Publications by authors named "Tayyab Shah"

Cardiovascular disease is the leading cause of death for women worldwide, with mortality rates due to cardiogenic shock (CS) remaining exceedingly high. Sex-based disparities in the timely delivery of optimal CS treatment contribute to poor outcomes; addressing these disparities is a major priority to improve women's cardiovascular health. This consensus statement provides a comprehensive summary of the current state of treatment of CS in women across the spectrum of cardiovascular disease states and identifies important gaps in evidence.

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•Early aortic valve replacement before the development of severe symptomatic aortic stenosis is not associated with a benefit for most hard endpoints including mortality and myocardial infarction but is associated with a benefit in stroke.•The mechanism for the potential benefit of early aortic valve replacement on stroke remains unclear.•Younger patients and women may derive a mortality benefit from early aortic valve replacement, but this warrants further study.

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Background: High-risk percutaneous coronary intervention (HRPCI) procedures supported by percutaneous left ventricular assist devices (pLVAD) are increasingly common, but existing PCI risk scores were developed in patients across the risk spectrum, including few pLVAD-assisted patients.

Objectives: Assess the performance of existing PCI risk scores in patients receiving pLVAD-assisted HRPCI and create a novel risk score specific to this group.

Methods: Patients in the PROTECT III multicenter, observational (46 US centers) study undergoing pLVAD-assisted HRPCI were assessed.

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Cardiovascular disease is the leading cause of death for women worldwide, with mortality rates due to cardiogenic shock (CS) remaining exceedingly high. Sex-based disparities in the timely delivery of optimal CS treatment contribute to poor outcomes; addressing these disparities is a major priority to improve women's cardiovascular health. This consensus statement provides a comprehensive summary of the current state of treatment of CS in women across the spectrum of cardiovascular disease states and identifies important gaps in evidence.

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Background: To understand the relative safety and efficacy of endovascular treatment modalities used for superficial femoral artery (SFA) disease, we performed a network meta-analysis to compare outcomes between percutaneous transluminal angioplasty (PTA), atherectomy (A), bare metal stent (BMS), brachytherapy/radiotherapy, covered stent graft (CSG), cutting balloon angioplasty (CBA), drug-coated balloon (DCB), drug-eluting stent (DES), and intravascular lithotripsy (L).

Methods: We performed a systematic literature search of PubMed from January 2000 to January 2023 to identify randomized trials comparing endovascular interventions for the treatment of SFA disease. The primary end points were technical success and 12-month primary patency.

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Purpose: To evaluate postpartum hemorrhage (PPH) and IR service landscapes in Kenya using geospatial analytic mapping for outreach planning.

Materials And Methods: Geographic information system (GIS) analysis of Kenya was performed using open-source data sets. Data at the regional and county levels from 2014 to 2018 were collected to evaluate demographics and variables related to PPH and healthcare access.

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Background: Aortic stenosis (AS) is the leading cause of valvular heart disease-related morbidity and mortality, but there are no medical treatments to slow its progression. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have pleiotropic effects which could be disease modifying in AS.

Objectives: The purpose of this study was to determine if SGLT2i usage is associated with slower progression of AS.

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Article Synopsis
  • The study examines the connection between acute brain injuries detected by diffusion-weighted MRI and stroke outcomes in patients who undergo transcatheter aortic valve replacement (TAVR).
  • A total of 495 patients were analyzed, revealing that 85% experienced brain injuries, with a significant link between the total lesion volume and the occurrence of clinical strokes.
  • The findings suggest that measuring the extent of brain injury could be important for predicting stroke risk and recovery in TAVR patients, indicating potential for enhancing stroke prevention strategies.
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Disparities in care access for health conditions where physiotherapy can play a major role are abetting health inequities. Spatial analyses can contribute to illuminating inequities in health yet the geographic accessibility to physiotherapy care across New Zealand has not been examined. This population-based study evaluated the accessibility of the New Zealand physiotherapy workforce relative to the population at a local scale.

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Background: Sirolimus-coated balloons (SCB) for the treatment of femoropopliteal (FP) lesions have not been systematically studied, but initial outcomes from early studies are promising.

Objectives: The authors sought to evaluate the safety and efficacy of the SELUTION SLR SCB, composed of proprietary microreservoir technology combining sirolimus and biodegradable polymer, when used to treat mild-to-moderate FP disease in a Japanese population.

Methods: This multicenter, prospective, single-arm study (SELUTION SFA JAPAN) enrolled 134 patients with FP disease.

