Mohammad Reza Movahed, Ashkan Bahrami, Sharon Bates
BACKGROUND: The prevalence of hypertrophic cardiomyopathy (HCM) can be silent and can present with sudden death as the first manifestation of this disease. The goal of this study was to evaluate any association between reported physical symptoms with the presence of suspected HCM. METHOD: The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001. A total of 4,120 subjects between the ages of 6 and 79 underwent echocardiographic screening...
April 11, 2024: Critical Pathways in Cardiology
Muhammad Ali Tariq, Minhail Khalid Malik, Zoha Khalid, Aeman Asrar
INTRODUCTION: Acute heart failure (AHF) is a leading cause of unplanned hospitalization often associated with poor outcomes. Decongestion with intravenous loop diuretics is the mainstay of treatment. Metrics such as door-to-diuretic time, the time between presentation of AHF to the hospital and administration of intravenous diuretics, may play an important role in faster decongestion and thereby reduce mortality. We sought to investigate whether early diuretic administration (door-to-diuretic [D2D] time 60≤mins) was associated with improved outcomes among hospitalized HF patients...
April 9, 2024: Critical Pathways in Cardiology
Chayakrit Krittanawong, Yichen Wang, Yusuf Kamran Qadeer, Bing Chen, Zhen Wang, Fu'ad Al-Azzam, Mahboob Alam, Samin Sharma, Hani Jneid
It is well known that individuals with liver cirrhosis are considered high risk for cardiac surgery, with an increased risk for morbidity and mortality as the liver disease progresses. In the last decade, there have been considerable advances in transcatheter aortic valve implantation (TAVI) as an alternative to surgical aortic valve replacement (SAVR) in individuals deemed to high risk for surgery. However, research surrounding TAVI in the setting of liver cirrhosis has not been as widely studied. In this national population-based cohort study, we evaluated the trends of mortality, complications, and healthcare utilization in liver cirrhotic patients undergoing TAVI, as well as analyze the basic demographics of these individuals...
April 8, 2024: Critical Pathways in Cardiology
Somayyeh Barati, Mohammad Mehdi Mohammadpour, Mohammad Ali Sadrameli, Saeed Hosseini, Majid Maleki, Reza Golpira, Hooman Bakhshandeh, Majid Kyavar, Jamal Moosavi, Bahram Mohebbi, Azita H Talasaz, Stefano Barco, Frederikus A Klok, Parham Sadeghipour
BACKGROUND: Regarding adjustments to warfarin dosage, numerous studies have shown that computerized methods are superior to those based on personal experience. OBJECTIVES: To report the efficacy of a computer-based warfarin management system (WMS) in the Iranian population. METHODS: By utilizing the existing dosing algorithms and obtaining expert opinions, we developed a computer-based WMS at a large tertiary cardiovascular center. The time in therapeutic range (TTR) and the number of international normalized ratio (INR) tests of clinic patients were compared before and after the implementation of WMS...
March 27, 2024: Critical Pathways in Cardiology
Sukardi Suba, Mary G Carey, Michele M Pelter
BACKGROUND: The occurrence of transient myocardial ischemia (TMI) is an important pathology in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), yet studies are scarce regarding when TMI occurs during hospitalization, particularly in relation to invasive coronary angiography (ICA). This study examined: (1) TMI before or after ICA; (2) patient characteristics and ischemic burden by TMI group (before or after ICA); and (3) major in-hospital complications (transfer to critical care, death) and length of stay (LOS) by TMI group (before or after ICA)...
March 22, 2024: Critical Pathways in Cardiology
Chayakrit Krittanawong, Yusuf Kamran Qadeer, Song Peng Ang, Zhen Wang, Mahboob Alam, Samin Sharma, Hani Jneid
Spontaneous coronary artery dissection (SCAD) can be treated conservatively. However, some SCAD patients can develop cardiogenic shock (CS). We evaluated the outcomes of SCAD-related CS using data from a national population-based cohort study from January 1, 2016, to December 30, 2019. In our study of 32,640 patients with SCAD, about 10.6% of patients presented with cardiogenic shock. We found that SCAD patients with cardiogenic shock had higher mortality as well as greater complications including use of mechanical circulatory devices, arrythmias, respiratory support, and acute heart failure compared to those without cardiogenic shock...
