المؤلفون: Devineni, Divya, Akbarpour, Meleeka, Gong, Yufan, Wong, Nathan

المصدر: Cardiovascular Drugs and Therapy. 38(2)

مصطلحات موضوعية: Cardiovascular risk, Diabetes, GLP-1 receptor agonists, SGLT2-inhibitors, Adult, Male, Humans, Glycemic Control, Precision Medicine, Cardiovascular Diseases, Sodium-Glucose Transporter 2, Risk Factors, Population Health, Diabetes Mellitus, Heart Disease Risk Factors, Atherosclerosis, Glucagon-Like Peptide 1, Glucose, Diabetes Mellitus, Type 2, Glucagon-Like Peptide-1 Receptor, Hypoglycemic Agents

الوصف: PURPOSE: Data are limited on sodium glucose co-transport 2 inhibitors (SGLT2-is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among real-world cohorts of underrepresented patients. We examined these therapies and glycemic control in US adults with diabetes mellitus (DM) by atherosclerotic cardiovascular disease (ASCVD) risk and sociodemographic factors. METHODS: In the NIH Precision Medicine Initiative All of Us Research Program, we categorized DM as (1) moderate risk, (2) high risk, and (3) with ASCVD. We examined proportions on DM therapies, including SGLT2-i or GLP-1 RA, and at glycemic control by sociodemographic factors and CVD risk groups. RESULTS: Our 81,332 adults aged ≥ 18 years with DM across 340 US sites included 22.3% non-Hispanic Black, 17.2% Hispanic, and 1.8% Asian participants; 31.1%, 30.3%, and 38.6% were at moderate risk, high risk, or with ASCVD, respectively. Those with DM and ASCVD were most likely on SGLT2-i (8.6%) or GLP-1 RA (11.9%). SGLT2-i use was

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/4qr8161gTest

المؤلفون: Akbarpour, Meleeka, Devineni, Divya, Gong, Yufan, Wong, Nathan

المصدر: Journal of Clinical Medicine. 13(4)

الوصف: In the original publication [...].

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9zn5s987Test

المؤلفون: Akbarpour, Meleeka, Devineni, Divya, Gong, Yufan, Wong, Nathan D

المصدر: Journal of Clinical Medicine. 12(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Atherosclerosis, Cardiovascular, Prevention, Patient Safety, Clinical Research, Diabetes, Heart Disease, Good Health and Well Being, dyslipidemia, diabetes mellitus, LDL-cholesterol, triglycerides, statins, treatment, Biomedical and clinical sciences

الوصف: Real-world data on lipid levels and treatment among adults with diabetes mellitus (DM) are relatively limited. We studied lipid levels and treatment status in patients with DM across cardiovascular disease (CVD) risk groups and sociodemographic factors. In the All of Us Research Program, we categorized DM as (1) moderate risk (≤1 CVD risk factor), (2) high risk (≥2 CVD risk factors), and (3) DM with atherosclerotic CVD (ASCVD). We examined the use of statin and non-statin therapy as well as LDL-C and triglyceride levels. We studied 81,332 participants with DM, which included 22.3% non-Hispanic Black and 17.2% Hispanic. A total of 31.1% had ≤1 DM risk factor, 30.3% had ≥2 DM risk factors, and 38.6% of participants had DM with ASCVD. Only 18.2% of those with DM and ASCVD were on high-intensity statins. Overall, 5.1% were using ezetimibe and 0.6% PCSK9 inhibitors. Among those with DM and ASCVD, only 21.1% had LDL-C < 70 mg/dL. Overall, 1.9% of participants with triglycerides ≥ 150 mg/dL were on icosapent ethyl. Those with DM and ASCVD were more likely to be on high-intensity statins, ezetimibe, and icosapent ethyl. Guideline-recommended use of high-intensity statins and non-statin therapy among our higher risk DM patients is lacking, with LDL-C inadequately controlled.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/8j58f2k3Test

المؤلفون: Sung, Shijun, Devineni, Divya, Philipopoulos, George, Kennedy, Gordon, Durkin, Anthony J, Ediriwickrema, Lilangi

مصطلحات موضوعية: Clinical Sciences, Dermatology & Venereal Diseases, Clinical sciences, Dentistry

الوصول الحر: https://escholarship.org/uc/item/6vn170zcTest

المؤلفون: Flores, Yvonne N, Datta, Geetanjali D, Yang, Liu, Corona, Edgar, Devineni, Divya, Glenn, Beth A, Bastani, Roshan, May, Folasade P

المصدر: Cancer Epidemiology Biomarkers & Prevention. 30(6)

مصطلحات موضوعية: Rare Diseases, Liver Disease, Liver Cancer, Cancer, Digestive Diseases, Clinical Research, Prevention, Good Health and Well Being, Carcinoma, Hepatocellular, Ethnicity, Female, Health Status Disparities, Humans, Incidence, Liver Neoplasms, Male, Neoplasm Staging, Racial Groups, Risk Factors, SEER Program, Social Class, Survival Rate, United States, Medical and Health Sciences, Epidemiology

الوصف: BackgroundLiver cancer is one of the most rapidly increasing cancers in the United States, and hepatocellular carcinoma (HCC) is its most common form. Disease burden and risk factors differ by sex and race/ethnicity, but a comprehensive analysis of disparities by socioeconomic status (SES) is lacking. We examined the relative impact of race/ethnicity, sex, and SES on HCC incidence, stage, and survival.MethodsWe used Surveillance, Epidemiology, and End Results (SEER) 18 data to identify histologically confirmed cases of HCC diagnosed between January 1, 2000 and December 31, 2015. We calculated age-adjusted HCC incidence, stage at diagnosis (local, regional, distant, unstaged), and 5-year survival, by race/ethnicity, SES and sex, using SEER*Stat version 8.3.5.ResultsWe identified 45,789 cases of HCC. Incidence was highest among low-SES Asian/Pacific Islanders (API; 12.1) and lowest in high-SES Whites (3.2). Incidence was significantly higher among those with low-SES compared with high-SES for each racial/ethnic group (P < 0.001), except American Indian/Alaska Natives (AI/AN). High-SES API had the highest percentage of HCC diagnosed at the local stage. Of all race/ethnicities, Blacks had the highest proportion of distant stage disease in the low- and high-SES groups. Survival was greater in all high-SES racial/ethnic groups compared with low-SES (P < 0.001), except among AI/ANs. Black, low-SES males had the lowest 5-year survival.ConclusionsWith few exceptions, HCC incidence, distant stage at diagnosis, and poor survival were highest among the low-SES groups for all race/ethnicities in this national sample.ImpactHCC prevention and control efforts should target low SES populations, in addition to specific racial/ethnic groups.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0qj8m31pTest

المؤلفون: Devineni, Divya, Akbarpour, Meleeka, Gong, Yufan, Wong, Nathan D.

المساهمون: Foundation for the National Institutes of Health

المصدر: Cardiovascular Drugs and Therapy ; ISSN 0920-3206 1573-7241

مصطلحات موضوعية: Pharmacology (medical), Cardiology and Cardiovascular Medicine, Pharmacology, General Medicine

الوصف: Purpose Data are limited on sodium glucose co-transport 2 inhibitors (SGLT2-is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among real-world cohorts of underrepresented patients. We examined these therapies and glycemic control in US adults with diabetes mellitus (DM) by atherosclerotic cardiovascular disease (ASCVD) risk and sociodemographic factors. Methods In the NIH Precision Medicine Initiative All of Us Research Program, we categorized DM as (1) moderate risk, (2) high risk, and (3) with ASCVD. We examined proportions on DM therapies, including SGLT2-i or GLP-1 RA, and at glycemic control by sociodemographic factors and CVD risk groups. Results Our 81,332 adults aged ≥ 18 years with DM across 340 US sites included 22.3% non-Hispanic Black, 17.2% Hispanic, and 1.8% Asian participants; 31.1%, 30.3%, and 38.6% were at moderate risk, high risk, or with ASCVD, respectively. Those with DM and ASCVD were most likely on SGLT2-i (8.6%) or GLP-1 RA (11.9%). SGLT2-i use was < 10% in those with heart failure or chronic kidney disease. The odds (95% CI) of SGLT2-i use were greater among men (1.35 [1.20, 1.53]) and Asian persons (2.31 [1.78, 2.96]), with GLP-1 RA being less common (0.78 [0.70, 0.86]) in men. GLP-1 RA use was greater among those with health insurance, and both GLP-1 RA and SGLT2-i greater within lower income groups. 72.0% of participants had HbA1c < 7%; Hispanic persons were least likely at glycemic control. Conclusions Treatment with SGLT2-is and GLP-1 RAs remains low, even among higher ASCVD risk persons with DM and use is even lower among underserved groups.

الإتاحة: https://doi.org/10.1007/s10557-022-07403-2Test

المؤلفون: Noh, Stephanie H., Devineni, Divya, Ediriwickrema, Lilangi S.

