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CDA 08-021
Cardiac Risk Factor Management Among CAD Patients After Cardiac Catheterization
Thomas M. Maddox MD MS BA
Rocky Mountain Regional VA Medical Center, Aurora, CO
Aurora, CO
Funding Period: May 2010 - April 2015

BACKGROUND/RATIONALE:
The traditional focus of cardiac care on obstructive coronary artery disease (CAD) may distract from the potential cardiac risks inherent in non-obstructive CAD. Little is known about cardiac adverse events among patients with nonobstructive coronary artery disease (CAD).

OBJECTIVE(S):
To compare myocardial infarction (MI) and mortality rates between patients with nonobstructive CAD, obstructive CAD, and no apparent CAD in a national cohort.

METHODS:
Design, Setting, and Participants Retrospective cohort study of all US veterans undergoing elective coronary angiography for CAD between October 2007 and September 2012 in the Veterans Affairs health care system. Patients with prior CAD events were excluded.

Exposures Angiographic CAD extent, defined by degree (no apparent CAD: no stenosis >20%; nonobstructive CAD: 1 stenosis 20% but no stenosis 70%; obstructive CAD: any stenosis 70% or left main [LM] stenosis 50%) and distribution (1, 2, or 3 vessel).

Main Outcomes and Measures The primary outcome was 1-year hospitalization for nonfatal MI after the index angiography. Secondary outcomes included 1-year all-cause mortality and combined 1-year MI and mortality.




FINDINGS/RESULTS:
Not yet available.

IMPACT:
Conclusions and Relevance In this cohort of patients undergoing elective coronary angiography, nonobstructive CAD, compared with no apparent CAD, was associated with a significantly greater 1-year risk of MI and all-cause mortality. These findings suggest clinical importance of nonobstructive CAD and warrant further investigation of interventions to improve outcomes among these patients.

PUBLICATIONS:

Journal Articles

  1. Pokharel Y, Tang F, Jones PG, Nambi V, Bittner VA, Hira RS, Nasir K, Chan PS, Maddox TM, Oetgen WJ, Heidenreich PA, Borden WB, Spertus JA, Petersen LA, Ballantyne CM, Virani SS. Adoption of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline in Cardiology Practices Nationwide. JAMA cardiology. 2017 Apr 1; 2(4):361-369.
  2. Armstrong EJ, Graham L, Waldo SW, Valle JA, Maddox TM, Hawn MT. Patient and lesion-specific characteristics predict risk of major adverse cardiovascular events among patients with previous percutaneous coronary intervention undergoing noncardiac surgery. Catheterization and Cardiovascular Interventions : Official Journal of The Society For Cardiac Angiography & Interventions. 2017 Mar 1; 89(4):617-627.
  3. Joynt KE, Maddox TM. Leading on Payment and Delivery Reform in Cardiology. JAMA cardiology. 2017 Feb 1; 2(2):121-123.
  4. Valle JA, Graham L, DeRussy A, Itani K, Hawn MT, Maddox TM. Triple Antithrombotic Therapy and Outcomes in Post-PCI Patients Undergoing Non-cardiac Surgery. World Journal of Surgery. 2017 Feb 1; 41(2):423-432.
  5. Patel MR, Calhoon JH, Dehmer GJ, Grantham JA, Maddox TM, Maron DJ, Smith PK. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2017 Feb 7; 69(5):570-591.
  6. Kalra A, Glusenkamp N, Anderson K, Kalra RN, Kerkar PG, Kumar G, Maddox TM, Oetgen WJ, Virani SS, PIQIP Investigators. American College of Cardiology (ACC)'s PINNACLE India Quality Improvement Program (PIQIP)-Inception, progress and future direction: A report from the PIQIP Investigators. Indian heart journal. 2016 Dec 1; 68 Suppl 3:S1-S4.
  7. Hsu JC, Akao M, Abe M, Anderson KL, Avezum A, Glusenkamp N, Kohsaka S, Lane DA, Lip GY, Ma CS, Masoudi FA, Potpara TS, Siong TW, Turakhia MP, Tse HF, Rumsfeld JS, Maddox TM. International Collaborative Partnership for the Study of Atrial Fibrillation (INTERAF): Rationale, Design, and Initial Descriptives. Journal of the American Heart Association. 2016 Nov 2; 5(11).
  8. Hollis RH, Holcomb CN, Valle JA, Smith BP, DeRussy AJ, Graham LA, Richman JS, Itani KM, Maddox TM, Hawn MT. Coronary angiography and failure to rescue after postoperative myocardial infarction in patients with coronary stents undergoing noncardiac surgery. American journal of surgery. 2016 Nov 1; 212(5):814-822.e1.
