27 results on '"Heidenreich, Paul A."'
Search Results
2. Expenditure on Heart Failure in the United States: The Medical Expenditure Panel Survey 2009-2018
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Bhatnagar, Roshni, Fonarow, Gregg C, Heidenreich, Paul A, and Ziaeian, Boback
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Adult ,Heart Failure ,health expenditure ,Medical Expenditure Panel Survey ,health care economics ,Health Services ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,United States ,Hospitalization ,Heart Disease ,Good Health and Well Being ,Clinical Research ,Diabetes Mellitus ,Ambulatory Care ,  ,Humans ,Health Expenditures ,Type 2 - Abstract
BackgroundWith rising United States health care expenditure, estimating current spending for patients with heart failure (HF) informs the value of preventative health interventions.ObjectivesThe purpose of this study was to estimate current health care expenditure growth for patients with HF in the United States.MethodsThe authors pooled MEPS (Medical Expenditure Panel Survey) data from 2009-2018 to calculate totalHF-related expenditure across clinical settings in the United States. A 2-part model adjusted for demographics,comorbidities, and year was used to estimate annual mean and incremental expenditures associated with HF.ResultsIn the United States, an average of $28,950 (2018 inflation-adjusted dollars) is spent per year for health care-related expenditure for individuals with HF compared with $5,727 for individuals without HF. After adjusting for demographics and comorbidities, a diagnosis of HF was associated with $3,594 in annual incremental expenditure compared with those without HF. HF-related expenditure increased from $26,864 annual per person in 2009-2010 to $32,955 in 2017-2018, representing a 23% rise over 10 years. In comparison, expenditure on myocardial infarction, type 2 diabetes mellitus, and cancer grew by 16%, 28%, and 16%, respectively. Most of the cost was related to hospitalization: $12,569 per year. Outpatient office-based care and prescription medications saw the greatest growth in cost over the period, 41% and 24%, respectively. Estimated incremental national expenditure for HF per year was $22.3 billion; total annual expenditure for adults with HF was $179.5 billion.ConclusionsHF is a costly condition for which expenditure is growing faster than that of other chronic conditions.
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- 2022
3. Economic Issues in Heart Failure in the United States
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Heidenreich, Paul A, Fonarow, Gregg C, Opsha, Yekaterina, Sandhu, Alexander T, Sweitzer, Nancy K, Warraich, Haider J, and HFSA Scientific Statement Committee Members Chair
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Comparative Effectiveness Research ,Cost-Benefit Analysis ,Adrenergic beta-Antagonists ,Clinical Trials and Supportive Activities ,Clinical Sciences ,Angiotensin-Converting Enzyme Inhibitors ,Nursing ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Angiotensin Receptor Antagonists ,Clinical Research ,Humans ,Heart Disease - Coronary Heart Disease ,Mineralocorticoid Receptor Antagonists ,Heart Failure ,Health Services ,United States ,Hospitalization ,Heart Disease ,Good Health and Well Being ,Cost Effectiveness Research ,Cardiovascular System & Hematology ,5.1 Pharmaceuticals ,HFSA Scientific Statement Committee Members Chair ,Development of treatments and therapeutic interventions ,Health and social care services research ,8.2 Health and welfare economics - Abstract
The cost of heart failure care is high owing to the cost of hospitalization and chronic treatments. Heart failure treatments vary in their benefit and cost. The cost effectiveness of therapies can be determined by comparing the cost of treatment required to obtain a certain benefit, often defined as an increase in 1 year of life. This review was sponsored by the Heart Failure Society of America and describes the growing economic burden of heart failurefor patientsand the health care system in the UnitedStates. It also provides a summary of the cost effectiveness of drugs, devices, diagnostic tests, hospital care, and transitions of care for patients with heart failure. Many medications that are no longer under patent are inexpensive and highly cost-effective. These include angiotensin-converting enzyme inhibitors, beta-blockers and mineralocorticoid receptor antagonists. In contrast, more recently developed medications and devices, vary in cost effectiveness, and often have high out-of-pocket costs for patients.
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- 2022
4. sj-docx-1-jtt-10.1177_1357633X211073428 - Supplemental material for Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic
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Kalwani, Neil M, Osmanlliu, Esli, Parameswaran, Vijaya, Qureshi, Lubna, Dash, Rajesh, Heidenreich, Paul A, Scheinker, David, and Rodriguez, Fatima
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111708 Health and Community Services ,111799 Public Health and Health Services not elsewhere classified ,FOS: Health sciences - Abstract
Supplemental material, sj-docx-1-jtt-10.1177_1357633X211073428 for Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic by Neil M Kalwani, Esli Osmanlliu, Vijaya Parameswaran, Lubna Qureshi, Rajesh Dash, Paul A Heidenreich, David Scheinker, and Fatima Rodriguez in Journal of Telemedicine and Telecare
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- 2022
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5. sj-docx-1-jtt-10.1177_1357633X211073428 - Supplemental material for Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic
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Kalwani, Neil M, Osmanlliu, Esli, Parameswaran, Vijaya, Qureshi, Lubna, Dash, Rajesh, Heidenreich, Paul A, Scheinker, David, and Rodriguez, Fatima
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111708 Health and Community Services ,111799 Public Health and Health Services not elsewhere classified ,FOS: Health sciences - Abstract
Supplemental material, sj-docx-1-jtt-10.1177_1357633X211073428 for Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic by Neil M Kalwani, Esli Osmanlliu, Vijaya Parameswaran, Lubna Qureshi, Rajesh Dash, Paul A Heidenreich, David Scheinker, and Fatima Rodriguez in Journal of Telemedicine and Telecare
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- 2022
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6. Association of Dual Eligibility for Medicare and Medicaid With Heart Failure Quality and Outcomes Among Get With The Guidelines-Heart Failure Hospitals
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Bahiru, Ehete, Ziaeian, Boback, Moucheraud, Corrina, Agarwal, Anubha, Xu, Haolin, Matsouaka, Roland A, DeVore, Adam D, Heidenreich, Paul A, Allen, Larry A, Yancy, Clyde W, and Fonarow, Gregg C
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Male ,Heart Failure ,Outcome Assessment ,Medicaid ,Eligibility Determination ,Health Services ,Medicare ,Cardiovascular ,Hospitals ,Insurance Coverage ,United States ,Health Care ,Heart Disease ,Clinical Research ,80 and over ,Quality Indicators ,Humans ,Female ,Guideline Adherence ,Healthcare Disparities ,Aged ,Quality of Health Care - Abstract
