bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 5592: In Acute Coronary Syndromes Being Totally Revascularized Is As Good As Having A Normal Coronary Angiogram
Authors: Teixeira Rogerio , Lourenco Carolina , Jorge Elisabete , Baptista Rui , Antonio Natalia , Monteiro Silvia , Monteiro Pedro , Freitas Mario , Providencia Luis A 
Published: July 2021

Background: Revascularization is a crucial therapy in acute coronary syndromes (ACS). Purpose: to assess ACS patients outcomes, stratified according to the coronary angiography and/or angioplasty.
Population and methods: 786 consecutive ACS patients submitted to an invasive strategy, divided in 3 groups: A (n=111) normal coronary angiogram; B (n=327) fully revascularized; C (n=348) incomplete revascularization. A 1-year follow up targeting major adverse cardiovascular events (MACE) was performed.
Results: Group A had more females (38.7 vs 21.1 vs 24.4% p<0.01), patients were more admitted for unstable angina (37.3 vs 14.9 vs 17.9% p<0.01) and had a higher left ventricular ejection fraction (LVEF). Group B were more on previous statin therapy, had more often an admission for ST elevation acute myocardial infarction (17.3 vs 51.7 vs 42.4% p<0.001) and higher peak levels of cardiac biomarkers. Group C were older and had more frequently a previous history of coronary disease. Group C patients had a worse in-hospital mortality (1.8 vs 1.2 vs 7.5% p<0.01) and morbidity. The MACE free survival rate was significantly lower for group C (92.9% vs. 92.9% vs. 78.2%; log rank p<0.001). In a multivariate Cox regression analysis, incomplete revascularization remained an independent predictor of MACE at 1 year (HR 2.74, CI 1.50 – 4.94), in a model that included, age, gender, LVEF, diabetes, coronary anatomy, and admission diagnosis.
Conclusion: Our data strongly support the use of an aggressive invasive strategy in ACS, aimed at achieving full revascularization, as these patients had the same medium term prognosis as those with normal coronary angiogram.
Abstract 5605: Real World Comparison of Long Term Mortality after Primary Percutanous Coronary Intervention (PPCI) versus Fibrinolysis for Acute St Elevation Myocardial Infarction: Initial Experience from the 24 Hour PPCI Program in Nova Scotia
Authors: Chan Boniface , Curran Helen , Love Michael P , Fort Stephen 
Published: July 2021

Background Randomized controlled trials indicate that acute ST elevation myocardial infarction (STEMI) patients have better clinical outcomes if rapid, complete and stable coronary artery patency can be achieved. The Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia (QEIIHSC) commenced a 24 hour PPCI program in November 2005. This real world study compares 2 year mortality in STEMI patients treated by PPCI versus patients treated by fibrinolysis with provisional rescue PCI within Nova Scotia, Canada.

Methods This was a single center retrospective cohort study. All consecutive Nova Scotia, fibrinolytic and PPCI eligible STEMI patients presenting within 12 hours of symptom onset between July 1
st
2005 and June 30
th
2006 treated by PPCI at the QEIIHSC or fibrinolyis outside the QEIIHSC were included. The outcome measure was all cause mortality censored on June 30
th
2007. The crude and independent association between PPCI versus fibrinolysis on mortality was estimated using a Cox regression model.

Results Data for 423 eligible patients (100% of cohort) comprised of 359/423 (85%) patients treated with fibrinolytics and 64/359 (18%) treated by PPCI were analyzed. The median follow-up was 1.4 years. The median (Q25 to Q75) door to needle times in the fibrinolytic group and corresponding door to balloon times in the PPCI group were: 0.5 (.3 to .9) and 1.5 (1.1 to 1.9) hours respectively. PPCI was associated with a consistent trend toward lower mortality versus fibrinolysis during hospitalization: 2/64 (3.1%) vs. 29/359 (8.1%), P=0.16 and at 30 days 2/64 (3.1%) vs. 32/359 (15%), P=0.12. This association was significant at 1 and 2 year follow-up: 2/64 (3.1%) vs. 41/359 (11%), P=0.043 and 2/64 (3.1%) vs. 45/359 (12%), P=0.027 respectively. This corresponded with an independent HR for 2 year mortality of: 0.1 (.01 to 0.8), p=0.03.
Conclusion Initial data from the PPCI program at the QEIIHSC in Halifax, Nova Scotia indicates that PPCI was associated significant reductions in mortality versus fibrinolysis for real world patients presenting with STEMI. This mortality reduction was achieved in the early pilot phase of a PPCI program with evolving door to balloon timelines versus an established fibrinolytic program with acceptable door to needle timelines.
Abstract P364: Preliminary Study of the Effects of Coffee Mannooligosaccharides Supplementation on Lipid Profile.
Authors: Tsai Stacy , RoyChoudhury Arindam , O'Keeffe Majella , St-Onge Marie-Pierre 
Published: July 2021

