bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 4143639: Night Shift Work is Associated With Coronary Microvascular Dysfunction: Involvement of Impaired Fatty Acid Utilization Revealed by Microbial and Metabolic Profiles
Authors: Xia Yan , Che Xinyu , Chen Ao , Chen Zhangwei , Qian Juying , Ge Junbo 
Published: November 2024

Background and Aims
Night shift work increases the risk of coronary artery diseases, contributing to worsened prognosis. However, the association between night shifts and coronary microvascular dysfunction (CMD) remains unclear. This study aimed to investigate whether night shift workers have a high incidence of CMD, and the potential mechanisms linking night shifts and CMD.
Methods
We collected cross-sectional clinical traits of traditional cardiovascular risk factors and sleep-related parameters in a security guards cohort at Fudan University. 101 subjects with no history of coronary artery disease were enrolled, of which 50 were night shift workers. Coronary flow reserve (CFR) < 2.0 evaluated by single-photon emission computed tomography (SPECT) myocardial perfusion imaging was recognized as CMD. Integrated analysis of fecal 16s sequencing and serum untargeted-metabolomics was conducted for mechanistic exploration. Microbial features were centered log-ratio(CLR)-transformed for differential enrichment analysis, while metabolic traits were inverse-normal transformed.
Results
After adjusting for age, BMI, remnant cholesterol, TyG (triglyceride-glucose index), NT-pro BNP, and melatonin, night shift work was associated with increased occurrence of CMD (OR 5.26, 95% CI 1.41-28.71; P = 0.012). One year of prolonged night work was 29% more likely to have declined CFR, with an increasing trend between shift durations and CMD (P for trend 0.005). Instead of evident abnormalities in traditional cardiovascular risk factors, night shifts favored a microbial and metabolic profile of perturbed lipid metabolism. Specifically, reduced abundances of probiotic Lactobacillus species and an array of Bacteroides species were the main contributors to the dysbiosis of night-shift gut microbiota. Circulating metabolites of increased 2-Hydroxyhexadecanoylcarnitine and reduced LysoPC(16:0/0:0), a potential feature of impaired palmitic acid utilization, partially mediated the association between night shifts and CMD. Species- and metabolites-based classifiers of CMD status added predicting power combined with night shift durations.
Conclusions
The current study found working night shifts is associated with CMD independent of traditional cardiovascular risk factors. Identifying gut microbiota and circulating metabolites linked to CMD will help to recognize high-risk night shift workers. Probiotics or metabolite supplementation may be promising in conducting a healthier night shift.
Abstract 4144133: Racial And Ethnic Disparities In Outcomes Of St Segment Elevated Myocardial Infarction With Percutaneous Coronary Intervention
Authors: Ajenaghughrure Godbless , Rahima Kenan , Shemisa Kamal , MISHRA AAVASH , Kishore Gehna , Jaafar Nadim 
Published: November 2024

Background:
Racial disparities in healthcare are a persistent and troubling issue, with profound implications for patient outcomes and societal well-being. Despite advances in medical science, studies consistently show that minority patients, particularly African Americans and Hispanics, face higher rates of STEMI incidence, delayed treatment, and poorer outcomes compared to their white counterparts.

Methods:
we examined the national inpatient sample 2017-2020 for adult admitted with st segment myocardial infarction,we compared the clincal outcome of patients admitted with stemi with pci based on racial distribution.STATA 18th edition was used for analyses. Age, gender, race, hypertension, diabetes, obesity, dyslipidemia, and Elixhauser comorbidity index were identified as confounders by univariate analyses and tested further with multivariate logistic regression models. The primary outcome was mortality. Secondary outcomes were the need for intubation, cardiac arrest, length of stay (LOS), and total hospital charges.

Results:
There were 582420 hospitalizations with STEMI with PCI. Mean age was 62 yrs and 71% were male. Among the admitted patients, Caucasians were 425064 (66.1%), Blacks were 47635(8.2%),Hispanics were 47555(8.2%), Asians were 16004(2.8%). . All-cause mortality in patients admitted with STEMI with PCI were 34090 where subgroup Analysis with Caucasians, Blacks ,Hispanics and Asians had 23700 (5.6%) vs 32870 (6%) vs 2915(6.1%) and 1155(7.2%) respectively.

Further subgroups analysis revealed that Asians (10.8%, aOR 1.77 CI 1.54-2.03,P value<0.001) were more likely to require intubation,followed by Hispanics(10.1% aOR 1.46 CI 1.33-1.6, p value <0.001) ,then Blacks (9.4% aOR 1.2,CI 1.09-1.32 P vale <0.001)and caucasians were least likely to require intubation(7.6% )
Finally, racial subgroup showed significant primary andsecondary outcomes that are presented in Table 1.

