bluuebunny/crossref_metadata_2025 huggingface dataset:
NCAM1 and GDF15 are biomarkers of Charcot-Marie-Tooth disease in patients and mice
Authors: Jennings Matthew J , Kagiava Alexia , Vendredy Leen , Spaulding Emily L , Stavrou Marina , Hathazi Denisa , Grüneboom Anika , De Winter Vicky , Gess Burkhard , Schara Ulrike , Pogoryelova Oksana , Lochmüller Hanns , Borchers Christoph H , Roos Andreas , Burgess Robert W , Timmerman Vincent , Kleopa Kleopas A , Horvath Rita
Published: February 2022

Molecular markers scalable for clinical use are critical for the development of effective treatments and the design of clinical trials. Here, we identify proteins in sera of patients and mouse models with Charcot-Marie-Tooth disease (CMT) with characteristics that make them suitable as biomarkers in clinical practice and therapeutic trials.

We collected serum from mouse models of CMT1A (C61 het), CMT2D (GarsC201R, GarsP278KY), CMT1X (Gjb1-null), CMT2L (Hspb8K141N) and from CMT patients with genotypes including CMT1A (PMP22d), CMT2D (GARS), CMT2N (AARS) and other rare genetic forms of CMT. The severity of neuropathy in the patients was assessed by the CMT Neuropathy Examination Score (CMTES). We performed multitargeted proteomics on both sample sets to identify proteins elevated across multiple mouse models and CMT patients. Selected proteins and additional potential biomarkers, such as growth differentiation factor 15 (GDF15) and cell free mitochondrial DNA, were validated by ELISA and quantitative PCR, respectively.

We propose that neural cell adhesion molecule 1 (NCAM1) is a candidate biomarker for CMT, as it was elevated in Gjb1-null, Hspb8K141N, GarsC201R and GarsP278KY mice as well as in patients with both demyelinating (CMT1A) and axonal (CMT2D, CMT2N) forms of CMT. We show that NCAM1 may reflect disease severity, demonstrated by a progressive increase in mouse models with time and a significant positive correlation with CMTES neuropathy severity in patients. The increase in NCAM1 may reflect muscle regeneration triggered by denervation, which could potentially track disease progression or the effect of treatments.

We found that member proteins of the complement system were elevated in Gjb1-null and Hspb8K141N mouse models as well as in patients with both demyelinating and axonal CMT, indicating possible complement activation at the impaired nerve terminals. However, complement proteins did not correlate with the severity of neuropathy measured on the CMTES scale. Although the complement system does not seem to be a prognostic biomarker, we do show complement elevation to be a common disease feature of CMT, which may be of interest as a therapeutic target.

We also identify serum GDF15 as a highly sensitive diagnostic biomarker, which was elevated in all CMT genotypes as well as in Hspb8K141N, Gjb1-null, GarsC201R and GarsP278KY mouse models. Although we cannot fully explain its origin, it may reflect increased stress response or metabolic disturbances in CMT. Further large and longitudinal patient studies should be performed to establish the value of these proteins as diagnostic and prognostic molecular biomarkers for CMT.
White matter microstructure in Parkinson’s disease with and without elevated rapid eye movement sleep muscle tone
Authors: Patriat Rémi , Pisharady Pramod K. , Amundsen-Huffmaster Sommer , Linn-Evans Maria , Howell Michael , Chung Jae Woo , Petrucci Matthew N. , Videnovic Aleksandar , Holker Erin , De Kam Joshua , Tuite Paul , Lenglet Christophe , Harel Noam , MacKinnon Colum D.
Published: February 2022

People with Parkinson’s disease who have elevated muscle activity during rapid eye movement sleep (REM sleep without atonia) typically have a worse motor and cognitive impairment compared with those with normal muscle atonia during rapid eye movement sleep. This study used tract-based spatial statistics to compare diffusion MRI measures of fractional anisotropy, radial, mean and axial diffusivity (measures of axonal microstructure based on the directionality of water diffusion) in white matter tracts between people with Parkinson’s disease with and without rapid eye movement sleep without atonia and controls and their relationship to measures of motor and cognitive function. Thirty-eight individuals with mild-to-moderate Parkinson’s disease and 21 matched control subjects underwent ultra-high field MRI (7 T), quantitative motor assessments of gait and bradykinesia and neuropsychological testing. The Parkinson’s disease cohort was separated post hoc into those with and without elevated chin or leg muscle activity during rapid eye movement sleep based on polysomnography findings. Fractional anisotropy was significantly higher, and diffusivity significantly lower, in regions of the corpus callosum, projection and association white matter pathways in the Parkinson’s group with normal rapid eye movement sleep muscle tone compared with controls, and in a subset of pathways relative to the Parkinson’s disease group with rapid eye movement sleep without atonia. The Parkinson’s disease group with elevated rapid eye movement sleep muscle tone showed significant impairments in the gait and upper arm speed compared with controls and significantly worse scores in specific cognitive domains (executive function, visuospatial memory) compared with the Parkinson’s disease group with normal rapid eye movement sleep muscle tone. Regression analyses showed that gait speed and step length in the Parkinson’s disease cohort were predicted by measures of fractional anisotropy of the anterior corona radiata, whereas elbow flexion velocity was predicted by fractional anisotropy of the superior corona radiata. Visuospatial memory task performance was predicted by the radial diffusivity of the posterior corona radiata. These findings show that people with mild-to-moderate severity of Parkinson’s disease who have normal muscle tone during rapid eye movement sleep demonstrate compensatory-like adaptations in axonal microstructure that are associated with preserved motor and cognitive function, but these adaptations are reduced or absent in those with increased rapid eye movement sleep motor tone.
EEG microstate correlates of emotion dynamics and stimulation content during video watching
Authors: Hu Wanrou , Zhang Zhiguo , Zhao Huilin , Zhang Li , Li Linling , Huang Gan , Liang Zhen
Published: February 2022

