bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Levels of Vitamin E Are Associated With Early Recurrence of Atrial Fibrillation After Electric Cardioversion
Authors: Ferro Domenico , Franciosa Pasquale , Cangemi Roberto , Carnevale Roberto , Pignatelli Pasquale , Loffredo Lorenzo , Perri Ludovica , Catasca Elisa , Violi Francesco 
Published: February 2012

Background—
Oxidative stress is suggested to play a role in favoring the occurrence of atrial fibrillation (AF). We analyzed whether vitamin E, a known antioxidant, or markers of oxidative stress are associated with AF recurrence in patients undergoing electric cardioversion.

Methods and Results—

A total of 144 patients (83 men; mean age, 71.1±5.4 years) underwent successful biphasic electric cardioversion of nonvalvular persistent AF. At baseline, urinary 8-isoprostaglandin F2α and serum soluble NOX2-derived peptide (sNOX2-dp), high-sensitivity C-reactive protein (hs-CRP), and vitamin E levels were measured in each patient. All patients underwent 3 months of clinical follow-up, including an office visit with ECG every week or in cases of symptom recurrence. During the follow-up, 94 patients maintained sinus rhythm, whereas 50 experienced AF recurrence. In unadjusted analysis, left atrial diameter and levels of urinary isoprostanes and serum sNOX2-dp and hs-CRP were significantly higher and serum vitamin E lower in patients with AF recurrence. In multivariable Cox analysis, serum vitamin E (hazard ratio, 0.734; 95% CI, 0.605–0.891;
P
<0.001) and, to a lesser extent, hs-CRP (
P
=0.047) remained significantly associated with AF recurrence. Urinary isoprostanes and serum sNOX2-dp levels were inversely correlated with serum vitamin E level (
r
=−0.626,
P
<0.001, and
r
=−0.460,
P
<0.001, respectively).

Conclusions—
The study shows that low serum vitamin E levels are associated with AF recurrence in patients who underwent cardioversion. Because vitamin E inversely correlated with oxidative stress, the findings reinforce the hypothesis of an interplay between oxidative stress and AF.
Determinants of Left Ventricular Mass in Patients on Hemodialysis
Authors: Chan Christopher T. , Greene Tom , Chertow Glenn M. , Kliger Alan S. , Stokes John B. , Beck Gerald J. , Daugirdas John T. , Kotanko Peter , Larive Brett , Levin Nathan W. , Mehta Ravindra L. , Rocco Michael , Sanz Javier , Schiller Brigitte M. , Yang Phillip C. , Rajagopalan Sanjay ,   the Frequent Hemodialysis Network (FHN) Trial Group
Published: February 2012

Background—
An increase in left ventricular mass (LVM) is associated with mortality and cardiovascular morbidity in patients with end-stage renal disease.

Methods and Results—

The Frequent Hemodialysis Network (FHN) Daily Trial randomized 245 patients to 12 months of 6 times per week daily in-center hemodialysis or conventional hemodialysis; the FHN Nocturnal Trial randomized 87 patients to 12 months of 6 times per week nocturnal hemodialysis or conventional hemodialysis. The main cardiac secondary outcome was change in LVM. In each trial, we examined whether several predefined baseline demographic or clinical factors as well as change in volume removal, blood pressure, or solute clearance influenced the effect of frequent hemodialysis on LVM. In the Daily Trial, frequent hemodialysis resulted in a significant reduction in LVM (13.1 g; 95% CI, 5.0–21.3 g;
P
=0.002), LVM index (6.9 g/m
2
; 95% CI, 2.4–11.3 g/m
2
;
P
=0.003), and percent change in geometric mean of LVM (7.0%; 95% CI, 1.0%–12.6;
P
=0.02). Similar trends were noted in the Nocturnal Trial but did not reach statistical significance. In the Daily Trial, a more pronounced effect of frequent hemodialysis on LVM was evident among patients with left ventricular hypertrophy at baseline. Changes in LVM were associated with changes in blood pressure (conventional hemodialysis:
R
=0.28,
P
=0.01, daily hemodialysis:
R
=0.54,
P
<0.001) and were not significantly associated with changes in other parameters.

