Risultati per: Aggiornamento 2024 sullo scompenso cardiaco

Circulation, Volume 150, Issue Suppl_1, Page A4135629-A4135629, November 12, 2024. Background:Regular physical activity provides numerous health benefits including improved cardiovascular health. Population-level physical activity surveillance is critical for informing research, practice, and policy efforts for supporting population health and health disparities. The United States Report Card on Physical Activity for Children and Youth addresses physical activity surveillance needs by integrating data from numerous sources capturing levels of physical activity and related behaviors (e.g., sedentary behavior, sleep), and facilitators and barriers for physical activity among United States youth. The 2024 Report Card is the 5thand decennial iteration in the series, released October 2024.Methods:A Report Card Working Group was assembled under the auspices of the Physical Activity Alliance and National Physical Activity Plan. Members reviewed the evidence for 11 indicators using data from nationally representative surveys and assigned grades. Data were examined for the overall population and, when possible, by age, sex, race/ethnicity, and disability subgroups. A standardized grading rubric was used to assign a letter grade to each indicator ranging from A to F. Trends in key benchmarks over time were examined since the first report card (2014) or earliest available data.Results:Sufficient data were available to assign grades for 8 of the 11 indicators. The assigned grades ranged from B- to F, with overall physical activity levels earning a D- (Table 1). No indicators improved since 2014. Five indicators – overall physical activity, organized sport participation, active transportation, sedentary behaviors, and school – worsened since 2014.Conclusions:The compiled surveillance report indicates generally poor grades and concerning trends over the recent decade. These findings highlight opportunities to improve physical activity levels and resources for supporting cardiovascular health among United States youth. Policy approaches are needed to combat societal factors that interfere with physical activity. Gaps in data availability, specificity, and quality point to needs for improved surveillance to track impacts. The 2024 Report Card can be a tool for supporting advocacy of regular physical activity at the national and local level.

Circulation, Volume 150, Issue Suppl_1, Page A4136286-A4136286, November 12, 2024. Introduction:Large bore thrombectomy is increasingly used to treat acute PE. Post-market surveillance using the U.S. FDA Manufacturer and User Facility Device Experience (MAUDE) database may capture serious device adverse events (AE) not described in small pre-market clinical trials. We aim to analyze serious AE associated with use of the Inari Medical (Irvine, California) large bore thrombectomy system to treat PE.Methods:All MAUDE events between January 1, 2018 and May 1, 2024 involving PE treatment with Triever and Flowtriever devices were reviewed and categorized based on device type, incident year, and clinical event. Based on narrative description, AE were placed into categories of cardiac, pulmonary, device malfunction, anemia, and other.Results:A total of 58 AE reports representing 50 unique clinical episodes were included. MAUDE event types were death (n=32), injury (n=23) and malfunction (n=3), and the majority (45/58) involved the larger aspiration catheters (Table 1). Death occurred in 27 of 50 unique episodes. Cardiac injury (n=19) and pulmonary injury (n=18) were most common and included 25 serious perforations. Serious AEs are listed in Table 2. Device malfunction/improper use was rare (n=7) and was not associated with death. Paradoxical embolism was described causing stroke and coronary occlusion. 3 of 4 blood loss AEs occurred prior to 2021.Conclusion:This report includes the largest description of reported AEs with large bore aspiration thrombectomy systems used to treat PE. This report describes serious events, often associated with death, that are likely infrequent and were not detected in pivotal studies or registries. Understanding these AEs may guide future technique and device refinement, and the current findings demonstrate the importance of large post-approval studies.

