tbuckley/cabot-search huggingface dataset:
Abstract P2049: Race and Ethnicity and Oral Anticoagulation Adherence in Older Adults with Atrial Fibrillation: A Nationwide Study
Authors: Utibe Essien, Jasmyn Tang, Mei Leng, Li-Jung Liang, Carol Mangione
Journal: Circulation (2025)

Background: Atrial fibrillation (AF) is the most common arrhythmia and is associated with morbidity from ischemic stroke. Oral anticoagulant (OAC) therapy reduces stroke risk. Prior work has shown lower OAC initiation in minoritized racial/ethnic groups. Less is known about how OAC adherence differs by race/ethnicity, which may contribute to higher stroke rates in minoritized groups. Hypothesis: Minoritized racial/ethnic groups will have poorer adherence to OAC therapy than White individuals. Goal/Aim: To examine the association of race/ethnicity and OAC adherence in AF. Methods: Using VA Corporate Data Warehouse data, we identified patients enrolled in VA from 1/1/2014-12/31/2020 with an AF diagnosis. We excluded those who received OAC before their index AF diagnosis, were on multiple OAC drugs within 1 year of treatment or died within 1 year of treatment. The independent variable was race/ethnicity (i.e., non-Hispanic Black, Other, White, and Hispanic). The primary outcome was adherence to OAC therapy (warfarin or direct oral anticoagulant, DOAC) defined as ≥80% proportion of days covered within the first year of index treatment. Multivariable logistic regression was used to estimate racial/ethnic differences in OAC adherence, adjusting for age, OAC type, stroke risk score, area deprivation index, and year of first OAC prescription. Results: We identified 99,461 OAC initiators: 3.4% Hispanic, 8.8% Non-Hispanic Black, 85.7% Non-Hispanic White, 2.1% Non-Hispanic Other, mean age 72.8 years. Overall, 1-year OAC adherence was 70%. Adherence varied by race/ethnicity with DOAC adherence greater than warfarin for all groups except Black patients ( Figure ). In adjusted models, Black (aOR 0.63, 95% CI 0.57-0.62), Hispanic (aOR 0.78, 95% CI 0.65-0.77), and Other patients (aOR 0.79, 95% CI 0.71-0.86) had significantly lower odds of adherence vs. White patients. Cumulatively, 1.4% of patients had a newly diagnosed stroke during their first year of treatment, with stroke rates lower in adherent (1.4%) vs. non-adherent (1.6%) patients. Adherent Black (2.9%) and Hispanic (1.7%) patients had significantly higher rates of strokes than White (1.3%) patients (P&lt;0.001). Conclusion: In a national cohort of VA patients with AF, we found significant racial/ethnic disparities in OAC adherence and incident stroke. Identifying drivers of these disparities is essential to improve outcomes in patients with AF including those managed in the largest, low-drug cost, US health care system.
Abstract 074: Interplays of ADH1B Genotype, Alcohol Consumption, and Gut Microbiota in Relation to Insulin Resistance
Authors: Brian Wang, Brandilyn Peters-Samuelson, Kai Luo, Yang Li, Christina Cordero, krista perreira, Amber Pirzada, Martha Daviglus, Robert Kaplan, Robert Burk, Qibin Qi
Journal: Circulation (2025)

