bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 1514: Effect of Prior Medication on Clinical Characteristics and Hospital Outcome of Acute Coronary Syndromes
Authors: Aguiar Carlos , Ferreira Jorge 
Published: July 2021

Background: Patients (Pts) with acute coronary syndrome (ACS) are often on medication at time of admission, because of risk factors and/or prior history of cardiovascular disease. We assessed the influence of prior medication on mode of presentation and prognosis of ACS.
Methods: We studied 18,400 Pts included in a nationwide prospective registry of ACS and determined the influence of prior medication with aspirin (ASA), beta-blockers (BB), angiotensin converting enzyme inhibitors (ACEI), and statins (Stat) on type of ACS and its effect on all-cause hospital mortality.

Results: ACS presentation was more benign in Pts previously medicated with ASA, BB, ACEI or Stat (Table

). Pts on prior medication with these drugs were older, more often female, less often smokers, and more often presented BMI >=25, diabetes, hypertension, hypercholesterolemia, and prior history of cerebrovascular or peripheral arterial disease, MI or myocardial revascularization. Of the 3453 Pts with prior MI, 63.9% were on ASA, 42.0% BB, 47.6% ACEI, and 49.4% Stat. Of the 2946 diabetics, 29.6% were on ASA, 32.5% ACEI, and 25.7% Stat. Of the 1275 Pts with prior stroke/TIA, 36.3% were on ASA and 24.2% Stat. Of the 382 Pts with peripheral arterial disease, 38.8% were on ASA and 33.7% Stat. Overall, 344 (3.4%) of the 9980 non-ST-elevation ACS and 703 (8.3%) of the 8420 ST-elevation MI Pts died. Prior BB was an independent predictor of hospital mortality in non-ST-elevation ACS (adjusted OR = 1.58; 95% CI, 1.09–2.29; p=0.016), but not ST-elevation MI. Prior medication with ASA, an ACEI or a Stat did not influence outcome of either type of ACS.

Conclusions: In the real world, Pts at high risk for atherothrombotic disease are insufficiently medicated with ASA, BB, ACEI and/or Stat. Prior medication with these drugs is associated with a more benign clinical presentation of ACS. Further studies are required to clarify the mechanisms conferring increased hospital mortality in Pts with non-ST-elevation ACS admitted on a BB.
Abstract 1613: Enhanced Expression of Tenascin-C in Granulomas of Patients With Active Cardiac Sarcoidosis
Authors: Terasaki Fumio , Hiroe Michiaki , Imanaka-Yoshida Kyoko , Tsukada Bin , Otsuka Kaoru , Katashima Takashi , Fujita Shuichi , Shimomura Hiroaki , Yoshida Toshimichi , Kitaura Yasushi 
Published: July 2021

