tbuckley/cabot-search huggingface dataset:
Abstract P399: Two-Year Trends and Determinants of Electronic Cigarette Use Among Patients With Cardiovascular Disease in the United States
Authors: Paul M Ndunda, Mohinder Vindhyal, Tabitha Muutu, Cyrus Munguti
Journal: Circulation (2019)

Background: The use of electronic cigarettes (e-cigarettes) is on the rise in the US. It increased in adults aged 25-44 years from 2.4% in 2012 to 4.2% in 2016 and from 2% to 2.8% between ages 55 to 64 over the same period. Among the youth, the increase was 900% between 2011 and 2015. Much remains to be known about the health effects of e-cigarette use, but epidemiologic studies suggest an independent association between e-cigarette use and cardiovascular disease. There is a need for data on the social and demographic factors that are predictive of use in adults with cardiovascular disease (CVD), to identify the appropriate focus of intervention. Methods: This is an analysis of the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) data, an annual chronic disease and behavioral risk factor survey conducted by the CDC. The sample included the 110,028 respondents that reported a history of heart attack, angina/coronary heart disease or stroke. The rates of e-cigarette use were calculated, and a multiple logistic regression analysis was used to assess associated factors. Results: Among respondents with CVD, there was no change in e-cigarette use between 2016 and 2017 [3.1% to 2.8% adjusted OR (aOR) 1.08 (95% CI 0.95 - 1.24)]. The median age of e-cigarette users was 58 years and that of non-users was 69 years (p&lt;0.0001). Women had a higher rate of e-cigarette use compared with men [3.2% vs 2.7% aOR 1.17(1.04-1.31)]. Other factors associated with e-cigarette use were: race [blacks vs whites 1.9% vs 3% aOR 0.37(0.28-0.49], sexual orientation [LGBTQ vs non-LGBTQ 7.1% vs 2.9% aOR 1.56 (1.24-1.96)], smoking [current smokers vs non-smokers 11.1% vs 1.2% aOR 6.0 (5.3-6.8), smoking on some days vs never smoked 12.7% vs 0.24 aOR 51(35.4-73.5)], mental illness [6.4% vs 1.8% aOR 1.57 (1.37-1.810)] and state of residence (p&lt;0.0001). Conclusion: In conclusion, there was no significant change in e-cigarette use between 2016-2017 among respondents with CVD. The highest rates of e-cigarette use were among subjects who were: smokers on some days, current smokers, LGBTQ and had a mental illness.
Abstract P028: Gut Microbiota-Related Metabolites and Long-Term Bone Health in Response to Weight-Loss Diets: The POUNDS Lost Trial
Authors: Tao Zhou, Yoriko Heianza, Yuhang Chen, Dianjianyi Sun, Xiaofang Pei, George Bray, Frank Sacks, Lu Qi
Journal: Circulation (2019)