  9. Brown JR, Solomon RJ, Robey RB, Plomondon ME, Maddox TM, Marshall EJ, Nichols EL, Matheny ME, Tsai TT, Rumsfeld JS, Lee RE, Sarnak MJ. Chronic Kidney Disease Progression and Cardiovascular Outcomes Following Cardiac Catheterization-A Population-Controlled Study. Journal of the American Heart Association. 2016 Oct 14; 5(10).
  10. Wasfy JH, Maddox TM. Worlds Apart: The Hype and Reality of Big Data to Improve Health Care. Circulation. Cardiovascular quality and outcomes. 2016 Sep 6; 9(5):495-7.
  11. Levitan EB, Graham LA, Valle JA, Richman JS, Hollis R, Holcomb CN, Maddox TM, Hawn MT. Pre-operative echocardiography among patients with coronary artery disease in the United States Veterans Affairs healthcare system: A retrospective cohort study. BMC cardiovascular disorders. 2016 Sep 5; 16(1):173.
  12. Arnold SV, Inzucchi SE, McGuire DK, Mehta SN, Goyal A, Sperling LS, Maddox TM, Einhorn D, Wong ND, Ratner RE, Hammar N, Fenici P, Sheehan JJ, Wong JL, Kosiborod M. Evaluating the Quality of Comprehensive Cardiometabolic Care for Patients With Type 2 Diabetes in the U.S.: The Diabetes Collaborative Registry. Diabetes Care. 2016 Jul 1; 39(7):e99-e101.
  13. Mentz RJ, Maddox TM. Targeting Comorbidities in Elderly Patients With Heart Failure: The OPTIMIZE-HFPEF Trial. Journal of cardiac failure. 2016 Jul 1; 22(7):545-7.
  14. Doll JA, Tang F, Cresci S, Ho PM, Maddox TM, Spertus JA, Wang TY. Change in Angina Symptom Status After Acute Myocardial Infarction and Its Association With Readmission Risk: An Analysis of the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) Registry. Journal of the American Heart Association. 2016 Jun 13; 5(6).
  15. Valle JA, Shetterly S, Maddox TM, Ho PM, Bradley SM, Sandhu A, Magid D, Tsai TT. Postdischarge Bleeding After Percutaneous Coronary Intervention and Subsequent Mortality and Myocardial Infarction: Insights From the HMO Research Network-Stent Registry. Circulation. Cardiovascular interventions. 2016 Jun 1; 9(6).
  16. Brilakis ES, O'Donnell CI, Penny W, Armstrong EJ, Tsai T, Maddox TM, Plomondon ME, Banerjee S, Rao SV, Garcia S, Nallamothu B, Shunk KA, Mavromatis K, Grunwald GK, Bhatt DL. Percutaneous Coronary Intervention in Native Coronary Arteries Versus Bypass Grafts in Patients With Prior Coronary Artery Bypass Graft Surgery: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. JACC. Cardiovascular interventions. 2016 May 9; 9(9):884-93.
  17. Vigen R, Maddox TM, O'Donnell CI, Grunwald GK, Bhatt DL, Tsai TT, Rumsfeld JS, Ho PM. Hospital Variation in Premature Clopidogrel Discontinuation After Drug-Eluting Stent Placement in the Veterans Affairs (VA) Healthcare System. Journal of the American Heart Association. 2016 May 5; 5(5).
  18. Holcomb CN, Graham LA, Richman JS, Itani KM, Maddox TM, Hawn MT. The Incremental Risk of Coronary Stents on Postoperative Adverse Events: A Matched Cohort Study. Annals of surgery. 2016 May 1; 263(5):924-30.
  19. Holcomb CN, Hollis RH, Graham LA, Richman JS, Valle JA, Itani KM, Maddox TM, Hawn MT. Association of Coronary Stent Indication With Postoperative Outcomes Following Noncardiac Surgery. JAMA surgery. 2016 May 1; 151(5):462-9.
  20. Hsu JC, Maddox TM, Kennedy KF, Katz DF, Marzec LN, Lubitz SA, Gehi AK, Turakhia MP, Marcus GM. Oral Anticoagulant Therapy Prescription in Patients With Atrial Fibrillation Across the Spectrum of Stroke Risk: Insights From the NCDR PINNACLE Registry. JAMA cardiology. 2016 Apr 1; 1(1):55-62.
  21. McConnell KJ, Lindrooth RC, Wholey DR, Maddox TM, Bloom N. Modern Management Practices and Hospital Admissions. Health economics. 2016 Apr 1; 25(4):470-85.