Introduction: Tenascin-C (TN-C) is a member of the matricellular proteins that do not subserve a primary structural role, but function rather as modulators of cell-matrix interactions, with being evident at sites of inflammation, tissue remodeling or wound healing. Although TN-C is likely involved in the inflammatory process in the granulomatous tissue, their in situ expression in the sarcoid heart has not been clarified.
Hypothesis: We assessed the hypothesis that serum levels of TN-C are increased in patients with sarcoidosis, and the expression of TN-C is upregulated in the myocardium of patients with active cardiac sarcoidosis.
Methods: Serum TN-C levels were measured in 40 patients with sarcoidosis and 23 patients with idiopathic dilated cardiomyopathy (DCM). Sera from 20 normal volunteers served as controls. In addition, we immunohistochemically examined the expression profiles of TN-C in the myocardium from 12 patients with active cardiac sarcoidosis and 10 DCM patients.
Results: Serum TN-C levels were significantly higher in patients with sarcoidosis than in normal controls [79.7±43.3 (SD) ng/ml vs. 30.9±8.8 ng/ml, p=0.001]. In the sarcoidosis group, serum TN-C levels in patients with definite cardiac involvement (n=10) were significantly higher than in those without it (n=30) (119.6±45.0 ng/ml vs. 66.4±34.0 ng/ml, p=0.005) and they were also higher than in DCM patients (vs. 68.2±24.3 ng/ml, p=0.006). Immunohistochemically, expression of TN-C was markedly enhanced in the extracellular matrix surrounding multinucleated giant cells and macrophages in the sarcoid granulomas. TN-C expression was limited to areas with well-formed, active granulomas.
Conclusions: TN-C, produced in extracellular matrix, may be involved in the pathogenesis of sarcoid granulomas. The measurement of serum TN-C levels is useful for the diagnosis of sarcoidosis, and their higher levels may suggest the cardiac involvement.
Abstract 1629: Genetic Polymorphism A1675G On Angiotensin Receptor Type 2, Is Implicated In The Expression Of Acute Phase Proteins And The Development Of Coronary Atherosclerosis In Hypertensive Patients
Authors: Tousoulis Dimitris , Koumallos Nikolas , Antoniades Charalambos , Kardara Despina , Antonopoulos Alexis S , Mentzikof D , Vasiliadou Carmen , Vlachopoulos Charalambos , Vavuranakis Emmanouil , Stefanadis Christodoulos 
Published: July 2021

Introduction: Renin-angiotensin system affects cardiovascular disease pathogenesis through a balance of angiotensin II effects on proatherogenic constitutive type 1 and antiatherogenic inducible type 2 (AT2R) receptors. The impact of A1675G polymorphism on the development of hypertension and advanced atherosclerosis is controversial. We examined the impact of A1675G polymorphism on AT2R, on the risk for arterial hypertension and coronary atherosclerosis, and its effect on the expression of proatherogenic inflammatory molecules.
Methods. The study population consisted of 310 males: 145 with arterial hypertension and 165 controls, matched for age and risk factors for atherosclerosis. Among hypertensive subjects, 37 had angiographically documented coronary atherosclerosis and 108 had no evidence of atherosclerosis. The presence of A1675G polymorphism on AT2R gene (located in chromosome X) was determined by PCR. Serum levels of C-reactive protein and fibrinogen was measured in all the participants.

Results. The frequency of the A allele was similar between patients with arterial hypertension (64/145, 44.1%) and non-hypertensive subjects (73/165, 44.2%, p=NS), while the risk for arterial hypertension was OR[95%CI]:1.004[0.641–1.574], p=0.985 for the G vs A carriers. However, the risk for coronary atherosclerosis within the group of hypertensive subjects was significantly elevated in the carriers of the A allele (OR[95%CI]:2.128[1.003–4.513], p=0.04 vs carriers of the G allele). Importantly, the presence of the A allele was also associated with significantly higher levels of CRP (4.8±0.8mg/dl) compared to the carriers of the G allele (3.0±0.3mg/dl, p<0.05). Similarly, fibrinogen levels were higher in A-allele carriers (median(25
th
–75th percentile) 395(340 – 455) mg/ml) compared to G-allele carriers (369(320 – 406) mg/ml, p<0.05).

Conclusions: Although genetic polymorphism A1675G on AT2R is not associated with the development of arterial hypertension, it affects the risk for coronary artery disease among hypertensive patients. The presence of the A allele also leads to higher levels of CRP and fibrinogen, implying that this polymorphism may induce atherogenesis by modulating acute phase response in hypertensive individuals.
Abstract 1680: Spatial Distribution of Myocardial Infarction in Patients with Diabetes Mellitus
Authors: Garg Pallav , Candia Susana , Wang John C , Kuntz Richard E , Mauri Laura 
Published: July 2021

