bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and Long‐term Prognosis of Angiographic Slow/No‐Reflow Phenomenon During Emergency Percutaneous Coronary Intervention for ST‐Elevated Acute Myocardial Infarction
Authors: Dong‐bao Li , Qi Hua , Zhi Liu , Shan Wang , Wei‐ying Jin 
Published: December 2010

AbstractObjectiveAngiographic slow/no‐reflow during emergency percutaneous coronary intervention (PCI) in patients with ST‐elevated acute myocardial infarction (AMI) may result in unfavorable outcomes. The aim of our study was to investigate the clinical factors and angiographic findings that predict slow/no‐reflow phenomenon and the long‐term prognosis of AMI patients with angiographic slow/no‐reflow.MethodsA total of 210 consecutive AMI patients, who underwent primary PCI within 12 hours of symptom onset were divided into a normal flow group (thrombolysis in myocardial infarction [TIMI] flow grade 3, n = 169) and a slow/no‐reflow group (≤TIMI flow grade 2, n = 41), based on cineangiograms performed during PCI.ResultsA total of 41 patients (19.5%) developed slow/no‐reflow phenomenon. Univariate analysis showed that delayed reperfusion, high thrombus burden on baseline angiography, and acute hyperglycemia all correlated with slow/no‐reflow (P < 0.05 for all). Multivariate analysis revealed that hyperglycemia on admission (≥10 mmol/L; odds ratio [OR]: 1.7, 95% confidence interval [CI]: 1.423–2.971, P = 0.012), reperfusion time (≥6 h; OR:1.4, 95% CI: 1.193–1.695, P = 0.040), and high thrombus burden (OR: 1.6, 95% CI: 1.026–2.825, P = 0.031) were significant and independent predictors of angiographic slow/no‐reflow. The 6‐month mortality and incidence of major adverse cardiac and cerebrovascular events (MACCE) were significantly higher in the slow/no‐reflow group than in the normal flow group. Angiographic slow/no‐reflow was independently predictive of MACCE (hazard ratio [HR]: 2.642, 95% CI: 1.304–5.932, P = 0.028).ConclusionDelayed reperfusion, high thrombus burden on baseline angiography, and blood glucose level on admission can be used to stratify AMI patients into a lower or higher risk for angiographic slow/no‐reflow during PCI. In addition, angiographic slow/no‐reflow predicts an adverse outcome in AMI patients. Copyright © 2010 Wiley Periodicals, Inc.
Two‐Dimensional Visualization of Cholesterol and Cholesteryl Esters Within Human Coronary Plaques by Near‐Infrared Fluorescence Angioscopy
Authors: Uchida Yasumi , Uchida Yasuto , Sugiyama Yukou , Tomaru Takanobu , Kawai Seiji , Kanamaru Ryohei , Shimoyama Ei 
Published: December 2010

AbstractBackground:Cholesterol (C) and cholesteryl esters (CE) within coronary plaques are minimally visualized directly by any of the available imaging modalities in vivo. If they are rendered visible in vivo, the progression of coronary plaques and the effects of respective therapies on these plaques can be objectively evaluated.Hypothesis:The C and CE within human coronary plaques can be visualized by near‐infrared fluorescence angioscopy (NIRFA).Methods:By exciting at 710 ± 25 nm and emitting at 780 nm, near‐infrared fluorescence (NIRF) of lipid components was examined by microscopy in vitro. Lipid components in 49 plaques of 32 excised human coronary arteries were examined by NIRFA in vitro. Coronary plaques were examined by NIRFA in 25 patients with coronary artery disease.Results:C, CE, and calcium (Ca) individually did not exhibit NIRF but did in the presence of β‐carotene, which is known to coexist with lipids in the vascular wall. Other substances that are contained in atherosclerotic plaques did not.2 The excised human coronary plaques were classified as those with NIRF and those without. The former plaques were classified into homogenous, doughnut‐shaped, and spotty types. Histological examinations revealed that these image patterns were determined by the differences in the locations of C, CE, and Ca, and that those deposited within 700 μm in depth from the plaque surface were imaged by NIRFA. Homogenous, doughnut‐shaped, or spotty NIRFA images were also observed in patients.Conclusions:NIRFA is feasible for 2‐dimensional imaging of C and CE deposited in human coronary plaques. Copyright © 2010 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.
Cardio‐Oncology/Onco‐Cardiology
Authors: Hong Robert A. , Iimura Takeshi , Sumida Kenneth N. , Eager Robert M. 
Published: December 2010

