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Javed Z, Valero-Elizondo J, Cainzos-Achirica M, Sharma G, Mossialos E, Parekh T, Hagan K, Hyder AA, Kash B, Nasir K. Race, Social Determinants of Health, and Risk of All-Cause and Cardiovascular Mortality in the United States. J Racial Ethn Health Disparities 2024; 11:853-864. [PMID: 37017921 DOI: 10.1007/s40615-023-01567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE To examine the independent and interdependent effects of race and social determinants of health (SDoH) and risk of all-cause and cardiovascular disease (CVD) mortality in the US. DATA SOURCE/STUDY DESIGN Secondary analysis of pooled data for 252,218 participants of the 2006-2018 National Health Interview Survey, linked to the National Death Index. METHODS Age-adjusted mortality rates (AAMR) were reported for non-Hispanic White (NHW) and non-Hispanic Black (NHB) individuals overall, and by quintiles of SDoH burden, with higher quintiles representing higher cumulative social disadvantage (SDoH-Qx). Survival analysis was used to examine the association between race, SDoH-Qx, and all-cause and CVD mortality. FINDINGS AAMRs for all-cause and CVD mortality were higher for NHB and considerably higher at higher levels of SDoH-Qx, however, with similar mortality rates at any given level of SDoH-Qx. In multivariable models, NHB experienced 20-25% higher mortality risk relative to NHW (aHR = 1.20-1.26); however, no association was observed after adjusting for SDoH. In contrast, higher SDoH burden was associated with up to nearly threefold increased risk of all-cause (aHR, Q5 vs Q1 = 2.81) and CVD mortality (aHR, Q5 vs Q1 = 2.90); the SDoH effect was observed similarly for NHB (aHR, Q5:all-cause mortality = 2.38; CVD mortality = 2.58) and NHW (aHR, Q5:all-cause mortality = 2.87; CVD mortality = 2.93) subgroups. SDoH burden mediated 40-60% of the association between NHB race and mortality. CONCLUSIONS These findings highlight the critical role of SDoH as upstream drivers of racial inequities in all-cause and CVD mortality. Population level interventions focused on addressing adverse SDoH experienced by NHB individuals may help mitigate persistent disparities in mortality in the US.
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Affiliation(s)
- Zulqarnain Javed
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.
- Center for Health Data Science and Analytics, Houston Methodist, Houston, TX, 77030, USA.
- Houston Methodist Academic Institute, Houston, TX, 77030, USA.
- Houston Methodist Research Institute, 7550 Greenbriar Dr, Houston, TX, 77030, USA.
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, TX, USA.
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Miguel Cainzos-Achirica
- Department of Cardiology, Hospital del Mar / Parc de Salut Mar, Barcelona, Spain
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Garima Sharma
- Division of Cardiology, Ciccarone Center for Prevention of Cardiovascular Disease, The Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elias Mossialos
- Department of Health Policy, London School of Economics, London, UK
| | - Tarang Parekh
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Health Data Science and Analytics, Houston Methodist, Houston, TX, 77030, USA
| | - Kobina Hagan
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Health Data Science and Analytics, Houston Methodist, Houston, TX, 77030, USA
| | - Adnan A Hyder
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Bita Kash
- Center for Health and Nature, Houston Methodist, Houston, TX, USA
- Texas A&M University School of Public Health, College Station, TX, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Health Data Science and Analytics, Houston Methodist, Houston, TX, 77030, USA
- Houston Methodist Academic Institute, Houston, TX, 77030, USA
- Houston Methodist Research Institute, 7550 Greenbriar Dr, Houston, TX, 77030, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, TX, USA
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Nguyen RT, Jain V, Acquah I, Khan SU, Parekh T, Taha M, Virani SS, Blaha MJ, Nasir K, Javed Z. Association of cardiovascular risk profile with premature all-cause and cardiovascular mortality in US adults: findings from a national study. BMC Cardiovasc Disord 2024; 24:91. [PMID: 38321396 PMCID: PMC10845615 DOI: 10.1186/s12872-023-03672-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/13/2023] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age < 65). METHODS This study used data from the National Health Interview Survey from 2006 to 2014, linked to the National Death Index for non-elderly adults aged < 65 years. A composite CRF score (range = 0-6) was calculated, based on the presence or absence of six established cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity. CRF profile was defined as "Poor" (≥ 3 risk factors), "Average" (1-2), or "Optimal" (0 risk factors). Age-adjusted mortality rates (AAMR) were reported across CRF profile categories, separately for all-cause and CVD mortality. Cox proportional hazard models were used to evaluate the association between CRF profile and all-cause and CVD mortality. RESULTS Among 195,901 non-elderly individuals (mean age: 40.4 ± 13.0, 50% females and 70% Non-Hispanic (NH) White adults), 24.8% had optimal, 58.9% average, and 16.2% poor CRF profiles, respectively. Participants with poor CRF profile were more likely to be NH Black, have lower educational attainment and lower income compared to those with optimal CRF profile. All-cause and CVD mortality rates were three to four fold higher in individuals with poor CRF profile, compared to their optimal profile counterparts. Adults with poor CRF profile experienced 3.5-fold (aHR: 3.48 [95% CI: 2.96, 4.10]) and 5-fold (aHR: 4.76 [3.44, 6.60]) higher risk of all-cause and CVD mortality, respectively, compared to those with optimal profile. These results were consistent across age, sex, and race/ethnicity subgroups. CONCLUSIONS In this population-based study, non-elderly adults with poor CRF profile had a three to five-fold higher risk of all-cause and CVD mortality, compared to those with optimal CRF profile. Targeted prevention efforts to achieve optimal cardiovascular risk profile are imperative to reduce the persistent burden of premature all-cause and CVD mortality in the US.
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Affiliation(s)
- Ryan T Nguyen
- Department of Medicine, Houston Methodist, Houston, TX, US
| | - Vardhmaan Jain
- Department of Cardiovascular Medicine, Emory University School of Medicine, Atlanta, GA, US
| | - Isaac Acquah
- Methodist DeBakey Heart and Vascular Center, Houston, TX, US
| | - Safi U Khan
- Methodist DeBakey Heart and Vascular Center, Houston, TX, US
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, US
| | - Tarang Parekh
- Cardiovascular Prevention and Wellness, Department of Cardiovascular Medicine, Houston, US
- Center for Health Data Science and Analytics, Houston Methodist, Houston, TX, US
| | - Mohamad Taha
- Methodist DeBakey Heart and Vascular Center, Houston, TX, US
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, US
| | - Salim S Virani
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
- Department of Cardiology, Texas Heart Institute, Baylor College of Medicine, Houston, TX, US
| | - Michael J Blaha
- Department of Cardiology, Johns Hopkins University, Baltimore, MD, US
| | - Khurram Nasir
- Methodist DeBakey Heart and Vascular Center, Houston, TX, US
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, US
- Cardiovascular Prevention and Wellness, Department of Cardiovascular Medicine, Houston, US
| | - Zulqarnain Javed
- Center for Cardiovascular Computational Health and Precision Medicine, Houston Methodist, Houston, TX, USA.
- Houston Methodist Academic Institute, Houston, TX, USA.
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Parekh T, Xue H, Al-Kindi S, Nasir K, Cheskin LJ, Cuellar AE. Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019. J Gen Intern Med 2024; 39:176-185. [PMID: 37507552 PMCID: PMC10853151 DOI: 10.1007/s11606-023-08335-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Upstream socioeconomic circumstances including food insecurity and food desert are important drivers of community-level health disparities in cardiovascular mortality let alone traditional risk factors. The study assessed the association between differences in food environment quality and cardiovascular mortality in US adults. DESIGN Retrospective analysis of the association between cardiovascular mortality among US adults aged 45 and above and food environment quality, measured as the food environment index (FEI), in 2615 US counties. FEI was measured by equal weights of food insecurity (limited access to a reliable food source) and food desert (limited access to healthy food), ranging from 0 (worst) to 10 (best). Age-adjusted cardiovascular mortality rates per 100,000 adults aged 45 and above in the calendar year 2017-2019. County-level association between CVD mortality rate and FEI was modeled using generalized linear regression. Data were weighted using county population. RESULT Median CVD deaths per 100,000 population were 645.4 (IQR 561.5, 747.0) among adults aged 45 years and above across US counties in 2017-2019. About 12.8% (IQR 10.7%, 15.1%) of residents were food insecure and 6.3% (IQR 3.6%, 9.9%) were living in food desert areas. Comparing counties by FEI quartiles, the CVD mortality rate was higher in the least healthy FE counties (704.3 vs 598.6 deaths per 100,000 population) compared to the healthiest FE counties. One unit increase in FEI was associated with - 12.95 CVD deaths/100,000 population. In the subgroup analysis of counties with higher income inequality, the healthiest food environment was associated with 46.4 lower CVD deaths/100,000 population than the least healthy food environment. One unit increase in FEI in counties with higher income inequality was associated with a fivefold decrease in CVD mortality difference in African American counties (- 18.4 deaths/100,000 population) when compared to non-African American counties (- 3.63 deaths/100,000 population). CONCLUSION In this retrospective multi-county study in the USA, a higher food environment index was significantly associated with lower cardiovascular mortality.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Sadeer Al-Kindi
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Khurram Nasir
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Lawrence J Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Alison E Cuellar
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
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Orji AF, Gimm G, Desai A, Parekh T. The Association of Cervical Cancer Screening With Disability Type Among U.S. Women (Aged 25-64 Years). Am J Prev Med 2024; 66:83-93. [PMID: 37582416 DOI: 10.1016/j.amepre.2023.08.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023]
Abstract
INTRODUCTION Despite a gradual decline in cervical cancer mortality because of greater use of screening, including Pap and human papillomavirus (HPV) tests, disparities in screening among adult women by disability type have not been examined. This study aims to assess the odds of cervical cancer screening using HPV tests by disability type among U.S. women aged 25-64 years. METHODS This study was analyzed in 2022 using pooled data from 2018 and the 2020 Behavioral Risk Factor and Surveillance System. The analytic sample included 189,795 women aged 25-64 years. Disability was defined as having any sensory disability, cognitive disability, physical disability, ≥2 disabilities, or no disability adapted from a standardized questionnaire. Descriptive analyses were used to estimate the proportion of HPV tests on the basis of 2020 American Cancer Society guidelines, which recommend testing within five years for all women aged 25-65 years. Multivariable analyses were conducted to estimate AORs of cervical cancer screening by disability type. RESULTS Overall, 53.8% of women met recommended 2020 American Cancer Society guidelines for cervical cancer screening using HPV tests. The proportion of HPV tests was higher in women with a cognitive disability (55.9%) and lower in those with sensory (49.7%), physical (48.2%), and ≥2 disabilities (47.8%) than in those without disabilities (54.8%). In adjusted analyses, women with any disability (AOR=0.95, 95% CI=0.88, 0.97), physical disability (AOR=0.96, 95% CI=0.80, 0.98), and ≥2 disabilities (AOR=0.88, 95% CI=0.78, 0.97) had lower odds of receiving cervical cancer screening with HPV testing than women without disabilities. CONCLUSIONS Disparities in screening with HPV tests among women with physical and ≥2 disabilities suggest the need for a targeted approach to improve prevention screening awareness, access, and availability in this population.
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Affiliation(s)
- Amarachukwu F Orji
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Aakash Desai
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Tarang Parekh
- College of Health Science, University of Delaware, Newark, Delaware.
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Bhatt P, Parmar N, Parekh T, Pemmasani S, Shaikh N, Boateng AJ, Donda K, Doshi H, Dapaah-Siakwan F. Predicting Lead-Time RSV-Related Pediatric Hospitalizations From Historic Google Trend Search. Hosp Pediatr 2023; 13:e325-e328. [PMID: 37860836 DOI: 10.1542/hpeds.2022-007095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) causes seasonal outbreaks of respiratory tract infections in children, leading to increased emergency department visits and hospitalizations. Although the risk of severe illnesses difficult to predict, the sudden surge in RSV may strain the health care system. Therefore, the objective of this study was to examine the utility of Google Trends search activity on RSV to predict changes in RSV-related hospitalizations in children in the United States in 2019. METHODS A retrospective cross-sectional analysis of pediatric hospitalization was conducted using the 2019 HCUP-Kids Inpatient Database. Google Trends search activity for "RSV" was abstracted as a monthly relative interest score for 2019. RSV-related hospitalizations were identified using International Classification of Diseases 9/10 codes. We applied finite distributed lag models to estimate the causal effect over time of historical relative search activity and long-run propensity to calculate the cumulative effect of changes in relative search activity on admission rate. RESULTS Of the total 102 127 RSV-related pediatric hospitalizations, 90% were in those aged ≤2 years. Admissions were common in males (55%), non-Hispanic Whites (50%), and South region (39%). Across 2o successive months, the cumulative effect of a 1-unit score increase in relative interest was associated with an increase of 140.7 (95% confidence interval, 96.2-185.2; P < .05) RSV-related admissions. CONCLUSIONS Historic Google Trends search activity for RSV predicts lead-time RSV-related pediatric hospitalization. Further studies are needed to validate these findings using regional health systems.
