Higher Prevalence Of Diabetes Mellitus Research Articles

D-dimer level and inflammatory markers in COVID-19 patients with and without diabetes mellitus - A comparative study during the first wave of the pandemic

Introduction and Aim: High prevalence of diabetes mellitus makes it crucial to understand the distinctive inflammatory features of COVID-19 infection. Hyperglycemia and diabetes mellitus are independent prognosticators for mortality and morbidity in SARS-CoV-2 infection. This study compares D-dimer and inflammatory markers in COVID-19 patients with and without T2DM during the first wave of the pandemic. Materials and Methods: A retrospective study was conducted at a tertiary care hospital. D-dimer, IL-6, Ferritin, CRP and LDH levels in COVID-19 patients with and without T2DM were compared. D-dimer values were correlated with the IL-6, Ferritin, CRP, LDH and checked for statistical evidence. HbA1c levels were assessed for association of the severity of COVID-19 infection. Results: Serum levels of inflammatory biomarkers of 205 COVID-19 patients were compared in which 106 had T2DM and 99 were non- diabetic. Ferritin and LDH showed statistically significant elevation in diabetic COVID-19 patients. D-dimer showed positive correlation with all the inflammatory markers both in diabetic and non-diabetic COVID-19 patients. HbA1c showed statistically significant positive correlation only with Ferritin in COVID-19 patients with T2DM. Conclusion: Ferritin was significantly associated with severity of diabetes as indicated by correlation to HbA1c. D-dimer, Ferritin, IL-6 and LDH levels were significant in COVID 19 patients having diabetes and those without.

Impact of diabetes mellitus on tuberculosis treatment outcomes: a cohort study in Bengaluru, India

Background: Tuberculosis (TB) remains a significant global health challenge, particularly in regions with a high prevalence of diabetes mellitus (DM). This study aims to evaluate the impact of DM on the treatment outcomes of TB patients in Bengaluru, India. Methods: In this cohort study, we examined 592 patients with smear-positive pulmonary TB, half of whom had a comorbid diagnosis of DM. Conducted in the Bruhat Bengaluru Mahanagara Palike area, the study included patients registered under the national TB elimination programme (NTEP). Data were collected on demographic characteristics, treatment adherence, sputum positivity, and treatment outcomes over six months. Results: The study revealed a high prevalence of DM among TB patients. Significant associations were observed between DM and various challenges, including higher rates of sputum positivity, poor adherence to anti-TB and anti-diabetic medications, increased adverse drug reactions (ADRs), and a higher default rate. TB patients with DM had a 1.5 times higher risk of unsuccessful treatment outcomes compared to non-diabetics. Furthermore, the risk of poor outcomes, particularly relapse, increased substantially in the TB-DM group during the six-month follow-up. Conclusions: Our findings highlight the crucial need for integrated TB and DM management strategies. This includes routine DM screening for TB patients, personalized treatment regimens, and enhanced patient education and support. These measures are essential for improving treatment outcomes in TB patients with comorbid DM.

Benefits of statin therapy within a year after kidney transplantation

Cardiovascular disease remains a leading cause of morbidity and mortality after kidney transplantation (KT). Although statins reduce cardiovascular risk and have renal benefits in the general population, their effects on KT recipients are not well-established. We studied the effects of early statin use (within 1-year post-transplantation) on long-term outcomes in 714 KT recipients from the Korean cohort study for outcome in patients with KT. Compared with the control group, statin group recipients were significantly older, had a higher body mass index, and had a higher prevalence of diabetes mellitus. During a median follow-up of 85 months, 74 graft losses occurred (54 death-censored graft losses and 20 deaths). Early statin use was independently associated with lower mortality (hazard ratio, 0.280; 95% confidence interval 0.111–0.703) and lower death-censored graft loss (hazard ratio, 0.350; 95% confidence interval 0.198–0.616). Statin therapy significantly reduced low-density lipoprotein cholesterol levels but did not decrease the risk of major adverse cardiovascular events. Biopsy-proven rejection and graft renal function were not significantly different between statin and control groups. Our findings suggest that early statin use is an effective strategy for reducing low-density lipoprotein cholesterol and improving patient and graft survival after KT.

