# Using Claims-Based Signatures of Frailty to Support Individualized Treatment of Aortic Valve Stenosis and Coronary Artery Disease

> **NIH NIH K24** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $120,294

## Abstract

PROJECT SUMMARY/ABSTRACT
Severe aortic valve stenosis and coronary artery disease afflict a large number of patients worldwide.
Choosing the optimal management strategies among various alternatives requires accounting for the
characteristics and comorbidities of individuals that best determine the potential benefits or harms from
different treatment approaches. However, randomized trials often do not collect the information necessary to
inform individualized treatment decisions – in particular, data on patient frailty is typically not captured. In this
grant, we will take advantage of linkages between two trial programs, the Dual Antiplatelet Therapy Study
(comparing shorter vs. longer duration of antiplatelet therapy after coronary stenting) and the US CoreValve
Program (comparing surgical versus transcatheter aortic valve replacement), with data from Medicare claims
as part of the NHLBI-sponsored Extending Trial-Based Evaluations of Medical Therapies Using Novel
Sources of Data (EXTEND) Study to answer these additional questions. First, we will identify variables
available in administrative claims that correlate with frailty among individuals undergoing aortic valve
replacement or coronary artery stenting and assess whether they predict long-term adverse cardiovascular
outcomes above traditional risk factors ascertained in trials. Next, we will determine whether claims-based
frailty indices derived from these non-trial data can identify heterogeneous treatment effects – i.e. treatment
effects that differ between individuals based on their personal characteristics – within the trials' randomized
populations. Based on these results, we will then create and pilot the implementation of quantitative decision
tools to support individualized treatment approaches for patients with aortic stenosis requiring aortic valve
replacement and those who require dual antiplatelet therapy after coronary stent procedures. The results of
this research will greatly enhance our understanding of whether administrative claims data can be used to
augment the evaluation of patient frailty within clinical trials, and determine whether frail patients with
cardiovascular disease require different treatment strategies. The results may also greatly improve the ability to
identify individual patients who have the most or least to gain from different treatment approaches for two
common and highly morbid cardiovascular conditions. Finally, the proposed research will help create evidence-
based decision tools that can be used to support shared decision making between clinicians and patients with
aortic valve stenosis and coronary artery disease.

## Key facts

- **NIH application ID:** 10071963
- **Project number:** 5K24HL150321-02
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Robert Yeh
- **Activity code:** K24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $120,294
- **Award type:** 5
- **Project period:** 2020-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071963

## Citation

> US National Institutes of Health, RePORTER application 10071963, Using Claims-Based Signatures of Frailty to Support Individualized Treatment of Aortic Valve Stenosis and Coronary Artery Disease (5K24HL150321-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10071963. Licensed CC0.

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