tbuckley/cabot-search huggingface dataset:
Abstract 4136969: Empagliflozin's Role in Post-Myocardial Infarction Management: Insights from a Meta-Analysis
Authors: Muhammad Ibraiz Bilal, Danish Ali Ashraf, Usman Ahmed, Syed Imam Naufil, Atta Ul Haq Burki, Farooq Kamran, Shahzaib Ahmed
Journal: Circulation (2024)

Background: Empagliflozin, a Sodium Glucose Cotransporter 2 (SGLT2) Inhibitor, is used to treat type 2 diabetes mellitus and heart failure. Its safety and efficacy in patients with Myocardial Infarction (MI) have been studied recently. Research Questions/Hypothesis: What is the role of Empagliflozin in post-myocardial infarction management by preventing cardiovascular deaths, reducing hospitalization due to heart failure, and minimizing adverse events? Goals/Aims: Role of Empagliflozin in post-myocardial infarction management by preventing cardiovascular deaths, reducing hospitalization due to heart failure, and minimizing adverse events Methods: A literature search was done on PubMed, Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials from inception until May 2024. All Randomized Control Trials (RCT) reporting the safety and efficacy of Empagliflozin in MI management were selected. Outcomes were pooled as Mean Difference (MD) or Risk Ratio (RR) with 95% Confidence Intervals (CI) in this meta-analysis using Revman 5.4. Results: Data from ten RCTs, with a combined sample size of 10,560 patients was pooled, and showed that Empagliflozin is superior to placebo in terms of Cardiovascular death (RR=0.75, 95% CI [0.64, 0.88],p &lt; 0.0004) and hospitalization due to heart failure (RR=0.70, 95% CI [0.59, 0.82], p &lt; 0.0001). However, the results were non-significant for both groups in terms of adverse events (RR=1.00, 95% CI [0.96, 1.03], p &lt; 0.78). Conclusion: Empagliflozin significantly lowers the risk of cardiovascular events in patients with MI who are at a high risk of death due to cardiovascular causes.
Abstract 4147633: Structural and Electrophysiological Cardiac Changes in Children with Osteogenesis Imperfecta (OI)
Authors: Krish Sardesai, Anuhya Dayal, Tarak Srivastava, Christopher Harrison, Brian Lee
Journal: Circulation (2024)

Introduction: Osteogenesis imperfecta (OI) is an inherited type 1 collagen disorder leading to bone fragility and increased fractures. Cardiovascular disease is the leading cause of death of adults with OI, but studies on cardiac changes from this collagen defect in children are sparse. We aim to fill this gap by assessing changes in EKG and echocardiogram (ECHO) variables in children with OI. Hypothesis: Children with OI will exhibit arrhythmogenic EKG changes and/or ECHO abnormalities which will precede changes that are documented in adults. Methods: 53 children with OI receiving care at Children’s Mercy-Kansas City were identified via ICD-10 codes. 64 with Duchenne Muscular Dystrophy (DMD, expected cardiac abnormalities) and 55 with non-accidental trauma (NAT, no expected cardiac abnormalities) served as controls. We specifically compared the most recent EKG and ECHO metrics extracted from medical charts by Kruskal-Wallis testing. Results: EKG: Children with OI differed from both NAT and DMD. OI had shorter median PR intervals (p&lt;0.001) plus longer median QRS (p&lt;0.001) and QTc intervals (p=0.002) than NAT. DMD had the shortest PR and longest QRS and QTc (see Table). Echo: The three groups showed no difference in systolic/diastolic BP or LV thickness. However, OI differed from NAT and/or DMD in other metrics. OI had higher end diastolic volume (p&lt;0.001), end systolic volume (p&lt;0.001) and stroke volume (p&lt;0.05) than NAT, but lower values than the DMD group. Similarly, OI children had higher LV mass and LV internal diastolic and systolic diameters than NAT, but lower than DMD (p&lt;0.001). OI LVOT diameter and Aortic root diameter were lower than NAT, but not as low as DMD (p&lt;0.05 and p&lt;0.001, respectively). Conclusion: Children with OI exhibit EKG and ECHO abnormalities that are similar to but less severe than for DMD, a group in which cardiovascular abnormalities are well documented. These abnormalities may be predictive of arrythmia/sudden cardiac death and/or functional decline in heart function. Our data suggest that OI children could benefit from ongoing routine cardiology studies along with orthopedic/metabolic management. Future studies would assess effects of age and OI treatments on cardiac abnormalities.
Abstract 4141457: Forms of Childhood Maltreatment and Subclinical Cardiovascular Disease Risk in Black men and women
Authors: Telisa Spikes, Roland Thorpe, Vasiliki Michopoulos, Whitney Wharton, Sandra Dunbar, Jordan Pelkmans, Latesha Harris, Puja Mehta, Priscilla Pemu, Herman Taylor, Arshed Quyyumi
Journal: Circulation (2024)

