bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute and long-term outcomes of acute coronary syndrome in patients with hematological malignancies
Authors: Lange S A , Schliemann C , Makowski L , Engelbertz C , Feld J , Gerss J , Droege P , Ruhnke J , Guenster T , Reinecke H , Koeppe J 
Published: November 2023

Abstract

Background
Coronary heart disease (CHD) and cancer are the leading causes of death. Treatment outcomes have improved significantly for both disease groups. In particular, patients with hematologic malignancies (HM) have an improved prognosis. However, knowledge of the interaction between acute coronary syndrome (ACS) and HM remains poor.

Objective
This analysis aimed to clarify how acute coronary syndrome affects the prognosis of HM patients.

Results
Between January 1, 2010, and December 31, 2018, 439,716 patients with ACS insured by AOK Germany were identified, of whom 2,104 (0.5%) also had HM. Myelodysplastic/myeloproliferative disorders, lymphocytic leukemias, and plasmacytomas predominated. These patients were approximately 6 years older and more likely to have had a myocardial infarction without ST-segment elevation. These patients had more concomitant cardiovascular disease and worse NYHA stage. They were less likely to receive coronary angiography and percutaneous coronary intervention (PCI), although the number of bleeding events was not significantly increased. Hospital stay was longer. All-cause mortality was increased regardless of age. After adjustment for patient risk profile, HM was associated with worse outcomes for all endpoints studied.

Conclusion
Survival is lower in ACS with HM, possibly due to the fact that these patients are less likely to undergo invasive diagnostics.Mortality, MACE and re-infarctionSurvival after STEMI and NSTEMI
Metabolomics to characterise adaptations in cellular metabolism for the stages of atrial fibrillation
Authors: Wijdeveld L F J M , Pool L , Van Weeghel M , Schomakers B V , De Groot N M S , Houtkooper R H , Brundel B J J M 
Published: November 2023

Abstract

Background
Atrial fibrillation (AF) is a highly prevalent, progressive cardiac arrhythmia associated with high cardiovascular comorbidity. Current treatments targeting electropathophysiology have high recurrence rates, prompting researchers to uncover alternative molecular mechanisms underlying AF, aiming to find novel targets for diagnostics and treatment. Highly relevant to several cardiovascular diseases, adaptations in cellular metabolism have gained interest in AF. However, changes in the metabolome across various AF stages have not yet been studied.

Aim
The study aims to identify leads for potential biomarkers and treatment targets by gaining more insight in metabolic adaptation and mechanisms in atrial fibrillation.

Methods
From the HALT&REVERSE biobank, 60 atrial appendage samples were selected [controls (SR=21), paroxysmal (ParAF=16), persistent (PerAF=11) and longstanding-persistent AF (Ls-PerAF=12)]. Metabolomics, a large-scale semi-quantitative method based on mass-spectrometry, was performed. Comparisons were made SR vs. AF, and SR vs. AF stages by Mann-Whitney U and Kruskal Wallis statistical tests with a Benjamini-Hochberg correction (FDR=0,10) for multiple testing.

Results
Comparing SR and AF, fructose-1,6-diphosphate (F1,6DP) was decreased (p&lt;0.001), whilst CDP (p&lt;0.001) and UMP were increased (p&lt;0.01). Comparing the AF stages, in SR vs. ParAF CDP was significantly increased. Regarding the AF stages, SR and LsperAF show the biggest differences in metabolites, presenting as decreases glycolysis and nicotinamide metabolites. Overall, metabolites associated with the glycolysis, nicotinamide, and carnitine metabolism show decreases in AF patients, whilst metabolites involved with pyrimidine metabolism are increased AF patients.

