Hongyan Ning, A. Perak, J. Siddique, J. Wilkins, D. Lloyd-Jones, N. Allen
{"title":"Association Between Life's Essential 8 Cardiovascular Health Metrics With Cardiovascular Events in the Cardiovascular Disease Lifetime Risk Pooling Project.","authors":"Hongyan Ning, A. Perak, J. Siddique, J. Wilkins, D. Lloyd-Jones, N. Allen","doi":"10.1161/CIRCOUTCOMES.123.010568","DOIUrl":"https://doi.org/10.1161/CIRCOUTCOMES.123.010568","url":null,"abstract":"BACKGROUND\u0000The American Heart Association recently launched updated cardiovascular health metrics, termed Life's Essential 8 (LE8). Compared with Life's Simple 7 (LS7), the new approach added sleep health as an eighth metric and updated the remaining 7 health factors and behaviors. The association of the updated LE8 score with long-term cardiovascular disease (CVD) outcomes and death is unknown.\u0000\u0000\u0000METHODS\u0000We pooled individual-level data from 6 contemporary US-based cohorts from the Cardiovascular Lifetime Risk Pooling Project. Total LE8 score (0-100 points), LE8 score without sleep (0-100 points), and prior LS7 scores (0-14 points) were calculated separately. We used multivariable-adjusted Cox models to evaluate the association of LE8 with CVD, CVD subtypes, and all-cause mortality among younger, middle, and older adult participants. Net reclassification improvement analysis was used to measure the improvement in CVD risk classification with the addition of LS7 and LE8 recategorization based on score quartile rankings.\u0000\u0000\u0000RESULTS\u0000Our sample consisted of 32 896 US adults (7836 [23.8%] Black; 14 941 [45.4%] men) followed for 642 000 person-years, of whom 9391 developed CVD events. Each 10-point higher overall LE8 score was associated with lower risk by 22% to 40% for CVD, 24% to 43% for congenital heart disease, 17% to 34% for stroke, 23% to 38% for heart failure, and 17% to 21% for all causes of mortality events across age strata. LE8 score provided more granular differentiation of the related CVD risk than LS7. Overall, 19.5% and 15.5% of the study participants were recategorized upward and downward based on LE8 versus LS7 categories, respectively, and the recategorization was significantly associated with CVD risk in addition to LS7 score. The addition of recategorization between LE8 and LS7 categories improved CVD risk reclassification across age groups (clinical net reclassification improvement, 0.06-0.12; P<0.01).\u0000\u0000\u0000CONCLUSIONS\u0000These findings support the improved utility of the LE8 algorithm for assessing overall cardiovascular health and future CVD risk.","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" 666","pages":"e010568"},"PeriodicalIF":6.9,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinician Decision Support Tools: Advances in Lipid-Lowering Treatment Intensification.","authors":"F. Marvel, Jelani K Grant, Seth S Martin","doi":"10.1161/CIRCOUTCOMES.124.010884","DOIUrl":"https://doi.org/10.1161/CIRCOUTCOMES.124.010884","url":null,"abstract":"","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" 20","pages":"e010884"},"PeriodicalIF":6.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond the Methods: Economic Stability and Cardiovascular Health.","authors":"Debra D Dixon, Eduardo J Sanchez","doi":"10.1161/CIRCOUTCOMES.124.010823","DOIUrl":"https://doi.org/10.1161/CIRCOUTCOMES.124.010823","url":null,"abstract":"","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":"629 1","pages":"e010823"},"PeriodicalIF":6.9,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140749397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Issam Motairek, Zhuo Chen, Mohamed H E Makhlouf, Salil Deo, Pedro R V O Salerno, Amgad Mentias, Khurram Nasir, Sanjay Rajagopalan, Sadeer G Al-Kindi
{"title":"Mapping Geographic Proximity to Cardiologists Across the United States.","authors":"Issam Motairek, Zhuo Chen, Mohamed H E Makhlouf, Salil Deo, Pedro R V O Salerno, Amgad Mentias, Khurram Nasir, Sanjay Rajagopalan, Sadeer G Al-Kindi","doi":"10.1161/CIRCOUTCOMES.123.010133","DOIUrl":"10.1161/CIRCOUTCOMES.123.010133","url":null,"abstract":"","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e010133"},"PeriodicalIF":6.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10216593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Manual to Modern: Accelerating Health Care Transformation With Automatized Electronic Medical Record Registries.","authors":"Khurram Nasir, Zulqarnain Javed","doi":"10.1161/CIRCOUTCOMES.123.010379","DOIUrl":"10.1161/CIRCOUTCOMES.123.010379","url":null,"abstract":"","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e010379"},"PeriodicalIF":6.