Background: Exposure to specific forms of childhood maltreatment have been associated with cardiovascular disease (CVD) risk factors and CVD events in adulthood. Heterogenous experiences of childhood maltreatment across race and sex exist, yet there is little evidence regarding these relationships and CVD risk in Black populations. Aims: To investigate the association between various forms of childhood maltreatment (emotional, general, physical, and sexual abuse) and surrogate markers of vascular dysfunction and test whether sex modify these associations. Methods: Forms of childhood maltreatment and indices of vascular function were assessed in a cohort of healthy Black adults without known CVD (n=404) from a large metropolitan southeastern city. Childhood maltreatment was assessed using the Early Trauma Inventory short form (ETISR-SF) consisting of physical, sexual, emotional, and general domains. A trauma severity index score was calculated by summing the indexes for each of the four domains. Higher scores are indicative of higher traumatic life events before age 18 years. Outcomes of central augmentation index (cAIx) corrected for a heart rate of 75 bpm and carotid femoral pulse wave velocity (CfPWV) were measured as indices of wave reflections and arterial stiffness using applanation tonometry (Sphygmocor Inc.), and central pulse pressure (CPP) was calculated as the difference between the aortic systolic and diastolic blood pressures. Associations between each domain and outcomes were assessed using multivariate-adjusted and sex-stratified linear regression models. Results: Mean age of the cohort was 53 + 10.3 years, 61% women. Exposure to emotional [ b = -1.5%, 95%CI: -2.7,-0.3] and physical abuse [ b = -1.3%, 95%CI: -2.5,-0.2] was associated with cAIx overall but not CPP or CfPWV after adjusting for sociodemographic, clinical factors, health behaviors, and depressive symptoms. Significant emotional abuseXsex ( P= 0.014) and physical abuseXsex ( P=&lt; 0.001) interactions were identified for cAIx. Among women, physical abuse was associated with higher cAIx [ b =1.5%, 95%CI: 0.6, 2.4] and among men emotional [ b =-1.6%, 95%CI: -3.2, -0.0] and physical [ b =-1.7%, 95%CI: -3.1, -0.3] abuse was associated with lower cAIx. Conclusions: Exposure to emotional and physical abuse as children was associated with vascular dysfunction; moreover, exposure to physical abuse among women and not men have adverse clinical implications for CVD risk and prospects for enhanced preventive care.
Abstract 4140163: Initial Experience with Mini-Crush Versus Double Kissing Crush in Bifurcation Percutaneous Coronary Intervention: Insights from PROGRESS-BIFURCATION registry
Authors: Pedro Carvalho, Dimitrios Strepkos, Athanasios Rempakos, Michaella Alexandrou, Deniz Mutlu, Ahmed Al-Ogaili, Barkin Kultursay, ali karagoz, Oleg Krestyaninov, Dmitrii Khelimskii, Mahmut Uluganyan, korhan soylu, Ufuk Yildirim, Olga Mastrodemos, Bavana Rangan, Sandeep Jalli, Konstantinos Voudris, M Nicholas Burke, Yader Sandoval, Emmanouil Brilakis
Journal: Circulation (2024)

