Citations

Background: Geographic and temporal distribution of disparity authorships is unclear. Our aim was to examine authorship trends in 2020-2023 American Heart Association (AHA) abstracts reporting social and demographic disparities. Methods: We reviewed 801 AHA conference abstracts, analyzing 723 reports. Regional information of authors and their reported disparities related to gender, race, region, healthcare access (HCA), comorbidities (CO), socioeconomic status (SES) were collected. Descriptive and trend analyses were performed using Chi-square tests, and Pearson's and Kendall's Tau b correlation tests. P <0.05 was considered significant. Results: We analyzed 1440 primary and senior authorships from 723 abstracts. The majority of authors (92%) were from North America, predominantly USA (90%), with a significant representation from the South (33.6%) vs. other regions (Image 1). Disparities on outcomes such as race, gender, SES, CO, geographical locations, and HCA were reported as 53.9%, 33.9%, 26.6%, 24.9%, 17.8%, and 13.6% respectively. From 2020 to 2023, there was a declining trend in authors reporting on gender (ptrend<0.001) and HCA (ptrend-0.03) disparities, whereas disparities on SES had an increasing trend (ptrend<0.001). An increase in reporting of gender disparities was associated with increased reporting of racial disparities (r = .081, τb = .081). We also found positive correlations between SES and HCA (r = .155, τb = .155). Conversely, there was a negative correlation between gender and SES (r = -0.133, τb = -0.133), and between CO and healthcare access HCA (r = -0.078, τb = -0.078). All correlations were statistically significant (p < 0.05). Conclusion: The trends show that authors have reported more SES disparities in recent times compared to HCA, race, and gender. With expected financially challenging times ahead, to address these findings, it remains important to focus research on income based equalities in HCA and outcomes.

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: The obesity paradox is a phenomenon observed in certain chronic diseases, particularly cardiovascular diseases, where individuals with obesity have better outcomes compared to those of normal weight. We aimed to study how COVID-19 affects MACCE results in metabolically healthy obese (MHO) individuals who have a BMI >30. Methods: Using the National Inpatient Sample (2020) and appropriate ICD-10-CM codes, we identified adult hospitalizations with COVID-19 and grouped them into two cohorts with and without obesity (MHO+ and MHO-, omitting hypertension, diabetes, and hyperlipidemia). MACCE (all-cause inpatient mortality, cardiac arrest, including ventricular fibrillation, and stroke) in COVID-19-related hospitalizations was the primary outcome. Results: 84,145 (21.9%) of 397,040 COVID-19 hospitalizations were MHO+. The MHO+ group was younger (median 43 vs 52 years), female (56.9% vs. 49.4%), black (19.4% vs 15.1%), Hispanic (35.2% vs 30.5%), and Native American (1.5% vs 1.2%) (p<0.001). Tobacco use disorder, past PCI, prior VTE, depression, chronic pulmonary disease, hypothyroidism, and other thyroid problems were more common in MHO+ patients (p<0.05). MHO+ patients were discharged routinely (76% vs. 66.7%) but stayed longer (5 days vs 4 days). After correcting for baseline variables, the MHO+ cohort had a lower rate of MACCE than the MHO- cohort (8% vs. 11.3%, OR 0.81, 95CI 0.74-0.89, p<0.001), and lower all-cause mortality (6.6 % vs 9.4%) compared to the MHO- cohort. On subgroup analysis, females had lower odds (aOR 0.79) than males (aOR 0.82), older individuals ≥65 years old had lower odds (aOR 0.71) vs 45-64 (aOR 0.79), and race- wise comparison, whites had lower odds of MACCE events (aOR 0.76). Conclusions: MHO+ patients had lower odds of MACCE events. The MHO group was younger, suggesting higher cardiorespiratory fitness, which could explain the obesity paradox and reduced odds of MACCE outcomes.

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.