AbstractAn understanding of onco‐cardiology or cardio‐oncology is critical for the effective care of cancer patients. Virtually all antineoplastic agents are associated with cardiotoxicity, which can be divided into 5 categories: direct cytotoxic effects of chemotherapy and associated cardiac systolic dysfunction, cardiac ischemia, arrhythmias, pericarditis, and chemotherapy‐induced repolarization abnormalities. Radiation therapy can also lead to coronary artery disease and fibrotic changes to the valves, pericardium, and myocardium. All patients being considered for chemotherapy, especially those who have prior cardiac history, should undergo detailed cardiovascular evaluation to optimize the treatment. Serial assessment of left ventricular systolic function and cardiac biomarkers might also be considered in selected patient populations. Cardiotoxic effects of chemotherapy might be decreased by the concurrent use of angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, or beta‐blockers. Antiplatelet or anticoagulation therapy might be considered in patients with a potential hypercoagulable state associated with chemotherapy or cancer. Open dialogue between both cardiologists and oncologists will be required for optimal patient care. Copyright © 2010 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.
Comparison of Actigraphic and Subjective Measures of Sleep in Implantable Cardioverter Defibrillator and Coronary Artery Disease Patients
Authors: Cross Natalie J. , McCrae Christina S. , Smith Karen M. , Conti Jamie B. , Sears Samuel F. 
Published: December 2010

AbstractBackground:Cardiac patients frequently have insomnia symptoms that may pose risk for future cardiac events. Poor sleep relates to hyperarousal, anxiety and depression, and the incidence of hypertension and myocardial infarction.Hypothesis:The authors hypothesized that implantable cardioverter defibrillator (ICD) patients would have poorer sleep than coronary artery disease (CAD) patients related to hypervigilance for device functioning and shock discharge.Methods:Authors investigated sleep efficiency and sleep latency in a sample of 60 patients (n = 30 CAD and n = 30 ICD) without obstructive sleep apnea at the University of Florida & Shands Hospital. For 14 days, participants completed a sleep diary. Additionally, half of the total sample also used actigraphy to objectively measure their sleep. Measures of somatic hypervigilance and psychosocial distress were administered.Results:Using actigraphy, mean sleep efficiency was poorer (69.76%) in CAD patients compared with ICD patients (82.80%). This difference was highly significant, F1,27 = 16.840, P < 0.001. CAD patients also had shorter mean total sleep times per sleep diaries compared with ICD patients (336.19 minutes or 5.60 hours, 430.65 minutes or 7.18 hours, respectively), F1,27 = 15.908, P < 0.001.Conclusions:The finding that ICD patients slept more efficiently than CAD patients is surprising given that CAD patients had higher ejection fractions and no concerns about ICD shocks. This difference cannot be accounted for by differences in hypervigilance, depression, anxiety, or physical activity. Results suggest that CAD patients may have more sleep problems and may warrant increased research attention. Copyright © 2010 Wiley Periodicals, Inc.Dr. Sears serves as a consultant to Medtronic, has or has had research grants from Medtronic and St. Jude Medical, and has received speaker honoraria from Medtronic, Boston Scientific, St. Jude Medical, and Biotronik. Dr. Conti serves as a consultant to Medtronic, has or has had research grants from Medtronic and St. Jude Medical, and has received speaker honoraria from Medtronic, Boston Scientific, and St. Jude Medical. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
The Prevalence of Endothelial Dysfunction in Patients With and Without Coronary Artery Disease
Authors: Toggweiler Stefan , Schoenenberger Andreas , Urbanek Nadja , Erne Paul 
Published: December 2010

