American journal of medicine open最新文献

{"title":"GLP-1 Receptor Agonists Initiation and Risk of Acute Pancreatitis and Pancreatic Cancer: A Real-World Comparative Study","authors":"Omar Faour MD ,&nbsp;Moheb Boktor MD ,&nbsp;Hanford Yau MD ,&nbsp;Mustafa Kinaan MD ,&nbsp;Ishak A Mansi MD","doi":"10.1016/j.ajmo.2025.100114","DOIUrl":"10.1016/j.ajmo.2025.100114","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide 1 receptor agonist (GLP-1RA) medications are widely used in managing type 2 diabetes because of their cardio-renal-metabolic benefits. However, concerns persist regarding their potential association with acute pancreatitis (AP) and pancreatic cancer. This study’s objective was to examine the association of GLP-1RAs with the risk of AP and pancreatic cancer.</div></div><div><h3>Methods</h3><div>This retrospective propensity score-matched cohort study used Veterans Health Administration national data during fiscal years 2006 to 2021. Using a new-user active comparator design, we included veterans who initiated either GLP-1RA or dipeptidyl peptidase-4 inhibitor (DPP-4i) medication, the latter as an active comparator. The primary outcomes were incident AP and pancreatic cancer. We excluded patients with a history of pancreatitis, pancreatic tumors, pancreatic congenital anomalies, and alcohol use. Secondary analysis included adjusting for confounders that may have been introduced during the follow-up period, such as gallbladder diseases, and <em>post hoc</em> analysis restricted analysis to people who had normal serum lipase during follow-up.</div></div><div><h3>Results</h3><div>We matched 88,972 pairs of GLP-1RA and DPP-4i users on all characteristics. AP was diagnosed in 214 (0.24%) DPP-4i users versus 273 (0.31%) GLP-1RA users (OR 1.28; 95% CI, 1.07-1.53), and pancreatic cancer was diagnosed in 154 (0.17%) DPP-4i users versus 211 (0.24%) GLP-1RA users (OR 1.37; 95% CI, 1.11-1.69). Secondary and <em>post hoc</em> analyses showed results consistent with the primary analysis.</div></div><div><h3>Conclusions</h3><div>GLP-1RAs are associated with a modest but statistically significant increase in the risk of AP and pancreatic cancer compared to DPP-4i.</div></div><div><h3>Clinical significance</h3><div>GLP-1RA use is associated with modestly increased odds ratio of acute pancreatitis and pancreatic cancer. Whereas the increased risk seems modest compared to their benefits as shown in the literature, vigilance is recommended, specifically, when GLP-1RAs are used for off label indications.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Different Antidiabetic Drugs on Fracture Risk in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials With a Focus on SGLT2 Inhibitors","authors":"Bushra Admani MBBS ,&nbsp;Fizza Zehra Raza MBBS ,&nbsp;Fatima Siddiqui MBBS ,&nbsp;Muhammad Talal Ashraf MBBS ,&nbsp;Muhammad Khuzzaim Khan MBBS ,&nbsp;Ifra Habib MBBS ,&nbsp;Ayesha Usman MBBS ,&nbsp;Bareeha Mansoor MBBS ,&nbsp;Zaira Nadeem MBBS ,&nbsp;Rana Jahanzeb Ghaffer MBBS ,&nbsp;Muhammad Riyyan MBBS ,&nbsp;Sawaira Sajid MBBS ,&nbsp;Muhammad Hassan Ali Chania MBBS ,&nbsp;Mahnoor Saleem MBBS ,&nbsp;Saad Javaid MBBS ,&nbsp;Nikhil Duseja MBBS ,&nbsp;Hussam Al Hennawi MD ,&nbsp;Sunita Lakhani MD","doi":"10.1016/j.ajmo.2025.100115","DOIUrl":"10.1016/j.ajmo.2025.100115","url":null,"abstract":"<div><div>SGLT2 inhibitors are a new class of antidiabetic drugs that have shown cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, their effects on fracture risk are unclear and may depend on the type and duration of treatment. This meta-analysis compares the fracture risk of different antidiabetic drugs, including SGLT2 inhibitors, based on data from randomized controlled trials (RCTs). We searched 4 databases for RCTs that reported fracture events in patients with T2DM who received different antidiabetic drugs. We included 117 RCTs that compared 9 types of antidiabetic drugs: SGLT2 inhibitors, DPP-4 inhibitors, α-glucosidase inhibitors, thiazolidinediones, insulin, GLP-1 receptor agonists, meglitinides, biguanides, and sulfonylureas. We used a statistical method called Frequentist meta-analysis to combine data from different studies and compare different treatments. The results showed that SGLT2 inhibitors were the only drug that significantly reduced the fracture risk compared to placebo and other drugs (OR 0.85; 95% CI, 0.74-0.98). The other antidiabetic drugs did not show any significant difference from placebo or from each other. The mechanisms behind the effects of SGLT2 inhibitors on bone health are not well understood and may involve changes in calcium, phosphate, sodium, and arginine vasopressin levels in the body. SGLT2 inhibitors demonstrated a favorable skeletal safety profile among antidiabetic drugs. More long-term studies focused on fracture as a primary outcome are needed to fully understand how SGLT2 inhibitors affect bone health and fracture risk in patients with T2DM.