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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
276 to 300 of 452 Research Studies DisplayedBostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care
Valley TS, Sjoding MW, Ryan AM
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
The researchers estimated the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI). They found that ICU admission did not confer a survival benefit for patients with uncertain ICU needs hospitalized with COPD exacerbation, HF exacerbation, or AMI.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
Ann Am Thorac Soc 2017 Jun;14(6):943-51. doi: 10.1513/AnnalsATS.201611-847OC.
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Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Heart Disease and Health, Outcomes
Barlow SE, Turer CB
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
This article comments on a 2017 study by de Ferranti, et al., published in the Journal of Pediatrics, which reported results from a survey of US pediatricians’ knowledge and implementation of child and adolescent cholesterol screening and treatment guidelines.
AHRQ-funded; HS022418.
Citation: Barlow SE, Turer CB .
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
J Pediatr 2017 Jun;185:16-18. doi: 10.1016/j.jpeds.2017.02.041..
Keywords: Children/Adolescents, Heart Disease and Health, Shared Decision Making, Guidelines
Parikh KS, Lippmann SJ, Greiner M
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Researchers used the Get With The Guidelines-Heart Failure (GWTG-HF) registry to characterize patients’ eligibility and potential barriers for sacubitril/valsartan initiation. The GWTG-HF registry was established by the American Heart Association to improve adherence to quality of care guidelines for patients hospitalized with heart failure. The FDA has approved sacubitril/valsartan for patients with heart failure with reduced ejection fraction (HFrEF); however, FDA labeling is broader than the trial entry criteria, and the scope of potential sacubitril/valsartan use in HFrEF is not well understood. Findings suggest that discharge from hospitalization from acute heart failure may be an opportunity for re-evaluating medications, including potentially switching the patient from ACEI/ARB, or starting sacubitril/valsartan.
AHRQ-funded; HS021092.
Citation: Parikh KS, Lippmann SJ, Greiner M .
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Circulation 2017 May 23;135(21):2077-80. doi: 10.1161/circulationaha.117.027773..
Keywords: Cardiovascular Conditions, Guidelines, Heart Disease and Health, Hospitalization, Medication, Registries
Desai NR, Giugliano RP, Wasserman SM
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
Levels of proprotein convertase subtilisin kexin type 9 (PCSK9) vary markedly across the population and are influenced by genetic and nongenetic factors. Evolocumab is a fully human, monoclonal antibody against PCSK9 that reduces low-density lipoprotein cholesterol (LDL-C) levels by 55% to 75%. The purpose of this study was to characterize variability in PCSK9 levels and determine whether the LDL-C level reduction achieved with evolocumab differed based on PCSK9 levels.
AHRQ-funded; HS023000.
Citation: Desai NR, Giugliano RP, Wasserman SM .
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
JAMA Cardiol 2017 May;2(5):556-60. doi: 10.1001/jamacardio.2016.5395..
Keywords: Heart Disease and Health
Adedinsewo D, Xu J, Agasthi P
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
The study’s goal was to examine risk factors for hospitalizations and mortality with digoxin use in a diverse real-world atrial fibrillation patient population and evaluate racial differences. It found an overall increased risk of hospitalizations and mortality with digoxin use. No racial/ethnic differences in outcomes were observed.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Xu J, Agasthi P .
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
Circ Arrhythm Electrophysiol 2017 May;10(5):e004573. doi: 10.1161/circep.116.004573.
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Keywords: Heart Disease and Health, Medication, Medicaid, Cardiovascular Conditions, Patient-Centered Outcomes Research
Jones CD, Bowles KH, Richard A
High-value home health care for patients with heart failure: an opportunity to optimize transitions from hospital to home.
Providing home health nursing and therapy could promote recovery in vulnerable HF patients with post-hospital syndrome and potentially reduce readmissions. The authors argue that understanding the characteristics of effective post-acute HHC for patients with HF will inform best practices, optimal outcomes for cost, and ultimately high-value care.
AHRQ-funded; HS024569.
Citation: Jones CD, Bowles KH, Richard A .
High-value home health care for patients with heart failure: an opportunity to optimize transitions from hospital to home.
Circ Cardiovasc Qual Outcomes 2017 May;10(5). doi: 10.1161/circoutcomes.117.003676.
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Keywords: Home Healthcare, Heart Disease and Health, Transitions of Care, Care Coordination, Medicare
Ritchey MD, Loustalot F, Wall HK
AHRQ Author: Steiner CA
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
This study describes the national surveillance and modeling methodology developed to monitor achievement of the Million Hearts initiative's aim of preventing 1 million acute myocardial infarctions, strokes, and other related cardiovascular events during 2012-2016. The authors concluded that around 115 000 events were prevented during the initiative's first 2 years compared with what would have occurred had 2011 rates remained stable.
