tbuckley/cabot-search huggingface dataset:
Abstract 15670: Age-related Differences in the Contribution of Systolic Blood Pressure and Biomarkers to Cardiovascular Disease Risk Prediction: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Mahmoud Al Rifai, Chiadi E Ndumele, James A De Lemos, Caroline Sun, Ron C Hoogeveen, David AGUILAR, Amit Khera, Salim S Virani, George E Taffet, Kunihiro Matsushita, Elizabeth Selvin, Christie M Ballantyne, VIJAY NAMBI
Journal: Circulation (2020)

I ntroduction: Systolic blood pressure (SBP) is an important component of all cardiovascular disease (CVD) risk prediction equations but its biological variability and impact on estimated risk is a concern. Furthermore, predictive value of SBP may differ in older individuals where traditional risk factors (TRF) are less predictive. Hypothesis: Biomarkers reflecting hypertension-related end organ injury (hsTnT, NT-proBNP, eGFR), improve CVD risk prediction in older but not middle age adults as compared to SBP. Methods: Using data from visits 2 (1990-92) and 5 (2011-13) of ARIC, we developed 3 models- Model 1 included all TRF; Model 2- all TRF except SBP + individual biomarkers and Model 3 all TRF + individual biomarkers. C-statistics were used to assess risk discrimination for coronary heart disease, stroke, heart failure, and CVD. Results: After excluding those with prevalent CVD, there were 12,567 individuals at visit 2 (mean age 57, SD 6 years; 43% men) and 4,508 individuals at visit 5 (mean age 76, SD 5 years; 37% men). Over a median (IQR) follow-up time of 22 (12.4–26.7) years and 6.2 (5.4–6.8) years, the incidence rates of CVD events (per 1000 person-years) were 19.0 and 21.8 at visits 2 and 5, respectively. At visit 2, the model with SBP and biomarkers resulted in the largest improvement in C-statistic and SBP contributed to all models. However, at visit 5, removing SBP from the models with the biomarkers had no impact on C-statistic while the addition of the biomarkers (especially hsTnT and NT-proBNP) significantly improved C-statistics for most outcomes ( Table ). Among the biomarkers eGFR had the least additive value. Conclusions: HsTnT and NT-proBNP significantly improve risk discrimination of CHD, stroke, and HF among middle and older adults, while SBP has value in middle age but not in older age. Biomarkers should be considered in risk prediction equations in older individuals where the value of TRF such as SBP decrease.
Abstract P205: A National Study Examining Association Between Frequency Of Cannabis Use And Demographic, Socioeconomic, And Behavioral Risk Factors
Authors: Abra M Jeffers, Amy Byers, Salomeh Keyhani
Journal: Circulation (2021)