ImportanceThe Centers for Medicare & Medicaid Services uses a new peer group-based payment system to compare hospital performance as part of its Hospital Readmissions Reduction Program, which classifies hospitals into quintiles based on their share of dual-eligible beneficiaries for Medicare and Medicaid. However, little is known about the association of a hospital's share of dual-eligible beneficiaries with the quality of care and outcomes for patients with heart failure (HF).ObjectiveTo evaluate the association between a hospital's proportion of patients with dual eligibility for Medicare and Medicaid and HF quality of care and outcomes.Design, setting, and participantsThis retrospective cohort study evaluated 436 196 patients hospitalized for HF using the Get With The Guidelines-Heart Failure registry from January 1, 2010, to December 31, 2017. The analysis included patients 65 years or older with available data on dual-eligibility status. Hospitals were divided into quintiles based on their share of dual-eligible patients. Quality and outcomes were analyzed using unadjusted and adjusted multivariable logistic regression models. Data analysis was performed from April 1, 2020, to January 1, 2021.Main outcomes and measuresThe primary outcome was 30-day all-cause readmission. The secondary outcomes included in-hospital mortality, 30-day HF readmissions, 30-day all-cause mortality, and HF process of care measures.ResultsA total of 436 196 hospitalized HF patients 65 years or older from 535 hospital sites were identified, with 258 995 hospitalized patients (median age, 81 years; interquartile range, 74-87 years) at 455 sites meeting the study criteria and included in the primary analysis. A total of 258 995 HF hospitalizations from 455 sites were included in the primary analysis of the study. Hospitals in the highest dual-eligibility quintile (quintile 5) tended to care for patients who were younger, were more likely to be female, belonged to racial minority groups, or were located in rural areas compared with quintile 1 sites. After multivariable adjustment, hospitals with the highest quintile of dual eligibility were associated with lower rates of key process measures, including evidence-based β-blocker prescription, measure of left ventricular function, and anticoagulation for atrial fibrillation or atrial flutter. Differences in clinical outcomes were seen with higher 30-day all-cause (adjusted odds ratio, 1.24; 95% CI, 1.14-1.35) and HF (adjusted odds ratio, 1.14; 95% CI, 1.03-1.27) readmissions in higher dual-eligible quintile 5 sites compared with quintile 1 sites. Risk-adjusted in-hospital and 30-day mortality did not significantly differ in quintile 1 vs quintile 5 hospitals.Conclusions and relevanceIn this cohort study, hospitals with a higher share of dual-eligible patients provided care with lower rates of some of the key HF quality of care process measures and with higher 30-day all-cause or HF readmissions compared with lower dual-eligibility quintile hospitals.
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- 2021
7. Kidney Function and Outcomes in Patients Hospitalized With Heart Failure
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Patel, Ravi B, Fonarow, Gregg C, Greene, Stephen J, Zhang, Shuaiqi, Alhanti, Brooke, DeVore, Adam D, Butler, Javed, Heidenreich, Paul A, Huang, Joanna C, Kittleson, Michelle M, Joynt Maddox, Karen E, McDermott, James J, Owens, Anjali Tiku, Peterson, Pamela N, Solomon, Scott D, Vardeny, Orly, Yancy, Clyde W, and Vaduganathan, Muthiah
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Male ,Kidney Disease ,Left ,Renal and urogenital ,heart failure ,Comorbidity ,Cardiorespiratory Medicine and Haematology ,Kidney ,outcomes ,Cardiovascular ,Rare Diseases ,Clinical Research ,Humans ,Ventricular Function ,Registries ,Renal Insufficiency ,Chronic ,Retrospective Studies ,Aged ,glomerular filtration rate ,therapy ,Prevention ,Middle Aged ,Quality Improvement ,United States ,Hospitalization ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,Public Health and Health Services ,Female ,Follow-Up Studies - Abstract
BackgroundFew contemporary data exist evaluating care patterns and outcomes in heart failure (HF) across the spectrum of kidney function.ObjectivesThis study sought to characterize differences in quality of care and outcomes in patients hospitalized for HF by degree of kidney dysfunction.MethodsGuideline-directed medical therapies were evaluated among patients hospitalized with HF at 418 sites in the GWTG-HF (Get With The Guidelines-Heart Failure) registry from 2014 to 2019 by discharge CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)-derived estimated glomerular filtration rate (eGFR). We additionally evaluated the risk-adjusted association of admission eGFR with in-hospital mortality.ResultsAmong 365,494 hospitalizations (age 72 ± 15 years, left ventricular ejection fraction [EF]: 43 ± 17%), median discharge eGFR was 51ml/min/1.73m2 (interquartile range: 34 to 72ml/min/1.73m2), 234,332 (64%) had eGFR 
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- 2021
8. Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized With Heart Failure and Reduced Ejection Fraction
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Fudim, Marat, Sayeed, Sabina, Xu, Haolin, Matsouaka, Roland A, Heidenreich, Paul A, Velazquez, Eric J, Yancy, Clyde W, Fonarow, Gregg C, Hernandez, Adrian F, and DeVore, Adam D
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Male ,Time Factors ,Left ,Clinical Decision-Making ,Medical Physiology ,Tetrazoles ,Eligibility Determination ,heart failure ,sacubitril valsartan ,Cardiorespiratory Medicine and Haematology ,brain natriuretic peptide ,Cardiovascular ,enalapril ,Patient Admission ,Natriuretic Peptide ,Risk Factors ,Clinical Research ,80 and over ,Humans ,Ventricular Function ,Protease Inhibitors ,Registries ,Aged ,Randomized Controlled Trials as Topic ,Heart Failure ,Evidence-Based Medicine ,Patient Selection ,Aminobutyrates ,Biphenyl Compounds ,Brain ,Stroke Volume ,Recovery of Function ,Middle Aged ,Peptide Fragments ,Drug Combinations ,Treatment Outcome ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,Valsartan ,Neprilysin ,Female ,Biochemistry and Cell Biology ,Angiotensin II Type 1 Receptor Blockers ,Biomarkers ,hospitalization - Abstract
BackgroundIn PIONEER-HF (Comparison of Sacubitril/Valsartan Versus Enalapril on Effect on NT-pro BNP in Patients Stabilized From an Acute Heart Failure Episode), the in-hospital initiation of sacubitril/valsartan in patients hospitalized for acute decompensated heart failure (ADHF) was well-tolerated and led to improved outcomes. We aim to determine the representativeness of the PIONEER-HF trial among patients hospitalized for ADHF using real-world data.MethodsThe study population was derived from all patients discharged alive for ADHF in the Get With The Guidelines-HF registry from 2006 to 2018 with HF with reduced ejection fraction (HFrEF; all HFrEF with ADHF). We then determined the proportion of patients meeting PIONEER-HF eligibility criteria (PIONEER-HF eligible) and those meeting a set of limited eligibility criteria (actionable cohort). Rates of HF readmissions and all-cause mortality were then compared between the all HFrEF with ADHF, PIONEER-HF eligible, and actionable cohorts using linked Medicare claims data.ResultsA total of 99 767 patients with HFrEF in Get With The Guidelines-HF were hospitalized for ADHF. PIONEER-HF inclusion criteria were met by 71 633 (71.8%) patients, and both inclusion and exclusion criteria were met by 20 704 (20.8%) patients. Further, 68 739 (68.9%) patients met the criteria for the actionable cohort. Among the Centers for Medicare and Medicaid-linked patients, the HF rehospitalization rate at 1 year was 35.1% (95% CI, 34.5-35.8) for all HFrEF with ADHF patients, 32.6% (95% CI, 31.3-33.9) for the PIONEER-HF eligible cohort, and 33.1% (95% CI, 32.3-33.9) for the actionable cohort. The 1-year all-cause mortality was 36.7% (95% CI, 36.1-7.4) for all HFrEF with ADHF patients, 31.6% (95% CI, 30.3-32.9) for the PIONEER-HF eligible cohort, and 32.2% (95% CI, 31.4-33.0) for the actionable cohort.ConclusionsPatient characteristics and clinical outcomes for patients eligible for PIONEER-HF only modestly differ when compared with those encountered in routine practice, suggesting that the in-hospital initiation of sacubitril/valsartan should be routinely considered for patients with HFrEF hospitalized for ADHF.
