Browsing by Author "Singson, Adrian"

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    The Impact of Covid-19 on Implantable Cardioverter Defibrillator Implantation in Heart Failure Patients with Reduced Ejection Fraction
    (2025-04-25) Ryan, Emily; Sparks-Thissen, Rebecca; Singson, Adrian
    The Impact of Covid-19 on Implantable Cardioverter Defibrillator Implantation in Heart Failure Patients with Reduced Ejection Fraction Emily Ryan, Rebecca Sparks-Thissen, Adrian Singson Background: Discrepancies in the utilization of implantable cardioverter defibrillators (ICD) in heart failure with reduced ejection fraction (HFrEF) patients is well documented. However, there is little real-world evidence investigating the impact of the Covid-19 pandemic on the utilization of ICDs in HFrEF patients. Study Objective/Hypothesis: The objective of this study was to assess how the Covid-19 pandemic impacted the odds of receiving an ICD implant in adult HFrEF patients. Methods: This study used data from the IU School of Medicine-Evansville RWEdataLab (CRC/Sidus Insights) Cardiology database, nationally sourced from de-identified electronic health record systems. Patients were filtered by adult age, HFrEF ICD-10 diagnosis codes, and presence or absence of ICD implant CPT codes. The pre-Covid and post-Covid periods were from June through November of 2018-2019 and 2022-2023, respectively. Patient groups were compared based on an initial HFrEF diagnosis and presence or absence of ICD implant during pre- and post-COVID periods. Results: Men and women were more likely to receive an ICD pre-Covid than post-Covid (OR 1.279, 95% CI (1.06-1.54) and OR 1.475, 95% CI (1.12-1.94), respectively). Men and women aged 71-80 received an ICD pre-Covid more than their post-Covid counterparts (OR 1.69, 95% CI (1.13-2.25) and OR 2.129, 95% CI (1.39-3.26)). More post-Covid men received an ICD than post-Covid women (OR 1.34, 95% CI (1.03-1.75)). Although there was no significant difference between all adult pre-Covid males versus females, males aged 81-90 received an ICD more than females (OR 1.707, 95% CI (1.21-2.40)). Conclusions: This study shows that Covid-19 reduced the odds of ICD utilization in HFrEF patients, especially older females. Future directions include investigating explanations for this healthcare inequity, including delayed medical procedures and increased mortality due to the pandemic. Further research should identify sources of age and gender disparities and minimize care inequities for older female HFrEF patients.
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    Use of SGLT2 Inhibitors Reduces Heart Failure and Hospitalization: A Multicenter, Real-World Evidence Study
    (Kaiser Permanente, 2023) Blanco, Christopher Antonio; Garcia, Kara; Singson, Adrian; Smith, William R.; Medicine, School of Medicine
    Background: New research has produced evidence to support the use of diabetic drugs to prevent heart failure (HF). However, evidence of their effect in real-world clinical practice is limited. Objective: The objective of this study is to establish whether real-world evidence supports clinical trial findings that use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces rate of hospitalization and incidence of HF for patients with cardiovascular disease and type 2 diabetes. Methods: This retrospective study used electronic medical records to compare rate of hospitalization and incidence of HF among 37,231 patients with cardiovascular disease and type 2 diabetes under treatment with SGLT2i, glucagon-like peptide-1 receptor agonist (GLP1-RA), both, or neither. Results: Significant differences were found between medication class prescribed and number of hospitalizations (p < 0.0001) and incidence of HF (p < 0.0001). Post-hoc tests revealed reduced incidence of HF in the group treated with SGLT2i relative to GLP1-RA alone (p = 0.004) or neither of these key drugs (p < 0.001). No significant differences were observed between the group receiving both drug classes compared to SGLT2i alone. Discussion: Results of this real-world analysis are consistent with clinical trial findings that SGLT2i therapy reduces incidence of HF. The findings also suggest the need for further points of research in demographic and socioeconomic status differences. Conclusion: Real-world evidence supports clinical trial findings of SGLT2i reducing both incidence of HF and rate of hospitalization.
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    Use of SGLT2 Inhibitors Reduces Heart Failures and Hospitalization: A Multicenter, Real-World Evidence Study
    (2023-04-28) Blanco, Christopher; Garcia, Kara; Singson, Adrian; Smith, William
    BACKGROUND: New research has produced evidence to support the use of diabetic drugs to prevent heart failure (HF). However, evidence of their effect in real-world clinical practice is limited. OBJECTIVE: The objective of this study is to establish whether real-world evidence supports clinical trial findings that use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces rate of hospitalization and incidence of HF for patients with cardiovascular disease and type 2 diabetes. METHODS: This retrospective study used electronic medical records to compare rate of hospitalization and incidence of HF among 37,231 patients with cardiovascular disease and type 2 diabetes under treatment with SGLT2i, glucagon-like peptide-1 receptor agonist (GLP1-RA), both, or neither. RESULTS: Significant differences were found between medication class prescribed and number of hospitalizations (p < 0.0001) and incidence of HF (p < 0.0001). Post-hoc tests revealed reduced incidence of HF in the group treated with SGLT2i relative to GLP1-RA alone (p = 0.004) or neither of these key drugs (p < 0.001). No significant differences were observed between the group receiving both drug classes compared to SGLT2i alone. DISCUSSION: Results of this real-world analysis are consistent with clinical trial findings that SGLT2i therapy reduces incidence of HF. The findings also suggest the need for further points of research in demographic and socioeconomic status differences. CONCLUSION: Real-world evidence supports clinical trial findings of SGLT2i reducing both incidence of HF and rate of hospitalization.