bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-P13-6: DEFINING THE RELATIONSHIP BETWEEN IMMUNE TRAITS AND LIPIDS IN TWINSUK
Authors: Christofidou Paraskevi , Liechti Thomas , Menni Cristina , Spector Tim , Roederer Mario , Mangino Massimo 
Published: January 2023

Objective:
The primary aim of this work was to evaluate associations of distinct immune cell subtypes and circulating lipids in a general population setting.

Methods:
The associations between 3,855 immune traits and lipids (HDL-C, LDL-C, TC, TG, non-HDL-C) were examined in 1,491 individuals from the TwinsUK cohort. Immune traits were defined by high-dimensional flow-cytometry which enabled in-depth assessment of all major lymphocyte and myeloid subsets in peripheral blood. Information on immune cell subset frequency (FREQ) and mean fluorescence intensity (MFI) was available. A linear mixed model regression analysis adjusted for family structure, gender, age, BMI and batch effect was used to examine the associations between immune traits and lipids. A sub-analysis in 441 individuals and 122 lipid metabolites quantified using nuclear magnetic resonance spectroscopy was undertaken to investigate the associations of 40 significant immune traits and lipoprotein particles. Secondary analyses explored the associations of lipids and immune traits with pulse wave velocity (PWV). A mediation model was constructed to test mediation effects of an immune marker on the total effect of lipids on PWV.

Results:
Significant associations were observed between 46 MFI and 6 FREQ immune traits and lipids (Bonferroni P < 2.45x10–5). These included associations between circulating lipids and different myeloid or lymphoid subsets including monocytes, NK cells and T cells. The top associations involved the expression of transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI) cytokine on classical (cM) and intermediate (iM) monocyte subsets. Decreased levels of non-HDL-C [cMP = 6.98x10–10, iMP = 3.72x10–7], LDL-C (cMP = 3.28x10–7, iMP = 1.75x10–5) and TG [cMP = 1.18x10–9, iMP = 2.97x10–6], and increased levels of HDL-C (cMP = 3.64x10–12, iMP = 1.44x10–10) were associated with higher TACI expression on both cM and iM subsets. Significant associations were identified between TACI expression and 13 lipid metabolites (Bonferroni P < 1.36x10–4). All linked metabolites referred to HDL related measures. Increased apolipoprotein A1 levels, total cholesterol in HDL and HDL2 and large and medium HDL related particles were associated with increased TACI expression on cM and iM subsets. The strongest association found between total cholesterol in HDL2-C and TACI expression levels on cM (P = 3.57x10–6). Mediation analysis showed that TACI expression on monocytes partially mediates the effect (∼10%) of TG on PWV.

Conclusions:
This study provides the first comprehensive picture of lipid-immune cell associations in the circulatory system. Interesting novel immune cell subset alterations and insights into the relationship between lipids, PWV and immunity have extended our knowledge. Further work is required to dissect the role of immune responses in cardiovascular disease.
PS-P13-7: O.N.E. (ONWARD NONCOMMUNICABLE DISEASE EDUCATION) CAVITE INITIATIVE: A COLLABORATIVE PROJECT TO IMPLEMENT PHILPEN AMONG PRIVATE PRACTITIONERS
Authors: Ona Deborah Ignacia David , Asis Leilanie Mercado , Bonzon Dolores D , Vilela Gilbert A , Diaz Alejandro F , Balmores Benjamin A , Garcia Rey an Nino L , Tejida Glenn M , Garcia Eileen Feliz Cortes , Tan Ardith Dominguez , Salvador David Raymond K , Mendoza Victor L , Dacayo Queenie G , Atilano Alberto A 
Published: January 2023

Objective:
Cardiovascular diseases account for most noncommunicable disease (NCD) deaths about 17.9 million people annually. The Philippine Department of Health (DOH) began implementing the PhilPEN (Philippine Package of Essential Noncommunicable Disease interventions) nationwide in 2014. The protocol screens adult Filipinos seen in the public health facilities for major cardiovascular disease risk factors and includes interventions such as lifestyle advice and medications to achieve target goals. ONE Cavite Project is a collaboration between DOH, the Philippine Society of Hypertension (PSH), and private practitioners in Cavite- a densely populated semi-urbanized province in the Philippines. The primary objective of the One Cavite Project is to engage private medical practitioners in Cavite in screening, diagnosing, and managing adult patients (20 years old and above) for the following significant cardiovascular risk (CV) factors: hypertension, type 2 diabetes mellitus, dyslipidemia, smoking and to complement the PhilPEN implementation by the DOH in all its public health facilities in Cavite by private general physicians.

