Risultati per: Sorveglianza nella post polipectomia nel cancro al colon-retto

Circulation, Volume 150, Issue Suppl_1, Page A4141782-A4141782, November 12, 2024. CD8+T-cells are adverse regulators post myocardial infarction (MI), leading to increased mortality and impaired cardiac function. We hypothesize that CD8+T-cells impair cardiac function by altering scar composition.MI was induced by ligating the left anterior descending coronary artery in C57BL6/J (WT; 3-7 months of age, n≥2/sex) and CD8atm1makmice (CD8-/-; 3-7 months of age, n≥2/sex/treatment). CD8-/-mice were injected with either vehicle or naïve splenic CD8+T-cells (2x106cells/injection) via tail vein, 4 hours post-MI. Infarct tissue was collected post-MI Day 7 and underwent biomechanical, histological, and biochemical analyses. Effects of granzyme (Gzm) A, B, and K on collagen cleavage were tested using a fluorogenic collagen cleavage assay to examine possible mechanisms of scar alteration.Mice lacking CD8+T-cells had improved ejection fraction and decreased dilation (p

Circulation, Volume 150, Issue Suppl_1, Page A4138062-A4138062, November 12, 2024. Introduction:Histone deacetylase (HDAC) 6 functions to remove acetyl groups from lysine residues on histone and non-histone proteins. We showed that the augmented activity of HDAC6 in diabetic mice undergoing myocardial ischemia/reperfusion injury (MIRI) was associated with mitochondrial damage. However, it remains unclear how the inhibition of HDAC6 activity affects post-MIRI cardiac remodeling and function in type 2 diabetes.Hypothesis:HDAC6 inhibition suppresses adverse cardiac remodeling and improves mitochondrial dynamics and cardiac function after MIRI in type 2 diabetic mice.Methods:Type 2 diabetic db/db, db/+, and C57BL/6 mice underwent coronary artery occlusion for 20 min followed by reperfusion. Tubastatin A, a selective inhibitor of HDAC6, was injected intraperitoneally 60 min before coronary artery occlusion and once daily after surgery. Mouse hearts were evaluated with echocardiography 28 days after surgery. Myocardium was imaged using electron microscopy, and the expression of mitochondrial dynamin-related protein 1 (DRP1) and fission 1 was measured by Western blotting analysis. H9c2 cardiomyocytes were subjected to hypoxia for 3 hours followed by normoxia for 24 hours in the presence of 5.5- or 25.0-mM D-dextrose and tubastatin A or vehicle.Results:There were no significant differences in the activity of HDAC6, left ventricular diameters and fractional shortening, mitochondrial density volume and surface area, and the ratios of DRP1/GAPDH and fission 1/GAPDH between the db/+ and C57BL/6 groups. Compared to both db/+ and C57BL/6 groups, HDAC6 activity was lower, left ventricular diameters at both end diastole and end systole were longer, fractional shortening and mitochondrial surface area were smaller, and the expression of DRP1 and fission 1 was increased in the db/db group 28 days after MIRI. Interestingly, 10 mg/kg Tubastatin A significantly mitigated these effects of MIRI in db/db mice. Hypoxia/reoxygenation in the presence of 25.0-mM D-dextrose augmented HDAC6 activity and increased the expression of DRP1 and FIS1, which were blocked by Tubastatin A.Conclusions:Tubastatin A prevents post-MIRI cardiac remodeling and improves cardiac function by limiting mitochondrial fission in type 2 diabetic mice.

