tbuckley/cabot-search huggingface dataset:
Abstract 12593: Comparison Between Appropriateness of Exercise EKG and Stress Myocardial Perfusion Imaging Based on 2013 Multimodality Appropriate Use Criteria
Authors: Ashish Mahajan, Susan Bal, Harvey Hahn
Journal: Circulation (2014)

Introduction:  The American College of Cardiology recently published 2013 multimodality Appropriate Use Criteria (AUC) for the detection and risk assessment of stable Ischemic Heart Disease. The criteria present potential diagnostic tests for common indications using a side-by-side rating system. Exercise EKG is a commonly used non-invasive test with excellent negative predictive value for coronary artery disease. The 2013 multimodality AUC are the first to define appropriate use of exercise EKG. The objective of our study was to evaluate appropriateness of exercise EKG in patients who underwent Stress Myocardial Perfusion Imaging (MPI).   Methods:  A total of 403 patients who underwent stress MPI at our institute were included in the study. Each stress MPI was classified into Appropriate, May be Appropriate or Rarely Appropriate based on 2013 multimodality AUC. The exercise EKG AUC was then applied to the same cohort of patients. For patients who underwent Stress MPI for Rarely Appropriate indications, appropriateness of exercise EKG was evaluated.   Results:  The mean age of the study population was 62.23±14 years (47.89% males). Out of 403 stress MPI studies, 24.31% were Rarely Appropriate based on 2013 multimodality AUC. Among the Rarely Appropriate stress MPI studies, exercise EKG was Appropriate in 69.38%. The most common indication for Rarely Appropriate stress MPI was “Evaluation of symptomatic patients with low pre-test probability of CAD with interpretable EKG and ability to exercise” (Indication 1 of AUC) accounting for 51.69% of Rarely Appropriate studies. Per 2013 multimodality AUC, exercise EKG was appropriate in all patients in this subgroup of low risk patients with interpretable EKG and ability to exercise.   Conclusion:  A majority of Rarely Appropriate stress MPI studies would have been appropriate if ordered only as an exercise EKG. This study highlights another opportunity to reduce healthcare cost as well as radiation burden from unnecessary stress myocardial perfusion imaging.
Heterogeneity in mouse spasmolytic polypeptide-expressing metaplasia lineages identifies markers of metaplastic progression
Authors: V. G. Weis, J. F. Sousa, B. J. LaFleur, K. T. Nam, J. A. Weis, P. E. Finke, N. A. Ameen, J. G. Fox, J. R. Goldenring
Journal: BMJ (2012)

Objectives  Spasmolytic polypeptide-expressing metaplasia (SPEM) develops as a preneoplastic lesion in the stomachs of mice and humans after parietal cell loss. To identify the commonalities and differences between phenotypic SPEM lineages, SPEM were studied from three different mouse models of parietal cell loss: with chronic inflammation with  Helicobacter felis  infection; with acute inflammation with L635 treatment; and without inflammation following DMP-777 treatment.  Design  RNA transcripts from laser capture microdissected normal chief cells and SPEM lineages were compared using gene microarray. Alterations in transcripts were validated by quantitative real-time PCR. Clusterin and cystic fibrosis transmembrane conductance regulator (CFTR) were selected for immunohistochemical analysis in all mouse models as well as in human SPEM, intestinal metaplasia and gastric cancer.  Results  Transcript expression patterns demonstrated differences among the phenotypic SPEM models. Clusterin expression was significantly upregulated in all three mouse SPEM models as well as in human SPEM. The highest clusterin expression in human gastric cancers correlated with poor survival. Conversely, CFTR expression was upregulated only in SPEM with inflammation in mice. In humans, intestinal metaplasia, but not SPEM, expressed CFTR.  Conclusions  While markers such as clusterin are expressed in all phenotypic SPEM lineages, distinct patterns of upregulated genes including CFTR are present in murine metaplasia associated with inflammation, indicative of progression of metaplasia towards a more intestinalised metaplastic phenotype.
Abstract P258: Traditional Risk Factors and a Genetic Risk Score Are Associated with Age of First Acute Coronary Syndrome
Authors: Christopher Labos, Leo Rui Wang, Louise Pilote, Peter Bogaty, James M Brophy, James C Engert, George Thanassoulis
Journal: Circulation (2014)

