Harlan M. Krumholz

Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health (Cardiology)
Section of Cardiovascular Medicine

Research Interests

Outcomes Research in Cardiovascular Disease

My research is focused on determining optimal clinical strategies and identifying opportunities for improvement in the prevention, treatment and outcome of cardiovascular disease with emphasis on under-represented populations. Using methods of clinical epidemiology and health services research, I have sought to illuminate the balance of risks, benefits and costs of specific clinical approaches. The research efforts are intended to provide critical information to improve the quality of health care, monitor changes over time, and guide decisions about the allocation of scarce resources.

I am currently leading initiatives through the Centers for Medicare and Medicaid Services (CMS) to develop national mortality measures for public reporting of hospital performance. In an effort to investigate ways that hospitals can improve outcomes through decreasing door-to-balloon times, I initiated and chair the steering committee of D2B: An Alliance for Quality, an international campaign launched by the American College of Cardiology to implement key evidence-based strategies to achieve guideline recommended door-to-balloon times. I also serve as Principal Investigator on two multi-center projects sponsored by the National Heart, Lung, and Blood Institute: the VIRGO study, an investigation of issues surrounding the care and outcomes of young women with acute myocardial infarction; and a study examining the effect of a telemonitoring strategy on the outcomes of patients with heart failure.

McNamara RL, Herrin J, Bradley EH, Portnay EL, Curtis JP, Wang Y-F, Magid DJ, Blaney M, Krumholz HM for the NRMI Investigators. Hospital improvement in time to reperfusion in patients with acute myocardial infarction, 1999-2002. J Am Coll Cardiol 2006;47:45-51.

Nallamothu BK, Wang Y-F, Magid DJ, McNamara RL, Herrin J, Bradley EH, Bates ER, Pollack CV, Jr., Krumholz HM. National Registry of Myocardial Infarction Investigators. Relation between hospital specialization with primary percutaneous coronary intervention and clinical outcomes in ST-segment elevation myocardial infarction. National Registry of Myocardial Infarction-4 analysis. Circulation 2006;113:222-229.

Bradley EH, Curry LA, Webster TR, Mattera JA, Roumanis SA, Radford MJ, McNamara RL, Barton BA, Berg DN, Krumholz HM. Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. Circulation 2006;113:1079-1085.

Foody JM, Shah R, Galusha D, Masoudi FA, Havranek EP, Krumholz HM. Statins and mortality among elderly patients hospitalized with heart failure. Circulation 2006;113:1086-1092.

Nallamothu BK, Bates ER, Wang Y-F, Bradley EH, Krumholz HM. Driving times and distances to hospitals with percutaneous coronary intervention in the United States: implications for prehospital triage of patients with ST-elevation myocardial infarction. Circulation 2006;113:1189-1195.

Spertus JA, Peterson E, Rumsfeld JS, Jones PG, Decker C, Krumholz HM. The Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER): evaluating the impact of myocardial infarction on patient outcomes. Am Heart J 2006;151:589-597.

Ross JS, Gross CP, Desai MM, Hong Y, Grant AO, Daniels SR, Hachinski VC, Gibbons RJ, Gardner TJ, Krumholz HM. Effect of blinded peer review on abstract acceptance. JAMA 2006;295:1675-1680.

Krumholz HM, Wang Y, Mattera JA, Wang Y-F, Han LF, Ingber MJ, Roman S, Normand S-LT. An administrative claims model suitable for profiling hospital performance based upon 30-day mortality rates among patients with an acute myocardial infarction. Circulation 2006;113:1683-1692.

Krumholz HM, Wang Y, Mattera JA, Wang Y-F, Han LF, Ingber MJ, Roman S, Normand S-LT. An administrative claims model suitable for profiling hospital performance based upon 30-day mortality rates among patients with heart failure. Circulation 2006;113;1693-1701.

Curtis JP, Portnay EL, Wang Y-F, McNamara RL, Herrin J, Bradley EH, Magid DJ, Blaney ME, Canto JG, Krumholz HM. The pre-hospital electrocardiogram and time to reperfusion in patients with acute myocardial infarction, 2000-2002. Findings from the National Registry of Myocardial Infarction-4. J Am Coll Cardiol 2006;47:1544-1552.