Navigating Heart Failure: Unveiling Sex Disparities in Guideline-Directed Medical Therapy Combinations

Major heart failure (HF) trials remain insufficient in terms of assessing the differences in clinical characteristics, biomarkers, treatment efficacy, and safety because of the under-representation of women. The study aimed to present sex-related disparities in HF management, including differences in demographics, co-morbidities, cardiac biomarkers, prescribed medications, and treatment outcomes. The study utilized anonymized data from the Turkish Ministry of Health's National Electronic Database between January 1, 2016, and December 31, 2022. The cohort analysis included 2,501,231 adult patients with HF. Specific therapeutic combinations were analyzed using a Cox regression model to obtain relative risk reduction for all-cause death. The primary end point was all-cause mortality. In the cohort, 48.7% (n = 1,218,911) were male, whereas 51.3% (n = 1,282,320) were female. Female patients exhibited a higher median age (71 vs 68 years) and manifested higher prevalence of diabetes mellitus, anemia, atrial fibrillation, anxiety, and ischemic stroke. Male patients demonstrated higher rates of previous myocardial infarction, dyslipidemia, chronic obstructive pulmonary disease, and chronic kidney disease. Higher concentrations of natriuretic peptides were observed in female patients. Renin-angiotensin aldosterone inhibitor, β blockers, mineralocorticoid receptor antagonists, sodium/glucose cotransporter 2 inhibitor (SGLT2i), and ivabradine were more commonly prescribed in male patients, whereas loop diuretics, digoxin, and ferric carboxymaltose were more frequent in female patients. Male patients had higher rates of cardiac resynchronization therapy and implantable cardioverter defibrillator implantation rates. All-cause mortality and hospitalization rates were higher in male patients. Compared with monotherapy, all combinations, including SGLT2i, showed a beneficial effect on all-cause mortality in both female and male patients with HF. In hospitalized patients with HF, the addition of digoxin to renin-angiotensin aldosterone inhibitor, mineralocorticoid receptor antagonists, and β blockers was superior to monotherapy regarding all-cause mortality in female patients with HF compared with male patients with HF. In conclusion, this study highlights that sex-specific responses to HF medication combinations compared with monotherapy and differences in co-morbidities underscore the importance of tailored management strategies. Digoxin showed a contrasting effect on all-cause mortality between both sexes after hospitalization, whereas SGLT2i exhibited a consistent beneficial effect in both sexes when added to all combinations.

Establishment of diabetes mellitus model using Bombyx mori silkworms in a low-temperature environment.

Due to the high prevalence of diabetes mellitus, researchers have conducted numerous experimental animal studies. However, the mammalian diabetes model is cumbersome and expensive to operate, while the cheap and simple common silkworm diabetes model has the disadvantage of a short cycle time. Since the growth of silkworms is greatly affected by environmental factors, we extended the five-age cycle of silkworms by lowering the ambient temperature to establish a novel low-temperature silkworm diabetes model. Our goal was to determine whether the low-temperature feeding of a high-sugar diet to silkworms could serve as an effective animal model for diabetes. Also, we aimed to resolve certain issues concerning the normal temperature silkworm diabetes model, such as the short time frame for experiments and erratic fluctuations in blood sugar levels. Silkworms weighing between 0.9 and 1.0 g at the beginning of the fifth instar were selected, and we created diabetic silkworms by feeding mulberry leaves containing 4% glucose daily in a 16-20°C environment. When the silkworms were kept at a cooler temperature, the fifth instar stage lasted for an additional 9-11 days. In the model group, 83.3% of the silkworms had blood glucose levels greater than 7.8 mmol/L, while the total prevalence of diabetic silkworms was 89.8%. Moreover, JNK phosphorylation expression rose in the model group, while PI3K expression fell. Additionally, the JNK and PI3K signaling pathway expressions matched diabetic signals. Therefore, using silkworms to create a diabetes model in a cool environment is a straightforward and cost-effective approach to studying diabetes in animals.

Correlates of diabetes mellitus and hypertension in India: Change as evidenced from NFHS- 4 and 5 during 2015-2021.

