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Percutaneous Left Atrial Appendage Closure Among Patients With Diabetes (Insights from a National Database)
Atrial fibrillation is a major risk factor for stroke. Left atrial appendage closure (LAAC) has emerged as an alternative to anticoagulation for patients with high risk of bleeding. Diabetes mellitus (DM) is associated with adverse events after cardiac procedures. We sought to compare procedural and hospital outcomes in patients who underwent LAAC with and without DM. The Nationwide Inpatient Database was queried for patients with atrial fibrillation who underwent LAAC between January 1, 2016, and December 31, 2019.
Source: The American Journal of Cardiology - July 11, 2023 Category: Cardiology Authors: Mohamed Hamed, Ramez Morcos, Ayman Elbadawi, Ahmed Osman, Hani Jneid, Wissam Khalife, Brijeshwar Maini, Houman Khalili Source Type: research

Impact of Frailty on In-Hospital Outcomes in Patients Who Underwent Percutaneous Left Atrial Appendage Occlusion
In patients with atrial fibrillation, frailty is associated with an increased risk of bleeding, especially if patients take oral anticoagulation for stroke prophylaxis.1 Left atrial appendage occlusion (LAAO) is an alternative in patients unable to tolerate anticoagulation. However, whether patients who are frail are more vulnerable to procedural complications associated with LAAO remains undefined.2 We therefore examined in-hospital outcomes in patients who undergo LAAO procedures using a nationally representative real-world cohort of patients.
Source: The American Journal of Cardiology - April 9, 2023 Category: Cardiology Authors: Siddharth Agarwal, Muhammad Bilal Munir, Agam Bansal, Christopher V. DeSimone, Usman Baber, Abhishek Deshmukh, Zain Ul Abideen Asad Source Type: research

Association of Frailty Status on the Causes and Outcomes of Patients Admitted With Cardiovascular Disease
Data are limited about the contemporary association between frailty and the causes and outcomes of patients admitted with cardiovascular diseases (CVD). Using the US National Inpatient Sample, CVD admissions of interest (acute myocardial infarction, ischemic stroke, atrial fibrillation (AF), heart failure, pulmonary embolism, cardiac arrest, and hemorrhagic stroke) were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of in-hospital mortality among different groups with frailty.
Source: The American Journal of Cardiology - January 24, 2023 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Muhammad Rashid, Jo Protheroe, Richard Partington, Christian Mallen, Mamas A. Mamas Source Type: research

Why Are Cardiologists Not Prescribing the New Diabetes Medications?
Randomized clinical trials and guidelines from multiple societies have established significant cardiovascular (CV) outcome benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes (T2D). Among patients with T2D, those with known CV disease and those at high risk who are receiving metformin have lower risks of death, myocardial infarction, and stroke if they are treated with GLP-1RAs, and those treated with SGLT2is have reduced risks of hospital admission for heart failure, CV mortality, and all-cause mortality.
Source: The American Journal of Cardiology - December 14, 2022 Category: Cardiology Authors: Lloyd W. Klein Source Type: research

Outcomes and Readmission in Patients With Retinal Artery Occlusion (from the Nationwide Readmission Database)
Retinal artery occlusion (RAO) is an ophthalmologic emergency, leading to sudden vision loss. Understanding its risk factors and garnering information on the incidence of adverse events can provide helpful information on the cost-effective evaluation of patients and secondary prevention. In this retrospective cohort study, we used the Nationwide Readmission Database from 2016 to 2018 and queried the database to identify patients with RAO. The clinical outcomes were cumulative incidence of myocardial infarction (MI), stroke, death (in-hospital and 6 months after discharge), resource utilization, all-cause readmission at 6 m...
Source: The American Journal of Cardiology - September 14, 2022 Category: Cardiology Authors: Kunal Suri, Monil Majmundar, Ashish Kumar, Kunal N. Patel, Xioa Yi Zhou, Harshvardhan Zala, Ankur Kalra Source Type: research

Comparison of In-Hospital Outcomes After Insertion of Watchman Device in Men Versus Women (from the National Inpatient Data)
This study aimed to analyze the National Inpatient Sample (NIS) data to evaluate gender disparities and further assess its impact on medical decision-making. The NIS data for 16,505 patients who underwent left atrial appendage occlusion with the Watchman device from 2016 to 2017 was used to perform a cross-sectional analysis.
Source: The American Journal of Cardiology - August 22, 2022 Category: Cardiology Authors: Jay Shah, Amir Khan, Ghulam Mujtaba Ghumman, Kritika Luthra, Ma'en Al-Dabbas, Muhammad Ahsan, Muhammad Shayan Khan, Mohammed Taleb, Hemindermeet Singh, Syed Sohail Ali Source Type: research

