and reactivation of latent herpesviruses. Patients have reported various changes in Long COVID symptoms after COVID-19 vaccinations, leaving uncertainty about whether vaccine-induced immune responses may alleviate or worsen disease pathology. METHODS: In this prospective study, we evaluated changes in symptoms and immune responses after COVID-19 vaccination in 16 vaccine-naïve individuals with Long COVID...
January 12, 2024: medRxiv
#31
JOURNAL ARTICLE
Snigdha Jain, Harlan M Krumholz
No abstract text is available yet for this article.
January 23, 2024: Annals of the American Thoracic Society
#32
JOURNAL ARTICLE
Christopher T Garner, Krithivasan Sankaranarayanan, Christopher A Abin, Rosa M Garner, Haiyuan Cai, Paul A Lawson, Lee R Krumholz
A bacterial strain, designated NLS-7T , was isolated through enrichment of landfill cover soil in methane-oxidizing conditions. Strain NLS-7T is a Gram-stain negative, non-motile rod, approximately 0.8 µm wide by 1.3 µm long. Phylogenetic analysis based on 16S rRNA gene sequencing places it within the genus Methylocystis , with its closest relatives being M. hirsuta , M. silviterrae and M. rosea , with 99.9, 99.7 and 99.6 % sequence similarity respectively. However, average nucleotide identity and average amino acid identity values below the 95 % threshold compared to all the close relatives and digital DNA-DNA hybridization values between 20...
January 2024: International Journal of Systematic and Evolutionary Microbiology
#33
Veer Sangha, Lovedeep Singh Dhingra, Evangelos Oikonomou, Arya Aminorroaya, Nikhil V Sikand, Sounok Sen, Harlan M Krumholz, Rohan Khera
BACKGROUND: Hypertrophic cardiomyopathy (HCM) affects 1 in every 200 individuals and is the leading cause of sudden cardiac death in young adults. HCM can be identified using an electrocardiogram (ECG) raw voltage data and deep learning approaches, but their point-of-care application is limited by the inaccessibility of these signal data. We developed a deep learning-based approach that overcomes this limitation and detects HCM from images of 12-lead ECGs across layouts. METHODS: We identified ECGs from patients with HCM features present on cardiac magnetic resonance imaging (CMR) or those within 30 days of an echocardiogram documenting thickened interventricular septum (end-diastolic interventricular septum thickness > 15mm)...
December 28, 2023: medRxiv
#34
REVIEW
Antoine Bejjani, Candrika D Khairani, Ali Assi, Gregory Piazza, Parham Sadeghipour, Azita H Talasaz, John Fanikos, Jean M Connors, Deborah M Siegal, Geoffrey D Barnes, Karlyn A Martin, Dominick J Angiolillo, Dawn Kleindorfer, Manuel Monreal, David Jimenez, Saskia Middeldorp, Mitchell S V Elkind, Christian T Ruff, Samuel Z Goldhaber, Harlan M Krumholz, Roxana Mehran, Mary Cushman, John W Eikelboom, Gregory Y H Lip, Jeffrey I Weitz, Renato D Lopes, Behnood Bikdeli
For most patients, direct oral anticoagulants (DOACs) are preferred over vitamin K antagonists for stroke prevention in atrial fibrillation and for venous thromboembolism treatment. However, randomized controlled trials suggest that DOACs may not be as efficacious or as safe as the current standard of care in conditions such as mechanical heart valves, thrombotic antiphospholipid syndrome, and atrial fibrillation associated with rheumatic heart disease. DOACs do not provide a net benefit in conditions such as embolic stroke of undetermined source...
January 23, 2024: Journal of the American College of Cardiology
#35
JOURNAL ARTICLE
Harlan M Krumholz
No abstract text is available yet for this article.
January 2024: Circulation. Cardiovascular Quality and Outcomes
#36
JOURNAL ARTICLE
Claudia See, Kevin M Wheelock, César Caraballo, Rohan Khera, Amarnath Annapureddy, Shiwani Mahajan, Yuan Lu, Harlan M Krumholz, Karthik Murugiah
BACKGROUND: Studies show that digoxin use is declining but is still prevalent. Recent data on digoxin prescription and characteristics of digoxin prescribers are unknown, which can help understand its contemporary use. METHODS: Using Medicare Part D data from 2013 to 2019, we studied the change in number and proportion of digoxin prescriptions and digoxin prescribers, overall and by specialty. Using logistic regression, we identified prescriber characteristics associated with digoxin prescription...
