Acute Coronary Syndromes (ACS), the usual reason for hospitalization of patients with coronary heart disease, is common and high-risk. Despite remarkable advances in the management of ACS in recent decades, unrealized health gains remain from underuse of available evidence for post-ACS patients. The proposed Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) will recruit a new longitudinal cohort of post-ACS patients, conduct two research projects using the cohort, and develop the careers of four early stage investigators (ESIs). We have 4 specific aims. 1) We will recruit and follow for 2 years a COHORT of 2,500 individuals, age 21-I-, 18% African-American and 10% Hispanic, at the time of their discharge from an ACS hospitalization at 8 medical centers in Massachusetts and Georgia. We will abstract medical records from the index and subsequent hospitalizations and outpatient records. Patient interviews at the time of discharge and at 2 and 6 weeks, and 3, 12, and 24 months later will include measurements of quality of life (QoL), cognitive impairment, adherence to medications, and health related behaviors. 2) TRANSITIONS PROJECT: We will characterize the 90-day transition process for patients discharged after an ACS. We will engage a national panel to develop an evidence-based Transition Measurement Set reflecting the first 90 days after discharge and going beyond existing systems that focus on the discharge process. We will test hypotheses on the associations between quality of care and outcomes (including rehospitalization and QoL), particularly as they pertain to health disparities. 3) ACTION SCORES PROJECT: We will develop and validate two novel """"""""Action Scores"""""""" that predict clinical events/mortality and QoL and which emphasize modifiable aspects of health care delivery and patient behaviors. 4) Using TRACE-CORE as a training laboratory, we will develop the CVD outcomes research careers of the four ESIs. This will include structured mentoring, key involvement of the ESIs astheco-PIs in the research projects, and preparation of new research proposals based on the TRACE-CORE infrastructure and findings. Our team involves prominent CVD outcomes researchers, methodologists, cardiologists, and other clinicians. Our innovative Action Scores should activate patients and providers to improve CVD outcomes;our Transitions Project will fill important knowledge gaps. Future studies will benefit from our data, infrastructure, Action Scores, and transition measures;building on these will also underpin the careers of future CVD outcomes researchers.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL105268-03
Application #
8312651
Study Section
Special Emphasis Panel (ZHL1-CSR-J (S1))
Program Officer
Cook, Nakela L
Project Start
2010-09-30
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
3
Fiscal Year
2012
Total Cost
$1,452,745
Indirect Cost
$470,054
Name
University of Massachusetts Medical School Worcester
Department
Other Health Professions
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655
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Hebert, Kasey M; Moore Simas, Tiffany A; Okwara, Noreen C et al. (2018) Is perception of excessive weight gain in a woman's last pregnancy associated with less weight gain in her current pregnancy? J Obstet Gynaecol :1-2
Waring, Molly E; McManus, David D; Amante, Daniel J et al. (2018) Online health information seeking by adults hospitalized for acute coronary syndromes: Who looks for information, and who discusses it with healthcare providers? Patient Educ Couns 101:1973-1981
Tisminetzky, Mayra; Nguyen, Hoa L; Gurwitz, Jerry H et al. (2018) Magnitude and impact of multiple chronic conditions with advancing age in older adults hospitalized with acute myocardial infarction. Int J Cardiol 272:341-345
Waring, Molly E; Moore Simas, Tiffany A; Oleski, Jessica et al. (2018) Feasibility and Acceptability of Delivering a Postpartum Weight Loss Intervention via Facebook: A Pilot Study. J Nutr Educ Behav 50:70-74.e1
Hajduk, Alexandra M; Hyde, Jacquelyn E; Waring, Molly E et al. (2018) Practical Care Support During the Early Recovery Period After Acute Coronary Syndrome. J Appl Gerontol 37:881-903
Li, Lin; Jesdale, Bill M; Hume, Anne et al. (2018) Who are they? Patients with heart failure in American skilled nursing facilities. J Cardiol 71:428-434
Nobel, Lisa; Jesdale, William M; Tjia, Jennifer et al. (2017) Neighborhood Socioeconomic Status Predicts Health After Hospitalization for Acute Coronary Syndromes: Findings From TRACE-CORE (Transitions, Risks, and Actions in Coronary Events-Center for Outcomes Research and Education). Med Care 55:1008-1016
Li, Lin; Jesdale, Bill M; Hume, Anne et al. (2017) Pharmacotherapy Use in Older Patients With Heart Failure and Reduced Ejection Fraction After a Skilled Nursing Facility Stay. J Card Fail 23:843-851
Bostrom, John A; Saczynski, Jane S; Hajduk, Alexandra et al. (2017) Burden of Psychosocial and Cognitive Impairment in Patients With Atrial Fibrillation. Crit Pathw Cardiol 16:71-75

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