bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 5695: Arrhythmogenic Cardiac Death in Implantable Cardioverter Defibrillator Recipients: A Long-term Study of 783 Consecutive Patients
Authors: Duray Gabor Z , Schmitt Jörn , Goβ Stefanie , Berkhoff Panja , Khattar Patrick , Cicek-Hartvig Sule , Israel Carsten W , Hohnloser Stefan H 
Published: July 2021

Introduction: Long-term mortality and cause of mortality of ICD recipients who are not enrolled in controlled clinical trials are not well known. This study seeked to determine cause-specific mortality in a large sample of unselected ICD recipients.
Methods: Consecutive ICD recipients followed at a tertiary referral center at regular 3-month intervals were included. In cases of missed visits, pts, their relatives and their family physicians were contacted. Based on all available evidence, causes of death were classified as cardiac arrhythmic (C–A), cardiac non-arrhythmic (C-NA), non cardial (non-C) and unknown.

Results: A total of 783 pts (primary prevention of sudden death in 252, secondary prevention in 531) were followed for 43 ± 30 months, during which time 193 pts died (24.7%, annual mortality 6.7%). Causes of death are shown in the figure

. Cox regression analysis revealed that all-cause morality was significantly affected by age (odds ratio 1.03, 95% confidence interval 1.01–1.05), LVEF (0.98, 0.96 – 0.99), NYHA > II (2.1, 1.35–3.26) at baseline, while ICD indication and development of electrical storm had no independent impact on all cause mortality. Predictors for arrhythmic mortality were LVEF (0.96, 0.91– 0.99), NYHA > II (5.3, 1.4 –19.6) spontaneous VT (9.9, 2.1– 45.2) or inducible VT (9.5, 2.0 – 44.2) as indication for ICD therapy.

Conclusion: In this unselected group of ICD recipients the mortality over 3.5 years was 25 %. Despite device therapy, at least 14% of patients died from presumably arrhythmic causes. Risk factors associated with arrhythmic mortality were a history of spontaneous or inducible monomorphic ventricular tachycardia, LVEF and higher NYHA class.
Abstract 5754: Cardiac CT Angiography vs. SPECT Perfusion Imaging for the Evaluation of Patients with Acute Chest Pain
Authors: Rogers Ian S , Moloo Jamaluddin , Chae Claudia U , Blankstein Ron , Bamberg Fabian , Pena Antonio J , Seneviratne Sujith K , Truong Quynh A , Nichols John H , Ferencik Maros , Brown David F , Nagurney John T , Brady Thomas J , Hoffmann Udo 
Published: July 2021

BACKGROUND: Over 5 million individuals present to EDs with acute chest pain each year, many of which are hospitalized for serial EKGs and cardiac enzymes followed by stress SPECT imaging. A potential alternative to SPECT is cardiac CT, which provides for the immediate and direct evaluation of coronary artery patency. We sought to determine the concordance between these modalities and the ability of CT to exclude ischemia in patients presenting with acute chest pain.
METHODS: We enrolled 368 subjects without a history of hemodynamically significant CAD who presented to the ED with acute chest pain yet had negative initial EKGs and cardiac enzymes. All subjects underwent 64-slice cardiac CTA, the results of which were blinded to caregivers, then were admitted for standard care including diagnostic testing, as deemed clinically warranted by the caregivers. CTA exams were scored as being diagnostically positive or negative for significant stenosis (>50% luminal narrowing) or as non-diagnostic. SPECT exams were scored as diagnostically pos or neg for ischemia or scar or as non-diagnostic (e.g., secondary to submaximal workload or artifact).
RESULTS: 151 of the 368 subjects (54±11 yrs, 56% men) had an exercise (n=109), adenosine (n=41), or dobutamine (n=1) SPECT exam as part of their clinical care. 115 (76%) of the SPECT exams were read as diagnostic (7 pos for ischemia, 2 pos for scar, and 106 neg), while 36 (24%) were non-diagnostic. In contrast, 135 of the 151 (89%) of the CT exams were read as diagnostic (17 pos, 118 neg), while only 16 (11%) were non-diagnostic (p <0.001). Among the 105 patients that had both diagnostic CT and SPECT exams, there was agreement between the modalities in 97/105 (92%) of patients. With SPECT defined as the standard for detecting ischemia, absence of significant stenosis on a diagnostic CT had a 98% NPV for excluding ischemia.
CONCLUSION: Cardiac CT appears to be as feasible as SPECT imaging in patients with acute chest pain but inconclusive initial ED evaluation and may have a lower rate of non-diagnostic exams. Consistent with the known high NPV of CCT, absence of significant stenosis on cardiac CT predicted the absence of SPECT based ischemia in 98% of subjects. Thus, cardiac CT may be sufficient to exclude ischemia in patients with acute chest pain.
Abstract P357: The Impact of Dietary and Metabolic Risk Factors on Cardiovascular and Diabetes Mortality in South Asia: An Analysis from the 2010 Global Burden of Disease (GBD) Study
Authors: Yakoob Mohammad Yawar , Micha Renata , Khatibzadeh Shahab , Afshin Ashkan , Shi Peilin , Singh Gitanjali , Ezzati Majid , Mozaffarian Dariush , On behalf of Global Burden of Diseases, Injuries,and Risk Fa  , Nutrition and Chronic Diseases Expert Group  ,   Metabolic Risk Factors of Chronic Diseases Collaborating Group
Published: July 2021

