tbuckley/cabot-search huggingface dataset:
Abstract 4141843: Cardiovascular Disease and Cancer Mortality by Cardiovascular Health: Life's Essential 8 in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Katherine Huether, Laura Pinheiro, Suzanne Judd, Leann Long, Monika Safford, Donald Lloyd-Jones, Tim Plante
Journal: Circulation (2024)

Introduction: Cardiovascular disease (CVD) and cancer are the top 2 causes of death among US adults. Life’s Essential 8 (LE8) is an updated cardiovascular health (CVH) metric that includes many factors known to reduce cancer risk. It is unclear how LE8-quantified CVH relates to CVD and cancer mortality in a competing risk framework. Methods: REGARDS recruited 30,239 Black and White adults from the 48 contiguous US states in 2003-07. We excluded individuals with prevalent CVD or cancer, missing LE8, or no follow-up. Baseline total LE8 scores were categorized as low (&lt;50), moderate (50-79), or high CVH (≥80). Cause-specific hazard models estimated relative hazard of CVD and cancer mortality as competing risks, adjusting for age, sex, race, level of education, and region. Results: Among 11,385 REGARDS participants who were free of CVD and cancer (mean [SD] age 65 [9] years, 52% women, 44% Black adults), 24%, 66%, and 10% had low, moderate, and high CVH, respectively. Over a median (IQR) follow-up of 14 (8-18) years, 8% died from CVD, 7% from cancer, and 17% from other causes. Moderate and high CVH were significantly associated with graded lower risk of CVD and cancer mortality after adjusting for potential confounders ( Table ). CVD mortality was lower across better physical activity, blood pressure, diet, sleep, smoking, and glucose CVH groupings. Cancer mortality was lower across better diet and smoking groupings. Conclusion: LE8-quantified CVH was independently associated with lower CVD and cancer mortality in a competing risk framework and in graded fashion. These findings underscore the significance of lifestyle modifications in mortality risk reduction for the top 2 causes of death in the US, advocating for their incorporation into clinical guidelines and preventive counseling.
Abstract 4141892: Insulin-like growth factor binding protein 7 induces cell senescence in vitro and is associated with cell senescence in the advanced atheroma.
Authors: Sergiy Sukhanov, Yusuke Higashi, Patricia Snarski, Svitlana Danchuk, Patrice Delafontaine
Journal: Circulation (2024)

BACKGROUND: Cellular senescence, an irreversible cell cycle arrest, has been associated with coronary heart disease (CHD). Senescent cells (SC) secrete proinflammatory molecules contributing to CHD. Insulin-like growth factor I (IGF1) protects against developing cell senescence and atherogenesis. IGF1 binding protein 7 (BP7) binds IGF1 and also interacts with IGF1 receptor (IGF1R), suppressing intracellular IGF1 signaling. HYPOTHESIS: SC secrete BP7, and BP7 promotes cell senescence via suppression of IGF1 signaling. METHODS: Cell senescence was induced by treatment of smooth muscle cells (SMC) with Bleomycin. Cell proliferation was quantified by live cell analysis system. BP7 levels were measured by Westerns in cell lysates and conditioned medium (CM) and by immunohistochemistry in atherosclerotic pigs. BP7/IGF1R binding was quantified by proximity ligation assay (PLA). RESULTS: Bleomycin arrested SMC proliferation at 16h, upregulated senescence markers (beta-galactosidase and γH2A.X histone), and elevated BP7 levels in CM (3-fold increase, P&lt;0.05) showing that SC secrete and upregulate BP7. We obtained CM from SC and used it to treat non-senescent SMC. CM inhibited IGF1-induced Akt phosphorylation in non-senescent cells, and CM incubation with BP7 antibody reversed this effect, indicating that BP7 mediates CM inhibitory effect on IGF1 signaling. BP7 overexpression (with pCMV-IGFBP7 vector) or inhibition of IGF1R (using Ganitumab, IGF1R antibody) suppressed cell proliferation, and upregulated senescence markers. BP7 overexpression also blocked IGF1-induced cell proliferation and migration (both are P&lt;0.05) consisted with BP7 inhibitory effect on IGF1 signaling. Increased BP7 levels was detected in SMC in the fibrous cap (FC) in porcine plaque compared to BP7 level in vascular media (1.8-fold increase, P&lt;0.05). BP7 upregulation in plaque correlated with elevated PLA signal indicating increased BP7/IGF1R binding. We used spatial transcriptomics to profile gene expression in the porcine atheroma. BP7 upregulation was detected in FC cluster (P&lt;0.001) and it was co-localized with increased senescence module score. CONCLUSIONS: SC upregulate BP7 and BP7 inhibits IGF1 signaling. Upregulated BP7 induces senescence in vitro and it was associated with SC in the advanced coronary plaque. Our results suggest a novel role of BP7 in senescence and atherogenesis and identify BP7 as a potential target for anti-atherogenic therapy.
