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  1. Article ; Online: Half-dose direct oral anticoagulation versus warfarin for atrial fibrillation following cardiac surgery.

    Hashim, Sabet W / Collazo, Susan / Greco, Amanda / Mather, Jeff F / McKay, Raymond G

    The Journal of cardiovascular surgery

    2024  Volume 65, Issue 2, Page(s) 169–176

    Abstract: Background: Optimal anticoagulation strategies have not been defined for patients with atrial fibrillation following cardiac surgery.: Methods: From a total cohort of 228 patients with pre-existing or new onset atrial fibrillation following coronary ... ...

    Abstract Background: Optimal anticoagulation strategies have not been defined for patients with atrial fibrillation following cardiac surgery.
    Methods: From a total cohort of 228 patients with pre-existing or new onset atrial fibrillation following coronary artery bypass grafting and/or valve surgery, we compared in-hospital and 30-day outcomes in 119 patients treated with low-dose aspirin and a half-dose direct oral anticoagulant (DOAC) versus 109 treated with low-dose aspirin and warfarin.
    Results: DOAC patients were older (73.1±7.0 vs. 68.7±11.4 years, P<0.001) and had a lower incidence of preoperative atrial fibrillation (37 [31.1%] vs. 69 [63.3%], P<0.001). Otherwise, the two cohorts were well matched for baseline demographics, cardiovascular risk factors, comorbidities, prior cardiac history and STS Risk Score. In comparison to Warfarin patients, DOAC patients had a shorter length of post-surgical stay (6 [5-8] vs. 7 [5-10] days, P=0.037). The two cohorts, however, had a similar incidence of stroke, transient ischemic attack, reoperation for bleeding and postoperative blood bank product usage. Follow-up 30-day outcomes did not differ between the two groups with respect to mortality (0 [0.0%] vs. 0 [0.0%], P=1.000) and hospital readmission (16 [13.4%] vs. 14 [12.8%], P=0.893), although two DOAC patients required drainage of sanguineous pericardial effusions.
    Conclusions: In comparison to warfarin, half-dose DOAC anticoagulation in patients with atrial fibrillation following cardiac surgery is associated with a shorter postoperative length of stay, without a significant increase in stroke/transient ischemic attack, reoperation for bleeding or postoperative blood product transfusion. Follow-up echocardiography in anticoagulated patients is recommended to rule out significant sanguineous pericardial effusions in the early postoperative period following hospital discharge.
    MeSH term(s) Humans ; Atrial Fibrillation/diagnosis ; Aged ; Male ; Female ; Warfarin/administration & dosage ; Warfarin/adverse effects ; Anticoagulants/administration & dosage ; Anticoagulants/adverse effects ; Administration, Oral ; Treatment Outcome ; Time Factors ; Risk Factors ; Retrospective Studies ; Middle Aged ; Aged, 80 and over ; Aspirin/administration & dosage ; Aspirin/adverse effects ; Stroke/etiology ; Stroke/prevention & control ; Cardiac Surgical Procedures/adverse effects ; Coronary Artery Bypass/adverse effects ; Length of Stay ; Factor Xa Inhibitors/administration & dosage ; Factor Xa Inhibitors/adverse effects
    Chemical Substances Warfarin (5Q7ZVV76EI) ; Anticoagulants ; Aspirin (R16CO5Y76E) ; Factor Xa Inhibitors
    Language English
    Publishing date 2024-03-12
    Publishing country Italy
    Document type Journal Article ; Comparative Study
    ZDB-ID 80143-4
    ISSN 1827-191X ; 0021-9509
    ISSN (online) 1827-191X
    ISSN 0021-9509
    DOI 10.23736/S0021-9509.24.12815-7
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  2. Article ; Online: The impact of asthma on in-hospital outcomes of COVID-19 patients.

    Mather, Jeffrey F / Mosleh, Wassim / McKay, Raymond G

    The Journal of asthma : official journal of the Association for the Care of Asthma

    2021  Volume 59, Issue 8, Page(s) 1680–1686

    Abstract: Objective: The impact of asthma as a possible risk factor for adverse clinical outcomes in patients diagnosed with COVID-19 remains controversial. The purpose of this study was to examine the impact of asthma on adverse clinical outcomes in a COVID-19 ... ...

