bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of cardiovascular complications and factors associated with higher case-fatality rate among hospitalized patients with sarcoidosis
Authors: Shoar S , Azargoon S , Swami S , Teklu B , Fantaye E , Patarroyo-Aponte G , Yun S , Asadi S , Das M , Tegene T , Saulters K J 
Published: October 2024

Abstract

Background
Cardiovascular (CV) involvement is a serious complication of sarcoidosis with exaggerated morbidity and mortality. However, the prevalence of CV comorbidities and their case-fatality rate have not been established among hospitalized patients with sarcoidosis.

Methods
Using the National Inpatient Sample (NIS) database, hospitalized patients with a diagnosis of sarcoidosis were identified. The prevalence of each CV comorbidity and the associated case-fatality rate was determined among this population of patients.

Results
Data of 406,315 admission cases with a diagnosis of sarcoidosis was analyzed from 2016 to 2020. Of this, 13,950 patients (3.4%) had AMI (STEMI: 0.3% and NSTEMI: 2.3%), 121,515 patients (30%) had HF (HFrEF: 8% and HFpEF: 13%), 7,470 patients (1.8%) had CVA, 8,825 patients had sarcoid myocarditis (2.2%), 8,965 patients (5.6%) had PVD, 71,815 patients had Afib (17.7%), 46,775 patients (11.5%) had cardiorenal syndrome, and 3,905 patients (1%) developed cardiac arrest. Case-Fatality rate was the highest for sarcoidosis patients who developed cardiac arrest (61.4%), followed by STEMI (11.6%), NSTEMI (7.7%), and cardiac tamponade (7.8%). Increasing age (2% for each year), male gender (14% more than females), and black race (25%) but not economic status was associated with increased odds of death among patients with sarcoidosis. While PCI was associated with a lower mortality rate (aOR: 0.4, 95%CI:0.2-0.7, P=0.005), revascularization with CABG (aOR: 0.3, 95% CI: 0.1-1.2, P=0.08) did not reduce the mortality rate.

Conclusion
Atrial fibrillation, heart failure (HFpEF &gt; HFrEF), and cardiorenal syndrome are the most common cardiovascular complications among hospitalized patents with sarcoidosis. However, case-fatality rate is significantly higher for other less prevalent cardiovascular comorbidities of sarcoidosis, which include cardiac arrest, acute myocardial infarction (STEMI &gt; NSTEMI), and cardiac tamponade.
Predictors of B-line count in hospitalized patients with COVID-19
Authors: Johannessen O , Espersen C , Platz E , Skaarup K G , Lassen M C H , Davidovski F S , Christensen J , Simonsen JØ , Nielsen A B , Johansen N D , Sengeloev M , Iversen K K , Schou M , Myhre P L , Sorensen T B 
Published: October 2024

Abstract

Background
B-lines on lung ultrasound (LUS) are non-specific signs of increased density within lung tissue, which can be secondary to pulmonary congestion, pneumonia, or fibrosis. LUS is recommended for managing acute heart failure (HF); however, its value in non-HF populations is less clear.

Purpose
To identify clinical, laboratory, and echocardiographic predictors of B-lines in a population with Coronavirus disease 2019 (COVID-19).

Methods
In the ECHOVID-19 study, hospitalized non-ICU patients ≥18 years with confirmed laboratory diagnosis of COVID-19 in Eastern Denmark underwent 8-zone LUS and echocardiography. We used trend and regression analyses to identify associations with the number of B-lines and adjusted for potential confounders (age, sex, body mass index, C-reactive protein, and pandemic wave).

