13 results on '"Tabada, Grace"'
Search Results
2. COVID-19 and Risk of VTE in Ethnically Diverse Populations.
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Go, Alan S., Reynolds, Kristi, Tabada, Grace H., Prasad, Priya A., Sung, Sue Hee, Garcia, Elisha, Portugal, Cecilia, Fan, Dongjie, Pai, Ashok P., and Fang, Margaret C.
- Abstract
Background: Limited existing data suggest that the novel COVID-19 may increase risk of VTE, but information from large, ethnically diverse populations with appropriate control participants is lacking.Research Question: Does the rate of VTE among adults hospitalized with COVID-19 differ from matched hospitalized control participants without COVID-19?Study Design and Methods: We conducted a retrospective study among hospitalized adults with laboratory-confirmed COVID-19 and hospitalized adults without evidence of COVID-19 matched for age, sex, race or ethnicity, acute illness severity, and month of hospitalization between February 2020 and August 2020 from two integrated health-care delivery systems with 36 hospitals. Outcomes included VTE (DVT or pulmonary embolism ascertained using diagnosis codes combined with validated natural language processing algorithms applied to electronic health records) and death resulting from any cause at 30 days. Fine and Gray hazards regression was performed to evaluate the association of COVID-19 with VTE after accounting for competing risk of death and residual differences between groups, as well as to identify predictors of VTE in patients with COVID-19.Results: We identified 6,319 adults with COVID-19 and 6,319 matched adults without COVID-19, with mean ± SD age of 60.0 ± 17.2 years, 46% women, 53.1% Hispanic, 14.6% Asian/Pacific Islander, and 10.3% Black. During 30-day follow-up, 313 validated cases of VTE (160 COVID-19, 153 control participants) and 1,172 deaths (817 in patients with COVID-19, 355 in control participants) occurred. Adults with COVID-19 showed a more than threefold adjusted risk of VTE (adjusted hazard ratio, 3.48; 95% CI, 2.03-5.98) compared with matched control participants. Predictors of VTE in patients with COVID-19 included age ≥ 55 years, Black race, prior VTE, diagnosed sepsis, prior moderate or severe liver disease, BMI ≥ 40 kg/m2, and platelet count > 217 k/μL.Interpretation: Among ethnically diverse hospitalized adults, COVID-19 infection increased the risk of VTE, and selected patient characteristics were associated with higher thromboembolic risk in the setting of COVID-19. [ABSTRACT FROM AUTHOR]- Published
- 2021
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3. COPD Comorbidity Profiles and 2-Year Trajectory of Acute and Postacute Care Use.
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Shen, Ernest, Lee, Janet S., Mularski, Richard A., Crawford, Phillip, Go, Alan S., Sung, Sue H., Tabada, Grace H., Gould, Michael K., and Nguyen, Huong Q.
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INTEGRATED health care delivery ,COMORBIDITY ,OBSTRUCTIVE lung diseases ,MEDICAL care use ,ELECTRONIC health records ,OBSTRUCTIVE lung disease treatment ,RESEARCH ,TERMINAL care ,TIME ,RESEARCH methodology ,RETROSPECTIVE studies ,MEDICAL cooperation ,EVALUATION research ,SUBACUTE care ,COMPARATIVE studies ,QUESTIONNAIRES ,LONGITUDINAL method - Abstract
Background: Multiple morbidity is the norm in advanced COPD and contributes to high symptom burden and worse outcomes.Research Question: Can distinct comorbidity profiles be identified and validated in a community-based sample of patients with COPD from a large integrated health care system using a standard, commonly used diagnostic code-based comorbidity index and downstream 2-year health care use data?Study Design and Methods: In this retrospective cohort study, we used latent class analysis (LCA) to identify comorbidity profiles in a population-based sample of 91,453 patients with a COPD diagnosis between 2011 and 2015. We included specific comorbid conditions from the Charlson Comorbidity Index (CCI) and accounted for variation in underlying prevalence of different comorbidities across the three study sites. Sociodemographic, clinical, and health-care use data were obtained from electronic health records (EHRs). Multivariate logistic regression analysis was used to compare rates of acute and postacute care use by class.Results: The mean age was 71 ± 11 years, 55% of patients were women, 23% of patients were people of color, and 80% of patients were former or current smokers. LCA identified four distinct comorbidity profiles with progressively higher CCI scores: low morbidity (61%; 1.9 ± 1.4), metabolic renal (21%; 4.7 ± 1.8), cardiovascular (12%; 4.6 ± 1.9), and multimorbidity (7%; 7.5 ± 1.7). In multivariate models, during 2 years of follow-up, a significant, nonoverlapping increase was found in the odds of having any all-cause acute (hospitalizations, observation stays, and ED visits) and postacute care use across the comorbidity profiles.Interpretation: Distinct comorbidity profiles can be identified in patients with COPD using standard EHR-based diagnostic codes, and these profiles are associated with subsequent acute and postacute care use. Population-based risk stratification schemes for end-to-end, comprehensive COPD management should consider integrating comorbidity profiles such as those found in this study. [ABSTRACT FROM AUTHOR]- Published
- 2021
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4. Contemporary Reevaluation of Race and Ethnicity With Outcomes in Heart Failure.
