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Introduction: In patients with cardiac sarcoidosis (CS), implantable cardioverter‐defibrillators (ICDs) are important for preventing sudden cardiac death. This study aimed to investigate sex disparities in CS patients undergoing ICD implantation. Methods: The 2016–2020 National Inpatient Sample (NIS) database compared the characteristics and outcomes of males and females with CS receiving ICDs. Results: Among 760 CS patients who underwent inpatient ICD implantation, 66.4% were male. Males were younger (55.0 vs. 56.9 years, p <.01), had higher rates of diabetes (31.7% vs. 21.6%, p <.01) and chronic kidney disease (CKD) (16.8% vs. 7.8%, p <.01) but lower prevalence of atrial fibrillation (AF) (11.9% vs. 23.5%, p <.01), sick sinus syndrome (4.0% vs. 7.8%, p =.024), ventricular fibrillation (VF) (9.9% vs. 15.7%, p =.02), and black ancestry (31.9% vs. 58.0%, p <.01). Unadjusted major adverse cardiovascular events (MACE), defined as a composite of in‐hospital death, myocardial infarction (MI), and ischemic stroke, was higher in females (11.8% vs. 6.9%, p =.024), but when adjusted for age and tCharlson Comorbidity Index (CCI), females demonstrated significantly lower odds of experiencing MACE (aOR: 0.048, 95% CI: 0.006–0.395, p =.005). Incidence of acute kidney injury (AKI) post‐ICD was significantly lower in females (15.7% vs. 23.8%, p =.01) as was the adjusted odds (aOR: 0.282, 95% CI: 0.146–0.546, p <.01). There was comparable mean length of stay and hospital charges. Conclusion: ICD utilization in CS patients is more common among males, who have a higher prevalence of diabetes and CKD but a lower prevalence of AF, sick sinus syndrome, and VF. Adjusted MACE and AKI were significantly lower in females. [ABSTRACT FROM AUTHOR]

Background Racial disparities in cardiovascular conditions are well documented. Whether similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement (SAVR) for aortic stenosis remains understudied. Methods We abstracted data from the National (Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 codes. We included patients aged ≥ 60 and ≤ 80 years with races recorded as White, African American, or Hispanic at the time of their hospitalization for surgery. We analyzed and reported the baseline characteristics, risk-adjusted inhospital mortality, and complications stratified by race. Results Of 420,181 patients studied, 90.0% identified as White, 4.0% as African American and 6.0% as Hispanic. Despite a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020, African Americans had higher odds of all-cause in-hospital deaths compared to Whites (aOR = 1.390, P < 0.001). Additionally, they were more likely to experience cardiogenic shock (aOR = 1.241, P < 0.001) and acute kidney injury (aOR = 1.314, P < 0.001) as well as more likely to require organ support such as IABP use (aOR = 1.336, P < 0.001) or invasive mechanical ventilation (aOR = 1.342, P < 0.001). Interestingly, African Americans were less likely to report events of acute ischemic stroke compared to Whites (aOR = 0.852, P < 0.001). Conclusions Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis, racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: There is a lack of data on the characteristics of teenagers admitted with acute myocardial infarction (AMI). Recent studies have hinted that with changes in lifestyle and easier access to substances of abuse, people may be prone to several cardiovascular complications at an earlier age. Material and methods: Our analysis was based on the 2016-2020 National Inpatient Samples. Logistic models allowed us to investigate the adjusted odds ratios (aOR) of AMI among teenagers. We explored outcomes and complications such as cardiogenic shock, extracorporeal membrane oxygenation (ECMO), coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), and mortality in these patients. Results: A total of 2170 cases of AMI were recorded between 2016 and 2020 (53.3 cases per 100,000 admissions among teenagers). Weekend admissions (26.3% vs. 20.9%, aOR = 1.298, p < 0.001), smokers (15.9% vs. 10.1%, aOR = 1.198, p = 0.007), cannabis users (18.9% vs. 8.4%, aOR = 1.558, p < 0.001), or cocaine users (5.3% vs. 0.6%, aOR = 4.84, p < 0.001) showed increased odds of recording a diagnosis of AMI. Females showed lower odds than males (32.7% vs. 65%, aOR = 0.264, 95% CI: 0.24-0.291, p < 0.001). Admissions were more likely among teenagers with hypertension (9.9% vs. 2.5%, aOR = 3.382, p < 0.001). Those not covered by Medicaid or private insurances were more likely to be admitted for AMI than Medicaid beneficiaries (12.4% vs. 8.2%, aOR = 1.278, p < 0.001). Finally, teenagers classified as Blacks showed higher odds than whites of being admitted for AMI (aOR = 1.37, p < 0.001). A total of 270 (12.5%) deaths were also noted. Conclusions: Various characteristics among teenagers influence their risk for AMI. Further studies and campaigns on educating teenagers about risk factors may provide long-term benefits. [ABSTRACT FROM AUTHOR]

