bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 6016: Pathology Of Hypersensitivity In Late Drug Eluting Stent Thrombosis
Authors: Ladich Elena , Nakazawa Gaku , Cook Stephane , Windecker Stephan , Burke Allen , Kolodgie Frank , Virmani Renu 
Published: July 2021

Background: Localized hypersensitivity (HS) has been reported as a pathologic risk factor for late DES thrombosis (DES-LST). The objectives of the study were to examine the pathologic features of HS in DES-LST and correlate with stent characteristics, underlying plaque morphologies and patient risk factors.
Materials and methods: From a registry of 153 DES patients, 33 patients with DES-LST were identified. LST was defined as platelet-rich thrombus in a coronary stent implanted > 30 days. Stented arteries were serially sectioned at 2–3 mm intervals and stained with H&E, Movat stain, Luna stain (eosinophils), and UCHL (T-lymphocytes). Localized HS was defined as an inflammatory cell infiltrate composed predominantly of eosinophils and T-lymphocytes limited to the arterial wall surrounding the stent. Patient data, risk factors, stent characteristics, and underlying plaque morphology were compared between two groups: hypersensitivity (HS), and non-hypersensitivity LST (NHS).
Results: Of the 33 DES-LST cases with occlusive thrombus, 6 (4 men, 2 women) demonstrated HS histologically (18%). The mean age was 54 years (range 40 – 62 years). All 6 had Cypher stents (mean stent length=24 mm), 4 had >1 stent, 2 with overlapping stents. The mean stent duration was 624 days (range 112 to 990 days). Three patients were on ASA and clopidogrel, 2 ASA only, 1 discontinued ASA/clopidogrel prior to non-cardiac surgery. Patient risk factors included hyperlipidemia (n=6), hypertension (n=5) and smoking (n=4). All demonstrated underlying fibroatheroma with stent struts penetrating necrotic core in 3 and 2 with previous rupture sites. Stent malapposition was present in 5 (83%). Twenty-seven patients demonstrated NHS-LST (Cypher=7, Taxus=20). Mean stent duration was 326 days (range 31–1200 days). Malapposition was identified in 10 (37%). Compared to NHS, the HS LST group was more likely to demonstrate stent malapposition (p=0.04) and longer implant times (p=0.049).
Conclusions: DES-LST is related to HS in 18% of cases, is associated with Cypher stents, malapposition and longer implantation time. Localized HS with stent thrombosis is a clinically important problem that may occur late after stenting and warrants further pathologic study.
Abstract 6189: Stent Fracture does not Affect Long Term Patency in the Femoro-popliteal Artery: Four Years Experience
Authors: Iida Osamu , Nanto Shinsuke , Uematsu Masaaki , Morozumi Takakazu , Watanabe Tetsuya , Awata Masaki , Onishi Toshinari , Sera Fusako , Minamiguchi Hitoshi , Yano Masamichi , Ikeoka Kuniyasu , Okamoto Shin , Tanaka Nobuaki , Yasui Haruyo , ishihara Takayuki , Dohi Tomoharu , Nagata Seiki 
Published: July 2021

[Background] Stent fracture in the femoro-popiteal (FP) artery has been related to poor long term patency. However, time course of patency with and without stent fracture beyond 2 years has not been explored.
[Methods] We studied consecutive 334 FP lesions that received provisional stenting with metallic or nitinol stents (Luminexx, Bard: 90 lesions and Smart, Cordis: 243 lesions). Stent fracture was determined by X-ray with multiple projections. Patency was either assessed by Duplex ultrasonography as peak systolic velocity ratio > 2.5 or by angiography (% diameter stenosis > 50%).
[Results] Stent fracture occurred in 19% (55/334) lesions and restenosis rate at mean follow up (16+/−12 months) was 20% (67/334). Primary patency with or without stent fracture was 83% with fracture versus 68% without fracture at 1 year, p=0.03; 75% versus 60% at 2 years, p=0.04; 68% versus. 60% at 3 years, p=0.05; 63% versus 60% at 4 years, p=0.06.
[Conclusion] Stent fracture affected the patency during the first 2 years, but unlikely affected the patency beyond 4 years.
Abstract 1245: The Mortality Rate from Cardiovascular Disease is more than Five Times Higher in Individuals with Diabetes Mellitus who have the Hp 2–2 Genotype as Compared to Individuals with Diabetes Mellitus who do not have the Hp 2–2 Genotype
Authors: Milman Uzi , Blum Shany , Shapira Chen , Levy Andrew 
Published: July 2021

