bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of success of elective electrical cardioversion in patients with atrial fibrillation and atrial flutter
Authors: Aguila Gordo D , Piqueras Flores J , Martinez Del Rio J , Negreira Caamano M , Mateo Gomez C , Soto Perez M , Cubides Novoa A F , Jimenez Diaz J , Moron Alguacil A , Andres Sierra M , Concepcion Suarez R , Freites Esteves A , Jimenez Rubio B , Blanco Lopez E , Soto Martin P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Electrical cardioversion is an effective therapy for the restoration of sinus rhythm. The success of cardioversion has been related to different clinical and echocardiographic variables, although the available evidence is scarce and heterogeneous.

Methods
Ambispective, observational, single-center registry that consecutively included 271 patients scheduled for elective electrical cardioversion (ECV) on the inpatient ward for atrial fibrilation (AF) or flutter fibrilation (AFL) &gt;48 hours of onset during the years 2018-2021. All patients scheduled for CVE that were ultimately discontinued on the day of the procedure were excluded, finally analyzing 244 patients.

Results
The baseline characteristics are shown in Picture 1. No statistically significant differences were observed in the main comorbidities, cardiovascular risk factors, CHAD2S2-VASc scale, the position of the paddles, or days to ECV between patients with successful ECV and those with a failed procedure. Neither were they observed in terms of pharmacological treatment, including the presence of previous antiarrhythmic treatment as part of a facilitated ECV strategy (Picture 2). Moderately-severely depressed systolic function and the presence of moderate-severe mitral regurgitation were associated with a higher rate of cardioversion failure (3% vs 2.6% p= 0.002; 3.3% vs 1.3% p=0.001), higher number of biphasic electric shocks (1.3 vs 1.6 p&lt;0.001; 1.2 vs 1.6 p&lt;0.001) and higher total voltage received (245J vs 310J p=0.32; 229J vs 325J p&lt;0.001). Moderate-severe tricuspid regurgitation was also associated with lower cardioversion success rate (96.7% vs 85% p=0.02) although no differences were seen with respect to the number of shocks or energy received. On the other hand, severe left atrial dilatation, although it had a neutral impact on the success of ECV, was associated with greater immediate recurrence (&lt;5 minutes after ECV) (4.2% vs 50% p&lt;0.001).

Conclusion
Patients with moderate-severe systolic dysfunction and significant mitral and tricuspid regurgitation have a lower success rate of ECV. Previous antiarrhythmic therapy presents a neutral effect on sinus rhythm restoration and immediate recurrence.
Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland
Authors: Alkandari A , Marques-Vidal P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Swiss National Science Foundation, GlaxoSmithKline, Faculty of Biology and Medicine of Lausanne.

Introduction
Good glycemic, blood pressure and lipid control in adults with diabetes reduces complications and improves health outcomes, particularly when achieved simultaneously. Therefore, regular monitoring and successfully achieving control targets are essential in diabetes management.

Purpose
To assess the 15-year trends in the level of glycemic, blood pressure and cholesterol control in adults with diabetes in Switzerland.

Methods
Data from a population-based cohort study of 6,733 adults aged 35-75 years in Switzerland was analyzed. Baseline recruitment in 2003-2006 was followed by three subsequent follow-ups between 2009-2012, 2014-2017 and 2018-2021. In adults with diabetes, glycemic control was defined as fasting plasma glucose &lt;7 mmol/L, blood pressure control as systolic and diastolic pressures of &lt;140/90 mmHg, and non-HDL cholesterol control &lt;3.4 mmol/L.

Results
Rates of glycemic control improved from 23.2% (95% CI, 19.5-27.3) in 2003-2006 to 32.8% (95% CI, 28.1-37.8) in 2018-2021. Blood pressure control also improved, from 51.5% at baseline (95% CI, 46.8-56.2) to 63.3% (95% CI, 58.2-68.1) 15 years later. The largest improvement was in non-HDL cholesterol control, from 29.1% (95% CI, 25.1-33.6) in 2003-2006 to 56.3% (95% CI, 51.1-61.4) in 2018-2021. Overall, simultaneous control of all three improved from 5.5% (95% CI, 3.7-8.1) at baseline to 17.2% (95% CI, 13.7-21.5) 15 years later. Improvements in risk factor control was accompanied by increases in the use of glucose-lowering agents, blood pressure-lowering medication and statins. Men were less likely to achieve blood pressure control but were more likely to achieve non-HDL cholesterol control. Caucasians were less likely to achieve simultaneous control than non-Caucasians.

