Waqas Qureshi | Wake Forest University (original) (raw)
Papers by Waqas Qureshi
PloS one, 2015
Atrial fibrillation (AF) is a common arrhythmia. Application of metabolomic approaches, which may... more Atrial fibrillation (AF) is a common arrhythmia. Application of metabolomic approaches, which may identify novel pathways and biomarkers of disease risk, to a longitudinal epidemiologic study of AF has been limited. We determined the prospective association of 118 serum metabolites identified through untargeted metabolomics profiling with the incidence of newly-diagnosed AF in 1919 African-American men and women from the Atherosclerosis Risk in Communities study without AF at baseline (1987-1989). Incident AF cases through 2011 were ascertained from study electrocardiograms, hospital discharge codes, and death certificates. During a median follow-up of 22 years, we identified 183 incident AF cases. In Cox proportional hazards models adjusted for age, sex, smoking, body mass index, systolic blood pressure, use of antihypertensive medication, diabetes, prevalent heart failure, prevalent coronary heart disease, and kidney function, two conjugated bile acids (glycolithocholate sulfate a...
Medical Education Online, 2015
The American Board of Internal Medicine (ABIM) exam's pass rate is consid... more The American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002-2006) and post-intervention (2007-2013). A time commitment survey was also given to physicians and DR residents at the end of the study. Residents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p<0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Although residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.
Journal of the American College of Cardiology
... 7272 Greenville Avenue, DOI: 10.1161/CIRCIMAGING.108.831164 published online September 8, 200... more ... 7272 Greenville Avenue, DOI: 10.1161/CIRCIMAGING.108.831164 published online September 8, 2009; Circ Cardiovasc Imaging Mouaz H. Al-Mallah, Rory Hachamovitch, Sharmila Dorbala and Marcelo Di Carli Stress SPECT with Renal Dysfunction Incremental Prognostic ...
International Journal of Hematology
Data from observational studies has shown a relationship of high levels of Von Wille brand factor... more Data from observational studies has shown a relationship of high levels of Von Wille brand factor (VWF) with migraines. We hypothesized that patients with VonWillebrand disease have lower rates of migraine. The aim of this analysis was to determine the rates of migraine in patients with Von Wille brand disease and to identify an association of Von Wille brand disease with migraines. Patients (n =394) with Von Wille brand disease were identified from the hospital database. A careful review of the patients' clinical records was carried out to authenticate the Von Wille brand disease. Analyses were based on clinic visits for headaches as defined by International Headache Society criteria during a follow up of 25 years (1985 -2010). Samples of 197 patients were finalized for which random age and sex matched controls were selected. Out of 197 patients (mean age 43.7 ± 17.5 years) with VoWille brand disease, 44 (22 %) were diagnosed with headaches and 37 (84%) of them suffered from migraines, while only 7 (3.5%) of the controls had headaches, all of them had migraine headaches. About 29 (15%) patients in Von Wille brand disease group were classified as migraine without aura and 8 (4%) had migraine with aura. VWD is an independent risk factor for headaches. (OR 7.11, 95% CI 3.10 -16.34, p = 0.001).Our analysis suggests that there is a very strong association of Von Wille brand disease with migraines. We hypothesize that it's the fluctuating factor levels that causes migraines and normalization of the VWF levels might protect this patient population from headaches, which can be quite debilitating in some patients.
International journal of stroke : official journal of the International Stroke Society, Jan 26, 2015
The association between resting heart rate and ischemic stroke remains unclear. To examine the as... more The association between resting heart rate and ischemic stroke remains unclear. To examine the association between resting heart rate and ischemic stroke. A total of 24 730 participants (mean age: 64 ± 9·3 years; 59% women; 41% blacks) from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment (2003-2007) were included in this analysis. Resting heart rate was determined from baseline electrocardiogram data. Heart rate was examined as a continuous variable per 10 bpm increase and also as a categorical variable using tertiles ( <61 bpm, 61 to 70 bpm, and >70 bpm). First-time ischemic stroke events were identified during follow-up and adjudicated by physician review. Over a median follow-up of 7·6 years, a total of 646 ischemic strokes occurred. In a Cox regression model adjusted for socio-demographics, cardiovascular risk factors, and potential confounders, each 10 bpm increase in heart rate was associated w...
