Mushtaq A, Singh S, Hanna J
… +5 more, Dhakal A, Yetmar ZA, Sheu M, Anwer F, Majeed A
Am J Med Sci
· 2026 Jun · PMID 42362188
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BACKGROUND: Patients with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) frequently suffer severe complications requiring intensive care unit (ICU) admission. While...BACKGROUND: Patients with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) frequently suffer severe complications requiring intensive care unit (ICU) admission. While sepsis is a recognized driver of these poor outcomes, its precise impact on short-term mortality in this specific population requires further clarification. METHODS: We conducted a retrospective cohort study of 65 adult AML patients admitted to the ICU within 100 days post-allo-HSCT at a single tertiary care center. Patients were stratified by the presence of sepsis. Clinical and microbiological data were collected, and univariable Cox proportional hazards regression was used to identify predictors of the primary outcome i.e. 90-day mortality. RESULTS: Sepsis was diagnosed in 70.8 % patients (n = 46) and required significantly more organ support, including invasive mechanical ventilation (67.4 % vs 15.8 %; p < 0.001) and renal replacement therapy (37.0%vs 5.3%; p = 0.009). The presence of sepsis was associated with significantly lower 90-day survival (log-rank p = 0.012). In univariable analysis, sepsis was the strongest predictor of 90-day mortality (Hazard Ratio [HR], 3.34; 95% CI, 1.47-7.57; p = 0.004). Mechanical ventilation (HR, 3.14; p < 0.001) and renal replacement therapy (HR, 2.35; p = 0.010) were also 4 significant predictors. The most frequently identified pathogens were Klebsiella species (18.5%), Enterococcus species (13.8%). Vancomycin-resistant Enterococcus (VRE) found in 9.2% patients. CONCLUSIONS: Sepsis is a primary and statistically significant driver of 90-day mortality in AML patients admitted to the ICU following allo-HSCT. These findings underscore the urgent need for early sepsis recognition, aggressive management, and robust antimicrobial stewardship in this highly vulnerable population.
Am J Med Sci
· 2026 Jun · PMID 42342032
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BACKGROUND: Cardiac complications associated with poorly controlled Graves' disease present a significant challenge in managing hyperthyroid patients. The relationship between thyrotoxicosis severity and cardiac complica...BACKGROUND: Cardiac complications associated with poorly controlled Graves' disease present a significant challenge in managing hyperthyroid patients. The relationship between thyrotoxicosis severity and cardiac complications remains to be confirmed. This study investigates the association between reverse triiodothyronine (rT3) and cardiac complications in hospitalized patients with uncontrolled Graves' disease. METHODS: This cross-sectional study evaluated 178 hospitalized patients with uncontrolled Graves' disease from 2016 to 2020. After excluding cardiac diseases unrelated to Graves' disease, atrial fibrillation and heart failure were identified as direct outcomes of uncontrolled thyrotoxicosis. Data were extracted from the Hospital Inpatient Sample database, including demographic information, disease duration, comorbidities, and serum thyroid hormone levels. Restricted cubic splines and multivariate logistic regression models were used to assess the association between serum rT3 levels and cardiac complications related to thyrotoxicosis. RESULTS: Among the 178 patients, 94 (54.0%) had cardiac complications. Multivariable logistic regression models adjusted for potential confounders (age, sex, duration of hyperthyroidism, diabetes, hypertension, and laboratory parameters) demonstrated a linear dose-response relationship between serum rT3 concentrations and cardiac complications. For each 1 nmol/L increase in rT3, the odds of cardiac complications rose by 65% (OR 1.65, 95% CI 1.28-2.14; P < 0.001). Subgroup analyses stratified by median age (50 years), median disease duration (12 months), sex, and anemia status showed that this association was consistent across all subgroups. CONCLUSION: Elevated serum rT3 is a robust biomarker for atrial fibrillation and heart failure in uncontrolled Graves' disease and associates with greater hyperthyroidism severity and related cardiac complications.