Circulation, Volume 150, Issue Suppl_1, Page A4145775-A4145775, November 12, 2024. Background:Cyclophosphamide is an alkylating agent of the nitrogen mustard class that has become standard of care for graft-versus-host disease prophylaxis after hematopoietic stem cell transplantation. Although its cardiac toxicity in conditioning regimens is well-documented, data on cardiac events after administration of post-transplant cyclophosphamide (PT-Cy) administration remains limited.Research Question:Is PT-Cy associated with a higher incidence of cardiac adverse events compared with no PT-Cy?Aims:We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing PT-Cy versus no PT-Cy in patients with hematological disorders who received hematopoietic stem cell transplantation.Methods:We searched PubMed, Embase, and Cochrane Library for studies comparing PT-Cy versus no PT-Cy in patients with hematological conditions who received hematopoietic stem cell transplantation. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analyses were performed using Review Manager 5.4.1, under a random-effects model. Heterogeneity was assessed using I2 statistics.Results:We included four studies, all of which were retrospective, with 1,546 patients, of whom 826 (53%) received PT-Cy. Age ranged from 18 to 77 years, and 840 (54%) were male. A total of 1549 allogeneic transplants were performed, primarily for malignant hematological conditions. The conditioning regimens used were myeloablative (52%), reduced intensity (33%), non-myeloablative (8%), and sequential (7%). The most common cardiac events in patients receiving PT-Cy were heart failure (28%) and cardiomyopathy (27%), followed by arrhythmias (25%), pericarditis/pericardial effusion (14%) and acute coronary syndrome (5%). The incidence of adverse cardiac events was significantly higher in patients who received PT-Cy compared with those who did not receive PT-Cy (RR 2.05; 95% CI 1.36, 3.10; p

Circulation, Volume 150, Issue Suppl_1, Page A4147497-A4147497, November 12, 2024. Background:There is strong data about the neuroprotective effects of targeted temperature management (TTM) in patients post cardiac arrest, however, there is limited literature on the cardiac effects. We evaluate the impact of targeted normothermia (TN) vs targeted hypothermia (TH) on left ventricular ejection fraction (LVEF). We hypothesized that targeted hypothermia would be more cardioprotective than targeted normothermia, thus manifesting in improved LVEF and/or reduced incidence of new heart failure at various points in time.Method:We queried the TriNetX Global collaborative network for adult (≥18 years) patients with LVEF >50% who suffered a Cardiac arrest (CA) and Coma within one day of CA, and we created two groups: therapeutic hypothermia and therapeutic normothermia. TTM was identified with International Classification of Diseases 10th edition (ICD-10) Procedure codes 6A4Z0ZZ, 6A4Z1ZZ, and SNOMED code 308693008 and the TN group excluded patients with documented temperature ≥ 99.6 °F or ≤ 97.6 °F within 1 day of CA. Similarly, the TH group was identified using the same ICD codes and excluded patients with documented temperatures ≥96.7°F or ≤ 91.3°F within 1 day of CA being excluded. Propensity Score Matching (PSM) done for age, race, sex, and multiple cardiovascular comorbidities. Outcomes were measured at 3-, 12-, and 36 months post-CA included the risk of LVEF ≤ 50%, new onset heart failure, and new prescription of loop diuretic.Results:After PSM 510 patients were analyzed, with 255 well-matched subjects in each group. At 3 months there were no significant odds of TH causing a decrease in cardiac ejection fraction to 50% or less (Odds Ratio [OR] 0.90, 95% CI: 0.37 – 2.18) compared to TN. No significant difference was seen at 12 months (OR 0.897, 95% CI: 0.37 – 2.18) or 36 months (OR 0.71, 95% CI: 0.32 – 1.60). Other outcomes at 3 months without significant difference include new HF (OR 0.97, 95% CI: 0.39 – 2.43), and new loop diuretic (OR 0.77, 95% CI: 0.33 – 1.80). These odds were similarly not significant at 12 and 36 months.Conclusions:In post-CA patients who received TTM, no cardioprotective effects were appreciated between hypothermia compared to normothermia at 3-, 12-, and 36 month follow up. There was no difference in new diagnosis of HF post-CA or new loop diuretic prescription. With the understanding that TN has fewer side effects than TH then the results reinforce the use of TN post cardiac arrest.

