Background: Clinical outcomes among older adults hospitalized with heart failure with preserved ejection fraction (HFpEF) in the setting of metabolically healthy obesity (MHO) remain insufficiently explored. This study aimed to evaluate whether MHO status is associated with different rates of major adverse cardiac and cerebrovascular events (MACCEs) during HFpEF-related hospitalizations compared to patients without MHO. Methods: Data from the 2019 National Inpatient Sample (NIS) database was analyzed using relevant ICD-10 codes to identify HFpEF admissions in older adults. Propensity score matching (1:1) was applied to generate balanced cohorts of patients with and without MHO. Multivariable adjustments were performed to assess primary outcomes, including MACCEs, all-cause mortality (ACM), acute myocardial infarction (AMI), dysrhythmia, cardiac arrest (CA), and stroke. Statistical significance was set at p < 0.05. Results: Each MHO cohort included 22,405 patients with a median age of 75 years. The MHO+ group demonstrated a significantly higher risk of dysrhythmia (OR 1.32, 95% CI 1.21–1.43, p < 0.001). Interestingly, an “obesity paradox” was observed, as the MHO+ cohort had lower odds of MACCEs (OR 0.70, 95% CI 0.61–0.81, p < 0.001), ACM (OR 0.66, 95% CI 0.54–0.82, p < 0.001), and AMI (OR 0.71, 95% CI 0.59–0.86, p = 0.001) compared to MHO−. No significant differences were found for CA or stroke between the groups. Conclusions: Although the MHO+ group had an elevated risk of dysrhythmia, they exhibited more favorable outcomes in terms of MACCEs, ACM, and AMI—supporting the concept of an “obesity paradox.” Further research is needed to better understand the role of MHO as a comorbid condition in patients with HFpEF.

Objective: To determine the birth weight of apparently healthy newborns delivered at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Materials and Methods: This prospective study was carried out between July 1, 2003 and June 30, 2004. The criteria were booked mothers, mothers with regular menstrual cycles, availability of mother's last menstrual period ± report of an obstetric ultrasound scan and absence of first trimester vaginal bleeding. Maternal weight, height, birth order and socioeconomic status were also obtained. 253 babies were enrolled. Results: There were 131 males and 122 females giving a male: female ratio of 1.1:1. Gestational age by maternal dates ranged from 28 to 44 weeks. There was a consistent increase in mean values of weight as the gestational age increased. The mean (SEM) weight for 24 babies of <33 weeks was 1146.82(79.49) grams. 43 babies, ≥ 33 to <37 weeks had mean (SEM) weight of 2007.25(66.01) grams, 140 babies, ≥ 37 to < 42 weeks had mean (SEM) weight of 3065(60.95) grams, and 46 babies, > 42 weeks had mean (SEM) weight of 3668.48(106.63) grams. The mean birth weight of the 253 infants in the study was 2472grams. Social class effect on birth weights recorded showed a higher birth weight series for social class I and II, and least for social class IV. Conclusion: These findings are at variance from studies elsewhere within the country. The birth weight remains an important factor for a continuing re-appraisal of any nation's health care delivery system. Keywords: birth weight, healthy Nigeria newborns, UDUTH, Sokoto Sahel Medical Journal Vol. 9(1) 2006: 19-22

