Risultati per: GPG: Versione 5.7.5 (Novembre 2021)

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 A4146340-A4146340, November 12, 2024. Background:Iron deficiency anemia (IDA) is a common comorbidity in patients undergoing Transcatheter Aortic Valve Implantation (TAVI). This study investigates the differences in outcomes between TAVI patients with and without IDA, focusing on mortality, procedural complications, and baseline characteristics.Methods:A retrospective analysis was conducted using data from the National Inpatient Sample (NIS) from 2016 to 2021. The outcomes for patients undergoing TAVI with IDA were compared to those without IDA. Multivariate logistic regression was employed to analyze outcomes.Results:The study included 367,440 patients without iron deficiency anemia and 16,030 patients with iron deficiency anemia. Baseline characteristics showed a significant difference in gender distribution, with 47.15% of IDA patients being male compared to 56.4% in the non-IDA group (P < 0.0001). Racial distribution varied significantly (P < 0.0001), with a higher % of Black patients in the IDA group (6.16% vs. 3.97%).Patients with IDA had higher odds of heart block (OR: 1.146, 95% CI: 1.061-1.238, P = 0.001), bleeding (OR: 1.229, 95% CI: 1.115-1.355, P < 0.001), transfusion (OR: 2.487, 95% CI: 2.209-2.800, P < 0.001), prosthetic dysfunction (OR: 1.377, 95% CI: 1.053-1.801, P = 0.02), post-procedure shock (OR: 1.450, 95% CI: 1.180-1.782, P < 0.001), intra-procedure shock (OR: 1.562, 95% CI: 1.264-1.931, P < 0.001), dialysis (OR: 1.450, 95% CI: 1.044-2.015, P = 0.027), atrial fibrillation (OR: 1.115, 95% CI: 1.033-1.204, P = 0.005), cardiogenic shock (OR: 1.587, 95% CI: 1.283-1.963, P < 0.001), sepsis (OR: 1.541, 95% CI: 1.122-2.117, P = 0.008), respiratory failure (OR: 1.635, 95% CI: 1.462-1.828, P < 0.001), and myocardial infarction (OR: 1.684, 95% CI: 1.421-1.996, P < 0.001). Patients with IDA had a longer length of stay (Coefficient: 2.067, 95% CI: 1.798-2.337, P < 0.001) and higher total hospital charges (Coefficient: $23,107, 95% CI: $16,471-$29,742, P < 0.001) compared to those without IDA.Conclusions:Patients with IDA undergoing TAVI are at higher risk for several complications, including heart block, bleeding, transfusion, prosthetic dysfunction, post-procedure and intra-procedure shock, dialysis, atrial fibrillation, cardiogenic shock, sepsis, respiratory failure, and myocardial infarction compared to those without IDA. These findings underscore the need for targeted management strategies and further research to optimize outcomes for TAVI patients with iron deficiency anemia.

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 A4148102-A4148102, November 12, 2024. Introduction:Ischemic stroke and renal failure frequently coexist, impairing patient outcomes. Comprehending this association is imperative in formulating a multidisciplinary methodology to augment patient outcomes and quality of life.Objective:We offer estimates showing the evolution of kidney dysfunction related ischemic stroke from 1990 to 2021. It will utilize disability-adjusted life years (DALYs), years of life lost (YLLs) and age-standardized death rates (ASDR) to find discrepancies overall survival outcomes in both sexes.Methods:Data on ASDR, DALY, and YLL were extracted from the GBD database. After examining global trends, we analyzed continents, socio-demographic index (SDI) and World Bank income level classification of countries. Using Joinpoint regression, the average annual percentage changes (AAPC) were determined.Results:The ASDR for kidney dysfunction related ischemic stroke showed a declining trend globally between 1990 and 2021. The ASDR was 7.29(95%UI: 4.68-10.07) in 1990 and dropped to 4.24 (AAPC: -1.73; 95% CI: -1.76 to -1.69) in 2021. DALYs dropped from 130.3(95%UI: 90.36-172.67) in 1990 to 82.1 (AAPC: -1.47; 95% CI: -1.50 to -1.44) in 2021. YLL had a consistent decline from 1980 to 2021, with an AAPC of -1.66 (95% CI: -1.69 to -1.62). High-middle and middle SDI region had higher death rates throughout the study period.Asia and America had lower ASDRs, whereas Europe and Africa had higher ASDRs across the board. Africa’s AAPC was -0.37 (95% CI: -0.4 to -0.32) between 1990 and 2021. Similarly, Europe’s AAPC of -2.85 (95% CI: -2.93 to -2.77) showed a decline from 1990 to 2021. Asia’s AAPC showed a drop, coming in at -1.19 (95% CI: -1.22 to -1.15). America’s AAPC was -1.97 (95% CI: -2.02 to -1.91).According to world bank income levels, upper-middle and lower-middle income countries had higher ASDRs.Conclusion:Due to similar risk factors and bidirectional effects, the combination of ischemic stroke and renal failure worsens patient outcomes. In order to effectively address the intricate interactions between various illnesses and enhance patient prognosis, an in-depth investigation of the reasons behind stark disparities in death rates is necessary.

