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Mondal A, Kanagala SG, Pingili A, Edusa S, Karipineni S, Mehdi S, Hazra S, Danish A, Borra V, Khatoon G, Chauhan S, Jain A, Desai R. CAN CEREBRAL EMBOLIC PROTECTION DEVICES (CEPD) REDUCE POSTOPERATIVE STROKE IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) WITH A PRIOR HISTORY OF STROKE/TRANSIENT ISCHEMIC ATTACK (TIA)? J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01266-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Mondal A, Gogineni A, Karipineni S, Nalluri SD, Meka GG, Abdelhafez S, Shah V, Bawa J, puli S, Venkata VS, Desai R. ASSOCIATION OF OBESITY WITH MAJOR ADVERSE CARDIAC OUTCOMES IN HFPEF PATIENTS OF DIFFERENT AGE GROUPS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00753-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Mondal A, Kanagala SG, Pingili A, Hazra S, Borra V, Mehdi S, Danish A, Khatoon G, Chauhan S, Jain A, Desai R. A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE LONG-TERM ALL-CAUSE MORTALITY IN CANCER PATIENTS WITH MYOCARDIAL INFARCTION UNDERGOING PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01394-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Jain A, Modi K, Arora N, Desai R, Doshi R, Arora S, Gupta PK, Dhar SK. RACIAL DISPARITIES IN RESOURCE UTILIZATION AND READMISSION RISK IN THE MANAGEMENT OF PREMATURE NSTEMI: A NATIONWIDE ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01640-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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55
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Shiza S, Alli-Ramsaroop B, AKINSETE AGATHAOLAWUNMI, RUDRA PRANATHI, Vegesna MSS, Wilson E, Bari M, Rizvi B, Jain A, Desai R. BURDEN AND TRENDS IN OBSTRUCTIVE SLEEP APNEA-RELATED HOSPITALIZATIONS AND ASSOCIATED ACUTE ISCHEMIC STROKE IN YOUNG WOMEN OF REPRODUCTIVE AGE GROUP STRATIFIED BY RACE - INSIGHTS FROM A NATIONAL INPATIENT SAMPLE ANALYSIS (2016-2019). J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02237-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Bachayev M, Brereton B, Mondal A, Alli-Ramsaroop BA, Dhakal R, Leon MCB, Quinones CM, Abdelal MEO, Jain A, Dhaduk K, Desai R. Takotsubo Syndrome in Orthotopic Liver Transplant: A Systematic Review and Pooled Analysis of Published Studies and Case Reports. Transplant Proc 2023:S0041-1345(22)00778-3. [PMID: 36858907 DOI: 10.1016/j.transproceed.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 03/03/2023]
Abstract
BACKGROUND Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited. METHODS A systematic review was performed through February 2022 using PubMed, Embase, Scopus, and Google Scholar to review case reports/series and original studies on liver transplant-associated TTS. Descriptive analysis was performed for case reports and pooled analysis for the prevalence using random effects models. RESULTS A total of 56 case reports were included from 30 articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe 8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl, 0.6%-1.7%) of all liver transplants with comparable rates in studies from India and the US (P = .92). Indications for liver transplant included end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis C virus infection (17.9%), hepatocellular carcinoma (10.7%), and non-alcohol-related steatohepatitis (8.9%); the average Model for End-Stage Liver Disease score was 24.75. TTS commonly presented as hypotension (30%), dyspnea (14%), and oliguria, occurring mostly post-transplant (82%), whereas 14% were intraoperative. Common electrocardiogram findings were ST changes, ventricular tachycardia, and atrial fibrillation. Common echocardiogram findings showed left ventricular apical ballooning in 46.5% of cases and reduced ejection fraction < 20% in 41.9% of cases. Common complications were cardiogenic shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac arrest, and hepatic artery thrombosis. Mechanical circulatory support was required in 30.3%. Recurrence was reported in 15, and mortality in 30.4% of patients. CONCLUSIONS Takotsubo syndrome prevalence after liver transplant is significantly higher than TTS prevalence in general US hospitalizations with potentially worse outcomes. Prospective registries reporting TTS in liver transplant recipients are warranted.
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Affiliation(s)
- Milana Bachayev
- Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis
| | - Brian Brereton
- Department of Medicine, Jersey General Hospital, Saint Helier, Jersey
| | - Avilash Mondal
- Department of Internal Medicine, Nazareth Hospital, Philadelphia, Pennsylvania
| | | | - Roshan Dhakal
- Department of Medicine, Nepal Medical College, Kathmandu, Nepal
| | - Maria C Buhl Leon
- Department of Medicine, Universidad de San Martin de Porres, Lima, Peru
| | - Camila M Quinones
- Department of Medicine, Universidad de San Martin de Porres, Lima, Peru
| | - Mohamed Eyad O Abdelal
- Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Kartik Dhaduk
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania.
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Desai R, Meka GG, Lavu VS, Ashfaque M, Gowda S, Brereton BJ, Chauhan S, Samala Venkata V, Puli S, Rupareliya C. Abstract WP74: Predictors Of Acute Ischemic Stroke In Young Adults With Cannabis Use Disorder: An Artificial Neural Network Analysis Using A Nationwide Cohort (2019). Stroke 2023. [DOI: 10.1161/str.54.suppl_1.wp74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
An increase in cannabis use disorder (CUD) has been associated with a rise in adverse cerebrovascular events in the United States. However, large-scale data on risk stratification of acute ischemic stroke (AIS) among young patients with CUD remains limited. We aim to determine predictors of AIS in the young CUD cohort using the Artificial Neural Network (ANN) model in a national cohort.
Methods:
We identified hospitalizations of young adults (18-44 years) with CUD (unweighted n=101094, weighted n=539125) using the National Inpatient Sample (2019). Later we grouped them into AIS and non-AIS cohorts. The neural network’s predictive factors were selected for AIS in CUD cohort. CUD admissions were randomly split between training (80%, n=80754) & testing datasets (20%, n=20340). Training data was used to calibrate ANN, while testing data was used to evaluate the algorithm's accuracy. We compared the frequency of incorrect prediction between training and testing data and measured the area under the curve (AUC) to determine ANN’s efficacy in predicting AIS with CUD.
Results:
The 2019 cohort consisted of a total of 539125 admissions (56.1% male, 52.9% white, 28.7% blacks, 12.4% Hispanic, 6.0% Asian or Pacific Islander) in young adults with CUD with a median age of 30 (IQR 24-36) years. The rate of AIS admissions in young CUD cohort was 0.5% (n=2535). Training data showed improved predictions with a significantly low error rate (0.5%), thereby depicting better accuracy. The normalized importance of independent predictors of AIS in the CUD cohort is displayed in
Fig. 1a
. History of PVD, prior stroke/TIA, hypertension and hyperlipidemia had the highest normalized importance. The AUC was 0.811
(Fig. 1b)
which shows an excellent ANN model for the prediction of AIS in young CUD cohort.
Conclusion:
The ANN model successfully revealed the order of prevalent independent predictors of AIS that can be utilized to screen high-risk young adults with CUD and improve outcomes.
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Affiliation(s)
| | | | | | - Mariam Ashfaque
- Dept of Neurology, Peoples Univ of Med and Health Sciences for Women (PUMHSW), Nawabshah, Pakistan
| | | | | | | | | | - Srikanth Puli
- Dept of Hosp Medicine, Cheshire Med Cntr/Dartmouth Health, Keene, NH
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Singh M, Anil Peethambar G, Rana N, Jitta SR, Perera A, Gudiwada MCVB, Sanikommu S, Juveria F, Desai R. Abstract TP167: Burden And Impact Of Comorbid Depression On In-hospital Outcomes Of Acute Ischemic Stroke-related Admissions In Women Of Reproductive Age Group: A Propensity-matched Analysis. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tp167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Depression has been identified as a risk factor for acute cerebrovascular events. Due to limited data focused on young females, we studied the burden and impact of comorbid depression on outcomes of acute ischemic stroke (AIS)-related admissions in young women of the reproductive age group.
Methods:
We used the National Inpatient Sample (2018) to identify admissions of young females (age 18-44 years) with AIS; and further classified it into two demographically (age, race, payer status, income) matched (1:1) groups based on the presence of comorbid depression. Comorbidities and outcomes were compared using relevant ICD-10 codes. Multivariable regression was used to analyze the association of comorbid depression with in-hospital mortality.
Results:
In 15850 young females admitted with AIS in 2018, 2465 (15.6%) had comorbid depression. Post-matching, the study cohort consisted of 4610 women admitted with AIS (Median age: 37, 66.2% whites) and 2305 women in each cohort, with and without depression. The matched AIS-depression arm often had younger women (median 37 vs 39 years), patients from the lower-income quartile (47.3% vs. 34.5%), and higher rates of obesity, peripheral vascular disease, and prior history of stroke but a lower prevalence of CVD risk factors
[Table 1].
The depression arm had a non-significant odd of all-cause mortality (OR 1.32, 95%CI:0.64-2.74) when adjusted for sociodemographic confounders and comorbid risk factors (p=0.452). The LOS was shorter (median 4 vs 5 days) with comparable hospital charges in the depression arm vs. no depression arm (p<0.001).
Conclusion:
This study revealed a nearly 15% burden of depression in young females admitted for AIS without significant impact on all-cause mortality when controlled for confounders. The impact of depression on long-term AIS outcomes needs further evaluation.
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Affiliation(s)
- Monika Singh
- Himalayan Institute of Med Sciences, Dehradun, India
| | | | | | | | | | | | | | - Fnu Juveria
- Deccan College of Med Sciences, Telangana, India
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59
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Desai R, Jain A, Patel BA, Sadolikar A, Alukal T. Young diabetics remain at higher risk of acute myocardial infarction with cannabis use disorder. Eur J Intern Med 2023; 108:125-127. [PMID: 36202716 DOI: 10.1016/j.ejim.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA.
| | - Bhavin A Patel
- Department of Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, MI, USA
| | - Ashish Sadolikar
- Department of Internal Medicine, Indiana University Health Southern Indiana Physicians, Bloomington, IN, USA
| | - Thomas Alukal
- Department of Internal Medicine, VCU Health, South Hill, VA, USA
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Desai R, Singh M, Anil Peethambar G, Rana N, Jitta SR, Madine M, Sanikommu S, Perera A, Juveria F, Gudiwada MCVB, Rupareliya C. Abstract TP80: Regional Trends And Variation In Mortality By Subgroups Following Mechanical Thrombectomy In Geriatric Acute Ischemic Stroke-related Hospitalizations In Urban Facilities, 2016-2019. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tp80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Mechanical thrombectomy (MT) has been proven to be a successful treatment option for patients with acute ischemic stroke (AIS) in numerous randomized controlled trials. The majority of trials underrepresent patients aged 70 and above, and there is little contemporary data on regional trends and variation in mortality.
Methods:
This retrospective study using the National Inpatient Sample (2016-2019) seeks to identify any regional relationships between geriatric patients' in-hospital mortality after MT for AIS at urban facilities and trends in inpatient mortality. Regional Inpatient mortality based on sex and race and trends between 2016 and 2019 were assessed.
Results:
Our study group consisted of 52455 AIS-MT admissions (median 78 yrs, 57.1% male, 77.2% white, 89.6% Medicare enrollees) with a 14.1% inpatient mortality rate. Despite having a lower comparative burden of traditional CVD risk factors, the hospitals from the Northeast had a higher inpatient mortality rate (17.2%, n=1650) and risk (adjusted OR:1.25, 95% CI:1.03-1.51) than the other regions. Similar trends were observed in male (18.1%), females (16.6%), white (17.3%) and black (13.8%) participants (P<0.001) undergoing AIS-MT. Highest inpatient mortality among Hispanics was linked to Midwest-based participants (16.2%) without regional variation in rates for Asians. There were declining trends in mortality between 2016 to 2019 in West region without any change in other regions (from 14.0% to 11.5%, ptrend=0.002)
(Fig. 1)
.
Conclusion:
Among demographically comparable geriatric patients with AIS undergoing MT in the US, the Northeast region admissions showed the highest inpatient mortality even after controlling for confounding factors with a relatively lower burden of CVD risk factors. This disparity warrants further research to validate these findings.
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Affiliation(s)
| | - Monika Singh
- Himalayan Institute of Med Sciences, Dehradun, India
| | | | | | | | | | | | | | - Fnu Juveria
- Deccan College of Med Sciences, Telangana, India
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61
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Desai R, Meka GG, Ashfaque M, Gowda SN, BRERETON B, Lavu VS, Chauhan S, Puli S, Samala Venkata VR, Rupareliya C. Abstract 142: Higher Risk Of Stroke Recurrence In Elderly With Prediabetes: A Nationwide Analysis Of Over 200,000 Hospitalizations From 2016 To 2019. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Prediabetes (preDM) is known to double the risk of strokes and also predicts poor functional outcomes. With rising prevalence of preDM among the elderly population in the US, this study aimed to analyze the risk and trends in secondary stroke in elderly with preDM.
Methods:
We queried the National Inpatient Sample (2016-2019) to identify secondary stroke (with prior stroke/transient ischemic attack, TIA) hospitalizations in elderly population (≥65 years) with vs. without preDM by using ICD-10 codes after excluding patients with diabetes mellitus. Trends and risk of recurrent stroke events, demographics, comorbidities, and outcomes were compared between two cohorts (preDM+ vs. preDM-).
Results:
Overall prevalence of secondary stroke in geriatric preDM population for 2016-2019 was 2.01% (4045/201120, 50.8% female, 68.4% white) with preDM+ cohort often consisting of younger (median 77 vs 81yrs), male vs females (49.2% vs 44.8%), blacks (14.7% vs 10.7%), Hispanics (8.9% vs 5.4%), Asian/Pacific Islanders (7.2% vs 2.6%) (p<0.001). There were declining trends in recurrent any/ischemic strokes among overall/preDM- cohort but nondeclining in preDM+ cohort
Table 1a
. The preDM+ cohort often had higher rates of hypertension, hyperlipidemia, obstructive sleep apnea, obesity and peripheral vascular disease. Multivariate analysis adjusted for confounders showed higher odds of any stroke (aOR:1.74, 95%CI:1.58-1.92) and ischemic strokes (aOR:1.83, 95%CI:1.64-2.03) (p<0.001) in preDM+ cohort vs. preDM- cohort [Table 1b] with prior history of stroke/TIA. The rates of transfer to short term hospitals and home health care requirements were higher among preDM+ cohort (3.2% vs. 2.9% & 18.7% vs. 17%).
