Risultati per: GPG: Versione 5.7.5 (Novembre 2021)

Circulation, Volume 150, Issue Suppl_1, Page A4127417-A4127417, November 12, 2024. Background:Atherosclerotic cardiovascular disease (ACVD) is the leading cause of mortality in the U.S, and increasing age is one of the greatest risk factors for the development and prognosis of ACVD. However, ACVD-related mortality trends in older adults have not yet been established.Aims:This study aims to highlight the annual trends and demographic differences in ACVD-related mortality among older adults in the U.S. from 1999 to 2021.Methods:The CDC WONDER multiple-cause of death database was examined from 1999 to 2021 for ACVD-related mortality in adults >65 years of age. Age-adjusted mortality rates (AAMRs) per 100,000 persons was calculated. Trends and annual percent changes (APCs) were calculated, and subsequently stratified by overall, sex, race/ethnicity, urbanization status, and census region.Results:Between 1999 and 2021, 9,307,495 ACVD-related deaths occurred among older adults in the U.S. AAMRs decreased from 1370.7 in 1999 to 803.5 in 2014 (APC, -3.64 [-3.89 to -3.46]), after which it gradually decreased to 741.3 in 2019 (APC, -1.24 [-2.54 to 0.19]), and then increased to 841.5 in 2021 (APC, 7.00 [3.92 to 9.18]). Men had consistently higher AAMRs than women from 1999 (AAMR men: 1754.1 vs women: 1122.2) to 2021 (AAMR men: 1169.6 vs women: 599.6). Non-Hispanic (NH) Black or African American older adults had the highest AAMR in 2020 (886.1), followed by NH White (849.4), NH American Indian/Alaska Native (752.5), Hispanics or Latino (718.3) and NH Asian or Pacific Islanders (494.4). AAMR also varied substantially by region (overall AAMR until 2020: Midwest 875.1; South 872.2; Northeast 801.0; West 789.2), and rural areas had higher ACVD-related mortality (993.5) than urban regions (954.7).Figure 1.Conclusion:Following a progressive decrease until 2019, ACVD-related mortality in U.S. older adults demonstrated a sharp increase in mortality in 2020 and 2021. The highest AAMRs were observed among Black or African American adults and men, and among patients living in the Midwestern and non-metropolitan areas. A targeted approach, with tailored strategies is required to counter the recent surge in ACVD-related mortality in older adults in the U.S.

Circulation, Volume 150, Issue Suppl_1, Page A4144666-A4144666, November 12, 2024. Background:There is limited data on the safety and efficacy of ventricular tachycardia (VT) ablation in patients with chronic kidney disease (CKD). We examined the outcomes of patients with CKD undergoing VT ablation in a nationally representative cohort of patients.Methods:The National Inpatient Sample Database (NIS) was analyzed from 2018 to 2021 to identify patients ≥18 years old with VT undergoing ablation. Patients with atrial fibrillation, atrial flutter, supraventricular tachycardia, or pre-excitation syndrome were excluded. Patients were divided into those with CKD and without CKD. A multivariable logistic regression model was utilized to assess the association of CKD with in-hospital mortality and outcomes after adjusting for confounders.Results:Our cohort included 1608 VT ablation procedures, of which 428 (27%) were performed on CKD patients. Mean age was 63 (±13) years, 318 (19%) were female, and 1194 (74%) were White. 1475 (92%) of the procedures were done at an urban teaching hospital, and 1240 (77%) at a private non-profit hospital. On multivariable analysis, CKD was associated with significantly higher odds of death (adjusted odds ration [aOR]: 3.43; 95% confidence interval [CI]: 1.79-6.5; p=0.0002), acute decompensated heart failure (aOR: 3.1; 95% CI 2.24-4.56; p