Introduction: Weight-loss diet interventions affect gut microbiota-related metabolites, such as trimethylamine N-oxide (TMAO) and its precursors (choline and L-carnitine), and improve cardiometabolic status. However, little is known about how these metabolites may affect bone mineral density (BMD) during weight loss. Hypothesis: We assessed the hypothesis that changes in gut microbiota-related metabolites are related to changes in BMD during weight loss. Methods: A total of 264 overweight and obese participants with measurement of BMD by dual-energy X-ray (DEXA) scan were included in the present analysis. The participants were randomly assigned to one of four diets varying in macronutrient intakes. We investigated the associations of changes in plasma levels of TMAO, choline, and L-carnitine from baseline to 6 months with changes in BMD. Results and Conclusions: We found that changes in plasma levels of TMAO from baseline to 6 months were positively related to changes of whole body ( P =0.011) and spine ( P =0.002) BMD over the 2-year intervention, independent of weight change. The association with whole body BMD was also significant at 6 months. The correlations between changes in TMAO and BMD were not modified by dietary macronutrients; while changes in TMAO precursor L-carnitine showed interactions with dietary fat intake on changes of spine and trochanter BMD (all P &lt;0.05). Participants with the least L-carnitine decrease showed less BMD reduction by eating a low-fat diet ( P spine =0.031 and P trochanter =0.017). In conclusion, our results suggest that decrease in TMAO during weight loss may be related to reduction in BMD.
Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease
Authors: Remo Panaccione, A. Hillary Steinhart, Brian Bressler, Reena Khanna, John K. Marshall, Laura Targownik, Waqqas Afif, Alain Bitton, Mark Borgaonkar, Usha Chauhan, Brendan Halloran, Jennifer Jones, Erin Kennedy, Grigorios I. Leontiadis, Edward V. Loftus, Jonathan Meddings, Paul Moayyedi, Sanjay Murthy, Sophie Plamondon, Greg Rosenfeld, David Schwartz, Cynthia H. Seow, Chadwick Williams, Charles N. Bernstein
Journal: Clinical Gastroenterology and Hepatology (2019)
Rates of occult brain metastases in patients (pts) with advanced renal cell carcinoma (RCC): A cohort study from patients treated across 22 clinical trials.
Authors: Ritesh Kotecha, Almedina Redzematovic, Robert J. Motzer, Martin Henner Voss
Journal: Journal of Clinical Oncology (2019)

673 Background: National guidelines for RCC management only recommend brain imaging ‘if clinically indicated’; the rate of occult brain metastases is not defined. Early detection of CNS disease has major implications as it typically triggers early intervention with the aim to limit morbidity, including major complications of local progression. In an effort to define the utility of brain screening, we investigated the rate of occult brain metastasis in a large cohort of metastatic RCC pts. Methods: We performed a retrospective review of completed and actively accruing metastatic RCC clinical trials conducted at Memorial Sloan Kettering Cancer Center. Individual charts of pts screening for those studies with mandatory brain imaging at baseline were reviewed to identify subjects harboring occult brain metastases. We collected patient demographics, International Metastatic Database Consortium (IMDC) risk status, sites of metastatic disease, and tumor histology. Patients with neurologic symptoms were excluded. Descriptive statistics were applied to analyze findings across the cohort. Results: A total of 22 clinical trials for metastatic RCC conducted from 2004-2017 required brain imaging at baseline, and a total of 535 pts were screened in this context. A total of 25/535 pts were found to have occult brain metastasis (4.67%), which was multi-focal in 10/25 (40%) and sub-cm in 15/25 (60%). For these 25 pts, the mean age at diagnosis was 56 years (38-77), and IMDC risk score at enrollment was: 1/24 favorable (4%), 21/24 intermediate (88%), and 2/24 poor-risk (8%) patients. 18/25 patients presented with de novo metastatic disease; 13/25 had received prior therapies; and 24/25 patients (96%) had &gt; 2 additional non-CNS sites of metastatic disease at time of screening. 21/23 pts and 2/23 pts were then treated with radiation and surgical resection, respectively. Conclusions: This retrospective cohort study shows a 5% rate of occult CNS disease in asymptomatic patients with advanced RCC. These findings can inform current screening guidelines for full disease assessment in metastatic RCC patients.
Abstract 15333: An Intermediary for Sirpα/Skap2-dependent Integrin-Stimulated Cytoskeletal Rearrangement in Macrophages, and the Implications for Atherosclerosis
Authors: Francis J Alenghat, Danielle Hyatt, Kenneth D Swanson, David E Golan
Journal: Circulation (2014)