Conclusion:
The study shows an increased risk of recurrent/secondary strokes (mainly ischemic) among elderly patients with preDM. Findings emphasize the need for strategies to achieve tighter glycemic control to mitigate risk of future cerebrovascular events.
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Affiliation(s)
| | | | - Mariam Ashfaque
- Peoples Univ of Med and Health Sciences for Women (PUMHSW),, Nawabshah, Sindh, Pakistan
| | | | | | | | | | - Srikanth Puli
- Dept of Hosp Medicine, Cheshire Med Cente, Keene, NH
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62
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Desai R, Fadah K, Srikanth S, Neha NFN, Jain A. Fibrinogen-albumin ratio predicting major adverse cardiovascular outcomes post-percutaneous coronary intervention: A systematic review and exploratory meta-analysis. Clin Cardiol 2023; 46:455-458. [PMID: 36722364 PMCID: PMC10106656 DOI: 10.1002/clc.23981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 02/02/2023] Open
Affiliation(s)
- Rupak Desai
- Independent Outcomes ResearcherAtlantaGeorgiaUSA
| | - Kahtan Fadah
- Department of Internal MedicineTexas Tech University Health Sciences CenterEl PasoTexasUSA
| | - Sashwath Srikanth
- Department of Internal MedicineEast Carolina University ‐ Vidant Medical CenterGreenvilleNorth CarolinaUSA
| | - N. F. N. Neha
- Department of MedicineUzhhorod National UniversityUzhhorodUkraine
| | - Akhil Jain
- Department of Internal MedicineMercy Catholic Medical CenterDarbyPennsylvaniaUSA
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63
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Raval M, Siddiq S, Sharma K, Sanghvi L, Jain A, Patel S, Trivedi J, Uttam Chandani K, Patel D, Desai R. A review of recent advances in the diagnosis of cardiac amyloidosis, treatment of its cardiac complications, and disease-modifying therapies. F1000Res 2023; 12:192. [PMID: 36911240 PMCID: PMC9995736 DOI: 10.12688/f1000research.130285.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
Cardiac amyloidosis (CA), a significant condition resulting in infiltrative cardiomyopathy and heart failure with preserved ejection fraction (HFpEF), is caused by extracellular deposition of amyloid fibrils in the heart. Even though this has been known for an extended period, its prevalence in elderly patients with heart failure is increasingly being recognized. Recent advances in diagnosis with non-invasive methods like technetium pyrophosphate-labeled cardiac scintigraphy (i.e., Tc-PYP scan) and treatment options with tafamidis have played a pivotal role in awareness of the burden of this disease. Management of cardiac complications like heart failure, atrial arrhythmias, conduction block, ventricular arrhythmias, coronary artery disease, and aortic stenosis is now more critical than ever. We aim to review and outline the recent advances in diagnoses of CA. We also review management strategies for cardiac complications of CA with a brief summary of disease-modifying therapies.
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Affiliation(s)
- Maharshi Raval
- Department of Internal Medicine, New York Medical College, Valhalla, New York, USA.,Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Sajid Siddiq
- Department of Cardiology, New York Medical College, Valhalla, New York, USA.,Department of Cardiology, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Kamal Sharma
- Department of Cardiology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Labdhi Sanghvi
- Department of Pediatrics, Ahmedabad Municipal Corporation Medical Education Trust Medical College, Ahmedabad, Gujarat, India
| | - Akhil Jain
- Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA
| | - Sagar Patel
- Department of Internal Medicine, New York Medical College, Valhalla, New York, USA.,Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Jaahnavee Trivedi
- Department of Internal Medicine, New York Medical College, Valhalla, New York, USA.,Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Kanishka Uttam Chandani
- Department of Internal Medicine, New York Medical College, Valhalla, New York, USA.,Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Dhriti Patel
- Department of Medicine, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, USA
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64
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Vyas A, Desai R, Patel V, Jain A, Doshi R. Peripheral vascular disease hospitalizations with cardiovascular disease risk and major adverse cardiac and cerebrovascular events occur at increasingly younger age across two nationwide cohorts selected 10-years apart. Indian Heart J 2023; 75:86-88. [PMID: 36493902 PMCID: PMC9986728 DOI: 10.1016/j.ihj.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/01/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ankit Vyas
- Baptist Hospitals of Southeast Texas, TX, USA
| | | | | | - Akhil Jain
- Mercy Catholic Medical Center, Darby, PA, USA
| | - Rajkumar Doshi
- St Joseph's University Medical Center, Paterson, NJ, USA.
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65
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Desai R, Li A, Mondal A, Shenwai P, Merugu B, Guzman FJN, Jain A. Direct Oral Anticoagulants Versus Vitamin K Antagonist (Warfarin) For Stroke Prevention In Frail Patients With Atrial Fibrillation: A Meta-Analysis. Proc AMIA Symp 2023; 36:274-275. [PMID: 36876251 PMCID: PMC9980567 DOI: 10.1080/08998280.2022.2155926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Rupak Desai
- Independent Outcomes Researcher, Atlanta, Georgia
| | - Aobo Li
- Department of Internal Medicine, Beijing Anzhen Hospital, Beijing, China
| | - Avilash Mondal
- Internal Medicine, Nazareth Hospital Philadelphia, Philadelphia, Pennsylvania
| | - Priya Shenwai
- Department of Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York
| | - Bhavyasri Merugu
- Department of Medicine, Vydehi Institute of Medical Sciences and Research Centre, Karnataka, India
| | | | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania
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Desai R, Edusa S, Reyaz N, Venkata VS, Puli S, Jain A. Seasonal variation in in-hospital outcomes of Takotsubo-syndrome-related admissions: A National Inpatient Analysis, 2019. Int J Cardiol Cardiovasc Risk Prev 2022; 16:200164. [PMID: 36588795 PMCID: PMC9794875 DOI: 10.1016/j.ijcrp.2022.200164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/12/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
Takotsubo syndrome (TTS) is a transitory stress-related cardiomyopathy characterized by acute but reversible left ventricular failure. The disease most commonly affects postmenopausal women following a traumatic experience, often presenting as an acute myocardial infarction (MI), and its prevalence is increasing globally. Cardiovascular events such as Acute Coronary Syndrome (ACS) and stroke have well-defined seasonal variations and are most common in the winter [[8], [9], [10]]. However, there is insufficient data on the impact of such climatic variations on the etiopathogenesis and outcomes of TTS-related hospitalization in the United States.
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Affiliation(s)
- Rupak Desai
- Independent Outcomes Researcher, Atlanta, USA
| | | | - Nafisa Reyaz
- Department of Medicine Jawaharlal Nehru Medical College, Aligarh, India
| | | | - Srikanth Puli
- Department of Hospital Medicine, Cheshire Medical Center/Dartmouth Health, Keene, NH, USA
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, PA, USA
- Corresponding author. Department of Internal Medicine, Mercy Catholic Medical Center, 1500 Lansdowne Avenue, Darby, PA 19023, PA, USA.
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Trivedi C, Desai R, Rafael J, Bui S, Husain K, Rizvi A, Hassan M, Mansuri Z, Jain S. Prevalence of Substance use disorder among young adults hospitalized in the US hospital: A decade of change. Psychiatry Res 2022; 317:114913. [PMID: 37732859 DOI: 10.1016/j.psychres.2022.114913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Mental health disorders (MHD) and substance use disorders (SUD) lead to outstanding socioeconomic costs and increased hospital visits. However, very few studies have quantified this trend over time and across specific conditions. Our study aims to investigate and compare the prevalence of MHDs and SUDs in hospitalizations between 2007 and 2017. METHODS We used hospital records for 2007 and 2017 from the National Inpatient Sample (NIS) datasets to identify young adults (18-44 years) hospitalized with MHD and SUD. The prevalence of MHD in hospitalized patients in 2017 vs. 2007 was measured and compared. We generated a multivariable logistic regression analysis controlled for confounders, including age, sex, race, and payer status. We evaluated these outcomes using Odds Ratio (OR) and 95% Confidence Interval (CI). RESULTS A total 10,353,890 patients were included in 2007, and 8,569,789 patients were included in 2017. The prevalence of drug abuse among hospitalized patients was 8.4% in 2017 vs. 6.2% in 2007. Prevalence increased in both genders (15.7% vs. 13.0% among male, 5.7% vs. 3.9% among females) in 2017 vs. 2007. All psychiatric disorders showed a higher prevalence in 2017 compared to 2007. When stratified by race, the prevalence of substance use disorder increased among all races except Black race between 2017 vs. 2007. On multivariable analysis, widespread drug abuse was significantly associated with hospital admissions in 2017 vs. 2007 (OR: 1.27, 95% CI: 1.20-1.34, p<0.001). These associations held across many substance abuse cases and mental health disorders except cocaine abuse (OR: 0.84, 95%CI: 0.76-0.93, p<0.001). CONCLUSION There was a significant rise in substance use disorder and psychiatric disorder a decade later, from 2007, in hospitalized patients in the age group 18-44 years. The most increase was observed in amphetamine use disorder and anxiety disorder. Suicide and intentional self-inflicted injury increased in all races, with a maximum increase observed in Native Americans. Further studies evaluating the factors responsible for this upward trend would be beneficial.
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Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Rupak Desai
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - John Rafael
- School of Medicine, Texas Tech University Health Science Center at Lubbock, TX, United States.
| | - Stephanie Bui
- School of Medicine, Texas Tech University Health Science Center at Lubbock, TX, United States.
| | - Karrar Husain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Abid Rizvi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
| | - Mudasar Hassan
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, MA, United States.
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/ Harvard Medical School, Boston, MA, United States.
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin Odessa, TX, United States.
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Desai R, Jain A, Sultan W, Gandhi Z, Raju AR, Varughese VJ, Jnaneswaran G, Agarwal C, Rizvi B, Mansuri Z, Gupta P, Kumar G, Sachdeva R. Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis. Medicina (Kaunas) 2022; 58:medicina58101465. [PMID: 36295625 PMCID: PMC9609556 DOI: 10.3390/medicina58101465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18−44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015−December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06−1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01−1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55−12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38−2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02−2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Correspondence: or
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19153, USA
| | - Waleed Sultan
- Department of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USA
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, USA
| | - Athul Raj Raju
- Department of Medicine, Karuna Medical College, Chittur-Thathamangalam 678103, Kerala, India
| | - Vivek Joseph Varughese
- Department of Internal Medicine, Government Medical College, Thiruvananthapuram 695011, Kerala, India
| | - Geethu Jnaneswaran
- Department of Medicine, SUT Academy of Medical Sciences, Thiruvananthapuram 695028, Kerala, India
| | - Charu Agarwal
- Department of Medicine, Sri Siddhartha Medical College, Tumakuru 572107, Karnataka, India
| | - Bisharah Rizvi
- Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA 93720, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Puneet Gupta
- Department of Cardiology, Baptist Health Deaconess Madisonville, Madisonville, KY 42431, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
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West H, Siddique M, Volpe L, Desai R, Lyasheva M, Dangas K, Tomlins P, Mitchell A, Kardos A, Casadei B, Channon K, Antoniades C. Automated deep learning quantification of epicardial adiposity on cardiac CT predicts atrial fibrillation risk immediately following cardiac surgery and long-term. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT) is a visceral fat deposit within the pericardial sac which surrounds the heart myocardium and coronary arteries. The automated quantification of EAT volume is possible from routine CCTA scans via a deep-learning approach. The use of automated EAT quantification for the assessment of atrial fibrillation (AF) risk in the post-operative period, and longer-term, has not been previously investigated.
Purpose
To apply a deep-learning approach for automated segmentation of EAT from routine CCTA scans to assess the immediate post-operative and long-term risk of AF conveyed by EAT.
Methods
A deep-learning automated EAT segmentation tool using a 3D Residual-U-Net neural network architecture for 3D volumetric segmentation of CCTA data was created and trained on over 2800 consecutive CCTA performed as part of clinical care in patients with stable chest pain from 2015 onwards within the European arm of the Oxford Risk Factors And Non Invasive Imaging (ORFAN) Study. External validation in 817patients demonstrated excellent correlation between machine and human expert (CCC = 0.972). The prognostic value of deep-learning derived EAT volume was assessed in the AdipoRedOx Study (n=253; UK patients undergoing cardiac surgery) against both immediate in-hospital outcomes and longer-term outcomes from UK-wide NHS data, with adjustment for AF risk factors.
Results
There were 97 cases of new-onset AF in the immediate post-operative period (38.3%). EAT volume was found to be an independent predictor of post-operative AF regardless of body mass index. Utilising the median EAT volume as the cut point, the adjusted hazard ratio (HR [95% CI]) for risk of new-onset post-operative AF in-hospital was 1.56 [1.09–3.85], p<0.01 (Figure 1A). In receiver-operator characteristic analysis EAT volume added significant incremental prognostic power for the discrimination of in-hospital post-operative AF over a traditional risk factor model ΔAUC=0.101, p<0.01 (Figure 1B).
Over a median follow-up period of 89 months there were 48 unique cases (19%) of confirmed AF found in nation-wide NHS hospital episode statistics data for the AdipoRedOx cohort. EAT volume was found to be a significant independent predictor of long-term AF. Utilising the median EAT volume as the cut point, the adjusted HR for risk of new-onset long-term AF following cardiac surgery was 1.25 [1.08–3.17], p<0.01 (Figure 1C).