AHRQ-authored.
Citation: Ritchey MD, Loustalot F, Wall HK .
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
J Am Heart Assoc 2017 May 2;6(5). doi: 10.1161/jaha.117.006021.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention
Zullo AR, Lee Y, Daiello LA
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
This study evaluated how often beta-blockers were started after acute myocardial infarction (AMI) in nursing home (NH) residents who previously did not use these drugs and to evaluate which factors were associated with post-AMI use of beta-blockers. It found that almost half of older NH residents in the United States do not initiate a beta-blocker after AMI.
AHRQ-funded; HS022998.
Citation: Zullo AR, Lee Y, Daiello LA .
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
J Am Geriatr Soc 2017 Apr;65(4):754-62. doi: 10.1111/jgs.14671.
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Keywords: Elderly, Healthcare Utilization, Nursing Homes, Heart Disease and Health, Medication
Palamaner Subash Shantha G, Bhave PD, Girotra S
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
This study assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. It concluded that the reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
AHRQ-funded; HS023104.
Citation: Palamaner Subash Shantha G, Bhave PD, Girotra S .
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2017 Apr;10(4). doi: 10.1161/circoutcomes.116.003418.
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Keywords: Elderly, Heart Disease and Health, Blood Thinners, Medication, Comparative Effectiveness, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Evidence-Based Practice
Masoudi FA, Curtis JP, Desai NR
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
In this article, the authors discuss cardiovascular medicine in the United States, specifically percutaneous coronary intervention (PCI) procedures. They discuss New York’s experience with PCI. They assert that systematic examination of trends in utilization and characteristics of patients undergoing PCI in New York could provide important insights into these actions’ potential impact on clinical care.
AHRQ-funded; K12 HS023000.
Citation: Masoudi FA, Curtis JP, Desai NR .
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
J Am Coll Cardiol 2017 Mar 14;69(10):1243-46. doi: 10.1016/j.jacc.2017.01.009..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery
Yim CK, Barron Y, Moore S
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. This descriptive analysis of Medicare fee-for-service beneficiaries found that home health care Medicare beneficiaries with advanced HF who enrolled in hospice had lower acute medical service utilization after their enrollment.
AHRQ-funded; HS020257.
Citation: Yim CK, Barron Y, Moore S .
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Circ Heart Fail 2017 Mar;10(3). doi: 10.1161/circheartfailure.116.003335.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Utilization, Medicare, Palliative Care
Wang SV, Rogers JR, Jin Y
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
The researchers tested algorithms for identifying atrial fibrillation (AF) patients who also have known risk factors for stroke and major bleeding using electronic healthcare records (EHRs) data. The performance of candidate algorithms in 1000 bootstrap resamples was compared to a gold standard of manual chart review by experienced resident physicians of 480 patient charts. For 11 conditions, the median positive predictive value of the EHR-derived algorithms was greater than 0.90.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
J Am Med Inform Assoc 2017 Mar 1;24(2):339-44. doi: 10.1093/jamia/ocw082.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk
Steinman MA, Zullo AR, Lee Y
Association of β-blockers with functional outcomes, death, and rehospitalization in older nursing home residents after acute myocardial infarction.
The researchers studied the association of beta-blockers after AMI with functional decline, mortality, and rehospitalization among long-stay nursing home residents 65 years or older. Use of beta-blockers after AMI was associated with functional decline in older nursing home residents with substantial cognitive or functional impairment, but not in those with relatively preserved mental and functional abilities.
AHRQ-funded; HS022998.
Citation: Steinman MA, Zullo AR, Lee Y .
Association of β-blockers with functional outcomes, death, and rehospitalization in older nursing home residents after acute myocardial infarction.
JAMA Intern Med 2017 Feb;177(2):254-62. doi: 10.1001/jamainternmed.2016.7701.
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Keywords: Nursing Homes, Patient-Centered Outcomes Research, Medication, Adverse Drug Events (ADE), Heart Disease and Health
Tam MC, Lee R, Cascino TM
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic hypertension (HTN) and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN.
AHRQ-funded; HS024567.
Citation: Tam MC, Lee R, Cascino TM .
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Curr Hypertens Rep 2017 Feb;19(2):12. doi: 10.1007/s11906-017-0709-2.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Stroke, Outcomes
Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. The purpose of this study was to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. The study concluded that standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.
AHRQ-funded; HS018443.
Citation: Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S .
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Crit Care Nurse 2017 Feb;37(1):13-26. doi: 10.4037/ccn2017178..
