tbuckley/cabot-search huggingface dataset:
Abstract 17349: Outcomes of Percutaneous Coronary Intervention (PCI) of Acute Myocardial Infarction (AMI) Patients With Chronic Total Occlusion (CTO) - National Database
Authors: Amitkumar Patel, Kirtenkumar Patel, Premalkumar Patel, Krunalkumar Patel, Perwaiz Meraj
Journal: Circulation (2020)

Introduction: Presence of Chronic Total Occlusion (CTO) in patients with Acute Myocardial Infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI) has not been studied previously. Hypothesis: To study in-hospital mortality &amp; resource utilization of AMI patients undergoing PCI associated with presence of CTO. Methods: We queried National Inpatient Sample from October 2015 - December 2017 using ICD 10 codes to identify patients over 18 years of age who underwent PCI &amp; had AMI with presence or absence of CTO. SAS 9.4 was used for univariate and multivariate analysis. Propensity score matching was performed to matched CTO vs Non-CTO group’s baseline characteristics &amp; Elixhauser comorbidities with Absolute standardized difference of 10% as matching limit. Results: A total of 576760 patients were identified who underwent PCI with AMI, out of which 525535 (91.12%) had no CTO while 51225(8.8%) had CTO. Each matched group contains 51210 patients. The In-hospital mortality was significantly higher in AMI PCI patients with CTO compared to Non-CTO (4.7% vs 3%, p &lt;0.0001). Length of hospital stay was higher in CTO patients (median 2 vs 3, p =0.001) and less percentage of patients were discharged to home (78.8% vs 81.1%, p &lt;0.0001). Median cost of hospital stay was higher in CTO group (20921$ vs 19856$, p &lt;.0001). Conclusions: Analysis of this large database of patients undergoing PCI with AMI suggests that presence of CTO results in higher In-hospital mortality, with longer hospital stay &amp; higher cost. Future observational studies should be directed towards CTO based outcomes in AMI patients undergoing PCI.
Abstract 17031: Noninvasive CT-Based Hemodynamic Assessment Using 3D Printing and Virtual Functional Assessment Index
Authors: Kranthi K Kolli, Abdul Zahid, Alexandre Caprio, Patricia Xu, Robert Shepherd, Sun-joo Jang, Tejas Doshi, Mohamed Zgaren, Varun Kashyap, Sahar Jalal, Matin Torabinia, Leslee J Shaw, Fay Y Lin, Bobak Mosadegh, Simon Dunham
Journal: Circulation (2020)

Background: Virtual functional assessment index (vFAI), an alternative approach for assessing hemodynamic significance of stenosis has been shown to enhance the diagnostic performance of coronary computed tomography angiography (CCTA) based on evaluating the area under pressure drop-flow curve for a stenosis. Previously, this was assessed via computational fluid dynamics. We investigated the evaluation of vFAI from CCTA images using 3D printing and an in vitro flow loop and its efficacy as compared to the invasively measured fractional flow reserve (FFR). Methods and Results: Eighteen patients with varying degrees of coronary artery disease who underwent non-invasive CCTA scans and invasive FFR of their left anterior descending coronary artery (LAD) were included. The LAD artery was segmented and reconstructed using Mimics (Materialise inc.,). The segmented models were then 3D printed using Carbon 3D printer (Carbon Inc.,) with rigid resins. An in vitro flow circulation system representative of invasive measurements in a cardiac catheterization laboratory was developed to experimentally evaluate the hemodynamic parameters of pressure and flow (Fig A). For each model, a range of physiological flow rates was applied by a peristaltic steady flow pump and titrated by a flow sensor. The pressure drop and the pressure ratio (Pd/Pa) were assessed for patient-specific aortic pressure and differing flow rates. vFAI was evaluated as the normalized area under the P d /P a vs Q curve from 0 to 240 mL/min. There was a strong correlation between vFAI and FFR, (R = 0.83, p &lt; 0.001; Fig B) and a very good agreement between the two parameters by Bland-Altman analysis. The mean difference of measurements from the two methods was 0.06 (SD = 0.08, p=0.0063; Fig C), indicating a small systematic overestimation of the FFR by vFAI. Conclusions: vFAI can be effectively derived from 3D CTCA datasets using 3D-printed in vitro models, based on evaluation over a range of hemodynamic conditions.
Abstract 16887: Utilization of Cardiovascular Procedures in Cardiac Amyloidosis
Authors: Benjamin Buck, Rami Kahwash, Yvonne Efebera, naresh bumma, Ajay Vallakati
Journal: Circulation (2020)

