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Boyle TA, Ha B, Haq I, Killu A, Yadav R, Spragg D, Wong CX, Kheiri B, Moss JD, Marchlinski FE, Frankel DS. Atrial fibrillation ablation in patients with pulmonary hypertension: Multicenter experience. Heart Rhythm 2024:S1547-5271(24)02383-X. [PMID: 38621500 DOI: 10.1016/j.hrthm.2024.04.056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Thomas A Boyle
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bao Ha
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ikram Haq
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Ammar Killu
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Ritu Yadav
- Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland
| | - David Spragg
- Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Christopher X Wong
- Division of Cardiology, University of California San Francisco, San Francisco, California
| | - Babikir Kheiri
- Division of Cardiology, University of California San Francisco, San Francisco, California
| | - Joshua D Moss
- Division of Cardiology, University of California San Francisco, San Francisco, California
| | - Francis E Marchlinski
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - David S Frankel
- Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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2
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Kheiri B, Howell S, Nazer B. Meta-Analysis on Subcutaneous Versus Transvenous Implantable Cardioverter-Defibrillator Therapy. Am J Cardiol 2023; 200:202-203. [PMID: 37354777 DOI: 10.1016/j.amjcard.2023.05.031] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/17/2023] [Indexed: 06/26/2023]
Affiliation(s)
- Babikir Kheiri
- Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Stacey Howell
- Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Babak Nazer
- Section of Cardiac Electrophysiology, Division of Cardiology, University of Washington, Seattle, Washington.
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Thosar SS, Hodovan J, Kheiri B, McHill AW, Bowles NP, Butler MP, Rice SPM, Emens JS, Shea SA, Lindner JR. Endogenous Circadian System Increases Capacity for Enhanced Coronary Microvascular Function in the Morning. Arterioscler Thromb Vasc Biol 2023; 43:1078-1080. [PMID: 37128924 PMCID: PMC10213130 DOI: 10.1161/atvbaha.123.319265] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Saurabh S. Thosar
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
- School of Medicine, Oregon Health & Science University, Portland OR 97239
- School of Nursing, Oregon Health & Science University, Portland OR 97239
- OHSU-PSU School of Public Health at Oregon Health & Science University, Portland, OR 97239
| | - James Hodovan
- School of Medicine, Oregon Health & Science University, Portland OR 97239
| | - Babikir Kheiri
- Division of Cardiology at University of California San Francisco, San Francisco, CA 94143
| | - Andrew W. McHill
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
- School of Nursing, Oregon Health & Science University, Portland OR 97239
| | - Nicole P. Bowles
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
| | - Matthew P. Butler
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
- Department of Behavioral Neuroscience at Oregon Health & Science University, Portland, OR 97239
| | - Sean P. M. Rice
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
| | - Jonathan S. Emens
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
- Portland VA Medical Center, Portland, OR 97239, USA
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Portland, OR 97239
- OHSU-PSU School of Public Health at Oregon Health & Science University, Portland, OR 97239
| | - Jonathan R. Lindner
- Division of Cardiovascular Medicine and Robert M. Berne Cardiovascular Research Center, Charlottesville, VA 22903
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Kheiri B, Vedantham V, Scheinman M. A very wide complex tachycardia. Heart Rhythm 2023; 20:937-939. [PMID: 37245898 DOI: 10.1016/j.hrthm.2022.08.030] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/30/2023]
Affiliation(s)
- Babikir Kheiri
- Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Vasanth Vedantham
- Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Melvin Scheinman
- Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, California.
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Abuelazm M, Abdelazeem B, Gamal M, Katamesh B, Abbas KS, Savarapu PK, Kheiri B, Paul TK. DIRECT ORAL ANTICOAGULANTS VERSUS STANDARD OF CARE IN PATIENTS WITHOUT AN INDICATION OF ANTI-COAGULANTS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01432-8] [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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6
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Sandhu U, Alkukhun L, Kheiri B, Hodovan J, Chiang K, Splanger T, Castellvi Q, Zhao Y, Nazer B. In vivo pulsed-field ablation in healthy vs. chronically infarcted ventricular myocardium: biophysical and histologic characterization. Europace 2023; 25:1503-1509. [PMID: 36793229 PMCID: PMC10105837 DOI: 10.1093/europace/euac252] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/11/2022] [Indexed: 02/17/2023] Open
Abstract
AIMS Data on ventricular pulsed-field ablation (PFA) are sparse in the setting of chronic myocardial infarction (MI). The objective of this study was to compare the biophysical and histopathologic characteristics of PFA in healthy and MI swine ventricular myocardium. METHODS AND RESULTS Myocardial infarction swine (n = 8) underwent coronary balloon occlusion and survived for 30 days. We then performed endocardial unipolar, biphasic PFA of the MI border zone and a dense scar with electroanatomic mapping and using an irrigated contact force (CF)-sensing catheter with the CENTAURI System (Galaxy Medical). Lesion and biophysical characteristics were compared with three controls: MI swine undergoing thermal ablation, MI swine undergoing no ablation, and healthy swine undergoing similar PFA applications that included linear lesion sets. Tissues were systematically assessed by gross pathology utilizing 2,3,5-triphenyl-2H-tetrazolium chloride staining and histologically with haematoxylin and eosin and trichrome. Pulsed-field ablation in healthy myocardium generated well-demarcated ellipsoid lesions (7.2 ± 2.1 mm depth) with contraction band necrosis and myocytolysis. Pulsed-field ablation in MI demonstrated slightly smaller lesions (depth 5.3 ± 1.9 mm, P = 0.0002), and lesions infiltrated into the irregular scar border, resulting in contraction band necrosis and myocytolysis of surviving myocytes and extending to the epicardial border of the scar. Coagulative necrosis was present in 75% of thermal ablation controls but only in 16% of PFA lesions. Linear PFA resulted in contiguous linear lesions with no gaps in gross pathology. Neither CF nor local R-wave amplitude reduction correlated with lesion size. CONCLUSION Pulsed-field ablation of a heterogeneous chronic MI scar effectively ablates surviving myocytes within and beyond the scar, demonstrating promise for the clinical ablation of scar-mediated ventricular arrhythmias.