Keywords: Adverse Drug Events (ADE), Adverse Events, Injuries and Wounds, Patient Safety, Heart Disease and Health
Lu Y, Zhou S, Dreyer RP
Sex differences in inflammatory markers and health status among young adults with acute myocardial infarction: results from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) Study.
This study assessed sex differences in post-acute myocardial infarction (AMI) inflammatory markers and whether such differences account for sex differences in 12-month health status, using data from 2219 adults with AMI, 18 to 55 years of age, in the United States. Overall, women had higher levels of inflammatory markers after AMI compared with men, and this remained statistically significant after multivariable adjustment.
AHRQ-funded; HS023000.
Citation: Lu Y, Zhou S, Dreyer RP .
Sex differences in inflammatory markers and health status among young adults with acute myocardial infarction: results from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) Study.
Circ Cardiovasc Qual Outcomes 2017 Feb;10(2):e003470. doi: 10.1161/circoutcomes.116.003470.
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Keywords: Cardiovascular Conditions, Health Status, Heart Disease and Health, Patient-Centered Outcomes Research, Sex Factors
Dreyer RP, Sciria C, Spatz ES
Young women with acute myocardial infarction: current perspectives.
The purpose of this cardiovascular perspective piece is to review recent studies of acute myocardial infarction (AMI) in young women. More specifically, it emphasizes differences in the epidemiology, diagnosis, and management of AMI in young women (when compared with men) across the continuum of care, including their pre-AMI, in-hospital, and post-AMI periods, and highlights gaps in knowledge and outcomes that can inform the next generation of research.
AHRQ-funded; HS023000.
Citation: Dreyer RP, Sciria C, Spatz ES .
Young women with acute myocardial infarction: current perspectives.
Circ Cardiovasc Qual Outcomes 2017 Feb;10(2). doi: 10.1161/circoutcomes.116.003480.
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Keywords: Cardiovascular Conditions, Health Status, Heart Disease and Health, Risk
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation: Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Guidelines, Medicare, Medication
Davis JD, Olsen MA, Bommarito K
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
In this study, the researchers investigated readmission characteristics and the magnitude of 30-day hospital readmissions after hospital discharge for heart failure using the Healthcare Cost and Utilization Project State Inpatient Databases (SID). They found in this large all-payer cohort, ∼70% of 30-day readmissions were for non-heart failure causes, and the median time to readmission was 12 days.
AHRQ-funded; HS019455.
Citation: Davis JD, Olsen MA, Bommarito K .
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
Am J Med 2017 Jan;130(1):93.e9-93.e28. doi: 10.1016/j.amjmed.2016.07.030..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitalization, Hospitals, Provider Performance
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
de Cordova PB, Johansen ML, Martinez ME
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
The purpose of this research was to determine if weekend and holiday presentation is associated with increased mortality in EDs among patients with acute myocardial infarction (AMI) in New Jersey. It found that weekend/holiday presentation to the ED for AMI was associated with increased mortality. The effect may be related to the limited availability of resources on weekend/holidays compared to weekdays.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Martinez ME .
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
Nurs Res 2017 Jan/Feb;66(1):20-27. doi: 10.1097/nnr.0000000000000196.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Mortality, Heart Disease and Health, Risk
Zullo MD, Gathright EC, Dolansky MA
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
The purpose of this study was to examine the association between depression diagnosis and participation in cardiac rehabilitation (CR) in a large sample of Medicare beneficiaries with recent myocardial infarction (MI). It concluded that diagnosis of depression in Medicare beneficiaries was strongly associated with attending CR and attending more sessions of CR compared with those without depression. Depression is not a barrier to CR participation after MI in Medicare beneficiaries.
AHRQ-funded; HS019795.
Citation: Zullo MD, Gathright EC, Dolansky MA .
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
J Cardiopulm Rehabil Prev 2017 Jan;37(1):22-29. doi: 10.1097/hcr.0000000000000222.
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Keywords: Heart Disease and Health, Depression, Medicare, Patient Adherence/Compliance, Comparative Effectiveness
Lu Y, Zhou S, Dreyer RP
Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: results from the VIRGO study.
This study characterized sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction (AMI). Young women with AMI had slightly favorable lipid and lipoprotein profiles compared with men, suggesting that difference in lipid and lipoprotein may not be a major contributor to sex differences in outcomes after AMI.
AHRQ-funded; HS023000.
Citation: Lu Y, Zhou S, Dreyer RP .
Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: results from the VIRGO study.
Am Heart J 2017 Jan;183:74-84. doi: 10.1016/j.ahj.2016.09.012.
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Keywords: Sex Factors, Heart Disease and Health, Healthcare Utilization, Women, Patient-Centered Outcomes Research