Am J Med Sci
· 2026 Jun · PMID 42320714
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BACKGROUND: During the COVID-19 pandemic, there was an increase in alcohol consumption. Here, we investigated COVID-19's impact on alcohol-associated hepatitis (AH) and alcohol-associated cirrhosis (AC) outcomes. METHODS...BACKGROUND: During the COVID-19 pandemic, there was an increase in alcohol consumption. Here, we investigated COVID-19's impact on alcohol-associated hepatitis (AH) and alcohol-associated cirrhosis (AC) outcomes. METHODS: Data from HCA's Enterprise Data Warehouse were examined (1/1/18 - 12/31/22). Patients aged > 18 years admitted for AH or AC were included. Pre- COVID-19 (2018-2019) and COVID-19 (2021-2022) time frames were evaluated. Statistical analyses were performed to evaluate LOS, discharge disposition, and mortality. RESULTS: Of the 3177 patients with AH and AC, 1752 were admitted during COVID-19 (AH: 815, AC: 937). Patients in both groups were predominantly male (AH: 68%, AC: 72%) and White (AH: 73%, AC: 79%), with patients in the AH group being younger than those in the AC group (49 vs. 56 years). During COVID-19, 369/815 (45%) patients in the AH group and 447/937 (48%) patients in the AC group were diagnosed with COVID-19. In patients with AH, those diagnosed with COVID-19 had a 2.4-day longer LOS (OR: 2.36, p < 0.001), a 39% decreased likelihood of home discharge (OR: 0.61, p < 0.05), and a 223% increase in mortality (OR: 2.23, p < 0.05), compared to patients with AH, but without COVID-19. In patients with AC, those with COVID-19 had a 2.2-day longer LOS (OR: 2.19, p < 0.001), though discharge disposition and mortality were not significantly affected by a COVID-19 diagnosis. CONCLUSIONS: Patients with COVID-19 and AH or AC had longer LOS. Mortality was increased in AH but not AC, perhaps reflecting greater acuity and severity of AH than AC.
Belviso I, Branca JJV, Thyrion FZ
… +5 more, Sarno A, Orsini D, Livi L, Paternostro F, Fagni N
Am J Med Sci
· 2026 Jun · PMID 42314905
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Injuries of the external ear caused by blunt trauma are among the most characteristic lesions of contact sports and have likely accompanied athletic competition since antiquity. Auricular hematoma is a well-recognized co...Injuries of the external ear caused by blunt trauma are among the most characteristic lesions of contact sports and have likely accompanied athletic competition since antiquity. Auricular hematoma is a well-recognized consequence of blunt trauma to the external ear and remains a common injury in modern contact sports. If untreated, subperichondrial blood accumulation may lead to cartilage ischemia and permanent auricular deformity, commonly known as cauliflower ear. Evidence of this condition may already appear in ancient artistic representations. The Hellenistic bronze statue known as the Boxer at Rest (late fourth-third century BCE) depicts an athlete with pronounced bilateral auricular deformities consistent with chronic auricular hematoma. In addition to these features, both ears display short, sharply defined linear lesions accentuated by copper inlays suggestive of active bleeding. This study reexamines these markings from a clinical and anatomical perspective. Their morphology, symmetry, and anatomical location closely correspond to sites commonly used in modern surgical drainage of auricular hematomas. This raises the possibility that the sculpture depicts not merely traumatic injury but a therapeutic intervention. Although classical medical texts do not explicitly describe the treatment of auricular hematoma, incision and evacuation of pathological fluid collections were well established in ancient medicine. The statue may therefore represent one of the earliest visual depictions of the management of sports-related ear trauma. This interpretation highlights the continuity of traumatic injuries associated with contact sports and their medical consequences across more than two millennia.
Bahar AR, Bahar Y, Elhussain M
… +4 more, Kaur P, Bolaji O, Raheem S, Abidov A
Am J Med Sci
· 2026 Jun · PMID 42303227
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BACKGROUND: Immune checkpoint inhibitors (ICIs) improve cancer outcomes but can cause immune-mediated cardiovascular toxicity, including myocarditis, which is associated with substantial morbidity and mortality. Pharmaco...BACKGROUND: Immune checkpoint inhibitors (ICIs) improve cancer outcomes but can cause immune-mediated cardiovascular toxicity, including myocarditis, which is associated with substantial morbidity and mortality. Pharmacovigilance data suggest possible differences in cardiovascular risk between programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) inhibitors, yet direct real-world comparisons remain limited. METHODS: We performed a retrospective cohort study using the TriNetX global research network to compare cardiovascular outcomes in adults initiating PD-1 versus PD-L1 inhibitors. Patients were compared using a 1:1 propensity score-matched design to balance baseline characteristics, with outcomes analyzed within the matched cohorts and reported as relative risks (RR) with 95% confidence intervals (CI). The primary outcome was incident myocarditis assessed at 1 year and 2 years. Secondary outcomes included pericarditis, heart failure, atrial fibrillation, ventricular arrhythmias, long QT syndrome, cardiomyopathy phenotypes, and atrioventricular block. RESULTS: After matching, 32,468 patients were included in each cohort with excellent covariate balance. PD-1 inhibitors were associated with a higher risk of myocarditis at 1 year (RR 1.49, 95% CI 1.13-1.96) and 2 years (RR 1.49, 95% CI 1.15-1.94). Pericarditis was more frequent with PD-1 inhibitors at 1 year (RR 1.28, 95% CI 1.01-1.64). Heart failure, arrhythmias, and cardiomyopathy phenotypes were largely similar between treatment groups. CONCLUSIONS: PD-1 inhibitors were associated with a higher risk of immune-mediated cardiac inflammation than PD-L1 inhibitors, while non-inflammatory cardiovascular outcomes were comparable. These findings have implications for cardio-oncology risk stratification, support closer early cardiovascular monitoring in patients initiating PD-1 therapy, and warrant prospective validation.