Background: Cannabis use is becoming increasingly common. Yet, little is known about the frequency of past month cannabis use and how it is associated with demographic, socioeconomic and behavioral risk factors. Hypothesis: Vulnerable populations will have higher frequency of cannabis use. Individuals that have lower socioeconomic status, and or other behavioral risk factors (e.g. smoking) will have higher frequency of use compared to non-users. Methods: We combined four years (2016-2019), of the Behavioral Risk Factor Surveillance Survey (BRFSS), a large national survey of adults conducted annually by the CDC. The large sample size (unweighted N = 394,285) allowed the categorization of cannabis use. We examined the distribution of use and categorized past 30 day use into four categories: non-use (0 days, 90.7%), infrequent use (1-5 days, 2.9%), frequent use (6-29 days, 3.0%) and daily use (30 days, 3.3%). The subcategorizations of cannabis use frequency were treated as an ordinal variable. Ordinal logistic regression was performed to examine the association of the frequency of cannabis use with demographics (age, gender race/ethnicity, marital status), socioeconomic (educational attainment, employment status, annual household income), and behavioral (access to legal cannabis, smoking status, e-cigarette use, alcohol use and risky alcohol use) factors. Results: A multivariate ordinal logistic regression analysis showed that being male (Adjusted Odds Ratio (AOR) = 1.51; 95% CI: 1.41, 1.61), black (AOR = 1.55; 95%CI: 1.40, 1.72), unemployed (AOR = 1.19; 95%CI: 1.11-1.29), having access to legal medical (AOR = 1.22; 95%CI: 1.12, 1.32) or recreational (AOR = 2.52; 95%CI: 2.30, 2.76) cannabis, were associated with greater frequency of cannabis consumption. In addition, smoking tobacco (AOR = 2.18; 95%CI: 2.00, 2.37), e-cigarettes use (AOR = 3.51; 95%CI: 3.08, 4.01), past month alcohol use (AOR = 1.96; 95%CI: 1.81, 2.13) and binge drinking (AOR = 1.78; 95%CI: 1.63, 1.94) were also associated with greater frequency of cannabis consumption. Being older (AOR = 0.18; 95%CI: 0.15, 0.20), Asian (AOR = 0.66; 95%CI: 0.55, 0.79), Hispanic (AOR = 0.67; 95%CI: 0.60, 0.75), married (AOR = 0.56; 95%CI: 0.52, 0.60), and higher income (AOR = 0.87; 95%CI: 0.79, 0.97) were all associated with lower frequency of cannabis use. Conclusion: The most salient factors associated with greater frequency of cannabis use had to do with low socioeconomic status, recreational access to cannabis, and use of substances such as cigarette smoking and alcohol consumption. Vulnerable populations had high odds of cannabis use, and frequent cannabis use was associated with health behaviors that increase cardiovascular risk.
Prediction of Coronary Artery Disease Severity by Means of Noninvasive Atherosclerotic Indicators
Authors: Shimizu Masato, Fujii Hiroyuki, Kida Natsuko, Seya Mie, Inamura Yukihiro, Nakamura Tomofumi, Takayama Kei, Kaneko Masashi, Yamawake Noriyoshi, Nishizaki Mitsuhiro, Isobe Mitsuaki
Journal: Circulation (2013)
The Role of Clips in Preventing Delayed Bleeding After Colorectal Polyp Resection: An Individual Patient Data Meta-Analysis
Authors: Ayla S. Turan, Heiko Pohl, Mio Matsumoto, Brian S. Lee, Masato Aizawa, Federico Desideri, Eduardo Albéniz, Gottumukkala S. Raju, Daniel Luba, Maximilien Barret, Suryakanth R. Gurudu, Francisco C. Ramirez, Wey-Ran Lin, Femke Atsma, Peter D. Siersema, Erwin J.M. van Geenen, Douglas K. Rex, Brian S. Lim, Karl K. Kwok, Kazutomo Togashi, Romain Coriat, Sarah B. Umar, Chun-Wei Chen, Jochim Terhaar sive Droste, Ruud Schrauwen, Gijs Kemper
Journal: Clinical Gastroenterology and Hepatology (2021)

Nonpedunculated colorectal polyps are normally endoscopically removed to prevent neoplastic progression. Delayed bleeding is the most common major adverse event. Clipping the resection defect has been suggested to reduce delayed bleedings. Our aim was to determine if prophylactic clipping reduces delayed bleedings and to analyze the contribution of polyp characteristics, extent of defect closure, and antithrombotic use.An individual patient data meta-analysis was performed. Studies on prophylactic clipping in nonpedunculated colorectal polyps were selected from PubMed, Embase, Web of Science, and Cochrane database (last selection, April 2020). Authors were invited to share original study data. The primary outcome was delayed bleeding ≤30 days. Multivariable mixed models were used to determine the efficacy of prophylactic clipping in various subgroups adjusted for confounders.Data of 5380 patients with 8948 resected polyps were included from 3 randomized controlled trials, 2 prospective, and 8 retrospective studies. Prophylactic clipping reduced delayed bleeding in proximal polyps ≥20 mm (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.44-0.88; number needed to treat = 32), especially with antithrombotics (OR, 0.59; 95% CI, 0.35-0.99; number needed to treat = 23; subgroup of anticoagulants/double platelet inhibitors: n = 226; OR, 0.40; 95% CI, 0.16-1.01; number needed to treat = 12). Prophylactic clipping did not benefit distal polyps ≥20 mm with antithrombotics (OR, 1.41; 95% CI, 0.79-2.52).Prophylactic clipping reduces delayed bleeding after resection of nonpedunculated, proximal colorectal polyps ≥20 mm, especially in patients using antithrombotics. No benefit was found for distal polyps. Based on this study, patients can be identified who may benefit from prophylactic clipping. (PROSPERO registration number CRD42020104317.).
Phase I/II trial of lenalidomide, methotrexate, leucovorin, cytarabine, and rituximab (LeMLAR) in relapsed or refractory diffuse large B cell lymphoma
Authors: Ulrich Dührsen, Mareike Tometten, Frank Kroschinsky, Arnold Ganser, Stefan Ibach, Stefanie Bertram, Andreas Hüttmann
Journal: Blood Cancer Journal (2021)
Abstract 17348: Cardiovascular Risk Prediction in Diabetes From Machine Learning: The ACCORD Study
Authors: WENJUN FAN, David N Wong, Xiaowei Li, Nathan Wong
Journal: Circulation (2020)