Background: There is limited data on use of the mini-crush technique in two-stent bifurcation percutaneous coronary intervention (PCI). Methods: This retrospective, observational, cohort study was performed across 6 centers in the United States, Russia, and Turkey between 2013-2024, as part of the Prospective Global Registry of Percutaneous Coronary Intervention in Bifurcation Lesions (PROGRESS-BIFURCATION, NCT05100992). We evaluated procedural characteristics of patients who underwent bifurcation stenting using the mini-crush technique and compared it with those who were treated with double kissing (DK) crush. Results: Of 1,138 PCIs involving 1,499 lesions, 46 (4.04%) were performed using the mini-crush technique and 147 lesions (12.91%) using the DK crush technique. Baseline characteristics of the patients were similar in both groups. There was no difference between mini-crush versus DK-crush in technical success (100.0% versus 98.6%; p=0.99), procedural success (95.1% versus 97.1%, p=0.62), procedural complications (10.9% versus 14.7%, p=0.51), or in-hospital major adverse cardiovascular events (MACE) (6.5% versus 5.7%, p=0.73). In contrast, mini-crush technique was associated with shorter procedure time (79.00 vs 116.50 minutes; p&lt;0.001; Figure 1A), fluoroscopy time (23.50 vs 30.35 minutes, p=0.002; Figure 1A), and lower contrast volume (150 versus 109 milliliters; p&lt;0.001; Figure 1B), and air kerma radiation dose (1.11 vs 1.71 gray; p=0.024; Figure 1C). Conclusion: In patients undergoing PCI for bifurcation lesions, the mini-crush technique had similar rates of procedural complications and in-hospital MACE as compared with the DK crush technique but required less contrast volume, fluoroscopy time, radiation dose, and procedural time.
Abstract 4136905: EF-24, a curcumin analog, reverses interleukin-18-induced miR-30b or miR-342-dependent TRAF3IP2 expression, RECK suppression, and the proinflammatory phenotype of human aortic smooth muscle cells
Authors: Yusuke Higashi, Ryan Dashek, Randy Rector, Patrice Delafontaine, Bysani CHANDRASEKAR
Journal: Circulation (2024)

Curcumin, a polyphenolic compound derived from the widely used spice Curcuma longa, has shown anti-atherosclerotic effects in cultured vascular cells and animal models. We previously reported that the induction of the proinflammatory molecule TRAF3IP2 (TRAF3 Interacting protein 2) or inhibition of the matrix metalloproteinase (MMP) regulator RECK (Reversion Inducing Cysteine Rich Protein with Kazal Motifs) contributes to agonist-induced proinflammatory, pro-oxidant, pro-mitogenic and pro-migratory effects in vascular smooth muscle cells. Here we hypothesized that, EF-24 ((3E,5E)-3,5-bis[2-fluorophenyl (methylene]-4piperidinone), a curcumin analog with better bioavailability and potency, reverses interleukin (IL)-18-induced TRAF3IP2 induction, RECK suppression and the proinflammatory phenotype of primary human aortic smooth muscle cells (ASMC). Exposure to recombinant human IL-18 (10 ng/ml) induced TRAF3IP2 mRNA and protein expression, but markedly suppressed RECK in a time-dependent manner. Further investigations revealed that IL-18 induced miR-30b, but suppressed miR-342, in a p38 MAPK and JNK-dependent manner. While miR-30b inhibitor blunted IL-18-induced TRAF3IP2 expression, miR-30b inhibitor and miR-342 mimic each restored RECK expression. Further, IL-18 induced ASMC migration (Boyden chamber assay) and proliferation (CyQUANT Cell Proliferation assay), and these effects were reversed by TRAF3IP2 knockdown or RECK overexpression. Our results also show that IL-18 induced MMP2 and MMP9 expression and activity, and targeting their expression inhibited IL-18-induced ASMC migration. TRAF3IP2 knockdown or RECK overexpression also reversed IL-18-induced ASMC proinflammatory phenotype switching as evidenced by the enhanced expression of the SMC markers ACTA2 and MYH11, and reduced expression of the proinflammatory markers Galectin 3, Olr1, VCAM, CCL2, IL-6, IL-8, and TNF-α. Importantly, preincubation with EF-24 markedly suppressed IL-18-induced SMC proliferation, MMP expression, migration and the proinflammatory phenotype switching. Together, these results suggest that the curcumin analog EF-24 has therapeutic potential in vascular inflammatory and proliferative diseases, including atherosclerosis, by differentially regulating TRAF3IP2 and RECK in vascular SMC.
Abstract 4141438: Predictors of Left Atrial Low Voltage Areas Were Different among Age Groups in Patients with Atrial Fibrillation Ablation
Authors: Hirotaka Ooka, Yasuhiro Matsuda, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yosuke Hata, Hiroyuki Uematsu, SHO NAKAO, Masaya Kusuda, Wataru Ariyasu, Satoshi Kudo, Subaru Fujii, Toshiaki Mano
Journal: Circulation (2024)