Introduction: Coffee-derived mannooligosaccharides (MOS) have been shown to have prebiotic activity and improve body composition in overweight individuals. However, the effects of MOS consumption on metabolic risk factors have not been studied. The overall goal of this study was to determine the effects of MOS consumption on body composition and metabolic risk factors.
Hypothesis: We hypothesized that the intake of MOS would result in improvements in lipid profile after controlling for changes in body weight.
Design: Two separate randomized, placebo-controlled studies, weight maintenance or weight loss, were conducted to assess the role of MOS for weight management. For each study, participants consumed MOS (4 g/d) or Placebo coffee beverages for 12 wk. Fasting blood samples were taken at baseline and endpoint of both studies. Complete datasets were available for 31 participants who consumed MOS (13 in weight loss study) and 32 (17 in weight loss study) who consumed the Placebo beverage. Regression analysis wasperformed including body weight, age, sex, time and time x beverage interaction as covariates to determine the effects of MOS supplementation on serum lipid levels. The regression analysis was additionally performed on a sub-sample with mildly elevated low-density lipoprotein cholesterol (LDL-C &#8805; 130 mg/dL).
Results: Participants had a mean age (SEM) and body mass index of 45.0 ± 11.3 y and 30.2 ± 2.6 kg/m2. In the whole sample analysis, there was no time x beverage interaction for any of the lipid parameters (all P> 0.05). Total cholesterol (TC) changed by -2.5 ± 15.8% in the MOS group and by -1.0 ± 11.3% in the Placebo group. LDL-C changed by -2.0 ± 30.1% in the MOS group and by -2.2 ± 21.4% in the Placebo group. In the sub-sample analysis (MOS n = 12, Placebo n = 18), there was no time x beverage interaction on TC (MOS-17.1 ± 9.1% vs Placebo -5.6±10.1%, P = 0.197). Similar results were observed for LDL-C (MOS -25.6 ± 14.4% vs Placebo -8.4 ± 17.3%, P = 0.164) and triglycerides (MOS -8.5 ± 100.2% vs Placebo -3.4± 25.9%, P = 0.358).
Conclusions: Our data provide preliminary information on the effects of MOS supplementation on cardiovascular risk profile. Although not significant, our results suggest that MOS consumption may be useful to improve lipid profile in individuals with elevated LDL-C but our sample size was inadequate to affirm this with confidence. Future studies should be specifically designed to determine the effects of MOS supplementation on lipid profiles of at risk individuals.
Abstract P165: The Long-term Effect of a Low-Carbohydrate Diet on Endothelial Dysfunction and Insulin Resistance: A Randomized Controlled Trial
Authors: Hu Tian , Reynolds Kristi , Yao Lu , Bunol Calynn , Liu Yanxi , Chen Chung-Shiuan , He Jiang , Bazzano Lydia 
Published: July 2021