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Affiliation(s)
- Parth Bhatt
- United Hospital Center, Bridgeport, West Virginia
| | | | - Tarang Parekh
- College of Health Sciences, University of Delaware, DE
| | | | - Nadia Shaikh
- University of Illinois College of Medicine Peoria, Peoria, Illinois
| | | | | | - Harshit Doshi
- Golisano Children's hospital of Southwest Florida, Fort Myers, Florida
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Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, Dalton BE, Duprey J, Cruz JA, Hagins H, Lindstedt PA, Aali A, Abate YH, Abate MD, Abbasian M, Abbasi-Kangevari Z, Abbasi-Kangevari M, Abd ElHafeez S, Abd-Rabu R, Abdulah DM, Abdullah AYM, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Abu-Zaid A, Adane TD, Adane DE, Addo IY, Adegboye OA, Adekanmbi V, Adepoju AV, Adnani QES, Afolabi RF, Agarwal G, Aghdam ZB, Agudelo-Botero M, Aguilera Arriagada CE, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad R, Ahmad S, Ahmad A, Ahmadi A, Ahmadi K, Ahmed A, Ahmed A, Ahmed LA, Ahmed SA, Ajami M, Akinyemi RO, Al Hamad H, Al Hasan SM, AL-Ahdal TMA, Alalwan TA, Al-Aly Z, AlBataineh MT, Alcalde-Rabanal JE, Alemi S, Ali H, Alinia T, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Amusa GA, Andrei CL, Anjana RM, Ansar A, Ansari G, Ansari-Moghaddam A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Arifin H, Arkew M, Armocida B, Ärnlöv J, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Aryan Z, Asemu MT, Asghari-Jafarabadi M, Askari E, Asmelash D, Astell-Burt T, Athar M, Athari SS, Atout MMW, Avila-Burgos L, Awaisu A, Azadnajafabad S, B DB, Babamohamadi H, Badar M, Badawi A, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bah S, Bahadory S, Bai R, Baig AA, Baltatu OC, Baradaran HR, Barchitta M, Bardhan M, Barengo NC, Bärnighausen TW, Barone MTU, Barone-Adesi F, Barrow A, Bashiri H, Basiru A, Basu S, Basu S, Batiha AMM, Batra K, Bayih MT, Bayileyegn NS, Behnoush AH, Bekele AB, Belete MA, Belgaumi UI, Belo L, Bennett DA, Bensenor IM, Berhe K, Berhie AY, Bhaskar S, Bhat AN, Bhatti JS, Bikbov B, Bilal F, Bintoro BS, Bitaraf S, Bitra VR, Bjegovic-Mikanovic V, Bodolica V, Boloor A, Brauer M, Brazo-Sayavera J, Brenner H, Butt ZA, Calina D, Campos LA, Campos-Nonato IR, Cao Y, Cao C, Car J, Carvalho M, Castañeda-Orjuela CA, Catalá-López F, Cerin E, Chadwick J, Chandrasekar EK, Chanie GS, Charan J, Chattu VK, Chauhan K, Cheema HA, Chekol Abebe E, Chen S, Cherbuin N, Chichagi F, Chidambaram SB, Cho WCS, Choudhari SG, Chowdhury R, Chowdhury EK, Chu DT, Chukwu IS, Chung SC, Coberly K, Columbus A, Contreras D, Cousin E, Criqui MH, Cruz-Martins N, Cuschieri S, Dabo B, Dadras O, Dai X, Damasceno AAM, Dandona R, Dandona L, Das S, Dascalu AM, Dash NR, Dashti M, Dávila-Cervantes CA, De la Cruz-Góngora V, Debele GR, Delpasand K, Demisse FW, Demissie GD, Deng X, Denova-Gutiérrez E, Deo SV, Dervišević E, Desai HD, Desale AT, Dessie AM, Desta F, Dewan SMR, Dey S, Dhama K, Dhimal M, Diao N, Diaz D, Dinu M, Diress M, Djalalinia S, Doan LP, Dongarwar D, dos Santos Figueiredo FW, Duncan BB, Dutta S, Dziedzic AM, Edinur HA, Ekholuenetale M, Ekundayo TC, Elgendy IY, Elhadi M, El-Huneidi W, Elmeligy OAA, Elmonem MA, Endeshaw D, Esayas HL, Eshetu HB, Etaee F, Fadhil I, Fagbamigbe AF, Fahim A, Falahi S, Faris MEM, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fazli G, Feng X, Ferede TY, Fischer F, Flood D, Forouhari A, Foroumadi R, Foroutan Koudehi M, Gaidhane AM, Gaihre S, Gaipov A, Galali Y, Ganesan B, Garcia-Gordillo MA, Gautam RK, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Getacher L, Ghadirian F, Ghamari SH, Ghasemi Nour M, Ghassemi F, Golechha M, Goleij P, Golinelli D, Gopalani SV, Guadie HA, Guan SY, Gudayu TW, Guimarães RA, Guled RA, Gupta R, Gupta K, Gupta VB, Gupta VK, Gyawali B, Haddadi R, Hadi NR, Haile TG, Hajibeygi R, Haj-Mirzaian A, Halwani R, Hamidi S, Hankey GJ, Hannan MA, Haque S, Harandi H, Harlianto NI, Hasan SMM, Hasan SS, Hasani H, Hassanipour S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Hessami K, Hiraike Y, Holla R, Hossain S, Hossain MS, Hosseini MS, Hosseinzadeh M, Hosseinzadeh H, Huang J, Huda MN, Hussain S, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ilic IM, Ilic MD, Inbaraj LR, Iqbal A, Islam SMS, Islam RM, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CCD, Iyamu IO, Iyasu AN, Jacob L, Jafarzadeh A, Jahrami H, Jain R, Jaja C, Jamalpoor Z, Jamshidi E, Janakiraman B, Jayanna K, Jayapal SK, Jayaram S, Jayawardena R, Jebai R, Jeong W, Jin Y, Jokar M, Jonas JB, Joseph N, Joseph A, Joshua CE, Joukar F, Jozwiak JJ, Kaambwa B, Kabir A, Kabthymer RH, Kadashetti V, Kahe F, Kalhor R, Kandel H, Karanth SD, Karaye IM, Karkhah S, Katoto PDMC, Kaur N, Kazemian S, Kebede SA, Khader YS, Khajuria H, Khalaji A, Khan MAB, Khan M, Khan A, Khanal S, Khatatbeh MM, Khater AM, Khateri S, khorashadizadeh F, Khubchandani J, Kibret BG, Kim MS, Kimokoti RW, Kisa A, Kivimäki M, Kolahi AA, Komaki S, Kompani F, Koohestani HR, Korzh O, Kostev K, Kothari N, Koyanagi A, Krishan K, Krishnamoorthy Y, Kuate Defo B, Kuddus M, Kuddus MA, Kumar R, Kumar H, Kundu S, Kurniasari MD, Kuttikkattu A, La Vecchia C, Lallukka T, Larijani B, Larsson AO, Latief K, Lawal BK, Le TTT, Le TTB, Lee SWH, Lee M, Lee WC, Lee PH, Lee SW, Lee SW, Legesse SM, Lenzi J, Li Y, Li MC, Lim SS, Lim LL, Liu X, Liu C, Lo CH, Lopes G, Lorkowski S, Lozano R, Lucchetti G, Maghazachi AA, Mahasha PW, Mahjoub S, Mahmoud MA, Mahmoudi R, Mahmoudimanesh M, Mai AT, Majeed A, Majma Sanaye P, Makris KC, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Mansouri B, Marateb HR, Mardi P, Martini S, Martorell M, Marzo RR, Masoudi R, Masoudi S, Mathews E, Maugeri A, Mazzaglia G, Mekonnen T, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Minh LHN, Mini GK, Miranda JJ, Mirfakhraie R, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Misganaw A, Misgina KH, Mishra M, Moazen B, Mohamed NS, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadshahi M, Mohseni A, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moniruzzaman M, Mons U, Montazeri F, Moodi Ghalibaf A, Moradi Y, Moradi M, Moradi Sarabi M, Morovatdar N, Morrison SD, Morze J, Mossialos E, Mostafavi E, Mueller UO, Mulita F, Mulita A, Murillo-Zamora E, Musa KI, Mwita JC, Nagaraju SP, Naghavi M, Nainu F, Nair TS, Najmuldeen HHR, Nangia V, Nargus S, Naser AY, Nassereldine H, Natto ZS, Nauman J, Nayak BP, Ndejjo R, Negash H, Negoi RI, Nguyen HTH, Nguyen DH, Nguyen PT, Nguyen VT, Nguyen HQ, Niazi RK, Nigatu YT, Ningrum DNA, Nizam MA, Nnyanzi LA, Noreen M, Noubiap JJ, Nzoputam OJ, Nzoputam CI, Oancea B, Odogwu NM, Odukoya OO, Ojha VA, Okati-Aliabad H, Okekunle AP, Okonji OC, Okwute PG, Olufadewa II, Onwujekwe OE, Ordak M, Ortiz A, Osuagwu UL, Oulhaj A, Owolabi MO, Padron-Monedero A, Padubidri JR, Palladino R, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pantea Stoian AM, Pardhan S, Parekh T, Parekh U, Pasovic M, Patel J, Patel JR, Paudel U, Pepito VCF, Pereira M, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Podder V, Postma MJ, Pourali G, Pourtaheri N, Prates EJS, Qadir MMF, Qattea I, Raee P, Rafique I, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Rahman MA, Rahman MHU, Rahman M, Rahman MM, Rahmani M, Rahmani S, Rahmanian V, Rahmawaty S, Rahnavard N, Rajbhandari B, Ram P, Ramazanu S, Rana J, Rancic N, Ranjha MMAN, Rao CR, Rapaka D, Rasali DP, Rashedi S, Rashedi V, Rashid AM, Rashidi MM, Ratan ZA, Rawaf S, Rawal L, Redwan EMM, Remuzzi G, Rengasamy KRR, Renzaho AMN, Reyes LF, Rezaei N, Rezaei N, Rezaeian M, Rezazadeh H, Riahi SM, Rias YA, Riaz M, Ribeiro D, Rodrigues M, Rodriguez JAB, Roever L, Rohloff P, Roshandel G, Roustazadeh A, Rwegerera GM, Saad AMA, Saber-Ayad MM, Sabour S, Sabzmakan L, Saddik B, Sadeghi E, Saeed U, Saeedi Moghaddam S, Safi S, Safi SZ, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahebkar A, Sahoo SS, Sahoo H, Saif-Ur-Rahman KM, Sajid MR, Salahi S, Salahi S, Saleh MA, Salehi MA, Salomon JA, Sanabria J, Sanjeev RK, Sanmarchi F, Santric-Milicevic MM, Sarasmita MA, Sargazi S, Sathian B, Sathish T, Sawhney M, Schlaich MP, Schmidt MI, Schuermans A, Seidu AA, Senthil Kumar N, Sepanlou SG, Sethi Y, Seylani A, Shabany M, Shafaghat T, Shafeghat M, Shafie M, Shah NS, Shahid S, Shaikh MA, Shanawaz M, Shannawaz M, Sharfaei S, Shashamo BB, Shiri R, Shittu A, Shivakumar KM, Shivalli S, Shobeiri P, Shokri F, Shuval K, Sibhat MM, Silva LMLR, Simpson CR, Singh JA, Singh P, Singh S, Siraj MS, Skryabina AA, Sohag AAM, Soleimani H, Solikhah S, Soltani-Zangbar MS, Somayaji R, Sorensen RJD, Starodubova AV, Sujata S, Suleman M, Sun J, Sundström J, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaeizadeh SA, Tabish M, Taheri M, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Taye BT, Temesgen WA, Temsah MH, Tesler R, Thangaraju P, Thankappan KR, Thapa R, Tharwat S, Thomas N, Ticoalu JHV, Tiyuri A, Tonelli M, Tovani-Palone MR, Trico D, Trihandini I, Tripathy JP, Tromans SJ, Tsegay GM, Tualeka AR, Tufa DG, Tyrovolas S, Ullah S, Upadhyay E, Vahabi SM, Vaithinathan AG, Valizadeh R, van Daalen KR, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Verma MV, Verras GI, Vo DC, Wagaye B, Waheed Y, Wang Z, Wang Y, Wang C, Wang F, Wassie GT, Wei MYW, Weldemariam AH, Westerman R, Wickramasinghe ND, Wu Y, Wulandari RDWI, Xia J, Xiao H, Xu S, Xu X, Yada DY, Yang L, Yatsuya H, Yesiltepe M, Yi S, Yohannis HK, Yonemoto N, You Y, Zaman SB, Zamora N, Zare I, Zarea K, Zarrintan A, Zastrozhin MS, Zeru NG, Zhang ZJ, Zhong C, Zhou J, Zielińska M, Zikarg YT, Zodpey S, Zoladl M, Zou Z, Zumla A, Zuniga YMH, Magliano DJ, Murray CJL, Hay SI, Vos T. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402:203-234. [PMID: 37356446 PMCID: PMC10364581 DOI: 10.1016/s0140-6736(23)01301-6] [Citation(s) in RCA: 250] [Impact Index Per Article: 250.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING Bill & Melinda Gates Foundation.
