tbuckley/cabot-search huggingface dataset:
Decreased Mortality of COVID-19 with Anticoagulants and Antiplatelet Therapy in Patients with High Risk of Thromboembolism a Meta-Analysis
Authors: Qiao Deng
Journal: Clinical Cardiology and Cardiovascular Interventions (2021)

BACKGROUND: The clinical presentation of patients with COVID-19 varied considerably, ranging from asymptomatic infection to severe pneumonia that may lead to coagulation abnormality and pulmonary thromboembolism. Targeted antithrombotic therapy may be beneficial to reduce the incidence of thromboembolism in patients with COVID-19. METHODS: We will conduct a systematic review based on searches of major databases (PUBMED, Web of Science and EMBASE) and clinical trial registries from inception to present. The search strategy included clinical date published until Aug 12, 2020. All published randomized retrospective, control and quasi-randomized trials, and observational studies related to antiplatelet/anticoagulant therapy for COVID-19 patients with high risk of thromboembolism will be included. The primary outcome was death events, secondary outcome was disease severity of COVID-19. We used Review Manager 5.3 software to calculate the odds ratio and corresponding 95% CI. The χ2 test (assessing the P) and the I2 statistic were performed to estimate the heterogeneity. RESULTS: Compared with non-antiplatelet/anticoagulant therapy, antiplatelet/anticoagulant therapy was not associated with disease severity (odds ratio, 0.70 [95% CI, 0.41–1.21], P=0.20, I2=52%) but was related to lower mortality of COVID-19 in patients with high risk of embolism (odds ratio, 0.33 [95% CI, 0.24–0.47], P&lt;0.001, I2=8%). CONCLUSION: Current evidence suggested that antiplatelet/anticoagulant therapy should be continued in COVID-19 patients with high risk of thromboembolism. the majority of patients with severe COVID‐19 should have received similar supportive treatment after admission.
Abstract 15511: A Negative Tachycardic-induced Stress Test Predicts Against Myocardial Infarction at 30 Days Post Renal Transplantation
Authors: Nicholas J Montarello, Tania Salehi, Alex P Bate, Patrick T Coates, Matthew I Worthley
Journal: Circulation (2020)

Background: Cardiovascular (CV) events remain a major cause of death in kidney transplant recipients and an accurate CV risk assessment is required prior to a patient being placed on an active transplant wait-list. Determining the optimal protocol and non-invasive test modality for CV work-up remains contentious. The aim of this study was to assess the CV assessment protocol used within a single centre. Methods: We conducted a retrospective analysis on the rates of myocardial infarction (MI) and CV death at 30 days post renal transplantation in patients who had been processed through the CV assessment pathway at the Central Northern Adelaide Renal and Transplantation Service over a 5-year period. This protocol does not require asymptomatic patients under the age of 45, who are non-smokers, have no history of diabetes mellitus, and have been dialysis dependent for less than 24 months, to undergo objective testing for coronary artery disease (CAD) prior to listing. For all other asymptomatic patients, a tachycardic-induced stress test is required. The primary endpoint was the composite of MI and CV death at 30 days post renal transplantation. Results: Between January 2015 and December 2019, 380 patients received kidney only transplants: 79 patients (20.8%) were deemed low-risk and placed on the active transplant list without further CV assessment; 270 patients (71.1%) underwent a tachycardic-induced stress test; 31 patients (8.1%) proceeded directly to ICA. In the five-year study period, a total of three patients (0.8%) experienced a MI at 30 days post transplantation. None of these occurred in the ‘low-risk’ or ‘tachycardic-induced stress test’ cohorts. There were no CV deaths at 30 days post transplantation in the entire cohort. Conclusions: Our review has validated tachycardic-induced cardiac stress testing in predicting MI following kidney transplant surgery. Patients with a valid negative tachycardic-induced stress test went on to have transplantation with no 30-day MI or CV death, supporting the listing without the need for invasive coronary testing. Similarly, we demonstrated that no preliminary testing is required for asymptomatic patients under 45 if they do not smoke or have diabetes, and if they have been dialysis dependent for less than 24 months.
Abstract 15686: Early Intervention versus Conservative Management for Asymptomatic Severe Aortic Stenosis: An Updated Systematic Review and Meta-analysis
Authors: Ashish Kumar, Monil Majmundar, Rajkumar P Doshi, Tikal Kansara, Mariam Shariff, Palak shah, devina adalja, Saraschandra Vallabhajosyula, SIDAKPAL S PANAICH, Vinod H Thourani
Journal: Circulation (2020)

