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Jaiswal V, Sawhney A, Nebuwa C, Borra V, Deb N, Halder A, Rajak K, Jha M, Wajid Z, Thachil R, Bandyopadhyay D, Mattumpuram J, Lavie CJ. Association between testosterone replacement therapy and cardiovascular outcomes: A meta-analysis of 30 randomized controlled trials. Prog Cardiovasc Dis 2024:S0033-0620(24)00055-0. [PMID: 38589271 DOI: 10.1016/j.pcad.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The Cardiovascular safety of testosterone replacement therapy (TRT) among men with hypogonadism is not well established to date. Hence, we sought to evaluate the cardiovascular disease (CVD) outcomes among patients receiving testosterone therapy by using all recently published randomized controlled trials. METHODS We performed a systematic literature search on PubMed, EMBASE, and Clinicaltrial.gov for relevant randomized controlled trials (RCTs) from inception until September 30th, 2023. RESULTS A total of 30 randomized trials with 11,502 patients were included in the final analysis. The mean age was ranging from 61.61 to 61.82 years. Pooled analysis of primary and secondary outcomes showed that the incidence of any CVD events (OR, 1.12 (95%CI: 0.77-1.62), P = 0.55), stroke (OR, 1.01 (95%CI: 0.68-1.51), P = 0.94), myocardial infarction (OR, 1.05 (95%CI: 0.76-1.45), P = 0.77), all-cause mortality (OR, 0.94 (95%CI: 0.76-1.17), P = 0.57), and CVD mortality (OR, 0.87 (95%CI: 0.65-1.15), P = 0.31) was comparable between TRT and placebo groups. CONCLUSION Our analysis indicates that for patients with hypogonadism, testosterone replacement therapy does not increase the CVD risk and all-cause mortality.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA.
| | - Aanchal Sawhney
- Department of Internal Medicine, Crozer Chester Medical Center, Upland, PA, USA
| | - Chikodili Nebuwa
- Department of Internal Medicine, Nuvance Health, Poughkeepsie, NY, USA
| | - Vamsikalyan Borra
- Department of Internal Medicine, University of Texas Rio Grande Valley, Weslaco, TX, USA
| | - Novonil Deb
- North Bengal Medical College and Hospital, India
| | - Anupam Halder
- Department of Internal Medicine, UPMC, Harrisburg, PA, USA
| | - Kripa Rajak
- Department of Internal Medicine, UPMC, Harrisburg, PA, USA
| | - Mayank Jha
- Department of Medicine, Government Medical College, Surat, India
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, USA
| | - Rosy Thachil
- Division of Cardiology, Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, USA
| | | | - Jishanth Mattumpuram
- Division of Cardiology, University of Louisville School of Medicine, KY 40202, United States
| | - Carl J Lavie
- Department of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA.
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Jaiswal V, Roy P, Ang SP, Shama N, Deb N, Taha AM, Rajak K, Sharma A, Halder A, Wajid Z, Agrawal V, Khela H, Biswas M. Association between rheumatoid arthritis and atrial fibrillation: A systematic review and meta-analysis. J Arrhythm 2024; 40:203-213. [PMID: 38586849 PMCID: PMC10995606 DOI: 10.1002/joa3.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 04/09/2024] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF). We aim to evaluate the association between RA and AF, and other clinical outcomes. We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until September 10, 2023. Primary clinical outcomes were AF. Secondary outcomes were acute coronary syndrome (ACS), stroke, and all-cause mortality (ACM). A total of 4 679 930 patients were included in the analysis, with 81 677 patients in the RA group and 4 493 993 patients in the nonrheumatoid arthritis (NRA) group. The mean age of the patients was 57.2 years. Pooled analysis of primary outcomes shows that RA groups of patients had a significantly higher risk of AF (odds ratios [OR], 1.53; 95% confidence interval [CI]: [1.16-2.03], p < .001) compared with NRA groups. Secondary Outcomes show that the RA group of patients had significantly higher odds of ACS (OR, 1.39; 95% CI: [1.26-1.52], p < .001), and ACM (OR, 1.19; 95% CI: [1.03-1.37], p = .02) compared with the NRA groups. However, the likelihood of stroke (OR, 1.02; 95% CI: [0.94-1.11], p = .61) was comparable between both groups of patients. Our study shows that RA groups of patients are at increased risk of having AF, ACS, and ACM.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular ResearchLarkin Community HospitalSouth MiamiFloridaUSA