Background: Alcohol consumption has been linked to alterations in gut microbiota and insulin resistance. The alcohol dehydrogenase 1B ( ADH1B) gene plays a crucial role in alcohol catabolism, where rs1229984 variant carriers (CT/TT) catabolize ethanol at an 80-fold faster rate than non-carriers (CC). Methods: We analyzed fecal metagenomic sequencing data from diabetes-free participants in the Hispanic Community Health Study/Study of Latinos. We used ANCOMBC to identify gut microbiota associated with alcohol consumption in non-carriers (n=1,399) and carriers (n=193). We constructed genotype-specific gut microbiome scores (GMSs) based on identified species associated with alcohol consumption to examine how microbiota may influence the relationship between alcohol consumption and insulin resistance in non-carriers and carriers. Insulin resistance was defined as HOMA-IR &gt; 2.5. Results: Higher alcohol consumption was associated with lower odds of insulin resistance in non-carriers. Distinct microbial species associated with alcohol consumption were identified in non-carriers (54 species) and carriers (16 species) ( Fig A ). In non-carriers, the genotype-specific GMS modified the relationship between alcohol consumption and insulin resistance (P interaction =0.011). The odds ratios (OR) for insulin resistance with increasing alcohol consumption levels across low, moderate, and high tertiles of GMS were 0.75 (95%CI 0.58-0.96), 0.82 (0.67-1), and 1.13 (0.93-1.39), respectively ( Fig B ). We identified that abundance of individual alcohol-related species in non-carriers, such as Prevotella copri (enriched with alcohol consumption) , Ruminococcus callidus (enriched) , and Erysipelatoclostridium ramosum (depleted) , modified the relationship between alcohol consumption and insulin resistance in non-carriers ( Fig C ). Conclusions: Our findings suggest a potential role of gut microbiota in the protective association between alcohol consumption and insulin resistance in ADH1B variant non-carriers.
Abstract P3011: Empirically derived biomarker patterns in the REasons for Geographic and Racial Differences in Stroke Study
Authors: Timothy Plante, Stephen Juraschek, Kathryn Foti, Mary Cushman, Suzanne Judd, Virginia Howard, George Howard, Nels Olson, Leann Long, Paul Muntner, Annie Green Howard
Journal: Circulation (2025)

Background: Contemporary molecular epidemiologic approaches often consider individual or small groups of biomarkers and their relationship to cardiovascular disease risk factors or events. Factor analysis can group many biomarkers that represent the physiology and dysfunction of multiple organ systems into a small number of distinct patterns. These patterns may better reflect the complexity of human physiology and advance understanding of cardiovascular disease onset. We sought to empirically identify such patterns using factor analysis, and hypothesized that biomarkers would cluster into distinct patterns. Methods: REGARDS recruited 30,239 Black and White adults aged ≥45 years from the continuous US in 2003-2007 with a second visit in 2013-2016. Specialized biomarkers were measured in specimens collected at baseline from 4,400 participants who attended both visits; lipids, C-reactive protein (CRP), cystatin C, urine albumin/creatinine ratio, complete blood count, blood urea nitrogen (BUN), and serum albumin were measured in all or most participants. Factor analysis was used to derive patterns in a random split sample. Scree plot guided selection of factors used an eigenvalue cut point of 1. Validity was confirmed across race, sex, and age groups (&lt;55, 55 to &lt;65, 65 to &lt;75, and ≥75 years) A congruence test coefficient &gt;0.5 was considered acceptable. Final factor patterns were derived in the entire analytical sample using a 3-factor solution and named based on biologically known pathways. Results: Of the 4,400 participants, 31% were excluded who were missing any biomarker leaving an analytical sample of 2,723. The congruence coefficient between the factors was &gt;0.78 for all subgroup comparisons. As is shown in the Figure , the “thrombo-inflammatory” pattern (pattern 1) had higher levels of inflammation, coagulation, and leptin; the “renal-inflammatory” pattern (pattern 2) had high levels of inflammation, renal dysfunction, and also high NT-proBNP and proenkephalin; the “dyslipidemic-inflammatory” pattern (pattern 3) had high levels of inflammation and triglycerides and low levels of HDL and adiponectin. Discussion: Three observed biomarker patterns had strong congruence across race, sex, and age groups. Future research will determine if these patterns are associated with cardiovascular risk factors and events.
Abstract P3016: Blood Pressure Measures are Not Associated with Early Metabolic Imbalance: The U.S. National Health and Nutrition Examination Survey
Authors: Luis Mendiola, Alok Dwivedi, David Cistola
Journal: Circulation (2025)

