tbuckley/cabot-search huggingface dataset:
Abstract 17301: Safety of Direct Oral Anticoagulants Compared to Warfarin for Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Ali Hage, Daniel Dolan, Viviane G Nasr, Luis Castelo-Branco, Daniel Motta-Calderon, Hiba Ghandour, Stefania Papatheodorou, Michael W Chu
Journal: Circulation (2020)

Introduction: The evidence for use of direct oral anticoagulants (DOACs) in the management of post-operative cardiac surgery atrial fibrillation (POAF) is limited and mostly founded on clinical trials that excluded this patient population. Hypothesis: We performed a systematic review and meta-analysis of clinical trials and observational studies to evaluate the hypothesis that DOACs are safe compared to warfarin for the anticoagulation of patients with POAF. Methods: We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, and the Cochrane Library for clinical trials and observational studies comparing DOAC with warfarin in patients ≥18 years old who had post-cardiac surgery atrial fibrillation. Primary outcomes included stroke, systemic embolization, bleeding, and mortality, with secondary outcome of hospital readmission. We performed a random-effects meta-analysis. Results: We found 3 clinical trials, 1 prospective and 12 retrospective cohort studies eligible for inclusion with a total of 10,538 patients (3,207 DOAC patients and 7,331 warfarin patients). The meta-analysis for the primary outcomes showed significantly lower risk of stroke with DOAC use (6 studies, 7143 patients, RR 0.64; 95% CI 0.50 to 0.81, I2: 0.0%) compared to warfarin, a trend towards lower risk of systemic embolization (4 studies, 7289 patients, RR 0.64, 95% CI 0.41 to 1.01, I2: 31.99%) and similar risks of bleeding (14 studies, 10182 patients, RR 0.91; 95% CI 0.74 to 1.10, I2: 26.6%) and mortality (12 studies, 9843 patients, relative risk [RR] 1.01; 95% CI 0.74 to 1.37, I2: 26.5%) The secondary outcome of hospital readmission had similar risk between groups. Conclusions: Current evidence suggests that DOACs, compared to warfarin, in the management of atrial fibrillation after cardiac surgery is associated with lower risk of stroke and a strong trend for lower risk of systemic embolization, and no evidence of increased risk for hospital readmission, bleeding or mortality.
Assessment of Coronary Arterial Lesion Responsible for Ischemia by Myocardial Contrast Echocardiography: A Multi-Center Trial
Authors: Nakagawa J, Saitoh H, Itoh M, Iwai(Takano) M, Fushimi E, Watanabe T, Hirono O, Kaneko K, Ito H
Journal: Circulation (2004)
Wound Healing: Synergistic Antibacterial and Anti‐Inflammatory Effects of a Drug‐Loaded Self‐Standing Porphyrin‐COF Membrane for Efficient Skin Wound Healing (Adv. Healthcare Mater. 8/2021)
Authors: Luo‐Gang Ding, Song Wang, Bing‐Jian Yao, Fei Li, Yan‐An Li, Guo‐Yan Zhao, Yu‐Bin Dong
Journal: Advanced Healthcare Materials (2021)

In article number 2001821, Bing-Jian Yao, Yu-Bin Dong, and co-workers report a porphyrin-COFbased “band-aid” type dressing that exhibits highly effective antibacterial and anti-inflammatory effects via synergistic light-induced singlet oxygen generation and controllable ibuprofen release for efficient skin wound healing.
Prenatal Exposure to Glyphosate and Its Environmental Degradate, Aminomethylphosphonic Acid (AMPA), and Preterm Birth: A Nested Case–Control Study in the PROTECT Cohort (Puerto Rico)
Authors: Monica K. Silver, Jennifer Fernandez, Jason Tang, Anna McDade, Jason Sabino, Zaira Rosario, Carmen Vélez Vega, Akram Alshawabkeh, José F. Cordero, John D. Meeker
Journal: Environmental Health Perspectives (2021)