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Nwana N, Makram OM, Nicolas J, Gullapelli R, Parekh T, Javed Z, Pan A, Al-Kindi SG, Guan J, Sun K, Jones S, Maddock J, Chang J, Nasir K. NEIGHBORHOOD WALKABILITY IS ASSOCIATED WITH LOWER BURDEN OF CV RISK FACTORS AMONG PATIENTS WITH CANCER WITHIN AN INTEGRATED HEALTH SYSTEM: HOUSTON METHODIST OUTPATIENT LEARNING HEALTH SYSTEM REGISTRY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02742-0] [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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Gimm G, Parekh T, Kitsantas P. Assessing the prevalence and risk factors of marijuana use in adults with disabilities. Addict Behav 2023; 138:107559. [PMID: 36459827 DOI: 10.1016/j.addbeh.2022.107559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Public support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. Given the growing prevalence and concerns about potential harms, a better understanding is needed of disparities in marijuana use among adults by disability status. METHODS Using 2015-2019 data from the National Survey on Drug Use and Health (NSDUH), we obtained a national sample of 195,130 working-age (18-64 year) adults. Descriptive and multivariable analyses were conducted to assess the prevalence and risk factors associated with marijuana use among adults by disability status and type. RESULTS We found the prevalence of marijuana use was higher among adults with disabilities (16.6% vs 10.9%) compared to those without disabilities, and this disparity widened from 2015 to 2019. Furthermore, the odds of marijuana use varied by disability type. Specifically, adults with vision disability only (OR 1.28; 95% CI 1.14-1.44), cognitive disability only (OR 1.24; 95% CI 1.13-1.35), and those with multiple disabilities (OR 1.22; 95% CI 1.11-1.34) had higher odds of marijuana use compared to adults without any disability. CONCLUSIONS Adults with disabilities have a higher prevalence of marijuana use compared to those without disabilities. Living in a state with legalized medical marijuana also increased the odds of marijuana use. These findings can help to inform policy and public health surveillance of marijuana use in the U.S. Further studies are needed to monitor the rising prevalence of marijuana use and examine how intensity of marijuana use affects health outcomes in adults with and without disabilities.
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Affiliation(s)
- Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, United States.
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, United States
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, United States
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Parekh T, Gimm G, Kitsantas P. Sexually Transmitted Infections in Women of Reproductive Age by Disability Type. Am J Prev Med 2023; 64:393-404. [PMID: 36528453 DOI: 10.1016/j.amepre.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The objectives of this study were to estimate the prevalence of sexually transmitted infections in women of reproductive age by disability type and examine the association between disability types, participant characteristics, and the prevalence of sexually transmitted infections (STIs). METHODS Pooled data from 2015 to 2019 National Survey on Drug Use and Health were analyzed in 2022. The analytic sample included 90,233 women of reproductive age (18-49 years). Disability was defined as having any sensory, cognitive, physical, or ≥2 disabilities.. A total of 15% of women reported having a disability. Descriptive analyses were used to estimate the prevalence of STI, and logistic regression analyses were conducted to examine the association of disability type and other participant characteristics with the odds of having STIs. RESULTS The prevalence of STIs was more than twice as high for women of reproductive age with cognitive disabilities (6.8%) or ≥2 disabilities (6.7%) as for those without disabilities (2.7%). Women with sensory disabilities (AOR=1.47; 95% CI=1.17, 1.85), cognitive disabilities (AOR=1.89; 95% CI=1.65, 2.17), or ≥2 disabilities (AOR=1.78; 95% CI=1.49, 2.14) had greater odds of STIs than those without disabilities. Bisexual women had higher odds (AOR=1.31; 95% CI=1.14, 1.50) of STIs than straight women, whereas lesbian/gay women had lower odds (AOR=0.41; 95% CI=0.27, 0.63). The odds of STIs were higher among non-Hispanic Blacks (AOR=1.42; 95% CI=1.24, 1.63) and lower among Asian women (AOR=0.62; 95% CI=0.43, 0.90) than among non-Hispanic Whites. The odds of STIs were also greater among participants having any alcohol, cannabis, or illicit drug use. CONCLUSIONS Women of reproductive age with disabilities have a higher prevalence of sexually transmitted infections. In addition to disability type, the odds of sexually transmitted infections varied by race/ethnicity, sexual orientation, and substance use.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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Hagan K, Javed Z, Parekh T, Ogunmola I, Nasir K, Lahan S, Yahya T. CANCER, ATHEROSCLEROTIC CARDIOVASCULAR DISEASE, AND CUMULATIVE SOCIAL DISADVANTAGE IN US ADULTS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02130-7] [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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Butt S, Javed Z, Hagan K, Arshad H, Nwana N, Khan S, Parekh T, Nasir K. MULTIDIMENSIONAL POVERTY AND RISK OF ALL-CAUSE AND CVD MORTALITYIN THE US: FINDINGS FROM A NATIONAL STUDY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02113-7] [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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Nwana N, Makram OM, Javed Z, Parekh T, Al-Kindi S, Nicolas C, Gullapelli R, Jones S, Nasir K. Abstract 07: Cardiovascular Health and Environmental Justice Concerns of Exposure to Fine Particulate Matter: Insights From the Houston Methodist Outpatient Learning Health System Registry. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Air pollution remains a public health concern affecting cardiovascular outcomes. In particular, fine particulate matter measuring ≤ 2.5 μm (PM
2.5
) is associated with cardiovascular disease (CVD). Of important concern is the potential for this impact to fall disproportionately on communities of low-income and color. We assessed whether living in neighborhoods with environmental justice concerns of exposure to PM
2.5
(EJPM
2.5
) is associated with CV risk factor burden and CV health (CVH). Our cross-sectional study used data from approximately 1.07 million patients aged 18+ years in the Houston Methodist Outpatient Disease Learning Health System Registry (2016-2021). Linking to the US Environmental Protection Agency (EPA)-Environmental Justice Screen (EJScreen) Database, each patient was assigned an EJPM
2.5
index, and then categorized into 1 of 5 quintiles according to their geocoded residential census block group. Individuals with missing data (n=27221) were excluded. Logistic regression models were used to examine the association between EJPM
2.5
and CV risk factors and CVH. Poor CVH was defined as study participants with ≥ 3 CV risk factors.We included 1044382 patients (mean age 52.31, female 59%, NHB 14%, and 15% Hispanics). Overall, 18% (n=240286) had poor CV health. In our cohort, 27% (n=287077) of patients were exposed to worst PM
2.5
levels (5
th
quintile). Overall, those with worst environmental justice concerns to PM 2.5 (EJPM
2.5
) were associated with higher odds of HTN, DM, obesity and poor CVH. These associations were attenuated, but remain statistically significant accounting for clinical risk factors, demographics and socioeconomic factors.
Table
. Our findings demonstrate association between EJPM
2.5
and CVD risk factors/CVH. These robust findings support the need to prioritize environmental policies for reducing ambient pollution in communities of color and low-income as this may mitigate the CVD-associated health disparities in these communities
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Parekh T, Javed Z, Khan SU, Xue H, Nasir K. Disparities in Influenza Vaccination Coverage and Associated Factors Among Adults with Cardiovascular Disease, United States, 2011-2020. Prev Chronic Dis 2022; 19:E67. [PMID: 36302382 PMCID: PMC9616130 DOI: 10.5888/pcd19.220154] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Influenza vaccination can reduce the incidence of cardiovascular disease (CVD) in the US. However, differences in state-level trends in CVD and sociodemographic and health care characteristics of adults with CVD have not yet been studied. METHODS In this repeated cross-sectional study, we extracted 476,227 records of adults with a self-reported history of CVD from the Behavioral Risk Factor Surveillance System from January 2011 through December 2020. We calculated the prevalence and likelihood of annual influenza vaccination by sociodemographic characteristics, health care characteristics, and CVD risk factors. Additionally, we examined annual trends of influenza vaccination by geographic location. RESULTS The annual age-adjusted influenza vaccination rate among adults with CVD increased from 38.6% (2011) to 44.3% (2020), with an annual average percentage change of 1.1%. Adults who were aged 18 to 44 years, male, non-Hispanic Black/African American, or Hispanic, or had less than a high school diploma, annual household income less than $50,000, and no health insurance had a lower prevalence of vaccination. The odds of vaccination were lower among non-Hispanic Black/African American (adjusted odds ratio, 0.73; 95% CI, 0.70-0.77) and non-Hispanic American Indian/Alaska Native (adjusted odds ratio, 0.86; 95% CI, 0.75-0.98) compared with non-Hispanic White adults. Only 16 states achieved a vaccination rate of 50%; no state achieved the Healthy People 2020 goal of 70%. Nonmedical settings (supermarkets, drug stores) gained popularity (19.2% in 2011 to 28.5% in 2018) as a vaccination setting. CONCLUSION Influenza vaccination among adults with CVD improved marginally during the past decade but is far behind the targeted national goals. Addressing existing disparities requires attention to the role of social determinants of health in determining access to vaccination, particularly among young people, racial and ethnic minority populations, people who lack health insurance, and people with comorbidities.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
- Center for Health Data Science and Analytics, Houston Methodist Hospital, 7550 Greenbriar Dr, Houston, TX 77030.
