Publications by authors named "Bahira Shahim"
Article Synopsis
- * Out of 9806 TAVR patients analyzed from 2008 to 2022, 566 required coronary angiography afterward, with younger age and more extensive coronary disease linked to higher risks.
- * The findings suggest that while the need for coronary angiography post-TAVR is low, procedural complexity increases with certain valve types and in patients with previous valve replacements, emphasizing the need for good coronary access in future TAVR procedures.
Article Synopsis
- - The prevalence of heart failure with preserved ejection fraction (HFpEF) is rising, leading to significant hospitalization (up to 80%) and mortality rates (50%) within five years, largely due to systemic inflammation and related cardiac dysfunction.
- - Diagnosing HFpEF is complex and relies on clinical assessments, imaging, biomarkers, and excluding other cardiac conditions that could mimic or contribute to HFpEF.
- - Treatments like sodium-glucose cotransporter 2 inhibitors, tailored therapies, exercise recommendations, and novel inflammation-targeting approaches show promise, especially for obese HFpEF patients who may benefit from glucagon-like peptide-1 agonists.
Article Synopsis
- * RMVI procedures were mostly successful at a rate of 80%, but patients who underwent RMVI experienced increased heart failure hospitalizations compared to those who did not.
- * Characteristics of patients needing RMVI included larger mitral annular diameters and more severe MR at discharge, with potential reasons for RMVI stemming from initial procedure failures or residual severe MR.
Article Synopsis
- The study aimed to analyze the causes of death in heart failure patients with different ejection fractions: preserved (HFpEF), mildly reduced (HFmrEF), and reduced (HFrEF).
- Data from around 100,584 patients over 21 years showed that cardiovascular causes were the leading reason for death across all ejection fractions, but HFpEF patients had a higher risk of dying from non-cardiovascular issues.
- Ischemic heart disease and cancer were identified as the most common causes of cardiovascular and non-cardiovascular deaths, respectively, with the risk of non-cardiovascular death increasing as ejection fraction improved.
Article Synopsis
- A study was conducted to examine hospital readmissions and their outcomes after revascularization procedures (PCI and CABG) for left main coronary artery disease (LMCAD) in the EXCEL trial, involving 1,905 patients.
- Results showed that within 5 years, nearly half of hospital survivors experienced readmissions, and the causes were split evenly between cardiovascular and noncardiovascular issues.
- Factors like PCI treatment, female sex, and preexisting health conditions were found to be significant predictors of readmission, which was linked to increased mortality risk, notably higher in patients who underwent PCI compared to CABG.
Cholinesterase inhibitors are associated with reduced mortality in patients with Alzheimer's disease and previous myocardial infarction.
Eur Heart J Cardiovasc Pharmacother
February 2024
Article Synopsis
- Cholinesterase inhibitors (ChEIs) are used as the primary treatment for mild-to-moderate Alzheimer's disease (AD) and may also influence heart function.
- A study evaluated the effects of ChEIs on patients with AD who had previously experienced a myocardial infarction (heart attack), using a large dataset from the Swedish Dementia Registry.
- Results showed that ChEI treatment was linked to a lower risk of all-cause death, particularly among patients taking higher doses, suggesting a potential benefit for those with a history of heart issues.
Article Synopsis
- * HFpEF has historically received less attention but significantly contributes to morbidity and mortality, though lower than HFrEF rates.
- * The review discusses the current burden of HFpEF, including epidemiology, clinical features, comorbidities, outcomes, costs, and treatment options.
Article Synopsis
- Heart failure (HF) affects around 64 million people worldwide, and while its incidence is stabilizing or declining in developed nations, its prevalence is rising due to an aging population and better survival rates after heart incidents.
- Despite advancements in treatment, HF is still linked to high rates of death, illness, and reduced quality of life, posing a significant strain on healthcare systems.
- The review discusses the global epidemiology of HF, highlighting variations in prevalence, incidence, mortality, and morbidity based on different causes and patient characteristics across various regions.
Article Synopsis
- Mitral regurgitation is a common heart valve issue affecting over 5 million Americans, with a focus on real-world data collection for regulatory and clinical purposes.
- The study aimed to create a standard set of essential data elements for mitral interventions, going through 703 options and reaching consensus on 127 core elements for effective data use.
- This core data set will enhance the national registry for transcatheter mitral devices, supporting safety monitoring, regulatory submissions, and improving hospital care quality.
Article Synopsis
- This study focused on the prevalence, characteristics, and outcomes of patients with heart failure (HF) who have mitral regurgitation (MR) and/or tricuspid regurgitation (TR).
- Among 11,298 patients studied, a significant majority (67%) had no MR/TR, while 17% had isolated MR, 5.5% had isolated TR, and 11% had both conditions.
- The findings indicated that those with HFpEF had a higher likelihood of isolated TR but were at a greater risk for poor outcomes, highlighting the need for targeted management in patients with isolated TR.
Article Synopsis
- The study aimed to evaluate how common and impactful moderate to severe aortic valve disease (AVD) is in patients with heart failure (HF), focusing on various types such as aortic stenosis (AS) and aortic regurgitation (AR).
- Data from over 15,000 HF patients indicated that approximately 10% had AVD, with AS and mixed AVD being more frequent in those with preserved ejection fraction, while AR was present in all HF types.
- AS and mixed AVD were linked to a higher risk of cardiovascular death and HF-related hospitalizations within 12 months, indicating their significant impact on patient outcomes compared to AR.