    Abstract Objective: The impact of asthma as a possible risk factor for adverse clinical outcomes in patients diagnosed with COVID-19 remains controversial. The purpose of this study was to examine the impact of asthma on adverse clinical outcomes in a COVID-19 hospitalized cohort.
    Methods: Retrospective, propensity-matched observational study of consecutive COVID-19-positive patients between February 24, 2020, and November 3, 2020 at a single health care system.
    Results: In the initial population of 1925 patients, 4.4% presented with asthma. Propensity score matching reduced the total sample to
    Conclusion: We conclude that asthma in hospitalized COVID-19 patients is associated with a lower risk of mortality and no increase in disease severity in hospitalized COVID-19 patients.
    MeSH term(s) Asthma/diagnosis ; COVID-19 ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans ; Respiration, Artificial ; Retrospective Studies
    Language English
    Publishing date 2021-06-29
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 603816-5
    ISSN 1532-4303 ; 0277-0903
    ISSN (online) 1532-4303
    ISSN 0277-0903
    DOI 10.1080/02770903.2021.1944187
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  3. Article: In-Hospital and One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients Requiring Supplemental Home Oxygen Use.

    Patail, Haris / Kompella, Ritika / Hoover, Nicole E / Reis, Wyona / Masih, Rohit / Mather, Jeff F / Sutton, Trevor S / McKay, Raymond G

    Cardiology research

    2023  Volume 14, Issue 3, Page(s) 228–236

    Abstract: Background: There have been limited reports with inconsistent results on the impact of long-term use of oxygen therapry (LTOT) in patients treated with transcatheter aortic valve replacement (TAVR).: Methods: We compared in-hospital and intermediate ... ...

    Abstract Background: There have been limited reports with inconsistent results on the impact of long-term use of oxygen therapry (LTOT) in patients treated with transcatheter aortic valve replacement (TAVR).
    Methods: We compared in-hospital and intermediate TAVR outcomes in 150 patients requiring LTOT (home O
    Results: Home O
    Conclusion: Home O
    Language English
    Publishing date 2023-05-26
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2598593-0
    ISSN 1923-2837 ; 1923-2829
    ISSN (online) 1923-2837
    ISSN 1923-2829
    DOI 10.14740/cr1497
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  4. Article ; Online: Impact of Famotidine Use on Clinical Outcomes of Hospitalized Patients With COVID-19

    Mather, Jeffrey F. / Seip, Richard L. / McKay, Raymond G.

    American Journal of Gastroenterology

    2020  Volume 115, Issue 10, Page(s) 1617–1623

    Keywords Hepatology ; Gastroenterology ; covid19
    Language English
    Publisher Ovid Technologies (Wolters Kluwer Health)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000000832
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  5. Article ; Online: Impact of Famotidine Use on Clinical Outcomes of Hospitalized Patients With COVID-19.

    Mather, Jeffrey F / Seip, Richard L / McKay, Raymond G

    The American journal of gastroenterology

    2020  Volume 115, Issue 10, Page(s) 1617–1623

    Abstract: Introduction: To compare outcomes in patients hospitalized with coronavirus (COVID-19) receiving famotidine therapy with those not receiving famotidine.: Methods: Retrospective, propensity-matched observational study of consecutive COVID-19-positive ... ...

