bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of depressive disorders on quality of life and three-year survival of patients with coronary heart disease
Authors: Nonka T G , Lebedeva E V , Repin A N 
Published: October 2021

Abstract

Background/Introduction
Depressive disorders (DD) affect more than 350 million people in the general population, especially among patients with cardiovascular diseases. World Health Organization predicts that by 2030 coronary heart disease (CHD) and DD will become the leading causes of disability in the civilized countries of the world. This fact indicates the need to identify DR at the early stages of examination of patients with CHD for timely correction and improvement of prognosis.

Purpose of the work
To assess the quality of life and three-year survival rate of patients with CHD in combination with DR.

Methods
122 patients with chronic CHD (with exertional angina of II-III functional classes) were included in the study on the basis of the cardiology department. The presence and level of depression, anxiety, and social adaptation were assessed using the Beck Depression Scales (BDI), Sheehan Anxiety (ShARS), Social Adaptation (Bosc). The three-year survival rate was also investigated. Two groups were formed: the first – 58 patients with CHD with DD and the second – 64 patients with CHD without DD. Data were presented as M ± SD. The difference was considered statistically significant at p&lt;0.05. The 3-year survival rate of patients was assessed using the Kaplan-Meier method with the determination of differences between groups using the Wilcoxon-Gehan test.

Results
The groups were comparable in terms of the main clinical and demographic characteristics and concomitant therapy. In patients with depression, compared with patients without it, was identified an increased level of depression (BDI – 7.3±4.3 points vs 2.3±1.6 points, p=0.ehab724.275201) and anxiety (Shikhana – 37.6±20.3 points vs 18.3±12.4 points, p=0.0002); lower level of social functioning (Bosc – 35.0±7.3 points vs 39.3±5.8 points, p=0.04). The 3-year survival rate was 92.6% (113 people), of which in the first group – 87.9% (51 people), in the second – 96.9% (62 people). The worst survival rate (Gehan-Wilcoxon test, p=0.03) was noted in the group of CHD with DD.

Conclusion(s)
In patients with chronic CHD in combination with DD, an increased level of anxiety and a lower quality of life were revealed, which can worsen the course of CHD. The 3-year survival rate is significantly worse in patients with CHD with a DD in comparison with patients without mental disorders.

Funding Acknowledgement
Type of funding sources: None.
Association of body mass index with non-achievement of target low-density lipoprotein level in older patients at very high cardiovascular risk: a multicentre study
Authors: Nguyen H T , Nguyen A H , Lam H M , Nguyen T T 
Published: October 2021

Abstract

Introduction
Low-density lipoprotein cholesterol (LDL-c) is a well-established risk factor for atherosclerotic cardiovascular disease. Nonetheless, the association of body mass index (BMI) with non-achievement of target LDL-c level in older patients with type 2 diabetes (T2D) at very high cardiovascular risk is unknown.

Purpose
To investigate whether BMI is associated with non-achievement of target LDL-c level in older patients with T2D at very high cardiovascular risk.

Methods
From December 2019 to June 2020, in this multicentre prospective cross-sectional study, we enrolled 733 consecutive outpatients aged ≥60 years with T2D at very high cardiovascular risk in whom LDL-c levels could be measured after any stable lipid-lowering therapy for ≥6 months. Achievement of target lipid level was assessed based on the 2019 guidelines of the European Society of Cardiology for dyslipidaemia. Factors associated with non-achievement of target LDL-c level were determined using logistic regression analysis.

Results
Of the total cases (age, 68.6±7.2 years; men, 51.3%), 654 patients (89.2%) did not achieve an aggressive target LDL-c level of &lt;1.4 mmol/L. Target non-high-density lipoprotein cholesterol level of &lt;2.2 mmol/L and triglyceride level of &lt;1.7 mmol/L were not achieved in 87.9% and 56.2% of the patients, respectively. In the multivariate model, BMI was the only factor associated with failure to achieve target LDL-c level, but not other factors such as age, sex, education level, smoking, and comorbidities. The adjusted odds ratio were 0.88 (95% confidence interval [95% CI], 0.24–3.21; P=0.84) for underweight, 1.57 (95% CI, 0.87–2.81; P=0.13) for overweight, and 2.63 (95% CI, 1.43–4.83; P=0.002) for obesity (normal weight was set as reference) status.