BACKGROUND: Acute coronary occlusions occur most frequently as a result of rupture of an atherosclerotic plaque. Previous studies have found greater extent of atherosclerotic disease in the coronary arteries of diabetic patients. While the burden of disease is higher in diabetics, less is known about the spatial distribution of myocardial infarction in this population.
METHODS: We sought to compare the spatial distribution of myocardial infarction (STEMI and Non-STEMI) in patients with diabetes mellitus and in those without, based on quantitative coronary and statistical analysis. We analyzed 756 patients with STEMI (n = 556) and NSTEMI (n=200), of which 175 patients comprised the diabetic cohort, and mapped the location of the acute coronary occlusion.
RESULTS: Coronary occlusions were not uniformly distributed throughout each of the major epicardial coronary arteries but tended to cluster within the proximal third of each of the vessels in both cohorts. There was no difference in the distribution of occlusions in diabetics vs. non-diabetics in any of the vessels (left anterior descending artery, P=0.35; left circumflex artery; P=0.33 right coronary artery, P=0.20; Figure).
CONCLUSIONS: Acute coronary occlusions leading to STEMI and NSTEMI in both diabetics and non-diabetics tend to cluster in predictable “hot spots” within the proximal third of the coronary arteries. Identification of these high-risk zones for acute coronary occlusions will lead to future advances in vulnerable plaque detection technology and potentially locally directed preventive strategies.

Spatial distribution of myocardial infarction in diabetics vs. non-diabetics using distance to lesion from the ostium of the coronary artery.
Abstract 1685: Clinical and Angiographic Outcomes following Percutaneous Coronary Intervention with Sirolimus-Eluting Stents vs. Bare Metal Stents in Hemodialysis Patients
Authors: Yachi Sen , Tanabe Kengo , Yamamoto Hirosada , Otsuki Shuji , Yagishita Atsuhiko , Kishi Satoru , Sasaki Shunsuke , Taniwaki Masanori , Nakano Masataka , Nakajima Hiroyoshi , Hara Kazuhiro 
Published: July 2021

Background Percutaneous coronary intervention in hemodialysis patients has been hampered by high rate of major adverse cardiac events (MACE). It remains uncertain whether sirolimus-eluting stent (SES) improves clinical outcomes in hemodialysis patients compared to bare metal stent (BMS).
Methods The present study consisted of consecutive 46 hemodialysis patients with 57 lesions treated with SES from August 2004 to April 2006. For comparison, the control group was composed of 67 hemodialysis patients with 70 lesions who were treated with BMS in three years before the introduction of SES. Clinical and angiographic follow-up were performed after 8 months. MACE included all-cause death, myocardial infarction and repeat target vessel revascularization.

Results Baseline characteristics were comparable between the 2 groups except for lesion length. Clinical follow-up was available in all patients. Angiographic follow-up was obtained in 39 patients (84.8%) in the SES group and 49 patients (73.1%) in the BMS group. There was no difference in MACE between the 2 groups (SES;28.3%, BMS;40.3%, p=0.19). As shown in the table

, quantitative angiographic analysis revealed a significant difference in late lumen loss (SES;0.66±0.80mm, BMS;1.07±0.75mm, p=0.01), however, the rate of binary restenosis was identical (SES;31.9%, BMS;40.4%, p=0.38). Of the angiographic restenosis lesions analyzed, focal restenosis pattern was frequently observed in the SES group than the BMS group(SES;93.3%, BMS;23.8%, p<0.0001), whereas diffuse restenosis pattern was dominant in the BMS group.

Conclusion Angiographic parameters favored inhibition of neointimal hyperplasia by SES. However, the inhibitory effect of sirolimus was not translated into clinical superiority over BMS in hemodialysis patients.

Table.

Serial QCA data
Abstract 1796: A Clinical Prediction Rule for Early Emergency Department Discharge of Lower Risk Patients with Chest Pain
Authors: Cotarlan Vlad , Ho David , Pineda John , Netrebko Pavlo I , McConnell Timothy , Qureshi Anwer , Shirani Jamshid 
Published: July 2021

Background. Emergency Department (ED) evaluation of patients with acute chest pain and non-diagnostic electrocardiography (ECG) remains a frequent and difficult problem. Stress testing is generally requested and may lead to costly, unnecessary and prolonged ED stay. We aimed to identify clinical characteristics that allow early discharge with outpatient evaluation of such patients.
Methods. Between 02/2006 and 02/2007, 459 adults [age 56±13 years, 228 (50%) men] who presented to ED with chest pain and had no ischemic ECG changes and 2 negative cardiac enzymes measurements on arrival and 6 hours later, underwent stress echocardiography (n=396) or coronary computed tomographic angiography (n=63) prior to discharge.