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10278642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arco J Teske, Rohit Moudgil, Teresa López-Fernández, Ana Barac, Sherry Ann Brown, Anita Deswal, Tomas G Neilan, Sarju Ganatra, Husam Abdel Qadir, Venu Menon, Aaron L Sverdlov, Richard K Cheng, Silvia Makhoul, Arjun K Ghosh, Sebastian Szmit, Vlad Zaha, Daniel Addison, Lili Zhang, Joerg Herrmann, Jun H Chong, Vivek Agarwala, Zaza Iakobishvili, Patricia Guerrero, Eric H Yang, Monika Leja, Nausheen Akhter, Avirup Guha, Tochukwu M Okwuosa, Carolina Carvalho Silva, Patrick Collier, Jeanne DeCara, Brenton Bauer, Carrie E Lenneman, Diego Sadler
{"title":"Global Cardio Oncology Registry (G-COR): Registry Design, Primary Objectives, and Future Perspectives of a Multicenter Global Initiative.","authors":"Arco J Teske, Rohit Moudgil, Teresa López-Fernández, Ana Barac, Sherry Ann Brown, Anita Deswal, Tomas G Neilan, Sarju Ganatra, Husam Abdel Qadir, Venu Menon, Aaron L Sverdlov, Richard K Cheng, Silvia Makhoul, Arjun K Ghosh, Sebastian Szmit, Vlad Zaha, Daniel Addison, Lili Zhang, Joerg Herrmann, Jun H Chong, Vivek Agarwala, Zaza Iakobishvili, Patricia Guerrero, Eric H Yang, Monika Leja, Nausheen Akhter, Avirup Guha, Tochukwu M Okwuosa, Carolina Carvalho Silva, Patrick Collier, Jeanne DeCara, Brenton Bauer, Carrie E Lenneman, Diego Sadler","doi":"10.1161/CIRCOUTCOMES.123.009905","DOIUrl":"10.1161/CIRCOUTCOMES.123.009905","url":null,"abstract":"<p><strong>Background: </strong>Global collaboration in cardio-oncology is needed to understand the prevalence of cancer therapy-related cardiovascular toxicity in different risk groups, practice settings, and geographic locations. There are limited data on the socioeconomic and racial/ethnic disparities that may impact access to care and outcomes. To address these gaps, we established the Global Cardio-Oncology Registry, a multinational, multicenter prospective registry.</p><p><strong>Methods: </strong>We assembled cardiologists and oncologists from academic and community settings to collaborate in the first Global Cardio-Oncology Registry. Subsequently, a survey for site resources, demographics, and intention to participate was conducted. We designed an online data platform to facilitate this global initiative.</p><p><strong>Results: </strong>A total of 119 sites responded to an online questionnaire on their practices and main goals of the registry: 49 US sites from 23 states and 70 international sites from 5 continents indicated a willingness to participate in the Global Cardio-Oncology Registry. Sites were more commonly led by cardiologists (85/119; 72%) and were more often university/teaching (81/119; 68%) than community based (38/119; 32%). The average number of cardio-oncology patients treated per month was 80 per site. The top 3 Global Cardio-Oncology Registry priorities in cardio-oncology care were breast cancer, hematologic malignancies, and patients treated with immune checkpoint inhibitors. Executive and scientific committees and specific committees were established. A pilot phase for breast cancer using Research Electronic Data Capture Cloud platform recently started patient enrollment.</p><p><strong>Conclusions: </strong>We present the structure for a global collaboration. Information derived from the Global Cardio-Oncology Registry will help understand the risk factors impacting cancer therapy-related cardiovascular toxicity in different geographic locations and therefore contribute to reduce access gaps in cardio-oncology care. Risk calculators will be prospectively derived and validated.</p>","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e009905"},"PeriodicalIF":6.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10572613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael P Thompson, James W Stewart, Hechuan Hou, Hari Nathan, Francis D Pagani, Alphonse DeLucia, Patricia F Theurer, Richard L Prager, Robert B Hawkins, Donald S Likosky