McNamara RM, Wang Y-F, Herrin J, Curtis JP, Bradley EH, Magid DJ, Peterson ED, Blaney M, Frederick PD, Krumholz HM for the NRMI Investigators. Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol 2006;47:2180-2186.

Chen J, Rathore SS, Wang Y-F, Radford MJ, Krumholz HM. Physician board certification and the care and outcomes of elderly patients with acute myocardial infarction. J Gen Intern Med 2006;21:238-244.

Smith GL, Shlipak MG, Havranek EP, Foody JM, Masoudi FA, Rathore SS, Krumholz HM. Serum urea nitrogen, creatinine, and estimators of renal function: mortality in older patients with cardiovascular disease. Arch Intern Med 2006;166:1134-1142.

Smith G, Lichtman JH, Bracken MB, Shlipak MG, Phillips CO, DiCapua P, Krumholz HM. Renal impairment and outcomes in heart failure: systematic review and meta-analysis. J Am Coll Cardiol 2006;47:1987-1996.

Bradley EH, Herrin J, Wang Y-F, McNamara RL, Radford MJ, Magid DJ, Canto JG, Blaney M, Krumholz HM. Door-to-drug and door-to-balloon times: where can we improve? Time to reperfusion therapy in patients with ST-elevation myocardial infarction (STEMI). Am Heart J 2006;151:1281-1287.

Spertus JA, Kettelkamp R, Vance C, Decker C, Jones PG, Rumsfeld JS, Messenger JC, Khanal S, Peterson ED, Bach RG, Krumholz HM, Cohen DJ. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation 2006;113:2803-2809.

Kosiborod M, Lichtman JH, Heidenreich PA, Normand S-LT, Wang Y, Brass LM, Krumholz HM. National trends in outcomes among elderly patients with heart failure. Am J Med 2006;119;616:e1-7.

Horwitz LI, Krumholz HM, Green ML, Huot SJ. Transfers of patient care between house staff on internal medicine wards: a national survey. Arch Intern Med 2006;166:1173-1177.

Bradley EH, Herrin J, Elbel B, McNamara RL, Magid DJ, Nallamothu BK, Wang Y, Normand S-L, Spertus JA, Krumholz HM. Hospital quality for acute myocardial infarction: correlation among process measures and relationship with short-term mortality. JAMA 2006;296;72-78.

Nallamothu BK, Payvar S, Wang Y-F, Kosiborod M, Masoudi FA, Havranek EP, Foody JM, Casscells SW, Krumholz HM. Admission body temperature and mortality in elderly patients hospitalized for heart failure. J Am Coll Cardiol 2006;47:2563-2564.

Coca SG, Krumholz HM, Garg AX, Parikh CR. Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease. JAMA 2006;296:1377-1384.

Rathore SS, Masoudi FA, Wang Y-F, Curtis JP, Foody JM, Havranek EP, Krumholz HM. Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: findings from the National Heart Failure Project. Am Heart J 2006;152:371-378.

Lichtman JH, Fathi A, Radford MJ, Lin ZQ, Loeser CS, Krumholz HM. Acute, severe noncardiac conditions in patients with acute myocardial infarction. Am J Med 2006;119:843-850.

Ho PM, Spertus JA, Masoudi FA, Reid KJ, Peterson ED, Magid DJ, Krumholz HM, Rumsfeld JS. Impact of medication therapy discontinuation on mortality after myocardial infarction. Arch Intern Med 2006;166:1842-1847.

Parikh CR, Coca SG, Smith GL, Vaccarino V, Krumholz HM. Impact of chronic kidney disease on health-related quality-of-life improvement after coronary artery bypass surgery. Arch Intern Med 2006;166:2014-2019.

Sedrakyan A, Vaccarino V, Elefteriades JA, Mattera JA, Lin ZQ, Roumanis SA, Krumholz HM. Health related quality of life after mitral valve repairs and replacements. Qual Life Res 2006;15:1153-1160.

Parashar S, Rumsfeld JS, Spertus JA, Reid KJ, Wenger NK, Krumholz HM, Amin A, Weintraub WS, Lichtman J, Dawood N, Vaccarino V. Time course of depression and outcome of myocardial infarction. Arch Intern Med 2006;166:2035-2043.

