bluuebunny/crossref_metadata_2025_split huggingface dataset:
microRNA profile of inflammatory response in COVID-19 participants
Authors: Russell S L , Lozahic C , Rahman M , Okwose N , Raleigh S M , Mcgregor G , Maddock H , Banerjee P , Jakovljevic D G , Sandhu H 
Published: June 2024

Abstract

Background
COVID-19 is associated with a cytokine storm leading to a pro-inflammatory response. Little is known about the miRNA expression profile associated with inflammatory signalling pathways i.e. high vascular endothelin growth factor (VEGF) and/ or creatine kinase (CK) in people with a history of COVID-19.

Purpose
To identify the signalling profile of circulating miRNAs associated with a high inflammatory level and analyse their pro-inflammatory signalling pathways in people following COVID-19 infection.

Methods
VEGF and CK levels were assessed in a cohort of 84 participants who tested positive for COVID-19 within the past 18 months. Plasma samples were pooled in the following groups: ‘high VEGF’ (&gt;115pg/mL), ‘high CK’ (&gt;200U/L) and ‘low inflammation’ (standard cardiovascular/metabolic biomarkers within normal range). High inflammation VEGF and CK versus low inflammation pools were analysed. Global miRNA was extracted from pooled plasma samples and analysed using the TaqMan Array Human MicroRNA A cards. Using Ingenuity Pathway Analysis (IPA, Qiagen), we identified relevant miRNA-regulated target genes associated with pro-inflammation.

Results
Twelve participants (15%, age: 58 ± 6.8 years, 9 females) were identified as having high VEGF (153±43 pg/mL), 13 participants (15%, age: 61 ± 7.02 years, 3 females) with high CK (281 ± 81U/L) and 20 participants (24%, age: 59 ± 6.26 years, 12 females) had low inflammation. Significant upregulated expression of 98 miRNAs was identified in the high VEGF group and two miRNAs in the CK group. Significant downregulated expression of five miRNAs was identified in the high VEGF group, and 178 in the high CK group. IPA analysis revealed changes in expression levels of circulating miRNAs relate to inflammatory pathways, i.e. miR-196b (associated with inhibition of angiogenesis) was 2.16-fold downregulated in high VEGF and 3.24-fold downregulated in high CK groups. This downregulation of miR-196b supports the knowledge of the angiogenic/ vasculogenic role of VEGF. Additionally, high circulating CK is linked to general inflammation which is known to promote vascular growth in acute inflammation environments. Conversely, miR-361 was 429.00-fold upregulated in high VEGF groups and 4.00-fold downregulated in high CK groups. Knockdown of miR-361 leads to increased neovascularisation, however the high VEGF group show increased miR-361 expression.

Conclusion
Pro-inflammatory-associated miRNAs are identified in people following COVID-19 infection. Exploring miRNA signatures and their involvement in pro-inflammatory signalling pathways improves understanding of the inflammatory response in middle age and older adults with a history of COVID-19.
Cardiovascular health assessment using Life's Essential Eight in Israeli adults aged 65 years or older and its association with long-term cancer incidence
Authors: Marzooq A , Hayek S , Cohen G , Kittany L , Gerber Y 
Published: June 2024

Abstract

Background
Cardiovascular disease (CVD) and cancer, leading global causes of death, share risk factors and frequently coexist. Understanding their underlying mechanisms remains incomplete, particularly regarding the association between cardiovascular health (CVH) and cancer incidence among older adults.

Objective
This retrospective cohort study determines the association between CVH, indicated by Life's Essential 8 (LE8) metric, and risk of cancer incidence in older Israeli adults.

Methods
A cohort of 1799 Israeli adults aged 65 or older participated in the 2005-2006 National Health and Nutrition Survey. After excluding individuals with cancer history at baseline, 1541 participants were included. Baseline data, including CVD risk factors, physical activity, diet, and sleep, were used to categorize participants based on the LE8 CVH construct (0-100 scale). Cancer diagnoses were obtained from the Israeli National Cancer Registry until December 2019. Cox Proportional Hazards Regression Models estimated hazard ratios (HR) and 95% confidence intervals (CI) for incident cancer, adjusting for sociodemographic variables.