Conclusions
Non-achievement of target LDL-c level is highly prevalent in older patients with T2D at very high cardiovascular risk. Obesity, defined by BMI, can be a factor associated with non-achievement of the target. The findings highlight the importance of management of lipid levels in older patients with T2D.

Funding Acknowledgement
Type of funding sources: None. Figure 1
In-hospital bleeding in elderly patients with acute coronary syndrome: are potent antiplatelet agents safe?
Authors: Keskin K , Sigirci S , Gurdal A , Sumerkan M , Ser O S , Kilci H , Kalender E , Alyan O 
Published: October 2021

Abstract

Background
Despite implementation of newer interventional techniques and therapeutic advances, elderly patients with acute coronary syndrome continue to be prone to in-hospital bleeding compared to their younger patients.

Purpose
To investigate in-hospital bleeding events, define the bleeding sites, characteristics and associated factors in elderly patients with acute coronary syndrome.

Methods
Patients 75 years or over who were admitted with acute coronary syndrome were included in the study. The definition of in-bleeding was defined as any bleeding requiring transfusion or clinically significant bleeding that altered the treatment course. The main outcome of the study was to find out the incidence of in-hospital bleeding events and associated risk factors. We also wanted to define the bleeding sites, characteristics as well as 1-year all-cause mortality with respect to in-hospital bleeding.

Results
Overall, 539 patients were included in the study. Mean age was 82.5±4.8 years and 282 (52.3%) patients were female. Of these patients 69 (12.8%) developed in-hospital bleeding. The most common site for bleeding was urinary tract followed by access site bleeding. Factors that were independently related with in-hospital bleeding were age (OR: 1.08; 1.01–1.14 CI 95%; p=0.01), acute kidney injury (OR: 3.66; 2.01–6.69 CI 95%; p&lt;0.01), tirofiban (OR: 4.43; 1.78–10.99 CI 95%; p&lt;0.01) and ticagrelor (OR: 1.93; 1.01–3.73 CI 95%; p=0.04) administration. The patients who developed in-hospital bleeding had also higher one-year all-cause mortality (p [log-rank] = 0.01).

Conclusion
In-hospital bleeding continues to be a frequent problem among older patients with acute coronary syndrome. Ticagrelor and tirofiban should be used cautiously. In addition to access site bleeding, urinary tract bleeding events were also common.

Funding Acknowledgement
Type of funding sources: None. Table 1Table 2
The new myokine myonectin is significantly associated with type 2 diabetes in elderly patients
Authors: Leiherer A , Muendlein A , Geiger K , Saely C H , Larcher B , Mader A , Maechler M , Sprenger L , Mutschlechner B , Benda M , Fraunberger P , Drexel H 
Published: October 2021

Abstract

The novel myokine myonectin is predominantly expressed in skeletal muscle and is involved in the regulation of metabolic homeostasis. A putative association between myonectin and type 2 diabetes mellitus (T2DM) has been discussed controversially in current literature.
The purpose of this study was to investigate the association between myonectin and T2DM at different ages.
We measured myonectin in 410 vascular risk patients with a mean age of 66 years.
Myonectin did not correlate with age (r=−0.19; p=0.697). From our patients 219 (53%) were &gt;65 years, with a mean age of 74 years and 191 ≤65 years, with a mean age of 57 years. The prevalence of T2DM was 40.6% vs. 42.4% in the older as compared to the younger age group. Myonectin concentrations were significantly decreased in elderly patients with T2DM compared to non-diabetic subjects (1.8 vs. 4.2 ng/ml; p=0.002), whereas no significant difference was observed in younger patients (2.6 vs. 2.3 ng/ml; p=0.183). Concordantly, regression analysis revealed an unadjusted odds ratio (OR) of 0.24 [0.07–0.81] (p=0.021) for the association between myonectin and T2DM in elderly patients but not in younger patients (OR=1.08 [0.80–1.45]; p=0.609). The association between myonectin and T2D; remained significant after adjusting for sex, body mass index, LDL cholesterol, HDL cholesterol, current smoking, as well as statin intake in elderly but remained non-significant in younger patients (OR=0.23 [0.07–0.81]; p=0.021 vs. OR=1.05 [0.76–1.46]; p=0.769).
We conclude that plasma myonectin levels are significantly associated with T2DM, particularly in elderly vascular risk patients.