Background: Cardiac amyloidosis (CA) is characterized by restrictive cardiomyopathy, atrial and ventricular arrhythmias, as well as atrioventricular block. However, it is unclear whether the use of procedures to treat these specific complications are utilized at different rates during admissions for heart failure (HF) patients with and without CA. Hypothesis: Patients with HF and CA undergo invasive and noninvasive cardiac procedures at a higher rate than those with HF alone. Methods: The National Inpatient Sample database was queried to identify hospitalizations from 2003 to 2014 for patients ≥18 years old admitted with a diagnosis of HF with or without CA. Admissions with CA were propensity-score matched 5:1 with admissions for HF without CA. Procedures, including cardioversion, pacemaker implantations and implantable cardioverter-defibrillator (ICD) implantations were identified by ICD-9 procedure codes; other comorbidities were identified by ICD-9 diagnosis codes. Rates of procedural utilization, length of stay, total charges cleared and discharge disposition were compared between matched groups. Results: Over the 12 years considered, we matched 10,519 admissions with HF and CA to 52,595 admissions for HF without CA. When compared to HF patients with CA, the rates of cardioversion and ICD implantation were higher and the rates of pacemaker implantation were lower in the HF patients without CA (p&lt;0.001 all comparisons). Discharge disposition was more favorable in the cohort without CA (p&lt;0.001); in particular the cohort with CA had a much higher in-hospital mortality rate (9.5% compared to 6.2%) as well as a longer length of stay (p&lt;0.001). There was no difference in charges cleared between the two groups. Procedure use is depicted in the figure. Conclusions: Despite longer hospital stays and higher inpatient mortality, the rates of utilization of procedures, particularly cardioversion and ICD implantation, was lower among HF patients with CA.
Abstract 14897: Activation Dyssynchrony Between Contact Multielectrode Mapping and Subsurface Near-Infrared Optical Mapping During Human Atrial Fibrillation
Authors: Aleksei Mikhailov, Brian Hansen, Matthew Fazio, Stanislav Zakharkin, Jichao Zhao, Aaqel Nalar, James Kennelly, Megan Subr, Miguel Rodrigo, Ning LI, Mylavarapu Uma, Anuradha Kalyanasundaram, Benjamin Buck, Peter J Mohler, Bryan Whitson, Nahush Mokadam, John Hummel, Vadim V Fedorov
Journal: Circulation (2020)

Due to complex 3D human atrial structure, atrial fibrillation (AF) mapping with multielectrode arrays (MEA) mostly represents surface activation. Therefore, MEA may not properly visualize patient specific AF mechanisms, which impairs ablation outcomes. Conversely, near-infrared optical mapping (NIOM) visualizes subsurface intramural activation and can efficiently reveal reentrant drivers responsible for AF maintenance. Delay between surface activation seen by MEA electrograms (EGMs) vs subsurface activation seen by NIOM optical action potentials (OAPs) occurs due to dyssynchrony between myocardium layers, especially during AF. Coronary perfused explanted human atria (n=7) were mapped with NIOM (0.3-0.9mm 2 resolution) and 64-electrode MEA (3mm 2 resolution). Unipolar EGMs were analyzed for the steepest negative deflection. The delay between [-dV/dtmax] of unipolar EGMs and corresponding optical action potentials (OAPs) was compared in 500ms and 300ms pacing and AF. Subsequent structural analysis was done by 9.4T MRI (154-180μm 3 resolution) with gadolinium enhancement and histology. Delay between EGM and OAP local activation times rate-dependently and heterogeneously increased from 6±3 ms and 10±4 ms during 500ms and 300ms pacing to 15±11 ms (with maximum delay 47±18 ms) during pacing induced AF (average cycle length 124±65ms). Large local OAP-EGM delay, seen during AF, correlates with higher fibrosis percentage and fiber twist (p&lt;0.05). NIOM identified reentrant drivers maintaining AF, which were incorrectly visualized as multiple breakthroughs in 68% of MEA maps (n=22). Higher frequency leads to an increased activation discrepancy between EGM and NIOM caused by increased dyssynchrony in regions of higher fibrosis percentage and fiber twist, which may prevent MEA from proper identification of AF drivers in diseased fibrotic human atria. Reannotation of EGM activation based on NIOM may be required for correct AF mechanisms visualization.
The Role of Mendelian Randomization Studies in Deciphering the Effect of Obesity on Cancer
Authors: Zhe Fang, Mingyang Song, Dong Hoon Lee, Edward L Giovannucci
Journal: JNCI Journal of the National Cancer Institute (2021)