Results
In this cohort (mean age, 74 years; 53% women), LE8 scores ranged from 7 to 97 [mean (SD), 56 (14)]. Higher LE8 scores were positively associated with age, education, and residential socioeconomic status and inversely related to male sex and Arab ethnicity. Over 11 years of follow-up, 345 participants (22%) were newly diagnosed with cancer. LE8 was inversely associated with cancer incidence [adjusted HR = 0.88, 95% CI: 0.79-0.98, per 1 standard deviation increase]. This association persisted after accounting for death as a competing risk (see figure). The reduced risk was more pronounced in CVD-free participants [HR = 0.84, 95% CI: 0.74-0.97 (n=936)] than in prevalent CVD patients [HR = 0.99, 95% CI: 0.81-1.21 (n=605)].

Conclusions
Higher LE8 scores, indicative of robust cardiovascular health, were associated with lower long-term cancer incidence in older adults. Integrating LE8 metrics into risk assessment may inform targeted cancer prevention strategies, extending its role beyond cardiovascular health assessment. Cumulative incidence of new cancer cases
From reactive to proactive preventive cardiovascular risk management in primary care: a feasibility study
Authors: Bongaerts V , Van Os H , Hageman S , Van Gestel L , Bonten T , Van Peet P , Dorresteijn J , Numans M , Vos R 
Published: June 2024

Abstract

Background
Empanelment – identification and systematic categorization of patients sharing the same risk for cardiovascular disease (CVD) in primary care – provides the opportunity to tailor preventive treatment strategies to the care needs of individual patients in a proactive manner. It might provide opportunities to allocate resources to alleviate the disease burden for patient and society. In practice however, interventions using routinely collected health care data for proactive risk stratification are challenging to develop and implement. These challenges are related to practical constraints such as high safety and availability demands of data infrastructure, quality of the health care data and heterogeneity in the population working with the intervention – relating to both patients and health care professionals (HCPs).

Purpose
The overall aim of the feasibility study was to assess health care professionals' attitudes towards implementation of the PROSPERA-tool: a multilevel guideline adherence tool directed at an organizational change towards proactive cardiovascular risk management in primary care on both a population- and individual patient level.

Methods
This study was designed as a qualitative study using consecutive focus group sessions to assess the feasibility, acceptability, usability and appropriateness of the PROSPERA-tool as perceived by HCPs in primary care in the Netherlands. Constructs of the Theoretical Domain Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR) were used for the focus group topic guide and thematic analysis.

Results
In total 9 HCP (4 practice nurses, 5 general practitioners) participated in four consecutive focus groups. Preliminary results included major facilitators identified in the increased insight that was provided to the HCPs in their cardiovascular population and the possibility of time allocation between well-controlled and poor-controlled patients. Other facilitators were found in the design of parts of the PROSPERA-tool and in external support in learning how to work with the tool. Main identified barriers were changing professional roles (‘letting go of the driver’s seat’) and fear of degradation of the confiding doctor-patient relationship. Other barriers were related to routines and the concern of having insufficient (digital) skills to work with the PROSPERA-tool.

Conclusions
Various facilitators and barriers were identified for implementation of the PROSPERA-tool in the workflow of HCPs. This highlights the importance for implementation strategies matched to the identified barriers. Attention should be paid to preservation of the doctor-patient relationship, the construction of a safety net, and a supportive environment including training for HCPs with the opportunity for skill-improvement.
Effects of cardiac rehabilitation on the functional capacity of hypertensive elderly people in primary care
Authors: Lopes Do Nascimento L L N , Carvalho Y F , Pacheco M P , Coelho G G , Santos G F , Leite Y A , Oliveira L C M , Silva R E N S 
Published: June 2024

Abstract

Background
Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary intervention that improves functional capacity (FC), quality of life (QOL) and reduces morbidity and mortality of patients with cardiovascular diseases. Improving exercise tolerance is an important outcome of cardiac rehabilitation for both patients and clinicians.

Purpose
The objective of this study was to investigate the benefits of CR program in hypertensive elderly people.

