bluuebunny/crossref_metadata_2025_split huggingface dataset:
The female gender as a risk factor of contrast-induced acute kidney injury in patients with chronic coronary syndromes
Authors: Mironova O , Isaev G O , Perekosova O I , Fomin V V 
Published: October 2021

Abstract

Background
The female gender is a well known risk factor of acute kidney injury that is included in many score widely used by cardiologists for assessment of the risk of contrast-induced acute kidney injury (CI-AKI). The exact influence of gender in patients with chronic coronary syndromes requiring intraarterial contrast media administration remains to be established.

Purpose
The aim of our study was to assess the influence of gender on the risk of the development of CI-AKI in patients with chronic coronary syndromes, receiving optimal medical treatment and with indications for percutaneous coronary interventions (PCI).

Methods
1023 patients with chronic coronary syndromes and indications to PCI were included in the prospective cohort clinical study. The CI-AKI was defined as a rise in serum creatinine equal to or more than 25% from baseline. Preventive measures included the administration of 0,9% saline with intravenous infusion speed of 1 ml/kg/h (0,5 ml/kg/h for patients with heart failure) before and after the procedure. The contrast media used were either iodixanol or iopromide, which are both known to cause less adverse events than high-osmolar contrast media.

Results
The CI-AKI developed in 132 patients (12,9%). The number of male patients was higher than the female ones (741 and 282, 72,4% and 27,6% respectively). The 95% confidence interval of the means was −0,004 to 0,0088. The F test was performed to compare variances: F was 1,297, DFn 281, Dfd 740, the p value was statistically significant. The CI-AKI developed in 45 females (16% of all the female patients) and 87 males (11,7% of all the male patients). Female patients were more likely to be enrolled in the study in older age (presented in population pyramid). This fact is likely to be due to the menopause and natural history of chronic coronary syndromes in female gender.

Conclusion
The female gender is a significant risk factor of the CI-AKI development in patients with chronic coronary syndromes undergoing percutaneous interventions. Women need to be screened and monitored more closely before any contrast media administration in catheterisation laboratory.

Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Sechenov University
Does transition through menopause affect cardiovascular disease risk factors? Results from a population-based cohort (CoLaus study)
Authors: Raguindin P F , Cardona I , Muka T , Lambrinoudaki I , Gebhard C , Franco O H , Marques-Vidal P , Glisic M 
Published: October 2021

Abstract

Introduction
Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying aging trajectories. We examined whether reproductive stages are differently associated with changes in cardiovascular risk factors.

Methods
This is a prospective population-based cohort study. We used data from women at baseline and follow-up (mean 5.5 years). We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years), and (iv) late (&gt;5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. In the cross-sectional analysis, we compared CVD risk factors at baseline across different reproductive stages using multivariable linear regression models. In the longitudinal analysis, we used multivariable linear mixed models. We used premenopausal women as a reference category and adjusted our analyses for age, medications, hormone replacement therapy, lifestyle, body mass index (BMI) at baseline and follow-up.

Results
We used the data from 2,558 women aged 35–75 years. At baseline, compared to premenopausal women, (i) transition and early postmenopausal groups had higher HDL, (ii) early- and late postmenopausal women had higher BMI, total cholesterol, adiponectin, and interleukin-6 levels, and (iii) all other women groups had higher diastolic blood pressure and glucose levels, while no differences were observed in the other CVD risk factors. At follow-up, women across the four reproductive categories showed an increase in BMI, total cholesterol, triglycerides, and fasting glucose compared to baseline. However, linear mixed models showed that, the changes in CVD risk factors were not significantly different in the other three menopausal categories compared to premenopausal women. When using age as a predictor variable and adjusting for menopause status, most of the CVD risk factors increased, while interleukin 6 and interleukin 1b decreased with advancing age. The estimates did not change when the analyses were restricted to women who did not report hormone therapy-use.

