26
|
Mountantonakis SE, Epstein LM, Coleman K, Martinez J, Saleh M, Kvasnovsky C, Brown RM, McCulloch E, Kuvin J, Richardson S, Makker P, Lesser M, Mieres JH, Davidson KW, Roswell RO. The Association of Structural Inequities and Race With Out-of-Hospital Sudden Death During the COVID-19 Pandemic. Circ Arrhythm Electrophysiol 2021; 14:e009646. [PMID: 33835821 PMCID: PMC8136460 DOI: 10.1161/circep.120.009646] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
[Figure: see text].
Collapse
|
27
|
Saleh M, Atteya G, Willner J, John RM. Use of general anesthesia to suppress incessant atrial fibrillation in a patient undergoing ablation for supraventricular tachycardia. HeartRhythm Case Rep 2021; 7:87-90. [PMID: 33665108 PMCID: PMC7897722 DOI: 10.1016/j.hrcr.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|
28
|
Coleman KM, Saleh M, Mountantonakis SE. Association between regional distributions of SARS-CoV-2 seroconversion and out-of-hospital sudden death during the first epidemic outbreak in New York. Heart Rhythm 2021; 18:215-218. [PMID: 33472765 PMCID: PMC7831674 DOI: 10.1016/j.hrthm.2020.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 02/01/2023]
Abstract
Background Increased incidence of out-of-hospital sudden death (OHSD) has been reported during the coronavirus 2019 (COVID-19) pandemic. New York City (NYC) represents a unique opportunity to examine the epidemiologic association between the two given the variable regional distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its highly diverse neighborhoods. Objective The purpose of this study was to examine the association between OHSD and SARS-CoV-2 epidemiologic burden during the first COVID-19 pandemic across the highly diverse neighborhoods of NYC. Methods The incidences of OHSD between March 20 and April 22, 2019, and between March 20 and April 22, 2020, as reported by the Fire Department of New York were obtained. As a surrogate for viral epidemiologic burden, we used percentage of positive SARS-CoV-2 antibody tests performed between March 3 and August 20, 2020. Data were reported separately for the 176 zip codes of NYC. Correlation analysis and regression analysis were performed between the 2 measures to examine association. Results Incidence of OHSD per 10,000 inhabitants and percentage of SARS-CoV-2 seroconversion were highly variable across NYC neighborhoods, varying from 0.0 to 22.9 and 12.4% to 50.9%, respectively. Correlation analysis showed a moderate positive correlation between neighborhood data on OHSD and percentage of positive antibody tests to SARS-CoV-2 (Spearman ρ 0.506; P <.001). Regression analysis showed that seroconversion to SARS-CoV-2 and OHSD in 2019 were independent predictors for OHSD during the first epidemic surge in NYC (R2 = 0.645). Conclusion The association in geographic distribution between OHSD and SARS-CoV-2 epidemiologic burden suggests either a causality between the 2 syndromes or the presence of local determinants affecting both measures in a similar fashion.
Collapse
|
29
|
Khairullah I, Saleh M, Alwi M, Masganti. Increasing productivity of rice through iron toxicity control in acid sulfate soils of tidal swampland. ACTA ACUST UNITED AC 2021. [DOI: 10.1088/1755-1315/648/1/012151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
30
|
Coleman KM, Saleh M, Makker P, Vaishnav AS, Atteya G, Shein J, Bhullar A, Skipitaris NT, Mountantonakis SE. Surface unipolar electrogram characteristics to predict site of origin of outflow tract arrhythmias using noninvasive mapping. J Cardiovasc Electrophysiol 2021; 32:391-399. [PMID: 33368754 DOI: 10.1111/jce.14857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Noninvasive electroanatomic mapping (NIEAM) demonstrate patterns of depolarization that are useful in identifying the chamber of origin (COO) in outflow tract ventricular arrhythmias (OTVA). However, its use in predicting exact site of origin (SOO) has not yet been validated. METHODS NIEAMs (CardioInsight, Medtronic) from 40 patients (age 62.5 ± 2.6) undergoing ablation for OTVA were reviewed for diagnostic accuracy in predicting the SOO. Earliest arrhythmia breakout and directionality of earliest instantaneous unipolar electrograms (uEGMs) on NIEAMs were evaluated subjectively by two observers for quality and amplitude. Sites with most negative earliest uEGMs on right and left ventricular outflow tracts, as well as epicardial surface were manually identified. Using NIEAM-based activation timing of the lateral mitral annulus and basal septum COO was identified for each OTVA. Predictions of SOO using NIEAMs was compared with true SOO from invasive study. NIEAMs SOO predictions were compared with subjective 12 lead electrocardiogram (ECG) review by two observers. RESULTS Review of arrhythmia breakout and signal directionality had poor diagnostic value in predicting SOO in OTVA (50.6% and 49.4%, 56.6% and 43.4%, respectively) and underperformed compared with ECG interpretation (59.1% and 80.5%). After excluding uEGMs with poor characteristics, the uEGM with most negative amplitude at the COO was predictive of the true SOO with 96.4% sensitivity and specificity. CONCLUSION We propose a stepwise approach when interpreting NIEAMs for OTVA where patterns of activation are evaluated first to determine the COO, followed by identification of the site with most negative amplitude instantaneous uEGM to determine SOO.
