tbuckley/cabot-search huggingface dataset:
Abstract 5612: Embolic Protection Devices in Acute Myocardial Infarction. Do They Confer the Same Clinical Benefit?
Authors: Mònica Masotti, Héctor Salazar, Ricardo Kiamco, Xavier Freixa, Amadeo Betriu
Journal: Circulation (2008)

Background Thromboembolic debris liberated during primary percutaneous coronary intervention (PCI) may result in impaired clinical outcomes. Conflicting data from randomized control trials (RCT’s) have precluded the widespread application of embolic protection devices (EPD’s) to complement primary PCI. Furthermore, current guidelines do not recommend routine use of EPD’s in this setting and longer follow-up data are lacking. Objective The aim of this study was to combine data from all RCT’s using EPD’s in patients presenting with ST-elevation myocardial infarction (STEMI). The primary end-point of our meta-analysis was to assess the impact of EPD’s on survival at 6 months. Methods Data from 8 RCT’s, including 2527 patients (pts), were analyzed. EPD’s used aspiration in 3 studies (De Luca, DEAR-MI, TAPAS; N=1295 pts), thrombectomy in 1 (X AMINE ST; N=201 pts), and filters in 4 (DIPLOMAT, ASPARAGUS, EMERALD, PREMIAR; N=1031 pts). In total, 1268 pts underwent active treatment and 1259 were controls. Results As shown in Table 1 , at 6 months the use of aspiration significantly reduced (by 51%) the risk of death. On the contrary, no benefit was derived from the use of either thrombectomy or filters. There was homogeneity among the trials, and when comparing the different types of EPD’s. Conclusion Aspiration devices, but not thrombectomy or filters, improve mid term mortality of STEMI patients undergoing primary PCI. This translates into 34 lives saved per 1000 patients treated. Table 1. Mortality at 6 months
Honeycombing pattern: A particular form of sarcoidosis-related pulmonary fibrosis
Authors: Aurelie Herve, Pierre-Yves Brillet, Diane Bouvry, Olivia Freynet, Jean-Marc Naccache, Marianne Kambouchner, Michel Brauner, Dominique Valeyre, Hilario Nunes
Journal: European Respiratory Journal (2011)

Introduction:  Pulmonary fibrosis, as defined as radiographic stage 4, is the major cause of morbidity and mortality in sarcoidosis. Three main patterns of pulmonary fibrosis have been described on HRCT: bronchial distorsion, hilo-peripheral linear opacities, and honeycombing (HC).   Aims:  To determine whether patients with HC pattern have a particular phenotype of sarcoidosis.   Methods:  Retrospective and monocenter study, comparing 34 patients with HC pattern (men: 62%, age: 56±14 years) with 34 controls with other HRCT pattern. Controls were matched with patients for the date of the first available workup with stage 4.   Results:  HC predominated in the upper lobes, but 5 cases (15%) had evidence of basal and peripheral predilection close to that seen in idiopathic pulmonary fibrosis. Patients differed from controls for a higher frequency of environment exposure (39 vs 15%, p=0,045), more altered gas exchanges (PaO2: 77±10 vs 82±11 mmHg, p=0,04 and DLCO: 38±16 vs 60±16%, p   Conclusion:  The phenotype of patients with HC is original. An exposure to inhaled particles may play a role in the development of this particular fibrosis evolution and explain the local respiratory severity of sarcoidosis while the disease seems less active and severe from a systemic point of view.
Abstract 17274: Increased Fibroblast Activation Protein and Matrix Metalloproteinase- 9 Expression are Associated With Altered Extra-Cellular Matrix Changes in Barlow’s Disease Compared to Fibro Elastic Deficiency in Mitral Valve Degenerative Disease - Implication in Disease Progression
Authors: Purushothaman K-Raman, Meerarani Purushothaman, David H Adams, Prakash Krishnan, Annapoorna Kini, Samin K Sharma, Valentin Fuster, Pedro R Moreno
Journal: Circulation (2014)

Introduction: Surgically defined degenerative mitral valve disease (DMVD) - Barlow’s disease (BD) and Fibro elastic deficiency (FED) may differ histologically. This may impart structural and functional differences in the extracellular matrix (ECM) remodeling. However ECM remodeling was not well characterized in these entities. Recently, it has been reported that Fibroblast Activation Protein (FAP), a serine protease may play an essential role in ECM remodeling in association with matrix metalloproteinase-9 (MMP-9) expression.