Conclusions
Automatically segmented EAT volume measured using a deep learning network predicts risk of both short-term new onset AF following cardiac surgery, and long-term risk of AF in the 7 years following the surgery independently of BMI and AF risk factors. This suggests that EAT is a potent mediator of AF risk in the post cardiac surgery setting.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation - TG/19/2/34831EU Commission - 965286
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Affiliation(s)
- H West
- University of Oxford , Oxford , United Kingdom
| | - M Siddique
- University of Oxford , Oxford , United Kingdom
| | - L Volpe
- University of Oxford , Oxford , United Kingdom
| | - R Desai
- Northwestern University , Chicago , United States of America
| | - M Lyasheva
- University of Oxford , Oxford , United Kingdom
| | - K Dangas
- University of Oxford , Oxford , United Kingdom
| | - P Tomlins
- Caristo Diagnostics , Oxford , United Kingdom
| | - A Mitchell
- Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - A Kardos
- Milton Keynes University Hospital NHS Trust , Milton Keynes , United Kingdom
| | - B Casadei
- University of Oxford , Oxford , United Kingdom
| | - K Channon
- University of Oxford , Oxford , United Kingdom
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Desai R, Singh S, Dyutima DR, Verma J, Raina J, Itare V, Rizvi B, Gandhi Z, Vyas A, Jain A. Predictors of acute pulmonary embolism-related hospitalizations – an artificial neural network analysis using a nationwide cohort in the United States. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Considering a paucity of large-scale data on predictors of pulmonary embolism (PE) and its higher association with complications and worse outcomes, we aimed to determine the predictors of PE in this United States population-based analysis using Artificial Neural Network (ANN) Model in a nationally representative cohort.
Methods
We identified PE-related hospitalizations using 2018's National Inpatient Sample database. The relevant predictive factors for ANN were selected for this cohort. Of all admissions (unweighted n=7,105,498, weighted n=35,527,481), PE cohort (weighted n=387805) consisted of 1.1% of all admissions in 2018. The 2018 cohort was randomly split into training data (unweighted n=4716132, 70.0%) which were used to calibrate ANN and testing data (unweighted n=2019290, 30%) which were used to assess the accurateness of the algorithm. We equated the rate of incorrect prediction between training and testing data and measured the Area under Receiver Operator Curve (AUC) to determine ANN's efficacy in predicting PE hospitalizations.
Results
Patients hospitalized with PE often consisted of older (mean age 62.5±17.1 years), female (51.3%), white (70.5%) patients, and patients from lower-income quartile (0–25% income quartile: 28.8%%), often admitted non-electively (93.7%) with higher rates of cardiovascular disease risk factors. PE admissions revealed significantly higher (6.5% vs. 1.9%, p<0.001) in-hospital mortality, less frequent routine discharges (51.4% vs. 68.1%) and more frequent other facility transfers and requirement of home health care. Normalized Predictors of PE admissions are displayed in Fig. 1. Our ANN model had AUC 0.873 which correlates with an excellent prediction model. Our data demonstrated low levels (0.8%) error in both testing and training models.
Conclusion
Our ANN model showed high performance to predict risk factors for PE admissions in the US population. It will enable clinicians to screen patients at high-risk for PE admissions, curtail complication rate, improve survival and lower the healthcare cost.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Desai
- Independent Researcher , Atlanta , United States of America
| | - S Singh
- Royal Free Hospital, Neurology and Stroke , London , United Kingdom
| | - D R Dyutima
- James Cook University Hospital, Internal Medicine , Middlesbrough , United Kingdom
| | - J Verma
- District Hospital Sangrur, Pulmonology, Sangrur , Punjab , India
| | - J Raina
- Brookdale University Hospital & Medical Center, Internal Medicine , Brooklyn , United States of America
| | - V Itare
- Bronxcare Health System, Internal Medicine , Bronx , United States of America
| | - B Rizvi
- Saint Agnes Medical Center, Internal Medicine , Fresno , United States of America
| | - Z Gandhi
- Geisinger Wyoming Valley Medical Center, Internal Medicine , Wilkes-Barre , United States of America
| | - A Vyas
- Baptist Hospitals of Southeast Texas, Internal Medicine , Beaumont , United States of America
| | - A Jain
- Mercy Catholic Medical Center, Internal Medicine , Darby , United States of America
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Mansuri Z, Patel K, Trivedi C, Desai S, Patel S, Desai R, Vadukapuram R, Lodhi A, Reddy A. Burden of Psychiatric Disorders in Moyamoya Disease. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21m03157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Tran KB, Lang JJ, Compton K, Xu R, Acheson AR, Henrikson HJ, Kocarnik JM, Penberthy L, Aali A, Abbas Q, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdelwahab AA, Abdoli G, Abdulkadir HA, Abedi A, Abegaz KH, Abidi H, Aboagye RG, Abolhassani H, Absalan A, Abtew YD, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Addison D, Addo IY, Adegboye OA, Adesina MA, Adnan M, Adnani QES, Advani SM, Afrin S, Afzal MS, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad R, Ahmad S, Ahmad S, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Ahmed Rashid T, Aiman W, Ajami M, Akalu GT, Akbarzadeh-Khiavi M, Aklilu A, Akonde M, Akunna CJ, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alessy SA, Algammal AM, Al-Hanawi MK, Alhassan RK, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Al-Maweri SAA, Almustanyir S, Alonso N, Alqalyoobi S, Al-Raddadi RM, Al-Rifai RHH, Al-Sabah SK, Al-Tammemi AB, Altawalah H, Alvis-Guzman N, Amare F, Ameyaw EK, Aminian Dehkordi JJ, Amirzade-Iranaq MH, Amu H, Amusa GA, Ancuceanu R, Anderson JA, Animut YA, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Ansha MG, Antony B, Antwi MH, Anwar SL, Anwer R, Anyasodor AE, Arabloo J, Arab-Zozani M, Aremu O, Argaw AM, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Aruleba RT, Aryannejad A, Asaad M, Asemahagn MA, Asemi Z, Asghari-Jafarabadi M, Ashraf T, Assadi R, Athar M, Athari SS, Atout MMW, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Awoke MA, Awoke T, Ayala Quintanilla BP, Ayana TM, Ayen SS, Azadi D, Azadnajafabad S, Azami-Aghdash S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azizi H, Azzam AYY, Babajani A, Badar M, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bahadory S, Baig AA, Baker JL, Bakhtiari A, Bakshi RK, Banach M, Banerjee I, Bardhan M, Barone-Adesi F, Barra F, Barrow A, Bashir NZ, Bashiri A, Basu S, Batiha AMM, Begum A, Bekele AB, Belay AS, Belete MA, Belgaumi UI, Bell AW, Belo L, Benzian H, Berhie AY, Bermudez ANC, Bernabe E, Bhagavathula AS, Bhala N, Bhandari BB, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bhuyan SS, Bibi S, Bilchut AH, Bintoro BS, Biondi A, Birega MGB, Birhan HE, Bjørge T, Blyuss O, Bodicha BBA, Bolla SR, Boloor A, Bosetti C, Braithwaite D, Brauer M, Brenner H, Briko AN, Briko NI, Buchanan CM, Bulamu NB, Bustamante-Teixeira MT, Butt MH, Butt NS, Butt ZA, Caetano dos Santos FL, Cámera LA, Cao C, Cao Y, Carreras G, Carvalho M, Cembranel F, Cerin E, Chakraborty PA, Charalampous P, Chattu VK, Chimed-Ochir O, Chirinos-Caceres JL, Cho DY, Cho WCS, Christopher DJ, Chu DT, Chukwu IS, Cohen AJ, Conde J, Cortés S, Costa VM, Cruz-Martins N, Culbreth GT, Dadras O, Dagnaw FT, Dahlawi SMA, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Danielewicz A, Dao ATM, Darvishi Cheshmeh Soltani R, Darwesh AM, Das S, Davitoiu DV, Davtalab Esmaeili E, De la Hoz FP, Debela SA, Dehghan A, Demisse B, Demisse FW, Denova-Gutiérrez E, Derakhshani A, Derbew Molla M, Dereje D, Deribe KS, Desai R, Desalegn MD, Dessalegn FN, Dessalegni SAA, Dessie G, Desta AA, Dewan SMR, Dharmaratne SD, Dhimal M, Dianatinasab M, Diao N, Diaz D, Digesa LE, Dixit SG, Doaei S, Doan LP, Doku PN, Dongarwar D, dos Santos WM, Driscoll TR, Dsouza HL, Durojaiye OC, Edalati S, Eghbalian F, Ehsani-Chimeh E, Eini E, Ekholuenetale M, Ekundayo TC, Ekwueme DU, El Tantawi M, Elbahnasawy MA, Elbarazi I, Elghazaly H, Elhadi M, El-Huneidi W, Emamian MH, Engelbert Bain L, Enyew DB, Erkhembayar R, Eshetu T, Eshrati B, Eskandarieh S, Espinosa-Montero J, Etaee F, Etemadimanesh A, Eyayu T, Ezeonwumelu IJ, Ezzikouri S, Fagbamigbe AF, Fahimi S, Fakhradiyev IR, Faraon EJA, Fares J, Farmany A, Farooque U, Farrokhpour H, Fasanmi AO, Fatehizadeh A, Fatima W, Fattahi H, Fekadu G, Feleke BE, Ferrari AA, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Foroumadi R, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gaipov A, Galehdar N, Gallus S, Garg T, Gaspar Fonseca M, Gebremariam YH, Gebremeskel TG, Gebremichael MA, Geda YF, Gela YY, Gemeda BNB, Getachew M, Getachew ME, Ghaffari K, Ghafourifard M, Ghamari SH, Ghasemi Nour M, Ghassemi F, Ghimire A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Ghozy S, Gilani SA, Gill PS, Ginindza TG, Gizaw ATT, Glasbey JC, Godos J, Goel A, Golechha M, Goleij P, Golinelli D, Golitaleb M, Gorini G, Goulart BNG, Grosso G, Guadie HA, Gubari MIM, Gudayu TW, Guerra MR, Gunawardane DA, Gupta B, Gupta S, Gupta VB, Gupta VK, Gurara MK, Guta A, Habibzadeh P, Haddadi Avval A, Hafezi-Nejad N, Hajj Ali A, Haj-Mirzaian A, Halboub ES, Halimi A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Hariri S, Harlianto NI, Haro JM, Hartono RK, Hasaballah AI, Hasan SMM, Hasani H, Hashemi SM, Hassan AM, Hassanipour S, Hayat K, Heidari G, Heidari M, Heidarymeybodi Z, Herrera-Serna BY, Herteliu C, Hezam K, Hiraike Y, Hlongwa MM, Holla R, Holm M, Horita N, Hoseini M, Hossain MM, Hossain MBH, Hosseini MS, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Hugo FN, Humayun A, Hussain S, Hussein NR, Hwang BF, Ibitoye SE, Iftikhar PM, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Innos K, Iranpour P, Irham LM, Islam MS, Islam RM, Islami F, Ismail NE, Isola G, Iwagami M, J LM, Jaiswal A, Jakovljevic M, Jalili M, Jalilian S, Jamshidi E, Jang SI, Jani CT, Javaheri T, Jayarajah UU, Jayaram S, Jazayeri SB, Jebai R, Jemal B, Jeong W, Jha RP, Jindal HA, John-Akinola YO, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kacimi SEO, Kadashetti V, Kahe F, Kakodkar PV, Kalankesh LR, Kalankesh LR, Kalhor R, Kamal VK, Kamangar F, Kamath A, Kanchan T, Kandaswamy E, Kandel H, Kang H, Kanno GG, Kapoor N, Kar SS, Karanth SD, Karaye IM, Karch A, Karimi A, Kassa BG, Katoto PDMC, Kauppila JH, Kaur H, Kebede AG, Keikavoosi-Arani L, Kejela GG, Kemp Bohan PM, Keramati M, Keykhaei M, Khajuria H, Khan A, Khan AAK, Khan EA, Khan G, Khan MN, Khan MAB, Khanali J, Khatab K, Khatatbeh MM, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khazeei Tabari MA, Khezeli M, Khodadost M, Kim MS, Kim YJ, Kisa A, Kisa S, Klugar M, Klugarová J, Kolahi AA, Kolkhir P, Kompani F, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy Y, Kucuk Bicer B, Kugbey N, Kulimbet M, Kumar A, Kumar GA, Kumar N, Kurmi OP, Kuttikkattu A, La Vecchia C, Lahiri A, Lal DK, Lám J, Lan Q, Landires I, Larijani B, Lasrado S, Lau J, Lauriola P, Ledda C, Lee SW, Lee SWH, Lee WC, Lee YY, Lee YH, Legesse SM, Leigh J, Leong E, Li MC, Lim SS, Liu G, Liu J, Lo CH, Lohiya A, Lopukhov PD, Lorenzovici L, Lotfi M, Loureiro JA, Lunevicius R, Madadizadeh F, Mafi AR, Magdeldin S, Mahjoub S, Mahmoodpoor A, Mahmoudi M, Mahmoudimanesh M, Mahumud RA, Majeed A, Majidpoor J, Makki A, Makris KC, Malakan Rad E, Malekpour MR, Malekzadeh R, Malik AA, Mallhi TH, Mallya SD, Mamun MA, Manda AL, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mantovani LG, Martini S, Martorell M, Masoudi S, Masoumi SZ, Matei CN, Mathews E, Mathur MR, Mathur V, McKee M, Meena JK, Mehmood K, Mehrabi Nasab E, Mehrotra R, Melese A, Mendoza W, Menezes RG, Mengesha SID, Mensah LG, Mentis AFA, Mera-Mamián AYM, Meretoja TJ, Merid MW, Mersha AG, Meselu BT, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Mijena