| | - Zulqarnain Javed
- Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, Texas
| | - Safi U Khan
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Khurram Nasir
- Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, Texas
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
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Mansuri Z, Patel K, Parekh T, Trivedi C, Patel S, Desai S, Desai R, Vadukapuram R, Reddy A, Baweja R. Frequency of Psychiatric Disorders in Adult Patients Hospitalized With Marital Problems. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21br03156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdoli A, Abdollahi M, Abdullah AYM, Abhilash ES, Abu-Gharbieh E, Acuna JM, Addolorato G, Adebayo OM, Adekanmbi V, Adhikari K, Adhikari S, Adnani QES, Afzal S, Agegnehu WY, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed H, Ahmed Rashid T, Akunna CJ, Al Hamad H, Alam MZ, Alem DT, Alene KA, Alimohamadi Y, Alizadeh A, Allel K, Alonso J, Alvand S, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Arabloo J, Arshad M, Artamonov AA, Aryan Z, Asaad M, Asemahagn MA, Astell-Burt T, Athari SS, Atnafu DD, Atorkey P, Atreya A, Ausloos F, Ausloos M, Ayano G, Ayanore MAA, Ayinde OO, Ayuso-Mateos JL, Azadnajafabad S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Badiye AD, Bagheri N, Bagherieh S, Bairwa M, Bakkannavar SM, Bakshi RK, Balchut/Bilchut AH, Bärnighausen TW, Barra F, Barrow A, Baskaran P, Belo L, Bennett DA, Benseñor IM, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bintoro BS, Blokhina EAE, Bodicha BBA, Boloor A, Bosetti C, Braithwaite D, Brenner H, Briko NI, Brunoni AR, Butt ZA, Cao C, Cao Y, Cárdenas R, Carvalho AF, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Castro-de-Araujo LFS, Cattaruzza MS, Chakraborty PA, Charan J, Chattu VK, Chaurasia A, Cherbuin N, Chu DT, Chudal N, Chung SC, Churko C, Ciobanu LG, Cirillo M, Claro RM, Costanzo S, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Dachew BA, Dadras O, Dai X, Damiani G, Dandona L, Dandona R, Daniel BD, Danielewicz A, Darega Gela J, Davletov K, de Araujo JAP, de Sá-Junior AR, Debela SA, Dehghan A, Demetriades AK, Derbew Molla M, Desai R, Desta AA, Dias da Silva D, Diaz D, Digesa LE, Diress M, Dodangeh M, Dongarwar D, Dorostkar F, Dsouza HL, Duko B, Duncan BB, Edvardsson K, Ekholuenetale M, Elgar FJ, Elhadi M, Elmonem MA, Endries AY, Eskandarieh S, Etemadimanesh A, Fagbamigbe AF, Fakhradiyev IR, Farahmand F, Farinha CSES, Faro A, Farzadfar F, Fatehizadeh A, Fauk NK, Feigin VL, Feldman R, Feng X, Fentaw Z, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Francis JM, Franklin RC, Gaal PA, Gad MM, Gallus S, Galvano F, Ganesan B, Garg T, Gebrehiwot MGD, Gebremeskel TG, Gebremichael MA, Gemechu TR, Getacher L, Getachew ME, Getachew Obsa A, Getie A, Ghaderi A, Ghafourifard M, Ghajar A, Ghamari SH, Ghandour LA, Ghasemi Nour M, Ghashghaee A, Ghozy S, Glozah FN, Glushkova EV, Godos J, Goel A, Goharinezhad S, Golechha M, Goleij P, Golitaleb M, Greaves F, Grivna M, Grosso G, Gudayu TW, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Hafezi-Nejad N, Haj-Mirzaian A, Hall BJ, Halwani R, Handiso TB, Hankey GJ, Hariri S, Haro JM, Hasaballah AI, Hassanian-Moghaddam H, Hay SI, Hayat K, Heidari G, Heidari M, Hendrie D, Herteliu C, Heyi DZ, Hezam K, Hlongwa MM, Holla R, Hossain MM, Hossain S, Hosseini SK, hosseinzadeh M, Hostiuc M, Hostiuc S, Hu G, Huang J, Hussain S, Ibitoye SE, Ilic IM, Ilic MD, Immurana M, Irham LM, Islam MM, Islam RM, Islam SMS, Iso H, Itumalla R, Iwagami M, Jabbarinejad R, Jacob L, Jakovljevic M, Jamalpoor Z, Jamshidi E, Jayapal SK, Jayarajah UU, Jayawardena R, Jebai R, Jeddi SA, Jema AT, Jha RP, Jindal HA, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabthymer RH, Kamble BD, Kandel H, Kanno GG, Kapoor N, Karaye IM, Karimi SE, Kassa BG, Kaur RJ, Kayode GA, Keykhaei M, Khajuria H, Khalilov R, Khan IA, Khan MAB, Kim H, Kim J, Kim MS, Kimokoti RW, Kivimäki M, Klymchuk V, Knudsen AKS, Kolahi AA, Korshunov VA, Koyanagi A, Krishan K, Krishnamoorthy Y, Kumar GA, Kumar N, Kumar N, Lacey B, Lallukka T, Lasrado S, Lau J, Lee SW, Lee WC, Lee YH, Lim LL, Lim SS, Lobo SW, Lopukhov PD, Lorkowski S, Lozano R, Lucchetti G, Madadizadeh F, Madureira-Carvalho ÁM, Mahjoub S, Mahmoodpoor A, Mahumud RA, Makki A, Malekpour MR, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martinez-Villa FA, Matzopoulos R, Maulik PK, Mayeli M, McGrath JJ, Meena JK, Mehrabi Nasab E, Menezes RG, Mensink GBM, Mentis AFA, Meretoja A, Merga BT, Mestrovic T, Miao Jonasson J, Miazgowski B, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mini GK, Mirica A, Mirijello A, Mirmoeeni S, Mirrakhimov EM, Misra S, Moazen B, Mobarakabadi M, Moccia M, Mohammad Y, Mohammadi E, Mohammadian-Hafshejani A, Mohammed TA, Moka N, Mokdad AH, Momtazmanesh S, Moradi Y, Mostafavi E, Mubarik S, Mullany EC, Mulugeta BT, Murillo-Zamora E, Murray CJL, Mwita JC, Naghavi M, Naimzada MD, Nangia V, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nepal S, Neupane SPP, Neupane Kandel S, Nigatu YT, Nowroozi A, Nuruzzaman KM, Nzoputam CI, Obamiro KO, Ogbo FA, Oguntade AS, Okati-Aliabad H, Olakunde BO, Oliveira GMM, Omar Bali A, Omer E, Ortega-Altamirano DV, Otoiu A, Otstavnov SS, Oumer B, P A M, Padron-Monedero A, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pardhan S, Parekh T, Park EK, Parry CDH, Pashazadeh Kan F, Patel J, Pati S, Patton GC, Paudel U, Pawar S, Peden AE, Petcu IR, Phillips MR, Pinheiro M, Plotnikov E, Pradhan PMS, Prashant A, Quan J, Radfar A, Rafiei A, Raghav PR, Rahimi-Movaghar V, Rahman A, Rahman MM, Rahman M, Rahmani AM, Rahmani S, Ranabhat CL, Ranasinghe P, Rao CR, Rasali DP, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Renzaho AMN, Rezaei N, Rezaei S, Rezaeian M, Riahi SM, Romero-Rodríguez E, Roth GA, Rwegerera GM, Saddik B, Sadeghi E, Sadeghian R, Saeed U, Saeedi F, Sagar R, Sahebkar A, Sahoo H, Sahraian MA, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Samy AM, Sanmarchi F, Santric-Milicevic MM, Sarikhani Y, Sathian B, Saya GK, Sayyah M, Schmidt MI, Schutte AE, Schwarzinger M, Schwebel DC, Seidu AA, Senthil Kumar N, SeyedAlinaghi S, Seylani A, Sha F, Shahin S, Shahraki-Sanavi F, Shahrokhi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shams-Beyranvand M, Sheikhbahaei S, Sheikhi RA, Shetty A, Shetty JK, Shiferaw DS, Shigematsu M, Shiri R, Shirkoohi R, Shivakumar KM, Shivarov V, Shobeiri P, Shrestha R, Sidemo NB, Sigfusdottir ID, Silva DAS, Silva NTD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sleet DA, Solmi M, SOLOMON YONATAN, Song S, Song Y, Sorensen RJD, Soshnikov S, Soyiri IN, Stein DJ, Subba SH, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Taheri M, Tan KK, Tareke M, Tarkang EE, Temesgen G, Temesgen WA, Temsah MH, Thankappan KR, Thapar R, Thomas NK, Tiruneh C, Todorovic J, Torrado M, Touvier M, Tovani-Palone MR, Tran MTN, Trias-Llimós S, Tripathy JP, Vakilian A, Valizadeh R, Varmaghani M, Varthya SB, Vasankari TJ, Vos T, Wagaye B, Waheed Y, Walde MT, Wang C, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wubetu AD, Xu S, Yamagishi K, Yang L, Yesera GEE, Yigit A, Yiğit V, Yimaw AEAE, Yon DK, Yonemoto N, Yu C, Zadey S, Zahir M, Zare I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zuniga YMH, Gakidou E. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 2022; 400:185-235. [PMID: 35843246 PMCID: PMC9289789 DOI: 10.1016/s0140-6736(22)00847-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING Bill & Melinda Gates Foundation.
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Parekh T, Xue H, Cheskin LJ, Cuellar AE. Food insecurity and housing instability as determinants of cardiovascular health outcomes: A systematic review. Nutr Metab Cardiovasc Dis 2022; 32:1590-1608. [PMID: 35487828 DOI: 10.1016/j.numecd.2022.03.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/26/2022] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
AIMS The primary objective of this study is to conduct a systematic review of existing literature on the association between food insecurity and housing instability with CVD and its subtypes-related outcomes. Summarizing the comprehensive evidence for independent/interchangeable relationship of food and housing instability with CVD outcomes may inform specific interventions strategies to reduce CVD-risk. DATA SYNTHESIS The search focused on English-language articles in PubMed/Medline, from January 1, 2010, to June 1, 2021, with restriction to the US adult population. We included studies estimating the association between food insecurity or/and housing instability(exposure) and CVD-subtypes-related health outcomes (outcome). The study methodological quality was assessed using the Study Quality Assessment Tools (SQAT). Nineteen studies met eligibility criteria, consisted of 15 cross-sectional and 4 cohort studies. Of total studies, 7 examined housing instability, 11 studies focused on food insecurity, and one examined both. Food insecurity/housing instability was associated with increased overall CVD-mortality rate and greater healthcare cost utilization, while evidence were mixed for hospital readmission rate. By subtype, stroke mortality was greater with food insecurity but not with housing instability. The likelihood of myocardial infarction, coronary heart disease, and congestive heart failure was greater with food insecurity. Although mortality with MI was higher with housing instability, readmission and surgical procedure rates were significantly lower than housing stable adults. CONCLUSION Findings from this review suggest an urgent need to test the impact of screening for food and housing insecurities, referral services, and community engagement for CV health, within clinical and public health settings. PROTOCOL REGISTRATION Prospero CRD4202123352.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Lawrence J Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Alison E Cuellar
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
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Cousin E, Duncan BB, Stein C, Ong KL, Vos T, Abbafati C, Abbasi-Kangevari M, Abdelmasseh M, Abdoli A, Abd-Rabu R, Abolhassani H, Abu-Gharbieh E, Accrombessi MMK, Adnani QES, Afzal MS, Agarwal G, Agrawaal KK, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi K, Ahmadi S, Ahmadi A, Ahmed A, Ahmed Salih Y, Akande-Sholabi W, Akram T, Al Hamad H, Al-Aly Z, Alcalde-Rabanal JE, Alipour V, Aljunid SM, Al-Raddadi RM, Alvis-Guzman N, Amini S, Ancuceanu R, Andrei T, Andrei CL, Anjana RM, Ansar A, Antonazzo IC, Antony B, Anyasodor AE, Arabloo J, Arizmendi D, Armocida B, Artamonov AA, Arulappan J, Aryan Z, Asgari S, Ashraf T, Astell-Burt T, Atorkey P, Atout MMW, Ayanore MA, Badiye AD, Baig AA, Bairwa M, Baker JL, Baltatu OC, Banik PC, Barnett A, Barone MTU, Barone-Adesi F, Barrow A, Bedi N, Belete R, Belgaumi UI, Bell AW, Bennett DA, Bensenor IM, Beran D, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bijani A, Bikbov B, Birara S, Bodolica V, Bonny A, Brenner H, Briko NI, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Cao Y, Cao C, Cerin E, Chakraborty PA, Chandan JS, Chattu VK, Chen S, Choi JYJ, Choudhari SG, Chowdhury EK, Chu DT, Corso B, Dadras O, Dai X, Damasceno AAM, Dandona L, Dandona R, Dávila-Cervantes CA, De Neve JW, Denova-Gutiérrez E, Dhamnetiya D, Diaz D, Ebtehaj S, Edinur HA, Eftekharzadeh S, El Sayed I, Elgendy IY, Elhadi M, Elmonem MA, Faisaluddin M, Farooque U, Feng X, Fernandes E, Fischer F, Flood D, Freitas M, Gaal PA, Gad MM, Gaewkhiew P, Getacher L, Ghafourifard M, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Ghozali G, Gill PS, Ginawi IA, Glushkova EV, Golechha M, Gopalani SV, Guimarães RA, Gupta RD, Gupta R, Gupta VK, Gupta VB, Gupta S, Habtewold TD, Hafezi-Nejad N, Halwani R, Hanif A, Hankey GJ, Haque S, Hasaballah AI, Hasan SS, Hashi A, Hassanipour S, Hay SI, Hayat K, Heidari M, Hossain MBH, Hossain S, Hosseini M, Hoveidamanesh S, Huang J, Humayun A, Hussain R, Hwang BF, Ibitoye SE, Ikuta KS, Inbaraj LR, Iqbal U, Islam MS, Islam SMS, Islam RM, Ismail NE, Isola G, Itumalla R, Iwagami M, Iyamu IO, Jahani MA, Jakovljevic M, Jayawardena R, Jha RP, John O, Jonas JB, Joo T, Kabir A, Kalhor R, Kamath A, Kanchan T, Kandel H, Kapoor N, Kayode GA, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khajuria H, Khan MAB, Khan MN, Khan M, Khater AM, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kimokoti RW, Kisa S, Kisa A, Kivimäki M, Korshunov VA, Korzh O, Koyanagi A, Krishan K, Kuate Defo B, Kumar GA, Kumar N, Kusuma D, La Vecchia C, Lacey B, Larsson AO, Lasrado S, Lee WC, Lee CB, Lee PH, Lee SWH, Li MC, Lim SS, Lim LL, Lucchetti G, Majeed A, Malik AA, Mansouri B, Mantovani LG, Martini S, Mathur P, McAlinden C, Mehedi N, Mekonnen T, Menezes RG, Mersha AG, Miao Jonasson J, Miazgowski T, Michalek IM, Mirica A, Mirrakhimov EM, Mirza AZ, Mithra P, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradpour F, Moradzadeh R, Mostafavi E, Mueller UO, Murray CJL, Mustafa A, Nagel G, Nangia V, Naqvi AA, Nayak BP, Nazari J, Ndejjo R, Negoi RI, Neupane Kandel S, Nguyen CT, Nguyen HLT, Noubiap JJ, Nowak C, Oancea B, Odukoya OO, Oguntade AS, Ojo TT, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, Palladino R, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Parekh T, Parvizi M, Pepito VCF, Perianayagam A, Petcu IR, Pilania M, Podder V, Polibin RV, Postma MJ, Prashant A, Rabiee N, Rabiee M, Rahimi-Movaghar V, Rahman MA, Rahman MM, Rahman M, Rahmawaty S, Rajai N, Ram P, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao S, Rawaf S, Rawaf DL, Rawal L, Renzaho AMN, Rezaei N, Rezapour A, Riahi SM, Ribeiro D, Rodriguez JAB, Roever L, Rohloff P, Rwegerera GM, Ryan PM, Saber-Ayad MM, Sabour S, Saddik B, Saeedi Moghaddam S, Sahebkar A, Sahoo H, Saif-Ur-Rahman KM, Salimzadeh H, Samaei M, Sanabria J, Santric-Milicevic MM, Sathian B, Sathish T, Schlaich MP, Seidu AA, Šekerija M, Senthil Kumar N, Seylani A, Shaikh MA, Shamshad H, Shawon MSR, Sheikhbahaei S, Shetty JK, Shiri R, Shivakumar KM, Shuval K, Singh JA, Singh A, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Soheili A, Sun J, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tadesse EG, Tariqujjaman M, Thankappan KR, Thapar R, Thomas N, Timalsina B, Tobe-Gai R, Tonelli M, Tovani-Palone MR, Tran BX, Tripathy JP, Tudor Car L, Tusa BS, Uddin R, Upadhyay E, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Verma M, Villalobos-Daniel VE, Vladimirov SK, Vo B, Vu GT, Vukovic R, Waheed Y, Wamai RG, Werdecker A, Wickramasinghe ND, Winkler AS, Wubishet BL, Xu X, Xu S, Yahyazadeh Jabbari SH, Yatsuya H, Yaya S, Yazie TSY, Yi S, Yonemoto N, Yunusa I, Zadey S, Zaman SB, Zamanian M, Zamora N, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zumla A, Naghavi M, Schmidt MI. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019. Lancet Diabetes Endocrinol 2022; 10:177-192. [PMID: 35143780 PMCID: PMC8860753 DOI: 10.1016/s2213-8587(21)00349-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/27/2021] [Accepted: 12/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990-2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. FINDINGS In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (-28·4 to -2·9) for all diabetes, and by 21·0% (-33·0 to -5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (-13·6% [-28·4 to 3·4]) and for type 1 diabetes (-13·6% [-29·3 to 8·9]). INTERPRETATION Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. FUNDING Bill & Melinda Gates Foundation.
