Sex Differences in the Safety and Efficacy of Different Durations of DAPT After PCI.

Background: Randomized controlled trials (RCTs) have examined the clinical impact of abbreviating the duration of dual antiplatelet therapy (DAPT) and have reported outcomes in men and women.

Objectives: The authors examined the safety and efficacy of different durations of DAPT following percutaneous coronary intervention (PCI) in men and women.

Methods: We searched Cochrane, Embase, MEDLINE, PubMed, Scopus, and Web of Science databases for RCTs that compared any 2 of 1, 3, 6, or 12 months of DAPT after PCI and reported outcomes in men and women.

Evaluation of navigation and robotic systems for percutaneous image-guided interventions: A novel metric for advanced imaging and artificial intelligence integration.

Purpose: Navigation and robotic systems aim to improve the accuracy and efficiency of percutaneous image-guided interventions, but the evaluation of their autonomy and integration of advanced imaging and artificial intelligence (AI) is lacking. The purpose of this study was to evaluate the level of automation and integration of advanced imaging and artificial intelligence in navigation and robotic systems for percutaneous image-guided interventions, using established and novel metrics to categorize and compare their capabilities.

Materials And Methods: Following PRISMA guidelines, a systematic review was conducted to identify studies on clinically validated navigation and robotic systems published between 2000 and May 2024.

Baseline Alpha-Fetoprotein Elevation and the Risk of Hepatocellular Carcinoma in Chronic Hepatitis B: A Multicentre Cohort Study.

Alpha-fetoprotein (AFP) level and its changes in chronic hepatitis B (CHB) may influence the risk of future hepatocellular carcinoma (HCC). This study aims to evaluate the HCC risk in CHB patients with no overt HCC but with elevated AFP level and to explore the prognostic role of longitudinal changes in AFP and liver-related laboratory values. This multicentre cohort study included 10,639 CHB patients without a history of HCC from seven medical facilities in South Korea.

Interrupted versus uninterrupted anticoagulation for cardiac rhythm management device insertion.

Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.

Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.

Absenteeism Among Healthcare Workers: Job Grade and Other Factors That Matter in Sickness Absence.

Background: Absenteeism among healthcare workers (HCWs) disrupts workflows and hampers the delivery of adequate patient care. The aim of the study was to examine predictors of sick leaves among HCWs in a tertiary medical center in Lebanon.

Methods: A retrospective analysis of sick leaves linked to health records of 2850 HCWs between 2015 and 2018 was performed.

Psycho-physiological foundations of human physical activity behavior and motivation: Theories, systems, mechanisms, evolution, and genetics.

Physical activity is a meaningful part of life, which starts before birth and lasts until death. There are many health benefits to be derived from physical activity, hence, regular engagement is recommended on a weekly basis. However, these recommendations are often not met.

Outcomes of chronic limb-threatening ischemia revascularization in patients with chronic kidney disease in the BEST-CLI trial.

Background: Chronic limb-threatening ischemia (CLTI) in patients with chronic kidney disease (CKD) has a high risk of poor outcomes. We aimed to compare the outcomes of lower extremity revascularization in patients with CLTI stratified by CKD severity in patients enrolled in the prospective, randomized Best Endovascular vs Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.

Methods: The BEST-CLI trial dataset was queried to categorize patients into three groups according to CKD stage.

Evaluation of a Machine Learning-Guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems.

Background: While universal screening for Lp(a; lipoprotein[a]) is increasingly recommended, <0.5% of patients undergo Lp(a) testing. Here, we assessed the feasibility of deploying Algorithmic Risk Inspection for Screening Elevated Lp(a; ARISE), a validated machine learning tool, to health system electronic health records to increase the yield of Lp(a) testing.

Pediatric Predictive Artificial Intelligence Implemented in Clinical Practice from 2010-2021: A Systematic Review.

Objective: To review pediatric artificial intelligence (AI) implementation studies from 2010-2021 and analyze reported performance measures.

Methods: We searched PubMed/Medline, Embase CINHAL, Cochrane Library CENTRAL, IEEE and Web of Science with controlled vocabulary.

Inclusion Criteria: AI intervention in a pediatric clinical setting that learns from data (i.

Cardiovascular Complications During Delivery Hospitalization in Patients With Psoriasis.

Background: Psoriasis in pregnancy is associated with adverse maternal outcomes. However, there are limited data on this subject.

Objectives: The purpose of our study was to investigate the association between psoriasis and related cardiovascular complications during delivery.

Improving cefazolin administration for surgical prophylaxis in reported penicillin allergy: A retrospective study of a health system intervention.

Background: Cefazolin is the most common first-line antibiotic to prevent surgical-site infections. Patients with penicillin allergy labels often receive alternative antibiotics, which is associated with increased rates of surgical-site infections, multi-drug-resistant infections, and cost.

Objective: We sought to determine whether a hospital-wide guideline recommending first-line surgical prophylaxis in patients with penicillin allergy labels can increase the use of cefazolin without compromising safety.

Finding a constrained number of predictor phenotypes for multiple outcome prediction.

Background: Prognostic models help aid medical decision-making. Various prognostic models are available via websites such as MDCalc, but these models typically predict one outcome, for example, stroke risk. Each model requires individual predictors, for example, age, lab results and comorbidities.

