9 results on '"Syed Z. Qamer"'
Search Results
2. Postoperative Myocardial Injury and Outcomes in Liver and Kidney Transplant Patients
- Author
-
Michael, Yang, Syed Z, Qamer, Andrew P, Hill, Brian C, Case, Alexander J, Gilbert, Rohit S, Satoskar, Alexander T, Lalos, Carolina, Valdiviezo, Toby, Rogers, Lowell F, Satler, Ron, Waksman, and Itsik, Ben-Dor more...
- Subjects
Postoperative Complications ,Heart Injuries ,Risk Factors ,Myocardial Infarction ,Humans ,Prospective Studies ,General Medicine ,Middle Aged ,Cardiology and Cardiovascular Medicine ,Kidney Transplantation ,Troponin ,Liver Transplantation ,Retrospective Studies - Abstract
Myocardial injury after noncardiac surgery (MINS) is associated with major adverse cardiac events (MACE), but its significance post-liver and post-kidney transplantation is not well-defined.We retrospectively studied consecutive patients undergoing single-organ liver or kidney transplantation at a large tertiary transplant center. Liver and kidney transplant patients with troponins drawn within 30 days of transplantation were included. The primary exposure was MINS, defined as troponin elevation above the 99th percentile of the upper reference limit within 30 days of transplantation. The primary outcome was MACE, defined as death, myocardial infarction, revascularization, stroke, or heart failure hospitalization.Overall, 112 patients were included: 58 (51.7%) were liver transplant recipients, and 54 (48.3%) were kidney transplant recipients. Patients with MINS were significantly older (mean age 59 vs. 54 years, p = 0.01) and more likely to have diabetes (35% vs. 17%, p = 0.03). Other baseline characteristics were similar. Sixteen patients (14.2%) developed MACE, including 11 (9.8%) with 1-year MACE. MINS patients were significantly more likely to develop 1-year MACE (adjusted hazard ratio, 10.4; 95% confidence interval, 1.8-198). Kaplan-Meier cumulative MACE was significantly higher in the MINS group (p = 0.03).Liver and kidney transplant recipients with MINS are significantly more likely to develop 1-year MACE compared to those without MINS. Future prospective studies are needed to further delineate the cardiac risk and outcomes in transplanted patients. more...
- Published
- 2022
- Full Text
- View/download PDF
Catalog
3. Pre-Operative Cardiovascular Testing before Liver Transplantation
- Author
-
Itsik Ben-Dor, Charan Yerasi, Toby Rogers, Brian J. Forrestal, Brian C. Case, Hayder Hashim, Ron Waksman, Rohit Satoskar, Alexander Lalos, Syed Z. Qamer, Michael Yang, Giorgio A. Medranda, Chava Chezar-Azerrad, Nelson L. Bernardo, Lowell F. Satler, and Sant Kumar more...
- Subjects
Adult ,Male ,Cardiac Catheterization ,medicine.medical_specialty ,Computed Tomography Angiography ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Liver transplantation ,Coronary Angiography ,Revascularization ,End Stage Liver Disease ,Coronary artery disease ,03 medical and health sciences ,Liver disease ,Postoperative Complications ,0302 clinical medicine ,Internal medicine ,Preoperative Care ,Myocardial Revascularization ,medicine ,Humans ,Myocardial infarction ,Mortality ,Non-ST Elevated Myocardial Infarction ,Aged ,Retrospective Studies ,Cardiac catheterization ,business.industry ,Myocardial Perfusion Imaging ,Middle Aged ,medicine.disease ,Liver Transplantation ,Transplantation ,Cardiovascular Diseases ,Echocardiography ,Exercise Test ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,030211 gastroenterology & hepatology ,Transthoracic echocardiogram ,Cardiology and Cardiovascular Medicine ,business - Abstract
End-stage liver disease (ESLD) is increasingly prevalent and shares many risk factors with coronary artery disease (CAD). No specific guidelines exist for pre-liver transplant evaluation of CAD, and pretransplant cardiovascular testing varies widely. The aim of this study is to characterize pre-transplant cardiac testing practices with post-transplant clinical outcomes. We retrospectively reviewed patients undergoing initial liver transplantation at our transplant center between January 2015 and March 2019. Patients with previous liver transplantation or multi-organ transplantation were excluded. Electronic medical records were reviewed for relevant demographic and clinical data. We included 285 patients with a mean follow-up of 2.4 years. Of 274 patients (96.1%) with pre-transplant transthoracic echocardiogram (TTE), 18 (6.6%) were abnormal. Non-invasive ischemic testing was performed in 193 (68%) patients: 165 (58%) underwent stress TTE, 24 (8%) underwent myocardial perfusion imaging, 3 underwent coronary computed tomography, and 1 underwent exercise electrocardiogram. Sixteen patients (6%) had left heart catheterization of which 10 (63%) were abnormal and 5 proceeded to revascularization before transplant. There were 4 (1.4%) deaths within 30 days of transplant and 23 deaths (8.1%) in total. ST-elevation myocardial infarction was seen in 1 patient within 30 days and 1 patient after 30 days (0.7% total). No cardiovascular deaths were observed. Among patients undergoing liver transplantation, pre-transplantation cardiovascular testing is exceedingly common and post-transplant cardiovascular complications are rare. Additional research is needed to determine the optimal testing and surveillance in this patient population. more...
