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1. Long COVID Characteristics and Experience: A Descriptive Study From the Yale LISTEN Research Cohort

Author

Sawano, Mitsuaki, Wu, Yilun, Shah, Rishi M., Zhou, Tianna, Arun, Adith S., Khosla, Pavan, Kaleem, Shayaan, Vashist, Anushree, Bhattacharjee, Bornali, Ding, Qinglan, Lu, Yuan, Caraballo, César, Warner, Frederick, Huang, Chenxi, Herrin, Jeph, Putrino, David, Michelsen, Teresa, Fisher, Liza, Adinig, Cynthia, Iwasaki, Akiko, and Krumholz, Harlan M.

Published
2024
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2. The PAX LC Trial: A Decentralized, Phase 2, Randomized, Double-Blind Study of Nirmatrelvir/Ritonavir Compared with Placebo/Ritonavir for Long COVID

Author

Krumholz, Harlan M., Sawano, Mitsuaki, Bhattacharjee, Bornali, Caraballo, César, Khera, Rohan, Li, Shu-Xia, Herrin, Jeph, Coppi, Andreas, Holub, Julie, Henriquez, Yashira, Johnson, Maria A., Goddard, Theresa B., Rocco, Erica, Hummel, Amy C., AL Mouslmani, Mohammad, Putrino, David F., Carr, Kevin D., Carvajal-Gonzalez, Santos, Charnas, Lawrence, De Jesus, Magdia, Ziegler, Frank W., III, and Iwasaki, Akiko

Published
2024
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4. Abstract 17709: ICD-10 Codes Have Low Sensitivity and Suboptimal Positive Predictive Value for Identifying Cases of Pulmonary Embolism With Cor Pulmonale in Electronic Healthcare Records

Author

Bejjani, Antoine, Khairani, Candrika D, Lo, Ying-Chih, Jimenez, David, Barco, Stefano, Mahajan, Shiwani, Caraballo, Cesar, Secemsky, Eric A, Klok, Erik, Hunsaker, Andetta, Aghayev, Ayaz, Muriel, Alfonso, Hussain, Mohamad A, Appah-Sampong, Abena, MOJIBIAN, HAMID, Lu, Yuan, Lin, Zhenqiu, Aneja, Sanjay, Khera, Rohan, Goldhaber, Samuel, Zhou, Li, Monreal, Manuel, Piazza, Gregory, Krumholz, Harlan M, and Bikdeli, Behnood

Published
2023
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5. Abstract 17700: Double Trouble With Identification of Isolated Sub-Segmental Pulmonary Embolism Using ICD-10 Discharge Diagnosis Codes: The PE-EHR+ Study

Author

Bejjani, Antoine, Khairani, Candrika D, Lo, Ying-Chih, Jimenez, David, Barco, Stefano, Mahajan, Shiwani, Caraballo, Cesar, Secemsky, Eric A, Klok, Erik, Hunsaker, Andetta, Aghayev, Ayaz, Muriel, Alfonso, Hussain, Mohamad A, Appah-Sampong, Abena, MOJIBIAN, HAMID, Lu, Yuan, Lin, Zhenqiu, Aneja, Sanjay, Khera, Rohan, Goldhaber, Samuel, Zhou, Li, Monreal, Manuel, Krumholz, Harlan M, Piazza, Gregory, and Bikdeli, Behnood

Published
2023
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6. Abstract 16342: Age- and Sex-Differences in Accuracy of ICD-10 Codes for Identifying Adults With Pulmonary Embolism: PE-EHR+ Study

Author

Mahajan, Shiwani, Lo, Ying-Chih, Bejjani, Antoine, Khairani, Candrika D, Jimenez, David, Barco, Stefano, Caraballo, Cesar, Secemsky, Eric A, Klok, Erik, Hunsaker, Andetta, Aghayev, Ayaz, Muriel, Alfonso, Hussain, Mohamad A, Appah-Sampong, Abena, MOJIBIAN, HAMID, Lu, Yuan, Lin, Zhenqiu, Aneja, Sanjay, Khera, Rohan, Goldhaber, Samuel, Zhou, Li, Monreal, Manuel, Piazza, Gregory, Krumholz, Harlan M, and Bikdeli, Behnood

Published
2023
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8. Abstract 14344: Pitfalls of ICD-10 Codes for Identifying Pulmonary Embolism in Electronic Records: Results From the Multicenter PE-EHR+ Study