Gross CP, McAvay GJ, Krumholz HM, Paltiel AD, Bhasin D, Tinetti ME. The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening. Ann Intern Med 2006;145:646-653.

Kashani A, Phillips CO, Foody JM, Wang Y-F, Mangalmurti S, Ko DT, Krumholz HM. Risks associated with statin therapy. A systematic overview of randomized clinical trials. Circulation 2006;114:2788-2797.

Gross CP, Andersen MS, Krumholz HM, McAvay GJ, Proctor D, Tinetti ME. Relation between Medicare screening reimbursement and stage at diagnosis for older patients with colon cancer. JAMA 2006;296:2815-2822.

Bradley EH, Herrin J, Wang Y-F, Barton BA, Webster TR, Mattera JA, Roumanis SA, Curtis JP, Nallamothu BK, Magid DJ, McNamara RL, Parkosewich J, Loeb JM, Krumholz HM. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006;355:2308-2320.

Masoudi FA, Foody JM, Havranek EP, Wang Y, Radford MJ, Allman RM, Gold J, Wiblin T, Krumholz HM. Trends in acute myocardial infarction in four US states between 1992 and 2001: clinical characteristics, quality of care, and outcomes. Circulation 2006;114:2806-2814.

Rathore SS, Epstein AJ, Nallamothu BK, Krumholz HM. Regionalization of ST-elevation acute coronary syndromes care: putting a national policy in proper perspective. J Am Coll Cardiol 2006;47:1346-1349.

Nunez Smith M, Curry LA, Bigby JA, Berg D, Krumholz HM. Impact of race on the professional lives of physicians of African descent. Ann Intern Med 2007;146:45-51.

Ross JS, Cha SS, Epstein AJ, Wang Y-F, Bradley EH, Herrin J, Lichtman JH, Normand S-LT, Masoudi FA, Krumholz HM. Quality of care for acute myocardial infarction at urban safety-net hospitals. Health Affairs 2007;26:238-248.

Krumholz HM, Normand S-LT, Spertus JA, Shahian DM, Bradley EH. Measuring performance for treating heart attacks and heart failure: the case for outcomes measurement. Health Affairs 2007;26:75-85.

Bernheim SM, Spertus JA, Reid KJ, Bradley EH, Desai RA, Peterson ED, Rathore SS, Normand S-LT, Jones PG, Rahimi A, Krumholz HM. Socioeconomic disparities in outcomes after acute myocardial infarction. Am Heart J 2007;153:313-319.

Rahimi AR, Spertus JA, Reid KJ, Bernheim SM, Krumholz HM. Financial barriers to health care and outcomes after acute myocardial infarction. JAMA 2007;297:1063-1072.

Ross JS, Lackner JE, Lurie P, Gross CP, Wolfe S, Krumholz HM. Pharmaceutical company payments to physicians: early experiences with disclosure laws in Vermont and Minnesota. JAMA 2007;297:1216-1223.

Nallamothu BK, Rogers MA. Chernew ME, Krumholz HM, Eagle KA, Birkmeyer JD. Opening of specialty cardiac hospitals and use of coronary revascularization in Medicare beneficiaries. JAMA 2007;297:962-968.

Ross JS, Ho V, Wang Y-F, Cha SS, Epstein AJ, Masoudi FA, Nallamothu BK, Krumholz HM. Certificate of need regulation and cardiac catheterization appropriateness after acute myocardial infarction. Circulation 2007;115:1012-1019.

Kosiborod M, Soto GE, Jones PG, Krumholz HM, Weintraub WS, Deedwania P, Spertus JA. Identifying heart failure patients at high risk for near-term cardiovascular events with serial health status assessments. Circulation 2007;115:1975-1981.

Horwitz LI, Cuny J, Cerese J, Krumholz HM. Failure to rescue: validation of an algorithm using administrative data. Med Care 2007;45:283-287.

Curtis JP, Cohen DJ, Jones P, Bach RG, Spertus JA, Krumholz HM. Impact of the Food and Drug Administration’s Public Health Notification on the adoption of drug eluting stents. Am J Cardiol 2007;99:1227-1229.

Morgan TM, Krumholz HM, Lifton RP, Spertus JA. Nonvalidation of reported genetic risk factors for acute coronary syndrome in a large-scale replication study. JAMA 2007;297:1551-1561.

