Publications by authors named "Mamas A Mamas"

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

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This article provides an overview of the current evidence on the epidemiology, overlapping risk factors, and pathophysiology of cardiovascular disease (CVD) in patients with cancer. It explores the cardiotoxic effects of anticancer therapy and their impact on prognosis. Although cancer survival rates have improved over the last two decades, the risk of CVD has risen over time in patients with cancer.

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Background: Initiating urate-lowering therapy can trigger gout flares. Gout flares have been associated with a temporally increased risk of cardiovascular events. Therefore, we aimed to estimate the risk of cardiovascular events in patients with gout initiating urate-lowering therapy with flare prophylaxis using colchicine (the drug recommended for gout flare prohphylaxis by many international societies) compared with no prophylaxis.

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Background: The prevalence of type 2 diabetes (T2D) and obesity are increasing in the United States. However, population-level data for mortality trends due to T2D and obesity are limited. This study aims to assess these death trends among adults in the United States categorized by sex, race, and geographical location.

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Aims: Atrial Fibrillation (AF) is one of the most strongly associated risk factors for stroke. Our study aims to analyze changes in mortality from 1999 to 2020 in patients with AF and stroke.

Methods: Using the Centre for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER), we retrospectively analyzed annual age-adjusted mortality rates (AAMR) per million from 1999 to 2020 in stroke patients with AF.

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Background: Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) allows better assessment of coronary artery lesion characteristics than angiography alone. This systematic review and meta-analysis aimed to comprehensively synthesize the available evidence regarding the efficacy of IVUS guidance compared to angiography-guided PCI.

Methods: A comprehensive literature search of major bibliographic databases from inception until April 2024 was conducted to identify randomized control trials (RCTs) comparing IVUS-guided PCI versus angiography-guided PCI.

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Introduction: Peripheral arterial disease (PAD) is a marker of significant atherosclerotic cardiovascular disease and is associated with greater healthcare burden and worse prognosis in individuals with chronic inflammatory disease (CID). We aimed to investigate temporal trends and disparities of PAD-related mortality in populations with CID from 1999-2020 across six common CIDs (i.e.

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Polyvascular disease, is a prevalent comorbidity among patients with acute heart failure (AHF). Previous research has shown that polyvascular disease is a poor prognostic factor in patients with heart failure. However, data on the relationship between the extent of vascular disease involvement and outcomes in AHF patients are limited.

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Patients with acute pulmonary embolism (PE) have a wide spectrum of clinical presentations, from incidental findings to sudden cardiac death. Management and treatment recommendations in currently available guidelines vary according to patient risk and haemodynamic profile. A clot-in-transit (CiT) in the right heart chambers may be occasionally identified and is, therefore, an under-recognised but challenging condition, often preceding an abrupt clinical deterioration, and associated with increased mortality.

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Aims: We investigate sex disparities in management and outcomes of myocardial infarction (MI) in contemporary practice in Scotland.

Methods And Results: This was a longitudinal cohort study including all MI admissions aged 45-80 years across Scotland between 2010-2016 and 2:1 age, sex, and general practice-matched general population controls. Participants were followed up until the end of 2021.

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Patients with cancer are at increased risk of ischemic heart disease (IHD). The increased risk of IHD in these patients is due to the interaction of shared risk factors, cancer type and stage, and immuno/chemotherapy and radiotherapy regimens. Management of IHD in cancer patients is challenging, due to atypical presentation, increased thrombotic and bleeding risk, and worse outcomes compared to patients without cancer.

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Article Synopsis
  • Percutaneous coronary intervention (PCI) for stable angina in the left main coronary artery has increased, with a study examining outcomes between men and women based on data from the UK's national PCI registry (2006-2022).
  • The study found that while women undergoing LMCA PCI were older and had fewer comorbid conditions, they experienced higher mortality rates and major bleeding events compared to men, with significant statistical differences in these outcomes.
  • The authors suggest that a sex-specific approach to treatment, taking into account factors like age and imaging techniques, could help improve the health outcomes for female patients undergoing this procedure.
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Transcatheter aortic valve replacement (TAVR) is considered more effective than surgical aortic valve implantation for patients with a small aortic annulus (SAA), however, the comparative efficacy of different transcatheter heart valves (THVs) remains uncertain. A literature search was performed across databases from their inception until June 2024 to identify eligible randomized controlled trials (RCTs) and propensity-score matched (PSM) studies. Clinical outcomes were evaluated using a random-effects model to pool risk ratios (RRs) with 95 % confidence intervals (CIs).