| | - Poulami Roy
- Department of Internal MedicineNorth Bengal Medical College and HospitalSiliguriIndia
| | - Song Peng Ang
- Department of Internal MedicineRutgers Health/Community Medical CenterToms RiverNew JerseyUSA
| | - Nishat Shama
- Department of Internal MedicineBangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic DisordersDhakaBangladesh
| | - Novonil Deb
- Department of Internal MedicineNorth Bengal Medical College and HospitalSiliguriIndia
| | | | - Kripa Rajak
- Department of Internal MedicineUPMC HarrisburgHarrisburgPennsylvaniaUSA
| | - Akanksha Sharma
- Department of Internal MedicineUPMC MercyPittsburghPennsylvaniaUSA
| | - Anupam Halder
- Department of Internal MedicineUPMC HarrisburgHarrisburgPennsylvaniaUSA
| | - Zarghoona Wajid
- Department of Internal Medicine, School of MedicineWayne State UniversityDetroitMichiganUSA
| | - Vibhor Agrawal
- Department of MedicineKing George's Medical UniversityLucknowIndia
| | - Harpriya Khela
- Department of MedicineRoyal College of Surgeons in IrelandDublinIreland
| | - Monodeep Biswas
- Department of ElectrophysiologyUniversity of MarylandBaltimoreMarylandUSA
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Jaiswal V, Ang SP, Deb N, Hanif M, Batra N, Kanagala SG, Vojjala N, Rajak K, Roy P, Sharath M, Waleed MS, Wajid Z, Mattumpuram J. Association between Statin Use and Chemotherapy-Induced Cardiotoxicity: A Meta-Analysis. Medicina (Kaunas) 2024; 60:580. [PMID: 38674227 PMCID: PMC11052115 DOI: 10.3390/medicina60040580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024]
Abstract
Background: Chemotherapy-induced cardiac dysfunction (CIC) is a significant and concerning complication observed among cancer patients. Despite the demonstrated cardioprotective benefits of statins in various cardiovascular diseases, their effectiveness in mitigating CIC remains uncertain. Objective: This meta-analysis aims to comprehensively evaluate the potential cardioprotective role of statins in patients with CIC. Methods: A systematic literature search was conducted using PubMed, Embase, and Scopus databases to identify relevant articles published from inception until 10th May 2023. The outcomes were assessed using pooled odds ratio (OR) for categorical data and mean difference (MD) for continuous data, with corresponding 95% confidence intervals (95% CIs). Results: This meta-analysis comprised nine studies involving a total of 5532 patients, with 1904 in the statin group and 3628 in the non-statin group. The pooled analysis of primary outcome shows that patients who did not receive statin suffer a greater decline in the LVEF after chemotherapy compared to those who receive statin (MD, 3.55 (95% CI: 1.04-6.05), p = 0.01). Likewise, we observed a significantly higher final mean LVEF among chemotherapy patients with statin compared to the non-statin group of patients (MD, 2.08 (95% CI: 0.86-3.30), p > 0.001). Additionally, there was a lower risk of incident heart failure in the statin group compared to the non-statin group of patients (OR, 0.41 (95% CI: 0.27-0.62), p < 0.001). Lastly, the change in the mean difference for LVEDV was not statistically significant between the statin and non-statin groups (MD, 1.55 (95% CI: -5.22-8.33), p = 0.65). Conclusion: Among patients of CIC, statin use has shown cardioprotective benefits by improving left ventricular function and reducing the risk of heart failure.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL 33143, USA
| | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health/Community Medical Center, Toms River, NJ 08755, USA
| | - Novonil Deb
- North Bengal Medical College and Hospital, Darjeeling 734012, West Bengal, India
| | - Muhammad Hanif
- Department of Internal Medicine, SUNY Upstate Medical University, 750 E Adams St., Syracuse, NY 13210, USA
| | - Nitya Batra
- Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI 48073, USA
| | - Sai Gautham Kanagala
- Department of Internal Medicine, Metropolitan Hospital Center, New York, NY 10029, USA
| | - Nikhil Vojjala
- Internal Medicine Department, Trinity Health Oakland/Wayne State University, Detroit, MI 48341, USA
| | - Kripa Rajak
- Department of Internal Medicine, UPMC Harrisburgh, 111 S Front St., Harrisburg, PA 17101, USA
| | - Poulami Roy
- North Bengal Medical College and Hospital, Darjeeling 734012, West Bengal, India
| | - Medha Sharath
- Bangalore Medical College and Research Institute, Kalasipalya, Bengaluru 560002, Karnataka, India