    Abstract Introduction: To compare outcomes in patients hospitalized with coronavirus (COVID-19) receiving famotidine therapy with those not receiving famotidine.
    Methods: Retrospective, propensity-matched observational study of consecutive COVID-19-positive patients between February 24, 2020, and May 13, 2020.
    Results: Of 878 patients in the analysis, 83 (9.5%) received famotidine. In comparison to patients not treated with famotidine, patients treated with famotidine were younger (63.5 ± 15.0 vs 67.5 ± 15.8 years, P = 0.021), but did not differ with respect to baseline demographics or preexisting comorbidities. Use of famotidine was associated with a decreased risk of in-hospital mortality (odds ratio 0.37, 95% confidence interval 0.16-0.86, P = 0.021) and combined death or intubation (odds ratio 0.47, 95% confidence interval 0.23-0.96, P = 0.040). Propensity score matching to adjust for age difference between groups did not alter the effect on either outcome. In addition, patients receiving famotidine displayed lower levels of serum markers for severe disease including lower median peak C-reactive protein levels (9.4 vs 12.7 mg/dL, P = 0.002), lower median procalcitonin levels (0.16 vs 0.30 ng/mL, P = 0.004), and a nonsignificant trend to lower median mean ferritin levels (797.5 vs 964.0 ng/mL, P = 0.076). Logistic regression analysis demonstrated that famotidine was an independent predictor of both lower mortality and combined death/intubation, whereas older age, body mass index >30 kg/m, chronic kidney disease, National Early Warning Score, and higher neutrophil-lymphocyte ratio were all predictors of both adverse outcomes.
    Discussion: Famotidine use in hospitalized patients with COVID-19 is associated with a lower risk of mortality, lower risk of combined outcome of mortality and intubation, and lower levels of serum markers for severe disease in hospitalized patients with COVID-19.(Equation is included in full-text article.).
    MeSH term(s) Aged ; Aged, 80 and over ; Betacoronavirus/isolation & purification ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/drug therapy ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Famotidine/therapeutic use ; Female ; Humans ; Intubation, Intratracheal/statistics & numerical data ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Propensity Score ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Tertiary Care Centers/statistics & numerical data ; Treatment Outcome ; COVID-19 Drug Treatment
    Chemical Substances Famotidine (5QZO15J2Z8)
    Keywords covid19
    Language English
    Publishing date 2020-08-27
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000000832
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  6. Article ; Online: Intermediate Follow-Up of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Implantation in Patients With Small Aortic Annuli.

    Mosleh, Wassim / Memon, Sarfaraz / Hoover, Nicole E / Mather, Jeff F / Hagberg, Robert C / Azemi, Talhat / Sadiq, Immad R / Haider, Jawad / McMahon, Sean R / Hashim, Sabet / McKay, Raymond G

    The American journal of cardiology

    2023  Volume 192, Page(s) 31–38

    Abstract: The clinical impact of prosthesis-patient mismatch (PPM) in patients with small aortic annuli who underwent transcatheter aortic valve (AV) implantation with either balloon-expandable (BE) or self-expanding (SE) valves remains controversial. We assessed ... ...

    Abstract The clinical impact of prosthesis-patient mismatch (PPM) in patients with small aortic annuli who underwent transcatheter aortic valve (AV) implantation with either balloon-expandable (BE) or self-expanding (SE) valves remains controversial. We assessed in-hospital and intermediate clinical outcomes in 573 patients with transfemoral transcatheter AV implantation with a small AV annulus, defined as an AV annulus area ≤430 mm
    MeSH term(s) Humans ; Transcatheter Aortic Valve Replacement/methods ; Aortic Valve Stenosis/surgery ; Follow-Up Studies ; Stroke Volume ; Heart Valve Prosthesis/adverse effects ; Treatment Outcome ; Prosthesis Design ; Hemodynamics ; Ventricular Function, Left ; Aortic Valve/surgery
    Language English
    Publishing date 2023-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2023.01.009
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  7. Article ; Online: Declines in Acute Cardiovascular Emergencies During the COVID-19 Pandemic.

    Zaleski, Amanda L / Taylor, Beth A / McKay, Raymond G / Thompson, Paul D

    The American journal of cardiology

    2020  Volume 129, Page(s) 124–125

    MeSH term(s) Acute Coronary Syndrome/epidemiology ; Acute Coronary Syndrome/therapy ; Aged ; Betacoronavirus ; COVID-19 ; Cardiac Catheterization/statistics & numerical data ; Connecticut/epidemiology ; Coronavirus Infections/epidemiology ; Emergencies ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/epidemiology ; Risk Factors ; SARS-CoV-2 ; ST Elevation Myocardial Infarction/epidemiology ; ST Elevation Myocardial Infarction/therapy
    Keywords covid19
    Language English
    Publishing date 2020-05-24
    Publishing country United States
    Document type Letter
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2020.05.029
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  8. Article ; Online: Outcomes of Transcatheter Aortic Valve Replacement in Patients Treated With Systemic Steroids.

