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1. Proportionate and Absolute Vascular Disease Mortality by Race and Sex in the United States From 1999 to 2019

Author

Scott E. Janus, Tarek Chami, Haytham Mously, Jamal Hajjari, Tarek Hammad, Yulanka Castro‐Dominguez, Foluso Fakorede, Khendi White Solaru, Mehdi H. Shishehbor, Sadeer G. Al‐Kindi, and Jun Li

Subjects
disparities, mortality, PVD, race, vascular, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Despite the known significant morbidity and mortality associated with cardiovascular disease and peripheral vascular disease (PVD), contemporary data describing racial demographics in PVD mortality are scarce. Methods and Results Using the multiple causes of death file from the Centers for Disease Control and Prevention’s Wide‐Ranging Online Data for Epidemiologic Research, we analyzed the trends of age‐adjusted mortality (AAMR) for PVD and its subtypes (aortic aneurysm/dissection, arterial thrombosis, venous thrombosis/disease, pulmonary embolism), by race and sex between 1999 and 2019. Of the 17 826 871 deaths attributed to cardiovascular disease, a total of 888 187 (5.0%) PVD deaths were analyzed during the study period (12.4% Black, 85.6% White). Between 1999 and 2019, AAMR for PVD decreased by 52% (24.8–11.8 per 100 000 people) in the overall population. Despite a decrease in the overall mortality across all race and sex groups, Black men and Black women continued to have higher mortality for PVD (1.5×), aortic dissection (1.8×), arterial thrombosis (1.3×), and venous thrombosis/disease (2.0×) mortality compared with White men and White women in 2019. While there was a 53% decrease in PVD among White individuals (AAMR 24.5–11.5 per 100 000), there was only a 43% decrease (30.0–17.1) in PVD AAMR in Black individuals between 1999 and 2019. The ratio of PVD AAMR increased from 1.2 (1999) to 1.5 (2019) in Black men/White men and from to 1.3 (1999) to 1.5 (2019) in Black women/White women. Similar trends were noted in aortic dissection (Black men/White men, 1.2–1.8; and Black women/White women, 1.5–1.7), arterial thrombosis (Black men/White men, 1.0–1.3; and Black women/White women, 0.9–1.3), and venous thrombosis/disease (Black men/White men, 1.7–1.8; and Black women/White women, 1.7–2.0). Conclusions In this retrospective review of death certificate data in the United States, we demonstrate continued significant disparities between Black and White populations in PVD mortality and its subtypes. Future studies should investigate etiologies and social determinants of PVD mortality.

Published
2022
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2. Routine Use of the 'Penumbra' Thrombectomy Device in Myocardial Infarction: A Real-World Experience—ROPUST Study

Author

Nour Tashtish, Tarek Chami, Tony Dong, Besher Chami, Sadeer Al-Kindi, Haytham Mously, Scott Janus, Tarek Hammad, Mehdi H. Shishehbor, and Anjan Gupta

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objectives. Evaluation of the safety and efficacy of the Penumbra device as an adjunct to percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI) and a large thrombus burden that requires thrombectomy. Background. For patients with acute MI, PCI is the primary reperfusion method. Large thrombus burden has always been a limitation of successful reperfusion. However, the use of current aspiration devices has been associated with an increased incidence of stroke. Methods. We performed a retrospective chart review at the University Hospitals Medical Center in Cleveland. Our study included data from patients who underwent PCI for ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) assisted by the Penumbra Cat RX device (a wide-lumen thrombus aspiration catheter) between May 2019 and February 2021. The primary outcome was the final thrombolysis in myocardial infarction (TIMI) flow. The secondary endpoints were a composite of adverse cardiac events at 6 months. About 50% of the patients did undergo transfemoral PCI as per preference of individual operators. The Penumbra thrombectomy device can be used both by radial and femoral approach and does not need any different guide catheter use. Results. TIMI flow 3 was achieved in 111 patients (90.2%). The secondary endpoint occurred in 11 patients (8.9%, 3 MI, 8 heart failure hospitalizations). There were no stroke events or device-related complications. The door-to-balloon time was not affected by usage of the Penumbra device. Failure in the restoration of TIMI 3 flow was associated with the use of balloon angioplasty prior to the application of the Penumbra device, leading to distal embolization. Conclusions. The Penumbra Cat RX provides safe and effective thrombus removal with better clinical outcomes, even in high-risk patients with acute coronary syndrome.

