bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer and Acute coronary syndrome
Authors: Marijana Knezevic Pravecek M K P , Blazenka Miskic B M , Katica Cvitkusic Lukenda K C L 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
Cardiovascular disease and Cancer are the leading causes of mortality in the world. This is due to the aging of the population and the fact that most of the classic cardiovascular risk factors also predispose to cancer. Cardiovascular disease is the most common cause of late morbidity and mortality among cancer survivors. The incidence of cancer and acute coronary syndrome in the same patient requiring PCI is increasing significantly. The reported prevalence of cancer among patients with acute coronary syndrome ranges between 3% and 17%.
In our institution in the past ten months, the prevalence of cancer among patients with ACS who underwent PCI was about 10% (3% in active cancer treatment). Patients with cancer and ACS 41% of patients presented as STEMI, 44% as NSTEMI and 15% as unstable angina. Multivessel coronary disease was confirmed in 36%, Takatsubo was diagnosed in 4%, %=% of patient were treated with percutaneous coronary intervention and stents implantation. They were treated with DAPT; in 39% ticagrelor, 10% prasugrel, others clopidogrel. It was found that lung, prostate, stomach, pancreas and breast cancer are the most common types associated with ACS, which corresponds to our observations.
A proinflammatory and hypercoagulable state with increased platelet activation and aggregation commonly occurs in cancer, increasing the prevalence of ACS. New cancer treatments have significantly improved cancer survival, on the other hand, this has at the same time led to an increase in the incidence of CVD. In the general population, NSTEMI is the most common clinical presentation of ACS in cancer patients. MINOCA and Takotsubo syndrome can also occur in cancer patients, more often in women.
Percutaneous coronary intervention improves the survival rate of ACS patients, lowering early and late cardiac events. One of the most relevant issues strongly limiting the invasive strategy in cancer patients is the prospect of dual antiplatelet therapy required after PCI. The presence of cancer should not limit the effective and safe treatment of ACS but requires a strict assessment of the risk of bleeding and thrombosis, in both cases with pharmacological and interventional treatment.
Ethnic differences in normal electrocardiographic findings in elite brazilian football players: b-pro foot ECG pilot study
Authors: Ferrari F , Donelli Da Silveira A , Gustavo Marin Emed L , Dalcin Dilda G , Guimaraes F , Bianchini Cardoso F , Freitas Teixeira M , Faria Isfer De Lima G , Machado Arantes M , Bassan F , Otavio Bougleux Alo R , Torres V , Dornelles M , Christo Aleixo H , Stein R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): CNPq, CAPES, FIPE-HCPA.

Introduction
The 12-lead electrocardiogram (ECG-12) is a useful tool in the assessment of athletes. The prevalence of normal electrocardiographic findings in elite Brazilian football players (EBFP) of different ethnicities is not well described.

Purpose
To compare the prevalence of normal ECG-12 findings in Caucasian, Mixed-race (MR), and Afro-Brazilian (AB) EBFP.

Methods
A multicenter cross-sectional descriptive study was conducted with exams performed on EBFP as a pre-participation assessment from February 18, 2002, through October 20, 2022.

Results
4,363 EBFP from 51 professional clubs (from all five regions of Brazil; 15 states, and 21 cities), aged 15-35 years (median: 19 years; IQR: 16-23) were evaluated. 2,027 were Caucasians, 1,324 were MRs, and 1,012 were ABs. In general, we recorded 4,155 ECG-12 with normal variations (95.2%). Positive Sokolow-Lyon criteria for left ventricular hypertrophy was more prevalent in ABs (41.8%) than in Caucasians (33.4%), or MRs (32.7%). The prevalence of early repolarization in ABs (41.5%) was higher than in Caucasians (34.6%), or MRs (35.5%). The PR interval was longer in ABs (157.1 ms) than in Caucasians (151.4 ms), or MRs (153.3 ms), and the first-degree atrioventricular block was more frequent in ABs compared to MRs (4.2% vs. 2.3%, respectively). On the other hand, Caucasians had a higher prevalence of incomplete right bundle branch block (14.2%) than MRs (11.2%), or ABs (9.7%). In our sample, only three EBFP showed second-degree atrioventricular block Mobitz type I (0.07%; one Caucasian and two AB athletes).

