Race, Ethnicity, and Gender Disparities in Acute Myocardial Infarction.

Cardiovascular disease continues to be the leading cause of morbidity and mortality in the United States. Despite advancements in medical care, there remain persistent racial, ethnic, and gender disparity in the diagnosis, treatment, and prognosis of individuals with cardiovascular disease. In this review we seek to discuss differences in pathophysiology, clinical course, and risk profiles in the management and outcomes of acute myocardial infarction and related high-risk states.

Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Severe Ischemic Left Ventricular Systolic Dysfunction.

Coronary artery disease is the most common cause of heart failure, which is the leading cause of cardiovascular-related death worldwide. There are insufficient data to make strong recommendations for percutaneous coronary intervention (PCI) in patients with severe ischemic left ventricular systolic dysfunction (LVSD). In that context, we performed a meta-analysis to compare the outcomes of PCI with those of optimal medical therapy alone in patients with severe ischemic LVSD.

Infective Endocarditis Risk with Melody versus Sapien Valves Following Transcatheter Pulmonary Valve Implantation: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

Background: Transcatheter pulmonary valve implantation (TPVI) is an effective non-surgical treatment method for patients with right ventricle outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are the two valves approved for use in TPVI. Since TPVI patients are typically younger, even a modest annual incidence of infective endocarditis (IE) is significant.

RIGHT VENTRICULAR DYSFUNCTION IN SEPSIS: AN UPDATED NARRATIVE REVIEW.

Sepsis is a multisystem disease process, which constitutes a significant public health challenge and is associated with high morbidity and mortality. Among other systems, sepsis is known to affect the cardiovascular system, which may manifest as myocardial injury, arrhythmias, refractory shock, and/or septic cardiomyopathy. Septic cardiomyopathy is defined as the reversible systolic and/or diastolic dysfunction of one or both ventricles.

Impact of sex on in-hospital mortality and 90-day readmissions in patients undergoing transcatheter mitral valve replacement (TMVR): Analysis from the nationwide readmission database.

Objectives: To evaluate sex differences in in-hospital mortality and 90-day readmission rates among patients undergoing transcatheter mitral valve replacement (TMVR) in the United States of America.

Background: Women have higher rates of mortality and rehospitalization than men following many cardiac procedures. TMVR has grown as an alternative to mitral valve surgery for patients at high surgical risk.

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis.

Femoral access is the gold standard for transcatheter aortic valve replacement (TAVR). Safe alternative access, that represents about 15 % of TAVR cases, remains important for patients without adequate transfemoral access. We aimed to perform a systematic review and -analysis of studies comparing transfemoral (TF) access versus transsubclavian or transaxillary (TSc/TAx) access in patients undergoing TAVR.

Impact of prior coronary artery bypass grafting on periprocedural and short-term outcomes of patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis.

Background: The effect of prior coronary artery bypass graft (CABG) on the outcomes of transcatheter aortic valve replacement (TAVR) remains incompletely characterized. In this meta-analysis, we investigated the impact of prior CABG on TAVR outcomes.

Methods: A systematic search was conducted in PubMed, Google Scholar, and Cochrane databases from inception to 24 July 2022, using the search terms 'TAVR', 'CABG', 'peri-procedural complications', and 'mortality'.

Trends in and predictors of multiple readmissions following heart failure hospitalization: A National wide analysis from the United States.

Background: Readmission following Heart failure (HF) hospitalization is common: 25% are readmitted within a month of discharge and ≈50% within 6 months. A small proportion of these patients can have multiple readmissions within this period, adding disproportionately to the health care costs. In this study, we assessed the trends, predictors and costs associated with multiple readmissions using National readmissions database (NRD).

Intermediate-Risk Pulmonary Embolism: A Review of Contemporary Diagnosis, Risk Stratification and Management.

Pulmonary embolism (PE) can have a wide range of hemodynamic effects, from asymptomatic to a life-threatening medical emergency. Pulmonary embolism (PE) is associated with high mortality and requires careful risk stratification for individualized management. PE is divided into three risk categories: low risk, intermediate-risk, and high risk.

Early Outcomes of Percutaneous Coronary Intervention in Patients with Cancer: A Systematic Review and Meta-analysis.