Collapse
|
31
|
Mba S, Ukponu W, Adekanye U, Saleh M, Agogo E, Dan-Nwafor C, Amao L, Oparah O, Olajide L, Oyegoke A, Mba N, Ilori E, Ihekweazu C. A description of Lassa Fever mortality during the 2019 outbreak in Nigeria. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
32
|
Saleh M, Gabriels J, Chang D, Fishbein J, Qiu M, Mountantonakis SE, Epstein LM. Safely Administering Potential QTc Prolonging Therapy Across a Large Health Care System in the COVID-19 Era. Circ Arrhythm Electrophysiol 2020; 13:e008937. [PMID: 33003964 PMCID: PMC7668332 DOI: 10.1161/circep.120.008937] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Supplemental Digital Content is available in the text. Background: The severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2) has resulted in a global pandemic. Hydroxychloroquine±azithromycin have been widely used to treat coronavirus disease 2019 (COVID-19) despite a paucity of evidence regarding efficacy. The incidence of torsade de pointes remains unknown. Widespread use of these medications forced overwhelmed health care systems to search for ways to effectively monitor these patients while simultaneously trying to minimize health care provider exposure and use of personal protective equipment. Methods: Patients with COVID-19 positive who received hydroxychloroquine±azithromycin across 13 hospitals between March 1 and April 15 were included in this study. A comprehensive search of the electronic medical records was performed using a proprietary python script to identify any mention of QT prolongation, ventricular tachy-arrhythmias and cardiac arrest. Results: The primary outcome of torsade de pointes was observed in 1 (0.015%) out of 6476 hospitalized patients with COVID-19 receiving hydroxychloroquine±azithromycin. Sixty-seven (1.03%) had hydroxychloroquine±azithromycin held or discontinued due to an average QT prolongation of 60.5±40.5 ms from a baseline QTc of 473.7±35.9 ms to a peak QTc of 532.6±31.6 ms. Of these patients, hydroxychloroquine±azithromycin were discontinued in 58 patients (86.6%), while one or more doses of therapy were held in the remaining nine (13.4%). A simplified approach to monitoring for QT prolongation and arrythmia was implemented on April 5. There were no deaths related to the medications with the simplified monitoring approach and health care provider exposure was reduced. Conclusions: The risk of torsade de pointes is low in hospitalized patients with COVID-19 receiving hydroxychloroquine±azithromycin therapy.
Collapse
|
33
|
Saleh M, Curtin J, Boyd L. Does race impact time to presentation in patients with endometrial cancer? Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
34
|
Zocher U, Okwor TJ, Dan-Nwafor C, Yahya D, Ita Ita O, Saleh M, Ogunniyi A, Ihekweazu C, Poggensee G. A participatory and systemic training approach for IPC improvement in Nigerian health facilities. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem. A large percentage of HAI in hospitals are preventable through effective infection prevention and control (IPC) measures. IPC trainings for health care personnel based only on technical content do not lead to sustainable improvement of IPC standard precautions. To address this problem, the Nigeria Centre for Disease Control (NCDC) in collaboration with the Robert Koch Institute (RKI) developed a multimodal training approach to facilitate the transfer of IPC competences into working routine in Nigerian health facilities.
Objectives
The training should foster the ability of health care workers to act and communicate participatory, analyze IPC problems systemically and to develop and perform tailored IPC activities in their health facilities. It should empower health care workers to initiate and promote sustainable IPC improvement locally.
Results
We developed a participatory training approach which focusses on the relational and organizational dimension of IPC. It addresses the human and infrastructural factors for IPC compliance in daily working routine. A variety of training methods offers practice tools in communication, systemic thinking and team work, and allows experiencing a participatory attitude. The training program consists of two face to face workshops and an interjacent field project. 28 Health care workers of 14 health facilities in Lagos State participated the first implementation of the training program in 2018. The training evaluation showed the high relevance of the training to the HCW. The field projects showed that the participants could apply the participatory approach for IPC improvement.