Introduction: The management of asymptomatic severe aortic stenosis (AS) is controversial and guidelines for the management of the same is not updated based on recently available evidence. Hypothesis: The main objective is to determine the optimal strategy for the management of asymptomatic severe AS between early intervention versus conservative management. Methods: We performed a systematic electronic search of the PubMed and Cochrane databases from the inception of the database to May 31 st , 2020. We used the Mantel Haenszel method with the Paule-Mandel estimator of Tau 2 and Hartung-Knapp adjustment to calculate relative risk (RR) with a 95% confidence interval (CI) and 95% prediction interval (PI). We used P curve analysis to assess publication bias and estimate the true effect of an intervention. All analysis was carried out using R version 3.6.2. Results: A total of seven studies were included in the final analysis, consisting of 1213 patients with early intervention and 2601 patients with conservative management. Early intervention as compared to conservative management was associated with reduced risk of all-cause mortality (RR: 0.32, 95% CI: 0.21-0.48) (Panel A) , cardiac mortality (RR: 0.36, 95% CI: 0.27-0.48) (Panel B) and non-cardiac mortality (RR: 0.40, 95% CI: 0.28-0.56) (Panel C) . There was no difference in the risk of sudden cardiac death (RR: 0.46, 95% CI: 0.15-1.40), stroke (RR: 0.79, 95% CI: 0.17-3.64), myocardial infarction (RR: 0.44, 95% CI: 0.01-16.82) or heart failure hospitalization (RR: 0.18, 95% CI: 0.01-5.29) between the groups. The pooled estimate for all the outcomes was associated with low-moderate heterogeneity. Conclusions: Among asymptomatic severe AS patients, early intervention is associated with reduced mortality without increasing any procedure-related clinical outcomes. Hence, this meta-analysis supports early intervention as opposed to watchful waiting for the management of asymptomatic severe AS.
Abstract 13352: Decreased Absolute Lymphocyte Count and Increased Neutrophil Lymphocyte Ratio With Immune Checkpoint Inhibitors-associated Myocarditis
Authors: Zsofia D Drobni, Amna Zafar, Leyre Zubiri, Daniel Zlotoff, Raza Alvi, Charlotte Lee, Sarah Hartmann, Hannah K Gilman, Alexandra-Chloe Villani, Anju Nohria, John D Groarke, Ryan J Sullivan, Kerry L Reynolds, Lili Zhang, Tomas G Neilan
Journal: Circulation (2020)

Introduction: Myocarditis due to immune checkpoint inhibitor (ICI) therapy is a potentially fatal immune-related adverse event (irAE). Hypothesis: Limited data have suggested an association between baseline and on-treatment absolute lymphocyte count (ALC) and neutrophil lymphocyte ratio (NLR) and the development of other irAEs; there are no data characterizing the role of ALC and NLR in ICI-associated myocarditis. Methods: This was a case control study of 55 patients with ICI myocarditis and 55 controls without any post-ICI irAEs. We leveraged clinical testing where patients underwent routine serial blood counts before and with each ICI cycle to compare the baseline and change in ALC and NLR between cases and controls. The association between the change in these parameters with clinical variables and major adverse cardiac events (MACE) was also tested. Results: In those who developed myocarditis, there was a decrease in ALC from baseline (1.6 K/μL, IQR 1.1-1.9) to admission (1.1 K/μL, IQR 0.7-1.3, p&lt;0.001, Panel A). Similarly, among those who developed myocarditis, there was an increase in NLR from baseline (3.5, IQR 2.3-5.4) to admission (6.6, IQR 4.5-14.1, p&lt;0.001, Panel B). There was no change in patients treated with an ICI who did not develop myocarditis. Among those who developed myocarditis, a greater decrease in ALC or increase in NLR was associated with a higher heart rate and a lower blood pressure at admission. In follow-up, there were 20 events; larger decreases in ALC or increases in NLR were associated with MACE (Panel C and D). Conclusions: A reduction in ALC and an increase in NLR was seen with ICI myocarditis. A greater decrease in ALC or increase in NLR were associated with subsequent MACE.
Abstract P057: The Association Of Diabetes Duration With Central Artery Stiffness And Its 5-year Change Among Older Adults: The Atherosclerosis Risk In Communities Study (ARIC).
Authors: Meera Marji, Gerardo M Heiss, James R Pike, Priya Palta, Michelle Meyer, Hirofumi Tanaka, Lee Stoner, Elizabeth Selvin, Vijay Nambi, Christie M Ballantyne, Anna Kucharska-newton
Journal: Circulation (2021)