Circulation, Volume 150, Issue Suppl_1, Page A4135178-A4135178, November 12, 2024. Background:Tricuspid regurgitation (TR) is no longer considered forgotten. Transcatheter tricuspid valve repair/replacement (TVRR) has become widely accepted as gauged by clinical outcomes. FDA approved two tricuspid valve devices for the purpose of improving quality of life and not necessarily to improve TR severity. We aim to support evidence-based use of TVRR, by summarizing the latest evidence on the clinical effectiveness in terms of post-procedural length of hospital stay, readmissions for heart failure and procedure success if an Intracardiac device is present.Methods:We searched Pubmed, Embase and Cochrane databases and performed a meta-analysis of the included cohort studies using a fixed-effects model. Studies were excluded if they did not present an outcome in each intervention group or did not have enough information required for continuous data comparison. We performed a meta-analysis of hazard ratio (HR) for two outcomes and odds ratio (OR) for one outcome using the random effects model to remove inconsistency and compared the results with fixed effects model. The compared findings of both methods were similar. The variables used for analysis were number of events in exposure group and total amount of events. All data analyses were performed using MedCalc® Statistical Software version 22.023.Results:Of 161 potentially relevant studies, 8 retrospective studies with a total of 1,717 patients were included in the meta-analysis. Procedure (TVRR) success was associated with fewer readmissions for heart failure in all three studies included in the analysis of pooled HR (HR = 0.46, 95% confidence interval [CI]: 0.33 – 0.63, p

Circulation, Volume 150, Issue Suppl_1, Page A4140630-A4140630, November 12, 2024. Introduction:Efforts to stratify mortality risk in pulmonary hypertension (PH) have focused on the minority of patients in WSPH group 1. Metabolomic studies in group 1 identify histidine, polyamines, tRNA metabolites, and homoarginine as predictors of mortality. Little is known about the role of metabolomics to predict mortality in the larger group of PH patients.Question:Which serum metabolites predict a composite of mortality or transplant in pre-capillary, post-capillary, and combined pre- and post-capillary PH (Cpc-PH), irrespective of WSPH group?Aims:To identify predictive metabolites in the Pulmonary Vascular Disease Phenomics Program (PVDOMICS) cohort and understand the pathobiology relating predictors to mortality/transplant.Methods:We generated peripheral venous metabolomic data in 649 PH subjects. We defined pre-capillary PH as pulmonary vascular resistance (PVR) >2 WU and pulmonary capillary wedge pressure (PCWP)≤15 mmHg (n = 453), post-capillary PH as PVR≤2 WU and PCWP >15 mmHg (n=25), and Cpc-PH as PVR >2 WU and PCWP >15 mmHg (n = 171). We used Cox models with multiple testing correction to identify predictive metabolites in each group. We then correlated select predictors with hemodynamic, laboratory, and echocardiographic data.Results:The hemodynamic groups included a mix of WSPH groups. We identified 249 predictors in pre-capillary PH, 0 in post-capillary PH, and 7 in Cpc-PH. Homoarginine predicts mortality/transplant in pre-capillary PH (HR=0.56, p

Circulation, Volume 150, Issue Suppl_1, Page AOr109-AOr109, November 12, 2024. Background:Nicotinamide mononucleotide (NMN), a precursor of nicotinamide adenine dinucleotide (NAD+), has been shown to increase NAD+levels, reduce inflammation, and improve short-term survival in a rodent model of hemorrhagic shock. NAD+levels decrease after cardiac arrest (CA), but the effect of NMN on outcomes after CA remains undefined.Hypothesis:NMN administration increases NAD+content in the brain, reduces systemic inflammation, and improves outcomes after CA.Aims:This study aimed to investigate the effects of systemic NMN administration on neurological function, survival, and systemic inflammation after CA.Methods:In a murine model of CA, asystole was induced using potassium chloride. After 10 minutes of CA, mice were resuscitated with continuous epinephrine injections. Mice were randomly assigned to the NMN group (60 mg/kg body weight i.p.) or the control group (normal saline i.p.) 1.5 minutes after the return of spontaneous circulation (ROSC). The same treatment was repeated at 24 and 48 hours after CA. Neurological function score (on a scale from 0 to 12) at 48 hours post-CA and 7-day survival were compared between the NMN and control groups. Brain NAD+levels were measured 30 minutes post-ROSC. Plasma cytokine levels (IL-6 and TNF-α) were measured 2 hours post-ROSC.Results:Brain NAD+levels significantly increased 30 minutes post-ROSC in the NMN group compared to the control group (186 ± 15 pg/mg tissue and 131 ± 14 pg/mg tissue, respectively; P=0.02). NMN significantly improved neurological function score at 48 hours post-CA (NMN group median 12 [9–12] vs. control group 8 [4–11]; P=0.03). Moreover, NMN improved survival rate up to 7 days post-CA (NMN group 61.1% [11/18] vs. control group 22.2% [4/18]; P=0.03). Mean arterial pressure tended to be higher in the NMN group, although the difference was not significant (NMN group 113.8 ± 2.1 mmHg vs. control group 107.8 ± 2.9 mmHg; P=0.08). NMN showed a trend toward decreased IL-6 (NMN group 52.7 ± 14.3 pg/ml vs. control group 114.6 ± 33.3 pg/ml; P=0.15) and TNF-α (NMN group 6.9 ± 1.2 pg/ml vs. control group 11.7 ± 2.3 pg/ml; P=0.12).Conclusions:Systemic administration of NMN post-CA increased brain NAD+levels and improved neurological function and survival. NMN also showed a trend toward reduced systemic inflammation. NMN is a promising approach to improve outcomes after CA.