Conclusions—
Frequent in-center hemodialysis reduces LVM. The benefit of frequent hemodialysis on LVM may be mediated by salutary effects on blood pressure.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00264758.
Prediction of Long-Term Mortality After Percutaneous Coronary Intervention in Older Adults
Authors: Weintraub William S. , Grau-Sepulveda Maria V. , Weiss Jocelyn M. , DeLong Elizabeth R. , Peterson Eric D. , O'Brien Sean M. , Kolm Paul , Klein Lloyd W. , Shaw Richard E. , McKay Charles , Ritzenthaler Laura L. , Popma Jeffrey J. , Messenger John C. , Shahian David M. , Grover Frederick L. , Mayer John E. , Garratt Kirk N. , Moussa Issam D. , Edwards Fred H. , Dangas George D. 
Published: February 2012

Background—
The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease.

Methods and Results—
The American College of Cardiology Foundation CathPCI Registry data were linked to the Centers for Medicare and Medicaid Services 100% denominator file by probabilistic matching. Preprocedure demographic and clinical variables from the CathPCI Registry were used to predict the probability of death over 3 years as recorded in the Centers for Medicare and Medicaid Services database. Between 2004 and 2007, 343 466 patients (66%) of 518 195 patients aged ≥65 years undergoing first percutaneous coronary intervention in the CathPCI Registry were successfully linked to Centers for Medicare and Medicaid Services data. This study population was randomly divided into 60% derivation and 40% validation cohorts. Median follow-up was 15 months, with mortality of 3.0% at 30 days and 8.7%, 13.4%, and 18.7% at 1, 2, and 3 years, respectively. Twenty-four characteristics related to demographics, clinical comorbidity, prior history of disease, and indices of disease severity and acuity were identified as being associated with mortality. The C indices in the validation cohorts for patients with and without ST-segment elevation myocardial infarction were 0.79 and 0.78. The model calibrated well across a wide range of predicted probabilities.

Conclusions—
On the basis of the large and nationally representative CathPCI Registry, we have developed a model that has excellent discrimination, calibration, and validation to predict survival up to 3 years after percutaneous coronary intervention.
Interleukin-1β Is Crucial for the Induction of Coronary Artery Inflammation in a Mouse Model of Kawasaki Disease
Authors: Lee Youngho , Schulte Danica J. , Shimada Kenichi , Chen Shuang , Crother Timothy R. , Chiba Norika , Fishbein Michael C. , Lehman Thomas J.A. , Arditi Moshe 
Published: February 2012

Background—
Kawasaki disease (KD) is the most common cause of acute vasculitis and acquired cardiac disease in US children. Untreated, children may develop coronary artery aneurysms, myocardial infarction, and sudden death as a result of the illness. Up to a third of KD patients fail to respond to intravenous immunoglobulin, the standard therapy, and alternative treatments are being investigated. Genetic studies have indicated a possible role for interleukin (IL)-1β in KD. We therefore explored the role of IL-1β in a murine model of KD.

Methods and Results—

Using an established mouse model of KD that involves injection of
Lactobacillus casei
cell wall extract (LCWE), we investigated the role of IL-1β and caspase-1 (activated by the inflammasome and required for IL-1β maturation) in coronary arteritis and evaluated the efficacy of IL-1 receptor antagonist as a potential treatment. LCWE-induced IL-1β maturation and secretion were dependent on the NLRP3 inflammasome in macrophages. Both caspase-1–deficient and IL-1 receptor–deficient mice were protected from LCWE-induced coronary lesions. Injection of recombinant IL-1β into caspase-1–deficient mice restored the ability of LCWE to cause coronary lesions in response to LCWE. Furthermore, daily injections of the IL-1 receptor antagonist prevented LCWE-mediated coronary lesions up to 3 days after LCWE injection.

Conclusions—
Our results strongly suggest that caspase-1 and IL-1β play critical roles in the development of coronary lesions in this KD mouse model, blocked by IL-1 receptor antagonist. Therefore, anti–IL-1β treatment strategies may constitute an effective, more targeted treatment of KD to prevent coronary lesions.
Postradiosurgery Hemorrhage Rates of Arteriovenous Malformations of the Brain
Authors: Parkhutik Vera , Lago Aida , Tembl José Ignacio , Vázquez Juan Francisco , Aparici Fernando , Mainar Esperanza , Vázquez Víctor 
Published: February 2012

Background and Purpose—
The long-term benefit of radiosurgery of brain arteriovenous malformations (AVM), especially nonhemorrhagic cases, is controversial. We calculated hemorrhage rates pre- and posttreatment and analyzed the risk factors for bleeding based on cases followed at our site.