GFW, Miller TR, Mir SA, Mirinezhad SK, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Mirzaei HR, Misganaw AS, Misra S, Mohammad KA, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohan S, Mohseni M, Moka N, Mokdad AH, Molassiotis A, Molokhia M, Momenzadeh K, Momtazmanesh S, Monasta L, Mons U, Montasir AA, Montazeri F, Montero A, Moosavi MA, Moradi A, Moradi Y, Moradi Sarabi M, Moraga P, Morawska L, Morrison SD, Morze J, Mosapour A, Mostafavi E, Mousavi SM, Mousavi Isfahani H, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mulita F, Munblit D, Munro SB, Murillo-Zamora E, Musa J, Nabhan AF, Nagarajan AJ, Nagaraju SP, Nagel G, Naghipour M, Naimzada MD, Nair TS, Naqvi AA, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Ndejjo R, Nduaguba SO, Negash WW, Nejadghaderi SA, Nejati K, Neupane Kandel S, Nguyen HVN, Niazi RK, Noor NM, Noori M, Noroozi N, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nzoputam CI, Nzoputam OJ, Oancea B, Odukoya OO, Oghenetega OB, Ogunsakin RE, Oguntade AS, Oh IH, Okati-Aliabad H, Okekunle AP, Olagunju AT, Olagunju TO, Olakunde BO, Olufadewa II, Omer E, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Otstavnov SS, Oulhaj A, Oumer B, Owopetu OF, Oyinloye BE, P A M, Padron-Monedero A, Padubidri JR, Pakbin B, Pakshir K, Pakzad R, Palicz T, Pana A, Pandey A, Pandey A, Pant S, Pardhan S, Park EC, Park EK, Park S, Patel J, Pati S, Paudel R, Paudel U, Paun M, Pazoki Toroudi H, Peng M, Pereira J, Pereira RB, Perna S, Perumalsamy N, Pestell RG, Pezzani R, Piccinelli C, Pillay JD, Piracha ZZ, Pischon T, Postma MJ, Pourabhari Langroudi A, Pourshams A, Pourtaheri N, Prashant A, Qadir MMF, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Raeisi M, Rafiee A, Rafiei A, Raheem N, Rahim F, Rahman MO, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajai N, Rajesh A, Ram P, Ramezanzadeh K, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Rehman AU, Rehman IU, Reitsma MB, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezapour A, Riad A, Rikhtegar R, Rios-Blancas M, Roberts TJ, Rohloff P, Romero-Rodríguez E, Roshandel G, Rwegerera GM, S M, Saber-Ayad MM, Saberzadeh-Ardestani B, Sabour S, Saddik B, Sadeghi E, Saeb MR, Saeed U, Safaei M, Safary A, Sahebazzamani M, Sahebkar A, Sahoo H, Sajid MR, Salari H, Salehi S, Salem MR, Salimzadeh H, Samodra YL, Samy AM, Sanabria J, Sankararaman S, Sanmarchi F, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sarvi F, Sathian B, Satpathy M, Sayegh N, Schneider IJC, Schwarzinger M, Šekerija M, Senthilkumaran S, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shah PA, Shahabi S, Shahid I, Shahrbaf MA, Shahsavari HR, Shaikh MA, Shaka MF, Shaker E, Shannawaz M, Sharew MMS, Sharifi A, Sharifi-Rad J, Sharma P, Shashamo BB, Sheikh A, Sheikh M, Sheikhbahaei S, Sheikhi RA, Sheikhy A, Shepherd PR, Shetty A, Shetty JK, Shetty RS, Shibuya K, Shirkoohi R, Shirzad-Aski H, Shivakumar KM, Shivalli S, Shivarov V, Shobeiri P, Shokri Varniab Z, Shorofi SA, Shrestha S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva LMLR, Silva Julian G, Silvestris N, Simegn W, Singh AD, Singh A, Singh G, Singh H, Singh JA, Singh JK, Singh P, Singh S, Sinha DN, Sinke AH, Siraj MS, Sitas F, Siwal SS, Skryabin VY, Skryabina AA, Socea B, Soeberg MJ, Sofi-Mahmudi A, Solomon Y, Soltani-Zangbar MS, Song S, Song Y, Sorensen RJD, Soshnikov S, Sotoudeh H, Sowe A, Sufiyan MB, Suk R, Suleman M, Suliankatchi Abdulkader R, Sultana S, Sur D, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabatabaei SM, Tabuchi T, Tadbiri H, Taheri E, Taheri M, Taheri Soodejani M, Takahashi K, Talaat IM, Tampa M, Tan KK, Tat NY, Tat VY, Tavakoli A, Tavakoli A, Tehrani-Banihashemi A, Tekalegn Y, Tesfay FH, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Thomas NK, Ticoalu JHV, Tiyuri A, Tollosa DN, Topor-Madry R, Touvier M, Tovani-Palone MR, Traini E, Tran MTN, Tripathy JP, Ukke GG, Ullah I, Ullah S, Ullah S, Unnikrishnan B, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vardavas C, Varthya SB, Vaziri S, Velazquez DZ, Veroux M, Villeneuve PJ, Violante FS, Vladimirov SK, Vlassov V, Vo B, Vu LG, Wadood AW, Waheed Y, Walde MT, Wamai RG, Wang C, Wang F, Wang N, Wang Y, Ward P, Waris A, Westerman R, Wickramasinghe ND, Woldemariam M, Woldu B, Xiao H, Xu S, Xu X, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yeshaw Y, Yismaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yousefian F, Yu C, Yu Y, Yunusa I, Zahir M, Zaki N, Zaman BA, Zangiabadian M, Zare F, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zeineddine MA, Zhang D, Zhang J, Zhang Y, Zhang ZJ, Zhou L, Zodpey S, Zoladl M, Vos T, Hay SI, Force LM, Murray CJL. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 400:563-591. [PMID: 35988567 PMCID: PMC9395583 DOI: 10.1016/s0140-6736(22)01438-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). INTERPRETATION The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. FUNDING Bill & Melinda Gates Foundation.
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Mansuri Z, Patel K, Parekh T, Trivedi C, Patel S, Desai S, Desai R, Vadukapuram R, Reddy A, Baweja R. Frequency of Psychiatric Disorders in Adult Patients Hospitalized With Marital Problems. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21br03156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdoli A, Abdollahi M, Abdullah AYM, Abhilash ES, Abu-Gharbieh E, Acuna JM, Addolorato G, Adebayo OM, Adekanmbi V, Adhikari K, Adhikari S, Adnani QES, Afzal S, Agegnehu WY, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed H, Ahmed Rashid T, Akunna CJ, Al Hamad H, Alam MZ, Alem DT, Alene KA, Alimohamadi Y, Alizadeh A, Allel K, Alonso J, Alvand S, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Arabloo J, Arshad M, Artamonov AA, Aryan Z, Asaad M, Asemahagn MA, Astell-Burt T, Athari SS, Atnafu DD, Atorkey P, Atreya A, Ausloos F, Ausloos M, Ayano G, Ayanore MAA, Ayinde OO, Ayuso-Mateos JL, Azadnajafabad S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Badiye AD, Bagheri N, Bagherieh S, Bairwa M, Bakkannavar SM, Bakshi RK, Balchut/Bilchut AH, Bärnighausen TW, Barra F, Barrow A, Baskaran P, Belo L, Bennett DA, Benseñor IM, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bintoro BS, Blokhina EAE, Bodicha BBA, Boloor A, Bosetti C, Braithwaite D, Brenner H, Briko NI, Brunoni AR, Butt ZA, Cao C, Cao Y, Cárdenas R, Carvalho AF, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Castro-de-Araujo LFS, Cattaruzza MS, Chakraborty PA, Charan J, Chattu VK, Chaurasia A, Cherbuin N, Chu DT, Chudal N, Chung SC, Churko C, Ciobanu LG, Cirillo M, Claro RM, Costanzo S, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Dachew BA, Dadras O, Dai X, Damiani G, Dandona L, Dandona R, Daniel BD, Danielewicz A, Darega Gela J, Davletov K, de Araujo JAP, de Sá-Junior AR, Debela SA, Dehghan A, Demetriades AK, Derbew Molla M, Desai R, Desta AA, Dias da Silva D, Diaz D, Digesa LE, Diress M, Dodangeh M, Dongarwar D, Dorostkar F, Dsouza HL, Duko B, Duncan BB, Edvardsson K, Ekholuenetale M, Elgar FJ, Elhadi M, Elmonem MA, Endries AY, Eskandarieh S, Etemadimanesh A, Fagbamigbe AF, Fakhradiyev IR, Farahmand F, Farinha CSES, Faro A, Farzadfar F, Fatehizadeh A, Fauk NK, Feigin VL, Feldman R, Feng X, Fentaw Z, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Francis JM, Franklin RC, Gaal PA, Gad MM, Gallus S, Galvano F, Ganesan B, Garg T, Gebrehiwot MGD, Gebremeskel TG, Gebremichael MA, Gemechu TR, Getacher L, Getachew ME, Getachew Obsa A, Getie A, Ghaderi A, Ghafourifard M, Ghajar A, Ghamari SH, Ghandour LA, Ghasemi Nour M, Ghashghaee A, Ghozy S, Glozah FN, Glushkova EV, Godos J, Goel A, Goharinezhad S, Golechha M, Goleij P, Golitaleb M, Greaves F, Grivna M, Grosso G, Gudayu TW, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Hafezi-Nejad N, Haj-Mirzaian A, Hall BJ, Halwani R, Handiso TB, Hankey GJ, Hariri S, Haro JM, Hasaballah AI, Hassanian-Moghaddam H, Hay SI, Hayat K, Heidari G, Heidari M, Hendrie D, Herteliu C, Heyi DZ, Hezam K, Hlongwa MM, Holla R, Hossain MM, Hossain S, Hosseini SK, hosseinzadeh M, Hostiuc M, Hostiuc S, Hu G, Huang J, Hussain S, Ibitoye SE, Ilic IM, Ilic MD, Immurana M, Irham LM, Islam MM, Islam RM, Islam SMS, Iso H, Itumalla R, Iwagami M, Jabbarinejad R, Jacob L, Jakovljevic M, Jamalpoor Z, Jamshidi E, Jayapal SK, Jayarajah UU, Jayawardena R, Jebai R, Jeddi SA, Jema AT, Jha RP, Jindal HA, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabthymer RH, Kamble BD, Kandel H, Kanno GG, Kapoor N, Karaye IM, Karimi SE, Kassa BG, Kaur RJ, Kayode GA, Keykhaei M, Khajuria H, Khalilov R, Khan IA, Khan MAB, Kim H, Kim J, Kim MS, Kimokoti RW, Kivimäki M, Klymchuk V, Knudsen AKS, Kolahi AA, Korshunov VA, Koyanagi A, Krishan K, Krishnamoorthy Y, Kumar GA, Kumar N, Kumar N, Lacey B, Lallukka T, Lasrado S, Lau J, Lee SW, Lee WC, Lee YH, Lim LL, Lim SS, Lobo SW, Lopukhov PD, Lorkowski S, Lozano R, Lucchetti G, Madadizadeh F, Madureira-Carvalho ÁM, Mahjoub S, Mahmoodpoor A, Mahumud RA, Makki A, Malekpour MR, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martinez-Villa FA, Matzopoulos R, Maulik PK, Mayeli M, McGrath JJ, Meena JK, Mehrabi Nasab E, Menezes RG, Mensink GBM, Mentis AFA, Meretoja A, Merga BT, Mestrovic T, Miao Jonasson J, Miazgowski B, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mini GK, Mirica A, Mirijello A, Mirmoeeni S, Mirrakhimov EM, Misra S, Moazen B, Mobarakabadi M, Moccia M, Mohammad Y, Mohammadi E, Mohammadian-Hafshejani A, Mohammed TA, Moka N, Mokdad AH, Momtazmanesh S, Moradi Y, Mostafavi E, Mubarik S, Mullany EC, Mulugeta BT, Murillo-Zamora E, Murray CJL, Mwita JC, Naghavi M, Naimzada MD, Nangia V, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nepal S, Neupane SPP, Neupane Kandel S, Nigatu YT, Nowroozi A, Nuruzzaman KM, Nzoputam CI, Obamiro KO, Ogbo FA, Oguntade AS, Okati-Aliabad H, Olakunde BO, Oliveira GMM, Omar Bali A, Omer E, Ortega-Altamirano DV, Otoiu A, Otstavnov SS, Oumer B, P A M, Padron-Monedero A, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pardhan S, Parekh T, Park EK, Parry CDH, Pashazadeh Kan F, Patel J, Pati S, Patton GC, Paudel U, Pawar S, Peden AE, Petcu IR, Phillips MR, Pinheiro M, Plotnikov E, Pradhan PMS, Prashant A, Quan J, Radfar A, Rafiei A, Raghav PR, Rahimi-Movaghar V, Rahman A, Rahman MM, Rahman M, Rahmani AM, Rahmani S, Ranabhat CL, Ranasinghe P, Rao CR, Rasali DP, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Renzaho AMN, Rezaei N, Rezaei S, Rezaeian M, Riahi SM, Romero-Rodríguez E, Roth GA, Rwegerera GM, Saddik B, Sadeghi E, Sadeghian R, Saeed U, Saeedi F, Sagar R, Sahebkar A, Sahoo H, Sahraian MA, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Samy AM, Sanmarchi F, Santric-Milicevic MM, Sarikhani Y, Sathian B, Saya GK, Sayyah M, Schmidt MI, Schutte AE, Schwarzinger M, Schwebel DC, Seidu AA, Senthil Kumar N, SeyedAlinaghi S, Seylani A, Sha F, Shahin S, Shahraki-Sanavi F, Shahrokhi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shams-Beyranvand M, Sheikhbahaei S, Sheikhi RA, Shetty A, Shetty JK, Shiferaw DS, Shigematsu M, Shiri R, Shirkoohi R, Shivakumar KM, Shivarov V, Shobeiri P, Shrestha R, Sidemo NB, Sigfusdottir ID, Silva DAS, Silva NTD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sleet DA, Solmi M, SOLOMON YONATAN, Song S, Song Y, Sorensen RJD, Soshnikov S, Soyiri IN, Stein DJ, Subba SH, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Taheri M, Tan KK, Tareke M, Tarkang EE, Temesgen G, Temesgen WA, Temsah MH, Thankappan KR, Thapar R, Thomas NK, Tiruneh C, Todorovic J, Torrado M, Touvier M, Tovani-Palone MR, Tran MTN, Trias-Llimós S, Tripathy JP, Vakilian A, Valizadeh R, Varmaghani M, Varthya SB, Vasankari TJ, Vos T, Wagaye B, Waheed Y, Walde MT, Wang C, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wubetu AD, Xu S, Yamagishi K, Yang L, Yesera GEE, Yigit A, Yiğit V, Yimaw AEAE, Yon DK, Yonemoto N, Yu C, Zadey S, Zahir M, Zare I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zuniga YMH, Gakidou E. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 2022; 400:185-235. [PMID: 35843246 PMCID: PMC9289789 DOI: 10.1016/s0140-6736(22)00847-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING Bill & Melinda Gates Foundation.