Background: Early onset myocardial infarction (MI) is frequently attributed to genetic factors that may accelerate the atherosclerotic process. However, early MI may also occur due to a high burden of traditional risk factors. We sought to examine the association between traditional risk factors as well as a genetic risk score on the age of a first acute coronary syndrome (ACS). Methods and Results: We included 460 participants (mean age 59 +/- 12 years, 22.4% female) with a first ACS enrolled in the Recurrence and Inflammation in the Acute Coronary Syndromes (RISCA) cohort. Participants were genotyped for 30 single nucleotide polymorphisms identified from prior myocardial infarction genome-wide association studies to construct a multilocus genetic risk score (GRS). Linear regression models were fit to estimate the association between traditional risk factors (TRFs) and the GRS with age of first ACS. Several TRFs were significantly associated with earlier age of first ACS (all β coefficients in years; p&lt;0.05 for all) : male sex [β=-6.9 (95%CI -9.7,-4.1)], current cigarette smoking [β=-8.1 (95% confidence interval [CI] -10.0, -6.1)], overweight (BMI&gt;25) [β=-2.6 (95%CI -4.8, -0.3)] and obesity (BMI&gt;30) [β=-5.24 (95%CI -7.9, -2.6)]. Use of hormone replacement therapy [β=-4.3 (95%CI -8.4, -0.3) ] and aspirin use were also associated with age of first ACS [β=3.7 (95%CI 0.3, 7.0)]. After multivariable adjustment for TRFs, a one standard deviation increment in the GRS was associated with a 1.0 (95%CI 0.1-2.0) year earlier age of first ACS. Conclusion: Among individuals with a first ACS, a GRS composed of 30 SNPs is associated with a younger age of presentation. Although common genetic predisposition modestly contributes to earlier ACS, a heavy burden of traditional risk factors is strongly associated with markedly earlier ACS.
Time-varying spectral analysis of heart rate and left ventricular pressure variability during balloon coronary occlusion in humans
Authors: Shuji Joho, Hidetsugu Asanoi, Hosam A Remah, Akihiko Igawa, Tomoki Kameyama, Takashi Nozawa, Katsumi Umeno, Hiroshi Inoue
Journal: Journal of the American College of Cardiology (1999)
Abstract 717: Novel potent antisense oligonucleotides targeting transforming growth factor beta1 (TGF-β1)
Authors: Frank Jaschinski, Hanna Korhonen, Stephan Braun, Katja Wosikowski, Michel Janicot
Journal: Cancer Research (2014)

Abstract Transforming growth factor beta (TGF-β) is a key member of a large family of cytokines, which play critical, pleiotropic roles in the pathophysiology of various human diseases, such as cancer, inflammation, autoimmune disease, and cirrhosis/fibrosis. TGF-β1, -2 and -3 isoforms are cytokines encoded by different genes but sharing strong sequence and structure homology. They function as the primary mediators of TGF-β signaling via both non-canonical and canonical signaling pathways. In Oncology, TGF-β isoforms are associated with a wide range of biological processes such as tumor cell invasion and migration, angiogenesis, immunosuppression, as well as regulation of tumor stem cell properties. Hence, blocking the TGF-β signaling pathway may have a multifold therapeutic benefit in Oncology, although therapeutic relevance of the respective TGF-β isoforms remains poorly documented. In order to evaluate the specific biological relevance of TGF-β1 isoform in cancer, we have initiated an extensive discovery program for identification of antisense oligodeoxynucleotide constructs selectively inhibiting expression of the TGF-β1 ligand. Based on the sequence of the human TGF-β1 mRNA, more than 150 Locked Nucleic Acid (LNA)-modified gapmers were designed, synthesized and tested in cell-based assays. Highly potent and selective TGF-β1 constructs were identified and selected based on efficient suppression of TGF-β1 mRNA/protein expression in different human and rodent tumor cell lines, and in human Peripheral Blood Mononuclear Cells (PBMCs). Effective target downregulation was demonstrated after lipofectamine aided-transfection (sub-nM concentration range), but also in the absence of any transfection agent (gymnotic delivery) at sub-µM concentrations. Selected TGF-β1 specific oligonucleotides were further tested in relevant animal xenograft models and strong target inhibition was also observed following systemic administration. Further details of this discovery program will be discussed and pharmacology properties and features of potent and selective TGF-β1 antagonists will be presented. Citation Format: Frank Jaschinski, Hanna Korhonen, Stephan Braun, Katja Wosikowski, Michel Janicot. Novel potent antisense oligonucleotides targeting transforming growth factor beta1 (TGF-β1). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 717. doi:10.1158/1538-7445.AM2014-717
Abstract 9533: Effect of Combined Ramipril-Canrenone on Atrial Fibrillation Recurrence in Hypertensive Patients With a History of Paroxysmal Atrial Fibrillation
Authors: Roberto Fogari, Amedeo Mugellini, Giuseppe Derosa, Maurizio Destro, Annalisa Zoppi, Pierangelo Lazzari
Journal: Circulation (2014)

