706 research outputs found
Guideline directed medical therapy for secondary prevention after coronary artery bypass grafting
No full textAtherosclerotic cardiovascular disease, and specifically coronary artery disease is a major cause of mortality and morbidity in the Unites States. A large proportion of patients with atherosclerotic cardiovascular disease receive coronary artery bypass grafting. However, despite this surgical intervention, patients are at continued risk for progression of atherosclerosis, both in their native coronary arteries as well as the conduits used for the coronary artery bypass surgery. Patients also have other cardiovascular risk factors, specifically diabetes, obesity, and many have poly-vascular disease. The American Heart Association has recommendations for pharmacotherapy in these patients, which is termed as guideline directed medical therapy for secondary prevention of cardiovascular disease.
The US Department of Veteran Affairs is the single largest unified healthcare system in the United States and supports the healthcare needs of approximately 9 million US Veterans. These people are older, more frail, and have more cardiovascular risk factors than the average US population. All these conditions put them at higher risk for recurrent cardiovascular events after receiving coronary artery bypass surgery.
Therefore, the overarching aim of my PhD was to study the use of guideline directed medical therapy and factors associated with non-use among US Veterans. To achieve this aim, six papers were completed and included in this thesis. The broad synopsis of the thesis is that guideline directed medical therapy does improve cardiovascular outcomes. However, the present use of these therapies among US Veterans is suboptimal; additionally, some reasons for non-use were identified. Therefore, in conclusion, more work needs to be done to ensure improved use of these life-saving therapies.
Links to the articles.
Manuscripts included in this thesis:
Deo SV, Al-Kindi S, Motairek I, McAllister D, Shah ASV, Elgudin YE, Gorodeski EZ, Virani S, Petrie MC, Rajagopalan S, Sattar N. Impact of Residential Social Deprivation on Prediction of Heart Failure in Patients With Type 2 Diabetes: External Validation and Recalibration of the WATCH DM Score Using Real World Data. Circ Cardiovasc Qual Outcomes. 2024 Mar;17(3):e010166. doi: 10.1161/CIRCOUTCOMES.123.010166. Epub 2024 Feb 8. PMID: 38328913; PMCID: PMC11093755.
Deo SV, Althouse A, Al-Kindi S, McAllister DA, Orkaby A, Elgudin YE, Fremes S, Chu D, Visseren FLJ, Pell JP, Sattar N. Validating the SMART2 Score in a Racially Diverse High-Risk Nationwide Cohort of Patients Receiving Coronary Artery Bypass Grafting. J Am Heart Assoc. 2023 Nov 7;12(21):e030757. doi: 10.1161/JAHA.123.030757. Epub 2023 Oct 27. PMID: 37889195; PMCID: PMC10727407.
Deo SV, McAllister D, LaForest S, Altarabsheh S, Elgudin YE, Dunlay S, Singh S, Parikh S, Sattar N, Pell JP. Disparities in PCSK9 Initiation Among US Veterans with Peripheral Arterial Disease or Cerebrovascular Disease. Am J Cardiovasc Drugs. 2023 May;23(3):311-321. doi: 10.1007/s40256-023-00576-7. Epub 2023 Mar 22. PMID: 36947397.
Deo S, Ueda P, Sheikh AM, Altarabsheh S, Elgudin Y, Rubelowsky J, Cmolik B,
Hawkins N, McAllister D, Ruel M, Sattar N, Pell J. Lipid Lowering in "Very High Risk" Patients Undergoing Coronary Artery Bypass Surgery and Its Projected Reduction in Risk for Recurrent Vascular Events: A Monte Carlo Stepwise Simulation Approach. J Cardiovasc Pharmacol. 2023 Feb 1;81(2):120-128. doi:10.1097/FJC.0000000000001374. PMID: 36315474.
Deo SV, McAllister DA, Al-Kindi S, Elgudin Y, Chu D, Pell J, Sattar N.
Trends in Prescriptions of Cardioprotective Diabetic Agents After Coronary
Artery Bypass Grafting Among U.S. Veterans. Diabetes Care. 2022 Dec
1;45(12):3054-3057. doi: 10.2337/dc22-0570. PMID: 36256925.