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Abstract
The established findings of lower representation of minority population in clinical trials are skewed by the national representation of the US population by race where they account only for 30%, making it difficult to compare the participation rate by race. We report the direct age-adjusted demographic and socioeconomic disparities in clinical trial participation among cancer survivors using the most recent national survey data. In 2018, 7.1% of cancer survivors reported participating in the clinical trial as a part of their cancer treatment. The participation rate was significantly higher among younger adults (age 18-24, 19.1%), male (8.5%), black (19.8%), and Hispanic (14.4%) cancer survivors, while rate was lower among female (4.2%), and white (5.4%). By marital status, 8.5% of unmarried and 3.5% of married cancer survivors reported clinical trial participation. These results help explain the demographic disparities in cancer survivors and drawing attention to targeted education and awareness intervention for ideal cancer care.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, 22030, USA.
| | - Aakash Desai
- Department of Medicine, University of Connecticut, Farmington, CT, USA
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Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, Abbasifard M, Abbasi-Kangevari M, Abd-Allah F, Abedi V, Abualhasan A, Abu-Rmeileh NME, Abushouk AI, Adebayo OM, Agarwal G, Agasthi P, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed Salih Y, Aji B, Akbarpour S, Akinyemi RO, Al Hamad H, Alahdab F, Alif SM, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Al-Shahi Salman R, Alvis-Guzman N, Ancuceanu R, Anderlini D, Anderson JA, Ansar A, Antonazzo IC, Arabloo J, Ärnlöv J, Artanti KD, Aryan Z, Asgari S, Ashraf T, Athar M, Atreya A, Ausloos M, Baig AA, Baltatu OC, Banach M, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barone MTU, Basu S, Bazmandegan G, Beghi E, Beheshti M, Béjot Y, Bell AW, Bennett DA, Bensenor IM, Bezabhe WM, Bezabih YM, Bhagavathula AS, Bhardwaj P, Bhattacharyya K, Bijani A, Bikbov B, Birhanu MM, Boloor A, Bonny A, Brauer M, Brenner H, Bryazka D, Butt ZA, Caetano dos Santos FL, Campos-Nonato IR, Cantu-Brito C, Carrero JJ, Castañeda-Orjuela CA, Catapano AL, Chakraborty PA, Charan J, Choudhari SG, Chowdhury EK, Chu DT, Chung SC, Colozza D, Costa VM, Costanzo S, Criqui MH, Dadras O, Dagnew B, Dai X, Dalal K, Damasceno AAM, D'Amico E, Dandona L, Dandona R, Darega Gela J, Davletov K, De la Cruz-Góngora V, Desai R, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Diaz D, Dichgans M, Dokova K, Doshi R, Douiri A, Duncan BB, Eftekharzadeh S, Ekholuenetale M, El Nahas N, Elgendy IY, Elhadi M, El-Jaafary SI, Endres M, Endries AY, Erku DA, Faraon EJA, Farooque U, Farzadfar F, Feroze AH, Filip I, Fischer F, Flood D, Gad MM, Gaidhane S, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Ghozali G, Ghozy S, Gialluisi A, Giampaoli S, Gilani SA, Gill PS, Gnedovskaya EV, Golechha M, Goulart AC, Guo Y, Gupta R, Gupta VB, Gupta VK, Gyanwali P, Hafezi-Nejad N, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hashi A, Hassan TS, Hassen HY, Havmoeller RJ, Hay SI, Hayat K, Hegazy MI, Herteliu C, Holla R, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iacoviello L, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Iqbal U, Irvani SSN, Islam SMS, Ismail NE, Iso H, Isola G, Iwagami M, Jacob L, Jain V, Jang SI, Jayapal SK, Jayaram S, Jayawardena R, Jeemon P, Jha RP, Johnson WD, Jonas JB, Joseph N, Jozwiak JJ, Jürisson M, Kalani R, Kalhor R, Kalkonde Y, Kamath A, Kamiab Z, Kanchan T, Kandel H, Karch A, Katoto PDMC, Kayode GA, Keshavarz P, Khader YS, Khan EA, Khan IA, Khan M, Khan MAB, Khatib MN, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Kolte D, Koolivand A, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Krishnamurthi RV, Kumar GA, Kusuma D, La Vecchia C, Lacey B, Lak HM, Lallukka T, Lasrado S, Lavados PM, Leonardi M, Li B, Li S, Lin H, Lin RT, Liu X, Lo WD, Lorkowski S, Lucchetti G, Lutzky Saute R, Magdy Abd El Razek H, Magnani FG, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Manafi N, Mansournia MA, Mantovani LG, Martini S, Mazzaglia G, Mehndiratta MM, Menezes RG, Meretoja A, Mersha AG, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Mirrakhimov EM, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Mokhayeri Y, Molokhia M, Moni MA, Montasir AA, Moradzadeh R, Morawska L, Morze J, Muruet W, Musa KI, Nagarajan AJ, Naghavi M, Narasimha Swamy S, Nascimento BR, Negoi RI, Neupane Kandel S, Nguyen TH, Norrving B, Noubiap JJ, Nwatah VE, Oancea B, Odukoya OO, Olagunju AT, Orru H, Owolabi MO, Padubidri JR, Pana A, Parekh T, Park EC, Pashazadeh Kan F, Pathak M, Peres MFP, Perianayagam A, Pham TM, Piradov MA, Podder V, Polinder S, Postma MJ, Pourshams A, Radfar A, Rafiei A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmani AM, Rajai N, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Reitsma MB, Renjith V, Renzaho AMN, Rezapour A, Rodriguez JAB, Roever L, Romoli M, Rynkiewicz A, Sacco S, Sadeghi M, Saeedi Moghaddam S, Sahebkar A, Saif-Ur-Rahman KM, Salah R, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sattin D, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Sepanlou SG, Seylani A, Sha F, Shahabi S, Shaikh MA, Shannawaz M, Shawon MSR, Sheikh A, Sheikhbahaei S, Shibuya K, Siabani S, Silva DAS, Singh JA, Singh JK, Skryabin VY, Skryabina AA, Sobaih BH, Stortecky S, Stranges S, Tadesse EG, Tarigan IU, Temsah MH, Teuschl Y, Thrift AG, Tonelli M, Tovani-Palone MR, Tran BX, Tripathi M, Tsegaye GW, Ullah A, Unim B, Unnikrishnan B, Vakilian A, Valadan Tahbaz S, Vasankari TJ, Venketasubramanian N, Vervoort D, Vo B, Volovici V, Vosoughi K, Vu GT, Vu LG, Wafa HA, Waheed Y, Wang Y, Wijeratne T, Winkler AS, Wolfe CDA, Woodward M, Wu JH, Wulf Hanson S, Xu X, Yadav L, Yadollahpour A, Yahyazadeh Jabbari SH, Yamagishi K, Yatsuya H, Yonemoto N, Yu C, Yunusa I, Zaman MS, Zaman SB, Zamanian M, Zand R, Zandifar A, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhong C, Zuniga YMH, Murray CJL. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20:795-820. [PMID: 34487721 PMCID: PMC8443449 DOI: 10.1016/s1474-4422(21)00252-0] [Citation(s) in RCA: 1651] [Impact Index Per Article: 550.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. METHODS We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FINDINGS In 2019, there were 12·2 million (95% UI 11·0-13·6) incident cases of stroke, 101 million (93·2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6·55 million (6·00-7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8-12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1-6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0-73·0), prevalent strokes increased by 85·0% (83·0-88·0), deaths from stroke increased by 43·0% (31·0-55·0), and DALYs due to stroke increased by 32·0% (22·0-42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0-18·0), mortality decreased by 36·0% (31·0-42·0), prevalence decreased by 6·0% (5·0-7·0), and DALYs decreased by 36·0% (31·0-42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0-24·0) and incidence rates increased by 15·0% (12·0-18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5-3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5-3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57-8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97-3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01-1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7-90·8] DALYs or 55·5% [48·2-62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3-48·6] DALYs or 24·3% [15·7-33·2]), high fasting plasma glucose (28·9 million [19·8-41·5] DALYs or 20·2% [13·8-29·1]), ambient particulate matter pollution (28·7 million [23·4-33·4] DALYs or 20·1% [16·6-23·0]), and smoking (25·3 million [22·6-28·2] DALYs or 17·6% [16·4-19·0]). INTERPRETATION The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. FUNDING Bill & Melinda Gates Foundation.
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Desai R, Parekh T, Raina J, Itare V, Gandhi Z, Ghadri JR, Templin C, Paul TK, Sachdeva R, Kumar G. Takotsubo syndrome in patients with influenza infection or anti-influenza (Flu) vaccination. Aging and Health Research 2021. [DOI: 10.1016/j.ahr.2021.100024] [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] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Stroke is the third leading cause of death in the United States, with evident differences in health outcomes by race and socioeconomic factors. We aim to focus on social determinants of health by race/ethnicity and education level that greatly influences the health-related quality of life in stroke survivors.
Method
Using the 2017 Behavior Risk Factor Surveillance System (BRFSS) survey data, the direct age-adjusted prevalence was standardized to the 2000 projected US population. Multivariable weighted logistic regression models were post-estimated to calculate marginal effects of age, gender, education, and race on social determinants of health (housing insecurity, food insecurity, healthcare access hardship) at mean values of other predictors for stroke survivors. Models were adjusted for demographics, socioeconomic position, and stroke risk factors. Marginal effects (ME) reported as predicted probabilities.
Result
Among stroke survivors, nearly 27% reported housing insecurity and healthcare access hardship, and 48% reported food insecurity. The prevalence of housing insecurity was significantly higher among female (31.69%) than male (21.98%) survivors, and of race, highest among Non-Hispanic-Black (37.49%), lower among Non-Hispanic-Whites (23.83%), and lowest among Hispanics (17.20%) stroke survivors. In contrast, food insecurity was highest among Hispanics (63.71%). Healthcare access hardship was similar across the group with a comparatively lower prevalence in Non-Hispanic-White stroke survivors (25.32%). The predicted probability of housing insecurity was significantly higher among young adults compared to older adults aged 65 or above [ME 26.8 (95CI: 14.5-39.1 vs. ME 1.4 (95CI: 0.9-2.0)]. Of race, Black, NH stroke survivors showed a higher probability of housing insecurity [ME 12.4 (95CI: 6.3-18.3)], while the probability of food insecurity [ME 39.3 (95CI: 11.1-67.6)] and healthcare access was higher among other Non-Hispanic groups. The probability of any insecurities was similar among male and female stroke survivors. Stroke survivors with less than high school education showed a significantly higher probability of housing and food insecurity, in addition to healthcare access.
Conclusion
Social inequalities along with racial disparities in stroke survivors necessitate tailored intervention to reduce the burden of stroke. It is crucial to address socioeconomic factors such as housing, food, and healthcare access that promote the development of stroke risk factors.
Abstract Figure.
