{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:08:11Z","timestamp":1783523291928,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The significant morbidity associated with systolic heart failure makes it imperative to identify patients with a reversible cause. We thus sought to evaluate the proportion of patients who received an ischemic evaluation after a hospitalization for new\u2010onset systolic heart failure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients admitted with a new diagnosis of heart failure and a reduction in left ventricular ejection fraction (\u226440%) were identified in the VA Healthcare System from January 2006 to August 2017. Among those who survived 90\u00a0days without a readmission, we evaluated the proportion of patients who underwent an ischemic evaluation. We identified 9625 patients who were admitted with a new diagnosis of systolic heart failure with a concomitant reduction in ejection fraction. A minority of patients (3859, 40%) underwent an ischemic evaluation, with significant variation across high\u2010performing (90th percentile) and low\u2010performing (10th percentile) sites (odds ratio, 3.79; 95% CI, 2.90\u20134.31). Patients who underwent an evaluation were more likely to be treated with angiotensin\u2010converting enzyme inhibitors (75% versus 64%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or beta blockers (92% versus 82%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and subsequently undergo percutaneous (8% versus 0%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or surgical (2% versus 0%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) revascularization. Patients with an ischemic evaluation also had a significantly lower adjusted hazard of all\u2010cause mortality (hazard ratio, 0.54; 95% CI, 0.47\u20130.61) compared with those without an evaluation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ischemic evaluations are underutilized in patients admitted with heart failure and a new reduction in left ventricular systolic function. A focused intervention to increase guideline\u2010concordant care could lead to an improvement in clinical outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019452","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T11:45:17Z","timestamp":1613389517000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Association of Ischemic Evaluation and Clinical Outcomes Among Patients Admitted With New\u2010Onset Heart Failure"],"prefix":"10.1161","volume":"10","author":[{"given":"Erin","family":"McGuinn","sequence":"first","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"},{"name":"University of Colorado School of Medicine Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Warsavage","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Plomondon","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"},{"name":"University of Colorado School of Medicine Aurora CO"},{"name":"CART Program VHA Office of Quality and Patient Safety Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9588-2808","authenticated-orcid":false,"given":"Javier A.","family":"Valle","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"},{"name":"University of Colorado School of Medicine Aurora CO"},{"name":"CART Program VHA Office of Quality and Patient Safety Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Michael","family":"Ho","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"},{"name":"University of Colorado School of Medicine Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0678-4873","authenticated-orcid":false,"given":"Stephen W.","family":"Waldo","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center Aurora CO"},{"name":"University of Colorado School of Medicine Aurora CO"},{"name":"CART Program VHA Office of Quality and Patient Safety Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000039105.49749.6F"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000558"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.12.047"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/HHF.0b013e318291329a"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.000138"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-10-1164"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003255"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003770"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8807"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.060"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020579806511"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.197"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.02.020"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.08.045"},{"key":"e_1_3_2_16_2","unstructured":"US Department of Veterans Affairs . 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