Eppalapally, Akhil kumar

Background: The association of prediabetes (pDM) with stroke risk in non-diabetic geriatric patients with AF is unclear. The findings from this analysis contribute to a better understanding of the interrelation between pDM, AF, and stroke, highlighting the need for targeted interventions and risk management strategies in this vulnerable population. Methods: Utilizing the 2019 National Inpatient Sample and employing ICD-10 CM coding, we identified all non-diabetic geriatric admissions with AF. Patients were categorized into two groups: pDM+ and pDM-. The primary outcomes of interest were stroke incidence, odds and potential sex disparities in odds as a risk factor for stroke in geriatric patients with AF. Results: Of the total 218130 non-diabetic geriatric AF admissions, 3525(1.6%) had pDM. The pDM+ cohort was relatively younger (median 75 vs 77 years), and often consisted of females (57.9%; p<0.359), white (80.1%), and from the higher-income quartile (28.5%); (p<0.001). The preDM+ group had significantly higher rates of complicated HTN (50.2 vs 43.6%), hyperlipidemia (66.4 vs 53.7%), obesity (30.2 vs 13.6%), PVD (15.3 vs 9.9%), stroke (1.4 vs 0.8%). After adjusting for baseline characteristics/comorbidities, the pDM+ cohort with AF admissions showed a higher rate and significantly higher odds of stroke vs the pDM- cohort (1.4% vs. 0.8%, OR 2.00, 95%CI 1.06-3.77; p=0.033). On subgroup analyses, males had a stronger association (OR 5.48, 95%CI 1.43-21.02; p=0.013) vs. females. Conclusion: Our research revealed that geriatric patients hospitalized with AF who had concomitant pDM were twice likely to develop stroke, with male preponderance. Further research is warranted to develop tailored interventions to mitigate the risk of stroke in AF patients with pDM.

Background: Cardiovascular disease is the leading cause of death worldwide, with a notable impact on postmenopausal women. However, contemporary large-scale population-based data for the burden and disparities of Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) in this population remains limited. Methods: The National Inpatient Sample (2020, ICD10 codes, age>55 years) was queried to identify postmenopausal women's hospitalizations. Socio-demographics, racial subgroups, comorbidities, and MACCE rates were retrieved with a more granular comparative analysis in postmenopausal women. A p<0.05 was considered statistically significant. Results: Of the total 8435195 postmenopausal women hospitalizations (median age 75 years), 1021375 (12.1%) were identified with MACCE. MACCE cohort, in comparison to non-MACCE cohort, had significantly higher prevalence of hypertension (77.1% vs 71.3), diabetes (39.8% vs 34.0%), hyperlipidemia (53.7% vs 48.4%), PVD (9.8% vs 7.1%), prior MI (8.3 vs 5.7%), prior TIA/stroke (10.5 vs 9%) and CKD (29.4 vs 23.4%). Significant clinical predictors for all-cause mortality were found to be race Asian/PI vs white ( 1.31 [1.09-1.18]), median household income national quartile (1.16 [1.13-1.20]), hypertension (1.18[1.16-1.20]) diabetes (1.20 [1.19-1.22]), hyperlipidemia (1.12[1.11-1.14]), prior MI (1.37[1.34-1.40]) and prior TIA stroke (1.0 5 [1.03-1.07] (all p<0.05). Conclusion: Among hospitalizations, Asian/Pacific Islanders, patients from the lowermost income quartile with co-existent hypertension, diabetes, hyperlipidemia, CKD, and cardiovascular comorbidities independently revealed the highest MACCE rates. Special emphasis needs to be laid on socio-demographics, comorbidities, and racial differences for CVD disease prevention, and risk factor modification in postmenopausal women.