BACKGROUND: Glyphosate (GLY) is the most heavily used herbicide in the world.Despite nearly ubiquitous exposure, few studies have examined prenatal GLY exposure and potentially adverse pregnancy outcomes.Preterm birth (PTB) is a risk factor for neonatal mortality and adverse health effects in childhood.OBJECTIVES: We examined prenatal exposure to GLY and a highly persistent environmental degradate of GLY, aminomethylphosphonic acid (AMPA), and odds of PTB in a nested case-control study within the ongoing Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) pregnancy cohort in northern Puerto Rico.METHODS: GLY and AMPA in urine samples collected at 18 ± 2 (Visit 1) and 26 ± 2 (Visit 3) wk gestation (53 cases/194 randomly selected controls) were measured using gas chromatography tandem mass spectrometry.Multivariable logistic regression was used to estimate associations with PTB (delivery <37 wk completed gestation).RESULTS: Detection rates in controls were 77.4% and 77.5% for GLY and 52.8% and 47.7% for AMPA, and geometric means (geometric standard deviations) were 0.44 (2.50) and 0.41 ð2:56Þ lg=L for GLY and 0.25 (3.06) and 0.20 ð2:87Þ lg=L for AMPA, for Visits 1 and 3, respectively.PTB was significantly associated with specific gravity-corrected urinary GLY and AMPA at Visit 3, whereas associations with levels at Visit 1 and the Visits 1-3 average were largely null or inconsistent.Adjusted odds ratios (ORs) for an interquartile range increase in exposure at Visit 3 were 1.35 (95% CI: 0.99, 1.83) and 1.67 (95% CI: 1.26, 2.20) for GLY and AMPA, respectively.ORs for Visit 1 and the visit average were closer to the null.DISCUSSION: Urine GLY and AMPA levels in samples collected near the 26th week of pregnancy were associated with increased odds of PTB in this modestly sized nested case-control study.Given the widespread use of GLY, multiple potential sources of AMPA, and AMPA's persistence in the environment, as well as the potential for long-term adverse health effects in preterm infants, further investigation in other populations is warranted.
Abstract P076: Increased Burden Of Chronic Illness Among Insured Compared To Uninsured Sudden Death Victims
Authors: Reaves Houston, Susan Keen, Chelsea Deitelzweig, Hannah Jones, Sarah Laible, Catherine Sauter, Ross J Simpson
Journal: Circulation (2021)

Introduction: Lack of health insurance is associated with reduced access to medical care and increased mortality. Chronic illness is associated with sudden death, a major cause of natural death. Insurance status of sudden death victims has not been characterized. Hypothesis: Uninsured compared to insured sudden death victims will have more chronic illnesses. Methods: From 2013-2015, emergency medical services-attended out of hospital deaths among ages 18-64 in Wake County, NC were screened to adjudicate sudden deaths. Medical records were reviewed for demographic, clinical, and health insurance status data. Insurance status was characterized as private, public, or no insurance. Cases were excluded from the analysis if no information on insurance was available. Comparisons of demographic and clinical characteristics were made between the three insurance status groups using Student’s t-test and ANOVA for continuous and categorical variables, respectively. Results: Of 399 cases of sudden death, insurance status data was available for 130: 25 (19.2%) had no insurance, 62 (47.7%) had public insurance, 31 (23.8%) had private insurance, and 12 (9.2%) had insurance of unknown type. Uninsured victims had lower frequencies of hypertension, hyperlipidemia, and chronic respiratory disease than those with private or public insurance, and lower frequencies of diabetes mellitus, mental illness, and substance abuse than those publicly insured (Table 1). No significant differences were found in coronary artery disease, age, gender, race, marital status, or years of education. Conclusion: Uninsured sudden death victims have less chronic illnesses than those insured. This counterintuitive finding suggests that uninsured sudden death victims have undiagnosed chronic illnesses that are treatable and preventable and contribute to their death. Our results suggest that expanding health insurance among working age adults may reduce the incidence of sudden death.
Involvement of vimentin in prostate cancer progression and invasion: A study in transgenic TRAMP model that closely mimics human disease.
Authors: Vaqar M. Adhami, Imtiaz A. Siddiqui, Nihal Ahmad, Hasan Mukhtar
Journal: Cancer Research (2004)