Introduction

EEG microstates have been widely adopted to understand the complex and dynamic-changing process in dynamic brain systems, but how microstates are temporally modulated by emotion dynamics is still unclear. An investigation of EEG microstates under video-evoking emotion dynamics modulation would provide a novel insight into the understanding of temporal dynamics of functional brain networks.

Methods

In the present study, we postulate that emotional states dynamically modulate the microstate patterns, and perform an in-depth investigation between EEG microstates and emotion dynamics under a video-watching task. By mapping from subjective-experienced emotion states and objective-presented stimulation content to EEG microstates, we gauge the comprehensive associations among microstates, emotions, and multimedia stimulation.

Results

The results show that emotion dynamics could be well revealed by four EEG microstates (MS1, MS2, MS3, and MS4), where MS3 and MS4 are found to be highly correlated to different emotion states (emotion task effect and level effect) and the affective information involved in the multimedia content (visual and audio).

Conclusion

In this work, we reveal the microstate patterns related to emotion dynamics from sensory and stimulation dimensions, which deepens the understanding of the neural representation under emotion dynamics modulation and will be beneficial for the future study of brain dynamic systems.
Antibiotic Stewardship Strategies and Their Association With Antibiotic Overuse After Hospital Discharge: An Analysis of the Reducing Overuse of Antibiotics at Discharge (Road) Home Framework
Authors: Vaughn Valerie M , Ratz David , Greene M Todd , Flanders Scott A , Gandhi Tejal N , Petty Lindsay A , Huls Sean , Feng Xiaomei , White Andrea T , Hersh Adam L
Published: February 2022

Background

Strategies to optimize antibiotic prescribing at discharge are not well understood.

Methods

In fall 2019, we surveyed 39 Michigan hospitals on their antibiotic stewardship strategies. The association of reported strategies with discharge antibiotic overuse (unnecessary, excess, suboptimal fluoroquinolones) for community-acquired pneumonia (CAP) and urinary tract infection (UTI) was evaluated in 2 ways: (1) all strategies assumed equal weight and (2) strategies were weighted based on the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework (ie, Tier 1—Critical infrastructure, Tier 2—Broad inpatient interventions, Tier 3—Discharge-specific strategies) with Tier 3 strategies receiving the highest weight.

Results

Between 1 July 2017 and 30 July 2019, 39 hospitals with 20 444 patients (56.5% CAP; 43.5% UTI) were included. Survey response was 100%. Hospitals reported a median (interquartile range [IQR]) 12 (9–14) of 34 possible stewardship strategies. On analyses of individual stewardship strategies, the Tier 3 intervention, review of antibiotics prior to discharge, was the only strategy consistently associated with lower antibiotic overuse at discharge (adjusted incident rate ratio [aIRR] 0.543, 95% confidence interval [CI]: .335–.878). On multivariable analysis, weighting by ROAD Home tier predicted antibiotic overuse at discharge for both CAP and UTI. For diseases combined, having more weighted strategies was associated with lower antibiotic overuse at discharge (aIRR 0.957, 95% CI: .927–.987, per weighted intervention); discharge-specific stewardship strategies were associated with a 12.4% relative decrease in antibiotic overuse days at discharge.

Conclusions

The more stewardship strategies a hospital reported, the lower its antibiotic overuse at discharge. However, Tier 3, or discharge-specific strategies, appeared to have the largest effect on antibiotic prescribing at discharge.
Model-based Analysis of Tuberculosis Genotype Clusters in the United States Reveals High Degree of Heterogeneity in Transmission and State-level Differences Across California, Florida, New York, and Texas
Authors: Shrestha Sourya , Winglee Kathryn , Hill Andrew N , Shaw Tambi , Smith Jonathan P , Kammerer J Steve , Silk Benjamin J , Marks Suzanne M , Dowdy David
Published: February 2022

Background

Reductions in tuberculosis (TB) transmission have been instrumental in lowering TB incidence in the United States. Sustaining and augmenting these reductions are key public health priorities.

Methods

We fit mechanistic transmission models to distributions of genotype clusters of TB cases reported to the Centers for Disease Control and Prevention during 2012–2016 in the United States and separately in California, Florida, New York, and Texas. We estimated the mean number of secondary cases generated per infectious case (R0) and individual-level heterogeneity in R0 at state and national levels and assessed how different definitions of clustering affected these estimates.