- Published
- 2021
- Full Text
- View/download PDF
4. RECURRENT CARDIAC MYXOMA COMPLICATED BY BRAIN METASTASES: ROLE OF MULTIMODALITY IMAGING IN DIAGNOSIS AND MANAGEMENT
- Author
-
Ryan Kabir, Syed Z. Qamer, Shahrad Shadman, Itsik Ben-Dor, Michael C. Slack, Christian Charles Shults, Vikram Nayar, Benjamin Weinberg, and Ana Barac
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
- Full Text
- View/download PDF
5. Digoxin Use and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction
- Author
-
Gregg C. Fonarow, Essraa Bayoumi, Steven N. Singh, Ioannis Kanonidis, Richard M. Allman, Phillip H. Lam, Charity J. Morgan, Awais Malik, Milton Packer, Ahmed Abdelmawgoud, Syed Z. Qamer, and Ali Ahmed more...
- Subjects
Bradycardia ,Male ,medicine.medical_specialty ,Digoxin ,Cardiotonic Agents ,Renal function ,030204 cardiovascular system & hematology ,Lower risk ,Medicare ,Patient Readmission ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Cause of Death ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Propensity Score ,Aged ,Heart Failure ,Ejection fraction ,business.industry ,Stroke Volume ,General Medicine ,medicine.disease ,United States ,Hospitalization ,Heart failure ,Propensity score matching ,Cardiology ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
Background Heart failure is a leading cause for hospital readmission. Digoxin use may lower this risk in patients with heart failure with reduced ejection fraction (HFrEF), but data on contemporary patients receiving other evidence-based therapies are lacking. Methods Of the 11,900 patients with HFrEF (ejection fraction ≤ 45%) in Medicare-linked OPTIMIZE-HF, 8401 were not on digoxin, of whom 1571 received discharge prescriptions for digoxin. We matched 1531 of these patients with 1531 not receiving digoxin by propensity scores for digoxin use. The matched cohort (n = 3062; mean age, 76 years; 44% women; 14% African American) was balanced on 52 baseline characteristics. We assembled a second matched cohort of 2850 patients after excluding those with estimated glomerular filtration rate Results Among the 3062 matched patients, digoxin use was associated with a significantly lower risk of heart failure readmission at 30 days (HR, 0.74; 95% CI, 0.59-0.93), 1 year (HR, 0.81; 95% CI, 0.72-0.92), and 6 years (HR, 0.90; 95% CI 0.81-0.99). The association with all-cause readmission was significant at 1 and 6 years but not 30 days. There was no association with mortality. Similar associations were observed among the 2850 matched patients without bradycardia or renal insufficiency. Conclusions Among hospitalized older patients with HFrEF receiving contemporary treatments for heart failure, digoxin use is associated with a lower risk of hospital readmission but not all-cause mortality. more...
