Publications

• Polypharmacy is broadly defined as the use of more medications than are medically necessary and is associated with a myriad of adverse outcomes including falls, disability, and hospitalizations.
• Our team is examining the impact of polypharmacy on readmissions among older adults hospitalized for heart failure. To do this, we are describing medication prescribing patterns among older adults following a heart failure hospitalization and analyzing the association of medication complexity with readmission.

Notable papers:

Complex and Potentially Harmful Medication Patterns in Heart Failure with Preserved Ejection Fraction.

Polypharmacy in Older Adults Hospitalized for Heart Failure.

• Deprescribing involves the discontinuation of agents for which the risks outweigh the benefits in the context of an individual's care goals, level of functioning, life expectancy, values, and preferences.
• We are exploring the strategy of optimizing medication prescribing practice to improve outcomes in older adults with multiple chronic conditions and high medication burden.
• Our team is pioneering the use of a patient-centered approach to medication optimization by conducting an innovative N-of-1 crossover trial to explore the decision to continue or discontinue beta-blockers in older adults with heart failure with preserved ejection fraction (HFpEF).

Notable papers:

N-of-1 trials to facilitate evidence-based deprescribing: Rationale and case study.

Attitudes toward deprescribing among adults with heart failure with preserved ejection fraction.

Physician Perspectives on Deprescribing Cardiovascular Medications for Older Adults.

• Understanding the features of incident heart failure, including risk factors for its development, can inform prevention and screening efforts and help mitigate the effects of the heart failure epidemic.
• We assembled a heart failure-free cohort from the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study to explore this area of interest.

Notable papers:

Post-operative atrial fibrillation and risk of heart failure hospitalization.

Association of Perceived Stress With Incident Heart Failure.

Assembling and validating a heart failure-free cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

• Hospital readmissions are costly and affect the morbidity, mortality and quality of life of the patient and their loved ones.
• Our team is examining and identifying novel factors including patient demographic and clinical characteristics that contribute to post-hospitalization outcomes, such as 30-day hospital readmissions.

Notable paper:

Frailty and Post-hospitalization Outcomes in Patients With Heart Failure With Preserved Ejection Fraction.

• Our team is using the domain management approach to provide comprehensive care consisting of 4-dimensions: medical, mind and emotions, physical function, and social environment.
• We are studying the role of frailty, depression, cognitive impairment, nutrition, and goals of care on the implementation and success of medical therapy.

Notable papers:

Malnutrition in Heart Failure with Preserved Ejection Fraction

Geriatric Domains in Patients with Heart Failure with Preserved Ejection Fraction

Perspectives on Implementing a Multidomain Approach to Caring for Older Adults With Heart Failure.

Domain Management Approach to Heart Failure in the Geriatric Patient: Present and Future.

• Social determinants of health are defined as the conditions in which people are born, grow, work, live, age, and the wider set of forces and systems shaping the conditions of daily life.
• We are investigating the effect of social determinants on post-hospitalization outcomes for older adults with heart failure, including mortality after heart failure hospitalization.

Notable papers:

Social Determinants of Health and Cardiologist Involvement in the Care of Adults Hospitalized for Heart Failure

Social Determinants of Health and 30-Day Readmissions Among Adults Hospitalized for Heart Failure in the REGARDS Study.

Social Determinants of Health and 90-Day Mortality After Hospitalization for Heart Failure in the REGARDS Study.

• Cardiac amyloidosis is a progressive clinical disorder that occurs when a protein called amyloid deposits in the heart. This condition is much more common than has been previously appreciated.
• We are collaborating with the Columbia Amyloidosis Multidisciplinary Program and other experts in the field to contribute to improved understanding and treatment of this condition.

Notable papers:

Association of Transthyretin Val122Ile Variant With Incident Heart Failure Among Black Individuals.

Lack of Association Between Neurohormonal Blockade and Survival in Transthyretin Cardiac Amyloidosis.

• We have developed a registry of over 4,000 patients admitted to NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian Lower Manhattan Hospital with data on patients out to almost 1 year following hospitalization.
• Our team is characterizing and documenting the clinical course of patients with COVID-19 including the manifestations of the disease at presentation and cardiovascular complications.

Notable papers:

Health Status, Persistent Symptoms, and Effort Intolerance One Year After Acute COVID-19 Infection.

Clinical Characteristics and Outcomes of Adults With a History of Heart Failure Hospitalized for COVID-19.

Obesity and COVID-19 in New York City: A Retrospective Cohort Study.

Clinical Characteristics of Covid-19 in New York City.