Objective: To determine if the Haptoglobin (Hp) genotype can predict the risk of death from cardiovascular disease in individuals with Diabetes Mellitus (DM) in a prospective community based longitudinal study. Background: The Hp gene is polymorphic in man with two classes of alleles denoted 1 and 2. Retrospective analysis of 5 longitudinal studies has demonstrated that the Hp genotype is a major determinant of the risk of incident CVD in DM individuals. Specifically, individuals with the Hp 2–2 genotype and DM were found to have a 2–5 fold increased risk of CVD as compared to Hp 1–1 or Hp 2–1 DM individuals.
Method: 2241 individuals with DM ≥55 years of age from 47 primary health care clinics were Hp genotyped and followed prospectively for three years for incident myocardial infarction, stroke and death (all cause and cardiovascular). All aspects of the medical care of individuals in the cohort were left to the discretion of the patient’s physician.
Results: The cohort consisted of 708 individuals with the Hp 2–2 genotype and 1533 individuals with the Hp 1–1 or 2–1 genotype. At baseline there were no significant differences between individuals with and without the Hp 2–2 genotype in their DM characteristics (HbA1c, duration) or in the prevalence of cardiovascular disease (25% in both groups). During the nearly 3 year period of follow up total mortality was increased in individuals with the Hp 2–2 genotype (2.5% vs 1.8%, HR 0.68, CI 0.35–1.25, p=0.2 by log rank). These differences in overall mortality were the result of a greater than 5 fold increase in CV death in Hp 2–2 individuals (1.1% vs 0.2%, HR 0.15, CI 0.038 – 0.44, p=0.001 by log rank). The incidence of non fatal MI was increased by over 50% in the Hp 2–2 group (3.9% vs. 2.5%, p=0.068). These differences were unaffected by adjustment for DM characteristics and conventional cardiovascular risk factors.
Conclusions. DM individuals with the Hp 2–2 genotype are at a dramatically increased risk of death due to cardiovascular disease. Pharmacogenomic treatment strategies targeted to this high risk population may provide considerable public health and economic benefit.
Abstract 3239: Risk of Stroke after New-Onset Atrial Fibrillation versus Chronic AF in Patients Undergoing Coronary Artery Bypass Surgery
Authors: Yeo Khung Keong , Li Zhongmin , Katz Scott , Douketis James , Danielsen Beate , White Richard H 
Published: July 2021

Background: Among patients undergoing isolated coronary artery bypass graft surgery (CABG), the risk of post-operative stroke has not been compared between patients with chronic atrial fibrillation (AF) versus patients with hospital-acquired new-onset AF (new-AF).
Methods: Using linked hospital discharge data together with comprehensive clinical data from the California CABG outcomes reporting program, we conducted a retrospective cohort study of all patients undergoing isolated CABG in California between years 2003–2006. Using hospital discharge data, chronic AF was defined as ICD-9-CM =427.31 present at time of admission and during a previous hospitalization. New-AF was defined as a first-ever code for AF that was not present at the time of admission. The risk of stroke < 30 days after surgery, defined using specific ICD-9-CM codes, was analyzed using logistic regression, with adjustment for 15 clinically important stroke risk factors. As a sensitivity analysis, we developed a propensity model for new-AF, and analyzed the risk of stroke after hospital discharge but within 30 days of surgery.
Results: Among 61,031 cases, 2081 (3.4%) had chronic AF; 9858 (17%) had new-AF; the 30-day incidence of stroke was 1222 (2.0%). Compared to patients with no-AF, the adjusted risk of stroke in patients with chronic AF was odds ratio (OR) = 1.2 (CI: 0.9 –1.5), whereas for new-AF, it was OR= 1.7 (CI: 1.5–1.9), c-statistic = 0.73. Using the propensity analysis, the risk of stroke after hospital discharge associated with new-AF versus no-AF was similar across quintiles of the risk score (OR range=1.7–1.8).
Conclusion: After adjusting for stroke risk factors, patients who developed AF during hospitalization for CABG had an approximately 70% higher risk of stroke within 30 days compared to patients without AF, whereas the risk of stroke in patients with chronic AF was not significantly increased. Interventions that reduce the incidence of new-AF after CABG surgery may reduce the incidence of subsequent stroke.
Abstract 5132: Positive Emotions and the Endothelium: Does Joyful Music Improve Vascular Health?
Authors: Miller Michael , Beach Valerie , Mangano Charles , Vogel Robert A 
Published: July 2021