Background: Catheter ablation is a well-established treatment for atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) is associated with atrial remodeling following the progression of atrial cardiomyopathy, and poor rhythm outcome after catheter ablation. However, the predictors of LVAs presence have not been fully elucidated in different age groups. Purpose: The purpose of this study was to investigate predictors of the prevalence of LVAs in different age groups. Methods: 1,488 (age, 69 ± 10 years; female, 501 [34%]) consecutive patients who underwent initial ablation were included. Age groups were divided into three groups, namely &lt;60 years old (younger age, n=272), 60-75 years old (intermediate age, n=864), ≥75 years old (older age, n=352). The definition of LVAs was areas with a bipolar voltage of &lt;0.5 mV covering ≥5 cm2 of left atrial surface. Multivariate logistic regression analysis was performed to investigate the clinical predictors of LVAs. Results: Of 1,488 patients, LVAs existed in 352 (24%) patients. In the younger age group, C-reactive protein (odds ratio [OR], 4.5; [95% confidence interval {CI}: 1.5-13], p = 0.006) and previous history of heart failure (OR, 5.6; [95% CI: 1.2-26], p = 0.027) were the independent predictors of LVAs. In the intermediate age group, female (OR, 3.8; [95% CI: 2.6-5.7], p &lt; 0.001), persistent AF (OR, 2.6; [95% CI: 1.7-4.1], p &lt; 0.001), lower body mass index (OR, 0.93; [95% CI: 0.88-0.98], p = 0.004), lower hemoglobin (OR, 0.81; [95% CI: 0.72-0.93], p = 0.002), C-reactive protein (OR, 1.4; [95% CI: 1.0 1-2.0], p = 0.047), diabetes mellitus (OR, 1.8; [95% CI: 1.1-2,8], p = 0.01), left atrial diameter (OR, 1.04; [95% CI: 1.01-1.1], p = 0.007) were the independent predictors of LVAs. In the older age group, female (OR, 2.3; [95% CI: 1.4-3.7], p = 0.01), persistent AF (OR, 3.1; [95% CI: 1.8-5.2], p &lt; 0.001) and lower hemoglobin (OR, 0.83; [95% CI: 0.71-0.97], p = 0.017) were the independent predictors of LVAs. Conclusion: In patients with atrial fibrillation ablation, the independent predictors of LVAs were different among age groups.
Abstract 4128491: Dietary N-3 Very-Long-Chain Polyunsaturated Fatty Acids Improve Retinal Function And Reduce Aortic Atherosclerosis In ApoE-Deficient Mice
Authors: Zhihong Yang, Julia Kun, Milton Pryor, Daniel Brock, Anupam Mondal, Todd Lydic, Seizo Sato, Isao Yamazaki, Hideaki Yamaguchi, Krishna Vamsi Rojulpote, Jingrong Tang, Hairui Xie, Zhen-Dan Shi, Rolf Swenson, Anand Swaroop, Alan Remaley
Journal: Circulation (2024)

Introduction: N-3 very-long-chain polyunsaturated fatty acids (VLCPUFA; C≥24), which are found primarily in retina and a few other select tissues, are known to play critical roles in specific biological systems. Although n-3 PUFA, such as eicosapentanoic acid (EPA, C20:5 n-3) and docosahexaenoic acid (DHA, C22:6 n-3), may confer cardiovascular benefits, they did not improve age-related macular degeneration (AMD), a leading cause of blindness worldwide, in clinical trials. The activity of ELOVL fatty acid elongase 2 (ELOVL2), an enzyme that converts EPA into tetracosapentaenoic acid (TPA, C24:5 n-3), is known to decrease in the retina with age due to promoter methylation. Hypothesis: We hypothesized that dietary VLCPUFA may delay or prevent AMD, by bypassing the ELOVL2-mediated lipid elongation step. We also hypothesize that VLCPUFA may benefit cardiometabolic health like shorter-chain n-3 PUFA through similar mechanisms. Aims: We aimed to investigate the effect of dietary VLCPUFA on retinal function and cardiometabolic risk factors in mice. Methods: We have produced a new fish oil that contains ~40% (w/w) of C24-C28-rich VLCPUFA. We fed 9-month-old ApoE -/- mice with normal or VLCPUFA fortified diet (1% or 3% (w/w)) for 8 weeks, and age-matched C57BL/6J mice were used as control. We conducted electroretinography (ERG) and cognitive ability tests at the end of feeding period. In in vitro studies, we performed PPAR reporter assay and investigated the anti-inflammatory effects of TPA in lipopolysaccharide-stimulated RAW264.7 cells. Results: Supplementation of VLCPUFA showed a significant and dose-dependent improvement in ERG response. Like EPA and DHA, we also observed favorable cardiometabolic changes and decreased atherosclerotic plaque area due to dietary VLCPUFA. Intriguingly, VLCPUFA supplemented aging mice exhibit better cognitive performance compared with control. Transcriptome analysis revealed that VLCPUFA-enriched fish oil favorably regulated genes involved in nuclear receptor signaling pathways, lipid metabolism and inflammation. Furthermore, purified TPA potently activates PPARs, and suppressed inflammation in macrophage cells. Conclusions: Overall, our studies revealed for the first time several potential health benefits for our new VLCPUFA-enriched fish oil in several age-related diseases and support its future development as a new dietary supplement.
Abstract 4147628: A Mixed Methods Analysis of Patient Knowledge in Peripheral Artery Disease
Authors: Margaret Reilly, Megan Alagna, Cassandra Iroz, Emily Ho, Andrew Hoel, Ashley Vavra, Alexander Lundberg, Karen Ho
Journal: Circulation (2024)

