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Chobufo MD, Ali S, Taha A, Duhan S, Patel N, Gonuguntla K, Ludhwani D, Thyagaturu H, Keisham B, Shaik A, Alharbi A, Sattar Y, Mamas MA, Kohli U, Balla S. Temporal Trends of Infant Mortality Secondary to Congenital Heart Disease: National CDC Cohort Analysis (1999-2020). Birth Defects Res 2024; 116:e2398. [PMID: 39219403 DOI: 10.1002/bdr2.2398] [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: 02/22/2024] [Revised: 07/20/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Infant mortality continues to be a significant problem for patients with congenital heart disease (CHD). Limited data exist on the recent trends of mortality in infants with CHD. METHODS The CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was queried to identify deaths occurring within the United States with CHD listed as one of the causes of death between 1999 and 2020. Subsequently, trends were calculated using the Joinpoint regression program (version 4.9.1.0; National Cancer Institute). RESULTS A total of 47,015 deaths occurred in infants due to CHD at the national level from the year 1999 to 2020. The overall proportional infant mortality (compared to all deaths) declined (47.3% to 37.1%, average annual percent change [AAPC]: -1.1 [95% CI -1.6 to -0.6, p < 0.001]). There was a significant decline in proportional mortality in both Black (45.3% to 34.3%, AAPC: -0.5 [-0.8 to -0.2, p = 0.002]) and White patients (55.6% to 48.6%, AAPC: -1.2 [-1.7 to -0.7, p = 0.001]), with a steeper decline among White than Black patients. A statistically significant decline in the proportional infant mortality in both non-Hispanic (43.3% to 33.0%, AAPC: -1.3% [95% CI -1.9 to -0.7, p < 0.001]) and Hispanic (67.6% to 57.7%, AAPC: -0.7 [95% CI -0.9 to -0.4, p < 0.001]) patients was observed, with a steeper decline among non-Hispanic infant population. The proportional infant mortality decreased in males (47.5% to 53.1%, AAPC: -1.4% [-1.9 to -0.9, p < 0.001]) and females (47.1% to 39.6%, AAPC: -0.9 [-1.9 to 0.0, p = 0.05]). A steady decline in for both females and males was noted. CONCLUSION Our study showed a significant decrease in CHD-related mortality rate in infants and age-adjusted mortality rate (AAMR) between 1999 and 2020. However, sex-based, racial/ethnic disparities were noted, with female, Black, and Hispanic patients showing a lesser decline than male, White, and non-Hispanic patients.
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Affiliation(s)
- Muchi Ditah Chobufo
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Shafaqat Ali
- Department of Medicine, Louisiana State University, Shreveport, Louisiana, USA
| | - Amro Taha
- Department of Medicine, Weiss Memorial Hospital, Chicago, Illinois, USA
| | - Sanchit Duhan
- Department of Cardiology, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Neel Patel
- Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
| | - Karthik Gonuguntla
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Dipesh Ludhwani
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Harshith Thyagaturu
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Bijeta Keisham
- Department of Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Ayesha Shaik
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut, USA
| | - Anas Alharbi
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Yasar Sattar
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK
| | - Utkarsh Kohli
- Department of Paediatric Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Sudarshan Balla
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
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Hamilton BCS, Eagle KA. Winning the battle but losing the war: increased population-based mortality from aortic dissection. Heart 2024; 110:307-308. [PMID: 37918899 DOI: 10.1136/heartjnl-2023-323302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Affiliation(s)
| | - Kim A Eagle
- Internal Medicine, Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USA
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Sainbayar E, Pham HN, Beauti W, Shahid M, Hickerson N, Hassan K, Salih M, Ibrahim R, Mamas MA. Regional Disparities and Death Trends Related to Hemopericardial Cardiovascular Mortality. Am J Cardiol 2024; 210:8-10. [PMID: 37898157 DOI: 10.1016/j.amjcard.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/30/2023]
Affiliation(s)
| | - Hoang Nhat Pham
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Wisam Beauti
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mahek Shahid
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Natalie Hickerson
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Kamal Hassan
- New York Presbyterian-Weill Cornell Medical Center, New York, New York
| | - Mohammed Salih
- Department of Cardiovascular Medicine, The Heart Hospital-Baylor University Medical Center, Plano, Texas
| | - Ramzi Ibrahim
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona.