Juvenile arthritis (JA) is an autoimmune condition affecting children. We used the 2017 National Inpatient Sample (NIS) to evaluate the impact of JA in the United States. The admission data were converted to weighted form and patients between the ages of 0 and 18 (inclusive) were used in our study. 560 weighted cases were found in 2017. It was more common in females than males (340 females, 220 males), Whites (235 cases), and Medicaid covered 61.6% of all patients with JA (345 cases). The total hospital charges were $25,147,389 while the mean length of stay (LOS) was 4.55 days. The highest number of cases was reported in April 2017. [ABSTRACT FROM AUTHOR]

Kawasaki disease (KD) is a medium-sized-vessel vasculitis that affects mostly children. The 2016 Healthcare Cost and Utilization Project Kid's Inpatient Database (HCUP KID) was used in weighted form to investigate differences in gender, month of year, race, region, total charges, and household income in the United States. 5503 weighted cases were found. It was more common in males (3345, 60.8%) than females (2158, 39.2%) (p < 0.01). Most admitted KD patients were white (1913, 38.1%). A higher prevalence of Kawasaki disease was seen among patients of Asian or Pacific Islander background (0.2%). The southern regions of the United States reported the highest rate of admission with 2036 patients (37%). The median age on admission was 2 years (interquartile range [IQR] of 1-5, p < 0.01) and the median charge was $32,170 (IQR: $20,825-$50,502.05) (p < 0.01). Most admissions of Kawasaki disease were recorded in winter with a peak in March (623, 11.3%) (p < 0.01). [ABSTRACT FROM AUTHOR]

Dear Editor, Cocaine use among teenagers has been linked with several detrimental cardiovascular complications.[1] We sought to analyze the risk of stroke due to cocaine use among children of ages 13 to 19 inclusive. The 2012 Kids' Inpatient Database (KID) is the largest pediatric hospitalization database in the United States that is provided by the Healthcare Cost and Utilization Project and sponsored by the Agency for Healthcare Research and Quality and its partners (www.hcup-us.ahrq.gov/kidoverview.jsp). [Extracted from the article]

Background: Cardiac tamponade or pericardial tamponade (PT) can be a complication following invasive cardiac procedures., Methods: Patients who underwent various procedures in the cardiac catheterization lab (viz. coronary interventions) were identified using the International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification (International classification of diseases [ICD]-9-Clinical modification [CM] and ICD-10-CM, respectively) from the Nationwide Inpatient Sample (NIS) database. Patient demographics, presence of comorbidities, PT-related events, and in-hospital death were also abstracted from the NIS database., Results: The frequency of PT-related events in the patients undergoing CI from 2010 to 2017 ranged from 3.3% to 8.4%. Combined in-hospital mortality/morbidity of PT-related events were higher with increasing age (odds ratio [OR] [95% CI]: chronic total occlusion (CTO) = 1.19 [1.10-1.29]; acute coronary syndrome (ACS) = 1.21 [1.11-1.33], both p < 0.0001) and female sex (OR [95%CI]: CTO = 1.70 [1.45-2.00]; ACS = 1.72 [1.44-2.06], both p < 0.0001). In-hospital mortality related to PT-related events was found to be 8.5% for coronary procedures. In-hospital mortality was highest amongst the patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for ACS (ACS vs. non-CTO PTCA vs. CTO PTCA: 15.7% vs. 10.4% and 14.4%, p < 0.0001 and ACS vs. non-CTO PTCA vs. CTO PTCA: 12.1% vs. 8.1% and 5.6%, p = 0.0001, respectively)., Conclusions: In the real-world setting, PT-related events in CI were found to be 3.3%-8.4%, with in-hospital mortality of 8.5%. The patients undergoing PTCA for ACS were found to have highest mortality. Older patients undergoing CTO PTCA independently predicted higher mortality., (© 2024 Wiley Periodicals LLC.)

