Phillip Lam
MedStar Washington Hospital Center
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Publication
Featured researches published by Phillip Lam.
International Journal of Cardiology | 2017
Phillip Lam; Daniel Dooley; Chakradhari Inampudi; Cherinne Arundel; Gregg C. Fonarow; Javed Butler; Wen-Chih Wu; Marc R. Blackman; Markus S. Anker; Prakash Deedwania; Michel White; Sumanth D. Prabhu; Charity J. Morgan; Thomas E. Love; Wilbert S. Aronow; Richard M. Allman; Ali Ahmed
BACKGROUND Therapy with evidence-based heart failure (HF) medications has been shown to be associated with lower risk of 30-day all-cause readmission in patients with HF and reduced ejection fraction (HFrEF). METHODS We examined the association of aldosterone antagonist use with 30-day all-cause readmission in this population. Of the 2443 Medicare beneficiaries with HF and left ventricular EF ≤35% discharged home from 106 Alabama hospitals during 1998-2001, 2060 were eligible for spironolactone therapy (serum creatinine ≤2.5 for men and ≤2mg/dl for women, and serum potassium <5mEq/L). After excluding 186 patients already receiving spironolactone on admission, the inception cohort consisted of 1874 patients eligible for a new discharge prescription for spironolactone, of which 329 received one. Using propensity scores for initiation of spironolactone therapy, we assembled a matched cohort of 324 pairs of patients receiving and not receiving spironolactone balanced on 34 baseline characteristics (mean age 72years, 42% women, 33% African American). RESULTS Thirty-day all-cause readmission occurred in 17% and 19% of matched patients receiving and not receiving spironolactone, respectively (hazard ratio [HR], 0.92; 95% confidence interval [CI], 0.64-1.32; p=0.650). Spironolactone had no association with 30-day all-cause mortality (HR, 0.84; 95% CI, 0.38-1.88; p=0.678) or HF readmission (HR, 0.74; 95% CI, 0.41 1.31; p=0.301). These associations remained unchanged during 12months of post-discharge follow-up. CONCLUSION A discharge prescription for spironolactone had no association with 30-day all-cause readmission among older, hospitalized Medicare beneficiaries with HFrEF eligible for spironolactone therapy.
European Journal of Heart Failure | 2018
Phillip Lam; Daniel Dooley; Gregg C. Fonarow; Javed Butler; Deepak L. Bhatt; Gerasimos Filippatos; Prakash Deedwania; Daniel E. Forman; Michel White; Ross D. Fletcher; Cherinne Arundel; Marc R. Blackman; Chris Adamopoulos; Ioannis Kanonidis; Inmaculada Aban; Kanan Patel; Wilbert S. Aronow; Richard M. Allman; Stefan D. Anker; Bertram Pitt; Ali Ahmed
To examine associations of below‐target and target dose of enalapril, an angiotensin‐converting enzyme (ACE) inhibitor, with outcomes in patients with heart failure and reduced ejection fraction (HFrEF) in the Studies of Left Ventricular Dysfunction (SOLVD) Treatment trial.
International Journal of Cardiology | 2017
Apostolos Tsimploulis; Helen Sheriff; Phillip Lam; Daniel Dooley; Markus S. Anker; Vasilios Papademetriou; Ross D. Fletcher; Charles Faselis; Gregg C. Fonarow; Prakash Deedwania; Michel White; Miroslava Valentova; Marc R. Blackman; Maciej Banach; Charity J. Morgan; Kannayiram Alagiakrishnan; Richard M. Allman; Wilbert S. Aronow; Stefan D. Anker; Ali Ahmed
BACKGROUND Isolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults. METHODS In the Cardiovascular Health Study (CHS), 5776 community-dwelling adults≥65years had data on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP<60mmHg (n=821), DBP≥90 and SBP<140mmHg (n=28), normal BP, taking anti-hypertensive drugs (n=1138), normal BP, not taking anti-hypertensive drugs, history of hypertension (n=193), and baseline HF (n=101). Of the remaining 3495, 1838 had ISH (SBP≥140 and DBP<90mmHg) and 240 had SDH (SBP≥140 and DBP≥90mmHg). The main outcome was centrally-adjudicated incident HF over 13years of follow-up. RESULTS Participants had a mean (±SD) age of 73 (±6)years, 57% were women, and 16% African American. Incident HF occurred in 25%, 22% and 11% of participants with ISH, SDH and no hypertension, respectively. Compared to no hypertension, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident HF associated with ISH and SDH were 1.86 (1.51-2.30) and 1.73 (1.23-2.42), respectively. Cardiovascular mortality occurred in 22%, 24% and 9% of those with ISH, SDH and no hypertension, respectively with respective multivariable-adjusted HRs (95% CIs) of 1.88 (1.49-2.37) and 2.30 (1.64-3.24). CONCLUSION Among older adults with hypertension, both SDH and ISH have similar associations with incident HF and cardiovascular mortality.