Am J Med Sci
· 2026 Jun · PMID 42303226
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BACKGROUND: Lung squamous cell carcinoma (LUSC) is a prevalent subtype pulmonary malignancy, characterized by high incidence and mortality rates. Previous research has highlighted the aberrant TRIM29 expression in variou...BACKGROUND: Lung squamous cell carcinoma (LUSC) is a prevalent subtype pulmonary malignancy, characterized by high incidence and mortality rates. Previous research has highlighted the aberrant TRIM29 expression in various tumor tissues, yet investigations into its specific function remain limited. METHODS: The GEPIA database and Kaplan-Meier Plotter database were used to assess TRIM29 expression in LUSC. TRIM29 expression in paired LUSC tumor and adjacent normal tissues as well as in LUSC cell lines was detected by immunohistochemistry, western blot, and qRT-PCR. CCK-8, EdU and colony formation assay were carried out to evaluate cell proliferation. Migration and invasion ability were measured by transwell assay. The expression levels of EMT-related proteins in LUSC cells were detected by western blot. The HumanTFDB was used to predict transcription factors that interact with TRIM29. Luciferase assay and ChIP assay were used to verify their targeting binding between them. Rescue experiments confirmed the binding interaction between TRIM29 and SHOX2. RESULTS: This study unveiled substantial upregulation of both TRIM29 and SHOX2 in LUSC tissues and cells. Functional in vitro experiments validated that knockdown of TRIM29 notably impeded the malignant phenotype of LUSC, suppressed epithelial-mesenchymal transition (EMT) progression and induced cell apoptosis. Bioinformatics analysis and rescue experiments uncovered that the transcription factor SHOX2 positively regulates TRIM29, influencing LUSC occurrence and progression. CONCLUSIONS: These research findings suggest that the regulatory influence of SHOX2 on TRIM29 enhanced the malignant progression and the EMT process in LUSC, presenting potential new avenues for both its diagnosis and treatment.
Am J Med Sci
· 2026 Jun · PMID 42288260
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Frailty is a multidimensional geriatric syndrome characterized by reduced physiologic reserve and increased vulnerability to stressors. Its prevalence is particularly high among patients with heart failure (HF), reflecti...Frailty is a multidimensional geriatric syndrome characterized by reduced physiologic reserve and increased vulnerability to stressors. Its prevalence is particularly high among patients with heart failure (HF), reflecting the interplay between aging, multimorbidity, and chronic cardiovascular disease. Frailty independently predicts poor outcomes, including higher hospitalization rates, mortality, and impaired quality of life. The Fried Frailty Phenotype defines frailty as the presence of three or more of the following five criteria: unintentional weight loss, exhaustion, weakness (grip strength), slow walking speed, and low physical activity. In this review, we explore the complex relationship between frailty and HF, with a focus on pathophysiology, clinical outcomes, biomarkers, and therapeutic considerations. We highlight differences across HF phenotypes-heart failure with reduced ejection fraction (HFrEF), preserved ejection fraction (HFpEF), and mildly reduced ejection fraction (HFmrEF)-underscoring the importance of tailored, phenotype-specific approaches. We also discuss emerging biomarkers including the stress hyperglycemia ratio (SHR) in HFpEF. Finally, we address limitations of current evidence and future directions for integrating frailty assessment into HF management.
