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2. Predicting adverse outcomes following catheter ablation treatment for atrial fibrillation

Author

Quiroz, Juan C., Brieger, David, Jorm, Louisa, Sy, Raymond W, Hsu, Benjumin, and Gallego, Blanca

Subjects
Computer Science - Machine Learning, Quantitative Biology - Quantitative Methods, Statistics - Other Statistics, J.3, G.3
Abstract

Objective: To develop prognostic survival models for predicting adverse outcomes after catheter ablation treatment for non-valvular atrial fibrillation (AF). Methods: We used a linked dataset including hospital administrative data, prescription medicine claims, emergency department presentations, and death registrations of patients in New South Wales, Australia. The cohort included patients who received catheter ablation for AF. Traditional and deep survival models were trained to predict major bleeding events and a composite of heart failure, stroke, cardiac arrest, and death. Results: Out of a total of 3285 patients in the cohort, 177 (5.3%) experienced the composite outcome (heart failure, stroke, cardiac arrest, death) and 167 (5.1%) experienced major bleeding events after catheter ablation treatment. Models predicting the composite outcome had high risk discrimination accuracy, with the best model having a concordance index > 0.79 at the evaluated time horizons. Models for predicting major bleeding events had poor risk discrimination performance, with all models having a concordance index < 0.66. The most impactful features for the models predicting higher risk were comorbidities indicative of poor health, older age, and therapies commonly used in sicker patients to treat heart failure and AF. Conclusions: Diagnosis and medication history did not contain sufficient information for precise risk prediction of experiencing major bleeding events. The models for predicting the composite outcome have the potential to enable clinicians to identify and manage high-risk patients following catheter ablation proactively. Future research is needed to validate the usefulness of these models in clinical practice., Comment: Under journal review; updated in response to reviewer comments

Published
2022
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10. Rationale and design for the myocardial ischemia and transfusion (MINT) randomized clinical trial

Author

Carson, Jeffrey L., Ghafghazi, Shahab, Cooper, Howard A., Wood, Frances, Menegus, Mark, Uretsky, Barry, Vallurupalli, Srikanth, Maniatis, Gregory, Gruberg, Luis, Roswell, Robert, Rossi, Joseph, Abtahian, Farhad, Tessalee, Meechai, Barsness, Gregory, Abbott, J. Dawn, Aronow, Herbert, Ramanathan, Kodangudi, Schmidhofer, Mark, Keating, Friederike, Carson, Michael, Kontos, Michael, Qureshi, Mansoor, Clegg, Stacey, Laskey, Warren, Polonsky, Tamar, Gupta, Rajesh, Sheikh, Mujeeb Abdul, Uhl, Lynne, Mullen, Paul, Bracey, Arthur, Matthai, William, Stowell, Christopher, Dudzinski, David, Marhefka, Gregary, Weinstock, Perry, Lawson, William, Keller, Norma, Yuriditsky, Eugene, Thomas, Michael, Jacobs, Alice, Hochberg, Claudia, Siddiqi, Omar, Schulman-Marcus, Joshua, Torosoff, Mikhail, Gitter, Michael, Dai, Xuming, Traverse, Jay, McCamant, Eric, Scott, Jason, Swaminathan, Rajesh, Rao, Sunil, Goldsweig, Andrew M., DeFilippis, Andrew P., Salisbury, Adam, Landers, David, Raveendran, Ganesh, Ebrahimi, Ramin, Bach, Richard, Delehanty, Joseph, Shah, Raj C., Brener, Sorin, Doroshow, Jonathan, Caixeta, Adriano, Precoma, Dalton, Dall'Orto, Frederico Toledo Campo, De Andrade, Pedro Beraldo, Dracoulakis, Marianna, Maia, Lília Nigro, Ritt, Luiz Eduardo Fontelles, Quadros, Alexandre, Filho, Dário Celestino Sobral, De Martino, Fernando, Huynh, Thao, Schnell, Greg, Senaratne, Manohara, Tandon, Vikas, Neary, John, Laflamme, David, Dery, Jean-Pierre, Bainey, Kevin, Haichin, Richard, Dehghani, Payam, Quraishi, Ata Ur Rehman, Potter, Brian J., Carrier, François Martin, Goldfarb, Michael, Fordyce, Christopher, Sia, Ying Tung, Daneault, Benoit, Madan, Mina, McPherson, Terry, Ducas, John, Minhas, Kunal, Brass, Neil, Bagai, Akshay, Robinson, Simon, Džavík, Vladimír, Khan, Razi, Michaud, Nicolas, Steg, Gabriel, Ducrocq, Gregory, Puymirat, Etienne, Lemesle, Gilles, Ferrari, Emile, Lattuca, Benoit, Silvain, Johanne, Vanzetto, Gérald, Cetran, Laura, Lhermusier, Thibault, Cottin, Yves, Rosamel, Yann, Angoulvant, Denis, Dillinger, Jean Guillaume, Thuaire, Christophe, Popovic, Batric, Durand, Eric, Bouleti, Claire, Roubille, François, Delorme, Laurent, Crozier, Ian, Benatar, Jocelyne, Nandra, Samraj, Ternouth, Ian, Fisher, Nick, Brieger, David, Hillis, Graham, Brooks, Maria Mori, Chaitman, Bernard R., Alexander, John H., Goodman, Shaun G., Bertolet, Marnie, Rao, Sunil V., Triulzi, Darrell J., Fergusson, Dean A., Kostis, William J., Noveck, Helaine, Simon, Tabassome, Steg, Philippe Gabriel, Lopes, Renato D., White, Harvey, Alsweiler, Caroline, Morton, Erin, and Hébert, Paul C.