Funding Acknowledgement
Type of funding sources: None.
Ipilimumab and Nivolumab exertes cardiotoxic and pro-fibrotic effects in mice through the overexpression of NLRP3 inflammasome, chemokines and leukotrienes
Authors: Quagliariello V , Passariello M , Rea D , Barbieri A , Buccolo S , Iovine M , Bonelli A , Caronna A , Botti G , De Lorenzo C , Maurea N 
Published: October 2021

Abstract

Background
Several strategies based on immune checkpoint inhibitors (ICIs) have been developed for cancer therapy, opening to advantages in cancer outcomes. However, several ICIs-induced side effects emerged in these patients, especially a rare but clinically significant cardiotoxicity with high rate of mortality.

Purpose
We studied cytotoxic and pro-inflammatory properties of Ipilimumab and Nivolumab in cellular and preclinical models

Methods
Co-cultures of human cardiomyocytes and hPBMCs were exposed to Ipilimumab or Nivolumab at 100 nM; cell viability and expression of leukotrienes, NLRP3 inflammasome, MyD88 (myddosome) and p65/NF-kB were performed. C57 mice were untreated (Sham; n=6) or treated with Ipilimumab (IPI, n=6) (15 mg/kg); analysis of fractional shortening, ejection fraction, radial and longitudinal strain were made before and after treatments through 2D-echocardiography (Vevo 2100). Expression of NLRP3, MyD88, p65/NF-kB, leukotrienes and 12 cytokines (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12, IL17-α, IFN-γ, TNF-α, G-CSF, and GM-CSF) have been analyzed in murine myocardium.

Results
Nivolumab and Ipilimumab induced cell death and apoptosis in cardiomyocutes. Both ICIs increased NLRP3, MyD88 and p65/NF-kB expression compared to untreated cells, however the most pro-inflammatory and cardiotoxic effects were seen after exposure to Ipilimumab. Mice treated with Ipilimumab showed a significant decrease of fractional shortening and radial strain compared to untreated mice. Metabolic studies clearly indicates that ipilimumab increases leukotrienes production and NLRP3 expression in heart tissues, probably due to increased iROS content (iROS are key inductors of leukotrienes expression). High expression of IL-6, IL-1 and IL-17 were also seein in mice treated with ipilimumab (p&lt;0,001).

Conclusions
Nivolumab and Ipilimumab exert cytotoxic effects mediated by NLRP3 inflammasome, leukotrienes and pro-inflammatory cytokines in heart tissues.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Ricerca Corrente Project
Early increase of high-sensitivity cardiac troponin predicts mortality in cancer patients undergoing chemotherapy
Authors: Nowakowska M A , Chrzanowski L , Miskowiec D , Wdowiak-Okrojek K , Wejner-Mik P , Lipiec P , Krakowska M , Potemski P , Plonska-Gosciniak E , Kasprzak J D 
Published: October 2021

Abstract

Introduction
High-sensitivity cardiac troponin test (hs-TnT) reveals subclinical myocardial damage in many cardiac conditions. We hypothesized that elevated hs-TnT may predict a development of cancer therapy-related cardiac dysfunction and clinical outcomes linked with antineoplastic therapies. We aimed to evaluate the predictive value of hs-TnT for all-cause mortality in a group of patients (pts) with recent diagnosis of cancer.

Material and methods
We included 80 pts (mean age 57±13 years; 98% women) with recently diagnosed cancer (78 breast cancer, 1 colon cancer, 1 DLBCL lymphoma). Transthoracic echocardiography and hs-TnT tests were performed at baseline and after 3, 6 and 12-months. Pts with LVEF &lt;50% and significant valvular disease were excluded.