- Published
- 2019
6. Abstract 17157: Clinical Impact of Digoxin Discontinuation at Hospital Discharge in Patients With Heart Failure With Reduced Ejection Fraction
- Author
-
Fahad Lodhi, Awais Malik, Syed Z Qamer, Cherinne Arundel, Helen Sheriff, Phillip Lam, Poonam Bhyan, Nankumar Singh, Prakash Deedwania, Gregg Fonarow, and Ali Ahmed
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Digoxin use is associated with a lower risk of hospital admission and readmission in patients with heart failure with reduced ejection fraction (HFrEF). Moreover, PROVED and RADIANCE trials have shown that digoxin discontinuation is associated with lower ejection fraction (EF), higher heart rate, and worse heart failure (HF) symptoms in chronic HFrEF patients. Despite these results, digoxin use has declined over recent years. In this study, we examined the clinical impact of digoxin discontinuation at hospital discharge in elderly patients with HFrEF. Hypothesis: Digoxin discontinuation at hospital discharge will increase mortality and heart failure readmission in HFrEF patients. Methods: Of 10,625 patients hospitalized with HFrEF (EF≤40%) in Medicare-linked OPTIMIZE-HF registry, 3,225 were receiving digoxin prior to admission but it was discontinued in 655 of these patients at the time of discharge. Propensity scores for digoxin discontinuation, estimated for each of the 3,225 patients, were used to match 616 pairs of patients (digoxin continued vs. discontinued) balanced on 60 baseline characteristics including age (mean 76 years), EF (mean 26%), gender (31% females) and race (15% African America) among others. Results: Among 1,232 matched patients, digoxin discontinuation was associated with a higher risk of all-cause mortality at 30-days (12% vs. 8%; HR 1.45; 95% CI 1.01-2.07; p=0.044) and 6-months (HR 1.32; p=0.009) but not at 1-year (HR 1.18; p=0.07). Digoxin discontinuation was also associated with increased combined heart failure readmission/all-cause mortality at 4-years of follow up (HR 1.16; 95% CI 1.03-1.30; p=0.017). Conclusions: In patients with HFrEF receiving digoxin prior to admission, digoxin discontinuation at discharge from hospital is associated with increased short-term all-cause mortality and long-term heart failure readmission/all-cause mortality. more...
- Published
- 2018
- Full Text
- View/download PDF
7. A Case Series of Biopsy-Proven Eosinophilic Myocarditis at a Tertiary Care Center
- Author
-
Selma F. Mohammed, Syed Z. Qamer, Mark Hofmeyer, Indra Bole, and Farooq H. Sheikh
- Subjects
medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Septic shock ,medicine.medical_treatment ,Population ,Autopsy ,Ventricular tachycardia ,medicine.disease ,Surgery ,Ventricular assist device ,Biopsy ,medicine ,Eosinophilia ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Pulmonary wedge pressure ,education ,business - Abstract
Background There is limited published literature on acute eosinophilic myocarditis (EM), a rare form of acute myocarditis, wherein eosinophils invade the myocardium with wide-ranging clinical sequalae. We aim to describe our experience in the largest contemporary case series of histologically-proven EM. Methods Two authors independently reviewed the surgical pathology and autopsy databases for acute EM (01/2009 to 12/2017). Only patients with endomyocardial biopsy/autopsy and clinical course consistent with acute EM were included. We abstracted demographic data, comorbidities, clinical diagnostics, and clinical outcomes. Results Seven patients had acute EM (Table). The average age was 53-years and five subjects were women. The most common etiology of EM was idiopathic. Five patients had peripheral eosinophilia. Three patients had elevated pulmonary capillary wedge pressure and three patients had reduced cardiac output. Six patients were treated with steroids, four of whom received IV pulse dosed steroids. Two patients required intra-aortic balloon pump support, one of whom subsequently underwent durable left ventricular assist device implantation. Two patients died during index hospitalization, one of septic shock and one of refractory ventricular tachycardia. Conclusion The etiologies, clinical presentation, and course of acute EM varied widely. Prompt diagnosis, treatment with immunosuppression, and circulatory support may reduce cardiovascular mortality in this population. more...
- Published
- 2019
- Full Text
- View/download PDF
8. INITIATION OF LOOP DIURETIC THERAPY IS ASSOCIATED WITH A LOWER RISK OF 30-DAY ALL-CAUSE READMISSION IN PATIENTS WITH HEART FAILURE NOT RECEIVING DIURETICS PRIOR TO HOSPITALIZATION
- Author
-
Harish Jarrett, Javed Butler, Prakash Deedwania, Syed Z. Qamer, Cherinne Arundel, Helen Sheriff, Gregg C. Fonarow, Fahad K. Lodhi, Ali Ahmed, and Phillip H. Lam
- Subjects
medicine.medical_specialty ,business.industry ,medicine.drug_class ,Loop diuretic ,medicine.disease ,Lower risk ,Electrolyte imbalance ,Heart failure ,Internal medicine ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,business ,All cause mortality - Abstract
Heart failure (HF) is the leading cause of 30-day all-cause readmission. Diuretics are often used to achieve and maintain euvolemia. However, they may cause neurohormonal activation and electrolyte imbalance and their use may increase the risk of long-term poor outcomes. We examined the association more...
- Published
- 2018
- Full Text
- View/download PDF
9. Asymptomatic Metachronous Lesion in the Pancreas After 25-Year Interval Disease Remission
- Author
-
Syed Z. Qamer, Fahad Lodhi, Charoen Mankongpaisarnrung, and Mitesh Patel
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Asymptomatic ,Lesion ,medicine.anatomical_structure ,Disease remission ,medicine ,Interval (graph theory) ,Radiology ,medicine.symptom ,Pancreas ,business - Published
- 2017
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.