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review","authors":"Austin Drysch ,&nbsp;Kathryn Fink ,&nbsp;Nikhil Sriram ,&nbsp;Marianne Kanaris ,&nbsp;Scott Wu ,&nbsp;Deep Upadhyay ,&nbsp;Katherine Welter ,&nbsp;Lisa Blankenship ,&nbsp;Melissa Bregger ,&nbsp;Kelli Scott ,&nbsp;Brent Schnipke ,&nbsp;Ashti Doobay-Persaud","doi":"10.1016/j.ajmo.2025.100113","DOIUrl":"10.1016/j.ajmo.2025.100113","url":null,"abstract":"<div><div>Hospitalization presents a critical opportunity to initiate medications for opioid use disorder (MOUD) and improve long-term outcomes for patients with opioid use disorder (OUD). While inpatient MOUD initiation significantly reduces mortality and relapse, many patients lack appropriate follow-up care after discharge. This scoping review synthesizes evidence from 52 studies on hospital discharge practices for patients with OUD initiated on MOUD to identify best practices that support continued treatment and recovery. Inpatient addiction consultation services, standardized protocols, and clinician education emerged as key facilitators of MOUD initiation. Transitional care strategies, such as bridge clinics, peer navigation, telemedicine, and structured discharge planning, were associated with increased outpatient linkage, reduced readmissions, and improved retention in treatment. Despite policy advances including X-waiver elimination, systemic barriers persist and disproportionately affect rural and minoritized populations. Multidisciplinary, patient-centered discharge pathways that integrate medical treatment with social support are critical. Effective linkage strategies must address both structural and individual barriers to care. We propose six pillars of MOUD continuity, including early initiation, warm handoffs, peer support, bridge care models, telemedicine integration, and attention to social determinants. Implementing these strategies is essential to closing care gaps and improving outcomes in the evolving landscape of MOUD treatment.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sleep Duration and Angina Characteristics in United States Adults","authors":"Maslahuddin HA Alhaque Roomi MD ,&nbsp;Nehal Eid MBBCh ,&nbsp;Aayush Visaria MD","doi":"10.1016/j.ajmo.2025.100109","DOIUrl":"10.1016/j.ajmo.2025.100109","url":null,"abstract":"<div><h3>Background</h3><div>Sleep is now recognized as a key factor in cardiovascular health by the American Heart Association's Life’s Essential 8. However, the relationship between sleep duration and stable angina remains unexplored.</div></div><div><h3>Methods</h3><div>This nationally representative cross-sectional study analyzed data from 18,385 U.S. adults aged 40 and older using the National Health and Nutrition Examination Survey (2005-2018). Daily sleep duration was categorized as &lt;7 hours, 7-8 hours (reference), and &gt;8 hours. Angina was assessed with the Rose Angina Questionnaire and classified by severity (Grade 1 or 2) and pain location (typical vs atypical). Covariates were identified a priori based on previous literature, and clinical relevance.</div></div><div><h3>Results</h3><div>Our study included 18,385 adults with a mean age of 57.6 years (SE 0.16). Out of these, 48.6% were female and 70% were non-Hispanic Whites. A total of 954 (5.2 %) participants reported experiencing angina. Among those with angina, 109 (11%) reported atypical symptoms. Univariate analysis revealed that both short (&lt;7 hours) and long (&gt;8 hours) sleep durations were associated with higher odds of Grade 2 angina compared to adequate sleep (7-8 hours). Adjusted analysis showed significantly higher odds of Grade 2 angina in individuals sleeping &gt;8 hours (OR [95% CI]: 2.16 [1.08-4.32] for females; 2.69 [1.15-6.29] for males). Additionally, sleep &lt;7 hours was associated with a greater likelihood of atypical angina presentation (OR: 1.77 [1.21-3.05]).