Background: Previous studies have demonstrated that music may influence physiologic parameters such as heart rate and blood pressure. However, the extent to which music may also affect endothelial function has not been previously investigated.
Methods: This was a randomized 4-phase crossover and counterbalanced trial in ten healthy, non-smoking volunteers (70% male, mean age= 35.6 yrs) that included self-selections of music evoking joy [joyful music] or anxiety [anxious music]. Two additional phases included video clips to induce laughter and audio tapes to promote relaxation. To minimize emotional desensitization, subjects were asked to refrain from using self-selected tapes and images for at least 2 wks before each study phase. Endothelial function was assessed by brachial artery flow mediated dilation (FMD) and measured as % diameter change after an overnight fast. Following baseline FMD measurements, subjects were randomized to a 30 min phase of the testing stimulus followed by post-study FMD; they returned a minimum of 1 wk later for the next phase. A total of 160 FMD measurements were made.

Results: Compared to baseline, mean upper arm FMD increased 26% during the music phase that evoked joy (
P
=
0.0002
) compared to a 6% decrease in FMD observed after listening to music that elicited anxiety (
P
=
0.005
) (Figure

). Mean FMD also increased 19% during the laughter phase (
P
=
0.08
) and 11% during relaxation (
P
=
NS
). Self-selected joyful music was associated with increased FMD to a magnitude previously observed with aerobic activity or statin therapy.

Conclusion: Listening to joyful music may be a useful adjunctive lifestyle measure to promote vascular health.
Abstract 6273: Changes in Metabolic Parameters, Adiponectin, and High Sensitivity C-reactive Protein in South Asian Women Migrating to the United States: A 3-Year Follow-Up Study
Authors: Arora Anjali , Vora Aaditya , Eapen Danny J , Khan Bobby 
Published: July 2021

Background: The incidence of cardiovascular disease in South Asian women is increasing, both in native and migrant populations. The reasons for this finding may be in part related to changes in lifestyle and alterations in cultural behavior.
Methods: We studied 301 healthy women (average age 28) recently migrated to the United States from the South Asian countries of India, Bangladesh, Pakistan, and Sri Lanka within 3 months of the time of arrival and at 3 years (31– 41 months) following their arrival. A questionnaire regarding activities pertaining to diet, physical activity, and socioeconomic status was performed. Measurements included changes in blood pressure (BP), total body weight, lipids, glucose, and determinations of high sensitivity CRP (hsCRP) and adiponectin from frozen serum specimen at these time points.
Results: In this diverse population, subjects reported an increase in food intake (including added salt and fat quantities) and no overall change in physical activity. Accordingly, there was a significant increase in total body weight after a 3 year period (119.7±14.4 to 127.9±15.3 pounds, p<0.005). There was a significant increase in serum LDL cholesterol (103.8±17.6 to 111.0±15.9 mg/dl, p=0.018), triglycerides (136.1±25.3 to 157.5±20.0 mg/dl, p=0.023), and glycosylated hemoglobin (4.9±0.7 to 5.3±0.6%, p=0.029). Moreover, the prevalence of diabetes mellitus (fasting glucose>125 mg/dl) increased from 3.3 to 9.7% in the 3-year follow-up period. There was an increase in serum hsCRP (1.80±0.19 to 2.05±0.18 mg/l, p=0.010) and a decrease in serum adiponectin (10.8±0.9 to 9.5±1.0 mg/l, p=0.022) in these subjects.
Conclusions: The population of South Asian women is at increased risk for cardiovascular disease and diabetes mellitus. Changes in lifestyle, including dietary intake and physical activity, affect parameters that may be crucial in the pathogenesis of these disease states.
Abstract 8: Influence of Receiving Hospital Characteristics on Survival after Cardiac Arrest
Authors: Callaway Clifton W , Schmicker Rob , Kampmeyer Mitch , Powell Judy , Nichol Graham , Rea Thomas D , Daya Mohamud , Aufderheide Tom , Davis Dan , Rittenberger Jon , Idris Ahamed H 
Published: July 2021