2089  Prostate Cancer (PCa) is the most common cancer and the second leading cause of cancer-related deaths in men in the United States. At present, there are inadequate treatment options for the management of this disease. Thus, there is a need to define novel targets that may lead to the development of effective approaches for combating PCa. PCa is a dynamic disease that progresses through stages that may be controlled via specific molecular determinants. Thus, identifying these controlling events may be useful for the management of stage-specific PCa. The transgenic adenocarcinoma of the mouse prostate (TRAMP) model mimics human disease where PCa progresses from benign prostatic intraepithelial neoplasia to malignant poorly differentiated adenocarcinoma. This transition to an aggressive phenotype is not completely understood. We have found an increasing trend in the levels of insulin-like growth factor (IGF), through the progression to malignant PCa in TRAMP mice. Studies have suggested possible involvement of vimentin, a mesenchymal intermediate filament, in the invasive phenotype in androgen-independent prostate cancer. IGF possesses a critical role in cancer-invasion via promoting cooperation between signals provided by cell attachment and cell motility proteins including vimentin. Employing TRAMP model, in this study, we assessed the involvement of vimentin in PCa progression from no cancer (8 weeks) to high grade prostatic intraepithelial neoplasia (PIN, 16 weeks) to well differentiated adenocarcinoma (24 weeks) and finally to poorly differentiated adenocarcinoma (32 weeks). Using immunoblot, immunofluorescence and RT-PCR studies, we found that the protein and mRNA expression of vimentin was enhanced in an age-dependent manner as the cancer progressed to invasive phenotype. Vimentin expression was absent in the non-transgenic litter mates and in the 8 week old transgenic animals. A moderately detectable vimentin expression was observed in transgenic animals with high grade PIN (at 16 weeks). This expression was further enhanced at 24 and 32 weeks of age suggesting the involvement of vimentin in progression of cancer to the aggressive phenotype. We next utilized two prostatic epithelial cell lines obtained from TRAMP prostate (TRAMP-C2 and TRAMP-C3) to assess the role of vimentin. Our data demonstrated a higher expression of vimentin in TRAMP-C2 cells as compared to TRAMP-C3 cells. Because TRAMP-C2 cells are tumorigenic whereas TRAMP-C3 cells do not form tumors when grafted into syngenic animals, this observation further suggested a critical role for vimentin in PCa progression to an invasive phenotype. We suggest that vimentin functions in association with IGF-I and other proteins, in the process of tumorigenesis and its invasion. However, additional studies are needed to establish the function and interactions of vimentin in PCa.
Associations of Microvascular Complications With the Risk of Cardiovascular Disease in Type 1 Diabetes
Authors: Rose Gubitosi-Klug, Xiaoyu Gao, Rodica Pop-Busui, Ian H. de Boer, Neill White, Lloyd P. Aiello, Ryan Miller, Jerry Palmer, William Tamborlane, Amisha Wallia, Mikhail Kosiborod, John M. Lachin, Ionut Bebu
Journal: Diabetes Care (2021)