Published
2023
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14. Use and outcomes of dual antiplatelet therapy for acute coronary syndrome in patients with chronic kidney disease: insights from the Canadian Observational Antiplatelet Study (COAPT)

Author

Graham, Carol Anne, Tan, Mary K., Chew, Derek P., Gale, Christopher P., Fox, Keith A. A., Bagai, Akshay, Henderson, Mark A., Quraishi, Ata ur Rehman, Déry, Jean-Pierre, Cheema, Asim N., Fisher, Harold, Brieger, David, Lutchmedial, Sohrab R., Lavi, Shahar, Wong, Brian Y. L., Cieza, Tomas, Mehta, Shamir R., Brass, Neil, Goodman, Shaun G., and Yan, Andrew T.

Published
2022
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17. Discontinuation of SGLT2i in people with type 2 diabetes following hospitalisation for heart failure: A cause for concern?

Author

Milder, Tamara Y., Lin, Jialing, Pearson, Sallie‐Anne, de Oliveira Costa, Juliana, Neuen, Brendon L., Pollock, Carol, Jun, Min, Greenfield, Jerry R., Day, Richard O., Stocker, Sophie L., Brieger, David, and Falster, Michael O.

Subjects
SODIUM-glucose cotransporter 2 inhibitors, ANGIOTENSIN-receptor blockers, ACE inhibitors, DIAGNOSIS related groups, TYPE 2 diabetes diagnosis, DIABETIC acidosis, DRUGSTORES, PUBLIC hospitals
Abstract

The article discusses the discontinuation of SGLT2 inhibitors (SGLT2i) in people with type 2 diabetes following hospitalization for heart failure. A study conducted in New South Wales, Australia, found that nearly 30% of SGLT2i users discontinued therapy within 90 days of discharge, with one in five remaining off treatment at 365 days. Factors such as age, hospitalization duration, number of prior hospitalizations, and chronic kidney disease were associated with higher discontinuation rates. The study highlights the importance of minimizing SGLT2i discontinuation to reduce mortality and readmission risks in this population. [Extracted from the article]

Published
2025
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29. Changing Epidemiology of Myocarditis in Australia: A Population-Based Cohort Study.

