bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 3342: Adequacy of Inclusion of Post-Procedural Bleeding in a Composite End Point for Assessment of Outcome After Percutaneous Coronary Intervention.
Authors: Schulz Stefanie , Ndrepepa Gjin , Mehilli Julinda , Iijima Raisuke , Bruskina Olga , Berger Peter B , Schömig Albert , Kastrati Adnan 
Published: July 2021

Objective: To assess the adequacy of inclusion of post-procedural bleeding in a quadruple composite end point for the prediction of mortality after percutaneous coronary intervention (PCI).
Methods: This study included 5384 patients from 4 ISAR randomized trials on the value of abciximab: ISAR-REACT, ISAR-SWEET, ISAR-SMART 2 and ISAR-REACT 2. Common inclusion criteria were the presence of native coronary artery disease requiring PCI and pretreatment with 600 mg of clopidogrel at least 2 hours prior to the intervention. Patients were randomized to receive either the standard dose of abciximab plus unfractionated heparin or placebo plus unfractionated heparin. Bleeding was defined according to the Thrombolysis in Myocardial Infarction (TIMI) criteria. Primary end point was one-year mortality.

Results: Within the first 30 days there were 314 myocardial infarctions (5.8%), 52 urgent revascularizations (1.0%) and 215 TIMI major or minor bleeding (4.0%). One-year mortality was 3.6% (n=197). Table

shows one-year mortality among patients with or without 30-day adverse events (myocardial infarction, urgent revascularization or bleeding). Cox proportional hazard model that included all of the 3 adverse events along with baseline characteristics of the patients showed that 30-day myocardial infarction, urgent revascularization or bleeding were all independently associated with one-year mortality with adjusted hazard ratios displayed in the table

. The prognostic value of bleeding was not dependent on its classification as major or minor.

Conclusion: Our study supports the inclusion of post-procedural bleeding in a quadruple end point along with death, myocardial infarction and urgent revascularization to assess outcome after percutaneous coronary intervention.

Table.
Abstract 3422: Absolute Myocardial Blood Flow Imaging At 3 Tesla: Comparison With 1.5 Tesla
Authors: Christian Timothy , Bell Stephen P , Frankish Mei Lee L , Whitesell Lawrence 
Published: July 2021

First-pass (FP) MR myocardial perfusion (perf) imaging can quantify absolute myocardial blood flow (MBF) but images are of low signal at conventional field strength. Purpose: To determine the accuracy of absolute FP MBF measures at 3 Tesla and compare these measures with FP 1.5T using MBF by microspheres (mcsp) as the gold-standard.
Methods: A pig model was used to alter MBF in a coronary artery during FP MRI (intracoronary adenosine followed by ischemia). This produces an active zone with a range of MBF and a control zone. Mcsp were injected into the left atrium with concurrent reference sampling. FP MR perf imaging was performed at 1.5T (n=8) or 3.0T (n=7) using a saturation-recovery gradient echo sequence in short-axis slices (SAX) during a bolus injection of 0.025mmol/kg gadolinium-DTPA. Fermi function deconvolution was performed on active and control ROI from SAX slices with an arterial input function from the LV cavity. These MR values of MBF were matched to mcsp values obtained from SAX slices at pathology.

Results: Occlusion MBF was 0.22±.26 ml/min/g, adenosine MBF was 2.11±1.13 ml/min/g and control zone MBF was 0.70±0.22ml/min/g. The correlation of MR FP MRI with mcsp is shown in Figure 1

: 3T) r=0.95, p<0.0001, 1.5T, r=0.94, P<0.0001. The 95% confidence limits were slightly narrower at 3T (3T=0.41ml/min/g, 1.5T=0.55ml/min/g, p=NS. FP MRI characteristics were better at 3T (noise, SNR, contrast enhancement all superior at 3T). In zones where MBF<0.50ml/min/g, the correlation with mcsp was closer at 3T (r=0.55 at 1.5T, r=0.85 at 3T).

