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Article ; Online: Target Aortic Stenosis: A National Initiative to Improve Quality of Care and Outcomes for Patients With Aortic Stenosis.

Lindman, Brian R / Fonarow, Gregg C / Myers, Gary / Alger, Heather M / Rutan, Christine / Troll, Katie / Aringo, Angeline / Shahriary, Melanie / Jessup, Mariell / Arnold, Suzanne V / Shah, Pinak B / Szeto, Wilson Y / Yancy, Clyde W / Otto, Catherine M

Circulation. Cardiovascular quality and outcomes

2023 Volume 16, Issue 6, Page(s) e009712

MeSH term(s)	Humans ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/surgery ; Aortic Valve/surgery ; Quality of Health Care ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/CIRCOUTCOMES.122.009712
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Article ; Online: Role of Data Registries in the Time of COVID-19.

Alger, Heather M / Williams, Joseph H / Walchok, Jason G / Bolles, Michele / Fonarow, Gregg C / Rutan, Christine

Circulation. Cardiovascular quality and outcomes

2020 Volume 13, Issue 5, Page(s) e006766

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Registries ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-04-16
Publishing country	United States
Document type	Letter
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/CIRCOUTCOMES.120.006766
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Article ; Online: Call to Action for Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care: A Presidential Advisory From the American Heart Association.

Wenger, Nanette K / Lloyd-Jones, Donald M / Elkind, Mitchell S V / Fonarow, Gregg C / Warner, John J / Alger, Heather M / Cheng, Susan / Kinzy, Claire / Hall, Jennifer L / Roger, Véronique L

Circulation

2022 Volume 145, Issue 23, Page(s) e1059–e1071

Abstract: Addressing the pervasive gaps in knowledge and care delivery to reduce sex-based disparities and achieve equity is fundamental to the American Heart Association's commitment to advancing cardiovascular health for all by 2024. This presidential advisory ... ...

Abstract	Addressing the pervasive gaps in knowledge and care delivery to reduce sex-based disparities and achieve equity is fundamental to the American Heart Association's commitment to advancing cardiovascular health for all by 2024. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders around the globe to identify and remove barriers to health care access and quality for women. A concise and current summary of existing data across the areas of risk and prevention, access and delivery of equitable care, and awareness and education provides a framework to consider knowledge gaps and research needs critical toward achieving significant progress for the health and well-being of all women.
MeSH term(s)	American Heart Association ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/therapy ; Female ; Health Services Accessibility ; Humans ; United States/epidemiology
Language	English
Publishing date	2022-05-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIR.0000000000001071
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Article: Role of Data Registries in the Time of COVID-19

Alger, Heather M / Williams, Joseph H / Walchok, Jason G / Bolles, Michele / Fonarow, Gregg C / Rutan, Christine

Circ Cardiovasc Qual Outcomes

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32298145
Database	COVID19

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Article ; Online: Site-level variability in the processes of care and outcomes over time among patients with COVID-19 and myocardial injury: Insights from the American Heart Association's COVID-19 Cardiovascular Disease Registry.

Sammour, Yasser M / Spertus, John A / Kennedy, Kevin / Morrow, David A / Daniels, Lori B / Jones, Phil / Alger, Heather / Stevens, Laura / Shah, Alpesh / Goel, Sachin S / de Lemos, James A / Hayek, Salim S / Sutton, Nadia R / Kleiman, Neal S

American heart journal plus : cardiology research and practice

2023 Volume 27, Page(s) 100265

Abstract: Background: Elevated cardiac troponin (cTn) levels in patients with COVID-19 has been associated with worse outcomes. Guidelines on best practices of those patients remain uncertain.: Methods: We included patients with COVID-19 and cTn above the ... ...

Abstract	Background: Elevated cardiac troponin (cTn) levels in patients with COVID-19 has been associated with worse outcomes. Guidelines on best practices of those patients remain uncertain. Methods: We included patients with COVID-19 and cTn above the assay-specific upper limit of normal (ULN) enrolled in the American Heart Association's COVID-19 registry between March 2020-January 2021. Site-level variability in invasive coronary angiography, LVEF assessment, ICU utilization, and inpatient mortality were determined by calculating adjusted median odds ratio (MOR) using hierarchical logistic regression models. Temporal trends were assessed with Cochran-Armitage trend test. Results: Among 32,636 patients, we included 6234 (19.4 %) with cTn above ULN (age 68.7 ± 16.0 years, 56.5 % male, 51.5 % Caucasian), of whom 1365 (21.6 %) had ≥5-fold elevations. Across 55 sites, the median rate of invasive coronary angiography was 0.1 % with adjusted MOR 1.5(1.0,2.3), median LVEF assessment was 25.5 %, MOR 3.0(2.2,3.9), ICU utilization was 41.7 %, MOR 2.2(1.8,2.6), and mortality was 20.9 %, MOR 1.7(1.5,2.0). Over time, we noted a significant increase in invasive coronary angiography (p-trend = 0.001), and LVEF assessment (p-trend<0.001), and reduction in mortality (p-trend<0.001), without significant change in ICU admissions (p-trend = 0.08). Similar variability and temporal trends were seen among patients with ≥5-fold cTn elevation. Conclusions: The use of invasive coronary angiography among patients with COVID-19 and myocardial injury was very low during the early pandemic. We found moderate institutional variability in processes of care with an uptrend in invasive catheterization and LVEF assessment, and downtrend in mortality. Comparative effectiveness studies are needed to examine whether variability in care is associated with differences in outcomes.
Language	English
Publishing date	2023-02-03
Publishing country	United States
Document type	Journal Article
ISSN	2666-6022
ISSN (online)	2666-6022
DOI	10.1016/j.ahjo.2023.100265
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Role of Data Registries in the Time of COVID-19