Conclusion
CDP, F1,6DP and UMP were strongly correlated with AF samples in univariate analyses and therefore should be further investigated in serum for their biomarker potential, specifically CDP which was already strongly increased in ParAF. F1,6DP and similar energy metabolites in the glycolysis and nicotinamide pathways are decreased in AF and therefore could be as a therapeutic target through supplementation. Leads from this analysis should be validated and further investigated in mechanistic studies of these metabolic pathways.
Clinical application of the HFA/ICOS score in breast cancer women: its added value in the prediction of chemotherapy-related cardiac dysfunction
Authors: Di Lisi D , Madaudo C , Ortello A , Comparato F , Sinagra F P , Damerino G , Gambino G , Novo G , Galassi A R 
Published: November 2023

Abstract

Background
Breast cancer is the most common malignancy in women. It is known that anti-cancer drugs can cause cardiovascular complications. Chemotherapy-related cardiac dysfunction (CTRCD) is the main complication of a treatment with anthracyclines, used to treat breast cancer. Echocardiography is fundamental in the evaluation of the left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) to define CTRCD as mild, moderate or severe, in accordance with 2022 ESC Guidelines on Cardio-Oncology. These guidelines recommend cardiovascular baseline risk stratification using the HFA/ICOS score, in order to plan the most appropriate surveillance program and implement cardioprotective strategies.

Purpose
to assess the usefulness of HFA/ICOS score in patients with breast cancer undergoing treatment with anthracyclines, in predicting the development of CTRCD.

Methods
A retrospective study was carried out enrolling 109 patients with breast cancer treated with anthracyclines. We performed a cardiological visit with an ECG and echocardiogram at baseline (T0), three months (T1), and six months (T2) after starting treatment. Baseline cardiovascular risk was assessed in all patients, using HFA/ICOS score and patients were classified into 4 groups: low-risk patients, medium-risk patients, high and very high risk patients. During the follow-up, we assessed the development of CTRCD analyzing changes in LVEF and in GLS.

Results
At baseline, 61 patients had low risk of developing cardiotoxicity, 34 patients had medium risk, 14 patients had high risk, no patients had very high risk. Analyzing the development of CTRCD, 21 patients (20,5%) developed asymptomatic mild CTRCD at T1 and 13 patients (14%) at T2. 1 patient developed moderate asymptomatic CTRCD at T1 and 1 patient at T2. No patient developed severe CTRCD. We found a significantly higher proportion of CTRCD in the high-risk group (57%, pvalue 0,03) than in the medium (41%) and low risk group (32%). In a subanalysis we found a correlation between the development of asymptomatic CTRCD and the presence of LVEF between 50-54% or arterial hypertension in intermedium/low risk patients.

Conclusion
our study confirms the usefulness of the HFA/ICOS score in the prediction of CTRCD in high risk breast cancer women; however the evidence of a correlation between the presence of LVEF 50-54% or arterial hypertension and the development of asymptomatic CTRCD emphasises the importance of cardiovascular monitoring also in intermediate risk patients, in which chemotherapy plays an additional role of developing CRTD.
Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
Authors: Choi Y , Na J O , Wi W Y , Cho G J 
Published: November 2023

Abstract

Background
Premature extra betas and supraventricular tachyarrhythmias are prevalent in the gestational period. Gestational diabetes mellitus (GDM) complicated a significant proportion of pregnancies worldwide.

Purpose
Given the high prevalence of cardiac arrhythmia (CA) among patients with diabetes, we aimed to investigate the association of CA with GDM.

Methods
This is a nationwide cohort study using the Korean Health Insurance database. We identified 1,113,729 women who gave birth between 2007 and 2015. After excluding subjects who did not undergo the national health screening test within a year before pregnancy, multi-pregnancy, and those with fasting blood glucose ≥126 mg/mL and/or diagnosed with diabetes before pregnancy CA was defined as atrial and ventricular premature beats, paroxysmal tachycardia, and atrial fibrillation. The primary outcome was the incidence of GDM. Subgroup analysis stratified by age and body mass index at pregnancy onset, and a history of hypertension before pregnancy were conducted.