Circulation, Volume 150, Issue Suppl_1, Page A4135923-A4135923, November 12, 2024. Introduction:Established predictors of recurrent atrial fibrillation (AF) following catheter ablation (CA) have not incorporated findings on post-CA ambulatory ECG monitoring (AECG).Aims:This study examined the predictive value of supraventricular tachycardia (SVT) detected on 7–14-day AECG for recurrent AF within one year post-CA.Methods:This single-center retrospective study included a select subset of patients who underwent CA for AF between 2015 and 2023 and had AECG monitoring within the first year post-CA. SVT presence and characteristics on AECG were analyzed.Data on demographics, AF risk factors, and AF recurrences were extracted from electronic health records. ROC curves determined SVT episode thresholds. A multivariable regression model included established risk factors and SVT thresholds, and best subsets regression identified predictors of AF recurrence.Results:Of 7,481 patients undergoing CA for AF, 1,245 were monitored within one year post-CA. Among this subset, 439 (35.26 %) had recurrent AF during the first year post- CA. Of the 439 patients with recurrent AF, 99 had AECG monitoring before recurrence. These 99 patients were compared with the 672 patients with no AF recurrence. Average duration of AECG monitoring for the entire cohort was 11±2.7 days. Mean SVT episodes per day ≥4.6 and total number of SVT episodes ≥14.5 were significantly associated with recurrent AF (OR =1.99, P =0.030, and OR =2.77, P =0.019, respectively). Significant predictors of AF recurrence were female gender, heart failure, confirmed SVT, cardioversion before ablation, mean SVT episodes per day, and total SVT episodes on AECG.Conclusion:High burden of SVT on AECG monitoring (defined in this study to be ≥4.6 episode per day or ≥14.5 total episodes per monitoring period) was significantly associated with AF recurrence. Longitudinal studies in larger unselected populations are needed to confirm these results.

Circulation, Volume 150, Issue Suppl_1, Page ASu1203-ASu1203, November 12, 2024. Background:A goal of post-resuscitation care among patients successfully resuscitated from in-hospital cardiac arrest (IHCA) is avoidance of fever. However, the incidence of post-resuscitation fever after the initial therapeutic hypothermia trials in 2002 and after the recent Targeted Temperature Management (TTM) trial in 2013 is unknown.Objective:Examine temporal trends in fever during the first 24 hours after return of spontaneous circulation (ROSC) from IHCA during 2005-2013 (after the initial hypothermia trials) and then during 2014-2022 (after the TTM trial).Methods:Within the Get With The Guidelines-Resuscitation registry for IHCA in the U.S., we identified adult patients with ROSC after an index IHCA from 127 hospitals that submitted data on IHCA during both time periods between 2005 and 2022. Patients with sepsis and COVID-19 infection were excluded. We evaluated temporal trends in post-resuscitation fever (defined as >100 °F) during 2005-2013 after the initial hypothermia trials, and then between 2014-2022 after the TTM trial.Results:Among 41,155 patients with ROSC after IHCA, the mean age was 64.8 years (±15.0); 60.0% were male, and 68.6% were of White race. Overall, 11,745 (28.5%) developed post-resuscitation fever (Figure 1). Following the therapeutic hypothermia trials in late 2002, the incidence of fever decreased from 39.1% in 2005 to 29.0% in 2013 (Pfor trend < 0.001) (Figure 2). After the publication of the TTM trial in late 2013, post-resuscitation fever in the years 2014-2022 did not go up but declined more modestly (Pfor trend = 0.003).Conclusions:Between 2005 and 2013, the incidence of post-resuscitation fever after IHCA decreased substantially. Since the publication of the TTM trial in late 2013, fever incidence has not increased; rather, it has remained relatively stable, even as reported use of therapeutic hypothermia has declined.