BACKGROUND: Cardiometabolic diseases are rising in South Asia. The impact of modifiable diet and metabolic risk factors on mortality due to these diseases has not been quantified for this region using consistent methodology.
OBJECTIVE: To estimate disease-specific mortality effects of major diet and metabolic risk factors by age and sex in South Asia.

METHODS: We used a comparative risk assessment analysis (CRA) framework, developed as part of the 2010 GBD study, for six countries of the region (India, Pakistan, Bangladesh, Afghanistan, Nepal, Bhutan). The current national risk factor exposure distribution for these countries was obtained from systematic literature searches of nationally representative surveys and direct author contact. We identified 8 surveys for diet and 50 for metabolic risks. The likely causal effect sizes of risk factor-disease relationships (RRs) were derived from meta-analyses of trials or epidemiological studies. Plausible optimal alternative exposure distributions were identified from other global studies or regions, and total disease-specific deaths were obtained from 2008 WHO data. Missing exposure data were imputed using multi-level hierarchical Bayesian models with time varying covariates. Inputs were combined to compute population attributable fractions and mortality preventable from these risks. We performed sensitivity analyses by varying choice of exposure metrics, causal effect sizes, and alternative distributions. Updated GBD estimates for smoking and physical activity are in progress. RESULTS: Among metabolic risks, high systolic blood pressure and high BMI produced the highest number of preventable cardiometabolic deaths in South Asia in 2008 in both men and women (
Figure
). Other risks, including fruits also contributed to a substantial number of deaths.

CONCLUSIONS: Use of CRA methods allows quantification of the impact of specific modifiable risk factors on disease, informing health policy and priority setting to improve diet and lifestyle in people of South Asia.
Abstract P360: The Impact of Dietary and Metabolic Risk Factors on the Burden of Cardiovascular Diseases and Diabetes in the Middle East and North Africa; An Analysis from the 2010 Global Burden of Diseases, Injuries, and Risk Factors: Nutrition and Chronic Diseases Expert Group, and Metabolic Risk Factors of Chronic Diseases Collaborating Group
Authors: Afshin Ashkan , Micha Renata , Khatibzadeh Shahab , Fahimi Saman , Shi Peilin , Singh Gitanjali , Yakoob Mohammad Y , Ezzati Majid , Mozaffarian Dariush 
Published: July 2021