The long-term effects of low-carbohydrate diets versus low-fat diets on endothelial dysfunction and insulin resistance are unclear.
A total of 148 study participants with a body mass index of 30 - 45 kg/m2 (Mean: 35.4 kg/m2) who were free of diabetes, cardiovascular diseases and kidney disease were recruited. The participants were randomly assigned to either a low-carbohydrate diet (<40 g/day; N=75) or a low fat (<30% energy from fat, <10% from saturated fat; N=73) diet. Two 24-hour dietary recalls were conducted at each clinic visit (0, 3, 6 and 12 months of intervention). Participants met with a study dietitian weekly for the first month followed by group settings bi-weekly for 5 months and monthly for the last 6 months. Each group was provided the same behavioral curriculum related to diet emphasizing portion control and eating habits. Biomarkers for endothelial function and insulin resistance included E-selectin, Intercellular Adhesion Molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), Insulin-like growth Factor-1 (IGF-1), serum insulin, and glucose. Mixed-effect regression models including group, time and their interaction were used to analyze the data.
Of the study participants, 60 in the low-fat group (81.1%) and 59 in the low-carbohydrate group (79.7%) completed the entire intervention. The mean age was 46.8 years, 88.5% were women and 55.1% were African-Americans. The low-carbohydrate group lost approximately 3.5 kg more body weight than did the low-fat group (P= 0.002) on average. Compared to the low-fat diet, the low-carbohydrate diet resulted in greater reductions in E-selectin (net change: -4.5, -4.3, and -3.8 ng/mL at 3, 6, and 12 months, respectively; overall P= 0.002) and ICAM-1 (net change: -7.3, -10.4, and -16.8 ng/mL at 3, 6, and 12 months, respectively; overall P= 0.06). There was no significant change in any other markers.
Our findings suggest that the low-carbohydrate is at least as effective as the low-fat diet at improving endothelial dysfunction and insulin resistance.
Abstract P115: How Many Coronary Heart Disease Deaths In Poland In 2020 Might Be Prevented By Further Reductions In Population Risk Factor Levels?
Authors: Bandosz Piotr , Guzman-Castillo Maria , Capewell Simon , Zdrojewski Tomasz , Critchley Julia , Rutkowski Marcin , O'Flaherty Martin 
Published: July 2021

Background:
Poland has experienced one of the most dramatic declines in coronary heart disease (CHD) mortality rates in recent decades. This decline reflects the use of evidence based treatments and, crucially, population wide changes in diet. Our aim is to explore the potential for further gains in Poland by achieving population wide reductions in smoking, dietary salt and saturated fat intake and physical inactivity levels.

Methods:
A validated and updated policy model was used to forecast potential decreases in CHD deaths by 2020 as consequence of lifestyle and dietary changes in the population. Data from the most recent Polish risk factor survey was used for the baseline (2011). We modeled two different policy scenarios regarding possible future changes in risk factors:

A) conservative scenario: reduction of smoking prevalence and physically inactivity rates by 5% between 2011 and 2020, and reduction of dietary consumption of energy from saturated fats by 1% and of salt by 10%.
B) ideal scenario: reduction of smoking and physically inactivity prevalence by 15%, and dietary reduction of energy from saturated fats by 3% and of salt by 30%. We also conducted extensive sensitivity analysis using different counterfactual scenarios of future mortality trends.

Results:
Baseline scenarios. By assuming continuing declines in mortality and no future improvements in risk factors the predicted number of CHD deaths in 2020 would be approximately 13,600 (9,838-18,184) while if mortality rates remain stable, the predicted number of deaths would approximate 22,200 (17,792-26,688). Conservative scenario. Assuming continuing declines in mortality, small changes in risk factors could result in approximately 1,500 (688-2,940) fewer deaths. This corresponds to a 11% mortality reduction. Under the ideal scenario, our model predicted some 4,600 (2,048-8,701) fewer deaths (a 34% mortality reduction). Reduction in smoking prevalence by 5% (conservative scenario) or 15% (ideal scenario) could result in mortality reductions of 4.5% and 13.8% respectively. Decreases in salt intake by 10% or 30% might reduce CHD deaths by 3.0% and 8.6% respectively. Replacing 1% or 3% of dietary saturated fats by poly-unsaturates could reduce CHD deaths by 2.6% or 7.7% Lowering the prevalence of physically inactive people by 5%-15% could decrease CHD deaths by 1.2%-3.7%.