Conclusions
This is the first large study to compare the prevalence of ECG-12 findings in EBFP from different ethnic groups. Those of AB origin have a significantly higher prevalence of ECG-12 findings compatible with the athlete's heart than Caucasians and MRs.
Psychosocial outcomes after a home cardiac rehabilitation program
Authors: Parada Barcia J , Maria Sol Bravo Amaro M B A , Cristina Prieto Fernandez C P F , Maria Concepcion Abreu Pazo M C A , Antonio Chamorro Comesana A C C , Iria Sanchez I S , Cristina Fernandez Caamano C F C , Maria Jesus Garrido Ferrero M J G , Marisol Samartin Ucha M S U , Isabel Caride Gonzalez I C G , Inmaculada Gonzalez Bermudez I G B , Noa Pineiro Fernandez N P F , Jose Manuel Olivares J M O , Enrique Cespon Outeda E C , Andres Iniguez Romo A I R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac Rehabilitation Programs (CRP) still do not reach all patients with this indication. In the context of COVID-19 pandemic, the new home-CRP model has been introduced.

Purpose
To evaluate the results in terms of improvement of psychosocial outcomes and changes in employment situation with home-CRP.

Methods
Cross-Sectional Observational study that included patients of both sexes, ≥ 18 years, after acute coronary syndrome or after coronary revascularization, included in home CRP. Information was collected from the computerized clinical history of the patients (diseased vessels, degree and type of revascularization, risk stratification). Data was collected at the beginning and in the end after 2 months of the home CRP: smoking habit, weight, abdominal perimeter, anxiety/ depression (measured by HADS: Hospital Anxiety and Depression scale) and employment status.

Results
A total of 173 patients has been studied. Mean age was 51.6 (SD: 7.94), 15.6% women. Indication for home CRP was non ST elevation myocardial infarction (NSTEMI) in 45.7%, 31.8% had STEMI, 17.9% after elective coronary interventions ,3.5% after cardiac arrest, and 1.2% corresponded to other causes. Patients were at low risk in 50%, 48% moderate and 2% high risk. With 1, 2, or 3 vessels disease in 38.1%, 28.3%, and 33.5% respectively. Coronary revascularization was obtained by percutaneous interventions in 80.9%, by surgery in 14.5% and 4.6% of patients received only medical treatment. At baseline, 33.5% obese and 55% smoked at index admission. After two months of home PRHC we obtained a reduction of 85.5% in smoking (p&lt;0.001), a loss of 4.6 kg of weight in obese people (p=0.125), reduction of anxiety (p= 0.0012) and depression (p=0.0013) amongst those who had a HADS scale higher than 10, and improvement in employment status with return to work in 61,2% (p&lt;0.001).

Conclusions
The present study indicates that home- cardiac rehabilitation programs reduce anxiety, depression and improve return to work after acute coronary syndrome.
More likely normal lungs in nowadays children with a congenital heart defect?
Authors: Hock J , Bessar M , Dalla Pozza R , Ewert R , Hager A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Stiftung KinderHerz Weserstr. 101 45136 Essen.

Background
For the last decades, surgical progress lead to better functional outcomes in patients with congenital heart defect (CHD), which may also affect lung function. Reduced lung volumes were found in about half of all patients with a CHD.

Purpose
This prospective study investigated lung function with spirometry and body plethysmography in children with CHD. Data reported were FVC, FEV1, and its ratio (spirometry), together with total lung capacity (TLC), and residual volume, presented as its ratio to TLC (RV/TLC) from body plethysmography.

Methods
From April 2018 to October 2022 fifty-eight young patients (14.0 ± 2.5 years, 16 girls) with CHD participated in the study. Their results are presented as z-scores, sticking to the latest Global Lung Initiative reference values (2021). Values of z-scores &lt;-1.645 in FVC, normal FEV1/FVC-z&gt;-1.645, and a reduced TLC (z&lt;-1.645) represent a restrictive pattern. A reduced FVC-z&lt;-1.645, normal FEV1/FVC-z&gt;-1.645, and an increased RV/TLC-z&gt;1,645 represent a non-specific pattern. FEV1/FVC-z &lt;-1.645 represent an obstructive pattern that can be approved with an increased RV/TLC.

Results
Results in FVC-z were -1.0 ± 1.3, FEV1-z -1.0 ± 1.2, and its ratio 0.0 ± 1.0. TLC-z was -0.4 ± 1.1 and RV/TLC-z reached 0.7 ± 0.7. Sixty-seven percent had normal results. However, 33% had a reduced FVC in spirometry. Only three patients showed decreased FEV1/FVC ratio. However, only five children show restriction (TLC&lt;-1,645), representing 9% of all investigated patients.

