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  1. Article: Regional Disparities of Cardiovascular Risk Factors and Major Cardiovascular Events in Non-electively Hospitalized Young Adults.

    Brereton, Brian J / Desai, Rupak V / Yarrarapu, Siva Naga S / Matos Urena, Jose G / Jain, Akhil P

    Journal of community hospital internal medicine perspectives

    2023  Volume 13, Issue 2, Page(s) 1–6

    Abstract: Background: Cardiovascular diseases contribute to considerable morbidity and mortality in the USA. We sought to establish regional disparities across the nation contributing to cardiovascular disease (CVD) among non-elective young adult hospitalizations. ...

    Abstract Background: Cardiovascular diseases contribute to considerable morbidity and mortality in the USA. We sought to establish regional disparities across the nation contributing to cardiovascular disease (CVD) among non-elective young adult hospitalizations.
    Methods: The National Inpatient Sample (2019) was utilized to identify the incidence of non-elective hospitalizations among young adults (18-44 yrs) and analyze the burden of CVD risk factors and outcomes (MACCE; all-cause mortality, AMI, cardiac arrest and stroke) in different US regions.
    Results: A total of 5,833,930 (median age 32 [26-37] years) non-elective admissions were recorded; plurality from the south (39.6%). Most admissions were white (51.4%) and female (65.5%) amid all regions. The burden of CVD risk factors was significantly higher in the South followed by the Mid-west regions. The South had the highest and the Northeast had the lowest rates of MACE (2.9% vs 2.3%) and stroke (1.0% vs 0.8%). The risk of AMI was high for the south and Midwest regions (1.1%). All-cause mortality was highest in South and West regions (0.7%). Multivariate adjusted odds for these cardiovascular events were higher in the West (aOR 1.22; 95%CI 1.12-1.33) followed by South (aOR 1.16; 95%CI 1.07-1.26) regions.
    Conclusions: This population-based study assessing non-elective admissions in the young revealed a higher burden of CVD risk factors and rate of MACCE in the South compared to other areas of the USA. Regional policies should be tailored to the local CVD risk burden.
    Language English
    Publishing date 2023-03-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2616884-4
    ISSN 2000-9666
    ISSN 2000-9666
    DOI 10.55729/2000-9666.1164
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Prevalence and impact of cannabis use disorder on acute ischemic stroke and subsequent mortality in elderly peripheral vascular disease patients: A population-based analysis in the USA (2016 - 2019).

    Desai, Rupak / Brereton, Brian / Patta, Harika Varma Chintapalli / Bansal, Prerna / Jain, Akhil / Vyas, Ankit

    Current problems in cardiology

    2023  Volume 49, Issue 1 Pt C, Page(s) 102162

    Abstract: Background: Given current evidence linking peripheral atherosclerotic disease, also known as cannabis arteritis, and acute ischemic stroke (AIS) in individuals with cannabis use disorder (CUD), we investigated the frequency and implications of CUD in ... ...