AbstractBackground:Endothelial dysfunction (ED) is frequently present in patients presenting with acute or stable coronary artery disease (CAD), but it is also found in patients presenting with chest pain without angiographic coronary lesions.Hypothesis:We hypothesized that even in patients without CAD, the presence of cardiovascular (CV) risk factors will correlate with the presence of ED.Methods:Our study included a total of 341 consecutive patients referred for coronary angiography. We used pulse wave analysis with a finger plethysmograph (peripheral arterial tonometry) to determine endothelial function. Hyperemia ratio was calculated as the ratio of the postischemic hyperemia response relative to baseline measurement.Results:The hyperemia ratio was significantly higher in patients without CAD (2.02 ± 0.52) compared with patients with chronic CAD (1.81 ± 0.44, P = 0.001) or acute CAD (1.74 ± 0.49, P < 0.001). Prevalence of ED was 33%, 46%, and 58%, respectively. In multivariate analysis, the presence of CAD, diabetes, and cigarette smoking, and the total number of CV risk factors, were strong predictors of ED. In 67% of the patients without CAD but with ≥3 CV risk factors, ED was present.Conclusions:Prevalence of ED in patients with chest pain depends on the presence of CAD and CV risk factors. Patients without CAD but with ≥3 risk factors frequently presented with ED. Such patients may be at increased risk for future CV events and may profit from intensified therapy to control CV risk factors.The authors have no funding, financial relationships, or conflicts of interest to disclose.This study was supported by the Swiss Heart Foundation, Bern, Switzerland, and the Kamillo Eisner Foundation, Hergiswil, Switzerland. Stefan Toggweiler was supported by a grant from the Swiss National Foundation. None of the granting institutions had any influence on the study design, data collection, analysis, or interpretation.
Obesity Is an Independent Risk Factor for Heart Failure: Zona Franca Cohort Study
Authors: Baena‐Díez José M. , Byram Alice O. , Grau María , Gómez‐Fernández Claudia , Vidal‐Solsona Marc , Ledesma‐Ulloa Gabriela , González‐Casafont Isabel , Vasquez‐Lazo Javier , Subirana Isaac , Schroder Helmut 
Published: December 2010

AbstractBackground:Heart failure (HF) is a major problem in developed countries. However, its relationship with obesity remains unclear, especially in low‐risk populations. The objective of the study was to analyze the relationship between obesity and HF in a low‐risk Mediterranean population.Hypothesis:Obesity is an independent predictor for HF.Methods:A prospective community‐based population cohort study with 10 years' follow‐up was conducted at 2 healthcare centers in the city of Barcelona, Spain. From a registered population of 35 275, the study included 932 randomly selected patients without HF, age 35–84 years. Obesity was defined as body mass index (BMI) ≥30 and HF according to European Society of Cardiology guidelines, confirmed by echocardiography. Cox proportional hazards regression was used to examine the association between obesity and heart failure.Results:The difference in HF incidence between obese subjects (4.7%) and nonobese subjects (1.6%) was 3.1% (95% confidence interval [CI]: 0.7–5.5). In the unadjusted model, incident HF was significantly associated with BMI: the hazard ratio [HR] was 1.09 for every 1 kg/m2 increase (95% CI: 1.05–1.14) and 3.01 for BMI ≥30 (95% CI: 1.34–6.77). After adjusting for age, sex, hypertension, ischemic heart disease, and diabetes mellitus, the results were similar: HR 1.06 (95% CI: 1.01–1.10) and HR 2.45 for BMI ≥30 (95% CI: 1.02–5.61). Overweight was not associated with HF in any of the models. The population‐attributable risk of HF due to obesity was 43.0% (95% CI: 13.9–74.9).Conclusions:High rate differences, HRs, and attributable risk indicate that obesity is an important risk factor for incident HF. Copyright © 2010 Wiley Periodicals, Inc.This work was supported by grants from Instituto de Salud Carlos III‐FEDER0 (PI080439), and by a joint contract of the Instituto de Salud Carlos III and the Health Department of the Catalan Government.
Perceived Quality of Care and Lifestyle Counseling Among Patients With Heart Disease
Authors: Jackson Elizabeth A. , Krishnan Sangeetha , Meccone Nancy , Ockene Ira S. , Rubenfire Melvyn 
Published: December 2010

AbstractBackground:To examine patients' perceived quality of care and reported receipt of information on diet and exercise related to cardiovascular disease prevention.Methods:Patients admitted with acute coronary syndromes or elective cardiac catheterization were eligible for enrollment. Baseline medical information was collected through medical‐record review. Patients completed surveys at the time of hospitalization that included items on perceived quality of care and whether they had received information from a healthcare provider on diet and exercise as related to their heart. Perceived quality of care was grouped into 3 categories: (1) poor to fair, (2) good, and (3) very good to excellent.Results:Among the 182 cardiac patients who completed the survey, those who reported poor to fair quality of care were more likely to report that they had received no advice regarding diet as compared with those who perceived their quality of care as good or very good to excellent (61%, 59%, and 26%, respectively, P < 0.0001). A similar pattern was observed for exercise (71%, 74%, and 36%, respectively, P < 0.0001).Conclusions:Patients with low perceived quality of care were less likely to have discussed diet and exercise habits with healthcare providers. Improving receipt of lifestyle counseling is warranted given the central role that diet and exercise play in secondary prevention. Copyright © 2010 Wiley Periodicals, Inc.Dr. Jackson receives support from the National Heart, Lung, and Blood Institute of the National Institutes of Health (K23 HL073310‐01). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Automatic External Defibrillator, Life Vest Defibrillator, or Both?
Authors: Richard Conti C. 
Published: December 2010