March 7, 2024: Critical Pathways in Cardiology
Muhammad Ali Muzammil, Neeru Chaudhary, Syed Muhammad Abbas, Owais Ahmad, Aqsa Nasir, Eesha Baig, Fnu Fariha, Azra Khan Afridi, Sahil Zaveri
Aortic dissection (AD) is a potentially fatal cardiovascular issue that needs to be diagnosed and treated very away. While early detection is essential for bettering patient outcomes, there are substantial obstacles with the diagnostic techniques used today. Promising pathways for improving AD prognosis evaluation and early detection are presented by recent developments in serum biomarkers. The most recent research on serum biomarkers for AD is reviewed here, with an emphasis on the prognostic and diagnostic utility of these indicators...
March 6, 2024: Critical Pathways in Cardiology
Rahul Rai, Payal Devi, Kapeel Kumar, Kainat Naeem, Hanesh Kumar, Kajal Kumari, Anish Kumar, Aman Kumar, Aqeel Muhammad, Muhammad Sohaib Khan, Ghulam Qadir, Shaheryar Ali, Mahveer Maheshwari, Muhammad Jawwad
OBJECTIVE: To find out whether Inclisiran sodium has different efficacy in heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) patient groups. METHODS: We conducted the systematic review and meta analysis of ORION Clinical Trials Pubmed, Embase and databases were searched for the relevant studies.Atheroscalerotic parameters considered for our objective were LDL-C,Total cholesterol,PCSK9, Apolipoportien-B, and Non HDL-C...
March 6, 2024: Critical Pathways in Cardiology
Shaun G Goodman, Denis Roy, Charles V Pollack, Kori Leblanc, Kevin F Kwaku, Geoffrey D Barnes, Marc P Bonaca, Mellanie True Hills, Elena Campello, John Fanikos, Jean M Connors, Jeffrey I Weitz
The global prevalence of atrial fibrillation is rapidly increasing, in large part due to the aging of the population. Atrial fibrillation is known to increase the risk of thromboembolic stroke by five times, but it has been evident for decades that well-managed anticoagulation therapy can greatly attenuate this risk. Despite advances in pharmacology (such as the shift from vitamin K antagonists to direct oral anticoagulants) that have increased the safety and convenience of chronic oral anticoagulation in atrial fibrillation, a preponderance of recent observational data indicates that protection from stroke is poorly achieved on a population basis...
February 21, 2024: Critical Pathways in Cardiology
Ahmed Labib Shehatta, Rasha Kaddoura, Bassant Orabi, Mohamed Izham Mohamed Ibrahim, Ayman El-Menyar, Sumaya Alsaadi Alyafei, Abdulaziz Alkhulaifi, Abdulsalam Saif Ibrahim, Ibrahim Fawzy Hassan, Amr S Omar
BACKGROUND: Cardiac arrest remains a critical condition with high mortality and catastrophic neurological impact. Extracorporeal cardiopulmonary resuscitation (ECPR) has been introduced as an adjunct in cardiopulmonary resuscitation modalities. However, survival with good neurological outcomes remains a major concern. This study aims to explore our early experience with ECPR and identify the factors associated with survival in patients presenting with refractory cardiac arrest. METHODS: A retrospective cohort study analyzing six-year data from a tertiary center, the country reference for ECPR...
