tbuckley/cabot-search huggingface dataset:
만성 바이러스간염 환자에서 간탄력도 측정을 이용한 간섬유화 진단
Authors: 강준구 ( Joon Koo Kang ), 정재연 ( Jae Youn Cheong ), 조성원 ( Sung Won Cho ), 조진희 ( Jin Hui Cho ), 박진선 ( Jin Sun Park ), 김영배 ( Yeong Bae Kim ), 김동준 ( Dong Joon Kim ), 황성규 ( Seong Gyu Hwang ), 양진모 ( Jin Mo Yang ), 박영년 ( Young Nyun Park )
Journal: Clinical and Molecular Hepatology (2007)

목적: FibroScan(R)은 간의 탄력도를 측정하여 비침습적으로 간의 섬유화 정도를 진단하는 검사로, 만성 바이러스간염 환자를 대상으로 검사의 유용성 여부를 확인하기 위해 연구를 시행하였다. 대상 및 방법: 2005년 10월부터 2006년 8월까지 Fibro-Scan(R)과 간조직검사를 시행한 만성 B형, C형간염환자 103명을 분석하였으며, 간조직검사 결과는 대한병리학회 기준에 따라 0-4단계로 분류하였다. 결과: 간의 탄력도는 3.5-57.1kPa (평균: 11.8, 표준편차: 8.9)였고, 간섬유화 정도에 따른 간탄력도의 평균은 F1, F2, F3, F4에서 각각 5.8±1.8 kPa, 11.3±6.8 kPa, 11.8±6.0 kPa, 23.4±16.5 kPa였다. 간탄력도는 간조직생검으로 확인한 간섬유화 정도와 유의한 상관관계를 보였다(r=0.56, P<0.001). AUROC 곡선은 F2 이상의 집단에서 0.93 (95%신뢰구간: 0.86-0.99)이었고, F3 이상과 F4에서는 각각 0.72 (95%신뢰구간: 0.62-0.82), 0.80 (95%신뢰구간: 0.67- 0.92)이었다. F2 이상의 간섬유화를 진단하는 값으로 7.5 kPa를 선정했을 때 민감도는 84%, 특이도는 90%였다. 결론: FibroScan(R)은 만성 바이러스간염환자의 유의한 섬유화(≥F2)와 간경변증을 잘 반영하였으며, 특히 F2 이상인 집단에서 측정된 간의 탄력도가 유의한 차이를 보여, 항바이러스치료의 결정에 유용할 것이다.
Abstract 13309: Soluble Fibrin Monomer Complex is Associated With Cardio- and Cerebro-vascular Events in Patients With Heart Failure
Authors: Yusuke KIMISHIMA, Akiomi YOSHIHISA, Yasuhiro Ichijo, Koichiro Watanabe, Yu Hotuki, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, ATSUSHI KOBAYASHI, Yasuchika Takeishi
Journal: Circulation (2020)