Background: Integrins mediate macrophage behaviors that are critical for atherogenesis. The macrophage membrane protein Sirpα cooperates with the adaptor protein Skap2 to control integrin-induced actin reorganization and migration. We hypothesized that CD47 interacts with these proteins to control actin polymerization and that, through their roles in macrophage function, these signaling elements modulate atherosclerosis. Results: Because Sirpα cooperates with Skap2 in an integrin-dependent manner, and because Sirpα is a known receptor for CD47, we tested integrin-induced actin polymerization in CD47-/- bone marrow-derived macrophages (BMMs). Similar to Skap2- and Sirpα-deficient cells, CD47-/- BMMs have impaired local integrin-induced actin polymerization compared to wild-type BMMs (1.1 ± 0.4 units vs. 7.9 ± 1.7 units, n = 20, p < 10-4). Furthermore, we find enhanced recruitment of CD47 to sites of antibody-mediated integrin ligation (3.1 ± 0.7 units vs. 1.0 ± 0.4 units for control antibody, n = 20, p < 5...
Abstract P396: Influence of Social Determinants of Health on Emergency Department Visits Among Individuals With Coronary Heart Disease and Stroke: an Analysis of the 2010-2016 National Health Interview Surveys
Authors: Diana Lyn Baptiste, Yvonne Commodore-Mensah, Ruth-Alma Turkson-Ocran, Cheryl R Dennison Himmelfarb, Hae-Ra Han
Journal: Circulation (2019)

Introduction: Coronary heart disease (CHD) and stroke are leading causes of morbidity and mortality in the U.S. Over 92 million Americans have been diagnosed with CHD/stroke and have more costly emergency department (ED) visits to manage acute and chronic symptoms. These visits are often attributed to poor access to primary care, advanced age, and poor social support. Social determinants of health (SDoH) have been suggested for a variety of health outcomes, yet their relation to healthcare utilization such as ED visits among individuals with CHD/stroke is unclear. Hypothesis: We hypothesized that SDoH would be associated with having ≥1 ED visit(s) in the prior 12 months among patients with CHD and stroke. Methods: A cross-sectional analysis of the 2010-2016 National Health Interview Survey was conducted among those who self-reported CHD/stroke diagnosis. Logistic regression analyses were performed with the outcome reporting ≥ 1 ED visit for any reason in the prior 12 months. SDoH examined were race, employment status, poverty, insurance status, and marital status. Results: We included 6,930 participants with diagnosis of CHD/stroke. The mean age (±sd) was 67.09 (±0.10) years. After adjusting for age, sex, perceived health status, Blacks (OR: 1.27, (95%CI: 1.14-1.41) and unmarried persons (OR: 1.21, 95% CI: 1.11-1.31) were more likely to report having at ≥ 1 ED visits than their White and married counterparts (Table) . Compared to Whites, Asians (OR: 0.65, 95%CI: 0.51-0.81) had lower odds of having ≥ 1 ED visit. Those who were employed were less likely (OR: 0.75, 95%CI: 0.67-0.83) to have ED visits compared to those who were unemployed. Those who were not poor/near poor (OR: 0.86, 95%CI: 0.78-0.96) had lower odds of ED visits than the poor. Conclusions: Being Black, poor, unemployed and unmarried were associated with a higher odds of ED visits in the prior 12 months among those with CHD/stroke. Targeted and culturally-appropriate strategies that address SDoH among this vulnerable, high risk population may help prevent costly ED visits.
Abstract 034: Omega-3 Fatty Acid Biomarkers and Incident Type 2 Diabetes: An Individual Participant-level Pooling Project of 20 Prospective Cohort Studies
Authors: Frank Qian, Andres V Ardisson Korat, Fumiaki Imamura, Matti Marklund, Nathan Tintle, Jyrki K Virtanen, Xia Zhou, Julie K Bassett, Heidi Lai, Yoichiro Hirakawa, Kuo-Liong Chien, Alexis C Frazier-Wood, Maria Lankinen, Rachel A Murphy, Cecilia Samieri, Johanna M Geleijnse, Vanessa de Mello, Nita G Forouhi, Jason H Wu, Rozenn N Lemaitre, Renata Micha, Dariush Mozaffarian, Qi Sun
Journal: Circulation (2019)

