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7 results on '"Khariton, Yevgeniy"'

1. Association Between Sacubitril/Valsartan Initiation and Health Status Outcomes in Heart Failure With Reduced Ejection Fraction

Author

Khariton, Yevgeniy, Fonarow, Gregg C, Arnold, Suzanne V, Hellkamp, Ann, Nassif, Michael E, Sharma, Puza P, Butler, Javed, Thomas, Laine, Duffy, Carol I, DeVore, Adam D, Albert, Nancy M, Patterson, J Herbert, Williams, Fredonia B, McCague, Kevin, and Spertus, John A

Subjects
Cardiovascular, Clinical Research, Heart Disease, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Aged, Aminobutyrates, Angiotensin Receptor Antagonists, Biphenyl Compounds, Cohort Studies, Drug Combinations, Female, Health Status, Heart Failure, Humans, Male, Middle Aged, Neprilysin, Stroke Volume, Tetrazoles, Treatment Outcome, Valsartan, health status, heart failure, sacubitril/valsartan, Cardiorespiratory Medicine and Haematology
Abstract

ObjectivesThis study sought to describe the short-term health status benefits of angiotensin-neprilysin inhibitor (ARNI) therapy in patients with heart failure and reduced ejection fraction (HFrEF).BackgroundAlthough therapy with sacubitril/valsartan, a neprilysin inhibitor, improved patients' health status (compared with enalapril) at 8 months in the PARADIGM-HF (Prospective Comparison of ARNI with ACE inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) study, the early impact of ARNI on patients' symptoms, functions, and quality of life is unknown.MethodsHealth status was assessed by using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ) in 3,918 outpatients with HFrEF and left ventricular ejection fraction ≤40% across 140 U.S. centers in the CHAMP-HF (Change the Management of Patients with Heart Failure) registry. ARNI therapy was initiated in 508 patients who were matched 1:2 to 1,016 patients who were not initiated on ARNI (no-ARNI), using a nonparsimonious time-dependent propensity score (6 sociodemographic factors, 23 clinical characteristics), prior KCCQ overall summary (KCCQ-OS) score, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker status.ResultsMultivariate linear regression demonstrated a greater mean improvement in KCCQ-OS in patients initiated on ARNI therapy (5.3 ± 19 vs. 2.5 ± 17.4, respectively; p

Published
2019

2. Association of Changes in Heart Failure Treatment With Patients’ Health Status Real-World Evidence From CHAMP-HF

Author

Thomas, Merrill, Khariton, Yevgeniy, Fonarow, Gregg C, Arnold, Suzanne V, Hill, Larry, Nassif, Michael E, Sharma, Puza P, Butler, Javed, Thomas, Laine, Duffy, Carol I, DeVore, Adam D, Hernandez, Adrian, Albert, Nancy M, Patterson, J Herbert, Williams, Fredonia B, McCague, Kevin, and Spertus, John A

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cardiovascular, Clinical Research, Heart Disease, Management of diseases and conditions, 7.1 Individual care needs, Good Health and Well Being, Adrenergic beta-Antagonists, Aged, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Diuretics, Female, Health Status, Heart Failure, Humans, Male, Middle Aged, Mineralocorticoid Receptor Antagonists, Neprilysin, Quality of Life, Registries, health status, heart failure with reduced ejection fraction, Kansas City Cardiomyopathy Questionnaire, medications, quality, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