Chemotherapeutic regimens have cardiotoxic properties and thorax irradiation is associated with accelerated coronary artery disease (CAD). There is limited data regarding the influence of cancer on outcomes after percutaneous coronary intervention (PCI), as cancer patients were not routinely included in the PCI trials. We performed a systematic review and meta-analysis to compare the early outcomes of PCI between patients with active/historical cancer and patients without a cancer history.

Meta-Analysis Comparing Catheter-Directed Thrombolysis Versus Systemic Anticoagulation Alone for Submassive Pulmonary Embolism.

The optimal therapy for submassive pulmonary embolism (sPE), defined by right ventricular dysfunction without hemodynamic instability, is uncertain. We conducted a systematic review and meta-analysis to compare the outcomes of catheter-directed thrombolysis (CDT) versus systemic anticoagulation (SA) alone in patients with sPE. We searched PubMed, EMBASE, Cochrane, ClinicalTrials.

Elevated troponin in patients with acute gastrointestinal bleeding: prevalence, predictors and outcomes.

Cardiac troponin (cTn) can also be elevated in patients with non-cardiac illnesses. The utility of elevated cTn in patients with acute gastrointestinal bleeding (AGIB) is unclear. We retrospectively identified all patients admitted with AGIB who had cTn ordered.

COVID-19 presenting with myocardial infarction with nonobstructive coronary arteries.

Cardiovascular complications contribute to approximately 40% of all COVID-19-related deaths. Thrombosis in COVID-19 infection is a well-known phenomenon, and the spectrum of thromboembolic diseases related to COVID-19 is wide, with venous thromboembolism being the most common manifestation. We describe a case of myocardial infarction with nonobstructive coronary arteries (MINOCA) that developed in the setting of mild COVID-19 infection.

Right atrial appendage thrombus in a patient with a left atrial appendage occlusion device.

Management of right atrial appendage (RAA) thrombus is a clinical dilemma. We describe a case of incidentally found RAA thrombus in a patient with a left atrial appendage closure device (WATCHMAN). Options for the management of RAA thrombus include observation, anticoagulation, thrombolytics, or surgical extraction.

Atrial invasion from primary lung adenocarcinoma extension the pulmonary vein.

Intravascular extension of lung adenocarcinoma is one of the four defined routes of metastasis to the heart but is rarely described in the literature. This is a rare case of primary lung adenocarcinoma with intravenous extension to the left atrium via the pulmonary vein. A 56-year-old female presented to the hospital with chest tightness and dyspnea.

Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention: Trends and Outcomes 2010-2019.

Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) optimize percutaneous coronary intervention (PCI) by characterizing lesion morphology, accurately measuring vessel dimensions, and optimizing stent characteristics. We sought to compare the utilization of OCT and IVUS to guide inpatient PCI and their relative association with in-hospital mortality and readmission rates. We queried the National Readmission Database to identify patients undergoing intracoronary imaging-guided PCI from 2010 to 2019 and compared outcomes and readmission rates between patients undergoing OCT-guided PCI and IVUS-guided PCI.

In-hospital mortality and readmission after ST-elevation myocardial infarction in nonagenarians: A nationwide analysis from the United States.

Objectives: To assess readmission rates in nonagenarians (age ≥ 90 years) with ST-elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI) versus no pPCI.

Background: There are limited data exploring readmissions following STEMI in nonagenarians undergoing pPCI versus no pPCI.

Methods: We retrospectively analyzed the Nationwide Readmissions Database to identify nonagenarians hospitalized with STEMI.

Histoplasmosis presenting as colitis and blood dyscrasias in a patient with systemic lupus erythematosus.

A 28-year-old woman with a history of systemic lupus erythematosus on hydroxychloroquine and steroid therapy presented with fever, dysentery, and thrombocytopenia. Marrow aspirate revealed yeast forms of histoplasmosis. She was treated with liposomal amphotericin B followed by itraconazole with resolution of symptoms and marrow recovery.

Trends, outcomes, and management of acute myocardial infarction in patients with chronic viral hepatitis.

Objectives: There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI).

Methods: We utilized the National Inpatient Sample database (2001-2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression.

Surgical Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: An Updated Systematic Review and Meta-Analysis.

Background: While aortic valve replacement (AVR) is indicated for symptomatic severe aortic stenosis (AS), the appropriate management of asymptomatic severe AS remains unclear. We conducted an updated meta-analysis to compare the outcomes of surgical AVR (SAVR) versus conservative treatment in patients with asymptomatic severe AS.

Methods: We searched PubMed, EMBASE, Cochrane, clinicaltrials.