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

The Use of Natural Language Processing to Characterize Episodes of Outpatient Worsening Heart Failure within an Integrated Health Care Delivery System

This study will assess the accuracy of using a natural language processing-based approach to retrospectively identify episodes of outpatient worsening heart failure in unstructured electronic health record data within an integrated health care delivery system and assess the burden and clinical characteristics of these outpatients.
Investigator: Ambrosy, Andrew
Funder: Northern California Community Benefit Programs

Outpatient Worsening Heart Failure in an Integrated Health Care Delivery System: An Innovative Approach to Characterizing a Novel Clinical Entity

While the Affordable Care Act-mandated Hospital Readmission Reduction Program launched in 2012 has modestly reduced readmissions, an unintended consequence has been the shift of a significant fraction of heart failure (HF)-related care to the outpatient setting. However, little is known about the epidemiology, clinical profile, treatment patterns, and/or outcomes of outpatient worsening HF (WHF). To address these critical knowledge gaps, we propose (1) to systematically describe the contemporary epidemiology, clinical characteristics, treatment patterns, and outcomes associated with outpatient WHF and (2) to evaluate the impact of an episode of outpatient WHF on generic and disease-specific HRQOL in the context of a fully integrated health care delivery system.
Investigator: Ambrosy, Andrew
Funder: National Heart, Lung, and Blood Institute

KP NOURISH: Evaluation of the Clinical Utility of Medically-Tailored Meals in Adults with Chronic Conditions

This pragmatic randomized clinical trial funded through National and NCAL Community Health/Benefits is testing the impact of medically-tailored meals and enhanced nutritional counseling compared to usual care on clinical and patient-centered outcomes in hospitalized adults with targeted medical conditions being discharged home from KP Santa Rosa or Santa Clara Medical Centers.
Investigator: Go, Alan; Ambrosy, Andrew
Funder: Kaiser Permanente Program Office

A Multi-center, Multi-country Retrospective Cohort Study to Evaluate the Clinical Outcomes in Adults with Severe COVID-19

This multi-center, multi-country retrospective cohort study will assess the clinical course and outcome of adults with severe COVID-19 not treated with remdesivir using a 7-point ordinal scale for clinical outcomes on Day 14 and all-cause mortality at Day 28 after admission. This study complements ongoing clinical trials of remdesivir for the treatment of severe COVID-19 infection.
Investigator: Go, Alan; Ambrosy, Andrew
Funder: Gilead Sciences, Inc.

Transcatheter Mitral-Valve Repair in Patients with Heart Failure and Functional Mitral Regurgitation - Potential Scope and Clinical Benefit of Early Adoption at an Integrated Healthcare Delivery System

This study will look at the clinical benefit of early adoption of the MitraClip device in patients with heart failure in a real-world setting. Previous research showed patients who have the MitraClip procedure have 50% fewer hospitalizations for heart failure within the next 24 months than those who receive the standard of care. The MitraClip is used to reduce mitral regurgitation, a common side effect of heart failure, that affects quality of life and functioning, increases risk of hospitalization, and reduces survival despite medical therapy.
Investigator: Ambrosy, Andrew
Funder: Abbott Laboratories

Evaluating Inpatient and OutpatIent Encounters Within a Learning and Integrated Health Care Delivery Organization Due to Worsening Heart Failure (UTILIZE-WHF)

This study will assess the inpatient and outpatient health care utilization and mortality of patients with heart failure and how it relates to their degree of systolic dysfunction.
Investigator: Ambrosy, Andrew
Funder: Novartis International AG

Pragmatic RandomIzed Trial of Icosapent Ethyl for High-Cadiovascular Risk Adults (MITIGATE)

The MITIGATE Study will evaluate the real-world clinical effectiveness of icosapent ethyl (Vascepa®) compared to usual care in patients with established atherosclerotic cardiovascular disease. The study will evaluate whether the drug, which is used to reduce the risk of heart disease and stroke, can also prevent or reduce the risk of complications from viral respiratory illnesses in older adults with heart disease.
Investigator: Ambrosy, Andrew
Funder: Amarin Corporation

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; Gordon, Nancy
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

