tbuckley/cabot-search huggingface dataset:
SURG-14. COMPARABLE SURVIVAL OUTCOMES BETWEEN THE ELDERLY AND THEIR YOUNGER COUNTERPARTS AFTER RESECTION OF BENIGN MENINGIOMAS
Authors: Jun Ma, Ali Alattar, Sanjay Dhawan, Asgeir Jakola, Jiri Bartek Jr, Clark Chen
Journal: Neuro-Oncology (2021)

Abstract OBJECTIVE Using the Surveillance, Epidemiology and End Results (SEER) database, we characterized the patterns of surgical recommendations and outcomes after benign meningioma resection in the elderly population. METHODS 27,839 adult meningioma patients were identified in SEER between 1973- 2015 and 6,967 patients were identified between 2016-18. Patients were stratified into four age groups:18-39, 40-59, 60-79, and &amp;gt; 80 years old. The likelihood for recommendation to proceed with resection, extent of resection, and survival outcome were determined using logistic regression models. RESULTS In a multi-variate model that accounted for gender, race, marital status, tumor size, and tumor location, the likelihood of recommendation to proceed with benign meningiomas resection decreased with advancing age. Relative to patients age 40-59, the likelihood of recommendation for surgery were 1.130 (95%CI=0.925-1.380, P=0.230), 0.593 (95%CI=0.531-0.662, P&amp;lt; 0.001), and 0.173 (95%CI=0.146-0.205, P&amp;lt; 0.001) for patients age 18-39, 60-79, and &amp;gt;= 80, respectively. A similar trend in the likelihood of gross total resection (GTR) was observed. Relative to patients age 40-59, the likelihood of gross total resection were 1.009 (95%CI=0.913-1.114, P=0.867), 0.903 (95%CI=0.849-0.961, P=0.001), and 0.580 (95%CI=0.512-0.657, P&amp;lt; 0.001) for patients age 18-39, 60-79, and &amp;gt;= 80, respectively. However, survival after meningioma resection did not vary significantly as a function of patient age. Relative to patients age 40-59, the hazard of death after GTR of meningioma resection were 1.324 (95%CI=0.795-2/203, P=0.280), 0.813 (95%CI=0.639-1.035, P=0.092), and 0.913 (95%CI=0.618-1.350, P=0.649) for patients age 60-79, and &amp;gt;= 80, respectively. These results were validated using SEER data from 2016-2018. CONCLUSION This analysis provide evidence that surgeons exert caution in surgical resection of benign meningioma in the elderly, with decreased likelihood for recommending surgery in this population. In patients selected for and underwent gross resection, survival outcome in the elderly was comparable to their younger counterparts, suggesting safety of procedure in appropriately selected elderly.
Impact of COVID-19 Vaccination on Glycemia in Individuals With Type 1 and Type 2 Diabetes: Substudy of the COVAC-DM Study
Authors: Felix Aberer, Othmar Moser, Faisal Aziz, Caren Sourij, Haris Ziko, Jacqueline Lenz, Farah Abbas, Anna M. Obermayer, Harald Kojzar, Peter N. Pferschy, Alexander Müller, Christina Unteregger, Marlies Leitner, Tamara Banfic, Max L. Eckstein, Nadine Wachsmuth, Susanne Kaser, Julia K. Mader, Norbert J. Tripolt, Harald Sourij
Journal: Diabetes Care (2021)
Abstract 14673: Development of an Atrial Fibrillation Risk Score in Patients With Diabetes: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Study
Authors: Ping Yang, Yanglu Zhao, Nathan D Wong
Journal: Circulation (2019)

Introduction: Atrial fibrillation (AF) is associated with increases in cardiovascular disease (CVD) risk in patients with diabetes mellitus (DM); however, predictors of incident AF in DM are not we...
Abstract 12918: COVID-19 Has Not Decreased the Volume of Transcatheter Aortic Valve Replacements Performed in the United States
Authors: Edgar Aranda-Michel, James Brown, Derek Serna-Gallegos, Hemal Gada, Dustin Kliner, Catalin Toma, Saurabh Sanon, Yisi Wang, Ibrahim Sultan
Journal: Circulation (2021)

