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 #
5U01HL105268-04
Application #
8528699
Study Section
Special Emphasis Panel (ZHL1-CSR-J (S1))
Program Officer
Bonds, Denise
Project Start
2010-09-30
Project End
2014-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
4
Fiscal Year
2013
Total Cost
$1,355,048
Indirect Cost
$435,722
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
Ramos, Sebastian Z; Waring, Molly E; Leung, Katherine et al. (2017) Attempted and Successful Vacuum-Assisted Vaginal Delivery by Prepregnancy Body Mass Index. Obstet Gynecol 129:311-320
Hshieh, Tammy T; Saczynski, Jane; Gou, Ray Yun et al. (2017) Trajectory of Functional Recovery After Postoperative Delirium in Elective Surgery. Ann Surg 265:647-653
Li, Lin; Jesdale, Bill M; Hume, Anne et al. (2017) Who are they? Patients with heart failure in American skilled nursing facilities. J Cardiol :
Erskine, Nathaniel A; Gandek, Barbara; Waring, Molly E et al. (2017) Survivors of an Acute Coronary Syndrome With Lower Patient Activation Are More Likely to Experience Declines in Health-Related Quality of Life. J Cardiovasc Nurs :
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
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
Torres Stone, Rosalie A; Waring, Molly E; Cutrona, Sarah L et al. (2017) The association of dietary quality with colorectal cancer among normal weight, overweight and obese men and women: a prospective longitudinal study in the USA. BMJ Open 7:e015619
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
Tisminetzky, Mayra; Goldberg, Robert; Gurwitz, Jerry H (2016) Magnitude and Impact of Multimorbidity on Clinical Outcomes in Older Adults with Cardiovascular Disease: A Literature Review. Clin Geriatr Med 32:227-46
Wanigatunga, Amal A; Sourdet, Sandrine S; LaMonte, Michael J et al. (2016) Physical impairment and body weight history in postmenopausal women: the Women's Health Initiative. Public Health Nutr 19:3169-3177

Showing the most recent 10 out of 134 publications