December 2023: Am J Med Open
#37
JOURNAL ARTICLE
Adam M Chekroud, Matt Hawrilenko, Hieronimus Loho, Julia Bondar, Ralitza Gueorguieva, Alkomiet Hasan, Joseph Kambeitz, Philip R Corlett, Nikolaos Koutsouleris, Harlan M Krumholz, John H Krystal, Martin Paulus
It is widely hoped that statistical models can improve decision-making related to medical treatments. Because of the cost and scarcity of medical outcomes data, this hope is typically based on investigators observing a model's success in one or two datasets or clinical contexts. We scrutinized this optimism by examining how well a machine learning model performed across several independent clinical trials of antipsychotic medication for schizophrenia. Models predicted patient outcomes with high accuracy within the trial in which the model was developed but performed no better than chance when applied out-of-sample...
January 12, 2024: Science
#38
JOURNAL ARTICLE
Aakriti Gupta, Makoto Mori, Yun Wang, Shubhadarshini G Pawar, Torsten Vahl, Tamim Nazif, Oyere Onuma, Celina M Yong, Rahul Sharma, Ajay J Kirtane, John K Forrest, Isaac George, Susheel Kodali, Joanna Chikwe, Arnar Geirsson, Raj Makkar, Martin B Leon, Harlan M Krumholz
PURPOSE: There are concerns that transcatheter or surgical aortic valve replacement (TAVR/SAVR) procedures are preferentially available to White patients. OBJECTIVE: Our objective was to examine differences in utilization of aortic valve replacement and outcomes by race/ethnicity in the US for patients with aortic stenosis. METHODS: We performed a serial cross-sectional cohort study of 299,976 Medicare beneficiaries hospitalized with principal diagnosis of aortic stenosis between 2012 and 2019 stratified by self-reported race/ethnicity (Black, Hispanic, Asian, Native American, and White)...
January 6, 2024: American Journal of Medicine
#39
JOURNAL ARTICLE
Behnood Bikdeli, Parham Sadeghipour, Junyang Lou, Antoine Bejjani, Candrika D Khairani, Sina Rashedi, Robert Lookstein, Alexandra Lansky, Suresh Vedantham, Piotr Sobieszczyk, Carlos Mena-Hurtado, Ayaz Aghayev, Peter Henke, Ghazaleh Mehdipoor, Antonella Tufano, Saurav Chatterjee, Saskia Middeldorp, Suman Wasan, Riyaz Bashir, Irene M Lang, Mehdi H Shishehbor, Marie Gerhard-Herman, Jay Giri, Matthew T Menard, Sahil A Parikh, Lucia Mazzolai, Lisa Moores, Manuel Monreal, David Jimenez, Samuel Z Goldhaber, Harlan M Krumholz, Gregory Piazza
The inferior vena cava (IVC) and superior vena cava are the main conduits of the systemic venous circulation into the right atrium. Developmental or procedural interruptions of vena cava might predispose to stasis and deep vein thrombosis (DVT) distal to the anomaly and may impact the subsequent rate of pulmonary embolism (PE). This study aimed to review the various etiologies of developmental or procedural vena cava interruption and their impact on venous thromboembolism. A systematic search was performed in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines per each clinical question...
January 4, 2024: Seminars in Thrombosis and Hemostasis
#40
JOURNAL ARTICLE
Dorothy Massey, Mitsuaki Sawano, Anna D Baker, Diana Berrent Güthe, Nick Güthe, Suzanne Pincus Shidlovsky, Liza Fisher, Connor B Grady, Cesar Caraballo, Tianna Zhou, Richa Sharma, Harlan M Krumholz
OBJECTIVES: To describe the experiences of patients who have postacute sequelae SARS-CoV-2 infection with internal vibrations and tremors as a prominent component, we leveraged the efforts by Survivor Corps, a grassroots COVID-19 patient advocacy group, to gather information from individuals belonging to its Facebook group with a history of COVID-19 suffering from vibrations and tremors. SETTING AND DESIGN: A narrative analysis was performed on 140 emails and 450 social media comments from 140 individuals collected as a response to a call to >180 000 individuals participating in Survivor Corps between 15 July and 27 July 2021...
December 28, 2023: BMJ Open
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