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, United Kingdom
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Sainbayar E, Ibrahim R, Pham HN, Beauti W, Shahid M, Hickerson N, Salih M, Ferreira JP, Mamas MA. Social Vulnerability and Hemopericardial Cardiovascular Death: Insight from the Centers for Disease Control and Prevention Databases. Am J Cardiol 2024; 210:143-145. [PMID: 37844718 DOI: 10.1016/j.amjcard.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Affiliation(s)
| | - Ramzi Ibrahim
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona.
| | - Hoang Nhat Pham
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Wisam Beauti
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mahek Shahid
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Natalie Hickerson
- Department of Medicine, University of Arizona Tucson, Tucson, Arizona
| | - Mohammed Salih
- Department of Cardiovascular Medicine, The Heart Hospital-Baylor University Medical Center, Plano, Texas
| | | | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, United Kingdom
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Chobufo MD, Atti V, Vasudevan A, Bhandari R, Badhwar V, Baddour LM, Balla S. Trends in Infective Endocarditis Mortality in the United States: 1999 to 2020: A Cause for Alarm. J Am Heart Assoc 2023; 12:e031589. [PMID: 38088249 PMCID: PMC10863783 DOI: 10.1161/jaha.123.031589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/04/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Data on national trends in mortality due to infective endocarditis (IE) in the United States are limited. METHODS AND RESULTS Utilizing the multiple causes of death data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database from 1999 to 2020, IE and substance use were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. Between 1999 and 2020, the IE-related age-adjusted mortality rates declined. IE-related crude mortality accelerated significantly in the age groups 25-34 years (average annual percentage change, 5.4 [95% CI, 3.1-7.7]; P<0.001) and 35-44 years (average annual percentage change, 2.3 [95% CI, 1.3-3.3]; P<0.001), but remained stagnant in those aged 45-54 years (average annual percentage change, 0.5 [95% CI, -1.9 to 3]; P=0.684), and showed a significant decline in those aged ≥55 years. A concomitant substance use disorder as multiple causes of death in those with IE increased drastically in the 25-44 years age group (P<0.001). The states of Kentucky, Tennessee, and West Virginia showed an acceleration in age-adjusted mortality rates in contrast to other states, where there was predominantly a decline or static trend for IE. CONCLUSIONS Age-adjusted mortality rates due to IE in the overall population have declined. The marked acceleration in mortality in the 25- to 44-year age group is a cause for alarm. Regional differences with acceleration in IE mortality rates were noted in Kentucky, Tennessee, and West Virginia. We speculate that this acceleration was likely due mainly to the opioid crisis that has engulfed several states and involved principally younger adults.