Stirrat T, Wilkey M, Ransibrahmanakul V
… +5 more, Singh L, Allen O, Kanth P, Rangnekar A, Redfield R
Am J Med Sci
· 2026 Jun · PMID 42285225
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Eosinophilic cholangitis (EC) is a rare inflammatory biliary disorder that can mimic primary sclerosing cholangitis and cholangiocarcinoma. We performed a PRISMA 2020-guided systematic review to summarize diagnostic feat...Eosinophilic cholangitis (EC) is a rare inflammatory biliary disorder that can mimic primary sclerosing cholangitis and cholangiocarcinoma. We performed a PRISMA 2020-guided systematic review to summarize diagnostic features, management, and outcomes. Web of Science, PubMed, MEDLINE, Embase, Scopus, and CINAHL were searched; 55 studies (55 patients) were included. Among cases with a preoperative impression (n = 39), malignancy was suspected in 19 (48.7%). Among cases with reported localization (n = 44), isolated extrahepatic disease occurred in 15 (34.1%) and isolated intrahepatic disease in 7 (15.9%). Tissue eosinophilic infiltration was reported in 52/53 (98.1%). Steroids were the primary treatment (35/42, 83.3%), with symptom resolution in 36/37 (97.3%) and biochemical normalization in 39/39 (100%). Serum IgE, when reported, was normal in 4/15 cases by author classification. EC commonly presents as an indeterminate biliary stricture with frequent eosinophilia and is often misdiagnosed as malignancy.
Saeed A, Yousuf S, Ali IA
… +10 more, Chen A, Khalid UAR, Noverati N, Hasnan GA, Akbar H, Qamar U, Beran A, Saleem N, Radlinski M, Kamal F
Am J Med Sci
· 2026 Jun · PMID 42285224
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Studies have compared proton pump inhibitors (PPI) with Histamine 2 receptor antagonists (H2RA) and placebo for upper gastrointestinal bleeding (UGIB) prophylaxis in mechanically ventilated patients. We conducted this me...Studies have compared proton pump inhibitors (PPI) with Histamine 2 receptor antagonists (H2RA) and placebo for upper gastrointestinal bleeding (UGIB) prophylaxis in mechanically ventilated patients. We conducted this meta-analysis to compare PPI with H2RA or placebo for UGIB prophylaxis in these patients. Our outcomes of interest were clinically important UGIB, overall UGIB, mortality, ventilator-associated pneumonia (VAP) and Clostridium difficile infection (CDI). We calculated pooled risk ratio (RR) with 95% confidence intervals (CI) for all outcomes. We included eight RCTs comprising 32,873 patients. Risk of clinically important UGIB was significantly lower in PPI group, RR (95%CI): 0.53 (0.32, 0.89). Risk of overall UGIB was also significantly lower in PPI group. There was no significant difference in mortality, VAP and CDI between groups. This meta-analysis demonstrates the superiority of PPI to H2RA and placebo for prophylaxis of UGIB in mechanically ventilated patients, without increasing the risk of adverse events.
Am J Med Sci
· 2026 Jun · PMID 42285223
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Intraductal papillary mucinous neoplasm (IPMN) is a rare precancerous pancreatic tumor that accounts for about 1% of pancreatic neoplasms and can impair both exocrine and endocrine function. We present the case of a woma...Intraductal papillary mucinous neoplasm (IPMN) is a rare precancerous pancreatic tumor that accounts for about 1% of pancreatic neoplasms and can impair both exocrine and endocrine function. We present the case of a woman with long-standing type 2 diabetes mellitus who developed worsening glycemic control due to pancreatic IPMN and its pathogenesis. Laboratory evaluation revealed evidence of severe pancreatic exocrine insufficiency, while imaging demonstrated a ductal lesion consistent with IPMN. Endoscopic ultrasound with biopsy confirmed a main-duct IPMN, and the patient subsequently underwent pancreaticoduodenectomy, with pathology demonstrating low-grade disease without invasion. This case highlights the connection between pancreatic structural disease and glucose metabolism. Progressive ductal obstruction and parenchymal injury from IPMN can result in combined endocrine and exocrine dysfunction, manifesting as pancreatogenic (type 3c) diabetes and malabsorption. Early recognition is critical, as it enables timely diagnostic evaluation, appropriate surgical management, and optimization of metabolic and nutritional status. Additionally, this case underscores the need for individualized diabetes management in the setting of pancreatic insufficiency and highlights ongoing uncertainties regarding the safety of certain glucose-lowering therapies in patients with premalignant pancreatic lesions.