Design and Methods:
The first phase of the project is to organize a series of seminars to gather, enroll, and engage private doctors to ensure proper screening, monitoring, and follow up of patients with hypertension, diabetes, dyslipidemia, and other CV risk factors. The second phase is to enroll the patients of these private doctors, where patient data was collected, collated, and submitted to PSH for descriptive analysis by a third party.

Results:
A total of 680 doctors were engaged with a total of 41,477 patients screened. Preliminary data showed that out of the 41,477 patients, 61% have hypertension, 17% have diabetes, 22% have dyslipidemia, and 16% are smokers. Moreover, 21% have both hypertension and diabetes, 19% have hypertension and dyslipidemia, while 7% have hypertension, diabetes, and dyslipidemia. On follow-up after six months, out of 18,348 patients with hypertension, 88% of patients with hypertension had their blood pressure under control. For the 5,024 patients with diabetes, 15% had a fasting blood sugar < 110 mg/dL, and 32% had an HBA1c< 6.5 mg/dl. Out of 7,146 patients with dyslipidemia, 14% had an LDL < 130 mg/dl, while for the 3,510 smokers, 56% quit smoking on follow-up.

Conclusion:
The One Cavite Project has shown that engagement of private medical practitioners in screening, diagnosing, and managing adult patients for significant cardiovascular risk (CV) factors have complemented the implementation of PhilPEN by the DOH and this led to active prevention and control of these risk factors.
PS-P13-9: A MULTI-DISCIPLINARY LIPID ADVOCATE INTERVENTION ACHIEVES A SUSTAINED INCREASE IN LIPID AND HBA1C SCREENING WITHIN AN ACS POPULATION
Authors: Phillips Richard , Khan Ahsan , Belasco Marcus , Zathar Zafraan , Khan Aimen , Pressler Nikki , Sharma Vinoda 
Published: January 2023

Objective:
Cholesterol is a key risk factor for atheroma and coronary heart disease. European Society of Cardiology (ESC) and National Institute for Clinical Excellence (NICE) guidelines both recommend that a full lipid profile is obtained for all patients presenting with an acute coronary syndrome (ACS) on admission. Here, we present an intervention study that aimed to improve lipid and HbA1c assessment in patients presenting with ACS at single UK NHS trust. The primary intervention included the creation of a multi-disciplinary lipid advocate team.

Design and method:
Data from 194 patients admitted with the diagnostic code acute coronary syndrome was collected over 4 discrete time intervals between August 2020 and January 2022 using electronic healthcare records. Data on whether total cholesterol, high-density lipoprotein (HDL), triglycerides and HbA1c tests were requested was collected as a baseline and after implementation of each quality improvement (QI) intervention. Interventions included establishing a lipid advocate team comprised of doctors and ward nursing colleagues to ensure that patients arriving on the ward with missing test results had further bloods sent. The final cohort of ACS patients was chosen 12 months after any QI intervention to assess sustainability of the interventions.

Results:
Analysis of the total cholesterol, HDL, triglycerides and HbA1c results across the 4 cohorts of patients presenting with ACS revealed a significant improvement in test compliance from the baseline cohort to the final cohort across all 4 parameters. After implementation of the lipid advocate team, compliance with test requesting rose significantly for total cholesterol (69.1% to 89.5%) and remained high after 12 months (94.3% compliance). Similar improvements were also shown with triglyceride, HDL and HbA1c measurements, with final compliance measurements at 92.4%, 79.2% and 90.6% respectively (compared to respective baselines of 65.4%, 60% and 67.3%).

Conclusion:
This longitudinal QI study of patients with ACS from a single cardiology centre demonstrated a significant and sustained improvement in compliance of lipid and HbA1c assessment. The implementation of a multi-disciplinary lipid advocate team led to significant improvements in compliance with lipid and HbA1c assessment. Utility of a combined nursing and medical-led service requires further exploration for in-hospital management of patients with ACS.
PS-P14-7: IMPACTS OF CONSTRUCTING AND OPERATING “KARUSHIOH” CERTIFICATION SYSTEM TO PROMOTE DELICIOUS LOW-SALT MEALS ON THE JAPANESE LOW-SALT FOODS MARKET
Authors: Akagawa Eiki , Tanaka Katsuhisa , Takemoto Sayuri , Sato Kaoru , Watanabe Sachie , Watanabe Satomi , Nagao Nobuyuki , Ohtani Misato , Asano Shigehiro , Tatsumi Eisuke , Miyaoto Yoshihiro 
Published: January 2023

Objective:
From the viewpoint of preventing and prognosis cardiovascular disease, it was created by National Cerebral and Cardiovascular Center (NCVC) of Japan to create a new concept of low-salt meal that brings out the delicious by using salt lightly under the name of “Karushioh”. As a mechanism for consumers to easily obtain delicious low-salt foods, the “Karushioh” certification system linked to the economic activities of companies, has been promoted by NCVC. Under this system, NCVC examines whether foods meet the certification criteria such as low salt and deliciousness, and permits the labeling of “Karushioh”, which is registered as a trademark for passed foods. Therefore, the purpose of this study was to sort out the current status of this certification and was to verify the spread of “Karushioh” certified foods and their impact on salt reduction.

Design and Methods:
The market size of certified foods was tabulated from the fiscal year 2020 sales performance report submitted by companies that manufactures/sells certified foods in accordance with the trademark license agreement. In addition, the amount of salt reduction associated with the launch of certified foods were estimated from the comparison target products in the “Karushioh” certification examination.

Results:
As an initiative linked to the industry, the market for delicious low-salt foods through the operation of the certification system is expanding, and the market size of the certified foods will exceed 2.1 billion yen in fiscal year 2020, and the number of certifications so far has increased. At the end of 2021, a total of 166 applications were submitted by 52 companies. In addition, the amount of salt reduction in fiscal year 2020 due to the launch of the certified food to the market was estimated to be 51 tons.

Conclusions:
In the several years since the certification system started, it has formed a market of over 2 billion yen, whereas in the market of low-salt foods in Japan, which is estimated to exceed 70 billion yen. With the future development of the certification system, more promotion of salt reduction can be expected.
PS-P14-9: SALT CONTENT IN COMMONLY CONSUMED PROCESSED PACKAGED FOODS AND THEIR CONFORMITY WITH LABEL INFORMATION IN BANGLADESH
Authors: Sobhan Sheikh Mohammad Mahbubus , Mamun Mohammad Abdullah Al , Bahar Nisarga , Sarwar Sneha , Ashraf Md Musharraf , Abedin Md Joynul , Karim Md Rizwanul , Alim Md Abdul , Ahmed Jasimuddin , Shamim Abu Ahmed , Shaheen Nazma , Amin Mohammad Robed , Choudhury Sohel Reza 
Published: January 2023

Objective:
Consumption of processed foods is surging in low and middle-income countries and gradually replacing home-cooked meals. Unfortunately, the salt content is usually high in these processed foods which eventually causes hypertension, heart diseases and stroke. As the reduction of overall salt intake serves as a preventive measure for Non-communicable Diseases, so, the present study was undertaken to estimate the content of salt in commonly consumed processed foods in Bangladesh and to assess their conformity with label declaration. Along with salt, total sugar, total fat, saturated fat, trans fat, protein, fiber and energy were also assessed.

Design and Methods:
It was a cross-sectional population-based study. A total of 11 most consumed processed packaged foods were identified from the 8 administrative divisions of Bangladesh through a household survey (n = 480) and a market survey (n = 24) done in 2019. Samples from all the 8 divisions were collected following a list of commonly consumed foods and brands. The foods included for analysis were chips, chanachur, fried peas, pulse, noodles, biscuits, lozenge/lollipop, milk chocolate, chutney, and ice cream. A brand-wise composite sample of each processed food item was prepared by pooling at least 12 samples in the Institute of Nutrition and Food Science. Samples were analyzed by ‘Association of Official Analytical Chemists’ and titrimetric method (IS-1743) method at an accredited lab. The healthiness of the products was evaluated in terms of the Health Star Rating scheme of Australia and the UK traffic light labelling system. Label information was compared with corresponding analytical values and per cent variation was calculated.

