Cardiovascular Diseases Commons^™

The Importance Of Serial 12-Lead Ecgs In The Prehospital Setting: A Case Of Transient St Elevation Myocardial Infarction (Tstemi), Zachary J. Blickley Nrp, Fp-C, Matthew E. Kent Nrp, Fp-C, Benjamin J. Lawner Do, Emt-P

Tower Health Research Day

No abstract provided.

Cardiotoxicity Induced By Capecitabine And Oxaliplatin In Gastric Cancer Treatment: A Rare Case Of Cardiac Arrest And Cardiogenic Shock., Muhammad Umer Riaz Gondal, Jared Segal, John Lemoine, Zainab Kiyani, Devi Parvathy Jyothi Ramachandran Nair, Brian Mccauley

Tower Health Research Day

No abstract provided.

Effect Of Perioperative Stroke On Survival After Carotid Intervention, Tommaso Cambiaghi, Alexander Mills, Samuel Leonard, Regina Husman, Syed T Zaidi, Ezra Y Koh, Kourosh Keyhani, S Keisin Wang

Journal Articles

OBJECTIVES: Perioperative stroke is the most dreaded complication of carotid artery interventions and can severely affect patients' quality of life. This study evaluated the impact of this event on mortality for patients undergoing interventional treatment of carotid artery stenosis with three different modalities.

METHODS: Patients undergoing carotid revascularization at participating Memorial Hermann Health System facilities were captured from 2003-2022. These patients were treated with either carotid endarterectomy (CEA), transfemoral carotid stenting (TF-CAS), or transcarotid artery revascularization (TCAR). Perioperative outcomes, including stroke and mortality, as well as follow-up survival data at 6-month intervals, were analyzed and stratified per treatment modality.

RESULTS: …

Congenital Disseminated Malignant Rhabdoid Tumor Mimicking A Vascular Lesion, Scott K Wang, Prabhath Mannam, Katerina Dukleska, Fabiola Balarezo

Journal Articles

A congenital disseminated malignant rhabdoid tumor (MRT) is an exceedingly rare and aggressive pediatric cancer marked by the presence of malignant rhabdoid cells in various organs, including the brain, kidneys, and soft tissues, at birth. It is often detected prenatally or shortly post-birth. The malignancy's aggressiveness results in a bleak prognosis, offering limited treatment options and low survival rates. Early diagnosis and comprehensive medical intervention are crucial, but managing this condition is complicated by its rarity. We herein presented a case of a 37 and 1/7 week gestation male infant with a rapidly growing arm soft tissue mass within two …

Definition Of Polypharmacy In Heart Failure: A Scoping Review Of The Literature, Keshav Patel, Jorge A Irizarry-Caro, Adil Khan, Travis Holder, Darrell Salako, Parag Goyal, Min Ji Kwak

Journal Articles

Patients with heart failure (HF) have a high prevalence of polypharmacy, which can lead to drug interactions, cognitive impairment, and medication non-compliance. However, the definition of polypharmacy in these patients is still inconsistent. The aim of this scoping review was to find the most common definition of polypharmacy in HF patients. We conducted a scoping review searching Medline, Embase, CINAHL, and Cochrane using terms including polypharmacy, HF and deprescribing, which resulted in 7,949 articles. Articles without a definition of polypharmacy in HF patients and articles which included patients < 18 years of age were excluded; only 59 articles were included. Of the 59 articles, 49% (n = 29) were retrospective, 20% (n = 12) were prospective, 10% (n = 6) were cross-sectional, and 27% (n = 16) were review articles. Twenty percent (n = 12) of the articles focused on HF with reduced ejection fraction, 10% (n = 6) focused on HF with preserved ejection fraction and 69% (n = 41) articles either focused on both diagnoses or did not clarify the specific type of HF. The most common cutoff for polypharmacy in HF was five medications (59%, n = 35). There was no consensus regarding the inclusion or exclusion of over-the-counter medications, supplements, or vitamins. Some newer studies used a cutoff of 10 medications (14%, n = 8), and this may be a more practical and meaningful definition for HF patients.

