Background: Sudden cardiac death (SCD) is a leading cause of mortality in the United States, with significant variations across demographic and geographic factors. This study analyzes trends in SCD‐related mortality among adults (> 25 years) from 1999 to 2020 using the CDC WONDER database.Methods: We extracted data on SCD‐related deaths (ICD‐10 code I46.1) and calculated age‐adjusted mortality rates (AAMR) per 100 000 population, stratified by sex, race/ethnicity, urbanization, and census region. Joinpoint regression was performed to estimate the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CI).Results: A total of 279 599 SCD‐related deaths were recorded from 1999 to 2020. Overall AAMR declined significantly (AAPC: −1.20%; 95% CI: −1.58% to −0.82%) until 2018, followed by a sharp increase from 2018 to 2020 (APC: +6.93%; 95% CI: +3.04% to +10.96%). Declines were most pronounced in American Indian/Alaska Native populations (−3.67%), while the highest increases post‐2018 were observed in Hispanic (+13.1%) and Asian/Pacific Islander groups (+12.3%). Urban areas experienced greater post‐2018 increases compared to rural areas. Regional disparities were evident, with the West showing the steepest rise in mortality.Conclusion: While SCD mortality declined from 1999 to 2018, a concerning reversal has emerged since 2018, particularly in specific racial/ethnic groups and urban areas. Further research is needed to investigate underlying causes, including the potential impact of COVID‐19, healthcare disparities, and lifestyle factors.

Introduction: Although previous meta-analyses have explored the efficacy and safety of direct oral anticoagulants (DOAC) compared to warfarin in patients with atrial fibrillation (AFib) and liver disease, recent studies and emerging data necessitate a re-evaluation of the topic. Therefore, we con ducted an updated meta-analysis to incorporate the latest evidence and provide a more comprehensive understanding of the literature. This meta-analysis aimed to assess the safety and efficacy of DOAC in patients diagnosed with AFib and liver disease. Methods: Following PRISMA guidelines, this meta-analysis is registered with PROSPERO (2024 CRD42024584964). A detailed search up to August 2024 was conducted for the studies comparing DOAC with warfarin. The quality of the included observational studies was evaluated using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Results: This meta-analysis included 53,224 participants with AFib and liver disease. The use of DOAC, in comparison to warfarin, was significantly linked to a lower risk of all-cause mortality (HR = 0.77; 95% CI: 0.60–0.98; p = 0.04) and a decreased occurrence of intracranial haemorrhage (HR = 0.49; 95% CI: 0.40–0.59; p < 0.00001). However, other outcomes did not demonstrate statistically significant differences. Conclusions: Recent studies indicate that DOAC are at least non-inferior to warfarin concerning efficacy and safety of patients with AFib and liver disease.

Background: Hereditary transthyretin amyloidosis (hATTR) is caused by mutations in the transthyretin (TTR) gene, which lead to the aggregation of misfolded TTR protein and amyloid accumulation in the peripheral nerves, heart, and gastrointestinal tract. Recently, RNA therapeutics, including small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs), have been approved for treating patients with hATTR. Objectives: To assess the neurological efficacy and safety of RNA therapeutics in hATTR patients. Design: Systematic review and meta-analysis. Data sources and methods: A systematic literature search was conducted on PubMed, Cochrane, and ClinicalTrials.gov from inception to August 14, 2024. Outcomes included changes from baseline in the Norfolk Quality of Life–Diabetic Neuropathy (Norfolk QOL-DN) score and the modified Neuropathy Impairment Score +7 (mNIS + 7), modified body mass index (mBMI), adverse effects, serious adverse events, and all-cause mortality. Results: Our study included four RCTs with 842 patients (568 in the RNA therapeutics group and 274 in the placebo group). RNA therapeutics significantly improved Norfolk QoL-DN (mean difference (MD), −18.79; 95% CI, −22.32 to −15.25; p < 0.00001; I ² = 28%) and mNIS + 7 scores (MD, −26.90; 95% CI, −31.67 to −22.13; p < 0.00001; I ² = 61%), with significant preservation of mBMI (MD, 114.98; 95% CI, 90.64–139.32; p < 0.00001; I ² = 59%) compared to placebo. There were no significant differences between the two groups regarding the risk of adverse effects (risk ratio (RR), 0.89; 95% CI, 0.69–1.15; p = 0.36; I ² = 34%), serious adverse effects (RR, 0.70; 95% CI, 0.31–1.58; p = 0.39; I ² = 20%), and all-cause mortality (RR, 0.70; 95% CI, 0.31 to 1.58; p = 0.39; I ² = 20%). Conclusion: RNA therapeutics are effective and well-tolerated in patients with hATTR, significantly improving quality of life and the progression of neurological impairment. siRNAs demonstrate better outcomes compared to ASOs. Trial registration: PROSPERO (CRD42024568346).