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Affiliation(s)
- T Parekh
- George Mason University, Fairfax, United States of America
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Mohammed T, Parekh T, Desai A. Cardiovascular risk management in cancer survivors: Are we doing it right? World J Clin Oncol 2021; 12:144-149. [PMID: 33767970 PMCID: PMC7968105 DOI: 10.5306/wjco.v12.i3.144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/12/2021] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
Although under-recognized, cancer survivors continue to be at an increased risk of death from cardiovascular complications post-remission or cure. This increased burden of cardiovascular disease results from the interplay of various factors. Adequate cardiovascular risk assessment and timely intervention through a multi-disciplinary approach in these patients plays a pivotal role in the prevention of cardiovascular morbidity and mortality. We discuss the shortcomings of using current risk prediction scores in cancer survivors and provide some insights into cardiovascular risk management relevant for primary care physicians, oncologists, and cardiologists alike.
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Affiliation(s)
- Turab Mohammed
- Department of Medicine, University of Connecticut, Farmington, CT 06030, United States
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, United States
| | - Aakash Desai
- Department of Hematology and Oncology, Mayo Clinic, Rochester, MN 55902, United States
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Parekh T, Owens C, Fay K, Phillips J, Kitsantas P. Use of e-Cigarettes and Development of Respiratory Conditions in Women of Childbearing Age. South Med J 2021; 113:488-494. [PMID: 33005962 DOI: 10.14423/smj.0000000000001158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Women of childbearing age are encouraged not to smoke because of well-documented adverse health outcomes. This study examines the association between e-cigarette use and respiratory conditions (asthma and chronic obstructive pulmonary disease [COPD]) among women of childbearing age. METHODS The study used data from the Behavioral Risk Factor Surveillance System 2016-2017. The sample consisted of 131,965 women of childbearing age (18-44 years old). The main independent variable was smoking status and the primary outcomes were self-reported respiratory conditions such as asthma and COPD. Data were analyzed using descriptive statistics and multivariate logistic regression to assess the effects of e-cigarettes on asthma and COPD. RESULTS In this sample of childbearing-age women, 2.79% were current e-cigarettes users with or without a history of combustible cigarette smoking and 3.02% were current dual users. Compared with nonsmokers, current e-cigarette users without a history of combustible cigarette smoking were associated with 74% higher odds of having asthma (adjusted odds ratio [AOR] 1.74, 95% confidence interval [CI] 1.29-2.35), whereas results were not significant for COPD. The odds of having COPD, however, were 3 times higher (AOR 3.28, 95% CI 2.62-4.12) for current e-cigarette users with a history of cigarette smoking, whereas current dual users showed 5 times higher odds (AOR 5.07, 95% CI 3.91-6.56) of COPD compared with nonsmokers. CONCLUSION Policies related to e-cigarettes need to be reevaluated and clearly communicated to improve prevention efforts for women of childbearing age.
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Affiliation(s)
- Tarang Parekh
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Constance Owens
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Kathryn Fay
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Joseph Phillips
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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Fong HK, Desai R, Faisaluddin M, Parekh T, Mahmood A, Shah V, Shah P, Varakantam VR, Abu Hassan F, Savani S, Doshi R, Gangani K. Sex disparities in cardiovascular disease outcomes among geriatric patients with prediabetes. Prim Care Diabetes 2021; 15:95-100. [PMID: 32631808 DOI: 10.1016/j.pcd.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/21/2020] [Indexed: 11/16/2022]
Abstract
AIMS To analyze the sex-based differences in the prevalence of cardiovascular disease risk factors and outcomes in older patients with prediabetes using demographically matched national cohorts of hospitalized patients aged ≥65 years. METHODS We queried the 2007-2014 National Inpatient Database to identify older patients (>65 years) admitted with prediabetes using ICD-9 Clinical Modification codes. The older patients were then subcategorized based on sex. Comparative analyses of their baseline characteristics, the prevalence of cardiovascular(CV) disease comorbidities, hospitalization outcomes, and mortality rates were performed on propensity-matched cohorts for demographics. RESULTS A total of 1,197,978 older patients with prediabetes (599,223 males; mean age 75years and 598,755 females; mean age 76years) were identified. Higher admission rates were found commonly among older white males (84.1%) and females (81.7%). Prediabetic older males showed a higher frequency of cardiovascular comorbidities compared to females. Prediabetic older males had higher all-cause in-hospital mortality (4.2% vs. 3.6%, p < 0.001), acute myocardial infarction (7.0% vs. 4.7%, p < 0.001), arrhythmia (36.3% vs. 30.5%, p < 0.001), stroke (4.8% vs. 4.6%, p < 0.001), venous thromboembolism (3.3% vs. 3.0%, p < 0.001) and percutaneous coronary intervention (3.1% vs. 1.5%, p < 0.001) compared to females. CONCLUSIONS Our analysis revealed that among older patients hospitalized with prediabetes, males suffered worse in-hospital CV outcomes and survival rates compared to females.
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Affiliation(s)
- Hee Kong Fong
- Division of Cardiovascular Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA.
| | | | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Ahmed Mahmood
- Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, ID, USA
| | - Vraj Shah
- Division of cardiology, Medical College Baroda, Vadodara, Gujarat, India
| | - Priyal Shah
- Department of Medicine, GMERS Medical College and General Hospital, Gotri, Vadodara, India
| | - Vaishnavi Reddy Varakantam
- Department of Medicine, Medi Citi Institute of Medical Sciences, Medchal Mandal, Ghanapur, Telangana, India
| | - Falah Abu Hassan
- Department of General Surgery, Princess of Wales hospital, Bridgend, CF31 1RQ, UK
| | - Sejal Savani
- Public Health, New York University, New York, New York, USA
| | - Rajkumar Doshi
- Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA
| | - Kishorbhai Gangani
- Department of Internal Medicine, Texas Health Arlington Memorial Hospital, Arlington, TX, USA
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Parekh T, Desai R. A Comparative Analysis of E-cigarette Users and State-Specific Prevalence Change in the United States Between 2017 and 2018. Cureus 2020; 12:e12079. [PMID: 33489497 PMCID: PMC7805501 DOI: 10.7759/cureus.12079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Despite states’ regulatory efforts, e-cigarettes are gaining popularity, which poses a public health concern. The study objective is to compare demographic and state prevalence changes in e-cigarette use from 2017 to 2018. Methods A retrospective analysis was conducted using publicly available data from the Behavioral Risk Factor Surveillance System survey (2017-2018). The prevalence of current e-cigarette use was analyzed with direct age-adjustment based on the 2010 United States Census population. Results The overall use of e-cigarettes increased from 4.3% in 2017 to 5.4% in 2018. Although most demographics reported increased prevalence from 2017 to 2018, the most significant change was observed in younger adults (18-24), males, Hispanics, college graduates, non-smokers, marijuana non-users, and heavy alcoholics. Oklahoma (9.8%), Hawaii (7.8%), Arkansas (7.7%), and Colorado (7.3%) greater prevalence in 2018. Significant inclining prevalence was observed in Alaska, Connecticut, and Massachusetts, while Illinois reported a sharp decline. California, the District of Columbia, and Puerto Rico consistently reported the lowest prevalence. Idaho, Maine, Michigan, North Dakota, and Oregon are transitioning to a higher prevalence of e-cigarette use from 2017 to 2018. Conclusion The rising prevalence of e-cigarettes across demographics warrants a holistic approach to behavioural change interventions, health awareness and education, and regulatory efforts.
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Gimm G, Parekh T, Rossheim ME. Prevalence and risk factors of e-cigarette use among working-age adults with and without disabilities in 2017-2018. Disabil Health J 2020; 14:101048. [PMID: 33309537 DOI: 10.1016/j.dhjo.2020.101048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/11/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite rapid growth in the use of electronic cigarettes (ECIGs) in the U.S., few studies have examined the national prevalence of ECIG use among adults with disabilities. OBJECTIVE To assess the national prevalence of and risk factors for ECIG use among working-age (18-64 years) adults with and without disabilities. METHODS This observational study relied on a sample of 560,858 working-age adults from the 2017-2018 Behavioral Risk Factor and Surveillance System (BRFSS). We conducted descriptive analyses to estimate the prevalence of ECIG use and multivariate logistic regression models to examine factors associated with ECIG use among adults with and without disabilities. RESULTS ECIG use was more prevalent among adults with a cognitive disability (12.0%), an independent living disability (11.0%), or two or more disabilities (9.2%), compared to adults without disabilities (4.8%). In the multivariate analysis, adults with a cognitive disability (OR = 1.45; p < .001), ambulatory disability (OR = 1.23; p < .05), and those with two or more disabilities (OR = 1.49; p < .001) had an increased likelihood of ECIG use compared to those without disabilities. Current smokers had greater odds of using ECIGs compared to never smokers (OR = 8.53, p < .001). CONCLUSIONS Adults with cognitive disabilities and independent living disabilities had more than twice the prevalence of ECIG use compared to adults without disabilities. Future studies should monitor the rising prevalence and risk factors for ECIG use as well as examine longitudinal associations between using ECIGs, dual use with cigarette smoking, and health outcomes among adults with disabilities.
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Affiliation(s)
- Gilbert Gimm
- George Mason University, Department of Health Administration and Policy, 4400 University Drive, MS-1-J3, Fairfax, VA, 22030, USA.
| | - Tarang Parekh
- George Mason University, Department of Health Administration and Policy, 4400 University Drive, MS-1-J3, Fairfax, VA, 22030, USA
| | - Matthew E Rossheim
- George Mason University, Department of Global and Community Health, Fairfax, VA, 22030, USA
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Desai R, Parekh T. Cannabis-Associated Stroke Presentations: No Smoke Without a Fire. J Emerg Med 2020; 59:606-607. [PMID: 33183680 DOI: 10.1016/j.jemermed.2020.02.033] [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: 02/05/2020] [Accepted: 02/16/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, Georgia
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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Desai R, Singh S, Parekh T, Sachdeva S, Sachdeva R, Kumar G. COVID-19 and diabetes mellitus: A need for prudence in elderly patients from a pooled analysis. Diabetes Metab Syndr 2020; 14:683-685. [PMID: 32438333 PMCID: PMC7215159 DOI: 10.1016/j.dsx.2020.05.021] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the pooled estimate of diabetes prevalence in young (<50 years) versus elderly (>50 years) COVID-19 cohorts. METHODS Studies published between December-2019 and March-2020 reporting demographic and clinical characteristics of COVID-19 cases were identified. A total of 11 studies included accounting for 2084 COVID-19 patients. RESULTS The overall prevalence of diabetes in COVID-19 patients with a mean age>50 years was 13.2%, whereas studies with relatively younger patients (mean age <50 years) had a pooled prevalence of 9.0% CONCLUSION: The overall prevalence of diabetes in COVID-19 patients was found to be 13.2% with studies including relatively elderly patients showing higher rates of diabetes. The intermingled effects of diabetes with other cardiovascular comorbidities warrant age-specific outcomes data including the impact of ongoing antidiabetic treatment.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA.
| | - Sandeep Singh
- Division of Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Sonali Sachdeva
- Department of Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA; Division of Cardiology, Medical College of Georgia, Augusta, GA, USA; Division of Cardiology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA; Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
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Desai R, Parekh T, Kumar G, Sachdeva R. First episodes versus first recurrent episodes of Takotsubo syndrome: Pathophysiologic findings remain significantly different with comparable clinical outcomes. Int J Cardiol 2020; 310:23-24. [DOI: 10.1016/j.ijcard.2020.04.018] [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: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 11/26/2022]
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Desai R, Patel U, Parekh T, Hanna B, Sitammagari K, Fong HK, Lodhi MU, Varma Y, Damarlapally N, Doshi R, Savani S, Kumar G, Sachdeva R. Nationwide Trends in Prevalent Cardiovascular Risk Factors and Diseases in Young Adults: Differences by Sex and Race and In-Hospital Outcomes. South Med J 2020; 113:311-319. [PMID: 32483642 DOI: 10.14423/smj.0000000000001106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored. METHODS A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors. RESULTS Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124). CONCLUSIONS Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.