Conclusion:
Small and eminently feasible population reductions in lifestyle related risk factors could substantially decrease future number of CHD deaths in Poland, thus consolidating the earlier gains.
Abstract P284: Social Engagement and Cardiovascular Risk Behaviors: The Multi-Ethnic Study of Atherosclerosis
Authors: Samuel Laura J , Dennison Himmelfarb Cheryl R , Seeman Teresa E , Echeverria Sandra E , Szklo Moyses , Diez-Roux Ana V 
Published: July 2021

Although social engagement is important to health behaviors, prior studies mostly considered only one of multiple different dimensions of it, with inconsistent results. Presence of countervailing or interacting influences of different types of social engagement may account for prior conflicting findings. This study identifies which dimensions of social engagement are associated with risk behaviors of smoking, low levels of physical activity, and a diet poor of fruit and vegetable intake.
Cross-sectional data from 5004 participants, aged 45-84 from the Multi-Ethnic Study of Atherosclerosis was used. Social support was measured using the ENRICHD Social Support Instrument, loneliness with a three item instrument derived from the revised University of California at Los Angeles Loneliness Scale, and neighborhood social cohesion with the instrument from the Project on Human Development in Chicago Neighborhoods. Prevalence ratios of behaviors associated with standardized social engagement variables were modeled with Poisson regression, using robust standard errors.

In unadjusted analyses, higher social support and neighborhood social cohesion were associated with slightly lower prevalence of smoking (prevalence ratio, PR=0.82, 95% CI: 0.77-0.87, and PR=0.91, 95% CI: 0.84-0.98, respectively) and slightly higher likelihood of achieving recommended levels of physical activity (PR=1.04, 95% CI: 1.02-1.07, and PR=1.05, 95% CI: 1.03-1.07, respectively). Higher loneliness was associated with slightly higher prevalence of smoking (PR=1.17, 95% CI: 1.10-1.24) and slightly less physical activity (PR=0.95, 95% CI: 0.93-0.98
)
. Associations of social support and loneliness with smoking, and associations of social support and neighborhood cohesion with physical activity, persisted after adjusting for individual characteristics. After further adjusting for all dimensions of social engagement, only neighborhood social cohesion remained associated with very slightly higher probability of achieving recommended physical activity levels (PR=1.03, 95% CI: 1.01, 1.05), and only social support remained associated with lower prevalence of smoking (PR=0.87, 95% CI: 0.81, 0.94) and higher probability of quitting, amongst those who had ever smoked (PR=1.03, 95% CI: 1.01, 1.06). Social support interacted with loneliness (p for interaction=0.001), such that these associations were present only amongst non-lonely individuals (PR=0.77, 95% CI: 0.69, 0.86). In fully adjusted models, no associations were found for fruit and vegetable intake.

This study is among the first to simultaneously investigate several dimensions of social engagement and their interactions in relation to risk behaviors. Social support is more consistently associated with smoking than other dimensions of social engagement and this association appears to be modified by loneliness.
Abstract P330: Cardiovascular Adipose Depots Of The Heart And Aorta Are Associated With CVD Risk Factors And Vascular Calcification In Women With SLE
Authors: Shields Kelly J , Ahearn Joseph M , Manzi Susan 
Published: July 2021

Introduction:
Women with systemic lupus erythematosus (SLE) are at greater risk of developing cardiovascular disease (CVD), which is not explained by traditional CVD and SLE-related risk factors. Mounting evidence implicates small visceral adipose depots surrounding the heart and vasculature in the pathogenesis of CVD. Previously, we found that women with SLE had a greater volume of aortic perivascular adipose tissue (aPVAT) compared to healthy controls (HC). Here we quantify epicardial (EPI), paracardial (PARA), and total heart (TOT = EPI+PARA) adipose and evaluate their associations with aPVAT, CVD risk factors and coronary artery (CAC) and aortic (AC) calcification.

Design:
Data included clinically CVD-free SLE women never (SLEc-) or ever (SLEc+) on corticosteroids, and healthy controls (HC) (HEARTS cohort). Electron beam CT scans were used to quantify adipose depots and AC/CAC. Logistic and linear regressions were used and final models were adjusted for waist-to-hip ratio.

Results:
In this study, age- and race-matched women participated: 15 SLEc-, 15 SLEc+, and 15 HC. More SLE women had hypertension (p=0.04), elevated circulating eSelectin (p=0.04), albumin (p=0.01), and homocysteine (p=0.02) compared to HC. SLEc+ women had decreased circulating C3 (p=0.04) and C4 (p<0.01) compared to SLEc- women. TOT tended to be greater in SLE (mean(std): 108(92)cm3, p=0.07) vs. HC (85.2(30) cm3) and in SLEc+ (122(45) cm3,p=0.06) vs. vs SLEc- (93.5(32) cm3). There were no differences in EPI (p=0.2) or aPVAT (p=0.3), but PARA was greater in SLEc+ (54.2(27) cm3) vs. SLEc-(36.9(19) cm3) (p=0.05).