Background: Effects of omega-3 fatty acids on the prevention of type 2 diabetes (T2D) are unclear. Relatively few prospective studies have utilized objective omega-3 biomarkers to assess risk. Aims: To assess the prospective relationship between circulating and tissue levels of alpha linoleic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), with respect to risk of T2D. Methods: A global consortium of 20 prospective cohort studies from 14 nations with assessments of ALA, EPA, DPA, or DHA in adults (age &gt; 18 years) were identified through July 2017 and included in this investigation. A pre-specified analytic protocol, including definitions for exposures, covariate list, disease outcome definitions, and subgroup analyses was developed and followed in new participant-level cohort analysis. Associations were pooled using inverse variance-weighted meta-analysis. Results: Among 65,147 participants, 16,693 incident cases of T2D occurred during follow-up (median follow-up in the cohorts ranged from 2.5 to 21.2 years). In pooled multivariate analysis, per interquintile range (difference between the midpoints of the first and fifth quintile for each fatty acid), EPA, DPA, DHA, and their sum ( Figure 1 ) were associated with 8%, 21%, 18%, and 19% lower risk of T2D, respectively (all P &lt;0.001). Higher levels of ALA were not significantly associated with T2D. Associations were consistent across different lipid compartments and pre-specified subgroups, including by age, sex, and geographic region, as well as in several sensitivity analyses. Conclusion: Higher circulating and tissue biomarkers of seafood-derived omega-3 fatty acids, EPA, DPA, and DHA, were associated with lower risk of T2D in a global consortium of prospective studies. Plant-derived ALA was not significantly associated with risk.
Abstract 19237: Frataxin Deficiency Induces Endothelial Metabolic Dysregulation to Promote Pulmonary Hypertension
Authors: Miranda K Culley, Jingsi Zhao, Ying Tang, Vinny Negi, Qiujun Yu, Catherine Corey, Sruti Shiva, Stephen Y Chan
Journal: Circulation (2017)

Background: Pulmonary hypertension (PH) is a vascular disease that causes increased pulmonary arterial pressure, right heart failure, and death. We have shown iron-sulfur (Fe-S) cluster deficiency due to repression of ISCU1/2 promotes mitochondrial dysfunction and PH. Frataxin (FXN), a binding partner of ISCU1/2, is crucial to Fe-S cluster assembly. Genetic FXN deficiency causes Friedreich’s ataxia, a disease of neurologic and cardiovascular dysfunction. The latter is often accompanied by PH, but the molecular etiology is unclear. Thus, there may be a direct role for FXN in PH. Hypothesis: FXN deficiency, due to genetic or acquired triggers, disrupts endothelial metabolism to promote PH. Methods: FXN expression was modulated in human pulmonary arterial endothelial cells (PAECs) by gene transfection and by exposure to the BET bromodomain inhibitor I-BET151, hypoxia, and IL-1β. Fe-S clusters were quantified by fluorescent sensor; glycolytic flux was measured by Seahorse assay. Phenotypic changes, such as ap...
Spontaneous Coronary Artery Dissection
Authors: Robert Jackson, Abtehale Al-Hussaini, Shiju Joseph, Gijs van Soest, Alice Wood, Fernando Macaya, Nieves Gonzalo, Jamil Cade, Adriano Caixeta, Ota Hlinomaz, Pavel Leinveber, Peter O’Kane, Marcos García-Guimaraes, Bernardo Cortese, Nilesh J. Samani, Javier Escaned, Fernando Alfonso, Thomas Johnson, David Adlam
Journal: JACC. Cardiovascular imaging (2019)
Abstract 13433: Coping Partnership Intervention Improves Heart Failure Self-Care Confidence and Reduces Unplanned Healthcare Utilization
Authors: Lucinda J Graven, Glenna Gordon, Jessica Bahorski, Joan Grant Keltner
Journal: Circulation (2016)