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Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, Adhikari S, Advani SM, Afzal MS, Aghaie Meybodi M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alhalaiqa FAN, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Alvand S, Alvis-Guzman N, Amini S, Ancuceanu R, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Arabloo J, Aryannejad A, Asghari Jafarabadi M, Athari SS, Ausloos F, Ausloos M, Awedew AF, Awoke MA, Ayana TM, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Badiye AD, Bagherieh S, Bahadory S, Baig AA, Baker JL, Banach M, Barrow A, Berhie AY, Besharat S, Bhagat DS, Bhagavathula AS, Bhala N, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bjørge T, Bodicha BBA, Braithwaite D, Brenner H, Calina D, Cao C, Cao Y, Carreras G, Carvalho F, Cerin E, Chakinala RC, Cho WCS, Chu DT, Conde J, Costa VM, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Danielewicz A, Demeke FM, Demissie GD, Desai R, Dhamnetiya D, Dianatinasab M, Diaz D, Didehdar M, Doaei S, Doan LP, Dodangeh M, Eghbalian F, Ejeta DD, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Enyew DB, Eyayu T, Ezzeddini R, Fakhradiyev IR, Farooque U, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fattahi H, Fattahi N, Fereidoonnezhad M, Fernandes E, Fetensa G, Filip I, Fischer F, Foroutan M, Gaal PA, Gad MM, Gallus S, Garg T, Getachew T, Ghamari SH, Ghashghaee A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Gizaw AT, Glasbey JC, Golechha M, Goleij P, Gonfa KB, Gorini G, Guha A, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Haque S, Hariri S, Hasaballah AI, Hassanipour S, Hay SI, Herteliu C, Holla R, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Humayun A, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Islami F, Iwagami M, Jahani MA, Jakovljevic M, Javaheri T, Jayawardena R, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jozwiak JJ, Kabir A, Kalhor R, Kamath A, Kapoor N, Karaye IM, Karimi A, Kauppila JH, Kazemi A, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khanali J, Khayamzadeh M, Khodadost M, Kim H, Kim MS, Kisa A, Kisa S, Kolahi AA, Koohestani HR, Kopec JA, Koteeswaran R, Koyanagi A, Krishnamoorthy Y, Kumar GA, Kumar M, Kumar V, La Vecchia C, Lami FH, Landires I, Ledda C, Lee SW, Lee WC, Lee YY, Leong E, Li B, Lim SS, Lobo SW, Loureiro JA, Lunevicius R, Madadizadeh F, Mahmoodpoor A, Majeed A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mantovani LG, Martorell M, Masoudi S, Mathur P, Meena JK, Mehrabi Nasab E, Mendoza W, Mentis AFA, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Mijena GFW, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Misra S, Mohammad KA, Mohammadi E, Mohammadi S, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Mokhtari Z, Molokhia M, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh R, Moraga P, Morgado-da-Costa J, Mubarik S, Mulita F, Naghavi M, Naimzada MD, Nam HS, Natto ZS, Nayak BP, Nazari J, Nazemalhosseini-Mojarad E, Negoi I, Nguyen CT, Nguyen SH, Noor NM, Noori M, Noori SMA, Nuñez-Samudio V, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Okati-Aliabad H, Olagunju AT, Olagunju TO, Ong S, Ostroff SM, Padron-Monedero A, Pakzad R, Pana A, Pandey A, Pashazadeh Kan F, Patel UK, Paudel U, Pereira RB, Perumalsamy N, Pestell RG, Piracha ZZ, Pollok RCG, Pourshams A, Pourtaheri N, Prashant A, Rabiee M, Rabiee N, Radfar A, Rafiei S, Rahman M, Rahmani AM, Rahmanian V, Rajai N, Rajesh A, Ramezani-Doroh V, Ramezanzadeh K, Ranabhat K, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Rastegar M, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezazadeh-Khadem S, Roshandel G, Saber-Ayad MM, Saberzadeh-Ardestani B, Saddik B, Sadeghi H, Saeed U, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Salimi A, Salimzadeh H, Samadi P, Samaei M, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sathian B, Satpathy M, Schneider IJC, Šekerija M, Sepanlou SG, Seylani A, Sha F, Shafiee SM, Shaghaghi Z, Shahabi S, Shaker E, Sharifian M, Sharifi-Rad J, Sheikhbahaei S, Shetty JK, Shirkoohi R, Shobeiri P, Siddappa Malleshappa SK, Silva DAS, Silva Julian G, Singh AD, Singh JA, Siraj MS, Sivandzadeh GR, Skryabin VY, Skryabina AA, Socea B, Solmi M, Soltani-Zangbar MS, Song S, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabibian E, Taheri M, TaheriAbkenar Y, Taherkhani A, Talaat IM, Tan KK, Tbakhi A, Tesfaye B, Tiyuri A, Tollosa DN, Touvier M, Tran BX, Tusa BS, Ullah I, Ullah S, Vacante M, Valadan Tahbaz S, Veroux M, Vo B, Vos T, Wang C, Westerman R, Woldemariam M, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yu C, Yuce D, Yunusa I, Zadnik V, Zahir M, Zare I, Zhang ZJ, Zoladl M. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:627-647. [PMID: 35397795 PMCID: PMC9192760 DOI: 10.1016/s2468-1253(22)00044-9] [Citation(s) in RCA: 157] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. METHODS Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. FINDINGS Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. INTERPRETATION The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. FUNDING Bill & Melinda Gates Foundation.
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West H, Siddique M, Volpe L, Desai R, Lyasheva M, Dangas K, Tomlins P, Mitchell A, Kardos A, Casadei B, Channon K, Antoniades C. 410 Automated Deep Learning Quantification Of Epicardial Adiposity On Cardiac CT Predicts Atrial Fibrillation Risk Immediately Following Cardiac Surgery And Long-term. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mishra V, Desai R, Chhina AK, Raina J, Itare V, Patel M, Doshi R, Gangani K, Sachdeva R, Kumar G. Cardiovascular disease risk factors and outcomes of acute myocardial infarction in young adults in two nationwide cohorts in the united states. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Acute myocardial infarction (AMI) can have considerable morbidity and devastating socioeconomic and psychological consequences in young adults. Previous studies reveal that the decline in mortality in AMI has mainly been in the older population while being comparatively less significant in younger patients. This study compares young adults (18 to 44 years) hospitalized with AMI across two nationwide cohorts, 2007 and 2017, in the United States (US). It examines the burden of AMI hospitalizations, the prevalence of comorbidities, and in-hospital outcomes in young adults a decade apart. It highlights the rise in AMI hospitalizations, lack of decrease in mortality, sex-based and racial disparities, the surge in post-MI complications, and the decline in reperfusion interventions in young AMI patients over a decade.
Purpose
Coronary heart disease prevalence is challenging to ascertain in younger adults because of limited data and frequent silent clinical presentations. AMI and its complications can cause considerable morbidity, psychological trauma, and socioeconomic burden in the young.
Methods
We identified hospitalizations for AMI in young adults in 2007 and 2017 using the weighted data from the National Inpatient Sample (NIS), which covers 20% of stratified data of all non-federal community hospitals in the US. We compared the following data between the two cohorts: admission rates, sociodemographic features, in-hospital morbidity, complications, mortality, rate of coronary interventions, and healthcare utilization between the two cohorts. We used Pearson’s Chi-square test and Mann-Whitney U test to compare categorical and continuous variables, respectively. We also applied multivariable regression analyses to assess and compare the risk of cardiovascular complications and in-hospital mortality while controlling for confounders, including age, sex, race, median household income quartile, primary insurance enrolment, and pre-existing comorbidities.
Results
AMI’s incidence was higher in males in both the cohorts, although with a decline (71.1% vs 66.1%), whereas it rose from 28.9% to 33.9% in females. Hypertension (47.8% vs 60.7%), smoking (49.7% vs 55.8%), obesity (14.8% vs 26.8%), and diabetes mellitus (22.0% vs 25.6%) increased in the 2017 cohort (Table 1). We found no significant difference in all-cause mortality (aOR = 1.01 (0.93-1.10), p=0.749). Post-AMI complications, cardiogenic shock (aOR = 1.16 (1.06-1.27), p=0.001), and fatal arrhythmias increased. Reperfusion interventions decreased in the 2017 cohort (PCI; aOR=0.95 (0.91-0.98), p<0.001; CABG; aOR=0.66 (0.61-0.71), p<0.001) (Table 2).
Conclusion
Our study highlights the rise in AMI hospitalizations, plateauing of mortality, gender disparity, the surge in post-MI complications, and a reassuring decline in the requirement of reperfusion interventions in young AMI patients over a decade.
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Affiliation(s)
- V Mishra
- Sir JJ Group of Hospitals, Mumbai, India
| | - R Desai
- Atlanta VA Medical Healthcare System, Cardiology, Atlanta, United States of America
| | - AK Chhina
- Washington D.C. Va Medical Center, Washington, DC, United States of America
| | - J Raina
- Brookdale University Hospital & Medical Center, Internal Medicine, Brooklyn, United States of America
| | - V Itare
- Brookdale University Hospital & Medical Center, Internal Medicine, Brooklyn, United States of America
| | - M Patel
- Smt. BK Shah Medical Institute and Research Centre, Medicine, Vadodara, India
| | - R Doshi
- St Joseph’s Regional Medical Center, Paterson, United States of America
| | - K Gangani
- Texas Health Arlington Memorial Hospital, Internal Medicine, Arlington, Texas, USA
| | - R Sachdeva
- Atlanta VA Medical Healthcare System, Cardiology, Atlanta, United States of America
| | - G Kumar
- Atlanta VA Medical Healthcare System, Cardiology, Atlanta, United States of America
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Desai R, Mandal A, Peethala MM, Raju AR, Valdez-Aquino C, Fatima B, Raina J, Itare V, Mishra V, Jain A. Frequency, risk and predictors of type 2 myocardial infarction hospitalizations in young obese patients: A nationwide population-based analysis in the United States. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Obesity in the young population is emerging as a challenging health concern. Though there is a rising prevalence of obesity and its potential association with demand ischemia-related myocardial infarction, data remains non-existent to evaluate the association of obesity or higher body mass index (BMI) with type 2 myocardial infarction (T2MI). We aim to identify the frequency, risk and predictors of T2MI in young hospitalized obese patients compared to non-obese patients in this population-based study.
Methods
We used National Inpatient Sample (2018, ICD-10 codes) to identify T2MI in young (18-44 years) hospitalized patients. Obesity was identified from comorbidities or using diagnostic codes for BMI>30 kg/m2. We performed multivariable regression analysis for the primary outcome of odds of T2MI in young obese patients compared to non-obese patients. The frequency of T2MI was compared between obese vs non-obese patients in overall and subgroup populations. Sociodemographic characteristics and comorbidities in T2MI-obese vs. T2MI-non-obese cohorts were also compared. A p<0.05 was considered a threshold for statistical significance.
Results
Out of 1,268,255 young hospitalized patients with obesity, 555 had T2MI. T2MI was significantly higher in young obese than non-obese (44 T2MI/100000 hospitalizations in young obese patients vs. 17 T2MI/100000 hospitalizations in young non-obese patients, overall 0.04% in obese vs. 0.02% in non-obese, p<0.001). Multivariate analysis revealed higher odds of T2MI in obese than nonobese when adjusted for demographics (aOR 2.65, 95% CI:2.42-2.90, p<0.001) and social demographics with comorbidities (aOR 1.60, 95% CI:1.24-2.07, p<0.001). In young obese, higher risk was found with advancing age (OR 1.07, 95% CI 1.03-1.11, p=0.001), in males than females (aOR 2.70, p<0.001), and blacks (aOR 2.22, p=0.011) and Native Americans (OR 3.91, 95% CI: 1.13-13.49, p=0.011) vs whites. Comorbidities including chronic obstructive pulmonary disease (OR 1.86), chronic kidney disease (CKD, OR 2.36), rheumatoid arthritis/collagen vascular disease (RA/CVD, OR 3.04) Iin young obese patients independently increased the risk of T2MI hospitalizations [Table 1]. The T2MI-obese cohort had a significantly higher rate of hyperlipidemia, hypertension, diabetes, COPD, and prior history of MI and TIA/stroke compared to the T2MI-nonobese cohort [Table 2].
Conclusion
This nationwide analysis revealed a significantly higher risk of T2MI in young obese patients compared to nonobese after excluding patients with concomitant diagnoses of T1MI. Males, blacks compared to females and whites, and comorbidities including COPD, CKD and RA/CVD predicted a higher risk of T2MI in young obese patients. Future studies are warranted to evaluate the role of higher body mass index in myocardial oxygen demand-supply mismatch and short-term/long-term risk and outcomes of T2MI.