Conclusion:
All obtained results revealed statistical significance and we considered Caucasian population as baseline. Mortality, intensive care services and resource utilization proportion was highest among Asian race followed by Hispanic race then by Black race. Understanding these disparities is essential for improving healthcare equity and ensuring that all patients receive appropriate and equitable care regardless of their racial or ethnic background.
Abstract 4144244: Delineating SCAD and Non-SCAD in Acute Myocardial Infarction: Prevalence, Demographic Predictors, and Clinical Outcomes
Authors: Tan Samuel , Watanabe Atsuyuki , Trenschel Robert , Siu Wenchy , Adinugraha Paulus 
Published: November 2024

Background:
Spontaneous Coronary Artery Dissection (SCAD) is an rare but increasingly recognized cause of acute myocardial infarction (AMI) traditionally thought to predominantly affect young healthy women without typical cardiac risk factors. Recent studies suggest that SCAD may be underdiagnosed, particularly among underrepresented ethnic minority groups, and that its prevalence and clinical characteristics may vary across different populations. Furthermore, gender specific differences have not yet been well explored. Contemporary population-based studies on SCAD are lacking while comparing risk factors and trends to SCAD are not well explored.

Research question:
This study aims to elucidate the trends, incidence, and risk factors associated with SCAD compared to non-SCAD acute myocardial infarction (AMI) patients. We hypothesize that there are demographic and clinical differences between SCAD and non-SCAD AMI patients

Objectives:
To describe the incidence and trends of SCAD among AMI patients.

To identify and compare risk factors for SCAD versus non-SCAD AMI.
To analyze in-hospital outcomes associated with SCAD.

Methods:
We utilized data from the Nationwide Inpatient Sample (NIS) database from January 1, 2016, to December 31, 2019, identifying patients with AMI who underwent angiography. Patients were stratified into SCAD and non-SCAD AMI groups. Multivariable logistic regression was performed to identify risk factors associated with SCAD, and in-hospital outcomes were compared between the two groups.

Results:
Out of 1,912,780 AMI patients, 0.93% were identified with SCAD. Female SCAD patients had a median age of 57 years compared to 72 years for non-SCAD females. For males, the median age was 62 years for SCAD and 67 years for non-SCAD. Older age was associated with a lower risk of SCAD, while female sex and fibromuscular dysplasia (FMD) increased the risk. SCAD patients experienced higher in-hospital mortality (5.1% vs 3.5%), more post-procedural bleeding (8.0% vs 6.6%), and greater use of mechanical circulatory support (MCS) (13.9% vs 6.2%).

Conclusion:
SCAD patients show distinct age and gender-specific risk factors compared to non-SCAD AMI patients. SCAD is associated with higher in-hospital complications, including mortality and post-procedural bleeding. Understanding these differences is crucial for improving the diagnosis and management of SCAD in diverse patient populations.
Abstract 4144351: Association of Blood Pressure Time in Target Range with Outcomes Among NIH "All of Us” Cohort
Authors: Agarwal Neel , St John Julie , Laffin Luke 
Published: November 2024

Novel means to account for BP fluctuations are being scrutinized to assess longitudinal control, including BP time in target range (TTR) assessment. TTR quantifies the percentage of time a patient’s BP is in the desired range. The present analysis sought to determine the relationship between BP TTR and long-term outcomes among participants in the NIH “All of Us” cohort.
Systolic and diastolic BP TTR are differentially associated with long-term outcomes among low-risk primary prevention participants compared to high-risk primary, as well as secondary prevention participants.
“All of Us” is an 800,000 participant cohort that is followed longitudinally and collects demographics, adverse events, medications, procedures, and laboratory and clinical measurements. A participant’s systolic BP was noted to be in target range if it was between 110-130 mm Hg and diastolic BP was in target range if it was between 70-80 mmHg. TTR was calculated via traditional and Rosendaal linear interpolation (RLI) methods. Participants were grouped into high and low-risk primary and secondary prevention groups and sorted into four groups based on the percentage of TTR: <25%, 25–50%, 50-75%, or ≥75%. Descriptive statistics, hazard ratios, and survival curves were generated to assess the association between TTR and a composite outcome of major adverse cardiovascular events and all-cause mortality.
156,183 participants had at least 4 BP readings and were analyzed. The cohort had a mean systolic BP of 125 mm Hg and diastolic BP of 74 mm Hg. Among secondary prevention patients, a lower risk of the composite outcome was seen among individuals with ≥75% systolic TTR compared with <25% using the traditional (HR 0.48, CI(0.28, 0.81), p=0.006) and RLI (HR 0.49, CI(0.28, 0.87), p=0.014). In high-risk primary prevention participants, higher systolic BP TTR by RLI was associated with decreased risk and in low-risk primary prevention participants, higher systolic BP TTR by the traditional method was associated with decreased risk. Survival curves corroborated this trend (Figure). Diastolic BP TTR analysis demonstrated similar associations.
Systolic and diastolic BP TTR predict long-term cardiovascular and all-cause mortality among the “All of Us” cohort.
Abstract 4144425: Identification and Management Practices of MINOCA at a Tertiary Care Center
Authors: Manalo Kathryn , Tieliwaerdi Xiarepati , Arrigo Alexis , Pulipati Yochitha , Khetrapal Sanchaya , Oehler Andrew 
Published: November 2024