Conclusions
Still, about one-third of children with CHD show striking results in lung volumes. Although studies suggest better results in nowadays patients, children’s lung function with spirometry and body plethysmography should be tested regularly in children with congenital heart disease. Since lung function is trainable, these patients might benefit from early diagnosis.
Cardiometabolic risk factors in young adults diagnosed with acute myocardial infarction
Authors: Fernandes R , Kevin Forey K F 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/introduction
Morbidity and mortality associated with atherosclerotic cardiovascular diseases are prevalent in young patients. Meanwhile, traditional cardiovascular risk calculators underestimate disease risk in young adults.

Purpose
To characterize cardiometabolic risk factors and lipid levels in young adults with acute myocardial infarction.
Setting: A multicenter, population-based analysis of patients diagnosed at our hospitals in Arizona, as well as our clinic health system spanning Minnesota and Wisconsin.

Methods
This is a retrospective cohort study including patients 18 to 50 years old diagnosed with acute myocardial infarction from October 1, 2015, to December 31, 2018. Parameters obtained included: Age, sex, ethnicity, body mass index, tobacco use, comorbid medical conditions, fasting blood glucose, hemoglobin A1c, lipid levels, and prescribed lipid-lowering therapy.

Results
Among 553 young patients diagnosed with acute myocardial infarction, the mean age at the time was 44.4 years, with men accounting for 69.1% of cases. The mean body mass index was 32.2 kg/m2. Hypertension, diabetes mellitus, and tobacco use were present in 64.7%, 25.9%, and 36.2% of patients. Insulin resistance, elevated triglycerides, and low HDL-C were present in 29.8%, 51.0%, and 62.8% of patients, respectively. Approximately 61.3% of patients within this cohort met World Health Organization criteria for diagnosis of metabolic syndrome. Mean LDL-C was 116 mg/dL and mean triglycerides were 190 mg/dL. Statin therapy was prescribed to 92 (16.6%) of patients prior to diagnosis of acute myocardial infarction, whereas 359 (67.3%) of patients met ACC/AHA criteria for lipid-lowering therapy. Within this subgroup receiving statin therapy, the mean serum LDL-C was 101 mg/dl, 26.1% had levels below 70 mg/dL, and 56.5% had LDL-C levels below 100 mg/dL. Thirty-four patients (6.1%) with LDL-C levels greater than 190 mg/dL, and 29 (85.3%) were not on lipid-lowering therapy.

Conclusions and Relevance
Multiple treatable risk factors were present in most young adults with acute myocardial infarction, including many with LDL-C levels below 100 mg/dL. Being overweight or obese was the most prevalent risk factor, while elevated non-HDL cholesterol was the most common lipid panel abnormality. In addition to known cardiometabolic risk factors, these findings build upon a growing body of evidence implicating triglyceride-rich lipoproteins in non-HDL and remnant cholesterol as an independent risk factor of ASCVD, which were common in this cohort of young patients presenting with myocardial infarction. In this cohort, lipid-lowering therapy was underutilized in young patients with known cardiometabolic risk factors, elevated estimated 10-year ASCVD risk, and individuals with phenotypic Familial Hypercholesterolemia.
External validation of Systematic COronary Risk Evaluation 2 - Older Persons (SCORE2-OP) in the EPIC-Norfolk prospective population study
Authors: Van Trier T , Snaterse M , Boekholdt S M , Scholte Op Reimer W J M , Visseren F L J , Hageman S H J , Dorresteijn J A N , Wareham N J , Peters R J G , Jorstad H T 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): EPIC Norfolk was supported by the Medical Research Council UK (programme grants numbers MRC G0401527, MRC G0701863, MRC G1000143) and Cancer Research UK (programme grant number CRUK 8257).

Introduction
The Systematic COronary Risk Evaluation 2 – Older Persons (SCORE2-OP) algorithm is developed to assess 10-year risk of fatal and non-fatal cardiovascular disease (CVD) in apparently healthy individuals aged ≥70 years. We evaluated the performance of SCORE2-OP in the European Prospective Investigation of Cancer Norfolk (EPIC-Norfolk) prospective population cohort.