Deo SV, Marsia S, McAllister DA, Elgudin Y, Sattar N, Pell JP. The time-varying cardiovascular benefits of glucagon-like peptide-1 receptor agonist therapy in patients with type 2 diabetes mellitus: Evidence from large multinational trials. Diabetes Obes Metab. 2022 Aug;24(8):1607-1616. doi: 10.1111/dom.14738. Epub 2022 May 23. PMID: 35491516; PMCID: PMC9540124
and other selected manuscripts published during the PhD period
Supplemental Material - County-Level Socio-Environmental Factors Associated With Stroke Mortality in the United States: A Cross-Sectional Study
No full textSupplemental Material for County-Level Socio-Environmental Factors Associated With Stroke Mortality in the United States: A Cross-Sectional Study by Pedro RVO Salerno, Issam Motairek, Weichuan Dong, Khurram Nasir, Neel Fotedar, Setareh S. Omran, Sarju Ganatra, Omar Hahad, Salil V. Deo, Sanjay Rajagopalan, and Sadeer G. Al-Kindi in Angiology</p
OB00199 - Deo-Baranark Pillar of Jivitagupta II
No full text[caption id="attachment_3982" align="alignnone" width="383"] Deo-Baranark Inscription (IN00214) of Jivitagupta II[/caption
Living with a left ventricular assist device:Capturing recipients experiences using group concept mapping software
No full textBACKGROUND: Left ventricular assist device (LVAD) implantation significantly impacts on a recipient's symptoms and quality of life. Capturing their experiences and post implant journey is an important part of clinical practice, research and device design evolution. Patient reported outcome measures (PROMs) are a useful tool for capturing that experience. However, patient reported outcome measures need to reflect recipients' experiences. Discussions with a patient partner group found that none of the frequently used cardiology PROMs captured their unique experiences.AIMS: To capture the experiences and important issues for LVAD recipients. Develop a conceptual map of domains and items that should be reflected in patient reported outcomes.METHODS: Group concept mapping (GCM) web-based software was used to remotely capture and structure recipients' experiences across a wide geographical area. GCM is a semi-quantitative mixed method consisting of 3 stages: item generation, item sorting and rating (importance, relevance and frequency). Patient partners were involved in all aspects of the study design and development.RESULTS: 18 LVAD recipients consented to take part. 101 statements were generated and multi-dimensional scaling, and hierarchical cluster analysis identified 9 clusters. Cluster themes included: Activities, Partner/family support, Travel, Mental wellbeing, Equipment and clothing, Physical and cognitive limitations, LVAD Restrictions, LVAD Challenges and positive impact of the LVAD (LVAD Positives). LVAD Positives were scored highest across all the rating variables, e.g., frequency (2.85), relevance (2.44) and importance (2.21). Other domains rated high for importance included physical and cognitive limitations (2.19), LVAD restrictions (2.11), Partner/family support (2.02), and Equipment and clothing (2.01).CONCLUSION: Online GCM software facilitated the inclusion of geographically dispersed recipients and provided useful insights into the experiences of LVAD recipients. The conceptual framework identifies important domains and items that should be prioritised and included in patient reported outcomes in future research, LVAD design evolution, and clinical practice.</p
Billboards. Two projects by Maurizio Montagna
No full textArchitecture, city, device, time: all of these issues are taken into account by the Milanese photographer Maurizio Montagna. A keen interpretation of places in their anthropic and cultural transformation emerges from all his works. This article aims to focus on two different projects, Billboards 2008 and Billboards site-specific Latronico 2018, in which the author reflects on the relationship among the object, the subject and the context/landscape where they belong
Pharmaceuticals in the Built and Natural Water Environment of the United States
No full textabstract: The known occurrence of pharmaceuticals in the built and natural water environment, including in drinking water supplies, continues to raise concerns over inadvertent exposures and associated potential health risks in humans and aquatic organisms. At the same time, the number and concentrations of new and existing pharmaceuticals in the water environment are destined to increase further in the future as a result of increased consumption of pharmaceuticals by a growing and aging population and ongoing measures to decrease per-capita water consumption. This review examines the occurrence and movement of pharmaceuticals in the built and natural water environment, with special emphasis on contamination of the drinking water supply, and opportunities for sustainable pollution control. We surveyed peer-reviewed publications dealing with quantitative measurements of pharmaceuticals in U.S. drinking water, surface water, groundwater, raw and treated wastewater as well as municipal biosolids. Pharmaceuticals have been observed to reenter the built water environment contained in raw drinking water, and they remain detectable in finished drinking water at concentrations in the ng/L to μg/L range. The greatest promises for minimizing pharmaceutical contamination include source control (for example, inputs from intentional flushing of medications for safe disposal, and sewer overflows), and improving efficiency of treatment facilities
Una nuova proposta per un antichissimo problema. Deo/dea in Verg. Aen. II 632
No full textL'articolo riesamina la vexata quaestio relativa alla variante deo/dea contenuta in Verg. Aen. II 632, con nuove considerazioni per la risoluzione del problema.About Verg. Aen. II 632 deo / dea the communis opinio, though persuaded that in any case the reference is to Venus, however prefers deo as lectio difficilior. Also the author of this article believes that deo is the right reading, but she is of the opinion that this word in the context denotes all deities in general, and in the Aeneas’ expression ducente deo she recognizes the pietas erga deos that Aeneas had preserved intact even amid the Troy’s ruin
Systematic review and meta-analysis: a brief introduction
No full textLearning objectives:
1. Understand the basic structure and parts of a systematic review
2. Be able to read and critically appraise a published systematic revie
Disputatio philosophica de dependentia creaturae a Deo in esse, fieri, et operari
No full textquam auspice Deo , sub praesidio Dn. Ioh. Rod. Ottii ... amico examini subiicit David Holzhalbius author & respondens ...Diss. Hohe Schule Zürich, 169
Zur Entstehungszeit und zum Text von Ps.-Victorinus, De Iesu Christo Deo et Homine
No full textThe author of the small poem De Iesu Christo Deo et Homineis influenced by Iuvencus and Prudentius, but his model, as argued, is Sedulius, who offers the terminus post quem. Textual notes, critical and interpretative, conclude the paper
- …
