bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabinoid and substance relationships of European congenital anomaly patterns: a space-time panel regression and causal inferential study
Authors: Reece Albert Stuart , Hulse Gary Kenneth 
Published: February 2022

AbstractWith reports from Australia, Canada, USA, Hawaii and Colorado documenting a link between cannabis and congenital anomalies (CAs), this relationship was investigated in Europe. Data on 90 CAs were accessed from Eurocat. Tobacco and alcohol consumption and median household income data were from the World Bank. Amphetamine, cocaine and last month and daily use of cannabis from the European Monitoring Centre for Drugs and Drug Addiction. Cannabis herb and resin Δ9-tetrahydrocannabinol concentrations were from published reports. Data were processed in R. Twelve thousand three hundred sixty CA rates were sourced across 16 nations of Europe. Nations with a higher or increasing rate of daily cannabis use had a 71.77% higher median CA rates than others [median ± interquartile range 2.13 (0.59, 6.30) v. 1.24 (0.15, 5.14)/10 000 live births (P = 4.74 × 10−17; minimum E-value (mEV) = 1.52]. Eighty-nine out of 90 CAs in bivariate association and 74/90 CAs in additive panel inverse probability weighted space-time regression were cannabis related. In inverse probability weighted interactive panel models lagged to zero, two, four and six years, 76, 31, 50 and 29 CAs had elevated mEVs (&lt; 2.46 × 1039) for cannabis metrics. Cardiovascular, central nervous, gastrointestinal, genital, uronephrology, limb, face and chromosomalgenetic systems along with the multisystem VACTERL syndrome were particularly vulnerable targets. Data reveal that cannabis is related to many CAs and fulfil epidemiological criteria of causality. The triple convergence of rising cannabis use prevalence, intensity of daily use and Δ9-tetrahydrocannabinol concentration in herb and resin is powerfully implicated as a primary driver of European teratogenicity, confirming results from elsewhere.
Echocardiography fails to detect an extensive aortic root abscess in a patient with infective endocarditis: a case report
Authors: Zogg Cheryl K , Avesta Arman , Bonde Pramod N , Mani Arya 
Published: February 2022

Abstract

Background
Echocardiography plays a central role in the diagnosis of infective endocarditis (IE). In recent years, additional imaging techniques have begun to challenge the conventional approach. We present a case where the use of transthoracic/transoesophageal echocardiography (TTE/TOE) in suspected IE failed to identify an extensive periannular abscess, later identified by 18F-flurodeoxyglucose–positron emission tomography (FDG–PET), requiring urgent intervention.

Case summary
A 69-year-old man with symptomatic Streptococcus sanguinis bacteraemia and a bicuspid aortic valve was found to have new-onset left bundle branch block that progressed to complete heart block. After starting on IV Penicillin G and having a temporary pacemaker inserted, his clinical condition improved. Transthoracic echocardiography and TOE showed no evidence of abscess. However, persistent first-degree atrioventricular block raised clinical suspicion of a possible extended infection. Subsequent FDG–PET revealed focal activity around the aortic root that extended inferiorly into the interatrial septum, consistent with active infection and possible abscess. Composite aortic root replacement with insertion of a mechanical prosthesis was carried out, revealing extensive IE and multiple periannular abscesses.

Discussion
As guidelines grapple with evolving understandings of how best to define the optimal imaging approach for the management of complicated IE, the results of this case clearly show the importance of heightened clinical suspicion and need for prompt operative intervention when faced with patients who present with predisposing conditions and concern for advanced conduction disease. Clinicians and researchers are encouraged to learn from the potential near-miss of an extensive periannular abscess to help guide guideline-development of imaging in complicated IE and prevent adverse outcomes in patients with similar presentations.
Intracoronary IgG4-related disease as an unusual cause of sudden cardiac arrest: a case series
Authors: Paratz Elizabeth D , Ross Laura , Zentner Dominica , Morgan Natalie , Bouwer Heinrich , Lynch Matthew , Parsons Sarah , La Gerche Andre 
Published: February 2022

Abstract

Background
IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition classically causing retroperitoneal fibrosis, aortitis, thyroiditis, or pancreatitis. Diagnosis includes the presence of lymphoplasmacytic infiltrate (with &gt;40% ratio IgG4+:IgG plasma cells) and fibrosis. Cardiac involvement may include aortic, pericardial, or coronary disease. Coronary manifestations encompass obstructive intra-luminal lesions, external encasing pseudo-tumour on imaging, or lymphoplasmacytic arteritis.