BACKGROUND: The burden of CVD and diabetes is rapidly increasing in the Middle East and North Africa. However, the impact of major dietary and metabolic risk factors on CVD and diabetes has not yet been quantified in this region.
OBJECTIVE: To quantify the CVD and diabetes mortality attributable to non-optimal diet and metabolic risk factors in the Middle East and North Africa.
METHODS: We used a comparative risk assessment framework to estimate the number of disease-specific deaths attributable to 14 dietary and 4 metabolic risk factors by age and sex. The specific inputs we assessed for this analysis included the current national exposure distribution, the etiological effect of risk factor on disease-specific mortality, the alternative exposure distribution associated with the lowest possible disease risk, and the total number of disease-specific deaths in the population. We obtained these inputs as a part of our work in the 2010 GBD study. Using a multi-level hierarchical Bayesian model, we imputed missing exposure data based on non-missing exposure data from other regions and available data on other characteristics in the region or country with the missing data of interest. The first three inputs were used to compute the disease-specific Population Attributable Fraction (PAF) for each dietary and metabolic risk factor. Disease-specific mortality was determined using the PAF and the fourth input. The robustness of the findings was evaluated by their sensitivity to varying assumptions, including likely effect sizes and feasible optimal levels.

RESULTS: In 2008, overweight/obesity and high fasting plasma glucose were responsible for 123,000 and 107,000 cardiometabolic deaths, respectively, in the Middle East and North Africa. Other dietary and metabolic risk factors also caused a substantial number of deaths in this region (
Figure
).

CONCLUSIONS: Our findings inform priorities for policy measures to improve diet and reduce metabolic risk factors to prevent CVD and diabetes in the Middle East and North Africa.
Abstract MP85: Lifestyle and Biologic Factors and Risk for Recurrent Coronary Heart Disease Events
Authors: Booth John N , Levitan Emily B , Brown Todd M , Farkouh Michael , Safford Monika , Muntner Paul 
Published: July 2021

The 2011 American Heart Association guidelines recommend lifestyle modification and risk factor management for secondary coronary heart disease (CHD) prevention. We determined the association of lifestyle behaviors and clinical management risk factors with recurrent CHD events among participants with electrocardiographic evidence or self-reported CHD history from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=30,239). Ideal health factors (normal waist circumference, physical activity ≥4 times/week, DASH diet adherence, not smoking, systolic/diastolic blood pressure (BP) < 120 / 80 mmHg and LDL-cholesterol (LDL-C) < 70 mg/dL) were assessed through questionnaires and an in home study visit.
Of the 4,174 REGARDS participants with CHD history, the mean age was 68.8 (SD=8.9) years, 35.1% were women and 34.1% were black. Over a median follow up of 4.3 (maximum=6.9) years, 447 (10.7%) participants had a nonfatal or fatal recurrent CHD event. After adjustment for demographics, clinical factors, and co-morbid conditions, participating in physical activity ≥4 times/week versus no activity and not smoking versus current smoking were associated with a reduced risk for recurrent CHD events (hazard ratio [95% confidence interval] 0.48 (0.34-0.68) and 0.45 (0.35-0.56), respectively). In contrast, DASH diet consistency, normal waist circumference, LDL-C and normal BP were not associated with statistically significant reductions in risk for recurrent CHD events. More ideal health factors were associated with a lower risk for recurrent CHD events (Figure). The hazard ratio for each additional ideal health factor was 0.76 (95% CI: 0.69-0.84). If these observations are causal, then if all people with established CHD participated in physical activity 4+ times/week and did not smoke, 40.5% (95% CI: 11.0-63.4) of recurrent CHD events could be avoided.
This analysis suggests that secondary prevention to lower the risk of recurrent CHD events should emphasize physical activity and smoking cessation.
Abstract P173: Community Engagement Makes for Recruitment Success into a Randomized Controlled Intervention Trial for Deaf Adults
Authors: Lowenstein Lisa M , DeWindt Lori , Sutter Erika , Barnett Steven , Pearson Thomas A ,   National Cntr for Deaf Health Rsch
Published: July 2021

The majority of Americans are either overweight or obese, including Deaf adults who use American Sign Language (ASL). Together, Deaf community members and researchers at the Rochester Prevention Research Center: National Center for Deaf Health Research (NCDHR) in Rochester, NY, identified obesity as a top health priority and chose to adapt a healthy lifestyle intervention for Deaf adults.
Since this is one of the few healthy lifestyle interventions involving the Deaf community, we wanted to learn more about recruiting Deaf adults to participate in a healthy lifestyle intervention. Thus, we explored different recruitment strategies to learn what worked to recruit Deaf individuals into a 16-week healthy lifestyle intervention, Deaf Weight Wise (DWW), delivered by a Deaf counselor who uses ASL. Prior to DWW recruitment, we implemented an educational campaign to increase the Deaf community’s knowledge and awareness of NCDHR and how and why the research is conducted. Several different recruitment strategies were used including NCDHR-hosted events, outreach to other Deaf organizations/groups and local faith-based organizations, social media, existing research recruitment lists, word of mouth, and peer recruitment. At the initial study visit, NCDHR research staff asked all individuals who inquired about DWW how they learned about the study. All responses were documented and entered into our database.