Background: The soluble fibrin monomer complex (SFMC) is a biomarker of fibrin formation, and has been shown to be abnormally elevated in various clinical situations of hypercoagulability. However, the association between SFMC and cardiovascular events in patients with heart failure (HF) remains uncertain. We aimed to examine the prognostic impact of SFMC concerning increased risk of major cardio- and cerebro-vascular events (MACCE) and all-cause mortality in patients with HF. Methods and Results: We conducted a prospective observational study. We analyzed data on 723 hospitalized patients with HF who discharged alive and measured SFMC at stable condition in prior to discharge. Patients were divided into tertiles based on levels of SFMC: 1 st (SFMC &lt;1.7 μg/ml, n = 250), 2 nd (1.8 ≤ SFMC &lt;2.9 μg/ml, n = 233), and 3 rd (3.0 μg/ml ≤ SFMC, n = 240) tertiles. We compared baseline patients’ characteristics and their post-discharge MACCE and mortality. Prevalence of chronic kidney disease (CKD) and anemia was significantly higher in the 3 rd tertile than in the 1 st and 2 nd tertiles. In contrast, age, sex, CHADS 2 -Vasc score, left ventricular ejection fraction, and prevalence of hypertension, diabetes and atrial fibrillation did not differ among the tertiles. During the median follow-up period of 422 days, 61 patients experienced MACCE, and 82 patients died. In the Kaplan-Meier analysis ( Figure ), accumulated event rates of both MACCE and all-cause mortality progressively increased from the 1 st to the 3 rd tertiles (MACCE, 4.8%, 8.6% and 12.1%, log-rank P=0.014; all-cause mortality, 6.4%, 9.4% and 18.3%, log-rank P&lt;0.001). In the multivariable Cox proportional hazard analysis, the 3 rd tertile was found to be an independent predictor of MACCE (HR 2.608, 95%CI 1.331-5.113, P=0.005) and all-cause mortality (HR 2.938, 95%CI 1.657-5.207, P&lt;0.001). Conclusion: SFMC is an independent predictor of adverse prognosis in patients with HF.
Association of Opioid Consumption Profiles After Hospitalization With Risk of Adverse Health Care Events
Authors: Siyana Kurteva, Michal Abrahamowicz, Tara Gomes, Robyn Tamblyn
Journal: JAMA Network Open (2021)

Although better pain management has guided policies for opioid use over the past few decades, evidence is limited regarding how patterns of use are associated with the risk of potentially avoidable opioid-related adverse events.To estimate the risk of harms associated with opioid dose and duration of use, and to ascertain whether the risk is modified by treatment indication and age.This ad hoc cohort study followed up patients who were enrolled in a cluster randomized trial of medication reconciliation between October 1, 2014, and November 30, 2016, 12 months after they were discharged from the McGill University Health Centre in Montreal, Quebec, Canada. To be eligible for this study, patients needed to have filled at least 1 opioid prescription 3 months after discharge. Patients with a history of using methadone or buprenorphine were excluded. Data analyses were performed between February 1, 2019, and February 28, 2020.Time-varying measures of opioid use included current use, daily morphine milligram equivalent (MME) dose, cumulative and continuous use duration, and type of ingredients in prescription opioids used. Hospitalization records, dispensed prescriptions records, and postdischarge interviews were used to evaluate adherence to the opioid prescriptions after discharge.Opioid-related emergency department visits, hospital readmissions, or all-cause death. Outcomes were ascertained using provincial medical services claims and hospitalization databases.Of 3486 participants in the cluster randomized trial (mean [SD] age of 69.6 [14.9] years; 2010 men [57.7%]), 1511 patients were included in this ad hoc cohort study. Among those with at least 1 opioid dispensation, 241 patients (15.9%) experienced an opioid-related emergency department visit, hospital readmission, or death. Results from marginal structural Cox proportional hazards regression models showed more than a 2-fold increase in the risk of opioid-related adverse events associated with a cumulative use duration of more than 90 days (adjusted hazard ratio, 2.56; 95% CI, 1.25-5.27) compared with 1 to 30 days. A 3-fold risk increase was found with a mean daily dose higher than 90 MME (adjusted hazard ratio, 3.51; 95% CI, 1.58-7.82) compared with 90 MME or lower.This study found an association between risk of adverse health care events and higher opioid doses and longer treatment duration. This finding can inform policies for limiting opioid duration and dose to attenuate the risk of avoidable morbidity.
Abstract 15759: Utility of the Sofa Score to Risk Stratify Patients in the Cardiac Intensive Care Unit at a Tertiary Care Center
Authors: Anika I Raja, Leonard Genovese, Ankit Vyas, PRAMITA BAGCHI, Palak Shah, Mitchell Psotka, Aaron J Bagnola, M C Flanagan, Timothy Welch, Carolyn Rosner, Behnam N Tehrani, Alexander Truesdell, Abdulla Damluji, Robert Cole, Lauren Cooper, Shashank Desai, Hala Moukhachen, Stephanie Garofalo, Wayne Batchelor, Christopher DEFILIPPI, Shashank S Sinha
Journal: Circulation (2020)