Background: Atherosclerotic cardiovascular disease (ASCVD) risk prediction in persons with type 2 diabetes (T2DM) using existing calculators is imprecise. We aimed to develop a machine-learning (ML) model for prediction of ASCVD events in adults with T2DM. Methods: We utilized subjects with T2DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial without known CVD and calculated their 10-year ASCVD risk using the ACC/AHA pooled cohort risk calculator (PCRC) predicting the composite outcome of myocardial infarction, non-fatal stroke and cardiovascular death using age, gender, race, systolic blood pressure (SBP), antihypertensive medication use, total cholesterol, high-density lipoprotein cholesterol, current smoking status and diabetes mellitus status. We developed an ASCVD risk calculator based on Random Forest (RF) ML algorithms using follow-up data from ACCORD with the same 9 predictors. 5-fold stratified random split was applied as cross-validation strategies. Results: A total of 6581 T2DM participants without baseline ASCVD were included in our final sample with a median follow up of 9.1 years. The performance of PCRC was modest with an AUC=0.604. In contrast, the ML model had much better performance with a RF AUC=0.866. The figure shows the rank of feature importance (%) from random forest modeling (from high to low): age, systolic blood pressure, total cholesterol, HDL-C, female gender, White ethnicity, current smoker, hypertension treatment. Conclusion: The ML ASCVD Risk Calculator outperforms the AHA/ACC PCRC in predicting ASCVD outcomes among those with T2DM from the ACCORD trial. Age, SBP, total cholesterol and HDL-C were the most important features in ASCVD prediction among those with T2DM. Future studies need to validate these and other ML algorithms and to explore their applicability in guidelines.
Abstract 14801: Can Plasma Tweak Predict Coronary Slow Flow in Patients With Chronic Kidney Disease?
Authors: Mustafa A Tatlisu, Adem Atici, Fatma Betul B Ozcan, Eray Kirac, Omer F Baycan, Mustafa Caliskan
Journal: Circulation (2020)

Introduction: The tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is one of the inflammatory mediators contributing to the atherosclerotic process. TWEAK has been studied in chronic kidney disease (CKD) patients and it has been shown that its level declines as eGFR decreases. Most studies have found that the decreased level of TWEAK was seen in atherosclerosis and was also associated with calcification of the plaque. This prospective study was designed to clarify any relationship between coronary slow flow (CSF) and TWEAK levels. Hypothesis: Our hypothesis was to show that the higher level of TWEAK might be seen in the setting of CSF due to lack of calcium deposits and TWEAK is not a reflection of healthy vessels. Methods: This prospective study included 93 consecutive patients undergoing invasive coronary angiography (ICA) for any reason except for acute coronary syndromes from May 2019 to March 2020 (Table 1). A total of 93 patients were divided into two groups with regard to having CSF (n=35) or no-CSF (n=58). Results: Patients with CSF had higher TWEAK levels than those without CSF (695.2± 225.2 vs 465.8±157.6, p&lt;0.001). As the number of coronary arteries with slow flow increased, the TWEAK level was increased statistically significant (r:0.635/ p&lt;0.001). The TWEAK level of 516 pg/mL was found for the prediction of CSF in ROC analysis. Conclusions: Our study has shown that plasma TWEAK level is an independent predictor for the CSF in patients with CKD (Table 2). Our study have found that elevated TWEAK levels may not reflect the healthy vessels as it was hypothesized in the past.
Intestinal microbiota defines the GUT-TESTIS axis
Authors: Emmanuelle Martinot, Laura Thirouard, Hélène Holota, Mélusine Monrose, Manon Garcia, Claude Beaudoin, David H Volle
Journal: Gut (2021)

Fertility disorders affect 15% of couples and around 40% of infertilities are attributed to men. Altered fertility could stem from cell damages following exposures to stresses such as metabolic disorders or chemodrugs. Recent publications in Gut1–4 demonstrate that reduction of the richness and/or diversity of intestinal microbiota (IM), in the context of high-fat/high-sugar (HF/HS) diet or exposure to anticancer drugs (Busufan), negatively impact testicular physiology leading to reduced sperm production. These works highlight that transplantation of the faecal microbiota (FMT) represents an emerging area of interest to restore spermatogenesis and cure some fertility disorders. Additional questions need to be addressed to better define the links between the IM and male fertility.

