Andrew P Ambrosy, MD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3607 (phone)
andrew.p.ambrosy@kp.org

Andrew P. Ambrosy, MD, is a practicing cardiologist at Kaiser Permanente in San Francisco as well as research scientist within the Division of Research’s section on Cardiovascular and Metabolic Conditions. His research interests are ischemic heart disease, cardiomyopathy, and heart failure, and he has extensive prior experience in health outcomes, implementation science, and traditional and pragmatic clinical trials. He previously completed a dedicated research fellowship at Duke University Medical Center/Duke Clinical Research Institute where he was a member of the operations team for the National Heart, Lung, and Blood Institute-funded Heart Failure Network and several industry-sponsored clinical trials. He has presented his research at national and international scientific meetings and has authored approximately 100 peer-reviewed manuscripts.

Current Position(s):

Staff Cardiologist, Department of Cardiology, The Permanente Medical Group, San Francisco
Research Scientist, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Cardiovascular and Metabolic Conditions

Primary Research Interests:

Ischemia Heart Disease
Cardiomyopathy
Heart Failure
Health Outcomes
Implementation Science
Clinical Trials

Studies

Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study

There is an unmet clinical need to better understand the impact of lifestyle choices with respect to diet and nutrition in high-risk heart failure patients who have been recently hospitalized. We will conduct a survey-based project using a combination of questionnaires to assess 4 clinically relevant domains: food access and security, dietary composition and quality, nutritional awareness and understanding, and attitudes toward nutrition-related research. The survey itself will take no more than 15 to 30 minutes to complete and will be administered via telephone to 1,000 consecutive patients recently hospitalized with a primary diagnosis of heart failure who are responsible for their own meal planning. In addition to the survey elements, outcomes of interest will include subsequent heart failure hospitalization, all-cause hospitalization, and mortality occurring within 30 days. These outcomes will be passively collected via Kaiser Permanente HealthConnect electronic health records.
Investigator: Ambrosy, Andrew; Go, Alan
Funder: Northern California Community Benefit Programs

Disparities in Residual Risk in Patients Receiving Statins for Primary or Secondary Prevention at an Integrated Health Care Delivery System

Patients with risk factors for or established atherosclerotic cardiovascular disease (ASCVD) remain at high risk for first-time or recurrent nonfatal and fatal events, despite guideline-directed medical therapy for primary and secondary prevention. In fact, even among patients who are appropriately treated with lipid-lowering therapies and have an LDL-C that is at goal and in line with current guideline recommendations, substantial residual risk persists. There is now a considerable body of evidence to suggest that plasma triglycerides contribute to residual risk and play a causal role in atherogenesis and ASCVD risk. Furthermore, older adults, women, and nonwhite participants may have a disproportionately different prevalence of elevated triglyceride levels and be at incrementally greater risk of recurrent ASCVD events. Given the public health implications, it is important to better understand the extent of age-, gender-, and ethnicity/race-related disparities in residual risk.
Investigator: Ambrosy, Andrew
Funder: Amarin Corporation

TRANSFORM-HF (ToRsemide compArisoN with furoSemide FOR Management of Heart Failure) Study

Patients with heart failure will be randomized 1:1 to either oral torsemide or oral furosemide prior to hospital discharge. The primary endpoint will be all-cause mortality over the follow-up period. Secondary endpoints are hospitalizations, quality of life, and depression.
Investigator: Ambrosy, Andrew
Funder: National Heart, Lung, and Blood Institute

Partnership for Anemia: Clinical and Translational Trials in the Elderly (PACTTE)

Within the CVRN-HF Network, and in collaboration with NIA-sponsored PACTTE consortium investigators, we will examine the following among a large, multi-center cohort of elderly patients with heart failure with reduced or preserved left ventricular systolic function: 1) to characterize the contemporary frequency of testing for and prevalence of anemia; 2) to assess the frequency, timing and extent of evaluation for reversible causes of anemia in those with documented anemia; 3) to evaluate contemporary adverse event rates by hemoglobin level; and 4) to examine the feasibility of conducting a potential pragmatic clinical trial of systematic evaluation of anemia in elderly heart failure patients.
Investigator: Ambrosy, Andrew; Go, Alan
Funder: National Institute on Aging

Highlighted Publications

No results found matching criteria

Publications

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Author(s): Patel PA; Ambrosy AP; Phelan M; Alenezi F; Chiswell K; Van Dyke MK; Tomfohr J; Honarpour N; Velazquez EJ

Eur J Heart Fail. 2019 Dec 21.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study

Disparities in Residual Risk in Patients Receiving Statins for Primary or Secondary Prevention at an Integrated Health Care Delivery System

TRANSFORM-HF (ToRsemide compArisoN with furoSemide FOR Management of Heart Failure) Study

Partnership for Anemia: Clinical and Translational Trials in the Elderly (PACTTE)

Highlighted Publications

Publications

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure: Secondary Analysis of the Open-label Extension of the PIONEER-HF Trial

Statin Therapy and Risk of Incident Diabetes Mellitus in Adults With Cardiovascular Risk Factors

Hyperglycemia and outcomes in acute heart failure - A bittersweet relationship

Are existing and emerging biomarkers associated with cardiorespiratory fitness in patients with chronic heart failure?

Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017

Haemoconcentration during treatment of acute heart failure with cardiorenal syndrome: from the CARRESS-HF trial

Should providers prescribe sacubitril/valsartan based on trial eligibility, approval indication, or guideline recommendations?