Circulation, Volume 150, Issue Suppl_1, Page A4145353-A4145353, November 12, 2024. Background:Myocardial injury complicating percutaneous coronary intervention (PCI) is associated with mortality, but sex differences in outcomes are uncertain. We explored sex differences in the incidence and long-term outcomes of post-PCI myocardial injury (PPMI).Methods:Adults who underwent PCI at NYU between 2011-2020 were included in this retrospective analysis. Patients with ACS as the indication for PCI were excluded. PPMI was defined as a peak CKMB concentration >99% of the upper reference limit. The incidence of PPMI by sex was compared by Chi-square tests. Independent predictors of elevated CKMB post-PCI were evaluated with linear regression models in subgroups by sex. Cox proportional hazard models were generated to evaluate relationships between PPMI and all-cause mortality by sex.Results:Of 10,807 adults undergoing PCI, 24.9% (2,694) were female. Females were older than males at the time of PCI (68.9 vs. 65.8, p

Circulation, Volume 150, Issue Suppl_1, Page A4141173-A4141173, November 12, 2024. Background:Heart transplantation remains definitive therapy for children with heart failure, but the burden of acute graft rejection remains. While adult data has shown cardiac magnetic resonance (CMR) offers reliable, non-invasive identification of graft rejection1-3, endo-myocardial biopsy (EMB) continues to be the gold-standard in children.Hypothesis:CMR can establish the presence/absence of rejection, guiding need for EMB and rejection therapy.Aims:To assess the (1) strength of CMR parametric mapping in discriminating presence of rejection (defined as need for new therapy), and (2) the ability of CMR to identify patients without rejection, negating the need for EMB.Methods:Pediatric heart transplant patients referred for EMB underwent concurrent noncontrast CMR with volumetry, flows, MOLLI T1 and T2 parametric mapping at 1.5T. Average and peak segmental native T1 and T2 were measured in 6 slices, and regions of sub-segmental ‘hotspot’ elevation (3 continuous voxels T1 >1050 ms or T2 >60 ms) were identified. Rejection treatment was per institutional protocol, blinded to CMR results, categorized as (A)new IV therapy, (B)oral augmentation of maintenance, or (C) no change. Sensitivity, specificity and ROC analyses were performed.Results:95 encounters in 34 patients (median age 13.1y (IQR 7.5-16.3), BSA 1.37 m2 (1.1-1.6), 47% female) were completed, with treatment groups A 13%, B 5%, and C 82%. Significantly higher T1 and T2 values were found in the rejection groups. ROC curve analysis identified elevated peak T1 levels as the strongest predictor of rejection (AUC = 0.848, 95% CI: 0.746, 0.950, p1099 ms. Subsegmental hotspots were present in all encounters with rejection requiring new therapy (100% sensitivity), however the type/ number of hotspots did not correlate with rejection. New rejection therapy was not initiated in any patient encounter without hotspots (NPV 100%).Conclusions:Elevated segmental T1 CMR values can identify children with graft rejection, and absence of subsegmental hotspot elevations can reliably identify patients without rejection. CMR is a promising non-invasive test to aid in graft surveillance and direct invasive testing and therapy.