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Affiliation(s)
- Muchi Ditah Chobufo
- Division of CardiologyWest Virginia University Heart & Vascular InstituteMorgantownWVUSA
| | - Varunsiri Atti
- Division of CardiologyWest Virginia University Heart & Vascular InstituteMorgantownWVUSA
| | | | - Ruchi Bhandari
- Department of Epidemiology and Biostatistics, School of Public HealthWest Virginia UniversityMorgantownWVUSA
| | - Vinay Badhwar
- Department of Cardiothoracic SurgeryWest Virginia University Heart & Vascular InstituteMorgantownWVUSA
| | - Larry M. Baddour
- Division of Infectious Diseases, Department of Internal Medicine, Mayo ClinicRochesterMNUSA
| | - Sudarshan Balla
- Division of CardiologyWest Virginia University Heart & Vascular InstituteMorgantownWVUSA
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Yan M. State-level disparities in burden of ischemic heart diseases mortality attributable to ambient fine particulate matter in the United States, 1990-2019: Observational analysis for the Global Burden of Disease (2019) study. CHEMOSPHERE 2023; 311:137033. [PMID: 36349585 DOI: 10.1016/j.chemosphere.2022.137033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND ambient fine particulate air pollution (PM2.5) is an important yet often overlooked risk factor for cardiovascular disease in the United States. However, epidemiologic evidence suggests that current knowledge does not comprehensively capture state-level disparities in mortality for ambient PM2.5-related ischemic heart diseases. METHODS I performed serial cross sectional analysis with ambient PM2.5-attributable ischemic heart diseases decedents between 1990 and 2019. I used the Global Health Data Exchange to extract age adjusted mortality rates in each state, and used Joinpoint software to calculate average annual percentage change. RESULTS the average age adjusted mortality rates (AAMR) for ischemic heart diseases attributable to ambient PM2.5 for both sex ranged from 1.5 (1.3-1.8) per 100,000 in Hawaii to 1.1 (0.9-1.3) per 100,000 in Mississippi, respectively. The rate of change in AAMR varied widely across states. Compared with the national level, the number of states with smaller decline has increased from 3 before 2002 to 10 after 2011. Oregon, Idaho, and Montana showed an upward trend in AAMR, which was independent of sex after 2011. Between 1990 and 2019, average AAMR for ischemic heart diseases attributable to ambient PM2.5 was higher for male than female in all states. But the number of states with sex disparities in the rate of change has decreased, from 13 in 1990-2002 to 5 after 2011. CONCLUSIONS wide state-level disparities exist in burden of ischemic heart diseases attributable to ambient PM2.5. After 2011, the association between rate of AAMR decline and sex weakened across states. State-level policies and programs are needed to address the avoidable burden of ischemic heart diseases deaths attributable to ambient particulate pollution, with priority for states with a higher burden.
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Affiliation(s)
- Mengmeng Yan
- Urban Vocational College of Sichuan, Chengdu, China; University of Electronic Science and Technology of China, Chengdu, China; Sichuan Cancer Hospital & Institute, Chengdu, China.
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Van Iterson EH, Laffin LJ, Svensson LG, Cho L. Individualized exercise prescription and cardiac rehabilitation following a spontaneous coronary artery dissection or aortic dissection. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac075. [PMID: 36518261 PMCID: PMC9741551 DOI: 10.1093/ehjopen/oeac075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/19/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Aims Prescribed aerobic-based exercise training is a low-risk fundamental component of cardiac rehabilitation (CR). Secondary prevention therapeutic strategies following a spontaneous coronary artery dissection (SCAD) or aortic dissection (AD) should include CR. Current exercise guidance for post-dissection patients recommends fundamental training components including target heart rate zones are not warranted. Omitting fundamental elements from exercise prescriptions risks safety and makes it challenging for both clinicians and patients to understand and implement recommendations in real-world practice. We review the principles of exercise prescription for CR, focusing on translating guidelines and evidence from well-studied high-risk CR populations to support the recommendation that exercise testing and individualized exercise prescription are important for patients following a dissection. Methods and results When patients self-perceive exercise intensity there is a tendency to underestimate intensities within metabolic domains that should be strictly avoided during routine exercise training following a dissection. However, exercise testing associated with CR enrolment has gained support and has not been linked to adverse events in optimally medicated post-dissection patients. Graded heart rate and blood pressure responses recorded throughout exercise testing provide key information for developing an exercise prescription. An exercise prescription that is reflective of medical history, medications, and cardiorespiratory fitness optimizes patient safety and yields improvements in blood pressure control and cardiorespiratory fitness, among other benefits. Conclusion This clinical practice and education article demonstrates how to develop and manage a CR exercise prescription for post-acute dissection patients that can be safe and effective for maintaining blood pressure control and improving cardiorespiratory fitness pre-post CR.
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Affiliation(s)
- Erik H Van Iterson
- Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195, USA
| | - Luke J Laffin
- Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195, USA
| | - Lars G Svensson
- Department of Thoracic and Cardiovascular Surgery, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., Desk J4-1, Cleveland, OH 44195, USA
| | - Leslie Cho
- Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195, USA
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