Case summary
Case 1: A fit and healthy 50-year-old man was found deceased. His only known medical condition was treated Hashimoto’s thyroiditis. Post-mortem examination demonstrated an isolated severe stenosis of the left anterior descending (LAD) coronary artery without histopathological evidence of acute myocardial infarction. Coronary plaque histopathology showed florid IgG4-positive plasma cell infiltrate throughout all layers of the artery with dense fibrous tissue connective tissue stroma, all features consistent with coronary artery IgG4-RD. Case 2: A 48-year-old man collapsed at work. Computed tomography scan 1 week prior reported an ill-defined para-aortic retroperitoneal soft tissue density. No cardiac symptoms were reported in life. Post-mortem examination showed coronary arteritis and peri-arteritis with sclerosing peri-aortitis in the LAD. There was myocardial fibrosis of the anterior left ventricle and focal myocarditis of the right ventricle.

Discussion
IgG4-related disease presenting as sudden cardiac death without any preceding symptoms is very rare (six prior cases identified on literature review). Reported targeted successful interventions for intracoronary IgG4-RD diagnosed in life have included steroid therapy and B cell depleting therapy (i.e. rituximab). If cardiac symptoms are present in a patient with known IgG4-RD, cardiac investigations should be promptly arranged.
The association between transthoracic echocardiographic parameters and severity of COVID-19 in hospitalised adults - a retrospective analysis
Authors: Agarwal R , Priyonugroho G , Hertine S , Wicaksono S H , Almazini P , Zamroni D , Muliawan H S 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with more than 220 million cases and 4.5 million deaths reported worldwide. Its clinical spectrum varies widely, and non-invasive prognostic markers are valuable as they can guide efficient resource allocation. Cardiovascular complications of COVID-19 include myocardial injury, acute heart failure, and arrhythmias. Both de novo cardiovascular complications and pre-existing cardiovascular co-morbidities are associated with a poor prognosis. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively.

Purpose
To investigate the association between TTE parameters and severity of disease in hospitalised adults with confirmed COVID-19

Methods
This single-centre retrospective analysis was conducted at a COVID-19 referral hospital in Indonesia. All consecutive adults hospitalised with confirmed COVID-19 who underwent TTE assessment between 3 April 2020 to 6 April 2021 were included. Comprehensive data including demographics, peak COVID-19 severity, pre-existing co-morbidities, and TTE findings were extracted from electronic medical records. Patients with mild-moderate and severe-critical disease were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%.

Results
A total of 488 patients were included in this study; 202 with mild-moderate disease and 286 with severe-critical disease. Frequency of old age (&gt;60 years), obesity, diabetes, chronic kidney disease, and congestive heart failure were higher in the severe-critical group (P &lt; 0.05). On TTE assessment, Patients with severe-critical disease had higher odds of left ventricular hypertrophy (LVH) (OR: 2.20; CI: 1.49 – 3.24), LV wall motion abnormality (OR: 3.33; CI: 1.68 – 6.60), diastolic dysfunction (OR: 1.46; CI: 1.02 – 2.11), valve abnormality (OR: 1.93; CI: 1.27 – 2.92), and right ventricular (RV) dysfunction (OR: 5.53; CI: 1.63 – 18.73). After matching for age, obesity, and diabetes, patients with severe-critical COVID-19 continued to have higher odds of LVH (OR: 1.91; CI: 1.21 – 3.02), LV wall motion abnormality (OR: 2.76; CI: 1.28 – 5.96), diastolic dysfunction (OR: 1.55; CI: 1.00 – 2.38), and RV dysfunction (OR: 3.86; CI: 1.06 – 14.08).

