Background: While obesity is associated with an increased risk of venous thromboembolism (VTE), there is some data to suggest that higher BMI is also associated with decreased all-cause mortality in patients with a pulmonary embolism (PE). Methods: Using PE Response Team (PERT) activation data from a large tertiary hospital between 27 October 2020 and 28 August 2023, we constructed a multivariate Cox proportional hazards model to assess the association between obesity as a dichotomous variable (defined as BMI ≥ 30 vs. BMI 18.5–29.9), BMI as a continuous variable, and 30-day PE-related mortality. Results: A total of 248 patients were included in this analysis (150 with obesity and 98 who were in the normal/overweight category). Obesity was associated with a lower risk of 30-day PE-related mortality (adjusted HR 0.29, p = 0.036, 95% CI 0.09–0.92). A higher BMI was paradoxically associated with a lower risk of PE-related mortality (HR = 0.91 per 1 kg/m² increase, p = 0.049, 95% CI 0.83–0.999). Conclusions: In our contemporary cohort of patients with a PERT activation, obesity was associated with a lower risk of PE-related mortality.

A 69-year-old man presented with corticosteroid-dependent colchicine-resistant chronic recurrent pericarditis initially thought to be idiopathic in etiology. Transitioning from anakinra to rilonacept revealed rheumatoid arthritis as the underlying cause. Anakinra demonstrated superior efficacy in managing both pericarditis and rheumatoid arthritis symptoms.

Paravalvular leak (PVL) remains a frequent complication of transcatheter aortic valve replacement (TAVR). The long-term consequences of mild PVL on outcomes have been debated. This study aimed to investigate the clinical and hemodynamic outcomes of mild PVL over a 2-year period. We conducted a retrospective cohort study of 2601 adult patients who underwent TAVR at the Cleveland Clinic between January 2016 and July 2021. Patients were categorized based on postprocedural PVL severity (mild vs. no/trace PVL). Differences in 2-year clinical outcomes, including all-cause mortality and heart failure hospitalizations, were assessed using Cox regression analysis, while hemodynamic changes were analyzed with a linear mixed model. Mild PVL was present in 140 patients (5%). Compared to those with no/trace PVL, these patients were older, had a lower body mass index, higher prevalence of concentric left ventricular hypertrophy, and more frequent significant mitral regurgitation. Hemodynamic parameters, including transvalvular aortic mean gradient, left ventricular ejection fraction, and ventricular dimensions, remained similar between groups at 30 days, 1 year, and 2 years. Multivariate Cox regression showed no significant association between mild PVL and 2-year all-cause mortality (hazard ratio: 1.24, 95% CI: 0.65 to 2.39, p = 0.51) or heart failure hospitalization (hazard ratio: 1.19, 95% CI: 0.53 to 2.66, p = 0.67). Mild PVL after TAVR is not associated with adverse long-term clinical outcomes or significant impairment in cardiac remodeling within the first 2 years postprocedure compared to no/trace PVL.