Results. Non-invasive evaluation for coronary artery disease (CAD) was negative in 367 (80%), indeterminate in 30 (7%) and positive in 62 (13%) [Table

]. Univariate predictors for a normal stress test were lower Framingham risk score, lower age, normal ECG (no ischemic changes), atypical chest pain and the absence of diabetes, hypertension, high cholesterol and previous CAD. Multivariate logistic regression identified normal ECG (RR=2.3, p=0.002), atypical chest pain (RR=3.0, p=0.001), no diabetes (RR=2.5, p=0.001) or absence of previous CAD (RR=2.8, p<0.001) as strong independent predictors for a negative non-invasive test. The same four variables were strong independent predictors of ED discharge. Of 459 patients, 186 (41%) had none of the four independent predictors. None of those had positive non-invasive test or obstructive CAD on angiogram (n=1).

Conclusion. A substantial portion (2/5) of patients seen in ED for chest pain evaluation can be safely discharged after 2 sets of negative cardiac enzymes (~6 hours) if they have a normal ECG, atypical chest pain, no diabetes or previous CAD. These patients can be evaluated for CAD as an outpatient. This strategy may significantly decrease length of stay, ED clutter and cost of in-patient evaluation.
Abstract 1877: Experimental Validation of Circumferential Subendocardial and Subepicardial Myocardial Strain during Dobutamine Stress Echocardiography in Ischemic Conditions
Authors: Reant Patricia , Labrousse Louis , Lafitte Stephane , Tariosse Lilianne , Bonoron-Adele Simone , Padois Philippe , Deville Claude , Roudaut Raymond , Santos Pierre Dos 
Published: July 2021

Background: Strain echocardiographic techniques have been developed in order to quantify myocardial contraction but are currently based on a transmural myocardial analysis whereas subendocardial (ENDO) and subepicardial (EPI) layers have different response to ischemia. Recent development in strain software enables to investigate simultaneously strain in 2 myocardial layers.
Objectives: To assess and validate this new tool for the detection of ischemia during dobutamine stress echocardiography (DSE).
Methods: In 6 open-chest anesthetized pigs, circumferential strain (CS) was studied before and during dobutamine infusion, in absence of coronary stenosis and in ischemic conditions produced by: 2 degrees of non flow-limiting stenoses reducing left anterior descending (LAD) artery hyperemic flow by 20% and then by 60% (NFLS20 and NFLS60), and 1 flow-limiting stenosis reducing resting LAD flow by 25% (FLS25). Agreement between CS echocardiography in ENDO and EPI layers in risk area (RA) and sonomicrometry was evaluated by linear regression and Bland-Altman analysis. CS in ENDO and EPI layers were studied in absence or coronary stenosis and in ischemic condition, in RA and in control area (CA).
Results: Good correlations and agreements were observed between echocardiography and sonomicrometry at rest and during dobutamine : ENDO CS: r=0.66, P<0.001 and r=0.69, P<0.0001; EPI CS: r=0.65, P<0.01 and r=0.62, P<0.001. At rest, both ENDO and EPI CS in the RA were significantly decreased in the presence of FLS25. During dobutamine infusion, ENDO CS was significantly reduced in the presence of NFLS20 and EPI CS in the presence of NFLS60.
Conclusions: Multilayer strain echocardiography provides accurate assessment of LV regional function. Evaluation of ENDO and EPI strains during DSE has real potential to improve detection of ischemia in clinical practice.
Abstract 1944: Atorvastatin Reduces Intracerebral Hemorrhage after Experimental Stroke
Authors: Elewa Hazem F , Kozak Anna , Rychly David , Ergul Adviye , Frye Reginald , El-Remessy Azza , Fagan Susan C 
Published: July 2021