ObjectivesThe aim of this study was to use a multicenter, observational outpatient registry of patients with heart failure with reduced ejection fraction (HFrEF) to describe the association between changes in patients' medications with changes in health status.BackgroundAlleviating symptoms and improving function and quality of life for patients with HFrEF are primary treatment goals and potential indicators of quality. Whether titrating medications in routine clinical care improves patients' health status is unknown.MethodsThe association of any change in HFrEF medications with 3-month change in health status, as measured using the 12-item Kansas City Cardiomyopathy Questionnaire Overall Summary Scale, was determined in unadjusted and multivariate-adjusted (25 clinical characteristics, baseline health status) models using hierarchical linear regression.ResultsAmong 3,313 outpatients with HFrEF from 140 centers, 21.9% had medication changes. Three months later, 23.7% and 46.4% had clinically meaningfully worse (≥5-point decrease) and improved (≥5-point increase) Kansas City Cardiomyopathy Questionnaire Overall Summary Scale scores. The 3-month median change in Kansas City Cardiomyopathy Questionnaire Overall Summary Scale score for patients whose HFrEF medications were changed was significantly larger (7.3 points; interquartile range: -3.1 to 20.8 points) than in patients whose medications were not changed (3.1 points; interquartile range: -4.7 to 12.5 points) (adjusted difference 3.0 points; 95% confidence interval: 1.4 to 4.6 points; p

Published
2019

3. Target Doses of Heart Failure Medical Therapy and Blood Pressure Insights From the CHAMP-HF Registry

Author

Peri-Okonny, Poghni A, Mi, Xiaojuan, Khariton, Yevgeniy, Patel, Krishna K, Thomas, Laine, Fonarow, Gregg C, Sharma, Puza P, Duffy, Carol I, Albert, Nancy M, Butler, Javed, Hernandez, Adrian F, McCague, Kevin, Williams, Fredonia B, DeVore, Adam D, Patterson, J Herbert, and Spertus, John A

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Rare Diseases, Cardiovascular, Heart Disease, Adrenergic beta-Antagonists, Adult, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Cross-Sectional Studies, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Prospective Studies, Registries, Stroke Volume, Treatment Outcome, heart failure, systolic blood pressure, target dose, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

ObjectivesThis study sought to determine the rate of use of target doses of foundational guideline-directed medical therapy (GDMT) in a contemporary cohort of patients with heart failure with reduced ejection fraction (HFrEF) across systolic blood pressure (SBP) categories.BackgroundPatients with HFrEF are infrequently titrated to recommended doses of GDMT. The relationship between SBP and achieving GDMT target doses is not well studied.MethodsPatients enrolled in the CHAMP-HF (Change the Management of Patients With Heart Failure) registry without documented intolerance to angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors (ARNIs), and beta blockers (BBs) were assessed at enrollment. We estimated the proportion receiving target doses (% of target dose [95% confidence interval (CI)]) based on the most recent American College of Cardiology/American Heart Association/Heart Failure Society of America heart failure guidelines at baseline in all patients, and by SBP category (≥110 vs.

Published
2019

4. Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure

Author

Khariton, Yevgeniy, Nassif, Michael E, Thomas, Laine, Fonarow, Gregg C, Mi, Xiaojuan, DeVore, Adam D, Duffy, Carol, Sharma, Puza P, Albert, Nancy M, Patterson, J Herbert, Butler, Javed, Hernandez, Adrian F, Williams, Fredonia B, McCague, Kevin, and Spertus, John A

Subjects
Basic Behavioral and Social Science, Behavioral and Social Science, Cardiovascular, Heart Disease, Clinical Research, Reduced Inequalities, Adult, Black or African American, Aged, Aged, 80 and over, Ambulatory Care, Female, Health Status Disparities, Heart Failure, Hispanic or Latino, Humans, Male, Middle Aged, Prospective Studies, Registries, Sex Factors, Social Class, United States, health disparities, heart failure, quality of life, Cardiorespiratory Medicine and Haematology
Abstract