From August 2011 to June 2012, a total of 165 individuals inquired about DWW. Out of the 165, 132 attended a screening visit, and 104 fully enrolled into the study. Out of the 104 who enrolled into the study, many learned about DWW through one of the community organizations (28%, n=29), study participants (24%, n=25), or NCDHR hosted events (22%, n=23). None of the study participants reported that they learned about the study via a faith-based organization or social media. Participants were 68% (71/104) female, 91% (95/104) White, and 33% (34/104) had at least a 4-year college degree. On average, participants were 53.5 years old, weighed 92.9 kg, and had a Body Mass Index of 33.3 kg/m
2
. Retention and participation in the randomized trial has been excellent.

In conclusion, recruitment was most successful with organizations and individuals with whom we had previously established relationships/networks with whom the NCDHR had long-term and positive engagement. Recruiting from faith-based organizations was challenging, which lacked this engagement. Future recruitment strategies include continued relationship-building with faith-based organizations and with individual community members and organizational leaders. Lessons learned from programs with the Deaf community likely also pertain to other linguistic and cultural groups.
Abstract P260: Low Physical Activity Level, Underweight and Abdominal Obesity among Nigerian Rural Adolescents; Implication for Cardiovascular Disease Prevention Program among Rural Adolescents in Nigeria
Authors: Odunaiya Nse A , Louw Quinette A , Grimmer-sommers Karen 
Published: July 2021

Cardiovascular disease (CVD) is a global health problem. Studies have shown that the majority of people dying from CVD have one or more major risk factors that are influenced by lifestyle. Major predisposing risk factors include obesity, physical inactivity, abdominal obesity. These risk factors have been seen in adolescents in developed countries. Throughout the world the risks are starting to appear earlier. Adolescence is a critical temporal window for the development of obesity in adult age. Researchers have advocated that children and adolescent populations should be the target for cardiovascular risk factors prevention programs, however, there is paucity of information on these risk factors especially among rural adolescents. It is a general belief in Nigeria that rural dwellers are active, consume natural foods as such CVD and other chronic diseases may not be highly prevalent among rural people However, primordial prevention for cardiovascular is needed even in rural communities since prevention is better than cure. The study aimed to ascertain selected CVD risk factors such as physical activity level, BMI Waist Hip ratio and dietary pattern of adolescents in rural Nigeria The study was a cross sectional survey of 1079 adolescents aged 15-18 years, attending schools at Ibarapa central local government of South West Nigeria. Ethical approval was sought and obtained from Stellenbosch University ethics committee, approval from the local Education authority and principals of the selected schools. Informed consent was obtained from the principals of the schools who acted in place of the parents and guardians who were not in the community and also from parents within the community. Assent was obtained from adolescents either written or verbal. CVD risk factors were assessed using standard measures .Result shows 23% of adolescents are underweight, 75% normal weight and 1.4% overweight. Waist hip ratio of 84.6% of adolescents are normal, 15.4% abdominal obesity, for physical activity level; 27.9% had low physical activity level, 36.5% moderate physical activity level and 35.6% high physical activity level. More female had low activity level compared to male, 63.5% compared to 36.5% The adolescents generally have bad dietary pattern such as high fat consumption, low fruit and vegetable intake
Underweight is still a major problem among rural adolescents. Many of the rural adolescents are not active enough to safeguard their future health. Sedentary living is more among female than male. Although these rural adolescents are not generally obese but there is a high prevalence of abdominal obesity, low fruit and vegetable consumption which is associated with cardiovascular disease
Implication; there is need for CVD primordial and primary prevention program for Nigerian rural adolescents
Abstract P084: Influence Of Amount And Rapidity Of Weight Loss On The Risk Of Subsequently Regaining Weight And Drop-out From Treatment Among Patients With Severe Obesity Dieting In Hospital Without Bariatric Surgery
Authors: Yamada Tomohide , Hara Kazuo , Kadowaki Takashi 
Published: July 2021