Krumholz HM, Ross JS, Presler AH, Egilman DS. What have we learnt from Vioxx? BMJ 2007;334:120-123.

Ko DT, Krumholz HM, Wang Y, Foody JM, Masoudi FA, Havranek EP, You JJ, Alter DA, Stukel TA, Newman AM, Tu JV. Regional differences in process of care and outcomes for older acute myocardial infarction patients in the United States and Ontario, Canada. Circulation 2007;115:196-203.

Nallamothu BK, Krumholz HM, Ko DT, LaBresh KA, Rathore SS, Roe MT, Schwamm L. Development of systems of care for ST-elevation myocardial infarction patients: gaps, barriers, and implications. Circulation 2007;116:e68-72.

Wang OJ, Wang Y, Lichtman JH, Bradley EH, Normand S-LT, Krumholz HM. “America’s Best Hospitals” in the treatment of acute myocardial infarction. Arch Intern Med 2007;167:1345-1351.

Alexander KP, Newby LK, Cannon CP, Armstrong PW, Gibler WB, Rich MW, Van de Werf F, White HD, Weaver WD, Naylor MD, Gore JM, Krumholz HM, Ohman EM. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology, in collaboration with the Society of Geriatric Cardiology. Circulation 2007:115:2549-2569.

Nallamothu BK, Blaney ME, Morris SM, Parsons L, Miller DP, Canto JG, Barron HV, Krumholz HM for the NRMI Investigators. Acute reperfusion therapy in ST-elevation myocardial infarction from 1994-2003. Am J Med 2007;120:693-699.

Horwitz LI, Kosiborod M, Lin Z, Krumholz HM. Changes in outcomes for internal medicine inpatients after work-hour regulations. Ann Intern Med 2007;147:97-103.

Phillips CO, Kashani A, Ko DT, Francis G, Krumholz HM. Adverse effects of combination angiotensin-II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from randomized clinical trials. Arch Intern Med 2007;167:1930-1936.

Lichtman JH, Spertus JA, Reid KJ, Radford MJ, Rumsfeld JS, Allen N, Masoudi FA, Weintraub WS, Krumholz HM. Acute noncardiac conditions and in-hospital mortality in patients with acute myocardial infarction. Circulation 2007;116:1925-1930.

McNamara RL, Herrin J, Wang Y-F, Curtis JP, Bradley EH, Magid DJ, Rathore SS, Nallamothu BK, Peterson ED, Blaney ME, Frederick P, Krumholz HM. Impact of delay in door-to-needle time on mortality in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2007;100:1227-1232.

Nallamothu BK, Wang Y-F, Bradley EH, Ho KKL, Curtis JP, Rumsfeld JS, Masoudi FA, Krumholz HM. Comparing hospital performance in door-to-balloon time between the Hospital Quality Alliance and the National Cardiovascular Data Registry. J Am Coll Cardiol 2007;50:1517-1519.

Ho V, Ross JS, Nallamothu BK, Krumholz HM. Cardiac certificate of need regulations and the availability and use of revascularization services. Am Heart J 2007;154:767-775.

Chaudhry SI, Wang Y-F, Concato J, Gill TM, Krumholz HM. Patterns of weight change preceding hospitalization for heart failure. Circulation 2007;116:1549-1554.

Nallamothu BK, Bradley EH, Krumholz HM. Time to treatment in primary percutaneous coronary intervention. N Engl J Med 2007;357:1631-1638.

Nallamothu BK, Wang Y-F, Cram P, Birkmeyer JD, Ross JS, Normand S-LT, Krumholz HM. Acute myocardial infarction and congestive heart failure outcomes at specialty cardiac hospitals. Circulation 2007;116:2280-2287.

Krumholz HM. Guideline recommendations and results: the importance of the linkage. Ann Intern Med 2007;147:342-343.

Chan PS, Krumholz HM, Nichol G, Nallamothu BK; American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med 2008;358:9-17.

Education:

B.S., Yale College, 1980 M.D., Harvard Medical School, 1985 MS.c., Harvard School of Public Health, 1992

Contact

Campus Address
Department of Internal Medicine
Yale University
School of Medicine
Box 208088
New Haven, CT
06520-8088

E-mail
harlan.krumholz@yale.edu

Telephone
203.737.1717