A Balancing Act: Preserving Renal Function and the Need for Decongestion

In-hospital initiation of sacubitril/valsartan in acute decompensated heart failure: being in the right place at the right time

Trends in Readmissions and Length of Stay for Patients Hospitalized With Heart Failure in Canada and the United States

Clinical Outcomes in Patients With Acute Decompensated Heart Failure Randomly Assigned to Sacubitril/Valsartan or Enalapril in the PIONEER-HF Trial

Natriuretic peptides as a surrogate endpoint in clinical trials - a riddle wrapped in an enigma

Incident Anemia in Older Adults with Heart Failure Rate, Etiology, and Association with Outcomes

Applying data science approaches to identify frequent flyers in heart failure: rise of the machines

Burden of medical co-morbidities and benefit from surgical revascularization in patients with ischaemic cardiomyopathy

Trimethylamine N-oxide and risk of heart failure progression: marker or mediator of disease

Left Ventricular Global Longitudinal Strain Can Reliably Be Measured from a Single Apical Four-Chamber View in Patients with Heart Failure

Is Time From Last Hospitalization for Heart Failure to Placement of a Primary Prevention Implantable Cardioverter-Defibrillator Associated With Patient Outcomes?

Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure

Relationship between timing of trial randomization, protocol completion, and clinical outcomes among patients hospitalized for heart failure: from the ASTRONAUT trial

Reassessing the Role of Surrogate End Points in Drug Development for Heart Failure.

Undiagnosed dysglycemia in patients hospitalized for worsening heart failure: not so sweet after all.

Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial.

Improving Postdischarge Outcomes in Acute Heart Failure.

Natural History of Patients Postacute Coronary Syndrome Based on Heart Failure Status.

Loop diuretic adjustments in patients with chronic heart failure: Insights from HF-ACTION.

Renal Function and Exercise Training in AmbulatoryHeart Failure Patients With a Reduced Ejection Fraction.

Combination drug therapy in heart failure: greater than the sum of its parts.

Sudden Death After Hospitalization for Heart Failure With Reduced Ejection Fraction (from the EVEREST Trial).

Is Time of the Essence? The Impact of Time of Hospital Presentation in Acute Heart Failure: Insights From ASCEND-HF Trial.

The role of angiotensin receptor-neprilysin inhibitors in cardiovascular disease-existing evidence, knowledge gaps, and future directions.

Angiotensin receptor-neprilysin inhibitor therapy in heart failure: An end that justifies the means.

Prevalent digoxin use and subsequent risk of death or hospitalization in ambulatory heart failure patients with a reduced ejection fraction-Findings from the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) randomized controlled trial.

Interaction of Body Mass Index on the Association Between N-Terminal-Pro-b-Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Predictors of Post-discharge Mortality Among Patients Hospitalized for Acute Heart Failure.

Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial.

Expanded algorithm for managing patients with acute decompensated heart failure.

Sudden cardiac death following admission for acute heart failure: adding insult to injury.

Lessons learned in acute heart failure.

Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND-HF.

Pre-discharge and early post-discharge troponin elevation among patients hospitalized for heart failure with reduced ejection fraction: findings from the ASTRONAUT trial.

Clinical profiles in acute heart failure: one size fits all or not at all?

Real-world dosing of evidence-based medications for heart failure: embracing guideline recommendations and clinical judgement.

Adverse Remodeling and Reverse Remodeling After Myocardial Infarction.

Building the case for aerobic exercise in ambulatory patients with heart failure and a reduced ejection fraction.

Clinical trials in acute heart failure: beginning of the end or end of the beginning?

Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure: From the ASCEND-HF Trial.

Trajectory of Congestion Metrics by Ejection Fraction in Patients With Acute Heart Failure (from the Heart Failure Network).

Aerobic exercise training and general health status in ambulatory heart failure patients with a reduced ejection fraction-Findings from the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)trial.

Reply: Factors That May Affect Body Change During and After Hospitalization for Acute Heart Failure.

Global Variations in Patient Populations and Outcomes in Heart Failure Clinical Trials.

Body Weight Change During and After Hospitalization for Acute Heart Failure: Patient Characteristics, Markers of Congestion, and Outcomes: Findings From the ASCEND-HF Trial.

Influence of atrial fibrillation on post-discharge natriuretic peptide trajectory and clinical outcomes among patients hospitalized for heart failure: insights from the ASTRONAUT trial.

Influence of Clinical Trial Site Enrollment on Patient Characteristics, Protocol Completion, and End Points: Insights From the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Targeting digoxin dosing to serum concentration: is the bullseye too small?

Heart Failure Clinical Trials in East and Southeast Asia: Understanding the Importance and Defining the Next Steps.

Changes in Dyspnea Status During Hospitalization and Postdischarge Health-Related Quality of Life in Patients Hospitalized for Heart Failure: Findings From the EVEREST Trial.

Digoxin for Worsening Chronic Heart Failure: Underutilized and Underrated.

Natriuretic peptide-guided management in heart failure.

In-Hospital Diuretic Agent Use and Post-Discharge Clinical Outcomes in Patients Hospitalized for Worsening Heart Failure: Insights From the EVEREST Trial.

Serum Osmolality and Postdischarge Outcomes After Hospitalization for Heart Failure.

The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF.

Hospitalized Heart Failure in the United States: Lessons Learned from Clinical Trial Populations.

Identifying Barriers and Practical Solutions to Conducting Site-Based Research in North America: Exploring Acute Heart Failure Trials As a Case Study.

Length of hospital stay and 30-day readmission following heart failure hospitalization: insights from the EVEREST trial.

Pulmonary Oedema-Therapeutic Targets.

International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT-HF): rationale for and design of a global registry.

Effect of minor liver function test abnormalities and values within the normal range on survival in heart failure.

Relation of serum uric acid levels and outcomes among patients hospitalized for worsening heart failure with reduced ejection fraction (from the efficacy of vasopressin antagonism in heart failure outcome study with tolvaptan trial).