National Healthcare Quality and Disparities Report
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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 319 Research Studies DisplayedBarnett AS, Bahnson TD, Piccini JP
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
This review summarized several recent advancements in catheter technology for atrial fibrillation (AF ablation) aimed at improving lesion formation It concluded that despite advances during the past decade, recurrence of AF after ablation is common. Recent technological innovations are likely to increase the safety, efficiency, and durability of lesion formation.
AHRQ-funded; HS021092.
Citation: Barnett AS, Bahnson TD, Piccini JP .
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
Circ Arrhythm Electrophysiol 2016 May;9(5). doi: 10.1161/circep.115.003299.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments
Holcomb CN, Graham LA, Richman JS
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
The objective of this study was to determine the incremental risk of coronary stents on adverse events in surgical patients and whether it varies over time from stent placement. It concluded that surgery after coronary stent placement is associated with an approximate 2 percent absolute risk for postoperative heart attack but no difference in mortality compared with nonstented matched controls.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
Ann Surg 2016 May;263(5):924-30. doi: 10.1097/sla.0000000000001246..
Keywords: Adverse Events, Risk, Surgery, Patient Safety, Heart Disease and Health, Cardiovascular Conditions
Sadeghi B, Walling AM, Romano PS
A hospital-based advance care planning intervention for patients with heart failure: a feasibility study.
The purpose of this study was to evaluate the feasibility of implementing a multiple-component hospital-based intervention on completion of advance care planning (ACP) forms among heart failure (HF) patients. It concluded that a hospital-based ACP intervention using nonclinician health educators is feasible to implement and has the potential to facilitate the ACP process.
AHRQ-funded HS019311.
Citation: Sadeghi B, Walling AM, Romano PS .
A hospital-based advance care planning intervention for patients with heart failure: a feasibility study.
J Palliat Med 2016 Apr;19(4):451-5. doi: 10.1089/jpm.2015.0269.
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Keywords: Cardiovascular Conditions, Decision Making, Education: Patient and Caregiver, Heart Disease and Health, Hospitals
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Redmond N, Booth JN, 3rd, Tanner RM
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
Using data from the Jackson Heart Study, an exclusively African American population-based cohort, the researchers evaluated the association of masked hypertension and prehypertension with left ventricular mass index and common carotid intima media thickness. Masked hypertension was common among African Americans with prehypertension and also normal clinic blood pressure, and was associated with subclinical cardiovascular disease.
AHRQ-funded; HS023009.
Citation: Redmond N, Booth JN, 3rd, Tanner RM .
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
J Am Heart Assoc 2016 Mar 29;5(3):e002284. doi: 10.1161/jaha.115.002284.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
Baik SH, Hernandez I, Zhang Y
Evaluating the initiation of novel oral anticoagulants in Medicare beneficiaries.
This study evaluated how patient demographics, clinical characteristics, types of insurance, and patient out-of-pocket spending affect the initiation of warfarin and 2 novel oral anticoagulants (NOACs)--dabigatran and rivaroxaban. It found that race, sex, type of Part D plans, and some clinical conditions were associated with the initiation of NOACs relative to warfarin.
AHRQ-funded; HS018657.
Citation: Baik SH, Hernandez I, Zhang Y .
Evaluating the initiation of novel oral anticoagulants in Medicare beneficiaries.
J Manag Care Spec Pharm 2016 Mar;22(3):281-92. doi: 10.18553/jmcp.2016.22.3.281.
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Keywords: Blood Thinners, Medication, Heart Disease and Health, Cardiovascular Conditions, Social Determinants of Health
Epps KC, Holper EM, Selzer F
Sex differences in outcomes following percutaneous coronary intervention according to age.
Women <50 years of age with coronary artery disease may represent a group at higher risk for recurrent ischemic events after percutaneous coronary intervention (PCI); however, no long-term, multicenter outcomes assessment exists in this population. This study found that, compared with older women, younger women remained at increased risk of major adverse cardiovascular events, whereas all outcome rates were similar in older women and men.
AHRQ-funded; HS000009.
Citation: Epps KC, Holper EM, Selzer F .
Sex differences in outcomes following percutaneous coronary intervention according to age.
Circ Cardiovasc Qual Outcomes 2016 Feb;9(2 Suppl 1):S16-25. doi: 10.1161/circoutcomes.115.002482.