Conclusion
The current study suggests that women have a worsening of cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the five year changes in cardiovascular risk factors may not depend on menopausal status per se. More studies are still needed to disentangle the contribution of age and menopause in postmenopausal CVD risk, and other pathways not explored in this study.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): COLAUS was supported by a research grants from GlaxoSmithKline and the Swiss National Science Foundation and
Spontaneous Coronary Artery Dissection (SCAD) and a family history of aortic artery dissection, a case series
Authors: McGrath-Cadell L , Hesselson S , Tarr I , Iismaa S E , Bax M , Junday K , Dunwoodie S E , Fatkin D , Kovacic J , Muller D W M , Giannoulatou E , Graham R M 
Published: October 2021

Abstract

Background/Introduction
SCAD typically affects women in their fifth or sixth decade with a paucity of cardiovascular risk factors.(1) It is caused by a coronary artery intramural haematoma with or without intimal tear. Resultant luminal occlusion manifests as myocardial ischaemia/infarction or death.
There are two published sporadic cases of SCAD who developed iatrogenic aortic dissection with coronary angiography.(2, 3) We are not aware of any SCAD cases with intercurrent or historical spontaneous aortic dissection. There is a published SCAD case with a familial history of aortic dissection, in her mother.(4) None of these cases reported a connective tissue disorder.

Methods
We searched our database of 338 SCAD cases, recruited via social media or cardiologist referral, for cases with a family history of aortic dissection. SCAD diagnosis was confirmed by review of coronary angiogram images by an expert interventional cardiologist blinded to the genetic analysis.
Genomic DNA was extracted from buccal cells collected using a cheek swab or mouthwash sample. Whole genome sequencing was performed using the Illumina HiSeq X Ten platform with 30x coverage.
These data are being analysed for rare variants in genes associated with familial aortopathies or connective tissue disorders (e.g. FBN1, COL3A1, TGFbR-1/2, SMAD3), as well as for novel gene associations with aortic dissection and/or SCAD.

Results
We identified 12 cases with a first- or second-degree relative with aortic dissection. Of these SCAD cases, 11 were female whereas 10 of 12 relatives with aortic dissection were male. In one instance, a maternal uncle, but not the index SCAD case, had Marfan's syndrome.
Whole genome sequencing has been performed on the 12 SCAD cases, 2 living relatives with aortic dissection and 2 relatives linking the SCAD and aortic dissection cases.

Conclusions
Coronary and aortic dissections have serious consequences and in some families there may be a genetic association between the two conditions. Early identification of variant carriers is critical for disease prevention.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This work was supported in part by grants from the Cardiac Society of Australia and New Zealand, the National Health and Medical Research Council, Australia (APP1161200), the St Vincent's Clinic Foundation, the Catholic Archdiocese of Sydney, Perpetual Philanthropy, NSW Health and SCAD Research Inc. LMC is funded by a University Postgraduate Scholarship through University of NSW and a grant from the Avant Foundation.
Management and outcome of non-ST-elevation acute coronary syndromes in the elderly admitted to spoke hospitals with no cath-lab facility
Authors: Mantovani F , Guerri E , Manca F , Calzolari M , Colaiori I , Musto D'amore S , Pignatelli G , Guiducci V , Navazio A 
Published: October 2021

Abstract

Background
Current guidelines recommend an early invasive strategy in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). However, the role of an invasive strategy in elderly patients remains controversial and may be difficult to achieve in spoke hospitals with no cath-lab facility.

Purpose
We aimed to analyze characteristics and outcomes of patients ≥80 years with NSTE-ACS admitted to spoke hospitals.

Methods
Observational retrospective study of all consecutive NSTE-ACS patients admitted to two spoke hospitals, where a service strategy (same-day transfer between spoke hospital and hub center with a cath-lab facility to perform coronary angiography) was available.