Transcatheter Electrosurgical Septotomy Technique For Chronic Postdissection Aortic Aneurysms, Aidin Baghbani-Oskouei, Safa Savadi, Thomas Mesnard, Titia Sulzer, Aleem K Mirza, Shadman Baig, Carlos H Timaran, Gustavo S Oderich

Journal Articles

Aortic dissection often results in chronic aneurysmal degeneration due to progressive false lumen expansion. Thoracic endovascular aortic repair and other techniques of vessel incorporation such as fenestrated-branched or parallel grafts have been increasingly used to treat chronic postdissection aneurysms. True lumen compression or a vessel origin from the false lumen can present considerable technical challenges. In these cases, the limited true lumen space can result in inadequate stent graft expansion or restrict the ability to reposition the device or manipulate catheters. Reentrance techniques can be used selectively to assist with target vessel catheterization. Transcatheter electrosurgical septotomy is a novel technique …

Dynamic Imaging Of Blood Coagulation Within The Hematoma Of Patients With Acute Hemorrhagic Stroke., Muhammad E Haque, Seth B Boren, James Mills, Kerry G Schneider, Maria Parekh, Stuart M Fraser, Ivo Bach, Praveen Hariharan, Pamela J Zelnick, Felix S Guerra Castanon, Asim Naveed, Muhammad Tariq, Octavio D Arevalo, Khader M Hasan, Miguel Escobar, Xiurong Zhao, Clark Sitton, Ponnada A Narayana, James C Grotta, Jaroslaw Aronowski, Sean I Savitz

Journal Articles

BACKGROUND: The dynamics of blood clot (combination of Hb [hemoglobin], fibrin, and a higher concentration of aggregated red blood cells) formation within the hematoma of an intracerebral hemorrhage is not well understood. A quantitative neuroimaging method of localized coagulated blood volume/distribution within the hematoma might improve clinical decision-making.

METHODS: The deoxyhemoglobin of aggregated red blood cells within extravasated blood exhibits a higher magnetic susceptibility due to unpaired heme iron electrons. We propose that coagulated blood, with higher aggregated red blood cell content, will exhibit (1) a higher positive susceptibility than noncoagulated blood and (2) increase in fibrin polymerization-restricted localized diffusion, …

Acute Coronary Syndrome Patterns In The Young: Risk Factor Profile And In-Hospital Outcomes In A Tertiary Referral Hospital In Kenya, Nadeem Kassam, Mzee Ngunga, Mohamed Varwani, Miriam Msunza, Jeilan Mohamed

Internal Medicine, East Africa

Introduction: Acute coronary syndrome (ACS) accounts for coronary artery disease (CAD) –related morbidity and mortality. There has been growing concern about the rising incidence of ACS among young individuals globally both in developed and developing countries, including Sub-Saharan Africa. This group’s phenotypic characteristics; risk factors and clinical outcomes are not well described. contextual and regional studies are necessary to understand the magnitude of ACS among young Individuals and help highlight challenges and opportunities for improved ACS outcomes in the region. The study aimed to describe the demographic and clinical characteristics of young individuals hospitalized with ACS and report on in-hospital …

Elucidating The Role Of Protease-Activated Receptor 2 In Elastase-Induced Abdominal Aortic Aneurysms, John Pitstick

Senior Theses

Cardiovascular diseases (CVDs) remain the leading cause of mortality in the world despite extensive research. As a type of CVD, abdominal aortic aneurysm (AAA) represents a critical medical condition characterized by the localized dilation of the abdominal aorta. Complications from aneurysm development results in catastrophic aortic rupture, which leads to mortality more than 80% of the time. As aneurysm development is typically asymptomatic, many AAAs remain untreated until they present a serious risk of rupture. Additionally, no pharmaceutical treatment exists for AAAs, with the only option being surgical intervention. Despite advancements in diagnostic methods and surgical techniques, the pathogenesis of …

