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1. Disparities and Outcomes in the First and Second Year of the Pandemic on Events of Acute Myocardial Infarction in Coronavirus Disease 2019 Patients.

Author

Sekhon, Manraj, Rajotia, Arush, Dang, Ashujot, Singh, Prabh, Bilal, Maham, Sakthivel, Hemamalini, Ahmed, Raheel, Verma, Renuka, Ramphul, Kamleshun, Sethi, Prabhdeep, and Dhaliwal, Jasninder

Subjects
COVID-19, United States, cardiovascular complications, epidemiology, mortality, national inpatient sample, Humans, COVID-19, Male, Female, Myocardial Infarction, Retrospective Studies, Middle Aged, Aged, SARS-CoV-2, Pandemics, Adult, Hospitalization, Aged, 80 and over
Abstract

Background and Objectives: Coronavirus disease 2019 (COVID-19) caused several cardiovascular complications, including acute myocardial infarction (AMI), in infected patients. This study aims to understand the overall trends of AMI among COVID-19 patients during the first two years of the pandemic and the disparities and outcomes between the first and second years. Materials and Methods: The retrospective analysis was conducted via the 2020 and 2021 National Inpatient Sample (NIS) database for hospitalizations between April 2020 and December 2021 being analyzed for adults with a primary diagnosis of COVID-19 who experienced events of AMI. A comparison of month-to-month events of AMI and mortality of AMI patients with concomitant COVID-19 was made alongside their respective patient characteristics. Results: Out of 2,541,992 COVID-19 hospitalized patients, 3.55% experienced AMI. The highest rate of AMI was in December 2021 (4.35%). No statistical differences in trends of AMI mortality were noted over the 21 months. AMI cases in 2021 had higher odds of undergoing PCI (aOR 1.627, p < 0.01). They experienced higher risks of acute kidney injury (aOR 1.078, p < 0.01), acute ischemic stroke (aOR 1.215, p < 0.01), cardiac arrest (aOR 1.106, p < 0.01), need for mechanical ventilation (aOR 1.133, p < 0.01), and all-cause mortality (aOR 1.032, 95% CI 1.001-1.064, p = 0.043). Conclusions: The incidence of AMI among COVID-19 patients fluctuated over the 21 months of this study, with a peak in December 2021. COVID-19 patients reporting AMI in 2021 experienced higher overall odds of multiple complications, which could relate to the exhaustive burden of the pandemic in 2021 on healthcare, the changing impact of the virus variants, and the hesitancy of infected patients to seek care.

Published
2024

2. An epidemiological study of multisystem inflammatory syndrome in children (MIS-C) and young adults among COVID-19-positive patients - data from National Inpatient Sample database.

Author

Aggarwal, Shruti, Dhaliwal, Jasninder, Kumar, Nomesh, Sakthivel, Hemamalini, Ahmed, Raheel, Verma, Renuka, and Ramphul, Kamleshun

Subjects
COVID-19, United States, epidemiology, multisystem inflammatory syndrome in children
Abstract

During the pandemic of COVID-19, a novel atypical set of clinical findings was seen among several children with recent or current exposure to the virus. It was termed the multisystem inflammatory syndrome in children (MIS-C). Our study used the 2021 National Inpatient Sample to study the associations of sex, race, and age with the incidence of MIS-C among COVID-19-positive children. Out of 69,440 COVID-19-positive children, 2,790 (4.0%) reported MIS-C. The incidence of MIS-C was highest among those aged 8 years old (17,130 MIS-C cases per 100,000 COVID-19 patients), Asian or Pacific Islanders (API) (5,346 MIS-C per 100,000 COVID-19 cases), and males (4,734 cases per 100,000 COVID-19 cases). Furthermore, 7.9% of MIS-C cases met the classification of Kawasaki disease.

Published
2024

3. Unmasking the cannabis paradox: in-hospital outcomes of cannabis users admitted with acute myocardial infarction over a 20-year period in the United States.