Results
From 2013 to 2017, 639 patients were admitted for NSTE-ACS in a spoke hospital of our provincial cardiology network; of these, 181 (28%) were ≥80 years (median 84, IQR 82–89). In the elderly conservative strategy was chosen in 76 patients (42%). When the invasive strategy was chosen, 104 patients (93%) were managed with a Service strategy with no major adverse event observed during the back transfer from the invasive center to the referring spoke center, whereas the rest of the patients (8, 7%) were transferred from the spoke hospital to the hub center and completed their hospital stay without returning to the spoke center. Of patients initially managed with the service strategy, a shift of strategy after the invasive procedure was necessary for 11 (10%) and the patients remained in the hub center. The median time to access to cath-lab was 50 hours (IQR 25–87), with 73 patients (70%) reaching the invasive procedure &lt;72 h from the hospital admission and 23 (22%) &lt;24 h.
Conservative strategy was associated with older age, known previous CAD, clinical presentation with symptoms of LV dysfunction, lower EF, renal failure, higher GRACE score, presence of PAD, and atrial fibrillation (all p&lt;0.03; Table).
At 1-year follow-up, the overall survival was significantly higher in patients treated with invasive strategy compared to patients managed conservatively (94%±2 vs. 54%±6, p&lt;0.001; HR: 10.4 [4.7–27.5] p&lt;0.001; Figure), even after adjustment for age, serum creatinine, known previous CAD and EF (adjusted HR: 2.0 [1.0–4.0]; p&lt;0.001).

Conclusion
An invasive strategy may confer a survival benefits in the elderly with NSTE-ACS. When the invasive strategy is chosen, the same-day transfer between spoke hospital and hub center with the cath-lab facility (service strategy) is safe and granted the access to cath-lab in a timely fashion even in the elderly.

Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1
Percutaneous transluminal angioplasty associated with a comparable risk of mortality in old patients with severe lower extremities arterial disease
Authors: Liu C W , Su M I 
Published: October 2021

Abstract

Background
Percutaneous transluminal angioplasty (PTA) improves limb salvage rates in patients with severe lower extremity arterial disease (LEAD). It remains unknown whether PTA can be safely performed to the older LEAD patients.

Purpose
We investigated the effect of age ≥85 vs &lt;85 years on prognoses in LEAD patients.

Methods
We analyzed 222 LEAD patients from our previous retrospective cohort study between 2013 and 2018. All patients received percutaneous transluminal angioplasty. Study outcomes were in-hospital mortality and 1-year all-cause mortality and major adverse limb events (MALEs).

Results
The study included 222 patients aged 74±11 years (54% male), and 12.6% had acute limb ischemia. The older group had significantly higher rates of in-hospital (17.8 vs. 5.1%, P=0.009) and all-cause mortality (37.8% vs. 19.2%, P=0.016), but MALEs were not different significantly (8.9% vs. 16.9%, P=0.247). In multivariate logistic regression analyses, age ≥85 years was not associated with the increased risks of the study outcomes after we adjusted for potential confounders. The risk factors associated with 1-year all-cause mortality was the presence of acute limb ischemia (adjusted HR: 2.978, 95% CI: 1.502–5.905, P=0.002) and Rutherfold stages (adjusted HR: 2.135, 95% CI: 1.248–3.652, P=0.005).

Conclusion
Compared with the patients aged less than 85 years, the LEAD patients aged more than 85 years had favorable risks of mortality after receiving PTA, and the incident MALEs were not significantly different.

Funding Acknowledgement
Type of funding sources: None. Study outcomes in LEAD patients
Invasive management in elderly patients with non-ST elevation myocardial infarction is beneficial regardless of frailty status
Authors: Fishman B , Sharon A , Itelman E , Tsur A M , Fefer P , Barbash I M , Segev A , Matetzky S , Guetta V , Grossman E , Maor E 
Published: October 2021

Abstract

Introduction
Elderly patients are underrepresented in clinical trials evaluating the management of non-ST elevation myocardial infarction (NSTEMI) patients. Moreover, frailty status is often not reported in these trials.

Purpose
To evaluate the association of invasive management with outcome among elderly (≥80) patients presenting with NSTEMI by frailty status.

Methods
Retrospective cohort of consecutive elderly patients who were hospitalized with NSTEMI as a primary clinical diagnosis between 2008 to 2019. Primary outcome was all-cause mortality. Frailty status was estimated as a continuous variable as well as categorized to low, medium, and high. Cox regression models were applied with stratification by frailty status. Additional sensitivity analyses were conducted including propensity score matching (PSM) and inverse probability treatment weighting (IPTW) models.