Impact of Hospital Volume on Utilization and Outcomes of Sentinel Cerebral Protection System During Transcatheter Aortic Valve Implantation
Stroke remains a serious complication of transcatheter aortic valve implantation (TAVI) with a significant impact on long-term morbidity and mortality. Although the etiology of strokes is multifactorial, most are a result of embolization of debris during the procedure.1 Multiple devices have emerged aiming to reduce the incidence of stroke through cerebral embolic protection. The Sentinel cerebral protection system (CPS) is the only Food and Drug Administration-approved device in the United States.
Source: The American Journal of Cardiology - July 13, 2022 Category: Cardiology Authors: Agam Bansal, Toshiaki Isogai, Mohamed M. Gad, Grant W. Reed, Rishi Puri, Amar Krishnaswamy, Samir R. Kapadia Source Type: research

Incidence and Outcomes of Pericardial Effusion/Tamponade Following Percutaneous Left Atrial Appendage Closure
Percutaneous left atrial appendage closure (LAAC) with Watchman (Boston Scientific, Marlborough, MA) has emerged as an alternative to anticoagulation for stroke prevention in patients with atrial fibrillation (AF). A US nationwide registry reported that even though the rate of major in-hospital complication of LAAC was low at 2.18%, pericardial effusion or pericardial tamponade (PE/PT) is a relatively common complication.1 In addition, case reports demonstrated the occurrence of delayed PE/PT after discharge.
Source: The American Journal of Cardiology - November 3, 2021 Category: Cardiology Authors: Toshiaki Isogai, Anas M. Saad, Shashank Shekhar, Shunsuke Kuroda, Abdelrahman I. Abushouk, Mohamed M. Gad, Oussama M. Wazni, Amar Krishnaswamy, Samir R. Kapadia Source Type: research

Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients with Coronavirus Disease 2019 (From the Yale COVID-19 Cardiovascular Registry)
Individuals with established cardiovascular disease or a high burden of cardiovascular risk factors may be particularly vulnerable to develop complications from coronavirus disease 2019 (COVID-19). We conducted a prospective cohort study at a tertiary care center to identify risk factors for in-hospital mortality and major adverse cardiovascular events (MACE; a composite of myocardial infarction, stroke, new acute decompensated heart failure, venous thromboembolism, ventricular or atrial arrhythmia, pericardial effusion, or aborted cardiac arrest) among consecutively hospitalized adults with COVID-19, using multivariable b...
Source: The American Journal of Cardiology - February 1, 2021 Category: Cardiology Authors: Manan Pareek, Avinainder Singh, Lina Vadlamani, Maxwell Eder, Justin Pacor, Jakob Park, Zaniar Ghazizadeh, Alex Heard, Ana Sofia Cruz-Solbes, Roozbeh Nikooie, Chad Gier, Zain V. Ahmed, James V. Freeman, Judith Meadows, Kim G.E. Smolderen, Rachel Lampert, Source Type: research

Prevalence of In-hospital Stroke Comparing MitraClip and Transcatheter Aortic Valve Implantation
Transcatheter aortic valve implantation (TAVI) and mitraclip (MC) are increasingly utilized for the treatment of aortic stenosis (AS) and mitral regurgitation (MR), respectively. Perioperative stroke is one of the most serious complications following TAVI given the valve calcification and possible embolization during valve implantation, and thus ongoing trials are assessing the use of embolic protection device following TAVI. On the other hand, no such trials are being conducted on MC as the evidence of stroke following MC is lacking and MC does not share the same etiology with TAVI 1.
Source: The American Journal of Cardiology - January 5, 2021 Category: Cardiology Authors: Anas M. Saad, Keerat Rai Ahuja, Omar M. Abdelfattah, Mohamed M. Gad, Toshiaki Isogai, Manpreet Kaur, Grant W. Reed, James Yun, Amar Krishnaswamy, Samir R. Kapadia Source Type: research