Abstract 4141790: Pre-Hospital Antiplatelet Therapy In Patients With Out-Of-Hospital Cardiac Arrest Suspected Of Acute Coronary Syndrome
Authors: Pierre CHARLEUX, Juliette Chommeloux, Anthony Elhadad, Niki PROCOPI, Paul Guedeney, Clelia Martinez, Stephanie Rouanet, Eric VICAUT, Mathieu Kerneis, Alexandre Demoule, Alain COMBES, Johanne Silvain, Gilles Montalescot, Michel Zeitouni
Journal: Circulation (2024)

Background: There are currently no specific guidelines regarding pre-hospital antiplatelet therapy in patients with out-of-hospital cardiac arrest (OHCA) suspected of acute coronary syndrome (ACS). Purpose: To evaluate efficacy and safety of pre-hospital administration of antiplatelet therapy in patients with OHCA directed to a cardiac catheterization laboratory (cath lab). Method: Using the cath lab database of a tertiary cardiovascular center, we included consecutive patients referred for coronary angiography within 24 hours of OHCA for suspected ACS from January 2012 to January 2024. Pre-hospital antiplatelet treatment was defined as prescribing any antiplatelet therapy before cath lab admission (aspirin alone or combined with a P2Y12 inhibitor). The outcomes of interest were: 1) all-cause death at 30 days, 2) intra-hospital major adverse cardiovascular events (MACE), defined by the composite of all-cause death, myocardial infarction, or stroke, and 3) intra-hospital major bleedings (BARC ≥ 3). To help account for the non-randomized pre-hospital antiplatelet administration, an Inverse Probability Weighting (IPW) approach was used to compare outcomes between the two groups. Result: Between January 2012 and January 2024, n = 411 patients with OHCA were referred to the cath lab, of whom 217 (52.8%) received a pre-treatment. Pre-hospital antiplatelet administration did not show a reduced risk of death from any cause at 30 days (56.7% [50.0%;63.1%] vs 59.8% [52.8%;66.4%], p=0.21) ( Figure 1 ). The rates of intra-hospital MACE (57.1% [50.5%;63.5%] vs (61.3% [54.3%;67.9%]), p=0.38) and major bleedings (18.9% [14.2%;24.6%] vs (18.6% [13.7%;24.6%], p=0.51) did not differ significantly in pre-treated patients compared to non-pre-treated ones. Conclusion: In our cohort of patients with OHCA suspected of ACS, we did not observe an association between pre-hospital administration of an antiplatelet loading dose and outcomes.