Open Repair With Latissimus Muscle Flap Coverage For Treatment Of Infected Thoracic Endovascular Aneurysm Repair, Lucas Ribé Bernal, Rana O Afifi, Anthony L Estrera

Journal Articles

A male patient, 70 years of age, was evaluated for an infected thoracic endovascular aneurysm repair (TEVAR). After presenting with persistent fever, a positron emission tomography scan found an infected aortic stent graft. The patient underwent open repair with explantation of the infected TEVAR, extensive periaortic debridement, graft replacement with a Dacron graft, and complete coverage with a latissimus dorsi muscle flap. Tissue culture revealed

1) Comprehensive Body Composition Assessments In College Aged Students, Erica Chapman, Marshuna Dalton, Natalie Izevbigie, Maddison Wilkes

Graduate Research Showcase

Introduction: According to the spring 2023 American College Health Association health survey, 5.5%, 22.8%, and 16% of college students self-reported being underweight, overweight, and obese, respectively. These statistics align with CDC figures suggesting 35-40% of college students are overweight and/or obese. Unfortunately, the vast majority of college students are not meeting national physical activity or nutritional standards. This trend towards unhealthy body composition, a sedentary lifestyle, and poor dietary habits has the potential to promote the development of chronic health conditions such as heart disease, cancer, diabetes, and osteoporosis. These risk-factors are avoidable and hold substantial physical, social, and economic …

Aortic Dissection: The Insidious Menace, Muhammad Umer Riaz Gondal, John Lemoine, Mohammad Baig, Prem Parajuli, Zainab Kiyani, Hamza Khan, Hassam Saif

Transformative Medicine (T-Med)

Introduction:

Aortic dissection represents a critical emergency characterized by the cleavage of aortic wall layers, creating a deceptive false lumen. Associated with high mortality rates, prompt diagnosis and intervention are needed to ensure survival.

Case:

A 63-year-old male with no significant medical history presented to the emergency with two days of worsening mid-sternal chest pain. Upon presentation, he was hemodynamically stable. Blood pressure was 130/85 mm Hg (similar in both arms), heart rate 90 bpm, and saturating 98 % on room air. Physical examination did not reveal any new murmurs. EKG showed normal sinus rhythm, no ischemic changes, and a …

Metformin Continuation Versus Holding Pre And Post Coronary Angiography With Normal Renal Function: A Systematic Review And Meta-Analysis, Mohammad Hamza, Yasar Sattar, Sadaf Fakhra, Neel Patel, Mubashar Karamat, Saman Razzaq, Aamir Saeed, Khaled M. Harmouch, Islam Elgendy, Mamas Mamas, Anand Prasad, Wael Aljaroudi, Ramesh Daggubati, M Chadi Alraies

Transformative Medicine (T-Med)

Background

It is common practice to withhold metformin prior to cardiac catheterization due to fear of developing lactic acidosis in the setting of contrast-associated acute kidney injury (AKI). The evidence behind this recommendation is currently weak.

Methods

We collected 851 articles from PubMed and Embase, of which 3 met our inclusion criteria. Inclusion criteria were age > 18 years, baseline use of long-term metformin with continued or interrupted metformin use in patients during diagnostic or interventional cardiac catheterization. The outcomes studied were differences between post-catheterization and pre-catheterization serum creatinine (SCr) and glomerular filtration rate (GFR). We excluded studies dealing with patients …

Reactive Oxygen Species In Acute Coronary Syndrome, Fernando Cisneros, Alex Zuo

Research Symposium

Background: Reactive oxygen species (ROS) have diverse functions in biomedicine, providing roles in cellular metabolism and signaling while posing a threat to cellular components through oxidative damage. This poster explores the significance of ROS in various cardiovascular diseases, specifically hypertension, atherosclerosis, and myocardial infarction, all of which are associated with acute coronary syndrome which are the conditions and symptoms caused by ischemia. We have studied over 30 most recent or related literature to the topic and determine important roles of ROS in cardiovascular disease. Correlations have linked ROS culprits, particularly upregulation of NADPH oxidase (NOX) 2 and NOX 4, with …