Both diabetes mellitus (DM) and hypertension (HTN) have been on the rise in recent decades all over the world more remarkably in developing countries like India. We intend to measure the prevalence of DM and HTN in the Indian population and to compare the trends and various correlates of these diseases in NFHS (National Family Health Survey)-4 and 5. Data of NFHS-4 and 5 were accessed from dhs program website. All statistical analyses were done in SAS (version 9.4). Mixed effects survey logistic regression models were used for estimating odds ratio (OR).p-values <0.05 were considered significant .1,637,762 individual case entries were evaluated. Both the diseases showed an increasing trend as per the advancing age in both sexes. The highest prevalence of DM is seen in the age group of 45-49 years (7.8%) in females and > 50 years (11.9%) in males as per NFHS-5. Similarly, the highest prevalence of HTN was seen in the age group of45-49 years (31.2%) in females and > 50 years (41.4%) in males as per NFHS-5. The OR (95% CI) of prevalence of DM, HTN and both the diseases in age group >50 years was 14.46 (13.14-15.7), 16.65 (15.78-17.6), 79.5 (64.76-97.73) respectively when compared to reference age group15-19 years. Highest odds for having both DM, HTN concurrently was in age >50 years with aOR(95% CI) 65.32 (52.26-72.63) in NFHS 4 and 35.57 (97.47-45.53) in NFHS 5.Rise in prevalence of DM, HTN and concurrent presence is noted with an apparent increase in cases.

Evaluation of Clinical, Echocardiographic, and Therapeutic Characteristics, and Prognostic Outcomes of Coexisting Heart Failure among Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study.

Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice. Heart failure (HF) can occur concurrently with AF. We compared different demographic, clinical, and echocardiographic characteristics between patients with AF+HF and patients with AF only. Furthermore, we explored whether concurrent HF independently predicts several outcomes (all-cause mortality, cardiovascular mortality, ischemic stroke/systemic embolism (IS/SE), major bleeding, and clinically relevant non-major bleeding (CRNMB)). Comparisons between the AF+HF and the AF-only group were carried out. Multivariable Cox proportional hazard models were constructed for each outcome to assess whether HF was predictive of any of them while controlling for possible confounding factors. A total of 2020 patients were included in this study: 481 had AF+HF; 1539 had AF only. AF+HF patients were older, more commonly males, and had a higher prevalence of diabetes mellitus, dyslipidemia, coronary artery disease, and chronic kidney disease (p≤0.05). Furthermore, AF+HF patients more commonly had pulmonary hypertension and low ejection fraction (p≤0.001). Finally, HF was independently predictive of all-cause mortality (adjusted HR 2.17, 95% CI (1.66-2.85) and cardiovascular mortality (adjusted HR 2.37, 95% CI (1.68-3.36). Coexisting AF+HF was associated with a more labile and higher-risk population among Jordanian patients. Furthermore, coexisting HF independently predicted higher all-cause mortality and cardiovascular mortality. Efforts should be made to efficiently identify such cases early and treat them aggressively.

The relationship between lung cancer and hepatosteatosis in patients with biopsy-confirmed lung cancer diagnosis.

The purpose of this study is to evaluate whether hepatosteatosis is associated with lung cancer in patients undergoing lung nodule biopsy. 359 patients (248 males, 69.1%) who underwent lung biopsy between the years 2016 and 2022 were included in this retrospective study. The average age of the patients was 64.59±14.05 (range=30-90) years. These patients were undergoing follow-up for a lung lesion and had undergone thoraco-abdominal CT scans. Attenuation measurements were performed on non-contrast CT scans from the liver and spleen parenchyma. Pathology results showed that the majority of diagnoses were malignant (n=265, 73.8%). Statistical analysis revealed a significantly higher number of patients with malignancy among those with hepatosteatosis compared to those without hepatosteatosis (73% vs. 57%, p=0.006). Furthermore, patients with malignancy were more frequently male (73 vs. 27%, p=0.010), older (65.80±12.83 years vs. 61.20±16.63 years; p=0.06) and had a higher prevalence of diabetes mellitus (DM) (43.7 vs. 31.9%, p=0.046). Logistic regression analysis indicated that advanced age, DM, and hepatosteatosis were associated with an increased risk of malignancy (p=0.049, 95% CI (1.000-1.036), p=0.044, 95% CI (0.0347-0.98736), p=0.013, 95% CI (1.154-3.323), respectively). The study findings suggest that hepatosteatosis might be associated with lung cancer. Therefore, due to its possible relationship with lung cancer, it should be taken very seriously, considering the chance of early diagnosis and treatment.