Abstractmagnified image The standard of practice for out‐of‐hospital defibrillation is the implantable cardioverter‐defibrillator. However, much has been written and discussed about the use of automated external defibrillators. Not as much has been written about life vest wearable defibrillators. Copyright © 2010 Wiley Periodicals, Inc.
Reactions of Antimalarial Peroxides with Each of Leucomethylene Blue and Dihydroflavins: Flavin Reductase and the Cofactor Model Exemplified
Authors: Haynes Richard K. , Cheu Kwan‐Wing , Tang Maggie Mei‐Ki , Chen Min‐Jiao , Guo Zu‐Feng , Guo Zhi‐Hong , Coghi Paolo , Monti Diego 
Published: December 2010

AbstractFlavin adenine dinucleotide (FAD) is reduced by NADPH–E. coli flavin reductase (Fre) to FADH2 in aqueous buffer at pH 7.4 under argon. Under the same conditions, FADH2 in turn cleanly reduces the antimalarial drug methylene blue (MB) to leucomethylene blue. The latter is rapidly re‐oxidized by artemisinins, thus supporting the proposal that MB exerts its antimalarial activity, and synergizes the antimalarial action of artemisinins, by interfering with redox cycling involving NADPH reduction of flavin cofactors in parasite flavin disulfide reductases. Direct treatment of the FADH2 generated from NADPH–Fre–FAD by artemisinins and antimalaria‐active tetraoxane and trioxolane structural analogues under physiological conditions at pH 7.4 results in rapid reduction of the artemisinins, and efficient conversion of the peroxide structural analogues into ketone products. Comparison of the relative rates of FADH2 oxidation indicate optimal activity for the trioxolane. Therefore, the rate of intraparastic redox perturbation will be greatest for the trioxolane, and this may be significant in relation to its enhanced in vitro antimalarial activities. 1H NMR spectroscopic studies using the BNAH–riboflavin (RF) model system indicate that the tetraoxane is capable of using both peroxide units in oxidizing the RFH2 generated in situ. Use of the NADPH–Fre–FAD catalytic system in the presence of artemisinin or tetraoxane confirms that the latter, in contrast to artemisinin, consumes two reducing equivalents of NADPH. None of the processes described herein requires the presence of ferrous iron. Ferric iron, given its propensity to oxidize reduced flavin cofactors, may play a role in enhancing oxidative stress within the malaria parasite, without requiring interaction with artemisinins or peroxide analogues. The NADPH–Fre–FAD system serves as a convenient mimic of flavin disulfide reductases that maintain redox homeostasis in the malaria parasite.
Activity of azacitidine in chronic myelomonocytic leukemia
Authors: Costa Rubens , Abdulhaq Haifaa , Haq Bushra , Shadduck Richard K. , Latsko Joan , Zenati Mazen , Atem Folefac D. , Rossetti James M. , Sahovic Entezam A. , Lister John 
Published: December 2010

AbstractBACKGROUND:Hypomethylating drugs are useful in the management of myelodysplastic syndrome (MDS). Two of these drugs, azacitidine and decitabine, have received FDA approval for the treatment of MDS and chronic myelomonocytic leukemia (CMML). However, phase 2 and 3 studies that assessed these agents in MDS included only a small number of patients with CMML. The objective of this study was to evaluate the efficacy and safety of azacitidine in the treatment of CMML.METHODS:The records of thirty‐eight patients diagnosed with CMML and treated with azacitidine at our institution were reviewed. Azacitidine was administered at 75 mg/m2/day for 7 days or 100 mg/m2/day for 5 days every 4 weeks. Patients who received at least 1 cycle of the drug were considered evaluable for response.RESULTS:Response was assessed by the modified International Working Group (IWG) criteria. The overall response rate was 39% (14 of 36); complete response (CR) rate was 11% (4 of 36); partial response (PR) rate was 3% (1 of 36); hematologic improvement (HI) was 25% (9 of 36). The median overall survival was 12 months. There was a statistically significant overall survival advantage in responders compared with nonresponders: 15.5 months versus 9 months, respectively (P = .04). Treatment was generally well tolerated. One of 2 patients had complete resolution of a skin rash that was due to monocytic infiltration.CONCLUSIONS:Azacitidine is active in the treatment of CMML. The therapy‐associated toxicity is acceptable. Our results support further investigation of azacitidine in CMML, particularly in combination with other agents. Cancer 2011;. © 2010 American Cancer Society.
Assessing gynecologic and breast cancer survivors' sexual health care needs
Authors: Hill Emily K. , Sandbo Stacey , Abramsohn Emily , Makelarski Jennifer , Wroblewski Kristen , Wenrich Emily R. , McCoy Stacy , Temkin Sarah M. , Yamada S. Diane , Lindau Stacy T. 
Published: December 2010

