Thakkar, Kamya U

Introduction: Racial, regional, and income disparities have been shown to impact cardiovascular outcomes in postmenopausal women with SARS-CoV-2. Addressing these disparities can improve healthcare equity and outcomes for this vulnerable population. Methods: A retrospective cohort study utilized data from the National Inpatient Sample (NIS)-2020 to examine female patients aged over 55 years who were admitted to hospitals in 2020. The study focused on primary endpoints, specifically major cardiac and cerebrovascular events (MACCE) including all-cause mortality, AMI, cardiac arrest, and stroke. Multivariable logistic regression was used to evaluate the association between demographic factors and cardiovascular outcomes, after controlling for confounding variables. Results: Of the total 547,225 postmenopausal women hospitalized with SARS-CoV-2, 19.8% had MACCE. Racial disparities were significant, as Native American, Hispanic, Asian and African American women exhibited higher rates of MACCE compared to Caucasian women, with odds ratios (OR) of 1.63 (95% CI: 1.33-1.98, p<0.001), 1.25 (95% CI: 1.18-1.32, p<0.001), 1.17 (95% CI: 1.07-1.28, p<0.001), and 1.11 (95% CI: 1.06-1.17, p<0.001), respectively. Regional variations were also observed, with the Northeast region demonstrating a higher prevalence of cardiovascular complications compared to the West (OR: 1.22, 95% CI: 1.14-1.32, p<0.001). Additionally, income level played a significant role, as women from the first- and second-income quartiles had higher MACCE rates compared to those in the fourth quartile (OR: 1.19, 95% CI: 1.12-1.26, p<0.001; OR: 1.09, 95% CI: 1.03-1.15, p<0.001). Conclusions: This study reveals significant racial, regional, and income disparities in cardiovascular outcomes among postmenopausal women with SARS-CoV-2. Targeted interventions and further research are necessary to improve healthcare equity and outcomes in vulnerable populations.

Background: Anemia in Type 2 Myocardial Infarction (T2MI) related hospitalizations has been linked to higher one year mortality along with other causes of hemodynamic stress. We conducted the first ever meta analysis to evaluate the overall global prevalence of Anemia among patients with T2MI with differences by subgroups. Methods: PUBMED, SCOPUS and Google Scholar Databases were systematically reviewed to find studies through January 2023 ascertaining prevalence of Anemia in T2MI. Binary Random Effects models were used to estimate the pooled prevalence and subgroup analysis of anemia in T2MI. Heterogeneity was assessed using I 2 statistics. Leave-One-Out sensitivity analysis was also performed. Results: A total of 16 cohorts with 28,629 patients, hospitalized with T2MI (Mean Age 74; SD13) revealed a 23.3% [95% CI 17.8% - 28.8%, I 2 -98.61%, P<0.001] pooled prevalence of Anemia and a Mean Hb level of 121; SD - 25 in g/L. The prevalence of Anemia was higher among T2MI cohorts with younger Mean Age [Mean <70 vs >70 Years; 24.6% (95% CI 14.1% - 34.1%) vs 21.4% (95% CI 15.6 - 27.2%)]; smaller sample size [ n<500 vs n>500; 26.6% (95% CI 18.4% - 34.8%) vs 18.6% (95%CI 10.4% - 26.8%)]; prospective studies [Prospective vs Retrospective; 26.1% (95%CI 17.4% - 34.7%) vs 18.7% (95%CI 12.7% - 24.7%)] and single center studies [Single Center vs Multi Center; 24.9% (95%CI 17.5% - 32.2%) vs 21.4% (95%CI 12.7% - 30.1%)]. The prevalence of Anemia in T2MI related hospitalizations was also higher in studies from Asia [36.2% (95%CI 24.6% - 47.7%)], Europe [21.9% (95% CI 14.1% - 29.7%)] and Multinational [21.1% (95%CI 11.9%-30.2%)] as compared to North America [16.4% (95%CI 8% - 24.8%)]. Conclusions: The pooled prevalence of Anemia in this worldwide meta analysis of T2MI hospitalized patients was 23.3% with wide variance among subgroups. Further studies should focus on scrutinizing the outcomes and devastating complications of Anemic patients with T2MI among various populations universally.