ObjectivesThis study sought to describe the health status of outpatients with heart failure and reduced ejection fraction (HFrEF) by sex, race/ethnicity, and socioeconomic status (SES).BackgroundAlthough a primary goal in treating patients with HFrEF is to optimize health status, whether disparities by sex, race/ethnicity, and SES exist is unknown.MethodsIn the CHAMP-HF (Change the Management of Patients with Heart Failure) registry, the associations among sex, race, and SES and health status, as measured by the Kansas City Cardiomyopathy Questionnaire-overall summary (KCCQ-os) score (range 0 to 100; higher scores indicate better health status) was compared among 3,494 patients from 140 U.S. clinics. SES was categorized by total household income. Hierarchical multivariate linear regression estimated differences in KCCQ-os score after adjusting for 31 patient characteristics and 10 medications.ResultsOverall mean KCCQ-os scores were 64.2 ± 24.0 but lower for women (29% of sample; 60.3 ± 24.0 vs. 65.9 ± 24.0, respectively; p < 0.001), for blacks (60.5 ± 25.0 vs. 64.9 ± 23.0, respectively; p < 0.001), for Hispanics (59.1 ± 21.0 vs. 64.9 ± 23.0, respectively; p < 0.001), and for those with the lowest income (

Published
2018

5. Health Status Variation Across Practices in Outpatients With Heart Failure

Author

Khariton, Yevgeniy, Hernandez, Adrian F, Fonarow, Gregg C, Sharma, Puza P, Duffy, Carol I, Thomas, Laine, Mi, Xiaojuan, Albert, Nancy M, Butler, Javed, McCague, Kevin, Nassif, Michael E, Williams, Fredonia B, DeVore, Adam, Patterson, J Herbert, and Spertus, John A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Cardiovascular, Clinical Research, Heart Disease, Good Health and Well Being, Adult, Aged, Aged, 80 and over, Ambulatory Care, Female, Health Status, Health Status Disparities, Health Status Indicators, Healthcare Disparities, Heart Failure, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Recovery of Function, Registries, Risk Assessment, Risk Factors, Stroke Volume, Surveys and Questionnaires, Time Factors, Treatment Outcome, United States, Ventricular Function, Left, heart failure, outcome assessment, quality of life, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Public health
Abstract

BACKGROUND:Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal is unknown. METHODS AND RESULTS:In the CHAMP-HF (Change the Management of Patients With Heart Failure) registry, associations between baseline practice characteristics and Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary (OS) and Symptom Frequency (SF) scores were assessed in 3494 patients across 140 US practices using hierarchical regression after accounting for 23 patient and 11 treatment characteristics. We then calculated an adjusted median odds ratio to quantify the average difference in likelihood that a patient would have excellent (KCCQ-OS, ≥75) health status or minimal (monthly or fewer) symptoms (KCCQ-SF, ≥75) when treated at one practice versus another, at random. The mean (±SD) KCCQ-OS and KCCQ-SF were 64.2±24 and 68.9±25.6, with 40% (n=1380) and 50% (n=1760) having KCCQ scores ≥75, respectively. The adjusted median odds ratio across practices, for KCCQ-OS ≥75, was 1.70 (95% confidence interval, 1.54-1.99; P

Published
2018

6. Health Status Variation Across Practices in Outpatients with Heart Failure: Insights from the CHAMP-HF Registry

Author

Khariton, Yevgeniy, Hernandez, Adrian F., Fonarow, Gregg C., Sharma, Puza P., Duffy, Carol I, Thomas, Laine, Mi, Xiaojuan, Albert, Nancy M., Butler, Javed, McCague, Kevin, Nassif, Michael E., Williams, Fredonia B., DeVore, Adam, Patterson, J. Herbert, and Spertus, John A.

Subjects
Adult, Male, Time Factors, Health Status, Risk Assessment, Article, Ventricular Function, Left, Risk Factors, Surveys and Questionnaires, Ambulatory Care, Health Status Indicators, Humans, Prospective Studies, Registries, Healthcare Disparities, Aged, Aged, 80 and over, Heart Failure, Stroke Volume, Health Status Disparities, Recovery of Function, Middle Aged, humanities, United States, Treatment Outcome, Quality of Life, Female
Abstract