Associations of obesity have been established for at least 11 cancer sites in observational studies, though some questions remain as to causality, strength of associations, and timing of associations throughout the life course. In recent years, Mendelian randomization (MR) has provided complementary information to traditional approaches, but the validity requires that the genetic instrumental variables be causally related to cancers only mediated by the exposure. We summarize and evaluate existing evidence from MR studies in comparison with conventional observational studies to provide insights into the complex relationship between obesity and multiple cancers. MR studies further establish the causality of adult obesity with esophageal adenocarcinoma and cancers of the colorectum, endometrium, ovary, kidney, and pancreas, as well as the inverse association of early life obesity with breast cancer. MR studies, which might account for lifelong adiposity, suggest that the associations in observational studies typically based on single measurement may underestimate the magnitude of the association. For lung cancer, MR studies find a positive association with obesity, supporting that the inverse association observed in some conventional observational studies likely reflects reverse causality (loss of lean body mass before diagnosis) and confounding by smoking. However, MR studies have not had sufficient power for gallbladder cancer, gastric cardia cancer, and multiple myeloma. In addition, more MR studies are needed to explore the effect of obesity at different timepoints on postmenopausal breast cancer and aggressive prostate cancer.
Postoperative circulating tumor DNA as markers of recurrence risk in stages II to III colorectal cancer
Authors: Gong Chen, Junjie Peng, Qian Xiao, Hao-Xiang Wu, Xiaojun Wu, Fulong Wang, Liren Li, Peirong Ding, Qi Zhao, Yaqi Li, Da Wang, Yang Shao, Hua Bao, Zhizhong Pan, Ke-Feng Ding, Sanjun Cai, Feng Wang, Rui-Hua Xu
Journal: Journal of Hematology & Oncology (2021)

Precise methods for postoperative risk stratification to guide the administration of adjuvant chemotherapy (ACT) in localized colorectal cancer (CRC) are still lacking. Here, we conducted a prospective, observational, and multicenter study to investigate the utility of circulating tumor DNA (ctDNA) in predicting the recurrence risk.
Drug Release Kinetics from Nondegradable Hydrophobic Polymers Can Be Modulated and Predicted by the Glass Transition Temperature
Authors: Jian Qian, Cory Berkland
Journal: Advanced Healthcare Materials (2021)

Abstract Controlling drug release kinetics within a desired therapeutic window is the central task when designing polymeric drug delivery systems. Complex polymer chemistries have often been explored to control water penetration, polymer degradation rate, or the mesh network size of delivery systems. Here, a simple parameter for controlling the release rate and duration of nondegradable hydrophobic polymers is discovered. A systematic study involving 59 polymers and multiple drugs demonstrates that the glass transition temperature, T g , is a critical factor that dictates drug release kinetics from nondegradable hydrophobic polymers. Drug release rate exhibits a unique and simple linear correlation of ( T − T g ) 0.5 despite variability of polymer structure and type. An empirical model established based on the special correlation can accurately simulate and predict drug release kinetics from polymers saving substantial time typically required to test long‐acting drug delivery systems.
Investigation of an outbreak of symptomatic SARS-CoV-2 VOC 202012/01-lineage B.1.1.7 infection in healthcare workers, Italy
Authors: Daniela Loconsole, Anna Sallustio, Marisa Accogli, Angela Leaci, Antonio Sanguedolce, Antonio Parisi, Maria Chironna
Journal: Clinical Microbiology and Infection (2021)