| | - Madeeha Subhan Waleed
- Department of Internal Medicine, Lower Bucks Hospital, Bristo, 501 Bath Rd., Bristol, PA 19007, USA
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, 540 E. Canfield Ave., Detroit, MI 48201, USA
| | - Jishanth Mattumpuram
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
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Jaiswal V, Wajid Z, Suresh V, Hanif M, Rajak K, Halder A, Endurance E, Aiwuyo H, Choudhari J, Naz S, Ang SP, Shrestha AB. Procedural safety of transcatheter aortic valve replacement with Portico valve: a systematic review. Int J Surg 2023; 109:3602-3608. [PMID: 37581642 PMCID: PMC10651300 DOI: 10.1097/js9.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/16/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The Portico transcatheter aortic heart valve is a self-expandable, fully resheathable bioprosthetic valve with a nitinol frame and porcine pericardial sealing cuff. It has been used among symptomatic severe aortic stenosis (AS) who are at high or extreme surgical risk. However, till date very few studies has been reported with inconclusive evidence for its postprocedure safety outcomes. OBJECTIVE The authors aim to evaluate the safety of the Portico transcatheter aortic valve replacement system among patients with AS. METHODOLOGY The authors conducted a systematic literature search on PubMed, Embase, and Scopus from inception till 10th April 2023 by using predefined MESH terms using 'AND' and 'OR'. The following search terms were used: 'Aortic Stenosis' AND 'Transcatheter aortic valve replacement' OR 'Portico valve'. Finally, descriptive statistics were used to summarize the data in this paper. The mean and SD were adopted to describe continuous variables, whereas frequencies and percentages were used for dichotomous data. RESULTS A total of 7 studies with 2782 patients were included in the analysis. The mean age of patients was 82.3 years, and 54.63% were female. The most common comorbidity was hypertension (65.21%) and diabetes mellitus (26.45%). Among patients of AS with Portico valve implants, postprocedural outcomes including 30-day mortality (2.32%), cardiovascular mortality (2.37%), stroke (2.23%), myocardial infarction (0.94%), major bleeding (3.97%), major vascular complications (4.91%), acute kidney injury (1.37%), and permanent pacemaker implantations in 15.73% patients were reported. Overall, device success was observed in 95.82% of patients. CONCLUSION Transcatheter aortic valve replacement with the repositionable Portico valve, a new bioprosthesis, appears to have a low postprocedural mortality rate and other clinical outcomes in high-risk patients with severe AS.
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Affiliation(s)
- Vikash Jaiswal
- Division of Cardiovascular Research, Larkin Community Hospital, South Miami, Florida
- JCCR Cardiology Research, Varanasi, India
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, Michigan
| | - Vinay Suresh
- Department of Medicine, King George’s Medical University, Lucknow
| | - Muhammed Hanif
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Kripa Rajak
- Department of Internal Medicine, UPMC Harrisburg, Pennsylvania
| | - Anupam Halder
- Department of Internal Medicine, UPMC Harrisburg, Pennsylvania
| | | | - Henry Aiwuyo
- Internal Medicine Department, St. Luke’s Hospital, St. Louis, Missouri
| | - Jinal Choudhari
- Division of Cardiovascular Research, Larkin Community Hospital, South Miami, Florida
| | - Sidra Naz
- The University of Texas, MD Anderson Cancer Center, Texas
| | - Song P. Ang
- Department of Medicine, Bangalore Medical College and Research Institute, Karnataka
| | - Abhigan B. Shrestha
- Department of Internal Medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh
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Jaiswal A, Jaiswal V, Ang SP, Hanif M, Vadhera A, Agrawal V, Kumar T, Nair AM, Borra V, Garimella V, Ishak A, Wajid Z, Song D, Attia AM, Huang H, Aguilera Alvarez VH, Shrestha AB, Biswas M. SGLT2 inhibitors among patients with heart failure with preserved ejection fraction: A meta-analysis of randomised controlled trials. Medicine (Baltimore) 2023; 102:e34693. [PMID: 37773799 PMCID: PMC10545009 DOI: 10.1097/md.0000000000034693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been recommended in the practice guidelines for the treatment of patients with heart failure with reduced ejection fraction; however, their