Myocardial infarction with nonobstructive coronary artery disease (MINOCA) is an ischemic cause of chest pain with normal appearing coronary vessels on angiography. The prognosis for these patients is extremely dependent on etiology highlighting the importance for appropriate evaluation. Currently, several imaging modalities have been useful in diagnostic workup, however no diagnostic guidelines have been developed. As a result, many patients are likely not getting proper evaluation. The study's main objective is to observe practice variations in the diagnostic evaluation for patients meeting criteria for MINOCA.
A review of electronic medical records of patients presenting to a tertiary care center between Jan 2018 – Dec 2022 for chest pain who were referred for left heart catheterization was performed. Patients with prior history of obstructive CAD, whose imaging evaluation uncovered obstructive stenosis or had stenosis >50% as measured on LHC were excluded. Next, patients diagnosed with a nonischemic cause of hospital presentation were excluded. Examples of nonischemic etiologies include stress induced cardiomyopathy, myocarditis and pulmonary embolism. Data regarding medical management and follow-up imaging were collected.
A total of 2,763 patients were reviewed. Among them, 168 patients met the exclusion criteria. Approximately 60% (n=101) of patients were female with an average age of 60 years. Medical management with aspirin (n=123), DAPT (n=22), beta-blocker (n=98), calcium channel blocker (n=58), statin (n=130), anti-anginal therapy (n=55), diuretics (n=47), and ACEi/ARB (n=69) were observed. Additional imaging was seen in only 26% of patients. The imaging modalities used were cardiac MRI (cMRI), fractional flow reserve (FFR) and intravascular ultrasound (IVUS). The most common imaging modality was cMRI (n=35), followed by FFR (n=8) and IVUS (n=1).
MINOCA was identified in 6% of patients presenting with AMI and was primarily comprised of women, which is consistent with other reported figures. Our data demonstrates that nearly 75% of these patients were placed on medical therapy without further evaluation. MINOCA is a diagnosis with multiple pathophysiological etiologies that requires thorough workup including additional imaging for complete evaluation. This study demonstrates the importance of considering MINOCA as a potential diagnosis in patients presenting with AMI and the need for guidelines on its evaluation.
Abstract 4144814: A novel small molecule synthesized based on a snail hibernation model induces hibernation in mouse fibroblasts and perfused hearts
Authors: PIAO JIYUAN , Zhang Yongneng , Zhao Yuan Yuan , Hannington Patrick , Tabatabaei Dakhili Seyed Amirhossein , Ussher John , Sutendra Gopinath , Michelakis Evangelos 
Published: November 2024

Animals during hibernation suffer no ischemic consequences from their very much decrease heart/respiration rates, otherwise incompatible with life, but humans lost the ability to hibernate (presumably when their ancestors gained independence from the weather) and are highly vulnerable to ischemia. In a snail hibernation model, we isolated a brain metabolite only present in the plasma and brain of hibernating snails, and we characterized it with HPLC/MS. We found it is an activator of PHLPP1, a critical phosphatase in the conserved AMPK/mTOR signaling networks implicated in hibernation and fuel sensing (O
2
, glucose, amino acids). We synthesized it chemically and named it Snail Neurometabolite Activator of PHLPP1 (SNAP). We hypothesized that SNAP may induce

hibernation in snails as well as mouse cells and organs that normally do not exhibit hibernation.
We utilized in vivo, in vitro and ex vivo models, using Alberta snails, mouse-derived fibroblasts and ischemia and reperfusion (IR) injury model with Langendorff-perfused mouse hearts, to assess the effects of SNAP on snail hibernation, as well as the fuel deprivation-induced stress resistance in mouse-derived cells and hearts.
SNAP injections in snails induced reversible hibernation indistinguishable from physiologic.