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- 2020
9. Eligibility of sodium-glucose co-transporter-2 inhibitors among patients with diabetes mellitus admitted for heart failure
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Sharma, Abhinav, Wu, Jingjing, Ezekowitz, Justin A, Felker, Gary Michael, Udell, Jacob A, Heidenreich, Paul A, Fonarow, Gregg C, Mahaffey, Kenneth W, Hernandez, Adrian F, and DeVore, Adam D
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diabetes mellitus type 2 ,SGLT-2 inhbitors ,heart failure ,Cardiorespiratory Medicine and Haematology ,eligibility - Abstract
AimsSodium-glucose co-transporter (SGLT)-2 inhibitors have been shown to reduce the risk of cardiovascular death and heart failure (HF) hospitalization in patients with type 2 diabetes mellitus (DM) and high cardiovascular risk in two large clinical outcome trials: empagliflozin in EMPA-REG OUTCOME and canagliflozin in CANVAS. The scope of eligibility for SGLT-2 inhibitors (empagliflozin and canagliflozin) among patients with type 2 DM and HF, based on clinical trial criteria and current US Food and Drug Administration (FDA) labelling criteria, remains unknown.Methods and resultsUsing data from the US Get With The Guidelines (GWTG)-Heart Failure registry, we evaluated the proportion of patients with DM and HF eligible for SGLT-2 inhibitor therapy based on the clinical trial criteria and the US FDA labelling criteria. The GWTG-HF registry is a quality improvement registry of patients admitted in hospital with HF in the USA. We included GWTG-HF registry participants meeting eligibility criteria hospitalized between August 2014 and 30 June 2017 from sites fully participating in the registry. The initial inclusion time point reflects when both drugs had FDA approval. Among the 139 317 patients (out of 407 317) with DM hospitalized with HF (in 460 hospitals; 2014 to 2017), the median age was 71 years, 47% (n = 65 685) were female, and 43% (n = 59 973) had HF with reduced ejection fraction. Overall, 43% (n = 59 943) were eligible for the EMPA-REG OUTCOME trial, 45% (n = 62 818) were eligible for the CANVAS trial, and 34% (n = 47 747) of patients were eligible for either SGLT-2 inhibitors based on the FDA labelling criteria. Among the FDA-eligible patients, 91.5% (n = 43 708) were eligible for either the EMPA-REG OUTCOME trial or the CANVAS trial. Patients who were FDA eligible, compared with those who were not, were younger (70.0 vs. 72.0 years of age), more likely to be male (57.7 vs. 50.3%), and had less burden of co-morbidities.ConclusionsThe majority of patients with DM who are hospitalized with HF are not eligible for SGLT-2 inhibitor therapies. Ongoing studies evaluating the safety and efficacy of SGLT-2 inhibitors among patients with HF may potentially broaden the population that may benefit from these therapies.
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- 2020
10. Additional file 1 of The association between Asian patient race/ethnicity and lower satisfaction scores
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Liao, Lillian, Sukyung Chung, Altamirano, Jonathan, Garcia, Luis, Fassiotto, Magali, Maldonado, Bonnie, Heidenreich, Paul, and Palaniappan, Latha
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Additional file 1: Table S1. The Press-Ganey mean satisfaction scores (1–100) for providers with varying percentages of Asian patients, considering responses from only Non-Hispanic White patients, and only Asian patients, and all patients regardless of race. These values correspond to those shown in Fig. 2. Data based on the original site (Site A).
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- 2020
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11. Rhythm Control Versus Rate Control in Patients With Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction: Insights From Get With The Guidelines-Heart Failure
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Kelly, Jacob P, DeVore, Adam D, Wu, JingJing, Hammill, Bradley G, Sharma, Abhinav, Cooper, Lauren B, Felker, G Michael, Piccini, Jonathan P, Allen, Larry A, Heidenreich, Paul A, Peterson, Eric D, Yancy, Clyde W, Fonarow, Gregg C, and Hernandez, Adrian F
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Male ,Heart Failure ,heart failure with preserved ejection fraction ,Aging ,rhythm control ,Stroke Volume ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Heart Disease ,Heart Rate ,Clinical Research ,Atrial Fibrillation ,Practice Guidelines as Topic ,80 and over ,Humans ,Female ,Retrospective Studies ,Aged ,rate control - Abstract
Background Limited data exist to guide treatment for patients with heart failure with preserved ejection fraction and atrial fibrillation, including the important decision regarding rate versus rhythm control. Methods and Results We analyzed the Get With The Guidelines-Heart Failure (GWTG-HF) registry linked to Medicare claims data from 2008 to 2014 to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation using inverse probability weighted analysis. Rhythm control was defined as use of an antiarrhythmic medication, cardioversion, or AF ablation or surgery. Rate control was defined as use of any combination of β-blocker, calcium channel blocker, and digoxin without evidence of rhythm control. Among 15682 fee-for-service Medicare patients, at the time of discharge, 1857 were treated with rhythm control and 13825 with rate control, with minimal differences in baseline characteristics between groups. There was higher all-cause death at 1year in the rate control compared with the rhythm control group (37.5% and 30.8%, respectively, P
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- 2019
12. Predictive models for identifying risk of readmission after index hospitalization for heart failure: A systematic review
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Mahajan, Satish M, Heidenreich, Paul, Abbott, Bruce, Newton, Ana, and Ward, Deborah
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Adult ,Male ,Heart Failure ,and over ,Nursing ,Middle Aged ,statistical models ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Patient Readmission ,Risk Assessment ,Hospitalization ,Heart Disease ,Logistic Models ,Theoretical ,Risk Factors ,Models ,80 and over ,Public Health and Health Services ,Humans ,Female ,Patient Safety ,Forecasting ,Aged - Abstract
AimsReadmission rates for patients with heart failure have consistently remained high over the past two decades. As more electronic data, computing power, and newer statistical techniques become available, data-driven care could be achieved by creating predictive models for adverse outcomes such as readmissions. We therefore aimed to review models for predicting risk of readmission for patients admitted for heart failure. We also aimed to analyze and possibly group the predictors used across the models.MethodsMajor electronic databases were searched to identify studies that examined correlation between readmission for heart failure and risk factors using multivariate models. We rigorously followed the review process using PRISMA methodology and other established criteria for quality assessment of the studies.ResultsWe did a detailed review of 334 papers and found 25 multivariate predictive models built using data from either health system or trials. A majority of models was built using multiple logistic regression followed by Cox proportional hazards regression. Some newer studies ventured into non-parametric and machine learning methods. Overall predictive accuracy with C-statistics ranged from 0.59 to 0.84. We examined significant predictors across the studies using clinical, administrative, and psychosocial groups.ConclusionsComplex disease management and correspondingly increasing costs for heart failure are driving innovations in building risk prediction models for readmission. Large volumes of diverse electronic data and new statistical methods have improved the predictive power of the models over the past two decades. More work is needed for calibration, external validation, and deployment of such models for clinical use.