Methods—
One hundred eight patients, age 36±17 years, 56 men. The mean follow-up was 65±44 months (median, 54; interquartile range, 33–94). Most AVMs were small (74.1% <3 cm in diameter); 48.1% were located in an eloquent area, 27.8% had deep drainage, and 39.8% presented with hemorrhage.

Results—
The annual hemorrhage rate for any undiagnosed AVM was 1.2%, and 3.3% for AVMs with hemorrhagic presentation. Older patients, cortical or subcortical AVMs, and cases with multiple draining veins were less likely to present with bleeding. During the first 36 months postradiosurgery, hemorrhagic AVMs had a rebleeding rate of 2.1%, and a rate of 1.1% from 3 years onwards. Nonhemorrhagic AVMs had a hemorrhage rate of 1.4% during the first 3 years and 0.3% afterward. Arterial hypertension and nidus volume were independent predictors of bleeding after treatment. Mean nidus obliteration time was 37±18 months (median, 32; interquartile range, 25–40), with hemorrhage rate of 1.3% before and 0.6% after obliteration, and 1.9% for AVMs that were not closed at the end of follow-up.

Conclusions—
Both hemorrhagic and nonhemorrhagic AVMs benefit from radiosurgical therapy, with gradual decrease in their bleeding rates over the years. Albeit small, the risk of hemorrhage persists during the entirety of follow-up, being higher for cases with hemorrhagic presentation and nonobliterated AVM.
Dietary Flavonoids and Risk of Stroke in Women
Authors: Cassidy Aedín , Rimm Eric B. , O'Reilly Éilis J. , Logroscino Giancarlo , Kay Colin , Chiuve Stephanie E. , Rexrode Kathryn M. 
Published: February 2012

Background and Purpose—
To date, few studies have examined associations between the wide range of flavonoid subclasses and risk of ischemic, hemorrhagic, and total stroke.

Methods—
We conducted a prospective study among 69 622 women from the Nurses' Health Study. Total flavonoid and subclass intakes were calculated from semiquantitative food frequency questionnaires collected every 4 years using an updated and extended US Department of Agriculture flavonoid database.

Results—

During 14 years of follow-up, 1803 incident strokes were confirmed. After adjusting for potential confounders, women in the highest compared with the lowest quintile of flavanone intake had a relative risk of ischemic stroke of 0.81 (95% CI, 0.66–0.99;
P
=0.04). Citrus fruits/juices, the main dietary source of flavanones, tended to be associated with a reduced risk for ischemic stroke (relative risk, 0.90; 95% CI, 0.77–1.05) comparing extreme quintiles.

Conclusions—
Total flavonoid intake was not inversely associated with risk of stroke; however, increased intake of the flavanone subclass was associated with a reduction in the risk of ischemic stroke. Citrus fruit consumption may be associated with a reduction in stroke risk, and experimental data support these epidemiological associations that the flavanone content of citrus fruits may potentially be cardioprotective. Further prospective studies are needed to confirm these associations.
Socioeconomic Status and Stroke
Authors: Addo Juliet , Ayerbe Luis , Mohan Keerthi M. , Crichton Siobhan , Sheldenkar Anita , Chen Ruoling , Wolfe Charles D.A. , McKevitt Christopher 
Published: February 2012

Background and Purpose—
Rates of stroke incidence and mortality vary across populations with important differences between socioeconomic groups worldwide. Knowledge of existing disparities in stroke risk is important for effective stroke prevention and management strategies. This review updates the evidence for associations between socioeconomic status and stroke.

Summary of Review—
Studies were identified with electronic searches of MEDLINE and EMBASE databases (January 2006 to July 2011) and reference lists from identified studies were searched manually. Articles reporting the association between any measure of socioeconomic status and stroke were included.

Conclusions—
The impact of stroke as measured by disability-adjusted life-years lost and mortality rates is >3-fold higher in low-income compared with high- and middle-income countries. The number of stroke deaths is projected to increase by >30% in the next 20 years with the majority occurring in low-income countries. Higher incidence of stroke, stroke risk factors, and rates of stroke mortality are generally observed in low compared with high socioeconomic groups within and between populations worldwide. There is less available evidence of an association between socioeconomic status and stroke recurrence or temporal trends in inequalities. Those with a lower socioeconomic status have more severe deficits and are less likely to receive evidence-based stroke services, although the results are inconsistent. Poorer people within a population and poorer countries globally are most affected in terms of incidence and poor outcomes of stroke. Innovative prevention strategies targeting people in low socioeconomic groups are required along with effective measures to promote access to effective stroke interventions worldwide.
Hemodynamic Differences Between Unruptured and Ruptured Intracranial Aneurysms During Observation
Authors: Takao Hiroyuki , Murayama Yuichi , Otsuka Shinobu , Qian Yi , Mohamed Ashraf , Masuda Shunsuke , Yamamoto Makoto , Abe Toshiaki 
Published: February 2012

