bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does low glycemic index diet superior than routine diet to control blood inflammation state and lipid parameters in patients with coronary artery disease?
Authors: Alyavi A L , Alyavi B A , Uzokov J , Payziev D D , Orziev D Z , Mukhamedova M G , Majidov I H 
Published: October 2022

Abstract

Background and aims
Low glycemic index diet has been shown several benefits in terms of reduction in atherosclerotic biomarkers in patients with coronary artery disease (CAD).

Objective of the study
To demonstrate superiority of the low glycemic index diet in patients with CAD in terms of blood inflammation state and lipid parameters.

Methods
One hundred and sixty patients aged 38–76 years established with CAD entered as 12 week dietary intervention either with low glycemic index (n=80) or routine diet (n=80) together with standard therapy from 2016 to 2019 (male=48%; 58.2±12.0 years). Laboratory (including hs-CRP, pro-inflammatory interleukins, IL-1β, IL-6, TNF-α, lipid parameters TC, TG, LDL-Cholesterol, HDL-Cholesterol) and instrumental data were obtained at baseline and in 12 weeks of the intervention.

Results
There were no statistically differences in biochemical data between two groups at their baseline characteristics. Low glycemic index diet positively influenced on hs-CRP (from 252.4±40.6 mg/dL to 161.9±28.5 mg/dL vs. from 237.8±35.6 mg/dL to 202.4±23.8 mg/dL; P&lt;0.05), HbA1c (from 6.95±1.95% to 4.78±1.18% vs. 6.80±1.65% to 6.25±1.45%; P&lt;0.05), TG (from 5.2±2.2 to 3.1±1.8 vs. from 5.8±2.8 to 4.9±2.0, P&lt;0.05), TNF-α (from 1.48±0.91 to 0.88±0.19 vs. from 1.55±1.35 to 1.12±0.35, P&lt;0.05), IL-6 (from 8.2 pg/mL to 4.9 pg/mL vs. from 8.2 pg/mL to 4.9 pg/mL, P&lt;0.005) than routine diet. Although reduction in IL-1β were observed in both groups (from 32.5±17.2 pg/ml to 28.9±16.8 pg/ml, P&gt;0.05; vs. 33.6±21.6 pg/ml to 29.8±20.4, P&gt;0.05;), however there were no statistically significant from baseline and between groups (P&gt;0.05).

Conclusions
Low glycemic index diet demonstrated superiority to routine diet to improve inflammatory state and lipid parameters in patients with CAD.

Funding Acknowledgement
Type of funding sources: None.
Prognostic impact of suboptimal adherence to statin therapy after STEMI: results from the FAST-STEMI registry
Authors: Annone U , Giammaria M , D'Ascenzo F , Gallone G , Gaido L , Della Valle A , Del Nevo F , Guagliumi G 
Published: October 2022

Abstract

Introduction
Patterns and prognostic impact of suboptimal adherence to statin therapy, after STEMI, remains understudied

Purpose
To identify predictors and to estimate the prognostic impact of low statin adherence after STEMI

Method
We evaluated real-world purchase of statins and typical cardiovascular drugs, after STEMI, in a large regional database that enrolled patients from 2012 to 2017; adherence was defined as the ratio of bought tablets divided by the number of expected tablets in the follow-up period. Cox regression was used for multivariate analysis; Kaplan Meier and Cox proportional hazard models were performed to evaluate cumulative event rates of all-cause mortality at follow-up

Results
A total of 4062 patients were enrolled, of which 12.6% died after a median of 4.7 years of follow up (IQR 3.7–5.7). Statin adherence lower than 80%, identified as the best cutoff at Youden's analysis, was identified in 42% of the registry population; statin adherent patients were more likely younger, with known dyslipidemia at enrollment, discharged with ACE inhibitors and a potent P2Y12 inhibitor (ticagrelor or prasugrel), and with a statin diverse from atorvastatin. After multivariate adjustment for in-study outcome predictors, low statin adherence was independently associated with all cause mortality (HR 0.57; 95% CI 0.46–0.70; p&lt;0.001), along with older age, not known dyslipidemia at enrollment and clopidogrel at discharge after STEMI

Conclusions
In the contemporary real-world setting, statin adherence following STEMI remains poor, especially in high risk patients, and is still a crucial independent predictor of all-cause mortality. Effective strategies to improve statint adherence remain an unmet clinical need.

Funding Acknowledgement
Type of funding sources: None.
Jena auf Ziel: get all patients with ST-elevation myocardial infarction on EAS/ESC-LDL-C targets
Authors: Makhmudova U , Samadifar B , Maloku A , Haxhikadrija P , Otto S , Schulze P C , Weingaertner O 
Published: October 2022

Abstract

Background and aims
Low-density lipoprotein cholesterol (LDL-C) reduction is an essential part of the 2019 ESC/EAS dyslipidemia guidelines [1]. Only 18% of patients achieve 2019 ESC/EAS LDL-C target goal in secondary prevention [2]. “Jena auf Ziel – JaZ” (“Jena on target”) is a prospective study that aims at LDL-C target attainment in all patients with ST-elevation myocardial infarction (STEMI) and determination of reasons for failed target attainment.

Methods
All STEMI patients were started on atorvastatin 80 mg/ezetimibe 10 mg on admission. LDL-C levels were monitored during the hospital stay and a 12 months follow-up period. Patients were educated about cardiovascular risk factor optimization. Individual patient cards to document LDL-C levels over time were used to enforce LDL-C target attainment.

Results
In the first 50 consecutive patients, LDL-C levels were 3.39±1.23 mmol/L on admission, 1.84±0.86 mmol/L on discharge and 1.30±0.65 mmol/L during the first follow-up visit (6–8 weeks). On atorvastatin 80 mg/ezetimibe 10 mg 14 out of 50 patients (28%) reached the LDL-C goal on discharge, 36 out of 50 patients (72%) after 6–8 weeks. After addition of bempedoic acid or PCSK9-inhibitors all patients which were followed up in our lipid clinic reach the EAS/ESC-LDL-C target. Only two patients reported myalgias of which one patient refused to continue with lipid-lowering drugs. One patient had elevated liver enzymes, which resolved after switching to a lower statin dose.

Conclusions
One out three STEMI patients reached the EAS/ESC-LDL-C target during the initial hospital stay on atorvastatin 80 mg/ezetimibe 10 mg. Adding bempedoic acid or PCSK9 inhibitors resulted in LDL-C target attainment of all patients during follow-up. EAS/ESC-LDL-C target attainment is feasible and well-tolerated in empowered, well-educated patients.

Funding Acknowledgement
Type of funding sources: None.
The effect of trehalose administration on miRNA-10a expression in patients with history of myocardial infarction (MI) and systemic inflammation
Authors: Ganjali S , Jamialahmadi T , Banach M , Sahebkar A 
Published: October 2022

Abstract

Background
MicroRNAs (miRNAs) are small non-coding RNAs involved in the regulation of endothelial function, inflammatory cells, and cholesterol homeostasis, may cause the onset of vascular inflammation which plays an important role in the development of cardiovascular disease. Trehalose is a nonreducing disaccharide which anti-inflammatory properties have been indicated in different experimental models.

Purpose
This study aimed to evaluate the effectiveness of intravenous (IV) trehalose administration on the circulating level of miRNA-10a as a biomarker of coronary inflammation in patients with history of myocardial infarction (MI) and elevated C-reactive protein (CRP).

Methods
This was a randomized, double-blind trial comprised 15 men (aged 18–80) with history of MI and evidence of systemic inflammation. The patients were randomly allocated to 2:1 ratio and respectively underwent the injection of either IV trehalose (15 g/week) or placebo for 12 weeks. At baseline and at the end of study, the serum level of miRNA-10a was measured by SYBR Green qPCR, quantified by the comparative method, and normalized to U6 expression. Relative expression software tool (REST) was used to analyze the miRNA-10a fold change (FC) expression level.

Results
At the baseline, patients in trehalose group showed slightly lower level of miRNA-10a relative to the placebo group (FC: 0.272, P=0.052), while it was not statistically significant. Within-group analysis showed that miRNA-10a had a significantly lower level in placebo group at the end of the study in comparison with the baseline (FC; 0.19, P=0.029). Albeit, miRNA-10a level increased after trehalose administration in relation to the baseline, while it was not statistically significant (FC: 1.963, P=0.114), Moreover, these changes in miRNA-10a levels were statistically significant in trehalose group related to the placebo group (P=0.047).

Conclusions
Together these findings demonstrate that trehalose administration could effectively increase the circulating level of miRNA-10a and may contribute to the regulation of coronary inflammation in patients with a history of MI and elevated CRP levels. This anti-inflammatory effect of trehalose can be confirmed in the large-scale studies or by evaluating other miRNAs related to the vascular inflammatory processes.

Funding Acknowledgement
Type of funding sources: None.
Differences in aerobic capacity evolution and cardiovascular risk factors between diabetic and non-diabetic patients at different stages of a cardiac rehabilitation
Authors: Uribe Heredia N G , Balaguer Recena J , Piccone Saponara L G , Benitez Peyrat J , Solorzano Guillen C , Jimenez Martinez M E , Toran Martinez C , Castillo Sandoval A , Perez Sanchez A , Casas Sanchez B , Novo Garcia E 
Published: October 2022

Abstract

Introduction
Type 2 diabetes mellitus (DM) is an important factor that is associated with increased cardiovascular morbidity, producing disorders in different devices and systems whose mechanisms are not entirely known. This study was conducted in order to understand the evolution of aerobic capacity and the different cardiovascular risk factors (CVRF) in diabetic patients compared to non-diabetic patients.

Methodology
Prospective observational study. A total of 301 patients were included consecutively in a conventional cardiac rehabilitation program from January 2017 to March 2020, after one month of having had acute coronary syndrome, phase II of which lasted 2 months, who had an analysis, ergometry with spire gas analysis, and anthropometric characteristics were included. Those who had signs of ischemia in ergometry were excluded from the study. The tests were conducted as recommended by the ATS/ACCP.

Results
301 patients were included, with an average age of 57.6±9.1 years, diabetics 92 (30,6%), LVEF average 56.9±9.6%, women 13.6%. Among the basal characteristics, diabetic patients had the highest prevalence of dyslipemia (89.1% vs 68.4% p s &lt;0.001), HTA (62% vs 47.8% p x 0.03) and lower FEVI (55.1±10.26 vs 57.8±8.9 p-0.03), in addition to lower peak oxygen consumption (VO2 ml/kg/min) (18.8±5.0 vs 22.9±6.3 p-&lt;0.001); DM being an independent predictor to obtain a lower VO2 with an OR 1.25 [IC (95%) 1.31–1.19 p&lt;0.001] (Table 1). At the end of Phase II, both groups gained better control of CVRF (Table 2) including an improvement in VO2; but in the DM group the gain rate was significantly lower (0.08±0.14 Vs 0.13±0.17 p=0.02). In phase III (average follow-up 7.3 months) the benefits in the control of CVRF (Table 2) were maintained in both groups with the highest rate of increase in VO2 in patients with DM (0.07±0.2 Vs 0.02±0.13 p=0.05) (Image 1).

Conclusions
In our study, patients with DM undergoing an RHC program achieve better control of FRCV and aerobic capacity in a similar way to non-diabetic patients, which is maintained at 7 months of follow-up in phase III, although initially the aerobic capacity gain in diabetics is slower, achieve a higher increase in VO2 in Phase III.

Funding Acknowledgement
Type of funding sources: None.
The impact of statin on post-operative atrial fibrillation after discharge from cardiac surgery: secondary analysis of the SEARCH-AF CardioLink-1 randomized trial
Authors: Hibibo M , Verma S , Pandey A , Quan A , Verma A , Bisleri G , Ha A , Mazer C D 
Published: October 2022

Abstract

Background
There is conflicting evidence regarding the use of statins to reduce the risk of post-operative atrial fibrillation (POAF) in patients undergoing cardiac surgery.

Purpose
We sought to determine the effects of statin use on the burden of new-onset post-discharge POAF in the Post-Surgical Enhanced Monitoring for Cardiac Arrhythmias and Atrial Fibrillation (SEARCH-AF) CardioLink-1 randomized controlled trial.

Methods
In the SEARCH-AF trial, 336 patients with risk factors for stroke (CHA2DS2-VASc score ≥2) and no history of preoperative AF were randomized to usual care or continuous cardiac rhythm monitoring for 30 days after discharge from cardiac surgery with a wearable, patched-based device. The primary endpoint was the occurrence of cumulative atrial fibrillation/flutter (AF/AFL) lasting for ≥6 minutes detected by continuous monitoring or AF/AFL documented by a 12-lead electrocardiogram within 30 days of randomization. Using time-to-event analysis and Cox regression, we evaluated the association between the risk of post-operative AF in relation to statin use and dosing intensity (low, moderate, high) at the time of discharge. We excluded patients who experienced post-operative AF during hospitalization in this analysis.

Results
In the overall cohort (n=336), 260 (77.4%) patients were treated with statins at the time of hospital discharge. There were 18 (5.4%) patients who experienced post-operative AF during hospitalization. Patients prescribed with statins were more likely to be male (p=0.018), had lower CHA2DS2-VASc scores (p=0.011), and were more likely to undergo isolated coronary artery bypass grafting (CABG) (p=0.083). Baseline characteristics were otherwise similar between the 2 groups. Patients treated with statins at discharge had a 2-fold lower rate of post-operative AF than those who were not treated with statins in the overall cohort (17.6% vs. 8.2%, Log-Rank p=0.017) and among those who were randomized to continuous cardiac rhythm monitoring (31.6% vs. 16.0%, Log-Rank p=0.027) (Figure). After adjusting for surgery type (CABG vs. valve surgery) and the CHA2DS2-VASc score, statin use at discharge was associated with a lower risk of post-operative AF within 30 days after surgery (hazard ratio 0.48, 95% CI 0.24–0.97). Furthermore, increasing intensity of statin therapy was associated with lower risk of POAF (ptrend=0.0012) (Figure 1)

Conclusion
Among cardiac surgery patients with risk factors for stroke and no history of pre-operative AF, the use of statins was associated with a reduction in post-operative AF risk within 30 days of discharge. The routine use of high-intensity statin to prevent post-operative AF after cardiac surgery deserves further study.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Heart and Stroke Foundation of Canada
The effect of achieving LDL-C &lt;1.8 mmol/L to prevent the first atherosclerotic cardiovascular events in the primary prevention settings of severe heterozygous familial hypercholesterolemia
Authors: Funabashi S , Kataoka Y , Hori M , Ogura M , Doi T , Noguchi T , Shiba M 
Published: October 2022

Abstract

Introduction
The International Atherosclerosis Society (IAS) has proposed “severe familial hypercholesterolemia” (FH) as a phenotype with the highest cardiovascular risk. LDL-C &lt;2.5 mmol/l is a recommended therapeutic goal for the primary prevention settings of severe FH. However, given that ESC guidelines recommends LDL-C &lt;1.8 mmol/l in FH patients, this stricter goal may be better to prevent the first atherosclerotic cardiovascular disease (ASCVD) in severe FH patients.

Purpose
To determine whether achieving LDL-C&lt;1.8 mg/dl is more beneficial to reduce the first ASCVD events.

Methods
A total of 148 severe FH subjects without any history of ASCVD were analyzed. Severe FH was defined as untreated LDL-C &gt;10.3 mmol/l, LDL-C &gt;8.0 mmol/l+ 1 high-risk feature, LDL-C &gt;4.9 mmol/l + 2 high-risk features according to IAS proposed statement. The occurrence of ASCVD (all-cause death, CAD, ischemic stroke and lower extremity artery disease (LEAD)) were compared in those with on-treatment LDL-C &lt; and ≥1.8 mmol/L.

Results
10.1% (=15/148) of study subjects achieved on-treatment LDL-C &lt;1.8 mmol/l. They were more likely to receive PCSK9 inhibitor (15.0 vs. 66.7%, p&lt;0.01), whereas there was no significant difference in FH-related physical characteristics (tendon xanthomas: 72.2 vs. 93.3%, p=0.12) and causative genotypes (LDLR: 68.4 vs. 66.7%, p=1.00, PCSK9: 8.3 vs. 6.7%, p=1.00, LDLR/PCSK9: 3.8 vs. 6.7%, p=0.48), untreated LDL-C (7.3±1.7 vs. 7.9±1.8 mmol/l, p=0.22) and lipoprotein(a) (23 [11–42] vs. 25 [15–70] mg/dl, p=0.41) levels between two groups. During the observational period (median=7.0 years), severe FH achieving on-treatment LDL-C &lt;1.8 mmol/l was associated with a lower likelihood of experiencing ASCVD events (Figure 1). Of note, any cardiovascular events did not occur in severe FH who achieved on-treatment LDL-C &lt;1.8 mmol/l. In those with on-treatment LDL ≥1.8 mmol/L, CAD (76.5%=26/34) was more dominant component of ASCVD, followed by ischemic stroke (17.6%=6/34) and LEAD (5.9%=2/34).

Conclusions
A significantly lower frequency of ASCVD was observed in severe FH who achieved LDL-C &lt;1.8 mmol/L in the primary prevention settings. Given that only 10.1% of severe FH patients achieved LDL-C &lt;1.8 mmol/l, more actions are required to motivate physicians for further intensified management of LDL-C in severe FH patients in the primary prevention settings.

Funding Acknowledgement
Type of funding sources: None.
Effectiveness of roux-en-Y gastric bypass vs sleeve gastrectomy on lipid levels in type 2 diabetes: a meta-analysis
Authors: Lobo L M , Nogueira J P , Clos C , Masson W , Molinero G , Lavalle Cobo A , Benincasa F , Delgado J , Losada P , Valero R 
Published: October 2022

Abstract

Introduction
Obesity and its co-morbidities, including type 2 diabetes (T2DM) and dyslipidemia, are accompanied by excess cardiovascular morbi-mortality. Aside from excess low density lipoprotein-cholesterol (LDL-C), atherogenic dyslipidemia (AD), mainly characterized by elevated triglycerides and decreased high density lipoprotein-cholesterol (HDL-C) levels, is often present in T2DM obese patients. Bariatric surgery, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), has become a reference treatment in that population. However, the respective effects of RYGB vs SG on lipid metabolism in T2DM patients have been rarely studied.

Methods
A meta-analysis of randomized controlled trials, comparing the effects of RGYBG vs SG on lipid metabolism 12 months after surgery in T2DM patients, was performed.

Results
Four studies including a total of 298 patients (151 patients in the RYGB and 147 patients in the SG group) were examined. Despite a greater decrease in body mass index and greater improvement in glycaemic control in RYGB compared to SG. RYGB vs SG was more effective in reducing total cholesterol, LDL-C and non-HDL-C levels (mean difference [MD] −24.10 mg/dL, 95% CI −33.76 to −14.44, p&lt;0.00001; [MD] −23.24 mg/dL, 95% CI −34.84 to −11.63, p&lt;0.00001 and MD 31.70 mg/dL, 95% CI −46.00 to −17.40, p&lt;0.00001, respectively).

Conclusions
The superiority of RYGB vs SG in reducing LDL-C, with an effect comparable to a moderate-intensity statin, suggests RYBG should be favoured in hypercholesterolemic T2DM patients in order to further reduce cardiovascular risk.

Funding Acknowledgement
Type of funding sources: None.
Association of propionate with coronary artery disease in a large cross-sectional study
Authors: Pagonas N , Sasko B , Seibert F , Ritter O , Babel N , Westhoff T 
Published: October 2022

Abstract

Background
Microbiome has been linked to the pathogenesis of coronary artery disease (CAD) but data providing direct evidence for an association of short-chain fatty acids (SCFA) like propionate with CAD are lacking.

Purpose
To study the association of propionate in blood samples with the presence of CAD

Methods
This was a cross-sectional study enrolling patients admitted to invasive coronary angiography in a university hospital in Germany. Patients were prospectively recruited between from March 2017 to January 2020. Patients with known or suspected CAD and risk factors for cardiovascular diseases were screened for eligibility to participate in the trial. Main exclusion criteria were inflammatory/rheumatic disease, active cancer disease and acute infection. Blood sampling was performed after overnight fasting and before invasive procedures. Measurement of propionate was performed though liquid chromatography.

Results
The study included 691 patients (median n [IQR] age, 69 [60–78] years; 406 men [59%]). A total of 368 had invasively confirmed CAD with at least one coronary artery stenosis ≥50% and 323 had non CAD and 194 had invasively excluded CAD. 129 additional patients without suspicion for CAD and without diabetes/smoking were also recruited in the no CAD group. CAD patients had significant lower levels of propionate (median) 6.08 μM (IQR, 4.31–7.65) compared to the no CAD groups 6.92 μM (4.89–9.25, &lt;0.05). Linear regression multivariate analysis adjusted for age, gender, body mass index, hypertension, smoking, diabetes and hyperlipidemia revealed an odds ratio of 0.92 (CI 0.89–0,96, p&lt;0.001) for propionate as predictor of CAD.

Conclusions
The study provides large-scale data for a protective role of propionate in the development of CAD, independent of the presence of other known cardiovascular risk factors.

Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Internal Grant, Medical School of Brandenburg