Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

ABI
: ankle–brachial (blood pressure) index
ABPM
: ambulatory blood pressure monitoring
ACCORD
: Action to Control Cardiovascular Risk in Diabetes
ACE-I
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndromes
ADVANCE
: Action in Diabetes and Vascular disease: PreterAx

2016 European Guidelines on cardiovascular disease prevention in clinical practice

Supplementary Table 9, column 'Edoxaban', row 'eGFR category', '95 mL/min' (page 15). The cell should be coloured green instead of yellow. It should also read "60 mg"instead of "60 mg (use with caution in 'supranormal' renal function)."In the above-indicated cell, a footnote has also been added to state: "Edoxaban should be used in patients with high creatinine clearance only after a careful evaluation of the individual thromboembolic and bleeding risk."Supplementary Table 9, column 'Edoxaban', row 'Dose reduction in selected patients' (page 16). The cell should read "Edoxaban 60 mg reduced to 30 mg once daily if any of the following: creatinine clearance 15-50 mL/min, body weight <60 kg, concomitant use of dronedarone, erythromycin, ciclosporine or ketokonazole"instead of "Edoxaban 60 mg reduced to 30 mg once daily, and edoxaban 30 mg reduced to 15mg once daily, if any of the following: creatinine clearance of 30-50 mL/min, body weight <60 kg, concomitant us of verapamil or quinidine or dronedarone."

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2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).

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2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.

The number of cancer survivors continues to increase in the United States because of the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate every 3 years to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries; vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics; and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Data Base are presented for the most prevalent cancer types. Cancer-related and treatment-related short-term, long-term, and late health effects are also briefly described. More than 16.9 million Americans (8.1 million males and 8.8 million females) with a history of cancer were alive on January 1, 2019; this number is projected to reach more than 22.1 million by January 1, 2030 based on the growth and aging of the population alone. The 3 most prevalent cancers in 2019 are prostate (3,650,030), colon and rectum (776,120), and melanoma of the skin (684,470) among males, and breast (3,861,520), uterine corpus (807,860), and colon and rectum (768,650) among females. More than one-half (56%) of survivors were diagnosed within the past 10 years, and almost two-thirds (64%) are aged 65 years or older. People with a history of cancer have unique medical and psychosocial needs that require proactive assessment and management by follow-up care providers. Although there are growing numbers of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based resources are needed to optimize care.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21565

Cancer treatment and survivorship statistics, 2019

Recurrent cardiac myxoma complicated by brain metastases: role of multimodality imaging in diagnosis and management

Chronic Chagas cardiomyopathy (CCC) is the most common cause of nonischemic cardiomyopathy in endemic Latin American countries. Immigrants to the United States suffer from this disease, but it is underrecognized. We describe the three hallmark clinical presentations: stroke, ventricular arrhythmias, and heart failure, which should prompt suspicion for CCC.

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Clinical Presentations of Chagas Cardiomyopathy

BACKGROUND Inferior vena cava filter (IVCF) use is common after a venous thromboembolic event (VTE). Cancer is associated with higher rates of VTEs and is also seen in a significant proportion of patients requiring IVCF. As hospital readmissions remain a frequently scrutinized metric, we sought to evaluate the impact of cancer on hospital-readmission rates and in-hospital outcomes among patients with VTEs who received an IVCF. METHODS Leveraging the 2013 to 2014 Nationwide Readmission Database, we identified adult patients presenting with a VTE in the United States and evaluated 30-day readmission rates and readmission in-hospital outcomes postindex-admission. Multivariable logistic regression was used to identify factors associated with readmission after an index-procedure, including traditional and nontraditional cardiovascular risk factors, as well as hospital-level characteristics. RESULTS Among the 619 241 patients presenting with a VTE at index-admission, 11.2% of patients received IVCF on index-admission, of which 30.9% had cancer. The 30-day readmission rate amongst IVCF recipients was 15.8% (N = 10 927), and 19.9% amongst those with cancer compared to 13.9% in patients without cancer (P < .001). Moreover, cancer patients had longer lengths of stay in the hospital (4.5 ± 0.2 vs 4.0 ± 0.1 days; P = .02), higher cost of care ($10 900 ± 308 vs $9242 ± 206; P = .007), but no difference in mortality (8.3% vs 6.3%; P = .70) during readmission compared to noncancer patients. CONCLUSION Readmission after IVCF placement is common. In patients readmitted after an IVCF implantation, those with cancer have longer hospital stays and higher costs of care. However, in-hospital mortality is similar to those without cancer.

Readmission after inferior vena cava filter placement for acute venous thromboembolism in the United States: Impact of a cancer diagnosis.

BACKGROUND
Racial/ethnic disparities in heart disease mortality by initial treatment type among breast cancer survivors have not been well described.


METHODS
We included 739,557 women diagnosed with first primary invasive breast cancer between 2000-2017 (aged 18-84 years, received surgery, survived ≥one year, followed through 2018) in the SEER-18 database. Standardized mortality ratios (SMRs; observed/expected) were calculated by race/ethnicity (Non-Hispanic/Latina Asian American, Native Hawaiians, and other Pacific Islanders [AANHP]); Non-Hispanic/Latina Black [Black]; Hispanic/Latina [Latina]; and Non-Hispanic/Latina White [White]) and initial treatment (surgery only; chemotherapy+surgery; chemotherapy, radiotherapy, +surgery; and radiotherapy+surgery) compared to the racial/ethnic-matched general population, and by clinical characteristics. Cumulative heart disease mortality was estimated accounting for competing risks.


RESULTS
SMRs were elevated for Black and Latina women treated with surgery only and chemotherapy+surgery (range = 1.15-1.21) and AANHPI women treated with chemotherapy, radiotherapy, +surgery (1.29; 95%CI = 1.11,1.48), whereas SMRs were <1 for White women (range = 0.70-0.96). SMRs were especially high for women with advanced (regional/distant) stage among Black women for all treatment (range = 1.15-2.89) and for AANHPI and Latina women treated with chemotherapy+surgery (range = 1.28-3.61). Non-white women diagnosed at age < 60 had higher SMRs, as did Black and AANHPI women diagnosed with estrogen receptor positive breast cancers. Black women had the highest ten-year cumulative risk of heart disease mortality: age < 60 (Black : 1.78%; 95%CI = 1.63%,1.94%) compared to White, AANHPI, and Latina women (<1%), and age ≥ 60 (Black : 7.92%; 95%CI = 7.53%,8.33%) compared to White, AANHPI, and Latina women (range = 3.90%-6.48%).


CONCLUSIONS
Our findings illuminated striking racial/ethnic disparities in heart disease mortality among Black, AANHPI, and Latina breast cancer survivors, especially after initial chemotherapy receipt.

Racial and ethnic disparities in treatment-related heart disease mortality among U.S. breast cancer survivors.

With the availability of new and very effective therapies, cancer has increasingly become a chronic condition and led to the need for close collaboration between the specialties of oncology and cardiology. Collaboration is developing in the clinic, research, and training arenas and has drawn the attention of major national and international cardiology and oncology associations to the field of cardio-oncology. This chapter discusses how the partnership of these two medical subspecialties in the future will improve outcomes for cancer patients.

Ana Barac

Papers

Recurrent cardiac myxoma complicated by brain metastases: role of multimodality imaging in diagnosis and management

Clinical Presentations of Chagas Cardiomyopathy

Readmission after inferior vena cava filter placement for acute venous thromboembolism in the United States: Impact of a cancer diagnosis.

Racial and ethnic disparities in treatment-related heart disease mortality among U.S. breast cancer survivors.

Future Clinical and Professional Directions in Cardio-oncology