Results
In the study group 44% pts had arterial hypertension, 54% dyslipidemia, 9% diabetes mellitus; 94% pts were treated with anthracyclines, 30% with trastuzumab, 54% with hormone therapy, 71% with radiotherapy. A significant decrease of LVEF were observed during follow-up (LVEF at baseline, 3, 6 and 12 months: 61.7±2.0%; 60.9±2.0%*; 60.8±2.9%*; 59.9±2.9%*; *p&lt;0.05 vs baseline). A significant reduction of global longitudinal strain was found only at 6-month follow-up (−19,2±2,2% vs −18,6±2,0%; p=0,003). In 38 pts at least a twofold (fourfold in37) increase in hs-TnT &gt;99th percentile was observed. A rise of hs-TnT was most often seen at 3 month (n=35; 43,8%). During median 1056 (221–1906) days off follow-up 18 (24%) pts died and ROC curve analysis revealed that early (0–3 months) hs-TnT increase more than 10 pg/ml [AUC=0,693 (0,545–0,806); p=0,017)] represented a predictor of death [OR=3,4 (1,99–11,87)].

Conclusions
Increase in hs-TnT in cancer patients detected at 3rd month of chemotherapy predicts mortality.

Funding Acknowledgement
Type of funding sources: None. Figure 1
Cardiovascular outcomes in hospitalized patients with COVID-19 and history of cancer: a CORONA-VTE analysis
Authors: Khairani C D , Barns B M , Rizzo S M , Pfeferman M B , Snyder J E , Goldhaber S Z , Piazza G ,   Thrombosis Research Group
Published: October 2021

Abstract

Background
In hospitalized patients with COVID-19, active cancer has been identified as a potential risk factor for adverse cardiovascular outcomes, including thrombosis. However, the impact of COVID-19 on outcomes in patients with a remote history of cancer is poorly understood. We evaluated hospitalized patients with a history of remote cancer and COVID-19 to examine whether a history of cancer contributes to 30-day major adverse cardiovascular outcomes among patients with COVID-19.

Methods
Using a retrospective cohort of 1114 patients from CORONA-VTE (Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19), we looked at 399 hospitalized patients diagnosed with polymerase chain reaction (PCR)-confirmed COVID-19 within a large heath care network that consists of two large academic medical centers and several community hospitals. Twenty-six patients with active cancer or receiving cancer treatment within 1-year of COVID-19 diagnosis and five patients with unknown cancer history were excluded. We assessed 46 patients with a history of cancer and 322 patients without any history of cancer. The primary endpoint was the frequency of adjudicated major adverse cardiovascular outcomes, defined as myocardial infarction, stroke, pulmonary embolism, deep vein thrombosis, and mortality.

Results
Among the 46 hospitalized patients with COVID-19 and a history of cancer, 23.9% were non-white and 43.48% women. Compared to patients without any history of cancer, patients with a history of cancer were older (median 59.0 vs. 75.5 years, p&lt;0.001) and had higher BMI (median 26.4 vs. 29.6 kg/m2, p&lt;0.05). Patients with a history of cancer had higher rates of underlying CVD than those without (42.4% vs. 23.2%). Rates of major adverse cardiovascular events were similar in patients with and without a history of cancer (28.3% vs. 23.6%, respectively). Those with a history of cancer had a higher mortality rate (28.9% vs. 11.2%, p&lt;0.05). Acute Respiratory Distress Syndrome (ARDS) and preexisting CVD were independently associated with mortality in this patient cohort (OR 19.7, 95% CI 7.5–51.7 and OR 2.9, 95% CI 1.2–6.9). History of remote cancer was not independently associated with mortality (OR 2.39, 95% CI 0.93–6.15, p=0.07).

Conclusion
Our findings indicate that a history of remote cancer is not independently associated with increased mortality in hospitalized COVID-19 patients. These data suggest that the cause of death among hospitalized patients with COVID-19 and history of cancer is most likely multifactorial, with a strong contribution from cardiovascular disease.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Janssen Pharmaceuticals
Rates of cardiovascular events are significantly different across cancer types
Authors: Mitchell J D M , Laurie M L , Xia Q X , Jain N J , Jain A J , Lane D L , Lenihan D J L 
Published: October 2021

Abstract

Background
As a result of the effects of both cancer treatment and underlying cardiovascular (CV) risk factors, patients with cancer have a 2 to 6-fold higher CV mortality rate than the general population. Certain cancer types appear to be associated with a greater CV risk, although much of our current understanding is limited to breast and pediatric cancer survivors. We sought to characterize the CV risk factor burden and incidence of CV events across different cancer types.