In December 2020, Italy began a national immunization campaign using the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine, prioritizing healthcare workers (HCWs). Immune serum from vaccinated subjects seems (largely) to retain titres of neutralizing antibodies, even against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) VOC 202012/01-lineage B.1.1.7. Here, we describe an outbreak of SARS-CoV-2 lineage B.1.1.7 infection in three HCWs in a hospital setting; two of the HCWs were fully vaccinated (i.e. had received two doses).Two physicians and one nurse working on the same shift on 20th February 2021 were involved in the outbreak. Real-time PCR, antigen tests, and serological tests for the IgG anti-spike protein of SARS-CoV-2 were performed, along with whole-genome sequencing (WGS).SARS-CoV-2 infection was confirmed in all three HCWs; all presented with mild symptoms of COVID-19. The two physicians were fully vaccinated with BNT162b2 vaccine, with the second dose administered 1 month before symptom onset. Both had high titres of IgG anti-spike antibodies at the time of diagnosis. WGS confirmed that all virus strains were VOC 202012/01-lineage B.1.1.7, suggesting a common source of exposure. Epidemiological investigation revealed that the suspected source was a SARS-CoV-2-positive patient who required endotracheal intubation due to severe COVID-19. All procedures were carried out using a full suite of personal protective equipment (PPE).This mini-outbreak highlights some important issues about the efficacy of vaccines against transmission of SARS-CoV-2 variants, the high risk of exposure among HCWs, and the need for optimized implementation of PPE in hospitals. The wide circulation of VOC 202012/01 in Europe and Italy highlights the need to improve surveillance and genetic sequencing.
Abstract 16678: Incidence and Timing of Post-Infarction Ventricular Arrhythmias in a Contemporary ST Elevation Myocardial Infarction Population Undergoing Primary PCI
Authors: Zachary K Wegermann, Shuang Li, Nathaniel Smilowitz, Hani Jneid, bryan H wilson, Tracy Y Wang, Jacqueline E Tamis-holland
Journal: Circulation (2020)

Introduction: Stable patients with STEMI and successful reperfusion may be considered for early discharge; however, little is known about the incidence of late ventricular tachycardia or fibrillation (VT/VF occurring at least 1 day after PCI) that may warrant further monitoring. Methods: We identified 162,822 STEMI patients treated with primary PCI and without VT/VF on the day of PCI in the NCDR Chest Pain-MI Registry from January 2015-December 2018. A low risk subgroup (n=96,188) was identified by excluding patients with prior MI, heart failure, systolic BP&lt;90 mmHg, cardiogenic shock, cardiac arrest, re-infarction on the day of PCI, or ejection fraction&lt;40%. The incidence and timing of VT/VF (any VT≥7 beats or VF) was determined in the overall and low risk cohorts. The association between late VT/VF and in-hospital mortality was evaluated using multivariable logistic regression. Results: Late VT/VF occurred in 2.6% of patients overall and 1.8% in the low risk cohort. In patients with late VT/VF, cardiac arrest occurred in 20.3% and 7.7% of the overall and low risk cohorts, respectively. Many late VT/VF events (37.0% overall, 24.4% low risk cohort) occurred ≥2 days after PCI. Patients with late VT/VF were older, more likely to be men, and have prior cardiovascular disease or risk factors than patients without VT/VF; they also had higher rates of post-PCI heart failure, cardiogenic shock, cardiac arrest, and stroke ( Figure ). The risk of death was higher for patients with vs. without VT/VF in both the overall (15.4% vs. 2.4%, adjusted OR [aOR] 6.40, 95% CI 5.63-7.29) and low risk cohorts (3.7% vs. 0.5%, aOR 8.74, 95% CI 6.53-11.70). Conclusions: Late VT/VF after STEMI was infrequent but often occurred ≥2 days post-PCI and was associated with an increased risk of death, even in the low risk cohort. Novel ways to monitor and rapidly treat late VT/VF may avoid prolonged hospitalization after STEMI.
Abstract 14055: Safety and Effectiveness of Exercise Therapy After Acute Pulmonary Embolism
Authors: Rafael S Cires-Drouet, Steven Prior, Minerva Mayorga-Carlin, Kathleen Dondero, Emily Redding, Rachel White, Shahab Toursavadkohi, John Sorkin, Brajesh Lal
Journal: Circulation (2019)

Introduction: Post pulmonary embolism (PE) syndrome or decrease in functional capacity, occurs in 45-50% of survivors of PE. Exercise therapy has been advocated to improve functional capacity, but ...
Abstract 15707: Histone Deacetylase Inhibition Reverses Preexisting Diastolic Dysfunction and Blocks Covert Extracellular Matrix Remodeling
Authors: Joshua G Travers, Sara A Wennersten, Brisa Pena, Rushita A Bagchi, Harrison E Smith, Rachel A Hirsch, Lauren A Vanderlinden, Ying-Hsi Lin, Evgenia Dobrinskikh, Kimberly M Demos-Davies, Maria A Cavasin, Luisa Mestroni, Christian Steinkuhler, Steven R Houser, Charles Y Lin, Maggie P Lam, Timothy A McKinsey
Journal: Circulation (2020)