Conclusions
The presence of LVH, LV wall motion abnormality, diastolic dysfunction, and RV dysfunction on TTE assessment were associated with severe-critical disease in hospitalised adults with COVID-19. These findings must be validated in a larger prospective study. Abstract Figure. Odds Ratios for the Entire Cohort Abstract Figure. Odds Ratios for the Matched Cohort
OCT-guided left-main PCI, a retrospective single-center analysis
Authors: Jariwala P , Jadhav KARTIK , Jadhav KARTIK 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
It is known that PCI is associated with non-optimal stent implantation utilizing angiography for only left main lesions as well as for bifurcation lesions and is characterised by a high risk of adverse long-term effects. The use of OCT for the left main stent makes it easier to enhance the effective implantation of stents and enhance the results of patients.

Methods
A single-center randomised study was performed to demonstrate the benefit of stent implantation under OCT control in the left main bifurcation lesions compared to standard implantation under angiographic control. The follow-up period was 1 year, and the study included 68 patients with 1:1 randomization. The final composite points were: cardiac death, ischaemia, or myocardial infarction. All patients were elective, with moderate to high-functional class of angina pectoris. PCI was done using one or two stents, using OCT or without OCT to perform kissing dilation and proximal optimization technique.

Results
As a result of the data review of 68 patients with or without OCT using PCI of left main bifurcation lesions, the primary endpoint parameters in the non-OCT group were 17.8% and 6% for the OCT group. In 43.1 % of cases, a single-stent technique was used rather than a two-stent when using OCT. In the OCT group, additional stent optimisation is 40% more common. In 96.7 % of cases, a 9-month follow-up in the OCT group showed complete or partial endothelization of the stent struts, allowing earlier termination of DAPT, which is critical in patients at high risk for significant bleeding.

Conclusions
The perioperative results of PCI for left main bifurcation can be improved by the use of OCT using regulated factors for optimal stent implantation. As a result, in patients with atrial fibrillation and a high risk of painful bleeding, the long-term effects of treatment are increased , the time to take DAPT is decreased and the number of implantable stents is decreased, which is significant.
Incidence, clinical correlates and associated outcomes of dementia in heart failure: a population-based cohort study
Authors: Ren Q W , Teng T H K , Wang T , Tse Y K , Wong P F , Li H L , Yu S Y , Wu M Z , Li X L , Tse H F , Lam C S P , Yiu K H 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Dementia, in the setting of heart failure (HF), portends poorer outcomes and poses great challenges in its clinical management.

Purpose
We investigated the incidence, types, clinical correlates, and the prognostic impact of dementia in a population-based cohort of patients with HF. Further, we examined the interactions of age and sex, and education status with dementia incidence.

Methods
The previously validated Hong Kong Clinical Data Analysis Reporting System (CDARS), a territory-wide database was interrogated to identify patients with HF (N= 202,121) from 1995 to 2018. Associations of clinical correlates with incident dementia and its risk with all-cause mortality were assessed using competing risk/multivariable Cox regression models where appropriate.

Results
Among a total cohort aged ≥18 years with HF (mean age: 75.3 ± 13.0 years, 51.3% women), new-onset dementia occurred in 22,145 (11.0%) over a median follow-up of 5.5 years. Alzheimer’s disease occurred in 27.0%; vascular dementia (18.1%) and unspecified dementia (in 55.1%). Age-standardized rate of dementia incidence in women was 1297 (95%CI, 1276-1318) (vs. 744, 95%CI, 723-765) per 10000 population in men. Other independent predictors of dementia include: Increasing age (HR 1.08), Female sex (HR 1.19), Nil/&lt; primary (vs tertiary) education (HR 1.29), Parkinson’s disease (HR 1.73), head injury (HR 1.37), peripheral vascular disease (HR 1.31), stroke (HR 1.29), depression (HR 1.18), alcohol intake (HR1.17), anaemia (HR 1.14), hypertension (HR 1.08), among other common comorbidities in HF (Figure 1A).
Notably, a significant interaction (p &lt; 0.001) between age and sex on dementia incidence was observed, such that women in all age groups were observed to have higher sHR compared to men (Figure 1B). After accounting for competing risk, dementia was not associated with adjusted hazard of all-cause mortality.