Published
2022
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3. Educational Experience of Interventional Cardiology Fellows in the United States and Canada

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Abdul Hakeem, Abhiram Prasad, Anand Prasad, Anna E. Bortnick, Basem Elbarouni, Hani Jneid, J. Dawn Abbott, Lorenzo Azzalini, Louis P. Kohl, Mario Gössl, Rajan A.G. Patel, Salman Allana, Tamim M. Nazif, Usman Baber, Olga C. Mastrodemos, Tarek Chami, Madeline Mahowald, Athanasios Rempakos, Bavana V. Rangan, Yader Sandoval, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023

4. Percutaneous mechanical thrombectomy and extracorporeal membranous oxygenation: A case series

Author

Haytham Mously, Jamal Hajjari, Tarek Chami, Tarek Hammad, Robert Schilz, Teresa Carman, Yakov Elgudin, Yasir Abu‐Omar, Marc P. Pelletier, Mehdi H. Shishehbor, and Jun Li

Subjects
Adult, Extracorporeal Membrane Oxygenation, Treatment Outcome, Humans, Radiology, Nuclear Medicine and imaging, General Medicine, Middle Aged, Pulmonary Embolism, Cardiology and Cardiovascular Medicine, Aged, Heart Arrest, Retrospective Studies, Thrombectomy
Abstract

Massive or high-risk pulmonary embolism (PE) is a potentially life-threatening diagnosis with significant morbidity and mortality if treatment is delayed. Extracorporeal membrane oxygenation (ECMO) and large bore thrombectomy (LBT) in isolation have been used to stabilize and treat patients with massive PE, however, literature describing the combination of both modalities is lacking. We present a case series involving 9 patients who underwent combined ECMO and LBT and their outcomes.This was a retrospective chart review of patients with confirmed PE, who underwent LBT and ECMO. We retrospectively captured clinical, therapeutic, and outcome data at the time of pulmonary embolism response team (PERT) activation and during the follow-up period for up to 90 days.Nine patients who had PERT activation with confirmed PE diagnosis have undergone combined LBT and ECMO initiation since the advent of our PERT program. The median age was 57 (range 28-68) years. Six patients out of 9 (55%) had cardiac arrest before therapy. All patients exhibited right heart strain on computed tomography and echocardiogram. The median ECMO duration was 5 days (range 2.3-11.6 days), with mean hospitalization of 16.1 days (range 1.5-30.9). Mortality was 22% at 90-day follow-up period.Patients with massive pulmonary embolism who suffer cardiac arrest have significant morbidity and mortality. ECMO in combination with LBT is a viable treatment option for patients with significant hemodynamic compromise.