Conclusion: Absolute MBF by FP perfusion imaging is accurate at both 1.5 and 3T. Signal quality is better at 3T which may confer a benefit in low MBF zones.
Abstract 3428: Presence Of Renal Simple Cysts Is Associated With Increased Risk For Abdominal Aortic Aneurysm
Authors: Song Bong Gun , Jang Shin Yi , Park Yong Hwan , Lee Sang Yeub , Choe Yeon Hyeon , Do Young Soo , Kim Dong Ik , Kim Young Wook , Sung Jidong , Kim Duk-Kyung 
Published: July 2021

Background : An increased prevalence of abdominal aortic aneurysm (AAA) has been demonstrated in patients with emphysema or inguinal hernia. Therefore, it has been suggested that the cause of AAA is a degenerative disorder of the connective tissue that can not always be explained by means of atherosclerosis. We hypothesized that the presence of renal simple cysts, another possible manifestation of connective tissue weakness, is associated with the increased risk for AAA. We compared incidence of renal simple cyst between the group of patients with AAA and healthy control group.
Methods : We reviewed 279 patients with AAA and 1397 healthy control group who underwent abdominal computed tomography as a routine health screening from 1994 to 2006 in Samsung Medical Center. AAA was defined as an aortic diameter equal to or greater than 40 mm. Comparisons between groups were made for established risk factors for AAA.

Results : AAA group has significantly more diabetes, smoking, history of anti-hyperlipidemic medication, hypertension, metabolic syndrome, higher systolic blood pressure than control group (all
p
values <0.0001). In the univariate analysis, prevalence of renal cysts (
p<
0.0001), bilateral renal involvement of cysts (
p<
0.0001), number of renal cysts (
p<
0.0001), and sum of sizes of renal cysts (
p<
0.0001) were significantly higher in AAA group as compared with control group. In the multivariate analysis, a person with renal cyst was more likely (OR: 4.379, CI: 3.402–5.636) to have AAA after adjustment for age, gender, smoking, hypertension, diabetes, HDL and LDL cholesterol. This relationship was similar for bilateral renal involvement of cysts, number of renal cysts, and sum of sizes of renal cysts. Neither a diameter nor an expansion rate of AAA was associated with the size of renal cysts.

Conclusion: Patients with AAA have increased burden of renal simple cysts compared to healthy control group. The structural weakness predisposing for renal simple cysts may be associated with the initiation of AAA formation. Prospective study is needed to determine whether the presence of renal cysts can be considered as a risk factor of AAA.
Abstract 3444: The Effect of Alpha Lipoic Acid on Porcine Coronary Stent Restenosis
Authors: Jeong Myung Ho , Bae Eun Hui , Lim Sang Yup , Moon Jae Youn , Kim Ju Han , Ahn Young Keun , Hong Young Joon , Cho Jeong Gwan , Kang Jung Chaee 
Published: July 2021

Objective: We evaluated the ability of alpha lipoic acid (ALA) to affect on coronary instent restenosis (ISR) in a porcine model.
Methods:

In vitro experiment: We stimulated porcine VSMC using G-CSF in the presence or absence of ALA. Activation of Akt, vascular endothelial growth factor (VEGF), extracellular signal-regulated kinase (ERK) and signal transducer and activator of transcription (STAT)-3 were determined using western blot. And also, cell proliferation and migration assay were determined.

In vivo experiment:Balloon overdilation injuries were performed in 2 coronary arteries in 12 pigs. Four weeks after the balloon overdilation injury, 24 bare metal stents were placed for 24 injured coronary arteries. We randomized into two groups (12 stents per group; control group: aspirin and clopidogrel only, ALA group: aspirin and clopidogrel plus 100 mg/kg ALA during 4 weeks).

16 bare metal stents were implanted randomized two coronary arteries in 8 pigs. Group I was control stent group (n=8), Group II was ALA coated stent group (n=8). Follow-up coronary angiogram (CAG) and histopathologic assessment were performed at 4 weeks after stenting.

Results:

G-CSF increased the phosphorylation of ERK and STAT-3, but after pretreatment of ALA, the phosphorylation of ERK and STAT-3 were significantly reduced.