Results
A total of 365,880 women were included in the final analysis. Of them, 3,253 (0.9%) had a diagnosis of CA. Subjects with CA were older at pregnancy onset (mean age 33.3±4.1 vs. 33.0±3.9 years, P&lt;0.001), and had a higher proportion of hypertension (5.2% vs. 1.0%, P &lt;0.001) than in subjects without CA. GDM was detected in 31,938 (8.7%) subjects and more commonly occurred in subjects with CA than those without (14.9% vs. 8.7%, P&lt;0.001). After adjusting for confounding factors, the incidence of GMD was statistically significantly higher in those with CA (adjusted OR 1.78, 95% CI 1.615–1.970, P&lt;0.001). Moreover, the relationship between CA with GDM was statistically significant regardless of age and body mass index (Figure 1). Meanwhile, despite a higher incidence of GDM, the association between CA and GDM was insignificant in subjects with a history of hypertension.

Conclusion
The risk of gestational diabetes was higher in subjects diagnosed with CA before or during pregnancy compared with those without CA.
Genetically determined lipoprotein(a) levels do not cause an increased risk of preeclampsia - a two-sample Mendelian randomization study
Authors: Golawski M , Lejawa M , Osadnik T , Mickiewicz A , Gierlotka M , Jozwiak J , Pawlas N , Banach M 
Published: November 2023

Abstract

Introduction
High blood levels of lipoprotein(a) [Lp(a)] were suggested to increase the risk of preeclampsia. Because excessive coagulation is involved in preeclampsia and Lp(a) is a known pro-coagulative protein, the hypothesis that Lp(a) is causally involved in preeclampsia seems to be consistent. Nevertheless, the exact impact and causal role of Lp(a) on preeclampsia was not well elucidated. Because the levels of Lp(a) are widely recognized to be highly genetics-dependent, we chose Mendelian Randomization [MR] as a tool to determine the impact of Lp(a) on the incidence of preeclampsia.

Purpose
To determine whether Lp(a) levels have impact on incidence of preeclampsia.

Methods
A two-sample MR study was conducted. Summary statistics were extracted from publicly available datasets. UK Biobank was the source of correlations for Lp(a) levels and FinnGen was used as the source of genetic correlations for preeclampsia. We restricted the variants used to LPA gene region. Inverse-variance-weighted mean was used as a primary analysis. Secondary analyses were performed using weighted median, mode, and MR-Egger methods. Sensitivity analysis was performed by leaving out random 30% of the variants as well as by using previously published variants correlated with Lp(a) levels.

Results
Summary statistics regarding genetic determinants of Lp(a) levels were retrieved for 318922 participants, while data regarding pre-eclampsia were available for 5922 cases and 176113 controls. Genetic associations of included variants with Lp(a) levels (horizontal axis) and with preeclampsia (vertical axis) are presented in Figure. Primary [p=0.562] and secondary analyses [median p=0.825; mode p=0.717; MR-Egger p=0.765] indicated that Lp(a) levels have no impact on the incidence of preeclampsia. Selected variants did not show appreciable pleiotropy as indicated by MR-Egger intercept test [p=0.898]. Sensitivity analysis did not yield statistically significant results [leave-30%-out analysis IVM p-values: 0.313-0.964].

Conclusions
Genetically determined Lp(a) levels were not correlated with and do not appear to have a causal role in preeclampsia. Therefore, Lp(a) screening provides no information as to patients' risk of preeclampsia and Lp(a) reduction is not a promising strategy aimed at preeclampsia prevention. It is nevertheless possible that Lp(a) is involved in the pathogenesis of preeclampsia without a causal, level-dependent role. Irrespectively, the effect of Lp(a) in recurrent pregnancy loss or intrauterine growth restriction needs to be further investigated.
Glomerular filtration rate predicts pro-vascular progenitor cell depletion: insights from the IPE-PREVENTION and ORIGINS-RCE studies
Authors: Bakbak E , Krishnaraj A , Quan A , Terenzi D C , Puar P , Pan Y , Bakbak A , Bari B , Terenzi K , Rotstein O D , Teoh H , Leiter L A , Bhatt D L , Hess D A , Verma S 
Published: November 2023