SNAP specifically dephosphorylates the PHLPP1 targets p-S6K and p-AKT (downstream of mTOR and AMPK respectively) in fibroblasts cultured in hypoxic and low-glucose conditions for 3 days, significantly suppressed O
2
consumption, apoptosis, and cell-cycle progression, but enhanced autophagy formation. Upon discontinuation of SNAP and return to normal culture conditions, the SNAP-treated cells had preserved metabolism and re-entered the cell cycle at much higher rates compared to the vehicle, suggesting protection from ischemia and reperfusion (IR) injury and entrance in a reversible hibernation-like state. Furthermore, SNAP conferred cardioprotective effects during IR injury by preserving LV pressure, max and min dp/dt and re-entering normal function much earlier at reperfusion compared to the vehicle.

SNAP offers protection from IR injury, inducing a hibernation-like state in mice cells and hearts, with wide implications for heart attack/stroke, preservation of donated organs for transplantation or even ultra-long space travel.
Abstract 4145195: Native Tricuspid Valve Hematoma and Pulmonary Artery Pseudoaneurysm Mimicking Cardiac Behcet's
Authors: Naseer Zaid , Motaweih Mohammad , Issa Najy , Kerley John , Aiken Matthew , Choudhry Mohammed , Schatz Aaron 
Published: November 2024

We report a case of a giant organizing hematoma attached to a native tricuspid valve in a 32-year-old man. In the absence of predisposing valvular disease, trauma, endocarditis, or a hypercoagulable disorder, intracardiac hematoma formation on a native tricuspid valve is an extremely rare entity with no reported incidence.
A recently incarcerated 32-year-old man presented with subacute hemoptysis, dyspnea, and night sweats. He had a history of unexplained penile ulcers. His exam was notable for multiple tattoos and a systolic murmur. Chest CTA revealed a 4.6 cm x 2.5 cm right ventricular mass, multiple pulmonary nodules, and bilateral pulmonary emboli. Transesophageal echocardiogram identified a large irregularly bordered mass attached to the anterior tricuspid valve leaflet and right ventricular free wall. Cardiac MRI confirmed a lobulated mass within the right ventricle and an additional 2 cm lesion adjacent to the septum. Multiple sets of blood cultures were negative. Patient had a positive QuantiFERON TB gold and a negative AFB culture, suggesting TB latency. An extensive infectious, hematologic, and rheumatologic workup was otherwise negative. Despite anticoagulation and antibiotics, the mass remained unchanged. The mass was surgically resected, and the tricuspid valve was replaced with a bioprosthetic valve. Histopathology demonstrated an exuberant inflammatory response with organizing granulation tissue from a non-neoplastic process such as organizing hematoma. Postoperatively, the patient developed worsening hemoptysis, requiring intubation and bronchoscopic removal of large airway clots, and upper extremity deep venous thrombosis. Repeat CTA showed multiple pulmonary artery pseudoaneurysms, raising suspicion for vasculitis.

Our patient met the International Criteria for Behcet’s, with a score
>
4. Hughes Stovin Syndrome is a rare hypothesized cardiovascular variant of Behcet’s Disease that presents with pulmonary artery aneurysms, venous thrombosis, and intracardiac thrombi. Hematomas on a native cardiac valve in this context have never been reported and may result from similar local endothelial vasculitic processes. Steroids are the mainstay treatment, and anticoagulation is avoided in the presence of pulmonary artery pseudoaneurysms.

Vasculitis should be considered in cases of unusual cardiac masses. Although vascular lesions in Behcet’s syndrome are rare, their recognition is essential as they can be fatal if improperly treated.
Abstract 4146886: Strive for Silver: A "Measure Accurately" Blood Pressure Peer Learning Accelerator
Authors: Alicki Rebecca , Smith Alison , Montgomery Liz , Overton Katherine 
Published: November 2024

Strive for Silver is a structured peer-learning quality improvement effort designed to help health care organizations adopt evidence-based approaches to blood pressure (BP) measurement and improve hypertension control rates. Developed by the American Heart Association (AHA), this opportunity also supports organizations participating in Target: BP™ to achieve annual awards.

Target:
BP is a national initiative created by the AHA and the American Medical Association (AMA) where participants report Controlling High Blood Pressure (MIPS 236) data and attest to 6 evidence-based BP measurement activities as of the prior year. Annual data submission for Target: BP recognizes organizations through awards for control rates ≥70% and/or adoption of ≥4 evidence-based activities.