On histopathologic analysis, injury score, internal elastic lamina(IEL) area did not differ significantly between the two groups. The neointimal area was 7.3±0.9 mm2 in control group and 2.2±1.1 mm2 in ALA group (p<0.001), and the histopathologic area of stenosis(AS) was 75.9±8.5 % in control group, 23.5±10.5 % in ALA group (p<0.001).

The injury score and IEL area were not significantly different between the two groups.

The neointimal area was 7.4±1.1 mm2 in control group and 1.4±0.8 mm2 in ALA group (p<0.001), and the AS was 77.6±10.9 % in control group, 15.6±7.6 % in ALA group (p<0.001). The number of inflammatory cells within neointima was lower in ALA group (63.2±23.7 % vs. 17.6±11.6 %, p<0.001).
Conclusion: ALA inhibits the activation of ERK, STAT-3 and proliferation of VSMC. Both high dose of oral ALA and ALA coated stents inhibit neointimal hyperplasia in a porcine ISR model
Abstract 3457: Methylenetetrahydrofolate Reductase Gene Polymorphism C677T And The Risk Of Premature Myocardial Infarction With “Normal” Coronary Arteries.
Authors: Rallidis Loukianos , Komborozos Christoforos , Gialeraki Argyri , Zolindaki Maria , Vavoulis Panagiotis , Papadopoulos Kostas , Travlou Anthi , Kremastinos Dimitrios 
Published: July 2021

Purpose: the pathogenetic mechanism of acute myocardial infarction (AMI) in young patients remains unknown. We explored the impact of homocysteine and its main genetic modulator

Table 2

methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in patients who sustained AMI under the age of 36 years.

Methods: we recruited 136 consecutive patients who had survived their first AMI before the age of 36 years (mean age=32 ± 3.1 years, range 23–35 years, 121 men). Blood was taken for lipids and homocysteine levels within 12 hours from admission. The MTHFR C677T polymorphism was also determined with polymerase chain reaction. All patients underwent cardiac catheterization. One hundred-three healthy individuals without a family history of coronary heart disease (CHD), matched for age and sex served as controls.
Results: coronary angiogram revealed significant CHD in 104 patients while 32 (23.5%) had no significant CHD. The prevalence of homozygotes for C677T polymorphism [T/T genotype] was 27.2% in patients and 14.6% in controls (p=0.02). In the subgroup of patients who had AMI and “normal” coronary arteries the frequency of homozygotes was 43.8% (p=0.001 versus controls and p=0.02 versus patients with significant CHD). The table presents lipids and homocysteine levels in AMI patients with “normal” coronary arteries and controls. Logistic regression model showed that the odds ratio for a young individual with T/T genotype to develop AMI with “normal” coronary arteries was 5.2 (confidence interval 1.2–23, p=0.03) adjusted for smoking habits, body mass index, hypertension and diabetes mellitus.
Conclusions: the presence of homozygocity for MTHFR C677T polymorphism is associated with 5-fold higher risk for premature AMI with “normal” coronary arteries. This suggests that homocysteine may be involved in the formation of an obstructive thrombus in coronary arteries, especially in young individuals without significant underlying atheromatic burden.
Abstract 3488: Hyperuricemia and the Risk of Isolated Hypertension among Young People without Cardiovascular and Metabolic Risk Factors: The CARDIA Study
Authors: Krishnan Eswar , Choi Hyon K , Kuller Lewis H , Liu Kiang 
Published: July 2021

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far.
METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up.
RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49).
CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.
Abstract 3791: Improved Ventricular-Arterial Coupling After 4 Weeks of Exercise Training in Patients with Chronic Heart Failure
Authors: Sandri Marcus , Gielen Stephan , Mangner Norman , Adams Volker , Erbs Sandra , Linke Axel , Hambrecht Rainer , Schuler Gerhard C 
Published: July 2021

Background: The concept of ventricular-arterial coupling implies that LV-function is determined by the three factors left ventricular diastolic, left ventricular systolic and arterial elastance. We have previously documented an improvement in endothelial function and systolic LV-function in patients with chronic heart failure (CHF) after 6 months of exercise training (ET). It remains, however, unclear, how shorter ET periods may affect endothelial, systolic and diastolic ventricular function as echocardiographic parameters related to ventricular arterial coupling in patients with CHF.