Purpose
To validate the SCORE2-OP model in men and women aged 70-80 years without prior myocardial infarction or stroke.

Methods
We included individuals aged 70-80 without prior myocardial infarction or stroke. We compared SCORE2-OP (low-risk algorithm) calculated 10-year risk with 10-year observed event rates in the EPIC-Norfolk cohort. SCORE2-OP was calculated using baseline EPIC-Norfolk data (1993-1997). Cardiovascular events were defined as a composite outcome of (i) death due to ischemic heart disease, cardiac failure, cerebrovascular disease or peripheral-artery disease, (ii) non-fatal myocardial infarction or (iii) non-fatal stroke. Observed rates were adjusted for competing fatal events. We evaluated discriminative power using C-statistic and calibration by plotting predicted versus observed event rates and calculating the observed/predicted ratios.

Results
SCORE2-OP was evaluated in 3,712 individuals (54% women) with a median (IQR) age of 73 (72-75) years. Ten-year SCORE2-OP was 10.3% (95% confidence interval (CI) 10.2-10.4) versus observed CVD of 16.8% (95% CI 15.6-18.0), yielding a ratio of 1.6 (95% CI 1.5-1.7). Observed events consisted of 9.4% (95% CI 8.4-10.3) fatal CVD events, 10.6% (95% CI 9.6-11.5) non-fatal myocardial infarctions, 10.5% (95% CI 9.5-11.5) non-fatal strokes, adjusted for 68.9% (95% CI 67.4-70.4) competing mortality events. C-statistic was 0.60 (95% CI 0.58-0.63), with a calibration plot demonstrating underestimation of risk across sex and risk groups.(Figure).

Conclusion
SCORE2-OP underestimates risk in individuals aged 70-80 years, and demonstrates suboptimal discriminative ability. However some underestimation of risk is to be expected given the EPIC-Norfolk baseline between 1993-1997, a low SCORE2-OP calculated risk should not be used as a standalone argument to withhold preventive efforts in older individuals.
The effects of catheter choice on accessory pathway mapping efficiency
Authors: Mariucci E M , Gamboa D , Laranjo S , Gass M , Papagiannis J , Matlock N , Wenzel E 
Published: May 2023

Abstract
Funding Acknowledgements: Type of funding sources: None.
Recent studies have assessed the use of a novel high density (HD) mapping catheter in pediatric patients, finding that the catheter is safe and effective in this population. However, there is a lack of understanding on use patterns of HD mapping technologies in this population and how these patterns affect intraprocedural workflows.
The objective of this analysis was to assess the role of mapping catheter choice on the efficiency of accessory pathway localization and ablation in patients with structurally normal hearts treated in a pediatric EP setting.
Acute data from 61 accessory pathway ablation cases in patients treated in a pediatric EP setting were prospectively collected from 14 hospitals in 6 countries in Europe and the US. Choice of mapping tools and strategy was left to physician discretion. Procedure data such as map collection duration and statistics were compared across three mapping catheter choices: Ablation Catheter (AC) (n=42), Linear Catheter (LC) (n=9), and HD Grid Catheter (HDC) (n=10).
Of the 61 procedures, 16 cases were patients aged 0-12 years (26%), 34 aged 13-17 years (56%), and 5 aged 18+ years (18%). Distribution of catheter use was similar across age groups with HDC use of 13%, 15%, and 27%, respectively. Pathway location did not correlate with catheter choice. There was 0% incidence of congenital heart disease.
Mean mapping times in the AC, LC, and HDC groups were 20.6±15.8, 18.8±12.9, and 14.2±13.8 minutes, respectively; differences in mapping times were not statistically significant but trended lower with higher density mapping. The mean number of mapping points used in each group was 44±46, 101±62, and 1521±908 points, respectively (p&lt;.01). Ablation was attempted in 57 (93%) of cases with 100% acute success eliminating accessory pathway conduction. Ablation time was analyzed in patients receiving RF ablation (93% of treated; n=53); mean RF time was 526s in the AC group, 369s in the LC group, and 367s in the HDC group; differences were not statistically significant (p&gt;.05). All groups had similar ablation target technique distributions including timing map and signal morphology. Mean procedure time was 2:11 (h:mm) in the AC group, 1:56 in the LC group, and 1:44 in the HDC group; differences were not statistically significant.
Analysis of this cohort of pathways in a pediatric setting shows multipolar catheters may provide more mapping information in shorter times. RF ablation and procedure times also trend shorter in procedures with HD Grid used for mapping, regardless of anatomic location of pathway. Further analysis in a larger cohort may be warranted to validate these findings and explore use of open window mapping described elsewhere.
Long term longevity of defibrillator leads: a prospective follow-up over 25 years
Authors: Davril C , Hammache N , Blangy H , Freysz L , Benali K , Girerd N , Sadoul N 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The implantable cardioverter defibrillator (ICD) lead is the most fragile part of the device. Several studies have focused on both the longevity of ICD and the factors associated with lead malfunction but long-term data (i.e., ≥ 10 years) are limited.