effects among patients with preserved ejection fraction have been debatable. OBJECTIVE We aim to evaluate the SGLT2 inhibitor effect among patients with heart failure with reduced ejection fraction, including DELIVER and EMPEROR-Preserved trials. METHODS We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 30th, 2022. Statistical analysis was performed by calculating hazard ratio (HR) using the random effect model with a 95% confidence interval (CI) and probability value (P). Statistical significance was met if 95% CI does not cross numeric "1" and P < .05. RESULTS Six studies with a total of 15,989 total patients were included in the final analysis. The mean age of patients enrolled in SGLT2 inhibitors and placebo was 69.13 and 69.37 years, respectively. The median follow-up duration was 2.24 years. SGLT2 inhibitors reduced composite cardiovascular mortality or first hospitalization for heart failure (HR, 0.80 [95% CI: 0.74-0.87], P < .001, I2 = 0%), heart failure hospitalization (HR, 0.74 [95% CI: 0.67-0.82], P < .001, I2 = 0%) compared with placebo. However, all-cause mortality (HR, 0.97 [95% CI: 0.89-1.06], P = .54, I2 = 0%) and cardiovascular mortality (HR, 0.96 [95% CI: 0.82-1.13), P = .66, I2 = 35.09%] were comparable between both groups. CONCLUSION Our study finding shows that SGLT2 inhibitors significantly reduced the risk of first HF hospitalization or cardiovascular death and HF hospitalization; however, all-cause mortality was comparable between the groups.
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Affiliation(s)
- Akash Jaiswal
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL
| | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health/Community Medical Center, NJ
| | - Muhammad Hanif
- Department of Internal Medicine, SUNY Upstate Medical University
| | | | | | - Tushar Kumar
- Department of Radiology, Sikkim Manipal Institute of Medical Science, Sikkim, India
| | | | | | | | - Angela Ishak
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, MI
| | - David Song
- Department of Internal Medicine, Ichan School of Medicine at Mount Sinai, NY
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland
| | | | | | - Monodeep Biswas
- Division of Cardiology, The University of Maryland, Baltimore, MD
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Jaiswal V, Ang SP, Shrestha AB, Wajid Z, Endurance EO, Ayoobkhan FS, Khan S, Garimellla V, Huang H, Ghanim M, Song D, Sharma P, Alraies MC, Biswas M. Amplatzer amulet versus watchman device for percutaneous left atrial appendage closure: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34185. [PMID: 37390240 PMCID: PMC10313297 DOI: 10.1097/md.0000000000034185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The Amplatzer Amulet (AA) and Watchman devices (WD) are the 2 most frequently used devices for percutaneous LAA closure globally. OBJECTIVE To evaluate the safety and clinical outcomes associated with these 2 devices in patients undergoing percutaneous LAA closure. METHOD We systematically searched all electronic databases from inception until February 21, 2023. The primary endpoint was procedure related complications. Secondary endpoints were device related thrombus, stroke, cardiovascular mortality, peri device leak, systemic embolism, and all-cause mortality. RESULTS A total of 3 randomized clinical trials with 2150 patients were included in this meta-analysis. The mean age was 75 and 76 years in the Amplatzer group and in the Watchman group, respectively. The odds of procedure-related complications (OR, 1.80 [95% CI: 1.21-2.67], P < .001) were significantly higher among patients with AA compared to the WD. However, the odds of all-cause mortality (OR, 0.75 (95% CI: 0.49-1.16), P = .20), stroke (OR, 0.79 [95% CI: 0.47-1.34], P = .39), systemic/pulmonary embolism (OR, 1.34 [95% CI: 0.30-6.04], P = .70), and major bleeding (OR, 1.10 [95% CI: 0.83-1.48], P = .50) were comparable between the two devices. The odds of device related thrombus (OR, 0.72 [95% CI: 0.46-1.14], P = .17) was comparable between both the group of patients, however the incidence of peri device leak was significantly lower in AA group (OR, 0.41 [95% CI: 0.26-0.66], P < .001) compared with WD group of patients. CONCLUSION The AA was not superior to the Watchman device in terms of safety and efficacy. However, the Amulet occluder was associated with a higher incidence of procedure-related complications, and lower peri device leak.