Conclusions
A participatory and systemic approach for IPC trainings enables health care workers to take action for IPC improvement locally.
Key messages
We developed and implemented a participatory training approach that addresses the relational and organizational dimension of IPC. Health care workers took tailored actions for IPC improvement locally.
Collapse
|
35
|
Vaishnav AS, Alderwish E, Coleman KM, Saleh M, Makker P, Bhasin K, Bernstein NE, Skipitaris NT, Mountantonakis SE. Anatomic predictors of recurrence after cryoablation for atrial fibrillation: a computed tomography based composite score. J Interv Card Electrophysiol 2020; 61:293-302. [PMID: 32602004 DOI: 10.1007/s10840-020-00799-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Effective pulmonary vein isolation (PVI) with cryoablation depends on adequate occlusion of pulmonary veins (PV) by the cryoballoon and is therefore likely to be affected by PV and left atrial (LA) anatomical characteristics and variants. Thus, the objective of this study was to investigate the effect of LA and PV anatomy, evaluated by computed tomography (CT), on acute and long-term outcomes of cryoablation for atrial fibrillation (AF). METHODS Fifty-eight patients (64.72 + 9.44 years, 60.3% male) undergoing cryoablation for paroxysmal or early persistent AF were included. Pre-procedural CT images were analyzed to evaluate LA dimensions and PV anatomical characteristics. Predictors of recurrence were identified using regression analysis. RESULTS 60.3% of patients had two PVs on each side with separate ostia, whereas 29.3% and 10.3% had right middle and left common PVs, respectively. The following anatomic characteristics were found to be independent predictors of recurrence: right superior PV ostial max:min diameter ratio > 1.32, left superior PV ostial max:min diameter ratio > 1.2, right superior PV antral circumference > 69.1 mm, right inferior PV antral circumference > 61.38 mm, right superior PV angle > 22.7°. Using these factors, LA diameter and right middle PV, a scoring model was created for prediction of "unfavorable" LA-PV anatomy (AUC = 0.867, p = 0.000009, score range = 0-7). Score of ≥ 4 predicted need for longer cryoenergy ablation (p = 0.039) and more frequent switch to radiofrequency energy (p = 0.066) to achieve PVI, and had a sensitivity of 83.3% and specificity of 82.5% to predict clinical recurrence. CONCLUSION CT-based scoring system is useful to identify "unfavorable" anatomy prior to cryo-PVI, which can result in procedural difficulty and poor outcomes.
Collapse
|
36
|
Saleh M, Gabriels J, Chang D, Soo Kim B, Mansoor A, Mahmood E, Makker P, Ismail H, Goldner B, Willner J, Beldner S, Mitra R, John R, Chinitz J, Skipitaris N, Mountantonakis S, Epstein LM. Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection. Circ Arrhythm Electrophysiol 2020; 13:e008662. [PMID: 32347743 PMCID: PMC7299095 DOI: 10.1161/circep.120.008662] [Citation(s) in RCA: 220] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is responsible for the global coronavirus disease 2019 pandemic. Small studies have shown a potential benefit of chloroquine/hydroxychloroquine±azithromycin for the treatment of coronavirus disease 2019. Use of these medications alone, or in combination, can lead to a prolongation of the QT interval, possibly increasing the risk of Torsade de pointes and sudden cardiac death. METHODS Hospitalized patients treated with chloroquine/hydroxychloroquine±azithromycin from March 1 to the 23 at 3 hospitals within the Northwell Health system were included in this prospective, observational study. Serial assessments of the QT interval were performed. The primary outcome was QT prolongation resulting in Torsade de pointes. Secondary outcomes included QT prolongation, the need to prematurely discontinue any of the medications due to QT prolongation, and arrhythmogenic death. RESULTS Two hundred one patients were treated for coronavirus disease 2019 with chloroquine/hydroxychloroquine. Ten patients (5.0%) received chloroquine, 191 (95.0%) received hydroxychloroquine, and 119 (59.2%) also received azithromycin. The primary outcome of torsade de pointes was not observed in the entire population. Baseline corrected QT interval intervals did not differ between patients treated with chloroquine/hydroxychloroquine (monotherapy group) versus those treated with combination group (chloroquine/hydroxychloroquine and azithromycin; 440.6±24.9 versus 439.9±24.7 ms, P=0.834). The maximum corrected QT interval during treatment was significantly longer in the combination group versus the monotherapy group (470.4±45.0 ms versus 453.3±37.0 ms, P=0.004). Seven patients (3.5%) required discontinuation of these medications due to corrected QT interval prolongation. No arrhythmogenic deaths were reported. CONCLUSIONS In the largest reported cohort of coronavirus disease 2019 patients to date treated with chloroquine/hydroxychloroquine±azithromycin, no instances of Torsade de pointes, or arrhythmogenic death were reported. Although use of these medications resulted in QT prolongation, clinicians seldomly needed to discontinue therapy. Further study of the need for QT interval monitoring is needed before final recommendations can be made.