February 20, 2024: Critical Pathways in Cardiology
Christian Osmar Chávez, Osmar Antonio Centurión, Alfredo Javier Meza, Rocío Del Pilar Falcón, Karina E Scavenius, Laura B García, Orlando R Sequeira, Judith M Torales, Erdulfo J Galeano
BACKGROUND: Left atrial peak systolic strain (LA-PSS) imaging is an emerging index of LA function, and it was shown to be decreased in heart failure with preserved ejection fraction. We aimed to determine whether LA-PSS could be used as an additional diagnostic parameter to current existing guidelines for the presence of left ventricle diastolic dysfunction (LVDD). MATERIALS AND METHODS: A total of 190 consecutive adult patients with cardiovascular risk factors and normal LV ejection fraction with no prior history of heart failure were included in the study...
February 19, 2024: Critical Pathways in Cardiology
Natalie Millet, Sam Parnia, Yevgeniy Genchanok, Puja B Parikh, Wei Hou, Jignesh K Patel
BACKGROUND: In-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. The objective of this study was to study the association of arterial carbon dioxide tension (PaCO2) on survival to discharge and favorable neurologic outcome in adults with IHCA. METHODS: The study population included 353 adults who underwent resuscitation from 2011 to 2021 for IHCA at an academic tertiary medical center with arterial blood gas testing done within 24 hours of arrest...
February 19, 2024: Critical Pathways in Cardiology
Ibtesam I El-Dosouky, Ahmed S Ammar, Abdelmaaboud Ahmed Abdelmaaboud, Moataz A Elkot
BACKGROUND: The triglyceride-glucose (TyG) index was shown to be an independent predictor of coronary artery disease (CAD) progression and prognosis. However, whether the TyG index can predict the severity of CAD in nondiabetic patients with chronic coronary syndrome (CCS) remains unclear. METHODS: A total of 118 individuals who underwent elective coronary angiography (CA) were classified into group A (59 with coronary lesions) and group B (59 with normal coronary arteries; as a control group) after CA, laboratory tests for fasting and the postprandial (PP) TyG index...
February 1, 2024: Critical Pathways in Cardiology
Delaney M Corcoran, Mary P Kovacevic, Heather Dell'Orfano, Katelyn W Sylvester, Jean M Connors
INTRODUCTION: Brigham and Women's Hospital (BWH) historically used titratable weight-based heparin nomograms with as needed boluses managed by extracorporeal membrane oxygenation (ECMO) specialists to achieve a pre-determined goal activated partial thromboplastin time (aPTT). Due to concern amongst providers that as needed boluses may lead to supratherapeutic aPTT's and subsequent bleeding, new nomograms without as needed boluses were implemented. The purpose of this retrospective observational analysis is to provide a comparison in safety and efficacy between the heparin nomograms with as needed boluses and the new nomograms without boluses...
January 30, 2024: Critical Pathways in Cardiology
Mohammad Reza Movahed, Kyvan Irannejad, Sharon Bates
BACKGROUND: Patients with hypertrophic cardiomyopathy (HCM) usually have abnormal electrocardiograms consistent with left ventricular hypertrophy (LVH). The goal of this study was to evaluate the prevalence of abnormal ECG findings (LVH, T wave inversion, left bundle branch block, and left atrial enlargement) in participants with suspected HCM detected during screening echocardiography. METHOD: The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001...