Introduction: Social support and social problem-solving, as coping resources, are related to HF self-care, but interventions which target these resources to enhance HF self-care and reduce unplanned emergency room visits and hospitalizations are lacking. Purpose: To determine the efficacy of a nurse-led telephone coping partnership intervention on HF self-care and unplanned healthcare utilization in patients with HF. Methodology: A 3 group randomized controlled pilot study was conducted with 107 HF patients for 3 months. The 12-week coping intervention ( n = 34) included 1 home visit, weekly telephone calls for month 1, and biweekly calls for months 2 and 3. The attention group ( n = 38) received telephone calls starting at week 2 which followed the same pattern as the intervention group. All groups received usual care, with the control group ( n = 35) receiving usual care only. Characteristics of HF patients were: mean age 61 years; 54.2% male; 54.2% African American; and NYHA I: 8.4%; II: 43.9%; III: 18.7%; IV: 29%. All groups provided data at baseline, 5 weeks, 9 weeks, and 13 weeks. HF self-care was assessed using the Self-Care of Heart Failure Index. Data analysis included descriptive statistics and linear mixed modeling. Results: A total of 64 patients completed the study (18 intervention; 24 attention; 22 control). Three linear mixed models were built, controlling for covariates (e.g., gender, race, marital status, NYHA HF class). No significant effects over time were noted by group for self-care maintenance and self-care management. However, significant effects over time were noted for self-care confidence in the intervention group ( p = .030). Patients in the intervention group also reported fewer emergency room visits at 13 weeks (5.6% versus 8.3 % attention; 27.3% control), as well as fewer hospitalizations (5.6% versus 12.5% attention; 27.3% control). Conclusions: Nurse-led telephone coping partnership interventions that strengthen support and social problem-solving appear to be most effective in improving self-care confidence and in reducing unplanned healthcare utilization in individuals with HF. Future research should explore the influence of other variables (e.g., dyadic relationship) on HF outcomes using telephone coping partnerships.
Abstract 14865: Comparative Analysis of Radial Versus Femoral Diagnostic Cardiac Catheterization Procedures in a Cardiology Training Program
Authors: Gurpreet Singh, Enrique P Campos, Clifford J Kavinsky, R. J Snell, Gary L Schaer, Neeraj Jolly
Journal: Circulation (2015)

Background: The use of radial access for cardiac catheterization has been increasing for both diagnostic coronary angiography and percutaneous coronary interventions. In comparison with femoral access, radial approach decreases access site complications and prolonged bed rest, which leads to patient preference. Comparison between these two techniques however, is limited with cardiology fellowship trainees as primary operators. Methods: We conducted a retrospective study of 163 consecutive radial and 180 consecutive femoral access diagnostic cardiac catheterization procedures, with cardiology fellowship trainees as primary operators. Variables including procedure time, fluoroscopy time, dose area product (DAP), and contrast volume used were recorded for all procedures. Mann-Whitney and rank Anova tests were used for statistical analysis. Results: The radial approach was associated with significantly higher fluoroscopy time (8.0±6.97 vs 4.25±3.01 minutes, p&lt;0.001), DAP (10775±6724 vs 7952±4236 micoGy/m 2 , p&lt;0.001), procedure time (38.31±12.25 versus 27±17.56 minutes, p&lt;0.001), procedure start to vascular access time (8.24±6.31 versus 5.31±4.59 minutes, p&lt;0.001), and vascular access to procedure end time (30±15.34 versus 21.2±9.57 minutes, p&lt;0.001). These differences persisted after adjusting for patients with bypass grafts and additional imaging (p&lt;0.001). The use of contrast amount was not significantly different between two groups (p=0.115). Procedure start to vascular access time improved significantly with fellowship training year in both the radial (9.57±6.96 vs 8.23±6.08 vs 5.57±4.82 minutes) and femoral groups (6.17±5.07 vs 5.47±4.75 vs 4.01±3.31 minutes). Fluoroscopy time showed significant difference only in femoral access group (p&lt;0.07). DAP did not improve with training in either access group. Conclusion: Radial procedures were associated with more radiation dose and procedure time. Despite decrease in total procedural time for radial cases with the level of training, total radiation dose did not decrease.
Prognosis and outcomes of adult secondary acute lymphoblastic leukemia (sALL).
Authors: Jason Porter, Michelle Tzue-e Chi, Smith Giri, David McCormick, Michael Gary Martin
Journal: Journal of Clinical Oncology (2015)