Circulation, Volume 150, Issue Suppl_1, Page A4147580-A4147580, November 12, 2024. Background and Aims:Hypertension stands as the foremost preventable cause of premature mortality and is expected to have a global burden of up to 55%. Here we aim to examine the trends in age-standardized death rates (ASDR), years of life lost (YLL), and disability-adjusted life years (DALY) for alcoholic hypertension, pinpoint the vulnerable populations, and raise awareness about the global health burden of alcohol-related hypertension.Methods:Data on alcohol-related hypertension was extracted from the Global Burden of Diseases 2021 study, including ASDR, YLL, and DALY from 1990 to 2021. The dataset was globally divided and categorized by continents and World Bank income levels. Joinpoint regression was performed to determine annual percentage change (APC) and average annual percentage change (AAPC) from 1990 to 2021.Results:Globally, the age standardized death rates (ASDR) for alcohol-related hypertension had an overall decline from 1990-2021. In 1990, ASDR was 1.12 (95% UI 0.72-1.6) and it declined to 0.94 in 2021 (AAPC=-0.54; 95% CI -0.57 to -0.50). Although the overall trend is declining, some prominent spikes in mortality rate were observed, with the most prominent one seen from 2006-2010 (APC=1.38; 95% CI 1.04-1.82). Globally, the disability-adjusted life-years (DALYs) rate was 23.75 in 1990 and it decreased to 18.86 in 2021 (AAPC=-0.73; 95% CI -0.76 to -0.69). From 1990 to 2021, the age standardized years of life lost (YLL) showed a continuous drop with an AAPC of -0.78 (95% CI -0.81 to -0.75). In continent-wise analysis, North America and Europe had higher ASDRs while Asia and Africa had lower ASDRs. From 1990 to 2021, North America and Europe had AAPC of 0.44 (95% CI 0.36 to 0.53) and AAPC of 0.23 (95% CI 0.16 to 0.31) respectively. Conversely, the AAPCs for Africa and Asia showed significant decline and were -0.16 (95% CI -0.19 to -0.15) and -1.37 (95% CI -1.41 to -1.33) respectively. According to World Bank income levels, upper-middle income countries had declining death rates while lower-middle and lower-income countries had increasing death rates throughout.Conclusion:Alcohol-related hypertension remains a global health concern. While overall trends show a decline in mortality rates, spikes and variations across continents and income levels highlight the need for targeted interventions.

Circulation, Volume 150, Issue Suppl_1, Page A4145765-A4145765, November 12, 2024. Background:The incidence burden of maternal hypertensive disorders has increased by 30% globally. This study analyzed the trends in prevalence and death rates from maternal hypertensive disorders across various states in the United States from 1990 to 2021.Methods:Using the Global Burden of Disease (GBD) database, we compared the following levels, stratified by state, between the beginning of 1990 and the end of 2021: hypertensive disorders of pregnancy, percentage prevalence change, mortality percentage change by age-standardized rates per 100,000 population, and age-stratified changes in the rate of incidence and mortality. The analysis was conducted using Microsoft Excel (16.7).Results:The analysis revealed notable interstate variability in the prevalence and death rates of maternal hypertensive disorders (Figure 1). Nevada exhibited the highest increase in prevalence (0.87%), followed by Hawaii (0.65%) and Idaho (0.54%). In contrast, Mississippi experienced the largest decrease in prevalence (-0.22%), followed by Louisiana (-0.20%) and Maine (-0.19%). Regarding death rates, the District of Columbia saw the most significant decrease (-0.67%), followed by New York (-0.45%) and New Jersey (-0.42%). Conversely, West Virginia had the highest increase in death rates (0.89%), followed by Alaska (0.52%) and Kentucky (0.51%). The analysis of Age stratified subgroups in each state showed the maximum increase in mortality change in the age group of 40–44 years, followed by 35–39 years, with West Virginia having the highest percentage change mortality rates (2.55%; age group 40–44 years) and District of Colombia showing a sharp decrease in the percentage mortality rates (-0.72%; age group 30-34 years). Incidence percentage changes showed similar patterns, with Virginia showing a (3.41%; 40–44 years), closely followed by New York (3.31%; 40–44 years).Conclusion:The data reveal significant disparities in both the prevalence and death rates of maternal hypertensive disorders across different states. Additionally, an increase in mortality and incidence rate changes of hypertension in pregnancy was observed in higher age groups, particularly among women aged 35–39 and 40–44. These findings highlight the need for tailored, state-specific public health strategies to effectively address targeted interventions for older age groups and mitigate the impact of maternal hypertensive disorders.