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- 2018
13. Association of the Affordable Care Act's Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure
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Wadhera, Rishi K, Joynt Maddox, Karen E, Fonarow, Gregg C, Zhao, Xin, Heidenreich, Paul A, DeVore, Adam D, Matsouaka, Roland A, Hernandez, Adrian F, Yancy, Clyde W, and Bhatt, Deepak L
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Male ,Time Factors ,Eligibility Determination ,heart failure ,Cardiorespiratory Medicine and Haematology ,Outcome and Process Assessment ,Cardiovascular ,quality of health care ,Clinical Research ,Humans ,Registries ,Hospital Mortality ,Healthcare Disparities ,Policy Making ,hospitalizations ,Poverty ,Aged ,Medicaid ,Patient Protection and Affordable Care Act ,Middle Aged ,Health Services ,Quality Improvement ,mortality ,United States ,Hospitalization ,Health Care ,Treatment Outcome ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,Quality Indicators ,Public Health and Health Services ,Female ,insurance - Abstract
BackgroundHeart failure (HF) is the leading cause of morbidity and mortality in the United States. Despite advancement in the management of HF, outcomes remain suboptimal, particularly among the uninsured. In 2014, the Affordable Care Act expanded Medicaid eligibility, and millions of low-income adults gained insurance. Little is known about Medicaid expansion's effect on inpatient HF care.Methods and resultsWe used the American Heart Association's Get With The Guidelines-Heart Failure registry to assess changes in inpatient care quality and outcomes among low-income patients (
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- 2018
14. Medicare Expenditures by Race/Ethnicity After Hospitalization for Heart Failure With Preserved Ejection Fraction
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Ziaeian, Boback, Heidenreich, Paul A, Xu, Haolin, DeVore, Adam D, Matsouaka, Roland A, Hernandez, Adrian F, Bhatt, Deepak L, Yancy, Clyde W, and Fonarow, Gregg C
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Male ,heart failure with preserved ejection fraction ,Aging ,health care disparities ,Ethnic Groups ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Medicare ,Cohort Studies ,BMI ,Clinical Research ,Ethnicity ,health care costs ,Humans ,hospital readmissions ,Aged ,African Americans ,Heart Failure ,Continental Population Groups ,CMS ,diastolic heart failure ,Racial Groups ,Stroke Volume ,Hispanic or Latino ,Health Services ,Middle Aged ,United States ,Hospitalization ,Heart Disease ,Female ,Hispanic Americans ,Health Expenditures - Abstract
ObjectivesThe purpose of this study was to analyze cumulative Medicare expenditures at index admission and after discharge by race or ethnicity.BackgroundHeart failure with preserved ejection fraction (HFpEF) is a growing proportion of heart failure (HF) admissions. Research on health care expenditures for patients with HFpEF is limited.MethodsRecords of patients discharged from the Get With The Guidelines-Heart Failure registry between 2006 and 2014 were linked to Medicare data. The primary outcome was unadjusted payments for acute care services. Comparisons between race/ethnic groups were made using generalized linear mixed models. Cost ratios were reported by race/ethnicity, and adjustments were made sequentially for patient characteristics, hospital factors, and regional socioeconomicstatus.ResultsMedian Medicare costs for index hospitalizations were $7,241 for the entire cohort, $7,049 for whites, $8,269 for blacks, $8,808 for Hispanics, $8,477 for Asians, and $8,963 for other races. Median costs at 30 days for readmitted patients were $9,803 and $17,456 for the entire cohort at 1-year. No significant differences were seen in index admissioncost ratios by race/ethnicity. At 30 days among readmitted patients, costs were 9% higher (95% confidence interval [CI]: 1% to 17%; p= 0.020) for blacks in the fully adjusted model than whites. At 1 year, costs were 14% higher (95% CI: 9% to 18%; p< 0.001) for blacks, 7% higher (95% CI: 0% to 14%; p= 0.041) for Hispanics, and 24% higher (95% CI: 8% to 42%; p= 0.003) for patients of other races. No significant differences between white and Asian expenditures were noted.ConclusionsMinority patients with HFpEF have greater acute care service costs. Further research of improving care delivery is needed to reduce acute care use for vulnerable populations.