OBJECTIVEWe examined whether the presence of microvascular complications was associated with increased subsequent risk of cardiovascular disease (CVD) among participants with type 1 diabetes in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study followed for >35 years.
62P Influence of PAM50 on therapeutic decisions in patients with early-stage luminal breast cancer in a single centre
Authors: A. Olivares Hernandez, R.A. Escala Cornejo, M. García Muñoz, L. Figuero-Perez, J. Martín Vallejo, M. Sancho de Salas, M.A. Gómez Muñoz, E. Escalera Martín, J. Claros Ampuero, Á. López Gutiérrez, E. Terán Brage, B. Barrios Collado, D. Casado Elia, G. Martín García, R. Seijas Tamayo, J.J. Cruz Hernandez, C.A. Rodríguez
Journal: Annals of Oncology (2021)
Abstract MP23: Neighborhood Disadvantage And Oral Anticoagulant Use In Patients With Atrial Fibrillation
Authors: Anne M McDermott, Nadejda Kim, Maria Mor, MICHAEL J FINE, Utibe Essien
Journal: Circulation (2021)

Background: Atrial Fibrillation (AF) is the most common heart rhythm disorder in the US and is treated with anticoagulation to mediate patients’ increased risk of ischemic stroke and death. Direct-acting oral anticoagulants (DOACs) are associated with better patient outcomes than warfarin, but prior studies show disparities in DOAC prescription. AF patients with low socioeconomic status (SES) have an increased risk of AF incidence, adverse outcomes, and mortality. Despite SES disparities in AF outcomes and prescribed medications, the impact of neighborhood SES (ADI) on AF management is unclear. We hypothesized that in comparison to patients with high ADI (e.g. the most disadvantaged), those with low ADI will be more likely to initiate any oral anticoagulants (OACs) and will be more likely to initiate DOACs. Methods: We conducted a retrospective observational study using national data from the Veterans Health Administration (VA) of newly diagnosed AF patients. Our independent variable was ADI, a marker of SES incorporating income, education, employment etc. Our model assessed numerous baseline patient, provider, and system-level covariates. We grouped patients into ADI quintiles, with Q1 being the lowest ADI (e.g., the least disadvantaged) and Q5 being the highest ADI, and used Q5 as a reference value. We used mixed effects logistic regression models, with site as a random effect, to determine the adjusted odds of initiating any OACs and of initiating DOACs by ADI quintile. Results: In our final cohort including 111,666 patients, 10,9386 (98.0%) were male and 2280 (2.0%) were female. The overall mean age at diagnosis was 72.86 (SD 10.4). Patients had the following medical comorbidities: Congestive heart failure: 18212, (16.3%); Hypertension: 84944, (76.1%); Diabetes: 70673, (63.3%); Vascular Disease: 46599, (41.7%). The ADI quintiles included the following patients: Q1: 21570, (20.3%); Q2: 21032, (19.8%); Q3: 21439, (20.2%); Q4: 20974, (19.8%); Q5: 21215, (20.0%). There was no significant difference in the odds of initiating any OAC between ADI quintiles compared to Q5 (Q1: adjusted odds ratio [95% CI], 0.95 [ 0.9, 1.01]; p=0.11). Among patients initiating DOAC, there was a significant association between low ADI and higher odds of initiating DOAC (Q1: 1.39 [1.29, 1.50]); (Q2: 1.18 [1.10, 1.27]); (Q3: 1.13 [1.06, 1.20]); (Q4: 1.09 [1.02, 1.16]). Each ADI quintile had a significantly higher odds of initiating DOACs compared to the highest ADI quintile. Conclusions: Patients with lower ADI are significantly more likely to be prescribed DOACs compared to patients with the highest levels of ADI. We found no significant difference in initiation of any OAC between ADI quintiles, which may result from high Warfarin utilization in the VA compared to the general population. Our data suggests that differences in neighborhood deprivation contribute to disparities in the prescribing DOACs in the VA.
Abstract 16558: The Burden of Arrhythmia in Cardiac Amyloidosis Hospitalizations: Perspective From a Nationwide Study
Authors: Samarthkumar J Thakkar, Harsh P Patel, Raj Patel, Medhat Chowdhury, Ashish Kumar, Rajkumar P Doshi, Bryan E-Xin Tan, Kirolos Barssoum, Shilpkumar Arora, Brinda Patel, Bipul Baibhav, Mohan Rao
Journal: Circulation (2020)