    Abstract Background: Given current evidence linking peripheral atherosclerotic disease, also known as cannabis arteritis, and acute ischemic stroke (AIS) in individuals with cannabis use disorder (CUD), we investigated the frequency and implications of CUD in relation to AIS risk and outcomes among elderly patients with peripheral vascular disease (PVD).
    Methods: The National Inpatient Sample (2016-2019) was used to compare geriatric patients with PVD and cannabis use disorder CUD. CUD was correlated with AIS admissions. Adjusted multivariable regression models assessed in-hospital mortality rates.
    Results: Of 5,115,824 geriatric admissions with PVD, 50.6 % were male and 77.5 % were white. 21,405 admissions had cardiovascular and CUD co-occurrence. 19.7 % of CUD patients had diabetes mellitus (DM), compared to 33.7 % of non-CUD patients. Smoking and HTN rates were comparable between groups. Patients with CUD used more recreational drugs concurrently than those without CUD. AIS prevalence was 5.2 % in CUD patients and 4.0 % in controls (p < 0.001). In the geriatric population with PVD, the presence of CUD was found to be associated with increased odds of hospitalizations due to AIS, with an adjusted odds ratio (aOR) of 1.34 (95 % confidence interval [CI] 1.18-1.52, p < 0.001). All-cause in-hospital mortality was not statistically significant, with an aOR of 0.71 (95 %CI 0.36-1.37, p = 0.302). In our study, older patients with PVD and hypertension (aOR 1.73) had a greater risk of AIS. Intriguingly, when we analyzed AIS predictors in elderly PVD patients with concurrent tobacco use disorder, we identified a counterintuitive protective effect (aOR 0.58, 95 % CI 0.42-0.79, p < 0.001).
    Conclusions: Our findings indicate that among geriatric patients with PVD and concurrent CUD, there is a notable 34 % risk of AIS. Importantly, this risk persists despite controlling for other CVD risk factors and substance use. Further investigations are warranted to elucidate and validate the intriguing phenomenon known as the smoker's paradox.
    MeSH term(s) Humans ; Male ; Aged ; United States/epidemiology ; Female ; Marijuana Abuse/complications ; Marijuana Abuse/epidemiology ; Ischemic Stroke/complications ; Prevalence ; Substance-Related Disorders/complications ; Substance-Related Disorders/epidemiology ; Hypertension ; Peripheral Vascular Diseases/epidemiology ; Peripheral Vascular Diseases/complications
    Language English
    Publishing date 2023-10-21
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 441230-8
    ISSN 1535-6280 ; 0146-2806
    ISSN (online) 1535-6280
    ISSN 0146-2806
    DOI 10.1016/j.cpcardiol.2023.102162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Se 505: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Takotsubo Syndrome in Orthotopic Liver Transplant: A Systematic Review and Pooled Analysis of Published Studies and Case Reports.

    Bachayev, Milana / Brereton, Brian / Mondal, Avilash / Alli-Ramsaroop, Bibi Amena / Dhakal, Roshan / Leon, Maria C Buhl / Quinones, Camila M / Abdelal, Mohamed Eyad O / Jain, Akhil / Dhaduk, Kartik / Desai, Rupak

    Transplantation proceedings

    2023  

    Abstract: Background: Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited.: Methods: A systematic review was performed through February 2022 using PubMed, ...

    Abstract Background: Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited.
    Methods: A systematic review was performed through February 2022 using PubMed, Embase, Scopus, and Google Scholar to review case reports/series and original studies on liver transplant-associated TTS. Descriptive analysis was performed for case reports and pooled analysis for the prevalence using random effects models.
    Results: A total of 56 case reports were included from 30 articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe 8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl, 0.6%-1.7%) of all liver transplants with comparable rates in studies from India and the US (P = .92). Indications for liver transplant included end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis C virus infection (17.9%), hepatocellular carcinoma (10.7%), and non-alcohol-related steatohepatitis (8.9%); the average Model for End-Stage Liver Disease score was 24.75. TTS commonly presented as hypotension (30%), dyspnea (14%), and oliguria, occurring mostly post-transplant (82%), whereas 14% were intraoperative. Common electrocardiogram findings were ST changes, ventricular tachycardia, and atrial fibrillation. Common echocardiogram findings showed left ventricular apical ballooning in 46.5% of cases and reduced ejection fraction < 20% in 41.9% of cases. Common complications were cardiogenic shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac arrest, and hepatic artery thrombosis. Mechanical circulatory support was required in 30.3%. Recurrence was reported in 15, and mortality in 30.4% of patients.
    Conclusions: Takotsubo syndrome prevalence after liver transplant is significantly higher than TTS prevalence in general US hospitalizations with potentially worse outcomes. Prospective registries reporting TTS in liver transplant recipients are warranted.
    Language English
    Publishing date 2023-02-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2022.11.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 835: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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