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 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 A4146248-A4146248, November 12, 2024. Introduction:Lower Extremity Peripheral Arterial Disease (PAD) ranks as the leading cause of incidence among all cardiovascular diseases (CVD) in the United States. Due to a significant lack of data on the overall burden of PAD, this pioneering study investigates the trends of PAD over the past three decades in the US, including the initial two years of the COVID-19 pandemic.Method:We estimated prevalence, incidence, deaths, and disability-adjusted life years (DALYs) due to PAD by age, sex, year and location across the US from 1990-2021 using the global burden of disease 2021 methodology. Results were presented in absolute counts and age-standardized rate (per 100,000 person-years)Results:From 1990 to 2021, the overall prevalence of PAD in the US rose from 8.6 million (95% uncertainty interval: 7.4-10 million) to 14.9 million (13.4-16.6 million). The total percentage change (TPC) in deaths increased by 93% (82%-102%), and DALYs by 87% (79%-96%). Pennsylvania recorded the highest increase in age-standardized incidence rate (ASIR) at 3%, followed by Delaware at 2%. Kansas saw the highest death rate (ASMR) increase at 20%, with Kentucky close behind at 19%. The 65-69 age group had the highest incidence count at 265,188, while the 85-89 age group saw the most deaths at 1,827, and the 70-74 age group recorded the most DALYs at 36,772 in 2021. Males experienced a higher increase in TPC across incidence, deaths, and DALYs compared to females, with figures at 85% vs 56%, 104% vs 85%, and 99% vs 76%, respectively.Conclusion:While deaths due to Peripheral Arterial Disease (PAD) constituted only 1.22% of all cardiovascular-related fatalities in the US in 2021, the growing burden of the disease highlights a critical area for public health focus. Although mortality rates remain relatively low, the high incidence compared to other cardiovascular diseases suggests the need for targeted prevention and early intervention strategies. Strengthening awareness, improving diagnostics, and enhancing treatment accessibility can help mitigate the rising impact of PAD and improve cardiovascular health outcomes nationwide.

Circulation, Volume 150, Issue Suppl_1, Page A4131486-A4131486, November 12, 2024. Background:Cardiovascular disease (CVD) mortality in the U.S. younger population is on the rise. However, limited data is available on CVD-related mortality trends in this population.Aim:This study aimed to assess the temporal trends and demographic differences in CVD-related mortality among the U.S. youth.Methods:The CDC WONDER dataset was analyzed from 1999-2021 for CVD-related mortality in children and young adults (age

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 A4120332-A4120332, November 12, 2024. Introduction:Sleep apnea (SA) is often underrecognized and undertreated despite its high prevalence in the adult population and its association with adverse cardiovascular outcomes. There are limited estimates of national trends on cardiovascular mortality in older patients with sleep apnea. We aimed to assess the sex and race-related trends of ischemic heart disease (IHD) mortality in the older adults with SA using a large population-based database.Methods:We utilized the Centers for Disease Control and Prevention Wide-Ranging, Online Data for Epidemiologic Research (CDC WONDER) database which provides information from death certificates of all US residents according to the International Classification of Diseases, Tenth Revision (ICD-10). The demographic and mortality data were obtained for the United States population >65 years from 1999 to 2021. Ischemic heart disease (ICD-10 codes I20-I25) was listed as the underlying cause of death, and SA (G47.3) as a contributing cause of death. Age adjusted mortality rates (AAMRs) per 1,000,000 population were calculated by standardizing deaths to the year 2000 US population. We used Jointpoint Regression Program to analyze temporal trends in mortality from 2000 to 2021. Average annual percentage change (AAPC) with 95% CI were calculated to examine trends in AAMR over time.Results:Overall, AAMR of IHD mortality for patients with SA increased from 7.9 per 1,000,000 (95% CI, 6.9-8.8) in 1999 to 53.4 per 1,000,000 (95% CI, 51.4-55.4) in 2021 with an AAPC of 9.1% per year (95% CI, 8.8-9.5). Men had consistently higher AAMR than women throughout the study period (overall AAMR men: 45.51 (95% CI, 44.8-46.2); women: 12.5 (95% CI, 12.2-12.8). Both the groups had a similar increasing trend in AAMR, with men having a steeper increase. [AAPC men: 9.3% (95% CI, 8.5-10.8) versus AAPC women: 8.6%, 95% CI, 8.1-9.7]. Non Hispanic (NH) White population had the greatest AAMR throughout the study period, followed by NH Black and Hispanic or Latino. The NH White population had the largest increase in AAMR from 1999 to 2021 (AAPC 9.4%, 95% CI:8.9-10.1).Conclusion:In the United States, there has been a general increase in IHD mortality related to sleep apnea over the last two decades. This rising trend as noted in our analysis is concerning and underscores the need for more robust cardiovascular surveillance in these patients.

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 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 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 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 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 A4147962-A4147962, November 12, 2024. Introduction:Heart transplants (HT) and left ventricular assist devices (LVADs) are treatment options for advanced heart failure refractory to standard therapy. Historically, LVADs have been used as either destination therapy or a bridge to transplant. However, recent changes to the organ allocation system have deprioritized patients on LVADs as transplant recipients, leading to divisive views on the role of an LVAD. We sought to describe outcomes with each modality, highlighting each option’s strengths and clinical utility.Aim:To assess costs related to index hospitalization, 30-day (30DRC) and 90-day (90DRC) readmission categories for both subgroups.Method:We analyzed the National Readmission Database (NRD) from January 1, 2018, to December 31, 2021, identifying patients with HT and LVAD via ICD-10-CM codes. We selected this recent time frame to limit the influence of older LVAD technology and heart allocation schemes. We excluded patients