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Affiliation(s)
- Rupak Desai
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Upenkumar Patel
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Tarang Parekh
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Bishoy Hanna
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Kranthi Sitammagari
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Hee Kong Fong
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Muhammad Uzair Lodhi
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Yash Varma
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Nanush Damarlapally
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Rajkumar Doshi
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Sejal Savani
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Gautam Kumar
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Rajesh Sachdeva
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
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Parekh T, Desai R. Response by Parekh and Desai to Letter Regarding Article, “Marijuana Use Among Young Adults (18–44 Years of Age) and Risk of Stroke: A Behavioral Risk Factor Surveillance System Survey Analysis”. Stroke 2020; 51:e92. [DOI: 10.1161/strokeaha.120.029413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
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Desai R, Singh S, Parekh T, Sachdeva S, Kumar L, Sachdeva R, Kumar G. COVID-19 and Shock: A Cautionary Tale for Elderly Patients From a Pooled Analysis. Ann Emerg Med 2020; 75:789-791. [PMID: 32471584 PMCID: PMC7151519 DOI: 10.1016/j.annemergmed.2020.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
| | - Sandeep Singh
- Division of Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Sonali Sachdeva
- Department of Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Lekshmi Kumar
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA; Division of Cardiology, Medical College of Georgia, Augusta, GA; Division of Cardiology, Morehouse School of Medicine, Atlanta, GA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA; Division of Cardiology, Emory University School of Medicine, Atlanta, GA
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Affiliation(s)
- Aakash Desai
- Aakash Desai, MBBS, MPH, Department of Medicine, University of Connecticut, Farmington, CT; Sonali Sachdeva, MBBS, Department of Medicine, Lady Hardinge Medical College, New Delhi, India; Tarang Parekh, MBBS, MS, Department of Health Administration and Policy, George Mason University, Fairfax, VA; Rupak Desai, MBBS; and Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
| | - Sonali Sachdeva
- Aakash Desai, MBBS, MPH, Department of Medicine, University of Connecticut, Farmington, CT; Sonali Sachdeva, MBBS, Department of Medicine, Lady Hardinge Medical College, New Delhi, India; Tarang Parekh, MBBS, MS, Department of Health Administration and Policy, George Mason University, Fairfax, VA; Rupak Desai, MBBS; and Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
| | - Tarang Parekh
- Aakash Desai, MBBS, MPH, Department of Medicine, University of Connecticut, Farmington, CT; Sonali Sachdeva, MBBS, Department of Medicine, Lady Hardinge Medical College, New Delhi, India; Tarang Parekh, MBBS, MS, Department of Health Administration and Policy, George Mason University, Fairfax, VA; Rupak Desai, MBBS; and Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
| | - Rupak Desai
- Aakash Desai, MBBS, MPH, Department of Medicine, University of Connecticut, Farmington, CT; Sonali Sachdeva, MBBS, Department of Medicine, Lady Hardinge Medical College, New Delhi, India; Tarang Parekh, MBBS, MS, Department of Health Administration and Policy, George Mason University, Fairfax, VA; Rupak Desai, MBBS; and Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
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Desai R, Bhuva R, Patel U, Mahmood A, Lodhi MU, Fong HK, Parekh T, Gangani K, Sachdeva R, Kumar G. POOLED FREQUENCY OF STROKE WITHIN 30-DAYS FOLLOWING MECHANICAL CIRCULATORY SUPPORT WITH IMPELLA 5.0®/LD® DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF STUDIES PUBLISHED IN THE LAST DECADE (2009-2019). J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31968-9] [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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Parekh T, Pemmasani S, Desai R. Risk of Stroke With E-Cigarette and Combustible Cigarette Use in Young Adults. Am J Prev Med 2020; 58:446-452. [PMID: 31924460 DOI: 10.1016/j.amepre.2019.10.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Rising trends in stroke incidence and hospitalizations because of combustible cigarette smoking have been noted among younger adults. However, the association between e-cigarette use and stroke in this population remains largely unknown. This study examines the association between e-cigarette use with or without a history of previous or concurrent combustible cigarette use and stroke among young adults. METHODS Pooled data (2016-2017) were analyzed from the Behavior Risk Factor Surveillance System, a nationally representative, cross-sectional telephone survey, in 2019. The sample size was 161,529 participants aged 18-44 years. The association between e-cigarette use and stroke was examined using logistic regression adjusting for patient demographics, relevant comorbidities without or with history, and concurrent use of combustible cigarette use. RESULTS Current dual use of e-cigarettes and combustible cigarettes was associated with 2.91 times higher odds of stroke versus nonsmokers (AOR=2.91, 95% CI=1.62, 5.25) and 1.83 times higher odds versus current sole combustible cigarette users (AOR=1.83, 95% CI=1.06, 3.17). Compared with nonsmokers, current sole e-cigarette users did not show significantly different odds of stroke (AOR=0.69, 95% CI=0.34, 1.42). However, odds of stroke were lower for sole e-cigarette users versus current sole combustible cigarette users (AOR=0.43, 95% CI=0.20, 0.93). CONCLUSIONS Sole e-cigarette use is not associated with greater odds of stroke in young adults. However, if young adults have former or current combustible cigarette use, odds of stroke are significantly increased even compared with current sole combustible cigarette use. Switching from combustible cigarettes to e-cigarettes does not confer stroke benefits.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
| | | | - Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, Georgia
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Jones RL, Demetri GD, Schuetze SM, Milhem M, Elias A, Van Tine BA, Hamm J, McCarthy S, Wang G, Parekh T, Knoblauch R, Hensley ML, Maki RG, Patel S, von Mehren M. Efficacy and tolerability of trabectedin in elderly patients with sarcoma: subgroup analysis from a phase III, randomized controlled study of trabectedin or dacarbazine in patients with advanced liposarcoma or leiomyosarcoma. Ann Oncol 2019; 29:1995-2002. [PMID: 30084934 DOI: 10.1093/annonc/mdy253] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Treatment options for soft tissue sarcoma (STS) patients aged ≥65 years (elderly) can be limited by concerns regarding the increased risk of toxicity associated with standard systemic therapies. Trabectedin has demonstrated improved disease control in a phase III trial (ET743-SAR-3007) of patients with advanced liposarcoma or leiomyosarcoma after failure of anthracycline-based chemotherapy. Since previous retrospective analyses have suggested that trabectedin has similar safety and efficacy outcomes regardless of patient age, we carried out a subgroup analysis of the safety and efficacy observed in elderly patients enrolled in this trial. Patients and methods Patients were randomized 2 : 1 to trabectedin (n = 384) or dacarbazine (n = 193) administered intravenously every-3-weeks. The primary end point was overall survival (OS); secondary end points were progression-free survival (PFS), time-to-progression, objective response rate (ORR), duration of response, symptom severity, and safety. A post hoc analysis was conducted in the elderly patient subgroup. Results Among 131 (trabectedin = 94; dacarbazine = 37) elderly patients, disease characteristics were well-balanced and consistent with those of the total study population. Treatment exposure was longer in patients treated with trabectedin versus dacarbazine (median four versus two cycles, respectively), with a significantly higher proportion receiving prolonged therapy (≥6 cycles) in the trabectedin arm (43% versus 23%, respectively; P = 0.04). Elderly patients treated with trabectedin showed significantly improved PFS [4.9 versus 1.5 months, respectively; hazard ratio (HR)=0.40; P = 0.0002] but no statistically significant improvement in OS (15.1 versus 8.0 months, respectively; HR = 0.72; P = 0.18) or ORR (9% versus 3%, respectively; P = 0.43). The safety profile for elderly trabectedin-treated patients was comparable to that of the overall trabectedin-treated study population. Conclusions This subgroup analysis of the elderly population of ET743-SAR-3007 suggests that elderly patients with STS and good performance status can expect clinical benefit from trabectedin similar to that observed in younger patients. Trial registration www.clinicaltrials.gov, NCT01343277.
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Affiliation(s)
- R L Jones
- Seattle Cancer Care Alliance, Seattle
| | - G D Demetri
- Center for Sarcoma and Bone Oncology, Dana Farber Cancer Institute, Ludwig Center at Harvard, Boston
| | | | - M Milhem
- University of Iowa Hospitals and Clinics, Iowa City
| | - A Elias
- University of Colorado Cancer Center, Aurora
| | - B A Van Tine
- Division of Oncology, Washington University in St. Louis, St. Louis
| | - J Hamm
- Norton Cancer Institute, Louisville
| | - S McCarthy
- Clinical Oncology, Janssen Research and Development, Raritan
| | - G Wang
- Clinical Biostatistics, Janssen Research and Development, Raritan
| | - T Parekh
- Clinical Oncology, Janssen Research and Development, Raritan
| | - R Knoblauch
- Clinical Oncology, Janssen Research and Development, Raritan
| | - M L Hensley
- Memorial Sloan Kettering Cancer Center, New York
| | - R G Maki
- Monter Cancer Center, Northwell Health, Lake Success; Cold Spring Harbor Laboratory, Cold Spring Harbor
| | - S Patel
- Department of Sarcoma Medical Oncology, Division of Cancer Medicine, University of Texas M.D. Anderson Cancer Center, Houston
| | - M von Mehren
- Department of Hematology and Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA.
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Parekh T, Pemmasani S, Desai R. Marijuana Use Among Young Adults (18-44 Years of Age) and Risk of Stroke: A Behavioral Risk Factor Surveillance System Survey Analysis. Stroke 2019; 51:308-310. [PMID: 31707926 DOI: 10.1161/strokeaha.119.027828] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Amidst legalization of therapeutic and recreational use of marijuana/cannabis in the United States, cerebrovascular effects of marijuana use remain largely unknown, especially among young adults. We aimed to examine the association between marijuana use (18-44 years) among young adults and stroke events. Methods- The study analyzed pooled data from the Behavioral Risk Factor Surveillance System (2016-2017)-a nationally representative cross-sectional survey collected by the Centers for Disease Control and Prevention. Weighted logistic regression models were used to examine an association of recent marijuana use (within the last 30 days) and stroke in young adults (18-44 years) adjusting for patient demographics, risk behavior, and relevant comorbidities. Results- Overall, 13.6% of participants (n=43 860; weighted 35.5 million; 49.9% men) reported using marijuana recently (in the last month), with 63.3% of them being men. Compared with nonusers, marijuana users were often younger (18-34 years; 73.8% versus 61%), non-Hispanic white or black, and with some college education. Marijuana users were often physically active (81.8% versus 77.5%), heavy drinkers (16.8% versus 4.9%), current combustible cigarette users (37.9% versus 15%) and had lower prevalence of hypertension, diabetes mellitus, and hyperlipidemia as compared with nonusers (P<0.01). Young adults with recent marijuana use showed 1.82× higher odds (adjusted odds ratio, 1.82 [95% CI, 1.08-3.10]) of stroke compared with nonusers, which further increased to 2.45× higher (adjusted odds ratio, 2.45 [95% CI, 1.31-4.60]) among frequent marijuana users (>10 days/month). Compared with nonusers, stroke odds were even higher among frequent marijuana users with concomitant combustible cigarette use (adjusted odds ratio, 3.12 [95% CI, 1.40-6.97]) and e-cigarette use (adjusted odds ratio, 2.63 [95% CI, 1.07-6.46]), respectively. Conclusions- There may be a significantly higher odds of stroke in young marijuana users (18-44 years) as compared with nonusers with even greater odds among frequent users (>10 days/month).
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Affiliation(s)
- Tarang Parekh
- From the Department of Health Administration and Policy, George Mason University, Fairfax, VA (T.P.)
| | | | - Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA (R.D.)
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Hanna B, Desai R, Parekh T, Guirguis E, Kumar G, Sachdeva R. Psychiatric disorders in the U.S. transgender population. Ann Epidemiol 2019; 39:1-7.e1. [DOI: 10.1016/j.annepidem.2019.09.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 01/04/2023]
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Desai R, Parekh T, Hanna B, Sachdeva R, Kumar G. Reply to: Regional variation in cardiac arrest for patients with sepsis. Resuscitation 2019; 144:211-212. [DOI: 10.1016/j.resuscitation.2019.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/14/2019] [Indexed: 11/29/2022]
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Desai R, Parekh T, Goyal H, Fong HK, Zalavadia D, Damarlapally N, Doshi R, Savani S, Kumar G, Sachdeva R. Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample. World J Cardiol 2019; 11:137-148. [PMID: 31171959 PMCID: PMC6536883 DOI: 10.4330/wjc.v11.i5.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/22/2019] [Accepted: 05/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate.
AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality.
METHODS We used the national inpatient sample (2010-2014) to identify the ACS and gout-related hospitalizations, relevant comorbidities, revascularization and post-revascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality.
RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACS-gout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17-1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization in-hospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, post-operative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort.