Circulation, Volume 150, Issue Suppl_1, Page A4140218-A4140218, November 12, 2024. Background:Prior data indicated a reduction in mortality among STEMI (ST-elevation myocardial infarction) patients with COVID-19 from 2020 to 2021 in the United States.Objective:To describe national trends and determinants of outcomes among STEMI patients with COVID-19 from 2020-2021.Methods:A retrospective cohort study was conducted using the 2020-2021 Nationwide Inpatient Sample of adults diagnosed with STEMI and COVID-19, assessing in-hospital mortality and the use of percutaneous coronary intervention (PCI), mechanical ventilation, and mechanical circulatory support (MCS).Results:The study included 6,195 STEMI patients with COVID-19 and revealed stable mortality (18% in 2020 to 21% in 2021,p=0.06). Demographic shifts occurred, with White patients increasing from 52% in 2020 to 66% in 2021 (p

Circulation, Volume 150, Issue Suppl_1, Page A4144731-A4144731, November 12, 2024. Introduction:In 2021, India reported an estimated 166,017 deaths related to Rheumatic Heart Disease (RHD). Since 2010, the Indian government has implemented various initiatives to reduce this burden. The Indian Council of Medical Research (ICMR) launched the “Jai Vigyan Mission Mode Project,” focusing on raising awareness, early detection, treatment, and infrastructure strengthening. The National Programme for Prevention&Control of Cancer, Diabetes, Cardiovascular Diseases&Stroke (NPCDCS) and Rashtriya Bal Swasthya Karyakram (RBSK) programs have established NCD clinics and cardiac care units, conducted health education campaigns, and trained medical staff for RHD prevention and control. Key initiatives include using RHD registers, regular penicillin prophylaxis, and promoting early diagnosis and treatment. The development of the low-cost Sree Chitra Valve has also increased treatment affordability. This study aims to evaluate the impact of these government efforts on reducing RHD-related mortality in India.Methods:Data from the Global Health Data Exchange (GHDx) for the 2021 Global Burden of Disease was analyzed to assess the global burden of RHD cases from India and the death rates per 100,000 population between 2010 and 2021 and predictive models adopted for estimates till 2030.Results:Between 2010 and 2014, the global mortality linked to RHD from India increased from 45.23% to 46.94%, then decreased gradually to 44.47% in 2021. Our predictive model estimates that India will contribute around 40.96% of global RHD deaths by 2030. Initially, the age-standardized RHD death rate per 100,000 population was lower among females than males, but it rose higher than males from 2013 onwards. A continuous reduction in the rate was observed in females from 2013 to 2021. Meanwhile, a declining trend was seen among males and combined (male + female) over the study period. By 2030, the overall death rate per 100,000 population is estimated to reach 9.23 (95% CI 7.24-11.22)(Figure 1).Conclusion:Our study confirms the downward trend of RHD mortality rates in India, likely linked to the multiple health initiatives. This highlights the need for sustained public health efforts to continue reducing RHD mortality.