Conclusion
Risk factor control in Swiss diabetes patients has improved in the last 15 years.
Lipoprotein (a) cholesterol burden predicts atherosclerotic risk in patients with elevated lipoprotein a
Authors: Vanderboom P , Baudhuin L M , Spears G M , Hartman S J , Somers V K , Berger P B , Mcconnell J P , Jaffe A S , Vasile V C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): Mayo Clinic Department of Laboratory Medicine and Pathology.

Background
Elevated lipoprotein(a) [Lp(a)] is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD). Treatment of patients with elevated Lp(a) usually includes marked reduction in low density lipoprotein cholesterol (LDL-C). However, there are uncertainties about whether all increases in Lp(a) are equivalent in there risk relationship.

Purpose
The aim of this investigation was to risk stratify patients with elevated Lp(a) mass [Lp(a)-M] based on Lp(a) cholesterol (Lp(a)-C) measurements. We assessed coronary artery disease (CAD) by coronary angiogram and major adverse cardiac events (MACE) in a cohort of patients with elevated Lp(a) mass (≥30mg/dL) over a 15 year followup.

Methods
Electrophoretic and immunologic assays were used to measure Lp(a)-C and Lp(a)-M, respectively. Univariate and multivariate logistic regression analysis was employed to test for association between Lp(a) and CAD in a cohort patients with elevated Lp(a)-M (≥30mg/dL). The relationship between Lp(a) and time to major cardiac events was evaluated using cox regression analysis. Receiver operator curve (ROC) analyses were used to identify optimal cutoff values for Lp(a)-M and C for predicting CAD in our model.

Results
We analyzed 179 patients with elevated Lp(a)-M. Cutoff values of 3.3mg/dL for Lp(a)-C and 42.1mg/dL for Lp(a)-M optimally predicted CAD in an ROC analysis. Of these patients, 84 were found to have Lp(a)-C &lt; 3.3mg/dL (low Lp(a)-C), while 95 patients had Lp(a)-C levels ≥ 3.3mg/dL (high Lp(a)-C). High Lp(a)-C was associated with CAD identified on coronary angiography in univariate (OR = 2.17, 95% CI = 1.18 – 4.00, p = 0.013) and multivariate (OR = 3.36, 95% CI = 1.64 – 6.89, p &lt; 0.001) models controlling for traditional risk factors. In univariate analyses high Lp(a)-C was also associated with MACE (HR = 2.38, 95% CI = 1.19 – 4.75, p = 0.01) while Lp(a)-M ≥ 42.1mg/dL (high Lp(a)-M) was not (HR = 1.68, 95% CI = 0.82 – 3.44, p = 0.15) (Table 1, Figure 1). Lp(a)-C remained significantly correlated with MACE after adjusting for traditional risk factors. When included in a model together, Lp(a)-C maintained its significance while Lp(a)-M failed to predict MACE, indicating that Lp(a)-C is a stronger predictor of MACE than Lp(a)-M.

Conclusion
This study demonstrates that patients with elevated Lp(a)-M and high Lp(a)-C are approximately 2.5 times more likely to encounter MACE over time when compared to patients with elevated Lp(a)-M and low Lp(a)-C. Our investigation suggests that Lp(a)-C can be used to risk stratify patients with elevated Lp(a)-M and identify those at higher risk.
History of heart failure in patients with acute coronary syndrome: population characterization and impact on prognosis
Authors: Carias M , Paralta M , Almeida A , Claudio F , Rocha R , Picarra B , Bento A , Trinca M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients with Heart Failure (HF) usually have multiple co-morbidities, so their approach in the context of Acute Coronary Syndrome (ACS) could be an important challenge.

Purpose
To characterize patients with ACS and previous HF and evaluate its impact on the therapeutic approach, complications and in-hospital mortality.

Methods
We studied 745 patients admitted to a Cardiac Intensive Care Unit with a diagnosis of ACS. We considered 2 groups: patients with previous HF and patients without a previous history of HF. Age, gender, personal history, clinical and electrocardiographic presentation of the ACS, treatment at admission, left ventricular ejection fraction (EFj), coronary angiography and angioplasty were recorded. The following in-hospital complications were defined: heart failure, cardiogenic shock, need for invasive mechanical ventilation (IMV), re-infarction, mechanical complications, sudden aborted death, stroke and major hemorrhage. In-hospital mortality was compared between both groups.