Heart failure risk stratification using artificial intelligence applied to electrocardiogram images: a multinational study.

Background And Aims: Current heart failure (HF) risk stratification strategies require comprehensive clinical evaluation. In this study, artificial intelligence (AI) applied to electrocardiogram (ECG) images was examined as a strategy to predict HF risk.

Methods: Across multinational cohorts in the Yale New Haven Health System (YNHHS), UK Biobank (UKB), and Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), individuals without baseline HF were followed for the first HF hospitalization.

Compensation Study of Vascular Surgeons in the United States.

Objective: The Society for Vascular Surgery (SVS) partnered with Phairify, Inc, an organization with experience in physician compensation data compilation for several other medical specialties, to survey its membership and assess factors influencing vascular surgeon compensation.

Methods: The SVS Compensation Study Task Force developed a vascular surgery-specific survey between January 2023 and May 2023 including experience level, academic rank, bonuses, incentives, gender, race, ethnicity, geography, on-call pay, and other factors influencing overall reimbursement. After a soft launch on May 1, 2023, with an initial phase of SVS leadership engagement in completion, the survey was formally introduced to the SVS membership on June 14, 2023.

The Scenic Route: Lingular Metastasectomy Through the Right Chest.

Metastasectomy for isolated pulmonary metastasis can improve disease-free and overall-survival in well-selected patients. When feasible, a minimally invasive wedge resection is the preferred approach. However, a hostile ipsilateral chest can hinder surgical resection.

Association between the proportionality of functional mitral regurgitation and survival after mitral valve operation.

Objective: The concept of proportionate and disproportionate functional mitral regurgitation suggests that transcatheter edge-to-edge mitral repair may benefit patients with a smaller left ventricle relative to a higher regurgitant burden. The clinical relevance of proportionality remains unknown in mitral operations for ischemic mitral regurgitation. We aimed to characterize the association between mitral regurgitation proportionality and outcomes after mitral valve operations.

Cardiac Biomarkers, Subclinical Brain Vascular Changes, and Cognitive Decline: Post Hoc Analysis of the SPRINT Trial.

Background: The association between subclinical cardiovascular disease (CVD) and cognitive decline in hypertensive adults and the underlying brain pathologies remain unclear. It is also undetermined whether intensifying blood pressure (BP) treatment slows down cognitive decline associated with subclinical CVD.

Methods: We conducted a post hoc analysis of the Systolic Blood Pressure Intervention Trial.

Left Ventricular Assist Device Therapy in Cold and Dry Patients.

Background: Patients with end-stage heart failure and low pulmonary capillary wedge pressure are referred to as cold and dry and represent an understudied minority in whom the benefit of left ventricular assist device (LVAD) therapy is unclear.

Methods: Adults receiving LVADs between 2006 and 2017 in the Interagency Registry for Mechanically Assisted Circulatory Support database were classified as cold and wet (pulmonary capillary wedge pressure >15 mm Hg) and cold and dry (pulmonary capillary wedge pressure ≤15 mm Hg) based on pre-LVAD hemodynamics obtained via right heart catheterization. The primary outcome was 1-year survival.

Efficacy and Safety of IV Thrombolysis for Acute Ischemic Stroke Patients With Moyamoya Disease.

Objectives: Moyamoya disease (MMD) is a rare cerebrovascular condition, and it is a well-known risk factor of acute ischemic stroke (AIS). While IV thrombolysis (IVT) is an established treatment for patients with AIS, its efficacy and safety for patients with MMD is largely unknown.

Methods: This was a large retrospective analysis of the 2016-2021 Nationwide Readmissions Database in the United States.

Barriers and Facilitators for the Use of Patient Lifts by Healthcare Workers: A Scoping Review.

(1) Background: Patient lifts are evidence-based engineering controls used in Safe Patient Handling Programs to assist healthcare workers in moving patients. They have been shown to be beneficial for both healthcare workers and patients. However, these devices are not consistently used.

Comparison of Outcomes Between Low-Risk Aortic Valve Replacement Trials and a Surgical Registry.

Importance: It remains unknown whether outcomes of the Placement of Aortic Transcatheter Valves 3 (PARTNER 3) and Evolut Low Risk trials are comparable with surgical outcomes in nontrial settings, considering the added risk of concomitant cardiac operations.

Objective: To compare 30-day mortality and stroke incidences of patients in the surgical aortic valve replacement (SAVR) arm of low-risk trials with those of similar patients in the US Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD).

Design, Setting, And Participants: A cross-sectional sampling study was conducted of adults in the STS ACSD with severe aortic stenosis at low surgical risk for AVR who underwent SAVR during the years low-risk AVR trials (PARTNER 3 and Evolut Low Risk) were enrolling (calendar years 2016-2018).

Real-world infection risk in multiple sclerosis patients on long-term immunomodulatory treatments.

Introduction: Numerous immunomodulatory treatments exist for multiple sclerosis (MS), including those that deplete immune cells (e.g. anti-CD20 medications), relocate immune cells (e.

Pharmacy technician education and training: Highlighting the partnership among a state pharmacy association, local community college, and healthcare system.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.