METHODS: In this ongoing study we randomised 43 patients with stable CHF (age 60.3 ± 2.9 years, EF 27.4 ± 1.7%, VO
2
max 14.7 ± 4.3ml/kg*min) to a training or a control group (C). Patients in the training group exercised 4 times daily at 70% of the individual heart rate reserve for 4 weeks under supervision. At baseline and after 4 weeks the E/A ratio and septal/lateral E’/A’ velocities were determined by echocardiography with tissue Doppler. Exercise capacity was measured by ergospirometry and flow-mediated dilatation (FMD) was assessed by high-resolution radial ultrasound.

RESULTS: After only 4 weeks of ET oxygen uptake at peak exercise increased from 14.9 ± 3.3 to 18.1 ± 4.7 ml/min/kg, (p<0.01 vs. C) in training subjects. Left ventricular ejection fraction improved from 26.8 ± 4.6 to 33.1 ± 5.5% (p<0.05 vs. C) in patients of the training group while it remained unchanged in the control group. E/A-ratio mended from 0.63 ± 0.12 to 0.81 ± 0.22 (p<0.01 vs. C) in training patients. Septal E’ velocities increased from 5.5 ± 0.5 to 7.8 ± 1.4 cm/s in training patients (p<0.05 vs. C). FMD of the radial artery improved from 8.2 ± 2.1 to 15.2 ± 3.8% (p<0.01 vs. C) as a result of ET.
CONCLUSIONS: Only 4 weeks of endurance training are highly effective with significantly improved FMD accompanied by an emended systolic and diastolic LV-function. We hypothesise that the improvement in LV-EF in training patients may be caused by a corrected ventricular-arterial coupling: ventricular diastolic relaxation and effective endothelial function are ameliorated resulting in an augmentation of stroke volume.
Abstract 52: An Evidence Based Animal Model Of Prolonged Ventricular Fibrillation Cardiac Arrest
Authors: Mader Timothy J 
Published: July 2021

Background: Promising basic science findings in cardiac resuscitation often do not translate into improved outcomes when studied in humans. One explanation is that the current animal models do not adequately reflect the out-of-hospital cardiac arrest (OHCA) clinical trial environment. The author sought to review the literature and devise a new model of prolonged VF with time intervals that more accurately simulate OHCA conditions.
Methods: A systematic review of the literature (01/90 –12/06) was conducted using PUBMED and a comprehensive list of appropriate MESH headings. All OHCA human clinical trials were included. The most relevant studies underwent explicit and detailed review. Mean values with 95%CI were calculated for each specified interval. Suitable conditions and establishment of appropriate times were then devised.
Results: Twenty-two papers with adequate detail for evaluation were examined, leading to the following recommendations: the duration of non-treatment (assuming no bystander CPR or first-responders) is 11” (3” for recognition and EMS activation, 7” response interval and 1” for paramedics to reach the patient); chest compressions are initiated immediately with passive oxygen insufflation; assuming they can be done simultaneously, IV access and intubation (ETI) are accomplished 4” after arrival; drugs are delivered by minute 16 - well into the metabolic phase; and 2” of CPR are needed to circulate the drugs for the first rescue shock (RS) at minute 18.
Conclusions: This proposed evidence based experimental model of prolonged untreated VF cardiac arrest has conditions and time intervals that simulate those of human OHCA clinical trials.
Abstract 5825: Association between Patterns of FDG Uptake and Arterial Wall Calcification on PET/CT and Atherogenic Risk Factors in Healthy Subjects
Authors: Narumi Hiroya , Yoshida Katsuya , Funabashi Nobusada , Hashimoto Naotake , Umehara Isao , Yoshida Shouji , Komuro Issei 
Published: July 2021

