bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of atrial fibrillation in patients with embolic stroke of undetermined source by prolonged monitoring with implantable loop recorders
Authors: Israel Carsten , Kitsiou Alkisti , Kalyani Malik , Deelawar Sameera , Ejangue Lucy Ekosso , Rogalewski Andreas , Hagemeister Christoph , Minnerup Jens , Schäbitz Wolf-Rüdiger 
Published: September 2017

SummaryRecently, the clinical entity embolic stroke of undetermined source (ESUS) has been defined for patients with ischemic strokes, where neither a cardioembolic nor a non-cardiac source can be detected. These patients may suffer from asymptomatic atrial fibrillation (AF), terminating spontaneously and thus eluding detection. Implantable loop recorders (ILR) with automatic AF detection algorithms can detect short-lasting, subclinical AF. The aim of this study was to prospectively assess and predict AF detection in patients with ESUS using ILR with daily remote interrogation. Patients with acute ESUS received an ILR, were seen every 6 months and additionally interrogated their ILR daily using remote monitoring. The incidence of AF detection was assessed and parameters which might predict AF detection (clinical and from magnetic resonance tomography) were analysed. ILR implantation was performed in 123 patients on average 20 days after stroke. During a mean follow-up of 12.7±5.5 months, AF was documented and manually confirmed in 29 of 123 patients (23.6%). First AF detection occurred on average after 3.6±3.4 months of monitoring. Patients with AF were on average older, had a higher CHA2DS2-VASc score and more often cerebral microangiopathy. In conclusion, AF can be documented in approximately 25% of patients with the diagnosis of ESUS after careful work-up within a year of monitoring by an ILR and daily remote interrogation. This had important therapeutic consequences (initiation of anticoagulation for secondary stroke prevention) in these patients.
Gráficos, cartas, mapas: traçando a história global da arte moderna
Authors: Joyeux-Prunel Béatrice 
Published: September 2017

Diversas novas tendências filosóficas nos estimulam a rever as metodologias em história da arte no sentido de descolonizar a mais poderosa de suas narrativas: o cânone modernista. Com este fim, o presente artigo explora como as abordagens quantitativas, cartográficas e estatísticas, combinadas com a utilização de outras abordagens mais tradicionais, podem nos ajudar a reconsiderar as hierarquias existentes no campo da história da arte. Utilizado geralmente para analisar grandes corpos de fontes similares, especialmente catálogos de exposições e periódicos, em longos períodos de tempo e em escalas globais, “o olhar distante” é útil para a construção de uma narrativa coerente e global, presente nas geopolíticas modernistas em suas dimensões sociais, quando a complexidade é restaurada e a agência das circulações artísticas encontra seu lugar.
Interleukin-18 Enhances Vascular Calcification and Osteogenic Differentiation of Vascular Smooth Muscle Cells Through TRPM7 Activation
Authors: Zhang Kun , Zhang Yinyin , Feng Weijing , Chen Renhua , Chen Jie , Touyz Rhian M. , Wang Jingfeng , Huang Hui 
Published: September 2017

Objective—
Vascular calcification (VC) is an important predictor of cardiovascular morbidity and mortality. Osteogenic differentiation of vascular smooth muscle cells (VSMCs) is a key mechanism of VC. Recent studies show that IL-18 (interleukin-18) favors VC while TRPM7 (transient receptor potential melastatin 7) channel upregulation inhibits VC. However, the relationship between IL-18 and TRPM7 is unclear. We questioned whether IL-18 enhances VC and osteogenic differentiation of VSMCs through TRPM7 channel activation.

