Publications by authors named "Nimish N Shah"
Multimodality Evaluation of Spontaneous Coronary Artery Dissection in a Patient With Connective Tissue Disease: A Case Report.
J Soc Cardiovasc Angiogr Interv
August 2023
Pragmatic Trial of Messaging to Providers About Treatment of Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial.
Circ Cardiovasc Qual Outcomes
May 2024
Background: Lipid-lowering therapy (LLT) is underutilized for very high-risk atherosclerotic cardiovascular disease. PROMPT-LIPID (PRagmatic Trial of Messaging to Providers about Treatment of HyperLIPIDemia) sought to determine whether electronic health record (EHR) alerts improve 90-day LLT intensification in patients with very high-risk atherosclerotic cardiovascular disease.
Methods: PROMPT-LIPID was a pragmatic trial in which cardiovascular and internal medicine clinicians within Yale New Haven Health (New Haven, CT) were cluster-randomized to receive an EHR alert with individualized LLT recommendations or no alert for outpatients with very high-risk atherosclerotic cardiovascular disease and LDL-C (low-density lipoprotein cholesterol), ≥70 mg/dL.
Article Synopsis
- Guidelines recommend using 3D echocardiography (3DE) for assessing left ventricular ejection fraction (LVEF) in transthoracic echocardiograms (TTE), but actual reporting rates depend on various factors.
- In a study analyzing 35,641 TTEs performed at a medical center, 51.6% reported 3DE LVEF, with outpatient TTEs showing higher rates than portable inpatient exams.
- The study found that the performing sonographer plays a crucial role in reporting rates, highlighting the need for improved training and initiatives to boost 3DE usage in diverse clinical settings.
Background: Despite guideline recommendations to optimize low-density lipoprotein cholesterol (LDL-C) reduction with intensification of lipid-lowering therapy (LLT) in patients with atherosclerotic cardiovascular disease (ASCVD), few of these patients achieve LDL-C < 70 mg/dL in practice.
Purpose: We developed a real-time, targeted electronic health record (EHR) alert with embedded ordering capability to promote intensification of evidence based LLT in outpatients with very high risk ASCVD.
Methods: We designed a pragmatic, multicenter, single-blind, cluster randomized trial to test the effectiveness of an EHR-based LLT intensification alert.
A High-Value Care Initiative to Reduce the Use of Intravenous Magnesium Sulfate Through an Electronic Indication-Based Order Set.
Jt Comm J Qual Patient Saf
December 2021
Background: Intravenous (IV) magnesium sulfate (MgSO) supplementation is common despite limited indications. Oral magnesium oxide (MgO) is an effective, lower-cost alternative. This project aimed to reduce IV MgSO use by 20% among the Internal Medicine (IM) service.
View Article and Find Full Text PDFA young man who presented with chest trauma from multiple gunshot wounds was found to have regional ST-segment elevations perioperatively. This case describes the rapid evaluation and clinical management by a multidisciplinary consultative team pursued for this unusual presentation of cardiac injury. ().
View Article and Find Full Text PDFBackground: Red blood cell (RBC) transfusion is an important treatment modality during severe sickle cell crisis (SCC). SCC patients who refuse, or cannot accept, RBCs present a unique challenge. Acellular hemoglobin (Hb)-based oxygen carriers (HBOCs) might be an alternative for critically ill patients in SCC with multiorgan failure due to life-threatening anemia.
View Article and Find Full Text PDFUnlabelled: The aim of this study was to assess myocardial blush (MB) using a novel software algorithm that quantifies time-density curves (TDC) after percutaneous coronary intervention (PCI).
Methods: Thirty-two patients referred for elective PCI were enrolled. TDC curves were generated and mean maximal myocardial contrast density (Dmax) was calculated from 5 regions of interest in the PCI territory.