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Affiliation(s)
- Uday Sandhu
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Laith Alkukhun
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - James Hodovan
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Kirby Chiang
- Galaxy Medical, 1531 Industrial Road, San Carlos, CA 94070, USA
| | - Taylor Splanger
- VDx Veterinary Diagnostics and Preclinical Research Services, 215 C St #301, Davis, CA 95616, USA
| | - Quim Castellvi
- Galaxy Medical, 1531 Industrial Road, San Carlos, CA 94070, USA
| | - Yan Zhao
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
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7
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Osman M, Regner S, Osman K, Shahan C, Kheiri B, Kadiyala M, Sokos G, Sengupta PP, Shapiro MD, Michos ED, Bianco C. Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2022; 31:1719-1726. [PMID: 33826862 PMCID: PMC9836700 DOI: 10.1089/jwh.2020.8733] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Breast arterial calcification (BAC), which may be detected during screening mammography, is hypothesized to be a noninvasive imaging marker that may enhance cardiovascular risk assessment. Materials and Methods: In this systematic review and meta-analysis, we sought to assess the association between BAC and coronary artery disease (CAD) by conducting a meta-analysis. We conducted a literature search of PubMed, Scopus, Cochrane library, ClinicalTrials.gov, and conference proceedings, from inception through December 24, 2019. The outcome of interest was the presence of CAD in patients with BAC. This was reported as crude and adjusted odds ratio (OR). Results: A total of 18 studies comprising 33,494 women (mean age of 60.8 ± 3.7 years, 25% with diabetes, 57% with hypertension, and 21% with history of tobacco smoking) were included in the current meta-analysis. The prevalence of BAC among study participants was 10%. There was a statistically significant association between BAC and CAD (unadjusted OR 2.14; 95% confidence interval [CI] 1.63-2.81, p < 0.001, I2 = 76.5%). Moreover, adjusted estimates were available from 10 studies and BAC was an independent predictor of CAD (OR 2.39; 95% CI 1.68-3.41, p < 0.001, I2 = 61.7%). In the meta-regression analysis, covariates included year of publication, age, hypertension, diabetes mellitus, and history of tobacco smoking. None of these study covariates explained the heterogeneity across studies. Conclusions: BAC detected as part of screening mammography is a promising noninvasive imaging marker that may enhance CAD risk prediction in women. The clinical value of BAC for cardiovascular risk stratification merits further evaluation in large prospective studies.
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Affiliation(s)
- Mohammed Osman
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Sean Regner
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Khansa Osman
- Department of Cardiology, Michigan Health Specialist, Michigan State University, Flint, Michigan, USA
| | - Cimmie Shahan
- Department of Cardiology, Division of Radiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Babikir Kheiri
- Department of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Madhavi Kadiyala
- Department of Cardiology, Michigan Health Specialist, Michigan State University, Flint, Michigan, USA
| | - George Sokos
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Partho P. Sengupta
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Michael D. Shapiro
- Department of Cardiology, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Erin D. Michos
- Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Christopher Bianco
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
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8
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Osman M, Syed M, Simpson TF, Bhardwaj B, Kheiri B, Divanji P, Golwala H, Zahr F, Cigarroa JE. Incidence and outcomes of cardiogenic shock among women with spontaneous coronary artery dissection. Catheter Cardiovasc Interv 2022; 100:530-534. [PMID: 36073664 DOI: 10.1002/ccd.30362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 02/10/2022] [Revised: 07/10/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a paucity of data on cardiogenic shock (CS) incidence and outcomes among patients with spontaneous coronary artery dissection (SCAD). METHODS Women admitted to the hospital for acute myocardial infarction (AMI) with and without SCAD were identified from the United States National Readmission Database from October 1, 2015 to December 31, 2018. We calculated the incidence of CS among women with AMI with and without SCAD and odds for developing CS after adjusting for baseline characteristics. In addition, we report the utilization of percutaneous coronary intervention, mechanical circulatory support, severe disability surrogates, and 30-day readmission rates. RESULTS A total of 664,292 patients admitted for AMI were eligible for analysis, including 6643 patients with SCAD and 657,649 without SCAD. Patients with SCAD were younger (57 years [interquartile range, IQR 48-68] vs. 71 years [IQR 60-81], p < 0.01) and had fewer comorbidities yet had a higher incidence of CS as compared to patients without SCAD (9% vs. 5%, p < 0.01) and remained at elevated risk after adjusting for baseline comorbidities (adjusted odds ratio 1.5 [95% confidence interval, CI 1.2-1.7]). Among patients who developed CS, those with SCAD had lower in-hospital mortality than non-SCAD (31% vs. 39%, p < 0.01), and were more likely to receive mechanical circulatory support. CONCLUSIONS In a nationally representative sample of women admitted for AMI, we found that patients with SCAD had a higher risk of developing CS and required more frequent use of mechanical circulatory support but were more likely to survive to discharge than women suffering AMI from causes other than SCAD.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.,Section of Cardiovascular Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut, USA
| | - Moinuddin Syed
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Timothy F Simpson
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Bhaskar Bhardwaj
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Babikir Kheiri
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Punag Divanji
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Harsh Golwala
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Firas Zahr
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Joaquin E Cigarroa
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
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Sandhu UG, Alkukhun L, Kheiri B, Hodovan J, Chiang K, Castellvi Q, zhao Y, Nazer B. PO-675-04 IN-VIVO PULSED FIELD ABLATION IN HEALTHY VERSUS CHRONICALLY INFARCTED VENTRICULAR MYOCARDIUM: BIOPHYSICAL AND HISTOLOGIC CHARACTERIZATION. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.452] [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: 11/04/2022]
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10
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Mohamed M, Osman M, Kheiri B, Saleem M, Lacasse A, Alkhouli M. Polypill for cardiovascular disease prevention: Systematic review and meta-analysis of randomized controlled trials. Int J Cardiol 2022; 360:91-98. [DOI: 10.1016/j.ijcard.2022.04.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/06/2022] [Accepted: 04/29/2022] [Indexed: 01/22/2023]
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11
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Mohamed MM, Shaikh S, Osman M, Kheiri B. Meta-analysis of Unguided De-escalation of Dual Antiplatelet Therapy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention. TH Open 2022; 6:e144-e146. [PMID: 35707620 PMCID: PMC9192185 DOI: 10.1055/a-1827-8128] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mohamed M.G. Mohamed
- Internal Medicine, SSM Health St Mary's Hospital St Louis, SAINT LOUIS, United States
| | - Safia Shaikh
- Internal Medicine, SSM Health St Mary's Hospital St Louis, St Louis, United States
| | - Mohammed Osman
- Cardiology, Oregon Health & Science University Knight Cardiovascular Institute, Portland, United States
| | - Babikir Kheiri
- Oregon Health & Science University Knight Cardiovascular Institute, Portland, United States
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12
