Background: Heart failure, a major public health concern, significantly contributes to hospital admissions. This study evaluates the impact of malnutrition on both patient and hospital outcomes in heart failure admissions, with a specific focus on variations in outcomes based on the severity of malnutrition. Methods: Utilizing the National Inpatient Sample (NIS) database, this retrospective cohort study included adult patients admitted with a principal diagnosis of heart failure. Malnutrition was identified using the well-validated ICD 10 codes. We compared outcomes between patients with and without malnutrition, focusing on mortality, length of stay (LOS), hospital charges, cardiac arrest, and cardiogenic shock. Results: Out of 1,110,085 heart failure patients, 36,522 (3.29%) were malnourished. Malnourished patients exhibited significantly higher adjusted in-hospital mortality rates (aOR 3.32; 95% CI 3.03–3.64), longer LOS (mean increase of 4.67 days; p < 0.001), and higher hospital charges (mean increase of USD 77,416.9; p < 0.01). Increased rates of cardiac arrest (aOR 2.39; 95% CI 1.99–2.86; p < 0.001) and cardiogenic shock (aOR 3.74; 95% CI 3.40–4.12; p < 0.001) were also noted in malnourished patients. Severely malnourished patients faced worse outcomes compared to those with mild to moderate malnutrition. Conclusions: Heart failure patients with malnutrition experience higher mortality rates, longer hospital stays, increased hospitalization charges, and greater complication rates, including cardiac arrest and cardiogenic shock, compared to non-malnourished patients. Outcomes deteriorate with the increasing severity of malnutrition. Timely and individualized nutritional interventions may significantly improve outcomes for heart failure admissions.

Background/Objectives: Heart failure presents a significant public health challenge, affecting millions in the US, with projections of increasing prevalence and economic burdens. Obstructive sleep apnea (OSA) is highly prevalent among HF patients. This study analyzes the impact of OSA on the outcomes in patients admitted with acute decompensated heart failure. Methods: We conducted a retrospective cohort study using the National Inpatient Sample database (NIS) 2020, focusing on patients admitted with acute heart failure. Patient outcomes were compared between those with and without a secondary diagnosis of OSA, identified via validated ICD-10 codes. Subgroup analysis was conducted between heart failure patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). Results: Among 65,649 patients with acute heart failure, 4595 (7%) patients were found to have OSA. The patients with OSA were more likely to be male, older in age and had a higher burden of comorbidities. No significant differences were observed in mortality between heart failure patients with and without OSA. In HFrEF patients, OSA was associated with longer hospital stays (6.45 days vs. 5.79 days, p < 0.001), higher rates of acute kidney injury (AKI) (adjusted odds ratio 1.28, 95% CI: 1.07–1.54, p = 0.007), and atrial fibrillation (adjusted odds ratio 1.35, 95% CI: 1.13–1.61, p = 0.001). In HFpEF patients, an association between OSA and AF was observed (adjusted odds ratio 1.20, 95% CI: 1.01–1.42, p = 0.03). Conclusions: OSA is associated with poor in-hospital outcomes in patients admitted with acute heart failure. HFrEF subgroup is especially vulnerable, with OSA leading to a significant increase in healthcare utilization and complication rates in these patients. This nationwide study underscores the importance of timely identification and treatment of OSA in heart failure to alleviate healthcare burdens and improve patient outcomes.

