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Desai R, Gandhi Z, Ravalani A, Mahfooz K, Mansuri U, Jain A, Vyas A, Gupta R, Lavie CJ. Outcomes of cardiac arrest hospitalizations in patients with obesity with versus without prior bariatric surgery status:A nationwide propensity-matched analysis. Int J Cardiol Cardiovasc Risk Prev 2024; 20:200235. [PMID: 38223490 PMCID: PMC10784668 DOI: 10.1016/j.ijcrp.2023.200235] [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: 05/09/2023] [Revised: 11/23/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024]
Abstract
Introduction Prior bariatric surgery (PBS) status in obese patients is thought to curtail the risk of cardiovascular events, but its role in change of outcomes of patients with obesity developing new acute cardiac events such as cardiac arrests (CA) remains largely unknown. Methods Hospitalizations among adult patients with obesity and CA were identified retrospectively using the National Inpatient Sample (2015 October-2017 December). Propensity-matched analysis (1:1) was performed for sociodemographic/hospital characteristics to identify two cohorts, with (PBS+) or without (PBS-) status. The primary endpoint was in-hospital mortality, and the secondary endpoint was healthcare resource utilization. Results Both cohorts (n = 1275 each), had patients with comparable age (mean 58 years), with a higher frequency of white (>70 %), females (>60 %), and Medicare enrollees (>40 %). PBS + cohort had lower rates of diabetes (27.8 % vs 36.1 %), hyperlipidemia (33.7 % vs 48.6 %), renal failure (17.3 % vs 22.0 %), chronic pulmonary disease (11.8 % vs 21.2 %) and higher rates of anemias (18.4 % vs 12.2 %), liver disease (5.1 % vs 2.4 %) and alcohol abuse (6.7 % vs 2.4 %) than PBS- cohort (p < 0.05). All-cause mortality (46.3 % vs 45.1 %, p = 0.551) was comparable between the two cohorts. The PBS + cohort was less often transferred routinely (p<0.001) but had a shorter hospital stay (p<0.001) with equivalent hospital charges compared to the PBS- cohort. Conclusions The PBS status (regardless of chronology) did not increase survival in CA admissions among patients with obesity. Preventive measures are necessary to manage enduring cardiovascular disease risk factors that may limit the advantages of surgery for patients with obesity and aggravate the worse outcomes of future cardiac events.
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Affiliation(s)
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA, USA
| | - Abhimanyu Ravalani
- Department of Internal Medicine, Saint Agnes Hospital, Baltimore, MD, USA
| | - Kamran Mahfooz
- Department of Internal Medicine, Lincoln Medical Center, New York, NY, USA
| | - Uvesh Mansuri
- Department of Internal Medicine, Medstar Harbor hospital, Baltimore, MD, USA
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA
| | - Ankit Vyas
- Division of Vascular Medicine, Ochsner Health, New Orleans, LA, USA
| | - Rajeev Gupta
- Consultant Cardiologist, Spectrum Medical Center and Burjeel Royal Hospital, Al Ain, United Arab Emirates
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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Mahfooz K, Carvalhais R, Tun HN, Najeed SA. Exploring Disparities in Mortality Rates Among Heart Failure Patients With Primary Diagnosis of Cardiac Arrest: A Nationwide Analysis of 2016-2020 Data. Curr Probl Cardiol 2023; 48:101837. [PMID: 37244512 DOI: 10.1016/j.cpcardiol.2023.101837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