Ischemic stroke is a leading cause of death and disability in the United States and diabetes mellitus is the fastest growing risk factor for stroke. In addition, hyperglycemia, which is usually associated with diabetes, tends to worsen ischemia/reperfusion injury and to induce more oxidative stress damage. Preliminary data from our laboratory showed that diabetic animals (Goto-Kakizaki rats (GKs) are more susceptible to vascular damage leading to intracerebral hemorrhage. Many studies have indicated that statins possess neuroprotective properties even when administered after the onset of ischemia. However, the acute vascular effects of statins after ischemic stroke have not been studied to date.
Objective: to evaluate the efficacy and magnitude of vascular protection of acute statin therapy in both GKs and their normoglycemic controls after experimental ischemic stroke.
Methods: Male Wistar (W) and GK rats (270–305 g) underwent 3 hours of middle cerebral artery occlusion (MCAO) followed by reperfusion for 21 hours. Animals were randomized to receive either atorvastatin (15mg/Kg) or methyl cellulose (0.5%), administered by oral gavage, the first dose 5 minutes after reperfusion and the second dose after 12 hours. Brain tissue was analyzed for infarct volume and hemoglobin content. In another set of Wistar rats (n=3), atorvastatin (15mg/Kg) was administered by oral gavage to compare its pharmacokinetic profile with that of humans
Results: Atorvastatin-treated groups had significantly lower hemoglobin (p=0.0156) and infarct volume (p=0.0132) compared to their controls. Atorvastatin peak concentration (27–77 ng/ml) in rats’ plasma was found to be similar to that seen after 80mg/day of atorvastatin in humans.
Conclusion: Atorvastatin can be a novel vascular protective agent after acute ischemic stroke especially in a high risk population like diabetics. The mechanisms through which these effects are mediated are currently being investigated.
Abstract 2131: The Association of Coarctation of Aorta Diminishes the Occurrence of Ascending Aorta Dilation in Children and Young Adults with Bicommissural Aortic Valves.
Authors: Nguyen Thieu , Beaton Andrea Z , Lai Wyman W , Ramaswamy Prema , Parness Ira A , Srivastava Shubhika 
Published: July 2021

Objectives: To explore the difference in ascending aortic dilatation between subgroups of bicuspid aortic valve (BAV) patients with and without coarctation of the aorta (CoA).
Methods: Our echocardiographic database (1993–2006) was searched for BAV patients with CoA (Group A) and without CoA (Group B). Measurements at the aortic annulus, root, sinotubular junction, and ascending aorta were obtained for each patient, and body surface area-adjusted Z-score values were compared. Exclusion criteria included more than mild aortic stenosis or regurgitation, previous balloon aortic valvuloplasty, or complex left heart disease; plus Turner, Noonan, Williams, and Marfan Syndromes.

Results: The median age in Group A (n=53) was 11.3 yrs (range 0 to 30) with median follow-up of 7 yrs (0 to 12.7); median age in Group B (n=145) was 8.7 yrs (0 to 29) with median follow-up of 4 yrs (0 to 13.1). Group B patients had significantly greater aortic annulus, sinotubular junction, and ascending aortic dimensions (ascending aorta Z-scores shown in Figure

, p<0.0001). Group A ascending aortic dimensions did not differ significantly from the normal population. The rate of growth of the ascending aorta in Group B was higher in the first 10 years of life.

Conclusion: The ascending aorta in patients with bicuspid aortic valve and coarctation does not dilate to the same degree as patients with isolated bicuspid aortic valve. This may reflect an inherent difference in aortic wall properties between the two groups.