Results

In clusters of genotypically linked TB cases that occurred within a state over a 5-year period (reference scenario), the estimated R0 was 0.29 (95% confidence interval [CI], .28–.31) in the United States. Transmission was highly heterogeneous; 0.24% of simulated cases with individual R0 >10 generated 19% of all recent secondary transmissions. R0 estimate was 0.16 (95% CI, .15–.17) when a cluster was defined as cases occurring within the same county over a 3-year period. Transmission varied across states: estimated R0s were 0.34 (95% CI, .3–.4) in California, 0.28 (95% CI, .24–.36) in Florida, 0.19 (95% CI, .15–.27) in New York, and 0.38 (95% CI, .33–.46) in Texas.

Conclusions

TB transmission in the United States is characterized by pronounced heterogeneity at the individual and state levels. Improving detection of transmission clusters through incorporation of whole-genome sequencing and identifying the drivers of this heterogeneity will be essential to reducing TB transmission.
Cannabinoid and substance relationships of European congenital anomaly patterns: a space-time panel regression and causal inferential study
Authors: Reece Albert Stuart , Hulse Gary Kenneth
Published: February 2022

With reports from Australia, Canada, USA, Hawaii and Colorado documenting a link between cannabis and congenital anomalies (CAs), this relationship was investigated in Europe. Data on 90 CAs were accessed from Eurocat. Tobacco and alcohol consumption and median household income data were from the World Bank. Amphetamine, cocaine and last month and daily use of cannabis from the European Monitoring Centre for Drugs and Drug Addiction. Cannabis herb and resin Δ9-tetrahydrocannabinol concentrations were from published reports. Data were processed in R. Twelve thousand three hundred sixty CA rates were sourced across 16 nations of Europe. Nations with a higher or increasing rate of daily cannabis use had a 71.77% higher median CA rates than others [median ± interquartile range 2.13 (0.59, 6.30) v. 1.24 (0.15, 5.14)/10 000 live births (P = 4.74 × 10−17; minimum E-value (mEV) = 1.52]. Eighty-nine out of 90 CAs in bivariate association and 74/90 CAs in additive panel inverse probability weighted space-time regression were cannabis related. In inverse probability weighted interactive panel models lagged to zero, two, four and six years, 76, 31, 50 and 29 CAs had elevated mEVs (< 2.46 × 1039) for cannabis metrics. Cardiovascular, central nervous, gastrointestinal, genital, uronephrology, limb, face and chromosomalgenetic systems along with the multisystem VACTERL syndrome were particularly vulnerable targets. Data reveal that cannabis is related to many CAs and fulfil epidemiological criteria of causality. The triple convergence of rising cannabis use prevalence, intensity of daily use and Δ9-tetrahydrocannabinol concentration in herb and resin is powerfully implicated as a primary driver of European teratogenicity, confirming results from elsewhere.
Echocardiography fails to detect an extensive aortic root abscess in a patient with infective endocarditis: a case report
Authors: Zogg Cheryl K , Avesta Arman , Bonde Pramod N , Mani Arya
Published: February 2022

Background

Echocardiography plays a central role in the diagnosis of infective endocarditis (IE). In recent years, additional imaging techniques have begun to challenge the conventional approach. We present a case where the use of transthoracic/transoesophageal echocardiography (TTE/TOE) in suspected IE failed to identify an extensive periannular abscess, later identified by 18F-flurodeoxyglucose–positron emission tomography (FDG–PET), requiring urgent intervention.

Case summary

A 69-year-old man with symptomatic Streptococcus sanguinis bacteraemia and a bicuspid aortic valve was found to have new-onset left bundle branch block that progressed to complete heart block. After starting on IV Penicillin G and having a temporary pacemaker inserted, his clinical condition improved. Transthoracic echocardiography and TOE showed no evidence of abscess. However, persistent first-degree atrioventricular block raised clinical suspicion of a possible extended infection. Subsequent FDG–PET revealed focal activity around the aortic root that extended inferiorly into the interatrial septum, consistent with active infection and possible abscess. Composite aortic root replacement with insertion of a mechanical prosthesis was carried out, revealing extensive IE and multiple periannular abscesses.

Discussion

As guidelines grapple with evolving understandings of how best to define the optimal imaging approach for the management of complicated IE, the results of this case clearly show the importance of heightened clinical suspicion and need for prompt operative intervention when faced with patients who present with predisposing conditions and concern for advanced conduction disease. Clinicians and researchers are encouraged to learn from the potential near-miss of an extensive periannular abscess to help guide guideline-development of imaging in complicated IE and prevent adverse outcomes in patients with similar presentations.
Intracoronary IgG4-related disease as an unusual cause of sudden cardiac arrest: a case series
Authors: Paratz Elizabeth D , Ross Laura , Zentner Dominica , Morgan Natalie , Bouwer Heinrich , Lynch Matthew , Parsons Sarah , La Gerche Andre
Published: February 2022

Background

IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition classically causing retroperitoneal fibrosis, aortitis, thyroiditis, or pancreatitis. Diagnosis includes the presence of lymphoplasmacytic infiltrate (with >40% ratio IgG4+:IgG plasma cells) and fibrosis. Cardiac involvement may include aortic, pericardial, or coronary disease. Coronary manifestations encompass obstructive intra-luminal lesions, external encasing pseudo-tumour on imaging, or lymphoplasmacytic arteritis.