Collapse
|
37
|
Alam MA, Saleh M, Mohsin GM, Nadirah TA, Aslani F, Rahman MM, Roy SK, Juraimi AS, Alam MZ. Evaluation of phenolics, capsaicinoids, antioxidant properties, and major macro‐micro minerals of some hot and sweet peppers and ginger land‐races of Malaysia. J FOOD PROCESS PRES 2020. [DOI: 10.1111/jfpp.14483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
38
|
Chang D, Saleh M, Gabriels J, Ismail H, Goldner B, Willner J, Beldner S, Mitra R, John R, Epstein LM. Inpatient Use of Ambulatory Telemetry Monitors for COVID-19 Patients Treated With Hydroxychloroquine and/or Azithromycin. J Am Coll Cardiol 2020; 75:2992-2993. [PMID: 32330546 PMCID: PMC7173810 DOI: 10.1016/j.jacc.2020.04.032] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/12/2020] [Accepted: 04/16/2020] [Indexed: 12/27/2022]
|
39
|
Kokoszyński D, Bernacki Z, Biegniewska M, Saleh M, Stęczny K, Zwierzyński R, Kotowicz M, Sobczak M, Żochowska-Kujawska J, Wasilewski P, Bucek T, Kmiecik M. Carcass, physicochemical and sensory characteristics of meat from genetic reserve ducks after two reproductive seasons. S AFR J ANIM SCI 2020. [DOI: 10.4314/sajas.v50i1.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to compare carcass composition and meat quality of i) Pekin ducks of French origin (P9), ii) crosses of wild mallard and Pekin duck (K2), and iii) crosses of Khaki Campbell drakes and Orpington Fauve ducks (KhO1). Twenty carcasses from 110-week-old ducks of each genetic group were used. Carcass weight of P9 was significantly higher than that of K2 and KhO1. Carcasses of K2 ducks had a significantly lower percentage of neck and leg muscles and giblet weight compared with P9 and KhO1 ducks, while carcasses of KhO1 ducks had a significantly higher percentage of wing meat compared with K2 and P9, and a significantly lower percentage of breast muscles compared with P9 ducks. Breast and leg muscles of P9 contained significantly more water than those of K2 and KhO1, and the breast muscles of P9 ducks had more protein and less fat than those of KhO1 birds. The leg muscles of KhO1 contained significantly more protein, and those of K2 had significantly more fat than the other duck groups. Breast muscles of P9 and KhO1 ducks had significantly more collagen but had less in leg muscles compared with K2. Breast fillets from P9 ducks showed higher L*, a*, and b* colour values and shear force than K2 and KhO1 ducks.
Keywords: carcass composition, conservation flocks, meat quality, spent duck
Collapse
|
40
|
Gabriels J, Saleh M, Chang D, Epstein LM. Inpatient use of mobile continuous telemetry for COVID-19 patients treated with hydroxychloroquine and azithromycin. HeartRhythm Case Rep 2020; 6:241-243. [PMID: 32363144 PMCID: PMC7194904 DOI: 10.1016/j.hrcr.2020.03.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|
41
|
Chang D, Saleh M, Garcia-Bengo Y, Choi E, Epstein L, Willner J. COVID-19 Infection Unmasking Brugada Syndrome. HeartRhythm Case Rep 2020; 6:237-240. [PMID: 32292696 PMCID: PMC7138191 DOI: 10.1016/j.hrcr.2020.03.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
42
|
Saleh M. [Placoid pigment epitheliopathy and serpiginous choroiditis]. J Fr Ophtalmol 2020; 43:243-255. [PMID: 32007311 DOI: 10.1016/j.jfo.2019.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 11/19/2022]
Abstract
Placoid pigment epitheliopathy and serpiginous choroiditis are among the white dot retinal syndromes and possess similarities that can cause confusion between these two diseases. However, they are very different in terms of their progression and prognosis, which requires a diagnosis of certainty in order to better manage the patients with the diseases and identify potentially serious progressive complications. The clinical presentation, results of testing, differential diagnoses and treatment of these two pathologies are discussed in this article.
