tbuckley/cabot-search huggingface dataset:
Abstract 12333: Intravenous Sotalol for Adenosine Refractory Supraventricular Tachycardia
Authors: Santiago O Valdes, Taylor Howard, Tam D Pham, Ellis Rochelson, Wilson W Lam, Christina Miyake, Jeffrey Kim
Journal: Circulation (2021)

Introduction: For re-entrant supraventricular tachycardia (SVT) that is refractory to adenosine, options of intravenous (IV) anti-arrhythmics for acute conversion are limited. IV sotalol has become more readily available, but experience in children with adenosine refractory SVT is limited. Hypothesis: IV sotalol is safe and effective for acute termination of adenosine refractory re-entrant SVT. Methods: A retrospective study of all pediatric patients receiving IV sotalol for SVT from 2016-2021, that had previously failed to convert with adenosine administration was performed. SVT consisting of orthodromic reciprocating tachycardia were included, all other supraventricular arrhythmias were excluded. Patient demographics, presence of congenital heart disease (CHD), arrhythmia type, efficacy of IV sotalol use and adverse effects were evaluated. For patients that failed to convert after the administration of adenosine a 1 mg/kg IV bolus of sotalol was given over 1 hour. Complete efficacy was defined as SVT terminating with IV sotalol bolus, partial efficacy was defined as adenosine converting SVT during or after the sotalol bolus, when adenosine had previously failed to convert SVT. Results: A total of 20 separate SVT events were treated with IV sotalol in 19 patients (53% male). Wolff-Parkinson-White syndrome was present in 5/19 patients (26%), and 9/19 patients (47%) had associated CHD. Patients had a median age of 0.24 yrs (IQR 0.03-6.86 yrs), median weight 4.30 kg (IQR 3.61 - 25.55 kg). Ventricular function prior to IV sotalol use was mildly or moderately depressed in 5/19 (26%) patients. Of the 20 events 5 (25%) were during the acute post-operative period. A single IV sotalol bolus was effective in converting adenosine refractory SVT in 19/20 (95%) events, with 16/20 (80%) having complete efficacy and 3/20 (15%) with partial efficacy. Median time to conversion was 0.5 hours (IQR 0.3-0.98 hours). No patient experienced an adverse effect during IV sotalol bolus. Conclusions: IV sotalol is a safe and effective antiarrhythmic option for acute conversion of adenosine refractory SVT.
Real-World Data on the Occurrence of Vaso-Occlusive Crises (VOCs) in Patients with Sickle Cell Disease (SCD) and a High Baseline Disease Burden Treated with Crizanlizumab: Results from a Managed Access Program (MAP)
Authors: Rodolfo D Cançado, Raffaella Colombatti, Antonella Quarta, Francesco Arcioni, Laurie DeBonnett, Wesam Soliman, Rajendra Sarkar, Ana Cristina Silva Pinto
Journal: Blood (2021)
Serum TARC Concentration Kinetic in Classical Hodgkin Lymphoma during First-Line Treatment
Authors: Ilaria Romano, Benedetta Puccini, Leonardo Signori, Michela Zizza, Giacomo Coltro, Marianna Palazzo, Elettra Galli, Lara Mannelli, Alberto Bosi, Alessandro Vannucchi, Luca Nassi
Journal: Blood (2021)
Abstract 9690: Perceived Control, but Not Health Literacy or Self-Care Link Income Inequity and Health-Related Quality of Life in Patients With Heart Failure
Authors: Jiarong R Wu, Debra K Moser
Journal: Circulation (2021)