Methods
The sample consisted of 40 hypertension elderly randomized into two groups: control group (CG) with 20 patients and rehabilitation group (RG) with 20 patients. Functional capacity assessment was performed using the incremental shuttle walk test (ISWT), and 1-min sit-to-stand test (1-MSTS). Patients were submitted to a supervised exercise program lasting 90 minutes, twice a week, for a period of 16 weeks. Each session consisted of a warm-up phase (10 minutes), conditioning (60 minutes), calm down (10 minutes) and health education (10 minutes). The CG maintained its usual activities. At the end of 16 weeks, the elderly underwent a reassessment on the ISWT and 1-MSTS.

Results
The sample was predominantly female (66%), with a mean age of 66.0 (±5.6) years in RG and 70.5 (±7.2) years in CG. Functional assessments at the end of CR showed a statistically significant improvement in 1-min sit-to-stand test (p&lt;0.001) and on distance travelled (p&lt;0.001), VO2est (p&lt;0.001) in ISWT (table 1). The mean improvement was 78.5m after rehabilitation (p&lt;0.001 pre/post), which was an important clinical difference. During the CR period, no complications prevented the completion of the protocol.

Conclusion
CR is well tolerated, safe and significantly improves functional capacity on hypertensive elderly people in primary care.
Is cognitive function a determinant of exercise capacity in patients with coronary artery disease?
Authors: Saklica D , Vardar-Yagli N , Ates A H , Yorgun H 
Published: June 2024

Abstract

Background
Exercise is often referred to as a 'polypill' due to its numerous beneficial effects on cardiovascular risk factors and the physiology of the cardiovascular system. Skeletal muscle weakness, cardiac ischemia, angina, and medications adversely affect exercise capacity in patients with coronary artery disease. In atherosclerotic patients, the presence of coronary microvascular dysfunction as determined by low coronary flow reserve is associated with abnormal cerebral flow hemodynamics and mild but significant impairment in cognitive function.

Purpose
The aim of our study was to investigate the relationship between cognitive status and exercise capacity in patients with coronary artery disease.

Methods
The study included 30 patients (59.8 ±7.20 years, 73% men) diagnosed with coronary artery disease. Patients were evaluated for cognitive impairments with the Montreal Cognitive Assessment (MoCA), and for exercise capacity with incremental shuttle walk test (ISWT). Additionally, the study documented sociodemographic, and physiological variables, number of cardiac risk factors with the cardiovascular risk factors questionnaire (obesity, physical inactivity, hyperlipidemia, hypertension, diabetes mellitus, smoking), International Physical Activity Questionnaire-Short Form, and comorbidities.

Results
Patients' waist hip ratio was 0.93±0.08, and body mass index was 27.54±4.24. About 43.3% (n=13) of the patients were actively employed. The number of risk factors was median 4 (min-max=2-7) and the number of comorbidities was median 0 (min-max: 0-5). Among the study participants, 96.6% (n=29) were physically inactive. There was a positive, high level, and statistically significant correlation between the ISWT distance and MoCA score (r=0.82, p=0.004).

Conclusion
The cognitive status of the patients significantly influenced their exercise capacity. Physiotherapists should consider patients' cognitive status when determining exercise capacity to ensure accurate measurements. Considering the cognitive status of patients with coronary artery disease when planning rehabilitation programs may be crucial for the success of these programs. Assessing cognitive functions and exercise ability before starting a cardiac rehabilitation program is critical for participation and commitment to exercise regimens.
Angiotensin II receptor blockers is associated a decreased left ventricular fibrosis in patients with obstructive hypertrophic cardiomyopathy
Authors: Nie C , Meng Y H , Xiao M H , Zhu C S , Lu Z Y , Wang S Y 
Published: June 2024

Abstract

Background
Myocardial fibrosis (MF) was implicated as a major risk factor for sudden cardiac death (SCD), which can lead to fatal ventricular arrhythmias. Angiotensin II receptor blockers (ARBs) have been reported to reduce MF in patients with nonobstructive HCM, whereas results were inconsistent. Here, we aimed to investigate the association between ARB use and the severity of MF in patients with obstructive HCM (oHCM).