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- 2018
15. Clinical Effectiveness of Hydralazine-Isosorbide Dinitrate in African-American Patients With Heart Failure
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Ziaeian, Boback, Fonarow, Gregg C, and Heidenreich, Paul A
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Adult ,Male ,cardiomyopathies ,Cardiotonic Agents ,heart failure ,Isosorbide Dinitrate ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Young Adult ,Clinical Research ,Humans ,heart failure with reduced ejection fraction ,race ,Aged ,African Americans ,nitrates ,Incidence ,Evaluation of treatments and therapeutic interventions ,Middle Aged ,Hydralazine ,mortality ,United States ,Drug Combinations ,Treatment Outcome ,Heart Disease ,Good Health and Well Being ,6.1 Pharmaceuticals ,Female - Abstract
ObjectivesThis study sought to evaluate the effectiveness of hydralazine-isosorbide dinitrate (H-ISDN) in AfricanAmericans with heart failure (HF) with reduced ejection fraction (HFrEF).BackgroundAmong African-American patients with HFrEF, H-ISDN was found to improve quality of life and lower HF-related hospitalization and mortality rates in the A-HEFT (African-American Heart Failure Trial). Few studies have evaluated the effectiveness of this therapy in clinical practice.MethodsVeterans Affairs patients with a hospital admission for HF between 2007 and 2013 were screened. Inclusion criteria included African-American race, left ventricular ejection fraction2.0 mg/dl, or intolerance to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Adjusted hazard ratios were calculated for patients who received H-ISDN 6-months before admission compared with patients who did not receive H-ISDN, by using inverse probability weighting of propensity scores and a time to death analysis for 18 months of follow-up. Propensity scores were generated using patients' characteristics, left ventricular ejection fraction, laboratory values, and hospital characteristics.ResultsThe final cohort included 5,168 African-American patients with HF (mean age 65.2 years), with 15.2% treated with H-ISDN before index admission. After 18 months, there were 1,275 reported deaths (24.7%). The adjusted mortalityrate at 18 months was 22.1% for patients receiving H-ISDN treatment and 25.2% for untreated patients (p=0.009); adjusted hazard ratio: 0.85 (95% confidence interval: 0.73 to 1.00; p= 0.057).ConclusionsH-ISDN remains underused in African-American patients with HFrEF. In this cohort, the study found that H-ISDN use was associated with lower mortality rates in African-American patients with HFrEF when controlling for patient selection by using an inverse probability weighting of propensity scores.
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- 2017
16. Race/Ethnic Differences in Outcomes Among Hospitalized Medicare Patients With Heart Failure and Preserved Ejection Fraction
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Ziaeian, Boback, Heidenreich, Paul A, Xu, Haolin, DeVore, Adam D, Matsouaka, Roland A, Hernandez, Adrian F, Bhatt, Deepak L, Yancy, Clyde W, and Fonarow, Gregg C
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African Americans ,Heart Failure ,heart failure with preserved ejection fraction ,Aging ,Whites ,diastolic heart failure ,Stroke Volume ,Hispanic or Latino ,Cardiorespiratory Medicine and Haematology ,Medicare ,Cardiovascular ,mortality ,Patient Readmission ,United States ,preserved ejection fraction ,Hospitalization ,Asians ,heart failure with ,Heart Disease ,Socioeconomic Factors ,Clinical Research ,ethnicity ,Humans ,race ,disparities - Abstract
ObjectivesThis study analyzed HFpEF patient characteristics and clinical outcomes according to race/ethnicity and adjusted for patient and hospital characteristics along with socioeconomic status (SES).BackgroundThe proportion of hospitalizations for heart failure with preserved ejection fraction (HFpEF) has increased over the last decade. Whether the short- and long-term outcomes differ between racial/ethnic groups is not well described.MethodsThe Get With The Guidelines-Heart Failure registry was linked to Medicare administrative data to identify hospitalized patients with HFpEF≥65 years of age with left ventricular ejection fraction≥50% between 2006 and 2014.Cox proportional hazards models were used to report hazard ratios (HRs) for 30-day and 1-year readmission and mortality rates with sequential adjustments for patient characteristics, hospital characteristics, and SES.ResultsThe final cohort included 53,065 patients with HFpEF. Overall 30-day mortality was 5.87%; at 1 year, it was 33.1%. The 30-day all-cause readmission rate was 22.2%, and it was 67.0% at 1 year. After adjusting for patient characteristics, hospital characteristics, and SES, 30-day mortality was lower for black patients (HR: 0.84; 95% confidence interval [CI]: 0.71 to 0.98; p= 0.031) and Hispanic patients (HR: 0.78; 95% CI: 0.64 to 0.96; p= 0.017) compared with white patients. One-year mortality was lower for black patients (HR: 0.93; 95% CI: 0.87 to 0.99; p=0.031), Hispanic patients (HR: 0.83; 95% CI: 0.75 to 0.91; p< 0.001), and Asian patients (HR: 0.76; 95% CI: 0.66 to 0.88; p< 0.001) compared with white patients. Black patients had a higher risk of readmission at 30 days (HR:1.09;95% CI: 1.02 to 1.16; p=0.012) and 1 year (HR: 1.14; 95% CI: 1.09 to 1.20; p< 0.001) compared with whitepatients.ConclusionsBlack, Hispanic, and Asian patients had a lower mortality risk after a hospitalization for HFpEF comparedwith white patients; black patients had higher readmission rates. These differences in mortality and readmissionrisk according to race/ethnicity persisted after adjusting for patient characteristics, SES, and hospital factors.
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- 2017
17. Patient and Facility Variation in Costs of VA Heart Failure Patients
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Yoon, Jean, Fonarow, Gregg C, Groeneveld, Peter W, Teerlink, John R, Whooley, Mary A, Sahay, Anju, and Heidenreich, Paul A
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Male ,Substance-Related Disorders ,costs ,heart failure ,Comorbidity ,Cardiorespiratory Medicine and Haematology ,Medicare ,Cardiovascular ,Databases ,Insurance ,Clinical Research ,Ambulatory Care ,80 and over ,Humans ,veterans ,Mortality ,Factual ,Aged ,Medically Uninsured ,Age Factors ,Health Care Costs ,Hispanic or Latino ,Middle Aged ,Health Services ,United States ,Hospitalization ,Black or African American ,United States Department of Veterans Affairs ,Heart Disease ,Good Health and Well Being ,Cost Effectiveness Research ,Health ,Regression Analysis ,Female ,Health Facilities - Abstract
ObjectivesThis study sought to determine the variation in annual health care costs among patients with heart failure in the Veterans Affairs (VA) system.BackgroundHeart failure is associated with considerable use of health care resources, but little is known about patterns in patient characteristics related to higher costs.MethodsWe obtained VA utilization and cost records for all patients with a diagnosis of heart failure in fiscal year 2010. We compared total VA costs by patient demographic factors, comorbid conditions, and facility where they were treated in bivariate analyses. We regressed total costs on patient factors alone, VA facility alone, and all factors combined to determine the relative contribution of patient factors and facility to explaining cost differences.ResultsThere were 117,870 patients with heart failure, and their mean annual VA costs were $30,719 (SD 49,180) with more than one-half of their costs from inpatient care. Patients at younger ages, of Hispanic or black race/ethnicity, diagnosed with comorbid drug use disorders, or who died during the year had the highest costs (all p< 0.01). There wasvariation in costs by facility as mean adjusted costs ranged from approximately $15,000 to $48,000. In adjusted analyses, patient factors alone explained more of the variation in health care costs (R(2)= 0.116) compared with the facility where the patient was treated (R(2)= 0.018).ConclusionsA large variation in costs of heart failure patients was observed across facilities, although this wasexplained largely by patient factors. Improving the efficiency of VA resource utilization may require increased scrutiny of high-cost patients to determine if adequate value is being delivered to those patients.