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Savitz, Samuel T., Leong, Thomas, Sung, Sue Hee, Lee, Keane, Rana, Jamal S., Tabada, Grace, and Go, Alan S.
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- 2021
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5. Cardiac valvular abnormalities associated with use and cumulative exposure of cabergoline for hyperprolactinemia: the CATCH study.
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Budayr, Amer, Tan, Thida C., Lo, Joan C., Zaroff, Jonathan G., Tabada, Grace H., Yang, Jingrong, and Go, Alan S.
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AGE distribution ,BROMOCRIPTINE ,COMBINATION drug therapy ,CONFIDENCE intervals ,ECHOCARDIOGRAPHY ,ERGOT alkaloids ,HEART valves ,HEART valve diseases ,PITUITARY diseases ,RISK assessment ,SEX distribution ,TREATMENT effectiveness ,DISEASE prevalence ,CROSS-sectional method ,TREATMENT duration ,ODDS ratio ,DISEASE risk factors - Abstract
Background: Whether lower dose cabergoline therapy for hyperprolactinemia increases risk of valvular dysfunction remains controversial. We examined valvular abnormalities among asymptomatic adults with hyperprolactinemia treated with dopamine agonists. Methods: This cross-sectional study was conducted among adults receiving cabergoline or bromocriptine for > 12 months for hyperprolactinemia and had no cardiac-related symptoms. Cardiac valve morphology and function were assessed from transthoracic echocardiograms at the study visit (except for two participants) with evaluation performed blinded to type and duration of dopamine agonist received. Results: Among 174 participants (mean age 49 ± 13 years, 63% women) without known structural heart disease before starting therapy, 62 received only cabergoline, 63 received only bromocriptine, and 49 received both. Median cabergoline use was 2.8 years in cabergoline only users and 3.2 years for those exposed to both cabergoline and bromocriptine; median bromocriptine use was 5.5 years in bromocriptine only users and 1.1 years for those exposed to both cabergoline and bromocriptine. Compared with bromocriptine only users (17.5%), regurgitation of ≥1 valve was more common for cabergoline only (37.1%, P = 0.02) but not for combined exposure (26.5%, P = 0.26). Compared with bromocriptine only exposure (1.6%), regurgitation of ≥2 valves was more common for cabergoline only (11.3%, P = 0.03) and combined exposure (12.2%, P = 0.04). Cabergoline only users had higher age-sex-adjusted odds for ≥1 valve with grade 2+ regurgitation compared to bromocriptine only users (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI]:1.3–7.5, P = 0.008), but the association for combined exposure to cabergoline and bromocriptine was not significant (aOR 1.7, 95%CI:0.7–4.3, P = 0.26). Compared to bromocriptine only, age-sex-adjusted odds of ≥2 valves with grade 2+ regurgitation were higher for both cabergoline only (aOR 8.4, 95% CI:1.0–72.2, P = 0.05) and combined exposure (aOR 8.8, 95% CI:1.0–75.8, P = 0.05). Cumulative cabergoline exposure > 115 mg was associated with a higher age-sex adjusted odds of ≥2 valves with grade 2+ regurgitation (aOR 9.6, 95%CI:1.1–81.3, P = 0.04) compared to bromocriptine only. Conclusions: Among community-based adults treated for hyperprolactinemia, cabergoline use and greater cumulative cabergoline exposure were associated with a higher prevalence of primarily mild valvular regurgitation compared with bromocriptine. Research is needed to clarify which patients treated with dopamine agonists may benefit from echocardiographic screening and surveillance. [ABSTRACT FROM AUTHOR]
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- 2020
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6. Influence of Multimorbidity on Burden and Appropriateness of Implantable Cardioverter‐Defibrillator Therapies.
