Category Archives: Biostatistics and Evaluation

New Study of Heart Rate and Mortality Risk

By | October 10, 2017

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Dr. Thomas E. Love has collaborated on a new study, “Heart Rate and Outcomes in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction“. Among older hospitalized patients with heart failure with preserved ejection fraction (HFpEF), a lower heart rate at discharge is associated with a lower risk of all-cause mortality, but not with lower HF-related or all-cause readmission, according to a study published Oct. 2 in the Journal of the American College of Cardiology. A lower heart rate is associated with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). Less is known about this association in patients with HF with preserved ejection fraction (HFpEF). Using data from the Medicare-linked OPTIMIZE-HF study, a group led by Phillip H. Lam and Daniel J. Dooley, and including Dr. Love, examined the associations of discharge heart rate with outcomes in 8,873 hospitalized patients with HFpEF. During a six-year follow-up, all-cause mortality for matched patients was 65 percent for those with a discharge heart rate <70 beats/min vs. 70 percent for those with ≥70 beats/min. A heart rate below 70 beats/min was also associated with a lower risk for the combined endpoint of HF readmission or all-cause mortality. Subgroup analyses demonstrated that the beneficial association between heart rate <70 beats/min and all-cause mortality was similar across various clinically relevant subgroups of patients, including those by baseline atrial fibrillation and beta-blocker use. “These findings suggest that the beneficial association of a lower heart rate and improved survival observed in patients with HFrEF [HF with reduced ejection fraction] might extend to those with HFpEF,” the study authors write. “Future studies are needed to develop and test interventions that might improve outcomes in patients with HFpEF and elevated heart rate.” Read details from the American College of Cardiology.

 

Researchers Combine EHR and Neighborhood Data to Improve Cardiovascular Risk Prediction

By | August 28, 2017


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Center researchers have published a landmark article demonstrating that neighborhood disadvantage is a powerful predictor of cardiovascular outcomes. Cleveland Clinic Statistician Dr. Jarrod Dalton, a Senior Scholar in the Center, was joined by Center Faculty including Dr. Perzynski, Dr. Einstadter and Dr. Dawson in authoring this important work in Annals of Internal Medicine. The study uses electronic health record (EHR) data and is a clear example of how interdisciplinary researchers can come together and examine how social and clinical factors combine to shape population health.

New study finds heart failure readmission associated with poorer long-term outcomes and cost for Medicare patients

By | November 1, 2016

In a study of more than 7500 Medicare beneficiaries hospitalized for heart failure in 1998-2001, 30-day all-cause readmission was associated with a higher risk of subsequent all-cause mortality, higher number of cumulative all-cause readmission, longer cumulative length of stay, and higher cumulative cost. Published this month in the American Journal of Medicine. the study, led by researchers at the Veterans Affairs Medical Center of Washington, DC, was co-authored by Dr. Thomas Love, director of Biostatistics and Evaluation for the Center for Health Care Research and Policy…

Study finds no strong link between spironolactone therapy and readmission for heart failure in patients with reduced ejection fraction

By | November 1, 2016

A discharge prescription for spironolactone had no association with 30-day all-cause readmission among older, hospitalized Medicare beneficiaries with heart failure and reduced ejection fraction who were eligible for spironolactone therapy. The study, published this month by the International Journal of Cardiology, was led by researchers at Georgetown University and the VA Medical Center of Washington DC, and co-authored by Dr. Thomas Love, Director of Biostatistics and Evaluation at the Center for Health Care Research and Policy…

Research Linking Neighborhood Deprivation to Increased Cardiovascular Risk Earns International Recognition

By | October 22, 2016

“Neighborhood Socioeconomic Status and Major Atherosclerotic Event Rates: An Analysis of Geocoded Electronic Health Data” identifies substantial geographic variation in various socioeconomic measures related to risk for and prevention of atherosclerotic cardiovascular disease. Researchers including Jarrod Dalton, Adam Perzynski, and Neal Dawson, in collaboration with experts in health policy, internal medicine, and social work presented their work at a “Top-Rated Abstracts” session of the Society for Medical Decision Making Meeting in Vancouver, Canada…