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that sleeping over 8 hours increases the likelihood of Grade 2 angina, while under 7 hours is linked to atypical presentations, complicating diagnosis. Clinicians could incorporate brief sleep assessments—asking about duration and quality—alongside angina tools like the ROSE questionnaire to identify potential sleep-related factors. While promising, these associations require further research before being translated into definitive clinical guidelines for angina management.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Resident Note Documentation: A Quality Improvement Initiative to Accurately Capture Patient Complexity","authors":"De-Vaughn Williams MD,&nbsp;Scott Keller MHA,&nbsp;Jennifer Mcentee MD, MPH, MAEd,&nbsp;Escher Howard-Williams MD,&nbsp;Cristin M. Colford MD","doi":"10.1016/j.ajmo.2025.100104","DOIUrl":"10.1016/j.ajmo.2025.100104","url":null,"abstract":"<div><div>Provider notes serve as a critical component of physician workflow, documenting essential aspects of patient care while also fulfilling regulatory and billing requirements. With increasing documentation complexity introduced by the Centers for Medicare and Medicaid Services and the 2021 mandate for open access to clinical notes, physicians in training must develop skills to accurately document patient complexity. This quality improvement initiative aimed to enhance inpatient note documentation by internal medicine residents, focusing on improving the capture of medical complexity in coding and billing standards.</div><div>Our intervention included the development and implementation of a standardized progress note template, a structured scoring rubric, multidisciplinary rounds and curriculum integrating faculty and peer-led feedback. The study measured documentation improvements through rubric scores, Length of Stay Index (LOSi), and complications or comorbidities (CC) and major complications or comorbidities (MCC) capture rates.</div><div>Results demonstrated improvements in LOSi and enhanced CC/MCC capture, leading to improved institutional performance metrics. This initiative highlights the necessity of integrating formal note-writing training within residency curricula to meet evolving documentation demands.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutional Accountability for Developing the Next Generation of Faculty Leaders","authors":"Julia Loewen ,&nbsp;Paul Salow BBA, MBA ,&nbsp;Patricia Andreski MA ,&nbsp;David J Brown MD ,&nbsp;Kanakadurga Singer MA, MD","doi":"10.1016/j.ajmo.2025.100102","DOIUrl":"10.1016/j.ajmo.2025.100102","url":null,"abstract":"<div><div>Faculty retention provides a competitive advantage in an academic medical center. Faculty surveys show that lack of career advancement and leadership opportunities are primary reasons faculty seek employment elsewhere. Leadership roles for faculty are frequently locally maintained and not available for institutional leaders to assess leadership opportunities and gaps, especially for women and race/ethnicity groups underrepresented in academic medicine.</div><div>Offices of Faculty Affairs, Faculty Development and Health Equity &amp; Inclusion launched a collaboration to frame and define the current state of faculty leadership at one institution. A desired faculty leadership philosophy, best practices, role descriptions, and overall title framework were developed and reviewed with department leaders. Departments identified all current faculty leaders using the title framework, and titles were entered as additional appointments into our human resource database at the faculty level.</div><div>Baseline demographic analysis of faculty leadership appointments demonstrated a gender and race/ethnicity disparity between the population of faculty and those in leadership roles. With the expanded tracking, the number of faculty leadership roles increased approximately sevenfold. While gender and race/ethnicity gaps closed substantially, the data revealed differences in higher-level leadership roles with more equity in mid-level and emerging roles.