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- 2016
18. Safety and Clinical Outcomes of Catheter Ablation of Atrial Fibrillation in Patients With Chronic Kidney Disease
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Ullal, Aditya J., Kaiser, Daniel W., Fan, Jun, Schmitt, Susan, Than, Claire T., Winkelmayer, Wolfgang C., Heidenreich, Paul A., Piccini, Jonathon P., Perez, Marco V., Wang, Paul J., and Turakhia, Mintu P.
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Adult ,Male ,Time Factors ,Adolescent ,Databases, Factual ,Comorbidity ,Kaplan-Meier Estimate ,Patient Readmission ,Article ,Disease-Free Survival ,Young Adult ,Recurrence ,Risk Factors ,Atrial Fibrillation ,Humans ,Renal Insufficiency, Chronic ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Heart Failure ,Incidence ,Middle Aged ,United States ,Treatment Outcome ,Chronic Disease ,Multivariate Analysis ,Catheter Ablation ,Female - Abstract
Data regarding catheter ablation of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) is limited. We therefore assessed the association of CKD with common safety and clinical outcomes in a nationwide sample of ablation recipients.Using MarketScanOf 21,091 patients included, 1,593 (7.6%) had CKD. Patients with CKD were older (64 years vs. 59 years, P0.001) with higher CHAAmong patients selected for AF ablation, those with and without CKD had similar rates of postprocedural complications although they were more likely to be re-admitted for heart failure. CKD was not independently associated with AF hospitalization, cardioversion, and repeat ablation. These findings can inform clinical decision-making in patients with AF and CKD.
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- 2016
19. Trends in 30-Day Readmission Rates for Patients Hospitalized With Heart Failure: Findings From the Get With The Guidelines-Heart Failure Registry
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Bergethon, Kristin E, Ju, Christine, DeVore, Adam D, Hardy, N Chantelle, Fonarow, Gregg C, Yancy, Clyde W, Heidenreich, Paul A, Bhatt, Deepak L, Peterson, Eric D, and Hernandez, Adrian F
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Male ,Time Factors ,Medical Physiology ,heart failure ,8.1 Organisation and delivery of services ,Practice Patterns ,Cardiorespiratory Medicine and Haematology ,Medicare ,Cardiovascular ,Patient Readmission ,inpatient ,Risk Factors ,Clinical Research ,80 and over ,Humans ,Registries ,Aged ,Physicians' ,Teaching ,Quality Improvement ,Hospitals ,United States ,attention ,Health Care ,Heart Disease ,Cardiovascular System & Hematology ,Multivariate Analysis ,Practice Guidelines as Topic ,outpatient ,Linear Models ,Quality Indicators ,Female ,Guideline Adherence ,Patient Safety ,Biochemistry and Cell Biology ,hospitalization ,Health and social care services research - Abstract
Reducing hospital readmissions for patients with heart failure is a national priority, and quality improvement campaigns are targeting reductions of ≥20%. However, there are limited data on whether such targets have been met. We analyzed data from the American Heart Association's Get With The Guidelines-Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. A total of 21,264 patients with heart failure were included from 70 US sites from January 2009 to October 2012. Overall hospital-level, risk-adjusted, 30-day all-cause readmission rates declined slightly, from 20.0% (SD, 1.3%) in 2009 to 19.0% (SD, 1.2%) in 2012 (P=0.001). Only 1 in 70 (1.4%) hospitals achieved the 20% relative reduction in 30-day risk-adjusted readmission rates. A multivariable linear regression model was used to determine hospital-level factors associated with relative improvements in 30-day risk-adjusted readmissions between 2009 and 2012. Teaching hospitals had higher relative readmission rates as compared with their peers, and hospitals that used postdischarge heart failure disease management programs had lower relative readmission rates. Although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
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- 2016
20. Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures
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Allen, Larry A, Fonarow, Gregg C, Liang, Li, Schulte, Phillip J, Masoudi, Frederick A, Rumsfeld, John S, Ho, P Michael, Eapen, Zubin J, Hernandez, Adrian F, Heidenreich, Paul A, Bhatt, Deepak L, Peterson, Eric D, Krumholz, Harlan M, and American Heart Association’s Get With The Guidelines Heart Failure (GWTG-HF) Investigators
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Male ,Clinical Sciences ,prescribing patterns ,heart failure ,Comorbidity ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Drug Prescriptions ,Body Mass Index ,Medication Adherence ,medication therapy management ,Drug Hypersensitivity ,Patient Admission ,Drug Therapy ,quality of health care ,Clinical Research ,80 and over ,Humans ,Aged ,American Heart Association’s Get With The Guidelines Heart Failure (GWTG-HF) Investigators ,Evidence-Based Medicine ,physician ,Drug Substitution ,Contraindications ,Cardiovascular Agents ,Middle Aged ,Patient Discharge ,Hospitals ,Drug Utilization ,Health Care ,Cross-Sectional Studies ,Heart Disease ,Cardiovascular System & Hematology ,Combination ,Practice Guidelines as Topic ,Polypharmacy ,Public Health and Health Services ,Female ,Guideline Adherence ,Quality Assurance - Abstract
BackgroundGuidelines for heart failure (HF) recommend prescription of guideline-directed medical therapy before hospital discharge; some of these therapies are included in publicly reported performance measures. The burden of new medications for individual patients has not been described.Methods and resultsWe used Get With The Guidelines-HF registry data from 2008 to 2013 to characterize prescribing, indications, and contraindications for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, β-blockers, aldosterone antagonists, hydralazine/isosorbide dinitrate, and anticoagulants. The difference between a patient's medication regimen at hospital admission and that recommended by HF quality measures at discharge was calculated. Among 158 922 patients from 271 hospitals with a primary discharge diagnosis of HF, initiation of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was indicated in 18.1% of all patients (55.5% of those eligible at discharge were not receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at admission), β-blockers in 20.3% (50.5% of eligible), aldosterone antagonists in 24.1% (87.4% of eligible), hydralazine/isosorbide dinitrate in 8.6% (93.1% of eligible), and anticoagulants in 18.0% (58.0% of eligible). Cumulatively, 0.4% of patients were eligible for 5 new medication groups, 4.1% for 4 new medication groups, 9.4% for 3 new medication groups, 10.1% for 2 new medication groups, and 22.7% for 1 new medication group; 15.0% were not eligible for new medications because of adequate prescribing at admission; and 38.4% were not eligible for any medications recommended by HF quality measures. Compared with newly indicated medications (mean, 1.45 ± 1.23), actual new prescriptions were lower (mean, 1.16 ± 1.00).ConclusionsA quarter of patients hospitalized with HF need to start >1 medication to meet HF quality measures. Systems for addressing medication initiation and managing polypharmacy are central to HF transitional care.