{"title":"Determinants and Outcomes Associated With Skilled Nursing Facility Use After Coronary Artery Bypass Grafting: A Statewide Experience.","authors":"Michael P Thompson, James W Stewart, Hechuan Hou, Hari Nathan, Francis D Pagani, Alphonse DeLucia, Patricia F Theurer, Richard L Prager, Robert B Hawkins, Donald S Likosky","doi":"10.1161/CIRCOUTCOMES.122.009639","DOIUrl":"10.1161/CIRCOUTCOMES.122.009639","url":null,"abstract":"<p><strong>Background: </strong>Skilled nursing facility (SNF) care is frequently used after cardiac surgery, but the patterns and determinants of use have not been well understood. The objective of this study was to evaluate determinants and outcomes associated with SNF use after isolated coronary artery bypass grafting.</p><p><strong>Methods: </strong>A retrospective analysis of Medicare Fee-For-Service claims linked to the Society of Thoracic Surgeons clinical data was conducted on isolated coronary artery bypass grafting patients without prior SNF use in Michigan between 2011 and 2019. Descriptive analysis evaluated the frequency, trends, and variation in SNF use across 33 Michigan hospitals. Multivariable mixed-effects regression was used to evaluate patient-level demographic and clinical determinants of SNF use and its effect on short- and long-term outcomes.</p><p><strong>Results: </strong>In our sample of 8614 patients, the average age was 73.3 years, 70.5% were male, and 7.7% were listed as non-White race. An SNF was utilized by 1920 (22.3%) patients within 90 days of discharge and varied from 3.2% to 58.3% across the 33 hospitals. Patients using SNFs were more likely to be female, older, non-White, with more comorbidities, worse cardiovascular function, a perioperative morbidity, and longer hospital lengths of stay. Outcomes were significantly worse for SNF users, including more frequent 90-day readmissions and emergency department visits and less use of home health and rehabilitation services. SNF users had higher risk-adjusted hazard of mortality (hazard ratio, 1.41 [95% CI, 1.26-1.57]; <i>P</i><0.001) compared with non-SNF users and had 2.7-percentage point higher 5-year mortality rate in a propensity-matched cohort of patients (18.1% versus 15.4%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>The use of SNF care after isolated coronary artery bypass grafting was frequent and variable across Michigan hospitals and associated with worse risk-adjusted outcomes. Standardization of criteria for SNF use may reduce variability among hospitals and ensure appropriateness of use.</p>","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e009639"},"PeriodicalIF":6.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mathilde Lavigne-Robichaud, Xavier Trudel, Denis Talbot, Alain Milot, Mahée Gilbert-Ouimet, Michel Vézina, Danielle Laurin, Clermont E Dionne, Neil Pearce, Gilles R Dagenais, Chantal Brisson
{"title":"Psychosocial Stressors at Work and Coronary Heart Disease Risk in Men and Women: 18-Year Prospective Cohort Study of Combined Exposures.","authors":"Mathilde Lavigne-Robichaud, Xavier Trudel, Denis Talbot, Alain Milot, Mahée Gilbert-Ouimet, Michel Vézina, Danielle Laurin, Clermont E Dionne, Neil Pearce, Gilles R Dagenais, Chantal Brisson","doi":"10.1161/CIRCOUTCOMES.122.009700","DOIUrl":"10.1161/CIRCOUTCOMES.122.009700","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial stressors at work, like job strain and effort-reward imbalance (ERI), can increase coronary heart disease (CHD) risk. ERI indicates an imbalance between the effort and received rewards. Evidence about the adverse effect of combined exposure to these work stressors on CHD risk is scarce. This study examines the separate and combined effect of job strain and ERI exposure on CHD incidence in a prospective cohort of white-collar workers in Quebec, Canada.</p><p><strong>Methods: </strong>Six thousand four hundred sixty-five white-collar workers without cardiovascular disease (mean age, 45.3±6.7) were followed for 18 years (from 2000 to 2018). Job strain and ERI were measured with validated questionnaires. CHD events were retrieved from medico-administrative databases using validated algorithms. Marginal Cox models were used to calculate hazard ratios (HR) stratified by sex. Multiple imputation and inverse probability weights were applied to minimize potential threats to internal validity.</p><p><strong>Results: </strong>Among 3118 men, 571 had a first CHD event. Exposure to either job strain or ERI was associated with an adjusted 49% CHD risk increase (HR, 1.49 [95% CI, 1.07-2.09]). Combined exposure to job strain and ERI was associated with an adjusted 103% CHD risk increase (HR, 2.03 [95% CI, 1.38-2.97]). Exclusion of early CHD cases and censoring at retirement did not alter these associations. Among 3347 women, 265 had a first CHD event. Findings were inconclusive (passive job HR, 1.24 [95% CI, 0.80-1.91]; active job HR, 1.16 [95% CI, 0.70-1.94]; job strain HR, 1.08 [95% CI, 0.66-1.77]; ERI HR, 1.02 [95% CI, 0.72-1.45]).