Background and Aims Contemporary data on the prevalence, trends, and outcomes of cardiovascular, diseases (CVD) in pregnant patients are limited. This study aimed to analyze the, prevalence, trends, and outcomes of CVD and their subtypes in hospitalized pregnant, patients in the United States (U.S.). Methods This retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients from January 1, 2010, to, December 31, 2019. Data analyses were conducted from January-February 2022., Pregnancy-associated hospitalizations were identified. Main outcomes were, prevalence and trend of CVD in pregnant patients. Results 39,212,104 hospitalized pregnant patients were identified: 4,409,924 with CVD (11.3%), and 34,802,180 without CVD (88.8%). The annual age adjusted CVD prevalence, increased from 9.2% in 2010 to 14.8% in 2019 (p < 0.001). Hypertensive disorder of, pregnancy (1069/10,000) was the most common, and aortic dissection (0.1/10,000), was the least common CVD. Trends of all CVD subtypes increased; however, the trend, of valvular heart disease decreased. Age adjusted in-hospital all-cause mortality was, 8.2/10,000 in CVD but its trend decreased from 8.1/10,000 in 2010 to 6.5/10,000 in, 2019 (p < 0.001). CVD was associated with 15.51 times higher odds of in-hospital allcause, mortality compared with non-CVD patients (odds ratio (OR): 15.51, 95% CI, 13.22-18.20, p < 0.001). CVD was associated with higher 6-week postpartum readmission (OR: 1.97, 95% CI: 1.95-1.99), myocardial infarction (OR: 3.04, 95% CI:, 2.57-3.59), and stroke (OR: 2.66, 95% CI: 2.41-2.94) (p < 0.001 for all). Conclusion There is an increasing age adjusted trend in overall CVD and its subtypes among, pregnant patients in the U.S. from 2010 to 2019. Pregnant patients with CVD had, higher odds of in-hospital mortality than those without CVD. However, in-hospital allcause, mortality among patients with and without CVD decreased over the past 10, years. CVD was associated with higher 6-week postpartum all-cause readmission, myocardial infarction, and stroke.
Background: Though the incidence of atrial fibrillation (AF) is increased in patients with cancer, the effectiveness of catheter ablation (CA) for AF in patients with cancer is not well studied. Methods: We conducted a retrospective cohort study of patients who underwent CA for AF. Patients with a history of cancer within 5-years prior to, or those with an exposure to anthracyclines and/or thoracic radiation at any time prior to the index ablation were compared to patients without a history of cancer who underwent AF ablation. The primary outcome was freedom from AF, with or without anti-arrhythmic drugs (AADs), and need for repeat CA at 12-months post-ablation. Secondary endpoints included freedom from AF at 12 months post-ablation with AADs and without AADs. Safety endpoints included bleeding, pulmonary vein stenosis, stroke, and cardiac tamponade. Multivariable regression analysis was performed to identify independent risk predictors of the primary outcome. Results: Among 502 patients included in the study, 251 (50%) had a history of cancer. Freedom from AF at 12 months did not differ between patients with and without cancer (83.3% vs 72.5%, p 0.28). Need for repeat ablation was also similar between groups (20.7% vs 27.5%, p 0.29). Multivariable regression analysis did not identify a history of cancer or cancer-related therapy as independent predictors of recurrent AF after ablation. There was no difference in safety endpoints between groups. Conclusion: CA is a safe and effective treatment for AF in patients with a history of cancer and those with exposure to potentially cardiotoxic therapy.
IMPORTANCEThe Bypass Versus Angioplasty for Severe Ischemia of the Leg randomized controlled trial showed comparable outcomes between endovascular revascularization (ER) and surgical revascularization (SR) for patients with critical limb ischemia (CLI). However, several observational studies showed mixed results. Most of these studies were conducted before advanced endovascular technologies were available. OBJECTIVE To compare ER and SR treatment strategies for 6-month outcomes among patients with CLI.
Aim To understand the global digital impact of World Hypertension Day and identify areas of further improvement to steer future policy development. Methods and Results We used three social media assessment tools (Sprout Social, SocioViz, Symplur) and Google Trends to obtain data about the total tweets and global impressions from countries worldwide about World Hypertension Day. Social network analysis of top influencers, associated hashtags, and keywords was done to understand the context of the posts. With over 60,000 tweets reaching more than 250 million impressions, World Hypertension Day was a highly impactful event. A large spike of over 800% yearly increase was seen in 2021 that has greatly helped in wider dissemination. However, there was limited collaboration amongst the top influencers and negligible participation from several African and non-English speaking European countries. Conclusion With backing from several governmental bodies, organizations, and media outlets, World Hypertension Day is a highly impactful healthcare awareness day and presents a global case study of effectively utilizing digital resources for creating awareness amongst the global audience. Prioritizing equitable involvement from the underrepresented and underprivileged communities shall be focused. Future policy development of other awareness events shall extract the constructive feedback from these findings to promote global and public health.
Background Though the incidence of atrial fibrillation (AF) is increased in patients with cancer, the effectiveness of catheter ablation (CA) for AF in patients with cancer is not well studied. Methods We conducted a retrospective cohort study of patients who underwent CA for AF. Patients with a history of cancer within 5-years prior to, or those with an exposure to anthracyclines and/or thoracic radiation at any time prior to the index ablation were compared to patients without a history of cancer who underwent AF ablation. The primary outcome was freedom from AF [with or without anti-arrhythmic drugs (AADs), or need for repeat CA at 12-months post-ablation]. Secondary endpoints included freedom from AF at 12 months post-ablation with AADs and without AADs. Safety endpoints included bleeding, pulmonary vein stenosis, stroke, and cardiac tamponade. Multivariable regression analysis was performed to identify independent risk predictors of the primary outcome. Results Among 502 patients included in the study, 251 (50%) had a history of cancer. Freedom from AF at 12 months did not differ between patients with and without cancer (83.3% vs 72.5%, p 0.28). The need for repeat ablation was also similar between groups (20.7% vs 27.5%, p 0.29). Multivariable regression analysis did not identify a history of cancer or cancer-related therapy as independent predictors of recurrent AF after ablation. There was no difference in safety endpoints between groups. Conclusion CA is a safe and effective treatment for AF in patients with a history of cancer and those with exposure to potentially cardiotoxic therapy.
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