Prevalence and Determinants of Atrial Fibrillation-associated In-hospital Ischemic Stroke in patients with Acute Myocardial Infarction undergoing Percutaneous Coronary Intervention
Atrial Fibrillation (AF) is an established risk factor ischemic stroke (IS) and is commonly encountered in patient hospitalized with acute myocardial infarction (AMI). Uncommonly, IS can occur as a complication resulting from percutaneous coronary intervention (PCI). There is limited real world data regarding AF-associated in-hospital IS (IH-IS) in patients admitted with AMI undergoing PCI. We queried the National Inpatient Sample database from January 2010 to December 2014 to identify patients admitted with AMI who underwent PCI.
Source: The American Journal of Cardiology - December 29, 2020 Category: Cardiology Authors: Shivaraj Patil, Karthik Gonuguntla, Chaitanya Rojulpote, Manish Kumar, Srinivas Nadadur, Robert J. Nardino, Christopher Pickett Source Type: research

Benefits and Risks of Prolonged Duration Dual Antiplatelet Therapy (Clopidogrel and Aspirin) after Percutaneous Coronary Intervention in High-Risk Patients with Diabetes Mellitus
The efficacy and safety of prolonged (>1-year) dual antiplatelet therapy (DAPT) duration in high-risk patients with diabetes mellitus (DM) undergoing PCI remain unknown. All patients undergoing PCI at Fuwai hospital between January 2013 and December 2013 were prospectively enrolled into the Fuwai PCI registry. 3696 high-risk diabetics patients with at least one additional atherothrombotic risk factor were screened for inclusion. The primary efficacy outcome was the composite of all-cause mortality, myocardial infarction, or stroke.
Source: The American Journal of Cardiology - December 4, 2020 Category: Cardiology Authors: Hao-Yu Wang, Zhong-Xing Cai, Dong Yin, Yue-Jin Yang, Wei-Hua Song, Ke-Fei Dou Source Type: research

Impact of Gender Differences on Outcomes of Peripheral Artery Disease Intervention (from a Nationwide Sample)
We aimed to evaluate the role of gender differences in the outcomes of catheter-based peripheral arterial disease interventions on a national level. We queried the National Inpatient Sample Database and identified all patients who presented with acute or symptomatic long term limb ischemia requiring transcatheter nonsurgical peripheral intervention in the years of 2016 to 2017. The primary outcome was major adverse cardiovascular events (MACE), defined as the composite end point of in-hospital mortality, nonfatal stroke, and acute myocardial infarction.
Source: The American Journal of Cardiology - November 17, 2020 Category: Cardiology Authors: Abdalla Hassan, Ashraf Abugroun, Hussein Daoud, Shafaq Mahmoud, Saria Awadalla, Annabelle Volgman, Alvaro Alonso Source Type: research

Impact of Sex Differences on Outcomes of Peripheral Artery Disease Intervention (From a Nationwide Sample)
We aimed to evaluate the role of sex differences in the outcomes of catheter-based peripheral arterial disease (PAD) interventions on a national level. We queried the National Inpatient Sample Database and identified all patients who presented with acute or symptomatic chronic limb ischemia (CLI) requiring transcatheter non-surgical peripheral intervention in the years of 2016 - 2017. The primary outcome was major adverse cardiovascular events (MACE), defined as the composite endpoint of in-hospital mortality, non-fatal stroke, and acute myocardial infarction.
Source: The American Journal of Cardiology - November 17, 2020 Category: Cardiology Authors: Abdalla Hassan, Ashraf Abugroun, Hussein Daoud, Shafaq Mahmoud, Saria Awadalla, Annabelle Volgman, Alvaro Alonso Source Type: research

Optimization of GRACE Risk Stratification by N-Terminal Pro-B-Type Natriuretic Peptide Combined with D-dimer in Patients with Non-ST-elevation Myocardial Infarction
We aimed to explore the utility of multiple biomarkers with GRACE risk stratification for non-ST-elevation myocardial infarction (NSTEMI). A total of 1357 patients diagnosed with NSTEMI were enrolled in this study at multiple medical centers in Tianjin, China. The outcomes were 1-year all-cause death and major adverse cardiac events (MACE: all-cause death, hospital admission for unstable angina, hospital admission for heart failure, non-fatal recurrent myocardial infarction, and stroke). C-index, NRI and IDI were calculated to verify that the biomarkers improve the predictive accuracy of the GRACE score.
Source: The American Journal of Cardiology - November 3, 2020 Category: Cardiology Authors: Peng-Ju Lu, Xiao-Wen Gong, Yin Liu, Feng-Shi Tian, Wen-Juan Zhang, Ying-Wu Liu, Zhu-Hua Yao, Ji-Xiang Wang, Peng Han, Ya-Nan Yang, Zhuang Cui, Jing Gao Source Type: research

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