Short-term and long-term mortality comparison between myocardial infarction with and without ST segment elevation undergoing myocardial revascularization by percutaneous coronary angioplasty

To compare the early and late mortality of patients that have suffered an ST segment elevation myocardial infarction (STEMI) and a non-ST segment elevated myocardialinfarction (NSTEMI). Retrospective study of patients treated at the Regional Clinical Hospital of Concepción from January the 1rst 2013 to December 31 rst 2015, with diagnostic of STEMI and NSTEMI that required coronary angioplasty during their hospitalization. Descriptive and multivariate analysis was performed to compare mortality rates between both populations before 30 days and in follow-up at 4 years. 1838 patients were included with an average follow-up of 82 months. The population with STEMI was 921 and was younger, with a higher prevalence of arterial hypertension and smoking. The population with NSTEMI had a higher prevalence of diabetes mellitus, a lower glomerular filtration rate, and a higher incidence of left main coronary artery disease and chronic occlusions. At the end of follow-up, the overall survival rate was 76%, with no significant difference between the two groups. Patients with STEMI had twice the risk of dying in the first 30 days (Long Rank: 0.012). After 30 days, mortality was higher in the NSTEMI group (80.8% vs 75.6%). This study did not show significant differences in overall mortality during prolonged follow-up of patients with STEMI and NSTEMI. The STEMI group had a higher risk of early death, while the NSTEMI group had higher long-term mortality.

Assessment of Diabetes Mellitus Prevalence and Associated Complications among Patients at Jinja Regional Referral Hospital

In recent years, Africa has witnessed a notable shift in its disease landscape from acute infectious conditions to chronic non-communicable diseases like diabetes. The economic impact of diabetes and its complications has become a significant concern, affecting individuals, families, healthcare systems, and national economies through direct medical costs and productivity loss. Uganda, in particular, has observed a rising prevalence of diabetes, with the Uganda Diabetes Association reporting a 1.4% prevalence, accounting for approximately 500,000 individuals affected. This surge in diabetes presents a dual challenge as both a public health issue and an economic burden, necessitating vigilant monitoring and stringent management. Recognizing its profound public health implications in terms of morbidity, mortality, and cost, a comprehensive investigation into the prevalence and complications of diabetes mellitus was conducted at Jinja Regional Referral Hospital (JRRH). Using a retrospective facility-based cross-sectional study design encompassing qualitative and quantitative approaches, this research reviewed 784 patient records admitted to JRRH from January 2018 to December 2018. The findings revealed a notably high prevalence of diabetes mellitus at 8.2%. Noteworthy gender disparities were observed, with a higher prevalence among males (12%) than females (6%) within the studied population. Moreover, urban dwellers exhibited a higher susceptibility to diabetes compared to rural counterparts, and the risk was observed to escalate with age. Complications associated with diabetes mellitus were alarmingly prevalent, reaching 89.23%, predominantly characterized by microvascular complications, accounting for 56.90%. Despite the severity of complications, the case fatality rate stood at 1.54%, lower than the documented 4%, possibly influenced by a spectrum of contributing factors both positive and negative. The study underscores the urgency for increased focus on diabetes care in Jinja, emphasizing the imperative for further research, robust health education initiatives, and enhanced funding allocation toward managing this escalating health concern. Keywords: Diabetes Mellitus, Diseases, Public Health, Complications, Males and Females.