Mid-Term Clinical And Hemodynamic Outcomes In Middle Age Patients Post Trifecta™ (Abbott) Aortic Valve Replacement: A Single-Center Study, Feras H. Khaliel, Mohammed Suliman Al Aboud, Suha A. Althibait, Saber Yezli, Elaf A Al Muaythir, Bandar Alamro, Domenico Galzerano

Journal of the Saudi Heart Association

Background: Trifecta™ is an externally wrapped bovine pericardial aortic valve with a favorable hemodynamic performance and acceptable rate of freedom from structural valve degeneration. However, recent reports of early Trifecta valve failure question its durability. Rheumatic valve disease in middle age population is predominant, there is no data on the Trifecta performance, durability or safety available worldwide over the middle age population, as well as there is no previous reports from Middle East region. We report on mid-term clinical and hemodynamic performance of Trifecta valve in middle age population with small aortic annuls, a single centre report. Methods: A retrospective …

Resolution Of Severe Portopulmonary Hypertension With Inhaled Treprostinil And Liver Transplantation, Alex J Chang, Choon Hwa Goh

The Texas Heart Institute Journal

Portopulmonary hypertension is a rare condition with a poor prognosis. Prompt management is essential for liver transplantation eligibility, a potentially curative option. This report presents a case of severe portopulmonary hypertension that resolved with a conservative therapeutic regimen of tadalafil, macitentan, and inhaled treprostinil, which ultimately enabled successful liver transplantation. There was no recurrence of pulmonary hypertension after transplantation, and the patient was weaned off most pulmonary arterial hypertension therapies. This case report is the first to provide evidence that inhaled treprostinil is a safe and effective alternative to continuous intravenous prostacyclins in portopulmonary hypertension.

A Novel Micropeptide, Slitharin, Exerts Cardioprotective Effects In Myocardial Infarction, Ahmed G. E. Ibrahim, Alessandra Ciullo, Shukuro Yamaguchi, Chang Li, Travis Antes, Xaviar Jones, Liang Li, Ramachandran Murali, Innokentiy Maslennikov, Niveda Sundararaman, Daniel Soetkamp, Eugenio Cingolani, Jennifer Van Eyk, Eduardo Marbán

Pharmacy Faculty Articles and Research

Purpose: Micropeptides are an emerging class of proteins that play critical roles in cell signaling. Here, we describe the discovery of a novel micropeptide, dubbed slitharin (Slt), in conditioned media from Cardiosphere-derived cells (CDCs), a therapeutic cardiac stromal cell type.

Experimental design: We performed mass spectrometry of peptide-enriched fractions from the conditioned media of CDCs and a therapeutically inert cell type (human dermal fibrobasts). We then evaluated the therapeutic capacity of the candidate peptide using an in vitro model of cardiomyocyte injury and a rat model of myocardial infarction.

Results: We identified a novel 24-amino acid micropeptide …

Streptococcus Canis Native Aortic Valve Endocarditis Linked To Cat Exposure: A Case Report And Review, Michael S. Wang, Maria Huaringa, Lauren Feld, Ken Ochiai, Tiffany Whelan, Nicholas M. Frazier

Journal of Community Hospital Internal Medicine Perspectives

Streptococcus canis is an uncommon human pathogen, but documented infections have been mostly associated with exposure to dogs. There are only five documented cases of endocarditis secondary to streptococcus canis, with all cases except one documenting exposure to a canine. We present a 74-year-old male with a history of Type 2 diabetes mellitus, CKD 3, moderate aortic stenosis and remote exposure to agent orange, who was found to have Streptococcus canis native valve endocarditis without exposure to a dog. To the best of our knowledge this case is the first case of endocarditis linked to feline exposure.