Background: Income, one of the social determinants of health, has a major impact on health outcomes, especially health-related quality of life (HRQOL) in patients with heart failure (HF). Yet, the mechanisms for the association between income inequity and HRQOL are not clear. Objective: To explore the effect of income inequity on HRQOL, as well as factors that mediate this relationship in patients with HF. Method: We included 540 patients with HF (age 65±13, female 41%, NYHA class III/IV 35%) in this study. Household income was collected by patient interview. HRQOL was measured using the Minnesota Living with Heart Failure. We collected demographic (age, ethnicity, education, marital status), clinical (NYHA, LVEF, ACE inhibitor use, beta-blocker use), and cognitive/behavioral data (health literacy, self-care behaviors, perceived control) as potential factors that might link income inequity and HRQOL. Chi-square, t-tests, and linear regression were used for data analyses. Results: About three quarters (74%) of patients had low household income (≤ $40K). Patients in the low household income group were more likely to be female, minority, not married, and to have less than a high school education, low health literacy, and lower levels of perceived control than those in the high household income group. There were no difference in age, LVEF, ACE inhibitor use, beta-blocker use, or self-care behaviors between low and high income groups. Income was associated with HRQOL. Patients in the low income group had poorer HRQOL. With and without adjustment for all covariates (age, gender, ethnicity, education, marital status, left ventricular ejection fraction, Angiotensin Converting Enzyme inhibitor use, beta-blocker use), income was not a significant predictor of HRQOL ( p = .29) after entering perceived control ( p &lt; .001) in the model, demonstrating mediation. Health literacy and self-care behaviors did not mediate the relationship between income and HRQOL. Conclusion: HF patients with low household income were more likely to have poorer HRQOL. Perceived control was a mediator between income inequity and HRQOL. This suggests intervention to enhance patients’ perceived control may reduce the impact of income inequity on HRQOL.
Abstract 12966: Novel, Low-Volume, Point-of-Care Coagulation Test Successfully Detects Anticoagulation Resistance in Hospitalized Patients With COVID-19
Authors: Galit H Frydman, rachel P rosovsky, Jarone Lee, Barry M Berger, Dimitrios Papageorgiou, Ryan Mize, Jonathan A Stefely, Bianca B Christensen, Jensyn K Cone Sullivan, Gabriella G Montgomery, John P Barranco, Gregory M Piazza, Michael Laposata, Elizabeth M Van Cott
Journal: Circulation (2021)

Introduction: Severe COVID-19 has been associated with aberrant coagulation factor activities, particularly in patients with a thrombotic event (TE). Management of anticoagulant is critical in the care of hospitalized patients with COVID-19. Hypothesis: Evaluation of a point-of-care (POC), functional, clot-time-based coagulation test to detect the anticoagulant effect of therapeutic unfractionated heparin (UFH) in hospitalized SARS-CoV-2-positive patients who developed a TE. Methods: An IRB-approved analysis of 36 citrated plasma specimens from 26 SARS-CoV-2-positive patients and 10 matched negative controls was performed. A Clotting Time Score (CTS), a measure of factor-specific inhibition (i.e. anticoagulant activity), was derived for each patient. CTS results were compared with traditional coagulation tests. Five UFH COVID-19 samples with low CTS scores (&lt;10) were spiked with uniform dosing of UFH, low molecular weight heparin (LMWH), apixaban, or argatroban and retested to assess anticoagulation response. Results: The CTS detected sub-therapeutic UFH anticoagulation levels more frequently in COVID-19 cases compared with controls (76% vs. 17%). Prothrombin Times, activated Partial Thromboplastin Times, anti-Xa levels, and antithrombin activity did not correlate with each other or with the CTS in the COVID-19 samples. CTS correlated with both FV and Factor X activity (R 2 =0.49, Spearman R=-0.68), which form the prothrombinase complex. The CTS was 94% sensitive and 67% specific for the occurrence of TEs in patients on UFH. CTS demonstrated a consistent anticoagulant response only to argatroban (100%) compared with other anticoagulants (60%). Conclusions: The CTS, generated using a novel, low-volume, rapid POC coagulation test is a strong indicator of the therapeutic effect of UFH anticoagulation in COVID-19 patients and may provide a predictive measure of TEs potentially occurring from anticoagulation resistance.
Abstract 8878: Does Gender Mismatch Affect Pediatric Heart Transplant Survival Outcome?
Authors: Ahad Firoz, Mohammed Kashem, Lamya Jaigirdar, Huaqing Zhao, Yoshiya Toyoda
Journal: Circulation (2021)