  22. Maron BA, Hess E, Maddox TM, Opotowsky AR, Tedford RJ, Lahm T, Joynt KE, Kass DJ, Stephens T, Stanislawski MA, Swenson ER, Goldstein RH, Leopold JA, Zamanian RT, Elwing JM, Plomondon ME, Grunwald GK, Barón AE, Rumsfeld JS, Choudhary G. Association of Borderline Pulmonary Hypertension With Mortality and Hospitalization in a Large Patient Cohort: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. Circulation. 2016 Mar 29; 133(13):1240-8.
  23. Rumsfeld JS, Joynt KE, Maddox TM. Big data analytics to improve cardiovascular care: promise and challenges. Nature reviews. Cardiology. 2016 Jun 1; 13(6):350-9.
  24. Hollis RH, Singletary BA, McMurtrie JT, Graham LA, Richman JS, Holcomb CN, Itani KM, Maddox TM, Hawn MT. Blood Transfusion and 30-Day Mortality in Patients With Coronary Artery Disease and Anemia Following Noncardiac Surgery. JAMA surgery. 2016 Feb 1; 151(2):139-45.
  25. Fleming LM, Jones P, Chan PS, Andrei AC, Maddox TM, Farmer SA. Relationship of Provider and Practice Volume to Performance Measure Adherence for Coronary Artery Disease, Heart Failure, and Atrial Fibrillation: Results From the National Cardiovascular Data Registry. Circulation. Cardiovascular quality and outcomes. 2016 Jan 1; 9(1):48-54.
  26. Harris WS, Kennedy KF, Maddox TM, Kutty S, Spertus JA. Multiple differences between patients who initiate fish oil supplementation post-myocardial infarction and those who do not: the TRIUMPH Study. Nutrition Research (New York, N.Y.). 2016 Jan 1; 36(1):65-71.
  27. Keach JW, Yeh RW, Maddox TM. Dual Antiplatelet Therapy in Patients with Stable Ischemic Heart Disease. Current Atherosclerosis Reports. 2016 Jan 1; 18(1):5.
  28. Brown JR, MacKenzie TA, Maddox TM, Fly J, Tsai TT, Plomondon ME, Nielson CD, Siew ED, Resnic FS, Baker CR, Rumsfeld JS, Matheny ME. Acute Kidney Injury Risk Prediction in Patients Undergoing Coronary Angiography in a National Veterans Health Administration Cohort With External Validation. Journal of the American Heart Association. 2015 Dec 11; 4(12).
  29. Martin SS, Faridi KF, Joshi PH, Blaha MJ, Kulkarni KR, Khokhar AA, Maddox TM, Havranek EP, Toth PP, Tang F, Spertus JA, Jones SR. Remnant Lipoprotein Cholesterol and Mortality After Acute Myocardial Infarction: Further Evidence for a Hypercholesterolemia Paradox From the TRIUMPH Registry. Clinical Cardiology. 2015 Nov 1; 38(11):660-7.
  30. Virani SS, Akeroyd JM, Nambi V, Maddox TM, Gillette MA, Michael Ho P, Rumsfeld J, Petersen LA, Ballantyne CM. Implications for Ezetimibe Therapy Use Based on IMPROVE-IT Criteria. The American journal of medicine. 2015 Nov 1; 128(11):1253-6.
  31. Virani SS, Maddox TM, Chan PS, Tang F, Akeroyd JM, Risch SA, Oetgen WJ, Deswal A, Bozkurt B, Ballantyne CM, Petersen LA. Provider Type and Quality of Outpatient Cardiovascular Disease Care: Insights From the NCDR PINNACLE Registry. Journal of the American College of Cardiology. 2015 Oct 20; 66(16):1803-12.
  32. Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World journal of diabetes. 2015 Oct 10; 6(13):1246-58.
  33. Maddox TM, Matheny MA. Natural Language Processing and the Promise of Big Data: Small Step Forward, but Many Miles to Go. Circulation. Cardiovascular quality and outcomes. 2015 Sep 1; 8(5):463-5.
  34. Spinler SA, Cziraky MJ, Willey VJ, Tang F, Maddox TM, Thomas T, Dueñas GG, Virani SS, NCDR. Frequency of Attainment of Low-Density Lipoprotein Cholesterol and Non-High-Density Lipoprotein Cholesterol Goals in Cardiovascular Clinical Practice (from the National Cardiovascular Data Registry PINNACLE Registry). The American journal of cardiology. 2015 Aug 15; 116(4):547-53.
  35. Maddox TM, Ferguson TB. The Potential of Learning Health Care Systems: The SWEDEHEART Example. Journal of the American College of Cardiology. 2015 Aug 4; 66(5):544-6.
  36. Arnold SV, Spertus JA, Lipska KJ, Tang F, Goyal A, McGuire DK, Cresci S, Maddox TM, Kosiborod M. Association between diabetes mellitus and angina after acute myocardial infarction: analysis of the TRIUMPH prospective cohort study. European journal of preventive cardiology. 2015 Jun 1; 22(6):779-87.