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- 2015
21. Heart rate at hospital discharge in patients with heart failure is associated with mortality and rehospitalization
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Laskey, Warren K, Alomari, Ihab, Cox, Margueritte, Schulte, Phillip J, Zhao, Xin, Hernandez, Adrian F, Heidenreich, Paul A, Eapen, Zubin J, Yancy, Clyde, Bhatt, Deepak L, Fonarow, Gregg C, and AHA Get With The Guidelines®‐Heart Failure Program
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Male ,Heart Failure ,Cardiorespiratory Medicine and Haematology ,AHA Get With The Guidelines®‐Heart Failure Program ,Cardiovascular ,Patient Readmission ,mortality ,Patient Discharge ,Heart Disease ,Good Health and Well Being ,Risk Factors ,Heart Rate ,Atrial Fibrillation ,80 and over ,Humans ,Female ,Retrospective Studies ,Aged - Abstract
BackgroundWhether heart rate upon discharge following hospitalization for heart failure is associated with long-term adverse outcomes and whether this association differs between patients with sinus rhythm (SR) and atrial fibrillation (AF) have not been well studied.Methods and resultsWe conducted a retrospective cohort study from clinical registry data linked to Medicare claims for 46 217 patients participating in Get With The Guidelines(®)-Heart Failure. Cox proportional-hazards models were used to estimate the association between discharge heart rate and all-cause mortality, all-cause readmission, and the composite outcome of mortality/readmission through 1 year. For SR and AF patients with heart rate ≥75, the association between heart rate and mortality (expressed as hazard ratio [HR] per 10 beats-per-minute increment) was significant at 0 to 30 days (SR: HR 1.30, 95% CI 1.22 to 1.39; AF: HR 1.23, 95% CI 1.16 to 1.29) and 31 to 365 days (SR: HR 1.15, 95% CI 1.12 to 1.20; AF: HR 1.05, 95% CI 1.01 to 1.08). Similar associations between heart rate and all-cause readmission and the composite outcome were obtained for SR and AF patients from 0 to 30 days but only in the composite outcome for SR patients over the longer term. The HR from 0 to 30 days exceeded that from 31 to 365 days for both SR and AF patients. At heart rates
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- 2015
22. Hospital variation in intravenous inotrope use for patients hospitalized with heart failure: insights from Get With The Guidelines
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Allen, Larry A, Fonarow, Gregg C, Grau-Sepulveda, Maria V, Hernandez, Adrian F, Peterson, Pamela N, Partovian, Chohreh, Li, Shu-Xia, Heidenreich, Paul A, Bhatt, Deepak L, Peterson, Eric D, Krumholz, Harlan M, and American Heart Association’s Get With The Guidelines Heart Failure Investigators
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Male ,Infusions ,Cardiotonic Agents ,Outcome Assessment ,physician's practice patterns ,Medical Physiology ,heart failure ,Practice Patterns ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Dose-Response Relationship ,Clinical Research ,Humans ,Registries ,Hospital Mortality ,Retrospective Studies ,Aged ,Inpatients ,physician’s practice patterns ,Physicians' ,Length of Stay ,outcome and process assessment ,Hospitals ,United States ,Survival Rate ,Health Care ,Cross-Sectional Studies ,Heart Disease ,Cardiovascular System & Hematology ,American Heart Association’s Get With The Guidelines Heart Failure Investigators ,Female ,Guideline Adherence ,Patient Safety ,Biochemistry and Cell Biology ,Drug ,Intravenous ,Follow-Up Studies - Abstract
BackgroundPrior claims analyses suggest that the use of intravenous inotropic therapy for patients hospitalized with heart failure varies substantially by hospital. Whether differences in the clinical characteristics of the patients explain observed differences in the use of inotropic therapy is not known.Methods and resultsWe sought to characterize institutional variation in inotrope use among patients hospitalized with heart failure before and after accounting for clinical factors of patients. Hierarchical generalized linear regression models estimated risk-standardized hospital-level rates of inotrope use within 209 hospitals participating in Get With The Guidelines-Heart Failure (GWTG-HF) registry between 2005 and 2011. The association between risk-standardized rates of inotrope use and clinical outcomes was determined. Overall, an inotropic agent was administered in 7691 of 126 564 (6.1%) heart failure hospitalizations: dobutamine 43%, dopamine 24%, milrinone 17%, or a combination 16%. Patterns of inotrope use were stable during the 7-year study period. Use of inotropes varied significantly between hospitals even after accounting for patient and hospital characteristics (median risk-standardized hospital rate, 5.9%; interquartile range, 3.7%-8.6%; range, 1.3%-32.9%). After adjusting for case-mix and hospital structural differences, model intraclass correlation indicated that 21% of the observed variation in inotrope use was potentially attributable to random hospital effects (ie, institutional preferences). Hospitals with higher risk-standardized inotrope use had modestly longer risk-standardized length of stay (P=0.005) but had no difference in risk-standardized inpatient mortality (P=0.12).ConclusionsUse of intravenous inotropic agents during hospitalization for heart failure varies significantly among US hospitals even after accounting for patient and hospital factors.
- Published
- 2014
23. Effect of Beta-Blockade on Mortality in Patients With Heart Failure: A Meta-Analysis of Randomized Clinical Trials 11All editorial decisions for this article, including selection of referees, were made by a Guest Editor. This policy applies to all articles with authors from the University of California San Francisco
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Heidenreich, Paul A, Lee, Tina T, and Massie, Barry M
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Cardiology and Cardiovascular Medicine - Abstract
Objectives. We sought to evaluate the current evidence for an effect of beta-blockade treatment on mortality in patients with congestive heart failure (CHF).Background. Although numerous small studies have suggested a benefit with beta-blocker therapy in patients with heart failure, a clear survival benefit has not been demonstrated. A recent combined analysis of several studies with the alpha- and beta-adrenergic blocking agent carvedilol demonstrated a significant survival advantage; however, the total number of events was small. Furthermore, it is unclear if previous studies with other beta-blockers are consistent with this finding.Methods. Randomized clinical trials of beta-blockade treatment in patients with CHF from January 1975 through February 1997 were identified using a MEDLINE search and a review of reports from scientific meetings. Studies were included if mortality was reported during 3 or more months of follow-up.Results. We identified 35 reports, 17 of which met the inclusion criteria. These studies included 3,039 patients with follow-up ranging from 3 months to 2 years. Beta-blockade was associated with a trend toward mortality reduction in 13 studies. When all 17 reports were combined, beta-blockade significantly reduced all-cause mortality (random effect odds ratio [OR] 0.69, 95% confidence interval [CI] 0.54 to 0.88). A trend toward greater treatment effect was noted for nonsudden cardiac death (OR 0.58, 95% CI 0.40 to 0.83) compared with sudden cardiac death (OR 0.84, 95% CI 0.59 to 1.2). Similar reductions in mortality were observed for patients with ischemic (OR 0.69, 95% CI 0.49 to 0.98) and nonischemic cardiomyopathy (OR 0.69, 95% CI 0.47 to 0.99). The survival benefit was greater for trials of the drug carvedilol (OR 0.54, 95% CI 0.36 to 0.81) than for noncarvedilol drugs (OR 0.82, 95% CI 0.60 to 1.12); however, the difference did not reach statistical significance (p = 0.10).Conclusions. Pooled evidence suggests that beta-blockade reduces all-cause mortality in patients with CHF. Additional trials are required to determine whether carvedilol differs in its effect from other agents.(J Am Coll Cardiol 1997;30:27–34)
- Published
- 1997
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24. ACC/AHA/HRS 2006 key data elements and definitions for electrophysiological studies and procedures: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (ACC/AHA/HRS Writing Committee to Develop Data Standards on Electrophysiology)
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Buxton, Alfred E., Calkins, Hugh, Callans, David J., DiMarco, John P., Fisher, John D., Leon Greene, H., Haines, David E., Hayes, David L., Heidenreich, Paul A., Miller, John M., Poppas, Athena, Prystowsky, Eric N., Schoenfeld, Mark H., Zimetbaum, Peter J., Goff, David C., Grover, Frederick L., Malenka, David J., Peterson, Eric D., Radford, Martha J., and Redberg, Rita F.