Case summary

Case 1: A fit and healthy 50-year-old man was found deceased. His only known medical condition was treated Hashimoto’s thyroiditis. Post-mortem examination demonstrated an isolated severe stenosis of the left anterior descending (LAD) coronary artery without histopathological evidence of acute myocardial infarction. Coronary plaque histopathology showed florid IgG4-positive plasma cell infiltrate throughout all layers of the artery with dense fibrous tissue connective tissue stroma, all features consistent with coronary artery IgG4-RD. Case 2: A 48-year-old man collapsed at work. Computed tomography scan 1 week prior reported an ill-defined para-aortic retroperitoneal soft tissue density. No cardiac symptoms were reported in life. Post-mortem examination showed coronary arteritis and peri-arteritis with sclerosing peri-aortitis in the LAD. There was myocardial fibrosis of the anterior left ventricle and focal myocarditis of the right ventricle.

Discussion

IgG4-related disease presenting as sudden cardiac death without any preceding symptoms is very rare (six prior cases identified on literature review). Reported targeted successful interventions for intracoronary IgG4-RD diagnosed in life have included steroid therapy and B cell depleting therapy (i.e. rituximab). If cardiac symptoms are present in a patient with known IgG4-RD, cardiac investigations should be promptly arranged.
The association between transthoracic echocardiographic parameters and severity of COVID-19 in hospitalised adults - a retrospective analysis
Authors: Agarwal R , Priyonugroho G , Hertine S , Wicaksono S H , Almazini P , Zamroni D , Muliawan H S
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with more than 220 million cases and 4.5 million deaths reported worldwide. Its clinical spectrum varies widely, and non-invasive prognostic markers are valuable as they can guide efficient resource allocation.  Cardiovascular complications of COVID-19 include myocardial injury, acute heart failure, and arrhythmias. Both de novo cardiovascular complications and pre-existing cardiovascular co-morbidities are associated with a poor prognosis. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively.

Purpose

To investigate the association between TTE parameters and severity of disease in hospitalised adults with confirmed COVID-19

Methods

This single-centre retrospective analysis was conducted at a COVID-19 referral hospital in Indonesia. All consecutive adults hospitalised with confirmed COVID-19 who underwent TTE assessment between 3 April 2020 to 6 April 2021 were included. Comprehensive data including demographics, peak COVID-19 severity, pre-existing co-morbidities, and TTE findings were extracted from electronic medical records. Patients with mild-moderate and severe-critical disease were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%.

Results

A total of 488 patients were included in this study; 202 with mild-moderate disease and 286 with severe-critical disease. Frequency of old age (>60 years), obesity, diabetes, chronic kidney disease, and congestive heart failure were higher in the severe-critical group (P < 0.05). On TTE assessment, Patients with severe-critical disease had higher odds of left ventricular hypertrophy (LVH) (OR: 2.20; CI: 1.49 – 3.24), LV wall motion abnormality (OR: 3.33; CI: 1.68 – 6.60), diastolic dysfunction (OR: 1.46; CI: 1.02 – 2.11), valve abnormality (OR: 1.93; CI: 1.27 – 2.92), and right ventricular (RV) dysfunction (OR: 5.53; CI: 1.63 – 18.73). After matching for age, obesity, and diabetes, patients with severe-critical COVID-19 continued to have higher odds of LVH (OR: 1.91; CI: 1.21 – 3.02), LV wall motion abnormality (OR: 2.76; CI: 1.28 – 5.96), diastolic dysfunction (OR: 1.55; CI: 1.00 – 2.38), and RV dysfunction (OR: 3.86; CI: 1.06 – 14.08).

Conclusions

The presence of LVH, LV wall motion abnormality, diastolic dysfunction, and RV dysfunction on TTE assessment were associated with severe-critical disease in hospitalised adults with COVID-19. These findings must be validated in a larger prospective study. Abstract Figure. Odds Ratios for the Entire Cohort  Abstract Figure. Odds Ratios for the Matched Cohort
OCT-guided left-main PCI, a retrospective single-center analysis
Authors: Jariwala P , Jadhav KARTIK , Jadhav KARTIK
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

It is known that PCI is associated with non-optimal stent implantation utilizing angiography for only left main lesions as well as for bifurcation lesions and is characterised by a high risk of adverse long-term effects. The use of OCT for the left main stent makes it easier to enhance the effective implantation of stents and enhance the results of patients.

Methods

A single-center randomised study was performed to demonstrate the benefit of stent implantation under OCT control in the left main bifurcation lesions compared to standard implantation under angiographic control. The follow-up period was 1 year, and the study included 68 patients with 1:1 randomization. The final composite points were: cardiac death, ischaemia, or myocardial infarction. All patients were elective, with moderate to high-functional class of angina pectoris. PCI was done using one or two stents, using OCT or without OCT to perform kissing dilation and proximal optimization technique.

Results

As a result of the data review of 68 patients with or without OCT using PCI of left main bifurcation lesions, the primary endpoint parameters in the non-OCT group were 17.8% and 6% for the OCT group. In 43.1 % of cases, a single-stent technique was used rather than a two-stent when using OCT. In the OCT group, additional stent optimisation is 40% more common. In 96.7 % of cases, a 9-month follow-up in the OCT group showed complete or partial endothelization of the stent struts, allowing earlier termination of DAPT, which is critical in patients at high risk for significant bleeding.