Alger, Heather M. / Williams, Joseph H. / Walchok, Jason G. / Bolles, Michele / Fonarow, Gregg C. / Rutan, Christine

Circulation: Cardiovascular Quality and Outcomes

2020 Volume 13, Issue 5

Keywords	Cardiology and Cardiovascular Medicine ; covid19
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publishing country	us
Document type	Article ; Online
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/circoutcomes.120.006766
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: American Heart Association Precision Medicine Platform Addresses Challenges in Data Sharing.

Stevens, Laura M / de Lemos, James A / Das, Sandeep R / Rutan, Christine / Alger, Heather M / Elkind, Mitchell S V / Zhao, Juan / Iyer, Kritika / Figueroa, C Alberto / Hall, Jennifer L

Circulation. Cardiovascular quality and outcomes

2021 Volume 14, Issue 9, Page(s) e007949

MeSH term(s)	American Heart Association ; Computational Biology ; Humans ; Information Dissemination ; Machine Learning ; Precision Medicine
Language	English
Publishing date	2021-09-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/CIRCOUTCOMES.121.007949
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Article ; Online: Heart failure quality of care and in-hospital outcomes during the COVID-19 pandemic: findings from the Get With The Guidelines-Heart Failure registry.

Keshvani, Neil / Mehta, Anurag / Alger, Heather M / Rutan, Christine / Williams, Joseph / Zhang, Shuiaqi / Young, Rebecca / Alhanti, Brooke / Chiswell, Karen / Greene, Stephen J / DeVore, Adam D / Yancy, Clyde W / Fonarow, Gregg C / Pandey, Ambarish

European journal of heart failure

2022 Volume 24, Issue 6, Page(s) 1117–1128

Abstract: Aims: To assess heart failure (HF) in-hospital quality of care and outcomes before and during the COVID-19 pandemic.: Methods and results: Patients hospitalized for HF with ejection fraction (EF) <40% in the American Heart Association Get With The ... ...

Abstract	Aims: To assess heart failure (HF) in-hospital quality of care and outcomes before and during the COVID-19 pandemic. Methods and results: Patients hospitalized for HF with ejection fraction (EF) <40% in the American Heart Association Get With The Guidelines©-HF (GWTG-HF) registry during the COVID-19 pandemic (3/1/2020-4/1/2021) and pre-pandemic (2/1/2019-2/29/2020) periods were included. Adherence to HF process of care measures, in-hospital mortality, and length of stay (LOS) were compared in pre-pandemic vs. pandemic periods and in patients with vs. without COVID-19. Overall, 42 004 pre-pandemic and 37 027 pandemic period patients (median age 68, 33% women, 58% White) were included without observed differences across clinical characteristics, comorbidities, vital signs, or EF. Utilization of guideline-directed medical therapy at discharge was comparable across both periods, with rates of implantable cardioverter defibrillator (ICD) placement or prescription lower during the pandemic (vs. pre-pandemic period). In-hospital mortality (3.0% vs. 2.5%, p <0.0001) and LOS (mean 5.7 vs. 5.4 days, p <0.0004) were higher during the pandemic vs. pre-pandemic. The highest in-hospital mortality during the pandemic was observed among patients hospitalized in the Northeast region (3.4%). Among patients concurrently diagnosed with COVID-19 (n = 549; 1.5%), adherence to ICD placement or prescription, prescription of aldosterone antagonist or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor at discharge were lower, and in-hospital mortality (8.2% vs. 3.0%, p <0.0001) and LOS (mean 7.7 vs. 5.7 days, p <0.0001) were higher than those without COVID-19. Conclusion: Among GWTG-HF participating hospitals, patients hospitalized for HF with reduced EF during the pandemic received similar care quality but experienced higher in-hospital mortality than the pre-pandemic period.
MeSH term(s)	Aged ; COVID-19/epidemiology ; Female ; Heart Failure/drug therapy ; Heart Failure/therapy ; Hospitalization ; Hospitals ; Humans ; Male ; Pandemics ; Quality of Health Care ; Registries ; United States/epidemiology
Language	English
Publishing date	2022-04-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1002/ejhf.2484
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Article ; Online: Research Goes Red: Early Experience With a Participant-Centric Registry.