Circulation, Volume 150, Issue Suppl_1, Page ASu1206-ASu1206, November 12, 2024. Introduction:Critical care after advanced cardiac life support can be pivotal for survival and outcomes in patients with out-of-hospital cardiac arrest (OHCA). Prior studies have demonstrated improvements in survival after OHCA with shorter door-to-therapeutic hypothermia (TH) initiation times. Post-cardiac arrest consult teams (PCACT) can facilitate TH to goal 33°C and other aspects of post-arrest care. However, the effects of such a service on TH have not been consistently quantified.Hypothesis:More OHCA patients would undergo TH and reach goal temperature sooner following implementation of a PCACT.Aims:We aim to evaluate the effectiveness of a PCACT in optimizing TH in survivors of OHCA.Methods:We conducted a retrospective chart review of 305 patients admitted between January 1, 2021 and December 31, 2022. Implementation of a dedicated PCACT, comprised of a neurointensivist and an advanced practice provider or neurocritical care fellow, occurred on January 1, 2022. The PCACT was active on weekdays only. One year before and after this date were designated as “pre-PCACT” and “post-PCACT”, respectively. De-identified patient demographics, clinical features of cardiac arrest, and TH data were collected and compared using Wilcoxon rank-sum and Chi-squared tests for continuous and categorical variables, respectively.Results:Of the 305 patients admitted during the study period, 149 were in the pre-PCACT group and 156 were in the post-PCACT group. Baseline demographics between the two groups were similar except that the post-PCACT group had more patients with non-shockable rhythms (64% vs. 54%,p=0.001). Patients were not cooled to 33°C more frequently (50 vs. 52%) pre- or post-PCACT. TH to 33°C was performed in 156 (51%) patients, 78 patients (50%) pre- and post-PCACT implementation. There were no baseline demographic or temperature differences between the two groups amongst patients undergoing TH to 33°C. Post-PCACT patients were quicker to reach 33°C (1.6 vs. 3 hours,p=0.001). After PCACT implementation, this difference was noted during weekdays but not during weekends (1.3 vs. 2.7 hours,p=0.05).There were no differences in survival or neurologic outcomes pre- and post-PCACT introduction, nor between patients who were or were not cooled to 33C.Conclusion(s):Implementation of a PCACT may streamline care to reduce time to goal temperature during TH. However, further study is required to determine whether a PCACT can improve outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4141879-A4141879, November 12, 2024. Background:Current guidelines recommend oral anticoagulation (OAC) for at least two months post-radiofrequency ablation (RFA) in all patients with atrial fibrillation (AF). The endothelial injury during RFA that can promote thrombus formation, does not happen in pulsed-field ablation (PFA).Objective:We evaluated the optimal duration of OAC therapy needed for effective stroke prevention following PFA.Methods:Consecutive patients undergoing PFA for AF were included in the study and prospectively followed-up for 1 year. Based on the duration of post-ablation OAC [non-vitamin K OAC (NOAC)] therapy they were classified intogroup 1:NOAC for 1 month and group 2: NOAC for ≥2 months. Patients were closely monitored for thromboembolic (TE) events via telemedicine. Stroke/transient ischemic attacks that occurred while the patients were in full compliance with the anti-thrombotic therapy, were counted as the reportable TE events.Results:A total of 120 patients were included in this analysis. The mean age of the study population was 59.80 ± 16.39 years; 70 (58%) were male and the CHA2DS2-VASc score was 4.27 ± 1.22. Mean number of PFA applications given was 76.64 ± 36.04.Group 1included 49 (40.8%) andgroup 2was comprised of 71 (59.2%) patients. Baseline characteristics were comparable between the groups.At 1 year,no stroke or transient ischemic attacks were reported in group 1 and 2. At that time point, 42 (85.7%) and 60 (84.5%) patients were arrhythmia-free in group 1 and 2 respectively (p=0.85).Conclusion:In this series of patients, OAC could be safely discontinued after 1 month following the PFA procedure. Thus, it seems redundant to continue OAC beyond 1 month after PFA.