Conclusions

The perioperative results of PCI for left main bifurcation can be improved by the use of OCT using regulated factors for optimal stent implantation. As a result, in patients with atrial fibrillation and a high risk of painful bleeding, the long-term effects of treatment are increased , the time to take DAPT is decreased and the number of implantable stents is decreased, which is significant.
Incidence, clinical correlates and associated outcomes of dementia in heart failure: a population-based cohort study
Authors: Ren Q W , Teng T H K , Wang T , Tse Y K , Wong P F , Li H L , Yu S Y , Wu M Z , Li X L , Tse H F , Lam C S P , Yiu K H
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Dementia, in the setting of heart failure (HF), portends poorer outcomes and poses great challenges in its clinical management.

Purpose

We investigated the incidence, types, clinical correlates, and the prognostic impact of dementia in a population-based cohort of patients with HF. Further, we examined the interactions of age and sex, and education status with dementia incidence.

Methods

The previously validated Hong Kong Clinical Data Analysis Reporting System (CDARS), a territory-wide database was interrogated to identify patients with HF (N= 202,121) from 1995 to 2018. Associations of clinical correlates with incident dementia and its risk with all-cause mortality were assessed using competing risk/multivariable Cox regression models where appropriate.

Results

Among a total cohort aged ≥18 years with HF (mean age: 75.3 ± 13.0 years, 51.3% women), new-onset dementia occurred in 22,145 (11.0%) over a median follow-up of 5.5 years. Alzheimer’s disease occurred in 27.0%; vascular dementia (18.1%) and unspecified dementia (in 55.1%). Age-standardized rate of dementia incidence in women was 1297 (95%CI, 1276-1318) (vs. 744, 95%CI, 723-765) per 10000 population in men. Other independent predictors of dementia include: Increasing age (HR 1.08), Female sex (HR 1.19), Nil/< primary (vs tertiary) education (HR 1.29), Parkinson’s disease (HR 1.73), head injury (HR 1.37), peripheral vascular disease (HR 1.31), stroke (HR 1.29), depression (HR 1.18), alcohol intake (HR1.17), anaemia (HR 1.14), hypertension (HR 1.08), among other common comorbidities in HF (Figure 1A).

Notably, a significant interaction (p < 0.001) between age and sex on dementia incidence was observed, such that women in all age groups were observed to have higher sHR compared to men (Figure 1B). After accounting for competing risk, dementia was not associated with adjusted hazard of all-cause mortality.

Conclusions

Female sex, lower socioeconomic status, increasing age and common comorbidities were associated with higher hazards of incident dementia. Abstract Figure 1A and Figure 1B
Clinical value of the HATCH score for predicting adverse outcomes in patients with heart failure
Authors: Shibata N , Kondo T , Morimoto R , Kazama S , Sawamura A , Nishiyama I , Kato T , Hiraiwa H , Okumura T , Murohara T
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The HATCH score is employed as a risk assessment tool for atrial fibrillation (AF) development. However, the impact of the HATCH score on the long-term adverse outcomes in patients with acute heart failure (AHF) is unknown.

Aimes

To investigate the clinical value of the HATCH score in AHF.

Methods

From a multicenter AHF registry, we retrospectively evaluated 1,543 consecutive patients admitted with AHF (median age, 78 [69–85] years; 42.3% women) from 2012 to 2019. These patients were divided into five groups based on their HATCH score at admission (scores 0, 1, 2, 3, and 4–7). The correlation between the HATCH score and composite outcome, including all-cause mortality and re-hospitalization due to HF, was analyzed using Kaplan-Meier and Cox proportional-hazard analyses.

Results

The median HATCH score was 2 [1-3]. During the follow-up period (median, 16.8 months), the composite endpoint occurred in 691 patients (44.8%), including 416 (27%) patients who died and 455 (29.5%) patients requiring re-hospitalizations due to HF. The Kaplan-Meier analysis showed a significant increase in the composite endpoint with increasing HATCH score (log-rank, p < 0.001). The multivariate Cox regression model revealed that the HATCH score was an independent predictor of the composite endpoint (hazard ratio [HR] 1.181; 95% confidence interval [CI]: 1.111–1.255; p < 0.001) with all-cause mortality (HR 1.153, 95% CI: 1.065–1.249; p < 0.001) and re-hospitalizations due to HF (HR 1.21; 95% CI: 1.124–1.303; p < 0.001) in patients with AHF.

Conclusions

The HATCH score is an independent predictor of adverse outcomes in patients with AHF. Abstract Figure. Kaplan-Meier analysis for outcome
Efficacy and safety of HDL/apoA-1 mimetics on human and mice with atherosclerosis: a systematic review and meta-analysis
Authors: Abudukeremu A , Li H , Sun R , Liu X , Wu X , Xie X , Huang J , Zhang J , Bao J , Zhang Y
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the National Natural Science Foundation of China

Background

Low high-density lipoprotein cholesterol (HDL-C) level as a residual risk factor of cardiovascular disease (CVD) is still causing concern, although using chemical drugs for raising HDL-C level failed. The effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerosis is controversial.

Aim

In this meta-analysis we analyzed the effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerotic lesion both in human and mice.