e18061 Background: While secondary myeloid neoplasms are well characterized, much less is known about sALL and its prognostic implications. Methods: We used the Surveillance, Epidemiology and End Results (SEER) 13 database to identify adult patients with de novo acute lymphoblastic leukemia (ALL) from 1992-2011. Secondary ALL (sALL) cases were identified using the multiple primary-standarized incidence ratio (MP-SIR) session of SEERstat version 8.1.5 using a latency period of 12 months among primary malignancies of breast, rectum, cervix, ovary and lymphomas. For survival comparisons, we used propensity matching to adjust for age, year of diagnosis, ALL subtype, gender and race. Weighted Cox proportional hazard regression analysis was done to account for remaining imbalances. All p-values were 2-sided and the level of significance was 0.05. Results: A total of 4124 cases of de novo ALL and 79 cases of sALL were identified. Compared with de novo cases, sALL was associated with older age at onset (median age 62, range 21-90 yrs vs 44 yrs, range 18-104 yrs; p < 0.01), more common in females (42% vs 86%; p< 0.01), and occurred later (median year of diagnosis 2005 versus 2003; p< 0.01). After propensity matching, the median overall survival (OS) (8 months versus 16 months; p < 0.01), 1 year OS (35% vs 47%; p= 0.05), 2 year OS (16% vs 31%; p< 0.01) and 5 year OS (7% vs 21%; p< 0.01) were significantly lower for sALL as compared to de novo ALL. Cox regression showed sALL to be an independent predictor of poor prognosis (adjusted HR 1.54; 95% CI 1.16-2.04, p< 0.01) after adjusting for age, sex, race, year of diagnosis, and ALL subtype. Conclusions: sALL is associated with shortened survival compared to de novo ALL cases.
Abstract P321: Leisure-Time Aerobic Physical Activity Reduces the Risk of Diabetes-Related Mortality: NHANES III
Authors: William Boyer, Samantha Ehrlich, Scott Crouter, James Churilla, Eugene Fitzhugh
Journal: Circulation (2019)

Background: Evidence exists to suggest physical activity (PA) reduces risk for diabetes-related mortality (DRM). However, these studies were limited to examining specific modes of PA with only walking, running, and sports participation being consistently related to a reduced risk for DRM. Given the spectrum of leisure-time PA is inclusive of many different modes, it is important to examine this relationship using a more robust measure of PA. Purpose: To examine the relationship between leisure-time moderate-to-vigorous intensity physical activity (MVPA) and the risk of DRM in the Third National Health and Nutrition Examination Survey (1988-1994). Methods: The study sample (n=11,017) included adults, 20-79 years of age, with Mobile Examination Center (MEC) data. An age-standardized physical activity score (PAS) was calculated from the self-reported frequency and intensity of 12 leisure-time aerobic activities. PASs were then used to categorize participants into no activity (PAS = 0) versus any MVPA (PAS &gt; 0). DRM was defined as death from diabetes mellitus, either as the primary cause or as a contributing cause in the National Death Index database. Cox Proportional Hazard models were adjusted for age, sex, race-ethnicity, education, smoking, alcohol consumption, healthy eating index, family history of diabetes, body mass index and diabetes status at the time of the MEC. Race-ethnicity specific models (i.e., non-Hispanic white, non-Hispanic black, and Mexican Americans) were also examined. Results: There was a 68% [HR=0.32 (95% CI 0.23-0.47)] reduction in the risk of DRM, adjusted for age. Following further adjustment for age, race-ethnicity, gender, education, family history of diabetes, body mass index, glycemic status, healthy eating index, smoking status, and alcohol consumption risk estimates were attenuated, but remained statistically significant [HR 0.63 (95% CI 0.43-0.93)]. No interaction between race-ethnicity and MVPA was found. Conclusions: The results of this large, nationally representative prospective study suggest that the accumulation of any volume of MVPA, across a plethora of activities, reduces the risk of DRM.