Coronary Angiographic Characteristic of Coronary Artery Disease of Young Adults Under Age Forty Years Compare to Those Over Age Forty

This study aimed to compare the coronary angiographic characteristics of coronary artery disease in young adults (≤40 years) and older adults (&gt;40 years). This was a retrospective analytic study. The study was conducted at the Department of Cardiology, Rajshahi Medical College Hospital. 100 patients with coronary artery disease were included in this study. Among the 100 patients, 50% were in the ≤40 years’ group (group A) and 50% were in the &gt;40 years’ group (group B). Coronary angiographic characteristics were analyzed for each group. Coronary artery disease was present in 72% of group A and 84% of group B. In group A, single vessel disease (SVD) was the most common pattern (38%, p=0.001), while in group B, double vessel disease (DVD) (36%, p=0.043), triple vessel disease (TVD) (26%, p=0.033), and left main vessel disease (LM) (8%, p=0.035) were more prevalent. Left ventricular dysfunction with hypokinesia was observed in the majority of patients. The left anterior descending (LAD) artery was most commonly involved in both groups, primarily in the mid and proximal segments. The right coronary artery (RCA) was the next commonly affected artery, with differences in involvement site between the two groups. This study highlights that SVD is more common among young adults, whereas DVD, TVD, and LM diseases are more prevalent in older individuals. Older age groups exhibited a higher prevalence of diabetes mellitus, while smoking, dyslipidemia, and hypertension were common risk factors for coronary artery disease in both age groups. TAJ 2023; 36: No-2: 01-09

Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0

IntroductionThere is scarce data linking pericardial fat volume (PFV) and classical coronary risk factors with non-calcified plaque presence among patients with CAC = 0 in the literature. Material and methodA total of 811 patients with chest pain suggestive of angina underwent CT coronary angiography for the assessment of coronary artery disease were collected. Of these, 417 with CAC = 0 were included in the analysis. ResultPatients with non-calcified plaque were older (54 ± 9 versus 50 ± 10, P = 0.01) and had a higher prevalence of diabetes mellitus (31% versus 17%, P = 0.02), high BMI (29.9 versus 28.3, P = 0.04), and increased PFV (123 cm3 versus 99 cm3, P < 0.01) compared to patients without plaque. In multivariate regression analysis, high BMI[OR(CI) = 1.1(1–1.3), P = 0.02] was an independent predictor of non-calcified coronary plaque presence among patients with CAC = 0 after adjustment to variables with P < 0.05 in the univariate analysis. ConclusionIn patients with a CAC score of 0, advanced age, diabetes mellitus, increased PFV, and high BMI were all associated with the presence of non-calcified plaque. After multivariate adjustment, increased BMI remained a significant independent predictor for non-calcified plaque presence.

Case-control analysis of venous thromboembolism risk in non-alcoholic steatohepatitis diagnosed by transient elastography.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Studies have shown a strong association between non-alcoholic steatohepatitis (NASH) cirrhosis and portal vein thrombosis. Specifically, there is paucity of data on the association of NASH and venous thromboembolism (VTE), with one such study predicting a 2.5-fold increased risk for VTE compared to other liver diseases in hospitalized patients. The mechanism is believed to be a hepatocellular injury, which causes a chronic inflammatory state leading to the unregulated activation of procoagulant factors. There has been no prior analysis of the degree of steatosis and fibrosis (measured using transient elastography, commonly known as FibroScan) in NASH and its association with VTE. To examine the association between the degree of hepatic steatosis and fibrosis, quantified by transient elastography, and the incidence of VTE in patients with NASH. In our case-control study, we included patients with a documented diagnosis of NASH. We excluded patients with inherited thrombophilia, hemoglobinopathy, malignancy, alcohol use disorder, autoimmune hepatitis, and primary biliary cirrhosis. The collected data included age, demographics, tobacco use, recreational drug use, medical history, and vibration controlled transient elastography scores. VTE-specific data included the location, type of anticoagulant, need for hospital stay, and history of VTE recurrence. Steatosis was categorized as S0-S1 (mild) and S2-S3 (moderate to severe) based on the controlled attenuation parameter score. Fibrosis was classified based on the kilopascal score and graded as F0-F1 (Metavir stage), F2, F3, and F4 (cirrhosis). χ2 and Mann-Whitney U tests were used for the qualitative and quantitative variable analyses, respectively. Furthermore, we performed a logistic regression using VTE as the dependent variable. A total of 415 patients were analyzed, and 386 met the inclusion criteria. 51 and 335 patients were included in the VTE and non-VTE groups, respectively. Patients with VTE had a mean age of 60.63 years compared to 55.22 years in the non-VTE group (P < 0.014). Patients with VTE had a higher body mass index (31.14 kg/m² vs 29.30 kg/m²) and a higher prevalence of diabetes mellitus (29.4% vs 13.1%). The history of NASH was significantly higher in the VTE group (45.1% vs 30.4%, P < 0.037). Furthermore, moderate-to-severe steatosis was significantly higher in the VTE group (66.7% vs 47.2%, P < 0.009). Similarly, the F2-F4 fibrosis grade had a prevalence of 58.8% in the VTE group compared to 38.5% in the non-VTE group (P < 0.006). On logistic regression, using VTE as a dependent variable, diabetes mellitus had an odds ratio (OR) =1.702 (P < 0.015), and F2-F4 fibrosis grade had an OR = 1.5 (P < 0.033). Our analysis shows that NASH is an independent risk factor for VTE, especially deep vein thrombosis. There was a statistically significant association between the incidence of VTE, moderate-to-severe steatosis, and fibrosis. All hospitalized patients should be considered for medical thromboprophylaxis, particularly those with NASH.