Methods

We systematically searched PubMed, Cochrane, Web of Science and EMBASE databases up to June 6, 2020 for eligible studies using wide search terms and included all the publications meet the including criteria. The methodological quality of the human studies was assessed using Review Manager (RevMan) software (version 5.3.). The methodological quality of the mice studies was assessed by using stair list. WMD(SMD) with 95% CI was used as a measure of the association between HDL/apoA-1 mimetics and plaque regression in human (in mice), after pooling data across trials in a random effect model. Sensitivity and subgroup analyses were used to explore sources of heterogeneity and the effect of potential confounders. STATA (version 14.0) was used to conduct all statistical analyses.

Results

We identified 15 randomized controlled trials in which 6 trails including 754 ACS (HDL/apoA-1 mimetics = 414, placebo = 340) patients used for efficacy analysis and all of 15 trails used for safety analysis and 17 controlled trials for animal study. The pooled results showed that the use of HDL/apoA-1 mimetics did not significant decreased the percent atheroma volume(p = 0.494) and total atheroma volume(p = 0.560) in patients with acute coronary syndrome (ACS). However, HDL/apoA-1 mimetics (or gene transfection) was significant associated with all of final percent lesion area, final lesion area and changes in lesion area (SMD, -1.75; 95% CI: -2.21∼-1.29, p = 0.000; SMD, -0.78; 95% CI: -1.18∼-0.38, p = 0.000; SMD: -2.06; 95% CI, -3.92∼-0.2, p = 0.03) in mice.

Conclusions

In human, HDL/apoA-1 mimetics cannot significantly improve atheroma volume in artery, although it is safe. However, in animal, the results suggest HDL/apoA-1 mimetics (or gene transfection) can decrease lesion area. So additional studies are needed to further investigate and explain the different efficacy of HDL/apoA-1 mimetic peptides between human and animal. Abstract Figure. Forest plots of human studies
Real world outcomes of Thai patient with acute coronary syndrome classified by achieved low-density lipoprotein level
Authors: Leesutipornchai T , Kunlamas Y , Areepium N , Bunditanukul K , Aekarach A
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

 Although lower low-density lipoprotein (LDL) level is recommended to improves clinical outcomes, little is known about the association between LDL level after treatment and outcomes in developing countries. The aim of the study was to evaluate the impact of LDL level on mortality rate and outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Methods

 We conducted a single center retrospective study of all patients with a diagnosis of STEMI who underwent primary PCI at a tertiary care hospital in Thailand from 2005-2015. Patients were classified by LDL level at 3 months after discharge. Characteristics, treatments, and outcomes were gathered. T-­test, and Chi-­square were used to analyze.

Result

 A total of 983 patients with STEMI who had undergone PPCI were identified STEMI. Of those, 418 patients had available follow LDL level at 3 months and were analyzed (mean age 59.9 ± 12.7 years, 27.3% female, 46.8% hypertension, 26.7% diabetes). There were only 32 and 67 patients who had LDL <55 and 55-70 mg/dL, respectively. The 2- year composite endpoint of death, unstable angina, myocardial infarction and stoke were not different between each group (12.5% vs. 14.9% vs. 17.6% for patient achieved LDL <55, <70 and ≥70 mg/dL, respectively; p = 0.69).

Conclusion

 In this single center experience, among patients with STEMI who underwent primary PCI in Thailand, only a quarter of patients achieving LDL level <70 mg/dL, and only 7% of all patient had LDL <55 mg/dL as recommended per international guidelines. The achieved LDL level was not associated better outcome.
Infective endocarditis post-transcatheter aortic valve replacement: a systematic review of epidemiology, clinical findings and prognosis
Authors: Jaiswal VIKASH , Jaiswal AKASH , Ishak ANGELA , Kumar RUCHIKA , Ujjawal ADITI , Batra NITYA , Sarfraz ZOUINA , Sarfraz AZZA , Sharma PRACHI , Michel JACK , Chaudhary GAURAV
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Transcatheter aortic valve replacement (TAVR) is a minimally invasive, catheter-based procedure to replace calcified narrow aortic valves. Available data on prosthetic valve endocarditis (PVE) post TAVR is limited to small subject populations in the form of case reports and case series. This systematic review aims to evaluate first the incidence of infective endocarditis post TAVR, second the microorganism profile and clinical findings, and third associated mortality/morbidity.

Methods

By adhering to the 2020 PRISMA statement guidelines, a systematic search was conducted to identify studies reporting the incidence of PVE post TAVR. An analysis of patient data including baseline characteristics, clinical findings, and outcomes was conducted. The following keywords were used by applying the BOOLEAN (and/or) logic: infective endocarditis, prosthetic endocarditis, transcatheter aortic valve replacement.

Results

In total, 18 studies were included, comprising 63,604 patients who underwent TAVR. All included studies were observational, i.e., seven multicenter registries, five retrospective studies, three cohort studies, two single-center observational studies, and one prospective study. The analysis yielded that 2.9% (1891) of the included patients suffered from post-TAVR infective endocarditis (IE). The patients with post-TAVR IE had a mean age of 79.2 ± 3.5 years, and 59.6% were males. Nine studies reported theuse of antibiotics for prophylaxis, with β-lactams being the most commonly used. Seventeen studies reported the type of bacteria isolated in cultures; all studies found enterococcus and staphylococcus

species, whereas Streptococcus was isolated in 7 of the 18 studies. Only 3% (60) of the patients had a prior history of IE. Of the reported complications post-TAVR, heart failure was the leading complication, with 0.2% of patients experiencing neurological symptoms, including stroke. The overall mortality rate ofpost-TAVR IE, estimated to be 23%, was alarmingly high.