Author

Bikdeli, Behnood, Bejjani, Antoine, Khairani, Candrika D, Lo, Ying-Chih, Jimenez, David, Barco, Stefano, Mahajan, Shiwani, Caraballo, Cesar, Secemsky, Eric A, Klok, Erik, Hunsaker, Andetta, Aghayev, Ayaz, Muriel, Alfonso, Hussain, Mohamad A, Appah-Sampong, Abena, MOJIBIAN, HAMID, Lu, Yuan, Lin, Zhenqiu, Aneja, Sanjay, Khera, Rohan, Goldhaber, Samuel, Zhou, Li, Monreal, Manuel, Piazza, Gregory, and Krumholz, Harlan M

Published
2023
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10. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial

Author

CHOUAIRI, FOUAD, FUERY, MICHAEL A., MULLAN, CLANCY W., CARABALLO, CESAR, SEN, SOUNOK, MAULION, CHRISTOPHER, WILKINSON, SAMUEL T., SURTI, TORAL, MCCULLOUGH, MEGAN, MILLER, P. ELLIOTT, PACOR, JUSTIN, LEIFER, ERIC S., FELKER, G. MICHAEL, VELAZQUEZ, ERIC J., FIUZAT, MONA, O'CONNOR, CHRISTOPHER M., JANUZZI, JAMES L, DESAI, NIHAR R., and AHMAD, TARIQ

Published
2021
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11. Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure

Author

Fuery, Michael A., Chouairi, Fouad, Januzzi, James L., Moe, Gordon W., Caraballo, Cesar, McCullough, Megan, Miller, P. Elliott, Reinhardt, Samuel W., Clark, Katherine, Oseran, Andrew, Milner, Aidan, Pacor, Justin, Kahn, Peter A., Singh, Avinainder, Ravindra, Neal, Guha, Avirup, Vadlamani, Lina, Kulkarni, Neeti S., Fiuzat, Mona, Felker, G. Michael, O’Connor, Christopher M., Ahmad, Tariq, Ezekowitz, Justin, and Desai, Nihar R.

Published
2021
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16. SalivaDirect: A simplified and flexible platform to enhance SARS-CoV-2 testing capacity

Author

Anastasio, Kelly, Askenase, Michael H., Batsu, Maria, Bickerton, Sean, Brower, Kristina, Bucklin, Molly L., Cahill, Staci, Cao, Yiyun, Courchaine, Edward, DeIuliis, Giuseppe, Earnest, Rebecca, Geng, Bertie, Goldman-Israelow, Benjamin, Handoko, Ryan, Khoury-Hanold, William, Kim, Daniel, Knaggs, Lynda, Kuang, Maxine, Lapidus, Sarah, Lim, Joseph, Linehan, Melissa, Lu-Culligan, Alice, Martin, Anjelica, Matos, Irene, McDonald, David, Minasyan, Maksym, Nakahata, Maura, Naushad, Nida, Nouws, Jessica, Obaid, Abeer, Odio, Camila, Oh, Ji Eun, Omer, Saad, Park, Annsea, Park, Hong-Jai, Peng, Xiaohua, Petrone, Mary, Prophet, Sarah, Rice, Tyler, Rose, Kadi-Ann, Sewanan, Lorenzo, Sharma, Lokesh, Shaw, Albert C., Shepard, Denise, Smolgovsky, Mikhail, Sonnert, Nicole, Strong, Yvette, Todeasa, Codruta, Valdez, Jordan, Velazquez, Sofia, Vijayakumar, Pavithra, White, Elizabeth B., Yang, Yexin, Vogels, Chantal B.F., Watkins, Anne E., Harden, Christina A., Brackney, Doug E., Shafer, Jared, Wang, Jianhui, Caraballo, César, Kalinich, Chaney C., Ott, Isabel M., Fauver, Joseph R., Kudo, Eriko, Lu, Peiwen, Venkataraman, Arvind, Tokuyama, Maria, Moore, Adam J., Muenker, M. Catherine, Casanovas-Massana, Arnau, Fournier, John, Bermejo, Santos, Campbell, Melissa, Datta, Rupak, Nelson, Allison, Dela Cruz, Charles S., Ko, Albert I., Iwasaki, Akiko, Krumholz, Harlan M., Matheus, J.D., Hui, Pei, Liu, Chen, Farhadian, Shelli F., Sikka, Robby, Wyllie, Anne L., and Grubaugh, Nathan D.

Published
2021
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30. Evaluation of Racial and Ethnic Disparities in Cardiac Transplantation.

Author

Chouairi, Fouad, Fuery, Michael, Clark, Katherine A., Mullan, Clancy W., Stewart, James, Caraballo, Cesar, Clarke, John-Ross D., Sounok Sen, Guha, Avirup, Ibrahim, Nasrien E., Cole, Robert T., Holaday, Louisa, Anwer, Muhammed, Geirsson, Arnar, Rogers, Joseph G., Velazquez, Eric J., Desai, Nihar R., Ahmad, Tariq, Miller, P. Elliott, and Sen, Sounok

Published
2021
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31. Outcomes in patients with anthracycline‐induced cardiomyopathy undergoing left ventricular assist devices implantation.