Approach and Results—

Coronary artery calcification and serum IL-18 were measured in patients by computed tomographic scanning and enzyme-linked immunosorbent assay, respectively. Primary rat VSMCs calcification were induced by high inorganic phosphate and exposed to IL-18. VSMCs were also treated with TRPM7 antagonist 2-aminoethoxy-diphenylborate or TRPM7 small interfering RNA to block TRPM7 channel activity and expression. TRPM7 currents were recorded by patch-clamp. Human studies showed that serum IL-18 levels were positively associated with coronary artery calcium scores (
r
=0.91;
P
<0.001). In VSMCs, IL-18 significantly decreased expression of contractile markers α-smooth muscle actin, smooth muscle 22 α, and increased calcium deposition, alkaline phosphatase activity, and expression of osteogenic differentiation markers bone morphogenetic protein-2, Runx2 (runt-related transcription factor 2), and osteocalcin (
P
<0.05). IL-18 increased TRPM7 expression through ERK1/2 (extracellular signal-regulated kinase 1/2) signaling activation, and TRPM7 currents were augmented by IL-18 treatment. Inhibition of TRPM7 channel by 2-aminoethoxy-diphenylborate or TRPM7 small interfering RNA prevented IL-18–enhanced osteogenic differentiation and VSMCs calcification.

Conclusions—
These findings suggest that coronary artery calcification is associated with increased IL-18 levels. IL-18 enhances VSMCs osteogenic differentiation and subsequent VC induced by β-glycerophosphate via TRPM7 channel activation. Accordingly, IL-18 may contribute to VC in proinflammatory conditions.
Socioeconomic Status and Incidence of Hospitalization With Lower‐Extremity Peripheral Artery Disease: Atherosclerosis Risk in Communities Study
Authors: Vart Priya , Coresh Josef , Kwak Lucia , Ballew Shoshana H. , Heiss Gerardo , Matsushita Kunihiro 
Published: September 2017

Background

Compared to coronary heart disease, heart failure, and stroke, the relationship between low socioeconomic status (
SES
) and peripheral artery disease (
PAD
) is less well established. We examined the association between
SES
and incidence of hospitalization with
PAD
and explored whether this association can be explained by traditional cardiovascular risk factors and healthcare access.

Methods and Results

A total of 12 517 participants in the Atherosclerosis Risk in Communities (ARIC) Study (1987‐1989) with no prior
PAD
were examined. Individual‐level
SES
was assessed from household income (low <$12 000/year, medium $12 000 to $24 999/year, and high ≥$25 000/year [double to approximate to values in 2016]) and educational attainment (<high school, high school, and >high school), and area‐level
SES
from area deprivation index (quintiles). During a median follow‐up of 23.6 (Interquartile range 19.6‐24.5) years, 433 participants had a hospitalization with
PAD
. In Cox proportional hazards regression analysis, the demographically adjusted hazard ratio was 2.42 (1.81‐3.23) for low household income, 2.08 (1.60‐2.69) for low educational attainment, and 2.18 (1.35‐3.53) for most deprived neighborhoods, compared to their high‐
SES
counterparts. After adjustment for traditional cardiovascular risk factors and heath care access, the associations were attenuated but remained significant, particularly for income and education. Results were consistent when stratified by race (
P
‐values for interaction >0.2 for all
SES
parameters).

Conclusions

Low individual‐ and area‐level
SES
are strong predictors of hospitalization with
PAD
, in part due to increased prevalence of cardiovascular risk factors and poor access to care in these groups. Additional risk factors may also need to be identified and acted on to eliminate
SES
disparities in
PAD
hospitalization.
Selection of Stent Type in Patients With Atrial Fibrillation Presenting With Acute Myocardial Infarction: An Analysis From the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry—Get With the Guidelines
Authors: Vora Amit N. , Wang Tracy Y. , Li Shuang , Chiswell Karen , Hess Connie , Lopes Renato D. , Rao Sunil V. , Peterson Eric D. 
Published: September 2017

Background
Patients receiving oral anticoagulation in addition to dual‐antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug‐eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI).

Methods and Results

From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry—Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014. Temporal trends and hospital variation in DES use were examined, as were patterns of use by stroke risk (CHA
2
DS
2
‐VASc) and bleeding risk ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation). Among patients with linked Medicare data (n=2844), multivariable Cox regression modeling was used to compare risks for a composite outcome (all‐cause mortality, readmission for stroke, or MI), readmission for stroke, revascularization, and major bleeding at 1 year. A DES was used in 8414 (58.9%) MI patients with AF, increasing from 47.1% in 2008 to 67.9% in 2014, with wide variation among hospitals. DES placement was more common than BMS placement among patients at high stroke risk (CHA
2
DS
2
‐VASc ≥2) and high bleeding risk (ATRIA ≥4). Although aspirin and a P2Y
12
inhibitor were prescribed for >95% of all patients regardless of stent type at discharge, warfarin was prescribed less frequently among patients receiving a DES than a BMS (31% versus 39%,
P
<0.001). The composite outcome was similar between patients with a DES or BMS at 1 year (22% versus 26%; adjusted hazard ratio: 0.88; 95% confidence interval [CI], 0.76–1.03).