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Affiliation(s)
- Vikash Jaiswal
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL
| | - Song Peng Ang
- Division of Internal Medicine, Rutgers Health/Community Medical Center, NJ
| | | | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI
| | | | | | - Shazia Khan
- Department of Medicine, Shadan Institute of Medical Science, India
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland
| | | | - David Song
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai Elmhurst Hospital Center, Queens, NY
| | - Prachi Sharma
- Division of Cardiology, Department of Internal Medicine, King George’s Medical University, India
| | | | - Monodeep Biswas
- Division of Cardiac Electrophysiology, University of Maryland Medical Center, Baltimore, MD
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Jaiswal V, Hanif M, Ang SP, Mehta A, Ishak A, Song D, Daneshvar F, Butey S, Gera A, Aujla S, Raj N, Iqbal A, Kumar V, Huang H, Mukherjee D, Jaiswal A, Wajid Z. Racial Disparity Among the Clinical Outcomes Post-Myocardial Infarction Patients: A Systematic Review and Meta-analysis. Curr Probl Cardiol 2023; 48:101528. [PMID: 36481389 DOI: 10.1016/j.cpcardiol.2022.101528] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
The clinical outcomes post-Myocardial Infarction (MI) between Black and White patients have not been well studied, with limited literature available. We conducted a meta-analysis to estimate the clinical outcomes between Black and White patients post-MI.We systematically searched the PubMed, Embase, and Scopus databases from inception until September 26, 2022. A total of 6 studies with 220,984 patients have been included in the analysis. The mean age of patients with White and Black race was 68.46 and 65.14 years, respectively. The most common comorbidity among White and Black patients was hypertension (53% vs 87.73%). Our analysis showed that the likelihood of all-cause mortality (OR, 0.71[95%CI: 0.56-0.91]), P=0.01] and stroke (OR, 0.74[95%CI: 0.67-0.81]), P<0.001] were significantly lower in white patients compared with black patients. However, Black patients had fewer utilization of CABG (OR, 1.38[95%CI: 1.19-1.62], P<0.001]) and PCI (OR, 1.31[95%CI: 1.101-1.68]), P=0.04] compared with White patients, while 30-day mortality was comparable between both the groups. To our knowledge, this is the first meta-analysis with the largest sample size thus far, highlighting that Black patients are at increased risk for all-cause mortality and stroke but have lower utilization of revascularization among MI patients than White patients.
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Affiliation(s)
| | - Muhammad Hanif
- Department of Internal Medicine, SUNY Upstate Medical University, NY
| | - Song Peng Ang
- Department of Internal medicine, Rutgers Health/Community Medical Center, NJ
| | - Aashna Mehta
- University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | | | - David Song
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, NY
| | | | - Swatika Butey
- Department of Medicine, Indira Gandhi Government Medical College, Nagpur, India
| | | | - Savvy Aujla
- Department of Medicine, Government Medical College, Amritsar, Punjab, India
| | | | - Abbas Iqbal
- Saidu Group of Teaching Hospital Swat, Dublin, Ireland
| | - Vikash Kumar
- Department of Medicine, The Brooklyn Hospital Center, NY
| | - Helen Huang
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, MI
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Song D, Jaiswal V, Jaiswal A, Wajid Z, Mehta A, Joshi A, Ang SP, Saleeb M, Shabani J, Sidhu J, Gonzalez A, Rubinstein DD. RACIAL DISPARITY AMONG THE CLINICAL OUTCOMES POST MYOCARDIAL INFARCTION PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01586-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Jaiswal VIKASH, Ang SONGP, Hameed MAHA, Momi NK, Shah MAITRI, Kanakannavar SS, Rajak KRIPA, Kalra KRITI, Chia JIAEE, Wajid Z, Roy S, Agrawal VIBHOR, Sharma PRACHI, Jaiswal AKASH. Association between non-alcoholic fatty liver disease and incidence of arrhythmia and other cardiovascular outcomes: a systematic review and meta-analysis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The association between non-alcoholic fatty liver disease (NAFLD) with cardiovascular and cerebrovascular outcomes, as well as their clinical impact, has yet to be established in the literature.
Objective
We aim to evaluate the association between NAFLD patients and the risk of atrial fibrillation (AF), heart failure (HF),stroke, cardiovascular mortality (CVM), and peripheral revascularization.