Method
We analyzed data from 1324 consecutive hospitalized oHCM patients from January 2012 to December 2019. All patients underwent gadolinium-based contrast agent-enhanced cardiac magnetic resonance (CMR) examinations prior to surgery. The extent of late gadolinium enhancement (LGE%) was compared between patients with and without ARBs treatment (termed ARB+ group and ARB- group).

Results
Of 1324 included patients, 86 (6.5%) patients had ARBs treatment. Compared to patients in ARB- group, patients in ARB+ group seemed much older, had a higher body mass index (BMI), a higher proportion of hypertension, a smaller intraventricular septal thickness (IVST), and a lower LGE% (3.6 [0.86, 6.68] vs. 4.4 [1.38, 9.74], p= 0.023). After propensity score matching with confounding variables at baseline, 86 paired patients were included in the matched cohort. The LGE% was still lower in ARB+ group than ARB - group (3.6 [0.86, 6.68] vs. 4.5 [1.28, 9.45], p = 0.043), respectively (Figure 1). The multiple linear analysis revealed that ARB use was independently associated with a lower LGE% (β= -2.12, 95% confidence interval (CI) [-4.19, -0.05], p=0.044) after adjusting for age, gender, BMI, hypertension, IVST and left ventricular outflow gradient (Figure2).

Conclusion
Our study suggested that ARB use was associated with a decreased left ventricular fibrosis in patients with oHCM, which may help SCD prevention in those patients. The extent of LGE% between groups Multiple linear regression analysis
Factors related to one-year mortality in nonagenarians with acute myocardial infarction: a nationwide analysis
Authors: Kupisz-Urbanska M K U , Teisseyre P T , Topor-Madry R T M , Jankowski P J 
Published: June 2024

Abstract

Background
Myocardial infarction (MI) has been stated as a major cause of death in the elderly. The prevalence of MI and mortality of patients with MI is strongly influenced by age.

Purpose
To characterize factors related to one-year mortality in patients with acute myocardial infarction aged at least 90 years.

Methods
We included all patients aged at least 90 years hospitalized for MI in Poland between 2014 and 2020 and followed them for one year.

Results
A total of 14970 patients (mean age 92.7±2.3 years; 4666 men and 10304 women) were included. Coronary angiography was performed in 47.0% of patients, PCI in 39.8%, and CABG in 0.2% of patients. In-hospital mortality was 27.8% (25.1% in men and 29.0% in female patients; P&lt;0.001), 23.0% in patients managed invasively and 32.1% in those managed conservatively (P&lt;0.001). All-cause mortality following discharge was 38.1% (females: 38.4%, males: 37.5%, P=0.27), the endpoint consisting of all-cause death, MI or stroke occurred in 42.6% patients (females: 42.8%, males: 42.2%, P=0.44), while all-cause death or cardiovascular hospitalization in 59.0% (females: 58.2%, males: 60.7%, P=0.046). The one-year all-cause mortality (in-hospital and post-discharge deaths combined) was 54.3% (females: 56.3%, males: 53.2%, P&lt;0.001), but sex was not related to one-year mortality after adjustment in multivariable analysis. Variables independently related to the higher risk of one-year mortality were: age per one year (HR 1.05 [CI 95% 1.04-1.06]), heart failure (1.09 [1.04-1.14]), diabetes (1.08 [HR 1.02-1.13]), and chronic obstructive pulmonary disease (HR 1.09 [1.01-1.18]). Meanwhile, hospitalisation in a department of cardiology or internal medicine respectively (0.76 [0.70-0.83]) and (0.85 [0.78-0.93]), invasive management (at least coronary angiography) (0.65 [0.62-0.69]), and hypertension (0.87 [0.82-0.92]) were linked to lower risk of one-year mortality.

Conclusion
Age and comorbidities, but not sex, are independent predictors of one-year mortality. Variables related to one-year mortality
Predictive value of glycated hemoglobin in multivessel coronary artery disease in STEMI patients with type 2 diabetes mellitus
Authors: Krasniqi X , Bakalli A , Kocinaj D , Vincelj J , Sejdiu B , Morina V , Morina P , Keka L , Krasniqi A , Bashota L , Zijabeg D , Veliu F , Krasniqi A , Mahmutaj V , Sejdiu J 
Published: June 2024

Abstract

Background
Increased level of glycated hemoglobin may be used to identify STEMI patients at risk for multivessel coronary artery disease, either insulin depending or non-insulin depending type 2 diabetes mellitus.