Introduction: Early metabolic imbalance (EMI) is a hidden condition prevalent in teens and young adults. It is characterized by compensated insulin resistance, where fasting glucose, triglycerides, HDL cholesterol, and hemoglobin A1c are all within normal limits (Fig. 1). Thus, EMI does not meet the criteria for prediabetes or metabolic syndrome and eludes risk screening for type 2 diabetes and CVD. In addition to hyperinsulinemia, EMI is associated with chronic inflammation, oxidative stress, and hypoxia. The overproduction of nitric oxide from high circulating insulin may keep blood pressure low. Therefore, we investigated the association of blood pressure with EMI. Hypothesis: In EMI, blood pressure measures are lower or unchanged compared to healthy balanced metabolism. Methods: The fasting subsample from the 2015-2018 U.S. National Health&amp;Nutrition Examination Survey was analyzed: 6,227 observations representing 270.2 million people in the U.S. ages 12 and up. Population-weighted multinomial logistic regression was performed using Stata v18.5. The outcome variable was cardiometabolic health, categorized into 1 of 4 groups: healthy balanced metabolism, EMI, prediabetes/dyslipidemia (PD), or type 2 diabetes/ASCVD (Fig. 1). EMI was defined as elevated fasting insulin with normal glucose, A1c, TG and HDL, using prognostic insulin cutpoints from timeROC analysis of the CARDIA cohort. The 1° exposure was systolic BP. Diastolic BP, mean arterial pressure, and pulse pressure were 2° exposures. The adjusted covariates were age, male gender, race/ethnicity, waist circumference, sedentary behavior, low-salt diet, and BP medications. For measuring association, the effect size was relative risk ratio with 95% confidence interval and p-value. Results: After adjusting for confounders, no significant change in systolic blood pressure was observed between the EMI and balanced metabolism groups (Table 1). By contrast, the PD and diabetes/ASCVD groups were associated with increases in systolic BP. Nearly identical results were obtained when diastolic BP, mean arterial pressure, or pulse pressure was substituted for systolic BP. Age emerged as the most influential confounder for the association between blood pressure and EMI. Conclusion: In EMI, blood pressure measures were unchanged compared with healthy balanced metabolism. Higher blood pressure values or taking BP medications may serve as a marker to help differentiate other cardiometabolic health categories from EMI.
Abstract P2048: Comparison of Incident Cardiovascular Diseases Between Asian American, Native Hawaiian and Other Pacific Islanders in Hawaii vs. Northern California: The PANACHE Study
Authors: Yihe Daida, Rishi Parikh, Andrew Ambrosy, Joan Lo, Stacey Alexeeff, Thida Tan, Connor Howick, Alan Go
Journal: Circulation (2025)

Introduction: Hawaii (HI) and California (CA) are home to the largest and fast-growing Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) populations in the U.S., yet our understanding about the influence of factors related to geographic location on cardiovascular disease (CVD) risks within the AANHPI population is limited. We compared incident CVD rates for eight AANHPI subgroups between HI and California CA. Methods: We identified AANHPI members of Kaiser Permanente Hawaii and Northern California aged ≥30 years with no prior CVD from 2012-2022. Outcomes included incident acute myocardial infarction (MI), stroke, heart failure (HF) and atrial fibrillation (AF) using validated diagnosis codes in electronic health records. Cox proportional hazards models stratified by AANHPI subgroup were performed to evaluate the association between geographic region (CA vs. HI) and each CVD outcome, after patient-level adjustment for age, sex, body mass index, census tract-level education and income, diabetes, hypertension, dyslipidemia, chronic kidney disease stage, depression, alcohol use, and smoking status. Results: Among 677,563 AANHPI adults with no prior CVD, mean age was 47±14 years, with higher proportion of women at both sites (53.0% HI, 58.8% CA), and a mean BMI of 28.2 in HI and 25.8 in CA. In stratified multivariable models that adjusted for demographic and CVD risk factors, rates of incident MI, stroke, HF and AF varied between CA and HI depending on the CVD outcome and AANHPI subgroup. Among Filipino adults, those living in CA had a higher adjusted rate of MI (adjusted hazard ratio [aHR] 1.35, 1.21-1.51), HF (aHR 1.14, 1.06-1.23) and AF (aHR 1.16, 1.07-1.25) than those living in HI. Among Native Hawaiian/Pacific Islander adults, those living in CA had a higher adjusted rate of MI (aHR 1.30, 1.13-1.49) but a lower adjusted rate of stroke (aHR 0.81, 0.68-0.98), HF (aHR 0.86, 0.77-0.95) and AF (aHR 0.71, 0.64-0.80) than those living in HI. In addition, the adjusted rate of stroke was lower for Japanese (aHR 0.77, 0.66-0.90) and Korean (aHR 0.58, 0.40-0.85) adults in CA. Conclusions: We observed varying rates of incident CVD events across AANHPI subgroups between HI and CA that were not explained by measured sociodemographic and clinical risk factors. Further investigation into environmental, structural, and behavioral risk factors that may contribute to the observed CVD outcome variation within AANHPI subgroups is needed.
3D‐Printed Hydrogel Patches Embedded with Cu‐Modified Liquid Metal Nanoparticles for Accelerated Wound Healing
Authors: Bo Wang, Xiaohui Shan, Jianye Gao, Weichen Feng, Ruizhi Yuan, Sen Chen, Hongzhang Wang
Journal: Advanced Healthcare Materials (2025)