Gilchrist, Susan C / Hall, Jennifer L / Khandelwal, Abha / Hidalgo, Bertha / Aggarwal, Brooke / Kinzy, Claire / Mallya, Pratheek / Conners, Katie / Stevens, Laura M / Alger, Heather M / Mehta, Laxmi / Wexler, Laura / Mega, Jessica L / Hernandez, Adrian / Hayes, Sharonne N / Mieres, Jennifer H / Jessup, Mariell / Roger, Veronique L

Circulation research

2022 Volume 130, Issue 3, Page(s) 343–351

Abstract: Rationale: Cardiovascular disease remains the leading cause of death in women. To address its determinants including persisting cardiovascular risk factors amplified by sex and race inequities, novel personalized approaches are needed grounded in the ... ...

Abstract	Rationale: Cardiovascular disease remains the leading cause of death in women. To address its determinants including persisting cardiovascular risk factors amplified by sex and race inequities, novel personalized approaches are needed grounded in the engagement of participants in research and prevention. Objective: To report on a participant-centric and personalized dynamic registry designed to address persistent gaps in understanding and managing cardiovascular disease in women. Methods and results: The American Heart Association and Verily launched the Research Goes Red registry (RGR) in 2019, as an online research platform available to consenting individuals over the age of 18 years in the United States. RGR aims to bring participants and researchers together to expand knowledge by collecting data and providing an open-source longitudinal dynamic registry for conducting research studies. As of July 2021, 15 350 individuals have engaged with RGR. Mean age of participants was 48.0 48.0±0.2 years with a majority identifying as female and either non-Hispanic White (75.7%) or Black (10.5%). In addition to 6 targeted health surveys, RGR has deployed 2 American Heart Association-sponsored prospective clinical studies based on participants' areas of interest. The first study focuses on perimenopausal weight gain, developed in response to a health concerns survey. The second study is designed to test the use of social media campaigns to increase awareness and participation in cardiovascular disease research among underrepresented millennial women. Conclusions: RGR is a novel online participant-centric platform that has successfully engaged women and provided critical data on women's heart health to guide research. Priorities for the growth of RGR are centered on increasing reach and diversity of participants, and engaging researchers to work within their communities to leverage the platform to address knowledge gaps and improve women's health.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/therapy ; Female ; Humans ; Middle Aged ; Patient Participation/methods ; Patient-Centered Care/methods ; Registries ; Social Media
Language	English
Publishing date	2022-02-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.121.320403
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Article ; Online: Identification and risk stratification of coronary disease by artificial intelligence-enabled ECG.

EClinicalMedicine

2023 Volume 65, Page(s) 102259

Abstract: Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide, driven primarily by coronary artery disease (CAD). ASCVD risk estimators such as the pooled cohort equations (PCE) facilitate risk stratification and ... ...

Abstract	Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide, driven primarily by coronary artery disease (CAD). ASCVD risk estimators such as the pooled cohort equations (PCE) facilitate risk stratification and primary prevention of ASCVD but their accuracy is still suboptimal. Methods: Using deep electronic health record data from 7,116,209 patients seen at 70+ hospitals and clinics across 5 states in the USA, we developed an artificial intelligence-based electrocardiogram analysis tool (ECG-AI) to detect CAD and assessed the additive value of ECG-AI-based ASCVD risk stratification to the PCE. We created independent ECG-AI models using separate neural networks including subjects without known history of ASCVD, to identify coronary artery calcium (CAC) score ≥300 Agatston units by computed tomography, obstructive CAD by angiography or procedural intervention, and regional left ventricular akinesis in ≥1 segment by echocardiogram, as a reflection of possible prior myocardial infarction (MI). These were used to assess the utility of ECG-AI-based ASCVD risk stratification in a retrospective observational study consisting of patients with PCE scores and no prior ASCVD. The study period covered all available digitized EHR data, with the first available ECG in 1987 and the last in February 2023. Findings: ECG-AI for identifying CAC ≥300, obstructive CAD, and regional akinesis achieved area under the receiver operating characteristic (AUROC) values of 0.88, 0.85, and 0.94, respectively. An ensembled ECG-AI identified 3, 5, and 10-year risk for acute coronary events and mortality independently and additively to PCE. Hazard ratios for acute coronary events over 3-years in patients without ASCVD that tested positive on 1, 2, or 3 versus 0 disease-specific ECG-AI models at cohort entry were 2.41 (2.14-2.71), 4.23 (3.74-4.78), and 11.75 (10.2-13.52), respectively. Similar stratification was observed in cohorts stratified by PCE or age. Interpretation: ECG-AI has potential to address unmet need for accessible risk stratification in patients in whom PCE under, over, or insufficiently estimates ASCVD risk, and in whom risk assessment over time periods shorter than 10 years is desired. Funding: Anumana.
Language	English
Publishing date	2023-10-24
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2023.102259
Database	MEDical Literature Analysis and Retrieval System OnLINE

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