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Affiliation(s)
- R Desai
- Independent Researcher, Atlanta, United States of America
| | - A Mandal
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - MM Peethala
- Rajeev Gandhi Institute of Medical Sciences, Department of Medicine, Kadapa, India
| | - AR Raju
- Karuna Medical College, Department of Medicine, Palakkad, India
| | - C Valdez-Aquino
- Instituto Nacional de Diabetes (INDEN), Santo Domingo, Dominican Republic
| | - B Fatima
- Deccan College of Medical Sciences, Hyderabad, India
| | - J Raina
- Brookdale University Hospital & Medical Center, Brooklyn, United States of America
| | - V Itare
- Bronxcare Health System, Bronx, United States of America
| | - V Mishra
- Grant Govt. Medical College and Sir J. J. Group of Hospitals, Mumbai, India
| | - A Jain
- Mercy Catholic Medical Center, Internal Medicine, Darby, United States of America
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Desai R, Mandal A, Peethala MM, Raju AR, Fatima B, Valdez-Aquino C, Raina J, Itare V, Mishra V, Jain A. Nationwide frequency, risk and outcomes of type-2 myocardial infarction in patients with versus without previously revascularized myocardial infarction (type 1). Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Type 2 myocardial infarction (T2MI), due to a mismatch between myocardial oxygen demand and supply, is being increasingly recognized with improved diagnostics. The upsetting concern of developing T2MI in patients with prior revascularized occlusive acute myocardial infarction (AMI) or type 1 MI (T1MI) makes it crucial to define the clinical profile and outcomes of T2MI in revascularized patients of ACS.
Purpose
To determine the risk and prognosis of T2MI in patients who had previously had coronary revascularization (PCI or CABG)
Methods
We used the National Inpatient Sample (2018) dataset from the United States to identify T2MI adult hospitalizations using ICD-10 codes and define our study arm as T2MI excluding secondary T1MI diagnoses but having prior revascularized (with percutaneous coronary intervention or coronary artery bypass grafting) AMI. We then compared demographics and comorbidities in T2MI cohort with vs without personal history of revascularized AMI. We used multivariate analysis to study the odds of T2MI hospitalizations with prior revascularized AMI and in-hospital outcomes (all-cause mortality, cardiogenic shock and resource utilization) adjusting for confounders.
Results
There were 33155 T2MI adult hospitalizations after excluding AMI (median age 71 years, 50.6% male, 67.3% white); 1435 (4.3%) had previously revascularized AMI. T2MI in the study arm had higher chances of hospitalization with prior revascularized AMI when adjusted for socio-demographics (aOR 6.92, 95% CI:6.50-7.36, p<0.001) and socio-demographics with comorbidities (aOR 5.70, 95%CI: 5.48-5.94, p<0.001) (Table 1). Study arm often had elderly (≥65 years old, 78.4% vs 65.8%), male (66.6% vs 49.9%), white (76.7% vs 66.9%), upper socio-economic class (20.2 vs 16.8%), patients who were often admitted to non-electively (99.3 vs 97.1%) and to rural (10.5 vs 9.3%) hospitalizations compared to control arm. The study arm had a significantly higher prevalence of diabetes mellitus, hyperlipidemia, peripheral vascular disease, chronic obstructive pulmonary disease, renal failure, deficiency anemias, prior TIA/stroke, depression and smoking. T2MI cohort with prior revascularized AMI did not show any significant association with in-hospital all-cause mortality (1.7 vs 3.0%, aOR 0.49, 95%CI 0.18-1.34, p=0.164) and cardiogenic shock (1.7% vs 2.1%, p=0.399) however, had lower hospital expenditure (median USD 31273 vs 36567) and fewer transfers to other facilities (19.5 vs 22.1%) than those without prior revascularized AMI (Table 2).
Conclusion
Population-based analysis of this nationally representative sample revealed up to six times higher risk of developing T2MI in patients with prior history of AMI (revascularized) but without any significant impact on all-cause in-hospital mortality or cardiogenic shock. Future studies are warranted to assess the short-term/long-term outcomes of T2MI in high risk patient population with previously revascularized AMI.
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Affiliation(s)
- R Desai
- Independent Researcher, Atlanta, United States of America
| | - A Mandal
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - MM Peethala
- Rajeev Gandhi Institute of Medical Sciences, Department of Medicine, Kadapa, India
| | - AR Raju
- Karuna Medical College, Department of Medicine, Palakkad, India
| | - B Fatima
- Deccan College of Medical Sciences, Hyderabad, India
| | - C Valdez-Aquino
- Instituto Nacional de Diabetes (INDEN), Santo Domingo, Dominican Republic
| | - J Raina
- Brookdale University Hospital & Medical Center, Brooklyn, United States of America
| | - V Itare
- Bronxcare Health System, Bronx, United States of America
| | - V Mishra
- Grant Govt. Medical College and Sir J. J. Group of Hospitals, Mumbai, India
| | - A Jain
- Mercy Catholic Medical Center, Department of Internal Medicine, Darby, United States of America
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Desai R, Sachdeva S, Jain A, Rizvi B, Fong HK, Raina J, Itare V, Alukal T, Jain A, Aggarwal A, Kumar G, Sachdeva R. Comparison of Percutaneous Coronary Intervention Outcomes Among Patients With Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease Overlap, and Pickwickian Syndrome (Obesity Hypoventilation Syndrome). Cureus 2022; 14:e24816. [PMID: 35686280 PMCID: PMC9170433 DOI: 10.7759/cureus.24816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) is often present in coronary artery disease patients and confers a high risk of complications following percutaneous coronary interventions (PCI). The impact of two commonly associated comorbid conditions, chronic obstructive pulmonary disease (COPD) and obesity hypoventilation syndrome (OHS, Pickwickian syndrome) in OSA patients undergoing PCI has never been studied. Methods The National Inpatient Sample (NIS; 2007-2014) was queried using the International Classification of Diseases, Clinical Modification 9 (ICD-9-CM) codes to compare baseline characteristics, comorbidities, and outcomes in adults undergoing PCI with OSA, COPD-overlap syndrome, and OSA+OHS. Results Of a total of 4,792,177 PCI-related inpatient encounters, OSA, OSA-COPD overlap syndrome, and OSA+OHS were found to be present in 153,706 (median age 62 years, 79.4% male), 65135 (median age 65 years, 66.0% male), and 2291 (median age 63 years, 58.2% males) patients, respectively. The OHS+OSA cohort, when compared to the COPD-OSA and OSA cohorts, was found to have the worst outcomes in terms of all-cause mortality (2.8% vs. 1.5% vs. 1.1%), hospital stay (median 6 vs. 3 vs. 2 days), hospital charges ($147, 209 vs. $101,416 vs. $87,983). Complications, including cardiogenic shock (7.3% vs. 3.4% vs. 2.6%), post-procedural myocardial infarction (11.2% vs. 7.1% vs. 6.0%), iatrogenic cardiac complications (6.1% vs. 3.5% vs. 3.7%), respiratory failure, acute kidney injury, infections, and pulmonary embolism, were also significantly higher in patients with OHS+OSA. Adjusted multivariable analysis revealed equivalent results with OHS+OSA having worse outcomes than OSA-COPD and OSA. Conclusion Concomitant OHS and COPD were linked to worse clinical outcomes in patients with OSA undergoing PCI. Future prospective studies are warranted to fully understand related pathophysiology, evaluate and validate long-term outcomes, and formulate effective preventive and management strategies.
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Desai R, Soni S, Ghumare I, Khanolkar V, Chintalapalli Patta HV, Yadav T, Asifali R, Asifali R, Asfeen UZ, Alukal T, Jain A. Abstract 220: Higher Odds Of Medication Non-compliance In Hospitalized Young Adults With Cannabis Use Disorder: A Nationwide Population-Based Study. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Medication non-compliance (MNC) is both a health and an economic burden. Considering a paucity of large-scale contemporary data, we aim to compare the rate of MNC in young adults hospitalized with vs without dependent cannabis use (cannabis use disorder) and study the risk factors of MNC.
Methods:
Young (18-44 years) patients with MNC were extracted from the National Inpatient Sample 2018 (ICD10 codes), divided into having and not having cannabis use disorder (CUD+ and CUD-). Rates of MNC were compared between 2 cohorts, CUD+ vs CUD-. Multivariate analysis was performed for predictors of MNC with CUD+.
Results:
Young hospitalized adults with CUD+ had an overall higher rate of MNC (7.2 vs 2.2%) vs CUD- cohort (p<0.001)
[Table 1]
. On subgroup analyses, significantly higher rates of MNC in CUD+ were seen in males (8 vs 4.2%), females (6 vs 1.4%), white (6.2 vs 1.4%), black (9.6 vs 3.8%), Hispanic (6.6 vs 1.7%), Asian/Pacific Islanders (6.7 vs 1%), Medicare enrollees (11.7 vs 5.8%), Medicaid enrollees (7.7 vs 2.8%), private insurees (4.9 vs 0.9%), in patients with concomitant depression (6.4 vs 3.7%), psychosis (8.3 vs 5.6%), alcohol abuse (7.3 vs 4.8%), tobacco use disorder (8.0 vs 4.5%) and overall drug abuse (7.6 vs 6.9%). When adjusted for confounders, young adults with CUD+ had higher odds of hospitalization with MNC vs. patients without CUD (aOR 1.19, 95CI 1.14-1.24, p<0.001). Statistically significant predictors for MNC in young adults with CUD were males (vs females, aOR 1.41, 95CI 1.31-1.52), blacks (vs whites, aOR 1.42, 95CI 1.28-1.57), psychosis (aOR 1.25, 95CI 1.12-1.40), tobacco use (aOR 1.36, 95CI 1.24-1.50) and drug abuse (aOR 1.92, 95CI 1.61-2.29).
Conclusion:
Medication non-compliance was significantly higher in all subgroups of young adults with CUD, with concomitant depression, psychosis, tobacco and alcohol use compared to non-cannabis users. Males, blacks, patients with psychosis, tobacco and drug users were likely to have MNC.
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Affiliation(s)
| | - Sukriti Soni
- Rural Med College, Ahmednagar, Maharashtra, India
| | - Ishan Ghumare
- Rural Med College of Pravara Med Trust, Ahmednagar, Maharashtra, India
| | - Vidhi Khanolkar
- Rural Med College of Pravara Med Trust, Ahmednagar, Maharashtra, India
| | | | - Tarun Yadav
- Institute of Human Behavior and Allied Sciences, Delhi, India
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Desai R, Dhaduk K, Verma J, Klair HSI, Merugu B, Dhakal R, Rizvi B, Jain A. Abstract 69: Predictors Of Cardiac Arrest-related Hospitalizations In Young (18-44 Years) Females - An Artificial Neural Network Analysis Using A Nationwide Cohort. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Considering the limited availability of data on Cardiac Arrest (CA) in young patients and especially females, we aimed to determine the predictors of CA in this population using Artificial Neural Network (ANN) Model in a national cohort from the United States.
Methods:
We identified CA-related hospitalizations among young females (18-44 years) using 2018’s National Inpatient Sample database. ANN’s predictive factors were selected for this cohort. Young females with CA (n=10810, 0.2% of all 2018 young female admissions) were randomly split into training data (n=7567, 70%) which were used to calibrate ANN and testing data (n=3243, 30%) which were used to evaluate the accuracy of the algorithm. We compared the frequency of incorrect prediction between training and testing data and measured the Area under Receiver Operator Curve (AUC) to determine ANN’s efficacy in predicting CA.
Results:
Young females with CA often consisted of older (median age 36 vs 30 years), blacks (25.3% vs 18%), and patients from lower-income quartile (0-25% income quartile:36.4% vs 29.9%) with higher rates of modifiable cardiovascular disease risk factors vs. females admitted without CA (p<0.001). Females with CA expectedly had significantly high (48.4%) in-hospital mortality. Normalized Predictors are displayed in Table 1. Our ANN model had AUC 0.902 (Fig 1) which correlates with an excellent prediction model. Our data showed 0.2% error in both testing and training models.
Conclusion:
Our ANN model achieved high performance to predict risk factors for CA admissions in young females. It will enable clinicians to screen high-risk young female hospitalized patients and improve survival in them.
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83
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Desai R, Aiya U, Rashid R, Deb A, Patel N, Alli-Ramsaroop B, Brereton B, Jain A, Rupareliya C. Abstract 177: Predictors Of All-cause Mortality In Young Onset Stroke: An Artificial Neural Network Analysis Using A Nationwide Cohort. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
It is crucial for providers to screen high risk patients with limited data being available on young onset stroke (YOS). We aimed to determine predictors of all-cause mortality in this population using the Artificial Neural Network (ANN) model in a national cohort.
Methods:
We identified young adult (18-44 yrs) YOS hospitalizations from the National Inpatient Sample (2018). ANN’s predictive factors were selected for all-cause mortality. YOS admissions were randomly split between training (70%) & testing datasets (30%). Training data was used to calibrate ANN while testing data was used to evaluate accuracy of the algorithm. We compared the frequency of incorrect prediction between training and testing data and measured area under the Receiver Operating Curve (AUC) to determine ANN’s efficacy in predicting in-hospital mortality in YOS.
Results:
The 2018 YOS cohort consisted of 39,040 admissions with a mean age of 36 ± 6 years (50.1% male, 51.1% white, 26.2% black, 15.5% Hispanic, 3.2% Asian or Pacific islanders) patients). The all-cause-in-hospital mortality was 5.3%. Training data showed an improved lower predictions in testing model vs testing (5.0% vs 5.2% error rate) , thereby depicting better accuracy. Normalized predictors are displayed in Figure 1a. The AUC was 0.82 (Fig 1b) which shows an excellent ANN model for inpatient mortality in YOS patients.
Conclusion:
The ANN model successfully revealed the order of prevalent predictors for all-cause mortality that can eventually be utilized to improve survival in high-risk patients.
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Desai R, Patel V, Vasavada A, Haque FA, Jain M, Shawl S, Desai R, Sadum N, Sanikommu S, Edusa S, Alukal T, Jain A. Abstract 229: Burden And Predictors Of Sepsis-associated Cardiac Arrest: A National Inpatient Sample Analysis, 2018. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Sepsis-induced myocardial dysfunction with the resultant cardiomyopathy carries a high risk of mortality. We aimed to study the risk factors of cardiac arrest (CA) in Sepsis-related hospitalizations (SRH).