Method
We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until July 20th, 2022. Odds ratios (OR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant.
Results
A total of 10 studies with 17886340 patients (2887214 NAFLD vs 14999126 non-NAFLD) were included in our analysis. The average age and percentage of males were comparable between groups, with a mean age of 55 years and 72.5% of males in the NAFLD group, whereas 52 years and 47.4% of males in the non-NAFLD group. The most common comorbidities among the NAFLD group included: hypertension (38% vs 24%), diabetes mellitus (14% vs 8%). The mean follow-up duration was 6.26 years. The likelihood of atrial fibrillation [OR, 1.42(95%CI: 1.18-1.70), P<0.001], heart failure [OR, 1.48(95%CI: 1.27-1.73), P<0.001], stroke (OR, 1.26(95%CI: 1.17-1.36), P<0.001], and peripheral revascularization (OR, 3.95(95%CI: 1.60-9.73), P=0.003] was significantly higher in NAFLD patients when compared with non-NAFLD patients. In contrast, cardiovascular mortality was comparable between both the groups of patients [OR, 3.11(95%CI: 0.32-30.03), P=0.33] respectively.
Conclusion
Patients with NAFLD demonstrated increased incidence of cardiovascular and/or cerebrovascular outcomes; heart failure, stroke, and arrhythmia. Patients with associated comorbidities were at higher risk of cardiovascular disease, implying a greater need for screening and adoption of cardio-protective measures amongst NAFLD patients.
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Affiliation(s)
| | - S O N G P Ang
- Rutgers Health/community medical center, Internal Medicine , New Jersey , United States of America
| | - M A H A Hameed
- Larkin Community Hospital , Miami , United States of America
| | - N K Momi
- Christian medical college and hospital , Ludhiana , India
| | | | | | - K R I P A Rajak
- UPMC, Internal Medicine , Harrisburg , United States of America
| | - K R I T I Kalra
- Medstar Washington Hospital Cenetr , Washington, D.C , United States of America
| | - J I A E E Chia
- Larkin Community Hospital , Miami , United States of America
| | - Z Wajid
- Wayne State University School of Medicine, Internal Medicine , Detroit, Michigan , United States of America
| | - S Roy
- King George's Medical University , Lucknow , India
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Jaiswal V, Peng Ang S, Hanif M, Savaliya M, Vadhera A, Raj N, Gera A, Aujla S, Daneshvar F, Ishak A, Subhan Waleed M, Hugo Aguilera-Alvarez V, Naz S, Hameed M, Wajid Z. The racial disparity among post transcatheter aortic valve replacement outcomes: A meta-analysis. Int J Cardiol Heart Vasc 2023; 44:101170. [PMID: 36660201 PMCID: PMC9843207 DOI: 10.1016/j.ijcha.2023.101170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/17/2022] [Accepted: 01/01/2023] [Indexed: 01/13/2023]
Abstract
Background Racial disparities have been well described in cardiovascular disease. However, the impact of race on the outcomes post - Transcatheter aortic valve replacement (TAVR) remains unknown. Objective We aim to evaluate the disparity among the race (black and white) post - TAVR. Methods We systematically searched all electronic databases from inception until September 26, 2022. The primary outcome was in-hospital all-cause mortality, and secondary outcomes was myocardial infarction (MI), acute kidney injury (AKI), permanent pacemaker implantation (PPI) or ICD, stroke, vascular complications, and major bleeding. Results A total of three studies with 1,02,009 patients were included in the final analysis. The mean age of patients with white and black patients was 82.65 and 80.45 years, respectively. The likelihood of in-hospital all-cause mortality (OR, 1.01(95 %CI: 0.86-1.19), P = 0.93), stroke (OR, 0.83(95 %CI:0.61-1.13), P = 0.23, I2 = 46.57 %], major bleeding [OR, 1.05(95 %CI:0.92-1.20), P = 0.46), and vascular complications [OR, 0.92(95 %CI:0.81-1.06), P = 0.26), was comparable between white and black patients. However, patients with white race have lower odds of MI (OR, 0.65(95 %CI:0.50-0.84), P < 0.001), and AKI (OR, 0.84(95 %CI:0.74-0.95), P = 0.01) and higher odds of PPI or ICD (OR, 1.16(95 %CI: 1.06-1.27), P < 0.001, I2 = 0 %) compared with black race patients. Conclusion Our findings suggest disparity post - TAVR outcomes existed, and black patients are at higher risk of MI and AKI than white patients.Key Clinical Message:•What is already known on this topic: Disparity has been witnessed among patients with cardiovascular disease. However, no studies have drawn a significant association among post-TAVR patients' outcomes•What this study adds: Among patients who underwent TAVR, there is a difference in the adverse outcomes between black and white race patients. White patients have a lower risk of post-procedure MI and AKI compared with Black patients.•How this study might affect research, practice, or policy: These disparities need to be addressed, and proper guidelines need to be made along with engaging patients with better medical infrastructure and treatment options..