Purpose
We evaluated diabetic patients who presented with ST-segment elevation myocardial infarction according to the level of HbA1C.

Methods
In this study we included eighty-two consecutive type 2 diabetes mellitus patients with STEMI of onset &lt;12h who underwent primary percutaneous coronary intervention. The levels of creatine kinase, the MB fraction of creatine kinase, troponin T, HbA1C, CRP, and other routine laboratory parameters were measured. Measurement of HbA1C was performed on the day of admission with ion-exchange high performance liquid chromatography. Thereafter patients were divided in two groups according to the percentage of HbA1C.

Results
In total 42 (51.2%) patients suffered from multivessel coronary artery disease, 17 (40.5%) of whom with HbA1C ≤9.5% and 25 (59.5%) with value &gt;9.5% (p &lt;0.001). As for the patients with insulin depending type 2 diabetes mellitus, the total number was 22 (26.8%), 10 (45.4%) of whom had HbA1C ≤9.5% and 12 (54.6%) with value &gt;9.5% (p &lt; 0.03) (Table 1). A receiver operating characteristics (ROC) curve plots the true positive rate against the false positive rate at different cut-off points, AUC=0.704 (95% CI: 0.59-0.81), p=0.001 (Figure 1). Table 2 presents the area under the curve for biochemical analysis (HbA1C, Hb, cholesterol, triglyceride, creatine kinase, creatine kinase-MB, troponin T and C-reactive protein). The AUC of 0.704 (95% CI: 0.59-0.81) for HbA1C is significant (p=0.001) as well as for creatine kinase-MB (AUC= 0.67, 95% CI: 0.55-0.80) with a p value of 0.006.

Conclusions
The value for the HbA1C above 9.5% in type 2 diabetes mellitus may be used to identify patients at risk for multivessel coronary artery disease, therefore warranting a more rigorous glycemic control.
Sex differences in risk factor relationships with subarachnoid haemorrhage and intracranial aneurysms: a Mendelian randomisation study
Authors: Tschiderer L , Bakker M K , Gill D , Burgess S , Willeit P , Ruigrok Y M , Peters S A E 
Published: June 2024

Abstract

Background
The prevalence of intracranial aneurysms (IAs) and incidence of aneurysmal subarachnoid haemorrhage (aSAH) is higher in women than in men. Although several cardiometabolic and lifestyle factors have been related to IAs or aSAH, it is unclear whether there are sex differences in causal relationships.

Purpose
The aim of this study was to determine sex differences in causal relationships between cardiometabolic and lifestyle factors and risk of aSAH and IA.

Methods
We conducted a sex-specific Mendelian randomisation study using summary-level data from genome-wide association studies. We analysed low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, non-HDL-C, total cholesterol, fasting glucose, systolic and diastolic blood pressure, smoking initiation, and alcohol use as exposures, and aSAH and IA (i.e., aSAH and unruptured IA combined) as outcomes.

Results
We found statistically significant sex differences in the relationship between genetically proxied non-HDL-C and aSAH risk, with odds ratios (ORs) of 0.72 (95% CI 0.58, 0.88) in women and 1.01 (0.77, 1.31) in men (P-value for sex difference 0.044). Moreover, genetic liability to smoking initiation was related to a statistically significantly higher aSAH risk in men compared to women (P-value for sex difference 0.007) with ORs of 3.81 (1.93, 7.52) and 1.12 (0.63, 1.99), respectively, and to a statistically significantly higher IA risk in men compared to women (P-value for sex difference 0.036) with ORs of 3.58 (2.04, 6.27) and 1.61 (0.98, 2.64), respectively.

Conclusion
Higher genetically proxied non-HDL-C was related to a lower risk of aSAH in women compared to men. Moreover, genetic liability to smoking initiation was associated with a higher risk for aSAH and IA in men compared to women. These findings may help improve understanding of sex differences in the development of aSAH and IA.