Background: Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity‐related mortality trends among adults in the United States stratified by age, sex, race and geographical location.Methods: The CDC‐WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age‐adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis.Results: From 1999 to 2022, a total of 273,761 CAD and obesity‐related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4–4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7–19.1). During the COVID‐19 pandemic (2020–2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non‐Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8–5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4–4.5).Conclusions: We observed increasing trends in CAD and obesity‐related deaths throughout the study period reaching a peak during the COVID‐19 pandemic.

Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a promising new technique to ablate epileptic foci in patients with hypothalamic hamartoma (HH). We aim to systematically synthesize all available evidence and determine the effectiveness of MRg-LITT in reducing seizures in patients with HH. We systematically searched MEDLINE (PubMed), Embase (Ovid), Scopus, and Google Scholar for all relevant articles. We used Open[Meta]Analyst to pool the number of seizure free patients after MRg-LITT treatment in a Random Effects model. Risk ratios (RRs) were calculated, and subgroups were analyzed. Comprehensive Meta Analysis was used to assess publication bias via funnel plots, Egger's regression test and Begg's correlation test. This review complies with the PRISMA guidelines. After screening the titles, abstracts, and full texts, we included seventeen articles in our meta-analysis, which revealed a 77.1% rate of seizure freedom (95% CI 0.696 to 0.837, p < 0.001), with moderate heterogeneity (I2 = 49.46%). Subgroup analysis by study design and sensitivity analyses excluding one study at a time did not impact the results substantially, and we found no evidence of publication bias. Adverse effects included electrolyte imbalances, weight gain, and transient neurologic disturbances. Magnetic resonance-guided laser interstitial thermal therapy might be a feasible and effective technique for ablation of epileptic foci, leading to seizure freedom in a large proportion of patients with hypothalamic hamartoma. However, there is a paucity of literature on the topic, and prospective clinical trials with larger number of participants, comparing MRg-LITT to open surgery, are needed.

Background: Surgical aortic valve replacement (SAVR) is the commonly used approach for aortic valve replacement (AVR) in patients with aortic stenosis at low or intermediate surgical risk. However, transcatheter aortic valve replacement (TAVR) has emerged as an alternative to SAVR for AVR. This meta-analysis aims to assess the comparative efficacy and safety of TAVR versus SAVR in low-to-intermediate surgical risk patients by analyzing temporal trends in the outcomes of TAVR and SAVR at various follow-up intervals, providing a more detailed understanding. Methods: A thorough literature search was performed across PubMed/MEDLINE, Embase, and the Cochrane Library from their inception up to May 2024 to identify eligible randomized controlled trials (RCTs). Clinical outcomes were evaluated using a random-effects model to pool risk ratios (RRs) with 95% CIs. Results: A total of 17 studies reporting data at different follow-ups for nine trials were included (n=9092). No statistically significant difference was observed between TAVR and SAVR for reducing all-cause death at 30 days, 1 year, and 2 years but significantly increased risk with TAVR at 5 years or longer follow-up (RR=1.13, 95% CI: 1.03–1.23). However, TAVR was associated with a significantly decreased risk for cardiac death at 1-year follow-up (RR=0.79, 95% CI: 0.64–0.96) and comparable risk for cardiac death at 30 days, 2 years, and 5 years or longer follow-up when compared with SAVR. No statistically significant difference was observed between TAVR and SAVR for reducing the risk of myocardial infarction (MI) at 30 days, 1 year, 2 years, and 5 years or longer follow-up. TAVR was associated with a significantly lower risk of major bleeding events at 30 days (RR=0.38, 95% CI: 0.21–0.67); lower risk of acute kidney injury (AKI) at 30 days (RR=0.38, 95% CI: 0.26–0.54) and 1 year (RR=0.58, 95% CI: 0.41–0.82) and lower risk of new onset or worsening atrial fibrillation (AF) at 30 days (RR=0.25, 95% CI: 0.18–0.34), 1 year (RR=0.26, 95% CI: 0.16–0.41) and 2 years (RR=0.32, 95% CI: 0.20–0.49) when compared with SAVR. However, TAVR was associated with a significantly increased risk of permanent pacemaker implantation (PPI) at 30 days (RR: 2.62, 95% CI: 1.40–4.91), at 1 year (RR: 2.19, 95% CI: 1.24–3.87), at 2 years (RR: 2.74, 95% CI: 1.31–5.71), and beyond 5 years (RR: 1.95, 95% CI: 1.20–3.15). TAVR was also associated with a significantly increased risk of prosthetic valve thrombosis at 2 years (RR=2.70, 95% CI: 1.08–6.71), though no significant association was observed at 30 days, 1 year, or 5 years. Similarly, no significant differences were observed in aortic-valve reintervention rates at 30 days, 2 years, or 5 years, but TAVR showed a significantly increased risk at 1 year (RR=1.98, 95% CI: 1.21–3.24). TAVR was associated with a significantly increased risk of major vascular complications at 30 days (RR=2.37, 95% CI: 1.38–4.04) and a significantly increased risk of TIA at 2 years (RR: 1.43, 95% CI: 1.02–2.00, I ²=0%). The risk of hospitalizations was comparable between the groups. Conclusion: TAVR and SAVR demonstrated comparable rates of all-cause death up to 2 years of follow-up. However, at 5 years or longer follow-up, TAVR was associated with a higher risk of all-cause death. While TAVR showed certain procedural advantages, such as a lower risk of major bleeding, AKI, and new-onset or worsening AF, the choice between TAVR and SAVR in patients with low or intermediate surgical risk should consider long-term outcomes, with SAVR potentially being more favorable due to better survival observed on longer follow-up durations.