Circulation, Volume 150, Issue Suppl_1, Page A4146565-A4146565, November 12, 2024. Introduction:Cardiovascular Disease (CVD) remains the primary cause of death and illness in the United States, incurring annual costs of $219 billion. Modifiable risk factors significantly contribute to the prevalence of CVD. This study is the first to estimate the burden of CVD attributable to high body mass index (HBMI) on CVD in the US over the past three decades, including the initial two years of the COVID-19 pandemic.Method:Using global burden of disease study 2021 standardized methodology, we estimated deaths, disability adjusted life years (DALYs), years lived with disability (YLDs) due to CVD attributable to HBMI by age, sex, year and location across the US from 1990-2021.Results:From 1990-2021, the total percentage change (TPC) in deaths attributable to CVD linked to HBMI increased by 54% (95% Uncertainty Interval: 36% to 92%), and YLDs soared by 159% (128% to 207%). In 2021, the highest number of deaths was recorded from ischemic heart disease at 85,522, followed by hypertensive heart disease at 43,430, stroke at 13,886, atrial fibrillation and flutter at 5,278, lower extremity peripheral arterial disease at 3,098, and aortic aneurysm at 1,295. Oklahoma exhibited the highest age-standardized mortality rate (ASMR) due to CVD from HBMI at 49.46 (33.57-68.08) per 100,000 person-years, with the lowest in Massachusetts at 16 (8.16-25.32) in 2021. Louisiana reported the highest YLDs rate at 72.58 (31.04-120.32). The age group 70-74 years old saw the highest number of deaths at 17,997, with the most years of life lost in the 60-64 age group at 430,068 and the highest YLDs in the 70-74 age group at 49,054. Males showed a greater increase in burden compared to females, with TPC in deaths at 65% vs. 42%, DALYs at 59% vs. 43%, and YLDs at 193% vs. 130% from 1990-2021.Conclusion:Deaths due to CVD attributable to HBMI accounted for 16.83% of all CVD related deaths in US in 2021. To combat this trend, it is essential to launch comprehensive health campaigns that leverage the power of e-health and mobile health technologies. These platforms should be utilized to disseminate evidence-based healthcare strategies and preventive measures. Furthermore, engaging influencers and celebrities in these campaigns can amplify the reach and impact, encouraging broader public adoption of healthier lifestyles. Such innovative and inclusive public health initiatives are crucial for reversing the rising trend in CVD-related health burdens.

Circulation, Volume 150, Issue Suppl_1, Page A4119072-A4119072, November 12, 2024. Introduction:Takotsubo Cardiomyopathy often presents very similarly to acute coronary syndromes (ACS). Although the gravity of the condition is being increasingly recognized, prognostic factors have been hardly established. We applied known near-term ACS mortality risk factors to determine their prognostic value in takotsubo cardiomyopathy.Methods:We analyzed the National Inpatient Sample database for 2021. Inclusion criteria were Principal Diagnosis of Takotsubo Syndrome (ICD 10 code “I5181”) and age 18 years or more. Different comorbidities, age, and gender were analyzed in these patients, and the primary outcome was inpatient mortality. Univariate logistic regression was used to test the association of each factor with mortality, and multivariate logistic regression was then used to test for independent predictive value. Analyses were performed using STATA/BE 18.0. Significance was set at 0.05.Results:9109 admissions for takotsubo syndrome were identified (10.3% males and 89.7% females) with a mean age of 67 years and an inpatient mortality rate of 2.31%. On univariate regression, age (OR 1.04; p=0.013), heart failure (OR 3.2; p

Circulation, Volume 150, Issue Suppl_1, Page A4147096-A4147096, November 12, 2024. Introduction:Increased prevalence and incidence of heart failure have resulted in a significant rise in the number of patients progressing to advanced heart failure (AHF). Heart transplantation (HT) has been the gold standard treatment for AHF. However, there is limited long-term data on trends in HT procedures and associated costs.Aim:This study aims to perform a comprehensive analysis to ascertain the trends in the number of HTs and the corresponding costs incurred.Methods:Utilizing the National Readmission Database 2010 to 2021, the study population was identified as new recipients of HT, and their median index admission charges were evaluated. We excluded patients aged < 18 with HT and LVAD during the index hospitalization.Results:We identified 36,379 weighted index hospital admissions from January to December 2010 - 2021. The annual HTs increased from 2,905 to 4,046, and the HT numbers increased by 39.28% (Figure 1). From 2010 to 2017, the HT numbers increased by approximately 11.46%; from 2018 to 2021, the increase was about 19.81%. Concurrently, median index admission costs increased from $146,817 in 2010 to $243,079 in 2021 (Figure 2), with a 65.57% cost increase. Considering patient demographics, 47% had private insurance, and Medicare covered 34%. Most patients were discharged home (48%) or to home with health care services (42%).Conclusion:Over the past 12 years, the total number of HT procedures rose by 39.28%. However, associated costs have surged disproportionately by 65.57% since 2010. A significant increase in OHT procedures from 2018 may be linked to policy changes by the United Network for Organ Sharing(Maitra, Dugger et al., 2023). Escalating costs warrant in-depth evaluation and potential policy revisions to curb healthcare expenses for managing advanced end-stage heart failure.