Background: Central artery stiffness is a predictor of cardiovascular risk and mortality among individuals with diabetes. Few studies examined whether the duration of diabetes relates to arterial stiffening and its rate of progression. Objective: To examine the association of diabetes duration from midlife to older adulthood with arterial stiffness and its 5-year change. Methods: Diabetes (defined by fasting glycemia level &gt;126 mg/dl or use of glucose lowering agents or self-reported) was ascertained at visit 1 (1988-1990), on repeated examinations and on telephone follow-up calls of 2,155 ARIC cohort members (58% women, 20% black, mean age 74 years), as well as time since ascertainment of diabetes. Carotid femoral pulse wave velocity (cfPWV), a measure of central artery stiffness, was obtained at cohort visits 5 (2011-13) and 6 or 7 (2016-19). Associations of duration of diabetes with visit 5 cfPWV and the 5-year cfPWV change from visit 5 to visit 6 or 7 were evaluated by multivariable linear regression adjusted for demographic factors. Results: Among study participants with diabetes ascertained from midlife to older adulthood (n=639 (29%)), the mean cfPWV at visit 5 was 78.6, 95%CI (52.9, 104.4) cm/s greater than those without diabetes. Over a mean of 4.9 (SD 3) years of follow-up, cfPWV increased by a median 137 cm/s. The 5-year change in cfPWV was 40.5, 95%CI (12.3, 68.8) cm/s greater among those with diabetes, as compared to those without diabetes. The mean diabetes duration was 8.1(SD 6.8) years for participants with diabetes. After adjusting for demographic factors, we observed a positive association of diabetes duration with the 5-year change in cfPWV in older adulthood (Figure). Conclusion: Duration of diabetes was associated with a greater rate of progression of central arterial stiffness in older adults.
ペルオキシ亜硝酸仲介ニトロ化を介した一酸化窒素のin situ検出のためのペプチド官能化蛍光粒子【Powered by NICT】
Authors: Y H Chang Jason, W Chow Lesley, Dismuke W. Michael, Ethier C. Ross, M Stevens Molly, Stamer W. Daniel, R Overby Darryl
Journal: Advanced Healthcare Materials (2017)
Abstract 043: Community-level Social Determinants Of Covid19 Mortality In The Chicago Area
Authors: Ashwin Sunderraj, Xiaoyun Yang, Amy Krefman, Kiarri N Kershaw, Sadiya Khan, Norrina B Allen, Lindsay Pool
Journal: Circulation (2021)

Introduction: Since the onset of the COVID-19 pandemic, large geographic differences in mortality rates have emerged, with higher rates in predominantly Black and Latinx neighborhoods. In this analysis we examined community-level differences across the city of Chicago to better understand how geographic differences are associated with COVID19 mortality. Hypothesis: We hypothesized there would be an association between higher community-level social vulnerability and COVID19 mortality rates. Methods: We examined publicly available data from the Cook County Medical Examiner data (Illinois) of all known COVID-19 deaths as of August 21, 2020. Decedent addresses (N = 2397) were restricted to the city of Chicago, geocoded, and classified according to the 77 recognized community areas in the city. Poisson regression models were used to determine significant community-level predictors of COVID19 mortality based on community-level demographic, social, health, and healthcare characteristics collected from the Chicago Health Atlas. Results: There was at least one COVID19-related death in each Chicago community area, with a crude mortality rate ranging from 0.571 - 24.5 deaths per 10,000 persons. In the fully adjusted model with 14 community-level predictors, higher community-level population density, percentage of males, living in crowded housing, and limited food access were associated with higher rates of COVID19 mortality. Higher community-level proportion of the population aged 65+ years and having a primary care provider were associated with lower COVID19 mortality. Differences by Black and Latinx race/ethnicity community-level demographics were not significant in the final model. Conclusions: Community-level factors of greater social vulnerability (crowded living conditions, limited food access) are strong predictors of community-level COVID19 mortality. These factors may limit effective social distancing and increase the necessity to enter public areas, raising community-level COVID19 mortality.
Abstract MP53: Consumption Of Ultra-processed Food Is Associated With Risk Of Coronary Heart Disease In The Atherosclerosis Risk In Communities Study
Authors: Shutong Du, Hyunju Kim, Josef Coresh, Casey M Rebholz
Journal: Circulation (2021)