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Hajduk, Alexandra M., Gurwitz, Jerry H., Tabada, Grace, Masoudi, Frederick A., Magid, David J., Greenlee, Robert T., Sung, Sue Hee, Cassidy‐Bushrow, Andrea E., Liu, Taylor I., Reynolds, Kristi, Smith, David H., Fiocchi, Frances, Goldberg, Robert, Gill, Thomas M., Gupta, Nigel, Peterson, Pamela N., Schuger, Claudio, Vidaillet, Humberto, Hammill, Stephen C., and Allore, Heather
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IMPLANTABLE cardioverter-defibrillators ,COMORBIDITY ,DISEASE risk factors ,CHRONIC disease treatment ,TREATMENT effectiveness ,CARDIAC arrest prevention ,CARDIAC pacing ,CHRONIC diseases ,LEFT heart ventricle ,RISK assessment ,SHOCK (Pathology) ,VENTRICULAR tachycardia ,RELATIVE medical risk ,DISEASE complications - Abstract
OBJECTIVE: To determine whether burden of multiple chronic conditions (MCCs) influences the risk of receiving inappropriate vs appropriate device therapies. DESIGN: Retrospective cohort study. SETTING: Seven US healthcare delivery systems. PARTICIPANTS: Adults with left ventricular systolic dysfunction receiving an implantable cardioverter‐defibrillator (ICD) for primary prevention. MEASUREMENTS: Data on 24 comorbid conditions were captured from electronic health records and categorized into quartiles of comorbidity burden (0‐3, 4‐5, 6‐7 and 8‐16). Incidence of ICD therapies (shock and antitachycardia pacing [ATP] therapies), including appropriateness, was collected for 3 years after implantation. Outcomes included time to first ICD therapy, total ICD therapy burden, and risk of inappropriate vs appropriate ICD therapy. RESULTS: Among 2235 patients (mean age = 69 ± 11 years, 75% men), the median number of comorbidities was 6 (interquartile range = 4‐8), with 98% having at least two comorbidities. During a mean 2.2 years of follow‐up, 18.3% of patients experienced at least one appropriate therapy and 9.9% experienced at least one inappropriate therapy. Higher comorbidity burden was associated with an increased risk of first inappropriate therapy (adjusted hazard ratio [HR] = 1.94 [95% confidence interval {CI} = 1.14‐3.31] for 4‐5 comorbidities; HR = 2.25 [95% CI = 1.25‐4.05] for 6‐7 comorbidities; and HR = 2.91 [95% CI = 1.54‐5.50] for 8‐16 comorbidities). Participants with 8‐16 comorbidities had a higher total burden of ICD therapy (adjusted relative risk [RR] = 2.12 [95% CI = 1.43‐3.16]), a higher burden of inappropriate therapy (RR = 3.39 [95% CI = 1.67‐6.86]), and a higher risk of receiving inappropriate vs appropriate therapy (RR = 1.74 [95% CI = 1.07‐2.82]). Comorbidity burden was not significantly associated with receipt of appropriate ICD therapies. Patterns were similar when separately examining shock or ATP therapies. CONCLUSIONS: In primary prevention ICD recipients, MCC burden was independently associated with an increased risk of inappropriate but not appropriate device therapies. Comorbidity burden should be considered when engaging patients in shared decision making about ICD implantation. [ABSTRACT FROM AUTHOR]
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- 2019
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7. Long-term Outcomes Associated With Implantable Cardioverter Defibrillator in Adults With Chronic Kidney Disease.