Comparison of Ascending Aorta Z Scores
Abstract 2280: Urine Albumin/creatinine Ratio, Cardiac Structure And Diastolic Function In Patients With Hypertension And Diastolic Dysfunction: The Validd Study
Authors: Verma Anil , Janardhanan Rajesh , Daley William L , Ritter Susan , Kaye William A , Naqvi Tasneem , Lacourcier Yves , Aurigemma Gerard , Thomas James D , Zile Michael , Solomon Scott D 
Published: July 2021

Background:
Increasing urine albumin/creatinine ratio (ACR) is associated with systemic microvascular damage and increased cardiovascular morbidity and mortality. However, the relationship between albuminuria and left ventricular (LV) diastolic function, an early measure of myocardial end-organ damage in hypertension, has not been well defined.

Methods:
Urine ACR and echocardiographic measures of LV structure and function were assessed in 384 patients enrolled in the VALsartan In Diastolic Dysfunction (VALIDD) trial with mild hypertension and no heart failure and evidence of diastolic dysfunction based on Doppler assessment of myocardial relaxation velocities.

Results:
Urine ACR was undetected in 151 (39.3%) subjects, between 1 to 30 mg/g in 194 (50.5%), and > 30mg/g in 39 (10.2%). The mean blood pressure in the cohort was 143.8 ± 16.1/86.2 ± 10.3 mmHg and LV hypertrophy was present in < 4% of enrolled patients. Higher urine ACR was associated with lower annular relaxation velocity (E′), higher E/E′ (Figure

), higher prevalence of concentric LV remodeling and higher NT-ProBNP even after adjusting for age, diabetes, systolic BP, eGFR and LV mass index (LVMi) (p < 0.02 for all associations).

Conclusion:
Albuminuria is associated with worsening diastolic function in patients with hypertension, and both measures may represent important and modifiable markers of early end-organ damage even in patients with mild blood pressure elevation.

E′ stratified by urine albumin creatinine ratio
E/E′ stratified by urine albumin creatinine ratio
Abstract 2378: The MinK G38S Polymorphism Associates with Atrial Arrhythmias after Subarachnoid Hemorrhage
Authors: Frangiskakis J M , Tanabe Masaki , Hravnak Marilyn , Crago Elizabeth A , Gorcsan John , Horowitz Michael B , London Barry 
Published: July 2021

Background: Subarachnoid hemorrhage (SAH) leads to significant death and disability. Cardiac abnormalities after SAH include atrial arrhythmias (AAs). The MinK (KCNE1) G38S polymorphism has been associated with atrial fibrillation, with the G38 allele being linked to increased action potential duration in heterologous expression systems. The relationship of AAs and ion channel polymorphisms after SAH is not known.
Methods: In 148 patients admitted for acute, aneurysmal SAH, EKG parameters, 24-hour Holter monitors, serum troponin (TnI), potassium (K), magnesium (Mg), and echocardiograms (ejection fraction [EF] and left atrial diameter [LA D]) were examined. MinK G38S was genotyped using fluorescent primers and analyzed with an ABI Prism 7000.

Results: No patient had AAs on presentation, but AAs developed in 101 (68%) patients: SVT (95; 64%); fibrillation (9; 6%); flutter (4; 3%); idioventricular rhythm (2; 1%); and 3° block (1; 1%). AAs were not associated with PR or QTc intervals, TnI, K, Mg, EF, LA D, or stroke severity. AAs were associated with older age (58±9 vs 51±10yrs; p<0.001), lower heart rate (HR; 80±10 vs 84±14bpm; p=0.02), and higher HR variability (SDNN; 97±34 vs 85±32; p=0.05). The MinK S38 allele was associated with AAs (Figure

; GS & SS 70% vs GG 51%; p=0.02), but not LA D.

Conclusions: Atrial arrhythmias are common following SAH and the MinK S38 allele is associated with an increased frequency of atrial arrhythmias. The SAH-induced catecholamine surge, followed by increased parasympathetic activity, may enhance the shortening of the atrial effective refractory period in patients carrying the MinK S38 allele and increase susceptibility to atrial arrhythmias.