Prevalence of physical health comorbidities and long-term functional outcomes among community-reintegrated veterans following lower limb amputation in Sri Lanka

IntroductionLower limb amputation (LLA) poses significant health challenges, including physical health comorbidities (PHCs) and functional limitations. Military veterans, who typically undergo traumatic LLA at a young age, endure these challenges...

Echocardiographic Changes in Saudi Patients with Type 2 Diabetes Mellitus.

Background and Objectives: Cardiovascular disease is one of the leading causes of morbidity and mortality among the diabetic population. Given the high prevalence of diabetes mellitus (DM) in Saudi Arabia and the high prevalence of heart failure in the diabetic population, this study assesses the echocardiographic changes in Saudi patients with type 2 DM (T2DM) compared with healthy controls. Materials and Methods: In this retrospective case-control study, 80 patients with diabetes (45 males, age: 58.78 ± 10.2 years) were compared with 80 controls (45 males, age: 58.6 ± 10 years) who underwent an echocardiographic study in the King Saud University Medical City, Riyadh, Saudi Arabia. Results: There were no significant differences between the patients with diabetes and controls in terms of aortic root diameter, left atrium diameter, posterior wall, interventricular wall thickness, left ventricular diameters and ejection fraction. However, diastolic dysfunction was statistically significantly higher in the diabetic group than in the control group (p < 0.05). Conclusions: This is the first case-control study in Saudi Arabia that assesses echocardiographic parameters in T2DM patients. DM is an independent risk factor for diastolic dysfunction regardless of its association with hypertension and dyslipidemia.

Predictors of optical coherence tomography-defined calcified nodules in patients with acute coronary syndrome: a substudy from TACTICS registry

Abstract Background We investigated the clinical predictors of optical coherence tomography (OCT)-defined calcified nodules (CN) in patients with acute coronary syndrome in a prospective multicenter registry. Methods We investigated 695 patients enrolled in TACTICS registry who underwent OCT assessment of the culprit lesion during primary percutaneous coronary intervention. OCT-CN was defined as eruptive calcific nodules into the lumen with disruption of the fibrous cap and an underlying calcified plate. Patient characteristics were compared between patients with and without OCT-CN. Results OCT-CN was detected in 28 patients (4.0%). Patients with OCT-CN were older (75.0 ± 11.3 vs. 65.7 ± 12.7 years, p &amp;lt; 0.001) and had a higher prevalence of diabetes mellitus (50.0% vs. 29.4%, p = 0.034), hemodialysis (21.4% vs. 1.6%, p &amp;lt; 0.001) and heart failure (Killip 3/4, 21.4% vs. 5.7%, p = 0.003) than patients without OCT-CN. The angiographic SYNTAX score was higher in patients with OCT-CN than those without (median, 15 [interquartile range, 11, 25] vs. 11 [7, 19], p = 0.003). Multivariable analysis demonstrated that age (odds ratio [OR], 1.072; 95% confidence interval [CI], 1.033–1.116; p &amp;lt; 0.001), Killip class 3/4 (OR, 4.466; 95% CI, 1.472–11.943; p = 0.004) and hemodialysis (OR, 16.571; 95% CI, 4.946–52.863; p &amp;lt; 0.001) were significantly associated with the presence of OCT-CN. In non-dialysis patients (n=678), age (OR, 1.081; 95% CI, 1.035–1.135; p &amp;lt; 0.001), Killip class 3/4 (OR, 4.414; 95% CI, 1.327–12.709; p = 0.009) and diabetes mellitus (OR, 3.046; 95% CI, 1.251–7.594; p = 0.014) were significantly associated with the presence of OCT-CN. Conclusions TACTICS registry demonstrated the clinical predictors of OCT-CN, which may be associated with worse prognosis.