Although many obese patients with type 2 diabetes lose weight by dieting, most subsequently regain it. We performed a retrospective cohort analysis to assess the influence of the amount and rapidity of weight loss during hospitalization on the risk of subsequently regaining weight and stopping treatment in patients with severe obesity who dieted without bariatric surgery.
A total of 131 severely obese patients (48±14 years old; BMI: 41.7±8.8; 75% with diabetes) received inpatient treatment that included diet, exercise, behavioral modification (charting weight four times daily), and educational seminars, and were followed after discharge. Regaining weight and drop-out were defined as returning to baseline body weight and failing to keep outpatient appointments, respectively.
Patients lost an average of 5.3±3.0kg (4.9±2.4%) in hospital (mean: 19 days). Over the median 2-year follow-up period, unadjusted analysis showed that patients with >3% weight loss in hospital had significantly less risk of regaining weight than patients losing≤3%. The risk decreased further with greater weight loss (>7% loss; hazard ratio (HR):0.06; 95% confidence interval:0.007-0.47).
Adjusted analysis revealed that >5% weight loss was associated with significantly less risk of regaining weight after adjustment for age, sex, BMI, smoke, diabetes, insulin, sulfonylurea, antidepressant medication, and duration of hospitalization (>7% loss; HR 0.04(0.004-0.36, p=0.004), 7%≥loss>5%; HR 0.3(0.11-0.85, p=0.02)).
No significant relation was observed between weight loss and drop-out. Among patients with >3% weight loss during hospitalization, rapid weight loss (>3% within 7 days) did not increase the risk of subsequently regaining weight compared with patients showing slower weight loss.
In conclusion, achieving >5% weight loss during comparatively brief hospitalization predicts subsequent maintenance of lower weight. Experiencing success in hospital might increase the motivation of obese patients.
Abstract P243: Long-Term Exposure to Air Pollution and Markers of Inflammation, Coagulation and Endothelial Activation: A Repeat Measures Analysis in the Multi-Ethnic Study of Atherosclerosis
Authors: Hajat Anjum , Diez-Roux Ana V , Jenny Nancy , Szpiro Adam , Kaufman Joel 
Published: July 2021

Air pollution is associated with CVD and systemic inflammation is posited to mediate this effect. Animal, experimental and epidemiologic studies suggest that increases in short-term air pollution cause an inflammatory response. Few studies, however, have assessed the contribution of long-term exposure to pollutants even though chronic inflammation may be more relevant to the observed risk of atherosclerotic disease. We assessed the hypothesis that long-term exposure to pollutants is associated with markers of inflammation, coagulation and endothelial activation.
We studied participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort with repeat measures of serum C-reactive protein (CRP), fibrinogen, D-dimer, soluble E-selectin and soluble Intercellular Adhesion Molecule-1 (sICAM-1). We estimated associations of these markers with outdoor PM2.5, individual-level ambient PM2.5 (integrating indoor concentrations and time-location data) and oxides of nitrogen (NOX). Pollutant concentrations were predicted from likelihood based models from cohort-specific monitoring and were averaged over the year prior to blood draw. CRP and D-Dimer were log-transformed for analysis. A random effects model controlling for relevant covariates was used to account for within person clustering. Participants with a recent history of acute infection were excluded from analysis.
A total of 713 participants contributed 1736 observations (mean 1.8 observations per person over 3 visits). After excluding those with a recent infection we were left with 1233 observations among 491 participants. In multivariable models, both D-dimer and E-selectin were associated with pollutants, specifically PM2.5 and NOx (see table). There was no association between pollutants and CRP, fibrinogen or sICAM-1.
In conclusion, these data are consistent with the hypothesis that associations between long-term exposure to particulate and traffic-related air pollution and CVD may be related to endothelial activation and fibrinolysis.