Author

Kumar, Nomesh, Paray, Nitish, Ramphul, Kamleshun, Verma, Renuka, Dhaliwal, Jasninder, Schroeder, Camryn, Liu, Lily, Bawna, Fnu, Sakthivel, Hemamalini, and Ahmed, Raheel

Subjects
cannabis, mortality, myocardial infarction, outcomes
Abstract

INTRODUCTION: Cannabis is increasingly becoming a socially acceptable substance, with multiple countries having legalised its consumption. Epidemiological studies have demonstrated an association between cannabis use and an increased risk of developing coronary artery disease. However, there is a lack of studies about the influence of cannabis consumption on the outcomes following acute myocardial infarction (AMI). MATERIAL AND METHODS: We retrospectively analysed hospitalised patients with a primary diagnosis of AMI from the 2001 to 2020 National Inpatient Sample (NIS). Pearsons χ2 tests were applied to categorical variables, and t-tests for continuous variables. We conducted a 1:1 propensity score matching (PSM). Multivariate regression models were deployed on the PSM sample to estimate the differences in several events and all-cause mortality. RESULTS: A total of 9,930,007 AMI patients were studied, of whom 117,641 (1.2%) reported cannabis use. Cannabis users had lower odds of atrial fibrillation (aOR = 0.902, p < 0.01), ventricular fibrillation (aOR = 0.919, p < 0.01), cardiogenic shock (aOR = 0.730, p < 0.01), acute ischaemic stroke (aOR = 0.825, p < 0.01), cardiac arrest (aOR = 0.936, p = 0.010), undergoing PCI (aOR = 0.826, p < 0.01), using IABP (aOR = 0.835, p < 0.01), and all-cause mortality (aOR = 0.640, p < 0.01), but with higher odds of supraventricular tachycardia (aOR = 1.104, p < 0.01), ventricular tachycardia (aOR = 1.054, p < 0.01), CABG use (aOR = 1.040, p = 0.010), and acute kidney injury (aOR = 1.103, p < 0.01). CONCLUSIONS: Among patients aged 18-80 years admitted to hospital with AMI between 2001 and 2020 in the United States, cannabis use was associated with lower risks of cardiogenic shock, acute ischaemic stroke, cardiac arrest, PCI use, and in-hospital mortality.

Published
2024

4. Trends in admissions for COVID-19 in the United States between April 2020 and December 2021 and cardiovascular events.

Author

Ramphul, Kamleshun, Singh Dhaliwal, Jasninder, Sombans, Shaheen, Passi, Jatin, Aggarwal, Shruti, Kumar, Nomesh, Sakthivel, Hemamalini, Ahmed, Raheel, and Verma, Renuka

Subjects
COVID-19, death, deep vein thrombosis, epidemiology, ischemic stroke, myocarditis, takotsubo, trends, united states
Abstract

INTRODUCTION: Coronavirus disease 2019 (COVID-19) can lead to cardiovascular complications. We aimed to understand the trends in admission for COVID-19 and the incidence of various cardiovascular events. MATERIAL AND METHODS: The 2020 and 2021 National Inpatient Sample (NIS) was studied for cases of COVID-19 between April 2020 and December 2021 in the United States. Linear-by-linear association helped us understand the trends of various events. RESULTS: The number of cases of COVID-19 was highest in January 2021 (261,469 patients). The incidence of acute pulmonary embolism rose from 2.08% in April 2020 to 4.82% in November 2021, while deep vein thrombosis cases rose from 1.74% in April 2020 to 2.63% in December 2021. The incidence of cardiac arrest varied, with a maximum of 3.00% in August 2021. Similarly, acute ischemic stroke cases experienced their highest incidence in January 2021 (0.91%). The incidence of myocarditis was highest in April and May 2020 (0.42% each). Peak takotsubo cases were seen between October and December 2021. The highest overall all-cause mortality among COVID-19 cases was seen in April 2020 (16.74%). CONCLUSIONS: Throughout the 21 months of our analysis, various trends in COVID-19 cases and incidence of cardiac events were noticed. This could relate to the different variants of COVID-19, their direct and indirect impact on coagulation pathways and the myocardial tissues, and the protective roles of the vaccines.