Methods:
We identified SRHs using the National Inpatient Sample (2018) and ICD10 codes to categorized them into with vs without CA. We then compared baseline characteristics and performed multivariate analysis adjusting for confounders to identify predictors of sepsis-associated CA.
Results:
Of SRH (1,345,595) in 2018, 0.8% (11,365) had a CA
(Table1)
. SRH with CA often had elderly (median age 70 vs 66 years), males (55.3% vs 48.8%), blacks (19.6% vs 13.3%), Hispanics (12.3 vs 11.7%), Medicare enrollees (69.9 vs 59.1%), and had patients from lower-income households (LIH, 36.9% vs 30.7%) than non-CA cohort. Statistically significant predictors for CA in SRH were age (5% increased risk every 5 years), male sex (aOR 1.28, 95CI 1.16-1.4), black (aOR 1.49, 95CI 1.3-1.7) & Hispanic (aOR 1.26, 95CI 1.09-1.45) race, LIH (aOR 1.31, 95CI 1.13-1.52), CHF (aOR 2.4, 95CI 2.16-2.68), pulmonary circulation disorder (aOR 2.14, 95CI 1.72-2.66), prior cardiac arrest (aOR 1.95, 95CI 1.16-3.27), coagulopathy (aOR 1.69, 95CI 1.5-1.9), alcohol abuse (aOR 1.42 95CI 1.17-1.74), PVD (aOR 1.36, 95CI 1.17-1.58), CKD (aOR 1.26, 95CI 1.14-1.39), cancer without metastasis (aOR 1.49, 95CI 1.24-1.8) and with metastasis (aOR 1.24, 95CI 1.01-1.52). Urban non-teaching vs rural (aOR 1.32, 95CI 1.1-1.57) and Southern vs Northeast hospitals (aOR 1.26, 95CI 1.09-1.46) showed higher odds of CA.
Conclusion:
SRH associated CA had high mortality with prevalent demographic and regional disparities, evident from black and Hispanic, males, patients from LHI and Southern hospitals revealing a higher risk of sepsis-associated CA. Congestive heart failure, pulmonary disease, prior cardiac arrest, coagulopathy, alcohol abuse, PVD, CKD, and cancers were the strongest predictors of CA in SRH.
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Affiliation(s)
| | | | | | | | - Manisha Jain
- Shri Bhausaheb Hire Government Med College, Dhule, Maharashtra, India
| | - Saima Shawl
- Chittagong medical college and hospital, Chittagong, Bangladesh
| | - Rohan Desai
- Texas Tech Univ Health Science Cntr, El Paso, TX
| | - Navya Sadum
- Kamineni Academy of Med sciences and Rsch Cntr, Hyderabad, India
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85
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Desai R, Singh S, Gowda SN, Cartagena-Santana J, Valdez C, Spasova V, Galan M, Buhl Leon MC, Rupareliya C, Alukal T, Jain A. Abstract 215: Increasing Risk Of Hospitalizations For Young-onset Stroke With Improving Survival Odds - A Nationwide Analysis Of Two Cohorts A Decade Apart In The United States. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
The scarcity of large-scale trends data on young-onset stroke prompted us to explore the difference in stroke hospitalization and inpatient outcomes among young adults from two nationwide cohorts 10 years apart.
Methods:
The National Inpatient Sample (2007 & 2017) was utilized to identify stroke admissions among young adults(18-44 years). We compared demographics, comorbidities, inpatient outcomes and gender/racial disparities in frequency of stroke admissions and mortality between the two cohorts 10-years apart.
Results:
There was an increase in stroke admissions of young adults in 2017 (0.7%, n=58965/8,568,874, aOR: 1.48, 95%CI:1.46-1.5, p<0.001) compared to 2007 (0.4%, n=41379/10,330,126)
[Table 1]
. The 2017 cohort often included female (49.0% vs 48.4%), non-elective admissions (94.0% vs 90.9%), Medicaid beneficiary (35% vs 23.4%) and urban teaching hospitalizations (81% vs 61.6%)(p<0.05) vs. the 2007 cohort. Cardiovascular comorbidities like hypertension, hyperlipidemia, obesity, peripheral vascular disorders, congestive heart failure and atrial fibrillation/flutter were significantly more prevalent in the 2017 cohort vs. 2007. Reassuringly, with advanced medical and interventional therapeutics in the last decade, the odds of in-hospital mortality decreased in 2017 (aOR 0.84, 95%CI: 0.79-0.89) vs. 2007. Females, Caucasians and Hispanics witnessed a higher relative increase in stroke hospitalizations in 2017. In addition, compared to 2007, a significant decline in mortality was noticed among both sexes but Hispanics and Asians did not show an improvement in survival odds in2017 vs 2007.
Conclusion:
Comparison of two young stroke cohorts a decade apart shows an alarming rise in stroke hospitalizations (nearly 50% higher) with cardiovascular disease risk factors, particularly in the female gender, with declining in-hospital mortality. Persistent racial disparities warrant an inclusive approach in preventive care.
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Affiliation(s)
| | | | | | | | - Confesora Valdez
- Univ Autónomade Santo Domingo (UASD), Santo Domingo, Dominican Republic
| | | | - Mirian Galan
- Univ Autónoma de Santo Domingo (UASD), Santo Domingo Oeste, Dominican Republic
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86
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Yarrarapu SNS, Raina J, Itare V, Vyas A, Jain A, Desai R. Abstract 164: Impact Of Chronic Kidney Disease On The Risk And Outcomes Of Type-2 Myocardial Infarction In Geriatric Patients With Prior Bypass Grafting. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Coronary artery disease associates with increasing age and correlates with CABG being more common in elderly. However, prognostic data of ischemic events post-CABG is limited especially in geriatric patients who are underrepresented in clinical-trials. Furthermore, CKD accelerates coronary atherosclerosis and although treatment practices improved, incidence of ischemic events remain high due to oxygen supple-demand mismatch. Thus, we aim to evaluate impact of CKD on risk of Type-2 Myocardial Infarction (T2MI) in geriatric patients post-bypass grafting.
Methods:
Data from National Inpatient Sample (2018) was used to identify T2MI-related hospitalizations in geriatric patients with prior history of CABG and CKD. Logistic regression was used to assess the odds of T2MI with CKD. In-hospital outcomes and co-morbidities were compared between CKD & non-CKD cohorts.
Results:
T2MI-associated hospitalizations among studied population has higher odds when controlled for confounders (OR 1.48, 95%CI: 1.33-1.64, p<0.001). The two cohorts, CKD(n=399485) vs non-CKD(n=676550), had comparable sociodemographics (Table 1b); age at admission (78 vs 77); males (70.6% vs 70%); race- white (77.9% vs 83.5%), black (8.7% vs 5.4%), Hispanic (7.8% vs 6.5%). The odds of adverse cardiac events (cardiac arrest, cardiogenic shock, and dysrhythmia), all-cause mortality, and hospital length-of-stay was higher in CKD cohort with an exception for stroke (Table 1c). Statistical significance was observed (p<0.001) for all co-morbidities (except age) and outcomes.
Conclusion:
CKD confers an increased risk of T2MI-related hospitalizations and adverse in-hospital outcomes in geriatric patients post-bypass grafting. It finds significance in the need to mitigate risk factors of T2MI and adopt appropriate treatment practices in this population subset.
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Affiliation(s)
| | | | | | - Ankit Vyas
- Baptist Hosp of Southeast Texas, Beaumont, TX
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87
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Aiya U, Rashid R, Patel N, Deb A, Brereton B, Alli-Ramsaroop B, Desai R. Abstract 162: Burden And Impact Of Chronic Kidney Disease On Admissions Of Cancer Survivors And Assessing The Odds Of Major Adverse Cardiac And Cerebrovascular Events. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Cancer-specific adverse events are not well defined despite chronic kidney disease (CKD) being associated with high mortality rates in cancer patients. This study explores the prevalence of major adverse cardiac and cerebrovascular events (MACCE) in cancer survivors with CKD from a national cohort.
Methods:
We identified cancer survivors with and without concomitant CKD along with their age, sex, race and other comorbidities who were admitted to hospitals in a National Inpatient Sample database (2018). We then identified odds of MACCE including all-cause mortality, AMI, cardiac arrest (including ventricular fibrillation) and stroke while subsequently analyzing healthcare resource utilization in patients with versus without CKD. Multivariable regression analyses were adjusted for patient and hospital level covariates and pre-existing comorbidities. A p-value <0.05 was considered statistically significant.
Results:
CKD prevalence was higher among patients with a prior history of cancer versus those without it (21.5% vs 14.6%, p<0.001) in the cohort. Higher rates of traditional cardiovascular disease risk factors, prior history of MI, stroke/TIA, VTE, CHF, coagulopathy and MACCE (11.5% vs 8.1%, OR 1.22 [CI 1.20 -1.25]) were observed in patients with versus without CKD
[Table 1]
in hospitalized cancer survivors. Said survivors with CKD were specifically noted to have higher rates of all-cause mortality (3.4% vs 2.2%, OR 1.33 [CI 1.29 -1.37]) and AMI (6.0% vs 3.3%, OR 1.54 [CI 1.50 - 1.58]) (all p<0.001). The CKD cohort had fewer routine discharges, more frequent transfers to other facilities, higher length of stay and hospital costs versus the non-CKD cohort (p<0.001).
Conclusion:
This large retrospective analysis shows elevated burden of CKD (21.5%) amongst hospitalized cancer survivors, which is associated with not only increased rates of MACCE, all-cause mortality, AMI, cardiac arrest but also greater overall healthcare costs.
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88
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Jain A, Dhaduk K, Taj Shiza S, Shawl S, Raina J, Itare V, Ijaz H, Alukal T, Singh S, Desai R. Abstract 61: Major Adverse Cardiovascular And Cerebrovascular Events Among Homeless Cancer Survivors: A Decade-apart Nationwide Hospitalizations Analysis. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Homelessness being one of the independent risks for cardiovascular disease (CVD), we explored the burden of CVD risk factors and major adverse cardiac and cerebrovascular events (MACCE) and in-hospital outcomes among homeless cancer survivors in the USA two-decade apart.
Methods:
We compared the baseline demographic, comorbidities, and inpatient MACCE outcomes (all-cause mortality, cardiac arrest including arrhythmia, and stroke) between 2007 and 2017 using homeless cancer survivors' hospitalizations from National Inpatient Sample datasets.
Results:
A total of 14973 (median age 59 years, 53.4% male) admissions among homeless cancer survivors were studied (4778 in 2007 & 10195 in 2017, Table 1). Cohort 2017 had younger (median age 57 vs. 71 years), male (59.5% vs. 40.5%), Hispanic (8.0% vs. 5%), non-elective (93.8% vs. 87.4%) and low household income (24.7% vs. 20.8%) (p<0.001) admissions, and had a significantly higher burden of traditional cardiovascular risk factors like smoking, hypertension, hyperlipidemia, diabetes with chronic complications, congestive cardiac failure, alcohol abuse, drug abuse and depression compared to 2007 cohort. Univariate incidence of composite MACCE (16.2 vs 19.5%) and all-cause mortality (0.9 vs 1.3%) were significantly lower in 2017 compared to 2007. Multivariate analysis after socio-demographics, admitting hospital-related characteristics and comorbidities did not reveal worsening for MACCE-related hospitalizations (aOR 1.16, 95 CI 0.83-1.62, p=0.381).
Conclusion:
Homeless cancer survivors tend to be younger in 2017 than in 2007, with higher prevalence of cardiovascular risk factors and hospitalizations related to MACCE. However, they also tend to have improved in-hospital outcomes. Propagating aggressive screening in such survivors may further prevent MACCE-related hospitalizations.
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Affiliation(s)
| | | | | | - Saima Shawl
- Chittagong Med College and Hosp, Chittagong, Bangladesh
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89
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Desai R, Haque FA, Vasavada A, Jain M, Desai R, Patel V, Shawl S, Sanikommu S, Edusa S, Sadum N, Alukal T, Jain A. Abstract 230: Prediabetes In Young Adults And Its Association With Type 1 Myocardial Infarction-related Admissions And Outcomes: A Population-based Analysis In The United States. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Prediabetes (pDM) has recently drawn attention for being associated with poor outcomes after acute myocardial infarction (MI). We aimed to analyze the incidence and odds of type 1 MI admissions, and outcomes using a nationally representative sample.
Methods:
We queried the National Inpatient Sample (2018) to identify T1MI-related hospitalizations (T1RH) in young (18-44 years) adults with vs without pDM using ICD-10 codes. T1RHs with DM were excluded. Demographics, comorbidities and outcomes including major cardiovascular and cerebrovascular adverse events (MACCE) were compared between two cohorts.
Results:
Overall prevalence of pDM in young adults hospitalized in 2018 was 0.4% (31460/7851019). T1RH was found to be significantly higher in the pDM vs. non-pDM cohort (2.15%, 675/31460 vs. 0.3%, 21655/7820953) among all non-diabetic admissions in young adults. T1RH with pDM often had males (78.5 vs 72.8%), blacks (26.7 vs 21%), Hispanics (18.3 vs 11.5%), Asian/Pacific Islanders (6.9 vs 3.1%), patients from higher-income quartile (19.1 vs 15.8%), urban-teaching (81.5 vs 72.2%), Midwest (23.7 vs 21.9%) and West (23 vs 16.4%) region hospitals, and patients with higher rates of hyperlipidemia (68.1 vs 47.3%), obesity (48.9 vs 25.7%), fluid-electrolyte imbalance (18.5 vs 15.3%). The univariate (OR 7.9, 95CI 6.54-9.53) and adjusted multivariate analysis (OR 1.71, 95CI 1.38-2.12) revealed significantly higher odds of T1MI in the pDM vs non-pDM cohort (p<0.001)
[Table 1]
. However, T1RH’s outcome for MACCE (adjusted) did not differ between two cohorts (P=0.074). Furthermore, T1RH with pDM had higher transfers to short-term facilities (6.7 vs 5.3%, p<0.001).