Hypothesis: We hypothesize that altered FAP and MMP-9 protein expression may be linked to altered collagen deposition in BD compared to FED.

Methods: Twenty human posterior mitral valve leaflets (10 from BD and 10 from FED) were studied. FAP and MMP-9 protein expressions were graded by immunohistochemistry. Collagens composition was evaluated by Picro-sirius red and polarization microscopy, valvular interstitial cells (VICs) by immunochemistry and elastic fibrils by elastic trichrome stain.

Results: See figure and table. Decreased FAP (p= 0.0001) and increased MMP-9 protein expression (p=0.07) were seen in BD compared to FED. VICs and type III collagen deposition were decreased in BD when compared to FED, indicating FED as an active and progressive lesion when compared to BD. (p =NS).

Conclusions: Altered fibroblast activation protein and MMP-9 expression are associated with extracellular matrix changes in Barlow’s disease. These findings may contribute to disease progression in Barlow’s and FED, specifically related to pathological ECM remodeling. Molecular mediators using micro RNA (miRNA) are under investigation to further elucidate these pathways.

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Abstract 2702: Changes in Filling Pressures Rather than in Daily Weights Predict Heart Failure Events with Active Heart Failure Disease Management
Authors: Dale G Renlund, Mark F Aaron, Anthony Magalski, Yong K Cho, Mariell Jessup, Robert C Bourge, Michael R Zile, Lynne W Stevenson
Journal: Circulation (2007)

Introduction : While active heart failure (HF) disease management (HFM) that includes frequent patient contact and education about symptoms, daily weights, and medication adjustment has been shown to decrease HF events, recurrent HF hospitalization for fluid overload remains frequent. To determine whether HF events that occur despite HFM can still be predicted from changes in serial weights and filling pressures, HF events were analyzed from the COMPASS-HF trial. Methods and Results : After a recent HF hospitalization and COMPASS-HF study enrollment at 28 experienced HF centers, 274 patients received HF education and averaged 24.7 staff contacts/6 months. HF event rates decreased from 1.9 in the 6 months prior to enrollment to 0.85 and 0.67 during 6 months after enrollment in the study (control and treatment arms, respectively). For 66 HF events, home weights and invasively measured right ventricular diastolic pressures (RVDP) transmitted from home were available from 7 weeks previously and were defined as baseline. RVDP rose steadily from 4 weeks to 1 day prior to the HF event, while weights varied without major increase until 1 day prior (figure ). RVDP increased by ≥ 2 mm Hg at least 1 week prior to 39/66 events (59%), while weight gain increased by ≥ 2 pounds at least 1 week prior to 19/66 events (29%). Conclusions : Events occurring despite HFM, which includes diuretic adjustment for symptoms and weight gain, were predicted by increasing cardiac filling pressures but not by weight gain. In addition to changes in daily weights, increases in filling pressures may guide interventions to avert HF events otherwise not anticipated from routine weights and frequent HFM contact.
The PNA-LNA PCR clamp as a feasible and reliable system to screen the EGFR mutation in clinical practice
Authors: Tomoaki Tanaka, Yoshiaki Nagai, Hitoshi Miyazawa, Nobuyuki Koyama, Hu Qun, Suguru Matsuoka, Akihisa Sutani, Kiyoshi Udagawa, Yoshitake Murayama, Makoto Nagata, Yoshihiko Shimizu, Kenji Ikebuchi, Minoru Kanazawa, Kunihiko Kobayashi, Koichi Hagiwara
Journal: Cancer Research (2007)

5026  Gefitinib is an inhibitor of the tyrosine kinase activity of epidermal growth factor receptor (EGFR). Recently, the responsiveness to gefitinib has been reported to closely link to the presence of EGFR mutations. Thus, information on EGFR mutations is considered crucial to choose appropriate therapeutic regimen to treat non-small cell lung cancers(NSCLC). We have established a clinical test that can detect EGFR mutations from cytological specimens that are contaminated by normal cells. This test is based on the peptide nucleic acid, locked nucleic acid polymerase chain reaction (PNA-LNA PCR) clamp method that can detect G719S, G719C, L858R, L861Q and seven different exon 19 deletions in the presence of 100-1000-fold wild-type alleles. Consequently, using a small aliquot of samples isolated to establish a cancer diagnosis, the EGFR mutation status is determined soon after the diagnosis of cancer is made. We investigated the EGFR mutation status in 132 patients using a variety of cytological specimens. Forty-five patients (34%) were positive for mutation. The sensitivity and the specificity of this test was 97% and 100%, respectively. EGFR mutation status thereby obtained was used to determine each patient’s therapeutic regimen. This test is easily integrated into the normal clinical practice for lung cancer, while allowing the medical staff to select therapeutic regimen depending on the EGFR mutation status.
Abstract 737: A Mutation in the Brugada Syndrome Gene Glycerol-3 Phosphate Dehydrogenase-1 Like Gene (GPD1-L) Disrupts Trafficking
Authors: Haider Mehdi, Laurie Kerchner, Xiadong Zhu, Michael Michalec, Shamarendra Sanyal, Prakash C Viswanathan, Arnold E Pfahnl, Lijuan L Shang, Mohan Madhusudanan, Samuel C Dudley, Barry London
Journal: Circulation (2006)