Purpose
We report our experience on the very long-term longevity of ICD leads.

Methods
Data from all patients ≥18 years implanted with an transvenous ICD at our university hospital between 1988 and May 2021 were prospectively collected and analyzed. Follow-up was censored in July 2022. Data included patient characteristics, lead characteristics and follow-up data. The primary endpoint of the study was the survival rate without lead failure defined by the 2017 HR consensus . Factors influencing longevity were analyzed.

Results
2093 ICD leads were included in our study. During follow-up (mean = 72.6±56.9 months, range = 11-299), there were 84 lead dysfunction. Lead survival rate was 97% at 5 years, 92% at 10 years, 88% at 15 years and 85% at 24 years respectively. In the multivariate analysis, factors associated with a higher risk of lead dysfunction revealed were: younger age (p = 0.001), channelopathy (p = 0.037), Linox leads (p = 0.041), Riata leads (p = 0.022) and Fidelis leads (p = 0.001). On the other hand, polyurethane coated leads (p &lt; 0.001), Durata leads (p = 0.036), Endotak reliance leads (p = 0.016) and Sprint quattro 6935 leads (p = 0.026) were associated with less lead dysfunction.

Conclusion
The survival rate of the leads decreased progressively between 1 and 24 years after implantation but the risk of lead rupture seems to be maximal within the first 10 years after implant with little increase thereafter.
Predictors of the efficacy of AV-optimised His bundle pacing in patients with a prolonged PR interval: a stratified analysis of the HOPE-HF clinical trial
Authors: Keene D , Kaza N , Arnold A D , Howard J P , Tanner M , Foley P , Chandrasekaran B , Moore P , Bassi S , Muthumala A , Adhya S , Agarwal S , Francis D P , Whinnett Z I , Shun-Shin M J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation.

Background
HOPE-HF was a randomised, placebo-controlled, cross-over trial of AV-optimised His bundle pacing in patients with heart failure (LVEF ≤40%), a PR interval (≥200ms) and without left bundle branch block.1,2.
In this analysis we studied the impact of baseline PR interval and acute blood pressure change at the optimal AV-delay on the placebo-controlled effect of His bundle pacing on the trial endpoints of peak VO2 (primary) and patient symptoms (using the Minnesota Living with Heart Failure Questionnaire).

Methods and Results
167 patients were successfully implanted and randomised to 6 month blocks of pacing and placebo. We performed a non-invasive, high-precision protocol to calculate the optimal AV delay and associated acute blood-pressure response at randomisation.
To test the impact of the baseline PR interval and acute BP response on the placebo-controlled effect of AV-optimised His bundle pacing on endpoints we compared Bayesian ordinal regression models and the relative explained variance (REV) of variables in the model.
There was weak evidence that His-bundle pacing improved peak VO2 across all patients (OR 1.31, 95% CrI 0.86 to 2.01, Pr(OR &gt; 1)=89%). The baseline PR interval had little impact on this benefit (REV 0%), and the blood pressure response was more likely (88% vs 12%) to be predictive.
However, there was strong evidence that overall AV-optimised His-bundle pacing improved patient symptoms as compared to placebo (OR 1.58, 95% CrI 1.04 to 2.40, Pr(OR&gt;1)=98%). Again, the baseline PR interval had little impact on this benefit (REV 0%) and the blood pressure response was much more likely (97% vs 3%) to be predictive.
Higher acute BP increments led to greater placebo-controlled improvements in MLWHF at 6-months.

Conclusion
An individual’s acute BP response with AV-optimised His-pacing is a powerful predictor of their placebo-controlled improvement in symptoms (MLWHF) at 6-months. This can form the basis of patient selection for future studies and clinical practice.