</p><p><strong>Conclusions: </strong>In this prospective cohort study, men exposed to job strain or ERI, separately and in combination, were at increased risk of CHD. Early interventions on these psychosocial stressors at work in men may be effective prevention strategies to reduce CHD burden. Among women, further investigation is required.</p>","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e009700"},"PeriodicalIF":6.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/fb/hcq-16-e009700.PMC10573112.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10675116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joyce L Woo, Christina Laternser, Brett R Anderson, William A Grobman, Michael C Monge, Matthew M Davis
{"title":"Association Between Prenatal Diagnosis and Age at Surgery for Noncritical and Critical Congenital Heart Defects.","authors":"Joyce L Woo, Christina Laternser, Brett R Anderson, William A Grobman, Michael C Monge, Matthew M Davis","doi":"10.1161/CIRCOUTCOMES.122.009638","DOIUrl":"10.1161/CIRCOUTCOMES.122.009638","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the prenatal diagnosis of congenital heart defects (CHDs) and age at CHD surgery is poorly understood, despite the known relationships between age at surgery and long-term outcomes. The objective of this study was to determine the associations between prenatal diagnosis of CHD and age at surgery, and whether these associations differ for critical and noncritical CHDs.</p><p><strong>Methods: </strong>This is a cohort analysis of patients aged 0 to 9 years who received their initial cardiac surgery at Ann & Robert H. Lurie Children's Hospital of Chicago between 2015 and 2021 with prenatal diagnosis as the exposure variable. All data were obtained from the locally maintained Society of Thoracic Surgeons Congenital Heart Surgery Database at Lurie Children's Hospital. We used multivariable fixed effects regression models to estimate the strength of the association of prenatal diagnosis with age at surgery among patients with critical (surgery ≤60 days) and noncritical (surgery >60 days) CHDs.</p><p><strong>Results: </strong>Of 1131 individuals who met inclusion criteria, 532 (47%) had a prenatal diagnosis, 428 (38%) had critical CHDs, 533 (47%) were female, and the median age at surgery was 119 days (interquartile range, 11-309 days). After controlling for demographics, comorbidities, and surgical complexity, the mean age at surgery was significantly younger in those with prenatally versus postnatally diagnosed critical CHD (7.1 days sooner, <i>P</i><0.001) and noncritical CHDs (atrial septal defects [12.4 months sooner, <i>P</i>=0.037], ventricular septal defects [6.0 months sooner, <i>P</i><0.003], and noncritical coarctation of the aorta [1.8 months sooner, <i>P</i>=0.010]).</p><p><strong>Conclusions: </strong>Younger age at CHD surgery, which is associated with postsurgical neurodevelopmental and physical outcomes, is significantly associated with prenatal CHD diagnosis. This relationship was identified for both critical and noncritical CHDs.</p>","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e009638"},"PeriodicalIF":6.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gregory J Dehmer, Cindy L Grines, Faisal G Bakaeen, Dorian L Beasley, Theresa M Beckie, Jack Boyd, Joaquin E Cigarroa, Sandeep R Das, Rebecca L Diekemper, Jennifer Frampton, Connie N Hess, Nkechinyere Ijioma, Jennifer S Lawton, Binita Shah, Nadia R Sutton
{"title":"2023 AHA/ACC Clinical Performance and Quality Measures for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures.","authors":"Gregory J Dehmer, Cindy L Grines, Faisal G Bakaeen, Dorian L Beasley, Theresa M Beckie, Jack Boyd, Joaquin E Cigarroa, Sandeep R Das, Rebecca L Diekemper, Jennifer Frampton, Connie N Hess, Nkechinyere Ijioma, Jennifer S Lawton, Binita Shah, Nadia R Sutton","doi":"10.1161/HCQ.0000000000000121","DOIUrl":"10.1161/HCQ.0000000000000121","url":null,"abstract":"","PeriodicalId":10301,"journal":{"name":"Circulation. Cardiovascular Quality and Outcomes","volume":" ","pages":"e00121"},"PeriodicalIF":6.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}