Brugada syndrome is a life threatening autosomal dominant disorder characterized by ST segment elevation in the right precordial leads of the surface ECG. Mutations of the cardiac sodium (Na+) chan...
Abstract 3248: Is It Safe to Train Residents to Perform Cardiac Surgery? Intermediate Term Follow-up
Authors: Billie Jean Martin, Dimitri Kalavrouziotis, Roger Baskett
Journal: Circulation (2007)

Introduction While there are rigourous assessments made of trainees’ knowledge through formal examinations, objective assessments of technical skills are not available. Little is known about the safety of allowing resident trainees to perform cardiac surgical operations. Methods Peri-operative date was prospectively collected on all patients who underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or a combined procedure between 1998 and 2005. Teaching-cases were identified by resident records and defined as cases which the resident performed skin to skin. Pre-operative characteristics were compared between teaching and non-teaching cases. Short-term adverse events were defined as a composite of: in-hospital mortality, stroke, intra- or post-operative intra-aortic balloon pump (IABP) insertion, myocardial infarction, renal failure, wound infection, sepsis or return to the operating room. Intermediate adverse outcomes were defined as hospital readmission for any cardiac disease or late mortality. Logistic regression and Cox proportional hazard models were used to adjust for differences in age, acuity, and medical co-morbidities. Outcomes were compared between teaching and non-teaching cases. Results 6929 cases were included, 895 of which were identified as teaching-cases. Teaching-cases were more likely to have an EF&lt;40%, pre-operative IABP, CHF, combined CABG/AVRs or total arterial grafting cases (all p&lt;0.01). However, a case being a teaching-case was not a predictor of in-hospital mortality (OR=1.02, 95%CI 0.67–1.55) or the composite short-term outcome (OR=0.97, 95%CI 0.75–1.24). The Kaplan-Meier event-free survival of staff and teaching-cases was equivalent at 1, 3, and 5 years: 80% vs. 78%, 67% vs. 66%, and 58% vs. 55% (log-rank p=0.06). Cox proportional hazards regression modeling did not demonstrate teaching-case to be a predictor of late death or re-hospitalization (HR=1.05, 95%CI 0.94 –1.18). Conclusions Teaching-cases were more likely to have greater acuity and complexity than non-teaching cases. Despite this, teaching cases did no worse than staff cases in the short or intermediate term. Allowing residents to perform cardiac surgery does not appear to adversely affect patient outcomes.
Abstract 1210: Interferon-gamma-induced CD40/CD40 Ligand Pathway Activation Mediates Atherosclerotic Plaque Progression and Destabilization in ApoE-Knockout Mice
Authors: AYAMI IKEDA, Hisashi Kai, Mitsuhisa Koga, Tsutomu Imaizumi
Journal: Circulation (2007)