(1) It remains to be defined to which types of obesity these encouraging data could be …
Abstract 17015: Understanding Sex Differences With Cardiac Risk Factors in the Young Adult Population
Authors: Erica Davis, Kathryn A Wood, Jeannie Cimiotti, Melinda Higgins, Rebecca Gary, Sandra Dunbar
Journal: Circulation (2020)

Introduction: The prevalence of coronary artery disease (CAD) is increasing in young adults (YA) (age&lt;40 years), and greater understanding of their cardiac risk factors is essential to create effective preventive strategies. Given the sex differences for CAD observed in older adults, understanding if sex differences exist for CAD risk factors in YAs is important. Hypothesis: There will be several risk factors associated with CAD in YAs that will differ between men and women. Methods: In this secondary analysis, 125,017 YAs between the ages of 18-44 were evaluated for health conditions and behaviors considered to be risk factors for CAD. The 2017 Behavior Risk Factor Surveillance System database from the Center for Disease Control was utilized. Frequency procedures, chi-square testing, and logistic regression modeling with odds ratios were analyzed using (SAS) 9.4 software. Results: Greater percentages of men (65.5%) than women (56.7%) were found to be overweight (BMI 25-30) or obese (BMI =&gt;30) (p&lt;.0001). Men reported higher rates of hypertension with 18.6% as compared to women with hypertension at 11.5% (p&lt;.0001). High cholesterol and heavy alcohol consumption were characteristic of men in this sample with percentages at 17.8% for high cholesterol and 7.5% for heavy alcohol use. YAs between the ages of 40-44 were over 2 times as likely to develop CAD than those aged 18-24, odds ratio (OR) 2.4. YAs between the ages of 25-29 were least likely to develop CAD compared to 18-24 with the lowest OR 1.3. Overall, significant risk factors for developing CAD in this population were HTN (OR 4.1), age 35-44 (OR &gt;2.2), high cholesterol (OR 2.2), smoking (OR 1.9), and prediabetes (OR 1.7). Physical activity (OR 0.6) and healthcare coverage (OR 0.7) were protective factors against CAD. There were 276 young adults in all who were diagnosed with CAD in this analysis. Conclusions: Greater efforts are needed to reduce the number of risk factors in YAs and prevent the development of CAD. There were significant gender differences noted in CAD risk factors within the YA population. Targeted interventions should include counseling as outlined in the American Heart Association Life’s Simple 7 Campaign in an effort to improve cardiovascular health in young adult men and women.
Abstract 17043: Predictors of Length of Stay Following Catheter Ablation of Atrial Fibrillation
Authors: Sahitya Allam, Evan Harmon, James M Mangrum, David Haines, Nishaki K Mehta
Journal: Circulation (2020)

Background: Catheter ablation (CA) of atrial fibrillation (AF) is a safe and effective management strategy for symptomatic AF. Traditionally, patients are observed overnight following CA, but recent data has suggested same day discharge may be feasible with low risk of complications. However, little data is available to predict length-of-stay (LOS) in AF patients undergoing CA. Methods: We conducted a single-center retrospective analysis of 200 consecutive patients undergoing CA at a tertiary care academic center from July 2017 through June 2018. Baseline demographic data, echocardiographic data, procedural characteristics and postprocedural outcomes were collected through chart review. Multivariate linear regression modeling was used to identify factors associated with increased LOS (LOS &gt; 1 day). Results: Among 200 patients, 11.5% (23) of patients had LOS &gt; 1 day (Group B) while the rest were discharged after overnight stay (Group A). The mean ages were similar in Groups A and B (64.8 years and 64.9 years respectively, p = 0.98). The mean LOS was 1.44 ± 1.83 days. Higher proportions of hypertension (p = 0.02), diabetes (p = 0.1), baseline loop diuretic use (p &lt; 0.001), EF &lt; 50% (p &lt; 0.001), increased LA diameter (p = 0.01), longer procedure time (p = 0.03), and recurrent AF following CA (p &lt; 0.001) were noted in Group B patients (Table 1). A multivariate linear regression model demonstrated that procedure time (p = 0.02) and LA diameter (p = 0.04) were positively associated with increased LOS. Conclusion: Identifying risk factors for increased LOS in patients undergoing CA of AF may guide appropriate patient selection for same day discharge. Table 1. Comparison of patients with overnight observation (Group A) and LOS &gt; 1 day (Group B) following AF ablation.
Abstract P108: Metabolic Profile Of Diet Quality In The Multi-Ethnic Study Of Atherosclerosis
Authors: Meghana Gadgil, Alexis F Wood, Ibrahim Karaman, Goncalo Gomes Da Graca, Ioanna Tzoulaki, Victor Zhong, Philip Greenland, Alka M Kanaya, Russell P Tracy, David M Herrington
Journal: Circulation (2021)