Circulation, Volume 150, Issue Suppl_1, Page A4145107-A4145107, November 12, 2024. Background:Kounis syndrome (KS), also known as allergic myocardial infarction, is a rare but potentially life-threatening condition characterized by acute coronary syndrome in the setting of allergic reactions triggered by drugs, foods, vaccines, or environmental exposure. Our study provides an updated comprehensive insight into this patient cohort on a large scale.Methods:We conducted a systemic literature search in PubMed, EMBASE, and Google Scholar between 2018 and 2024, using MeSH terms and keywords for “Kounis syndrome”, “drug”, and allergy to identify the cases of drug-induced KS. Initial search yielded 325 articles. After excluding duplicates, review articles and irrelevant studies, we included only 51 articles reporting drug-induced KS.Results:Our study identified 51 patients of KS with a median age of 56 ± 14 years. Of those, 56.86% were female. The most frequently implicated drugs in KS were antimicrobials (37.25%), followed by iodinated contrast media (19.60%), NSAIDs (15.68%), and antineoplastics (9.80%). Of those, 64.70% of patients were diagnosed with KS-I, 13.72% with KS-II, and 21.56% with KS-III. Chest pain (94.1%), dyspnea (90.1%), and palpitations (60.78%) were predominant initial manifestations, and most cases (78.43%) were presented within 1st hour of drug ingestion. ST-segment changes (100%) were common ECG findings, and 64.70% of patients had elevated cardiac troponin. All patients had reduced left ventricular ejection fraction (LVEF) (

Circulation, Volume 150, Issue Suppl_1, Page ASa901-ASa901, November 12, 2024. Introduction:In the United States, the incidence of in-hospital cardiac arrest (IHCA) ranges from 0.1-0.5% and most larger studies report about 20% of patients survive to hospital discharge. IHCA after cardiac surgery is unique because patients are often monitored closely and arrest etiologies are frequently reversible. This may contribute to improved survival, however current data on cardiac arrest outcomes that reflect the rapidly evolving landscape of cardiac surgery and intensive care are lacking.Aims:To identify the incidence, prognostic features, and outcomes of cardiac arrest following cardiac surgery at a single high-volume academic center.Methods:We identified all adult (≥18 years) patients who underwent cardiac surgery and experienced in-hospital cardiac arrest at our institution from 2011-2024 in our local Society of Thoracic Surgery database. The primary outcome was the incidence of cardiac arrest after cardiac surgery. In an exploratory analysis, we fit a multivariable logistic regression for death before discharge, adjusting for variables noted in Tables 1 and 2. All analyses were performed in R (Version 2024.04.1+748). A p value < .05 was considered significant. No adjustment for the family-wise error rate was made – all analyses should be considered hypothesis-generating.Results:Of 10,152 surgeries, 263 cases (2.6%) of postoperative cardiac arrest were identified. Survival to discharge occurred in 123 (50%) of cases. Median age was 67 (IQR 57-75) and 103 (39%) patients were female (Table 1). In adjusted analyses, death before discharge was significantly associated with use of extracorporeal membrane oxygenation (OR 3.52, CI 1.51-8.23, p=0.003), postoperative dialysis (OR 3.27, CI 1.57-6.77, p=0.001), pre-operative stroke (OR 2.28, CI 1.17-4.46, p=0.016), post-operative stroke (OR 3.01, CI 1.04-8.73, p=0.042), and age (OR 1.03, CI 1.01-1.05, p=0.016) (Figure 1). Survival to discharge was associated with placement of permanent pacing device (OR 0.30, CI 0.11-0.81, p=0.017).Conclusions:Incidence of IHCA after cardiac surgery is much higher than in the general inpatient population. However, survival to discharge is also common, suggesting that cardiac surgical patients have distinctly different outcomes after IHCA compared to other inpatient populations. In an exploratory analysis, we identified several factors associated with survival to hospital discharge after cardiac arrest which can be examined in future studies.

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Circulation, Volume 150, Issue 19, Page 1484-1486, November 5, 2024.

New England Journal of Medicine, Volume 391, Issue 17, Page 1633-1641, October 31, 2024.

New England Journal of Medicine, Volume 391, Issue 17, Page 1663-1663, October 31, 2024.

The UK Congress of Obesity (UKCO) is an annual conference of the Association for the study of Obesity (ASO), a charitable organisation that aims to understand obesity and its prevention and treatment. The ninth UKCO took place on September 24–25, 2024, at Rhodes House in Oxford, UK, with the theme of “Breaking barriers: shaping the future of obesity prevention and management”. Through a range of posters, presentations, and discussions, the programme covered a variety of topics under this theme, including, new and emerging treatments for obesity, the role of the food environment and food policy, barriers to accessing treatment, childhood and adolescent obesity, obesity policy, and food insecurity and obesity.

Stroke, Volume 55, Issue 11, Page 2589-2589, November 1, 2024.

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Oncologia pediatrica sostenuta da chef Romito e da Jre-Italia

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Per scoperte sull’infiammazione del cancro e l’immunità innata