المصدر: Plastic Surgery of the Lower Eyelids ; page 1-9 ; ISBN 9783031361746 9783031361753

الإتاحة: https://doi.org/10.1007/978-3-031-36175-3_1Test

المؤلفون: Watkinson, Neftali, Devineni, Divya, Joe, Victor, Givargis, Tony, Nicolau, Alexandru, Veidenbaum, Alexander

المصدر: 2023 IEEE International Parallel and Distributed Processing Symposium Workshops (IPDPSW)

الإتاحة: https://doi.org/10.1109/ipdpsw59300.2023.00036Test
http://xplorestaging.ieee.org/ielx7/10196463/10196505/10196627.pdf?arnumber=10196627Test

المؤلفون: Do, Trinh, Grace, Kyrillos, Gong, Yufan, Devineni, Divya, Lombardo, Dawn, Wong, Nathan D, Lee, Andy

المصدر: Circulation ; volume 148, issue Suppl_1 ; ISSN 0009-7322 1524-4539

الوصف: Background: Despite its high prevalence, HFpEF is difficult to diagnose and treat due to its complex pathophysiology. Unlike HFrEF, treatments are limited for HFpEF. A combination of SGLT2i, angiotensin receptor neprilysin inhibitor (ARNi), and mineralocorticoid antagonist (MRA) has been shown to improve cardiovascular outcomes; however, acceptance of GDMT remains an obstacle in clinical practice. We sought to investigate the relationship of social determinants of health (SDOH), demographics, comorbidities, and risk factors with prescription patterns to GDMT for HFpEF. Methods: The All of Us Research Program, which began in May 2018, is a diverse database that prioritizes historically marginalized populations. Demographics, risk factors, and SDOH measurements were compared with use of GDMT for HFpEF adults aged 18 years and over. Multiple logistic regression analysis was used to examine the association among demographics, comorbidities, risk factors and SDOH with use of at least two of the recommended GDMT therapies for HFpEF (SGLT2 inhibitor, angiotensin receptor/ARNi, and MRA). Result: The study found that 38.4% (3773) of the 9823 adults with chronic heart failure had HFpEF. 51% of those with HFpEF do not take any GDMT, 11% take 2/3 of the GDMT, and only 1% take all three. Furthermore, a multiple logistic regression analysis revealed a greater odds of being on at least 2 GDMT for HFpEF among participants with known ASCVD (1.96 [1.41, 2.78]), diabetes (2.15 [1.56, 3.01]), and BMI ≥ 35 kg/m2 (1.02 [1.01, 1.04]). In addition, female sex is also associated with increased odds of being on at least two agents (1.46 [1.08, 2.00]). The likelihood of being prescribed GDMT for HFpEF was not predicted by race, education, income, or health insurance type. Conclusion: Risk factors such as ASCVD, diabetes and obesity were shown to be associated with an increased rate of GDMT use, while sex differences are also present.

الإتاحة: https://doi.org/10.1161/circ.148.suppl_1.14848Test

المؤلفون: Do, Trinh K, Grace, Kyrillos, Gong, Yufan, Devineni, Divya, Lombardo, Dawn, Wong, Nathan D, Lee, Andy

المصدر: Circulation ; volume 148, issue Suppl_1 ; ISSN 0009-7322 1524-4539

الوصف: Background: HFrEF is associated with significant morbidity and mortality. The standard of care is guideline-directed medical therapy (GDMT) consisting of evidence-based pharmacological interventions which have demonstrated improved outcomes in HFrEF. However, paltry adherence to GDMT remains an ongoing challenge. We examined in US adults the relationship between social determinants of health (SDOH), demographics, and risk factors on GDMT adherence for HFrEF. Methods: The NIH All of Us Research Program started in May 2018 with the goal of enrolling over 1 million US residents. Over 315,000 participants have shared electronic health records, physical measurements, surveys, and lab results. Demographics, risk factors, and SDOH measures were captured for HFrEF in US adults 18 years or older. Patients with HFrEF who were on quadruple therapy (ACE-inhibitor/angiotensin receptor/combination angiotensin receptor-neprilysin inhibitor, beta-blocker, SGLT2 inhibitor, mineralocorticoid antagonist) were compared to those on fewer. Multiple logistic regression analyses were conducted to examine the association between risk factors/SDOH measures and medical therapy optimization. Results: In the All of Us data, 6049 patients were identified with HFrEF. Of those patients, 5838 (97%) patients were on less than 4 GDMT, while 210 (3%) patients were on quadruple therapy. Multiple logistics regression showed participants with ASCVD, and diabetes had higher odds (95% CI) of being on quadruple therapy, 2.19 [1.28, 3.99] and 9.07 [4.88, 18.84], respectively, while hypertension had lower odds (0.64 [0.43, 0.95]). Race, income, education, and health insurance types did not predict medical therapy optimization. Conclusion: Various cardiovascular conditions were associated with higher odds of being on quadruple therapy. However, sociodemographic factors did not show a correlation of predicting the odds of achieving maximal medical therapy.

الإتاحة: https://doi.org/10.1161/circ.148.suppl_1.12492Test