Heart Failure and Beta-Blocker Use in Older Adults

老年人心力衰竭和 β 受体阻滞剂的使用

• 批准号: 6629891
• 负责人: ALI AHMED
• 金额: $ 12.33万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6629891
• 关键词: ACE inhibitors; aging; beta antiadrenergic agent; combination chemotherapy; educational resource design /development; epidemiology; gender difference; health care service utilization; health education; heart disorder chemotherapy; heart failure; heart ventricle; hospital utilization; human data; human mortality; human old age (65+); human subject; human therapy evaluation; information dissemination; interview; outcomes research; patient oriented research; postdoctoral investigator

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：该修订后的NIA K23奖励申请（1 K23 AG19211-01A1）的目的是为候选人提供经过奖学金培训的老年医生Ali Ahmed，MD，MPH，提供额外的培训和研究经验，使他能够成为伴有老年抗衰老肠胃失败的独立研究者，并具有特殊的肠胃失败。艾哈迈德博士对阿拉巴马州质量保证基金会（AQAF）数据库（n = 1,000）进行了次要分析，以研究心力衰竭老年人ACE抑制剂的相关性和结果。在过去的四年中，这些研究导致了15份首次创作的手稿（一份发表，《新闻/接受》中的九本书，三项正在审查中，其中2项在准备中进行了准备）。在此目前的应用中，他建议以他以前在卫生服务和流行病学研究的经验为基础，以对来自CMS资助的阿拉巴马州心力衰竭项目（n = 10,000）得出的更大的数据库进行一系列分析，这反映了1998年至2001年之间出现的心力衰竭病例，他的研究将使他的研究能够定义与贝塔蛋白的相关性和贝塔克（Beta Blocker）的相关性，并在beta blocker的使用范围内与Beta-Blocker的相关性以及Beta-blocker的相关性，一定是Beta-blocker的关联，而One Cossication consection and Andera则是Beta-Blocker的相关性。 失败。候选人将学习和使用高级结果研究方法，例如用于调整风险的多元模型，包括倾向分数和工具变量。他还建议在奖励期的最后三年内进行试点干预研究，以增加心力衰竭老年人的ACE抑制剂和β受体阻滞剂的使用。他计划利用这些研究的结果和经验在奖励期的最后两年中申请R01研究赠款。此外，他还将与医学博士Louis Dell'italia（UAB心脏病学和生理学）合作制定试点研究计划，以提供对上述研究的重要发现之一的机械洞察力。艾哈迈德（Ahmed）博士提出了一项职业发展计划，其中包括伯明翰大学（UAB）和AQAF的阿拉巴马大学的课程和实地调查。他的主要赞助商Richard M. Aiiman，医学博士（UAB Geriatrics）和共同赞助商Louis Dell'italia，医学博士Louis Dell'italia和医学博士（UAB预防医学和生物统计学）的Catarina Kiefe，与其他高级UAB和外部教师团队合作，将监督其培训和研究活动。他的长期目标是毕业于NIA夏季衰老研究所和NIH K30临床研究培训计划，是在老年人中以患者为导向的心力衰竭成果研究的研究者的独立性，并研究与心力衰竭的各种因素相关的各种因素，并设计出适当的干预措施以改善结果。拟议的培训和研究将为他提供必要的技能和经验，以将自己的职业发展升级到下一阶段，成为在涉及老年人心力衰竭的结果研究中的独立研究者。