Abstract 12984: Impact of Cardio-Ankle Vascular Index on New Cancer Diagnosis in Patients With Coronary Artery Disease

Introduction: Cardiovascular risk factors are associated with increased risk of future cancer. However, the relationship between quantitative parameters of atherosclerosis and the risk of future cancer is unclear. Here we investigated the association between cardio-ankle vascular index (CAVI), an indicator of arterial stiffness, and future new cancer diagnosis in patients with coronary artery disease. Methods: This was a prospective observational study which enrolled consecutive 1122 patients with coronary artery disease, excluding patients with atrial fibrillation or dialysis. According to the receiver operating characteristic curve analysis, the cut-off value of CAVI in predicting new cancer diagnosis was 8.70. We divided patients into two groups: the high-CAVI group (CAVI ≥ 8.70, n = 578, 51.6%) and the low-CAVI group (CAVI &lt; 8.70, n = 544, 48.4%). We compared the patients’ characteristics and followed the incidence of new cancer diagnosis. Results: The high-CAVI group, as compared with the low-CAVI group, were older (72.3 vs. 64.0 years, P &lt; 0.001) and had higher prevalence of diabetes mellitus (53.8 vs. 45.6%, P = 0.006), chronic kidney disease (47.1 vs. 32.5%, P &lt; 0.001) and anemia (46.0 vs. 32.9%, P &lt; 0.001). In contrast, there was no difference in the prevalence of smoking, hypertension, dyslipidemia, heart failure and history of malignancies between two groups. In the follow up period (mean of 2182 days), there were 141 new cancer diagnosis. The cumulative incidence of new cancer diagnosis was significantly higher in the high-CAVI group than in the low-CAVI group ( P = 0.007). In the multivariable Cox proportional hazard analysis after adjusting for confounding factors, CAVI was found to be an independent predictor of new cancer diagnosis (hazard ratio 1.51, 95% confidence interval 1.05-2.17, P = 0.022). Conclusions: High CAVI is associated with the risk of future cancer in patients with coronary artery disease.

Abstract 14789: Atrial Anatomical Variations Between Atrial Fibrillation Patients Compared to Other Subjects Without Atrial Fibrillation

Introduction: In this study, we evaluated the anatomical atrial variations using gated cardiac computed tomography (CCT) between patients with and without atrial fibrillation (AF). Hypothesis: The aim of the study is to evaluate if there are specific anatomical characteristics that are associated with poor clinical outcomes following ablation in patients with AF. Methods: We retrospectively included 502 CCT scans of patients with AF prior to their pulmonary vein isolation procedure, and 1058 CCT scans of patients without AF performed to evaluate pulmonary vein anatomy and to rule out coronary artery disease between 2014 to 2017. Anatomical variations of the atria and interatrial septum included the Bachman bundle shunt (BBS - defined as a vascular channel crossing between the atria through the Bachman bundle), and atrial diverticulae. Results: Five-hundred and two patients with AF were older (67±14 vs. 63±13 years, P = 0.039), had a higher prevalence of diabetes mellitus (24.4% vs 14.7%, p = 0.006), and cerebrovascular disease (3.8% vs. 0.9%, p = 0.044) compared to patients without AF. Furthermore, CCTs analysis of AF patients demonstrated a significantly higher prevalence of BBS: (11% vs 4.1%, p &lt;0.0001, left atrial diverticula (19% vs 7.7%), p &lt;0.0001, and right atrial diverticula (9.8% vs 2.1%), P &lt;0.0001 compared to patients without AF. Conclusions: This study is the first to analyze BBS and atrial diverticular prevalence in patients using CCT. We found that patients with AF are associated with a higher prevalence of structural atrial abnormalities including BBS, left and right atrial diverticula in comparison to individuals with no previous history of AF. Whether these anatomical variations influence AF incidence or AF recurrence after catheter ablation is yet to be determined.