Published
2022

7. Case series of closure devices complications

Author

Tarek Chami, Scott E. Janus, Mehdi H. Shishehbor, and Jun Li

Subjects
Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine
Published
2022

8. List of contributors

Author

Nidal Abi Rafeh, Pierfrancesco Agostoni, Sukru Akyuz, Khaldoon Alaswad, Ziad A. Ali, Salman S. Allana, Chadi Alraies, Mario Araya, Alexandre Avran, Lorenzo Azzalini, Avtandil Babunashvili, Subhash Banerjee, Sripal Bangalore, Baktash Bayani, Michael Behnes, Ravinay Bhindi, Nicolas Boudou, Nenad Ž. Božinović, Leszek Bryniarski, Alexander Bufe, Christopher E. Buller, M. Nicholas Burke, Pedro Pinto Cardoso, Mauro Carlino, Joao L. Cavalcante, Tarek Chami, Raj H. Chandwaney, Konstantinos Charitakis, Victor Y. Cheng, James W. Choi, Evald Høj Christiansen, Yashasvi Chugh, Antonio Colombo, Claudia Cosgrove, Kevin Croce, Ramesh Daggubati, Félix Damas de los Santos, Rustem Dautov, Rhian E. Davies, Tony de Martini, Ali E. Denktas, Joseph Dens, Carlo di Mario, Roberto Diletti, Zisis Dimitriadis, Darshan Doshi, Parag Doshi, Kefei Dou, Mohaned Egred, Basem Elbarouni, Ahmed M. ElGuindy, Amr Elhadidy, Stephen Ellis, Javier Escaned, Panayotis Fasseas, Farshad Forouzandeh, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Robert Gallino, Roberto Garbo, Santiago Garcia, Gabriele Gasparini, Junbo Ge, Lei Ge, Pravin Kumar Goel, Omer Goktekin, Nieves Gonzalo, Sevket Gorgulu, Luca Grancini, J. Aaron Grantham, Raviteja Guddeti, Elias V. Haddad, Allison B. Hall, Jack J. Hall, Sean Halligan, Franklin Leonardo Hanna Quesada, Colm Hanratty, Stefan Harb, Scott A. Harding, Raja Hatem, David Hildick-Smith, Jonathan M. Hill, Taishi Hirai, Mario Iannaccone, Wissam Jaber, Farouc A. Jaffer, Yangsoo Jang, Brian K. Jefferson, Allen Jeremias, Risto Jussila, Nikolaos Kakouros, Artis Kalnins, Sanjog Kalra, Arun Kalyanasundaram, David E. Kandzari, Hsien-Li Kao, Judit Karacsonyi, Dimitri Karmpaliotis, Hussien Heshmat Kassem, Kathleen Kearney, Jimmy Kerrigan, Jaikirshan Khatri, Dmitrii Khelimskii, Ajay J. Kirtane, Paul Knaapen, Spyridon Kostantinis, Michalis Koutouzis, Mihajlo Kovacic, Oleg Krestyaninov, A.V. Ganesh Kumar, Prathap Kumar N., Katherine J. Kunkel, Pablo Manuel Lamelas, Seung-Whan Lee, Thierry Lefevre, Gregor Leibundgut, Nicholas J. Lembo, Martin Leon, John R. Lesser, Raymond Leung, Soo-Teik Lim, Sidney Tsz Ho Lo, William Lombardi, Michael Luna, Ehtisham Mahmud, Madeline K. Mahowald, Anbukarasi Maran, Konstantinos Marmagkiolis, Evandro Martins Filho, Kambis Mashayekhi, Margaret B. McEntegart, Michael Megaly, Perwaiz Meraj, Lampros Michalis, Anastasios N. Milkas, Owen Mogabgab, Jeffrey Moses, Muhammad Munawar, Bilal Murad, Alexander Nap, Andres Navarro, William J. Nicholson, Anja Øksnes, Göran Olivecrona, Mohamed A. Omer, Jacopo Andrea Oreglia, Lucio Padilla, Mitul P. Patel, Rajan A.G. Patel, Taral Patel, Ashish Pershad, Duane Pinto, Paul Poommipanit, Marin Postu, Srini Potluri, Stylianos Pyxaras, Alexandre Schaan de Quadros, Michael Ragosta, Sunil V. Rao, Vithala Surya Prakasa Rao, Sudhir Rathore, Joerg Reifart, Athanasios Rempakos, Jeremy Rier, Robert Riley, Stéphane Rinfret, Juan J. Russo, Meruzhan Saghatelyan, Gurpreet S. Sandhu, Yader Sandoval, Ricardo Santiago, James Sapontis, Alpesh Shah, Evan Shlofmitz, Kendrick A. Shunk, George Sianos, Bahadir Simsek, Elliot J. Smith, Anthony Spaedy, James Spratt, Julian W. Strange, Bradley Strauss, Péter Tajti, Hector Tamez, Khalid O. Tammam, Craig A. Thompson, Aurel Toma, Catalin Toma, Ioannis Tsiafoutis, Etsuo Tsuchikane, Imre Ungi, Barry F. Uretsky, Georgios J. Vlachojannis, Minh Nhat Vo, Hoang Vu Vu, Simon Walsh, Daniel Weilenmann, Gerald Werner, Jarosław Wójcik, Jason Wollmuth, Eugene B. Wu, R. Michael Wyman, Iosif Xenogiannis, Bo Xu, Masahisa Yamane, Luiz F. Ybarra, and Robert W. Yeh

Published
2023

10. E-35 | Educational Experience of Interventional Cardiology Fellows in the United States and Canada

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Abdul Hakeem, Abhiram Prasad, Anand Prasad, Anna Bortnick, Basem Elbarouni, Hani Jneid, J. Dawn Abbott, Lorenzo Azzalini, Louis P. Kohl, Mario Goessl, Rajan A. Patel, Salman S. Allana, Tamim M. Nazif, Usman Baber, Olga C. Mastrodemos, Tarek Chami, Madeline Mahowald, Athanasios Rempakos, Bavana V. Rangan, Yader B. Sandoval, and Emmanouil S. Brilakis

Published
2023

11. Clot in Transit and Pulmonary Artery Percutaneous Mechanical Thrombectomy

Author

Scott Janus, Tarek Chami, Jamal Hajjari, Mohammed Osman, and Mohamad Karnib

Subjects
medicine.medical_specialty, Percutaneous, pulmonary embolism, percutaneous aspiration thrombectomy, business.industry, Case Report, medicine.disease, deep vein thrombosis, Pulmonary embolism, Mechanical thrombectomy, Internal medicine, medicine.artery, Pulmonary artery, medicine, Cardiology, Transit (astronomy), business
Published
2021

12. Reported Pericardial Toxicities Associated with Acute Myelogenous Leukemia Treatments: A Pharmacovigilance Analysis of the FDA Adverse Reporting Database