March 1, 2024: Critical Pathways in Cardiology
Amin Daoulah, Wael Qenawi, Ali Alshehri, Maryam Jameel Naser, Youssef Elmahrouk, Mohammed Alshehri, Ahmed Elmahrouk, Mohammed A Qutub, Badr Alzahrani, Nooraldaem Yousif, Amr A Arafat, Wael Almahmeed, Abdelmaksoud Elganady, Ziad Dahdouh, Ahmad S Hersi, Ahmed Jamjoom, Mohamed N Alama, Ehab Selim, Shahrukh Hashmani, Taher Hassan, Abdulrahman M Alqahtani, Abdulwali Abohasan, Mohamed Ajaz Ghani, Faisal Omar M Al Nasser, Wael Refaat, Mina Iskandar, Omar Haider, Adnan Fathey Hussien, Ahmed A Ghonim, Abeer M Shawky, Seraj Abualnaja, Hameedullah M Kazim, Ibrahim A M Abdulhabeeb, Khalid Z Alshali, Jairam Aithal, Issam Altnji, Haitham Amin, Ahmed M Ibrahim, Turki Al Garni, Abdulaziz A Elkhereiji, Husam A Noor, Osama Ahmad, Faisal J Alzahrani, Abdulaziz Alasmari, Abdulaziz Alkaluf, Ehab Elghaysha, Salem Owaid Al Wabisi, Adel N Algublan, Naveen Nasim, Sameer Alhamid, Basim Sait, Abdulrahman H Alqahtani, Mohammed Balghith, Omar Kanbr, Mohammed Abozenah, Amir Lotfi
BACKGROUND: The use of dual antiplatelet therapy (DAPT) after coronary revascularization for left-main disease is still debated. The study aimed to characterize patients who received dual versus single antiplatelet therapy (SAPT) after coronary artery bypass grafting (CABG) for unprotected left-main disease and compare the outcomes of those patients. RESULTS: This multicenter retrospective cohort study included 551 patients who were grouped into 2 groups: patients who received SAPT (n = 150) and those who received DAPT (n = 401)...
March 1, 2024: Critical Pathways in Cardiology
Khawaja M Talha, John G Winscott, Vishal Patel, Alejandro Lemor, Kellan E Ashley, William F Campbell, Michael R McMullan, Gabriel A Hernandez
The use of Impella assist device for high-risk percutaneous coronary interventions and cardiogenic shock has increased in the last decade and requires a large bore arterial access (LBA). However, LBA closure following Impella removal is associated with significant complications. Herein, we describe the safety and efficacy of a novel method of LBA closure using arterial recoil following Impella removal. We performed a retrospective review of electronic medical records of patients who underwent LBA closure using this method from July 1, 2018 to June 30, 2022...
March 1, 2024: Critical Pathways in Cardiology
Ibtesam I El-Dosouky, Montaser M El Seqelly, Ahmed M Ebrahiem, Mohamed Abdelhady Mohamed
BACKGROUND: The burden of modifiable risk factors in young Egyptian adults presenting with first acute myocardial infarction (AMI), sex differences, sex-age interplay and its relationship with demographic, angiographic characteristics and type of AMI is a good topic for discussion. METHODS: The study enrolled 165 young (≤45 years old) consecutive, eligible patients diagnosed with first AMI (ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), for their demographic, angiographic, echocardiographic and laboratory investigations and gender differences...
December 29, 2023: Critical Pathways in Cardiology
Mohammad Reza Movahed, Mahsa Motieian, Sharon Bates
OBJECTIVE: Hypertension (HTN) is a major risk factor for cardiovascular disease. Obesity has been found to be associated with HTN. However, there are not many studies available to evaluate any association between overweight alone and HTN. METHODS: A database from the Anthony Bates Foundation that performs preventive cardiovascular examinations including measurement of body mass index (BMI) and blood pressure across the United States was used for our study. Using recorded measurements, we evaluated any association between being overweight defined as a BMI of 25 to 30 and the occurrence of systolic and diastolic HTN in adults over the age of 18 years...
December 1, 2023: Critical Pathways in Cardiology
Mohammad Reza Movahed, Arman Soltani Moghadam, Mehrnoosh Hashemzadeh, Mehrtash Hashemzadeh
BACKGROUND: Aortic valve surgery has been performed increasingly in high-risk patients. The goal of this study was to evaluate this trend based on gender in the United States before the availability of percutaneous aortic valve replacement. METHOD: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted utilization rate for aortic valve surgery from 1988 to 2011 in the United States using ICD-9 coding for aortic valve surgery. RESULTS: A total population of 258, 506 patients underwent aortic valve between 1988-2011 were available for our study over the age of 20...
November 30, 2023: Critical Pathways in Cardiology
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