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Osman M, Syed M, Kheiri B, Bianco C, Kalra A, Cigarroa JE, Mamas MA, Dawn Abbott J, Grines CL, Fonarow GC, Balla S. Age stratified sex-related differences in incidence, management, and outcomes of cardiogenic shock. Catheter Cardiovasc Interv 2022; 99:1984-1995. [PMID: 35391503 DOI: 10.1002/ccd.30177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 06/21/2021] [Revised: 11/24/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is a lack of data on age-stratified sex differences in the incidence, treatment, and outcomes of cardiogenic shock (CS). We sought to study these differences from a contemporary database. METHODS Patients admitted with CS (2004-2018) were identified from the United States National Inpatient Sample. We compared CS (acute myocardial infarction-related cardiogenic shock [AMI-CS] and non-acute myocardial infarction-related cardiogenic shock [Non-AMI-CS]) incidence, management, and outcomes in males and females, stratified into four age groups (20-44, 45-64, 65-84, and ≥85 years of age). Propensity score matching (PSM) was used for adjustment. RESULTS A total of 1,506,281 weighted hospitalizations for CS were included (AMI-CS, 39%; Non-AMI-CS, 61%). Across all age groups, females had a lower incidence of CS compared with males. After PSM and among the AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 45-64 (28.5% vs. 26.3%) and 65-84 years (39.3% vs. 37.9%) (p < 0.01, for all). Among the Non-AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 20-44 (33.5% vs. 30.5%), 45-64 (35.1% vs. 31.9%), and 65-84 years (41.7% vs. 40.3%) (p < 0.01, for all). Similar age-dependent differences in the management of CS were also observed between females and males. CONCLUSIONS Females have a lower incidence of CS regardless of age. Significant disparities in the management and outcomes of CS were observed based on sex. However, these disparities varied by age and etiology of CS (AMI-CS vs. Non-AMI-CS) with pronounced disparity among females in the age range of 45-84 years.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.,Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Moinuddin Syed
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Babikir Kheiri
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Ankur Kalra
- Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Joaquin E Cigarroa
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, UK.,Division of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Jinnette Dawn Abbott
- Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cindy L Grines
- Division of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA
| | - Gregg C Fonarow
- Division of Cardiology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
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Mohamed MMG, Taha M, Kheiri B, Osman M. Meta-Analysis of Aortic Valve Replacement in Asymptomatic Patients With Severe Aortic Stenosis. Am J Cardiol 2022; 168:174-176. [PMID: 35131098 DOI: 10.1016/j.amjcard.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Mohamed M G Mohamed
- Internal Medicine Department, SSM Health, St. Mary's Hospital-St. Louis, Missouri
| | - Moutaz Taha
- Internal Medicine Department, University of Nevada, Reno, Nevada
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Mohammed Osman
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
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14
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Lahan S, Bharadwaj A, Cheng R, Parwani P, Miller R, Cheung W, Bianco C, Kheiri B, Osman M, Mohamed M, Mamas M. In-Hospital Characteristics and 30-Day Readmissions for Acute Myocardial Infarction and Major Bleeding in Patients With Active Cancer. Am J Cardiol 2022; 166:25-37. [PMID: 34937657 DOI: 10.1016/j.amjcard.2021.11.015] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/01/2022]
Abstract
There are limited data on readmission with ischemic and major bleeding events in patients with acute myocardial infarction (AMI) with active cancer. The purpose of our study was to evaluate in-hospital characteristics and 30-day readmission rates for recurrent AMI and major bleeding by cancer type in patients with AMI and active cancer. From 2016 through 2018, patients in the Nationwide Readmission Database admitted with AMI and underlying active colon, lung, breast, prostate, and hematological cancers were included. Thirty-day readmission for recurrent AMI and major bleeding were reported. Of 1,524,677 index hospitalizations for AMI, 35,790 patients (2.2%) had cancer (0.9% hematological; 0.5% lung; 0.4% prostate; 0.2% breast; and 0.1% colon). Compared with patients without cancer, patients with cancer were about 6 to 10 years older and had a higher proportion of atrial fibrillation, valvular heart disease, previous stroke, and a greater co-morbidity burden. Of all cancer types, only active breast cancer (adjusted odds ratios 1.82, 95% CI 1.11 to 2.98) was found to be significantly associated with elevated odds of readmission for major bleeding; no such association was observed for recurrent AMI. In conclusion, AMI in patients with breast cancer is associated with significantly greater odds of readmission for major bleeding within 30 days after discharge. Management of patients with concomitant AMI and cancer is challenging but should be based on a multidisciplinary approach and estimation of an individual patient's risk of major coronary thrombotic and bleeding events.
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Mohamed MMG, Shaikh S, Osman M, Kheiri B. ONE-MONTH DURATION OF DUAL ANTIPLATELET THERAPY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01665-5] [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: 11/26/2022]
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16
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Simpson TF, Kheiri B, Chadderdon S, Song HK, Lantz G, Cigarroa J, Zahr F, Golwala H. TAVR operator volumes, trends, and geographic variations amongst Medicare beneficiaries in the United States. Catheter Cardiovasc Interv 2022; 99:1181-1185. [PMID: 35188321 DOI: 10.1002/ccd.30134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 12/05/2020] [Revised: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To evaluate transcatheter aortic valve replacement (TAVR) operator procedural volumes, and describe temporal and geographic trends. BACKGROUND TAVR is the standard of care for most patients with severe symptomatic aortic stenosis. Despite an association between operator procedural volume and outcomes, nationwide TAVR operator volumes have been incompletely described. METHODS We queried the National Medicare Provider Utilization and Payment Database for transfemoral TAVRs from 2014 to 2018. Annual operator volume, state and regional volumes, and longitudinal trends were extracted and analyzed using descriptive statistics. RESULTS In 2018, the mean annual operator volume was 23.6 TAVRs. The highest 1% of operators by volume performed 7.6% of total TAVR procedures in the United States, while 35.7% of operators performed 10 or fewer TAVRs per year. From 2014 to 2018, there was a 53.9% annualized increase in TAVRs, and the mean annual volume per operator grew from 12.5 to 23.6. There was more than five-fold variability in the density of operators (range 0.35-1.79 operators per 100,000 population) and mean operator volume by state (range 14.2-52.4 TAVRs per operator). CONCLUSIONS In this nationally representative study of operators performing transfemoral TAVRs among Medicare patients, we found the mean annual volume of TAVR in 2018 to be 23.6 and has increased since 2014. There was considerable variability in operator density and procedural volumes, with a significant proportion of operators performing 10 or fewer TAVRs per year. Ambiguity remains in regard to the optimal balance of procedural requirements to sustain high efficacy outcomes and ensure critical access to TAVR therapies.
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Affiliation(s)
- Timothy F Simpson
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Babikir Kheiri
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Scott Chadderdon
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Howard K Song
- Division of Cardiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Gurion Lantz
- Division of Cardiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Joaquin Cigarroa
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Firas Zahr
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Harsh Golwala
- Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
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Abdelazeem B, Elbadawy MA, Awad AK, Kheiri B, Kunadi A. The cardiovascular outcomes of finerenone in patients with chronic kidney disease and type 2 diabetes: A meta-analysis of randomized clinical trials. Intractable Rare Dis Res 2022; 11:31-33. [PMID: 35261849 PMCID: PMC8898394 DOI: 10.5582/irdr.2020.01008] [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] [Received: 01/23/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 11/05/2022] Open
Abstract
Recently, a few randomized control trials (RCTs) suggested that finerenone has been shown to reduce cardiovascular events in patients with CKD and DM-2. We aimed to analyze the cardiovascular benefits of using finerenone in patients with CKD and DM-2. Electronic databases were systematically searched to identify only RCTs comparing finerenone versus placebo. Pooled risk ratios (RR) and their 95% confidence intervals (CI) were calculated using random-effects models. Three RCTs were included, with a total of 13,847 patients. Compared with the placebo group, the use of finerenone was associated with significantly lower rates of cardiovascular events (RR: 0.88; 95% CI: 0.80, 0.96; p < 0.01), which was mainly driven by lower hospitalizations for heart failure (RR: 0.79; 95% CI: 0.66, 0.94; p = 0.01). However, there were no significant differences between groups in terms of cardiovascular death (RR: 0.88; 95% CI: 0.76, 1.02; p = 0.09), non-fatal myocardial infarction (RR: 0.91; 95% CI: 0.74, 1.12; p = 0.38), non-fatal stroke (RR: 0.99; 95% CI: 0.80, 1.22; p = 0.90).