Introduction: Transcatheter aortic valve replacement (TAVR) is the predominant technique for aortic valve replacements. The COVID19 pandemic caused significant disruptions to hospital procedural and surgical volume and revenue, which could affect patients with aortic stenosis. Hypothesis: The COVID-19 pandemic may have decreased the volume of TAVRs in the United States. Methods: The National Readmission Database (NRD) was reviewed for all adults from 2012 to 2017 who underwent a TAVR procedure based on ICD 9 and 10 coding. A linear regression based on year and quarter was used to project the trend of volume and cost through the end of 2020. Institutional TAVR volume was compared from 2020 to 2019 to generate an estimate of COVID’s effect on volume. This trend effect was utilized for the 2020 projections to create national estimates of changes in volume and hospital costs. The NRD weights were used to generate national estimates, charge-cost ratios were used to convert hospital charges to hospital costs, and all monetary values were adjusted to 2020 dollars via the GDP. Results: A total of 172,546 TAVR procedures were performed. TAVR volume has been increasing since 2012 with an estimated 21,516 cases in the last quarter of 2020 ( Figure 1A). The linear regression was well fit with a R 2 of 0.995. Similarly, hospital costs of TAVR have been increasing since 2012 with a projected 4.18 billion dollars in 2020 (Figure 1B) . The linear regression was also well fit with a R 2 of 0.968. There were two quarters in which hospital volume outperformed predicted values and two in which it underperformed (Figure 1C). Throughout the pandemic, there was a net increase of 1,918 TAVR procedures and an associated increase of 114 million dollars in hospital costs. Conclusions: TAVR volumes have been steadily increasing, with commensurate escalation in hospital hosts. The COVID-19 pandemic has caused minimal derailment to this trend, with an actual increase in volume and hospital costs during this time.
Association Between Neighborhood Socioeconomic Inequality and Cervical Cancer Incidence Rates in New York City
Authors: Stephanie Cham, Alicia Li, J. Alejandro Rauh-Hain, Ana I. Tergas, Dawn L. Hershman, Jason D. Wright, Alexander Melamed
Journal: JAMA Oncology (2021)

This cross-sectional study uses Agency for Healthcare Research and Quality data to compare incidence of cervical cancer in the lowest–socioeconomic status neighborhoods with that in higher–socioeconomic status neighborhoods of New York City from 2012 through 2016.
Abstract 16487: IPS Cell-Deriverd Cardiac Tissue From Dilated Cardiomyopathy Patients With Lamin Variant Showed Impaired Systolic Function
Authors: Koichiro Miura, Katsuhisa Matsuura, Yu Yamasaki, Daisuke Sasaki, Yoshiyuki Furutani, Emiko Hayama, Masamichi Ito, Hiroyuki Morita, Masashi Toyoda, Akihiro Umezawa, Toshio Nakanishi, Nobuhisa Hagiwara, Issei Komuro, Tatsuya Shimizu
Journal: Circulation (2019)

Introduction: Dilated cardiomyopathy (DCM) is genetic disorders that cause left ventricular dysfunction and heart failure. DCM patients with lamin variant have been reported to show the poor progno...
Population birth outcomes and experiences of expectant mothers during the COVID-19 pandemic in Wales: a mixed methods study
Authors: Hope Jones, Mike Seaborne, Laura Cowley, David Odd, Shantini Paranjothy, Ashley Akbari, Sinead Brophy
Journal: The Lancet (2021)