Introduction: Despite conflicting results between studies, there have been many single-center analyses done to elucidate the relationship between gender mismatch and survival outcome following adult heart transplant (HTx). However, there are limited studies investigating how gender mismatch affects HTx survival in pediatric patients, particularly using a large database cohort. Hypothesis: Does donor-to-recipient gender match or mismatch affect pediatric HTx survival outcome? Methods: We retrospectively analyzed 10,619 pediatric patients (0-18yrs) from the UNOS database between 1987-2020. Patients were stratified into groups based on age (0-2yrs, 3-5yrs, 6-12yrs, and 13-18yrs) and recipient gender. Donor-to-recipient gender mismatch was then compared within each group using Kaplan Meier curves, log-rank test, and Cox regression model. A p-value of p&lt;0.05 was considered significant. Results: Comparing donor-to-recipient groups, 34% were M:M, 22% F:M, 25% M:F, and 19% F:F. Summary analysis revealed the following data within each age group: 0-2yrs (n=4,390, 54% M), 3-5yrs (n=997, 55% M), 6-12yrs (n=2,193, 49% M), and 13-18yrs (n=3,039, 64% M). Kaplan Meier curves between donor-to-recipient genders for each age group are presented in Figure 1. Log-rank test results comparing donor:recipient gender combinations for all patients, as well as for male and female patients, respectively, are also listed in Figure 1 for each age group. All log-rank test p-values were insignificant. Additionally, all stratified groups had an insignificant Cox regression p-value. Conclusions: Our study demonstrates that there is no significant difference in survival outcome for any of the pediatric patient age groups 0-2yrs, 3-5yrs, 6-12yrs, and 13-18yrs between any donor:recipient gender combination. These findings suggest that gender, irrespective of donor vs. recipient sex, does not play a significant impact on pediatric HTx survival. Further studies are warranted.
Employment status and occupational positions of childhood cancer survivors from Denmark, Finland and Sweden: A Nordic register-based cohort study from the SALiCCS research programme
Authors: Line Elmerdahl Frederiksen, Camilla Pedersen, Hanna Mogensen, Luzius Mader, Andrea Bautz, Mats Talbäck, Elli Hirvonen, Filippa Nyboe Norsker, Henrik Hasle, Nea Malila, Laura Madanat-Harjuoja, Maria Feychting, Friederike Erdmann, Jeanette Falck Winther
Journal: The Lancet Regional Health - Europe (2021)

A childhood cancer diagnosis and late effects of treatment may affect survivors' possibilities of employment or highly skilled occupations later in life. In this study, we compared the employment and occupational status of childhood cancer survivors with population comparisons and siblings.In a cohort study based on Nordic registers, we identified 10 461 survivors of childhood cancer diagnosed before age 20 years in Denmark, Finland and Sweden since 1971. Survivors were compared with 48 928 population comparisons matched to survivors by age, sex and geographical region and 12 605 siblings of survivors. Annual outcome information on employment, unemployment, health-related unemployment and occupational position was obtained from the statistical institutes between 1980-2017 and assessed in multivariate logistic regression analyses from age 30 onwards.By 30 years of age, 9.2% (95% CI, 8.6-9.9%) of survivors were unemployed for health reasons. Childhood cancer survivors had considerably higher odds of health-related unemployment at ages 30, 40 and 50 than population comparisons (ORage30, 2.57; 95% CI, 2.35-2.81) and siblings (ORage30, 2.50; 95% CI, 2.15-2.90). We observed no large difference in unemployment unrelated to health or in occupational position. Health-related unemployment was particularly pronounced among survivors of central nervous system tumours and survivors diagnosed below 15 years of age.Survivors at risk of health-related unemployment should be offered comprehensive survivorship care and interventions for obtaining and maintaining suitable employment.NordForsk [76111], the Danish Childhood Cancer Foundation [2016-0293], Aarhus University [43239402], the Swedish Childhood Cancer Foundation [PR2020-0130] and [OB2019-0003], Tømrermester Jørgen Holm og Hustru Elisa F. Hansens Mindelegat [20088] and the Swiss National Science Foundation to LM [P2LUP3_175288].
Abstract 11398: Association of Electronic Nicotine Delivery Systems Use with Circulating Angiogenic Cell Levels
Authors: Alok R Amraotkar, Ugochukwu S Owolabi, Marina Malovichko, Emelia J Benjamin, Jessica L Fetterman, Glenn A Hirsch, Sanjay Srivastava, Aruni Bhatnagar, Naomi Hamburg, Rachel J Keith
Journal: Circulation (2021)