Conclusions
Use of DESs among MI patients with AF has increased over time, but substantial hospital‐level variation was observed. Patients with AF meeting indications for anticoagulation are more likely to receive a DES than a BMS, even among those at high predicted risk of both stroke and bleeding.
Cardiac Adaptations to High‐Intensity Aerobic Training in Premenopausal and Recent Postmenopausal Women: The Copenhagen Women Study
Authors: Egelund Jon , Jørgensen Peter G. , Mandrup Camilla M. , Fritz‐Hansen Thomas , Stallknecht Bente , Bangsbo Jens , Nyberg Michael , Hellsten Ylva 
Published: September 2017

Background
We examined the role of menopause on cardiac dimensions and function and assessed the efficacy of exercise training before and after menopause.

Methods and Results

Two groups of healthy premenopausal (n=36, 49.4±0.3 years) and postmenopausal (n=37, 53.5±0.5 years) women with no history of cardiovascular disease and with a mean age difference between groups of only 4 years were studied. Cardiac dimensions and systolic and diastolic function were determined by transthoracic echocardiography with tissue Doppler imaging and 2‐dimensional speckle tracking. Measurements were performed at baseline and after a 12‐week period of high‐intensity aerobic cycle training. LV internal diastolic diameter and LV mass were similar in the 2 groups at baseline and increased by ≈2% to 8% (
P
=0.04–0.0007) with training in both groups. Left atrial end‐diastolic and end‐systolic volumes were similar for both groups and increased by 23% to 36% (
P=
0.0006–0.0001) with training. Systolic function assessed by mean global strain was similar in both groups at baseline and increased by ≈8% (
P
=0.0004) with training in the postmenopausal group. LV displacement increased by ≈3% (
P
=0.04) in the premenopausal women only. Diastolic function assessed by E/A ratio was similar at baseline and increased by ≈7% (
P
=0.01) in the premenopausal group and 11% (
P
=0.0001) in the postmenopausal group with training.

Conclusions
These results suggest that training‐induced cardiac adaptations are preserved in the early postmenopausal phase. Furthermore, the hormonal changes associated with the menopausal transition do not appear to affect cardiac dimensions and function.

Clinical Trial Registration

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02135575.
Socioeconomic Position Is Associated With Carotid Intima–Media Thickness in Mid‐Childhood: The Longitudinal Study of Australian Children
Authors: Liu Richard S. , Mensah Fiona K. , Carlin John , Edwards Ben , Ranganathan Sarath , Cheung Michael , Dwyer Terence , Saffery Richard , Magnussen Costan G. , Juonala Markus , Wake Melissa , Burgner David P. , Olds Tim , Baur Louise , Gold Lisa , Lycett Kate , Kerr Jessica A. , Davies Sarah 
Published: September 2017

Background

Lower socioeconomic position (
SEP
) predicts higher cardiovascular risk in adults. Few studies differentiate between neighborhood and family
SEP
or have repeated measures through childhood, which would inform understanding of potential mechanisms and the timing of interventions. We investigated whether neighborhood and family
SEP
, measured biennially from ages 0 to 1 year onward, was associated with carotid intima–media thickness (
IMT
) at ages 11 to 12 years.

Methods and Results

Data were obtained from 1477 families participating in the Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children. Disadvantaged family and neighborhood
SEP
was cross‐sectionally associated with thicker maximum carotid
IMT
in separate univariable linear regression models. Associations with family
SEP
were not attenuated in multivariable analyses, and associations with neighborhood
SEP
were attenuated only in models adjusted for family
SEP
. The difference in maximum carotid
IMT
between the highest and lowest family
SEP
quartile measured at ages 10 to 11 years was 10.7 μm (95%
CI
, 3.4–18.0;
P
=0.004), adjusted for age, sex, pubertal status, passive smoking exposure, body mass index, blood pressure, and arterial lumen diameter. In longitudinal analyses, family
SEP
measured as early as age 2 to 3 years was associated with maximum carotid
IMT
at ages 11 to 12 years (difference between highest and lowest quartile: 8.5 μm; 95%
CI
, 1.3–15.8;
P
=0.02). No associations were observed between
SEP
and mean carotid
IMT
.