  37. Eapen ZJ, Tang F, Jones PG, Maddox TM, Oetgen WJ, Spertus JA, Rumsfeld JS, Heidenreich PA, Peterson ED, Drozda JP. Variation in performance measure criteria significantly affects cardiology practice rankings: Insights from the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry. American heart journal. 2015 Jun 1; 169(6):847-53.
  38. Hsu JC, Chan PS, Tang F, Maddox TM, Marcus GM. Differences in anticoagulant therapy prescription in patients with paroxysmal versus persistent atrial fibrillation. The American journal of medicine. 2015 Jun 1; 128(6):654.e1-654.e10.
  39. Hsu JC, Chan PS, Tang F, Maddox TM, Marcus GM. Oral Anticoagulant Prescription in Patients With Atrial Fibrillation and a Low Risk of Thromboembolism: Insights From the NCDR PINNACLE Registry. JAMA internal medicine. 2015 Jun 1; 175(6):1062-5.
  40. Arnold SV, Stolker JM, Lipska KJ, Jones PG, Spertus JA, McGuire DK, Inzucchi SE, Goyal A, Maddox TM, Lind M, Gumber D, Shore S, Kosiborod M. Recognition of incident diabetes mellitus during an acute myocardial infarction. Circulation. Cardiovascular quality and outcomes. 2015 May 1; 8(3):260-7.
  41. Bandeali SJ, Gosch K, Alam M, Kayani WT, Jneid H, Fiocchi F, Wilson JM, Chan PS, Deswal A, Maddox TM, Virani SS. Coronary artery disease performance measures and statin use in patients with recent percutaneous coronary intervention or recent coronary artery bypass grafting (from the NCDR PINNACLE registry). The American journal of cardiology. 2015 Apr 15; 115(8):1013-8.
  42. Davis MB, Maddox TM, Langner P, Plomondon ME, Rumsfeld JS, Duvernoy CS. Characteristics and outcomes of women veterans undergoing cardiac catheterization in the Veterans Affairs Healthcare System: insights from the VA CART Program. Circulation. Cardiovascular quality and outcomes. 2015 Mar 1; 8(2 Suppl 1):S39-47.
  43. Ho PM, O'Donnell CI, Bradley SM, Grunwald GK, Helfrich C, Chapko M, Liu CF, Maddox TM, Tsai TT, Jesse RL, Fihn SD, Rumsfeld JS. 1-year risk-adjusted mortality and costs of percutaneous coronary intervention in the Veterans Health Administration: insights from the VA CART Program. Journal of the American College of Cardiology. 2015 Jan 27; 65(3):236-42.
  44. Holcomb CN, Graham LA, Richman JS, Rhyne RR, Itani KM, Maddox TM, Hawn MT. The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting. Journal of the American College of Cardiology. 2014 Dec 30; 64(25):2730-9.
  45. Borden WB, Maddox TM, Tang F, Rumsfeld JS, Oetgen WJ, Mullen JB, Spinler SA, Peterson ED, Masoudi FA. Impact of the 2014 expert panel recommendations for management of high blood pressure on contemporary cardiovascular practice: insights from the NCDR PINNACLE registry. Journal of the American College of Cardiology. 2014 Dec 2; 64(21):2196-203.
  46. Maddox TM, Borden WB, Tang F, Virani SS, Oetgen WJ, Mullen JB, Chan PS, Casale PN, Douglas PS, Masoudi FA, Farmer SA, Rumsfeld JS. Implications of the 2013 ACC/AHA cholesterol guidelines for adults in contemporary cardiovascular practice: insights from the NCDR PINNACLE registry. Journal of the American College of Cardiology. 2014 Dec 2; 64(21):2183-92.
  47. Maddox TM, Plomondon ME, Petrich M, Tsai TT, Gethoffer H, Noonan G, Gillespie B, Box T, Fihn SD, Jesse RL, Rumsfeld JS. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program). The American journal of cardiology. 2014 Dec 1; 114(11):1750-7.
  48. Yeo KK, Maddox TM, Carey E, Low RI, Shunk KA. Right- and left-sided heart catheterization as a quality marker for catheterization laboratories (from the national Veterans Affairs clinical assessment reporting and tracking program). The American journal of cardiology. 2014 Dec 1; 114(11):1758-62.
  49. Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, Fonarow GC, Lange RA, Levine GN, Maddox TM, Naidu SS, Ohman EM, Smith PK. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014 Nov 4; 130(19):1749-67.
  50. Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, Fonarow GC, Lange RA, Levine GN, Maddox TM, Naidu SS, Ohman EM, Smith PK. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2014 Nov 4; 64(18):1929-49.