Background: Circulating Angiogenic Cells (CAC) are known to aid in endothelial repair and are a promising marker of vascular function. Electronic Nicotine Delivery Systems (ENDS) have been hypothesized to impact vascular health, however the association between ENDS and CACs is unknown. Hypothesis: We hypothesize that ENDS use, sole or dual, will be significantly associated with CAC levels. Methods: We analyzed CAC levels of 314 human participants enrolled in the Cardiovascular Injury due to Tobacco Use study, which is a multi-center cross-sectional study of healthy participants 21-45 years age, without known cardiovascular disease or cardiovascular disease risk factors. Four study groups were determined a priori - non-smokers (n=62), sole cigarette users (n=207), sole ENDS users (n=17), and dual users (cigarette and ENDS) (n=28). A total of 15 CACs were measured via a standardized flowcytometry protocol using four cell surface markers - CD146 (endothelial), CD34 (stem cell), CD45 (leukocyte), and ACC133 (early progenitor/stem cell). Regression analysis was conducted using a General Linear Model with gamma distribution and log-link. Model was adjusted for age, sex, race, ethnicity, and enrollment site. Results: Among sole ENDS users, two CACs were significantly higher and four CACs were significantly lower, as compared to referent non-smokers (all P&lt;0.05) (Figure 1-A). Similarly, among dual users, seven CACs were significantly higher and one CAC was significantly lower, as compared to non-smokers (all P&lt;0.05) (Figure 1-B). Conclusion: CACs are sensitive to ENDS use, including dual use. Although CACs with endothelial surface markers were most commonly associated with ENDS/dual use, CACs with stem and early progenitor surface markers were also associated with ENDS/dual use. CACs are promising biomarkers of vascular function and further research is needed to quantify the effect of individual CAC on vascular function.
Abstract 12258: Angiotensin Receptor-neprilysin Inhibitor Therapy is Associated With Improved Echocardiographic Parameters in Chronic Heart Failure Patients With Reduced Ejection Fraction
Authors: Gregor Poglajen, Ajda Anžic Drofenik, Dominika Jurca, Gregor Zemljic, Andraz Cerar, Renata Okrajšek, Miran Sebestjen, Sabina Frljak, Bojan Vrtovec
Journal: Circulation (2019)

Introduction: Although angiotensin receptor-neprilysin inhibitors (ARNI) have been shown to improve survival of patients with heart failure with reduced ejection fraction (HFrEF), data on the effec...
Abstract 13983: Beta-Blocker Adherence Among Patients With Congenital Long QT Syndrome: A Nationwide Study
Authors: Johanna Kroell, Henrik Jensen, Jacob Tfelt-hansen, Christian Torp-Pedersen, Emil Fosbøl, lars Koeber, Jorgen Kanters, Camilla Jespersen, Gunnar Gislason, Jawad Butt, Henning Bundgaard, Peter E Weeke
Journal: Circulation (2021)