Introduction: Poor dietary quality is a well-known risk factor for diabetes and cardiovascular disease (CVD), however metabolites marking adherence to U.S. dietary guidelines are unknown. Our goal was to determine a pattern of metabolites associated with the Healthy Eating Index-2015 (HEI-2015). We hypothesize that there will be metabolites positively and negatively associated with the HEI-2015 score, including those previously linked to diabetes and CVD. Methods: Sample: 2269 adult men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study without known cardiovascular disease or diabetes. Data/specimens: Fasting serum specimens, diet and demographic questionnaires at baseline. Metabolomics: Untargeted 1 H NMR CPMG spectroscopy (600 MHz) annotated by internal and external reference data sets. Statistical analysis: Metabolome-wide association study (MWAS) using linear regression models specifying each spectral feature as the outcome in separate models, HEI-2015 score as the predictor, and adjustment for age, sex, race, and study site, accounting for multiple comparisons. Elastic net regularized regression was used to select an optimal subset of features associated with HEI-2015 score. Separately, hierarchical clustering defined discrete groups of correlated NMR features also tested for association with HEI-2015 score. Results: MWAS identified 1914 spectral features significantly associated with the HEI-2015 diet score. After elastic net regression, 35 metabolomic spectral features remained associated with HEI-2015 diet score. Cluster analysis identified seven clusters, three of which were significantly associated with HEI-2015 score after Bonferroni correction. (Table) Conclusions: Cholesterol moieties, proline betaine, proline/glutamate and fatty acyls chains were significantly associated with higher diet quality in the MESA cohort. Further analysis may clarify the link between dietary quality, metabolites, and pathogenesis of diabetes and CVD.
Abstract 13433: Predictors of Contrast Induced Nephropathy in Patients With Acute Coronary Syndromes and Normal Baseline Glomerular Filtration Rate
Authors: Daniel Negreanu, Michael Gagnon, anh nguyen, Samer Mansour, Michel T Nguyen, Martine Montigny, Claude Lauzon, Mark Eisenberg, Stephane Rinfret, Simon kouz, Marc Afilalo, Philippe L L'Allier, Bernard De la Rocheliere, Bernard Cantin, Jean-Claude Tardif, Thao Huynh
Journal: Circulation (2020)

Background: The incidence and predictors of contrast-induced nephropathy (CIN) in patients with normal glomerular filtration rate (GFR) are not well ascertained. We aim to determine the incidence and predictors for CIN after coronary catheterization (CATH) for acute coronary syndromes (ACS). Methods: We combined the datasets of two studies. The AMI-QUEBEC was an observational cohort of patients with ST-segment elevation myocardial infarctions in 2003. The AMI-OPTIMA was a study of patients hospitalized with ACS in 2009 and 2012. For this analysis, we retained only patients with GFR &gt; 60 ml/min who underwent CATH. We defined “hyperfiltrators” as patients with GFR above the 95th percentile age and sex-adjusted value. CIN was defined as an increase in serum creatinine &gt;0.5 mg/dL (44.2 μmols/L) or &gt; 50% from baseline serum creatinine. Results: There were 3,188 patients with GFR &gt; 60 ml/min : 39 hyperfiltrators and 3,149 without hyperfiltration. The mean age was similar between the two groups of patients (62 years); 21% and 27% females in hyperfiltrators and non-hyperfiltrators (p&lt;0.0001). The prevalences of diabetes mellitus and hypertension were 36% and 64%, respectively in hyperfiltrators compared to 20% and 46%, respectively in non-hyperfiltrators. The mean baseline GFR and creatinine were 112 ml/min and 50 μmols/L, respectively in hyperfiltrators; 84.2 ml/min and 80 μmols/L in non-hyperfiltrators. There were 225 CIN following CATH; 7.1% of the whole cohort with 35.9% in the hyperfiltrators and 6.7% in non-hyperfiltrators. Hyperfiltration was independently associated with a 13-fold increase in the risk of CIN (Table 1). Each year of increase in age was associated with a 5% increase in the risk of CIN. Shock was also associated with an 11-fold increase in the risk of CIN. Conclusion: Hyperfiltrators may be at high risk of CIN following CATH in ACS. The risk of CIN associated with hyperfiltration should be evaluated in other populations.
Re: Stanley Weng, Renzo G. DiNatale, Andrew Silagy, et al. The Clinicopathologic and Molecular Landscape of Clear Cell Papillary Renal Cell Carcinoma: Implications in Diagnosis and Management. Eur Urol 2021;79:468–77
Authors: Sounak Gupta, Beth A. Pitel, Shannon M. Knight, Kevin C. Halling, Rafael E. Jimenez, John C. Cheville
Journal: European Urology (2021)