Introduction: The Sequential Organ Failure Assessment (SOFA) score predicts intensive care unit (ICU) mortality within a medical ICU population but utility of the SOFA score in the contemporary cardiac ICU (CICU) is unclear. Methods: Data from consecutive patients with primary cardiac (PC) and non-cardiac (PNC) disease admitted to the CICU at a tertiary care center from 1/1/19-2/28/19 and 10/1/19-11/30/19 were collected and analyzed by retrospective chart review, including demographics, comorbidities, primary reasons for admission, labs and SOFA score parameters. Patients were grouped into three categories based on their highest SOFA score within the first 24 hours of CICU admission: SOFA Score ≤ 6, 7-11 and ≥ 12. CICU and in-hospital mortality rates (adjusted for age, gender, race, and comorbidities) were compared using multivariate linear regression. Results: Of the 453 patients admitted to the CICU during the studied time period, 321 had PC diagnoses and 132 PNC diagnoses. The mean age was 63.5 and 59.6 ( p&lt; 0.05) , 65.1% and 50.7% were male ( p&lt; 0.05) , and 53.6% and 62.9% were white ( p=0.07) , and 70.4% and 56.8% had at least three or more comorbidities ( p&lt;0.05) for the PC and PNC cohorts, respectively. The top three comorbidities were hypertension (70%), heart failure (39%), and diabetes mellitus (36%) for the PC group and hypertension (60%), diabetes mellitus (33%), and pulmonary disease (26%) for the PNC group, respectively. Increasing SOFA scores were associated with increased CICU and in-hospital mortality (Table) for patients with both PC and PNC diagnoses. Conclusion: Increased SOFA scores were associated with higher risk of CICU and in-hospital mortality. The SOFA score may be useful for risk stratification of CICU patients with both primary cardiac and non-cardiac diagnoses.
143P Fertility rates in young breast cancer patients (YBCP) and evolution: A new challenge
Authors: M. Mendez Garcia, B. Nunez Garcia, M. Blanco Clemente, J.C. Sánchez, S. Herrero, V. Engels, G. Visedo, M. Martinez Cutillas, M. Provencio Pulla, B. Cantos Sanchez De Ibarguen
Journal: Annals of Oncology (2021)
Abstract 15242: Increased Mortality Among African American Patients With Heart Failure Caused by Hereditary Transthyretin Amyloid Cardiomyopathy
Authors: Meena Zareh, Alina Levine, John L Berk, Omar K Siddiqi, Deepa M Gopal, Lawreen H Connors, Denise Fine, Codruta Chiuzan, Mathew S Maurer, Frederick L Ruberg
Journal: Circulation (2020)

