Background: Liver cell carcinoma (LCC) and hepatic failure (HF) are significant contributors to liver-related mortality in the United States. This study assessed LCC- and HF-related mortality trends (1999–2023) using CDC WONDER data, stratified by demographics and geography.
Methods: Deaths among U.S. adults aged ≥25 years with LCC (ICD-10: C22.0) or HF (ICD-10: K72.9) as underlying or contributing causes were analyzed. AAMRs per 1,000,000 were calculated by direct standardization to the 2000 U.S. standard population. Joinpoint regression estimated annual percent changes (APCs) in AAMRs, stratified by sex (1999–2023) and race/ethnicity, urban-rural status, census region, and state (1999–2020).
Results: From 1999–2023, 22,963 adult deaths were recorded (77.6% men). Overall AAMR declined from 1999–2007 (APC: −2.4), was stable through 2017 (APC: +0.2), then fell through 2023 (APC: −3.5). Male AAMR followed a non-linear trajectory (APC: −2.1, 1999–2010; +0.7, 2010–2017; −4.4, 2017–2023); female AAMR was stable post-2006 (APC: −0.1). NH Asian or Pacific Islanders showed the steepest decline (APC: −6.7); Hispanics increased post-2010 (APC: +0.6). Metropolitan AAMR declined overall; non-metropolitan AAMR increased (APC: +1.3). The West had the highest regional AAMR (5.6 per 1,000,000); Hawaii the highest state-level AAMR (10.3 per 1,000,000).
Conclusion: LCC- and HF-related mortality declined overall, with descriptive subgroup variation by sex, race/ethnicity, urbanization, and geography. Targeted screening, hepatitis management, and equitable healthcare access are needed to address these patterns.
S. Khan, Muneeb Khawar, Muhammad Haris Khan et al.· ASIDE Gastroenterology· 0 citations
Background: ST-segment elevation myocardial infarction (STEMI) requires primary percutaneous coronary intervention (PCI) and dual antiplatelet therapy with aspirin and a purinergic receptor Y12 inhibitor to reduce thrombotic risks. Ticagrelor, a potent purinergic receptor Y12 inhibitor, offers faster and stronger platelet inhibition than clopidogrel, but evidence on its efficacy and safety in STEMI patients post-PCI is conflicting. This study aims to compare the efficacy and safety of ticagrelor versus clopidogrel in STEMI patients undergoing primary PCI. Methods: This systematic review and meta-analysis, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, searched PubMed, Embase, ScienceDirect, and ClinicalTrials.gov up to July 2025. Included were randomized controlled trials and observational studies comparing ticagrelor to clopidogrel in adult STEMI patients post-PCI, reporting cardiovascular outcomes. Data were pooled using odds ratios (ORs) with 95% confidence intervals (CIs) via random-effects models. Results: Eight studies (5 randomized controlled trials, 3 observational; n = 31,729) showed ticagrelor significantly reduced all-cause mortality (OR = 0.64, 95% CI = 0.47–0.88; P = .006), cardiovascular mortality (OR = 0.68, 95% CI = 0.60–0.93; P = .01), major adverse cardiovascular events (OR = 0.71, 95% CI = 0.60–0.84; P = .01), myocardial infarction (OR = 0.71, 95% CI = 0.61–0.83; P < .00001), stent thrombosis (OR = 0.66, 95% CI = 0.55–0.79; P < .00001), and major bleeding (OR = 0.87, 95% CI = 0.78–0.97; P = .01), but increased target vessel revascularization (OR = 1.30, 95% CI = 1.05–1.61; P = .02). No significant difference was observed in stroke risk (OR = 1.16, 95% CI = 0.89–1.52; P = .28). Conclusion: Ticagrelor outperforms clopidogrel in STEMI post-PCI, reducing key adverse outcomes, though higher target vessel revascularization risk warrants caution.
Mohammad Shahid, M. Sajjad, Sanket Patel et al.· Medicine· 0 citations
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