Author

Kwan, Timothy Nathan, Kwan, Gemma, Brieger, David, Kritharides, Leonard, Chow, Vincent, and Ng, Austin Chin Chwan

Subjects
HEART failure, COVID-19 vaccines, MYOCARDITIS, COVID-19 pandemic, HOSPITAL mortality
Abstract

Background: Myocarditis is a serious disease that has drawn increasing attention due to its association with COVID-19 and vaccination. This study investigates the epidemiology of myocarditis beyond the COVID-19 pandemic, including its incidence and outcomes over time. Methods: We analyzed the population-wide retrospective data from the Admitted-Patient-Data-Collection database of patients admitted to hospitals in New South Wales (NSW), Australia, with a diagnosis of myocarditis from 2001 to 2022. The incidence of myocarditis, changing classification of myocarditis over time, and complications of myocarditis over time were all calculated. Results: There were 4071 patients diagnosed with their first episode of myocarditis, with a median age of 42 years old, and 66% were male. The incidence of myocarditis in NSW has tripled over 20-years to 8.3 per-100,000-persons by 2022. Reactive myocarditis (i.e., myocarditis within 30-days of a respiratory or digestive illness) accounted for 38% of first presentations of myocarditis. Post COVID-19 myocarditis, a subset of reactive myocarditis, accounted for 42% of myocarditis admissions since the onset of the COVID-19 pandemic in Australia. Eight percent of patients had a background history of malignancy, and 6% had a history of autoimmune disease. In-hospital mortality was 4.5% during the entire study period but has been falling by 11% per year. During follow up, most readmissions for myocarditis occurred within 6-months; with 5.1% recurrence at 6-months compared to only 6.7% at 5-years. Conclusions: Myocarditis is an important condition with increasing incidence in Australia and with markedly changing characteristics in the pandemic and post pandemic era. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Clinical perspectives: Takotsubo cardiomyopathy.

Author

Ravindran, Jayant and Brieger, David

Subjects
*TAKOTSUBO cardiomyopathy, *ADRENERGIC beta blockers, *ANGIOTENSIN converting enzyme, *DISEASE complications, *CHEMICAL inhibitors
Abstract

Takotsubo syndrome is a condition characterised by temporary acute left ventricular dysfunction with regional wall abnormalities extending beyond a single coronary artery territory. Initially thought to be benign, this condition, which is challenging to distinguish from acute coronary syndrome, has substantial morbidity and mortality. The mechanism behind this condition remains elusive, but multiple theories have been proposed. Although beta blockers and angiotensin‐converting enzyme inhibitors are used as treatments for left ventricular dysfunction, currently, there are no randomised controlled trials to support their use. In this paper, we review the latest evidence regarding aetiologies, pathophysiology, diagnostic criteria, prognosis, complications and management of Takotsubo syndrome. [ABSTRACT FROM AUTHOR]

Published
2024
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31. The national Cardiovascular Health Leadership Research Forum: a new data‐driven model placing research at the centre of improving patient outcomes.

Author

Figtree, Gemma A, Doyle, Kerry, Nedkoff, Lee, Cadilhac, Dominique A, Kovacic, Jason, Brieger, David, Cadilhac, Dominique, Chant, Kerry, Chew, Derek, Chow, Clara, Gall, Seana, Greaves, Kim, Jennings, Garry, Larson, Stefan, Levesque, Jean‐Frederic, McNeil, Keith, Nicholls, Stephen J, On, Miriam Lum, Redfern, Julie, and Verdicchio, Christian

Abstract

The article discusses the establishment of the Cardiovascular Health Leadership Research Forum (CV HLRF) in Australia to address the high burden of cardiovascular disease (CVD) and stroke. The forum aims to connect health leaders, clinicians, researchers, and industry partners to drive new preventive and therapeutic strategies. By harmonizing data and clinical quality indicators, the CV HLRF seeks to identify and address health challenges, particularly focusing on improving outcomes for diverse populations. The forum also aims to influence policy, practice, and resource allocation by aligning research priorities with national health challenges and leveraging partnerships for impactful research and innovation. [Extracted from the article]

Published
2024
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