Introduction: Hereditary transthyretin amyloid cardiomyopathy (pV142I hATTR-CM) is an under-recognized cause of heart failure (HF) in elderly patients of African origin. While we have previously demonstrated that the endogenous TTR ligand retinol binding protein 4 (RBP4) identifies patients with hATTR-CM, its capacity to predict outcomes is unexplored. Further, comparative data are lacking describing clinical outcomes in hATTR-CM vs. matched patients with HF. Hypothesis: Reduced survival is associated with pV142I hATTR-CM when compared to an age, race, sex matched patients with HF. Methods: Retrospective, single center, cohort study of self-reported African American patients ≥ 60 years of age with normal TTR genotype, HF, and LV wall thickness ≥ 12mm (n=84) were compared to a cohort with biopsy-proven pV142I hATTR-CM (n=30). Patients did not receive ATTR-specific therapies, as study occurred prior to FDA approvals. Baseline laboratory values were measured. All-cause mortality was estimated and compared between groups based on a median followup of 45.4 months. Analyses were conducted with Fisher Exact, Kruskal Wallis, and Kaplan-Meier with log-rank testing. Results: hATTR-CM patients were slightly older but less likely to have concomitant HTN or DM (Table 1). Baseline RBP4 concentration was lower while troponin level higher in patients with hATTR-CM (Table 1). hATTR-CM patients had a higher hazard of all-cause mortality after adjusting for age (HR=3.5, 95% CI: 1.8 – 6.7, p&lt;0.001). Baseline RBP4 was not a significant predictor of mortality (p-value=0.195). Conclusions: Patients pV142I hATTR-CM demonstrate significantly reduced survival (a 3.5-fold increased risk of death, 43% 4-year survival) compared to control subjects with HF in the absence of amyloidosis. Baseline RBP4 concentration did not associate with survival. These data suggest that hATTR-CM recognition is essential to permit implementation of available therapies that can improve survival.
Abstract 15768: Social Connectedness is Independently Associated With Cardiovascular Health
Authors: Erica J Ambeba, Dorothy D Sears, Tarik Benmarhnia, Loki Natarajan, Cheryl A Anderson, Steven Zamora, Marta Jankowska
Journal: Circulation (2020)

Introduction: Social connectedness (SC) is an important determinant of maintaining overall health, and the strength of connections with others may influence cardiovascular health (CVH) in part through improvement in cardiovascular disease risk factors. However, there is a lack of research on the role of SC in promoting CVH, as defined by the American Heart Association’s 2020 Impact Goals. The objective of this study is to determine the effect of SC on CVH among adults. Hypothesis: Higher SC will be associated with higher odds of optimal CVH, relative to inadequate CVH. Methods: Data are from the Community of Mine study, a cross-sectional study of 602 participants (42% Hispanic, 56% female, mean age 59 years) living in San Diego County. CVH was based on Life’s Simple 7 using six metrics including smoking, physical activity, body mass index, total cholesterol, blood pressure, and fasting glucose. A 12-point summary score was used to classify participants as having inadequate (0-6), average (7-8), or optimal (9-12) CVH. SC was assessed using a 7-item scale designed to assess social relationships and strength of connections with others (Cronbach’s alpha=0.92). A mean score across all items was generated. Multinomial logistic regression was used to estimate the association between SC and CVH. We adjusted for age, race/ethnicity, governmental cash assistance, income, education, sex, history of medical comorbidities, family history of heart disease, and depressive symptoms. Results: SC was independently associated with CVH (p=0.04). More specifically, a 1-unit increase in mean SC score was associated with a 46% increase in relative odds of having optimal CVH compared to inadequate CVH (OR=1.46, 95% CI: 1.07-1.98), and a 21% increase in relative odds of having average CVH compared to inadequate CVH (OR=1.21, 95% CI: 0.96-1.52). Conclusions: Higher social connectedness is associated with a greater likelihood of having optimal CVH. Individuals’ perceptions of the strength of their relationships could have cardioprotective benefits through promotion of favorable cardiovascular health behaviors and factors.
Abstract 12970: High Power Short Duration and Low Power Long Duration in Atrial Fibrillation Ablation: A Systematic Review and Meta-analysis
Authors: Jakrin Kewcharoen, Chol Techorueangwiwat, Chanavuth Kanitsoraphan, Thiratest Leesutipornchai, Wasawat Vutthikraivit, Pattara Rattanawong, T J Bunch, Leenhapong Navaravong
Journal: Circulation (2020)