Results
Patients with previous HF constituted 7.1% (53 patients) of the population studied. These were older (77.3 ± 8.9 vs 66.6 ± 13.6, p&lt;0.001), a higher prevalence of arterial hypertension (88.7% vs 76.2%; p=0.03), of myocardial infarction (50.9% vs 24.3%, p&lt;0.001), coronary artery bypass graft surgery (18.9% vs 5.2%, p&lt;0.001), valvular disease 22.6% vs 1, 4%, p&lt;0.001), peripheral arterial disease 22.6% vs 5.1%, p&lt;0.001), chronic renal failure (41.5% vs 10.1%, p&lt;0.001), chronic lung disease 22.6% vs 4.2%, p&lt;0.001 and hemorrhage (9.6% vs 1.8%, p&lt;0.001). Patients with HF presented more frequently with AMI without ST elevation (62.3% vs 45.7%; p&lt;0.001) and infarction of undetermined location (26.4% vs 4.6%, p=0 .02) and Killip-Kimbal class ≥ 2 (64.2% vs 16.8%, p&lt;0.001) and less with ST-elevation AMI (5.7% vs 42.5%, p&lt;0.001) and pain (58.5% vs 87.7%, p&lt;0.001). On admission, patients with previous HF underwent fewer coronary angiograms (56.6% vs 86.7%, p&lt;0.001) and via the radial approach (53.6% vs 79.0%, p=0.001)5.7%, p&lt;0.001), and less angioplasties (32.1% vs 68.7%, p&lt;0.001). The presence of HF was associated with lower EFj (40.9 ± 10.4% vs 48.2 ± 9.9%, p=0.004), with greater development of HF during hospitalization (47.2% vs 12, 4%, p&lt;0.001), greater need for non-invasive ventilation (17.0% vs 2.2%, p&lt;0.001) and higher in-hospital mortality (13.7% vs 4.8%, p=0.008).

Conclusion
The previous presence of HF seems to condition the clinical and electrocardiographic presentation of the ACS and is associated with greater development of HF and in-hospital mortality.
Effect of adjuvant trastuzumab for HER2 positive breast cancer combined with radiation therapy and anthracyclines on left ventricular function
Authors: Krstic I , Deljanin Ilic M , Pejcic I , Vrbic S , Marinkovic D , Stojanovic M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although trastuzumab has benefits in treatment of HER2 positive breast cancer, its use is associated with an increased risk of cardiotoxicity.

Purpose
To assess the effect of adjuvant trastuzumab in HER2 positive breast cancer pts, in addition to prior radiation and antracyclines therapy, on left ventricular function.

Methods
Fifty HER2 positive female breast cancer patients (mean age, 59.57±9.6 years) were enrolled in the study. In all patients (pts) left ventricular left ventricular ejection fraction-LVEF(%) and left ventricular mass – LVM (g) were assesed at the beginning and after the therapy with trastuzumab. All pts were on sequential therapy with anthracyclines (IV cycles) within the FAC regimen (fluorouracil 500 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2) on day 21, and after that followed with trastuzumab (6 mg/kg of body weight on day 21) for the period of one year. The pts are divided in two groups: the group of patients (N=32 pts) who had prior radiation therapy (25 daily sessions of 2 Gy dose each, up to the total dose of 50 Gy) and group without radiation therapy (N=18).

Results
After completion of trastuzumab therapy pts who underwent radiation therapy, reduced LVEF by 2.24 % (from 66.58 ± 5.36 % to 64.34±7.34 %; p=0.048) and increased LVM by 17.95 g (from 160.38 ± 46.21 g to 178.33 ± 53.14 g; p=0.018) . The group of pts without radiation therapy, reduced LVEF by 0,72 % (from 63.33±7.60 % to 62.61±6.92 %; p=0.979) and increased LVM 23.34 g (from 141.98±35.82 g to 165.32±47.45 g; p=0.062).

Conclusion
The results of the study showed that the decline of LVEF and increase of LVM after completion of adjuvant trastuzumab therapy for HER2 positive breast cancer iz related with previous prior radiation administration. The pts with radiation had greater reduction of LVEF and increase of LVM than those without radiation.
Impact of cardiac rehabilitation programme in patients older than 65 and 75 y.o
Authors: Coto Morales B , Delgado Cavia F A , Basabe Velasco M E , Gomez Sanchez M I , De Juan Bitria C , Marschal A F , Duarte Torres J , Biscotti Rodil M B , Marti Sanchez D , Fuertes Pereira J , Casanova Lopez M P , Molinos A C , Rodriguez Biedma M F , Rodriguez Gamero M A , Alvarez Anton S A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Initially cardiac rehabilitation programmes excluded the eldery, but over the time it has been shown that the benefitial effects are maintained regardlees of age. However, many programmes still exclude older patients. Our objetive is to characterize and evaluate the impact of our cardiac rehabilitation programme on patients older than 65 and 75 y.o.