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Bansal, Nisha, Szpiro, Adam, Reynolds, Kristi, Smith, David H., Magid, David J., Gurwitz, Jerry H., Masoudi, Frederick, Greenlee, Robert T., Tabada, Grace H., Sung, Sue Hee, Dighe, Ashveena, and Go, Alan S.
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- 2018
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8. Short-Term Outcomes and Factors Associated With Adverse Events Among Adults Discharged From the Emergency Department After Treatment for Acute Heart Failure.
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Sax, Dana R., Mark, Dustin G., Hsia, Renee Y., Tan, Thida C., Tabada, Grace H., and Go, Alan S.
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- 2017
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9. Treatment Effectiveness in Heart Failure with Comorbidity: Lung Disease and Kidney Disease.
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Gurwitz, Jerry H., Magid, David J., Smith, David H., Tabada, Grace H., Sung, Sue Hee, Allen, Larry A., McManus, David D., Goldberg, Robert J., Tisminetzky, Mayra, and Go, Alan S.
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TREATMENT effectiveness ,HEART failure treatment ,ADRENERGIC beta blockers ,LUNG disease treatment ,ACE inhibitors ,CHRONIC kidney failure ,COMORBIDITY ,ANGIOTENSIN-receptor blockers ,PATIENTS ,THERAPEUTICS ,CONFIDENCE intervals ,GLOMERULAR filtration rate ,HEART failure ,HOSPITAL care ,LUNG diseases ,MORTALITY ,PROBABILITY theory ,RELATIVE medical risk ,RETROSPECTIVE studies ,ANGIOTENSIN receptors ,DESCRIPTIVE statistics ,VENTRICULAR ejection fraction ,DISEASE complications - Abstract
Objectives To assess the clinical effectiveness of beta-blocker therapy in individuals with heart failure ( HF) and chronic lung disease and of angiotensin-converting enzyme inhibitors ( ACE-Is) and angiotensin II receptor blockers ( ARBs) in individuals with HF and chronic kidney disease. Design Retrospective cohort study. Setting Community. Participants Individuals with HF with reduced ejection fraction ( HFr EF) or HF with preserved ejection fraction ( HFp EF). Methods We undertook separate new-user cohort studies to assess the effectiveness of beta-blocker therapy in treating HF and chronic lung disease and ACE-Is and ARBs in treating HF and chronic kidney disease ( CKD). Individuals with a chronic lung disease diagnosis were included in the group with HF and chronic lung disease ( International Classification of Diseases, Ninth Revision, codes 490-496, 518). Individuals with an estimated glomerular filtration rate less than 60 mL/min per 1.73 m
2 were included in the group with HF and CKD. The clinical outcomes of interest were death from any cause, hospitalization for HF, and hospitalization for any reason. We fitted pooled logistic marginal structural models using inverse probability weighting, stratified according to HF type. Results For individuals with HFr EF with chronic lung disease, beta-blocker therapy was protective against death (relative risk ( RR) = 0.58, 95% confidence interval ( CI) = 0.44-0.77) and hospitalization for HF ( RR = 0.78, 95% CI = 0.60-1.00). For those with HFp EF, no statistically significant associations between beta-blocker therapy use and any of the outcomes were observed. We found ACE-I and ARB use to be protective against all three outcomes of interest in individuals with HFr EF (death from any cause: RR = 0.60, 95% 0.40-0.91; hospitalization for HF: RR = 0.43, 95% CI = 0.28-0.67; hospitalization for any reason: RR = 0.63, 95% CI = 0.45-0.89, respectively) and those with HFp EF (death from any cause: RR = 0.52, 95% CI = 0.33-0.81; hospitalization for HF: RR = 0.35, 95% CI = 0.18-0.68; hospitalization for any reason: RR = 0.67, 95% CI = 0.47-0.95). Conclusion Large observational studies may allow for identification of important subgroups of individuals with HF that might benefit from existing treatment approaches. Our findings may also better inform the design of more-definitive future observational studies and randomized trials. [ABSTRACT FROM AUTHOR]- Published
- 2017
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10. Kidney function and appropriateness of device therapies in adults with implantable cardioverter defibrillators.