Circulation Cardiovascular Quality and Outcomes
![Research paper thumbnail of Effect of Falls on Frequency of Atrial Fibrillation and Mortality Risk (From the REasons for Geographic And Racial Differences in Stroke [REGARDS] Study)](https://attachments.academia-assets.com/40009509/thumbnails/1.jpg)
](The American Journal of Cardiology, 2015
It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared wit... more It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared with those in the general population and if falls increase mortality beyond that observed in AF. A total of 24,117 (mean age 65 -9.3 years; 55% women; 38% black) participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were included. AF was identified from baseline electrocardiogram data and by self-reported history. Falls were considered present if participants reported ‡2 falls within the year before the baseline examination. Logistic regression was used to examine the relationship between prevalent AF and falls. Cox regression was used to examine the risk of death in those with AF and falls, separately and in combination, compared with those without either condition. A total of 2,007 participants (8.3%) had baseline AF and 1,655 (6.7%) reported falls. A higher prevalence of falls was reported in those with AF (n [ 209; 10%) than those without AF (n [ 1,446; 6.5%; p <0.0001). After adjustment for fall risk factors, AF was significantly associated with falls (odds ratio 1.22, 95% confidence interval [CI] 1.04 to 1.44). Compared with no history of AF or falls, the concomitant presence of AF and falls (hazard ratio [HR] 2.12, 95% CI 1.64 to 2.74) was associated with a greater risk of death than AF (HR 1.44, 95% CI 1.28 to 1.62) or falls (HR 1.61, 95% CI 1.42 to 1.82). In conclusion, patients with AF are more likely to report a history of falls in REGARDS. Additionally, participants with AF who report falls have an increased risk of death than those with either condition in isolation. Ó 2015 Elsevier Inc. All rights reserved. (Am J Cardiol 2015;-:-e-)
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 4, 2015
It is unclear whether left ventricular hypertrophy (LVH) detected by electrocardiography (ECG-LVH... more It is unclear whether left ventricular hypertrophy (LVH) detected by electrocardiography (ECG-LVH) is equally predictive of heart failure as LVH detected by echocardiography (echo-LVH). This analysis included 4,008 white participants (41% men) aged 65 years or older from the Cardiovascular Health Study who were free of stroke and major intraventricular conduction defects. ECG-LVH was defined by the Cornell criteria from baseline ECG data and echo-LVH was calculated from baseline echocardiography measurements. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ECG-LVH and echo-LVH and adjudicated incident stroke events, separately. Harrell's concordance indices (C-index) were calculated for the Framingham Stroke Risk Score with inclusion of ECG-LVH and echo-LVH, separately. ECG-LVH was detected in 136 (3.4%) participants and echo-LVH was present in 208 (5.2%) participants. Over a median follow-up of 13 years, a to...
International Journal of Cardiology, 2015
Annals of Behavioral Medicine, 2015
Background The association between perceived stress and atrial fibrillation (AF) remains unclear.
Journal of the American Heart Association, 2015
The prognostic significance of modest elevations in exercise systolic blood pressure response has... more The prognostic significance of modest elevations in exercise systolic blood pressure response has not been extensively examined. We examined the association between systolic blood pressure response and all-cause death and incident myocardial infarction (MI) in 44 089 (mean age 53±13 years, 45% female, 26% black) patients who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project (1991-2010). Exercise systolic blood pressure response was examined as a categorical variable (>20 mm Hg: referent; 1 to 20 mm Hg, and ≤0 mm Hg) and per 1 SD decrease. Cox regression was used to compute hazard ratios (HR) and 95% CI for the association between systolic blood pressure response and all-cause death and incident MI. Over a median follow-up of 10 years, a total of 4782 (11%) deaths occurred and over 5.2 years, a total of 1188 (2.7%) MIs occurred. In a Cox regression analysis adjusted for demographics, physical fitness, and cardiovascular risk factors, an...