Results
Among 270 (89%) patients with adequate LUS images, the mean age was 69±14 years, 58% were male and 11% had prior HF. Median time from hospital admission to LUS was 4 [2-8] days. In total, 263 (97%) had ≥1 B-line (median B-line number 14 [9-22]) and median left ventricular ejection fraction [LVEF] was 59 [54-63]). In adjusted models, more B-lines were associated with higher levels of C-reactive protein with an incidence rate ratio (IRR) of 16% (95%CI: 8%-24%) per log-unit increase (P&lt;0.001) and higher Early Warning Score (IRR 5% [95%CI: 1%-0%] per point, P=0.02). Higher tricuspid regurgitation gradient was associated with more B-lines: IRR 2% (95%CI: 1%-3%) per mmHg, P&lt;0.001) (Figure 1). Echocardiographic measures of left ventricular (LV) function (including LVEF and global longitudinal strain, left atrial volume, and LV filling pressures (E/e’)) and right ventricular function were not significantly associated with the number of B-lines. B-lines were not associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations, even in patients with established HF. Lastly, B-lines were not associated with 30-day mortality.

Conclusions
Among hospitalized patients with COVID-19, B-lines on LUS are associated with markers of infectious disease severity and pulmonary hypertension but not with markers of left-sided HF.Figure1.Predictors of B-lines
Impact of sex and age on culprit plaque type of acute coronary syndrome in Japanese patients from TACTICS registry
Authors: Mori H , Suzuki H , Shinke T 
Published: October 2024

Abstract

Background
In acute coronary syndrome (ACS), plaque rupture (PR) is the most frequent etiology followed by plaque erosion (PE) while calcified nodule (CN) is the least etiology. These three are known as major etiologies of ACS. Traditionally, it has been believed that sex and age have impact on etiology of ACS. For example, plaque erosion was thought to often occur in young female while calcified nodule often occur in elderly patients. However, impact of sex and age have not been well described.

Methods
This is a sub-study from TACTICS registry which consist of 702 Japanese ACS patients who underwent primary percutaneous coronary intervention under optical coherence tomography (OCT) from multicenter. Based on the OCT findings, patients were divided into PR, PE, CN and others. These data were stratified by sex and ages (&lt;50, 50s, 60s, 70s, 80 or over). In this sub-study, we mainly focused on 3 major etiologies of ACS (PR, PE, CN) and compared incidence and clinical characteristics based on sex and ages.

Results
Distribution of culprit plaque type in ACS patients are shown in figure 1A (male) and 1B (female). PR remained top etiology of ACS in any sex and any age category. However, trend of PE was different between male and female. In male, as patients get younger, incidence of PE increased. In male patients under 50, incidence of PE was almost similar as PR. On the other hand, in female, incidence of PE was greatest in 70s followed by 80 or over. Surprisingly, young female showed the least incidence of PE. CN was the least etiology of three but increased especially from 80. Clinical characteristics are shown in table 1A (male) and 1B (female). In male, most of the baseline characteristics differ between different ages while in female, most of the baseline characteristic did not differ between different ages.

Conclusion
In our data, PE was more distinct in younger male ACS patients while PE was not that distinct in younger female ACS patients. The impact of sex and age on culprit plaque type of ACS might be variable depending on population.
Circulating Galectin-3 distinguishes global aortic aging among older women
Authors: Wong J , Cai H Y , Zhang H Z , Leng S , Gao F , Zhao X D , Tan R S , Liang Z , Koh A S M 
Published: October 2024

Abstract

Background
Traditional cardiovascular risk factors may underestimate age-associated cardiovascular risk, particularly in estimating discrepant risks between sexes. As a marker of adverse cardiovascular events, aortic stiffness may improve risk assessment, but the requirement for advanced imaging equipment restrict widespread translation of this paradigm. Conversely, circulating blood biomarkers may augment mechanistic understanding and distinguish sex-based differences in aortic stiffness.

Purpose
Hypothesizing that Galectin-3 (Gal-3) is associated with aortic aging among older adults, we examined sex-based differences between Gal-3 and global aortic stiffness as assessed by a novel cardiac magnetic resonance (CMR)-derived measurement of aortic global longitudinal strain (AOGLS).