Author

Scott E. Janus, Andrew C. Heisler, Mustafa Al Jammal, Nicole Chahine, Tarek Chami, Jamal Hajjari, Haytham Mously, Anshul Badhwar, Shilpkumar Arora, Taha Al-Juhaishi, Sadeer G. Al-Kindi, and Brian D. Hoit

Subjects
Adult, Sulfonamides, Adolescent, Triazines, United States Food and Drug Administration, Cytarabine, Aminopyridines, General Medicine, Bridged Bicyclo Compounds, Heterocyclic, Decitabine, Gemtuzumab, United States, Leukemia, Myeloid, Acute, Pharmacovigilance, Azacitidine, Cladribine, Humans, Pericarditis, Anthracyclines, Cardiology and Cardiovascular Medicine
Abstract

Acute myelogenous leukemia (AML) is one of the most common leukemias experienced in adults and conveys significant morbidity and mortality. While the traditional anthracycline based treatments of AML involves cytarabine, developments in alternatives (liposomal cytarabine, fludarabine, cladribine, azacitidine, decitabine), and targeted agents (midostaurin, gilteritinib, enasidenib, ivosidenib, gemtuzumab ozogamicin, and venetoclax) exist. Multiple cardiovascular adverse events, notably pericardial toxicity, have been observed in small studies; however, to date little is known about the comparative pericardial toxicity among these newer regimens. Due to the paucity of data, we sought to investigate the reported pericardial events and mortality associated with treatments for AML. Utilizing the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS), we identified all adverse events associated with FDA approved treatments for AML (2002-2022). Pericardial events were defined as pericarditis, pericardial effusion and tamponade. We excluded any individuals with age18 years old. Logistic regression was utilized to identify factors associated with pericardial events. Out of 94,262 reported adverse events, 675 pericardial toxicities were included (243 pericarditis, 479 tamponade). Pericardial events occurred less often in Cladribine (0.3%, P0.001), fludarabine (0.4%, P0.001), Venetoclax (0.3%, P0.001), enasidenib (0.3%, P value0.001), and ivosidenib (0.3%, P0.001) compared to Cytarabine (0.9%). Tamponade events occurred significantly less often in cladribine (0.1%, P0.001), fludarabine (0.4%, P = 0.001), enasidenib (0.1%, P = 0.006), ivosidenib (0.1%, P = 0.01), and venetoclax (0.1%, P0.001) compared to cytarabine 0.7%. After adjusting for age and sex, Cladribine (reporting odds ratio [ROR] 0.35 [95% CI 0.18-0.68], P = 0.008) and Fludarabine (ROR 0.65 [0.45-0.92], P = 0.03), venetoclax (ROR 0.57 [0.41-0.79], P0.001) remained significantly associated with lower incidence of reported pericardial events. While cytarabine has been the routinely used and/or drug of choice for induction chemotherapy for AML, alternatives like cladribine may have a greater safety profile regarding pericardial toxicities. Future studies should be directed at further investigating cardiovascular safety profiles of AML induction therapy.

Published
2022

16. Non-invasive Imaging in the Evaluation of Cardiac Allograft Vasculopathy in Heart Transplantation: A Systematic Review

Author

Steven C. Ajluni, Haytham Mously, Tarek Chami, Jamal Hajjari, Amber Stout, Michael Zacharias, Chantal ElAmm, David Wilson, Scott E. Janus, and Sadeer G Al-Kindi

Subjects
Echocardiography, Heart Transplantation, Humans, General Medicine, Coronary Artery Disease, Cardiology and Cardiovascular Medicine, Allografts, Coronary Angiography
Abstract

Cardiac allograft vasculopathy (CAV) is the leading cause of long-term graft dysfunction in patients with heart transplantation and is linked with significant morbidity and mortality. Currently, the gold standard for diagnosing CAV is coronary imaging with intravascular ultrasound during traditional invasive coronary angiography. Invasive imaging, however, carries increased procedural risk and expense to patients in addition to requiring an experienced interventionalist. With the improvements in non-invasive cardiac imaging modalities such as transthoracic echocardiography, computed tomography, magnetic resonance imaging and positron emission tomography, an alternative non-invasive imaging approach for the early detection of CAV may be feasible. In this systematic review, we explored the literature to investigate the utility of non-invasive imaging in diagnosis of CAV in3000 patients across 49 studies. We also discuss the strengths and weaknesses for each imaging modality. Overall, all 4 imaging modalities show good to excellent accuracy for identifying CAV with significant variations across studies. Majority of the studies compared non-invasive imaging with invasive coronary angiography without intravascular imaging. In summary, non-invasive imaging modalities offer an alternative approach to invasive coronary imaging for CAV. Future studies should investigate longitudinal non-invasive protocols in low-risk patients after heart transplantation.

Published
2021

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