Temporal trends in the outcomes of acute heart failure: between consolatory evidences and real progress

Author(s): Chioncel O; Ambrosy AP; Maggioni AP

Eur J Heart Fail. 2021 Feb 18.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

The Use of Natural Language Processing to Characterize Episodes of Outpatient Worsening Heart Failure within an Integrated Health Care Delivery System

Outpatient Worsening Heart Failure in an Integrated Health Care Delivery System: An Innovative Approach to Characterizing a Novel Clinical Entity

KP NOURISH: Evaluation of the Clinical Utility of Medically-Tailored Meals in Adults with Chronic Conditions

A Multi-center, Multi-country Retrospective Cohort Study to Evaluate the Clinical Outcomes in Adults with Severe COVID-19

Transcatheter Mitral-Valve Repair in Patients with Heart Failure and Functional Mitral Regurgitation - Potential Scope and Clinical Benefit of Early Adoption at an Integrated Healthcare Delivery System

Evaluating Inpatient and OutpatIent Encounters Within a Learning and Integrated Health Care Delivery Organization Due to Worsening Heart Failure (UTILIZE-WHF)

Pragmatic RandomIzed Trial of Icosapent Ethyl for High-Cadiovascular Risk Adults (MITIGATE)

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

Temporal trends in the outcomes of acute heart failure: between consolatory evidences and real progress

Risk of atherosclerotic cardiovascular disease by cardiovascular health metric categories in approximately 1 million patients

Management of Renin-Angiotensin-Aldosterone System blockade in patients admitted to hospital with confirmed coronavirus disease (COVID-19) infection (The McGill RAAS-COVID- 19): A structured summary of a study protocol for a randomized controlled trial

Making The Case For Sacubitril/Valsartan In Patients With Heart Failure With A Preserved Ejection Fraction

Loop Diuretic Use and Outcomes in Chronic Stable Heart Failure With Preserved Ejection Fraction-Reply

Rationale and Design of the Pragmatic Randomized Trial of Icosapent Ethyl for High Cardiovascular Risk Adults (MITIGATE)

Implications of peripheral oedema in heart failure with preserved ejection fraction: a heart failure network analysis

Improving adherence to guideline-directed medical therapies and outcomes in the developing world: A call to end global inequities in heart failure

Hospitalizations for Heart Failure and Mortality Risk During the Evolving Coronavirus Disease 2019 Pandemic - The Wave May Break but A Dangerous Undertow Persists

The Degree of the Predischarge Pulmonary Congestion in Patients Hospitalized for Worsening Heart Failure Predicts Readmission and Mortality

Baseline Functional Capacity and Transcatheter Mitral Valve Repair in Heart Failure With Secondary Mitral Regurgitation

Angiotensin-Neprilysin Inhibition in Black Americans: Data From the PIONEER-HF Trial

Angiotensin Receptor-Neprilysin Inhibition Based on History of Heart Failure and Use of Renin-Angiotensin System Antagonists

Hospitalizations for heart failure during the COVID-19 pandemic: making sense of the known knowns, known unknowns, and unknown unknowns

Improving Physical Activity and Exercise Capacity in Heart Failure Taking the First Step is Always the Hardest

Sacubitril/Valsartan in Advanced Heart Failure With Reduced Ejection Fraction: Rationale and Design of the LIFE Trial

The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction

Effects of Liraglutide on Worsening Renal Function Among Patients With Heart Failure With Reduced Ejection Fraction: Insights From the FIGHT Trial

The burden of non-cardiac comorbidities and association with clinical outcomes in an acute heart failure trial - insights from ASCEND-HF

Periprocedural Risk and Survival Associated With Implantable Cardioverter-Defibrillator Placement in Older Patients With Advanced Heart Failure

A reduced transferrin saturation is independently associated with excess morbidity and mortality in older adults with heart failure and incident anemia

One-year mortality after implantable cardioverter-defibrillator placement within the Veterans Affairs Health System

Spontaneous Coronary Artery Dissection and Incident Ventricular Arrhythmias: Frequency, Clinical Characteristics, and Outcomes

Risk of atherosclerotic cardiovascular disease by cardiovascular health metric categories in approximately 1 million patients

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.