TOT was correlated with aPVAT in SLE (rho,p: 0.47, 0.01) and HC (0.69, <0.01) with PARA volume (SLE(0.43, 0.02) and HC (0.57, 0.03)) driving this association. In HC, EPI and PARA were correlated with insulin (p<0.03) and HOMA-IR (p<0.04) while PARA was correlated with CRP (p=0.04). Glucose levels were correlated with EPI in SLEc+ (0.53, 0.04) and with PARA in SLEc- (-0.55, 0.03).
AC was detected in 21/28 SLE women and 11/15 HC while CAC was detected in 13/28 SLE and 4/15 HC. Only aPVAT was associated with increasing AC (OR(95%CI),p): 1.09 (1.0-1.2), 0.04) and CAC (1.11 (1.0-1.2), 0.03) in SLEc+. In adjusted models, only aPVAT(log) remained associated with greater extent of AC in SLE(β(SE),p: 2.90(1.3), 0.04), which was driven by SLEc+ (5.13(1.8), 0.02) women.

Conclusion:
Adipose depots surrounding the heart and vasculature are greater in clinically CVD-free women with SLE and specifically SLEc+, with significant associations among CVD risk factors and calcification dependent on their location. Corticosteroid treatment may suppress circulating inflammatory markers, but is associated with greater adipose volumes surrounding the heart and increased calcification. Just as AC generally precedes CAC development, aPVAT may be a precursor to extensive PARA and EPI development, with PARA more strongly associated.
Abstract P354: Elevated Adiponectin And Tnf-alpha Levels Are Markers For Gluten And Lectin Sensitivity
Authors: Gundry Steven R 
Published: July 2021

Adiponectin is a protein hormone secreted by adipose cells and is thought to be a precursor for the inflammatory cytokine TNF-alpha. Although low levels of Adiponectin are associated with visceral adiposity and high levels with weight loss, there is a strong association of elevated Adiponectin and TNF-alpha levels in thin women with dementia, osteopenia, and/or coronary artery disease. This paradox led us to consider that these biomarkers correlated to sensitivity to the plant defense proteins: gluten and other lectins.
We studied serial Adiponectin and TNF-alpha levels every 3 months in 1,000 pts, M:F ratio 1:1 in response to a lectin and gluten elimination diet (The Matrix Diet). All samples were sent to a core lab (Singulex, Alameda, CA). The diet consisted of avoidance of grains, sprouted grains, pseudo-grains, beans and legumes, soy, peanuts, cashews, nightshades, melons and squashes, and non-Southern European cow milk products (Casein A1), and grain and/or bean fed animals.
Eight hundred pts (80%) related some history of autoimmune disease (AID) personally or among family members, including Hashimotos thyroiditis, IBS, arthritis, RA, Lupus, Crohns, colitis, GERD, CAD, Type 1 DM.
Adiponectin levels were elevated in all 800 pts with family hx or personal history of AID (16.6-83 ug/ml)(nl<16.5). TNF-alpha levels were elevated in 760/800pts with AID hx (95%) (>3.0 pg/mL). In contrast, Adiponectin was normal in 200 remaining pts without AID history (<16.5 ug/ml), while TNF-alpha was normal in 100/200 (50%) of pts without AID.
When the lectin and gluten free diet was instituted, all TNF-alpha levels became normal in all 1,000 pts (<3.0 pg/mL), within 6 months and remained normal, if the diet was followed, for up to one year of study. However, despite normal TNF-alpha levels, Adiponectin levels remained elevated in 790/800 pts with AID hx. Late lack of adherence to the diet occurred in 56/1,000 pts (6%) (as determined by questionnaire) resulted in re-elevation of TNF-alpha in 56/56 pts (100%).
We conclude that elevated Adiponectin is a marker for lectin and gluten sensitivity, while TNF-alpha can be used as a marker for gluten/lectin exposure in sensitive individuals. These findings probably explain the Adiponectin paradox. TNF-alpha levels appear to be useful as a marker of response to a lectin/gluten limited diet, and as a marker for degree of adherence to such a diet.