Background and Purpose—
We evaluated several hemodynamic parameters for the prediction of rupture in a data set of initially unruptured aneurysms, including aneurysms that ruptured during follow-up observation.

Methods—
Aneurysm geometry was extracted from CT angiographic images and analyzed using a mathematical formula for fluid flow under pulsatile blood flow conditions. Fifty side-wall internal carotid posterior communicating artery aneurysms and 50 middle cerebral artery bifurcation aneurysms of medium size were investigated for energy loss, pressure loss coefficient, wall shear stress, and oscillatory shear index. During follow-up observation, 6 internal carotid posterior communicating artery and 7 middle cerebral artery aneurysms ruptured (44 and 43 remained unruptured, respectively, with the same location and a similar size as the ruptured cases).

Results—

A significant difference in the minimum wall shear stress between aneurysms that ruptured and those that remained unruptured was noted only in internal carotid artery aneurysms (
P
<0.001). Energy loss showed a higher tendency in ruptured aneurysms but statistically not significant. For pressure loss coefficient, a significant difference was noted in both internal carotid artery (
P
=0.0046) and middle cerebral artery (
P
<0.001) aneurysms.

Conclusions—
Pressure loss coefficient may be a potential parameter to predict future rupture of unruptured aneurysms.
Tissue Factor Pathway Inhibitor, Activated Protein C Resistance, and Risk of Ischemic Stroke due to Postmenopausal Hormone Therapy
Authors: Rossouw Jacques E. , Johnson Karen C. , Pettinger Mary , Cushman Mary , Sandset Per Morten , Kuller Lewis , Rosendaal Frits , Rosing Jan , Wasserthal-Smoller Sylvia , Martin Lisa W. , Manson JoAnn E. , Lakshminarayan Kamakshi , Merino Jose G. , Lynch John 
Published: February 2012

Background and Purpose—
To test whether changes in plasma tissue factor pathway inhibitor (TFPI) levels or activated protein C resistance (normalized activated protein C resistance ratio [nAPCsr]) modify the increased risk of ischemic stroke due to postmenopausal hormone therapy.

Methods—
Nested case–control study of 455 cases of ischemic stroke and 565 matched control subjects in the Women's Health Initiative trials of postmenopausal hormone therapy.

Results—

Baseline free TFPI was associated with ischemic stroke risk (OR per SD increase, 1.17; 95% CI, 1.01–1.37;
P
=0.039), but baseline nAPCsr was not (OR per SD increase, 0.89; 95% CI, 0.75–1.05;
P
=0.15). Baseline TFPI levels and nAPCsr did not modify the effect of postmenopausal hormone therapy on ischemic stroke. Treatment-induced mean changes of −28% in free TFPI and +65% in nAPCsr did not change the risk of ischemic stroke (interaction
P
=0.452 and 0.971, respectively). In subgroup analyses, baseline nAPCsr was inversely associated with lacunar strokes (OR per SD increase, 0.74; 95% CI, 0.57–0.96;
P
=0.025) and baseline free TFPI interacted with treatment to increase large vessel atherosclerotic strokes (
P
=0.008).

Conclusions—
Procoagulant changes in TFPI or nAPCsr do not modify the increased ischemic stroke risk due to postmenopausal hormone therapy.

Clinical Trial Registration—

URL:
www.clinicaltrials.gov
. Unique identifier: NCT 00000611.
Myelin Loss Associated With Neuroinflammation in Hypertensive Rats
Authors: Jalal Fakhreya Y. , Yang Yi , Thompson Jeffrey , Lopez Anita C. , Rosenberg Gary A. 
Published: February 2012

Background and Purpose—
Small vessel disease is the major cause of white matter injury in patients with vascular cognitive impairment. Matrix metalloproteinase (MMP)-mediated inflammation may be involved in the white matter damage with oligodendrocyte (Ol) death. Therefore, we used spontaneously hypertensive stroke-prone rats to study the role of neuroinflammation in white matter damage.