JAMA Internal Medicine, 2015
Circulation, Jan 22, 2015
hn hns Ho opk pk pkins C Ciccarone Center for the Preven nt t tio o on of Heart Di i ise s s ase,... more hn hns Ho opk pk pkins C Ciccarone Center for the Preven nt t tio o on of Heart Di i ise s s ase, B Baltimore, MD; 5 Wayne S S Sta a ate University ty y, De Detr tr roi i oit t t, M M MI; I; I; 6 6 6 Ki i ing ng ng A A Ab bdul-A -A -Aziz Ca a ard d dia ia iac c C Ce Cen n nter r r, N N Nati ti io o ona al G G Gu u uard d H H He e ealt lt lth h h A Af Affa fa fair r rs,
PloS one, 2015
Atrial fibrillation (AF) is a common arrhythmia. Application of metabolomic approaches, which may... more Atrial fibrillation (AF) is a common arrhythmia. Application of metabolomic approaches, which may identify novel pathways and biomarkers of disease risk, to a longitudinal epidemiologic study of AF has been limited. We determined the prospective association of 118 serum metabolites identified through untargeted metabolomics profiling with the incidence of newly-diagnosed AF in 1919 African-American men and women from the Atherosclerosis Risk in Communities study without AF at baseline (1987-1989). Incident AF cases through 2011 were ascertained from study electrocardiograms, hospital discharge codes, and death certificates. During a median follow-up of 22 years, we identified 183 incident AF cases. In Cox proportional hazards models adjusted for age, sex, smoking, body mass index, systolic blood pressure, use of antihypertensive medication, diabetes, prevalent heart failure, prevalent coronary heart disease, and kidney function, two conjugated bile acids (glycolithocholate sulfate a...
Medical Education Online, 2015
The American Board of Internal Medicine (ABIM) exam&amp;amp;amp;#39;s pass rate is consid... more The American Board of Internal Medicine (ABIM) exam&amp;amp;amp;#39;s pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002-2006) and post-intervention (2007-2013). A time commitment survey was also given to physicians and DR residents at the end of the study. Residents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p&amp;amp;amp;lt;0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Although residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.
Journal of the American College of Cardiology
... 7272 Greenville Avenue, DOI: 10.1161/CIRCIMAGING.108.831164 published online September 8, 200... more ... 7272 Greenville Avenue, DOI: 10.1161/CIRCIMAGING.108.831164 published online September 8, 2009; Circ Cardiovasc Imaging Mouaz H. Al-Mallah, Rory Hachamovitch, Sharmila Dorbala and Marcelo Di Carli Stress SPECT with Renal Dysfunction Incremental Prognostic ...
International Journal of Hematology
Data from observational studies has shown a relationship of high levels of Von Wille brand factor... more Data from observational studies has shown a relationship of high levels of Von Wille brand factor (VWF) with migraines. We hypothesized that patients with VonWillebrand disease have lower rates of migraine. The aim of this analysis was to determine the rates of migraine in patients with Von Wille brand disease and to identify an association of Von Wille brand disease with migraines. Patients (n =394) with Von Wille brand disease were identified from the hospital database. A careful review of the patients' clinical records was carried out to authenticate the Von Wille brand disease. Analyses were based on clinic visits for headaches as defined by International Headache Society criteria during a follow up of 25 years (1985 -2010). Samples of 197 patients were finalized for which random age and sex matched controls were selected. Out of 197 patients (mean age 43.7 ± 17.5 years) with VoWille brand disease, 44 (22 %) were diagnosed with headaches and 37 (84%) of them suffered from migraines, while only 7 (3.5%) of the controls had headaches, all of them had migraine headaches. About 29 (15%) patients in Von Wille brand disease group were classified as migraine without aura and 8 (4%) had migraine with aura. VWD is an independent risk factor for headaches. (OR 7.11, 95% CI 3.10 -16.34, p = 0.001).Our analysis suggests that there is a very strong association of Von Wille brand disease with migraines. We hypothesize that it's the fluctuating factor levels that causes migraines and normalization of the VWF levels might protect this patient population from headaches, which can be quite debilitating in some patients.
International journal of stroke : official journal of the International Stroke Society, Jan 26, 2015
The association between resting heart rate and ischemic stroke remains unclear. To examine the as... more The association between resting heart rate and ischemic stroke remains unclear. To examine the association between resting heart rate and ischemic stroke. A total of 24 730 participants (mean age: 64 ± 9·3 years; 59% women; 41% blacks) from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment (2003-2007) were included in this analysis. Resting heart rate was determined from baseline electrocardiogram data. Heart rate was examined as a continuous variable per 10 bpm increase and also as a categorical variable using tertiles ( <61 bpm, 61 to 70 bpm, and >70 bpm). First-time ischemic stroke events were identified during follow-up and adjudicated by physician review. Over a median follow-up of 7·6 years, a total of 646 ischemic strokes occurred. In a Cox regression model adjusted for socio-demographics, cardiovascular risk factors, and potential confounders, each 10 bpm increase in heart rate was associated w...