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Bansal, Nisha, Szpiro, Adam, Masoudi, Frederick, Greenlee, Robert T., Smith, David H., Magid, David J., Gurwitz, Jerry H., Reynolds, Kristi, Tabada, Grace H., Sue Hee Sung, Dighe, Ashveena, Cassidy-Bushrow, Andrea, Garcia-Montilla, Romel, Hammill, Stephen, Hayes, John, Kadish, Alan, Sharma, Param, Varosy, Paul, Vidaillet, Humberto, and Go, Alan S.
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IMPLANTABLE cardioverter-defibrillators ,KIDNEY function tests ,CARDIAC arrest ,CORONARY heart disease treatment ,PUBLIC health ,CARDIAC arrest prevention ,HEART failure treatment ,PREVENTIVE health services ,CHRONIC kidney failure ,COMPARATIVE studies ,ELECTRIC countershock ,GLOMERULAR filtration rate ,HEART physiology ,LEFT heart ventricle ,KIDNEYS ,HEART failure ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,PROSTHETICS ,COMPLICATIONS of prosthesis ,RESEARCH ,TIME ,EVALUATION research ,TREATMENT effectiveness ,STROKE volume (Cardiac output) ,EQUIPMENT & supplies ,DIAGNOSIS - Abstract
Objective: Patients with chronic kidney disease (CKD) have higher risk of sudden cardiac death; however, they may not receive implantable cardioverter defibrillators (ICDs), in part due to higher risk of complications. We evaluated whether CKD is associated with greater risk of device-delivered shocks/antitachycardia pacing (ATP) therapies among patients receiving a primary prevention ICD.Methods: We studied participants in the observational Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter Defibrillators. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Outcomes included all delivered shocks/ATPs therapies and type of shock/ATP therapies (inappropriate or appropriate, determined by physician adjudication) within the 3 years. We evaluated the associations between CKD and time to first device therapy, burden of device therapy, and inappropriate versus appropriate device therapy, adjusting for demographics, comorbidity, laboratory values and medication use.Results: Among 2161 participants, 1066 (49.3%) had CKD (eGFR 44±11 mL/min/1.73 m2) at ICD implantation. During mean of 2.26±0.89 years, 9.8% and 18.5% of participants had at least one inappropriate and appropriate shock/ATP therapies, respectively. CKD was not associated with time to first shock/ATP therapies (adjusted HR 0.87, 95% CI 0.73 to 1.05), overall burden of shock/ATP therapies (adjusted relative rate 0.93, 95% CI 0.74 to 1.17) or inappropriate versus appropriate shock/ATP therapies (adjusted relative risk 0.88, 95% CI 0.68 to 1.14) compared with not having CKD.Conclusions: In adults receiving a primary prevention ICD, mild-to-moderate CKD was not associated with the timing, burden or appropriateness of subsequent device therapy. Potential concern for inappropriate ICD-delivered therapies should not preclude ICDs among eligible patients with CKD. [ABSTRACT FROM AUTHOR]- Published
- 2017
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11. Assessment of the Risk of Venous Thromboembolism in Nonhospitalized Patients With COVID-19.
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Fang, Margaret C., Reynolds, Kristi, Tabada, Grace H., Prasad, Priya A., Sung, Sue Hee, Parks, Anna L., Garcia, Elisha, Portugal, Cecilia, Fan, Dongjie, Pai, Ashok P., and Go, Alan S.
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- 2023
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12. Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease.
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Chang, Tara I., Tabada, Grace H., Jingrong Yang, Tan, Thida C., Go, Alan S., and Yang, Jingrong
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- 2016
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13. Abstract 12623: A New ASCVD Risk Estimator is More Accurate Than the ACC/AHA Pooled Cohort Equation in Four Diverse Community-Based Populations in the U.S. and Canada.
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Go, Alan S, Tabada, Grace, Reynolds, Kristi, Fortmann, Stephen P, Garg, Amit, Scott, Ronald D, Young, Joseph, Lo, Joan C, Solomon, Matthew D, Wei, Rong, Allison, Michael J, McArthur, Eric, Nash, Danielle M, Sung, Sue Hee, and Rana, Jamal S
- Published
- 2018
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