Background: A triggering role of interferon-gamma (IFN-g) is suggested in atherosclerotic plaque formation by activating inflammatory process. Soluble mutant of IFN-g receptor (sIFNgR) blocks IFN-g-induced activation of the target cells in vivo. The immune mediator CD40 ligand (CD40L) and its receptor CD40 are crucial for initiation of plaque formation and for progression and destabilization of advanced plaque by producing monocyte chemoattracting protein-1 (MCP-1) and matrix metalloproteinase-9 (MMP-9). We assessed the hypothesis that postnatal inhibition of intrinsic IFN-g would reduce and stabilize advanced plaques via inhibition of the CD40L/CD40 pathway. Methods and Results: From 8-week old (w), apoE-knockout (apoEKO) mice were fed daily high-fat diet. At 12 w when aortic plaques had been established, mice were randomized to 2 groups: sIFNgR-treated mice received gene transfer of naked DNA plasmid encoding sIFNγR into the thigh muscle twice at 12 and 14 w. Mock-treated mice received the empty plasmid. At 16 w, mock-treated apoEKO mice showed progression of aortic plaque. They had massive oil red O-stained lipid core and bulky MOMA2-labeled macrophage accumulation accompanied by thin Azan-stained fibrous cap with little smooth muscle cells (SMCs). These findings demonstrated markedly low plaque stability. sIFNgR treatment reduced plaque area by more than 50% versus mock-treated mice. Moreover, sIFNgR treatment stabilized the plaque by decreasing lipid and macrophage areas and increasing the areas of SMCs and collagen. In mock-treated mice, CD40 and CD40L as well as MCP-1 and MMP-9 were markedly upregulated in aortic plaque at 16 w, which were inhibited by sIFNgR treatment. sIFNgR treatment not only reduced the mobilization of peritoneal macrophages but also attenuated the CD40L/CD40 expressions of macrophages. Circulating monocyte count and serum cholesterol levels were not affected by sIFNgR treatment. Conclusions: It was suggested that intrinsic IFN-g function blocking reduced and stabilized advanced plaque in apoEKO mice in part by inhibiting CD40L/CD40 pathway. Targeting IFN-g may be a new strategy for regression and stabilization of atherosclerosis.
Abstract 16854: Iodine Deficiency and Risk of Coronary Heart Disease Events Among Low Risk Healthy US Adults
Authors: Sandip K Zalawadiya, Vikas Veeranna, Krithi Ramesh, Ashutosh Neeraj, Luis Afonso, Nandalal Bagchi
Journal: Circulation (2011)

Background: Prevalence of iodine deficiency (ID) has increased among general US population. No study has evaluated ID's effect on primary risk of coronary heart disease (CHD) events. Objective: Evaluate the relationship between ID and CHD risk Design: Cross-sectional Methods: We evaluated 10,037 adults, free of cardiovascular disease and diabetes, participating in National Health and Nutrition Examination Surveys . Participants were assigned Framingham risk score (FRS) per Adult Treatment Plan guidelines. Urine iodine levels (mcg/L) were used to define ID per World Health Organization criteria: Group 1 -: None(≥100), Group 2 -: Mild(50-99) and Group 3 -: Moderate-severe(&lt;50). Multivariate regression analysis was performed to analyze the effect of ID on the risk of having higher FRS. Results: Mean FRS increased with higher degrees of ID (Group 1: 7.5±8.1 vs Group 3: 9.4±7.4, p&lt;0.001). ID significantly predicted (p&lt;0.001) higher FRS after adjusting for race, body mass index, history of thyroid dysfunction, hemoglobin A1c, high sensitivity C-reactive protein, estimated glomerular filtration rate, serum T4, serum thyroid stimulating hormone and selenium levels [beta co-efficient 0.69(95% confidence interval (CI):0.38-1.00) for group 2 and 1.46(95% CI:1.08-1.84) for group 3 compared to group 1]. Similar results were observed when FRS was evaluated in categories. (Table 1) Conclusion: ID is associated with CHD risk independent of thyroid dysfunction and traditional cardiovascular risk factors. Further validation of our study results is warranted since ID is easily remediable through public health policies.
Abstract 13760: A Caveolin Targeted L-type Ca2+ Channel Antagonist Inhibits Hypertrophic Signaling Without Reducing Contractility of Cardiac Myocytes
Authors: Catherine Makarewich, Robert N Correll, Hui Gao, Hongyu Zhang, Remus M Berretta, Baohua Yang, Victor Rizzo, Jeffery D Molkentin, Steven R Houser
Journal: Circulation (2011)

The Ca2+ that activates pathological hypertrophy is not thought to be the same Ca2+ that activates contraction. We hypothesize that Ca2+ influx through a subpopulation of L-type Ca2+ channels (CaV1...
Abstract 13962: Fibrosis is the target for Slow Conduction Related Arrhythmias
Authors: Harold V van Rijen, Toon A van Veen, Marc A Vos, Jacques M de Bakker
Journal: Circulation (2010)