</div><div>Results enhanced awareness of the importance of tracking and evaluating leadership roles at all levels. Consequently, faculty leadership data were translated into real-time data visualizations. Tracking of who holds leadership positions increases accountability for initiatives designed to diversify leadership in an academic medical center, and demonstrates a commitment to diversity, equity, and inclusion.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Stress Hyperglycemia in a Cohort of Brazilian Patients With COVID-19","authors":"Ana Julia de Magalhães Pina MS ,&nbsp;Luís Fernando de Oliveira Mr ,&nbsp;Letícia de Oliveira Nascimento MS ,&nbsp;Deborah Maciel Cavalcanti Rosa MS ,&nbsp;Jefferson Barela Mr ,&nbsp;Bruno Martinelli PhD ,&nbsp;Carlos Antonio Negrato PhD","doi":"10.1016/j.ajmo.2025.100101","DOIUrl":"10.1016/j.ajmo.2025.100101","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of stress hyperglycemia (SH) in a cohort of Brazilian patients with COVID-19 admitted to a tertiary care level hospital.</div></div><div><h3>Methods</h3><div>This retrospective cohort study enrolled 754 patients with COVID-19 hospitalized at Hospital Estadual de Bauru, São Paulo, in 2020. Data were collected from the E-pront system and covered sociodemographic, clinical, and laboratory aspects, including mechanical ventilation, comorbidities, and outcomes. Included patients were those &gt;18 years old, with confirmed COVID-19 diagnosis, who required hospitalization, with or without preexisting type 2 diabetes (T2DM), or who developed SH. Patients younger than 18 years, with other types of diabetes, or incomplete data were excluded.</div></div><div><h3>Results</h3><div>Patients with SH had longer hospital and intensive care unit (ICU) stay (<em>P</em> &lt; .001) as well as longer mechanical ventilation duration (<em>P</em> &lt; .001). Additionally, this group needed a higher number of orotracheal intubations (<em>P</em> &lt; .001) and presented higher mortality rates (<em>P</em> &lt; .001) and fewer discharges 284 (<em>P</em> &lt; .001) compared to patients with T2DM and normoglycemia.</div></div><div><h3>Conclusions</h3><div>Patients who developed SH presented poorer clinical outcomes; needed more frequently orotracheal intubation, mechanical ventilation, and longer hospitalization and ICU stay; and had higher mortality rates and fewer discharges compared to patients with T2DM and normoglycemia.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Disparity Clusters of Off Label Prescriptions for Glucagon-Like Peptide 1 Receptor Agonists","authors":"Kateri J. Spinelli ,&nbsp;Allison H. Oakes ,&nbsp;Shih-Ting Chiu ,&nbsp;Mary T. Imboden ,&nbsp;Austin Miller ,&nbsp;Sanjula Jain ,&nbsp;Ty J. Gluckman","doi":"10.1016/j.ajmo.2025.100100","DOIUrl":"10.1016/j.ajmo.2025.100100","url":null,"abstract":"<div><h3>Background</h3><div>Off-label prescribing of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) may exacerbate health disparities.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of data from the Trilliant Health national all-payer claims database, US Census Bureau data (race, ethnicity, median household income), and Centers for Disease Control and Prevention social vulnerability index (SVI). Patients with prescriptions for GLP-1 RAs approved for type 2 diabetes mellitus (T2DM) between January 1, 2022, and December 31, 2022 were included. Those without an ICD-10 code for T2DM in their medical claims were considered off-label. Correlations between county-level off-label rates and health disparity variables were examined using visual mapping, geographically weighted regression models, and hierarchical clustering on principle components (HCPC).</div></div><div><h3>Results</h3><div>A total of 3,688,430 GLP-1 RA prescriptions from 2783 (89%) US counties were included. The median off-label prescribing rate was 37.7% [30.0%-46.3%]. Higher household income was modestly correlated with a higher off-label prescribing rate. HCPC modeling produced seven clusters with distinct geographic locations. The highest off-label prescribing rate (51.6%) occurred in a cluster of counties in Hawaii with high median income ($92,124). The lowest off-label prescribing rate (31.2%) occurred in a cluster of counties that included American Indian Tribal reservation lands, with low median income ($52,437) and high SVI (0.88). Other clusters showed unique patterns of racial and ethnic diversity, income, SVI, and off-label prescribing rates.