Background: Although high power, shorter duration (HPSD) ablation and low power, longer duration (LPLD) ablation strategies for atrial fibrillation (AF) are frequently advocated to enhance safety and efficacy, there exists a need for comparative data from large populations. We performed a meta-analysis to compare arrhythmia-free survival, procedure time and complications rates between the two strategies. Methods: We searched the databases of MEDLINE and EMBASE from inception to April 2020. Included studies were case-control studies, cohort studies, or randomized controlled trials that compared patients undergoing HPSD and LPLD strategies for AF ablation and reported either of the following outcomes: freedom from atrial tachyarrhythmia (AT) including AF and atrial flutter, procedure time, or periprocedural complications. Data from each study were combined using the random-effects model to calculate odds ratio (OR) and weighted mean difference (WMD) with 95% confidence interval (CI). Results: Ten studies from 2006 to 2020 involving 2,189 patients were included (1,350 patients underwent HPSD strategy and 839 patients underwent LPLD strategy). Both HPSD and LPLD strategies resulted in a similar freedom from AT at 12-month follow-up (OR=1.36, 95% CI:0.91-2.04, p=0.13, Figure 1A). HPSD strategy did result in a significant reduction in total procedure time (WMD=47.34, 95% CI:29.47-65.21, p&lt;0.001, Figure 1B) compared to LPSD. HPSD wasn’t associated with reduction in esophageal ulcer/arterioesophageal fistula (OR=0.35, 95%CI=0.12-1.06, p=0.06) or pericardial effusion/cardiac tamponade (OR=0.96, 95%CI: 0.24-3.79, p=0.95) Conclusions: In this large meta-analysis both LPLD and HPSD are equally effective and safe. Although HPSD is often advocated to reduce esophageal injury, risk was similar between approaches. However, HPSD strategy significantly lowers procedure times.
Abstract 15642: Race Sex Disparities in Atherosclerotic Cardiovascular Disease in Hospitalized Patients With Diabetes, 2005-2015 Potential Warning Signs for Future U.S. Public Health
Authors: Gursukhman Sidhu, Charisse J Ward, Keith Ferdinand
Journal: Circulation (2020)

Introduction: Despite a recent gradually slowing and perhaps recent increase in the burden of atherosclerotic cardiovascular disease (ASCVD) related hospitalization in the United States population with diabetes, it is unclear whether the prior downward trend was uniform or there was an unbalanced division amongst sex and race. Methods: Adults aged ≥40 years old with comorbid diabetes as a secondary diagnosis were identified using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The prevalence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), procedures like major amputations in the secondary diagnosis field and their association with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis were determined. Complex samples multivariate regression was used to determine the odds ratio (O.D.) with 95% confidence limits (C.L.s). Sex and race risk-adjusted ASCVD related in-hospital mortality rates were estimated. Results: The rate of total ASCVD hospitalizations adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women cumulatively compared to a stable downtrend in white men and white women. There was a higher odd of an ASCVD hospitalizations if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% Confidence Interval (CI) 95% 1.28 - 1.31), dyslipidemia (OR 2.03; 95% CI 2.01 - 2.05), renal failure (OR 1.84; 95% CI 1.82 - 1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29 - 1.33). When compared to white men, black men (OR 1.43; 95% CI 1.3 - 1.57) and black women (OR 1.15; 95% CI 1.04 - 1.27) had a higher likelihood of undergoing a major limb amputation during an ASCVD hospitalization. Conclusions: Blacks with diabetes continue to have a higher hospitalizations burden with a concomitant disparity in procedures and outcomes.
Abstract 17361: How Leptin Harms the Heart in High Fat Diet-Induced Obesity
Authors: Maria Pini
Journal: Circulation (2020)