Published
2024

8. Factors associated with inpatient mortality during daunorubicin and cytarabine induction in adults with acute myeloid leukemia—a national inpatient sample analysis

Author

Savani, Saloni, Chennapragada, Suma Sri, Ramphul, Kamleshun, Dandwani, Mehndi, Verma, Renuka, Sanikommu, Sailaja, Pagidipally, Alekhya, Arti, FNU, Kumar, Vijay, Sombans, Shaheen, Ramphul, Yogeshwaree, Mejias, Stephanie G., Dhillon, Balkiranjit Kaur, Lohana, Petras, and Sharma, Shivani

Published
2024
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13. Characteristics and Outcomes of Hospitalized Patients With Heart Failure and Sarcoidosis: A Propensity-Matched Analysis of the Nationwide Readmissions Database 2010-2019

Author

Ahmed, Raheel, Sawatari, Hiroyuki, Amanullah, Khadija, Okafor, Joseph, Wafa, Syed Emir Irfan, Deshpande, Saurabh, Ramphul, Kamleshun, Ali, Isma, Khanji, Mohammed, Mactaggart, Sebastian, Abou-Ezzeddine, Omar, Kouranos, Vasilis, Sharma, Rakesh, Somers, Virend K., Mohammed, Selma F., and Chahal, C. Anwar A.

Published
2024
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43. Abstract 11711: Factors Predicting Acute Ischemic Stroke Following Surgical Repair of Acute Type A Aortic Dissection (ATAAD) in Adults

Author

Pekyi-Boateng, Prince K, Prempeh, Isaac, Blankson, George, Bonsu, Rex, Agbinko-Djobalar, Babbel, Agyeman Badu, Nana, Dhillon, Balkiranjit Kaur, Memon, Rahat A, Wuni, Nadia I, Blewusi, George, Boateng, Derick, Frimpong, Smith, lohana, petras, Asempa, Joshua, Gbekor, Stephen K, AYIREBI-ACQUAH, EWURADJOA, Abimbilla, Hamilton, Buckner, Richmond, Adjei-Sefah, Kwame, Pekyi-Boateng, Patrick D, Sakthivel, Hemamalini, Ramphul, Kamleshun, and Duodu, Fiifi

Published
2023
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47. Predictors of disseminated intravascular coagulation in patients with acute myeloid leukemia with severe sepsis and septic shock.

Author

Adla Jala, Saisree Reddy, primary, Gadhiya, Dhruvkumar, additional, Ramphul, Yogeshwaree, additional, Mal, Madho, additional, Tummala, Nayanika, additional, Dhaliwal, Kanwar Bir Singh, additional, Sakthivel, Hemamalini, additional, Dandwani, Mehndi, additional, Ramphul, Kamleshun, additional, and Chennapragada, Suma Sri, additional

Published
2024
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50. Sex disparities in cardiac sarcoidosis patients undergoing implantable cardioverter‐defibrillator implantation.

Author

Ahmed, Raheel, Jamil, Yumna, Ramphul, Kamleshun, Mactaggart, Sebastian, Bilal, Maham, Singh Dulay, Mansimran, Shi, Rui, Azzu, Alessia, Okafor, Joseph, Memon, Rahat A, Sakthivel, Hemamalini, Khattar, Rajdeep, Wells, Athol Umfrey, Baksi, John Arun, Wechalekar, Kshama, Kouranos, Vasilis, Chahal, Anwar, and Sharma, Rakesh

Subjects
SARCOIDOSIS treatment, TREATMENT of cardiomyopathies, HOSPITAL charges, SEX distribution, HOSPITAL care, MAJOR adverse cardiovascular events, QUESTIONNAIRES, SARCOIDOSIS, RETROSPECTIVE studies, TREATMENT effectiveness, DESCRIPTIVE statistics, HOSPITAL mortality, DISEASE prevalence, ACUTE kidney failure, ODDS ratio, IMPLANTABLE cardioverter-defibrillators, MEDICAL records, ACQUISITION of data, ATRIAL fibrillation, CARDIAC arrest, COMPARATIVE studies, CONFIDENCE intervals, LENGTH of stay in hospitals, DISEASE incidence, COMORBIDITY, DISEASE risk factors
Abstract

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]

Published
2024
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