Introduction:  Angiotensin II and Aldosterone are key factors responsible for structural and electrical atrial remodelling in patients with atrial fibrillation (AF).   Hypothesis:  Aim of this study was to evaluate the effect of ramipril/hydrochlorothiazide (HCTZ) combination (R/H) vs ramipril/canrenone (R/C) combination on symptomatic AF episode recurrence documented on the electrocardiogram (ECG) in hypertensive patients in sinus rhythm but with at least 2 episodes of AF in the previous 6 months. Canrenone is a derivative active metabolite of spiranolattone with lower antiandrogen activity.   Methods:  a cohort of 195 consecutive hypertensive out-patients (aged 67 years, 103 men) were randomized to R/H or R/C for 1 year. Clinic blood pressure (BP) and 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. P wave dispersion (PWD) and procollagen type I carboxy-terminal peptide (PIP) were evaluated before and after 12 month of treatment.   Results:  SBP and DBP were similarly and significantly reduced by both treatments (p   Conclusions:  These findings suggest that in these patients R/C combination is more effective than R/H combination in reducing AF recurrence as well as in improving PWD and cardiac fibrosis despite a similar BP reduction. This data outline the importance of aldosterone receptor blockade in prevention of AF recurrence.
Monitoring the safety of over the counter drugs
Authors: D. Clark, D. Layton, S. A W Shakir
Journal: BMJ (2001)

Last year the Food and Drug Administration in the United States recommended that phenylpropanolamine be removed from non-prescription and prescription medicines and that pharmaceutical companies voluntarily discontinue products containing phenylpropanolamine. This was in response to a case-control study by the Yale haemorrhagic stroke project investigators designed to determine the risk of haemorrhagic stroke in people exposed to phenylpropanolamine.1 Though this action was not followed in the United Kingdom, because the market conditions for phenylpropanolamine are different, the findings of the haemorrhagic stroke project highlight the need for continued monitoring of the safety of non-prescription medicines.

In the United States formulations of phenylpropanolamine contain up to 150 mg of a racemic mixture of two enantiomers of (±)-norephedrine,2 and withdrawal of appetite suppressants and cough and cold preparations containing phenylpropanolamine may well have been an appropriate response to the haemorrhagic stroke project data. In Europe the licensed maximum daily dose in non-prescription cough and cold remedies is lower (100 mg), and appetite suppressants containing phenylpropanolamine are not available in the United Kingdom. …
Response to Letter Regarding Article, “Assisted Beating of the Ischemic Heart: How to Manage the Pulseless ST-Segment–Elevation Myocardial Infarction Patient”
Authors: Christopher Lotz, Oliver Ritter, Ralf Michael Muellenbach
Journal: Circulation (2015)

We thank Drs Reddy and Leesar for their interest in our article 1 and their informative letter on the complementary use of venoarterial extracorporeal membrane oxygenation (vaECMO) and intra-aortic balloon counterpulsation (IABP).In clinical practice, IABP is frequently used as the primary method of mechanical support for patients experiencing a myocardial infarction and cardiogenic shock.This choice is often based on years of experience with the device, whereas extracorporeal support is added only if IABP support does not suffice.Recent studies suggest that the concomitant use of IABP and vaECMO can actually be useful 2 ; however, the pathophysiological changes are complex.The success of this interaction may very much depend on the generation of antegrade flow by the native heart, as well as its ability to open the aortic valve.If upper-body oxygenation can be warranted only via retrograde vaECMO flow and the opening of the aortic valve is not impaired, IABP may actually worsen cerebral and coronary perfusion. 3,4n cases in which the native heart is unable to open the aortic valve, cardiac afterload reduction is of paramount importance.This situation is frequently encountered during extracorporeal cardiopulmonary resuscitation as a function of retrograde vaECMO flow leading to increased cardiac afterload.Ideally, vaECMO blood flow should be to set to a level high enough to secure perfusion of the brain and coronary arteries while still allowing opening of the aortic valve.However, optimal ECMO blood flows and the targeted mean arterial pressure remain unclear.In this regard, continuous monitoring of cerebral tissue oxygenation might be useful.The adjunct use of IABP may help to lower cardiac afterload and act as a relatively low-risk left ventricular decompression procedure during extracorporeal cardiopulmonary resuscitation.However, we believe that additional data are required before recommending IABP as the first-line left ventricular venting device.We would actually use an Impella pump as far as the clinical situation permits, considering that it has been shown to reduce major adverse cardiac and cerebral events compared with IABP during high-risk percutaneous coronary intervention. 5Nevertheless, we agree with Drs Reddy and Leesar that placement of a microaxial pump is nearly impossible at the bedside during chest compressions.Current evidence further supports the use of IABP concomitant with vaECMO therapy on an individual risk-to-benefit analysis, all in all making it a valuable option during extracorporeal cardiopulmonary resuscitation outside the catheterization laboratory.
Abstract P156: Health Literacy and Health Behaviors Associated with Racial Disparities in Blood Pressure
Authors: Jia Pu, Dave Vanness, David Kreling, Betty Chewning
Journal: Circulation (2014)