BackgroundPregnancy can be a stressful time and the COVID-19 pandemic is thought to have heightened maternal stress. This study aimed to investigate the effect of the COVID-19 pandemic on population birth outcomes, uptake of primary immunisations, and expectant mothers' experiences of pregnancy in Wales.MethodsIn this mixed methods study we analysed stillbirths, prematurity, birthweight and caesarean section births before (2016–19) and during (2020) the pandemic using national routine anonymised data held in the Secure Anonymised Information Linkage Databank. Uptake of the first three scheduled primary immunisations were compared between 2019 and 2020. Immunisations were extracted from the routinely collected data in the National Community Child Health Database. We compared percentages between years the ran χ2 with Yates correction for the three percentages given. Expectant mothers (aged ≥16 years) in Wales completed an online survey about their experiences of pregnancy during the pandemic. Inclusion criteria was being aged 16 years or older and living in Wales. The qualitative survey data was analysed using codebook thematic analysis. Ethical approval was granted by Swansea University Ethics Committee and each participant provided written consent before answering any survey questions.FindingsThere was no significant difference between annual outcomes including gestation and birthweight, stillbirths, and caesarean sections for infants born in 2020 compared with 2016–19. Difference in gestation (moderate to late preterm difference –0·26%, 95% CI –0·52% to –0·01%). Difference in low birthweight 0·13% (0·00% to 0·26%). Difference in stillbirths –0·01% (–0·02% to 0·00%). Difference in caesarean sections –0·42% (–1·13% to 0·29%). There was an increase in late-term births (≥42 weeks gestation) during the first lockdown (odds ratio [OR] 1·28, p=0·019) and a decrease in moderate to late preterm births (32–36 weeks gestation) during the second lockdown (OR 0·74, p=0·001). Fewer babies were born in 2020 (n=29 031) compared with 2016–19 (n=32 582; mean [SD 1561]). All babies received their immunisations in 2020, but there were minor delays in the timings of vaccines. Those vaccinations due at 8-weeks were 8% less likely to be on time (within 28 days) and, at 16-weeks, they were 19% less likely to be on time. The pandemic had a negative effect on the mental health of 151 (72%) of 211 survey respondents, who reported feeling anxious, nervous, or depressed; this finding was associated with attending scans without their partner, giving birth alone, and minimal contact with midwives.InterpretationThe COVID-19 pandemic had a negative effect on mothers' experiences of pregnancy; however, population data suggests that this did not translate to adverse birth outcomes for babies born during the pandemic.FundingHealth Care Research Wales
Management of MDS with Isolated Del(5q) Patients in the European MDS (EUMDS) Registry, a Unique Prospective Real-World Dataset
Authors: David Bowen, Adele Taylor, Pierre Fenaux, Agnes Guerci-Bresler, Raphael Itzykson, Argiris Symeonidis, Ioannis Kotsianidis, Moshe Mittelman, Guillermo Sanz, Dominic J. Culligan, Jaroslav Cermak, Reinhard Stauder, Eva Hellstrom Lindberg, Luca Malcovati, Saskia M. C. Langemeijer, Ulrich Germing, Howard S. Oster, Krzysztof Madry, Mette Skov Holm, Alexandra Smith, Corine van Marrewijk, Theo M de Witte
Journal: Blood (2021)
Abstract 10434: Gaps in Ldl-C Control According to Cardiovascular Risk Status and Statin Use in Us Adults
Authors: Yueh-Ning Yang, WENJUN FAN, Nathan D Wong
Journal: Circulation (2021)