Hospital management of out-of-hospital cardiac arrest (OHCA) patients after return of spontaneous circulation (ROSC) can influence patient survival via interventions such as hypothermia and cardiac catheterization (CATH). This study tested the hypothesis that survival differed between different types of hospitals for subjects with ROSC after OHCA.
Methods: Adult (≥ 18 years) subjects with paramedic-documented ROSC or who lived >1 day after OHCA were identified with their receiving hospital in a prospective database from 9 regions in the US and Canada. Hospitals were characterized using the American Hospital Directory or the Guide to Canadian Healthcare Facilities. Hospitals were categorized by bed number (large >400; medium 250 – 400; small <250) and CATH capability. Associations between clinical variables, hospital categories, survival time, and survival to hospital discharge were determined using Cox regression and analysis of variance.
Results: Between December 2005 and July 2007, 3644 OHCA subjects were treated in 254 hospitals, with similar numbers in large (1026), medium (1094) and small (1276) hospitals. CATH hospitals treated 2123 (58%) subjects, and patient features (63% male, 42% VF/VT, 67% witnessed collapse, and mean call-arrival interval of 5.7 (SD 2.8) minutes) did not differ between hospital categories. CATH hospitals had higher survival than non-CATH hospitals in large (35.1% vs. 27.7%), medium (34.4% vs. 30.7%) and small (38.6% vs. 26.5%) categories (F=19.55; p<0.001). VF/VT (p < 0.001), age (p < 0.001) and witnessed collapse (p < 0.001) were associated with survival time. When adjusted for initial rhythm, call-arrival interval, witnessed collapse, age, sex, region, teaching institution, and trauma center level, there was no significant effect of CATH. However, the interaction of large hospital and CATH was associated with lower hazard of death (0.71, 95% CI [0.54, 0.93]).
Conclusions: Transport to a CATH hospital is associated with increased probability of survival to discharge after OHCA. These data cannot determine whether cardiac catheterization was performed or if CATH hospital is a surrogate for more comprehensive cardiac care. Therefore, further work should examine what aspects of in-hospital care affected outcome.
Abstract P15: Periodic Acceleration (pGz) Preconditioning in Swine Increases Endothelial Derived NO and Phosphorylated eNOS via Akt Pathway
Authors: Adams Jose A , Arias Jaqueline , Bassuk Jorge , Wu Heng , Uryash Arkady , Webster Keith , Lamas Gervasio , Kurlansky Paul 
Published: July 2021