Conclusions
Female sex, lower socioeconomic status, increasing age and common comorbidities were associated with higher hazards of incident dementia. Abstract Figure 1A and Figure 1B
Clinical value of the HATCH score for predicting adverse outcomes in patients with heart failure
Authors: Shibata N , Kondo T , Morimoto R , Kazama S , Sawamura A , Nishiyama I , Kato T , Hiraiwa H , Okumura T , Murohara T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The HATCH score is employed as a risk assessment tool for atrial fibrillation (AF) development. However, the impact of the HATCH score on the long-term adverse outcomes in patients with acute heart failure (AHF) is unknown.
Aimes
To investigate the clinical value of the HATCH score in AHF.

Methods
From a multicenter AHF registry, we retrospectively evaluated 1,543 consecutive patients admitted with AHF (median age, 78 [69–85] years; 42.3% women) from 2012 to 2019. These patients were divided into five groups based on their HATCH score at admission (scores 0, 1, 2, 3, and 4–7). The correlation between the HATCH score and composite outcome, including all-cause mortality and re-hospitalization due to HF, was analyzed using Kaplan-Meier and Cox proportional-hazard analyses.

Results
The median HATCH score was 2 [1-3]. During the follow-up period (median, 16.8 months), the composite endpoint occurred in 691 patients (44.8%), including 416 (27%) patients who died and 455 (29.5%) patients requiring re-hospitalizations due to HF. The Kaplan-Meier analysis showed a significant increase in the composite endpoint with increasing HATCH score (log-rank, p &lt; 0.001). The multivariate Cox regression model revealed that the HATCH score was an independent predictor of the composite endpoint (hazard ratio [HR] 1.181; 95% confidence interval [CI]: 1.111–1.255; p &lt; 0.001) with all-cause mortality (HR 1.153, 95% CI: 1.065–1.249; p &lt; 0.001) and re-hospitalizations due to HF (HR 1.21; 95% CI: 1.124–1.303; p &lt; 0.001) in patients with AHF.

Conclusions
The HATCH score is an independent predictor of adverse outcomes in patients with AHF. Abstract Figure. Kaplan-Meier analysis for outcome
Efficacy and safety of HDL/apoA-1 mimetics on human and mice with atherosclerosis: a systematic review and meta-analysis
Authors: Abudukeremu A , Li H , Sun R , Liu X , Wu X , Xie X , Huang J , Zhang J , Bao J , Zhang Y 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the National Natural Science Foundation of China

Background
Low high-density lipoprotein cholesterol (HDL-C) level as a residual risk factor of cardiovascular disease (CVD) is still causing concern, although using chemical drugs for raising HDL-C level failed. The effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerosis is controversial.

Aim
In this meta-analysis we analyzed the effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerotic lesion both in human and mice.

Methods
We systematically searched PubMed, Cochrane, Web of Science and EMBASE databases up to June 6, 2020 for eligible studies using wide search terms and included all the publications meet the including criteria. The methodological quality of the human studies was assessed using Review Manager (RevMan) software (version 5.3.). The methodological quality of the mice studies was assessed by using stair list. WMD(SMD) with 95% CI was used as a measure of the association between HDL/apoA-1 mimetics and plaque regression in human (in mice), after pooling data across trials in a random effect model. Sensitivity and subgroup analyses were used to explore sources of heterogeneity and the effect of potential confounders. STATA (version 14.0) was used to conduct all statistical analyses.

Results
We identified 15 randomized controlled trials in which 6 trails including 754 ACS (HDL/apoA-1 mimetics = 414, placebo = 340) patients used for efficacy analysis and all of 15 trails used for safety analysis and 17 controlled trials for animal study. The pooled results showed that the use of HDL/apoA-1 mimetics did not significant decreased the percent atheroma volume(p = 0.494) and total atheroma volume(p = 0.560) in patients with acute coronary syndrome (ACS). However, HDL/apoA-1 mimetics (or gene transfection) was significant associated with all of final percent lesion area, final lesion area and changes in lesion area (SMD, -1.75; 95% CI: -2.21∼-1.29, p = 0.000; SMD, -0.78; 95% CI: -1.18∼-0.38, p = 0.000; SMD: -2.06; 95% CI, -3.92∼-0.2, p = 0.03) in mice.