Abstract 12875: Echocardiographic Findings Associated With Subsequent Risk of Native Valve Endocarditis

Introduction: The association of echocardiographic measurements and subsequent risk of left-sided native valve endocarditis (LS-NVE) is undefined. Aim: To determine if transthoracic echocardiographic (TTE) measurements are associated with the subsequent development of LS-NVE in patients without recognized cardiac predisposing conditions. Methods: Institutional databases were evaluated for adults diagnosed with LS-NVE from 2008 to 2020. Patients with prosthetic valves, cardiovascular implantable electronic devices, intracardiac devices, injection drug use, and recognized predisposing cardiac conditions were excluded. Patients with a TTE performed 6 months to 3 years before developing LS-NVE were included as cases. Controls were patients within the same Mayo Clinic location with a TTE report and were matched in a 1:3 ratio according to age, gender, Charlson Comorbidity Index (CCI), and echocardiography date. Multivariate logistic-regression analyses adjusting significant variables between cohort's were performed. A p-value &lt;0.05 was considered significant. Results: There were 148 cases and 431 matched controls. The median age was 63.8 (IQR: 53.6 - 74.6) years, and 329 (56.8%) patients were males. LS-NVE cases had a higher prevalence of diabetes mellitus (46.6% vs. 30.4%) and chronic kidney disease (46.6% vs. 28.1%) when compared with controls (p&lt;0.001 both). The median CCI score was 3 (IQR: 0-6) for cases and 2 (IQR: 0-6) for controls. After performing adjusted analyses, left ventricular outflow tract velocity (p=0.017), left ventricular ejection fraction (p=0.018), and E: e’ ratio (p=0.050) were associated with the development of LS-NVE ( Figure 1) . Conclusions: Echocardiographic measurements were associated with subsequent LS-NVE development in this preliminary investigation. A larger cohort of LS-NVE patients is needed to validate these findings.

Abstract 17053: Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Mortality in Hypertrophic Cardiomyopathy: A Retrospective Study

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been demonstrated to improve outcomes in congestive heart failure (HF). However, their effect in hypertrophic cardiomyopathy (HCM) is unknown. Research Question: Can SGLT2i improve clinical outcomes in HCM patients? Methods: Using TriNetX Global Research Network from March 2013 to February 2021, patients diagnosed with HCM (ICD-10 codes I42.1, I42.2) were identified and categorized into 2 groups: those on SGLT2i vs. those who are not. To avoid inclusion of other causes of left ventricular hypertrophy, patients with aortic stenosis or systemic hypertension were excluded. Propensity score matching (PSM) was used to limit confounders. Primary outcome was all-cause mortality and secondary outcomes were HF exacerbation, all-cause hospitalization, and documented cardiovascular symptoms (chest pain, dyspnea, palpitations, or leg edema) over a 2-year follow-up period. Results: A total of 27,561 HCM patients were identified; 408 (1.5%) on SGLT2i and 27,153 (98.5%) were not. Patients on SGLT2i were older (55 ± 15 vs. 48 ± 19, p&lt;0.01) and had more comorbidities, including a nearly 6-fold higher prevalence of diabetes mellitus (44% vs. 7%, p&lt;0.01) and congestive HF (65% vs. 10%, p&lt;0.01). After PSM, each group consisted of 355 patients. HCM patients on SGLT2i had lower rates of all-cause mortality (OR 0.22 [95% CI: 0.12, 0.39]; p&lt;0.01), hospitalizations (OR 0.72 [95% CI: 0.53, 0.98]; p=0.04), and cardiovascular symptoms (OR 0.71 [95% CI: 0.52, 0.97]; p=0.029) when compared to patients not on SGLT2i. There was no statistical difference in the rate of HF exacerbation (OR 0.82 [95% CI: 0.54, 1.24]; p=0.3). Conclusion: In this large dataset, SGLT2i use in a select subset of HCM patients was associated with improved survival, less hospitalizations, and fewer cardiovascular symptoms. These data support future randomized trials to evaluate the efficacy and safety of SGLT2i in more diverse HCM patient populations.