Methods
Community older adults without cardiovascular disease underwent simultaneous CMR with serum Gal-3 quantification using chemiluminescent microparticle immunoassays. Poorer AOGLS was defined as values below the 75th percentile of AOGLS measurements. Multivariable regression models were used to assess the association of Gal-3 with AOGLS.

Results
Of 255 participants (mean age 70.8 ±9.1 years, LVEF 66.3 ±8.3%), 44.3% were women. Poorer AOGLS was characterized by higher Gal-3 (B coefficient = -0.101, 95%CI [-0.167, -0.034], p = 0.003), mean age (B = -0.126, 95%CI [-0.154, -0.098], p &lt;0.001), male sex (B = -0.991, 95%CI [-0.409, -1.572], p = 0.001), history of hypertension (B = -0.777, 95%CI [-1.364, -0.189], p = 0.010), diabetes mellitus (B = -0.888, 95%CI [-1.617,-0.158], p = 0.017), smoking (B = -1.346, 95%CI [-2.15, -0.542], p=0.001), pulse rate (B = -0.032, 95%CI [-0.055, -0.01], p = 0.005), systolic BP (B = -0.014, 95%CI [-0.025, -0.004], p = 0.009), and diastolic BP (B = -0.033, 95%CI [-0.06, -0.006], p = 0.018) on univariable linear regressions; no associations were observed with urine albumin-to-creatinine ratio, serum NT-ProBNP, or hs-Troponin I. After multivariable adjustments for sex, age, significant cardiovascular risk factors (hypertension, diabetes, smoking), and pulse rate, the inverse relationship between Gal-3 and AOGLS (Figure 1) persisted (B = -0.071 95%CI [-0.135, -0.008], adj. p = 0.028, R2 = 0.217). The association between Gal-3 and AOGLS was more marked among women (Figure 2), compared to men. Among women, higher Gal-3 characterized women with poorer AOGLS (17.04 ±3.73 ng/mL vs 15.48 ±3.55 ng/mL p = 0.040) (B = -0.120, OR 0.887, 95% CI [0.787, 0.999], adj. p = 0.048), independent of age.

Conclusions
Galectin-3 was adversely associated with novel CMR-derived AOGLS. Among these older adults with age-associated observations in AOGLS, Gal-3 highlighted sex-based differences in AOGLS and differentiated women with poorer AOGLS from women with better AOGLS. Serum Gal-3 measurements may be useful for detecting adverse patterns of aortic aging, particularly as an early approach in community older adults.
Sex-specific associations between remnant cholesterol and cardiovascular risk in patients undergoing percutaneous coronary intervention: a 5-year large-sample study from the real world
Authors: Yan K , Li J , Zhang K , Yuan J , Zhao X 
Published: October 2024

Abstract

Background
Differences in the pathophysiological characteristics and cardiovascular risk between female and male patients with coronary artery disease (CAD) are well-established. Recent studies on the relationship between remnant cholesterol (RC) and cardiovascular risk in coronary artery disease patients have gained popularity. To date, little is known about the RC-related cardiovascular risk disparities between males and females.

Purpose
The aim is to investigate sex-specific differences in the association between RC and cardiovascular risk among CAD patients undergoing percutaneous coronary intervention (PCI).

Methods
A prospective cohort study was conducted among 10,724 CAD patients undergoing PCI from January to December in 2013. RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE, including cardiac mortality, revascularization and ischemic stroke) and the secondary outcomes were each component of MACCE.

Results
Among 9,587 PCI patients included (the average age was 58.43 ± 10.26 years and 2,181 (22.70%) were female), 1,864 (19.4%) MACCEs were recorded during the 5-year follow-up. For primary outcome, a significant interaction was observed between RC levels and sex (P for interaction = 0.007 and 0.011, for continuous and categorical RC variables, respectively). Specifically, in male patients, no significant MACCE risk was observed at any RC level (both P &gt; 0.05) (Figure 1). However, in female patients, both continuous RC levels (hazard ratio [HR] 1.412, 95% confidence interval [CI] 1.103-1.807) and the upper two quartiles of RC relative to the lowest quartile (Q3: HR 1.458, 95% CI 1.062-2.001; Q4: HR 1.496, 95% CI 1.081-2.070) were associated with higher MACCE risk. For secondary outcomes, higher RC levels were linked to an increased risk of cardiac mortality and revascularization in female patients but not in males (Table 1).