Abstract 4141813: Assessing Short-Term Prognostic Value of eGFR Formulas in Patient with Acute Heart Failure: Comparison of Chronic Kidney Disease Epidemiology Collaboration 2021, 2009 Formula, and Modification of Diet in Renal Disease in Asian Population – A Study from Vietnam
Authors: DIEU HIEN TRAN, THIEN TAN TRI TAI TRUYEN, MINH NGHIEM NGUYEN, VAN KHOA NGUYEN, PHUC DAI VO, HOANG PHUC LE, Trí Dinh, Loc Vu, Doan Thi Kieu, CHAU DO, THI KIM CHUC NGUYEN, Ngoc Anh Vu Pham, HOANG SON PHAN, TRI CUONG PHAN, NGUYEN LE MY HAN, HUONG DUNG NGUYEN THI, Le Y Nhi Vo, DOAN THI BICH HUYEN CAO, THANH PHONG TRAN, VAN DUONG TRAN, NGOC HUYEN NGUYEN, THANH PHONG PHAM
Journal: Circulation (2024)

Introduction: In 2021, the American Society of Nephrology Task Force recommended using the new CKD-EPI 2021 formula to estimate the glomerular filtration rate (eGFR) and to classify CKD. Evidence to compare the efficacy of this new formula with the current utilized formula, including MDRD and CKD-EPI 2009, in predicting the short-term outcomes of Asian patients with acute heart failure (AHF) is lacking. Hypothesis: The eGFR calculated by the CKD-EPI 2021 formula predicts short-term outcomes of patients with AHF more accurately than those calculated by the MDRD and CKD-EPI 2009 formulas. Methods: We conducted a pilot retrospective cohort study from January 1, 2023, to December 31, 2023, at Can Tho Central General Hospital in Can Tho, Vietnam. Our study included patients aged ≥18 who were admitted with AHF, NT-pro BNP levels exceeding 300 pg/mL, and creatinine result within 24 hours of admission. eGFR was calculated using 3 different formulas such as CKD-EPI 2021, CKD-EPI 2009, and MDRD. The short-term outcome was determined by 3-months post-discharge all causes mortality. Results: The final cohort comprised 146 patients, with a mean age of 65.6 ± 14.2 years and male proportion of 46%. Significant correlations were observed among the three formulas, with the strongest correlation observed between the CKD-EPI 2021 and 2009 formulas. In predicting short-term outcomes, the CKD-EPI 2021 and CKD-EPI 2009 formulas demonstrated superior performance compared to the MDRD formula, with respective area under the curve values of 0.634, 0.635, and 0.607. After multivariable analysis, from 90mL/min/1.73m 2 , every 10 ml/min/1.73 m 2 decrease in eGFR calculated by CKD-EPI 2021, CKD-EPI 2009, and MDRD was associated with a 32% (95% CI: 9-49), 26% (95% CI: 4-47), and 30% (95% CI: 8-47) increase in the odds of all-cause mortality among patients with AHF. Only CKD-EPI 2021 formula showed significant predictive prognostic value (log-rank test, p=0.049) (Figure). Conclusion: The CKD-EPI 2021 formula showed superior prognostic efficacy for short-term outcomes in Asian patients with acute heart failure (AHF) compared to current formulas. Further research involving larger patient cohorts and longer-term outcomes is warranted.