The Utility Of Non-Specific Ecg Findings In The Setting Of Low High-Sensitivity Cardiac Troponin Levels, Arqam Husain, Nathan Klausner, Emily Schwab, Joseph Miller, Kaab Husain

Medical Student Research Symposium

Objective: Our objective was to assess the relationship between non-specific ischemic electrocardiogram (nsi-ECG) findings and the occurrence of major adverse cardiac events (MACE) within a 30-day timeframe among patients in the Emergency Department (ED) with low high-sensitivity cardiac troponin (hs-cTnI) levels.

Methods: We conducted a secondary analysis of the RACE-IT trial, a randomized trial performed across 9 EDs from July 2020 through March 2021 that looked at the effectiveness of hs-cTnI in evaluating the risk for acute myocardial infarction (AMI). Our study assessed the association between nsi-ECG findings (left bundle branch block, ST-segment changes, or T-wave inversions) and 30-day MACE …

Clinicopathological Evaluation Of Papillary Thyroid Microcarcinoma, Ando Takahito, Kimihito Fujii, Hirona Banno, Masayuki Saito, Yukie Ito, Mirai Ido, Manami Goto, Yukako Mouri, Junko Kousaka, Tsuneo Imai, Shogo Nakano

Journal Articles

BACKGROUND AND AIMS: Clinicians sometimes encounter papillary thyroid microcarcinoma (PMC) that is less than 10 mm, associated with lymph node metastasis. In this study, we assessed PMC clinicopathologically to clarify risk factors for poor prognosis.

PATIENTS AND METHODS: Fifty-one patients who underwent thyroid surgery at Aichi Medical University from September 2009 to October 2016 were included. Patients were divided into two groups, pEX-positive (23 patients) and pEX-negative (28 patients), based on the pathological finding of thyroid capsule invasion. The former indicates that the tumor infiltrated the thyroid capsule and spread to the neighboring tissue, and the latter indicates no capsule …

Chronic Glp1 Therapy Reduces Postprandial Il6 In Obese Humans With Prediabetes, Vala Hamidi, Hongyu Wang, Vi Pham, Karla Bermudez Saint Andre, Heinrich Taegtmeyer, Absalon D Gutierrez

Journal Articles

Single-dose glucagon-like peptide 1 (GLP1) therapy increases postprandial plasma IL6 levels in prediabetic, obese humans. GLP1-IL6 interactions underly multiple antidiabetic effects, but these may differ after acute versus chronic therapy. This study examines postprandial effects of GLP1 after chronic therapy. Seven humans (six Black) with prediabetes and obesity completed 6 weeks of exenatide extended release therapy. Then subjects returned for pre- and post-meal measurements of plasma IL6, GLP1, glucagon, and related inflammatory markers. Weight, which was measured before and after therapy, did not change. Plasma IL6 decreased from baseline to postmeal state ( = 0.016), with decreases in free fatty …

The Frequency Of Pathogenic Variation In The All Of Us Cohort Reveals Ancestry-Driven Disparities, Eric Venner, Karynne Patterson, Divya Kalra, Marsha M Wheeler, Yi-Ju Chen, Sara E Kalla, Bo Yuan, Jason H Karnes, Kimberly Walker, Joshua D Smith, Sean Mcgee, Aparna Radhakrishnan, Andrew Haddad, Philip E Empey, Qiaoyan Wang, Lee Lichtenstein, Diana Toledo, Gail Jarvik, Anjene Musick, Richard A Gibbs

Journal Articles

Disparities in data underlying clinical genomic interpretation is an acknowledged problem, but there is a paucity of data demonstrating it. The All of Us Research Program is collecting data including whole-genome sequences, health records, and surveys for at least a million participants with diverse ancestry and access to healthcare, representing one of the largest biomedical research repositories of its kind. Here, we examine pathogenic and likely pathogenic variants that were identified in the All of Us cohort. The European ancestry subgroup showed the highest overall rate of pathogenic variation, with 2.26% of participants having a pathogenic variant. Other ancestry groups …

Interplay Of Periodontal Bacterial Metabolites In The Progression Of Coronary Artery Disease: A System Biological Approach, Janakiraman V