Introduction: Cardiac amyloidosis (CA) is a significantly underdiagnosed cause of infiltrative and restrictive cardiomyopathy, which leads to rapidly progressive heart failure associated with poor outcomes. Hypothesis: There is a paucity of data on the incidence and outcomes of arrhythmia among CA hospitalizations. Methods: Nationwide Inpatient Sample from 2016 to 2017 was used for the present analysis. CA hospitalizations with concurrent arrhythmia were identified by using appropriate ICD-10 CM codes, and it was compared with CA hospitalizations without arrhythmia. The primary outcome was all-cause in-hospital mortality, and secondary outcomes were the length of stay and total hospital cost. The adjusted odds ratio was calculated by multivariable regression analysis after adjusting for baseline characteristics and comorbidities. Results: A total of 5030 hospitalizations with CA were identified, of which 1570 had associated arrhythmia. CA hospitalizations with arrhythmia had higher mortality compared to without arrhythmia (150 (10.82%) vs. 215 (6.21%), P=0.012) (Table 1). Length of stay (9.74 days vs. 8.20 days, P=0.02) and total cost of hospitalization (avg. $ 112840 vs. $88638, P=0.02) were significantly higher in CA hospitalizations with concomitant arrhythmia (Table 1). Among arrhythmia, atrial fibrillation was the most common (89.38%) (Figure 1). Adjusted odds of in-hospital mortality due to any arrhythmia (aOR (adjusted odds ratio) = 1.83, CI (confidence interval) = 1.14 - 2.92, P=0.012) or atrial fibrillation (aOR= 1.73, CI= 1.075-2.277, P= 0.02) were significantly higher in CA hospitalization (Table 2). Conclusions: CA hospitalizations with arrhythmia had a higher adjusted odds of in-hospital mortality as compared to without arrhythmia. Additionally, CA hospitalization with arrhythmia had a longer length of stay, and cost of care. Among all arrhythmia, atrial fibrillation was the most common.
Efficacy of Sirolimus, Paclitaxel, Everolimus-Eluting Stent and Drug-Eluting Balloon on the Outcome of Patients with Diffuse In-Stent Restenosis
Authors: Nakamura Sunao, Ogawa Hisao, Yeohans Cahyadi, Wasan Udayachalerm, Damras Tresukosol, Sudaratana Tansuphaswadikul
Journal: Circulation (2013)
Abstract 15671: Adipocyte-derived Exosomal Lncrna Nbr2 Promotes Diabetic Myocardial Fibrosis Through Regulating the Ikba/nf-kb Pathway
Authors: Yue Guo, Xingfeng Xu, Lingling Wu, Xiaodong Zhuang, Xinxue Liao
Journal: Circulation (2020)