CONCLUSION Although gout was not independently associated with an increased risk of post-revascularization in-hospital mortality in ACS, it did increase post-revascularization complications.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA 30033, United States
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, United States
| | - Hemant Goyal
- Department of Internal Medicine, Macon University School of Medicine, Macon, GA 31207, United States
| | - Hee Kong Fong
- Department of Internal Medicine, University of Missouri-Columbia, Columbia, MO 65212, United States
| | - Dipen Zalavadia
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18503, United States
| | - Nanush Damarlapally
- Department of Health Sciences, Coleman College of Health Sciences, Houston, TX 77030, United States
| | - Rajkumar Doshi
- Department of Internal Medicine, University of Nevada School of Medicine, Reno, NV 89557, United States
| | - Sejal Savani
- Public Health, New York University, New York, NY 10010, United States
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA 30033, United States
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA 30033, United States
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, United States
- Division of Cardiology, Morehouse School of Medicine, Atlanta, GA 30310, United States
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Desai R, Parekh T, Singh S, Patel U, Fong HK, Zalavadia D, Savani S, Doshi R, Sachdeva R, Kumar G. Alarming Increasing Trends in Hospitalizations and Mortality With Heyde's Syndrome: A Nationwide Inpatient Perspective (2007 to 2014). Am J Cardiol 2019; 123:1149-1155. [PMID: 30660352 DOI: 10.1016/j.amjcard.2018.12.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
We studied the trends and outcomes of patients with intestinal angiodysplasia-associated gastrointestinal bleeding (Heyde's syndrome [HS]) with aortic stenosis (AS) who underwent surgical aortic valve replacement (SAVR) versus transcatheter aortic valve implantation (TAVI). The National Inpatient Sample (2007 to 2014) and International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify HS hospitalizations, pertinent co-morbidities, and outcomes of SAVR versus TAVI from 2011 to 2014. The incidence of HS with AS was 3.1%. The trends in hospitalizations and all-cause inpatient mortality showed relative surges of 29.16% (from 48 to 62 per 100,000) and 22.7% (from 3.7 to 4.54 per 100,000) from 2007 to 2014. HS patients were older (mean age ∼80 vs 77 years) females (54.3% vs 52.2%) compared with AS without HS. The all-cause mortality (6.9% vs 4.1%), length of stay (LOS) (∼7.0 vs 5.8 days), and hospitalization charges ($58,519.31 vs $57,598.67) were higher in HS (p<0.001). No differences were reported in all-cause mortality and hospital charges in HS patients who underwent either SAVR or TAVI. However, the TAVI cohort showed lower rates of stroke (1.7% vs 10.0%) and blood transfusion (1.7% vs 11.7%), a shorter LOS (18.3 vs 23.9 days; p<0.001), and more routine discharges (21.7% vs 14.8%, p = 0.01). An older age, male gender, Asian race, congestive heart failure, coagulopathy, fluid and/or electrolytes disorders, chronic pulmonary disease, and renal failure raised the odds of mortality in HS patients. In conclusion, we observed increasing rates of hospitalizations with HS and higher inpatient mortality from 2007 to 2014. The HS patients who underwent TAVI had fewer complications without any difference in the all-cause mortality compared with SAVR.
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Affiliation(s)
- Rupak Desai
- Department of Cardiology, Atlanta VA Medical Center, Decatur, Georgia
| | - Tarang Parekh
- Department of Health Administration, George Mason University, Fairfax, Virginia
| | - Sandeep Singh
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Upenkumar Patel
- Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York
| | - Hee Kong Fong
- Department of Internal Medicine, University of Missouri-Columbia, Columbia, Missouri
| | - Dipen Zalavadia
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania
| | - Sejal Savani
- Department of Public Health, New York University, New York, New York
| | - Rajkumar Doshi
- Department of Internal Medicine, University of Nevada School of Medicine, Reno, Nevada
| | - Rajesh Sachdeva
- Department of Cardiology, Atlanta VA Medical Center, Decatur, Georgia; Department of Cardiology, Morehouse School of Medicine, Atlanta, Georgia; Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Gautam Kumar
- Department of Cardiology, Atlanta VA Medical Center, Decatur, Georgia; Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
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Desai R, Gupta S, Singh S, Bhuva R, Zalavadia D, Parekh T, Patel U, Vyas M, Goyal H, Kumar G, Sachdeva R. OUTCOMES OF SAVR VERSUS TAVR IN AORTIC STENOSIS HOSPITALIZATIONS WITH ANGIODYSPLASIA-ASSOCIATED GASTROINTESTINAL BLEEDING (HEYDE'S SYNDROME): INSIGHTS FROM A NATIONWIDE PROPENSITY-MATCHED ANALYSIS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31847-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tabernero J, Infante J, Mita A, Keung C, Skee D, Xie H, Parekh T, De Porre P, Luo F, Soria JC. Pharmacokinetics (PK) of the pan-FGFR inhibitor erdafitinib in urothelial carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Monk B, Ghatage P, Parekh T, Henitz E, Knoblauch R, Matos-Pita A, Nieto A, Park Y, Cheng P, Li W, Favis R, Ricci D, Poveda A. Effect of BRCA1 and XPG mutations on treatment response to trabectedin and pegylated liposomal doxorubicin in patients with advanced ovarian cancer: exploratory analysis of the phase 3 OVA-301 study. Ann Oncol 2015; 26:914-920. [DOI: 10.1093/annonc/mdv071] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/09/2015] [Indexed: 01/05/2023] Open
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Monk B, Ghatage P, Parekh T, Henitz E, Knoblauch R, Soto Matos-Pita A, Nieto A, Park Y, Ricci D, Poveda A. Effect of BRCA1 and XPG mutations on treatment response to trabectedin and pegylated liposomal doxorubicin in subjects with advanced ovarian cancer: Exploratory analysis of phase III OVA-301 study. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.03.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Velasco AP, Monk B, Kaye S, Vermorken J, Nieto A, Gomez J, Park Y, Parekh T, Colombo N, Vergote I. 8031 POSTER Prediction of Overall Survival (OS) Adjusted by Continuous Platinum-free Interval (PFI) at Fixed Timepoints in Patients With Recurrent Ovarian Cancer (ROC) – Results From OVA-301. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thertulien R, Manikhas GM, Dirix LY, Vermorken JB, Park K, Jain MM, Jiao JJ, Natarajan J, Parekh T, Zannikos P, Staddon AP. Effect of trabectedin on the QT interval in patients with advanced solid tumor malignancies. Cancer Chemother Pharmacol 2011; 69:341-50. [PMID: 21739119 PMCID: PMC3265736 DOI: 10.1007/s00280-011-1697-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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] [Received: 03/17/2011] [Accepted: 06/15/2011] [Indexed: 01/17/2023]
Abstract
PURPOSE The primary objective of this study was to access the potential effects of trabectedin on the QT/QTc interval in patients with locally advanced or metastatic solid tumors. METHODS Patients (n = 75) who had received ≤3 previous lines of chemotherapy and had either relapsed or had progressive disease were enrolled. Patients were administered 3-h intravenous infusions of placebo (saline) on day 1 and trabectedin (1.3 mg/m(2)) on day 2. Time-matched serial triplicate ECG recordings and pharmacokinetic blood samples were collected over 24 h on both days. Heart rate corrected mean QT intervals and changes from predose baseline in QTc (ΔQTc) were assessed. The difference in ΔQTc between trabectedin and placebo was calculated at each time point (ΔΔQTc). RESULTS The upper limits of the 90% confidence interval for ΔΔQTcF and ΔΔQTcB at all time points were less than the prespecified noninferiority margin of 10 ms (≤6.65 ms). No patient had a QTc > 500 ms or a time-matched increase from baseline in QTc > 60 ms at any time point. Regression analyses indicated ΔΔQTc was poorly correlated with trabectedin concentration. No adverse events suggestive of proarrhythmic potential were reported. CONCLUSION Trabectedin did not prolong the QTc interval. Safety and pharmacokinetic profiles of trabectedin were similar to that observed in other ovarian and breast cancer studies.
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Affiliation(s)
- R Thertulien
- Cancer Centers of North Carolina-Asheville, 20 Medical Park Drive, Asheville, NC 28803, USA.
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Kaye SB, Colombo N, Monk BJ, Tjulandin S, Kong B, Roy M, Chan S, Filipczyk-Cisarz E, Hagberg H, Vergote I, Lebedinsky C, Parekh T, Santabárbara P, Park YC, Nieto A, Poveda A. Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer delays third-line chemotherapy and prolongs the platinum-free interval. Ann Oncol 2011; 22:49-58. [PMID: 20643863 PMCID: PMC3003617 DOI: 10.1093/annonc/mdq353] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [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] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 05/10/2010] [Accepted: 05/12/2010] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD; CentoCor Ortho Biotech Products L.P., Raritan, NJ, USA). over single-agent PLD in 672 patients with relapsed ovarian cancer, particularly in the partially platinum-sensitive subgroup [platinum-free interval (PFI) of 6-12 months]. This superiority has been suggested to be due to the differential impact of subsequent (platinum) therapy. PATIENTS AND METHODS a detailed analysis of subsequent therapies and survival outcomes in the overall population and in the subsets according to platinum sensitivity was therefore conducted. RESULTS similar proportions of patients received subsequent therapy in each arm (76% versus 77%), including further platinum-based regimens (49% versus 55%). Patients in the trabectedin/PLD arm received subsequent chemotherapy at a later time (median delay 2.5 months versus PLD arm). Overall survival from subsequent platinum was significantly prolonged in the partially platinum-sensitive disease subset (hazard ratio = 0.63; P = 0.0357). CONCLUSION the superiority of trabectedin/PLD over single-agent PLD in OVA-301 cannot be explained by differences in the extent or nature of subsequent therapies administered to these patients. On the other hand, these exploratory analyses support the hypothesis that the enhanced survival benefits in the partially platinum-sensitive subset might be due to an extended PFI leading to longer survival with subsequent platinum.
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Affiliation(s)
- S B Kaye
- Section of Medicine, Institute of Cancer Research, The Royal Marsden Hospital, Sutton, Surrey, UK.
| | - N Colombo
- Medical Gynecologic Oncology Unit, European Institute of Oncology, Milan, Italy
| | - B J Monk
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, USA
| | - S Tjulandin
- Department of Clinical Pharmacology and Chemotherapy, Russian Cancer Research Center, Moscow, Russia
| | - B Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, Shandong, China
| | - M Roy
- Department of Gynecologic Oncology, University Hospital Center, Quebec, Canada
| | - S Chan
- Department of Clinical Oncology, Nottingham University Hospital, Nottingham, UK
| | | | - H Hagberg
- Department of Oncology, Akademiska Sjukhuset, Uppsala, Sweden
| | - I Vergote
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospital, Leuven, Belgium
| | - C Lebedinsky
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - T Parekh
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ, USA
| | - P Santabárbara
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - Y C Park
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ, USA
| | - A Nieto
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - A Poveda
- Department of Medical Oncology, Valencian Institute of Oncology, Valencia, Spain
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Poveda A, Vergote I, Tjulandin S, Kong B, Roy M, Chan S, Filipczyk-Cisarz E, Hagberg H, Kaye SB, Colombo N, Lebedinsky C, Parekh T, Gómez J, Park YC, Alfaro V, Monk BJ. Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer: outcomes in the partially platinum-sensitive (platinum-free interval 6-12 months) subpopulation of OVA-301 phase III randomized trial. Ann Oncol 2011; 22:39-48. [PMID: 20643862 PMCID: PMC3003616 DOI: 10.1093/annonc/mdq352] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [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] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 05/25/2010] [Accepted: 05/25/2010] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD) over PLD alone in relapsed ovarian cancer. The optimal management of patients with partially platinum-sensitive relapse [6-12 months platinum-free interval (PFI)] is unclear. PATIENTS AND METHODS within OVA-301, we therefore now report on the outcomes for the 214 cases in this subgroup. RESULTS Trabectedin/PLD resulted in a 35% risk reduction of disease progression (DP) or death [hazard ratio (HR) = 0.65, 95% confidence interval (CI), 0.45-0.92; P = 0.0152; median progression-free survival (PFS) 7.4 versus 5.5 months], and a significant 41% decrease in the risk of death (HR = 0.59; 95% CI, 0.43-0.82; P = 0.0015; median survival 23.0 versus 17.1 months). The safety of trabectedin/PLD in this subset mimicked that of the overall population. Similar proportions of patients received subsequent therapy in each arm (76% versus 77%), although patients in the trabectedin/PLD arm had a slightly lower proportion of further platinum (49% versus 55%). Importantly, patients in the trabectedin/PLD arm survived significantly longer after subsequent platinum (HR = 0.63; P = 0.0357; median 13.3 versus 9.8 months). CONCLUSION This hypothesis-generating analysis demonstrates that superior benefits with trabectedin/PLD in terms of PFS and survival in the overall population appear particularly enhanced in patients with partially sensitive disease (PFI 6-12 months).
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Affiliation(s)
- A Poveda
- Area of Gynecologic Oncology, Valencian Institute of Oncology, Valencia, Spain.
| | - I Vergote
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospital, Leuven, Belgium
| | - S Tjulandin
- Department of Clinical Pharmacology and Chemotherapy, Russian Cancer Research Center, Moscow, Russia
| | - B Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, Shandong, China
| | - M Roy
- Department of Gynecologic Oncology, University Hospital Center, Quebec, Canada
| | - S Chan
- Department of Clinical Oncology, Nottingham University Hospital, Nottingham, UK
| | | | - H Hagberg
- Department of Oncology, Akademiska Sjukhuset, Uppsala, Sweden
| | - S B Kaye
- Department of Cancer Medicine, The Royal Mardsen Hospital, Sutton, Surrey, UK
| | - N Colombo
- Medical Gynecologic Oncology Unit, European Institute of Oncology, Milan, Italy
| | - C Lebedinsky
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - T Parekh
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ
| | - J Gómez
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - Y C Park
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ
| | - V Alfaro
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - B J Monk
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, USA
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