The purpose of this revised NIA K23 award application (1 K23 AG19211-01A1) is to provide the candidate, Ali Ahmed, MD, MPH, a fellowship trained geriatrician with additional training and research experience that will enable him to become an independent investigator in geriatric outcomes research with a special focus on heart failure. Dr. Ahmed has conducted secondary analyses of an Alabama Quality Assurance Foundation (AQAF) database (N =1,000) to study correlates and outcomes of ACE inhibitors in older adults with heart failure. These studies have resulted in fifteen first-authored manuscripts (one published, nine in press/accepted, three under review and two in preparation) over the last four years. In this current application, he proposes to build upon his previous experience in health services and epidemiological research to conduct a series of analyses of a much larger database derived from the CMS-funded Alabama Heart Failure Project (N = 10,000), reflecting heart failure cases discharged between 1998 and 2001. His research will permit him to define correlates of beta-blocker use and the association between beta-blocker use and one-year mortality and hospitalization in older adults with heart failure. The candidate will learn and use advanced outcomes research methodologies such as multivariate models for risk adjustment, including propensity scores and instrumental variables. He also proposes to conduct a pilot intervention study during the last three years of the award period to increase the use of ACE inhibitor and beta-blockers in older adults with heart failure. He plans to use the results and the experience of these studies to apply for an R01 research grant during the last two years of the award period. In addition, he will also develop plans for a pilot study in collaboration with Louis Dell'Italia, MD (UAB Cardiology and Physiology) to provide mechanistic insight into one of the important findings of the above studies. Dr. Ahmed proposes a career development plan that includes coursework and fieldwork at the University of Alabama at Birmingham (UAB) and at the AQAF. His primary sponsor Richard M. AIIman, MD (UAB Geriatrics) and co-sponsors Louis Dell'Italia, MD and Catarina Kiefe, PhD, MD (UAB Preventive Medicine and Biostatistics), in collaboration with a team of other senior UAB and external faculty will supervise his training and research activities. A graduate of the NIA Summer Institute on Aging Research and NIH K30 Clinical Research Training Program, his long-term goal is to attain independence as an investigator in the field of patient-oriented heart failure outcomes research in older adults and study various factors associated with outcomes in older adults with heart failure and to design appropriate interventions to improve outcomes. The proposed training and research will provide him the necessary skills and experience to advance his career to the next phase, in becoming an independent investigator in outcomes research involving heart failure in older adults.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Nayfield, Susan G
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University of Alabama Birmingham
Internal Medicine/Medicine
Schools of Medicine
United States
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Lam, Phillip H; Dooley, Daniel J; Inampudi, Chakradhari et al. (2017) Lack of evidence of lower 30-day all-cause readmission in Medicare beneficiaries with heart failure and reduced ejection fraction discharged on spironolactone. Int J Cardiol 227:462-466
Sanam, Kumar; Bhatia, Vikas; Bajaj, Navkaranbir S et al. (2016) Renin-Angiotensin System Inhibition and Lower 30-Day All-Cause Readmission in Medicare Beneficiaries with Heart Failure. Am J Med 129:1067-73
Kheirbek, Raya E; Fletcher, Ross D; Bakitas, Marie A et al. (2015) Discharge Hospice Referral and Lower 30-Day All-Cause Readmission in Medicare Beneficiaries Hospitalized for Heart Failure. Circ Heart Fail 8:733-40
Feller, Margaret A; Mujib, Marjan; Zhang, Yan et al. (2012) Baseline characteristics, quality of care, and outcomes of younger and older Medicare beneficiaries hospitalized with heart failure: findings from the Alabama Heart Failure Project. Int J Cardiol 162:39-44
Perry, Gilbert J; Ahmed, Mustafa I; Desai, Ravi V et al. (2011) Left ventricular diastolic function and exercise capacity in community-dwelling adults ?65 years of age without heart failure. Am J Cardiol 108:735-40
Adamopoulos, Chris; Ahmed, Ali; Fay, Renaud et al. (2009) Timing of eplerenone initiation and outcomes in patients with heart failure after acute myocardial infarction complicated by left ventricular systolic dysfunction: insights from the EPHESUS trial. Eur J Heart Fail 11:1099-105
Ahmed, Mustafa I; White, Michel; Ekundayo, O James et al. (2009) A history of atrial fibrillation and outcomes in chronic advanced systolic heart failure: a propensity-matched study. Eur Heart J 30:2029-37
Ekundayo, O James; Markland, Alayne; Lefante, Christina et al. (2009) Association of diuretic use and overactive bladder syndrome in older adults: a propensity score analysis. Arch Gerontol Geriatr 49:64-8
Ahmed, Ali; Allman, Richard M; Fonarow, Gregg C et al. (2008) Incident heart failure hospitalization and subsequent mortality in chronic heart failure: a propensity-matched study. J Card Fail 14:211-8
Ahmed, Ali; Young, James B; Love, Thomas E et al. (2008) A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure. Int J Cardiol 125:246-53

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