Circulation, Volume 150, Issue Suppl_1, Page A4138225-A4138225, November 12, 2024. Background:Timely transfer for PCI is paramount in the management of STEMI. This has been shown to reduce myocardial damage, optimize reperfusion therapy and mitigate the post procedural complications associated with PCI. This study’s aim was to describe the in-hospital outcomes associated with acute inter-hospital transfer of patients with STEMI for PCI in comparison with patients directly admitted to a primary PCI center.Methods:The National Inpatient Sample (NIS) was used to identify patients who underwent PCI for STEMI between the years 2016-2021. Based on several transfer indicators, primarily admitted patients and patients with acute inter-hospital transfer were identified. Logistic and linear regression models were used to analyze the primary outcome of in-hospital mortality and secondary outcomes of length of hospital stay, hospital charge, and occurrences of post-procedure complications.Results:Observations were weighted to obtain a national estimate of 748,430 patients with known transfer status who underwent PCI for STEMI. Of these, 625,520 patients were primarily admitted at PCI centers and 122, 910 patients were transferred from non-PCI centers. The mean age of patients with STEMI undergoing PCI was 62 years, and 72 % of the patients were male. There was no significant difference in mortality between patients transferred and patients primarily admitted for PCI due to STEMI. However, patients transferred had longer hospital stay and significantly higher healthcare cost, with a mean difference of 0.72 days (95% CI: 0.65 – 0.81 days, p-value

Circulation, Volume 150, Issue Suppl_1, Page A4141813-A4141813, November 12, 2024. Introduction:In 2021, the American Society of Nephrology Task Force recommended using the new CKD-EPI 2021 formula to estimate the glomerular filtration rate (eGFR) and to classify CKD. Evidence to compare the efficacy of this new formula with the current utilized formula, including MDRD and CKD-EPI 2009, in predicting the short-term outcomes of Asian patients with acute heart failure (AHF) is lacking.Hypothesis:The eGFR calculated by the CKD-EPI 2021 formula predicts short-term outcomes of patients with AHF more accurately than those calculated by the MDRD and CKD-EPI 2009 formulas.Methods:We conducted a pilot retrospective cohort study from January 1, 2023, to December 31, 2023, at Can Tho Central General Hospital in Can Tho, Vietnam. Our study included patients aged ≥18 who were admitted with AHF, NT-pro BNP levels exceeding 300 pg/mL, and creatinine result within 24 hours of admission. eGFR was calculated using 3 different formulas such as CKD-EPI 2021, CKD-EPI 2009, and MDRD. The short-term outcome was determined by 3-months post-discharge all causes mortality.Results:The final cohort comprised 146 patients, with a mean age of 65.6 ± 14.2 years and male proportion of 46%. Significant correlations were observed among the three formulas, with the strongest correlation observed between the CKD-EPI 2021 and 2009 formulas. In predicting short-term outcomes, the CKD-EPI 2021 and CKD-EPI 2009 formulas demonstrated superior performance compared to the MDRD formula, with respective area under the curve values of 0.634, 0.635, and 0.607. After multivariable analysis, from 90mL/min/1.73m2, every 10 ml/min/1.73 m2decrease in eGFR calculated by CKD-EPI 2021, CKD-EPI 2009, and MDRD was associated with a 32% (95% CI: 9-49), 26% (95% CI: 4-47), and 30% (95% CI: 8-47) increase in the odds of all-cause mortality among patients with AHF. Only CKD-EPI 2021 formula showed significant predictive prognostic value (log-rank test, p=0.049) (Figure).Conclusion:The CKD-EPI 2021 formula showed superior prognostic efficacy for short-term outcomes in Asian patients with acute heart failure (AHF) compared to current formulas. Further research involving larger patient cohorts and longer-term outcomes is warranted.