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Affiliation(s)
- Basel Abdelazeem
- Department of Internal Medicine, McLaren Health Care, Flint, Michigan, USA
- Michigan State University, East Lansing, Michigan, USA
- Address correspondence to:Basel Abdelazeem, Department of Internal Medicine, McLaren Health Care, 401 S Ballenger Hwy, Flint, MI 48532, USA. E-mail:
| | | | - Ahmed K. Awad
- Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Arvind Kunadi
- Department of Internal Medicine, McLaren Health Care, Flint, Michigan, USA
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18
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Osman M, Benjamin MM, Balla S, Kheiri B, Bianco C, Sengupta PP, Daggubati R, Malla M, Liu SV, Mamas M, Patel B. Index Admission and Thirty-Day Readmission Outcomes of Patients With Cancer Presenting With STEMI. Cardiovasc Revasc Med 2022; 35:121-128. [PMID: 33888417 PMCID: PMC8521583 DOI: 10.1016/j.carrev.2021.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND National-level data of cancer patients' readmissions after ST-segment elevation myocardial infarction (STEMI) are lacking. OBJECTIVES The primary aim of this study was to compare the rates and causes of 30-day readmissions in patients with and without cancer. METHODS Among patients admitted with STEMI in the United States National Readmission Database (NRD) from October 2015-December 2017, we identified patients with the diagnosis of active breast, colorectal, lung, or prostate cancer. The primary endpoint was the 30-day unplanned readmission rate. Secondary endpoints included in-hospital outcomes during the index admission and causes of readmissions. A propensity score model was used to compare the outcomes of patients with and without cancer. RESULTS A total of 385,522 patients were included in the analysis: 5956 with cancer and 379,566 without cancer. After propensity score matching, 23,880 patients were compared (Cancer = 5949, No Cancer = 17,931). Patients with cancer had higher 30-day readmission rates (19% vs. 14%, p < 0.01). The most common causes for readmission among patients with cancer were cardiac (31%), infectious (21%), oncologic (17%), respiratory (4%), stroke (4%), and renal (3%). During the first readmission, patients with cancer had higher adjusted rates of in-hospital mortality (15% vs. 7%; p < 0.01) and bleeding complications (31% vs. 21%; p < 0.01), compared to the non-cancer group. In addition, cancer (OR 1.5, 95% CI 1.2-1.6, p < 0.01) was an independent predictor for 30-day readmission. CONCLUSIONS About one in five cancer patients presenting with STEMI will be readmitted within 30 days. Cardiac causes predominated the reason for 30-day readmissions in patients with cancer.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mina M. Benjamin
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Partho P. Sengupta
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Midhun Malla
- Division of Oncology, West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Stephen V. Liu
- Division of Oncology, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, United Kingdom,Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Brijesh Patel
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA,Corresponding author at: WVU Heart & Vascular Institute, West Virginia University, One Medical Center Drive, Box 8003, Morgantown, WV 26506., USA.
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19
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Osman M, Syed M, Kheiri B, Divanji P, Zahr F, Cigarroa JE, Golwala H. Survival After Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation. Am J Cardiol 2022; 162:205-206. [PMID: 34702553 DOI: 10.1016/j.amjcard.2021.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/21/2021] [Indexed: 01/14/2023]
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20
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Kheiri B, Sanghai S, Alhamoud H, Osman M, Stecker E, Henrikson CA, Nazer B. Meta-Analysis of Implantable Loop Recorder for Atrial Fibrillation Detection in Patients With Ischemic Stroke. Am J Cardiol 2021; 161:115-116. [PMID: 34794608 DOI: 10.1016/j.amjcard.2021.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Saket Sanghai
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Hani Alhamoud
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Eric Stecker
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
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21
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Abdelazeem B, Malik B, Mohamed MMG, Savarapu P, Isa S, Kheiri B, Hassan M. Meta-analysis comparing dexmedetomidine versus standard of care for sedation in patients with sepsis. Proc AMIA Symp 2021; 35:184-189. [DOI: 10.1080/08998280.2021.1997063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Basel Abdelazeem
- McLaren Health Care, Flint/Michigan State University, Flint, Michigan
| | - Bilal Malik
- McLaren Health Care, Flint/Michigan State University, Flint, Michigan
| | | | - Pramod Savarapu
- Ochsner Louisiana State University Health, Monroe, Louisiana
| | - Sakiru Isa
- McLaren Health Care, Flint/Michigan State University, Flint, Michigan
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Mustafa Hassan
- McLaren Health Care, Flint/Michigan State University, Flint, Michigan
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22
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Osman M, Syed M, Kheiri B, Bianco C, Kalra A, Cigarroa J, Mamas M, Abbott JD, Grines C, Fonarow G, Balla S. TCT-486 Age-Stratified Sex-Related Differences in Incidence, Management, and Outcomes of Cardiogenic Shock. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Osman M, Syed M, Osman K, Patel B, Kawsara A, Kheiri B, Balla S, Masri A, Wei L, Bianco CM. Sex-based outcomes of surgical myectomy for hypertrophic cardiomyopathy: An analysis from the National Readmission Database. J Thorac Cardiovasc Surg 2021:S0022-5223(21)01660-3. [DOI: 10.1016/j.jtcvs.2021.11.043] [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] [Received: 01/06/2021] [Revised: 10/27/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022]
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24
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Gumaa Mohamed MM, Shaikh S, Osman M, Kheiri B. TCT-176 One-Month Duration of Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention: A Meta-analysis of Randomized Controlled Trials. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1029] [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: 11/17/2022]
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25
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Osman M, Syed M, Patel B, Munir MB, Kheiri B, Caccamo M, Sokos G, Balla S, Basir MB, Kapur NK, Mamas MA, Bianco CM. Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality. J Am Heart Assoc 2021; 10:e021808. [PMID: 34514850 PMCID: PMC8649539 DOI: 10.1161/jaha.121.021808] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in‐hospital outcomes in patients who received IHM versus no IHM in a real‐world contemporary database. Methods and Results Patients with cardiogenic shock admitted during October 1, 2015 to December 31, 2018, were identified from the National Inpatient Sample. Among this group, we compared the outcomes among patients who received IHM versus no IHM. The primary end point was in‐hospital mortality. Secondary end points included vascular complications, major bleeding, need for renal replacement therapy, length of stay, cost of hospitalization, and rate of utilization of left ventricular assist devices and heart transplantation. Propensity score matching was used for covariate adjustment. A total of 394 635 (IHM=62 565; no IHM=332 070) patients were included. After propensity score matching, 2 well‐matched groups were compared (IHM=62 220; no IHM=62 220). The IHM group had lower in‐hospital mortality (24.1% versus 30.6%, P<0.01), higher percentages of left ventricular assist devices (4.4% versus 1.3%, P<0.01) and heart transplantation (1.3% versus 0.7%, P<0.01) utilization, longer length of hospitalization and higher costs. There was no difference between the 2 groups in terms of vascular complications, major bleeding, and the need for renal replacement therapy. Conclusions Among patients with cardiogenic shock, the use of IHM is associated with a reduction in in‐hospital mortality and increased utilization of advanced heart failure therapies. Due to the observational nature of the current study, the results should be considered hypothesis‐generating, and future prospective studies confirming these findings are needed.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology West Virginia University School of Medicine Morgantown WV.,Knight Cardiovascular InstituteOregon Health and Science University Portland OR