Organizations that submitted data to Target: BP in 2022 but were ineligible for awards based on performance thresholds were invited to join a Strive for Silver cohort. The initiative consisted of four 1-hour weekly sessions with a brief didactic introduction reviewing the evidence-based measurement activities and related practice tools, followed by interactive breakout groups for collaborative peer-learning.
Beginning in September 2022, 14 organizations participated in the pilot peer-learning series and were monitored via their Target: BP data submissions in 2023 and 2024. Of the 14 pilot organizations, 10 submitted data in both years. When comparing pre-implementation (2022), and post-implementation (2024) Target: BP data submissions, 100% of organizations saw an increase in BP control from baseline, with an average absolute increase of 10.1%, ranging from <1%-31% improved BP control. BP measurement activity attestations increased from an average of 2.4 to 3.9, respectively. A post-assessment survey showed all participants felt that the collaborative was “very valuable.”
The Strive for Silver peer-learning accelerator appears to be an effective approach to helping organizations improve evidence-based practice adoption and improve BP control rates. The model has been replicated with an additional Strive for Silver cohort in 2023 and will continue to be monitored post-intervention. In 2024, Strive for Silver will expand into a Hypertension Control Accelerator with a goal of improving BP control through additional guideline-directed activities. The AHA recognizes Strive for Silver has the potential to expand into other facets of improving BP control as well as other chronic CVD conditions.
Abstract 4146890: Analysis of In-Hospital Outcomes of Transcatheter Edge-to-Edge Repair of Mitral Valve in Patients with and without COVID-19: Insights from the National Inpatient Sample Data (2020-2021)
Authors: Agrawal Siddharth , Raval Maharshi , Shah Aalesh , Sanghvi Labdhi , Bhatia Hitesh , Siddiq Sajid 
Published: November 2024

Background:
COVID-19 has introduced new complexities in the management of patients undergoing the transcatheter edge-to-edge repair (TEER) procedure of the mitral valve. This study compares outcomes of mitral valve TEER in patients with and without COVID-19, utilizing data from the National Inpatient Sample (2020-2021).

Methods:
We conducted a retrospective cohort study on 23,465 patients without COVID-19 and 85 patients with COVID-19 undergoing mitral valve TEER. Multivariate logistic regression was employed to compare outcomes, adjusting for potential confounders. Primary outcomes included mortality and major complications, while secondary outcomes encompassed specific procedural complications.

Results:
Patients with COVID-19 were younger (mean age: 73.176 vs. 76.178 years, p-value <0.001) and exhibited differences in gender distribution (male: 64.71% vs. 54.80%, female: 35.29% vs. 45.20%, p=0.4125)

Patients with COVID-19 exhibited a significantly higher prevalence of mortality (OR: 16.331, 95% CI: 4.842-55.08, p<0.001), transfusion (OR: 5.424, 95% CI: 1.511-19.47, p=0.01), post-procedure shock (OR: 7.521, 95% CI: 2.731-20.708, p<0.001), intra-procedure stroke (OR: 7.892, 95% CI: 2.87-21.704, p<0.001), mechanical ventilation (OR: 13.918, 95% CI: 4.072-47.562, p<0.001), acute renal failure (OR: 7.523, 95% CI: 2.454-23.059, p<0.001), sudden cardiac arrest (OR: 26.127, 95% CI: 7.2-94.803, p<0.001), cardiogenic shock (OR: 7.971, 95% CI: 2.894-21.955, p<0.001), septic shock (OR: 23.176, 95% CI: 5.226-102.78, p<0.001), and sepsis (OR: 18.371, 95% CI: 4.926-68.51, p<0.001). The odds of bleeding (OR: 2.983, 95% CI: 0.94-9.47, p=0.064) did not significantly differ between groups.
Patients with COVID-19 had a longer length of stay (LOS) (coefficient: 11.26409 days, p=0.001) and higher total hospitalization cost (coefficient: $230,944.2, 95% CI: $107,037.8-$354,850.5, p<0.001).

Conclusion:
Patients with COVID-19 undergoing mitral valve TEER procedure face elevated risks of mortality, post-procedure shock, stroke, mechanical ventilation, acute renal failure, sudden cardiac arrest, cardiogenic shock, septic shock, and sepsis compared to those without COVID-19. Additionally, they experience longer hospital stays and incur higher total health charges. Clinicians should consider these heightened risks when evaluating the appropriateness of mitral valve TEER in COVID-19 patients. Further research is warranted to explore strategies for risk mitigation in this population.