Circulation, Volume 150, Issue Suppl_1, Page A4138426-A4138426, November 12, 2024. Background:Geographic inequities in cardiovascular mortality are pervasive in the US. Pandemic-related delays in screening and treatment, economic loss, and worsening social determinants may have widened geographic disparities in cardiometabolic health, particularly in states that were hardest hit by these spillover effects. Understanding changes in state-based inequities could inform targeted public health efforts to advance cardiovascular health.Questions:Did the prevalence of cardiometabolic risk factors (diabetes, hypertension, hyperlipidemia, obesity) and lifestyle factors (alcohol consumption, physical inactivity, tobacco use) change between 2011 and 2021? How did between-state differences change over this period?Methods:We included adults from the CDC’s Behavioral Risk Factor Surveillance System. Survey-weighted logistic regressions models were used to calculate age and sex-adjusted risk difference between states with the highest and lowest adjusted prevalence rates of each risk factor in 2011 and 2011, respectively. An interaction term for state and year was included to assess for differential changes in between-state disparities.Results:From 2011 to 2021, there were increases in the age- and sex-adjusted prevalence of diabetes (10.9% [95% CI, 10.7,11.0] to 12.4% [12.2,12.6]), hypertension (32.4% [32.1,32.7] to 33.7% [33.4,34.0]), and obesity (27.5% [27.2,27.7] to 33.1% [32.8,33.5]). Geographic inequities widened, with increases in the difference between states with the highest vs lowest prevalence of diabetes (5.7% [5.3,6.1] to 7.8% [7.3,8.3]), hypertension (14.2% [13.6,14.8] to 17.2% [16.4,17.9]) and obesity (14.3% [13.6,15.0] to (15.7% [14.7,16.7])(Table).The prevalence of alcohol consumption (18.0% [17.7,18.2] to 15.6% [15.3,15.8]), physical inactivity (25.7% [25.4,27.4] to 24.0% [23.6,23.7]), and tobacco use (44.9% [44.5,45.3] to 36.3% [35.8,36.8]) decreased, and between-state differences did not widen.Conclusion:In this national study, the prevalence of hypertension, obesity, and diabetes increased from 2011 to 2021, and state-based inequities widened. Our findings highlight the urgent need for public health interventions to address widening state-based disparities in cardiometabolic health.

Circulation, Volume 150, Issue Suppl_1, Page A4146029-A4146029, November 12, 2024. Introduction:Ischemic heart disease (IHD) remains a significant cause of morbidity and mortality in the United States, with dietary risk factors playing a critical role. This study provides the first comprehensive estimate of the IHD burden attributable to various dietary risk factors over the last three decades, including the initial two years of the COVID-19 pandemic.Methods:Using the Global Burden of Disease Study 2021 tool, we estimated the deaths and disability due to IHD associated with twelve dietary risk factors across different age groups, genders, and years spanning from 1990 to 2021 in the US.Results:Over the period from 1990 to 2021, there was a 25% decrease in both the total percentage change (TPC) in deaths and years of life lost (YLLs), while years lived with disability (YLDs) saw a 35% increase (95% uncertainty intervals: 19%-86%). The highest mortality was associated with diets low in whole grains, resulting in 54,046 deaths, followed by diets low in Omega 3 fatty acids (36,886 deaths), and diets high in processed meat (27,280 deaths). Additional significant dietary factors included low fibre (26,681 deaths), low legumes (25,601 deaths), high sodium (21,484 deaths), high red meat (20,411 deaths), low fruits (18,551 deaths), low vegetables (13,000 deaths), low nuts and seeds (8,222 deaths), low omega 6 fatty acids (5,089 deaths), and high sugar-sweetened beverages (360 deaths). The age group with the highest number of deaths was 85-89 years old, accounting for 22,514 deaths. Males experienced a disproportionately higher disease burden compared to females over these three decades.Conclusion:Deaths due to IHD attributable to dietary risk factors accounted for 36.86% of all CVD-related deaths in the US in 2021. To reduce the burden of ischemic heart disease linked to dietary risks, targeted interventions such as eHealth education, mHealth apps for personalized diet tracking, and partnerships with influencers to promote evidence-based health messages are essential. These strategies can enhance public awareness and encourage healthier dietary choices, potentially improving public health outcomes significantly.