Introduction: Ultra-processed food defined as food and drink products formulated through sequences of industrial processes, and generally contain non-culinary used additives. Previous studies have linked higher ultra-processed food intake with several cardiometabolic and cardiovascular diseases. However, longitudinal evidence from US populations remains scarce. Hypothesis: We hypothesized that higher intake of ultra-processed food is associated with higher risk of coronary heart disease (CHD). Methods: We selected 12,607 adults aged 44-66 years in 4 US communities from the ARIC study at baseline. Dietary intake data were collected through a validated 66-item food frequency questionnaire. Ultra-processed foods were defined using the NOVA classification and the level of intake was calculated for each participant. We conducted Cox proportional hazards models to study the association between quartiles of ultra-processed food intake and incident CHD. Nonlinearity was assessed by using restricted cubic spline regression. Results: There were 1,899 incident CHD cases documented after an median follow up of 27 years (291,285.2 person-years). Incidence rates were higher in the highest quartile of ultra-processed food intake (71.6 per 10,000 person-years; 95% CI, 65.8-78.0) compared to the lowest quartile (59.7 per 10,000 person-years; 95% CI, 54.3-65.7). Participants in the highest vs. lowest quartile were associated with a 18% higher risk of CHD (Hazard ratio 1.18 [95% CI, 1.04 - 1.34]; P-trend = 0.010) after adjusting for sociodemographic factors and health behaviors. An approximately linear relationship was observed between ultra-processed food intake and risk of CHD after 4 servings/day ( Figure ). Conclusion: In conclusion, higher ultra-processed food intake was associated with a higher risk of coronary heart disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed food may affect health.
Abstract 12985: Efficacy and Safety of Mechanical versus Manual Compression in Cardiac Arrest and Cardiogenic Shock Patients
Authors: Takashi Nagasaka
Journal: Circulation (2020)

Introduction: Mechanical chest compression (MCC) provides consistent pressure and timing of each chest compression in line with latest evidenced-based practice. However, there has been no evidence from large randomized trials about the effectiveness of the mechanical device compared with manual chest compression. Furthermore, few studies focused on cardiogenic shock and cardiac arrest related to heart disease. Hypothesis: The aim is to assess the effectiveness and safety of mechanical chest compressions versus manual chest compressions in patients with out of hospital cardiogenic shock and cardiac arrest due to heart disease. Methods: We conducted a retrospective observational study of comparing the outcomes of mechanical and manual chest compressions. A total of 69 consecutive patients with out of hospital cardiogenic shock and cardiac arrest were enrolled between April 2014 and May 2018. 39 patients of them received only manual cardiopulmonary resuscitation (CPR) and 30 utilized a mechanical CPR device. Baseline characteristics, resuscitation details, and outcomes were compared between patients who received manual (manual group) and mechanical compressions (MCC group). Results: There was no significant difference in age, gender, the rate of bystander CPR and arterial blood gases at baseline. No differences were found for the rate of ROSC and 30-day survival between two groups. However, MCC group had significantly higher rate of bleeding events than manual group. In addition, fifty-four patients of them were treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO). Among patients underwent VA-ECMO, the rate of 30-day survival was significantly lower in MCC group. (Figure 1). Conclusions: This study showed that mechanical chest compression increased bleeding events than manual chest compression. Furthermore, in the patients underwent ECMO, the use of mechanical chest compression might be associated with higher mortality.
Abstract P151: <i>Acculturation Predicts Activity-specific Parenting Practices In Hispanic/Latino Youth</i>
Authors: Christopher J Gonzalez, Madison N Lecroy, Martha L Daviglus, Linda Van Horn, Linda Gallo, Franklyn Gonzalez, Krista Perreira, Maria Llabre, Carmen R Isasi
Journal: Circulation (2021)