Urinary tract infections (UTIs) rank among the most common bacterial infections globally, impacting around 404 million individuals each year. This research investigates trends in mortality associated with UTIs in adult patients across the United States from 1999 to 2023. We retrospectively examined death statistics from the CDC WONDER database, examining mortality trends where UTI was the primary or contributing cause. Age-adjusted mortality rates (AAMR) per 1,00,000 were computed and categorized by sex, race/ethnicity, urbanization, state, and census region. Trends were evaluated using joinpoint regression to determine annual percentage change (APC) with 95% confidence intervals. From 1999 to 2023, there were a total of 10,83,913 UTI-related deaths among individuals aged 25 and older. The overall AAMR decreased from 1999 to 2018 (APC: −0.80; 95% CI: −1.13 to −0.46), followed by a significant increase up to 2023 (APC: 3.95; 95% CI: 1.60–6.36). Females consistently displayed higher AAMRs compared to males. Non-Hispanic (NH) American Indian/Alaskan Native individuals experienced the highest (AAMR) among racial groups. In terms of geography, nonmetropolitan areas exhibited higher rates than metropolitan regions, while the South reported the highest AAMR when considering census regions. Tennessee had the highest AAMR (30.48) between 1999 and 2020. Mortality related to UTIs has been on the rise since 2018, with the most notable rates found among females, NH American Indian/Alaskan Native, nonmetropolitan residents, and those in the Southern region. These disparities emphasize the necessity for ongoing initiatives and targeted interventions aimed at these high-risk groups.

Anthracyclines (ANT) are widely used in chemotherapy, but their dose-dependent Cardiotoxicity limits long-term use. Carvedilol, a non-selective beta-blocker, has shown potential as a Cardioprotective agent for patients receiving ANT, though its overall effectiveness remains unclear. This systematic review and meta-analysis aimed to assess the impact of carvedilol on cardiac function and survival in patients with anthracycline-induced Cardiotoxicity. We performed a comprehensive search of major electronic databases through March 2025 for studies comparing carvedilol with placebo or no treatment in human subjects with ANT-Induced Cardiotoxicity. Primary outcomes included left ventricular ejection fraction (LVEF), left ventricular systolic dysfunction (LVSD), left ventricular systolic and diastolic diameters (LVsD, LVdD), and mortality. Secondary outcomes included echocardiographic and Doppler parameters. Random-effects models were used to calculate standard mean differences (SMDs) and risk ratios (RR) using RevMan 5.4. A total of fourteen studies were included, thirteen in the meta-analysis and one in the systematic review only, comprising 1,245 participants (carvedilol: 679; control: 566). Carvedilol significantly preserved LVEF (SMD: 0.33, 95% CI: 0.09, 0.58) and reduced the risk of LVSD (RR: 0.26, 95% CI: 0.11, 0.62). It also decreased systolic (SMD: −0.39, 95% CI: −0.53, −0.26) as well as diastolic ventricular diameter (SMD: −0.19, 95% CI: −0.38, −0.00). However, no significant difference in short-term mortality was observed. Carvedilol appears to protect cardiac function in patients undergoing ANT therapy, though it does not significantly impact mortality. Further research is needed to determine optimal dosing, timing, and long-term survival benefits.