Racial disparity in cardiac surgery risk and outcome: Report from a statewide quality initiative
Publication date: Available online 18 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Michael Mazzeffi, Sari D. Holmes, Diane Alejo, Clifford E. Fonner, Mehrdad Ghorieshi, Chetan Pasrija, Stefano Schena, Thomas Metkus, Rawn Salenger, Glenn Whitman, Niv Ad, Robert S.D. Higgins, Bradley Taylor, Maryland Cardiac Surgery Quality Initiative (MCSQI)AbstractBackgroundRacial disparities persist in healthcare. Our study objective was to evaluate racial disparity in cardiac surgery in Maryland.MethodsPatients were identified using a statewide database. Demographics, comorbidities, and predicted risk of mortality were compared between races. Crude mortality and incidence of complications were compared between groups, as were risk-adjusted odds for mortality and major morbidity or mortality.ResultsThe study included 23,094 patients. The majority of patients were white (75.8%), followed by African American (16.3%), Asian (3.8%), and other races (4.1%). African Americans had higher preoperative risk for mortality based on the Society of Thoracic Surgeons predictive models compared to white patients (3.0% versus 2.3%, P
An 85-year-old man presented with left hemiparesis, too late for any intervention. Brain computed tomography (CT) revealed a right hemispheric infarct. He had a history of diabetes mellitus (on metformin, statin), hypertension (on losartan/lercanidipine), past smoking, COPD (on inhalers) and peripheral artery disease (on aspirin).
Abstract BACKGROUND: Racial disparities persist in healthcare. Our study objective was to evaluate racial disparity in cardiac surgery in Maryland. METHODS: Patients were identified using a statewide database. Demographics, comorbidities, and predicted risk of mortality were compared between races. Crude mortality and incidence of complications were compared between groups, as were risk-adjusted odds for mortality and major morbidity or mortality. RESULTS: The study included 23,094 patients. The majority of patients were white (75.8%), followed by African American (16.3%), Asian (3.8%), and other races (...
ConclusionsA significant number of patients with T2DM developed acute kidney injury following CABG. There was no difference in infective complications such as pneumonia and catheter-associated urinary tract infection, between the two groups.
Discussion: From 2 to 5 years of follow-up CPAP did not significantly reduce the number of patients who actually had CV or metabolic events in the MOSAIC trial. Therefore, whilst CPAP reduces daytime sleepiness, it cannot be recommended as a treatment to reduce CV or metabolic events in patients with minimally symptomatic OSA.References:1. PMID 23111478.2. PMID 24508706
ConclusionsDiabetic nephropathy was common among Chinese patients with type 2 diabetes in primary care in Hong Kong. Early identification and control of the modifiable risk factors are of upmost importance in preventing the complication.
Abstract Objective: To evaluate the prognostic value of CHA2DS2-VASc score in individuals undergoing isolated coronary artery bypass grafting (CABG) surgery. Methods: Records of consecutive 464 patients who underwent elective isolated CABG, between January 2015 and August 2017, were retrospectively reviewed. A major adverse cardiac event (MACE) was the primary outcome of this study. MACE in patients with low (L) ( 2 had 52.6% sensitivity and 84.1% specificity (AUC: 0.752, P
Publication date: Available online 7 November 2019Source: Journal of NeuroradiologyAuthor(s): Burcu Yuksel, Pınar Koc, Eylem Ozaydin Goksu, Ertan Karacay, Fatma Kurtulus, Yesim Cekin, Yasemin Bicer GomceliABSTRACTBackground: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. We aimed to discuss possible predisposing factors to atherosclerosis such as carotid intima media thickness (CIMT) and high-sensitivity C-reactive protein (Hs-CRP) levels in MS.Methods: Thirty-five ambulatory patients with relapsing-remitting MS (RRMS) (22 females and 13 males) and 34 healthy controls (21 f...
Conclusion: In this real word, retrospective, observational study, we found a significant difference in the prevalence of MINOCA pts according to different types of myocardial infarction. In the MINOCA group, the mortality of women with STEMI was substantially higher. Orv Hetil. 2019; 160(45): 1791-1797. PMID: 31680539 [PubMed - in process]
Discussion: Ambulatory BP reductions after RDN were substantially more pronounced in female and in nondiabetic patients despite lower baseline BP. It is concluded that in terms of efficacy female patients and nondiabetic patients might benefit more from RDN.
Publication date: Available online 9 September 2019Source: Canadian Journal of CardiologyAuthor(s): Mony Shuvy, Donna R. Zwas, Chaim Lotan, Andre Keren, Israel GotsmanAbstractBackgroundUrinary albumin to creatinine ratio (UACR) is common in patients with heart failure (HF) and may have an impact on clinical outcome. We evaluated the effect of UACR on clinical outcome in a real-world cohort of patients with HF.MethodsAll patients with HF at a health maintenance organization were followed for cardiac-related hospitalizations and death.ResultsThe study cohort included 4,668 HF patients and was divided into 3 groups based on U...