Introduction: Conduction slowing is an important risk factor for reentry based arrhythmias. During arrhythmogenic remodeling of the diseased heart, the levels of sodium channels (Nav1.5) and gap junction channels (Cx43) are decreased, while the levels of fibrosis are increased. We have used several mouse models to explore individual and combined clinically relevant changes in these conduction parameters to search for the dominant and therapeutically important target of slow conduction related ventricular arrhythmias. Methods and Results: Mice expressing only half the amount of Cx43 or Nav1.5 or with increased levels of fibrosis, had near normal conduction velocities and were not susceptible to arrhythmias. Mice with a combined 50% reduction of both Cx43 and Nav1.5 had moderate conduction slowing (up to 20%), but were not arrhythmogenic. Mice with 50% Nav1.5 expression, combined with increased fibrosis showed severe conduction slowing up to 50%, but no arrhythmias. When reduced Cx43 expression was combined...
Abstract 13386: Pulmonary Complications in Right Sided Endocarditis
Authors: Ana Clara T Rodrigues, Fernando U Kay, Andrea Ogawa, Katia Nishiyama, Ana Lucia Arruda, Edgar Lira Filho, Ingrid Kowatsch, Meive Furtado, Giovanni G Cerri, Jose L Andrade
Journal: Circulation (2013)

Right-sided endocarditis (RSE) is a life-threatening infectious disease with increasing incidence; there is scant data, however, regarding pulmonary complications. Methods: we assessed patients ref...
Psychiatric catchment areas in an urban center: a policy in disarray
Authors: L R Marcos, R M Gil
Journal: American Journal of Psychiatry (1984)

This study of the catchment area policy in New York City's 10 municipal psychiatric inpatient units and emergency rooms showed that of a total of 52,170 emergency room visits and 18,558 admissions in 1982, 35% and 24%, respectively, were of patients from outside the hospitals' catchment areas. The authors discuss the factors associated with the relative ineffectiveness of the policy and the implications for municipal hospitals' funding and patient care. They suggest that policy makers consider a different model for acute-care hospitals and propose a network approach as a plausible alternative. The need for further research is also emphasized.
Value of Platelet Reactivity in Predicting Response to Treatment and Clinical Outcome in Patients Undergoing Primary Coronary Intervention
Authors: Gianluca Campo, Marco Valgimigli, Donato Gemmati, Gianfranco Percoco, Silvia Tognazzo, Giordano Cicchitelli, Linda Catozzi, Patrizia Malagutti, Maurizio Anselmi, Corrado Vassanelli, Gianluigi Scapoli, Roberto Ferrari
Journal: Journal of the American College of Cardiology (2006)
Abstract 9811: Medical Resource Use, Costs and Quality of Life are Similar Between Patients with Acute Decompensated Heart Failure Treated with Nesiritide Versus Placebo
Authors: Shelby D Reed, Padma Kaul, Adrian F Hernandez, Yanhong Li, Zubin J Eapen, Kevin A Schulman, David J Whellan, Cindy M Westerhout, Barry Massie, Jonathan G Howlett, Paul W Armstrong, Randy Starling, Christopher M O'Connor, Robert M Califf
Journal: Circulation (2011)

Introduction: In the recent Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure Trial (ASCEND-HF), treatment with nesiritide did not reduce heart failure rehospitalization or mortality at 30 days relative to treatment with placebo. Dyspnea was marginally improved with nesiritide, but did not reach pre-specified levels for statistical significance. Our study reports on a prospective economic and quality of life evaluation that was conducted as part of the trial. Objective: Compare medical resource use, costs and quality of life outcomes between patients randomized to nesiritide versus placebo in the ASCEND-HF. Methods: Detailed resource use data, including data on length of stay and readmissions within 30 days were collected on the case report form. Quality of life was assessed using the EQ-5D, administered at baseline, 24 hours, discharge, and 30 days. Hospital billing data representing 1253 admissions for US patients were used to develop a cost prediction model (R 2 =0.70), which was used to generate inpatient cost estimates for patients without billing data (US and non-US). To lessen the influence of geographical variations in length of stay when estimating costs, we applied an adjustment in which length of stay was reweighted based on the mean LOS in the US relative to each country. Generalized linear models were used to compare resource use and costs. Responses to the EQ-5D were converted to US utility weights. Patients who died were assigned an EQ-5D value of 0. ANOVA was used to compare EQ-5D utilities between treatment groups. Results: Of 7141 patients randomized, 7007 received study drug. Estimates of resource use, direct medical costs and EQ-5D utility weights are reported in the Table. Conclusions: Consistent with main study findings, measures of medical resource use, costs, and EQ-5D health utilities were similar between nesiritide and placebo in this trial.