| | - Moinuddin Syed
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Brijesh Patel
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Muhammad Bilal Munir
- Division of Cardiovascular Medicine University of California San Diego La Jolla CA
| | - Babikir Kheiri
- Knight Cardiovascular InstituteOregon Health and Science University Portland OR
| | - Marco Caccamo
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - George Sokos
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Sudarshan Balla
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Mir Babar Basir
- Division of Cardiology Department of Medicine Henry Ford Health System Detroit MI
| | - Navin K Kapur
- The Cardiovascular Center Tufts Medical Center Boston MA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group Keele University Keele United Kingdom.,Royal Stoke University Hospital, Division of Cardiology Stoke-on-Trent United Kingdom
| | - Christopher M Bianco
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
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Mohamed MMG, Faisaluddin M, Kheiri B, Osman M. Meta-analysis of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery. Am J Cardiol 2021; 155:150-151. [PMID: 34315567 DOI: 10.1016/j.amjcard.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Mohamed M G Mohamed
- Internal Medicine Department, SSM Health St. Mary's Hospital, St. Louis Missouri
| | | | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
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27
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Kheiri B, Simpson TF, Przybylowicz R, Merrill M, Alhamoud H, Osman M, Dalouk K, Stecker E, Henrikson CA, Nazer B. Ablation Versus Antiarrhythmic Drugs as First-Line Treatment of Paroxysmal Atrial Fibrillation: A Meta-Analysis of Randomized Trials. Circ Arrhythm Electrophysiol 2021; 14:e009692. [PMID: 34397264 DOI: 10.1161/circep.120.009692] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Timothy F Simpson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Ryle Przybylowicz
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Miranda Merrill
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Hani Alhamoud
- Division of Cardiology, West Virginia University School of Medicine, Morgantown (H.A., M.O.)
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown (H.A., M.O.)
| | - Khidir Dalouk
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Eric Stecker
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland (B.K., T.F.S., R.P., M.M., K.D., E.S., C.A.H., B.N.)
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28
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Osman M, Syed M, Patibandla S, Sulaiman S, Kheiri B, Shah MK, Bianco C, Balla S, Patel B. Fifteen-Year Trends in Incidence of Cardiogenic Shock Hospitalization and In-Hospital Mortality in the United States. J Am Heart Assoc 2021; 10:e021061. [PMID: 34315234 PMCID: PMC8475696 DOI: 10.1161/jaha.121.021061] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background There is a lack of contemporary data on cardiogenic shock (CS) in-hospital mortality trends. Methods and Results Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the overall population and selected subgroups. Among a total of 563 949 644 hospitalizations during the period from January 1, 2004, to December 30, 2018, 1 254 358 (0.2%) were attributed to CS. There has been a steady increase in hospitalizations attributed to CS from 122 per 100 000 hospitalizations in 2004 to 408 per 100 000 hospitalizations in 2018 (Ptrend<0.001). This was associated with a steady decline in the adjusted trends of in-hospital mortality during the study period in the overall population (from 49% in 2004 to 37% in 2018; Ptrend<0.001), among patients with acute myocardial infarction CS (from 43% in 2004 to 34% in 2018; Ptrend<0.001), and among patients with non-acute myocardial infarction CS (from 52% in 2004 to 37% in 2018; Ptrend<0.001). Consistent trends of reduced mortality were seen among women, men, different racial/ethnic groups, different US regions, and different hospital sizes, regardless of the hospital teaching status. Conclusions Hospitalizations attributed to CS have tripled in the period from January 2004 to December 2018. However, there has been a slow decline in CS in-hospital mortality during the studied period. Further studies are necessary to determine if the recent adoption of treatment algorithms in treating patients with CS will further impact in-hospital mortality.
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Affiliation(s)
- Mohammed Osman
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
- Knight Cardiovascular InstituteOregon Health and Science UniversityPortlandOR
| | - Moinuddin Syed
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | | | - Samian Sulaiman
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Babikir Kheiri
- Knight Cardiovascular InstituteOregon Health and Science UniversityPortlandOR
| | - Mahek K. Shah
- Division of CardiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Christopher Bianco
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Sudarshan Balla
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Brijesh Patel
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
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29
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Kheiri B, Przybylowicz R, Simpson TF, Merrill M, Osman M, Dalouk K, Rahmouni H, Stecker E, Nazer B, Henrikson CA. Imaging-guided cardiac resynchronization therapy: A meta-analysis of randomized controlled trials. Pacing Clin Electrophysiol 2021; 44:1570-1576. [PMID: 34255376 DOI: 10.1111/pace.14316] [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] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/07/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among patients with heart failure and left ventricular (LV) dysfunction despite guideline directed medical therapy, cardiac resynchronization (CRT) is an effective technology to reverse LV remodeling. Given that a large portion of patients are non-responders, alternatives to traditional LV-lead placement have been explored. A promising alternative is image targeted placement of an LV-lead to latest mechanically activated segment without scar. METHODS Electronic database search for randomized controlled trials (RCTs) that evaluated the imaging-guided LV-lead placement on clinical, echocardiographic, and functional outcomes. The primary outcome was a composite of mortality and heart failure hospitalization. The secondary outcomes included CRT responders, New York Heart Association (NYHA), 6-minute walk test, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and ejection fraction (EF) changes. RESULTS Analysis included 4 RCTs of 691 patients with an average follow-up of 2 years (age 69.5 ± 10.3 years, 76% males, 54% ischemic cardiomyopathy, 81% with NYHA classes III/IV, and EF of 24.4% ± 8). The most common site for LV-lead paced segment was the anterolateral segment (45%) and at mid-LV (49%). Compared with the control, imaging-guided LV-lead placement was associated with a significant reduction of the primary outcome (hazard ratio [HR] = 0.60; 95% CI = 0.40-0.88; p = .01), higher CRT responders (odd ratio [OR] = 2.10; p < .01), more NYHA improvements by ≥1 (OR = 1.89; p = .01), increased 6MWT (mean difference [MD] = 25.78 feet; p < .01), and lower MLHFQ (MD = -4.04; p = .04), without significant differences in the LVEF (p = .08). CONCLUSIONS In patients undergoing CRT, imaging-guided LV-lead placement was associated with improved clinical, echocardiographic, and functional status.
