Current Problems in Cardiology

OBJECTIVES: Neointimal hyperplasia and lumen irregularities are major contributors to vein graft failure and the use of VEST(R) should prevent this. In this review, we aim to evaluate the angiographic outcomes of externally supported vein grafts. METHODS: Medline, Embase and Cochrane Library were systematically reviewed for randomized clinical trials published by August 2022. The primary outcome was graft failure. Secondary outcomes included graft ectasia, intimal hyperplasia area and thickness, and graft non-uniformity...

BACKGROUND: The safety and clinical outcomes of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) among patients with solid organ transplants (SOT) is not well understood. OBJECTIVE: This study aimed to evaluate the clinical outcomes of TAVR and SAVR among patients with a history of solid organ transplantation. METHOD: We performed a systematic literature search of databases for relevant articles from inception until May 1st, 2022...

Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of non-invasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method...

BACKGROUND: The long-term risk of incident atherosclerotic cardiovascular diseases (ASCVD) among cancer patients remains incompletely defined. This study aimed to evaluate the long-term ASCVD risk in cancer patients compared with the non-cancer population. METHODS: This was a prospective population-based study using data from the Kailuan cohort, 6,204 individuals with newly diagnosed cancer, free of ASCVD, were matched in a 1:1 ratio to non-cancer controls for age (±1) and sex, from June 2006 to December 2020...

Directed by two decades of technological processes and remodeling, the dynamic quality of healthcare data combined with the progress of computational power has allowed for rapid progress in artificial intelligence (AI). In interventional cardiology, AI has shown potential in providing data interpretation and automated analysis from electrocardiogram (ECG), echocardiography, computed tomography angiography (CTA), magnetic resonance imaging (MRI), and electronic patient data. Clinical decision support has the potential to assist in improving patient safety and making prognostic and diagnostic conjectures in interventional cardiology procedures...

Chest pain is a common concern of women evaluated in both the inpatient and outpatient setting. There are significant differences in pathophysiology when comparing coronary artery disease (CAD) in women and men, including a higher prevalence of non-obstructive CAD. Furthermore, significant sex disparities exist in the care of women with acute coronary syndromes that stem from factors such as delays in diagnosis and inconsistencies in treatment. The 2021 AHA/ACC/Multisociety Guideline for the Evaluation and Diagnosis of Chest Pain is an important document comprised of recommendations for the assessment of acute and stable chest pain...

BACKGROUND: Hospital readmissions following acute myocardial infarction (AMI) pose a significant economic burden on health care utilization. The hospital readmission reduction program (HRRP) enacted in 2012 focused on reducing readmissions by penalizing CMS Medicare hospitals. We aim to assess the trend of readmissions after AMI hospitalization between 2010-2019 and assess the impact of HRRP. METHODS: The NRD was queried to identify AMI hospitalizations between 2010 and 2019...

OBJECTIVE: This survey aimed to investigate the extent of bullying among junior physicians in cardiology departments, by way of an anonymous web-based questionnaire in Pakistan METHODS: A survey of Pakistan cardiology trainees was piloted as a cross-sectional qualitative survey of junior cardiologists (including resident physicians and senior registrars) from teaching institutes all over Pakistan. Negative Acts Questionnaire-Revised (NAQ-R) was used as the tool for monitoring and reporting bullying nationwide...

BACKGROUND: Transcatheter aortic valve replacement (TAVR) procedures have increased since adoption in 2010. Readmission for TAVR patients with underlying chronic congestive heart failure (cCHF) remains challenging. Therefore, we sought to determine the 30-day readmission rate (30-DRr) of patients who undergo TAVR & co-existing cCHF & its impact on mortality & healthcare utilization in the United States. METHODS: We performed a retrospective study using the national readmission database year 2017 and 2018...

We aimed to develop a machine learning (ML) model for predicting cardiovascular (CV) events in patients with diabetes (DM). This was a prospective, observational study where clinical data of patients with diabetes hospitalized in the diabetology center in Poland (years 2015 - 2020) were analyzed using ML. The occurrence of new CV events following discharge was collected in the follow-up time for up to 5 years and 9 months. An end-to-end ML technique which exploits the neighborhood component analysis for elaborating discriminative predictors, followed by a hybrid sampling/boosting classification algorithm, multiple logistic regression, or unsupervised hierarchical clustering was proposed...