Background: Augmented metabolic activity of macrophages leads to enough F-18 Fluorodeoxyglucose (FDG) uptake to allow visualization by positron emission tomography (PET). A large body of data, based on computed tomography (CT), has also accumulated concerning the relevance of vascular calcification to the atherosclerotic process. FDG PET/CT can localize both inflammatory changes and vascular calcification. The purpose of this study was to investigate risk factors contributing to these changes in the aorta in healthy subjects.
Materials and Methods: A total of 66 consecutive healthy subjects (44 men, 22 women; age range, 30–82 years, mean age, 55.8 years) participating in a health check protocol including FDG PET/CT were evaluated retrospectively. We placed regions of interest on the arterial wall to measure FDG uptake by PET images. To assess arterial calcification, the calcium score of the aorta was measured on CT images.
Results: FDG uptake was observed most commonly in proximal, followed by descending, thoracic, and abdominal segments. On the other hand, the most common site of vascular calcification was the descending thoracic aorta, followed by abdominal and, proximal segment. Whole aortic calcification (total calcium score of the whole aorta) was significantly correlated with age (r= 0.353, P= 0.004). On the other hand, FDG uptake (total SUV max of the whole aorta) was significantly correlated with systolic blood pressure (SBP) (r= 0.303, P= 0.013), triglyceride (TG) (r= 0.281, P= 0.022), fasting plasma glucose (FPG) (r= 0.317, P= 0.010), HbA1c (r= 0.433, P< 0.001), visceral abdominal fat area (r= 0.319, P= 0.005), and was negatively correlated with high density lipoprotein (HDL) (r= −0.317, P= 0.010), and adiponectin (r= −0.273, P= 0.029).
Conclusions: Aortic calcification was significantly correlated with age. On the other hand, FDG uptake was significantly correlated with the components of metabolic syndrome such as SBP, TG, FPG, HbA1c, visceral adipose fat area and negatively correlated with HDL and adiponectin, but not with age. Our results may suggest that the components of metabolic syndrome and aging affect the progression of atherosclerosis differently.
Abstract P78: Teaching Basic Life Support to School Children in Northern Ireland Using the ’ABC for life’ Programme
Authors: Toner Philip , Connolly Michael , McGrath Patrice , Laverty Leanne , Connolly David , McCluskey David 
Published: July 2021

Aims: Northern Ireland has one of the highest incidences of ischaemic heart disease in the world. Teaching BLS to school children has previously been recommended. Our aim was to assess if eleven year old children can aquire and retain knowledge of basic life support (BLS) skills six months after a course of instruction (Study 1) and to assess the effectiveness of a three tier ‘peer training’ model using medical students, teachers and pupils (Study 2). This would be a cost effective way of significantly decreasing mortality from out-of-hospital cardiac arrests.
Methods: The ‘ABC for Life’ programme is a regional course in BLS training in Northern Ireland specifically designed for 10 –12 year old school children. Medical students are trained as instructors in BLS by cardiac resuscitation officers at a major teaching hospital. Children were given a 22 point questionnaire before training and immediately after training to assess acquisition of BLS, and again six months after training to assess retention of knowledge (Study 1). In study 2, medical students instructed teachers how to teach BLS to their pupils. Pupils were given the same questionnaire to assess knowledge of BLS immediately before and after a teacher led training session at their school.
Results: Study 1: Children showed a highly significant increase in knowledge following the training session (46.8% vs 82.7%, p<0.001). Six months later their knowledge remained significantly higher than that of a control group who had never been trained (61.1% vs 46.8%, p<0.01). Study 2: Thirty eight teachers were trained from one education board. The first five children trained at each school were randomly selected. Questionnaires were returned for 44.7% pupils at baseline and 42.1% pupils after training. Mean baseline scores improved significantly after training (57.2% vs 77.7%, p<0.001).

Conclusion
These studies demonstrate that by using medical students and teachers, a large number of children can be trained in a short time period and at relatively low cost. Children can acquire and retain knowledge of BLS for at least six months. The initiative provides manikins and training resources to all schools. To date, the programme has trained 350 schools. We have commenced research of physical skills using a recordable mainikin.