Conclusion

This synthesis collates a low (2.9%) incidence of infective endocarditis post-TAVR, however high mortality and morbidity by means of heart failure and stroke is documented. Ultimately, appropriate medical care ought to be taken to reduce post-TAVR complications, with cautious and warranted measures of antibiotics prophylaxis to avoid valve complications.
Optical coherence tomography versus angiography to guide percutaneous intervention: a real-world single center propensity-matched analysis
Authors: Dadarwal A , Roy S , Sharma A K , Sharma K K
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Optical coherence tomography (OCT) with its superior resolution has several benefits over coronary angiography (CA) to guide percutaneous coronary intervention (PCI).  Despite the benefits of OCT in comparison with angiography, it is not widely used in developing countries like India data is limited in India specifically in all comer population to meet unmet need.

Objective

Here we aim to determine the clinical efficacy and safety outcomes of OCT versus CA alone in guiding PCI in all-comer patients.

Methods

This was a retrospective study which included 434 all comer patients which were propensity matched. These patients underwent PCI at our center between December 2018 and June 2020.  The primary endpoint was MACE, a composite of cardiovascular death, repeat revascularization, stent thrombosis, recurrent ischemia and target vessel myocardial infarction (TV-MI) at 6 months. Secondary endpoint was target lesion failure (TLF), composite of stent thrombosis and in-stent restenosis. Safety endpoints were post-PCI s. creatinine and hospital stay and other outcome includes post PCI rise in CK-MB.

Results

A total of 217 patients were included in each group: the OCT group and conventional angiography guided PCI (angio group) after propensity matching. Compared to angio group, patients presenting with unstable angina, NSTEMI were significantly higher in the OCT group (55.7% vs 43.3%, p = 0.0095; 17.5% vs 10%, p = 0.02, respectively) while patients with STEMI were significantly low in the OCT (23.5% vs 41.5%, p = 0.00005). Number of balloons, maximum balloon size and left main interventions and contrast volume were more in OCT group than angio group (4.21 ± 1.67 vs 3.86 ± 1.76, P= 0.0034; 3.77 ± 0.63 mm vs 3.51 ± 0.52 mm,P < 0.0001; 24.52% vs 13.36 %,P = 0.003 and 202.53 ± 73.15 ml vs 161.91 ± 69.23 ml, P< 0.0001 respectively). The incidence of MACE at 6 months was numerically lower in the OCT group vs angio group but the difference was not statistically significant (15 [6.9%] vs 21 [9.7%]; p = 0.2964). No cases of TV-MI, TLF (stent thrombosis or in-stent restenosis) is observed in both the groups. Post procedure rise in CKMB was more in Angio group in comparison to OCT group (6.16 ± 31.28 ng/ml vs 39.5 ± 108.71 ng/ml, p < 0.001). Optimal stent expansion (>80%) was seen in 71.5% patients in post OCT-guided PCI. In OCT guided PCI group, OCT identified stent underexpansion in 28.5%, stent malapposition in 3.7%, stent edge dissection in 4.1%, and tissue prolapse in 10% of the patients.

Conclusion

In this large retrospective study, OCT guided PCI is feasible and OCT-guided PCI has tendency to improve clinical outcomes at six months follow up compared to conventional angiography guided PCI in all comer patients. Abstract Figure. central illustration  Abstract Figure. Identification of PCI complications
Serum uric acid is positively associated with systolic and diastolic blood pressure in young adults
Authors: Correa T , De Oliveira I O
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Science and Technology Department of the Brazilian Ministry of Health.

Introduction

Uric acid is the final product of purine metabolism, and its increase can be related to excessive production or decreased renal excretion. Serum uric acid (SUA) has been positively and independently associated with inflammatory markers, insulin resistance, and cardiometabolic diseases in observational studies, but causal roles remain unclear.1,2

Purpose

The aim of this study is to assess the associations of SUA with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in 22-year-old individuals from a 1993 birth cohort in Brazil.

Methods

During 1993, all live born babies in the city were invited to take part in a prospective study and sub-samples of this cohort were followed-up since then. At the 22-year follow-up, interviews and clinical measurements were performed and non-fasting blood samples were drawn from the participants. SBP and DBP were obtained calculating the mean of two measurements (at the beginning and the end of the interview) using a blood pressure monitoring device. SUA was evaluated by enzymatic-colorimetric assay. The co-variables taken into consideration were cardiometabolic risk factors (body mass index, glucose, and total cholesterol) and behavioral risk factors (excessive alcohol consumption, physical inactivity, and smoking). Sex-stratified linear regressions have been performed and p < 0.05 was considered statistically significant.