Conclusions
In a large-scale 5-year follow-up study from the real world, we are the first to demonstrate that RC-related cardiovascular risk is specifically observed in female CAD patients undergoing PCI, suggesting that female patients merit closer surveillance and more aggressive RC management to reduce cardiovascular risk.
Sex differences in association between dietary sodium intake and white matter hyperintensity volume
Authors: James S N , Maddock J , Chaturvedi N , Schott J , Hughes A 
Published: October 2024

Abstract

Background
There is limited evidence on the relationship between dietary sodium intake (dNa) and brain health, and very little on sex differences in associations.

Purpose
To study the relationship between dNa and imaging measures of brain health in men and women from the INSIGHT 46 substudy of the MRC National Survey of Health and Development (British 1946 birth cohort).

Methods
Participants had measurements (dNa using 5-day food diary, anthropometrics, blood pressure (BP) body mass index (BMI)) at 60-64years. Whole-brain and hippocampal volumes, white matter hyperintensity volume (WMHV) and florbetapir amyloid-β positivity were measured using MRI-PET imaging at 69-71years. Associations (β (95% confidence intervals)) were estimated separately in men and women using generalized linear models with robust standard errors adjusted for potential confounders (age, diet quality, energy intake, socioeconomic status) or potential mediators (BMI, BP).

Results
Participants’ characteristics are shown in Table 1. In women but not men dNa was positively associated with higher WMHV (β[women]=32(1, 72) %/g; p=0.043; β[men]=-10(-27, 11)%/g; p=0.342); this relationship in women was independent of BMI (β = 32(1, 72)%/g; p = 0.043) or systolic BP (β = 31(1, 70)%/g; p=0.041). dNa was not associated with total brain volume, hippocampal volume or amyloid-β positivity in either sex.

Conclusions
Elevated sodium consumption in the diet is associated with cerebral small vessel disease in older age women but not men. This association was independent of BMI or BP.Table 1
Heart rate and prognosis of heart failure with reduced ejection fraction in women and men in sinus rhythm
Authors: Mansur A , Del Carlo C H , Pereira-Barreto A C 
Published: October 2024

Abstract

Background
Resting heart rate (HR) is a well-established therapeutic target for treating heart failure (HF). Beta-blockers are the primary drugs to reduce HR. Elevated HR is associated with higher mortality in heart failure with reduced ejection fraction (HFrEF). However, the influence of HR on mortality and predictors of death in women with HFrEF in sinus rhythm is not well understood.

Purpose
to analyse mortality for HR ≤60&gt;bpm and ≤70&gt;bpm in women and men.

Methods
From February 2017 to January 2022, we analysed the influence of resting HR (≤60&gt; and ≤70&gt;bpm) on mortality and predictors of death in women and men with HFrEF in sinus rhythm. Baseline data included clinical characteristics and echocardiographic findings. The HR used in the analysis was obtained at the closest outpatient visit to the death event. We used the adjustment for multiple comparisons for the log-rank test of Kaplan-Meier (K-M) and Cox proportional hazards methods to analyse mortality rates and search for death predictors for women and men.