Introduction: Beta-blocker treatment represents a cornerstone in reducing risk of malignant ventricular arrhythmias among cLQTS patients (class Ib recommendation). We examined long-term beta-blocker adherence, risk factors associated with poor beta-blocker adherence, and its potential impact on mortality among cLQTS patients. Methods: All Danish cLQTS patients claiming a prescription for a beta-blocker within the first year after the cLQTS diagnosis were identified using nationwide registries and specialized inherited cardiac disease clinics (1995-2017). Patients were followed for up to five years. Treatment breaks &gt;30 days, &gt;60 days, and &gt;90 days were identified. Risk factors of treatment breaks &gt;60 days (i.e. proxy for poor adherence) and mortality, after cLQTS diagnosis, were assessed using multivariable cox regression. Results: Overall, 431/633 (68%) cLQTS patients claimed a prescription for a beta-blocker within the first year after cLQTS diagnosis (median age=38 years, IQR: 17-50 years; and 63.8% female). During follow-up, cLQTS patients with treatment breaks &gt;30 days, &gt;60 days, and &gt;90 days comprised 50.1%, 40.0%, and 31.6%, respectively. Overall, 10/431 (2.3%) cLQTS patients in beta-blocker treatment died (median age=63 years, IQR: 49-79 years). Of these, ≤3 had a treatment break &gt;30 days before time of death (HR=0.4, 95%CI: 0.03-2.9). Risk factors significantly associated with treatment break &gt;60 days were self-reported beta-blocker side effects (HR=3.0, 95%CI: 1.9-4.7) and psychiatric disease (HR=1.8, 95%CI: 1.1-2.9) (figure). Conclusion: More than one-third of cLQTS patients had at least one beta-blocker treatment break &gt;60 days. Moreover, cLQTS patients experiencing beta-blocker side effects or having known psychiatric disease were more likely to display poor beta-blocker adherence. Treatment breaks were not readily associated with mortality, but numbers were low. Figure: Risk factors associated with &gt;60 days treatment break.
Abstract 10519: The Epidemiology of Race- and Sex-Specific Hospitalizations for Abdominal Aortic Aneurysms
Authors: Shimena R Li, Katherine M Reitz, Lucine Gabriel, Amanda R Phillips, Paula K Shireman, Mohammad Eslami, Tzeng Edith
Journal: Circulation (2021)

Introduction: Established predominantly among White males, early detection of abdominal aortic aneurysms (AAA) with risk-factor guided screening decreases AAA-related mortality. Minimal epidemiologic data exists for AAA in racial and sex minority groups despite having increased morbidity and mortality following repair. Methods: Using data from the National Inpatient Sample and US Census (2012-18), we quantified age, race, and sex-specific incidences of intact and ruptured AAA (iAAA, rAAA) hospitalizations, associated risk factors, and in-hospital mortality. Adjusted odds ratios (OR) quantified AAA hospitalization and mortality risks. Interaction terms evaluated subgroups. Results: Of 1,728,374,183 US residents (78% White, 13% Black, 6% Asian; 51% female), 211,501,703 were hospitalized (65% White, 14% Black, 3% Asian; 58% female) with 291,850 for AAA (82% White, 6% Black, 2% Asian; 23% female). AAA hospitalizations were highest for Whites and males ( Fig ). For iAAA, compared to Whites, Blacks (OR 0.5 [95%CI 0.4-0.5]) and Asians (OR 0.9 [95%CI 0.8-0.9]) and compared to males, females (OR 0.3 [95%CI 0.3-0.3]) had reduced odds of hospitalization. For rAAA, reduced odds of hospitalization for Blacks (OR 0.5 [95%CI 0.5-0.6]) and females (OR 0.3 [95%CI 0.3-0.3]) persisted, but not for Asians (OR 1.0 [95%CI 0.8-1.2]). In subgroup analysis, associations between AAA hospitalizations, race and sex were smaller and closer to Whites and males for Black females and Blacks and females who were older or had peripheral vascular disease (PVD; P-interactions &lt;0.001). Female sex (OR 1.5 [95%CI 1.4-1.7]) but not Black and Asian races, was associated with increased mortality. Conclusions: Black and Asian races and female sex were associated with substantial decrease while older age and PVD conferred increase in the contemporary incidence and odds of AAA hospitalizations. However, AAA screening guidelines do not include PVD or race-specific differences. Changes may be warranted.
Abstract P363: Annexin-A1 Deficiency Exaggerates Cardiac Remodeling In Angiotensin II-induced Hypertension
Authors: Kristy Jackson, Jaideep Singh, Yen Zhi Ng, Cheng Peng, Anida Velagic, Tara Scott, Owen L Woodman, Rebecca H Ritchie, Geoff Head, Chengxue H Qin
Journal: Circulation Research (2021)