Results:
Most of the analyzed foods contained excessive amounts of salt, sugar and saturated fat. Alarmingly, for salt, where WHO labels ‘> 1.5 g/100g’ as ‘High/Excessive’ the products range from 4 g to 0.14 g per 100 g. Among them, 8 out of 11 food items were red marked. None of the brands qualifies for health claims in the star rating scheme and the UK traffic light system due to high content of salt and other critical nutrients. Most of the products misreported the nutrient content on labels.

Conclusions:
For the sake of public health, modification is highly needed in the processing of commonly consumed processed foods to make them healthy and less salt-containing. Study findings strongly advocate the necessity for strict regulations for appropriate user-friendly nutritional labelling. These measures will help in attaining Sustainable Development Goal 3-the health targets.
PS-P15-9: EFFECT OF MINERALOCORTICOID RECEPTOR BLOCKER, ESAXERENONE, ON HOME BLOOD PRESSURE AND CARDIAC HYPERTROPHY IN HYPERTENSIVE PATIENTS WITH LVH (ESES-LVH STUDY)
Authors: Yamamoto Eiichiro , Usuku Hiroki , Sueta Daisuke , Suzuki Satoru , Nakamura Taishi , Matsui Kunihiko , Matsushita Kenichi , Taguchi Takashi , Shiosakai Kazuhito , Sugimoto Kotaro , Tsujita Kenichi 
Published: January 2023

Objective:
Cardiac hypertrophy is a prognostic factor in hypertensive patients, and attenuation of the hypertrophy with sustained antihypertensive treatment is important to delay the progression to heart failure. Although most classes of antihypertensive agents have evidence of cardiac hypertrophy regression, there is insufficient evidence for mineralocorticoid receptor blockers (MRB); only one report states that MRB has a more pronounced regressive effect when used in combination with a renin-angiotensin system (RAS) inhibitor. Esaxerenone is a novel selective nonsteroidal MRB which has been recently approved for the treatment of hypertension, to date however, there is little evidence of the effectiveness and safety of esaxerenone in hypertensive patients with cardiac hypertrophy.
The study was aimed to evaluate the effectiveness and safety of esaxerenone in Japanese hypertensive patients with left ventricular hypertrophy (LVH) whose blood pressure (BP) was inadequately controlled with a RAS inhibitor or calcium channel blocker (CCB).

Design and method:
ESES-LVH study (jRCTs071190043) was a multicenter, open-label, interventional study. Main inclusion criteria were hypertensive patients (20 years) with morning and bedtime home BP: 135–159 mmHg systolic BP (SBP) and/or 85–99 mmHg diastolic BP (DBP) taking a RAS inhibitor or CCB, and patients with LVH (diagnosed with echocardiography, ECG, or left ventricular mass index [LVMI]). Over the 24-week study period, the initial dose of esaxerenone was started at 1.25 or 2.5 mg/day, and increased to 5 mg/day at weeks 4 and 8, based on the individual patient's condition. The primary endpoints were change from baseline in morning home BP, and change and %change in LVMI, at the end of treatment (EOT). Secondary endpoints included changes in bedtime home and office BP, proportion of patients achieving target BP, changes in echocardiographic parameters, and safety variables including adverse events, eGFR, and serum potassium levels.

Results:
Baseline characteristics of the 58 enrolled patients were mean age, 64.8 years; male, 70.7%; RAS inhibitor/CCB, 32.8/67.2%; mean morning home SBP/DBP, 142.8/85.0 mmHg; mean LVMI 118.1 g/m2; left ventricular ejection fraction 62.8%; serum potassium level 4.1 mEq/L; and mean eGFRcreat 71.3 mL/min/1.73m2. Mean change from baseline at EOT was -11.5/-4.7 mmHg in the morning home BP, and mean change and % change in LVMI were -9.9 g/m2 and-8.5%, respectively (p < 0.001 each). Detailed effectiveness and safety results will be presented.

Conclusions:
ESES-LVH study will provide the first clinical evidence of not only the antihypertensive and LVH-regressive effects of esaxerenone, but also its safety in Japanese hypertensive patients with cardiac hypertrophy.
PS-P16-4: VALIDATION OF CHO ET AL FORMULA FOR APOLIPOPROTEIN B100 CALCULATION; A POTENTIAL ATHEROSCLEROTIC RISK TOOL IN LIMITED RESOURCES SETTINGS
Authors: Amusat Saheed Oladele 
Published: January 2023

Objectives:
Increased atherogenic lipid molecules such as low-density lipoprotein cholesterol (LDL) concentration is associated with increased risk of atherosclerotic, but a substantial risk of cardiovascular disease often remains after LDL and other lipid parameters concentrations have been extensively treated to healthy level. Owning to the lack of assay procedure in the current research geographical area, this study aims to determine the sensitivity and specificity of Apolipoprotein B100 derived from Cho's formula in conjunction with existing routine lipid profile parameters.

Method:
The lipid profile parameters (TC, LDLC, HDLC, Apo B100, TG and non-HDL-C) in the fasting samples of 301 adult patients in the Chemical Pathology Laboratories of the Federal Medical Centre; Birnin Kudu Jigawa State, and Birnin Kebbi, Kebbi State Nigeria. The Apo B100 was calculated using Cho equation (Cho et al., 2012). Receiver Operating Curve (ROC) was employed to determine the sensitivity and reliability of lipid parameters in the assessment of atherosclerotic risk.

Cho^’ s Equation:
ApoB100 = -33.12 + 0.675*LDLc + 11.95*ln(Trig)

Results:
From the table 1, the areas under the curves represent the probability that the lipid assay for a randomly chosen atherosclerotic risk case (sensitivity) will exceed the result for a randomly chosen no risk case (specificity). The asymptotic significance for HDL-C, TC, LDL-C Apo B100 and non-HDL-C were less than 0.05, and AUC greater than 0.7. Furthermore, LDL-C, Apo B100, non-HDL-C, and TC have AUC of 1.00, 0.990, 0.976, and 0.885 respectively. In addition to their high AUC, the specificity of TC, HDL-C, LDL-C Apo B100 and non-HDL-C for ASCVD risk were 74.4, 37.2, 100.0, 94.8 and 88.4 percent respectfully, whereas TG has no significant influence (AUC) on risk of ASCVD. It is worthy to mention that the AUC of HDL-C was statistically significant, but lower than 0.70 (0.429). The serum TC, LDL-C, Apo B100, and non-HDL-C level of greater than 172.1mmg/dl, 106.3 mg/dl, 95.6 mg/dl, and 135.3 mg/dl respectively were associated with a high risk of atherosclerotic as indicated by their specificities and sensitivities.

Conclusion:
It can be concluded that using the TC, LDL-C, Apo B100 and non-HDL-C for atherosclerotic risk estimation guaranteed significant reliability. It can be concluded that Apo B100 derived using Cho formula showed a high sensitivity and specificity in predicting atherosclerotic risk at a serum level of approximately 96 mg/dl. Therefore, Apo B100 derived from Cho formula may be a useful tool in the management of atherosclerotic cardiovascular disease in limited resources settings.
PS-R06-3: A CASE OF CEREBRAL INFARCTION IN AN ELDERLY HYPERTENSIVE PATIENT WITH 24-HOUR STRICT BLOOD PRESSURE CONTROL
Authors: Nishizawa Masafumi , Hoshide Satoshi , Kario Kazuomi 
Published: January 2023

Introduction:
In elderly patients, hypertension is a major risk factor of stroke. Therefore, strict blood pressure (BP) control provides most effective for the prevention of stroke incidence. Here, we report the case of stroke occurred under strict BP control in an elderly patient.

Case:
A 80-year-old Japanese women with the treatment of hypertension and dyslipidemia was admitted to our hospital with suddenly vertigo. Before admission, her BP control was controlled, which her ambulatory BP monitoring performed three months prior to admission showed that 24-hour, daytime and nighttime BP were 107/61 mmHg, 112/64 mmHg and 94/53 mmHg, respectively, and diurnal BP variation showed dipper pattern. On admission, her electrocardiography showed sinus rhythm, and her head magnetic resonance imaging showed the bilateral cerebellum infarction, which is the area dominated by posterior inferior cerebellar artery. The D-dimer level was 1.2 μg/ml. Transesophageal echocardiography was performed to search for an embolic source of stroke and revealed a patent foramen ovale (PFO). Leg vein echocardiography showed the thrombus in the bilateral soleus veins. Based on the above results, we diagnosed a paradoxical cerebral embolism caused by deep vein thrombosis of the lower extremities and PFO.

Conclusion:
The patient had achieved strict BP control assessed by ABPM prior to the onset of the stroke and was considered to be at low risk of stroke. Paradoxical cerebral embolism is a common cause of stroke in younger patients, however, physicians should be also noted as a cause of cerebral infarction even in the elderly patients.