  51. Patel MR, Dai D, Hernandez AF, Douglas PS, Messenger J, Garratt KN, Maddox TM, Peterson ED, Roe MT. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. American heart journal. 2014 Jun 1; 167(6):846-52.e2.
  52. Shore S, Carey EP, Turakhia MP, Jackevicius CA, Cunningham F, Pilote L, Bradley SM, Maddox TM, Grunwald GK, Barón AE, Rumsfeld JS, Varosy PD, Schneider PM, Marzec LN, Ho PM. Adherence to dabigatran therapy and longitudinal patient outcomes: insights from the veterans health administration. American heart journal. 2014 Jun 1; 167(6):810-7.
  53. Arnold SV, Kosiborod M, Tang F, Zhao Z, Maddox TM, McCollam PL, Birt J, Spertus JA. Patterns of statin initiation, intensification, and maximization among patients hospitalized with an acute myocardial infarction. Circulation. 2014 Mar 25; 129(12):1303-9.
  54. Maddox TM, Chan PS, Spertus JA, Tang F, Jones P, Ho PM, Bradley SM, Tsai TT, Bhatt DL, Peterson PN. Variations in coronary artery disease secondary prevention prescriptions among outpatient cardiology practices: insights from the NCDR (National Cardiovascular Data Registry). Journal of the American College of Cardiology. 2014 Feb 18; 63(6):539-46.
  55. Bradley SM, Maddox TM, Stanislawski MA, O'Donnell CI, Grunwald GK, Tsai TT, Ho PM, Peterson ED, Rumsfeld JS. Normal coronary rates for elective angiography in the Veterans Affairs Healthcare System: insights from the VA CART program (veterans affairs clinical assessment reporting and tracking). Journal of the American College of Cardiology. 2014 Feb 11; 63(5):417-26.
  56. Shore S, Borgerding JA, Gylys-Colwell I, McDermott K, Ho PM, Tillquist MN, Lowy E, McGuire DK, Stolker JM, Arnold SV, Kosiborod M, Maddox TM. Association between hyperglycemia at admission during hospitalization for acute myocardial infarction and subsequent diabetes: insights from the veterans administration cardiac care follow-up clinical study. Diabetes Care. 2014 Feb 1; 37(2):409-18.
  57. Shore S, Maddox TM, Tang F, Jones PG, Lanfear DE, Ho PM. Gap between clinical guidelines and practice: the case of aldosterone-antagonists in patients with myocardial infarction. International Journal of Cardiology. 2013 Dec 28; 172(1):e151-3.
  58. Masoudi FA, Ponirakis A, Yeh RW, Maddox TM, Beachy J, Casale PN, Curtis JP, De Lemos J, Fonarow G, Heidenreich P, Koutras C, Kremers M, Messenger J, Moussa I, Oetgen WJ, Roe MT, Rosenfield K, Shields TP, Spertus JA, Wei J, White C, Young CH, Rumsfeld JS. Cardiovascular care facts: a report from the national cardiovascular data registry: 2011. Journal of the American College of Cardiology. 2013 Nov 19; 62(21):1931-47.
  59. Vigen R, O'Donnell CI, Barón AE, Grunwald GK, Maddox TM, Bradley SM, Barqawi A, Woning G, Wierman ME, Plomondon ME, Rumsfeld JS, Ho PM. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA. 2013 Nov 6; 310(17):1829-36.
  60. Arnold SV, Spertus JA, Masoudi FA, Daugherty SL, Maddox TM, Li Y, Dodson JA, Chan PS. Beyond medication prescription as performance measures: optimal secondary prevention medication dosing after acute myocardial infarction. Journal of the American College of Cardiology. 2013 Nov 5; 62(19):1791-801.
  61. Heidenreich PA, Lin S, Knowles JW, Perez M, Maddox TM, Ho MP, Rumsfeld JS, Sahay A, Massie BM, Tsai TT, Witteles RM. Variation in use of left ventriculography in the Veterans Affairs Health Care System. Circulation. Cardiovascular quality and outcomes. 2013 Nov 5; 6(6):687-93.
  62. Marzec LN, Maddox TM. Medication adherence in patients with diabetes and dyslipidemia: associated factors and strategies for improvement. Current Cardiology Reports. 2013 Nov 1; 15(11):418.
  63. Peterson PN, Chan PS, Spertus JA, Tang F, Jones PG, Ezekowitz JA, Allen LA, Masoudi FA, Maddox TM. Practice-level variation in use of recommended medications among outpatients with heart failure: Insights from the NCDR PINNACLE program. Circulation. Heart failure. 2013 Nov 1; 6(6):1132-8.
  64. Arnold SV, Lipska KJ, Li Y, Goyal A, Maddox TM, McGuire DK, Spertus JA, Kosiborod M. The reliability and prognosis of in-hospital diagnosis of metabolic syndrome in the setting of acute myocardial infarction. Journal of the American College of Cardiology. 2013 Aug 20; 62(8):704-8.
