Background: As of 2016, ≈1.4 million people in the United States identify as transgender. Despite their growing number and increasing specific medical needs, there has been a lack of research on cardiovascular disease (CVD) and CVD risk factors in this population. Recent studies have reported that the transgender population had a significantly higher rate of CVD risk factors without a significant increase in overall CVD morbidity and mortality. These studies are limited by their small sample sizes and their predominant focus on younger transgender populations. With a larger sample size and inclusion of broader age range, our study aims to provide insight into the association between being transgender and cardiovascular risk factors, as well as myocardial infarction. Methods and Results: The Behavioral Risk Factor Surveillance System data from 2014 to 2017 were used to evaluate the cross-sectional association between being transgender and the reported history of myocardial infarction and CVD risk factors. A logistic regression model was constructed to study the association between being transgender and myocardial infarction after adjusting for CVD risk factors including age, diabetes mellitus, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise. Multivariable analysis revealed that transgender men had a >2-fold and 4-fold increase in the rate of myocardial infarction compared with cisgender men (odds ratio, 2.53; 95% CI, 1.14–5.63; P =0.02) and cisgender women (odds ratio, 4.90; 95% CI, 2.21–10.90; P 2-fold increase in the rate of myocardial infarction compared with cisgender women (odds ratio, 2.56; 95% CI, 1.78–3.68; P <0.01) but did not have a significant increase in the rate of myocardial infarction compared with cisgender men. Conclusions: The transgender population had a higher reported history of myocardial infarction in comparison to the cisgender population, except for transgender women compared with cisgender men, even after adjusting for cardiovascular risk factors.

Pancytopenia is a rare side effect of levetiracetam (LEV) that is associated with severe morbidity that requires hospitalization. Here, we report a patient with a right temporoparietal tumor who underwent a temporal craniotomy with resection of the mass and was started on LEV for seizure prophylaxis per the neurosurgery local protocol. The patient developed LEV-induced pancytopenia, which was successfully managed by discontinuation of this medication. Our report aims to increase awareness of this rare cause of pancytopenia among clinicians.

Background: Electronic cigarettes (e-cigarettes) have been increasing in popularity among young adults due to the misconception about the safety of e-cigarettes. Our study aims to identify the prevalence rate of e-cigarette use among college students, the reason behind their use, and the relationship between the use of electronic cigarettes and cardiovascular symptoms among college students. Methods: An online questionnaire was sent to students of Taibah University between 2021 and 2022. Data from this survey were analyzed to obtain the prevalence of e-cigarette use among Taibah University students and to compare the demographic and health characteristics differences between e-cigarette users and non-users. The prevalence of cardiovascular symptoms was also compared between the two groups. Results: A total of 519 students participated in this study. The prevalence rate of e-cigarette use was 24%. Compared to non-users, e-cigarette users were more likely to be male (71% vs. 40%, p 7%, p = 0.02), and palpitation (12% vs. 6%, p = 0.03). The association between e-cigarette use and cardiovascular symptoms was significant even after adjusting for students' characteristics. Students' main reasons for e-cigarette use were to enjoy the flavors of e-cigarettes, quit tobacco smoking, and improve depression. Conclusion: The prevalence rate of e-cigarette use among college students was 24%. The self-reported cardiovascular disease symptoms rate was doubled among e-cigarette users compared to non-users.

There have been significant advances in the treatment of patients with cardiomyopathy with reduced ejection fraction (EF < 40%). However, there is a dearth of information in the treatment of patients with cardiomyopathy and midrange EF (40–50%). Current guidelines state to treat these patients similarly to patients with cardiomyopathy and preserved EF. Data from the Prevention of Events with Angiotensin-Converting Enzyme Inhibition (PEACE) trial were used to elucidate whether angiotensin-converting enzyme (ACE) inhibitors improve clinical outcomes in patients with ischemic cardiomyopathy and midrange EF. A post hoc subgroup analysis of the PEACE trial was conducted to evaluate the effect of ACE inhibitors in a subgroup of patients with ischemic cardiomyopathy and midrange EF (40–50%). A Chi-square test and a Student‘s t-test were used to examine and compare the binary and continuous variables of baseline characteristics and outcomes between experimental and comparison groups. We studied a subgroup of patients from the PEACE trial with ischemic cardiomyopathy and midrange EF (n = 2512 of 8290 total patients). Patients were assigned to either the interventional group (n = 1247) or the placebo group (n = 1265). There were no significant differences in baseline demographic and health characteristics between the two groups. During a total of 7 years (mean 4.7 years) of follow up, the risk of composite outcomes [all-cause mortality, nonfatal myocardial infarction, and stroke; relative risk (RR) 0.79, 95% confidence interval (CI) 0.63–0.98; p = 0.03] and all-cause mortality (RR 0.85, 95% CI 0.73–0.99; p = 0.03) was reduced in patients treated with trandolapril. This study revealed the benefit of ACE inhibitors among patients with ischemic cardiomyopathy and midrange EF.