Annual Research Symposium

Purpose:

The purpose of this study is to investigate the intricate relationship between periodontal disease (PD) and coronary artery disease (CAD), as evidenced by epidemiological associations. Metalloproteinase inhibitor (TIMP1) plays a pivotal role in cellular signaling, differentiation, cell death, and migration by binding to target metalloproteinases, forming complexes with other molecules (collagenases) to inactivate them. However, the expression of TIMP1 is reduced in both PD and CAD, leading to an upregulation of other metalloproteinases. This research explores the hypothesis that metabolites released from (Porphyromonas gingivalis), a prevalent bacterium in atherosclerotic patients, may inhibit TIMP1, thereby influencing CAD progression. …

Cannula Placement For Cerebral Protection Without Circulatory Arrest In Patients Undergoing Hemiarch Aortic Aneurysm Repair, Joseph C Sweeney, Jaimin R Trivedi, Toyokazu Endo, Akhila Ankem, Siddharth V Pahwa, Mark S Slaughter, Brian L Ganzel

The Texas Heart Institute Journal

BACKGROUND: Aortic aneurysms involving the proximal aortic arch, which require hemiarch-type repair, typically require circulatory arrest with antegrade cerebral perfusion. Left carotid antegrade cerebral perfusion (LCP) via distal arch cannulation without circulatory arrest was used in this study's patient population. The goal was to assess the operative efficiency and clinical outcomes of using a distal arch cannulation technique that would not require any hypothermic circulatory arrest (HCA) time compared with more traditional brachiocephalic artery cannulation with right-sided unilateral antegrade cerebral perfusion (RCP) and HCA.

METHODS: A single-center retrospective review of patients with replacement of the distal ascending aorta involving the …

Differing Radiation Exposure In Scrub Technicians And Rotating Staff In Cardiac Catheterization Laboratory: Occupation Matters, Nasir Rahman, Maleeha Javed, Ghufran Adnan, Maria Khan, Zeenat Nizar, Izat Shah

Section of Cardiology

Background: Radiation exposure is a significant hazard associated with invasive Cardiology, with most studies based on primary operator exposure. This prospective, observational study aimed to find out over lead radiation exposure as effective dose acquired by non-physician staff comprising scrub technicians and rotating staff in the cath laboratory. Effective dose (ED) measured per procedure via Raysafe i2®dosimeter badges worn by both rotating staff and scrub technicians over lead aprons along with dose area product (DAP), fluoroscopy time (FT) and procedure time (PT) in minutes was collected prospectively over forty-six invasive Cardiology procedures.
Results: This study shows that rotating staff acquire …

‘I Want To Be A Member Of My Heart Team’: Insights From Patients’ Experiences Of Minimalist Transcatheter Aortic Valve Implantation, Celeste G. Percy, A. Fuchsia Howard Dr., Bobby Lee Dr., Janarthanan Sathananthan Dr., David A. Wood Dr., John G. Webb, Sandra B. Lauck Dr.

Journal of Perioperative Nursing

Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge home. Best practices that are emerging include adopting a minimalist approach and transition from general anaesthesia to conscious sedation or local anesthesia only. We aimed to explore what could be learned from patients’ experiences of their care in this rapidly evolving context

Methods: We conducted a qualitative study of patients in the first week after TAVI to explore their perspectives of …

Association Of Cardiovascular Risk Profile With Premature All-Cause And Cardiovascular Mortality In Us Adults: Findings From A National Study, Ryan T. Nguyen, Vardhmaan Jain, Isaac Acquah, Safi U. Khan, Tarang Parekh, Mohamad Taha, Salim S. Virani, Michael J. Blaha, Khurram Nasir, Zulqarnain Javed Zulqarnain Javed