Cardiac arrest is a dangerous threat to patients with heart failure. In this analysis, the authors aim to investigate the disparities between patients with heart failure who died with a diagnosis of cardiac arrest in terms of race, income, sex, hospital location, hospital size, hospital region, and insurance. Do social determinants of life impact cardiac arrest in patients with heart failure? A total of 8840 patients with heart failure who had a primary diagnosis of cardiac arrest, were admitted non-elective, were adults, and died during the admission were included in this study. A total of 215 (2.43%) patients had cardiac arrest due to cardiac cause, 95 (1.07%) had cardiac arrest due to other specified causes, and 8530 (96.49%) patients had cardiac arrest due to unspecified cause. The study group had a mean age of 69 years and had more males (53.91%). In terms of cardiac arrest due to any cause among adult patients with heart failure, the difference was significantly different in female patients (OR 0.83, p-value = 0.001, 95% CI 0.74-0.93), Black patients (OR 1.44, p-value < 0.001, 95% CI 1.25-1.67), Asian patients (OR 1.66, p-value = 0.002, 95% CI 1.20-2.29), Native American patients (OR 1.96, p-value = 0.022, 95% CI 1.10-3.48), other race patients (OR 1.59, p-value = 0.007, 95% CI 1.14-2.23), patients on hospital from south region (OR 1.59, p-value = 0.007, 95% CI 1.14-2.23), patients from large hospitals (OR 1.21, p-value = 0.015, 95% CI 1.04-1.41), and patients from teaching hospitals (OR1.19, p-value = 0.018, 95% CI 1.03-1.37). In terms of cardiac arrest due to cardiac cause among adult patients with heart failure, there was no significant difference in the variables analyzed. In terms of cardiac arrest due to other specified causes among adult patients with heart failure, the difference was significantly different in female patients (OR 0.19, p-value = 0.024, 95% CI 0.04-0.80), and urban-based hospitals (OR 0.10, p-value = 0.015, 95% CI 0.02-0.64). In terms of cardiac arrest due to unspecified causes among adult patients with heart failure, the difference was significantly different in female patients (OR 0.84, p-value = 0.004, 95% CI 0.75-0.95), Black patients (OR 1.46, p-value < 0.001, 95% CI 1.26-1.69), Asian patients (OR 1.60, p-value = 0.006, 95% CI 1.14-2.23), Native American patients (OR 2.06, p-value = 0.014, 95% CI 1.16-3.67), other race patients (OR 1.58, p-value = 0.010, 95% CI 1.12-2.23), patients on the hospital from the south region (OR 1.25, p-value = 0.014, 95% CI 1.05- 1.48), patients on the hospital from Midwest region (OR 1.22, p-value = 0.033, 95% CI 1.02-1.46), patients from large hospitals (OR 1.21, p-value = 0.016, 95% CI 1.04-1.41), patients from teaching hospitals (OR 1.18, p-value = 0.022, 95% CI 1.02-1.36), patients from urban hospitals (OR 1.37, p-value = 0.023, 95% CI 1.04-1.80). In conclusion, it is imperative for physicians to remain cognizant of health disparities while assessing patients to preempt bias during the evaluation process. The present analysis convincingly demonstrates the influence of gender, race, and hospital location on the incidence of cardiac arrest in individuals afflicted with heart failure. Nonetheless, the paucity of cases pertaining to cardiac arrest attributed to cardiac causes or other specified etiologies considerably compromises the analytical robustness for this particular subtype of cardiac arrest. Thus, further investigations are warranted to ascertain the underlying factors contributing to such disparities among patients with heart failure, while concurrently necessitating physicians' awareness regarding the potential existence of bias in their evaluative endeavors.
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Affiliation(s)
| | | | - Han Nuang Tun
- Larner College of Medicine, University of Vermont, Burlington VT
| | - Syed A Najeed
- Department of Cardiology, Boonshoft School of Medicine, Wright State University
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Mahfooz K, Sohail H, Gvajaia A, Arif U, Grewal D, Muppidi MR, Vohra V, Tarique A, Vasavada A. Rasburicase in treating tumor lysis syndrome: An umbrella review. Cancer Pathog Ther 2023; 1:262-271. [PMID: 38327601 PMCID: PMC10846299 DOI: 10.1016/j.cpt.2023.07.001] [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] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 02/09/2024]
Abstract
Tumor lysis syndrome (TLS) remains a debilitating cause of hospitalization and death in patients with cancer and is a significant challenge for healthcare providers despite advancements in its management. This umbrella review analyzed the results of meta-analyses on the use of rasburicase in the treatment of patients with cancer. A literature search was performed of five databases (PubMed, Google Scholar, Cochrane Library, Scopus, Global Index Medicus, and ScienceDirect) for articles with full texts available online. A measurement tool to assess systematic reviews 2 (AMSTAR 2) was used to assess the quality of the included studies, and Review Manager software was used to conduct all statistical analyses. The systematic search identified eight relevant meta-analyses, with primary analyses including outcome data that analyzed mortality, renal failure, and comparisons with allopurinol. The pooled data showed that rasburicase effectively reduced TLS development and serum uric acid levels in children and adults with malignancies. Most outcomes did not differ significantly compared with those of allopurinol. Future trials should focus on the cost-effectiveness of rasburicase compared to that of allopurinol while including high-, intermediate-, and low-risk patients. Rasburicase is safe and effective for managing patients with TLS. However, recent large-scale meta-analyses have reported conflicting results. Most meta-analyses were graded as low to critically low as per AMSTAR 2. The analysis revealed that the benefit of rasburicase did not differ significantly from that of allopurinol, which has higher cost-effectiveness and fewer side effects.
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Affiliation(s)
- Kamran Mahfooz
- Department of Internal Medicine, Lincoln Medical Center, Community Hospital, New York, 10451, USA
| | - Haris Sohail
- Department of Internal Medicine, Lincoln Medical Center, Community Hospital, New York, 10451, USA
| | - Ani Gvajaia
- Department of Internal Medicine, Lincoln Medical Center, Community Hospital, New York, 10451, USA
| | - Uroosa Arif
- Department of Internal Medicine, Lincoln Medical Center, Community Hospital, New York, 10451, USA
| | - Daisy Grewal
- Department of Internal Medicine, St. Georges University, St. Georges, Grenada
| | - Monica Reddy Muppidi
- Department of Internal Medicine, Lincoln Medical Center, Community Hospital, New York, 10451, USA
| | - Vanya Vohra
- Department of Pediatrics, St Barnabas Hospital, Bronx, NY, 10457, USA
| | - Aamir Tarique
- Department of Medicine, ESIC Medical College, Faridabad, 121001, India
| | - Advait Vasavada
- Department of Medicine, MP Shah Medical College, Jamnagar, 361008, India
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Mahfooz K, Najeed S. Comment on: Prevalence and Related Factors of Do-Not-Resuscitate Orders Among In-Hospital Cardiac Arrest Patients. Curr Probl Cardiol 2023; 48:101782. [PMID: 37172881 DOI: 10.1016/j.cpcardiol.2023.101782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
We read the article by Tangxing Jiang et al. entitled "Prevalence and related factors of do-not-resuscitate orders among in-hospital cardiac arrest patients" with delight.1 This manuscript was beneficial to read, and the author's insights are admirable. We concur with the summary that newly diagnosed coronary artery disease patients are less likely to have a DNR order established. To enhance the standard of palliative care, DNR orders should be developed. However, we are compelled to present additional points that will strengthen the credibility of this report and add to the existing body of knowledge.
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Affiliation(s)
- Kamran Mahfooz
- Oncology, New York Health and Hospital Corporation/ Lincoln Medical Center, New York, NY, United States.
| | - Syed Najeed
- Department of Medicine, Wright State University, Dayton, OH, United States
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Mahfooz K, Najeed S. Comment on: Simplified Geleijnse Score for Identifying Chest Pain Features Associated With Coronary Ischemia. Curr Probl Cardiol 2023; 48:101803. [PMID: 37209800 DOI: 10.1016/j.cpcardiol.2023.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Kamran Mahfooz
- Department of Oncology, New York Health and Hospital Corporation, Lincoln Medical Center, New York, NY.
| | - Syed Najeed
- Department of Medicine, Wright state University, Dayton, OH
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Mahfooz K, Najeed S. Comment on: Cardiovascular Outcomes of Patients Referred to Home Based Cardiac Rehabilitation. Curr Probl Cardiol 2023; 48:101804. [PMID: 37209798 DOI: 10.1016/j.cpcardiol.2023.101804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Kamran Mahfooz
- Institute: New York Health and Hospital Corporation/ Lincoln Medical Center, Department: Oncology, New York, NY.
| | - Syed Najeed
- Department of Medicine, Wright state University
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Jyotsna F, Mahfooz K, Sohail H, Kumar S, Adeeb M, Anand D, Kumar R, Rekha F, Varrassi G, Khatri M, Kumar S. Deciphering the Dilemma: Anticoagulation for Heart Failure With Preserved Ejection Fraction (HFpEF). Cureus 2023; 15:e43279. [PMID: 37692595 PMCID: PMC10492587 DOI: 10.7759/cureus.43279] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [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: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Impairment in ventricular relaxation and preserved left ventricular ejection fraction are the two main features of heart failure with preserved ejection fraction (HFpEF) a difficult clinical condition. Therapeutic choices for HFpEF patients are still scarce despite its rising frequency and negative effects on morbidity and mortality, necessitating creative methods to enhance results. The increased thromboembolic risk seen in these individuals raises questions about the relevance of anticoagulation in the therapy of HFpEF. Although anticoagulation has been shown to be beneficial in heart failure with decreased ejection fraction (HFrEF) and other high-risk cardiovascular disorders, its efficacy and safety in HFpEF present a challenging therapeutic challenge. Anticoagulants have been the subject of clinical trials in HFpEF, but the results have been conflicting, giving clinicians only a little information with which to make decisions. The decision-making process is made more difficult by worries about potential bleeding hazards, particularly in susceptible elderly HFpEF patients with other comorbidities. The link between heart failure and anticoagulant medication in HFpEF is thoroughly analyzed in this narrative review. In HFpEF, cardiac fibrosis and endothelial dysfunction create a prothrombotic milieu, as is highlighted in this passage. Also covered are recent developments in innovative biomarker research and cutting-edge imaging techniques, which may provide ways to spot HFpEF patients who might benefit from anticoagulation. This therapeutic conundrum may be resolved by using precision medicine strategies based on risk classification and individualized therapy choices. This review emphasizes the need for more research to establish the best use of anticoagulation in HFpEF within the framework of personalized therapy and shared decision-making. To successfully manage thromboembolic risk and reduce bleeding consequences in HFpEF patients, it is essential to perform well-designed clinical studies and advance our understanding of the pathophysiology of HFpEF. These developments may ultimately improve the prognosis and quality of life for people who suffer from this difficult and mysterious ailment.
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Affiliation(s)
- Fnu Jyotsna
- Medicine, Dr. Bhim Rao Ambedkar Medical College and Hospital, Sahibzada Ajit Singh Nagar, IND
| | - Kamran Mahfooz
- Internal Medicine, Lincoln Medical Center, New York City, USA
| | - Haris Sohail
- Medicine, Lincoln Medical Center, New York City, USA
| | - Sumeet Kumar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Maham Adeeb
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Dev Anand
- Medicine, Bahria University Medical and Dental College, Karachi, USA
| | - Rahul Kumar
- Medicine, Liaquat University of Medical and Health Sciences, Karachi, PAK
| | - Fnu Rekha
- Medicine, Liaquat University of Medical and Health Sciences, Karachi, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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Jyotsna F, Mahfooz K, Patel T, Parshant F, Simran F, Harsha F, Neha F, Jyotishna D, Mishra D, Subedi S, Khatri M, Kumar S, Varrassi G. A Systematic Review and Meta-Analysis on the Efficacy and Safety of Finerenone Therapy in Patients with Cardiovascular and Chronic Kidney Diseases in Type 2 Diabetes Mellitus. Cureus 2023; 15:e41746. [PMID: 37575756 PMCID: PMC10421409 DOI: 10.7759/cureus.41746] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
The purpose of this study is to assess the safety and efficacy of finerenone therapy in type 2 diabetes mellitus (T2DM) patients with cardiovascular and chronic renal diseases. This meta-analysis assesses the efficacy and safety of finerenone in the treatment of diabetic kidney disease (DKD). A comprehensive search of PubMed, Embase, and Google Scholar databases was performed to identify relevant randomized controlled trials (RCTs). To quantify the effects of finerenone, the analysis included the estimation of aggregated mean differences (MDs) and relative risks (RRs), as well as 95% confidence intervals (CIs). This meta-analysis included seven double-blind trials with patients suffering from chronic kidney disease (CKD) and T2D. Participants received finerenone or a placebo was assigned at random. The primary efficacy outcomes were cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure, kidney failure, a sustained 57% decrease in the estimated glomerular filtration rate from baseline over four weeks, or renal death. Among the 39,995 patients included in the analysis, finerenone treatment was associated with a lower risk of cardiovascular and renal-related mortality compared to placebo (RR = 0.86 (0.80, 0.93), p = 0.0002; I-squared statistic (I2 ) = 0%) and (RR = 0.56 (0.17, 1.82), p = 0.34; I2 = 0%). In addition, finerenone treatment was associated with a marginally reduced risk of serious adverse events (RR = 0.95 (0.92, 0.97), p = 0.0001; I2 = 0%), although no significant difference in the overall risk of adverse events was observed between the two groups (RR = 1.00 (0.99, 1.01), p = 0.56; I2 = 0%). This study's findings suggest that finerenone administration can reduce the risk of end-stage kidney disease, renal failure, cardiovascular mortality, and hospitalization. Patients with both T2DM and CKD are therefore advised to consider finerenone therapy.
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Affiliation(s)
- Fnu Jyotsna
- Medicine, DR. B.R. (Bharatha Rathna) Ambedkar Medical College & Hospital, Bengaluru, IND
| | - Kamran Mahfooz
- Internal Medicine, Lincoln Medical Center, New York, USA
| | - Tirath Patel
- Medical Student, American University of Antigua, St. John's, ATG
| | - Fnu Parshant
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Fnu Simran
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Fnu Harsha
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Fnu Neha
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Dev Jyotishna
- Cardiology, TU (Tribhuvan University) Teaching Hospital, International Organization for Migration, Mohali, NPL
| | - Dipesh Mishra
- Medicine, Chirayu National Hospital and Medical Institute, Kathmandu, NPL
| | - Sirjana Subedi
- Medicine, University of Medicine and Health Sciences, Basseterre, NPL
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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Khatri M, Kumar S, Mahfooz K, Sugandh F, Dembra D, Mehak F, Rachna Panjwani GA, Islam H, Islam R, Ibn E Ali Jaffari SM, Patel T, Kumar A, Kumar N, Varrassi G. Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e38215. [PMID: 37252538 PMCID: PMC10224769 DOI: 10.7759/cureus.38215] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Drug-eluting stents have transformed the treatment of coronary artery disease (CAD), and there are two types: polymer-free and polymer-coated stents. Polymer-free stents have a coating that is quickly absorbed by the body, whereas polymer-coated stents have a coating that remains on the stent surface. This meta-analysis and systematic review aimed to compare the clinical outcomes of these two stent types in patients with coronary artery disease. The literature and abstracts from significant databases were reviewed to compare polymer-free drug-eluting stents (PF-DES) and polymer-coated drug-eluting stents (PC-DES) for the treatment of coronary artery disease (CAD). The primary efficacy endpoints of the study were all-cause mortality and deaths from cardiovascular and non-cardiovascular causes. Among the secondary outcomes were incidences of myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), stent thrombosis, stroke, and major adverse cardiovascular events (MACEs). In terms of the primary outcomes, the combined analysis revealed a marginally lower risk of all-cause mortality (relative risk, RR (95% CI) = 0.92 (0.85, 1.00), p = 0.05, I2 = 0%) with the use of PF-DES versus PC-DES. Nonetheless, there was no significant difference in cardiovascular mortality (RR (95% CI) = 0.97 (0.87, 1.08)) or non-cardiovascular mortality (RR (95% CI) = 0.87 (0.69, 1.10), p = 0.25, I2 = 9%) between the groups. Furthermore, univariate meta-regression revealed that male gender and prior myocardial infarction were independently associated with an increased risk of all-cause mortality and cardiovascular disease. According to the current meta-analysis, no statistically significant differences existed in PF-DES and PC-DES outcomes. More extensive research is needed to investigate these findings further and establish their validity.
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Affiliation(s)
- Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Kamran Mahfooz
- Internal Medicine, New York Health and Hospital Corporation, Lincoln Medical Center, New York, USA
| | - Fnu Sugandh
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
- Medicine, Civil Hospital Karachi, Sukkur, PAK
| | - Deepak Dembra
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Fnu Mehak
- Surgery, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | | | - Hamza Islam
- Research, Punjab Medical College, Faisalabad, PAK
| | - Rabia Islam
- Research, Faisalabad Medical University, Faisalabad, PAK
| | | | - Tirath Patel
- Surgery, American University of Antigua, St. John, ATG
| | - Ajay Kumar
- Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA
| | - Nomesh Kumar
- Surgery, Detroit Medical Center-Wayne State University of Sinai Grace, Michigan, USA
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Dahrab M, Gaddipati SP, Patel KB, Patel T, Gaddam AR, Jain M, Gudi TR, Meenashi Sundaram D, Mahfooz K, Vasavada AM. The Effect of Percutaneous Coronary Intervention on QT Dispersion and the Association Between Them: A Systematic Review. Cureus 2023; 15:e36226. [PMID: 37065409 PMCID: PMC10103800 DOI: 10.7759/cureus.36226] [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] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
Electrocardiography (ECG) parameters are significant in the prognosis of ischemia and other cardiovascular conditions. Reperfusion or revascularization techniques are essential in reestablishing blood flow to ischemic tissues. This study aims to demonstrate the association between percutaneous coronary intervention (PCI), a revascularization technique, and the electrocardiography (ECG) parameter, QT dispersion (QTd). We conducted a systematic review of the association between PCI and QTd through a literature search in three electronic databases, ScienceDirect, PubMed, and Google Scholar, for empirical studies published in English. Review Manager (RevMan) 5.4 (Cochrane Collaboration, Oxford, England) was used for statistical analysis. Of 3,626 studies, 12 articles met the inclusion criteria, enrolling a total of 1,239 patients. After a successful PCI procedure, QTd and corrected QT (QTc) tremendously reduced at various time intervals with statistical significance in most of the studies. There was a clear association between ECG parameters QTd, QTc, and corrected QT dispersion (QTcd), and PCI, in that there is a considerable reduction in these ECG parameters after PCI treatment.
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Mahfooz K, Najeed S. Comment on: Exercise capacity assessed with the one-minute sit-to-stand test (1-min STST) and echocardiographic findings in patients with heart failure with preserved ejection fraction (HFpEF). Heart Lung 2023; 58:245-246. [PMID: 36635164 DOI: 10.1016/j.hrtlng.2022.12.017] [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] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Kamran Mahfooz
- Lincoln Medical Center, New York Health and Hospital corporation, USA.
| | - Syed Najeed
- Department of Medicine, Wright state University, USA
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Mahfooz K. Comment on: Echocardiographic 60-day mortality markers in patients hospitalized in intensive care for COVID-19. Heart Lung 2023; 58:247-248. [PMID: 36609121 PMCID: PMC9771747 DOI: 10.1016/j.hrtlng.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Kamran Mahfooz
- New York City Health and Hospitals Corporation, United States of America.
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Mahfooz K, Vasavada AM, Joshi A, Pichuthirumalai S, Andani R, Rajotia A, Hans A, Mandalia B, Dayama N, Younas Z, Hafeez N, Bheemisetty N, Patel Y, Tumkur Ranganathan H, Sodala A. Waterpipe Use and Its Cardiovascular Effects: A Systematic Review and Meta-Analysis of Case-Control, Cross-Sectional, and Non-Randomized Studies. Cureus 2023; 15:e34802. [PMID: 36915837 PMCID: PMC10008028 DOI: 10.7759/cureus.34802] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Approximately 100 million people globally smoke cigarettes, making it a significant and quickly spreading global tobacco epidemic. Substance use disorders are frequently evaluated by non-randomized studies. Tobacco use and its impacts on the cardiovascular system were the subjects of a comprehensive search across five electronic databases: Cochrane, MEDLINE, Scopus, Embase, and PubMed. The findings demonstrated that waterpipe smokers in comparison to non-smokers have immediate elevations in heart rate and blood pressure, lower levels of high-density lipoprotein, higher levels of low-density lipoprotein, higher levels of triglycerides, higher levels of fasting blood glucose, and a higher heart rate. Users of waterpipes and cigarettes had similar average heart rates, blood pressure, and lipid levels, with the exception that waterpipe smokers had greater total cholesterol. Smoking a waterpipe has significant negative effects on the cardiovascular system comparable to cigarette smoking, and non-randomized studies proved to yield substantial evidence related to its cardiovascular effects. Such study designs can be used to evaluate substance use and its cardiovascular impact.
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Affiliation(s)
- Kamran Mahfooz
- Internal Medicine, Lincoln Medical Center, New York, USA
| | - Advait M Vasavada
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Arpit Joshi
- Medicine, B. J. (Byramjee Jeejeebhoy) Medical, Ahmedabad, IND
| | | | - Rupesh Andani
- Internal Medicine, Jeevandhara Hospital, Jamnagar, IND
| | | | - Aakash Hans
- Internal Medicine, Henry Ford Health System, Detroit, USA
| | - Bilvesh Mandalia
- House Officer, Lokmanya Tilak Municipal General Hospital and Medical College, Sion Mumbai, Mumbai, IND
| | - Neeraj Dayama
- Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Zara Younas
- Medicine, King Edward Medical University, Lahore, PAK
| | | | - Niharika Bheemisetty
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Yash Patel
- Medicine, Gujarat Cancer Society Medical College, Ahmedabad, IND
| | | | - Ashok Sodala
- Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
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Kilani Y, Laxamana T, Mahfooz K, Yusuf MH, Perez-Gutierrez V, Shabarek N. A Case of Hemophagocytic Lymphohistiocytosis (HLH) Secondary to T Cell Lymphoma and Cytomegalovirus (CMV) Infection and Complicated by Tumor Lysis Syndrome (TLS). Am J Case Rep 2022; 23:e935915. [PMID: 35361746 PMCID: PMC8982473 DOI: 10.12659/ajcr.935915] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patient: Male, 48-year-old
Final Diagnosis: CMV infection • hemophagocytic lymphohistiocytosis (HLH) • lymphoma • tumor lysis syndrome
Symptoms: Altered mental state • anasarca • respiratory distress • sepsis • shock • splenomegaly
Medication: —
Clinical Procedure: —
Specialty: Hematology • Immunology • Infectious Diseases • General and Internal Medicine • Oncology
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Affiliation(s)
- Yassine Kilani
- Department of Internal Medicine, Lincoln Medical Center, New York City, USA
| | - Trisha Laxamana
- Department of Internal Medicine, Lincoln Medical Center, New York City, USA
| | - Kamran Mahfooz
- Department of Internal Medicine, Lincoln Medical Center, New York City, USA
| | - Mubarak H. Yusuf
- Department of Internal Medicine, Lincoln Medical Center, New York City, USA
| | | | - Nehad Shabarek
- Department of Internal Medicine, Lincoln Medical Center, New York City, USA
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