Results
We analysed 2,984 patients, with a mean age of 61 ± 13.8 years, 1,922 (64.4%) men. Age, body mass index, myocardial infarction, diabetes, chronic kidney disease, stroke, carvedilol dosage, hospitalization, and initial left ventricular ejection fraction (LVEF) were similar in both genders. Over the follow-up period of 3.7±1.6 years, we observed an increase in LVEF in men (29.5%±6.7% vs. 36.7%±12.9%; p&lt;0.001) and women (29.9%±6.4 vs. 38.0%±13.4%; p&lt;0.001), and HR reduced in men (73.1±13.0 to 72.1±11.8 bpm; p=0.007) and women (72.8±12.7 to 71.8±11.3 bpm; p=0.026). Death incidence was higher in men (43.7% vs. 36.7%; p&lt;0.001). The cumulative incidence of death was higher in men with HR&gt;60bpm (K-M: log-rank p&lt;0.001) and &gt;70bpm (K-M: log-rank p=0.011) compared to women. Cox regression for death, adjusted for covariates with p&lt;0.25, showed age (HR=1.01;95%CL:1.008-1.017; p&lt;0.001), men (HR=0.80;95%CL:0.71-0.90; p&lt;0.001), LVEF (HR=0.986;95%CL:0.98-0.99; p=0.001), and HR (HR=1.005;95%CL:1.00-1.01; p=0.025) as independent death variables. For men, the independent variables were age (HR=1.01;95%CL:1.01-1.02; p=0.002), LVEF (HR=0.98;95%CL:0.97-0.99; p=0.001), and HR (HR=1.008;95%CL:1.00-1.01; p=0.008), and for women, only the age (HR=1.02;95%CL:1.01-1.02; p&lt;0.001).

Conclusion
Increased HR was an independent variable of death in men but not in women. Future studies are needed to determine the best reference HR for a chronotropic drug intervention to reduce mortality in women with HFrEF in sinus rhythm.
Effects of SGLT2 inhibitors on the cardiovascular outcomes in patients with cancer: a systematic review and meta-analysis
Authors: Liu L , Chen H H , Kuo H H , Lin P L 
Published: October 2024

Abstract

Introduction
The incidence of cardiovascular diseases in cancer survivors has gradually increased due to well-documented drug-associated cardiotoxicity and the expanding population resulting from advances in cancer treatment. Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have demonstrated efficacy in reducing cardiovascular risk in patients with type 2 diabetes mellitus, independent of glycemic control. Previous bench and animal research, along with several cohort studies, suggest potential benefits of SGLT2 inhibitors on cardiovascular outcomes in patients with cancer, with or without anthracycline therapy. This systematic review and meta-analysis aim to explore the potential of SGLT2 inhibitors as a therapeutic intervention to reduce cardiovascular risks in cancer patients, especially those undergoing chemotherapy.

Methods
We systematically searched Cochrane, PubMed, and Embase from inception until February 29, 2024, without language restrictions. Observational cohort studies with a follow-up period of at least 1 year were included to analyze the effects of SGLT2 inhibitors on cardiovascular outcomes in type 2 diabetes patients with cancer. Inclusion and exclusion criteria were predefined. Using random-effects models, we calculated odds ratios (OR) and 95% confidence intervals (CI). Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity and explore the impact of SGLT2 inhibitors on mitigating cardiotoxicity. Primary outcomes of interest were mortality, heart failure hospitalization, sepsis, and diabetic ketoacidosis.

Results
Six studies involving 2959 patients in the SGLT2i group and 29169 patients in the non-SGLT2i group were included. Type 2 diabetes patients receiving SGLT2i exhibited significantly lower odds of mortality than those without SGLT2i (OR=0.34, 95% CI=[0.26-0.46], I²=77%). Subgroup analysis revealed a similar reduction in mortality among patients on SGLT2i treated with anthracyclines (OR=0.44, 95% CI=[0.23-0.82], I²=69%). Odds ratios for heart failure hospitalization and sepsis were also significantly lower in the SGLT2i group than the non-SGLT2i group (OR=0.46, 95% CI=[0.35-0.60], I²=0%, and OR=0.28, 95% CI=[0.20-0.40], I²=0%, respectively). The risk for diabetic ketoacidosis was not increased in the SGLT2i group (OR=0.66, 95% CI=[0.20-2.17], I²=0%).