  65. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Piña IL, Trogdon JG, American Heart Association Advocacy Coordinating Committee, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Radiology and Intervention, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Stroke Council. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circulation. Heart failure. 2013 May 1; 6(3):606-19.
  66. McConnell KJ, Lindrooth RC, Wholey DR, Maddox TM, Bloom N. Management practices and the quality of care in cardiac units. JAMA internal medicine. 2013 Apr 22; 173(8):684-92.
  67. Byrd JB, Vigen R, Plomondon ME, Rumsfeld JS, Box TL, Fihn SD, Maddox TM. Data quality of an electronic health record tool to support VA cardiac catheterization laboratory quality improvement: the VA Clinical Assessment, Reporting, and Tracking System for Cath Labs (CART) program. American heart journal. 2013 Mar 1; 165(3):434-40.
  68. Heidenreich PA, Maddox TM, Nath J. Measuring the quality of echocardiography using the predictive value of the left ventricular ejection fraction. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2013 Mar 1; 26(3):237-42.
  69. Tsai TT, Box TL, Gethoffer H, Noonan G, Varosy PD, Maddox TM, Fihn SD, Gross TP, Jesse RL, Rumsfeld JS. Feasibility of proactive medical device surveillance: the VA Clinical Assessment Reporting and Tracking (CART) program. Medical care. 2013 Mar 1; 51(3 Suppl 1):S57-61.
  70. Vigen R, Maddox TM, Allen LA. Aging of the United States population: impact on heart failure. Current heart failure reports. 2012 Dec 1; 9(4):369-74.
  71. Maddox TM. Cardiovascular risks of stopping antiplatelet therapy before non-cardiac surgery for patients with coronary stents. Evidence-based medicine. 2012 Aug 1; 17(4):122-3.
  72. Stickrath C, Druck J, Hensley N, Maddox TM, Richlie D. Patient and health care provider discussions about the risks of medical imaging: not ready for prime time. Archives of internal medicine. 2012 Jul 9; 172(13):1037-8.
  73. Maddox TM, Ho PM, Tsai TT, Wang TY, Li S, Peng SA, Wiviott SD, Masoudi FA, Rumsfeld JS. Clopidogrel use and hospital quality in medically managed patients with non-ST-segment-elevation myocardial infarction. Circulation. Cardiovascular quality and outcomes. 2012 Jul 1; 5(4):523-31.
  74. Tillquist MN, Maddox TM. Update on diabetic cardiomyopathy: inches forward, miles to go. Current Diabetes Reports. 2012 Jun 1; 12(3):305-13.
  75. Stolker JM, Spertus JA, McGuire DK, Lind M, Tang F, Jones PG, Inzucchi SE, Rathore SS, Maddox TM, Masoudi FA, Kosiborod M. Relationship between glycosylated hemoglobin assessment and glucose therapy intensification in patients with diabetes hospitalized for acute myocardial infarction. Diabetes Care. 2012 May 1; 35(5):991-3.
  76. Chan PS, Maddox TM, Tang F, Spinler S, Spertus JA. Practice-level variation in warfarin use among outpatients with atrial fibrillation (from the NCDR PINNACLE program). The American journal of cardiology. 2011 Oct 15; 108(8):1136-40.
  77. Fitzgerald AA, Powers JD, Ho PM, Maddox TM, Peterson PN, Allen LA, Masoudi FA, Magid DJ, Havranek EP. Impact of medication nonadherence on hospitalizations and mortality in heart failure. Journal of cardiac failure. 2011 Aug 1; 17(8):664-9.
  78. Bradley SM, Bryson CL, Maynard C, Maddox TM, Fihn SD. Recent hospitalization for non-coronary events and use of preventive medications for coronary artery disease: an observational cohort study. BMC cardiovascular disorders. 2011 Jul 9; 11:42.
  79. Tillquist MN, Maddox TM. Cardiac crossroads: deciding between mechanical or bioprosthetic heart valve replacement. Patient preference and adherence. 2011 Feb 17; 5:91-9.
  80. Maddox TM, Ho PM, Roe M, Dai D, Tsai TT, Rumsfeld JS. Utilization of secondary prevention therapies in patients with nonobstructive coronary artery disease identified during cardiac catheterization: insights from the National Cardiovascular Data Registry Cath-PCI Registry. Circulation. Cardiovascular quality and outcomes. 2010 Nov 1; 3(6):632-41.
Journal Other

  1. Hsu JC, Maddox TM, Marcus GM. Reply: Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed. [Letter to the Editor]. Journal of the American College of Cardiology. 2016 Dec 6; 68(22):2493.