Collapse
|
43
|
Saleh M. Placoid pigment epitheliopathy and serpiginous choroiditis. J Fr Ophtalmol 2020; 43:e55-e66. [PMID: 31932062 DOI: 10.1016/j.jfo.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/14/2019] [Accepted: 12/10/2019] [Indexed: 12/17/2022]
Abstract
Placoid pigment epitheliopathy and serpiginous choroiditis are among the white dot retinal syndromes and possess similarities that can cause confusion between these two diseases. However, they are very different in terms of their progression and prognosis, which requires a diagnosis of certainty in order to better manage the patients with the diseases and identify potentially serious progressive complications. The clinical presentation, results of testing, differential diagnoses and treatment of these two pathologies are discussed in this article.
Collapse
|
44
|
Saleh M, Ahsan MJ, Lateef N, Shokr M, Badran H, Hassanin M, Aboeata A. P963Coronary orbital atherectomy manufacturers and user facility device experience (MAUDE) database: a 5-year analysis of real-world complications. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary Orbital Atherectomy System was approved by the United States FDA (food and Drug Administration) on October 21st, 2013. The initial safety data were published in the ORBIT I trial.
Purpose
Evaluation of the reported real-life complications related to utilization of orbital coronary atherectomy system since its approval in the United States using the online FDA database.
Methods
The Manufacturer and User facility Device Experience (MAUDE) database was queried for all complication reports involving the orbital atherectomy (OA) “Diamondback 360 coronary orbital atherectomy system” from 1/1/2013 through 12/31/2018. All reports were searched for complications; mortality, perforation, dissections, device fragmentation, and the need for surgical intervention among reported procedures. Duplicate entries and data with no reporting on final procedure outcome were excluded.
Results
Over the allocated interval519 reports were identified. Seven reports were excluded (according to exclusion criteria).
Over the period of slightly more than five years, coronary perforation was the most commonly reported complication mounting to 44.14% of all the reports (226 reports). Device fragmentation was reported in 18.94% of the reports (97 reports). Surgery was needed to retrieve device fragments in 13 cases (13.4% of all device fragmentation reports). Coronary dissection represented 16.21% of the reports (83 reports) and total surgical interventions were needed in 14.25% of the cases (73 reports). Finally, total reported deaths were 121 cases (23.63% of the total reports).
Year 2013 2014 2015 2016 2017 2018 Number of reported complications 4 28 46 81 113 247
Percentage of reported complications
Discussion
The current analysis, representing data from real world reported complications to the FDA over a period of 5 years, shows that the most common reported complication during coronary orbital atherectomy was coronary perforations, followed by device breakings and fragmentation (which necessitated surgical intervention in almost 13.4% of those device fragmentation cases reported). It is hard to compare these data with published safety trials since the FDA database is involved in reporting complications and not total number of procedures. However the most striking complication involved device fragmentation, which was not seen or reported among the pivotal trials evaluating device safety. The current analysis may shed some light on a non reported complication among patients undergoing orbital atherectomy which might represent a gap between the device performance in real world as opposed to a well-designed study world.
Collapse
|
45
|
Meric-Bernstam F, Somaiah N, DuBois S, Dumbrava EEI, Shapiro G, Patel M, Goel S, Bauer T, Pinchasik D, Annis A, Aivado M, Vukovic V, Saleh M. A phase IIa clinical trial combining ALRN-6924 and palbociclib for the treatment of patients with tumours harboring wild-type p53 and MDM2 amplification or MDM2/CDK4 co-amplification. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
46
|
Almuntaser S, Saleh M, Kashyape P. Novel gene mutation of molybdenum cofactor deficiency. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Paluri R, Naik G, Li P, Mcardle T, Anderson A, Young M, Saleh M. Outcomes of Gastrointestinal cancers treated on Phase 1 clinical trials at O’Neal Comprehensive Cancer Center. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
48
|
Saleh M, Cassier P, Eberst L, Naik G, II VM, Pant S, Terret C, Gao L, Long A, Mao H, McNeely S, Carlesi R, Fu S. Ramucirumab plus merestinib in previously treated metastatic colorectal cancer: safety, pharmacokinetic, and preliminary efficacy findings from a Phase 1 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Gerber D, Curtin J, Saleh M, Boyd L, Lymberis S, Schiff P, Pothuri B, Lee J. Gastrointestinal fistula formation in cervical cancer patients who received bevacizumab. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
50
|
Abdel-Basset M, Saleh M, Gamal A, Smarandache F. An approach of TOPSIS technique for developing supplier selection with group decision making under type-2 neutrosophic number. Appl Soft Comput 2019. [DOI: 10.1016/j.asoc.2019.01.035] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|