Results

The sample was composed of 1660 (47.7%) men and 1822 (53.7%) women of approximately 22 years old. Mean (±SD) SUA (mg/dL) was higher in men (5.2 ± 1.2 vs. 3.9 ± 1.1). The same was observed for SBP (mmHg) [131.6 ± 12.3 vs. 116.9 ± 11.0] and DBP (mmHg) [73.8 ± 8.6 vs. 72.4 ± 8.7]. The adjusted linear regression coefficient (95%CI) between SUA and SBP was 0.014 (0.009; 0.019) for men and 0.015 (0.010; 0.019) for women; both with p < 0.001. The adjusted linear regression coefficient (95%CI) between SUA and DBP was 0.03 (0.023; 0.037) for men and 0.021 (0.015; 0.027) for women; both with p < 0.001. Higher tertiles of SBP and DBP were independently associated with higher SUA concentrations in men and women (p < 0.001) (Table).

Conclusions

In our study, SUA was positively associated with SBP and DBP in men and women independent of potential confounders. This finding reinforces that uric acid is associated with cardiovascular risk factors since early adult age. Abstract Figure.
Normal weight central obesity among Filipinos and its association with cardiovascular diseases: a cross-sectional study
Authors: Toledano B , Yap E M , Vilela G
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Philippine Lipid Atherosclerotic Society

Background

Normal weight central obesity reflects an increased visceral fat and low lean mass hence its association with cardiovascular diseases

Purpose

The study aims to measure the prevalence of normal weight central obesity, to measure its association with cardiovascular diseases and to compare it across the different types of obesity among Filipinos.

Methods

The participants were Filipinos aged 20 years old and above who had participated and completed the desired data in the National Nutrition Survey II which employed a stratified multistage sampling that covered the entire Philippine population. The participants were categorized into the following groups: normal weight (NW) (BMI 18.5-24/9 kg/m²) and no central obesity; normal weight with central obesity (NWCO) (WC ≥80cm or WHR ≥ 0.85 for females, WC≥ 90cm or WHR ≥ 0.90 for males); overweight (OW) (BMI ≥ 25-29.9kg/m²); overweight with central obesity (OWCO); obese (OB) (BMI ≥30kg/m²) and obese with central obesity (OBCO). A Binary logistic regression was utilized to determine the odds ratio (OR) and 95% confidence intervals (CI) for hypertension, diabetes and dyslipidemia.

Results

A total of 5,920 participants (2,883 men and 3,037 women) were analyzed. The prevalence of NWCO was 39.3%. In comparison to NW, the ORs for hypertension (OR = 1.84, 95% CI, 1.58-2.1, p=.001), diabetes (OR = 2.1, 95% CI 1.5-3.0, p=.001), dyslipidemia (OR = 1.3, 95% CI 1.1-1.5, p=.002), in OBCO hypertension (OR = 2.2, 95% CI 1.7,2.8, p<.001), diabetes (OR 2.7, 95% CI 1.8,3.9, p<.001) and in OWCO hypertension (OR = 1.65, 95% CI 1.43-1.9, p=.001), diabetes (OR = 1.58, 95% CI 1.2-2.0, p=.001), dyslipidemia (OR 1.28, 95% CI 1.1-1.5, p=.004) were significantly higher in NWCO

Conclusion

Normal weight central obesity is a common finding among Filipinos and is associated with higher risk of hypertension, diabetes, and dyslipidemia in comparison to obese and overweight with or without central obesity. Abstract Figure. Prevalence and CO vs non CO  Abstract Figure. NWCO versus OBCO and OWCO
Cardiovascular Outcomes Among Older Individuals With Depression Prescribed Amphetamines: A Retrospective Cohort Study
Authors: Latronica James R , Tuan Wen Jan , Clegg Taylor J , Silvis Matthew L , Bone Curtis
Published: February 2022

Background

Prescription amphetamines are utilized for treatment of depression in older adults, yet cardiovascular risks in this population are not well described. The purpose of this study is to evaluate risk of cardiovascular events among adults aged 65 and older with depression who were prescribed amphetamines.

Methods

We conducted a retrospective matched cohort study utilizing the TriNetx database and statistical software. The 1:1 propensity score matching technique was performed using logistic regression to balance the baseline characteristics of the population. Inclusion criteria were a diagnosis of depression and age 65 years and older. We excluded individuals with an adverse cardiovascular event or diagnosis of attention deficit and hyperactivity disorder prior to enrollment. Individuals were followed from January 1, 2018 to December 31, 2020. Those prescribed an amphetamine were considered exposed and others served as controls. We used descriptive statistics and calculated risk ratios to assess the relationship between amphetamine prescriptions and cardiovascular events in these cohorts.

Results

There were 4 434 included in the exposed cohort and 4 434 matched controls in the unexposed group. The cohort exposed to amphetamines had higher high-density lipoprotein along with lower low-density lipoprotein, total cholesterol, hemoglobin A1C, systolic blood pressure, and body mass index than the control group, but increased risk of cardiovascular events (risk ratio: 8.9; 95% confidence interval: 6.39, 12.48).

Conclusions

Amphetamines offer potential benefits to people with depression; however, these data suggest increased risk of cardiovascular events among older individuals. Additional research is warranted to fully characterize risk among subpopulations of older adults and inform patient–provider decision making.
Older Adults in the United States Have Worse Cardiometabolic Health Compared to England
Authors: Pongiglione Benedetta , Ploubidis George B , Dowd Jennifer B
Published: February 2022

Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on “deaths of despair,” but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries.