bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventive role of angiotensin receptor blockers on the recurrent AF in hypertensive patients
Authors: Hazarapetyan LG , Grigoryan SV , Zelveian PA , Stepanyan AA 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The structural remodeling makes important contributions to the AF substrate. The formation of connective tissue in response to injury (cardiac fibrosis) is a hallmark of arrhythmogenic structural remodeling. The atrial fibrosis decrease can be helpful in preventing the onset and recurrence of AF. Inflammatory mechanisms may form a basis for new agents more likely to prevent recurrent episodes of AF. The renin-angiotensin-aldosterone system plays an important role in the pathogenesis of AF in correlation with the inflammatory process. The aim of this study is to access the role of long-term treatment by sartans on the regression of left heart remodeling and the frequency of AF recurrence after successful cardioversion in hypertensive patients.

Methods
We have follow up 119 hypertensive patients with paroxysmal / persistent AF after successful cardioversion during 10-12 months. All patients divided into two groups: group A (62 patients) treated by Losartan daily dose 50 -100 mg or Valsartan daily dose 160mg for 10-12 months. As a control group B of similar 57 patients received standard antihypertensive therapy, but without taking sartans. Both groups were received supporting antiarrhythmic therapy with Аmiodarone (200-300 mg daily). The patients underwent clinical examination, echocardiography, ECG Holter monitoring and determination of plasma levels of inflammatory and fibrosis markers - high sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6) and profibrotic cytokine - transforming growth factor beta (TGF-β1) by ELIZA. Statistical analysis was performed by SPSS-16.

Results
The obtained results have shown that it was no significant differences of the antihypertensive effect in both patients groups. But the obtained data of structural remodeling regression in A and B groups were differed significantly. Thus, in the A group decrease in LVTDV, TMZHP and LVEDD and an improvement in left ventricular diastolic function were revealed, on compared to the B group which showed only a tendency to improve these indicators. Moreover, in group A, there was a significant decrease in the concentration of inflammation and fibrosis markers compared with the control group. We obtained a positive correlation between hsCRP and LAD (r=0.58, p&lt;0.001) and LVEDD (r=0.51, p&lt;0.001), between TGF-β1 and LAD (r=0.55, p&lt;0.001), LVEDD (r=0.59, p&lt;0.001) and number of AF episodes (r=0.489, p&lt;0.001.). The negative correlation was found between hsCRP and TGF-β1 (r=-0.36, p&lt;0.01). It was revealed that in a group recurrence of AF was less than in B group (6.8% vs 10%).

Conclusion
These results confirmed that the use of angiotensin receptor blockers improves some cardiac remodeling parameters, decreases the frequency of AF recurrence in hypertensive patients with successful cardioversion and contributes to prevent AF episodes.
Omecamtiv mecarbil in heart failure with reduced ejection fraction: systematic review and meta-analysis
Authors: Shalaby M , Sayed A , Awad AK , Moustafa K , Okasha O , Hariri E , Abdelfattah OM 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Heart failure (HF) is a growing public health challenge worldwide, with high rates of mortality and morbidity. Omecamtiv Mecarbil (OM) is a cardiac myosin activator and the first of a novel class of myotropes, agents that directly improve myocardial function by selectively improving cardiac sarcomere function. Data on its effect on cardiovascular outcomes remains scarce.

Objectives
To evaluate the safety and efficacy of Omecamtiv Mecarbil in Heart Failure with Reduced Ejection Fraction (HFrEF) and its effect on mid-term clinical outcomes.

Methods
We systematically searched MEDLINE/Pubmed, CENTRAL, clinicaltrials.gov, and the International Clinical Trials Registry Platform for randomized clinical trials (RCTs) evaluating OM safety and efficacy in HFrEF. Outcomes of interest included all-cause mortality, cerebrovascular events, hospitalization, myocardial infarction (MI), anginal events, atrial fibrillation (AF) or flutter, and hypotension. Data screening and extraction was performed by two independent reviewers. We used a random-effects model using the Dersimonian-Laird and Mantel-Haenszel methods to calculate the risk ratio (RR) with 95% confidence intervals.

Results
A total of 232 records were identified, of which six RCTs (N = 9,547; Omecamtiv: 4,889; Placebo: 4,658) met inclusion criteria. The average age was 64.4 years (standard deviation (SD): 0.82), and 79.0% (N = 7,538) were males. The weighted follow-up duration was 19.4 months. OM was associated with a significant reduction in the incidence of cerebrovascular events (RR: 0.68; 95% CI: 0.51 to 0.91). Moreover, OM was associated with a significant increase in the risk of hypotension (RR: 1.45; 95% CI: 1.03 to 2.02), compared to placebo when utilized as an adjuvant therapy to HF guideline-directed medical therapy (GDMT). No statistically significant difference was noted with all-cause mortality (RR: 1.00; 95% CI: 0.93 to 1.07), hospitalization (RR: 0.96; 95% CI: 0.90 to 1.03), incidence of atrial fibrillation or flutter (RR: 0.79; 95% CI: 0.61 to 1.02), anginal events (RR: 1.32; 95% CI: 0.92 to 1.88) or myocardial infarction (RR: 1.07; 95% CI: 0.84 to 1.36). Heterogeneity was low (I2 = 0%) in all analyses.
Relationship between the spread of coronavirus disease 2019, social frailty and depressive symptoms in patients with heart failure
Authors: Shakuta S , Yamashita M , Kamiya K , Hamazaki N , Nozaki K , Uchida S , Noda T , Ueno K , Maekawa E , Yamaoka-Tojo M , Matsunaga A , Ako J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Japan Society for the Promotion of Science (JSPS) KAKENHI

Background
Owing to the spread of coronavirus disease 2019 (COVID-19), people have refrained from going out unnecessarily and have been maintaining social distance. These new lifestyle approaches have affected people physically, psychologically, and socially. Patients with heart failure (HF) are more likely to have social frailty, physical frailty, cognitive impairment, and depressive symptoms, and an overlap of these conditions leads to adverse events. Therefore, multi-domain assessment and understanding of the condition of patients with HF are important for disease management. The spread of COVID-19 is a predicted risk factor for these events, but its impact in patients with HF has not been investigated.

Purpose
We investigated whether the spread of COVID-19 is associated with the development of the multi-domain of frailty in patients with HF.

Methods
Patients who were independent in their daily activities before admission were included in the study. The presence of social frailty (Makizako’s five items), physical frailty (Fried phenotype model), cognitive impairment (Mini-Cog), and depressive symptoms (the Patient Health Questionnaire-2) in patients with HF were assessed at hospital discharge. Logistic regression analyses were used to examine the impact of the spread of COVID-19 on the development of the multi-domain of frailty in patients with HF.

Results
We included 482 patients in this study. Median patient age was 74 years, and 64.5% were male. In multivariate logistic regression analyses, the spread of COVID-19 was significantly associated with the development of social frailty (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.02–1.30) and depressive symptoms (OR: 1.14, 95% CI: 1.02–1.27) but not with the development of physical frailty (OR: 1.24, 95% CI: 0.51–3.02) and cognitive impairment (OR: 1.72, 95% CI: 0.80–3.73).

Conclusion
The spread of COVID-19 was associated with the development of social frailty and depressive symptoms in patients with HF. Evaluation of social frailty and depressive symptoms during hospitalization would support disease management and understand their social and psychological conditions specific to the spread of COVID-19.
Temporal trends over 20 years of smoking prevalence in patients with acute myocardial infarction. Data from the RICO survey
Authors: Chague F , Bichat F , Saint Jalmes M , Maza M , Cottin Y , Zeller M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): ARS Bourgogne Franche Comté

Background
Over the last 2 decades, tobacco smoking, a major cardiovascular (CV) risk factor, has decreased in France, but remains among the highest in European countries.

Aim
From a large database of patients with acute myocardial infarction (MI), we aimed to investigate the evolution of smoker’s prevalence and characteristics over a 20-y period.

Methods
From the RICO survey, 18,769 patients hospitalized from 2001 to 2020 for an acute MI in one region of France were included. Current smokers were compared with ex-smokers or non-smokers and according to gender.

Results
Temporal trends showed that smoking rate did not decrease in men and dramatically increased in women by 50% (figure). Rate of smoking was higher in men than in women (34% vs 18%, p&lt;0.001). Median age increased across the year groups whatever the smoking status. When compared with ex or non-smokers, smokers were much younger (54 vs 71 y for men and 56 vs 79 y for women, p&lt;0.001), had more frequent family history of CAD but less modifiable risk factors such as diabetes and hypertension. ST-segment elevation MI was more common in smokers, for both sex. Although in-hospital adjusted mortality was similar for both groups, smokers had more common ventricular arrhythmias (VF/VT).

Conclusions
Over the last 2 decades, tobacco use remains common in patients with acute MI and is associated with a younger age of occurrence and severe acute complications. Our findings also reveal an alarming increasing prevalence of smoking in women. More effective prevention strategies are necessary to reduce tobacco use, in particular in women.
Does pre-diabetes predict the extent of coronary artery disease?
Authors: Soman B , Cheong MLH , Makuloluwa K , Salem A , Agarwal M , Chattopadhyay S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Extensive coronary artery disease (CAD) is common in diabetes mellitus. This relation between the extent of CAD and prediabetes (pDM)is less well established.

Purpose
To explore whether non-diabetic hyperglycaemia, assessed by HbA1c, is associated with extent of angiographic CAD, independent of traditional cardiovascular risk factors.

Methods
Retrospective cohort analysis of consecutive patients, without known DM undergoing coronary angiography for stable angina, who were screened for hyperglycaemia over 18 months. HbA1c was measured; pre-diabetes was defined as HbA1c 5.7-6.4%.Extent of CAD was assessed using the SYNTAX score. Presence of CAD was defined as visually estimated ≥50% luminal obstruction in arteries ≥1.5 mm diameter. Age, BMI, risk factors for CAD, HbA1c, total and LDL-cholesterol were recorded. The pre-diabetes and normal groups were compared using Mann-Whitney test for continuous variables and chi-squared test for categorical variables. Multiple logistic and linear regressions were used to assess the effect variables on SYNTAX score. Spearman rank correlation was used to assess the relation between HbA1c and SYNTAX score.

Results
1071 patients had angiograms done. 207 had DM, 19 had new diagnosis of DM and 181 missed the screening leaving 664 who had HbA1c measured. 51 poor quality angiograms were excluded from SYNTAX calculation. Data was analysed for 613 (306 normal, 307 pDM) patients. The patients with prediabetes were older, had higher prevalence of risk factors, BMI, fasting glucose and SYNTAX score. HbA1c (OR 2.07, 95% CI 1.32 to 3.25, p=0.002) and the presence of pDM (OR 1.89, 95% CI 1.32 to 2.69, p&lt;0.001) independently predicted the presence of CAD. HbA1c (Coefficient 2.42, SE 1.09, p=0.027) and the presence of pDM (Coefficient 2.25, SE 0.92, p=0.015) independently predicted the SYNTAX score. The correlation between HbA1c and SYNTAX score was weak but significant (Spearman's coefficient 0.206, 95% CI 0.129 to 0.281, p&lt;0.0001).

Conclusion
HbA1c predicts the extent of CAD as measured by SYNTAX score in patients without known diabetes. Presence of pre-diabetes is an independent predictor of extent of CAD.
Can we prevent the occurrence of stroke in patients admitted with non-ST-segment elevation myocardial infarction?
Authors: Paula S , Santos M , Santos H , Almeida I , Figueiredo M , Almeida S , Almeida L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardio-cerebral vascular diseases are a leading cause of deaths worldwide.
Stroke is a potential complication in high-risk patients who had non-ST-segment elevation myocardial infarction (NSTEMI).

Purpose
Identify high-risk patients with stroke and their prognosis in the setting of NSTEMI.

Methods
Based on a multicenter retrospective study, data collected from admissions between January 2013 and January 2020. Patients without data on previous cardiovascular history or uncompleted clinical data were excluded. Patients were divided in 2 groups (G): G1 – patients who suffered stroke; G2 - patients without stroke. Logistic regression and survival analysis were performed.

