PROJECT SUMMARY
Candidate: Dr. Strom received an MD from Harvard Medical School (HMS), and has completed clinical
training in internal medicine (MGH), cardiology (BIDMC), and non-invasive cardiac imaging (BIDMC).
Additionally, he completed an MSc in Epidemiology program at the Harvard T.H. Chan School of Public Health,
in May, 2018. He is now a junior faculty member at BIDMC with 75% protected time to conduct clinical
research. Through this proposed 5-year program, Dr. Strom will pursue additional training in advanced
prediction modeling, machine learning, patient-oriented research, and metabolomics. The candidate’s long-
term goal is to become an R01-funded investigator in the area of applied outcomes research.
Environment: The candidate will be mentored by Robert W. Yeh (Primary Mentor), Associate Professor of
Medicine at HMS and Director of the Smith Center for Outcomes Research in Cardiology, Robert E. Gerszten
(Co-Mentor), Professor of Medicine at HMS and Chief of Cardiovascular Medicine at BIDMC, and Changyu
Shen (Co-Mentor), upcoming Associate Professor of Medicine at HMS and Lead Biostatistician for the Smith
Center. Dr. Yeh has a track record of leading practice-changing studies and successful mentorship of clinician
investigators. Dr. Gerszten is an internationally recognized expert in molecular phenotyping of cardiovascular
diseases using metabolomics and proteomics and has mentored several K-award and R01 funded clinical
investigators. Dr. Shen has a long track record of NIH funding, expertise in evaluating heterogeneity of
treatment effect in cardiovascular diseases, and has mentored multiple prior trainees.
Research: The optimal therapy for a given individual with aortic stenosis remains uncertain. This proposal
seeks to define the clinical and biologic components of frailty that modify risk after aortic valve replacement
(AVR) and alter treatment benefit. For Aims 1-2, we will leverage the unique linkage of Medicare data to the
US CoreValve Pivotal trials, a collection of clinical trials that randomized individuals with severe aortic stenosis
to transcatheter AVR (TAVR) with a self-expanding bioprosthesis vs. surgical AVR (SAVR). In Aim 1, we will
we will identify which variables, related to in-person assessments of frailty and candidate frailty codes, best
predict adverse outcomes after AVR. In Aim 2, we will identify if novel variables identified in Aim 1, identify a
heterogeneous treatment response in individuals undergoing AVR. In Aim 3, we will prospectively enroll
patients undergoing TAVR at BIDMC with concurrent frailty phenotyping to identify whether metabolites
associated with longevity correlate with frailty and predict adverse outcomes, independent of age and
comorbidities. The research will identify the mechanisms by which frailty confers adverse risk and differential
treatment benefit in AVR, providing insights that may personalize treatment selection and improve patient care.