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Keywords: Women, Heart Disease and Health, Outcomes, Adverse Events, Cardiovascular Conditions
Killian JT, Holcomb CN, Graham LA
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
The researchers sought to determine whether the presence of a coronary stent affected the timing of colorectal cancer resection and the postoperative outcomes. They found that the median time from diagnosis to surgery was 100 days for patients who received a stent after a colonoscopy and 42 days for patients whose stent was present at the time of the colonoscopy.
AHRQ-funded; HS013852.
Citation: Killian JT, Holcomb CN, Graham LA .
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
JAMA Surg 2016 Jan;151(1):86-8. doi: 10.1001/jamasurg.2015.3130..
Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Colonoscopy, Heart Disease and Health, Surgery
Wallaert JB, Nolan BW, Stone DH
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
The researchers investigated whether the choice of carotid artery stenting (CAS) vs. carotid endarterectomy (CEA) varies as a function of treating physician specialty, which would result in regional variation in the relative use of these treatment types They found that the proportion of all carotid revascularization procedures performed as CAS varies markedly by geographic region, and regions with the highest proportion of cardiologists perform the most CAS procedures.
AHRQ-funded; HS021581.
Citation: Wallaert JB, Nolan BW, Stone DH .
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
J Vasc Surg 2016 Jan;63(1):89-97. doi: 10.1016/j.jvs.2015.08.068.
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Keywords: Heart Disease and Health, Medicare, Cardiovascular Conditions, Disparities, Outcomes
Desai NR, Parzynski CS, Krumholz HM
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
The researchers sought to determine whether internal review of percutaneous coronary intervention (PCI) appropriateness using appropriate use criteria is associated with differences in procedural appropriateness, quality of care, and patient outcomes. They concluded that there was a modest association between procedural appropriateness and clinical outcomes and a similarly modest correlation between nonacute PCI volume and procedural appropriateness.
AHRQ-funded; HS023000
Citation: Desai NR, Parzynski CS, Krumholz HM .
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
JAMA Intern Med. 2015 Dec;175(12):1988-90.
Keywords: Cardiovascular Conditions, Patient-Centered Outcomes Research, Heart Disease and Health, Registries
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai NR, Bradley SM, Parzynski CS
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
The researchers examined trends in percutaneous coronary intervention (PCI) utilization, patient selection, and procedural appropriateness following the introduction of Appropriate Use Criteria. They concluded that there have been significant reductions in the volume of nonacute PCI. The proportion of nonacute PCIs classified as inappropriate has declined, although hospital-level variation in inappropriate PCI persists.
AHRQ-funded; HS023000.
Citation: Desai NR, Bradley SM, Parzynski CS .
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
JAMA 2015 Nov 17;314(19):2045-53. doi: 10.1001/jama.2015.13764.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Utilization
Cooper LB, Hammill BG, Peterson ED
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
No large studies have examined whether laboratory monitoring occurs routinely in community practice. The researchers observed low rates of monitoring in clinical practice: after initiation of mineralocorticoid receptor antagonist therapy in a large cohort, only 1,384 patients (13.3 percent) and 3,122 patients (29.9 percent) received appropriate testing in early and extended follow-up, respectively.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
JAMA 2015 Nov 10;314(18):1973-5. doi: 10.1001/jama.2015.11904..
Keywords: Heart Disease and Health, Cardiovascular Conditions
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
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Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Silverberg JI
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
The authors sought to determine whether adult eczema is associated with increased cardiovascular and cerebrovascular disease. They concluded that adults with atopic dermatitis may have increased cardiovascular disease, heart attack, and stroke.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
Allergy 2015 Oct;70(10):1300-8. doi: 10.1111/all.12685.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Cancer: Skin Cancer
Burns KM, Encinosa WE, Pearson GD
AHRQ Author: Encinosa WE
Electrocardiogram in preparticipation athletic evaluations among insured youths.
The researchers retrospectively characterized electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). They found that thirteen percent of PPEs with ECG and 0.5 percent of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18 percent (2 percent sports-limiting); after PPEs alone, cardiac disease was identified in 0.5 percent (0.03 percent sports-limiting).
AHRQ-authored.
Citation: Burns KM, Encinosa WE, Pearson GD .
Electrocardiogram in preparticipation athletic evaluations among insured youths.