Background: CHA2DS2-VASc score is used to assess thromboembolic risk in patients with atrial fibrillation (AF)/atrial flutter (AFL), however its utilization to predict outcomes and readmission at following discharge in patients undergoing coronary artery bypass grafting (CABG) regardless of AF/AFL presence is understudied. We sought to assess its utility in predicting outcomes, length of hospital stay (LOS), and healthcare-associated costs (HAC) in these patients., Method: The National Readmission Database (NRD) was queried from 2010 to 2017 for patients with/without AF/AFL undergoing CABG using the International Classification of Diseases, Ninth and Tenth editions (ICD-9-&-10). Multiple regression analysis and multivariate analysis using Cox-Hazard analysis were used to evaluate outcomes up to 90-day readmission from discharge, LOS, and HAC against CHA 2 DS 2 -VASc score (cut-off-score:6) were abstracted from the database., Results: Of the 420,458 patients that underwent CABG, 76,859 (18.3 %) were re-admitted to hospital within 90-days from discharge. Statistically significant increase in 90-day all-cause readmissions were demonstrated with increasing CHA 2 DS 2 -VASc score [No AF/AFL vs AF/AFL: score-0 (2.4 % vs1.4 %), score-6 (3.1 % vs 4.5 %, p-value<0.0001]. Similar trends were seen in re-admissions for TIA/Stroke and heart failure. The survival rate for all events were lower with incremental increase in CHA 2 DS 2 -VASc score (score-0 = 100 %; score-6 = 73 %, p-value<0.0001). Greater LOS and HAC was associated with increasing higher CHA 2 DS 2 -VASc score (standardized-beta[β]; no AF/AFL vs AF/AFL: LOS = score-1: 0.08 vs 0.06, score-6: 0.12 vs 0.13. HAC = score-1: 0.02 vs 0.009, score-6: 0.02 vs 0.01, p-value <0.001)., Conclusion: CHA 2 DS 2 -VASc score is an easy-to-use tool that predicts poorer outcomes, higher readmission, longer LOS, higher HAC, not just in patients with AF/AFL undergoing CABG, but also in those without AF/AFL., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. C. Anwar A. Chahal reports a relationship with American Heart Association that includes: funding grants. Dr. C. Anwar A. Chahal reports a relationship with National Institutes of Health that includes: funding grants. Dr. C. Anwar A. Chahal reports a relationship with Mayo Foundation for Medical Education and Research that includes: funding grants. Dr. C. Anwar A. Chahal reports a relationship with Paul and Ruby Tsai Foundation that includes: funding grants. Dr. Virend K. Somers reports a relationship with ResMed that includes: consulting or advisory. Dr. Virend K. Somers reports a relationship with Respicardia that includes: consulting or advisory. Dr. Virend K. Somers reports a relationship with Lilly and Jazz Pharmaceuticals that includes: consulting or advisory. Dr. Virend K. Somers reports a relationship with Sleep Number Scientific Advisory Board that includes: board membership. Other authors have no conflicts if interest to declare., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Sarcoidosis is associated with a poor prognosis. There is a lack of data examining the outcomes and readmission rates of sarcoidosis patients with heart failure (SwHF) and without heart failure (SwoHF). We aimed to compare the impact of non-ischemic heart failure on outcomes and readmissions in these two groups., Methods: The US Nationwide Readmission Database was queried from 2010 to 2019 for SwHF and SwoHF patients identified using the International Classification of Diseases, 9th and 10th Editions. Those with ischemic heart disease were excluded, and both cohorts were propensity matched for age, gender, and Charlson Comorbidity Index (CCI). Clinical characteristics, length of stay, adjusted healthcare-associated costs, 90-day readmission and mortality were analyzed., Results: We identified 97,961 hospitalized patients (median age 63 years, 