Periodic acceleration (pGz) is the motion of the supine body using a motorized platform (3Hz & ±0.4G). pGz produces pulsatile shear stress increasing release of endothelial derived NO (eNO) which, also decreases myocardial stunning and improves outcomes from ventricular fibrillation (VF) cardiac arrest. Preconditioning with pGz (PRE-pGz) prior to VF cardiac arrest ameliorates global post resuscitation cardiac dysfunction and reduces arrhythmias. To test whether pGz and PRE-pGz increase eNOS and phosphorylated eNOS (p-eNOS) via the PI3-kinase-Akt pathway, anesthetized, intubated male swine (40 –50lbs) were studied. Five animals had no intervention (BL) and 5 received 1 hr pGz preconditioning (pGz) followed by Western Blot of myocardial tissue. Additional animals (10 per group) received 1 hr pGz (PRE-pGz) or no treatment (CPR-CONT). In the latter groups VF was electrically induced and unsupported for 8 min followed by continuous manual chest compression and defibrillation for 10 min or until return of spontaneous circulation (ROSC). PRE-pGz animals showed less hemodynamically significant arrhythmias after ROSC than CPR-CONT (35 vs 7; p<0.05) and less myocardial stunning. eNOS and phosphorylated-eNOS (p-eNOS) significantly increased after pGz and after CPR but were significantly higher in pGz preconditioned animals along with increased phosphorylated Akt (p-Akt). The graph below shows % changes relative to BL (M±SD). *p < 0.01 PRE-pGz vs CPR-CONT.
Conclusion: pGz applied prior to ischemia reperfusion injury increases eNOS and p-eNOS expression and increased p-Akt. Thus, pGz preconditioning protects myocardium during I-R in part by activating eNOS through p-Akt
Abstract P76: Assessment of Resuscitation Skills in Foundation Year 1 Hospital Doctors in Northern Ireland
Authors: Connoly Michael , Toner Philip , Sayee Nicole , McCluskey David , Stevenson Mike 
Published: July 2021

Aims: To assess Foundation Year 1 (F1) doctors’ ability to perform effective cardiopulmonary resuscitation (CPR) using different chest compression:ventilation ratios.
Methods: All forty F1 doctors working in a major teaching hospital were asked to participate in the study. Thirty four doctors participated, eighteen male and sixteen female. BMI was recorded in each case. They were asked to perform two, three minute sessions of CPR on a skills reporter manikin separated by a five minute rest period. Half of the doctors started using a ratio of 15:2 and half used 30:2. After a five minute rest the alternate ratio was performed. Their performance was assessed both objectively, by measuring the rate and depth of chest compressions, and subjectively by a panel of five advanced life support (ALS) instructors who reviewed tracings of each CPR session.

Results: Mean compression rate per minute was sixty five while performing 15:2 and ninety one at 30:2. Chest compressions were effective if >38mm. Twenty three doctors (67.7%) achieved >80% effective chest compressions at a ratio of 15:2, compared with nineteen doctors (55.9%) at 30:2. At 15:2, males were 89% effective compared to 44% of females. At 30:2 males were 83 % effective compared to 25% of females. At 15:2 82% of compressions were effective in BMI>24 group compared with 50% of BMI<24. At 30:2 BMI>24 achieved 76% effective compared with 35% in BMI<24 group. Outcome measures shown in table 1

show no statistical difference between 15:2 and 30:2. Subjectively, 41% of doctors were deemed effective at 15:2 compared with 35% at 30:2.

Conclusions:
A
significant number of F1 doctors are unable to perform effective CPR. Objectively, F1 doctors performed better at 15:2 than 30:2 but no statistical significance was noted. Subjectively, ALS instructors favoured the 15:2 regieme. CPR was performed better by males and doctors with BMI>24. F1 doctors’ should be carefully assessed before they act as first responders at in-hospital cardiac arrests.

Mean difference between 15:2 and 30:2
Abstract P80: Short-term Outcomes of Vasopressin Administerd with Epinephrine versus Epinephrine Alone in ED for Out-of-hospital Cardiac Arrest
Authors: Kim Tae Yun , Lee Sun Woo , Kim Kyuseok , Rhee Joong Eui , Jung Sung Koo 
Published: July 2021