Recent randomized trials comparing coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI) utilizing drug-eluting stents in patients with left main (LMD) disease and/or multivessel disease (MVD), reported conflicting results. We performed a study level meta-analysis comparing the two interventions for the treatment of LMD or MVD. Using electronic databases, we retrieved 6 trials, between January, 2010 and December, 2022. Five-years Kaplan-Meier curves of endpoints where reconstructed...

OBJECTIVES: Transcatheter mitral valve replacement has become a useful alternative for patients with failed mitral prosthesis or annuloplasty rings who are deemed high risk for re-do surgery. We aimed to compare the clinical outcomes following transseptal (TS) and transapical (TA) approaches in transcatheter mitral valve-in-valve and valve-in-ring implantation (TMViV/R) METHODS: Electronic databases PubMed, MEDLINE, and Embase were searched through November 2022. Both clinical trials and observational studies comparing patients undergoing TS and TA TMViV/R were eligible for inclusion...

We aimed to compare the characteristics and outcomes of adult patients hospitalized with myocarditis and either concomitant COVID-19 or influenza, and elucidate clinical predictors associated with adverse outcomes in both groups. The study used the National Inpatient Sample (NIS) from 2019 to 2020 to identify 27,725 adult myocarditis hospitalizations, of which 5,840 had concomitant COVID-19 and 1,045 had concomitant influenza. After propensity score matching, the in-hospital mortality from myocarditis was significantly higher in COVID-19 compared to influenza...

BACKGROUND: Majority of patients with heart failure (HF) die in either nursing homes or inpatient facilities. Social vulnerability captures multiple domains of socioeconomic position and has been linked with higher HF mortality. We sought to investigate the trends in location of death in patients with HF and its association with social vulnerability. METHODS: We utilized the multiple cause of death files from the US (1999-2021) to identify decedents with HF as the underlying cause of death and linked them with county-level social vulnerability index (SVI) available from CDC/ATSDR database...

BACKGROUND: Sleep duration and chronotype have been associated with increased morbidity and mortality. We assessed for associations between sleep duration and chronotype on cardiac structure and function. METHODS: UK Biobank participants with CMR data and without known cardiovascular disease were included. Self-reported sleep duration was categorized as short (<7 hours/day), normal (7-9 hours/day) and long (>9 hours/day). Self-reported chronotype was categories as 'definitely morning' or 'definitely evening'...

BACKGROUND: There is limited data on the mortality trends of HCM in the US. OBJECTIVE: To study the demographics and trends of mortality in patients with HCM. METHODS: A retrospective cohort analysis was done with mortality data of patients with HCM listed as an underlying cause of death in the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (CDC-WONDER) from January 1999 to December 2020...

Pulmonary embolism (PE) is a potentially life-threatening condition that can occur during pregnancy and pose a significant risk to the mother and the developing fetus. It is a major contributor to pregnancy-related morbidity and mortality in any trimester. It is estimated that the incidence of PE during pregnancy is approximately 1 in 1000 pregnancies. The mortality rate for pregnant women with PE is about 3%, significantly higher than that for non-pregnant women with PE. Overall, the topic of PE and pregnancy is essential for healthcare professionals to be aware of the risks, signs, and treatment options to improve outcomes and ensure the best possible care for both the mother and the developing fetus...

Over the past two decades, genome-editing technique has proven to be a robust editing method that revolutionizes the field of biomedicine. At the genetic level, it can be efficiently utilized to generate various disease-resistance models to elucidate the mechanism of human diseases. It also develops an outstanding tool and enables the generation of genetically modified organisms for the treatment and prevention of various diseases. The versatile and novel CRISPR/Cas9 system mitigates the challenges of various GETs such as ZFNs, and TALENs...

Hypertension is one of the most common disorders encountered, yet pharmacotherapy for resistant hypertension has limited effective options. Aprocitentan is postulated to be a novel anti-hypertensive. The main goal was to determine the effect of aprocitentan on blood pressure among patients with hypertension. A thorough search of five electronic databases, including PubMed Central, PubMed, EMBASE, Springer, and Google Scholar, was carried out. The study included nine articles with a total of 2024 participants...

Unusually angulated coronary anatomy can decrease the success rate of coronary interventions by hindering successful wiring and equipment delivery. Additionally, due to the technical challenges involved, there is increased risk for complications such as perforations, dissections, stent loss, and equipment entrapment. In this case series, we illustrate the advantages of using angulated microcatheters to facilitate successful treatment of such patients in various clinical scenarios.