Office of the Provost

Objective: To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age < 65).
Methods: This study used data from the National Health Interview Survey from 2006 to 2014, linked to the National Death Index for non-elderly adults aged < 65 years. A composite CRF score (range = 0-6) was calculated, based on the presence or absence of six established cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity. CRF profile was defined as "Poor" (≥ 3 risk factors), "Average" (1-2), or "Optimal" (0 risk factors). Age-adjusted mortality rates (AAMR) were reported across CRF profile categories, separately for all-cause and CVD mortality. Cox proportional hazard models were used to evaluate the association between CRF profile and all-cause and CVD mortality.
Results: Among 195,901 non-elderly individuals (mean age: 40.4 ± 13.0, 50% females and 70% Non-Hispanic (NH) White adults), 24.8% had optimal, 58.9% average, and 16.2% poor CRF profiles, respectively. Participants with poor CRF profile were more likely to be NH Black, have lower educational attainment and lower income compared to those with …

Phaeochromocytoma-Induced Takotsubo Cardiomyopathy Presented With Cardiogenic Shock, Wong Lai Sze Alice, Yu Cheuk-Man, Hong Kam Fai Jeffrey, Tsang Man Wo, Wat Yiu Kin Jason, Tong Mei Wa Gensy

Journal of the Hong Kong College of Cardiology

Background: Phaeochromocytoma, on its own, is a rare endocrine condition. Patient that presents with cardiogenic shock as a result of phaeochromocytoma-induced Takotsubo cardiomyopathy is even rarer, as phaeochromocytoma classically presents with hypertension. Clinical awareness and understanding of this disease entity is important for early identification and appropriate management of this endocrine emergency. Case presentation: A 39-year-old woman presented with one day history of repeated vomiting associated with epigastric pain. Her condition deteriorated rapidly with acute cardiac and renal failure with cardiogenic shock after intravenous fluid infusion, requiring high flow oxygen and high dose inotropic support in intensive care unit. Subsequent …

Incidence And Predictors Of Post-Thrombotic Syndrome In Patients With Proximal Dvt In A Real-World Setting: Findings From The Garfield-Vte Registry., Paolo Prandoni, Sylvia Haas, Meg E Fluharty, Sebastian Schellong, Harry Gibbs, Eric Tse, Marc Carrier, Barry Jacobson, Hugo Ten Cate, Elizaveta Panchenko, Peter Verhamme, Karen Pieper, Gloria Kayani, Lord A Kakkar

Journal Articles

Although substantial progress has been made in the pathophysiology and management of the post-thrombotic syndrome (PTS), several aspects still need clarification. Among them, the incidence and severity of PTS in the real world, the risk factors for its development, the value of patient's self-evaluation, and the ability to identify patients at risk for severe PTS. Eligible participants (n = 1107) with proximal deep-vein thrombosis (DVT) from the global GARFIELD-VTE registry underwent conventional physician's evaluation for PTS 36 months after diagnosis of their DVT using the Villalta score. In addition, 856 patients completed a Villalta questionnaire at 24 months. Variable selection …

Artificial Intelligence Model Predicts Sudden Cardiac Arrest Manifesting With Pulseless Electric Activity Versus Ventricular Fibrillation, Lauri Holmstrom, Bryan Bednarski, Harpriya Chugh, Habiba Aziz, Hoang Nhat Pham, Arayik Sargsyan, Audrey Uy-Evanado, Damini Dey, Angelo Salvucci, Jonathan Jui, Kyndaron Reinier, Piotr J Slomka, Sumeet S Chugh

Journal Articles

BACKGROUND: There is no specific treatment for sudden cardiac arrest (SCA) manifesting as pulseless electric activity (PEA) and survival rates are low; unlike ventricular fibrillation (VF), which is treatable by defibrillation. Development of novel treatments requires fundamental clinical studies, but access to the true initial rhythm has been a limiting factor.

METHODS: Using demographics and detailed clinical variables, we trained and tested an AI model (extreme gradient boosting) to differentiate PEA-SCA versus VF-SCA in a novel setting that provided the true initial rhythm. A subgroup of SCAs are witnessed by emergency medical services personnel, and because the response time is …