Introduction: Racial disparity in cardiovascular disease has prompted efforts to improve cardiovascular outcomes through patient education and health behavior promotion. However, little is known about the long-term effects of health literacy and health behaviors on cardiovascular disease outcomes. Hypothesis: This study aims to explore whether racial differences in long-term blood pressure outcomes are associated with baseline levels of health literacy, mediated through longitudinal patterns of health behaviors. Methods: This study used a prospective cohort from the Coronary Artery Risk Development in Young Adults (CARDIA) project, funded by NHLBI. Blood pressure was measured by trained CARDIA researchers at seven examinations between 1985 and 2005. Self-reported health behaviors (including smoking, binge drinking, overweight and sedentary lifestyle) were obtained at each examination. Cardiovascular health literacy was assessed as part of the 1990 observation. We used growth curve modeling to explore racial disparities in blood pressure and to examine if blood pressure outcomes could be explained by participants’ health literacy and their health behavior change. This study included 3,546 CARDIA study participants who remained in the most recent examination at year 2005, with 47% African Americans and 43% males. Results: Racial disparities were observed in participants’ initial blood pressure, blood pressure progression rate, health literacy and health behaviors. African Americans had higher blood pressure at baseline (systolic: 109 vs. 105; diastolic: 70 vs. 67 P&lt;0.0001) and greater increases over time. Caucasians had a higher health literacy score (4 vs. 3.5 P&lt;0.0001) and reported fewer risk behaviors on average. There was a positive relationship between health literacy, education attainment, parents’ education attainment, family income, having health insurance and having fewer risk behaviors. Participants with fewer risk behaviors had lower blood pressure. Blood pressure improved in years with fewer risk behaviors. Higher baseline health literacy was associated with having fewer risk behaviors in the following fifteen years. Overall, the results indicated that blood pressure outcomes were indirectly influenced by baseline health literacy through longitudinal patterns of risk behaviors. This relationship was stronger in Caucasians. Conclusions: This study suggests that racial differences in blood pressure are associated with both health literacy and health behaviors. In response to these findings, important gaps in hypertension preventive care and health behavior promotion should be identified and addressed through efforts to improve cardiovascular health literacy. For minority and high risk populations, multifaceted approaches in addition to patient education may be needed to initiate behavior change.
Cardiovascular Effects of Ephedra—Reply
Authors: C. Michael White
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Adolescents With Depression
Authors: Arthur Rifkin, William Rifkin
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract P186: Circulating Desphospho-uncarboxylated Matrix Gla Protein and the Risk of Coronary Heart Disease and Stroke
Authors: Geertje W Dalmeijer, Yvonne T van der Schouw, Elke J Magdeleyns, Cees Vermeer, W. Monique M Verschuren, Jolanda M Boer, Joline W Beulens
Journal: Circulation (2014)

Background: Matrix Gla protein (MGP) is a vitamin K dependent protein and a potent inhibitor of vascular calcification. Desphospho-uncarboxylated MGP (dp-ucMGP) is a marker for vitamin K status with high dp-ucMGP concentration reflecting a low vitamin K status. High dp-ucMGP concentrations are thought to be associated with an increased risk of cardiovascular disease, but this has never been investigated in the general population. Objective: This study aimed to investigate the association of dp-ucMGP with incident coronary heart disease (CHD) or stroke in the general population. Design and Methods: A prospective case-cohort study with a representative baseline sample of 1406 participants and 1154 and 380 incident cases of CHD and stroke, respectively, was nested within the EPIC-NL study. Dp-ucMGP concentrations were measured by ELISA technique in baseline plasma samples. The incidence of fatal and non-fatal CHD and stroke was obtained by linkage to national registers. Cox proportional hazard models adapted for the case-cohort design were used to calculate hazard ratios (HRs) per standard deviation (SD) and per quartile of circulating dp-ucMGP levels, adjusted for cardiovascular risk factors. Results: This case-cohort study had an average follow-up of 11.5 years. Circulating dp-ucMGP levels were not associated with CHD risk with a HR per SD of 1.00 (95% CI: 0.93-1.07) and a HR Q4 vs Q1 of 0.94 (95% CI: 0.79-1.13) after multivariate adjustment. Circulating dp-ucMGP was not associated with stroke risk with a HR per SD of 0.98 (95% CI: 0.90-1.08) and a HR Q4 vs Q1 of 1.09 (95% CI: 0.78-1.51). Conclusion: This study does not support the hypothesis that high dp-ucMGP levels, reflecting a poor vitamin K status, are associated with increased CHD or stroke risk.