Systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is a life-threatening vascular complication of SSc, marked by high morbidity and mortality. Early diagnosis remains a major challenge due to nonspecific symptoms and the limitations of conventional tools such as echocardiography (ECHO), pulmonary function tests (PFTs), and serum biomarkers. This review evaluates the emerging role of artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), in improving the diagnostic landscape of SSc-PAH. A comprehensive literature search was conducted across PubMed, Scopus, IEEE Xplore, Embase and Google Scholar to identify studies involving AI applications in SSc, pulmonary arterial hypertension (PAH), and their intersection. Evidence indicates that AI models can assist interpretation across modalities, including heart sounds, ECGs, chest X-rays (CXRs), ECHOs, CT pulmonary angiography (CTPA), and omics-based biomarkers. While several models show encouraging diagnostic performance, their accuracy varies by dataset and modality, and most require external validation against right heart catheterization (RHC)-confirmed cohorts. Integrating multimodal data through AI frameworks may enhance early recognition and individualized risk stratification; however, these tools remain exploratory. Future work should emphasize harmonized hemodynamic definitions, transparent validation protocols, and SSc-specific datasets to ensure clinical applicability and reproducibility.

Background: Patients with substance use disorder (SUD) have high rates of hospitalization, readmission, and prolonged lengths of stay. Objectives: To conduct a systematic review and meta-analysis of the impact of addiction consult services in the inpatient setting for patients with SUD. Methods: Five databases were systematically searched from their earliest available records through January 2025. Two authors independently screened articles, extracted data, and assessed the quality of each study with the Newcastle-Ottawa Scale for observational studies and the Cochrane risk-of-bias tool for randomized clinical trials. Pooled odds ratios (ORs) with 95% CIs were calculated for dichotomous outcomes, and mean differences were calculated for continuous outcomes. Results: The search retrieved 20 studies that met inclusion criteria. The intervention for all studies was an addiction medicine consult, but the definition of this consult varied. The meta-analysis did not detect statistically significant differences in hospital length of stay, hospital readmission, or emergency department visits at 1 year among patients who received the consult compared with those who did not; however, many of these outcomes were likely underpowered. However, addiction medicine consults significantly improved the odds of inpatient initiation of medication for SUD (OR, 7.30; 95% CI, 3.30-16.13; P <.001) and postdischarge SUD treatment linkage and adherence (OR, 3.31; 95% CI, 2.06-5.32; P <.001). Conclusion: Inpatient addiction consult services are associated with increased inpatient initiation of medication for SUD treatment and postdischarge treatment linkage and adherence. No clear association was identified between the consult and readmissions, emergency department utilization, or length of stay.

Background: Cocaine use and cardiovascular disease (CVD)-related mortality trends in the U.S. are underreported. Using the CDC’s Wide-Ranging Online Data for Epidemiologic Research database, we analyzed the relationship between cocaine use and CVD-related deaths. Methods: We analyzed death certificates from the Multiple Cause of Death dataset to identify CVD-related deaths involving cocaine use. Age-adjusted mortality rates (AAMRs) per 1 000 000 and annual percentage changes (APCs) were calculated using Joinpoint Regression. Results: From 1999 to 2022, 82 944 deaths were linked to cocaine use and CVDs. AAMRs rose from 9.6 in 1999 to 32 in 2022. Mortality trends varied by demographics and regions. Males and females showed early increases (1999–2006), declines (2006–2012), and sharp rises (2012–2022), with APCs of 11.8% and 12.8%, respectively. Non-Hispanic Black individuals exhibited consistently higher rates than non-Hispanic Whites, though both groups experienced sharp increases starting in 2014 (APCs: 12.5 and 12.7%). Geographic trends revealed early 2000s increases, mid-2000s declines, and rapid rises beginning in the 2010s. The Northeast and South had notable APCs of 13.5 and 12.6% (2013–2022). Rural areas initially showed steeper increases than urban areas but displayed steady upward trends since 2011 (APC: 9.5%). Age-wise, older adults experienced a particularly sharp rise from 2012 to 2022 (APC: 15.0%). Conclusion: Cocaine use and CVD-related mortality rose significantly from 1999 to 2022, with pronounced increases among men, non-Hispanic Black individuals, older adults, urban residents, and those in the South. These findings highlight a growing public health crisis.