Methods
We included all patients diagnosed with 9 different cancer types (breast, lung, prostate, melanoma, myeloma, kidney, colorectal cancer, leukemia, or lymphoma) after June 1, 2011 in a large US administrative claims database (PharMetrics). Patients had continuous enrollment in the database for ≥12 months prior to cancer diagnosis, and were followed until they had a specified CV event or were disenrolled. Incidence rates for CV events were calculated and Cox proportional hazard multivariable models were used for time-to-event analysis for each cancer type, accounting for baseline CV risk factors.

Results
Over 800,000 patients with cancer were identified across the 9 cancer types. The incidence of CV events was generally &gt;5-fold higher in lung cancer than in breast cancer. The adjusted hazard ratio for the combined CV events of myocardial infarction, stroke, unstable angina, and heart failure was 2.7 (95% confidence interval 2.6–2.7) for lung cancer relative to breast cancer, with a cumulative incidence of 25% by 4 years. Multiple myeloma and leukemia had the next highest cumulative incidence of CV events, while breast cancer and melanoma had the lowest (Table 1 and Figure 1).

Conclusion
CV events were significantly increased in certain cancer types, especially lung, multiple myeloma and leukemia, even after accounting for baseline CV risk factors. Patients with lung cancer had a 25% cumulative incidence of combined CV events within 4 years. Understanding the wide variation of CV events in patients with cancer can help inform CV risk factor modification and strategies to minimize CV toxicity, with the aim of reducing the risk of future CV events and improving the morbidity and mortality of cancer survivors.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bristol Meyers Squibb
Association between baseline ldl-c and prognosis among patients with coronary artery disease and advanced kidney disease
Authors: Wang B , Liu J , Chen S Q , Luo Q H , Liu Y , Tan N 
Published: October 2021

Abstract

Background
Lower low-density lipoprotein cholesterol (LDL-C) is significantly associated with improved prognosis in patients with coronary artery disease (CAD). However, LDL-C reduction does not decrease all-cause mortality among CAD patients when renal function impairs. There are currently no studies examining the association of low baseline LDL-C concentration (&lt;1.8 mmol/L) with mortality among patients with CAD and advanced kidney disease (AKD). We aimed to evaluate prognostic value of low baseline LDL-C level for all-cause death in these patients.

Methods
In this observational study, 803 CAD patients complicated with AKD (eGFR &lt;30 mL/min/1.73 m 2) were enrolled between January 2008 to December 2018. Patients were divided into two groups (LDL-C &lt;1.8 mmol/L, n=138; LDL-C ≥1.8 mmol/L, n=665). We used Kaplan-Meier methods and Cox regression analyses to assess the association between baseline low LDL-C levels and long-term all-cause mortality.

Results
Among 803 participants (mean age 67.4 years; 68.5% male), there were 315 incidents of all-cause death during a median follow-up of 2.7 years. Kaplan–Meier analysis showed that low LDL-C levels were associated with worse prognosis. After adjusting for full 24 confounders (e.g., age, diabetes, heart failure, and dialysis, etc.), multivariate Cox regression analysis revealed that lower LDL-C level (&lt;1.8mmol/L) was significantly associated with higher risk of all-cause death (adjusted HR, 1.38; 95% CI, 1.01–1.89).

Conclusions
Our data demonstrated that among patients with CAD and AKD, a lower baseline LDLC level (&lt;1.8mmol/L) did not present a higher survival rate but was related to a worse prognosis, suggesting a cautiousness of too low LDL-C levels among patients with CAD and AKD.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This study was supported by the National Natural Science Foundation of China (Grant No. 81670339 and Grant No. 81970311), Cardiovascular Research Foundation Project of the Chinese Medical Doctor Association (SCRFCMDA201216) and Beijing Lisheng Cardiovascular Health Foundation (LHJJ20141751).