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Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Ryle Przybylowicz
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Timothy F Simpson
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Miranda Merrill
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Mohammed Osman
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.,Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Khidir Dalouk
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Hind Rahmouni
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Eric Stecker
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
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Mohamed MMG, Rauf A, Adam A, Kheiri B, Lacasse A, El-Halawany H. Terlipressin effect on hepatorenal syndrome: Updated meta-analysis of randomized controlled trials. JGH Open 2021; 5:896-901. [PMID: 34386597 PMCID: PMC8341180 DOI: 10.1002/jgh3.12600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/05/2021] [Accepted: 06/11/2021] [Indexed: 12/14/2022]
Abstract
Background and Aim Hepatorenal syndrome (HRS) is a fatal complication of liver cirrhosis with a limited pharmacological option. Terlipressin is a vasoconstrictor that is approved in many countries but not yet in the United States. This is a meta‐analysis of randomized controlled trials (RCTs) to review terlipressin effect on HRS and the safety profile. Methods We searched electronic databases for RCTs comparing terlipressin versus placebo in addition to albumin in patients with type 1 or 2 HRS. Primary outcome was HRS reversal. Secondary outcomes were change in serum creatinine (Cr), requirement for renal replacement therapy (RRT) at 30 days of randomization, and 90‐day survival. Risk ratios (RRs) and mean differences (MD) were calculated with 95% confidence intervals (CIs) using a random‐effects model. Results We identified eight RCTs with a total of 974 patients, and median follow up of 100 days. Mean age was 55 ± 10 years, 61% were males. Alcoholic liver disease represented 56%. Compared with placebo, terlipressin was associated with a significantly higher likelihood of HRS reversal (RR 2.08; 95% CI [1.51, 2.86], P < 0.001), significantly lower serum Cr (MD −0.64; 95% CI (−1.02, −0.27), P < 0.001], and a trend toward less RRT requirements (RR 0.61; 95% CI [0.36, 1.02], P = 0.06). There was no difference in survival at 90 days between groups (RR 1.09; 95% CI (0.84, 1.43), P = 0.52). Major adverse effects (AEs) were gastrointestinal cramps, discomfort, and respiratory distress. Conclusion In patients with liver cirrhosis complicated by HRS, terlipressin was associated with significant HRS reversal and decrease in serum Cr. No survival benefit was detected at 90 days.
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Affiliation(s)
- Mohamed M G Mohamed
- Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis Missouri USA
| | - Abdul Rauf
- Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis Missouri USA
| | - Abubakr Adam
- Hospital Medicine Department, School of Medicine University of Missouri Colombia Missouri USA
| | - Babikir Kheiri
- Department of Cardiology, Knight Cardiovascular Institute Oregon Health & Science University Portland Oregon USA
| | - Alexandre Lacasse
- Internal Medicine Department SSM Health St. Mary's Hospital-St. Louis St. Louis Missouri USA
| | - Hani El-Halawany
- Department of Gastroenterology, Hepatobiliary and Endoscopy SSM Health St. Mary's Hospital-St. Louis St. Louis Missouri USA
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Kheiri B, Abdelazeem B, Osman M, Dalouk K, Stecker E, Raitt MH, Henrikson CA, Nazer B. Meta-analysis of Pacemaker Therapy in Patients With Neurocardiogenic Syncope. Am J Cardiol 2021; 149:159-160. [PMID: 34147166 DOI: 10.1016/j.amjcard.2021.03.015] [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] [Received: 03/02/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
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Osman M, Balla S, Patibandla S, Kheiri B, Caccamo M, Bianco C, Sokos G. Regional Variation in the Adoption of Invasive Hemodynamic Monitoring for Cardiogenic Shock in the United States. Am J Cardiol 2021; 148:174-175. [PMID: 33667450 DOI: 10.1016/j.amjcard.2021.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia.
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Saikrishna Patibandla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon
| | - Marco Caccamo
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - George Sokos
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
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Mohamed MMG, Shaikh S, Osman M, Kheiri B. Meta-Analysis of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure Patients Without Diabetes. Am J Cardiol 2021; 148:175-176. [PMID: 33689699 DOI: 10.1016/j.amjcard.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 01/26/2023]
Affiliation(s)
| | - Safia Shaikh
- SSM Health St. Mary's Hospital, St. Louis, Missouri, USA
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA.
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Osman M, Ghaffar YA, Osman K, Kheiri B, Mohamed MMG, Kawsara A, Balla S, Roda-Renzelli A, Daggubati R. Gender-based outcomes of coronary bifurcation stenting: A report from the National Readmission Database. Catheter Cardiovasc Interv 2021; 99:433-439. [PMID: 33991413 DOI: 10.1002/ccd.29704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 04/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is a paucity of data focusing on women's outcomes after percutaneous coronary interventions (PCI) for coronary bifurcation lesions (CBLs). METHODS Patients who received PCI for CBLs in the context of acute coronary syndrome (ACS) during the period of 01 October 2015- 31 December 2017, were identified from the United States National Readmission Database. The primary endpoint of this study was in-hospital major adverse events (MAEs). The secondary endpoints were in-hospital mortality, vascular complications, major bleeding, post-procedural bleeding, need for blood transfusion, severe disability surrogates (non-home discharge and need for mechanical ventilation), resources utilization surrogates (length of stay and cost of hospitalization), and 30-day readmission rate. A 1:1 propensity score matching was used to compare the outcomes between women and men. RESULTS A total of 25,050 (women = 7,480; men = 17,570) patients were included in the current analysis. After propensity score matching, women had higher in-hospital MAEs (7 vs 5.2%, p < .01), major bleeding (1.8 vs 0.8%, p < .01), post-procedural bleeding (6.1 vs 3.4%, p < .01), need for blood transfusion (6.4 vs 4.2%, p < .01), non-home discharges (10.2 vs 7.1%; p < .01), longer length of hospital stay (3 days [IQR 2-6] vs. 3 days [IQR 2-5], p < .01) and higher 30-day readmission rate compared to men (14.2 vs. 11.5%, p < .01). CONCLUSIONS Among all-comers who received PCI for CBLs in the context of ACS, women suffered higher MAEs and 30-day readmission rates compared to their men' counterparts. The higher MAEs in the women were mainly driven by higher postprocedural bleeding rates and the need for blood transfusion.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Yasir Abdul Ghaffar
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Khansa Osman
- Michigan Health Specialists, Michigan State University, Flint, Michigan, USA
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Akram Kawsara
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Anthony Roda-Renzelli
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
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Kheiri B, Syed M, Raina S, Osman M. Meta-analysis of restrictive versus liberal blood transfusion among patients with coronary artery disease. J Thromb Thrombolysis 2021; 52:1081-1083. [PMID: 33956282 DOI: 10.1007/s11239-021-02469-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 01/28/2023]
Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Moinuddin Syed
- Division of Cardiology, West Virginia University School of Medicine, WVU Heart & Vascular Institute, 1 Medical Center Drive, Box 8003, Morgantown, WV, 26506, USA
| | - Sameer Raina
- Division of Cardiology, West Virginia University School of Medicine, WVU Heart & Vascular Institute, 1 Medical Center Drive, Box 8003, Morgantown, WV, 26506, USA
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, WVU Heart & Vascular Institute, 1 Medical Center Drive, Box 8003, Morgantown, WV, 26506, USA.