Abstract Wound healing is significantly challenged by resistant bacterial infections. Gallium‐based liquid metal (LM) antibacterial agents show promise due to their non‐inducement of resistance, though their efficacy remains limited. Here, we graft copper onto nano‐LM surfaces via ultrasonication to create copper‐modified LM nanoparticles (Cu‐LMNPs) with enhanced antibacterial properties. Specific experiments suggest that Cu‐LMNPs enhance antibacterial efficacy against ampicillin‐resistant Escherichia coli ( E. coli ) and methicillin‐resistant Staphylococcus aureus ( MRSA ) in vitro, achieving ≈100% antibacterial effectiveness. The remarkable antibacterial efficacy stems from the considerable increase in Cu 2 ⁺ and Ga 3 ⁺ concentrations. Further, the Cu‐LMNPs and epidermal growth factors (EGF) are incorporated into the rheology‐tunable hydrogels with excellent printability and biocompatibility for accelerating chronically infected wound healing. In vivo experiments demonstrate that the hydrogel patches effectively treated MRSA ‐infected wounds in mice. Sustained release of multiple ions and EGF promotes epithelial regeneration, collagen deposition, and neovascularization, making the wound markedly distinct from the control group and nearly fully healed within 10 days. Overall, this research presents a novel 3D‐printed mesh hydrogel patch that not only combats bacterial infections but also accelerates wound healing.
Abstract P2058: Hypertension in Young Adults: Social Determinants and Control Using EHR Data
Authors: Thomas Alexander, Yaojie Wang, Lucia Petito, Abigail Gauen, Ciaran Kohli-Lynch, Thomas Carton, Steven Smith, Greg Merritt, Catherine Benziger, Faraz Ahmad, Norrina Allen
Journal: Circulation (2025)

Introduction: Young adults are at risk for long-term cardiovascular complications if hypertension (HTN) remains unmanaged. There is limited exploration of how specific social determinants of health (SDoH), particularly in young adults, influence HTN control. Methods: HTN control was assessed among young adult patients (20 to 44 years) who completed SDoH screening in the Northwestern Medicine Health System. Exposures included 6 SDoH: no usual source of care, difficulty affording medication, mental health concerns, housing instability, transportation needs, and food insecurity. Sample included participants with SDoH measures and HTN as defined per 2017 ACC/AHA guidelines or ICD-10 code between 2018 and 2024 (N=36,377). Control was defined as blood pressure (BP) &lt;140/&lt;90 mmHg. Multivariable regression estimated the association between specific SDoH with HTN control, adjusted for age, sex, and race/ethnicity. Results: BP control at one year was 81.7% among hypertensive young adults. Hypertensive young adults with difficulty affording medication (OR 0.74; 95% CI 0.60-0.94; P=0.011) and housing instability (OR 0.63; 95% CI 0.43-0.96; P=0.027) were less likely to be controlled compared to those without these SDoH. Non-Hispanic Black young adults with HTN were less likely to be controlled compared to Non-Hispanic White young adults (OR 0.69; 95% CI 0.56-0.86; P&lt;0.001). Hypertensive young adults on Medicaid were less likely to be controlled than those with a commercial health plan (OR 0.79; 95% CI 0.63-1.01; P=0.053). Conclusions: Improving medication accessibility and housing stability for young adults could improve HTN control. Future research should explore strategies to integrate SDoH screening into routine hypertension care.
Abstract 072: Plasma Metabolome Predicts Long-term Body Weight Gain and Type 2 Diabetes in Non-Obese Individuals
Authors: Zhiyuan Wu, Binkai Liu, Jun Li, Oana Zeleznik, A Heather Eliassen, Clemens Wittenbecher, Frank Hu, Molin Wang, Mingyang Song, Yang Hu, Qi Sun
Journal: Circulation (2025)