Conclusion:
Young patients with prediabetes had significantly higher T1MI hospitalizations without any impact on subsequent MACCEs. This highlights the need for aggressive management of CVD risk factors in the young by primary care physicians to curtail acute cardiac events and healthcare costs.
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Affiliation(s)
| | | | | | - Manisha Jain
- Shri Bhausaheb Hire Government Med College, Dhule, Maharashtra, India
| | - Rohan Desai
- Texas Tech Univ Health Science Cntr, El Paso, TX
| | | | - Saima Shawl
- Chittagong medical college and hospital, Chittagong, Bangladesh
| | | | | | - Navya Sadum
- Kamineni Academy of Med sciences and Rsch Cntr, Hyderabad, India
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90
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Desai R, Chintalapalli Patta HV, Soni S, Ghumare I, Khanolkar V, Yadav T, Bansal P, Asifali R, Asifali R, Asfeen UZ, Alukal T, Jain A. Abstract 222: Paradoxical Favorable Clinical In-hospital Outcomes In Geriatric HF(pEF) Patients With Depression. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Depression has been identified as a risk factor for acute cardiovascular events. Considering limited data on the subject, we studied the burden and impact of comorbid depression on heart failure with preserved affection fraction (HFpEF)-related hospitalizations and outcomes using a nationally representative sample.
Methods:
Elderly (≥65 years) patients’ hospitalizations with HFpEF (after excluding HFrEF) were extracted from the National Inpatient Sample 2018 (ICD-10) and divided into with or without comorbid depression. Demographics, clinical profile and major cardiovascular and cerebrovascular events (MACCE, all-cause mortality, AMI, cardiac arrest and stroke) were compared between cohorts. Multivariable regression analysis was performed controlling covariates to assess the risk of MACCE in geriatric HFPEF admissions with depression.
Results:
Of 1,599,220 HFpEF hospitalizations in elderly patients (median age 80 years, 61.1% females) 14.1% (n=224,970) had comorbid depression (median age 77 years, 70.6% females). Females had a higher depression prevalence than males (16.2 vs. 10.6%, p<0.001). The HFpEF-depression arm often had relatively younger (77 vs. 80 years), white (83.1 vs. 76.1%), female (70.6 vs. 59.6%) patients with a significantly higher burden of CVD risk factors including hypertension, DM, hyperlipidemia, obesity, smoking, prior MI/TIA/stroke, alcohol abuse, anxiety-related and bipolar disorder vs. non-depression arm. Interestingly, the depression arm had a significantly lower rate (10.9% vs. 13.6%) and lower odds of MACCE (aOR 0.85, 95CI 0.82-0.88) when adjusted for sociodemographic confounders and comorbid risk factors (p<0.001)
[Table 1]
.
Conclusion:
The elderly patients with HFpEF have a high burden (female>males, whites>non-whites) of comorbid depression, however, our analysis revealed the “depression paradox” effect for in-hospital MACCE in geriatric HFpEF admissions and needs further evaluation.
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Affiliation(s)
| | | | - Sukriti Soni
- Rural medical college, PIMS, Ahmednagar, Maharashtra, India
| | - Ishan Ghumare
- Rural Med College of Pravara Med Trust, Ahmednagar, Maharashtra, India
| | - Vidhi Khanolkar
- Rural Med College of Pravara Med Trust, Ahmednagar, Maharashtra, India
| | - Tarun Yadav
- Institute of Human Behavior and Allied Sciences, Delhi, India
| | - Prerna Bansal
- Rural Med College, PIMS, Ahmednagar, Maharashtra, India
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91
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Desai R, Taj Shiza S, Shawl S, Yarrarapu SN, Raina J, Itare V, Ijaz H, Rida T, Alukal T, Singh S, Jain A. Abstract 62: Burden And Disparities Of Major Adverse Cardiac And Cerebrovascular Events In Nationwide Adult Hospitalizations With Cannabis Use Disorder. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Following the legalization/decriminalization of recreational cannabis use in the United States, an associated increase in the cardiac-deaths has been reported. Therefore, we aimed to study the burden and healthcare disparities in major adverse cardiac and cerebrovascular events (MACCE) in cannabis use disorder (CUD)-related hospitalizations using a nationwide cohort.
Methods:
We queried the National Inpatient Sample (2018) to identify CUD-related adult (≥18 years old) hospitalizations and associated MACCE (all-cause mortality, acute myocardial infarction-AMI, cardiac arrest and stroke) using ICD10 diagnostic codes. We also evaluated disparities in MACCE based on sex, race, household income, and geography.
Results:
Of 436,440 CUD-related admissions (34±14 years, 63.4% males, 53.4% white, 30% black, and 11.2% Hispanic), 4% (n=17335) patients experience in-hospital MACCE. All MACCE events including all-cause mortality were highest among geriatric patients followed by 45-64 years and 18-44 years age group with CUD
[Table 1]
. There was a sex disparity with males (4.6%) having higher MACCE than females (2.9%). Blacks (4.5%) compared to whites (3.9%) demonstrated a higher overall MACCE. Asian or Pacific Islanders with CUD had overall higher rates of all-cause mortality (1%) and cardiac arrest (1%) vs. others. Lowest income quartile CUD hospitalized patients had higher MACCE than higher-income quartile (4.3 vs 3.3%). MACCE were highest in Southern hospitals (5%) with CUD-related admissions.
Conclusion:
Among CUD-related admissions, elderly vs. younger patients, males vs. females, black and Asians compared to whites, and lowest income quartile patients and Southern region are prone to have increased MACCE. A multitude of factors including age, sex, race, socioeconomic status, and access to health care seems to play role in MACCE incidence and its outcomes in cannabis users which warrants attention by policymakers and physicians.
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Affiliation(s)
| | | | - Saima Shawl
- Chittagong Med College and Hosp, Chittagong, Bangladesh
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Dhaduk K, Patel V, Verma J, Merugu B, Klair HS, Dhakal R, Shingala R, Bambhroliya Z, Rizvi B, Jain A, Desai R. Abstract 158: Burden And Predictors Of Mortality And Major Adverse Cardiovascular Outcomes In Heart Failure Preserved Ejection Fraction Patients Admitted With Acute Respiratory Distress Syndrome (ARDS). Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Relation between Acute Respiratory Distress Syndrome (ARDS) and heart failure with preserved ejection fraction (HFpEF) are understudied and the data on these two concomitantly is lacking in the literature. Therefore, we sought to assess the burden and predictors of major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality in ARDS patients with HFpEF.
Methods:
The National Inpatient Sample (NIS) database was used to identify patients with HFpEF (after excluding patients with heart failure reduced ejection fraction) who required inpatient hospitalization for ARDS. Administrative ICD10 codes were used to identify the population of interest. Multivariate regression analysis was performed to assess the predictors of all-cause mortality and major adverse cardiovascular outcomes in the selected cohort.
Results:
Of 28,731,562 hospital admissions, 3,010 (0.14%) patients were admitted with ARDS and had HFpEF. Of those patients, 1,095 (36.4%) had all-cause mortality, and 1,415 (47.0%) had MACCE. In multivariate regression analysis, older age (OR 3.60, CI 1.40-9.28), 26-50
th
quartile income (OR 2.10, CI 1.13-3.91), urban hospital admissions (OR 2.19, CI 1.20-4.01) as well as comorbidities such as coagulopathy (OR 1.77, CI 1.09-2.88), fluid and electrolyte imbalance (OR 1.65, CI 1.05-2.60), prior CABG (OR 2.99, CI 1.19-7.47), need for mechanical ventilation (OR 2.18, CI 1.12-4.23) were significant predictors of all-cause mortality. In our analysis, chronic pulmonary disease, valvular heart disease, hypertension, smoking, obesity were not significant predictors. The result of our analysis is reported in Table 1.
Conclusion:
These results suggest HFpEF remains important comorbidity in ARDS patients. Here, we identified predictors of poor outcomes in this patient population which may help physicians to identify the high-risk patients and decrease mortality.
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93
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Mitchell EJ, Goodman K, Wakefield N, Cochran C, Cockayne S, Connolly S, Desai R, Hartley S, Lawton SA, Oatey K, Rhodes S, Savage JS, Taylor J, Youssouf NFJ. Clinical trial management: a profession in crisis? Trials 2022; 23:357. [PMID: 35477835 PMCID: PMC9044377 DOI: 10.1186/s13063-022-06315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/12/2022] [Indexed: 11/24/2022] Open
Abstract
Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the COVID-19 pandemic. Academic clinical trial units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in the delivery on the Department of Health and Social Care's Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this.
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Affiliation(s)
- E J Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - K Goodman
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, G4 0NA, UK
| | - N Wakefield
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - C Cochran
- Centre for Healthcare and Randomised Controlled Trials (CHaRT), Health Services Research Unit, University of Aberdeen, Aberdeen, AB23 2ZD, UK
| | - S Cockayne
- York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - S Connolly
- Royal Marsden Clinical Trials Unit, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK
| | - R Desai
- King's Ophthalmology Research Unit, King's College Hospital, London, SE5 9RS, UK
| | - S Hartley
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - S A Lawton
- Keele Clinical Trials Unit, School of Medicine, Keele University, Keele, ST5 5BG, UK
| | - K Oatey
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - S Rhodes
- Exeter Clinical Trials Unit, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK
| | - J S Savage
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - J Taylor
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - N F J Youssouf
- Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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94
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Jain A, Gandhi Z, Desai R, Mansuri U, Rizvi B, Alvarez M, Gupta P. Nationwide Trends in Hospitalizations and Outcomes of Pulmonary Circulation Disorders Among Patients With Cannabis Use Disorder in the United States. Cureus 2022; 14:e22897. [PMID: 35399488 PMCID: PMC8983119 DOI: 10.7759/cureus.22897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/05/2022] Open
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95
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Jain A, Shenwai P, Lakshmanan A, Neha AM, Merugu B, Gaddam N, Guzman FN, Itare V, Raina J, Desai R. DIRECT ORAL ANTICOAGULANTS VERSUS WARFARIN/VITAMIN K ANTAGONISTS FOR STROKE PREVENTION IN FRAIL PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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96
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Jain A, Shenwai P, Lakshmanan A, Gaddam N, Agadi K, Neha SS, Mohammad A, Merugu B, Desai R. “DEPRESSION PARADOX”: FAVORABLE IN-HOSPITAL OUTCOMES OF FEMALE TAKOTSUBO SYNDROME PATIENTS WITH COMORBID DEPRESSION: A PROPENSITY-MATCHED ANALYSIS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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97
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Sachdeva S, Manaktala P, Malik FA, Gupta U, Desai R. COVID-19 in Patients With Rheumatic Diseases: Is There a Need to Worry? J Clin Rheumatol 2022; 28:e401-e406. [PMID: 33902097 DOI: 10.1097/rhu.0000000000001746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVES SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), first described in December 2019, has infected more than 33 million people and claimed more than 1 million deaths worldwide. Rheumatic diseases are chronic inflammatory diseases, the prevalence and impact of which in COVID-19 patients are poorly known. We performed a pooled analysis of published data intending to summarize clinical presentation and patient outcomes in those with established rheumatic disease diagnosis and concurrent COVID-19. METHODS PubMed and Google Scholar were searched to identify studies reporting data about rheumatic disease patients who were diagnosed with SARS-CoV-2 infection and published until July 22, 2020. Random-effects models were used to estimate the pooled incidence and rates of hospitalization, intensive care unit admission, and mortality among these patients, and interstudy heterogeneity was identified using I2 statistics with greater than 75% value indicating substantial interstudy variation. RESULTS Twenty studies were included, giving a total sample size of 49,099 patients positive for SARS-CoV-2. Of 49,099 COVID-19 patients, a total of 1382 were also diagnosed with a rheumatic disease in the past. The random-effects pooled prevalence of COVID-19 among rheumatic disease patients was found to be 0.9%. The rates of hospitalization, intensive care unit admission, and mortality were 70.7%, 11.6%, and 10.2%, respectively. CONCLUSIONS Although the prevalence of SARS-CoV-2 infection is not dramatically high in rheumatic disease patients, concurrent COVID-19 does seem to play a role in determining disease severity and outcomes to some extent. Further studies are needed to give conclusive evidence about whether this subset of the population is at a higher risk of COVID-19 and related outcomes compared with the population at large.
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Affiliation(s)
- Sonali Sachdeva
- From the Department of Internal Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Pritika Manaktala
- Department of Internal Medicine, Canton Medical Education Foundation, Canton, OH
| | - Faizan Ahmad Malik
- Department of Internal Medicine, Texas Tech University Health Sciences Center at Permian Basin, Odessa, TX
| | - Udita Gupta
- From the Department of Internal Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Rupak Desai
- Division Cardiology, Atlanta VA Medical Center, Decatur, GA
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98
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Jain A, Desai R, Sachdeva S, Baralo B, Isufi M, Gupta PK. CARDIOVASCULAR EVENTS AND MORTALITY FOLLOWING CAR-T THERAPY- A POOLED ANALYSIS OF RANDOMIZED CONTROLLED TRIALS AND OBSERVATIONAL STUDIES. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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99
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Sachdeva S, Gupta U, Bhandari J, Mondal A, Hashem A, Sukaina M, Khandait H, Yasmin F, Desai R, Jain A, Ijaz HM, Vyas A. HIGH-DOSE STATIN GIVEN AS LOADING DOSE PRIOR TO PCI REDUCES NO-REFLOW PHENOMENON IN ACUTE CORONARY SYNDROME: A META-ANALYSIS OF 4829 PROCEDURES. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01924-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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100
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Jain A, Shenwai P, Lakshmanan A, Guzman FN, Gaddam N, Akah O, Karki S, Ghimire S, Neha, Mohammad A, Desai R, Merugu B. SEPSIS-ASSOCIATED TYPE 2 VERSUS TYPE 1 MYOCARDIAL INFARCTION WITH DIFFERENCES IN COMORBIDITIES AND OUTCOMES: A PROPENSITY-MATCHED NATIONWIDE ANALYSIS (2018). J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02148-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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