Results
Study population included 2,317 patients with median age of 86 years (IQR 83–90) of whom 1,243 (54%) were men. Patients who were managed invasively (n=581 [25%]) were less likely to be frail (7% vs. 44%, p&lt;.001). During the follow up (median of 19 months, [IQR 4–41]), 1,599 (69%) patients died. Kaplan Meier survival curves (Figure 1) show that the cumulative probability of death at 19 months was 50% among patients who were managed conservatively compared with 21% among invasively managed patients (p Log rank &lt;.001). In the multivariable Cox model, invasive approach was associated with a significant 39% decrease in the risk of death (95% CI 0.53–0.71). The benefit of invasive approach was consistent among low, medium, and high frailty subgroups with adjusted HRs of 0.74 [0.58–0.93], 0.65 [0.50–0.85] and 0.52 [0.34–0.78], respectively; p for interaction NS). Results were consistent with PSM and IPTW analyses (HR of 0.6 [0.50–0.71] and 0.67 [0.55–0.82], respectively). Additional sensitivity analysis addressing potential immortal time bias and residual confounding yielded similar results.

Conclusions
Invasive approach is associated with improved survival among elderly patients with NSTEMI irrespective of frailty status. Our results support and extend recent ESC recommendations for the management of elderly patients with NSTEMI

Funding Acknowledgement
Type of funding sources: None. Figure 1
Prediction of radiation-related cardiotoxicity using F-18 FDG PET in non-small-cell lung cancer
Authors: Cho S G , Kim Y H , Park H J , Park K S , Kim J H , Ahn S J , Bom H S 
Published: October 2021

Abstract

Background
Radiation-related cardiotoxicity has been refocused nowadays as the follow-up was increased amomg the patients with advanced lung cancer. The early recognition of the occult cardiotoxicity enables the early intervention preventing clinically significant cardiac events or worsening of severity.

Purpose
We aim to search whether the F-18 fluorodeoxyglucose positron emission tomography (FDG PET) performed immediately after radiotherapy could predict the late cardiac events.

Methods
We retrospectively enrolled 133 patients with locally advanced, unresectable stage III NSCLC who underwent F-18 fluorodeoxyglucose positron emission tomography (FDG PET) immediately after CCRT for the response evaluation and survived at least for 6 months. Heart was recontoured according to the RTOG 0617 secondary analysis atlas for the dose volume analysis. Standardized uptake values (SUV) of the left ventricular myocardium were measured on FDG PET images. The patients were regularly followed up for the disease progression and complications. The primary end-point was the cardiac events grade ≥2 based on the Common Terminology Criteria for Adverse Events (version 5.0).

Results
FDG PET was performed at median interval of 11 days after CCRT. Fourty-two patients experienced cardiotoxicity during a median follow-up of 47 months (range, 12 – 123 months). In univariable analysis, mean heart dose, maximum SUV of the left ventricle (LV SUVmax), white blood cell count, and diabetes were associated with the risk of cardiotoxicity. In multivariable analysis, only higher mean heart dose (&gt;11.1 Gy, hazard ratio 3.930 [95% confidence interval 1.933–7.988]; p=0.0002) and higher LV SUVmax (&gt;12.84, 2.189 [1.162–4.124]; p=0.0152) were independently associated with increased risk of cardiotoxicity. In subgroup analyses, LV SUVmax remained predictive of cardiotoxicity among those with higher mean heart dose, but not among those with lower mean heart dose.

Conclusion
Early FDG PET after CCRT for NSCLC could predict the late cardiac events, especially in patients with high dose cardiac irradiation.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): This work was supported by a grant of the Basic Science Research Program through the National Research Foundation funded by the Ministry of Education, Republic of Korea (Principal Investigator: Sang-Geon Cho)
Incident cardiovascular events among healthy subjects are associated with increased risk of subsequent cancer diagnosis
Authors: Fardman A , Tiosano S , Kaplan A , Kalstein M , Moshkovits Y , Segev S , Klempfner R , Segev A , Grossman E , Maor E 
Published: October 2021

Abstract

Introduction
While Cardiovascular disease (CVD) and cancer share common risk factors, data on the temporal association between the occurrence of CVD and cancer is limited.