37.9% male) with a diagnosis of sarcoidosis (35.9% SwHF vs 64.1% SwoHF). On index admission, heart failure patients had higher prevalences of atrioventricular block (3.3% vs 1.4%, P < .0001), ventricular tachycardia (6.5% vs 1.3%, P < .0001), ventricular fibrillation (0.4% vs 0.1%, P < .0001) and atrial fibrillation (22.1% vs 7.5%, P < .0001). SwHF patients were more likely to be readmitted (hazard ratio 1.28, P < .0001), had higher length of hospital stay (5 vs 4 days, P < .0001), adjusted healthcare-associated costs ($9,667.0 vs $9,087.1, P < .0001) and mortality rates on readmission (5.1% vs 3.8%, P < .0001). Predictors of mortality included heart failure, increasing age, male sex, higher CCI, and liver disease., Conclusion: SwHF is associated with higher rates of arrhythmia at index admission, as well as greater hospital cost, readmission and mortality rates compared to those without heart failure., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: While the exact pathogenesis of peripartum cardiomyopathy, a potentially life-threatening condition, is still unknown, its incidence is rising globally. We sought to understand the differences in outcomes and complications based on age., Methods: Records from the 2016-2020 National Inpatient Sample were used for our study. The sample consisted of females diagnosed with peripartum cardiomyopathy that required hospitalization care. They were divided into two age-based cohorts: 15-29 years and 30-40 years. We evaluated differences in in-hospital complications between the two groups using multivariable regression., Results: The analysis consisted of 20520 females diagnosed with peripartum cardiomyopathy, of whom 57.3 % were in the 30-40 years cohort and 42.7 % in the 15-29 years group. The prevalence of cardiovascular risk factors such as smoking, obesity, hypertension, diabetes and lipid disorder was higher among women aged 30-40 years (p < 0.01). These patients also demonstrated higher odds of reporting acute ischemic stroke (aOR 1.354, 95 % CI 1.038-1.767, p = 0.026) while having a reduced risk of cardiogenic shock (aOR 0.787, 95 % CI 0.688-0.901, p < 0.01) as compared to those aged 15-29 years during their hospitalisation with PPCM. No statistically significant differences were noted for events of acute kidney injury (aOR 1.074, 95 % CI 0.976-1.182, p = 0.143), acute pulmonary oedema (aOR 1.147, 95 % CI 0.988-1.332, p = 0.071) or in-hospital mortality (aOR 0.978, 95 % CI 0.742-1.290, p = 0.877)., Conclusion: Peripartum cardiomyopathy is a serious condition that requires appropriate care and management. Our study linked cases of ages 30-40 years with increased odds of acute ischemic stroke but lower odds of cardiogenic shock., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Cardiac sarcoidosis (CS) is frequently associated with conduction abnormalities and arrhythmias. In this study, we aim to evaluate racial disparities in the frequency of arrhythmias, and associated co-morbidities, among patients with CS., Methods: White and African American (AA) patients diagnosed with CS were identified and compared from the 2016-2020 National Inpatient Sample (NIS) database whilst adjusting for confounders via logistic regression models., Results: A total of 7,935 patients with CS were included in the study. The propensity-matched sample comprised of 5,570 patients, of whom 2,785 were White and 2,785 were AA. AA patients had a longer mean length of hospital stay (LOS) (7.84 vs. 6.94, p<0.01), a higher mean Charlson Comorbidity Index (CCI) score (3.10 vs. 2.84, p<0.01), and significantly higher incidences of cardiogenic shock [(9.2% vs 6.3%, p<0.01), aOR 1.45 (95% CI 1.17-1.78), p<0.01] and acute kidney injury (AKI) [(34.3% vs. 26.9%, p<0.01), aOR 1.41 (95% CI 1.24-1.61), p<0.01]. From an arrhythmia perspective, AA CS patients were shown to have a lower frequency of: (1) ventricular tachycardia (32.5% vs. 37.9%, p<0.01), (2) ventricular fibrillation (5.4% vs.7.2%, p<0.01), (3) first-degree AV block (1.8% vs. 4.1%, p<0.01), (4) complete AV block (6.3% vs. 14.2%, p<0.01), and (5) atrial fibrillation (31.8% vs. 34.8%, p=0.016) when compared to Whites with CS. Mortality remained higher for AAs (3.8% vs. 2.7%, p=0.024)., Conclusion: Our study demonstrates a higher incidence of cardiac arrhythmias among White patients but a higher incidence of cardiogenic shock, AKI, mean LOS, and mortality among AA patients with cardiac sarcoidosis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: With changes in state laws, cannabis is now more accessible in many parts of the United States. The drug has previously been associated with a higher incidence of acute ischemic stroke (AIS). Our study analyzed the effect of cannabis use on AIS outcomes., Methods: The 2019 National Inpatient Sample from Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality was used to evaluate the AIS patients ages 25 and more. Cannabis users were compared with nonusers. Their mortality risks were also assessed., Results: Five hundred thirty-nine thousand eight hundred eighty patients with AIS were in our study and 8850 used cannabis. Among the cannabis users with AIS, 69.8% were males, 50.6% were white, 61.8% were aged 46 to 65, 32.1% used Medicaid, 86.1% were nonobese, 72.0% were nondiabetics, 81.7% had hypertension, 80.7% did not have a history of alcohol abuse, and 77.5% were smokers (nicotine). Only 12.8% of cannabis users reported any cardiac dysrhythmia, whereas 5.4% required mechanical thrombectomy, and 8.0% received intravenous tissue plasminogen activator (tPA).After adjusting the variables, cannabis users covered by Medicare, with diabetes, a history of alcohol abuse, cardiac dysrhythmias, and who underwent mechanical thrombectomy had a higher risk of dying. The overall adjusted odds ratio of dying among cannabis users with AIS was 0.603 (95% CI, 0.504-0.722, P <0.01)., Conclusions: Although the overall mortality risk seems to be lower among cannabis users, those with certain risk factors still present higher mortality risks. Patients with cannabis use should therefore be monitored closely for possible complications and mortality after AIS., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To provide an estimate on the most recent burden of neonatal abstinence syndrome (NAS) in the United States., Methods: The 2016 Kids' Inpatient Database, provided by the Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality and its partners, was used to identify patients with NAS in the United States. The data consisted of pediatric admissions from 4200 US hospitals recorded between January 1, 2016, and December 31, 2016. Data were converted to weighted form to project a national estimate on the possible number of neonates affected by NAS. Differences in sex, race, location, household income, primary payer form, length of stay, and total charges were studied., Results: The sample contained 32 128 patients with NAS (0.8%), among whom 17 164 (53.5%) were boys and 14 935 (46.5%) were girls ( P < .001); 23 027 (80.4%) were white ( P < .001), and 13 583 (42.3%) were from the southern parts of the United States ( P < .001). Medicaid covered 83.8% of patients, and 40.2% had an income within the first quartile of national averages ( P < .001). The overall mean and median length of stay were 16.45 and 12.00 days, respectively, and the mean and median total charges were calculated as $79 937.75 and $38 537.00, respectively. The total charges of NAS were $2 549 098 822., Conclusions: The incidence of NAS is on a constant rise; the number of cases rose from 21 732 in 2012 to 32 128 in 2016. Hospital charges have also tripled over the last 7 years to $2.5 billion in 2016., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)