Background: Heart failure with preserved ejection fraction (HFpEF) is a condition with limited large-scale data on the short- and long-term effects of SARS-CoV-2 infection. This study aimed to evaluate the prevalence of major adverse cardiac and cerebrovascular events (MACCEs) in HFpEF patients hospitalized with SARS-CoV-2 and identify sex-specific risk factors and predictors of MACCEs in this population. Methods: This retrospective study analyzed HFpEF patients hospitalized with SARS-CoV-2 from the 2020 National Inpatient Sample (NIS) using ICD-10 codes. Patients hospitalized with HFpEF and SARS-CoV-2 were categorized by age (18–44, 45–64, ≥65 years). Multivariate logistic regression was used to adjust for potential confounders, with the statistical significance set at a two-tailed p-value < 0.05. Results: Among 109,750 HFpEF patients hospitalized with SARS-CoV-2, 31,960 (29.1%) experienced MACCEs. Males experienced a higher rate of MACCEs than females (31.1% vs. 27.5%, OR: 1.20, 95% CI: 1.12–1.28, p < 0.001). Adjusted analysis revealed that elderly patients (≥65 years, OR: 1.47, 95% CI: 1.33–1.62) compared with the 45–64 age group and males (OR: 1.20, 95% CI: 1.12–1.28, p < 0.001) had a higher risk of MACCEs. Key predictors included prior coronary artery bypass grafting (CABG; OR: 1.15, 95% CI: 1.02–1.30), cancer (OR: 1.24, 95% CI: 1.08–1.42), and chronic kidney disease (OR: 1.15, 95% CI: 1.08–1.23). Subgroup analysis identified additional sex-specific risk factors. In males, hyperlipidemia, obesity, tobacco use disorder, prior stroke/transient ischemic attack (TIA), prior venous thromboembolism (VTE), alcohol abuse, depression, and valvular disease were significant predictors of MACCEs. In females, hyperlipidemia, tobacco use disorder, prior stroke/TIA, prior VTE, and depression were significant predictors. Conclusions: HFpEF patients hospitalized with SARS-CoV-2 have a high risk of MACCEs, with male sex, older age, prior CABG, cancer, and chronic kidney disease as key risk factors. This study provides the first large-scale analysis of sex-specific predictors of MACCEs in HFpEF patients hospitalized with SARS-CoV-2. These findings underscore the need for focused research and clinical gender-based strategies to mitigate cardiovascular risks in this unique and high-risk population.

Disparities in health care access and utilization have been widely documented in cardiovascular interventions. The intra-aortic balloon pump (IABP), a critical mechanical circulatory device used in high-risk coronary artery bypass graft (CABG) patients, has shown significant variability in utilization across sociodemographic groups. This study examines the influence of social determinants of health, including sex, race, ethnicity, income, and insurance status, on IABP utilization prior to CABG. This retrospective cohort study utilized the Nationwide Inpatient Sample from 2016-2021 to identify patients undergoing CABG. IABP use was defined as preoperative utilization in patients awaiting CABG. Multivariable logistic regression analyzed the impact of sociodemographic factors on IABP use, adjusting for baseline comorbidities and hospital characteristics. Propensity score matching was employed to compare in-hospital outcomes between IABP and non-IABP groups. Statistical significance was set at P < .05. Of 471,985 CABG patients, IABP was utilized in 14,535 patients (3.1%) preoperatively. Adjusted analyses revealed significant disparities: women were less likely to receive IABP, while Hispanic and Asian patients were more likely to receive IABP compared to Whites. Medicaid coverage increased the odds of IABP use, whereas income quartiles showed no significant impact. Regional disparities were noted, with lower odds of IABP use in the South and West. Weekend admissions were associated with higher IABP utilization. Subgroup analysis identified higher IABP use among Hispanic men and women. Significant disparities in IABP utilization exist across sociodemographic and regional lines, with lower use among women and patients in the South and West regions, and higher use among Hispanic and Asian patients. These findings underscore the presence of sex-based disparities and significant variation in racial/ethnic patterns of IABP utilization, highlighting the need for further investigation and targeted interventions to ensure equitable application of advanced cardiovascular therapies.

Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO-without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients. We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser comorbidity index, we identified patients with and without obesity, defined as BMI > 30 kg/m ² and propensity score matching was done for age and sex. Later, multivariable regression analysis was done for in-hospital post-PCI outcomes. Among 25605 metabolically healthy patients who had AMI and underwent PCI, 2825 had obesity, and 22780 didn't. After propensity score matching (PSM) for age and sex, both cohorts had 2795 patients each. There was no statistically significant difference in in-hospital all-cause mortality (adjusted odds ratio [OR] 1.14, 95 % confidence interval [CI] 0.63-2.10, p = 0.661), post-PCI stroke (aOR 1.17, 95 % CI 0.50-2.75, p = 0.714), acute kidney injury (aOR 1.20, 95 % CI 0.84-1.72, p = 0.322), post-PCI bleeding (aOR 1.04, 95 % CI 0.35 to 3.12, p = 0.940) and intra or post-PCI cardiac arrest (aOR 1.14, 95 % CI 0.30 to 4.42, p = 0.835) between both cohorts. No statistically significant association was found between obesity and post-PCI outcomes in metabolically healthy patients with AMI. Larger studies are needed to explore the controversial "obesity paradox" in cardiovascular diseases.