Circulation, Volume 150, Issue Suppl_1, Page A4138507-A4138507, November 12, 2024. Background:SARS-CoV2 infection has been associated with cardiovascular consequences, including myocarditis and cardiac arrhythmias. Myocarditis secondary to SARS-CoV2 infection and cardiac arrhythmias may often go unrecognized and can present with late and nonspecific symptoms. Predicting those at risk allows for prompt treatment and prevention of their potentially life-threatening consequences.Methods:The National COVID Cohort Collaborative (N3C) database was used to identify patients aged 0-30 years with COVID-19 index date between 1/1/2020 and 3/31/2022, whose sites provided data for at least six months beyond the index date. Outcomes included myocarditis and new arrythmias within 6 months of the index visit. Patients with known cardiac comorbidities were excluded. Predictors included gender, race, COVID severity as an ordinal scale, vaccination status, clinical comorbidities, and Area Deprivation Index (ADI). The data were stratified by age groups (0-4, 5-17, 18-30). Random forest models were used for data analysis and SHapley Additive exPlanations (SHAP) method was applied to optimize results. These analyses were conducted using the NCATS N3C Data Enclave.Results:Of the 1,487,741 patients in our study population, 4,105 (0.28%) had the measured outcomes; 404 had myocarditis only, 3,634 had arrhythmia only and 67 had both. Severity of COVID (SHAP 0.2344 for 0-4 years, 0.2114 for 5-17, 0.1370 for 18-30) was identified as the most important risk factor for de-novo myocarditis and arrhythmias overall. Increase in ADI (indicating lower socioeconomic status) was the second most important risk factor for the 0-4 and 5-17 age groups (SHAP: 0.0370, 0.0223). Among the 18-30 age group, race (SHAP 0.0321) and gender (SHAP 0.0289) were the second and third most important risk factors, with White and Black patients more likely to develop an event and Hispanic patients less likely. Women were less likely to develop a cardiac outcome than men.Conclusion:The severity of COVID was identified as the most important risk factor for the occurrence of myocarditis or cardiac arrhythmia within 6 months of infection. ADI, race, and gender were also identified as important, though less influential, risk factors.

Circulation, Volume 150, Issue Suppl_1, Page ASu1101-ASu1101, November 12, 2024. Introduction:Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are interventions that can increase survival rates of out-of-hospital cardiac arrests (OHCA). However, willingness and comfort levels of such interventions amongst laypersons vary greatly, especially in racial and ethnic minoritized groups including African Americans and Hispanics.Research Question:To assess the comfort level and perceived barriers of participants before and after community-based CPR and AED education.Methods:We conducted a family-centered quasi-experimental study in primarily Black and Hispanic churches around the Will and Dupage counties of Illinois. Informed consent was obtained. Participants watched an instructor-facilitated CPR and AED 10-minute educational video. Comfort levels pre- and post-training were assessed on a scale of 1 (least confident) to 5 (extremely confident) and reported as percentages. A semi-structured questionnaire was used to assess perceived barriers to performing CPR.Results:Out of 27 participants who completed training assessment, majority were females 55.6% (n=15), with 44.4% (n=12) males; 66.7% (n=18) African Americans, and 33.3% (n=9) Hispanic or Latino. 70.4% (n=19) of the participants spoke English while 29.6% (n=8) spoke Spanish. Before training, 73% (n=19) and 81% (n=21) of participants were not confident in administering CPR or using AED respectively on someone in cardiac arrest. After training, confidence level increased to 100% for both CPR and AED use. Perceived barriers to CPR prior to training included participants not knowing how to perform CPR correctly (65%), concern that they may further harm someone (4%), concerns about potential legal liability (4%), and loss of recall on how to perform CPR (4%), while 23% had no barrier.Conclusion:Comfort levels of individuals performing CPR and AED use increased significantly after community-based CPR and AED education. Data collection is ongoing to assess comfort level with a larger number of participants. Implementing community-based CPR training in churches allows for community-oriented CPR trainings and may help improve bystander comfort level and willingness to perform CPR during OHCA, especially in minoritized communities.

Circulation, Volume 150, Issue Suppl_1, Page A4144055-A4144055, November 12, 2024. Background:Maternal cardiovascular health is a critical concern, particularly during and following pregnancy. Previous studies have highlighted the influence of social determinants on health outcomes, but the specific impact of adverse Physical Environment, Housing, and Economic Conditions on maternal cardiovascular health remains underexplored.Methods:Using the TriNetX global health research network within the US Collaborative Network, we explored how adverse Physical Environment, Housing, and Economic Conditions (ICD10CM: Z58 and ICD10CM: Z59) impact maternal cardiovascular health during pregnancy and within one year postpartum. Using, propensity score matching (PSM) analysis, our study compared two cohorts: women aged 15 to 60 who experienced issues related to Physical Environment, Housing, and Economic Conditions during or after pregnancy from 2008 to 2023, and women in the same age range who did not face such issues, thus representing a favorable physical environment, housing, and economic conditions.Results:Challenges related to the physical environment, housing, and economic conditions significantly increased the risk of all-cause mortality (OR: 3.237, 95% CI: 2.064 to 5.075, p