Method
Prospective observational study of all consecutive patients during the 2021 period who entered the Cardiac rehabilitation Programme of our centre. Inclusion criteria: 1- &gt; 65 y.o. 2-Informed consent signed 3- Adecuate ergometer/cicloergometer adaptability. We evaluated the impact before and after the programme perfoming analysis by age subgroup (65-74 and &gt;75). Statistical analysis was performed for cuatitative variables and paired samplesusing the Wilcoxon test. For cualitative variables, Fisher´s test / Chi-square test and Student´s T-test for age subgroups.

Results
During 2021 140 patients were included incardiac rehabilitation programa, 70 (50%) of the older than 65 y.o. The main results of this 70 patients are pressented in Table 1. The main age of the group was 75 /- 5 y, only 22% were women. High prevalence of risk factors (77%HTA, 63% dyslipemia, 36% diabetes). The main reason for incusion is ischemic cardiomiopaty. The main parameters of improvement after the intervention were: functional capacity (measured int METS), minutes of exercise on ergometer test and LDL control, wich was maintained after analysis by age subgroup (65-74 and &gt;75).

Conclusions
Cardiac rehabilitation brings improvement to patients older than 65y.o y and older than 75 y.o., without differences in the improvement between both age groups.
It is necessary to increase efforts to indicate cardiac rehabilitation programs to older adults to favor their self-care capacity and adherence to healthy life styles, in addition to improving exercise capacity and quality of life.
Eicosapentaenoic acid (EPA) treatment increased the ratio to arachidonic (EPA/AA) and reduced adhesion molecule expression in vascular endothelium during inflammation
Authors: Sherratt S C R , Libby P , Bhatt D L , Mason P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Amarin Pharmaceutical, Inc. Elucida Research LLC.

Background
Omega-3 fatty acid (n3-FA) treatment reduces cardiovascular (CV) risk in relation to circulating EPA/AA ratios. Treatment with icosapent ethyl (IPE), a highly purified EPA formulation, increased the EPA/AA ratio in treated patients (MARINE, ANCHOR). Unlike mixed n3-FA formulations, IPE reduced a composite of CV events in high-risk patients (REDUCE-IT) in relation to on-treatment EPA levels. These benefits of EPA may result in part from effects on vascular endothelial function and fatty acid content during inflammation.

Purpose
We measured the effect of EPA on human endothelial cells (HUVECs) during inflammatory activation, monitoring the release of soluble intercellular adhesion molecule-1 (sICAM-1) and changes in fatty acid content.

Methods
HUVECs were challenged with IL-6 (12 ng/mL) for 2 hours and then treated with EPA (40 µM) or vehicle for 24 hours. Total protein content was measured in cell lysates. Total fatty acids were extracted and derivatized using methanol containing 14% boron trifluoride to form fatty acid methyl esters (FAME). Gas chromatography measured total fatty acid content from C14-C24 and normalized to total protein. Levels of sICAM-1 were measured in cell supernatant using immunochemistry.

Results
EPA treatment increased the EPA/AA ratio by &gt;20-fold compared to IL-6 treatment alone (1.55 ± 0.11 vs. 0.07 ± 0.003, p&lt;0.001). The increased EPA/AA ratio correlated with EPA and docosapentaenoic acid (DPA) levels in lysates, which increased by 19-fold (26.71 ± 1.28 vs. 1.28 ± 0.05 mg/g protein, p&lt;0.001) and 4-fold (29.42 ± 1.91 vs. 6.17 ± 0.36 mg/g protein, p&lt;0.001), respectively, compared to IL-6. While IL-6 treatment increased sICAM-1 release (83%, p&lt;0.001), subsequent treatment with EPA reduced sICAM-1 release by 39% (p&lt;0.001).