Results
7180 patients were admitted with NSTEMI, stroke occurred in 35 patients (0.49%). Regarding epidemiological and past history G1 was older (72±9 vs 66±12, p= 0.004), had more females (54.3% vs 45.75, p&lt;0.001), had higher rates of type 2 diabetes mellitus (51.3% vs 35.2%, p=0.05), previous strokes / transient ischemic attack (24.2% vs 7.0%, p=0.007) and dementia (3.3% vs 0.8%, p&lt;0.001). Arterial hypertension (77.1 vs 72.8%, p=0.56), dyslipidaemia (61.8% vs 63.0%, p=0.88) and smoking (17.6% vs 26.0%, p=0.27) were similar between groups. Patients who presented with chest pain (72.7% vs 92.0%, p&lt;0.001) and patients who were not revascularized were more likely to suffer a stroke (43.3% vs 17.5%, p&lt;0.001).
Logist regression only confirmed that females were more likely to have a stroke (p&lt;0.001, OR 4.13, CI 1.87-9.15) and patients who presented with chest pain (p=0.001, OR 0.23, CI 0.10-0.54). One year event-free survival was higher in patients who did not have stroke (95.3% vs 80.0%, p=0.005, OR 4.50, CI 1.43-14.15)

Conclusion
Since sex gender and form of presentation of NSTEMI are not modifiable factors we cannot prevent strokes from happening in the context of NSTEMI.
Secondary prevention of acute coronary syndrome by reducing depression and anxiety
Authors: Liblik K , Theberge E , Menon N , Gomes Z , Gobran J , Burbidge E , Johri AM 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Cardiovascular disease is expected to reach an annual mortality rate of 23 million individuals by 2030, primarily due to acute coronary syndrome (ACS) and cerebrovascular events. Simply stating the mortality associated with cardiovascular disease underrepresents its true burden considering the associated disability, healthcare expenditure, and loss of quality of life. Specifically, there has been increasing interest in the prevalence of depression and anxiety post-ACS as depressive and anxious symptoms are seen in up to 45% and 30% of patients, respectfully. These symptoms are associated with increased morbidity and mortality as well as decreased quality of life. Thus, it is crucial that secondary prevention be prioritized in this population with a specific focus on psychological wellbeing.

Purpose
The purpose of the present systematic review is to summarize the current literature on secondary prevention following ACS via interventions aimed at reducing depression and anxiety.

Methods
A systematic review was conducted of the databases PubMed, EMBASE, Web of Science, ClinicalTrials.gov, and Cochrane for studies which implemented an intervention to improve depression or anxiety in patients following ACS.

Results
The initial literature search identified 6,536 studies, of which 97 were added for inclusion with a total of 23,965 participants. Study design comprised 83 randomized control trials, two quasi-experimental studies, and 12 non-randomized experimental studies. The majority of interventions which significantly reduced symptoms of post-ACS anxiety involved modified cardiac rehabilitation programs (20%), aromatherapy (13%), and initiation of a new therapeutic (11%). Conversely, the majority of post-ACS interventions which significantly improved depressive symptoms involved therapy (24%), modified cardiac rehabilitation (24%), and initiation of a new therapeutic (20%). Notably, all aromatherapy (n=6), arts-based (n=3), exercise (n=7), meditation (n=3), and nature therapy (n=1) intervention studies extracted reported significant improvement in either depression or anxiety scores.

Conclusions
Depressive and anxious symptoms following ACS are associated with increased risk of death, rehospitalization, and poor quality of life. Programs which involve modified cardiac rehabilitation programs, aromatherapy, therapeutic agents, and therapy may increase secondary prevention of ACS by improving symptoms of depression and anxiety. Due to the heterogeneity of the programs identified, significant differences in sample size across studies, and the variety of depression/anxiety scales used, a large-scale randomized control trial comparing intervention efficacy is needed. Such a trial, as well as the present systematic review, may improve secondary prevention of ACS by identifying strategies to reduce depression and anxiety in this population.
Does allopurinol improve inflammatory biomarkers and post-revascularization coronary blood flow in Non-STEMI patients?
Authors: Kermani-Alghoraishi M , Heshmat-Ghahdarijani K , Sanei H , Sadeghi M , Asadi A , Safaei A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Isfahan University of Medical Sciences, isfahan, Iran.

Background
Medical evidence suggests inflammatory processes responsible for the incidence of cardiovascular events including acute coronary syndrome and increased oxidative stress have a substantial role in cardiac events pathogenesis and prognosis. In the recent studies, usage of allopurinol has shown promising outcomes in favor of reducing oxidative processes responsible for atherogenic-related cardiovascular events and ischemia-reperfusion injury.

Purpose
This study aims to assess the effects of allopurinol bolus on the inflammatory biomarkers and post-revascularization coronary blood flow according to Thrombolysis in Myocardial Infarction (TIMI) flow grading in patients with non-ST segment elevated myocardial infarction (NSTEMI).