    Joshi, Saurabh / Mosleh, Wassim / Amer, Mostafa R / Tawayha, Mays / Mather, Jeffrey F / Kiernan, Francis J / McKay, Raymond G / Piccirillo, Bryan

    The Journal of invasive cardiology

    2022  Volume 34, Issue 1, Page(s) E49–E54

    Abstract: Background: Chronic steroid therapy is associated with higher vascular complication rates in patients undergoing transcatheter aortic valve replacement (TAVR). The effect of corticosteroids on aortic annular complications has not been directly assessed ... ...

    Abstract Background: Chronic steroid therapy is associated with higher vascular complication rates in patients undergoing transcatheter aortic valve replacement (TAVR). The effect of corticosteroids on aortic annular complications has not been directly assessed in this population.
    Methods: A retrospective analysis of 1095 patients undergoing transfemoral TAVR was performed. Patients treated with chronic steroids at the time of the procedure (n = 99) were compared with those who received no steroids (n = 992). The primary outcome included a composite of aortic annular complications, defined as a combination of aortic annular rupture, aortic dissection/perforation, and left ventricular perforation.
    Results: The primary outcome was significantly higher in the steroid group (4.0% vs 0.5%; P<.01). This finding was primarily driven by higher rates of acute annular rupture in the steroid group (2.0% vs 0.2%; P=.04). Steroid use was associated with higher rates of intraoperative cardiac arrest (5.1% vs 1.5%; P=.03), device capture/retrieval (4.0% vs 0.8%; P=.01), and emergent conversion to open heart surgery (4.0% vs 0.6%; P<.01). There were no differences with respect to in-hospital mortality, stroke, myocardial infarction, need for permanent pacemaker, bleeding complications, minor vascular complications, hospital length of stay, hospital 30-day readmission, or 30-day echocardiographic findings. Additionally, within the steroid group, there were no significant differences between balloon-expandable vs self-expanding TAVR prostheses with respect to composite aortic annular complications.
    Conclusion: Chronic steroid therapy increases the risk of aortic annular complications in patients undergoing TAVR, with detrimental consequences including intraoperative cardiac arrest and conversion to open heart surgery. Steroid use should be considered in patient selection and determination of procedural technique for TAVR.
    MeSH term(s) Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/surgery ; Heart Valve Prosthesis/adverse effects ; Humans ; Postoperative Complications/epidemiology ; Retrospective Studies ; Risk Factors ; Steroids/adverse effects ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome
    Chemical Substances Steroids
    Language English
    Publishing date 2022-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1154372-3
    ISSN 1557-2501 ; 1042-3931
    ISSN (online) 1557-2501
    ISSN 1042-3931
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  9. Article ; Online: Racial and ethnic disparities in the treatment and outcomes for witnessed out-of-hospital cardiac arrest in Connecticut.

    Sutton, Trevor S / Bailey, David L / Rizvi, Asad / Al-Araji, Rabab / Kasliwala, Qayyoom / Nero, Thomas / Scalzo, Megan / Panza, Gregory / Mather, Jeff F / Orlando, Rocco / Hashim, Sabet / McKay, Raymond G

    Resuscitation

    2023  Volume 188, Page(s) 109850

    Abstract: Background: Racial and ethnic disparities in the treatment and outcomes for witnessed out-of-hospital cardiac arrest (OHCA) in the United States have been previously described. We sought to characterize disparities in pre-hospital care, overall survival, ...

