American Journal of Medicine

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BACKGROUND: Anemia (either pre-existing or hospital-acquired) is considered an independent predictor of mortality in acute coronary syndromes. However, it is still not clear whether anemia should be considered as a marker of worse health status or a therapeutic target. We sought to investigate the relationship between hospital-acquired anemia and clinical and laboratory findings and to assess the association with mortality and major cardiovascular events (MACE) at long term follow-up...

OBJECTIVE: The ongoing emergence of novel SARS-CoV-2 strains such as the Omicron variant amplifies the need for precision in predicting severe COVID-19 outcomes. This study presents a machine learning model, tailored to the evolving COVID-19 landscape, emphasizing novel risk factors and refining the definition of severe outcomes to predict the risk of a patient experiencing severe disease more accurately. METHODS: Utilizing electronic health records from the Healthjump database, this retrospective study examined over one million US COVID-19 diagnoses from March 2020 to September 2022...

Persistence of COVID-19 symptoms may follow SARS-CoV-2 infection. The incidence of long COVID increases with the severity of acute disease, but even mild disease can be associated with sequelae. The symptoms vary widely with fatigue, shortness of breath, and cognitive dysfunction being the most common. Abnormalities of multiple organs have been documented and histopathology has revealed widespread microthrombi. Elevated levels of complement are present in acute COVID-19 patients and may persist at lower levels in long COVID...

BACKGROUND: Many patients with atrial fibrillation suffer from comorbid vascular disease. The comparative efficacy and safety of different types of oral anticoagulation (OAC) in this patient group have not been widely studied. METHODS: Adults with newly-diagnosed atrial fibrillation were recruited into the prospective observational registry, GARFIELD-AF, and followed for 24 months. Associations of vascular disease with clinical outcomes were analysed using adjusted hazard ratios (HR), obtained via Cox proportional-hazard modelling...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Recent guidelines do not recommend routine use of aspirin for primary cardiovascular prevention (ppASA) and suggest avoidance of ppASA in older individuals due to bleeding risk. However, ppASA is frequently taken without an appropriate indication. Estimates of the incidence of upper gastrointestinal bleeding due to ppASA in the United States are lacking. In this study, we provide national estimates of upper gastrointestinal bleeding incidence, characteristics, and costs in ppASA users from 2016-2020...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Persistent symptoms after SARS-COV-2 (long-COVID) occur in 10-55% of individuals, but the impact on daily functioning and disability remains unquantified. METHODS: To characterize disability associated with long-COVID, we analyzed baseline data from an online, US-based cohort study. Adult participants included those reporting a history of COVID-19 (n=8,874) or never having COVID-19 (n=633) without prior disability. The main outcomes were self-reported physical mobility, instrumental activities of daily living (IADL), and mental fatigue disability, assessed by measuring five disability components: difficulty walking ¼ mile and/or climbing 10 stairs (mobility), difficulty doing light or heavy housework (IADL), and Wood Mental Fatigue Inventory score (mental fatigue)...

Coronary artery calcium (CAC) scanning is a routine test for assessing the severity of atherosclerosis in asymptomatic individuals. This inexpensive, non-invasive test quantifies the calcium deposition in the four principal coronary arteries. Correct interpretation is important to the physician (for recommending therapy) and to the patient (for determining his/her lifetime risk of a cardiovascular event). A score of zero indicates that a cardiovascular event is extremely unlikely in the next five years. In contrast, a score greater than zero portends a coronary event...

OBJECTIVE: Our objective was to explore evolving trends in US drug overdose mortality overall and by age, gender, race, urbanization, and geography from 1999-2020. METHODS: This is a descriptive epidemiologic study. We used the US Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research and Multiple Cause of Death files from the National Center for Health Statistics. We used crude and age-adjusted cause of death and mortality rate ratios (MRR) as measures of effects and 95% confidence limits to test for significance...

BACKGROUND: In this study, we evaluated the diagnostic accuracy of Google Bard, a generative artificial intelligence (AI) platform. METHODS: We searched published case reports from our department for difficult or uncommon case descriptions and mock cases created by physicians for common case descriptions. We entered the case descriptions into the prompt of Google Bard to generate the top ten differential-diagnosis lists. As in previous studies, other physicians created differential-diagnosis lists by reading the same clinical descriptions...

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BACKGROUND: Atrial fibrillation and heart failure commonly coexist due to shared pathophysiological mechanisms. Prompt identification of patients with heart failure at risk of developing atrial fibrillation would allow clinicians the opportunity to implement appropriate monitoring strategy and timely treatment, reducing the impact of atrial fibrillation on patient's health. METHODS: Four machine learning models combined with logistic regression and cluster analysis were applied post hoc to patient level data from the Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm (WARCEF) trial7 to identify factors which predict development of atrial fibrillation in patients with heart failure...