Methods—
Permanent unilateral carotid artery occlusion was performed at 12 weeks of age in spontaneously hypertensive stroke-prone rats. Following surgery, rats were placed on a Japanese permissive diet and received 1% NaCl in drinking water. MRI, histology, biochemistry, and ELISA characterized white matter lesions, and cognitive impairment was tested by Morris water maze.

Results—
White matter damage was observed 4 to 5 weeks following permanent unilateral carotid artery occlusion/Japanese permissive diet. Immunoblotting showed marked reduction in myelin basic protein and upregulation of immature Ols. Mature Ols underwent caspase-3-mediated apoptosis. Morris water maze showed cognitive impairment. Abnormally appearing vessels were observed and surrounded by inflammatory-like cells. IgG extravasation and hemorrhage, indicating blood-brain barrier (BBB) disruption, was closely associated with MMP-9 expression. Lesions in white matter showed reactive astrocytosis and activated microglia that expressed tumor necrosis factor-α. MMP-3 and MMP-9 were significantly increased, and MMP-2 was reduced in both astrocytes and Ol.

Conclusions—
We found apoptosis of mature Ols with an increase in immature Ols. Increased MMP-3, MMP-9, and tumor necrosis factor-α were associated with myelin breakdown and BBB disruption. Neuroinflammation is an important factor in white matter damage and Ol death, and studies using this new model can be performed to assess agents to block inflammation.
Impact of Primary Stroke Center Certification on Location of Acute Ischemic Stroke Care in Georgia
Authors: Switzer Jeffrey A. , Akinwuntan Abiodun , Waller Jennifer , Nichols Fenwick T. , Hess David C. , Bruno Askiel 
Published: February 2012

Background and Purpose—
Primary stroke centers (PSCs) are associated with greater rates of tissue plasminogen activator use and improved outcomes. The American Stroke Association has advocated for the preferential transport of stroke patients to PSCs. We investigated the impact of PSC certification on hospital stroke discharge patterns in Georgia communities with a choice between PSC and non-PSC.

Methods—
We analyzed data from the Georgia Discharge Data System before (2004) and after stroke certification (2009). Only Metropolitan Statistical Areas containing ≥1 PSC and ≥1 non-PSC were included in the analysis. We calculated the odds of acute stroke discharge from a PSC in 2009 compared with 2004.

Results—

In Georgia Metropolitan Statistical Areas with at least 1 PSC and 1 non-PSC hospital, the percent of patients discharged from a subsequently designated PSC increased from 50.2% to 56.6% between 2004 and 2009 (OR, 1.29;
P
<0.0001). In 4 Metropolitan Statistical Areas, the proportion of stroke discharges from PSCs increased, whereas in 2 Metropolitan Statistical Areas, there was no significant increase, and in 1, there was a trend toward less stroke discharges from PSCs.

Conclusions—
Although there has been an overall increase in stroke discharges from PSCs, the impact of stroke certification on patient destination was small and inconsistent across the state suggesting that local factors influence the location of hospitalization.
Cathodal Iontophoresis of Treprostinil Induces a Sustained Increase in Cutaneous Blood Flux in Healthy Volunteers
Authors: Blaise Sophie , Roustit Matthieu , Hellmann Marcin , Millet Claire , Cracowski Jean‐Luc 
Published: February 2012

AbstractObjectiveProstacyclin analogues are the most effective drugs to treat sclerodermic digital ulcers, but their systemic use is limited by their frequent side effects. The authors tested whether the prostacyclin analogues treprostinil and iloprost, delivered by cutaneous iontophoresis, induce sustained vasodilatation.MethodsTwenty healthy volunteers received treprostinil by cathodal iontophoresis on the forearm. Skin blood flux was quantified using laser Doppler imaging.ResultsTreprostinil 250 µM induced an increase in cutaneous vascular conductance AUC80 min (31 897 ± 24 390 %BL·min) compared with NaCl 0.9% (P < .005), treprostinil 2.5 µM (P < .005), and treprostinil 25 µM (P < .005). This was confirmed when flux was recorded for up to 10 hours. Systemic and skin tolerance of treprostinil were good. Iloprost was stopped early because of local toxicity.ConclusionTreprostinil cathodal iontophoresis induces a sustained increase in cutaneous blood flow with good local tolerance. This could be investigated as a new local therapy for digital ulcers in scleroderma.