  2. Maddox TM, Masoudi FA, Oetgen WJ, Rumsfeld JS. The Capacity of Evidence to Inform Practice: The Rapid Registry Response (RRR) Initiative. Journal of the American College of Cardiology. 2015 May 26; 65(20):2252-3.
  3. Maddox TM, Oetgen WJ, Rumsfeld JS. Reply: getting guidelines correct: their evidence-based recommendations for use of nonstatins added to statins and the need for follow-up lipid testing. Journal of the American College of Cardiology. 2015 May 12; 65(18):2052-3.
  4. Shore S, Maddox TM. Response to comment on Shore et al. Association between hyperglycemia at admission during hospitalization for acute myocardial infarction and subsequent diabetes: insights from the Veterans Administration Cardiac Care Follow-up Clinical Study. Diabetes Care 2014;37:409-418. Diabetes Care. 2014 Jul 1; 37(7):e168.
  5. Hawn MT, Richman JS, Maddox TM. Cardiovascular event risk after noncardiac surgery--reply. JAMA : the journal of the American Medical Association. 2014 Feb 5; 311(5):525-6.
  6. Maddox TM. Promise and peril of clinical decision support: translating medical evidence to the individual patient. [Editorial]. Circulation. Cardiovascular quality and outcomes. 2013 Jan 1; 6(1):7-8.
Conference Presentations

  1. Maddox TM, Ho M. Non-Obstructive Coronary Artery Disease Is Not Benign: Insights from the VA CART Program on the Association between Non-Obstructive Disease and Cardiac Events. Poster session presented at: Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Scientific Annual Forum; 2014 Jun 2; Baltimore, MD.
  2. Maddox TM, McCreight M, Plomondon ME, Ho M, Rumsfeld JS. Temporal Variation in Clopidogrel Filling Delays after Percutaneous Coronary Intervention Hospital Discharge: Insights from the VA CART. Poster session presented at: Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Forum; 2014 Jun 2; Baltimore, MD.
  3. Valle J, Maddox TM. The Impact of Aspirin Primary Prevention Treatment Guidelines: Temporal Trends in Aspirin Use for Primary vs Secondary Prevention, 2005 - 2013. Poster session presented at: Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Scientific Annual Forum; 2014 Jun 2; Baltimore, MD.
  4. Valle J, Maddox TM. The Sex Gap among Cardiovascular Disease Encounters in India. Poster session presented at: Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Forum; 2014 Jun 2; Baltimore, MD.
  5. Valle J, Maddox TM. Association of Pre-Operative INR Evaluation with Risk of Major Adverse Cardiac Events and Bleeding Complications in Cardiac patients Undergoing non-Cardiac Surgery. Poster session presented at: Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Forum; 2014 Jun 2; Baltimore, MD.
  6. Arnold S, Spertus J, Fengming T, McGuire D, Maddox TM, Karrowni WY, Kosiborod M. Patterns and Predictors of Intensive Statin Therapy Among Patients with Type 2 Diabetes Mellitus After an Acute Myocardial Infarction. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  7. Bandeali SJ, Mahboob M, Mitanegi S, Waleed TK, Wilson J, Maddox TM, Chan P, Gosch KL, Virani SS. Coronary Artery Disease Performance Measures and Statin Use Between Patients with Recent Percutaneous Coronary Intervention (PCI) and Patients with Recent Coronary Artery Bypass Grafting (CABG): An Analysis from the NCDR. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  8. Box TL, Maddox TM, Tsai TT, Gethoffer H, Grunwald GK, Jesse RL, Fihn SD, Rumsfeld JS. Implementation of a Nationwide Health IT System for Cardiac Cath Labs in the VA Hospital System: The CART Program. Paper presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  9. Carey E, Maddox TM, Plomondon ME, Ho M, Rumsfeld JS, Tsai TT, Bradley SM. The Association between Patient Rural Status, distance to Cath Lab, and Likelihood to Undergo Coronary Angiography: Insights from the VA CART Program. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  10. Fleming L, Maddox TM, Andrei AC, Chan P, Jones P, Farmer S. Relationships of Provider and Practice Volume to Performance Measure Adherence: Results from the NCDR. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  11. Ho M, O CI, Bradley SM, Grunwald G, Helfrich CD, Chapko M, Liu C, Maddox TM, Tsai TT, Jesse R, Fihn S, Rumsfeld JS. Value of Percutaneous Coronary Intervention in the VHA Integrated Health Care Delivery System: Insights from the VA CART Program, Quality of Care and Outcomes Research. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  12. Nkonde-Price C, Plomondon ME, Maddox TM, Rumsfeld JS, Duvernoy C. Presentations and Outcomes of Women Veterans with Suspected Ischemia and Nonobstructive Coronary Artery Disease: Insights from the VA Clinical Assessment, Reporting and Tracking Program. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  13. Shore S, Ho M, Maddox TM, Lanfea D, Jones PG, Buchanan D. TRIUMPH Aldosterone Antagonist. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  14. Valle J, Tsai TT, Gurm HS, Varosy PD, Bradley SM, Maddox TM, Rumsfeld JS, Ho M, Tsai TT, Carey E, Grossman P, Petrich M, Nallamothu BK. Veteran Exposure to Radiation in the Cardiac Catheterization Laboratory. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  15. Valle JA, Petrich M, Carey E, Bradley SM, Gurm HS, Grossman PM, Maddox TM, Duvernoy CS, Nallamothu BK, Rumsfeld JS, Ho M, Tsai TT. A Multimodal Radiation Reduction Intervention for Intra-procedural Radiation Exposure in Patients Undergoing Cardiac Catheterization in Veterans Affairs Hospitals. Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2013 May 16; Baltimore, MD.