Introduction: Patient knowledge of lower extremity peripheral artery disease (PAD) is low compared to other cardiovascular diseases. Research Questions/Hypothesis: We hypothesize that demographic and socioeconomic factors impact patient knowledge of PAD. Goals/Aims: To obtain qualitative description of and identify factors associated with patient knowledge of PAD. Methods/Approach: We performed a convergent parallel mixed methods study of participants with an established PAD diagnosis. Participants completed an 87-item survey assessing demographics, awareness of PAD diagnosis, and PAD knowledge. Functional health literacy (FHL) was measured using the short Test of Functional Health Literacy Assessment. Multivariable linear regression was used to identify factors associated with PAD knowledge scores. Semi-structured interviews were used to describe understanding of PAD. Transcripts were analyzed with inductive and deductive coding, and a constant comparative approach was used to identify themes. Results/Data: There were 91 participants (77.2% response rate, 49.5% female, 29.7% Black, mean age 68.6 years). Most participants (51.7%) had chronic limb-threatening ischemia and 17.6% had a previous major amputation. While 21.3% had poor FHL and 24.4% were unaware of their PAD diagnosis, the average knowledge score was 79.1%. On bivariate analysis, non-White race, non-ambulatory status, poor FHL, lack of awareness of PAD diagnosis, and not knowing the chronicity of diagnosis were inversely associated with knowledge score. Multivariate linear regression showed that poor FHL, non-White race, and not knowing the chronicity of PAD diagnosis were independently associated with low PAD knowledge. Qualitative analysis of 22 participants revealed that patients have difficulty understanding the name “PAD”, confuse PAD with other comorbidities, and have incorrect beliefs about PAD despite high knowledge scores. Conclusions: Knowledge of PAD is associated with health literacy. However, patients have incorrect beliefs and difficulty understanding the terminology associated with PAD despite a high average knowledge score. Knowledge scores may not adequately reflect understanding. Future research will focus on optimizing patient education, identifying strategies to appropriately gauge patient understanding, and understanding the association between knowledge and behavior in PAD.
Abstract 4140116: Adherence to Lipid Lowering Therapy among US Veterans with Atherosclerotic Cardiovascular Disease
Authors: Rachel Ward, Helen Wellman, Nedim Yel, Melissa Young, Mason Coleman-Lopez, Xiaoli Niu, Sean McElligott, David Gagnon, Luc Djousse, Michael Gaziano
Journal: Circulation (2024)

Introduction/Background: US Veterans experience a high burden of cardiovascular disease (CVD). Improved adherence to lipid-lowering therapy (LLT) is strongly associated with reducing low-density lipoprotein cholesterol (LDL-C), which has the potential to reduce morbidity and mortality among Veterans with atherosclerotic cardiovascular disease (ASCVD). Goals/Aims: To describe adherence to statin and non-statin LLT among US Veterans with ASCVD. Methods/Approach: Using Veterans’ Health Administration (VHA) electronic health records from January 1, 2003, to December 31, 2019, we identified regular users of the VHA who were on at least one LLT within 12-months after ASCVD diagnosis. ASCVD diagnosis was identified using ICD9/10 and Current Procedural Terminology codes. Medication possession ratio (MPR) was calculated as the sum of days’ supply for all fills of a given LLT during 12-, 24-, and 36-month follow-up, divided by the number of days in the follow-up period. Medication adherence was defined as MPR ≥ 0.80. Results/Data (descriptive and inferential statistics): The total number of Veterans on an LLT within 12-months after ASCVD diagnosis was 2,194,684 [mean (SD) age=68 (10) years, 98% male, and 75% white race]. Overall proportion of patients who were adherent to LLT was 68%, 64%, and 62%, at 12-, 24-, and 36-months post ASCVD diagnosis, respectively (Table). Conclusion(s): Suboptimal adherence to LLT was observed in one third of US Veterans with ASCVD. Adherence rates were highest in the first 12 months post ASCVD diagnosis. Future studies are needed to understand factors contributing to low and declining LLT adherence over time among Veterans.