Conclusion
In human ECs, EPA increased the EPA/AA ratio along with other n3-FAs under conditions of inflammation. Changes in the EPA/AA ratio correlated with reductions in sICAM-1 release with IL-6 exposure. As on-treatment EPA levels predict reduced CV risk, these direct vascular benefits of EPA may contribute to reduced CV risk observed in outcome trials.
Physical activity levels and sedentary behaviour pattern in cardiovascular disease patients attending a community-based phase III CR program
Authors: Ribeiro M , Sa G , Borges M , Pires M , Pinto F , Abreu A , Pinto R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Cardiovascular rehabilitation (CR) programs are an effective component of recovery from cardiac events or revascularization procedures. The CR recommendations advise that cardiovascular disease (CVD) patients must be encouraged to improve their physical activity (PA) levels to meet the current guidelines. However, the sedentary behaviour (SB) in this population remains high during and following standard CR programs. Furthermore, SB targets and recommendations are still lacking and undefined.

Purpose
To characterize the pattern of SB and PA levels in CVD patients admitted to a community-based phase III CR program and after 12 months.

Methods
This retrospective cohort study included a total of 124 CVD patients admitted to a community-based phase III CR program (3 supervised exercise sessions/week). PA and SB were measured using accelerometers at baseline (M0) and after 12 months (M1). Outcome measures were minutes spent in light PA, moderate PA, vigorous PA, moderate to vigorous PA (MVPA) and SB, where the number of breaks/day was assessed (interruption in sedentary time of at least 1 minute).

Results
Eighty CVD patients (62±9 years; 83.8% male; 89% with coronary artery disease) completed all assessments. After one year intervention, minutes of MVPA decreased from 51±28 mins/day to 45±25 mins/day (p=0.021), despite the majority of patients (80%) targeting PA recommendations and 46.3% reaching more than 300 mins/week of MVPA. Light PA did not change from 3.0±0.8 hours/day to 2.8±0.9 hours/day (p=0.058) and SB remained high (M0: 11.1±1.3 hours/day vs M1: 11.0±1.4 hours/day, p=0.674). Our results showed that SB time was less fragmented in terms of number of breaks after one year (M0: 107±64 breaks/day vs M1: 92±29 breaks/day, p=0.030) and the difference in these SB periods did not change (p=0.201).

Conclusion(s)
Patients attending a CR long-term program kept their PA levels on target after one year intervention. The SB time remained high and there was a decline in number of breaks per day. Despite the aim to improve PA behaviour, our findings highlight the need to additionally address personalized interventions focused on changing the amount and distribution of SB.
Effects of the 2019 guideline-update on lipid therapy in patients with acute coronary syndromes
Authors: Galli L , Schrutka L , Haider P , Distelmaier K , Wojta J , Hengstenberg C , Krychtiuk K , Speidl W 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): 2 Ludwig Boltzmann Institute for Cardiovascular Research.

Background
The European Society of Cardiology regularly updates its clinical practice guidelines. However, it is not well established whether guideline-changes have significant effects on actual clinical practice. Therefore, we retrospectively analyzed lipid therapy at discharge after acute coronary syndrome (ACS) in a one-year period until 3 months before and a one-year period starting 6 months after publication of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias, respectively.

Methods and Results
In total we included 702 patients that were discharged alive after treatment for ACS. 360 patients were treated in the period before and 342 were treated in the period after guideline change. 67.7 % of patients were male and 59.1% were treated for ST-elevation myocardial infarction (STEMI). After guideline change the proportion of patients that were discharged on high dose statin was significantly higher as compared to the period before the new guidelines were published (89.2 % vs 79.2 %; p=0.001). Ezetimibe was prescribed more often after the new guidelines (15.0 % vs 3.0 %; p&lt;0.00001). Whereas proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) were not prescribed at discharge in the earlier period, five patients were discharged on PCSK9i in the later period. The higher proportion of ezetimibe use and the introduction of PCSK9i resulted in an increased number of patients on high intensity treatment (high dose statin or moderate dose plus ezetimibe or PCSK9i: 92.4 % vs. 79.7 %; p&lt;0.0001) in the period after the new guidelines. In 32.3 % of patients, cholesterol levels were available for the time period between one month and one year after discharge. Median on treatment LDL was significantly higher in the period before (64.4 IQR 47.4 – 94.2 mg/dL) than after the publication of the 2019 guidelines (46.2 IQR 33.8 – 61.8 mg/dl; p&lt;0.00001).

Conclusions
The update of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias was associated with a significant improve in the proportion of high dose statin and ezetimibe treatment in patients after ACS resulting in a significant lower LDL plasma level in a subgroup of patients. The change of these guidelines rapidly translated into clinical practice resulting in improved risk factor control in high-risk patients.