Introduction: Atrial fibrillation (AF) is highly prevalent in heart failure (HF) and is linked to increased mortality and hospitalization in both preserved (HFpEF) and reduced ejection fraction (HFrEF). Catheter ablation (CA) has emerged as an effective rhythm-control strategy beyond medical therapy (MT), but phenotype-specific differences remain unclear. We compared the efficacy and safety of CA versus MT in AF with HFpEF or HFrEF. Methods: PubMed, Embase, Scopus, and Cochrane databases were searched through December 2025. Random-effects meta-analyses were conducted in R (version 4.5.3), reporting risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Results: Fifteen studies involving 27,130 patients (CA: 13,579; MT: 13,551) were included. Catheter ablation significantly reduced overall all-cause mortality (RR 0.44), with a significant benefit in HFpEF (RR 0.44), whereas the reduction in HFrEF did not reach statistical significance (RR 0.53, 95% CI 0.21–1.38). Cardiovascular mortality and cardiovascular hospitalization were also reduced overall, without significant differences between HF phenotypes. Stroke and atrial arrhythmia recurrence were not significantly reduced in the primary analyses, and favorable findings observed in sensitivity analyses were considered exploratory . Catheter ablation significantly improved LVEF in HFrEF but not in HFpEF, while effects on exercise capacity and biomarkers varied across outcomes and phenotypes. Adverse events were comparable between treatment strategies. Conclusion: Catheter ablation was associated with favorable clinical outcomes compared with medical therapy in AF with HF; however, the magnitude and statistical certainty of benefit varied across heart failure phenotypes and outcomes.

Background: New-onset atrial fibrillation (AF) is a common complication of sepsis, affecting 5–25% of patients, and is associated with increased mortality and ischemic stroke. With limited high-quality evidence, the net clinical benefit of early oral anticoagulant (OAC) initiation in this high-risk setting remains uncertain. Methods: Adults ≥18 hospitalized with sepsis who developed new-onset AF within 3 days were identified from the TriNetX database. Cohort one included patients who received at least three doses of OAC within 3 days after AF onset and was compared to those who did not receive OAC (cohort two). Propensity score matching (1:1; 90 covariates; caliper 0.1) was employed to balance the groups. The primary outcomes assessed were evaluated at 7, 14, and 30 days. Risk ratios and risk differences with 95% confidence intervals were estimated using intention-to-treat analysis. Results: Among 136,172 eligible patients, 10,773 were matched per group. Early OAC use was associated with significantly lower mortality at 7, 14, and 30 days (RR 0.19-0.35; all p < 0.001) and reduced ischemic stroke risk across the same intervals (RR 0.74-0.83; p ≤ 0.004). Major bleeding rates were also lower (RR 0.40-0.49; all p < 0.001). MACEs showed a modest reduction at 7 days (RR 0.92; p = 0.001) but not afterward. Thromboembolic events were similar beyond the first week. The need for thrombolytics (RR 0.55-0.59) and anti-hemorrhagic therapy (RR≈0.69) consistently remained lower with OACs (all p < 0.001). Falsification outcomes were neutral, except for a minimal late increase for osteoarthritis at 30 days (RR 1.16; p = 0.03). Conclusion: In sepsis-associated NOAF, early OAC initiation was associated with reduced short-term mortality and ischemic stroke without excess bleeding or thromboembolic risk. The large magnitude of mortality benefit and paradoxical reduction in bleeding likely reflect residual confounding by clinical stability and patient selection. Findings warrant cautious interpretation given the observational design; prospective trials are needed.