Circulation, Volume 150, Issue Suppl_1, Page A4147113-A4147113, November 12, 2024. Background:Transcatheter Aortic Valve Implantation (TAVI) is a rapidly evolving procedure with significant implications for patient outcomes. Understanding trends in TAVI outcomes over time can help identify areas for improvement and guide clinical practice. This study aims to analyze trends in mortality, procedural complications, length of stay (LOS), and total charges for TAVI patients from 2016 to 2021.Methods:We performed a trend analysis of TAVI procedures using data from the National Inpatient Sample (NIS) from 2016 to 2021. Outcomes assessed included in-hospital mortality, transfusion rates, permanent pacemaker (PPM) insertion, postprocedure shock, prosthetic valve dysfunction, intraprocedure stroke, LOS, and total hospital charges. The P-trend test was used to determine statistical significance over the six-year period.Results:A total of TAVI procedures were analyzed from 2016 to 2021. In-hospital mortality decreased significantly from 1.76% in 2016 to 1.06% in 2021 (P-trend

Circulation, Volume 150, Issue Suppl_1, Page A4146890-A4146890, November 12, 2024. Background:COVID-19 has introduced new complexities in the management of patients undergoing the transcatheter edge-to-edge repair (TEER) procedure of the mitral valve. This study compares outcomes of mitral valve TEER in patients with and without COVID-19, utilizing data from the National Inpatient Sample (2020-2021).Methods:We conducted a retrospective cohort study on 23,465 patients without COVID-19 and 85 patients with COVID-19 undergoing mitral valve TEER. Multivariate logistic regression was employed to compare outcomes, adjusting for potential confounders. Primary outcomes included mortality and major complications, while secondary outcomes encompassed specific procedural complications.Results:Patients with COVID-19 were younger (mean age: 73.176 vs. 76.178 years, p-value

Circulation, Volume 150, Issue Suppl_1, Page A4146172-A4146172, November 12, 2024. Background:Transcatheter Aortic Valve Implantation (TAVI) is increasingly used to treat severe aortic stenosis in patients who are at high risk for conventional surgery. Patients with leukemia represent a unique subset, often presenting with additional comorbidities and a higher susceptibility to complications. Gender differences in clinical outcomes following TAVI in leukemia patients remain under-explored. Understanding these differences is crucial for optimizing patient care and improving procedural outcomes in this vulnerable population.Methods:A retrospective analysis using the National Inpatient Sample (NIS) data from 2016 to 2021 compared male and female leukemia patients undergoing TAVI. Multivariate logistic regression was utilized to analyze variables such as in-hospital mortality, transfusion requirements, bleeding, and other complications. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was determined by P-values.Results:The study included 2,175 male and 1,055 female leukemia patients undergoing TAVI. The majority of patients were White, with 91.92% of males and 92.12% of females. Black patients constituted 2.14% of the male and 2.46% of the female groups.The mean age of male patients was 79.25 years, while female patients were slightly older, with a mean age of 80.66 years. Total charges were comparable between genders, with males incurring $217,554.6 and females $224,248.3. The length of stay was also similar, with males staying an average of 3.48 days and females 3.82 days. Mortality was significantly higher in females compared to males, with an odds ratio (OR) of 8.824 (95% CI: 1.415-55.017, P=0.02). Females also had higher odds of requiring transfusions (OR=2.049, 95% CI: 1.052-3.989, P=0.035) and experiencing bleeding complications (OR=2.039, 95% CI: 1.17-3.555, P=0.012). Other complications, such as vascular injury, permanent pacemaker (PPM) insertion, arrhythmias, and respiratory failure, did not show significant gender differences.Conclusion:Female leukemia patients undergoing TAVI are at a significantly higher risk of mortality, requiring more transfusions, and experiencing increased bleeding compared to their male counterparts. These findings underscore the urgent need for gender-specific management strategies and further research to enhance outcomes for this high-risk population.