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Tucson, AZ, United States

Movahed M.R.,University of Arizona | Khan M.F.,The Southern Arizona VA health Care system | Hashemzadeh M.,University of Arizona | Hashemzadeh M.,Long Beach Medical Center
Cardiovascular Revascularization Medicine | Year: 2015

Background: Recent improvement in the care of patients with myocardial infarction should lead to better outcome. The goal of this study was to evaluate the incidence of all cause cardiogenic shock (CS) and CS occurring in the setting of ST elevation myocardial infarction (STEMI) in the United States. Method: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted incident rate of CS from 1996 to 2006 based on ICD-9 coding in the setting of STEMI. Furthermore, we evaluated this trend based on race and gender. Results: A total population of 52,784,917 patients was available between 1996 and 2006. We found that the incidence of all cause CS has not changed over time. However, in the setting of STEMI, CS has been declining slowly over the last 10. years. The age-adjusted rate for CS was 4.3 per 100,000 in 1996 which remained steady with an incidence of 3.1 per 100.000 in 2006 (p < 0.01). This decline was persistent across different race or gender. However, African Americans and female gender had persistently lower rate of CS. Conclusion: Advancement in the treatment of acute STEMI has led to gradual reduction in the incidence of STEMI related cardiogenic shock irrespective of ethnicities or gender suggesting improving outcome of patients presenting with STEMI in recent years. © 2014 Elsevier Inc.


Khoubyari R.,University Physician Hospital | Khoubyari R.,University of Arizona | Arsanjani R.,University of Arizona | Habibzadeh M.R.,University of Arizona | And 2 more authors.
Cardiovascular Revascularization Medicine | Year: 2012

Since its introduction by Campeau in 1989, the transradial approach for coronary angiography has gained significant popularity among interventional cardiologists due to its lower access site complication rates, cost-effectiveness, and shorter hospital course. Although the transradial approach is much safer than the transfemoral approach, it has its own inherent rare complications including radial artery occlusion, thrombosis, nonocclusive radial artery injury, vasospasm, and compartment syndrome. Herein, we present an unusual case of entrapment and kinking of a catheter in the radial artery, which was successfully removed by using a gooseneck snare via the transfemoral route. The distal and proximal tips were then simultaneously rotated in opposite directions, allowing for the unkinking and removal of the catheter. To our knowledge, this is the first report of this rare complication. © 2012.


Movahed M.R.,The Southern Arizona VA health Care system | Movahed M.R.,University of Arizona | Hashemzadeh M.,Long Beach Veteran Administration Health Care System | Khoynezhad A.,Creighton University | And 3 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2010

Objective: This study examined nationwide trends in use of coronary artery bypass grafting between 1988 and 2004. Methods: The Nationwide Inpatient Sample database was used to calculate age-adjusted rate of coronary artery bypass grafting from 1988 to 2004. Specific International Classification of Diseases, Ninth Revision, Clinical Modification codes for coronary artery bypass grafting were used to compile data. Patient demographic data were also analyzed. Results: The database recorded 1,145,285 patients older than 40 years who underwent coronary artery bypass grafting from 1988 to 2004. Mean age was 60.21 ± 10.55 years. Male patients underwent coronary artery bypass grafting more than twice as frequently as female patients (70.6% vs 29.4%). From 1988, total age-adjusted rate gradually increased for 10 years until 1997 (79.29 per 100,000 with 95% confidence interval 70.88-87.71 per 100,000 in 1988, 131.31 per 100,000 with 95% confidence interval 119.02-143.59 per 100,000 in 1997, P < .01), with ensuing rapid decline to nearly the lowest level at end of study in 2004 (83.01 per 100,000 with 95% confidence interval 75.68-90.33 per 100,000, P < .01). Although trends were similar across ethnicity and sex, female and ethnic minority patients had lower rates of bypass surgery than did male and white patients. Conclusions: Use of coronary artery bypass grafting has decreased dramatically in recent years, with even lower use among female and ethnic minority patients. This decline may be related to significant advances in percutaneous coronary interventions and improved medical treatment of atherosclerosis in the past 10 years.

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