AbstractBACKGROUND:The objective of this study was to identify patterns of interest in receiving care for sexual concerns among women who were survivors of gynecologic and breast cancers.METHODS:Survey and medical records data were collected from June 2008 to March 2009 from 261 gynecologic and breast cancer patients. Logistic regression was used to estimate the effect of age and months since treatment on interest in receiving sexual healthcare.RESULTS:The mean participant age was 55 years (range, 21‐88 years). Only 7% of women had recently sought medical help for sexual issues, yet 41.6% were interested in receiving care. Greater than 30% responded that they would be likely to see a physician to address sexual matters, and 35% of all women were willing to be contacted if a formal program was offered. Compared with older women (aged >65 years), younger women (ages 18‐47 years) were significantly more likely to report interest in receiving care to address sexual issues (odds ratio [OR], 2.94; 95% confidence interval [CI], 1.14‐7.54) and to see a physician to address sexual matters (OR, 4.51; 95% CI, 1.51‐13.43), and they were more willing to be contacted for a formal program (adjusted OR [AOR], 5.00; 95% CI, 1.63‐15.28). Compared with women who were currently in treatment, women who last received treatment >12 months previously were significantly more interested in receiving care (AOR, 2.02; 95% CI, 1.02‐4.01) and were more willing to be contacted (AOR, 2.49; 95% CI, 1.18‐5.26).CONCLUSIONS:Greater than 40% of survivors expressed interest in receiving sexual healthcare, but few had ever sought such care. The current results indicated that there is an unmet need for attention to sexual concerns among women with gynecologic and breast cancers. Cancer 2011;. © 2010 American Cancer Society.
Medical expenditures of adult cancer survivors aged <65 years in the United States
Authors: Short Pamela Farley , Moran John R. , Punekar Rajeshwari 
Published: December 2010

AbstractBACKGROUND:To the authors' knowledge, this is the first study to provide national estimates of medical expenditures for all adult cancer survivors aged <65 years. Most studies of expenditures for cancer survivors in this age group have been based on the Medical Expenditure Panel Survey (MEPS) and were limited to “affected survivors.”METHODS:MEPS expenditure data for 2001 to 2007 were linked to data identifying all survivors from the National Health Interview Survey (NHIS), which is the MEPS sampling frame. The sample was comprised of adults ages 25 to 64 years. Propensity‐score matching was used to estimate the effects of cancer on average total and out‐of‐pocket expenditures for all services and separately for prescriptions. Probit models were used to estimate effects on the probability of exceeding different expenditure thresholds.RESULTS:Mean annual expenditures on all services in 2007 were $16,910 ± $3911 for survivors who were newly diagnosed with cancer, $7992 ± $972 for survivors who had been diagnosed in previous years, and $3303 ± $103 for other adults. Fifty‐three percent of survivors were not identified in MEPS but only by linking to NHIS. Expenditures for all survivors averaged approximately $9300 compared with $13,600 for “affected survivors.” For previously diagnosed survivors, the increase in mean expenditures attributable to cancer was approximately $4000 to $5000 annually. On average, relatively little of the increase was paid out of pocket, but cancer nearly doubled the risk of high out‐of‐pocket expenditures.CONCLUSIONS:Previous MEPS analyses overstated average expenditures for all survivors. Nevertheless, the current results indicated that the increase in expenditures attributable to cancer is substantial, even for longer term survivors, and that cancer increases the relative risk of high out‐of‐pocket expenditures. Cancer 2011;. © 2010 American Cancer Society.