Conclusions
In human, HDL/apoA-1 mimetics cannot significantly improve atheroma volume in artery, although it is safe. However, in animal, the results suggest HDL/apoA-1 mimetics (or gene transfection) can decrease lesion area. So additional studies are needed to further investigate and explain the different efficacy of HDL/apoA-1 mimetic peptides between human and animal. Abstract Figure. Forest plots of human studies
Real world outcomes of Thai patient with acute coronary syndrome classified by achieved low-density lipoprotein level
Authors: Leesutipornchai T , Kunlamas Y , Areepium N , Bunditanukul K , Aekarach A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although lower low-density lipoprotein (LDL) level is recommended to improves clinical outcomes, little is known about the association between LDL level after treatment and outcomes in developing countries. The aim of the study was to evaluate the impact of LDL level on mortality rate and outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Methods
We conducted a single center retrospective study of all patients with a diagnosis of STEMI who underwent primary PCI at a tertiary care hospital in Thailand from 2005-2015. Patients were classified by LDL level at 3 months after discharge. Characteristics, treatments, and outcomes were gathered. T-­test, and Chi-­square were used to analyze.

Result
A total of 983 patients with STEMI who had undergone PPCI were identified STEMI. Of those, 418 patients had available follow LDL level at 3 months and were analyzed (mean age 59.9 ± 12.7 years, 27.3% female, 46.8% hypertension, 26.7% diabetes). There were only 32 and 67 patients who had LDL &lt;55 and 55-70 mg/dL, respectively. The 2- year composite endpoint of death, unstable angina, myocardial infarction and stoke were not different between each group (12.5% vs. 14.9% vs. 17.6% for patient achieved LDL &lt;55, &lt;70 and ≥70 mg/dL, respectively; p = 0.69).

Conclusion
In this single center experience, among patients with STEMI who underwent primary PCI in Thailand, only a quarter of patients achieving LDL level &lt;70 mg/dL, and only 7% of all patient had LDL &lt;55 mg/dL as recommended per international guidelines. The achieved LDL level was not associated better outcome.
Infective endocarditis post-transcatheter aortic valve replacement: a systematic review of epidemiology, clinical findings and prognosis
Authors: Jaiswal VIKASH , Jaiswal AKASH , Ishak ANGELA , Kumar RUCHIKA , Ujjawal ADITI , Batra NITYA , Sarfraz ZOUINA , Sarfraz AZZA , Sharma PRACHI , Michel JACK , Chaudhary GAURAV 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Transcatheter aortic valve replacement (TAVR) is a minimally invasive, catheter-based procedure to replace calcified narrow aortic valves. Available data on prosthetic valve endocarditis (PVE) post TAVR is limited to small subject populations in the form of case reports and case series. This systematic review aims to evaluate first the incidence of infective endocarditis post TAVR, second the microorganism profile and clinical findings, and third associated mortality/morbidity.

Methods
By adhering to the 2020 PRISMA statement guidelines, a systematic search was conducted to identify studies reporting the incidence of PVE post TAVR. An analysis of patient data including baseline characteristics, clinical findings, and outcomes was conducted. The following keywords were used by applying the BOOLEAN (and/or) logic: infective endocarditis, prosthetic endocarditis, transcatheter aortic valve replacement.

Results
In total, 18 studies were included, comprising 63,604 patients who underwent TAVR. All included studies were observational, i.e., seven multicenter registries, five retrospective studies, three cohort studies, two single-center observational studies, and one prospective study. The analysis yielded that 2.9% (1891) of the included patients suffered from post-TAVR infective endocarditis (IE). The patients with post-TAVR IE had a mean age of 79.2 ± 3.5 years, and 59.6% were males. Nine studies reported theuse of antibiotics for prophylaxis, with β-lactams being the most commonly used. Seventeen studies reported the type of bacteria isolated in cultures; all studies found enterococcus and staphylococcus
species, whereas Streptococcus was isolated in 7 of the 18 studies. Only 3% (60) of the patients had a prior history of IE. Of the reported complications post-TAVR, heart failure was the leading complication, with 0.2% of patients experiencing neurological symptoms, including stroke. The overall mortality rate ofpost-TAVR IE, estimated to be 23%, was alarmingly high.

Conclusion
This synthesis collates a low (2.9%) incidence of infective endocarditis post-TAVR, however high mortality and morbidity by means of heart failure and stroke is documented. Ultimately, appropriate medical care ought to be taken to reduce post-TAVR complications, with cautious and warranted measures of antibiotics prophylaxis to avoid valve complications.