Conclusions

We report a robust association between lower
SEP
in early childhood and carotid
IMT
in mid‐childhood. Further investigation of mechanisms may inform pediatric cardiovascular risk assessment and prevention strategies.
Delayed Care and Mortality Among Women and Men With Myocardial Infarction
Authors: Bugiardini Raffaele , Ricci Beatrice , Cenko Edina , Vasiljevic Zorana , Kedev Sasko , Davidovic Goran , Zdravkovic Marija , Miličić Davor , Dilic Mirza , Manfrini Olivia , Koller Akos , Badimon Lina 
Published: September 2017

Background

Women with
ST
‐segment–elevation myocardial infarction (
STEMI
) have higher mortality rates than men. We investigated whether sex‐related differences in timely access to care among
STEMI
patients may be a factor associated with excess risk of early mortality in women.

Methods and Results

We identified 6022
STEMI
patients who had information on time of symptom onset to time of hospital presentation at 41 hospitals participating in the
ISACS
‐TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (
NCT
01218776) from October 2010 through April 2016. Patients were stratified into time‐delay cohorts. We estimated the 30‐day risk of all‐cause mortality in each cohort. Despite similar delays in seeking care, the overall time from symptom onset to hospital presentation was longer for women than men (median: 270 minutes [range: 130–776] versus 240 minutes [range: 120–600]). After adjustment for baseline variables, female sex was independently associated with greater risk of 30‐day mortality (odds ratio: 1.58; 95% confidence interval, 1.27–1.97). Sex differences in mortality following STEMI were no longer observed for patients having delays from symptom onset to hospital presentation of ≤1 hour (odds ratio: 0.77; 95% confidence interval, 0.29–2.02).

Conclusions

Sex difference in mortality following
STEMI
persists and appears to be driven by prehospital delays in hospital presentation. Women appear to be more vulnerable to prolonged untreated ischemia.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov/
. Unique identifier: NCT01218776.
Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry
®
Authors: Arnold Suzanne V. , Goyal Abhinav , Inzucchi Silvio E. , McGuire Darren K. , Tang Fengming , Mehta Sanjeev N. , Sperling Laurence S. , Maddox Thomas M. , Einhorn Daniel , Wong Nathan D. , Hammar Niklas , Fenici Peter , Khunti Kamlesh , Lam Carolyn S. P. , Kosiborod Mikhail 
Published: September 2017

Background

Although guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry
®
(DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States.

Methods and Results

We assessed the frequency of achievement of 7 diabetes mellitus–related quality metrics and variability across the Diabetes Collaborative Registry
®
sites. Among 574 972 patients with diabetes mellitus from 259 US practices, median (interquartile range) achievement of the quality metrics across the practices was the following: (1) glycemic control: 19% (5–47); (2) blood pressure control: 80% (67–88); (3) angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers in patients with coronary artery disease: 62% (51–69); (4) nephropathy screening: 62% (53–71); (5) eye examination: 0.7% (0.0–79); (6) foot examination: 0.0% (0.0–2.3); and (7) tobacco screening/cessation counseling: 86% (80–94). In hierarchical, modified Poisson regression models, there was substantial variability in meeting these metrics across sites, particularly with documentation of glycemic control and eye and foot examinations. There was also notable variation across specialties, with endocrinology practices performing better on glycemic control and diabetes mellitus foot examinations and cardiology practices succeeding more in blood pressure control and use of angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers.

Conclusions

The Diabetes Collaborative Registry
®
was established to document and improve the quality of outpatient diabetes mellitus care. While target achievement of some metrics of cardiovascular risk modification was high, achievement of others was suboptimal and highly variable. This may be attributable to fragmentation of care, lack of ownership among various specialists concerning certain domains of care, incomplete documentation, true gaps in care, or a combination of these factors.
Self‐Reported Health and Outcomes in Patients With Stable Coronary Heart Disease
Authors: Stewart Ralph A. H. , Hagström Emil , Held Claes , Wang Tom Kai Ming , Armstrong Paul W. , Aylward Philip E. , Cannon Christopher P. , Koenig Wolfgang , López‐Sendón José Luis , Mohler Emile R. , Hadziosmanovic Nermin , Krug‐Gourley Susan , Ramos Corrales Marco Antonio , Siddique Saulat , Steg Philippe Gabriel , White Harvey D. , Wallentin Lars ,   on behalf of the STABILITY Investigators
Published: September 2017

Background
The major determinants and prognostic importance of self‐reported health in patients with stable coronary heart disease are uncertain.

Methods and Results

The STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial randomized 15 828 patients with stable coronary heart disease to treatment with darapladib or placebo. At baseline, 98% of participants completed a questionnaire that included the question, “Overall, how do you feel your general health is now?” Possible responses were
excellent, very good, good, average
, and
poor
. Adjudicated major adverse cardiac events, which included cardiovascular death, myocardial infarction, and stroke, were evaluated by Cox regression during 3.7 years of follow‐up for participants who reported excellent or very good health (n=2304), good health (n=6863), and average or poor health (n=6361), before and after adjusting for 38 covariates. Self‐reported health was most strongly associated with geographic region, depressive symptoms, and low physical activity (
P
<0.0001 for all). Poor/average compared with very good/excellent self‐reported health was independently associated with major adverse cardiac events (hazard ratio [
HR
]: 2.30 [95% confidence interval (
CI
), 1.92–2.76]; adjusted
HR
: 1.83 [95%
CI
, 1.51–2.22]), cardiovascular mortality (
HR
: 4.36 [95%
CI
, 3.09–6.16]; adjusted
HR
: 2.15 [95%
CI
, 1.45–3.19]), and myocardial infarction (
HR
: 1.87 [95%
CI
, 1.46–2.39]; adjusted
HR
: 1.68 [95%
CI
, 1.25–2.27];
P
<0.0002 for all).

Conclusions
Self‐reported health is strongly associated with geographical region, mood, and physical activity. In a global coronary heart disease population, self‐reported health was independently associated with major cardiovascular events and mortality beyond what is measurable by established risk indicators.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifier:
NCT
00799903.
Hospital Practice of Direct‐Home Discharge and 30‐Day Readmission After Transcatheter Aortic Valve Replacement in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry
Authors: Dodson John A. , Williams Mathew R. , Cohen David J. , Manandhar Pratik , Vemulapalli Sreekanth , Blaum Caroline , Zhong Hua , Rumsfeld John S. , Hochman Judith S. 
Published: September 2017

Background
Nearly 17% of patients are readmitted within 30 days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home versus to skilled nursing facilities, and readmission remains unclear.

Methods and Results

The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry was used to evaluate readmissions among patients undergoing transcatheter aortic valve replacement (2011‐2015). Hospitals were divided into quartiles (Q1‐Q4) based on the percentage of patients discharged directly home. We assessed patient and hospital level characteristics and used hierarchical logistic regression to analyze the association of discharge disposition with 30‐day readmission. Our cohort included 18 568 transcatheter aortic valve replacement patients at 329 US hospitals, of whom 69% were discharged directly home. Hospitals in the highest quartile of direct home discharge (Q4) compared with hospitals in the lowest (Q1) were more likely to use femoral access (75.2% versus 60.1%,
P
<0.001), had fewer patients receiving transfusion (26.4% versus 40.9%,
P
<0.001), and were more likely to be located in the Southern United States (48.8% versus 18.3%,
P
<0.001). Median 30‐day readmission rate was 17.9%. There was no significant difference in 30‐day readmissions among quartiles (
P
=0.14), even after multivariable adjustment (odds ratio Q4 versus Q1=0.89, 95%
CI
0.76‐1.04;
P
=0.15). Factors most strongly associated with 30‐day readmission were glomerular filtration rate, in‐hospital stroke or transient ischemic attack, and nonfemoral access.

Conclusions
There was no statistically significant association between hospital practice of direct home discharge post–transcatheter aortic valve replacement and 30‐day readmission. Further research is needed to understand regional variations and optimum strategies for postdischarge care.