Introduction: Out-of-hospital cardiac arrest (OOHCA) victims are increasing, but emergency medical service system (EMSS) is not ready for them in Korea. A previous randomized, controlled clinical trial has suggested that vasopressin followed epinephrine was superior to epinephrine in patients with asystole. According to the Korean national registry of OOHCA, patients with asystole were more than two thirds of them. In Korean EMSS, no drugs are permitted to administer in the prehospital phase by law. Thereafter epinephrine or vasopressin cannot be administered until patients are transported to emergency departments (EDs). This study was to evaluate whether the combined administration of vasopressin and epinephrine in ED for OOHCA patients would increase the return of spontaneous circulation (ROSC) and survival discharge.
Methods: From October 2007 to May 2008, we changed the CPR protocol in adult, nontraumatic OOHCA that 40 U of vasopressin was administered as soon as possible after the first dose of epinephrine (the after group). Cardiac arrest data were collected using the Utstein template. Data from January to September 2007, when vasopressin has not been used, were also collected for comparative analysis (the before group). These two groups were compared in terms of ROSC, and survival discharge
Results: There were 45 and 50 patients in the before and after groups, respectively. There was no significant differences in the initial ECG rhythm of asystole (67% vs 78%), witnessed arrest (73% vs 72%), bystander CPR (16% vs 10%), time from collapse to BLS time (6 min vs 8.5 min), and time from collapse to study drugs (23 min vs 26.5 min). The rate of sustained ROSC was similar between the before and after groups (53% vs 48%, P=0.604) as was the survival discharge (27% vs 14%, P=0.123).
Conclusions: Vasopressin with administerd with epinephrine does not increase the rate of ROSC nor the survival discharge.
Abstract P124: CGEN-855A, a Small Peptide Agonist of the Formyl Peptide Receptor-Like 1 Reduces Myocardial Reperfusion Injury
Authors: Jiang Rong , Hecht Iris , Rutledge Caleb , Zhao Zhiqing , Rotman Galit , Cohen Yossi , Vinten-Johansen Jakob 
Published: July 2021

Background: Neutrophils (PMNs) mediate reperfusion injury in part. Reperfusion (R) accelerates the accumulation of PMNs into ischemic myocardium. Postconditioning (PC) inhibits PMN activation and accumulation in area at risk (AAR) myocardium. Formyl-peptide receptor-like1 (FPRL1) agonists directly inhibit PMN transmigration. Accordingly, this study tests the hypotheses that

the FPRL1 agonist CGEN-855A applied at R reduces infarct size by inhibition of PMN infiltration;

the infarct reduction by CGEN-855A is comparable to that of the mechanical intervention Postconditioning; and

since both CGEN-855A and PC share a common property of PMN inhibition, the combination of CGEN-855A and Postconditioning (PC) will not have an additive effect on infarct size reduction.

Methods: In anesthetized open-chest rats, the left coronary artery (LCA) was occluded for 30 min and reperfused for 3 hours. Rats (n=10) were randomly assigned to:

Control- equal volume vehicle 5 min before R;

PC: three cycles of 10-s R followed by 10-s re-occlusion during the first minute of R;

2 mg/kg CGEN-855A administered 5 min before R;

2 mg/kg CGEN-855A + PC at R. Separate experiments were performed to assess PMN accumulation in AAR tissue by immunohistochemistry in control, CGEN-855A and PC groups.

Results: The AAR (% left ventricular mass, AAR/LV) was comparable among groups. Infarct size (necrosis as % AAR, AN/AAR), was significantly less in the PC (41.2 ± 2.7*) and CGEN-855A (43.6 ± 2.9*) groups vs Control (57.0 ± 2.3). There was no additive effect of the combination of CGEN-855A and PC at R (44.6 ± 1.3). Both CGEN-855A (30.1 ± 0.6/HPF) and PC (34.8 ± 1.5/HPF) significantly reduced PMN accumulation in AAR tissue vs control (43.2 ± 0.7/HPF).
Conclusions:

stimulation of the FPRL1 with agonist CGEN-855A exerts cardioprotection at R by reducing infarct size;

CGEN-855A peptide inhibits PMN accumulation;

the extent of cardioprotection and PMN inhibition by CGEN-855A is similar to that of PC;

there is no additive effect of their combination, consistent with a similar physiological pathway of PMN inhibition. *P<0.05 vs Control