Background: Elderly hip fractures represent a global health care burden. Several reports expected a massive increase in the incidence of hip fractures by the next few decades. Knowing the epidemiology of hip fractures is crucial for planning health care policies. The purpose of this study is to provide a nationwide epidemiological overview of hip ‎fractures in Jordan and to report the perioperative outcomes that may help to improve the delivered healthcare. ‎. Methods: We conducted ‎ a retrospective study at 2 university hospitals and 2 major ‎governmental hospitals in Jordan.‎ We reviewed the records for all patients (age > 55 years) who were diagnosed with hip fractures ‎over a 3 years duration (2019– 2021). ‎We documented the patient’s characteristics and the perioperative data (including preoperative, intraoperative, and postoperative details including the 1-year mortality).‎ Results: The total number of included patients was 1268; more than half (53.7%) were females.‎ The mean age is ‎ 75 years (SD 9.7). ‎ The most common fracture type was trochanteric (66.2%)‎. ‎ 7% of patients had a prior contralateral hip fracture‎. The average time from admission to surgery was 2.96 days (SD 2.63). The surgery was done within 48 ‎hours for ‎ 56.7%‎ of patients.‎ Approximately, one-third of all patients (34.5%) received a blood transfusion.‎ The average length of hospital stay is 7.44 days (SD 5). The overall rate of postoperative thromboembolic events, readmission within 1 month, and revision ‎for the same surgery are 2.4%‎, 10.7%‎, and 3% respectively.‎ The 1-month, 6-month, and 12-month mortality rates are 4.5%, 9.1%, and 12.8% respectively. Conclusion: The annual incidence of elderly hip fractures in Jordan is approximately 96 per 100,000 individuals. The 1-year mortality rate of hip fractures in Jordan ‎is ‎ 12.8%‎.‎ Both findings are ‎in the lower range of nearby Arab countries.

Background: Heart failure (HF) is a common final pathway of various insults to the heart, primarily from risk factors including diabetes mellitus (DM) type 2. This study analyzed the clinical characteristics of HF in a Jordanian population with a particular emphasis on the relationship between DM and HF. Methods: This prospective study used the Jordanian Heart Failure Registry (JoHFR) data. Patients with HF were characterized by DM status and HF type: HF with preserved ejection fraction (HFpEF) or HF with reduced ejection fraction (HFrEF). Demographics, clinical presentations, and treatment outcomes were collected. Statistical analyses and machine learning techniques were carried out for the prediction of mortality among HF patients: Recursive Feature Elimination with Cross-Validation (RFECV) and Synthetic Minority Over-sampling Technique with Edited Nearest Neighbors (SMOTEENN) were employed. Results: A total of 2007 patients with HF were included. Notable differences between diabetic and non-diabetic patients are apparent. Diabetic patients were predominantly male, older, and obese (p < 0.001 for all). A higher incidence of HFpEF was observed in the diabetes cohort (p = 0.006). Also, diabetic patients had significantly higher levels of cholesterol (p = 0.008) and LDL (p = 0.003), reduced hemoglobin levels (p < 0.001), and more severe renal impairment (eGFR; p = 0.006). Machine learning models, particularly the Random Forest Classifier, highlighted its superiority in mortality prediction, with an accuracy of 90.02% and AUC of 80.51%. Predictors of mortality included creatinine levels > 115 μmol/L, length of hospital stay, and need for mechanical ventilation. Conclusion: This study underscores notable differences in clinical characteristics and outcomes between diabetic and non-diabetic heart failure patients in Jordan. Diabetic patients had higher prevalence of HFpEF and poorer health indicators such as elevated cholesterol, LDL, and impaired kidney function. High creatinine levels, longer hospital stays, and the need for mechanical ventilation were key predictors of mortality.

Coronary artery ectasia (CAE) is an abnormal dilatation of coronary artery segments, often linked with atherosclerosis. This report discusses two cases of CAE presenting as acute coronary syndrome. A 36-year-old man had proximal blockage in the left circumflex artery (LCx) and ectasia in the obtuse marginal artery and left anterior descending artery (LAD), while a 53-year-old male smoker had an ectatic LAD with a substantial thrombus. Both were treated with dual antiplatelet therapy (aspirin and clopidogrel) and non-vitamin K antagonist oral anticoagulants (NOACs), specifically apixaban, along with atorvastatin. The first patient had complete resolution of LCx occlusion after 1 year, and the second patient had complete thrombus dissolution in the LAD in 2 months. These cases highlight the potential benefits of NOACs in managing CAE in acute coronary syndrome, suggesting that triple therapy can significantly improve clinical outcomes.

Introduction: Heart failure (HF) and atrial fibrillation (AF) are constantly linked together as predictors of a substantial increase in morbidity and mortality. In this study, we investigated the effects of atrial fibrillation in patients with heart failure. Methods: This study was a prospective observational multicenter national registry encompassing 21 health institutes in Jordan, comprising university hospitals, private hospitals, and private clinics. Patients visiting the cardiology clinic or inpatients admitted due to acute decompensated HF were included. The collected variables included age, sex, BMI, comorbidities, HDL, LDL, triglycerides, BNP, Sodium, potassium, hemoglobin, and creatinine. Results: Our study of 1571 patients showed significant differences between those with and without atrial fibrillation (AF). AF patients included more females (49.4% vs 34.0%), had a higher prevalence of hypertension (88.0% vs 78.5%), and were older (57.8% aged ≥ 70 years). Smoking rates were lower in patients with AF (22.3% vs 37.0%), while dyslipidemia was less common (54.5% vs 65.3%). Patients with AF also had more hospital admissions than those without AF (16% vs 11.6%). In addition, triglyceride levels were notably lower, hemoglobin levels were < 10 g/dL, and eGFR was reduced in patients with AF. In predicting death, the Random Forest Classifier had the highest accuracy (93.02%) and AUC (92.51%), whereas Logistic Regression had higher sensitivity (72.09%). Creatinine, Length of Hospital Stay, and other factors influenced the predictions, with creatinine levels being a strong predictor of patient outcomes. Conclusion: Atrial fibrillation patients were older and had a higher proportion of females compared than non-atrial fibrillation patients. Hypertension, a family history of premature coronary artery disease, and structural heart disease were notably higher in the atrial fibrillation group. Patients with atrial fibrillation had higher rates of hospital admissions than those without atrial fibrillation.

Corrigendum for the article Impact of Diabetes Mellitus on Heart Failure Patients: Insights from a Comprehensive Analysis and Machine Learning Model Using the Jordanian Heart Failure Registry

Corrigendum to: Coronary Artery Ectasia in Acute Coronary Syndrome: The Role of Non-vitamin K Antagonist Oral Anticoagulants in Management.