Am J Med Sci
· 2026 Jun · PMID 42276457
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Obstructive sleep apnea (OSA) is a highly prevalent and heterogeneous disorder strongly associated with cardiovascular morbidity and mortality. This review examines the pathophysiological mechanisms linking OSA to cardio...Obstructive sleep apnea (OSA) is a highly prevalent and heterogeneous disorder strongly associated with cardiovascular morbidity and mortality. This review examines the pathophysiological mechanisms linking OSA to cardiovascular disease, and evaluates current evidence regarding the impact of positive airway pressure (PAP) therapy on cardiovascular outcomes and mortality. OSA is an independent risk factor for hypertension, coronary artery disease, heart failure, arrhythmias, stroke, and metabolic dysfunction, mediated by mechanisms including intermittent hypoxia, sympathetic activation, oxidative stress, endothelial dysfunction, and systemic inflammation. Although PAP therapy improves symptoms, apnea-hypopnea index, and intermediate cardiometabolic parameters-particularly among adherent patients-randomized controlled trials have yielded inconsistent results for reducing cardiovascular events and mortality. Emerging evidence indicates that treatment adherence, disease severity, and distinct OSA phenotypes and endotypes substantially influence cardiovascular risk. Methodological limitations, population heterogeneity, and inadequate long-term follow-up continue to fuel controversy, highlighting the need for individualized, phenotype-driven research approaches.
Bian YZ, Zou S, Lyu Y
… +3 more, Xu YJ, Zhang GF, Yang YQ
Am J Med Sci
· 2026 Jun · PMID 42264084
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BACKGROUND: Life's Simple 7 (LS7) has been associated with lung function and chronic obstructive pulmonary disease, and abnormal sleeping increases the risk of cardio-pulmonary diseases and associated comorbidities. We a...BACKGROUND: Life's Simple 7 (LS7) has been associated with lung function and chronic obstructive pulmonary disease, and abnormal sleeping increases the risk of cardio-pulmonary diseases and associated comorbidities. We aimed to examine the relation between Life's Essential 8 (LE8), with sleep quality added as the 8th metric to LS7, and lung disease and function. METHODS: In this cross-sectional study, the data from the National Health and Nutrition Examination Survey in 2005-2012 were used, which included 9202 participants. LE8, as a cardiovascular health index, was introduced by the American Heart Association. The outcomes were respiratory symptoms related to chronic bronchitis, asthma, and chronic lung disease. Multivariable logistics and restricted cubic spline regressions were utilized to assess the associations. RESULTS: Approximately 11.53%, 9.60%, 14.94%, 31.82%, 13.02%, 7.06%, and 2.63% of participants self-reported cough, phlegm production, wheezing, exertional dyspnea, asthma, chronic bronchitis, and emphysema, respectively. Participants in the highest category of LE8 had the lowest incidence of lung symptoms and diseases. For every 1-point increase in LE8, the risk odds decreased by 1% to 4% in lung symptoms and diseases. The health behavior score was independently associated with all outcomes, while the health factor score was relevant to wheezing, exertional dyspnea, and asthma. CONCLUSIONS: A higher LE8 score is associated with a lower presence of lung symptoms and diseases. Optimizing LE8 holds a promise for improving clinical outcomes in patients with comorbidities of chronic pulmonary and cardiovascular diseases, a widely recognized modern healthcare challenge.
Yu J, Wang L, Zhu SL
… +6 more, Xiao M, Huang HX, Shao YH, Bao QC, Ma MM, Chen YY
Am J Med Sci
· 2026 Jun · PMID 42264082
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BACKGROUND: To investigate the association between exposure to six heavy metals (Pb, Cd, Mn, Se, total Hg, and MeHg) in the blood and the risk of liver fibrosis in populations with and without a history of GDM. METHODS:...BACKGROUND: To investigate the association between exposure to six heavy metals (Pb, Cd, Mn, Se, total Hg, and MeHg) in the blood and the risk of liver fibrosis in populations with and without a history of GDM. METHODS: Data were retrospectively gathered from the 2011-2018 NHANES database. Interaction tests (metal × GDM) were performed in multivariable logistic regression to formally assess effect modification by GDM. Logistic regression was utilized to confirm the association between heavy metals and liver fibrosis risk. The WQS and BKMR models were applied to evaluate the combined effect of heavy metal mixtures on liver fibrosis risk. RESULTS: Interaction tests showed significant GDM interactions for log Pb (P for interaction=0.039), log total Hg (P for interaction =0.033), and log MeHg (P for interaction =0.037) in liver fibrosis. After FDR correction, fully adjusted logistic regression results showed that log Pb (OR=5.685, 95%CI: 4.230-7.665, q < 0.001), log Cd (OR=3.076, 95%CI: 2.291-4.141, q < 0.001), and log Se (OR=0.147, 95%CI: 0.039-0.548, q = 0.009) were related to liver fibrosis risk in the group without a history of GDM. WQS and BKMR results indicated that the overall impact of co-exposure to six heavy metals on liver fibrosis risk was positively correlated, with log Pb, log Cd, and log Se playing a dominant role in the mixed effects on the risk of liver fibrosis. CONCLUSIONS: log Pb, log Cd, and log Se were significantly associated with the risk of liver fibrosis in women without a history of GDM.
Am J Med Sci
· 2026 Jun · PMID 42264081
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BACKGROUND: Obesity is a major global health issue with significant metabolic heterogeneity. While it is associated with accelerated biological aging, the relationship between distinct metabolic obesity phenotypes and bi...BACKGROUND: Obesity is a major global health issue with significant metabolic heterogeneity. While it is associated with accelerated biological aging, the relationship between distinct metabolic obesity phenotypes and biological age (BA) remains unclear. In this study, we evaluated the interaction between metabolic health status and adiposity in relation to biological aging. METHODS: We analyzed data from 8986 adults participating in NHANES 1999-2018. Participants were categorized into four BMI-metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obesity (MHOO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obesity (MUOO). BA was estimated using phenotypic age (PhenoAge), and age acceleration was calculated. Weighted multivariable regression, subgroup, interaction, and sensitivity analyses were conducted. RESULTS: Our study included 8986 participants (38.5% male) with a mean chronological age of 48.15 ± 17.18 years and a PhenoAge of 47.65 ± 18.82 years. MHOO individuals showed 1.91 years greater PhenoAge acceleration than MHNW (β = 1.91; P < 0.001), while MUNW showed 1.21 years (β = 1.21; P = 0.006). The largest effect was observed in MUOO individuals, with 3.70 years accelerated aging (β = 3.70; P < 0.001). Subgroup analyses showed the MHOO association was more pronounced in younger adults, while the MUNW effect was stronger in older individuals. Females consistently showed larger effect sizes than males. CONCLUSIONS: Compared to the MHNW group, the MUOO, MUNW, and MHOO phenotypes all demonstrated accelerated biological aging, with the most pronounced effect observed in the MUOO group. These findings underscore the importance of evaluating both metabolic health and excess adiposity in mitigating aging-related risks.
Alsmairat Y, Kidess G, Sheffeh MA
… +6 more, Lin Z, Alsmairat A, Koh JY, Burhan M, AlJaroudi W, Alraies MC
Am J Med Sci
· 2026 Jun · PMID 42252057
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BACKGROUND: Research has demonstrated that individuals with acute myocardial infarction (AMI) and peripheral artery disease (PAD) experience more complications compared to those with AMI only. This study examines the imp...BACKGROUND: Research has demonstrated that individuals with acute myocardial infarction (AMI) and peripheral artery disease (PAD) experience more complications compared to those with AMI only. This study examines the impact of PAD on in-hospital outcomes in patients admitted with AMI. METHODS: A retrospective cohort analysis of the National Inpatient Sample (NIS) was performed from January 2018 to December 2021. Adults (≥18 years) with a primary diagnosis of AMI were identified and stratified by the presence or absence of PAD as a comorbidity. Matching was done for patient demographics, comorbidities, and clinical characteristics. Multivariate logistic regression was employed to adjust for confounders. RESULTS: After matching, each cohort included 96,955 patients. Compared to patients without PAD, those with PAD experienced significantly worse in-hospital outcomes. Patients with PAD had higher rates of all-cause in-hospital mortality (OR = 1.34, [1.29-1.41], p < 0.001), acute kidney injury (AKI) (OR = 1.08, [1.06-1.10], p < 0.001), and cerebrovascular accidents (CVAs) (OR = 1.28, [1.19-1.38], p < 0.001). There were no statistically significant differences in the incidence of access site hemorrhage (OR = 1.19, [0.88-1.60], p = 0.25) or retroperitoneal hemorrhage (OR = 0.84, [0.70-1.02], p = 0.08). Length of stay was not significant between groups (β = 0.007 days, [-0.10 to 0.11], p = 0.89). CONCLUSIONS: AMI with PAD patients was associated with increased in-hospital mortality, higher complication rates, and worse outcomes. These findings emphasize the need for focused efforts to improve outcomes in this high-risk patient subgroup.