Journal of the American College of Cardiology | 2016
Samad Zaheeruddin; Phillip Lam; Lakshmi Tummala; Umberto Campia
Interventricular septal hematoma is a rare occurrence involving dissection of the myocardium. It can result from myocardial infarction, trauma, surgery, or percutaneous coronary intervention (PCI). Management is not well defined. A 72 year old male presented with chest pain. His medical history was
Journal of the American College of Cardiology | 2018
Syed Z. Qamer; Harish Jarrett; Phillip Lam; Helen Sheriff; Cherinne Arundel; Fahad K. Lodhi; Prakash Deedwania; Javed Butler; Gregg C. Fonarow; Ali Ahmed
Heart failure (HF) is the leading cause of 30-day all-cause readmission. Diuretics are often used to achieve and maintain euvolemia. However, they may cause neurohormonal activation and electrolyte imbalance and their use may increase the risk of long-term poor outcomes. We examined the association
Journal of the American College of Cardiology | 2018
Cherinne Arundel; Helen Sheriff; Fahad K. Lodhi; Charity J. Morgan; Steven Singh; Phillip Lam; Selma F. Mohammed; Charles Faselis; Gregg C. Fonarow; Ali Ahmed
Determining a 6mo life expectancy for hospice referral may be challenging in heart failure (HF) patients, especially in HFpEF. We conducted 2 case-control studies to identify admission clinical features associated with 6-month poor outcomes in HFpEF and HFrEF. In Medicare-linked OPTIMIZE-HF, 8873
Journal of the American College of Cardiology | 2018
Amiya Ahmed; Evangelos Kanonidis; Markus S. Anker; Apostolos Tsimploulis; Phillip Lam; Helen Sheriff; Prakash Deedwania; Wilbert S. Aronow; Gregg C. Fonarow; Ali Ahmed
Cigarette smoking is a risk factor for heart failure (HF; PMC5499230), but in patients hospitalized for HF smoking has a paradoxical short-term beneficial association (PMID: 18487210). We examined the association of smoking with long-term outcomes in HFpEF. Of the 8873 patients hospitalized for HF
Journal of the American College of Cardiology | 2018
Poonam Bhyan; Phillip Lam; Apostolos Tsimploulis; Helen Sheriff; Charles Faselis; Prakash Deedwania; Wilbert S. Aronow; Gregg C. Fonarow; Ali Ahmed
According to the 2017 update of 2013 ACCF/AHA HF guideline, SBP should be lowered to <130 mmHg in patients with HFpEF and HTN. However, less is known about the association of lower SBP and outcomes in HFpEF without HTN. Of the 8873 hospitalized patients with HF and EF ≥50% in Medicare-linked
Clinical Cardiology | 2018
Phillip Lam; Poonam Bhyan; Cherinne Arundel; Daniel Dooley; Helen Sheriff; Selma F. Mohammed; Gregg C. Fonarow; Charity J. Morgan; Wilbert S. Aronow; Richard M. Allman; Finn Waagstein; Ali Ahmed
Digoxin use has been associated with a lower risk of 30‐day all‐cause admission and readmission in patients with heart failure and reduced ejection fraction (HFrEF).
Journal of the American College of Cardiology | 2017
Poonam Bhyan; Apostolos Tsimploulis; Daniel Dooley; Phillip Lam; Cherinne Arundel; Prakash Deedwania; Gregg Fonarow; Javed Butler; Michelle White; Wen-Chih Wu; Wilbert Aronow; Ioannis Kanonidis; Charity Morgan; Bertram Pitt; Marc Blackman; Deepak Bhatt; Aliy Ahmed
Background: In the DIG trial, 6800 patients with HFrEF (EF≤45%) were randomized to receive either placebo (n=3403) or digoxin (n=3397) and followed for a mean of 37 months. Digoxin significantly reduced the risk of HFH by 28% (HR, 0.72; 95% CI, 0.66–0.79). However, 27% of patients in the digoxin