Background: Obesity presents a significant global health impact and is linked to cardiovascular diseases. While obesity often exacerbates the severity of cardiovascular conditions, an “obesity paradox” has previously been observed, where patients with higher body mass index (BMI) exhibit improved in-hospital and long-term outcomes in certain contexts. As minimally invasive procedures such as percutaneous coronary intervention (PCI) continue to become more relevant, understanding the impact of different patient characteristics on clinical outcomes becomes increasingly important. Methods: A comprehensive analysis was conducted using a large cohort of patients who underwent PCI. In this study, we identified patients who underwent PCI in the year 2020 using the International Classification of Disease (ICD) codes. Patients were categorized into five groups based on their Body Mass Index (BMI). This study aimed to examine the impact of BMI on inpatient outcomes among patients undergoing PCI, focusing on mortality, length of stay, and hospitalization costs across different BMI categories. Results: Our analysis revealed a U-shaped relationship between BMI and inpatient outcomes. Patients with a BMI ≥ 25 demonstrated significantly reduced inpatient mortality (adjusted odds ratio 0.31, 95% CI: 0.18 to 0.54 for BMI 25–29.9 group and adjusted odds ratio 0.32, 95% CI: 0.20 to 0.51 for the BMI 30–39.9 group, with p ≤ 0.001); shorter hospital stays (BMI of 25 or higher with mean reduction of −2.40 to −3.66 days, with p ≤ 0.001); and lower hospitalization costs with a cost reduction of −$40,881 (95% CI: −$64,540 to −$17,223) for the BMI 25–29.9 group, −$57,900 (95% CI: −$80,308 to −$35,492) for the BMI 30–39.9 group, and −$41,463 (95% CI: −$65,151 to −$17,775) for the BMI ≥40 group compared to those with normal BMI (20–24.9). However, these benefits diminished for patients with a BMI ≥ 40, where no significant differences in mortality or cost reductions were observed. Conclusions: These findings underscore the complexity of the obesity paradox and its limitations in extreme obesity. This study highlights the need for tailored management strategies in PCI patients with varying BMI profiles.

Around 30-40% of acute ischemic strokes are cryptogenic, with potential causes including atrial fibrillation, paradoxical embolism through a Patent Foramen ovale (PFO), or substenotic atherosclerosis. Aortic atherosclerosis, while rare, is a significant cause of systemic embolization. Despite its rarity

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a global pandemic that emerged in 2019. During this period, a significant disparity in hospitalization and mortality rates emerged, particularly in terms of Ethnicity and sex. Notably, this study aims to examine the influence of sex and Ethnicity on acute coronary syndrome outcomes, specifically during the global SARS-CoV-2 pandemic. Methods: This retrospective observational study analyzed adult patients hospitalized with a primary diagnosis of acute coronary syndrome in the United States in 2020. Primary outcomes included inpatient mortality and the time from admission to percutaneous coronary intervention (PCI). Secondary outcomes encompassed the length of stay and hospital costs. The National Inpatient Sample (NIS) database was utilized to identify and study patients in our test group. Results: A total of 779,895 patients hospitalized with a primary diagnosis of acute coronary syndrome in the year 2020 and 935,975 patients in 2019 were included in this study. Baseline findings revealed that inpatient mortality was significantly higher in 2020 compared to 2019, regardless of sex and Ethnicity (adjusted odds ratio (aOR) 1.20, 95% confidence interval (CI) 1.12–1.23, p-value < 0.001). Concerning primary outcomes, there was no difference in inpatient mortality for hospitalized patients of different sexes between 2019 and 2020 (STEMI: aOR 1.05, 95% CI 0.96–1.14, p-value 0.22; NSTEMI/UA aOR 1.08, 95% CI 0.98–1.19, p-value 0.13). Regarding time to admission for PCI, NSTEMI/UA cases were found to be statistically significant in female patients compared to males (mean difference 0.06 days, 95% CI 0.02–0.10, p-value < 0.01) and African Americans compared to Caucasians (mean difference 0.13 days, 95% CI 0.06–0.19, p < 0.001). In terms of the length of stay, female patients had a shorter length of stay compared to males (mean difference −0.22, 95% CI −0.27 to −0.16, p-value < 0.01). Conclusions: As acute coronary syndrome is an urgent diagnosis, a global pandemic has the potential to exacerbate existing healthcare disparities related to sex and Ethnicity. This study did not reveal any difference in inpatient mortality, aligning with studies conducted prior to the pandemic. However, it highlighted significantly longer treatment times (admission to PCI) for NSTEMI/UA management in female and African American populations. These findings suggest that some disparities may have diminished during the pandemic year, warranting further research to confirm these trends in the years to come.

There was an error in the original publication