Article Synopsis
- The study investigates the impact of peripheral artery disease (PAD) on the outcomes of transcatheter mitral valve repair (TMVr) in heart failure (HF) patients with severe mitral regurgitation, comparing results with guideline-directed medical therapy (GDMT) alone.
- Among 614 patients, 109 had PAD; findings showed that PAD was linked to higher mortality but did not affect hospitalization rates for heart failure.
- TMVr significantly reduced mortality for patients without PAD, but not for those with PAD; however, it consistently decreased hospitalization rates and improved health status and exercise capacity for all patients regardless of PAD status.
Article Synopsis
- The study explored the relationship between high platelet reactivity (HPR) on clopidogrel and the risk of major adverse cardiac events (MACE) in patients undergoing coronary interventions, particularly focusing on those with diabetes mellitus (DM).
- Among the 8,582 patients in the study, it was found that HPR was more common in individuals with DM, and both groups (with and without diabetes) experienced increased rates of MACE linked to HPR.
- However, the impact of HPR on MACE risk differed based on diabetes type, with non-insulin-treated diabetes mellitus (non-ITDM) showing a stronger association compared to insulin-treated diabetes mellitus (ITDM).
Article Synopsis
- The study aimed to investigate the effects of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, on heart function in patients with recent heart issues and newly detected dysglycaemia (impaired glucose tolerance or type 2 diabetes).
- Forty-two patients were randomized to receive either empagliflozin or a placebo, and various measures of heart function and glucose metabolism were assessed over the course of the study.
- While empagliflozin improved glucose levels and reduced body weight, it did not affect important heart function measures such as left ventricular volume or flow reserve, indicating that its benefits on heart function may be limited in this specific patient group.
Article Synopsis
- The study examines the neutrophil-to-lymphocyte ratio (NLR) as a potential indicator of systemic inflammation and its link to prognosis in patients with severe aortic stenosis undergoing TAVR or SAVR.
- Data from 5881 patients showed that a higher baseline NLR significantly correlated with increased risks of death or rehospitalization after 3 years, highlighting its potential as a risk stratification tool.
- Additionally, a decrease in NLR levels within the first year post-surgery was associated with improved outcomes, further suggesting the importance of monitoring NLR in patient management.
Article Synopsis
- TAVR is recognized as the standard treatment for severe aortic stenosis, making real-world data collection critical for assessing its benefits and risks across various health organizations, like the FDA and Medicare.
- A systematic review of existing TAVR research was conducted to identify essential data elements necessary for efficient data collection, resulting in the consensus on 132 core elements from an original pool of 276.
- The established core dataset aims to streamline evidence gathering for TAVR, enhancing regulatory submissions, safety monitoring, and evaluations of best practices in healthcare institutions.
Article Synopsis
- Transcatheter aortic valve replacement (TAVR) is the main treatment option for patients with severe aortic stenosis, and real-world data collection is crucial for evaluating its benefits and risks.
- A systematic review was conducted to identify essential data elements needed for effective data collection related to TAVR, involving key organizations and experts.
- The final consensus identified 132 core data elements, focusing on efficient, reusable data for regulatory, safety, and quality assessments while considering the practical challenges of data collection.
Transporting Results of TAVR Trials to the Real World: A Long and Winding Road.
JACC Cardiovasc Interv
October 2021
Article Synopsis
- The study evaluated the effects of transcatheter mitral valve repair (TMVr) combined with guideline-directed medical therapy (GDMT) on patients with heart failure and severe mitral regurgitation, focusing on outcomes based on sex.
- Among the 614 participants, women were generally younger and had fewer health issues but reported a lower quality of life and functional capacity at the start of the study.
- Results showed that while TMVr led to better clinical outcomes for both sexes, men experienced a greater reduction in hospitalizations due to heart failure compared to women when treated with TMVr.
Article Synopsis
- This study investigated how diabetes affects the outcomes of transcatheter mitral valve repair (TMVr) in heart failure patients with secondary mitral regurgitation (SMR).
- The research found that diabetic patients had higher two-year death rates and tended to have more heart failure hospitalizations compared to non-diabetic patients, but both groups benefited from TMVr.
- Patients with diabetes showed similar improvements in survival rates and quality of life after TMVr as those without diabetes, indicating the procedure is beneficial regardless of diabetes status.
Article Synopsis
- - The study aimed to evaluate the occurrence and impact of early (in-hospital) and late (post-discharge) atrial fibrillation or flutter (POAF) in patients with severe aortic stenosis undergoing transcatheter (TAVR) or surgical (SAVR) valve replacement.
- - Results showed that early POAF was more common after SAVR (36.6%) than TAVR (4.3%), while late POAF occurred in 7.0% of patients within a year post-surgery.
- - The findings indicated that early POAF did not predict late POAF or worse outcomes like death, stroke, or rehospitalization, whereas late POAF significantly increased the risk for
Article Synopsis
- The study aimed to compare the long-term effectiveness of ultrathin-strut drug-eluting stents (DES) to conventional 2nd-generation thin-strut DES in patients undergoing coronary interventions, building on previous findings of reduced target lesion failure (TLF) rates with ultrathin-strut DES.!
- A meta-analysis of 16 randomized controlled trials with over 20,000 patients found that ultrathin-strut DES led to a 15% decrease in long-term TLF risk, primarily due to a 25% reduction in clinically driven target lesion revascularization.!
- Overall, after an average follow-up of 2.5 years, ultrathin-strut DES showed better long-term outcomes compared