Introduction: We have previously demonstrated that the naturally-occurring anti-inflammatory and pro-resolving protein Annexin-A1 (Anx-A1) limits the acute inflammatory response post myocardial infarction, but its impact on chronic inflammation, such as hypertension, has not been explored. This study aims to investigate the role of Anx-A1 in a preclinical model of hypertension, induced by angiotensin-II (Ang-II). Methods: 15-week-old male C57BL/6 or ANXA1 -/- were anesthetized (isoflurane, 2-4% v/v) and implanted with an osmotic minipump randomly assigned to receive Ang-II (0.7mg/kg/day) or vehicle (saline). Radiotelemetry recordings of blood pressure were taken at 10 intermittent timepoints from baseline to the end of the 29-day infusion period. Animals were euthanized with pentobarbitone (100mg/kg; i.p.) at endpoint and organ weights recorded and normalized to bodyweight. Left ventricle (LV) samples were stained with picrosirius red to assess total LV collagen deposition. Results: Ang II-induced mice at the end of the study had elevated mean arterial pressure (MAP), cardiac hypertrophy and fibrosis compared to normotensive mice (Table). Anx-A1 deficient mice given Ang II had an even greater increase in MAP and cardiac remodeling compared to WT. Interestingly, MAP of Anx-A1 deficient mice at baseline is significantly higher compare to C57BL/6 counterparts (Table). Conclusion: This is the first study to demonstrate that deficiency of Anx-A1 exaggerates cardiac remodeling in AngII-induced hypertension, suggesting that endogenous Anx-A1 might play previously unappreciated physiological role in regulating blood pressure. This supports the development of Anx-A1 based pharmacotherapy against hypertension-induced cardiac damage.
<i>Bacteroidota</i> and <i>Lachnospiraceae</i> integration into the gut microbiome at key time points in early life are linked to infant neurodevelopment
Authors: Kaitlyn Oliphant, Mehneez Ali, Mark D’Souza, Patrick D. Hughes, Dinanath Sulakhe, Annie Z. Wang, Bingqing Xie, Rummanu Yeasin, Michael E. Msall, Bree Andrews, Erika C. Claud
Journal: Gut Microbes (2021)

The early life microbiome plays critical roles in host development, shaping long-term outcomes including brain functioning. It is not known which initial infant colonizers elicit optimal neurodevelopment; thus, this study investigated the association between gut microbiome succession from the first week of life and head circumference growth (HCG), the earliest validated marker for neurodevelopment. Fecal samples were collected weekly from a preterm infant cohort during their neonatal intensive care unit stay and subjected to 16S rRNA gene sequencing for evaluating gut microbiome composition, in conjunction with clinical data and head circumference measurements. Preterm infants with suboptimal HCG trajectories had a depletion in the abundance/prevalence of Bacteroidota and Lachnospiraceae, independent of morbidity and caloric restriction. The severity of gut microbiome depletion matched the timing of significant HCG pattern separation between study groups at 30-week postmenstrual age demonstrating a potential mediating relationship resultant from clinical practices. Consideration of the clinical variables indicated that optimal infant microbiome succession is primarily driven by dispersal limitation (i.e., delivery mode) and secondarily by habitat filtering (i.e., antibiotics and enteral feeding). Bacteroidota and Lachnospiraceae are known core taxa of the adult microbiome, with roles in dietary glycan foraging, beneficial metabolite production and immunity, and our work provides evidence that their integration into the gut microbiome needs to occur early for optimal neurodevelopment.