Conclusion
SGLT2 inhibitors demonstrate a reduction in mortality, heart failure hospitalization, and sepsis in type 2 diabetes cancer patients treated with or without anthracyclines in cohort studies. Our findings support the need for further investigation through randomized controlled trials.Forest plots of mortality with subgroupForest plots of other primary outcomes
SGLT2 inhibitors in patients with amyloidosis and heart failure: a worldwide retrospective cohort study
Authors: Belo Nunes R , Costa L M A , Neves P M M , Sato V A H , Cantarelli M J C , Avezum A 
Published: October 2024

Abstract

Background
Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the combined risk of death and hospitalization in patients with heart failure with reduced or preserved left ventricular ejection fraction. However, evidence of their impact on patients with heart failure due to amyloidosis is lacking.

Purpose
To evaluate the effects of SGLT2 inhibitors on mortality and hospitalization in patients with amyloidosis and heart failure.

Methods
In this retrospective cohort study, we used real-world data from 108 healthcare organizations worldwide from the global health research collaborative network TriNetX. We identified 24,619 patients with amyloidosis and heart failure without exposure to SGLT2 inhibitors (control group) and 2,988 patients with amyloidosis and heart failure under treatment with SGLT2 inhibitors (SGLTi group). We performed propensity score matching for demographic and clinical characteristics and Kaplan–Meier plots, log-rank tests, and Cox proportional hazard models were calculated. The outcomes were 12-month all-cause death and 12-month hospitalization.

Results
After propensity score matching, 2,237 patients were analyzed in each group. During the 12-month follow-up, 198 (8.8%) patients died in the SGLT2i group, and 431 (19.2%) patients died in the control group (hazard ratio 0.51, 95% CI 0.43-0.61). In the SGLT2i group, 974 (44.5%) patients were hospitalized, and in the control group, 1508 (53.5%) patients were hospitalized (hazard ratio 0,79, 95% CI 0.72-0.86). The Kaplan-Meier curves are shown in Figure 1.

Conclusions
In conclusion, in this retrospective cohort study with a large number of patients with amyloidosis and heart failure, SGLT2 inhibitors were associated with a lower 12-month all-cause mortality and hospitalization. Further evidence from randomized controlled studies are needed to confirm the efficacy of SGLT2 inhibitors in patients with cardiac amyloidosis.Figure 1.Kaplan-Meier curves
Can haemodynamic force analysis be used to identify cancer treatment-related cardiac dysfunction? A comparison with strain and ejection fraction.
Authors: Sivaraj E , Marwick T 
Published: October 2024

Abstract

Background
Haemodynamic Force Analysis (HDF) is an approach to quantification of intraventricular pressure gradients, from routine transthoracic echocardiography. HFA is potentially a sensitive means of assessing LV dysfunction, and has been used for the prediction of LV remodelling, but its use in the detection of subclinical LV dysfunction remains undefined. We sought whether HDF could be used to detect Cancer Treatment-Related Cardiac Dysfunction (CTRCD).

Methods
From a group of 240 pts undergoing echos at baseline and every 3 months in the course of potentially-cardiotoxic chemotherapy, we matched 28 pts who developed CTRCD with 33 controls. HDF was calculated by tracking the endocardial contour throughout the cardiac cycle (Figure). CTRCD was defined by the development of a 12% relative change in GLS, or an asymptomatic absolute EF change of 10% at 3, 6, 9 and 12 months.

Results
Of 28 pts developed CTRCD; 17 at 3 months, 5 at 6 months, 3 at 9 months and 3 at 12 months. At the time of developing CTRCD, there was a difference between absolute GLS (p-0.04) and borderline difference in EF (p=0.08). However, although there was a small difference in HDF between groups, the variance of this parameter was large, and the values were not significantly different (Table). There was no difference in total HDF (Table).

Conclusions
Although absolute levels of systolic HDF were different between pts with CTRCD and controls, the scatter of this parameter was large and no significant difference was documented. HDF may be better for predicting the evolution of abnormal LVs than ion the detection of subclinical dysfunction.