BACKGROUND: While a key treatment goal for patients with heart failure and reduced ejection fraction (HFrEF) is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal is unknown. METHODS AND RESULTS: In the CHAMP-HF registry, associations between baseline practice characteristics and Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS) and Symptom Frequency (KCCQ-SF) scores were assessed in 3,494 patients across 140 US practices using hierarchical regression after accounting for 23 patient and 11 treatment characteristics. We then calculated an adjusted median odds ratio (aMOR) to quantify the average difference in likelihood that a patient would have excellent (KCCQ-OS ≥75) health status or minimal (monthly or fewer) symptoms (KCCQ-SF≥75) when treated at one practice versus another, at random. The mean (±SD) KCCQ-OS and KCCQ-SF were 64.2±24 and 68.9±25.6, with 40% (n=1,380) and 50% (n= 1,760) having KCCQ scores ≥ 75, respectively. The aMOR across practices, for KCCQ-OS ≥ 75, was 1.70 (95% CI 1.54, 1.99; p < 0.001) indicating a median 70% higher odds of a patient having good to excellent health status when treated at one random practice versus another. In regard to KCCQ-SF, the aMOR for KCCQ-SF ≥75 was 1.54 (95% CI 1.41, 1.76; p = 0.001). CONCLUSIONS: In a large, contemporary registry of outpatients with chronic HFrEF, we observed significant practice-level variability in patients’ health status. Quantifying patients’ health status as a measure of quality should be explored as a foundation for improving care. CLINICAL TRIAL REGISTRATION: URL: https://www.centerwatch.com; Unique Identifier: TX144901

Published
2018

7. Health Status Benefits of Successful Chronic Total Occlusion Revascularization Across the Spectrum of Left Ventricular Function: Insights From the OPEN-CTO Registry

Author

Khariton, Yevgeniy, Airhart, Sophia, Salisbury, Adam C., Spertus, John A., Gosch, Kensey L., Grantham, J. Aaron, Karmpaliotis, Dimitrios, Moses, Jeffrey W., Nicholson, William J., Cohen, David J., Lombardi, William R., Sapontis, James, and McCabe, James M.

Subjects
Male, Time Factors, Health Status, Stroke Volume, Recovery of Function, Middle Aged, Severity of Illness Index, Article, United States, Ventricular Function, Left, Ventricular Dysfunction, Left, Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Quality of Life, Humans, Female, cardiovascular diseases, Registries, Cardiomyopathies, Aged
Abstract

This study sought to describe the association between chronic total occlusion (CTO) revascularization (CTO percutaneous coronary intervention [PCI]) and health status in patients with and without cardiomyopathy.Prior PCI trials for cardiomyopathy have excluded CTO patients. Whether patients with reduced left ventricular ejection fraction (LVEF) receive similar health status benefit from CTO-PCI compared with patients with normal LVEF is unclear.We assessed health status change, using the Seattle Angina Questionnaire (SAQ) Summary, SAQ Angina Frequency, and Rose Dyspnea Scale scores, among patients undergoing successful CTO PCI in the OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion) Registry. Participants were classified by LVEF (normal, ≥50%; mild-moderate, 30% to 49%; and severe, 30%), with higher SAQ and lower Rose Dyspnea Scale scores indicating better health status. Differences in 1-year outcomes were compared using hierarchical multivariable regression.Of 762 patients, 506 (66.4%), 193 (25.3%), and 63 (8.3%) had normal, mild-moderate, and severely reduced LVEF. SAQ Summary score improvements were observed in each group (27.1 ± 20.4, 26.7 ± 21.2, and 20.3 ± 18.1, respectively). Compared with patients with LVEF ≥50%, those with LVEF 30% had less improvement in SAQ Summary Score (-5.2 points; 95% confidence interval: -9.0 to -1.5; p = 0.01) and Rose Dyspnea Scale (+0.5 points; 95% confidence interval: 0.1 to 0.8; p = 0.01), with no difference in odds of angina (odds ratio: 1.3; 95% confidence interval: 0.6 to 3.0; p = 0.48). Health status improvement was similar between patients with LVEF ≥50% and LVEF 30% to 49%.Although health status improvement was less in patients with severely reduced LVEF compared with those with normal LVEF, each group experienced large health status improvements after CTO-PCI.

Published
2018

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