Abstract

Background
People living with cardiometabolic disease and impaired renal function are at increased risk of experiencing adverse cardiovascular outcomes(1,2). Recent evidence indicates that individuals living with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (T2D) exhibit a reduction in circulating vascular regenerative (VR) cells that are essential for maintaining blood vessel homeostasis(3). However, there is limited data on whether VR cell content changes in response to cardiometabolic and kidney disorders.

Purpose
We sought to determine if there is an association between estimated glomerular filtration rate (eGFR) and VR cell content in individuals with ASCVD and/or diabetes. Data were from participants enrolled in the IPE-PREVENTION and ORIGINS-RCE studies.

Methods
IPE-PREVENTION participants had moderately elevated triglycerides (1.5 - 5.65 mmol/L) with established ASCVD and/or T2D. ORIGINS-RCE participants had established ASCVD or T2D and at least one additional cardiovascular risk factor. Circulating mononuclear cells were isolated from peripheral blood and characterized using side scatter properties (SSC) and high aldehyde dehydrogenase activity to quantify pro-angiogenic early myeloid progenitor cells (ALDHhi), and primitive versus lineage-specific cell surface marker co-expression. Participants were stratified according to those with an eGFR &lt;60 mL/min/1.73m², or ≥60 mL/min/1.73m².

Results
Median [IQR] eGFR of the pooled cohort (n=169) was 75 [59, 88] mL/min/1.73m²; 45% had an eGFR that was &lt;60 mL/min/1.73m². The stratum with eGFR &lt;60 mL/min/1.73m² had fewer circulating ALDHhiSSClow progenitor cells (0.037 vs. 0.051%; P&lt;0.01) (Figure 1A) and ALDHhiSSClow cells expressing CD34+ and CD133+ (49 vs. 54%; P=0.03) (Figure 1B) than that with an eGFR ≥60 mL/min/1.73m². The predictive value of eGFR on ALDHhiSSClowCD34+CD133+ frequency was conserved even after controlling for age, sex, LDL-C, BMI, and HbA1c (P&lt;0.01) (Table 1). The frequency of ALDHhiSSCmid monocyte precursor cells did not differ based on eGFR status.

Conclusions
Low eGFR was predictive for the depletion of ALDHhiSSClow primitive progenitor cells that co-express the stem cell markers CD133 and CD34 in individuals with ASCVD and/or T2D suggesting that diminished kidney function is associated with a decrease in vessel reparative pro-angiogenic progenitor cell content. Strategies that improve circulating VR cell content in individuals living with kidney and cardiometabolic disease may provide clinically meaningful benefits.Figure 1Table 1
C-reactive protein in Stroke-Heart-Syndrome: a propensity-matched analysis of a global federated health network
Authors: Bucci T , Sagris D , Harrison S , Pastori D , Ntaios G , Mcdowell G , Buckley B J R , Lip G Y H 
Published: November 2023

Abstract

Introduction
The role of inflammation in the Stroke-Heart-Syndrome is unclear.

Purpose
To assess the predictive role of C-Reactive Protein (CRP) for early cardiovascular complications in patients with stroke.

Methods
Electronic medical records from TriNetX, a global federated health research network, were used for this retrospective analysis. Patients with ischemic stroke and CRP levels measured within 24 hours post-stroke, were categorized into three groups: i)&lt;1mg/L, ii)1-3 mg/L and iii)&gt;3mg/L. The primary outcome was a composite outcome of cardiac complications (heart failure (HF), atrial fibrillation (AF), ischemic heart disease, ventricular arrhythmias, and Takotsubo cardiomyopathy) or death at 30 days from the index event. Cox-regression analyses were used to produce hazard ratios (HRs) and 95% confidence intervals (CI) following 1:1 propensity score matching.