J Pediatr 2015 Oct;167(4):804-09.e1. doi: 10.1016/j.jpeds.2015.06.011..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Doll JA, Hellkamp A, Ho PM
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
This study identified opportunities to improve the use of cardiac rehabilitation by older adults. It concluded that quality improvement efforts should focus not only on increasing referral rates but also on addressing barriers to attending rehabilitation sessions, such as travel distance, copayments, and lack of coordination between inpatient and outpatient clinicians.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp A, Ho PM .
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
JAMA Intern Med 2015 Oct;175(10):1700-2. doi: 10.1001/jamainternmed.2015.3819..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions
Hess CN, Peterson ED, Peng SA
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
The authors sought to determine appropriate antithrombotic therapy for acute myocardial infarction (MI) patients with atrial fibrillation (AF) treated with percutaneous coronary intervention (PCI). They found that approximately 1 in 4 older AF patients undergoing PCI for MI were discharged on triple therapy. Those receiving triple therapy versus dual antiplatelet therapy had higher rates of major bleeding without a measurable difference in composite MI, death, or stroke.
AHRQ-funded; HS021092.
Citation: Hess CN, Peterson ED, Peng SA .
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
J Am Coll Cardiol 2015 Aug 11;66(6):616-27. doi: 10.1016/j.jacc.2015.05.062.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication
Kaplan RM, Irvin VL
AHRQ Author: Kaplan RM
Likelihood of null effects of large NHLBI clinical trials has increased over time.
This study explores whether the number of null results in large National Heart Lung, and Blood Institute (NHLBI) funded trials has increased over time. It found that the number NHLBI trials reporting positive results declined after the year 2000. Prospective declaration of outcomes in RCTs, and the adoption of transparent reporting standards, as required by clinicaltrials.gov, may have contributed to the trend toward null findings.
AHRQ-authored
Citation: Kaplan RM, Irvin VL .
Likelihood of null effects of large NHLBI clinical trials has increased over time.
PLoS One 2015 Aug 5;10(8):e0132382. doi: 10.1371/journal.pone.0132382..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Registries
Kabra R, Cram P, Girotra S
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
The researchers sought to determine whether there are any racial differences in the outcomes of death and stroke in patients with newly diagnosed AF in patients >65 years. They found that the risks of death and stroke are higher in blacks and Hispanics compared with whites. The increased risk was eliminated or significantly reduced after adjusting for preexisting co-morbidities.
AHRQ-funded; HS021992.
Citation: Kabra R, Cram P, Girotra S .
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
Am J Cardiol 2015 Jul 15;116(2):230-5. doi: 10.1016/j.amjcard.2015.04.012..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Stroke, Mortality, Risk
Bhave PD, Lu X, Girotra S
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
The researchers sought to determine whether significant race and sex differences exist in the treatment of newly diagnosed AF in Medicare beneficiaries. They found that there were statistically significant differences in the use of AF-related services by both race and sex, with white patients and male patients receiving the most care.
AHRQ-funded; HS021992.
Citation: Bhave PD, Lu X, Girotra S .
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
Heart Rhythm 2015 Jul;12(7):1406-12. doi: 10.1016/j.hrthm.2015.03.031..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Sex Factors, Disparities
Allen LA, Fonarow GC, Simon DN
Digoxin use and subsequent outcomes among patients in a contemporary atrial fibrillation cohort.
This study sought to describe digoxin use over time in patients with AF who were stratified by the presence or absence of heart failure (HF), to characterize the predictors of digoxin use and initiation, and to correlate digoxin use with outcomes. It found that, after adjustment for detailed clinical factors, digoxin use in registry patients with AF had a neutral association with outcomes under most circumstances.
AHRQ-funded; HS021092.
Citation: Allen LA, Fonarow GC, Simon DN .
Digoxin use and subsequent outcomes among patients in a contemporary atrial fibrillation cohort.
J Am Coll Cardiol 2015 Jun 30;65(25):2691-8. doi: 10.1016/j.jacc.2015.04.045..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medication
Lopes RD, Gharacholou SM, Holmes DN
Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.
The researchers evaluated mortality and cause-specific rehospitalization rates in elderly non-ST-segment elevation myocardial infarction survivors with ischemic heart disease. They found that rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses.
AHRQ-funded; HS021092.
Citation: Lopes RD, Gharacholou SM, Holmes DN .
Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.
Am J Med 2015 Jun;128(6):582-90. doi: 10.1016/j.amjmed.2014.12.032.
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Keywords: Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions