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Ali S, Sattar Y, Erdem S, Hussain B, Duhan S, Atti L, Patel N, Hamza M, Gonuguntla K, Jalil B, Havistin R, Alamzaib SM, Elgendy IY, Daggubati R, Alraiyes AH, Alraies MC. Predictors and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients With ARDS: A Propensity-Matched Analysis of National Inpatient Sample. Curr Probl Cardiol 2023; 48:101988. [PMID: 37473942 DOI: 10.1016/j.cpcardiol.2023.101988] [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: 07/07/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
Extracorporeal membrane oxygenation (ECMO) is a significant treatment modality for COVID-19 patients on ventilators. The current data is limited for understanding the indicators and outcomes of ECMO in COVID-19 patients with acute respiratory distress syndrome (ARDS). The National Inpatient Sample (NIS) database from 2020 was queried in this study. Among 1,666,960 patients admitted with COVID-19, 99,785 (5.98%) patients developed ARDS, and 60,114 (60.2%) were placed on mechanical ventilation. Of these mechanically ventilated COVID-ARDS patients, 2580 (4.3%) were placed on ECMO. Patients with ECMO intervention had higher adjusted odds (aOR) of blood loss anemia (aOR 9.1, 95% CI: 6.16-13.5, propensity score-matched (PSM) 42% vs 5.4%, P < 0.001), major bleeding (aOR 3.79, 95% CI: 2.5-5.6, PSM 19.9% vs 5.9%, P < 0.001) and acute liver injury (aOR 1.7, 95% CI: 1.14-2.6 PSM 14% vs 6%, P = 0.009) compared to patients without ECMO intervention. However, in-hospital mortality, acute kidney injury, transfusions, acute MI, and cardiac arrest were insignificant. On subgroup analysis, patients placed on veno-arterial ECMO had higher odds of cardiogenic shock (aOR 13.4, CI 3.95-46, P < 0.0001), cardiac arrest (aOR 3.5, CI 1.45-8.47, P = 0.0057), acute congestive heart failure (aOR 4.18, CI 1.05-16.5, P = 0.042) and lower odds of major bleeding (aOR 0.26, CI 0.07-0.92). However, there was no significant difference in mortality, intracranial hemorrhage, and acute MI. Further studies are needed before considering COVID-19 ARDS patients for placement on ECMO.
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Affiliation(s)
- Shafaqat Ali
- Department of Medicine, Louisiana State University, Shreveport, LA
| | - Yasar Sattar
- Department of Cardiology, West Virginia University, Morgantown, WV
| | - Saliha Erdem
- Detroit Medical Center, Wayne State University, Detroit, MI
| | - Bilal Hussain
- Department of Medicine, The Brooklyn Hospital Center, Brooklyn, NY
| | - Sanchit Duhan
- Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD
| | - Lalitsiri Atti
- Department of Medicine, Sparrow Hospital-Michigan State University, Lansing, MI
| | - Neel Patel
- Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI
| | - Mohammad Hamza
- Department of Medicine, Albany Medical Center, Albany, NY
| | | | - Bilal Jalil
- Department of Cardiology, West Virginia University, Morgantown, WV
| | - Ruby Havistin
- Department of Cardiology, West Virginia University, Morgantown, WV
| | | | - Islam Y Elgendy
- Gill Heart & Vascular Institute, University of Kentucky, Lexington, KY
| | - Ramesh Daggubati
- Department of Cardiology, West Virginia University, Morgantown, WV
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Manubolu VS, Kinninger A, Verghese D, Alalawi L, Aldana-Bitar J, Fazlalizadeh H, Pourafkari L, Havistin R, Roy S, Earls JP, Fialkow JA, Cainzos-Achirica M, Elizondo JV, Cury RC, Nasir K, Budoff MJ. DISTRIBUTION OF CORONARY ATHEROSCLEROSIS BY SEX IN ASYMPTOMATIC U.S POPULATION USING QUANTITATIVE CT PLAQUE ANALYSIS: RESULTS FROM THE MIAMI HEART STUDY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01691-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Manubolu VS, Mao S, Kinninger A, Dahal S, Ahmad K, Havistin R, Gao Y, Dailing C, Carr JJ, Roy SK, Budoff MJ. Association between coronary artery calcium and thoracic spine bone mineral density: Multiethnic Study of Atherosclerosis (MESA). Nutr Metab Cardiovasc Dis 2023; 33:532-540. [PMID: 36642601 PMCID: PMC9974807 DOI: 10.1016/j.numecd.2022.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/04/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Previously, osteoporosis and coronary artery disease were considered unrelated. However, beyond age, these two conditions appear to share common etiologies that are not yet fully understood. We examined the relationship between thoracic spine bone mineral density (BMD) and severity of coronary artery calcium (CAC) score. METHODS AND RESULTS MESA is a prospective cohort study of 6814 men and women between the ages of 45 and 84 years, without clinical cardiovascular disease. This study included participants who underwent non-contrast chest CT scans to determine CAC score and thoracic spine BMD. The thoracic spine BMD was categorized into osteoporosis (defined as T score: ≤ -2.5), osteopenia (T-score between: -2.5 and -1) and normal BMD (T-score ≥ -1). There were 3392 subjects who had CAC >0 at baseline. The prevalence of CAC >0 was 36% in normal BMD group, 49% in the osteopenia and 68% in osteoporosis group. After adjusting for risk factors of atherosclerosis, in multivariate regression models we found a significant association between CAC and osteoporosis (OR: 1.40, 95% CI 1.16-1.69, p value < 0.0004). Furthermore, we stratified our results by gender and found a statistically significant association in both men and women. CONCLUSION Results from this cross-sectional analysis of a large population based ethnically diverse cohort indicate a significant inverse relationship between thoracic BMD and CAC in both genders independent of other cardiovascular risk factors. Future studies need to explore the underlying pathophysiological mechanisms relating BMD and coronary artery calcification.
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Affiliation(s)
| | - Song Mao
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - April Kinninger
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Suraj Dahal
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Khadije Ahmad
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ruby Havistin
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yanlin Gao
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Chris Dailing
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - J Jeffrey Carr
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sion K Roy
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Matthew J Budoff
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
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Havistin R, Lakshmanan S, Budoff MJ. Behind the Age Cutoff in the Chest Pain Guidelines. JACC Cardiovasc Imaging 2023; 16:137-138. [PMID: 36599562 DOI: 10.1016/j.jcmg.2022.08.015] [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: 01/25/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/06/2022]
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Nasir K, Cainzos-Achirica M, Valero-Elizondo J, Ali SS, Havistin R, Lakshman S, Blaha MJ, Blankstein R, Shapiro MD, Arias L, Saxena A, Feldman T, Budoff MJ, Ziffer JA, Fialkow J, Cury RC. Coronary Atherosclerosis in an Asymptomatic U.S. Population. JACC: Cardiovascular Imaging 2022; 15:1604-1618. [DOI: 10.1016/j.jcmg.2022.03.010] [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] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 12/13/2022]
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Aldana Bitar J, Lakshmanan S, Manubolu V, Dahal S, Shafter A, Havistin R, Ahmad K, Crabtree T, Earls J, Jonas R, Choi A, Jennings R, Min J, Budoff M. Differential Effects Of Apixaban Versus Rivaroxaban On Atherosclerosis Plaque Progression In Patients With Atrial Fibrillation. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.266] [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: 11/15/2022]
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Manubolu VS, Dahal S, Kinninger A, Lakshmanan S, Calicchio F, Havistin R, Ahmad K, Ghanem A, Rezvanizadeh V, Roy S, Budoff M. PROGNOSTIC UTILITY OF COMBINED TOTAL CALCIUM SCORE AND NUMBER OF LESIONS IN PREDICTING OBSTRUCTIVE CORONARY ARTERY DISEASE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02801-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Calicchio F, Onuegbu A, Mao SS, Kinninger A, Havistin R, Manubolu VS, Golub I, Cherukuri L, Birudaraju D, Ahmad K, Rezvanizadeh V, Ghanem A, Budoff M. ARTERIAL STIFFNESS AND LEFT VENTRICULAR GEOMETRY IN A MULTI-ETHNIC POPULATION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02675-9] [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: 11/17/2022]
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Dahal S, Calicchio F, Kinninger A, Lakshmanan S, Manubolu VS, Havistin R, Ahmad K, Rezvanizadeh V, Ghanem A, Hamal S, Behjatnia D, Crahan TC, Roy S, Budoff M. PREVALENCE OF OBSTRUCTIVE CORONARY ARTERY DISEASE ASSESSED BY CORONARY CT ANGIOGRAPHY IN DIFFERENT AGE POPULATION WITH CORONARY ARTERY CALCIUM SCORE OF ZERO. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02727-3] [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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Havistin R, Ahmad K, Hartnett S, Kinninger A, Ghanem A, Calicchio F, Manubolu VS, Rezvanizadeh V, Dahal S, Lakshmanan S, Budoff M. THE VALUE OF ZERO BEYOND THE CORONARIES. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02798-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ahmad K, Lakshmanan S, Nimmagadda M, Verghese D, Cherukuri L, Kinninger A, Ghanem AK, Rezvanizadeh V, Dahal S, Manubolu V, Havistin R, Joshi T, Hadeed SJ, Hamal S, Flores F, Budoff MJ. CAN SIGNAL-PROCESSED ELECTROCARDIOGRAM (SPECG) DIAGNOSE SUBCLINICAL ATHEROSCLEROSIS? J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02673-5] [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: 11/30/2022]
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Orgeron GM, Havistin R, Hahn LS, Wang J, Crichlow C, Mugmon M, Mahajan A, Jourdan A, Sekhsaria S. Prevalence and management of aspirin hypersensitivity in a cardiology practice. Allergy Asthma Proc 2020; 41:120-125. [PMID: 32122448 DOI: 10.2500/aap.2020.41.190032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Data are lacking with concern to the prevalence and management of aspirin (ASA) hypersensitivity. Objective: To study the prevalence, different types of reactions, and implications for clinical management of ASA hypersensitivity in a cardiology practice. Methods: We conducted an electronic medical record review of 11,375 individuals, 5052 (44%) in the ambulatory setting, and 6323 (56%) admitted for percutaneous coronary intervention (PCI), from January 2012 to December 2013. Results: The prevalence of ASA hypersensitivity was 1.88% (n = 214). Skin reactions were the most common (40 [19%]), followed by angioedema (10 [4.6%]), respiratory (9 [4.2%]), and anaphylaxis (6 [2.8%]). No records were found for 74 patients (34.5%), and 69 patients (32.2%) were mistakenly labeled as allergic for having gastrointestinal symptoms. Of the 214 patients who had documented ASA hypersensitivity, 108 individuals (50.46%) had coronary artery disease. The medications at discharge were the following: ASA (30 [14%]), thienopyridine (48 [22%]), a combination of ASA and thienopyridine (13 [6%]), anticoagulation only (26 [12%]), and no antiplatelet (97 [43%]). Conclusion: ASA hypersensitivity is often not documented correctly or is often misdiagnosed or not appropriately managed. There is a need for improved management of ASA hypersensitivity, including appropriate referral for ASA desensitization and combating unnecessary avoidance in patients with intolerance due to adverse effects.
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Affiliation(s)
| | - Ruby Havistin
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | - Laura S. Hahn
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | - John Wang
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | - Candace Crichlow
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | - Marc Mugmon
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | - Anshul Mahajan
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
| | | | - Sudhir Sekhsaria
- From the Medstar Union Memorial Hospital, Baltimore, Maryland, and
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