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Background Arrhythmias are observed to increase during high influenza activity seasons (HIA, December to February) with significant clinical impact among high-risk patients, so their outcomes may be optimized through closer monitoring of these populations. It is unknown if cancer is such a risk factor. Methods This is a retrospective analysis of arrhythmia-related mortality and the effect of health disparities in patients with cancer during HIA and non-HIA seasons in a nationally representative database. Machine Learning-augmented Propensity Score adjusted multivariable regression (ML-PSr) was performed using the 2016–2018 National Inpatient Sample (NIS), the United States’ largest all-payer hospitalized dataset. Results 16,795,379 (18.48%) patients presented with arrhythmia of whom 3,214,914 (19.14%) were during HIA. In ML-PSr, HIA did not significantly increase the odds of arrhythmia for cancer patients (OR 1.01, 95%CI 0.99–1.03, p = 0.37), but the odds of arrhythmia-related mortality were higher during HIA seasons (OR 1.19, 95%CI 1.12–1.27, p

Objective Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and Glucagon-like Peptide-1 Agonists (GLP-1RA) are two common anti-hyperglycemic agents prescribed by clinicians. The effects on cardiovascular conditions such as heart failure (HF) hospitalization, stroke, myocardial infarctions, and other cardiovascular conditions are not well studied. The purpose of this study is to analyze existing data on the effect of SGLT-2 inhibitors and GLP-1RA on preventing these cardiovascular conditions. Methods A retrospective meta-analysis of all existing literature of the effect of SGLT-2 inhibitors and GLP-1RA on the rates of the following categories was researched: primary cardiovascular outcomes, heart failure hospitalizations, atrial fibrillation, stroke, myocardial infarction, left ventricle ejection fraction (LVEF), and heart failure symptoms. Hazard ratios for each category were obtained, and overall Hazard Ratio (HR)’s to determine overall statistical significance were computed. Result Both medication classes provided statistically significant reduction in preventing major cardiovascular events. Only SGLT-2 inhibitors provided statistically significant reduction in heart failure hospitalizations. Only GLP-1RA provided statistically significant reduction in preventing stroke. Neither medication class provided a statistically significant benefit in preventing myocardial infarctions or improving LVEF. More studies are needed on effects of either SGLT-2 inhibitors or GLP-1RA agonists on preventing HF symptoms or atrial fibrillation. Conclusion This study demonstrates that SGLT-2 inhibitors and GLP-1RA are important for improving both diabetic and cardiovascular health. In patients at risk for a major cardiovascular event, SGLT-2 inhibitors or GLP-1RA may be prescribed by clinicians. More studies must be performed to draw more conclusions.

Background Mortality disparities in sex, income, and race are unknown among patients with cancer who undergo percutaneous coronary intervention (PCI). Methods Propensity score adjusted multivariable regression for mortality was performed in this case-control study of the 2016 National Inpatient Sample. Regression models by PCI weighted by the complex survey design were adjusted for age, race, income, cancer metastases, NIS-calculated mortality risk by Diagnosis Related Group (DRG), acute coronary syndrome (ACS), and the likelihood of undergoing PCI. Model optimization was conducted with forward and backward stepwise regression, standard regression diagnostics, and performance comparison to backward propagation neural network machine learning (ML) according to root mean squared error (RMSE). Results Of 4,659,200 hospitalized adult cancer patients, females were less likely than males to have ACS (41.52% versus 58.48%), and less likely to undergo PCI during ACS (37.86% versus 62.14%). Multivariable regression in the subgroup of cancer patients who underwent PCI found significant disparities in mortality reduction according to sex, males (OR 0.56; 95%CI 0.50–0.62; p

Cardiac magnetic resonance imaging (CMR)-derived ejection fraction (EF) predicts adverse outcomes in repaired tetralogy of Fallot (rTOF) and drives timing of pulmonary valve replacement. Certain patient populations require sedation for successful CMR image acquisition. General anesthesia (GA) has been shown to depress EF and heart rate (HR) in animal models, however, its effect on congenital heart disease is unknown. A retrospective review was conducted of all CMR patients referred with rTOF between January 2011 and May 2019. The cohort was separated into GA and non-GA groups. Propensity score matching (PSM) adjusted for selection bias. A kernel matching algorithm was used to match subjects and the differences in mean treatment effect on the treated were computed for left ventricular (LV) and right ventricular (RV) EF, HR, and cardiac index (CI). 143 patients met criteria, 37 patients under GA (mean age 15 years, range 2–45, 59% male), and 106 patients without GA (mean age 21 years, range 10–53, 50% male). Unmatched analysis showed significant depression of LV EF (50 vs. 57%, p