Circulation Cardiovascular Quality and Outcomes
The American Journal of Cardiology, 2015
It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared wit... more It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared with those in the general population and if falls increase mortality beyond that observed in AF. A total of 24,117 (mean age 65 -9.3 years; 55% women; 38% black) participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were included. AF was identified from baseline electrocardiogram data and by self-reported history. Falls were considered present if participants reported ‡2 falls within the year before the baseline examination. Logistic regression was used to examine the relationship between prevalent AF and falls. Cox regression was used to examine the risk of death in those with AF and falls, separately and in combination, compared with those without either condition. A total of 2,007 participants (8.3%) had baseline AF and 1,655 (6.7%) reported falls. A higher prevalence of falls was reported in those with AF (n [ 209; 10%) than those without AF (n [ 1,446; 6.5%; p <0.0001). After adjustment for fall risk factors, AF was significantly associated with falls (odds ratio 1.22, 95% confidence interval [CI] 1.04 to 1.44). Compared with no history of AF or falls, the concomitant presence of AF and falls (hazard ratio [HR] 2.12, 95% CI 1.64 to 2.74) was associated with a greater risk of death than AF (HR 1.44, 95% CI 1.28 to 1.62) or falls (HR 1.61, 95% CI 1.42 to 1.82). In conclusion, patients with AF are more likely to report a history of falls in REGARDS. Additionally, participants with AF who report falls have an increased risk of death than those with either condition in isolation. Ó 2015 Elsevier Inc. All rights reserved. (Am J Cardiol 2015;-:-e-)
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 4, 2015
It is unclear whether left ventricular hypertrophy (LVH) detected by electrocardiography (ECG-LVH... more It is unclear whether left ventricular hypertrophy (LVH) detected by electrocardiography (ECG-LVH) is equally predictive of heart failure as LVH detected by echocardiography (echo-LVH). This analysis included 4,008 white participants (41% men) aged 65 years or older from the Cardiovascular Health Study who were free of stroke and major intraventricular conduction defects. ECG-LVH was defined by the Cornell criteria from baseline ECG data and echo-LVH was calculated from baseline echocardiography measurements. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ECG-LVH and echo-LVH and adjudicated incident stroke events, separately. Harrell's concordance indices (C-index) were calculated for the Framingham Stroke Risk Score with inclusion of ECG-LVH and echo-LVH, separately. ECG-LVH was detected in 136 (3.4%) participants and echo-LVH was present in 208 (5.2%) participants. Over a median follow-up of 13 years, a to...
International Journal of Cardiology, 2015
Annals of Behavioral Medicine, 2015
Background The association between perceived stress and atrial fibrillation (AF) remains unclear.
Journal of the American Heart Association, 2015
The prognostic significance of modest elevations in exercise systolic blood pressure response has... more The prognostic significance of modest elevations in exercise systolic blood pressure response has not been extensively examined. We examined the association between systolic blood pressure response and all-cause death and incident myocardial infarction (MI) in 44 089 (mean age 53±13 years, 45% female, 26% black) patients who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project (1991-2010). Exercise systolic blood pressure response was examined as a categorical variable (>20 mm Hg: referent; 1 to 20 mm Hg, and ≤0 mm Hg) and per 1 SD decrease. Cox regression was used to compute hazard ratios (HR) and 95% CI for the association between systolic blood pressure response and all-cause death and incident MI. Over a median follow-up of 10 years, a total of 4782 (11%) deaths occurred and over 5.2 years, a total of 1188 (2.7%) MIs occurred. In a Cox regression analysis adjusted for demographics, physical fitness, and cardiovascular risk factors, an...
JAMA Internal Medicine, 2015
Circulation, Jan 22, 2015
hn hns Ho opk pk pkins C Ciccarone Center for the Preven nt t tio o on of Heart Di i ise s s ase,... more hn hns Ho opk pk pkins C Ciccarone Center for the Preven nt t tio o on of Heart Di i ise s s ase, B Baltimore, MD; 5 Wayne S S Sta a ate University ty y, De Detr tr roi i oit t t, M M MI; I; I; 6 6 6 Ki i ing ng ng A A Ab bdul-A -A -Aziz Ca a ard d dia ia iac c C Ce Cen n nter r r, N N Nati ti io o ona al G G Gu u uard d H H He e ealt lt lth h h A Af Affa fa fair r rs,