    Abstract Background: Racial and ethnic disparities in the treatment and outcomes for witnessed out-of-hospital cardiac arrest (OHCA) in the United States have been previously described. We sought to characterize disparities in pre-hospital care, overall survival, and survival with favorable neurological outcomes following witnessed OHCA in the state of Connecticut.
    Methods: We performed a cross-sectional study to compare pre-hospital treatment and outcomes for White versus Black and Hispanic (Minority) OHCA patients submitted from Connecticut to the Cardiac Arrest Registry to Enhance Survival (CARES) between 2013 and 2021. Primary outcomes included bystander CPR use, bystander automated external defibrillator (AED) use with attempted defibrillation, overall survival, and survival with favorable cerebral function.
    Results: 2,809 patients with witnessed OHCA were analyzed (924 Black or Hispanic; 1885 White). Minorities had lower rates of bystander CPR (31.4% vs 39.1%, P = 0.002) and bystander AED placement with attempted defibrillation (10.5% vs 14.4%, P = 0.004), with lower rates of survival to hospital discharge (10.3% vs 14.8%, P = 0.001) and survival with favorable cerebral function (65.3% vs 80.2%, P = 0.003). Minorities were less likely to receive bystander CPR in communities with median annual household income >$80, 000 (OR, 0.56; 95% CI, 0.33-0.95; P = 0.030) and in integrated neighborhoods (OR, 0.70; 95% CI, 0.52-0.95; P = 0.020).
    Conclusions: Black and Hispanic Connecticut patients with witnessed OHCA have lower rates of bystander CPR, attempted AED defibrillation, overall survival, and survival with favorable neurological outcomes compared to White patients. Minorities were less likely to receive bystander CPR in affluent and integrated communities.
    MeSH term(s) Humans ; United States ; Cardiopulmonary Resuscitation ; Connecticut/epidemiology ; Out-of-Hospital Cardiac Arrest/therapy ; Cross-Sectional Studies ; Emergency Medical Services ; Registries ; Treatment Outcome
    Language English
    Publishing date 2023-05-23
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2023.109850
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  10. Article ; Online: Enhanced Recovery After Surgery Is Associated With Reduced Hospital Length of Stay after Urgent or Emergency Isolated Coronary Artery Bypass Surgery at an Urban, Tertiary Care Teaching Hospital: An Interrupted Time Series Analysis With Propensity Score Matching.

    Takata, Edmund T / Eschert, John / Mather, Jeff / McLaughlin, Tara / Hammond, Jonathan / Hashim, Sabet W / McKay, Raymond G / Sutton, Trevor S

    Journal of cardiothoracic and vascular anesthesia

    2022  Volume 37, Issue 1, Page(s) 31–41

    Abstract: Objective: To evaluate whether enhanced recovery after surgery (ERAS) was associated with reduced length of stay (LOS) after urgent or emergency coronary artery bypass graft surgery (CABG).: Design: A retrospective analysis of an institutional ... ...

    Abstract Objective: To evaluate whether enhanced recovery after surgery (ERAS) was associated with reduced length of stay (LOS) after urgent or emergency coronary artery bypass graft surgery (CABG).
    Design: A retrospective analysis of an institutional database for urgent or emergency isolated CABG before versus after ERAS. Propensity matching identified comparable subpopulations pre- versus post-ERAS. Interrupted time series analysis was used to evaluate LOS.
    Setting: At a tertiary care teaching hospital.
    Participants: A total of 1,012 patients undergoing urgent or emergent CABG-346 from 2016 to 2017 (pre-ERAS), and 666 from 2018 to 2020 (post-ERAS). Emergent CABG was performed within 24 hours, and urgent CABG was performed during the same hospitalization to reduce clinical risk.
    Interventions: None.
    Measurements and main results: Propensity-matched post-ERAS (n = 565) versus pre-ERAS patients (n = 330) demonstrated reduced LOS (9 [8-13] v (10 [8-14] days p = 0.015), increased likelihood of extubation within 6 hours (46.0% v 35.8%, p = 0.003), shorter ventilation time (6.3 [5.1-10.2] v (7.2 [5.4-12.2] hours, p = 0.003), reduced morphine milligram equivalent use on postoperative days 1 and 2 (69.6 ± 62.2 v 99.0 ± 61.6, p < 0.001), and increased intraoperative ketamine use (58.8% v 35.2%, p < 0.001). There were no differences regarding reintubation, intensive care unit readmission, or 30-day morbidity. Adjusted segmental regression (n = 1,012) for LOS demonstrated reduced mean LOS of approximately 2 days after ERAS (β
    Conclusions: Enhanced recovery after surgery was associated with reduced LOS after urgent or emergency CABG without adverse effects on prolonged ventilation, reintubation, intensive care unit readmission, or 30-day outcomes.
    MeSH term(s) Humans ; Length of Stay ; Retrospective Studies ; Enhanced Recovery After Surgery ; Propensity Score ; Interrupted Time Series Analysis ; Tertiary Healthcare ; Coronary Artery Bypass/adverse effects ; Hospitals, Teaching ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Postoperative Complications/etiology
    Language English
    Publishing date 2022-10-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.10.009
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