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Mohamed MMG, Kheiri B, Osman M. DRUG-COATED BALLOONS VERSUS DRUG-ELUTING STENTS FOR DENOVO CORONARY ARTERY DISEASE: META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02391-3] [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: 11/29/2022]
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Dekker S, Lin L, Kheiri B, McCallum R, Lima AS, Kang D, Fuss C, Ferencik M. ANOMALOUS ORIGIN OF THE RIGHT CORONARY ARTERY FROM THE NON-CORONARY CUSP. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04047-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: 10/21/2022]
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Osman M, Ghaffar YA, Osman K, Kheiri B, Mohamed MM, Kawsara MA, Balla S, Roda-Renzelli A, Daggubati R. GENDER-BASED OUTCOMES OF CORONARY BIFURCATION STENTING. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02271-3] [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: 10/21/2022]
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Kheiri B, Przybylowicz R, Simpson T, Merrill M, Osman M, Dalouk K, Rahmouni H, Stecker E, Nazer B, Henrikson C. IMAGING-GUIDED CARDIAC RESYNCHRONIZATION THERAPY: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01719-8] [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: 10/21/2022]
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Simpson T, Kheiri B, Chadderdon S, Song H, Lantz G, Cigarroa J, Zahr F, Golwala H. VOLUME, TRENDS AND GEOGRAPHIC VARIATIONS IN TRANSCATHETER AORTIC VALVE REPLACEMENT PROCEDURES BY OPERATOR AMONGST MEDICARE BENEFICIARIES IN THE UNITED STATES. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02262-2] [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: 10/21/2022]
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Kheiri B, Simpson T, Przybylowicz R, Merrill M, Alhamoud H, Osman M, Dalouk K, Stecker E, Henrikson C, Nazer B. ABLATION VS ANTIARRHYTHMIC DRUGS AS FIRST-LINE TREATMENT OF PAROXYSMAL ATRIAL FIBRILLATION: A META-ANALYSIS OF RANDOMIZED TRIALS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01714-9] [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: 11/27/2022]
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Kheiri B, Simpson TF, Osman M, Balla S, Rahmouni H, Mehta A, Pokharel Y, Nasir K, Fazio S, Shapiro MD. Familial hypercholesterolemia related admission for acute coronary syndrome in the United States: Incidence, predictors, and outcomes. J Clin Lipidol 2021; 15:460-465. [PMID: 34053910 DOI: 10.1016/j.jacl.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Individuals with Familial Hypercholesterolemia (FH) are at high risk for atherosclerotic cardiovascular disease (ASCVD) events. OBJECTIVES The purpose of this study was to evaluate the incidence, predictors, and outcomes of admissions for acute coronary syndromes (ACS) in this high-risk group. METHODS Utilizing the National Readmission Databases, we identified individuals with or without FH admitted to participating hospitals for ACS. The primary outcome was admission for recurrent ACS at 11 month follow-up. RESULTS There were a total of 1,697,513 ACS admissions from 10/2016 to 12/2017 (non-FH=1,696,979 and FH=534). Individuals with FH admitted for ACS were younger (median age 57 vs 69 y), had fewer comorbidities (hypertension 74.7% vs 79.6%; diabetes mellitus 30.5% vs 39.0%;p<0.01), were more likely to present with ST-elevation-myocardial infarction (32.8% vs 22.6%;p<0.01) and more likely to undergo multivessel percutaneous coronary intervention (11.4% vs 7.6%;p<0.01) than patients without FH. After propensity-score matching, FH patients more commonly experienced in-hospital VT arrest (11.8% vs 8.0%;p<0.01) and required more mechanical circulatory support (8.6% vs 3.3%; p<0.01). The 30-day readmission in those with FH was more frequently for cardiovascular disease (81.5% vs 46.5%; =p<0.01). At 11-month follow-up, FH patients were more likely to be readmitted with recurrent ACS compared to those without FH (hazard ratio=2.34; 95% confidence interval=1.30-4.23; p<0.01). CONCLUSIONS Individuals with FH admitted for ACS are younger, have fewer comorbidities, and more frequently present with STEMIs compared to those without FH. FH patients were more likely to suffer in-hospital cardiac complications and have a higher incidence of recurrent ACS.
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Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Timothy F Simpson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Hind Rahmouni
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Anurag Mehta
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Yashashwi Pokharel
- Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Khurram Nasir
- Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Sergio Fazio
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Michael D Shapiro
- Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Saleem M, Osman M, Khan S, Kheiri B, Waqar F, Jamali HK. Meta-Analysis Comparing Ticagrelor or Prasugrel Versus Clopidogrel in Patients Undergoing Elective Percutaneous Coronary Intervention. Am J Cardiol 2021; 143:160-162. [PMID: 33383006 DOI: 10.1016/j.amjcard.2020.12.054] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Maryam Saleem
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mohammed Osman
- Department of Cardiovascular Medicine, West Virginia University, Morgantown, West Virginia
| | - Sarah Khan
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Fahad Waqar
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Hina K Jamali
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, Ohio.
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Mohamed MM, Saleem M, Kheiri B, Osman M. Meta-Analysis of Drug-Coated Balloons Versus Drug-Eluting Stents for Small Vessel De-Novo Coronary Artery Disease. Am J Cardiol 2021; 142:157-158. [PMID: 33417874 DOI: 10.1016/j.amjcard.2020.12.071] [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] [Received: 12/19/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022]
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Kheiri B, Przybylowicz R, Simpson TF, Alhamoud H, Osman M, Dalouk K, Nazer B, Henrikson CA, Stecker E. Meta-analysis of Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Bioprosthetic Valves. Am J Cardiol 2021; 142:140-141. [PMID: 33285096 DOI: 10.1016/j.amjcard.2020.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Ryle Przybylowicz
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Timothy F Simpson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Hani Alhamoud
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Khidir Dalouk
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Eric Stecker
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
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Osman M, Syed M, Balla S, Kheiri B, Faisaluddin M, Bianco C. A Meta-analysis of Intravenous Iron Therapy for Patients With Iron Deficiency and Heart Failure. Am J Cardiol 2021; 141:152-153. [PMID: 33259800 DOI: 10.1016/j.amjcard.2020.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/30/2022]
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Zayed Y, Kheiri B, Barbarawi M, Banifadel M, Abdalla A, Chahine A, Obeid M, Haykal T, Yelangi A, Malapati S, Bachuwa G, Seedahmed E. Extended duration of thromboprophylaxis for medically ill patients: a systematic review and meta-analysis of randomised controlled trials. Intern Med J 2021; 50:192-199. [PMID: 31276276 DOI: 10.1111/imj.14417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/19/2019] [Accepted: 07/01/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND The benefit of extended-duration thromboprophylaxis in patients hospitalised for acute medical illness beyond hospital stay remains controversial. AIMS To perform a meta-analysis of randomised controlled trials (RCT) in order to examine the efficacy and safety of extended-duration anticoagulation for venous-thromboembolism (VTE) prophylaxis in this high-risk population. METHODS An electronic database search was conducted to include all RCT comparing between extended-duration versus short-duration prophylactic anticoagulation in medically ill patients. The primary efficacy outcome was the composite events of asymptomatic deep vein thrombosis (DVT), symptomatic VTE and death from VTE-related causes. RESULTS Five RCT were included totalling 40 124 patients, with a mean age of 71 years and 51% were male. In comparison to standard-duration therapy, extended-duration thromboprophylaxis was associated with a significant reduction in the primary efficacy outcome (risk ratio (RR) 0.75; 95% confidence interval (CI) 0.67-0.85; P < 0.01), symptomatic VTE (RR 0.53; 95% CI 0.33-0.84; P < 0.01) and asymptomatic DVT (RR 0.81; 95% CI 0.71-0.94; P < 0.01). However, there were no significant differences between both groups with regard to VTE-related death (RR 0.81; 95% CI 0.60-1.10; P = 0.18) or all-cause death (RR 0.97; 95% CI 0.88-1.08; P = 0.64). In contrast, extended-duration thromboprophylaxis was associated with an increased risk of major bleeding (RR 2.04; 95% CI 1.42-2.91; P < 0.01) and non-major clinically relevant bleeding (RR 1.81; 95% CI 1.29-2.53; P < 0.01). CONCLUSIONS Among hospitalised medically ill patients, prolonging venous thromboprophylaxis was associated with a decreased risk of composite events of the primary efficacy outcome and increased risk of bleeding with no significant difference in VTE-related death.