  16. Hsu JC, Chan PS, Tang F, Dewland TA, Maddox TM, Marcus GM. Differences in Anticoagulant Therapy Prescription in Patients with Paroxysmal versus Persistent Atrial Fibrillation: Insights from the NCDR PINNACLE Program. Poster session presented at: Heart Rhythm Society Annual Scientific Sessions; 2013 May 9; Denver, CO.
  17. Harris WS, Kennedy KJ, Maddox TM, Jones PG, Spertus JA, Maddox TM. Fish Oil Supplementation in Post-Myocardial Infarction Patients in the TRIUMPH study: Defining characteristics and relations with 2-year mortality. Poster session presented at: American College of Cardiology Annual Scientific Session; 2013 Mar 9; San Francisco, CA.
  18. Vigen R, Barqawi A, Maddox TM, Grunwald G, O'Donnell CI, Enright J, Ho M. The Association Between Testosterone Replacement Therapy and Adverse Cardiovascular Outcomes in Veterans Undergoing Coronary Angiography. Paper presented at: American Heart Association Annual Scientific Sessions; 2012 Nov 7; Los Angeles, CA.
  19. Maddox TM. Practice Variation is a Significant Contributor to Secondary Prevention Medication Use: Insights from the NCDR PINNACLE Program. Poster session presented at: American Heart Association Quality of Care and Outcomes Research Council Annual Scientific Session; 2012 May 9; Atlanta, GA.
  20. Maddox TM, Gylys-Colwell I, McDermott K, Ho M, Tillquist M, Lowy E, McGuire D, Stolker JM, Kosiborod M. Hyperglycemia During MI Hospitalization Predicts Subsequent Diabetes: Insights from the VA IHD-QUERI Cardiac Care Follow-Up Clinical Study (CCFCS). Poster session presented at: American Heart Association Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Annual Scientific Sessions; 2012 May 6; Atlanta, GA.
  21. Maddox TM. Hospital-Level Variation in Delays to Clopidogrel Filling Following Stent Implantation and Short-Term Cardiovascular Outcomes: Insights from the National VA Clinical Assessment, Reporting, and Tracking (CART) Program. Poster session presented at: American Heart Association Annual Scientific Sessions; 2011 Nov 15; Orlando, FL.
  22. Maddox TM, Bradley SM, Stanislawski M, O'Donnell CI, Grunwald GK, Tsai TT, Rumsfeld JS. Prior Non-Invasive Testing and Diagnostic Yield of Elective Cardiac Catheterization in the VA: Insights from the Clinical Assessment, Reporting, and Tracking System for Cath Labs (CART-CL). Poster session presented at: American Heart Association Annual Scientific Sessions; 2011 Nov 12; Orlando, FL.
  23. Maddox TM. The VA Clinical Assessment, Reporting, and Tracking (CART) Program: Current Status and Future Directions. Paper presented at: VA Improvement Forum Annual Workshop; 2011 Sep 19; Las Vegas, NV.
  24. Maddox TM. Angina and Secondary Prevention in the Post-COURAGE Era. Paper presented at: Colorado Integrative Medicine Annual Conference; 2011 Jul 17; Estes Park, CO.
  25. Maddox TM, Stanislawski M, O'Donnell CI, Grunwald GK, Tsai TT, Rumsfeld JS. Prior Non-Invasive Testing and Diagnostic Yield of Elective Cardiac Catheterization in the VA: Insights from the VA Clinical Assessment, Reporting, and Tracking System for Cath Labs (CART-CL). Poster session presented at: American Heart Association Quality of Care and Outcomes Research Council Annual Scientific Session; 2011 May 12; Washington, DC.


DRA: Aging, Older Veterans' Health and Care, Cardiovascular Disease
DRE: Epidemiology, Prevention
Keywords: Career Development, Outcomes
MeSH Terms: none