Background: Hispanic youth are less physically active and more sedentary than non-Hispanic youth, contributing to relatively high rates of obesity among the nation’s largest ethnic minority group. Though parents can influence children’s behavior, it is unclear whether parenting practices related to the child’s physical activity are associated with activity in Hispanic/Latino youth, and whether cultural and environmental contexts predict the use of these parenting practices. Objective: We assessed 1) whether activity-specific parenting practices (ASPPs) are associated with moderate-to-vigorous physical activity (MVPA) and sedentary activity among Hispanic/Latino youth, and 2) if higher parental acculturation and greater perceived neighborhood-level socioeconomic challenges are associated with the use of less effective ASPP patterns. Methods: Youth from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth; n=976) were examined. Activity was assessed using 7-day accelerometer data. ASPPs were identified from the Parenting strategies for Eating and Activity Scale (PEAS) using exploratory and confirmatory factor analysis of the ten items on activity. We used survey-weighted linear regression models to assess whether derived ASPPs predicted mean daily MVPA and sedentary time. K-means cluster analysis was used to group individuals based on ASPP use. Finally, we used survey-weighted multinomial logistic regression models to examine the association of parent acculturation-related measures and perceived neighborhood socioeconomic status and barriers to activity with ASPP cluster membership. Results: Factor analysis of the activity-specific PEAS items identified three ASPPs: Limit Setting, Discipline, and Monitoring/Reinforcement. Discipline predicted higher MVPA in females only (β 1.89 [95% CI 0.11-3.67]), and Monitoring/Reinforcement predicted higher MVPA in males only (β 4.71 [95% CI 0.68-8.74]). There was no association between Limit Setting and MVPA or any ASPPs and sedentary activity. K-cluster analysis revealed three ASPP patterns: Restrictive (high scores for Limit Setting and Discipline), Supportive (high scores for Limit Setting and Monitoring/Reinforcement) and Permissive (low score across ASPPs). Higher Anglo-orientation on the Brief ARSMA-II acculturation measure predicted membership in the Supportive compared to Permissive cluster (p= 0.03), while perceived neighborhood characteristics did not predict ASPP cluster membership. Conclusions: ASPPs are associated with MVPA in sex-specific ways but have no association with sedentary activity in Hispanic/Latino youth. Among acculturation and neighborhood characteristics, only Anglo-orientation predicted ASPPs patterns. More research is needed to understand how acculturation is influencing ASPPs and if ASPPs can be leveraged to change children’s activity.
Development of CAR T-cell lymphoma in 2 of 10 patients effectively treated with<i>piggyBac</i>-modified CD19 CAR T cells
Authors: David C. Bishop, Leighton E. Clancy, Renee Simms, Jane Burgess, Geetha Mathew, Leili Moezzi, Janine A. Street, Gaurav Sutrave, Elissa Atkins, Helen M. McGuire, Brian S. Gloss, Koon Lee, Wei Jiang, Karen Maddock, Georgia McCaughan, Selmir Avdic, Vicki Antonenas, Tracey A. O’Brien, Peter J. Shaw, David O. Irving, David J. Gottlieb, Emily Blyth, Kenneth P. Micklethwaite
Journal: Blood (2021)
Socioeconomic biases in asthma control and specialist referral of possible severe asthma
Authors: Kjell Erik Julius Håkansson, Vibeke Backer, Charlotte Suppli Ulrik
Journal: European Respiratory Journal (2021)

Background Although socioeconomic impact on asthma control has been investigated, little is known about its relationship to specialist referral of patients with possible severe asthma, especially in a public healthcare setting. The present study aims to identify socioeconomic patterns in disease control and referral of patients with asthma in a nationwide cohort of adult patients treated with inhaled corticosteroids (ICS). Methods Asthma patients fulfilling the following criteria were included: aged 18–45 years and redeeming two or more prescriptions of ICS during 2014–2018 based on data from Danish national registers. Possible severe asthma was defined as Global Initiative for Asthma 2020 step 4 (with either two or more courses of systemic steroids or at least one hospitalisation) or step 5 treatment. Findings presented as odds ratios (95% confidence intervals). Results Out of 60 534 patients (median age 34 years, 55% female), 3275 (5.7%) were deemed as having possible severe asthma, of whom 61% were managed in primary care alone. Odds of specialist management for possible severe asthma decreased with age (OR 0.66, 95% CI 0.51–0.85; 36–45 versus 18–25 years), male sex (OR 0.75, 95% CI 0.64–0.87), residence outside the Capital Region (OR 0.70, 95% CI 0.59–0.82) and with receiving unemployment or disability benefits (OR 0.75, 95% CI 0.59–0.95). Completion of higher education increased odds of specialist referral (OR 1.28, 95% CI 1.03–1.59), when compared to patients with basic education. Conclusion Even in settings with nationally available free access to specialist care, the majority of patients with possible severe asthma are managed in primary care. Referral of at-risk asthma patients differs across socioeconomic parameters, calling for initiatives to identify and actively refer these patients.