Results
Of the 104,741 patients enrolled, 51% were female and the mean age was 67±2 years. Cardiac complications or death within 30 days occurred in 40.4% patients with CRP&gt;3 mg/L, in 27.6% patients with CRP 1-3 mg/L and in 23.2% patients with CRP&lt;1 mg/L. After propensity score matching, patients with CRP levels of 1-3mg/L and &gt;3mg/L had higher risk of the composite outcome (HR: 1.10, 95%CI: 1.05-1.50;HR: 1.51, 95%CI: 1.45-1.58), death (HR:1.43, 95%CI:1.24-1.64; HR:3.50, 95%CI:3.10-3.96), HF (HR:1.08, 95%CI:1.01-1.16; HR:1.51, 95%CI:1.41-1.61), AF (HR:1.10, 95% CI:1.02-1.18; HR:1.42, 95%CI:1.33-1.52), and ventricular arrhythmias (HR:1.24, 95% CI:1.02-1.52, HR:1.67, 95% CI:1.39-2.01) compared to those with CRP&lt;1 mg/L. Ischemic heart disease was more common only in patients with CRP levels &gt;3mg/L (HR:1.33, 95% CI:1.26-1.40) compared to those with CRP&lt;1mg/L. No association with Takotsubo cardiomyopathy was found. At the sensitivity analysis, these results were also confirmed considering only older patients or excluding those with possible confounding factors.

Conclusion
CRP levels at the admission for an ischemic stroke predict the 30-day risk of cardiac complications or death.
Evaluation of cardiovascular risk in the population with a diagnosis of organic mental illness, a cohort study carried out in South America
Authors: Dulcey L , Theran J , Ciliberti M , Blanco E , Caltagirone R 
Published: November 2023

Abstract

Background
Patients with severe mental illness (SMI), such as schizophrenia or bipolar disorders, are more frequently affected by metabolic syndrome and cardiovascular (CVD) diseases than the general population, with a significant reduction in life expectancy.

Purpose
Beyond metabolic syndrome, quantifying the risk of CVD morbidity in the long-term may help clinicians to put in place preventive strategies. In this study, we assessed 10-year CVD risk in patients with SMI and healthy individuals using an algorithm validated previously.

Methods
Patients aged 35–69 years diagnosed with SMI were consecutively recruited from psychiatric acute care units. Single CV risk factors were assessed, and 10-year CV risk calculated by means of the CUORE Project 10-year CV risk algorithm, based on the combination of the following risk factors: age, systolic blood pressure, total and high-density lipoprotein cholesterol, diabetes, smoking habit, and hypertensive treatment. Patients’ data were compared with those from the general population. The 10-year CVD risk was log-transformed, and multivariable linear regression was used to estimate mean ratios, adjusting for age, and education.

Results
Three hundred patients and 302 controls were included in the analysis. Among men, the 10-year CVD risk score was very similar between patients with SMI and the general population (mean ratio (MR): 1.02; 95%CI 0.77–1.37), whereas a 39% increase in 10-year CVD risk was observed in women with SMI compared to the general population (MR: 1.39; 95%CI 1.16–1.66).

Conclusions
In our study, women with SMI were consistently more at risk than the general population counterpart, even at younger age.
Sudden cardiac death in people with schizophrenia: higher risk, poorer resuscitation profiles and differing pathologies
Authors: Paratz E , Van Heusden A , Zentner D , Morgan N , Smith K , Thompson T , James P , Connell V , Pflaumer A , Semsarian C , Ingles J , Parsons S , Rauchberger I , Stub D , La Gerche A 
Published: November 2023

Abstract

Background
People with schizophrenia account for approximately 1.0% of the population and appear to experience increased rates of sudden cardiac death (SCD). This study determined characteristics of increased SCD in people with schizophrenia.