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Electrophysiology ,Cardiovascular Diseases ,Data Collection ,Terminology as Topic ,Diagnostic Techniques, Cardiovascular ,Humans ,American Heart Association ,Electrophysiologic Techniques, Cardiac ,United States - Published
- 2006
25. Genetic Variation Near HCRTR2 Associates With Dramatic Improvement of Heart Function in Patients With Heart Failure
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Perez, Marco V., Pavlovic, Aleksandra, Wheeler, Matthew T., Miller, Clint L., Thanaporn, Porama, Dewey, Frederick E., Pan, Stephen, Absher, Devin, Cretti, Elizabeth, Southwick, Audrey, Heidenreich, Paul, Sedehi, Daniel, Brandimarto, Jeffrey, David Kao, Salisbury, Heidi, Chan, Khin, Rosenthal, David, Bernstein, Daniel, Fowler, Michael B., Robbins, Robert C., Meyers, Richard, Quertermous, Thomas, Cappola, Thomas, and Ashley, Euan
26. Universal Definition and Classification of Heart Failure A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure
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Biykem Bozkurt, Coats, Andrew J. S., Tsutsui, Hiroyuki, Abdelhamid, Magdy, Adamopoulos, Stamatis, Albert, Nancy, Anker, Stefan D., Atherton, John, Bohm, Michael, Butler, Javed, Drazner, Mark H., Felker, G. Michael, Filippatos, Gerasimos, Fonarow, Gregg C., Fiuzat, Mona, Gomez-Mesa, Juan-Esteban, Heidenreich, Paul, Imamura, Teruhiko, Januzzi, James, Jankowska, Ewa A., Khazanie, Prateeti, Kinugawa, Koichiro, Lam, Carolyn S. P., Matsue, Yuya, Metra, Marco, Ohtani, Tomohito, Piepoli, Massimo Francesco, Ponikowski, Piotr, Rosano, Giuseppe M. C., Sakata, Yasushi, Starling, Randall C., Teerlink, John R., Vardeny, Orly, Yamamoto, Kazuhiro, Yancy, Clyde, Zhang, Jian, and Zieroth, Shelley
27. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography
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Luigi P. Badano, Jan Bogaert, Ronald G. Schwartz, Steven C. Port, Marielle Scherrer-Crosbie, Maurizio Galderisi, Samuel Wann, Philippe Coucke, Brian P. Griffin, Jutta Bergler, Vuyisile T. Nkomo, Juan Carlos Plana, Phillip C. Yang, Patrizio Lancellotti, Laurent Davin, Paul A. Heidenreich, Thor Edvardsen, Jens-Uwe Voigt, Raluca Elena Dulgheru, Oliver Gaemperli, Igal A. Sebag, Koen Nieman, Bernard Cosyns, University of Zurich, Lancellotti, Patrizio, Nkomo, Vuyisile T., Badano, Luigi P., Bergler, Jutta, Bogaert, Jan, Davin, Laurent, Cosyns, Bernard, Coucke, Philippe, Dulgheru, Raluca, Edvardsen, Thor, Gaemperli, Oliver, Galderisi, Maurizio, Griffin, Brian, Heidenreich, Paul A., Nieman, Koen, Plana, Juan C., Port, Steven C., Scherrer Crosbie, Marielle, Schwartz, Ronald G., Sebag, Igal A., Voigt, Jens Uwe, Wann, Samuel, Yang, Phillip C., Radiology & Nuclear Medicine, Nkomo, Vuyisile T, Badano, Luigi P, Bergler Klein, Jutta, Heidenreich, Paul A, Plana, Juan C, Port, Steven C, Schwartz, Ronald G, and Sebag, Igal A
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Cardiac magnetic resonance ,Heart disease ,medicine.medical_treatment ,Multimodal Imaging ,Coronary artery disease ,Cardiovascular Disease ,Nuclear Medicine and Imaging ,Neoplasms ,Radiation Injurie ,Adjuvant ,Cardiac imaging ,Radiation ,medicine.diagnostic_test ,Heart ,General Medicine ,Middle Aged ,Europe ,Cardiovascular Diseases ,Echocardiography ,10209 Clinic for Cardiology ,Radiology ,Cardiology and Cardiovascular Medicine ,Human ,Cardiac computed tomography ,Nuclear cardiology ,Radiotherapy ,Adult ,Dose-Response Relationship, Radiation ,Humans ,Radiation Injuries ,Radiotherapy, Adjuvant ,Risk ,Radiology, Nuclear Medicine and Imaging ,medicine.medical_specialty ,Consensus ,Consensu ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine ,Dose-Response Relationship ,SDG 3 - Good Health and Well-being ,medicine ,Medical imaging ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,Intensive care medicine ,Cardiotoxicity ,cardiac computed tomography ,cardiac magnetic resonance ,echocardiography ,heart disease ,nuclear cardiology ,radiotherapy ,United States ,business.industry ,Cancer ,Magnetic resonance imaging ,medicine.disease ,Radiation therapy ,Neoplasm ,business - Abstract
Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality associated with its cardiac complications. While radiosensitivity of the heart was initially recognized only in the early 1970s, the heart is regarded in the current era as one of the most critical dose-limiting organs in radiotherapy. Several clinical studies have identified adverse clinical consequences of radiation-induced heart disease (RIHD) on the outcome of long-term cancer survivors. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications of radiotherapy by cardiac imaging are also proposed.
- Published
- 2013
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