Background: Current US guidelines since 2013 have recommended statin use for high cardiovascular (CV) risk adults including those with atherosclerotic cardiovascular disease (ASCVD), regardless of LDL-C levels. Recent data among US population-representative adults regarding extent of LDL-C control in high CV risk persons are lacking. Methods: We examined among 4,484 US adults (representing 231 million) from the National Health and Nutrition Examination Surveys 2015-2018 the extent of statin use and remaining high LDL-C levels according to risk group as defined by the pooled cohort equation (PCE): low (&lt;5%), intermediate (5- &lt; 20%), high risk without ASCVD (&gt;20% 10-year risk), diabetes without ASCVD, and high and very high risk ASCVD as defined by the 2018 cholesterol management guideline based on multiple major ASCVD events or high risk conditions. Results: Overall, 18.9% (representing 43.7 million) of US adults were on statin therapy in our cohort; this varied across risk groups from 1.4% (low risk), 10.7% (intermediate risk), 26.2% (high risk without ASCVD), 48.8% (diabetes without ASCVD), 50.8% (ASCVD high risk) and 75.4% (ASCVD very high risk), with additional ezetimibe use &lt;5% in all groups. The figure below shows, despite statin therapy (with or without ezetimibe), &gt;45% of high-risk primary prevention persons still have LDL-C &gt; 100 mg/dL, &gt;70% of those with DM to have LDL-C &gt; 70 mg/dL, and &gt;60% of high risk and &gt;70% of very high-risk adults with ASCVD to have LDL-C &gt; 70 mg/dL. Conclusions: Despite statin-focused guidelines since 2013, many US adults recommended for statin therapy are not on statins, and of those on statins, many have suboptimal LDL-C levels, warranting further LDL-C lowering with higher intensity statins and/or non-statin agents.
Abstract 11110: Triomic Approach Reveals the Metabolic, Genomic and Proteomic Influences of the Endogenous Histidyl Dipeptides on Heart
Authors: Keqiang Yan, Zhanlong Mei, Jingjing Zhao, Detlef Obal, Kartik Katragadda, David Hoetker, Dheeraj Kumar Posa, Jasmit Shah, Pawel Lorkiewicz, Aruni Bhatnagar, Shahid P Baba
Journal: Circulation (2021)

Background: Histidyl dipeptides, such as carnosine (β-alanine-histidine) are synthesized in the heart via enzyme carnosine synthase (CARNS1). These dipeptides are present in the myocardium in micro-millimolar concentration, where they facilitate glycolysis and glucose oxidation by proton buffering and attenuate ischemia reperfusion injury. However, a composite understanding of their roles in myocardium is lacking. Objective: To understand the role of endogenous histidyl dipeptides in regulating the metabolic, genomic and proteomic profiles of heart under basal and ischemic conditions. Methods and Results: We found that mice with cardio specific overexpression of CARNS1, had higher myocardial levels of carnosine, anserine and homocarnosine. Under aerobic conditions, the transgenic hearts had lower levels of short- (dodecanal) and long-chain (propionic) fatty acids and TCA intermediate -succinic acid, and an increase in pyroglutamic acid-an intermediate of glutathione metabolism. When subjected to 5 and 15 min of ischemia, WT hearts showed progressive accumulation of fatty acids and depletion of amino acids, such as aspartate that were significantly attenuated in transgenic hearts. Further, the ischemic transgenic hearts had increased accumulation of citric acid cycle (TCA) intermediate - fumaric acid. Parallel with the increase in β-fatty acid oxidation and TCA cycle, transgenic hearts were enriched in enzymes of β-fatty acid oxidation and TCA cycle. Expression of enzyme glutathione synthetase that regulates pyroglutamic acid synthesis was decreased in the transgenic hearts. Overexpression of CARNS1 also led to a decrease in several micro RNAs, such as miR-6989 and miR-3100 which are paralleled to increased expression of succinate dehydrogenase and 2,3 enoyl-CoA hydratase. Further miR-142 levels in transgenic hearts were decreased that parallels with decreased glutathione synthetase. Conclusion: Our integrated analysis of metabolomics, transcriptomics and proteomics shows histidyl dipeptides are critical regulators of myocardial function and energetics. Importantly these dipeptides promote β-fatty acid oxidation and glycolytic activity under the basal and ischemic conditions.
Abstract 11706: His Bundle Pacing and Atrioventricular Nodal Ablation in the Management of Refractory Atrial Fibrillation, a Systematic Review and Meta-Analysis
Authors: Shakeel Jamal, Steve Balian, Zulfiqar Qutrio Baloch, Sandeep Banga, Abdul Minhas, Sardar H Ijaz, Abbas Ali, Matthew Wilcox, John Ip
Journal: Circulation (2021)