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Affiliation(s)
- Yazan Zayed
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Babikir Kheiri
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Mahmoud Barbarawi
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Momen Banifadel
- Internal Medicine Department, University of Toledo, Toledo, Ohio, USA
| | - Ahmed Abdalla
- Division of Hematology and Oncology, St John Hospital, Grosse Pointe Woods, Michigan, USA
| | - Adam Chahine
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Michele Obeid
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Tarek Haykal
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Anitha Yelangi
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Sindhu Malapati
- Division of Hematology and Oncology, St John Hospital, Grosse Pointe Woods, Michigan, USA
| | - Ghassan Bachuwa
- Department of Internal Medicine, Michigan State University, Flint, Michigan, USA
| | - Elfateh Seedahmed
- Pulmonary and Critical Care Department, Hurley Medical Center, Michigan State University, Flint, Michigan, USA
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Osman M, Syed M, Balla S, Kheiri B, Golwala H, Zahr F. Meta-Analysis of Aspirin Monotherapy Versus Dual Antiplatelet Therapy After Transcatheter Aortic Valve Implantation. Am J Cardiol 2020; 135:187-188. [PMID: 32961110 DOI: 10.1016/j.amjcard.2020.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
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Kheiri B, Simpson TF, Nazer B. Meta-analysis of catheter ablation in patients with post-infarct cardiomyopathy undergoing defibrillator implantation. Pacing Clin Electrophysiol 2020; 44:171-175. [PMID: 33188524 DOI: 10.1111/pace.14111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/12/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with post-infarct cardiomyopathy and ventricular arrhythmias (VT) necessitating implantable cardioverter defibrillators (ICD) are at risk of recurrent shocks with increased morbidity. METHODS A comprehensive search of electronic databases for all randomized clinical trials that evaluated the role of catheter ablation as a preventive strategy at the time of secondary prevention ICD implantation was performed. We calculated hazard ratios (HR) and 95% confidence intervals (CI) using random-effects model. RESULTS Four trials were identified with a total of 505 patients (average age 66.4 ± 9.0 years; 87.7% were male). Preventive ablation was associated with a significant reduction in appropriate device therapies (shocks and/or anti-tachycardia therapy) (HR = 0.62; 95% CI = 0.46-0.82; P < .01), sustained VT (HR = 0.74; 95% CI = 0.55-0.99; P = .04) compared to control. There were no differences in inappropriate device shocks (HR = 0.80; 95% CI = 0.38-1.71), all-cause death (HR = 0.93; 95% CI = 0.53-1.64), cardiac death (HR = 0.63; 95% CI = 0.29-1.36), arrhythmic death (HR = 0.26; 95% CI = 0.05-1.31), or cardiac hospitalization (HR = 0.79; 95% CI = 0.57-1.11) between strategies. Preventive ablation was associated with improved SF-36 physical component (mean difference = 2.81; 95% CI-0.53-5.10; P = .02), but not the mental component (mean difference = 1.30; 95% CI = -2.06-4.66). CONCLUSION Among patients with post-infarct cardiomyopathy and VT, preventive catheter ablation at the time of ICD implantation is associated with a significant reduction of appropriate ICD therapy and sustained VT, and improvement in the physical component of quality-of-life, but no reduction in mortality.
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Affiliation(s)
- Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Timothy F Simpson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
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Syed M, Osman M, Alhamoud H, Saleem M, Munir MB, Kheiri B, Balla S, Kawsara A, Daggubati R. The state of renal sympathetic denervation for the management of patients with hypertension: A systematic review and meta-analysis. Catheter Cardiovasc Interv 2020; 97:E438-E445. [PMID: 33179863 DOI: 10.1002/ccd.29384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 08/30/2020] [Revised: 10/13/2020] [Accepted: 10/26/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Sympathetic nervous system plays a central role in the development and persistence of essential hypertension. In recent years renal sympathetic denervation (RSD) has emerged as a promising option for the treatment of patients with hypertension. METHODS We conducted a literature search of PubMed, EMBASE, Cochrane library and Clinicaltrials.gov from inception through April 20, 2020. Outcomes of interest were change in 24-hour ambulatory systolic (ASBP) or diastolic blood pressure (ADBP) and change in office systolic (OSBP) or diastolic blood pressure (ODBP). We pooled data from randomized controlled trials (RCTS) comparing RSD to sham procedures in the management of hypertension using the random effect model. RESULTS A total of 1,363 patients from eight studies were included in the current meta-analysis. The mean age of the included patients was 56 ± 2.6 years, 29% were women and the median duration of maximum follow up was 6-month (range 3-12 month). There was more reduction favoring RSD in ASBP (Weighted mean difference [WMD] -3.55; 95% CI -4.91 - -2.19, p < .001, I2 = 0%), ADBP (WMD -1.87; 95% CI -3.07 - -0.66, p = .002, I2 = 43%), OSBP (WMD -5.5; 95% CI -7.59 - -3.40, p < .001, I2 = 7%) and ODBP (WMD -3.20; 95% CI -4.47 - -1.94, p < .001, I2 = 14%). CONCLUSION The use of RSD for the management of hypertension resulted in effective reduction in the ambulatory and office blood pressure compared to sham procedure. Adequately powered RCTs of RSD are needed to confirm safety, reproducibility and assess the impact on clinical outcomes.
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Affiliation(s)
- Moinuddin Syed
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Hani Alhamoud
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Maryam Saleem
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Muhamad Bilal Munir
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Akram Kawsara
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
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