</div></div><div><h3>Conclusions</h3><div>We identified distinct populations with varying GLP-1 RA off-label prescribing and known health disparities. These results could inform clinical and market strategies to increase access to GLP-1 RAs in underserved populations.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Patient-Reported Outcomes in Ischemic Heart Disease: Validation of the Greek HeartQoL Questionnaire","authors":"Ioanna Dimitriadou ,&nbsp;Christi Deaton ,&nbsp;Evangelos C. Fradelos ,&nbsp;John Skoularigis ,&nbsp;Ioannis Vogiatzis ,&nbsp;Evangelos Sdogkos ,&nbsp;Aikaterini Toska ,&nbsp;Eleni Tsiara ,&nbsp;Anastasios Christakis ,&nbsp;Dimitra Anagnostopoulou ,&nbsp;Maria Saridi","doi":"10.1016/j.ajmo.2025.100098","DOIUrl":"10.1016/j.ajmo.2025.100098","url":null,"abstract":"<div><h3>Background</h3><div>The Greek HeartQoL questionnaire is designed to assess health-related quality of life (HRQoL) in patients with ischemic heart disease.</div></div><div><h3>Objectives</h3><div>This study aims to validate its psychometric properties in Greek patients diagnosed with angina pectoris, myocardial infarction, and ischemic heart failure.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 158 patients from five clinical sites in Greece. Participants completed the Greek HeartQoL, the Short Form-36 Health Survey, and the Hospital Anxiety and Depression Scale. Psychometric evaluations included Mokken scale analysis, reliability testing with Cronbach's alpha, and validity assessments through Spearman correlation coefficients, and analysis of covariance.</div></div><div><h3>Results</h3><div>The Greek HeartQoL exhibited excellent internal consistency, with Cronbach's alpha values exceeding 0.90. Factor analysis confirmed the questionnaire's two-factor structure, effectively capturing physical and emotional dimensions of HRQoL. Convergent validity was demonstrated by strong correlations with Short Form-36 Health Survey (<em>r</em> &gt; 0.70), and discriminative validity was confirmed by significant differences in HRQoL scores between patients with angina pectoris, myocardial infarction, and ischemic heart failure (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The findings suggest that the Greek HeartQoL demonstrates strong reliability and validity in assessing HRQoL in Greek ischemic heart disease patients. However, further studies with larger and more diverse samples are needed to confirm its psychometric properties across different clinical populations.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"14 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Takayasu's Arteritis as a Risk Factor for Acute Coronary Syndrome","authors":"Maria Emilia Romero Noboa MD ,&nbsp;Shilpa Arora MD ,&nbsp;Preeti Kansal MD ,&nbsp;Augustine M. Manadan MD","doi":"10.1016/j.ajmo.2025.100096","DOIUrl":"10.1016/j.ajmo.2025.100096","url":null,"abstract":"<div><h3>Introduction</h3><div>Takayasu's arteritis (TAK) is a rare chronic granulomatous vasculitis that primarily affects the aorta and its major branches but is also known to affect the coronary arteries. This involvement can result in acute coronary syndrome (ACS). This study aims to analyze TAK as an ACS risk factor in a US adult inpatient population.</div></div><div><h3>Methods</h3><div>We performed a retrospective study of ACS in 2016-2020 National Inpatient Sample (NIS) database. TAK and traditional cardiovascular (CV) risk factors were included in a multivariable logistic regression analysis for an outcome of ACS. The results were reported as adjusted odds ratios (OR_adj) with <em>P</em> values &lt;.05 considered significant.</div></div><div><h3>Results</h3><div>There were 148,767,786 adult hospitalizations in the 2016-2020 NIS database. Of the 3,282,749 hospitalizations with ACS, 180 (0.005%) had TAK. Multivariable analysis showed that age (OR_adj 1.02), lowest income quartile (OR_adj 1.03), diabetes (OR_adj 1.19), hypertension (OR_adj 1.06), hyperlipidemia (OR_adj 2.94), nicotine dependence/tobacco use (OR_adj 1.96), obesity (OR_adj 1.21), and TAK (OR_adj 1.78) were associated with a higher odds of ACS.</div></div><div><h3>Conclusions</h3><div>Despite rare occurrence of concurrent ACS and TAK, we found TAK was independently associated with ACS similar to traditional CV risk factors. These results should alert physicians to the high risk of ACS in TAK inpatients.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}