Introduction: Ventricular rate control is critical in management of atrial fibrillation (AF). When pharmacologic therapy fails in controlling the ventricular rate, atrioventricular nodal ablation (AVNA) and pacing is considered an effective therapy for symptomatic management. His bundle pacing (HBP) is considered a physiologic mode of pacing with AVNA ensuring synchronized activation of right and left ventricles preserving ventricular functioning. Hypothesis: HBP and AVNA are feasible, safe, and effective for management of refractory AF. Methods: We identified 218 studies after literature review of EMBASE, Medline, and Cochrane databases. Our analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results: Six studies (two randomized controlled trials, four observational cohorts) were included in the final meta-analyses. A total of 275 patients underwent attempted permanent HBP and AVNA. The mean age of patients was 70.74 (SD 4.38; 95% CI 62.15-79.32). Mean implant success rate for acute HBP was 94.5% (SD 10.12; 95% CI 74.70, 100.00). Selective HBP was noted in 44.7% (95% CI 12.5-76.9), while Non-selective-HBP was noted at rate of 42.2% (95% CI 10.2-74.2). The mean follow-up duration was 21.71 months (SD 3.77; 95% CI 14.32-29.11). All-cause mortality had a pooled proportion of 0.107 (SD 0.110, 95% CI -0.109-0.323); hospitalization proportion was 0.078 (SD 0.072; 95% CI -0.063-0.219). We noted a significant improvement in left ventricular ejection fraction (LVEF) (Baseline [BL] 41.84%, Follow-up [FU] 53.63%, Standardized mean difference [SMD] 0.646, p 0.028), NYHA class (BL 2.77, FU 1.55, SMD -2.542, p &lt;0.001) and LV end diastolic volume (SMD -0.495, 95% CI -0.721, -0.269, p &lt;0.001). We found a significant rise of threshold potential (BL 1.12 V, FU 1.49 V, SMD 0.393, p &lt;0.001 and an increase between baseline and follow up QRS duration (BL 102.21 ms, FU 106.90 ms, SMD 0.646, p 0.028). Conclusion: HBP and AVNA are feasible, safe, effective and has high success rate for management of refractory AF. Further studies are needed to evaluate its role in comparison to left bundle branch area pacing and cardiac resynchronization therapy to evaluate comparative efficacy in refractory AF.
Abstract 11063: Non-Ischemic Fibrosis on Cardiac Magnetic Resonance Impacts Adverse Left Ventricular Remodeling and Mortality Among Patients with Functional Mitral Regurgitation
Authors: Jaya Kanduri, Hannah W Mitlak, Christine Park, Lakshmi Nambiar, Katherine Tak, Romina Tafreshi, Richard B Devereux, Robert A Levine, Mark B Ratcliffe, Jiwon Kim, Jonathan W Weinsaft
Journal: Circulation (2021)