Author

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

Subjects
ANTHRACYCLINES, TREATMENT of cardiomyopathies, HEART assist devices
Abstract

Aims: Improved cancer survivorship has led to a higher number of anthracycline‐induced cardiomyopathy patients with end‐stage heart failure. We hypothesize that outcomes following continuous‐flow LVAD (CF‐LVAD) implantation in those with anthracycline‐induced cardiomyopathy are comparable with other aetiologies of cardiomyopathy. Methods and results: Using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) from 2008 to 2017, we identified patients with anthracycline‐induced cardiomyopathy who received a CF‐LVAD and compared them with those with idiopathic dilated (IDM) and ischaemic cardiomyopathies (ICM). Mortality was studied using the Cox proportional hazards model. Other adverse events were evaluated using competing risk models. Overall, 248 anthracycline‐induced cardiomyopathy patients underwent CF‐LVAD implantation, with a median survival of 48 months, an improvement compared with those before 2012 [adjusted hazards ratio (aHR): 0.53; confidence interval (CI): 0.33–0.86]. At 12 months, 85.1% of anthracycline‐induced cardiomyopathy, 86.0% of IDM, and 80.2% of ICM patients were alive (anthracycline‐induced cardiomyopathy vs. IDM: aHR: 1.12; CI: 0.88–1.43 and anthracycline‐induced cardiomyopathy vs. ICM: aHR: 0.98; CI: 0.76–1.28). Anthracycline‐induced cardiomyopathy patients had a higher major bleeding risk compared with IDM patients (aHR: 1.23; CI: 1.01–1.50), and a lower risk of stroke and prolonged respiratory support compared to ICM patients (aHR: 0.31 and 0.67 respectively; both P < 0.05). There was no difference in the risk of major infection, acute kidney injury, and venous thromboembolism. Conclusions: After receiving a CF‐LVAD, survival in patients with anthracycline‐induced cardiomyopathy is similar to those with ICM or IDM. Further research into differential secondary endpoints‐related disparities is warranted. [ABSTRACT FROM AUTHOR]

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

Author

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

Subjects
HEART assist devices, CLINICAL trials, CHRONIC kidney failure, HEART failure, ARTIFICIAL respiration, HEART failure patients
Abstract

Importance: Patient outcomes in heart failure clinical trials are generally better than those observed in real-world settings. This may be related to stricter inclusion and exclusion criteria in clinical trials. Objective: We study sought to characterize the clinical implications of differences between patients in clinical trials and those in a real-world registry of patients receiving left ventricular assist devices (LVADs). Design, setting, and participants: This retrospective cohort study included all patients in INTERMACS (the Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with an axial flow LVAD from 2010 to 2015 to allow for equivalent comparisons. Main outcomes and measures: Differences in patient characteristics and 2-year rates of adverse outcomes with those reported in the ENDURANCE and MOMENTUM 3 clinical trials. Survival analyses were used to assess the relationships between prespecified patient factors and clinical outcomes. Results: Of the 10,937 LVAD recipients identified in INTERMACS between 2010–2015, 44% met at least 1 clinical trial exclusion criterion. The 2-year incidence of stroke and death amongst LVAD recipients in INTERMACS and the landmark clinical trials differed significantly (P<0.04, both). Nevertheless, patients who would have been excluded from the clinical trials did not have dramatically different 2-year mortality outcomes in INTERMACS [2y survival estimate: 66.4%, 95% CI (64.9–67.9%) versus 71.9%, 95% CI (70.6–73.1%)]. Clinical interventions driving a significantly increased risk of death were relatively rare (<5% of implants) and included mechanical ventilation, ECMO, severe thrombocytopenia, and dialysis. Conclusions and relevance: Most exclusion criteria used in LVAD clinical trials did not afford a substantially greater risk to patients in the real-world setting. In the relatively infrequent cases of end stage renal disease, thrombocytopenia, respiratory failure, and need for ECMO, the risks and benefits of LVAD therapy need careful weighting and further study. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Relationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure.

Author

Mahajan, Shiwani, Gu, Jianlei, Caraballo, Cesar, Lu, Yuan, Spatz, Erica S., Zhao, Hongyu, Zhang, MaoZhen, Sun, NingLing, Zheng, Xin, Lu, Hui, Yuan, Hong, Ma, Zheng J., and Krumholz, Harlan M.