Introduction: Sedentary lifestyle and excessive calorie intake are risk factors for CVD. We have demonstrated the cardioprotective effect of exercise in aged mice and the critical role of visceral adiposity and its profibrotic secretome in increasing cardiovascular risks in obesity and aging. The association between exercise, lowered plasma leptin and reduced inflammatory leukocytes has been recently shown in patients with atherosclerosis. It remains unclear whether elevated plasma leptin can preserve or alter cardiovascular function in obesity. Methods: We analyzed the effect of high fat diet (HFD) in C57BL/6J male mice on the heart in terms of function, structure, histology and key molecular markers. Two interventions were used: 1) active fat mass loss via exercise (daily swimming) during HFD; 2) passive fat mass loss via surgical removal of the visceral adipose tissue (VAT lipectomy) followed by HFD. Results: HFD increased body weight and adiposity, leading to higher plasma leptin, glucose and insulin levels, compared to control diet (CD) mice. HFD impaired left ventricle (LV) structure (hypertrophy, interstitial fibrosis) and cardiac function (echocardiography, in vivo hemodynamics). Atria of HFD mice had enhanced pro-inflammatory protein production. Exercise reduced circulating leptin levels in HFD mice by 50%, in line with fat mass loss. In contrast, lipectomy reduced visceral fat mass, but body weight, adiposity and plasma leptin did not change. Both exercise and VAT lipectomy improved cardiac contractility, reversed collagen deposition and oxidative stress in HFD mice. Both interventions downregulated LV pro-inflammatory markers. We proved the role of leptin in cardiac remodeling in vitro by incubating primary cardiac fibroblasts with hyperleptinemic plasma from HFD mice. Remarkably, plasma from HFD-EX (exercise) suppressed the fibro-proliferative and pro-inflammatory responses of cardiac fibroblasts. Conclusions: Leptin directly contribute to cardiac fibrosis in obesity via activation and proliferation of cardiac fibroblasts. Understanding how leptin signals to the heart might have implications in a wide range of CVD, potentially helping early stratification and personalized care.
Abstract P050: Natural History Of Prediabetes In Middle-aged Adults
Authors: Amelia S Wallace, Mary R Rooney, Justin Echouffo Tcheugui, Morgan Grams, Elizabeth Selvin
Journal: Circulation (2021)

Background: Few studies have examined the natural history of prediabetes, specifically, regression to normoglycemia as well as progression to clinical diabetes. Furthermore, there are several definitions of prediabetes in current use. Methods: We conducted a prospective cohort analysis of 8214 participants without diabetes who attended visit 2 (1990-1992) and visit 4 (1996-1998) of the Atherosclerosis Risk in Communities (ARIC) Study. We used multinomial logistic regression to compare cumulative incidence of diabetes and regression to normoglycemia among persons meeting different definitions of prediabetes (American Diabetes Association criteria): fasting glucose (FG) 100-125 mg/dL; A1C 5.7-6.4%; or elevations in both tests (single-sample confirmatory). Incident diabetes was defined as a self-reported diagnosis, medication use, or both FG ≥ 126 mg/dL and A1C ≥ 6.5%; normoglycemia was defined as both FG &lt; 100mg/dL and A1C &lt; 5.7% and no diabetes diagnosis or medication use. Analyses were adjusted for age, sex, and race-center. Results: The prevalence of prediabetes at visit 2 (age range, 46-69; 57% female; 17% black) was 37.6% (n=3089) based on FG criteria, 17.4% (n=1427) based on A1C criteria, and 10.6% (N=867) by both FG and A1C criteria. The 6-year cumulative incidence of diabetes was 7.2% in participants with FG-defined prediabetes, 17.1% in participants with A1C-defined prediabetes, and 22.4% in participants meeting both criteria. Among participants with prediabetes by FG criteria, regression to normoglycemia was 1.9 times as likely as progression to diabetes (14.0% vs. 7.2%). However, when prediabetes was defined by A1C and by confirmatory criteria, progression to diabetes was 1.5 times and 3.5 times more likely than regression to normoglycemia, respectively. Conclusions: Risks of progression to diabetes and regression to normoglycemia differed by prediabetes definition. Prediabetes identified by A1C criteria and single-sample confirmatory criteria identified people at highest risk for diabetes.
Bad Air and Parkinson Disease—The Fog May Be Lifting
Authors: E. Ray Dorsey, Michael S. Okun, Caroline M. Tanner
Journal: JAMA Neurology (2021)

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