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Affiliation(s)
- Vikash Jaiswal
- JCCR Cardiology, Varanasi, India
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
- Corresponding author at: JCCR Cardiology, Varanasi, India.
| | - Song Peng Ang
- Division of Internal Medicine, Rutgers Health/Community Medical Center, NJ, USA
| | - Muhammad Hanif
- Department of Internal Medicine, SUNY Upstate Medical University, USA
| | - Mittal Savaliya
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | - Ananya Vadhera
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Nishchita Raj
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | - Asmita Gera
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | - Savvy Aujla
- Department of Medicine, Government Medical College Amritsar, Punjab, India
| | | | - Angela Ishak
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | - Madeeha Subhan Waleed
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | | | - Sidra Naz
- The University of Texas, MD Anderson Cancer Center, Texas, USA
| | - Maha Hameed
- Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USA
| | - Zarghoona Wajid
- Department of Internal Medicine, Wayne State University School of Medicine, USA
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Javaeed A, Shahid M, Khan SS, Ghauri SK, Khan SH, Wajid Z. Knowledge, attitudes, and practices related to diabetes mellitus among diabetic patients with complications in Rawalakot, Azad Kashmir. J PAK MED ASSOC 2021; 70:667-673. [PMID: 32296212 DOI: 10.5455/jpma.9502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the knowledge, attitudes and practices of type 2 diabetes mellitus patients. METHODS The cross-sectonal study was conducted at Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawalakot, Azad Kashmir, from March 26 to September 25, 2017, and comprised patients of type 2 diabetes mellitus who were enrolled using convenience sampling. Each participant completed a self-administered 35-item questionnaire. Data was analysed using SPSS 23 to determine the correlations among variables. RESULTS Of the 116 patients, 74(63.8%) were females, and the largest group 58(50%) was aged 51-70 years. Of the total, 111(95.6%) had heard about type 2 diabetes mellitus, 112(96.6%) had sought treatment after diagnosis, and 115(99.1%) had blood sugar tested within the preceding year. There was a positive correlation between knowledge and attitude (p=0.005), knowledge and practice (p<0.001), and attitude and practice (p<0.001). Knowledge, attitude and practice improved with increase in education (p>0.05). CONCLUSIONS The subjects had fair knowledge and good attitude toward type 2 diabetes mellitus, and they appeared willing to improve diabetic control. However, diabetes-related practice was found to be poor.
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Affiliation(s)
- Arslaan Javaeed
- Department of Pathology, Poonch Medical College, Azad Kashmir, Pakistan
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Abstract
Objective To determine the frequency of people at risk of developing diabetes mellitus type 2 (DMT2) and their risk of developing the disease over the next five years, using the Australian type 2 diabetes risk assessment (AUSDRISK) tool. Methods A cross-sectional study was done involving 152 adults; both males and females were randomly selected from city populations in Rawalakot and Muzaffarabad of the Azad Kashmir, irrespective of weight, family history and dietary habits. Patients with the apparent clinical features of DMT2 were excluded from the study. Data were collected over a nine-month period from April 2017 using an interviewer-administered questionnaire based on the AUSDRISK tool. Results Statistical analysis was done using SPSS version 23.0 (IBM, Armonk, NY, USA). Descriptive statistics were used to calculate the frequencies and percentages. Fifty-four (35.5%) participants had a low risk, 88 (57.9%) had an intermediate risk, and 10 (6.6%) had a high risk of developing DMT2 over the next five years. Conclusion Most of the city occupants had an intermediate-to-high risk of developing DMT2 (64.5%) over the next five years.
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Affiliation(s)
| | | | - Saima Sadiq
- Pathology, Poonch Medical College, Rawalakot, PAK
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