Subjects
AGE distribution, CARDIOGRAPHY, CONFIDENCE intervals, HEMODYNAMICS, HYPERTENSION, CROSS-sectional method, DESCRIPTIVE statistics
Abstract

BACKGROUND Age is known to be associated with the prevalence and pathophysiology of hypertension. However, there is little information on whether age stands as a good proxy for the specific hemodynamic profile of an individual with elevated blood pressure (BP), which could be important in the selection of therapy. DESIGN This is a cross‐sectional study. SETTING People who underwent a noninvasive, hemodynamic assessment using impedance cardiography at 51 sites of iKang Health Checkup Centers throughout China between January 2012 and October 2018. PARTICIPANTS We included 116,851 individuals, aged 20 to 80 years. MAIN OUTCOMES AND MEASURES Relationship between age and hemodynamic parameters (cardiac index, systemic vascular resistance index [SVRI]), among individuals with elevated BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg). RESULTS: Final study population included 45,082 individuals with elevated BP: 29,194 men and 15,888 women with a mean (±SD) age of 48 (±13) and 54 (±12) years, respectively. Cardiac index was negatively associated with age with an adjusted, per decade decrease of 0.17 (95% confidence interval [CI] = 0.17‐0.18) L/min/m2 in men and 0.24 (95% CI = 0.23‐0.25) L/min/m2 in women. SVRI was positively associated with age with an adjusted, per‐decade increase of 174.2 (95% CI = 168.8‐179.7) dynes·s·cm−5·m2 in men and 214.1 (95% CI = 204.3‐223.8) dynes·s·cm−5·m2 in women. However, there was substantial overlap in the distribution of these parameters across different age groups in both sexes. CONCLUSIONS: In this large study, we observed that cardiac index decreased and SVRI increased with age among individuals with elevated BP. Even though there was a general trend with age, we observed heterogeneity within age strata, suggesting that age alone is inadequate to indicate the hemodynamic profile for an individual. J Am Geriatr Soc 68:1520‐1528, 2020. [ABSTRACT FROM AUTHOR]

Published
2020
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47. EXCESS ISCHEMIC HEART DISEASE MORTALITY AND YEARS OF POTENTIAL LIFE LOST AMONG THE BLACK POPULATION: A TWO-DECADE ANALYSIS INCLUDING THE COVID-19 PANDEMIC.

Author

Sawano, Mitsuaki, Khosla, Pavan, Arun, Adith, Kaleem, Shayaan, Mouslmani, Mohammad AL, Caraballo, Cesar, Lu, Yuan, Herrin, Jeph, Murugiah, Karthik, Khera, Rohan, Taylor, Herman A., Watson, Karol E., Yancy, Clyde W., and Krumholz, Harlan M.

Subjects
*HEART disease related mortality, *MYOCARDIAL ischemia, *CORONARY disease, *BLACK people, *COVID-19 pandemic
Published
2024
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49. Characterisation of internal tremors and vibration symptoms.

Author

Massey D, Sawano M, Baker AD, Güthe DB, Güthe N, Shidlovsky SP, Fisher L, Grady CB, Caraballo C, Zhou T, Sharma R, and Krumholz HM

Subjects
Humans, Tremor etiology, Vibration, Delivery of Health Care, Post-Acute COVID-19 Syndrome, COVID-19 complications
Abstract

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. We used common coding techniques and the constant comparative method for qualitative data synthesis and categorising emails. Coded data were entered into NVivo V.12 to identify recurrent themes, theme connections and supporting quotations. Comments were analysed using Word Clouds, generated with R V.4.0.3 using quanteda , wordcloud and tm packages., Main Outcome Measures: Patient-reported long COVID symptom themes and domains related to internal tremors and vibration., Results: The respondents' emails represented 22 themes and 7 domains pertaining to their experience with internal tremor and vibrations. These domains were as follows: (1) symptom experience, description and anatomic location; (2) initial symptom onset; (3) symptom timing; (4) symptom triggers or alleviators; (5) change from baseline health status; (6) experience with medical establishment and (7) impact on individuals' lives and livelihood. There were 22 themes in total, each corresponding to one of the broader domains. Among the responses, many described symptoms that varied in location, timing and triggers, occurred soon after their COVID-19 infection, and were markedly debilitating. There were often frustrating experiences with the healthcare system., Conclusions: This study describes key themes and experiences among a group of people reporting long COVID and having a prolonged and debilitating symptom complex that prominently features internal tremors and vibrations., Competing Interests: Competing interests: In the past 3 years, Dr Krumholz reported receiving personal fees from Massachusetts Medical Society, UpToDate, Element Science, Eyedentify and F-Prime. He is a cofounder of HugoHealth, Refactor Health and Ensight-AI. He is associated with grants and/or contracts, through Yale New Haven Hospital, from the Centers for Medicare & Medicaid Services and through Yale University from Johnson & Johnson Consumer, Janssen and Pfizer. The other authors report no potential conflicts., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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