Introduction: Diastolic dysfunction is associated with the development of heart failure with preserved ejection fraction and other cardiac maladies, including atrial fibrillation. Inhibition of histone deacetylase (HDAC) activity has previously been shown to prevent diastolic dysfunction by enhancing myofibril relaxation. Here, we further addressed the therapeutic potential of HDAC inhibition in a model of established diastolic dysfunction with preserved ejection fraction. Methods: Four weeks following uninephrectomy (UNX) and implantation with deoxycorticosterone acetate (DOCA) pellets, when diastolic dysfunction was clearly evident, one cohort of mice was administered the clinical-stage HDAC inhibitor ITF2357/Givinostat. Serial echocardiography, blood pressure measurements, and endpoint invasive hemodynamic analyses were performed, along with the evaluation of pathological cardiac fibrosis and remodeling. Results: HDAC inhibition completely normalized diastolic function without lowering blood pressure in this model of systemic hypertension. Cardiac fibrosis was not evident in any mouse cohorts based on picrosirius red staining or second harmonic generation microscopy. However, mass spectrometry revealed induction in the expression of more than one hundred extracellular matrix (ECM) proteins in LVs of UNX/DOCA mice, which correlated with profound tissue stiffening based on atomic force microscopy. Remarkably, ITF2357/Givinostat treatment entirely blocked ECM expansions and LV stiffening. The HDAC inhibitor was subsequently shown to suppress cardiac fibroblast activation, at least in part, by blunting recruitment of the pro-fibrotic chromatin reader protein, BRD4, to key gene regulatory elements. Conclusions: These findings demonstrate the potential of HDAC inhibition as a therapeutic intervention to reverse existing diastolic dysfunction, and establish blockade of ECM remodeling as a second mechanism by which HDAC inhibitors improve ventricular filling. Additionally, our data reveal the existence of pathophysiologically relevant ‘covert’ cardiac fibrosis that is below the limit of detection of histochemical stains, highlighting the need to evaluate fibrosis of the heart using diverse methodologies.
40TiP SOLTI-1802 ONAWA trial: A window of opportunity trial of onapristone (ONA) in postmenopausal women with estrogen and progesterone receptor-positive/HER2-negative (ER+/PgR+/HER2-) early breast cancer (EBC)
Authors: M. Bellet, S. Morales Murillo, A. Gasol Cudos, K. Amillano, N. Chic, X. González-Farré, P. Villagrasa, J.M. Ferrero-Cafiero, T. Pascual, A. Prat, C. Lange, C. Saura Manich
Journal: Annals of Oncology (2021)
Abstract 16815: Female Sex and Its Relation With Poor Control of Oral Anticoagulation With Coumarin Derivatives: A Systematic Review and Meta-Analysis
Authors: Catiane Costa Viana, Marcus Fernando da Silva Praxedes, Waleska Jaclyn Freitas Nunes de Sousa, Frederico Bartolazzi, Mayara Sousa Vianna, José Luiz Padilha da Silva, Maria A Martins
Journal: Circulation (2020)

Introduction: Sex-differences in the quality of oral anticoagulation control have been reported,although with controversial evidence. Our hypothesis was that sex would be associated withoral anticoagulation control. We performed a systematic review and meta-analysis to investigatethis association. Methods: We searched for studies on MEDLINE, BVS, CINAHL, EMBASE,Cochrane and Web of Science. We included observational and experimental studies withparticipants aged &gt;18 years of both sexes, on oral anticoagulation with warfarin or othercoumarin derivatives indicated for long-term use. The outcome of interest was time intherapeutic range (TTR), calculated by the Rosendaal method. We synthesized data from theselected studies and developed the meta-analysis. Odds ratios (OR) for binary variables andmean differences (MD) for continuous variables were pooled using the random-effects modelswith estimation via the DerSimonian-Laird method. Results: Thirteen studies with 89,745patients (45.08% women) were included. Nine studies were assessed in the meta-analysis frombinary variables (OR=0.89; 95% CI=0.80, 1.00; z=-1.96; p=0.05; I 2 =74%) (Fig. 1) and fourstudies with continuous variables (MD=-3.02; 95% CI=-4.43, -1.62; z=-4.22; p&lt;0.0001; I 2 =0%)(Fig. 2). The pooled estimates indicated that women were associated with lower TTR than men. Fig. 1 Analysis of sex effect on oral anticoagulation control. Fig. 2 Analysis of sex effect on oral anticoagulation control. In conclusion, this systematic review showed that the female sex was associated with lowerTTR than male sex. Our results suggest the need for innovative strategies to improve healthcarefocused on women.