Purpose
This study investigated the association between incident CVD events future cancer among apparently healthy subjects.

Methods
We evaluated asymptomatic self-referred adults who participated in a screening program. All subjects were free of CVD and cancer at baseline. CVD was defined as the composite of acute coronary syndrome, percutaneous coronary intervention, or stroke. Study endpoint was the development of cancer during follow up. Cancer and mortality data were available for all subjects from national registries. Cox regression models were applied with CVD as a time-dependent covariate and death as a competing risk event.

Results
Final study population included 26,574 subjects. Median age was 46 years (Interquartile range [IQR] 40–53) and 69% were men. During median follow up time of 10 years (IQR 3–16) 2,463 (9%) subjects developed CVD, 2,040 (8%) developed cancer and 869 (3%) died. Most common cancer types were prostate among men (N=406, 2.2%) and breast among women (N=283, 3.4%). Compared with patients who were free of CVD and cancer during follow up, risk of death was 5, 34 and 54 times higher for patients who developed CVD event, cancer, or both during follow up, respectively (p &lt;.001 for all). Time dependent survival analysis showed that subjects who developed CVD during follow up were 50% more likely to develop cancer in a univariate model (95% Confidence Interval [CI] 1.3–1.7, p&lt;.001). Interaction analysis demonstrated that the association of incident CVD with the risk of future cancer diagnosis was age dependent such that in younger subjects (≤52 years; N=19,052) incident CVD was associated with a significant 30% increased risk of subsequent cancer diagnosis (95% CI 1.03–1.67, p=.027) while in older subjects incident CVD was not associated with increased risk of cancer in the multivariable model (p for interaction =.018).

Conclusion
Incident CVD is independently associated with increased risk of subsequent cancer diagnosis among young adults. Active cancer surveillance should be considered among young patients recovering from a CVD event.

Funding Acknowledgement
Type of funding sources: None.
Effect of the number of parity on right heart chamber quantification
Authors: Keskin M , Borklu E B , Dogan S , Ozturk B , Tenekecioglu E , Keser N , Orhan A L 
Published: October 2021

Abstract

Introduction
Pregnancy is a process that causes several physiological changes including all systems as well as cardiovascular system. Ventricular hypertrophy and dilation of cardiac chambers are seen as a result of these changes. Although there are studies about pregnancy-related changes in echocardiographic examination; there is no data about the long-term effects of parity on these alterations. Therefore, we have evaluated the long-term effect of pregnancy on right ventricular (RV) dilation and RV hypertrophy and their relation to the parity number.

Methods
This prospective study included a total of 600 women (200 consecutive women who had no parity, 200 women who had a parity number of 1 to 4 and 200 women who had a parity number of more than 4). Right chambers' measurements were compared between the groups.

Results
In echocardiographic analysis, RV and right atrial dimensions and areas and RV wall thickness were higher in parous women. On the other hand, RV systolic function parameters were significantly lower in parous women. These significant changes showed a gradual increase or decrease by increasing parity number. By multivariate hierarchical logistic regression analysis, the 4 independent factors that increased the risk of RV dilation were age (OR: 1.16 CI: 1.10 – 1.20), body mass index (OR: 1.05, CI: 1.02 to 1.08), smoking (OR: 1.87, CI: 1.28 to 4.02), and giving a birth (OR: 3.94 CI: 1.82 – 8.81). There were also independent relationship between the number of parity and RV hypertrophy even after adjustment for several confounders.

Conclusion
Pregnancy-related physiological changes mostly resolve after delivery. This study about long-term effects of pregnancy on RV has demonstrated that there is a significant relation between the number of parity and either RV dilation or RV hypertrophy. Each parity had also additive effect on these changes.

Funding Acknowledgement
Type of funding sources: None.