Methods
A prospective state-wide registry compared people aged 15-50 years with and without schizophrenia who experienced SCD within a two-year time-period and were referred for forensic evaluation.

Results
579 individuals were identified, of whom 65 (11.2%) had schizophrenia. Patients with schizophrenia were more commonly smokers (46.2% vs 23.0%, p&lt;0.0001), consumed excess alcohol (32.3% vs 21.4%, p=0.05), and used QTc-prolonging medications (69.2% vs 17.9%, p&lt;0.0001). They were less likely to arrest while exercising (0.0% vs 6.4%, p=0.04). Unfavourable arrest-related factors included lower rates of witnessed arrest (6.2% vs 23.5%, p&lt;0.0001), more likely to be found in asystole (92.3% vs 73.3%, p&lt;0.0001), and being more likely to be found as part of a welfare check after a prolonged period of time (median 42 vs 12 hours, p=0.003). There was more frequent evidence of decomposition, and they more commonly underwent autopsy (41.2% vs 26.4%, p=0.04 and 93.8% vs 82.5%, p=0.05), with diagnosis of non-ischaemic cardiomyopathy being more common (29.2% vs 18.1%, p=0.04).

Conclusion
People with schizophrenia account for 11% of young SCD patients referred for forensic investigations, exceeding population rates eleven-fold. They have higher pre-existing cardiac risk factor burden, unfavourable resuscitation profiles and higher rates of non-ischaemic cardiomyopathy. Strategies targeting biopsychosocial support may deliver not only psychological benefits but also help reduce unwitnessed cardiac arrest.
Severe mental illness and symptoms of acute coronary syndrome in emergency calls
Authors: Storgaard Noerskov A , Torp-Pedersen C , Nordgaard J , Bang C F N 
Published: November 2023

Abstract

Background
It can be lifesaving to act fast and correct when acute life-threatening diseases occur. This is, however, challenging in some patients with severe mental illness as they sometimes experience symptoms differently than patients without severe mental illness. This changed perception can affect the patients’ chances of receiving adequate help, as these patients are already stigmatized even by healthcare personnel.

Purpose
We aimed to determine whether patients with severe mental illness reported different symptoms of acute coronary syndrome (ACS) in emergency calls than patients without severe mental illness.

Methods
In this registry-based study, we analyzed symptoms of ACS in emergency calls made from 2014 to 2018 in the Capital Emergency Medical Services, including the Emergency Number (1-1-2) and the Out-of-hours Service (medical helpline). The study population comprised patients with severe mental illness (defined by schizophrenia, bipolar affective disorder, and depression) and a control group of patients without severe mental illness. Additionally, we investigated whether psychotropics (defined by antipsychotics, mood stabilizers, and antidepressants) were associated with altered symptom presentation of ACS. Furthermore, we determined the time from the emergency call to hospitalization. Analyses were performed by logistic regression adjusted for sex and age and t-tests.

Results
In total, 11,113 emergency calls were included; 917 were from patients with severe mental illness (45.4% were female, average age was 64.6 years), and 10,196 were from patients without severe mental illness (35.3% were female, average age was 67.7 years). Severe mental illness was associated with less frequent chest pain in ACS (odds ratio 0.80, 95%CI: 0.70-0.92, p=0.002). Furthermore, treatment with psychotropics was associated with less frequent chest pain in ACS (odds ratio 0.73, 95%CI: 0.64-0.82, p&lt;0.001). The mean time difference from the emergency call to hospitalization was 17 minutes longer for patients with severe mental illness (1 hour 21 minutes vs. 1 hour 4 minutes, p=0.002)

Conclusion
Patients with severe mental illness presented less frequent chest pain in ACS in emergency calls than patients without severe mental illness and had increased time to hospitalization. This calls for increased awareness of symptom presentation in patients with severe mental illness to improve the identification and management of ACS.