Methods
In this randomized double blind clinical trial, Eighty NSTEMI patients were randomly divided into two groups, including the case group (n=40) medicated with a high loading dose of 600 mg allopurinol before the coronary angiography and angioplasty, while the control group (n=40) received the same shape medication as a placebo. The highly sensitive C-reactive protein (hs-CRP) was measured at baseline and within 24 hours after the cardiac interventions and compared between the case and control groups. Post percutaneous coronary intervention (PCI) TIMI flow grading was also evaluated as a revascularization outcome and coronary blood flow. The patients were also monitored for incidence of ischemic symptoms and occurrence of major adverse cardiac events (MACEs) as well as ventricular and supra-ventricular arrhythmia.

Results
The mean age of study population was 60.03 (10.02) and 62.78 (11.37) in case and control groups respectively (P-value=0.22). The two groups of the study were similar in terms of demographic, clinical, laboratory and angiographic characteristics (P-value&gt;0.05). TIMI flow grading assessments as the revascularization endpoint revealed insignificant difference between cases versus controls in both prior to (P-value=0.14) and after (P-value=0.39) the PCI.
Post-angiographic assessment of adjusted hs-CRP revealed an insignificant statistically difference between the cases and the controls (P-value=0.104). The incidence of ischemic symptoms, arrhythmia and MACEs were similar between the groups (P-value&gt;0.05).

Conclusion
Our findings showed that, premedication with high dose allopurinol bolus in NSTEMI patients did not affect on hs-CRP, as an inflammatory biomarker, as well as revascularization outcome (according to TIMI flow). Further long-term studies on more extended biomarkers are strongly recommended.
Cardiac biomarker release following myocardial infarction: role of exercise
Authors: De Koning IA , Van Bakel BMA , Rotbi H , Van Geuns RJM , Eijsvogels TMH , Thijssen DHJ 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ZonMw

Background
Regular exercise training is an important factor in the prevention of myocardial infarction (MI) and engagement in exercise training is associated with reduced mortality risks following MI. However, the relation between exercise engagement and the magnitude of cardiac biomarker release following MI have not been investigated yet.

Purpose
To explore the relation between exercise engagement and cardiac biomarker release following a MI. We hypothesized that exercise engagement is associated with lower peak concentrations of cardiac biomarker following MI compared to their non-exercising peers.

Methods
In this cohort study, we recruited hospitalised MI patients and retrospectively assessed the amount of exercise engagement in the seven days preceding MI onset. Exercise levels were evaluated using a validated questionnaire during a bedside interview. Patients were assigned to the exercise group if they performed any moderate-to-vigorous intensity exercise in the week prior MI and to the control group if they did not perform exercise. Maximum concentrations of cardiac troponin T (max-cTnT), in ng/mL, and creatine kinase (max-CK), in U/L, during hospital stay were extracted from digital health records. Both cardiac biomarker data were classified into 3 groups; 0-499 (small), 500-1499 (medium), and ≥1500 (large). The association of exercise engagement on post-MI cardiac biomarkers was analysed using the Mann-Witney U-test and the chi-square test.

Results
We included 200 MI patients (male: 64.5%, age 65.2 ± 10.4, 49% STEMI, 51% NSTEMI) of which 39 (19.5%) patients were allocated to the exercise group and 161 (80.5%) to the control group. No differences in time from symptom onset to coronary angiography (565 [136-2048] min versus 581 [135-2059] min, p=0.767) or incident hospital-based major adverse cardiac events (5.6% vs 5.1%, p=0.910) was found across groups. Albeit lower, those engaged in exercise do not significantly differ from controls in post-MI max-cTnT concentrations (788 [326-1344] ng/mL vs 1197 [340-3590] ng/mL, p=0.103) and max-CK concentrations (382 [211-744] U/L vs 564 [203-1374] U/L, p=0.147). The magnitude of max-cTnT was more often classified as ‘small’ in the exercise versus control group (x² (2) = 7.71, p=0.021), whilst a trend was found for max-CK levels (x² (2) = 4.97, p=0.083).

Conclusion
Engagement in exercise prior to MI may be associated with lower cardiac biomarker release. This could add novel insights into the potential protective effects of exercise engagement in the severity of MI.