Introduction: Functional mitral regurgitation (FMR) alters left ventricular (LV) remodeling, providing a nidus for non-ischemic fibrosis (NIF). Cardiac magnetic resonance (CMR) can measure FMR and LV tissue properties. Prevalence, remodeling manifestations, and prognostic implications of NIF in patients with FMR are unknown. Hypothesis: Among post-myocardial infarction (MI) patients with FMR, NIF associates with advanced LV remodeling and predicts adverse prognosis. Methods: The population comprised post-MI patients with FMR undergoing CMR. CMR exams were retrieved from a single-center registry, reviewed for MR etiology (degenerative excluded) and analyzed for FMR severity, LV structure/function, and late gadolinium enhancement (LGE) including ischemic pattern MI and NIF, which was defined via established criteria (mid-myocardial or epicardial LGE). Follow-up was performed for all-cause mortality. Results: 467 consecutive FMR patients (74% male, 63±16 years old) were studied, of whom 14% had NIF. Prevalence of NIF increased stepwise with FMR severity (12% mild, 16% moderate, 21% severe; p=0.33). Patients with NIF had higher LV end-diastolic (241±72ml vs 194±64ml) and end-systolic volumes (174±70ml vs 120±63ml), paralleled by lower EF (31±13% vs 41±15%) and stroke volumes (67±20ml vs 74±24ml); all p&lt;0.001. LV infarct size was similar between patients with and without NIF (13±8.6 vs 15±10, p=0.17). During follow-up (mean 3.0±2.5 years), overall mortality was 14% and was increased in patients with advanced (≥ moderate) FMR (HR 1.65 [CI 1.13-2.42], p=0.01) and NIF (HR 2.35 [CI 1.32-4.19], p=0.004: Figure). In multivariate analysis, NIF conferred over a 2-fold increase in risk for death (HR 2.15 [CI 1.20-3.85], p=0.01) independent of age and FMR severity. Conclusions: Among post-MI patients with FMR, NIF identifies an aggressive phenotype as evidenced by associations with adverse LV remodeling on CMR and increased mortality.
Abstract 10558: Characteristics and Prognosis of Anti-Neutrophil Cytoplasmic Autoantibody-Associated Vasculitis with Cardiac Involvement
Authors: Huazhen Liu, Yongfa Huang, Xiaoxiao Guo
Journal: Circulation (2021)

Introduction: Cardiac involvement (CI) is relatively common in anti-neutrophil cytoplasmic autoantibody-associated vasculitis (AAV), including granulomatosis with polyangiitis/microscopic polyangiitis (GPA/MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). The characteristics of AAV-CI require further investigation. Hypothesis: The cardiac manifestations and prognosis differ between GPA/MPA-CI and EGPA-CI. Methods: AAV-CI patients admitted to our hospital from Jan 1998 to Dec 2020 were retrospectively recruited. Prognosis was analyzed with log-rank test and multivariable Cox regression. Results: A total of 71 AAV-CI patients, including 37 (52.1%) females and 32 (45.1%) EGPA patients, were enrolled and EGPA-CI patients were significantly younger (49 [34-61] vs 64 [55-76] years, P &lt; 0.01). CI presented as cardiomyopathy (63.4%), arrhythmia (28.2%), and acute coronary syndrome (22.5%). EGPA-CI patients were less complicated with atrial fibrillation ( P &lt; 0.01), and more with pericardial effusion ( P = 0.04) and cardiomyopathy ( P = 0.02). Intraventricular thrombosis was more common in EGPA-CI, but the difference was not significant (1, 2.7% vs 5, 15.6%, P = 0.09). During a median follow-up of 19 months, 24 (33.8%) patients died. The survival rate of our cohort was 75.7% at 1 year, and EGPA-CI patients survived GPA/MPA-CI patients (82.0% vs 70.5% at 1 year, P = 0.02). The independent prognostic factors for GPA/MPA-CI included peak NT-proBNP &gt; 12870 pg/ml (HR 5.1 [95%CI 1.6-16.2], P &lt; 0.01), peak CRP &gt; 74.5 mg/L (4.4 [1.2-15.9], P = 0.03), and functional tricuspid regurgitation (26.0 [2.7-248.4], P &lt; 0.01), while gastrointestinal involvement (8.9 [1.6-49.1], P = 0.01) was identified as the sole independent prognostic factor for EGPA-CI. Conclusions: Cardiomyopathy, pericardial effusion and intraventricular thrombosis were more frequent in EGPA-CI than in GPA/MPA-CI. EGPA-CI had better prognosis than GPA/MPA-CI with different predictors.