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Background: Data are limited that examine potential sex-based disparities in the utilization and complications of septal reduction therapy (SRT) in patients with obstructive hypertrophic cardiomyopathy. Our aim was to assess the use and in-hospital outcomes of SRT, according to sex. We performed a retrospective cohort study using the 2017-2019 National Inpatient Sample database.

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Aim: To evaluate outcomes after percutaneous coronary intervention (PCI) in patients with cancer and atrial fibrillation (AF).

Methods: Data of all adult discharges undergoing PCI between October 2015 and December 2018 were obtained from the National Inpatient Sample (NIS) database. Adjusted odds ratios (aOR) of adverse complications were calculated using binominal logistic regression.

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Background: Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.

Methods: In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital.

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Background: The comparative outcomes with immediate, staged in-hospital, and staged out-of-hospital complete revascularization for patients with ST-segment-elevation myocardial infarction and multivessel disease remain unclear.

Methods And Results: An electronic search of MEDLINE, SCOPUS, and Cochrane databases was performed through August 2023 for randomized trials evaluating immediate, staged in-hospital, and staged out-of-hospital complete revascularization for patients with ST-segment-elevation myocardial infarction and multivessel disease. The primary outcome was major adverse cardiac events (MACEs).

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Article Synopsis
  • Nearly half of US adults have obesity, leading to a rise in coronary artery disease (CAD) deaths, which researchers are tracking by age, sex, race, and location.
  • * The study analyzed data from the CDC-WONDER database, revealing that deaths related to CAD and obesity increased from 1999 to 2022, with a significant surge during the COVID-19 pandemic.
  • * Males and non-Hispanic Black individuals experienced higher mortality rates compared to females and other racial groups, and rural areas had higher death rates than urban counterparts.*
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Article Synopsis
  • - The study investigates peripartum cardiomyopathy (PPCM) mortality rates from 1999 to 2020 and how they relate to social vulnerability as measured by the Social Vulnerability Index (SVI), finding significant disparities based on demographics and geographical locations.
  • - Researchers analyzed mortality data and SVI rankings across U.S. counties, revealing that Black populations and residents in the Southern U.S. experienced the highest age-adjusted mortality rates (AAMRs), with higher SVI linked to increased excess deaths.
  • - The findings highlight that higher social vulnerability is associated with increased PPCM mortality, indicating that both racial background and geographic location contribute to health disparities in the U.S.
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Background: Acute myocardial infarction with cardiogenic shock (AMI-CS) carries a significant risk of inpatient mortality compared with AMI alone, although it is unclear what the longer-term outcomes of AMI-CS survivors is, and whether the inpatient quality of care received influences this.

Methods: Using the Myocardial Ischaemia National Audit Project (MINAP) registry, linked to Office for National Statistics (ONS) mortality data, we analyzed 330,517 UK AMI patients; 3330 (1 %) with CS. Patients dying within thirty-days of admission were excluded.

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Takotsubo syndrome (TTS) still remains as an enigmatic phenomenon. In particular, long-term challenges (including clinical recurrence and persistent symptoms) and specific entities in the setting of TTS have been the evolving areas of interest. On the other hand, a significant gap still exists regarding the proper risk-stratification of this phenomenon in the short and long terms.

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In the recent years, there has been a burgeoning interest in Takotsubo syndrome (TTS), which is renowned as a specific form of reversible myocardial dysfunction. Despite the extensive literature available on TTS, clinicians still face several practical challenges associated with the diagnosis and management of this phenomenon. This potentially results in the underdiagnosis and improper management of TTS in clinical practice.

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