Introduction: Body weight is known to modulate the human blood metabolome, although whether certain plasma metabolomic profiles predict long-term weight change remains unknown. Hypothesis: We hypothesize that there are inter-relationships between plasma metabolome, current weight, weight change, and incident type 2 diabetes (T2D). Methods: We measured 260 annotated metabolites among 7, 499 participants in Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study using nontargeted LC-MS. We assessed the associations of these metabolites and BMI trajectory since blood draw during 26.0 years of follow-up using a mixed-effect model, also by BMI groups at blood draw (lean: 18.5-24.9 kg/m 2 , overweight: 25.0-29.9 kg/m 2 , and obese: ≥30 kg/m 2 ). A metabolomic score reflecting BMI change slope was identified using elastic net regression with a training/testing approach. Associations between the metabolomic scores and T2D were evaluated using Cox proportional hazards regression. Results: Cross-sectionally, metabolites associated with current BMI level among lean, overweight, and obese individuals minimally overlapped (of 260 metabolites, 2 overlapping among the three groups). Distinct metabolomic profiles associated with BMI trajectories were also identified among the three groups. While 46 metabolites significantly predicted BMI change slope in the lean group, only 20 and 13 metabolites predicted the slope among overweight and obese groups, respectively, with no metabolites overlapping among the three groups. Among lean individuals, the elastic net regression identified 82 metabolites, predominantly lipids and organic acids, to construct a score that reflected faster BMI gain. The score was significantly associated with the BMI slope in lean group (training: Spearman r = 0.33; testing: Spearman r = 0.20), but the correlation was weaker among overweight, and obese groups (Spearman r = 0.15, and 0.08, respectively). The metabolomic score was significantly associated with a higher risk of T2D in the lean group (aHR per 1SD: 1.41 [95% CI 1.25-1.59]) and overweight group (aHR per 1SD: 1.29 [95% CI 1.17-1.42]) groups, but not in the obese group. Conclusions: Metabolomic profiles associated with current BMI and BMI trajectory differ significantly among lean, overweight, and obese individuals. A metabolomic score that predicts BMI change is associated with higher T2D risk in lean and overweight individuals, but not among obese individuals.
Abstract P1100: Risk of Incident Heart Failure by Gender Identity among US Veterans
Authors: Ian Everitt, Meredith Duncan, Kory Heier, Hill Wolfe, John OLeary, Guneet Jasuja, Carl Streed, Monica Mukherjee
Journal: Circulation (2025)

Background: Disparities in heart failure (HF) are driven in part by social and structural determinants of health. Rates of HF among transgender and gender diverse (TGD) individuals relative to cisgender (cis) peers are not well described. Methods: We used EHR data from the Veterans Healthcare Administration (VHA) to identify veterans with &gt;2 outpatient encounters from 2010-2019. Gender identity was ascertained using natural language processing in combination with gender-affirming hormone therapy (GAHT) and a validated algorithm utilizing ICD codes and VHA data. Among 1,103,923 veterans, 42,157 were classified as TGD. We examined sample characteristics by gender identity and used Cox regression to assess the association of gender identity with incident HF. Results: TGD veterans’ mean age was 46 years (cis females=40; cis males=53). Median follow-up was 9.41 years. There were 107,766 incident HF events (3,078 among TGD veterans). The HF rate among TGD veterans was 8.19 [95% CI: 7.90-8.48] per 1,000 person-years compared to 13.05 [12.97-13.13] and 3.87 [3.76-3.98] among cis male and cis female veterans, respectively. Adjusting for age, race, Hispanic ethnicity, and sexual minority identity, TGD veterans had 1.51 [1.44-1.58] and 0.89 [0.86-0.92] times the risk of HF compared to cis females and cis males, respectively. Results remained statistically significant with adjustment for additional social, clinical, and structural factors ( Table ). When stratified by gender identity, trans feminine veterans (HR [95% CI]: 1.19 [1.07-1.33]) were at higher HF risk than cis females; trans masculine (HR [95% CI]: 0.79 [0.72-0.86]) and trans feminine veterans (HR [95% CI]: 0.80 [0.72-0.89]) were at lower HF risk than cis males. Conclusion: Trans feminine veterans experienced greater HF risk than cis females, while trans feminine and trans masculine veterans’ HF risk was less than cis males. Future studies should consider the underlying mechanisms of these associations, HF subtypes (HFrEF and HFpEF), and the role of GAHT on HF risk.