Introduction: The activation of NF-κB is the dominant process that correlates with the pathogenesis of diabetic cardiomyopathy (DCM). Recently, accumulating evidence shows that long noncoding RNAs (lncRNAs) play crucial roles in sustaining the NF-κB pathway. However, the underlying mechanisms remain unclear. In this study, we identified the upregulated expressed lncRNA NBR2 in adipocyte-derived exosomes (AdEXO) and investigated its regulatory role in diabetic myocardial fibrosis. Hypothesis: We hypothesized that AdEXO-NBR2 promotes diabetic myocardial fibrosis through regulating the IκBα/NF-κB pathway. Methods: We examined the effect of exosomes from diabetic (db/db) mice-derived adipocytes on ANG-II-induced cardiac fibrosis and function in non-diabetic (C57BL/6J mice). In the invitro study, HG (33mmol/L)-stimulated AdEXO were cultured with adult human cardiac fibroblasts (aHCFs). Differentially expressed lncRNAs in AdEXO were screened using lncRNA sequencing. Results: Intramyocardial injection of diabetic AdEXO in the non-diabetic heart significantly exacerbated myocardial fibrosis, as evidenced by poorer cardiac function and enhancer collagen deposition. Whereas administration of a exosomes biogenesis inhibitor mitigated cardiac fibrosis in diabetic mice. We found lncRNA-NBR2 is a common molecule significantly increased in diabetic AdEXO and HG-stimulated non-diabetic AdEXO. After four weeks of ANG II infusion, EXO-db/dbWT-injected mice displayed fibrosis in the heart. However, interestingly, mice receiving NBR2-deficient db/db-EXO showed a decrease in cardiac fibrosis. Similarly, AdEXO-NBR2 promoted aHCFs proliferation and transformation capabilities in vitro. Mechanistically, NBR2 was loaded to AdEXO by directly interacting with heterogeneous nuclear ribonucleoprotein K (hnRNPK). Subsequently, AdEXO-NBR2 was internalized by aHCFs and epigenetically downregulated IκBα expression by recruitment of hnRNPK/SETDB1 and increasing the H3K9 trimethylation level in the IκBα promoter, ultimately activating the NF-κB pathway. Conclusions: Our findings highlight a novel epigenetic mechanism of AdEXO lncRNA-mediated diabetic cardiac fibrosis and identify NBR2 as a therapeutic target of DCM.
Abstract 16986: Reduced Medical Spending Overtime With Use of a Home Blood Pressure Monitoring Program
Authors: Roberta James, Wei Lu, Jennifer Schnieder, Bimal R Shah
Journal: Circulation (2020)

Background: Livongo’s Applied Health Signals Home Blood Pressure Monitoring Program (HBMP) offers patients a Bluetooth connected blood pressure cuff, hypertension (HTN) management education, and access to health coaches. Previous studies have demonstrated the clinical benefits of HBPM so the objective of this study was to also evaluate the impact on U.S. medical spending within the first year. Methods: People younger than 65 years with continuous enrollment in health benefits for the 12 months before and 12 months after launch of the HBMP and use of the program for at least three months were selected. Medical spending for those participants was compared to eligible but non-HBMP participant controls who were identified utilizing propensity score with nearest-neighbor matching methodology on age, gender, and pre-period medical spending with exact matching on Charlson Comorbidity Score Index in a 1:1 ratio. People with medical spending exceeding $50,000 monthly or $100,000 annually were excluded from the analysis. The HBPM participant baseline blood pressures were compared to BP values at 12-months to assess improvement in BP management. Mean medical spending based on the total allowed amounts per member per month (PMPM) was compared between the HBPM and non-HBPM groups using intention-to-treat difference-in-difference (DiD) analysis. Results: There were 1,417 HBPM participants with mean age of 51 years, 52% female, 64% with uncontrolled HTN (BP &amp;gt = 130/80) at baseline, and mean pre-period medical spending of $490 PMPM. For participants with uncontrolled HTN, mean systolic and diastolic BP reductions were 14.2 mmHg and 10.1 mmHg, respectively, with 54% decreasing in HTN stage or considered controlled. The HBPM group had a 1% reduction in medical spending to $474 PMPM while the non-HBPM group had an 18% increase in medical spending from $410 PMPM to $486 PMPM resulting in a medical savings of $81 PMPM. The HBPM group also had a reduction of 33% in inpatient utilization and 14% in ED visits. Conclusion: HBPM participants experienced improved BP control and a reduction in total medical cost savings resulting in a positive return on investment. The main drivers of medical savings were a reduction in ED and inpatient hospital utilization.
Blocking FcγRIIB in Smooth Muscle Cells Reduces Hypertension
Authors: Xiaomin Song, Xuan Zou, Weipeng Ge, Cuiliu Hou, Zhujie Cao, Hongmei Zhao, Tiantian Zhang, Ling Jin, Yi Fu, Wei Kong, Chen Yan, Jun Cai, Jing Wang
Journal: Circulation Research (2021)

[Figure: see text].