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Thermal management is a critical challenge in advanced systems such as electric vehicles (EVs), electronic components, and photoelectric modules. Thermal alleviation is carried out through the cooling systems in which the coolant and the heat exchangers are the key components. The study examines recent literature on nanofluids and heat exchanger tubes along with state-of-the-art concepts being tested for heat transfer intensification.

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Background: Post-transcatheter aortic valve replacement (TAVR) conduction disturbances and atrial fibrillation (AF) are associated with markedly worse short- and long-term prognosis. Statins have multiple pleotropic effects that may be beneficial in mitigating the risk of these procedural complications as has been found for various other cardiac procedures and surgeries.

Methods: Data were retrospectively collected on consecutive patients in the Yale New Haven Health TAVR Registry who did not have a prior pacemaker, had at least 1 pre- and post-TAVR electrocardiogram, and did not have a change to their statin regimen during the index hospitalization.

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Background: Prior studies have found that female patients have worse outcomes following high-risk percutaneous coronary intervention (HRPCI).

Objectives: The authors sought to evaluate sex-based differences in patient and procedural characteristics, clinical outcomes, and safety of Impella-supported HRPCI in the PROTECT III study.

Methods: We evaluated sex-based differences in the PROTECT III study; a prospective, multicenter, observational study of patients undergoing Impella-supported HRPCI.

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Article Synopsis
  • - The study aimed to determine the impact of colchicine and high-intensity rosuvastatin on the progression of COVID-19 in hospitalized patients, compared to standard care alone.
  • - Conducted as a randomized controlled trial across four centers within the Yale New Haven Health System, it involved 250 non-critically ill hospitalized COVID-19 patients, with a follow-up period of 30 days.
  • - The trial was halted early for futility, as there was no notable difference in severe disease progression or thromboembolic events between the treatment group and the control group.
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Background: Blood pressure (BP) elevations are commonly treated in hospitalized patients; however, treatment is not guideline directed. Our objective was to assess BP response to commonly prescribed antihypertensives after the development of severe inpatient hypertension (HTN).

Methods: This is a cohort study of adults, excluding intensive care unit patients, within a single healthcare system admitted for reasons other than HTN who developed severe HTN (systolic BP>180 or diastolic BP >110 mmHg at least 1 hour after admission).

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Purpose: Although there have been marked improvements in the standard of care for treatment of ST-elevation myocardial infarction, women, especially younger women, continue to have significantly worse outcomes than men.

Recent Findings: This review highlights the current sex differences in presentation, etiology, treatment, and outcomes among these patients in order to make providers aware of the heterogeneous entities that cause ST-elevation myocardial infarction particularly in women and of disparities in treatment that lead to poorer outcomes in women. Furthermore, it emphasizes evidence-based strategies including standardized protocols for early revascularization, mechanical circulatory support, and access methodology that can reduce sex-based disparities in treatments and outcomes.

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Severe hypertension (HTN) that develops during hospitalization is more common than admission for HTN; however, it is poorly studied, and treatment guidelines are lacking. Our goal is to characterize hospitalized patients who develop severe HTN and assess blood pressure (BP) response to treatment. This is a multi-hospital retrospective cohort study of adults admitted for reasons other than HTN who developed severe HTN.

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Background: Sex differences in presentation, treatment, and outcomes persist in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). Sex-based outcomes of patients with AMICS undergoing percutaneous coronary intervention (PCI) with percutaneous left ventricular assist device (pLVAD) support are poorly defined.

Methods: From January 2017 to August 2019, consecutive patients undergoing PCI who received Impella support within 48 ​hours of myocardial infarction were enrolled in the prospective RECOVER III postmarket registry.

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Background: There are limited and nonconcordant data on the rapidity and safety of blood pressure response to clonidine in the setting of asymptomatic severe hypertension. We evaluated the blood pressure response to clonidine in hospitalized patients with asymptomatic severe hypertension.

Methods: We performed a review of hospitalized, noncritically ill patients receiving clonidine within 6 hours of developing asymptomatic severe hypertension (systolic blood pressure [SBP] >180 or diastolic blood pressure [DBP] >110 mm Hg in the absence of acute hypertension-mediated target organ damage).

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A 65-year-old woman with type II diabetes mellitus complicated by non-healing ulcers with recurrent osteomyelitis was admitted for progression of cellulitis after treatment failure with an outpatient course of amoxicillin-clavulanate. She was found to have persistent osteomyelitis and started on ceftazidime for a culture documented infection. After two parenteral doses, she had a rapid rise in liver function tests (LFTs) in a hepatocellular pattern.

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