Abstract 4141831: Estimating Time to Incidence and Progression of Cardiovascular-Kidney-Metabolic Multimorbidity: A Large-Scale Longitudinal Cohort Study
Authors: John Ostrominski, Jamie Hirsch, Benjamin Miao, Brendan Clark, Bonnie MK Donato, Jonathan Woolley, Christina Parrinello, Thomas O'Connell, Muthiah Vaduganathan
Journal: Circulation (2024)

Background: Cardiovascular-kidney-metabolic (CKM) conditions, such as heart failure (HF), chronic kidney disease (CKD), and type 2 diabetes (T2D), commonly coexist. However, whether specific pathways and timing of CKM multimorbidity onset and progression vary in relation to background CKM status has not been rigorously evaluated. Methods: In this retrospective cohort study using Optum Market Clarity, a longitudinal (2007-2023) US database comprising electronic health records of &gt;80M unique individuals linked to claims, we estimated incidence rates of CKM conditions (clinical cardiovascular disease [cCVD; myocardial infarction, stroke, peripheral artery disease, and atrial fibrillation], HF, CKD, and T2D) and multimorbidity (≥2 CKM conditions). CKM conditions were identified via administrative codes and/or laboratory data. Time-to-onset and progression of CKM multimorbidity was evaluated by baseline CKM status (number/type of CKM conditions), using Cox proportional hazards models. Results: Overall, 604,732 individuals were included in the analysis (mean [SD] age, 48.4 [17.1] years; 56% female), of which 136,886 (23%) had ≥1 CKM condition at baseline. In patients with 1 CKM condition, HF was associated with the highest rate of progression to CKM multimorbidity (incidence rate, 15.99 per 100 patient-years), followed by CKD, cCVD, and T2D ( Figure, A ). Among those who experienced progression to CKM multimorbidity, median times to a second CKM condition ranged between 1.2 to 2.0 years. When the full spectrum of baseline CKM status was evaluated, rates of multimorbidity progression and all-cause death generally increased with higher baseline CKM burden ( Figure, B ). However, progression of CKM multimorbidity varied by background CKM status; cCVD and T2D occurred most frequently among those without CKM conditions, HF and T2D occurred most frequently among those with cCVD, and cCVD occurred most frequently among those with HF, CKD, and T2D. Conclusions: These findings provide novel insights into pathways and timing of CKM multimorbidity progression in the US, stressing the need for intensive management strategies to prevent or delay the often rapid onset of sequential CKM conditions once one is established.
Abstract 4141781: "Simple Arithmetic Representation to Classify of Right Ventricular Outflow Tract in Tetralogy of Fallot Patients "
Authors: isabella casallas, CAMILO EDUARDO PEREZ CUALTAN, Javier Navarro Rueda, Laura Acosta-Izquierdo, Julian Francisco Forero, Juan Manuel perez, Juan Carlos Briceno, Carlos Guerrero
Journal: Circulation (2024)

In patients with tetralogy of Fallot (TOF) repaired with a transannular patch (TAP), right ventricular outflow tracts (RVOT) are classified by shape using complex 3D measurements. RVOT shape is crucial for evaluating transcatheter pulmonary valve replacement (TPVR). Aim: To evaluate if a simple graphical representation of the RVOT in TOF patients repaired with TAP can classify RVOTs than Level III imaging experts in a Latin American tertiary care center. Methods: This retrospective single-center study included TOF post-TAP patients who underwent cardiac magnetic resonance (CMR) between 2014 and 2023. Dynamic CMR angiography images were used to segment and create 3D reconstructions of the RVOT and pulmonary artery. Centerline-based measurements derived from perimeter were taken at six RVOT points (bifurcation, mid trunk, supravalvular, pulmonary valve annulus, subvalvular, and RVOT) following the TPVR planning protocol by Canan et al. to measure the area and create a graphical representation (Figure 1). The graphs and 3D reconstructions were categorized into five RVOT types based on Schievano et al.'s classification. Graphs were compared to the original classification by overlaying graph forms, and 3D files were classified by three Level III cardiac imagers. The correlation between evaluators and graphs was measured using the Kappa coefficient. Results: The study population included 60 patients (55% male, mean age 17 ± 12 years at CMR). The RVOT type distribution, according to the graph representation, was 53.3% type 1, 13.3% type 2, 5% type 3, 10% type 4, and 15% type 5. Only 3% of the graphs did not fit the established classification. The initial agreement among the three evaluators regarding 3D classification was 28%. Compared with the graphs, evaluator 1 agreed fairly (Kappa=0.24, p=0.0006), evaluator 2 slightly (Kappa=0.197, p=0.0008), and evaluator 3 poorly (Kappa=0.07, p=0.15). Conclusions: Our approach reclassified RVOT shapes more effectively than imaging experts, showing a high fit in classification and low agreement among cardiac imagers. This method could be an additional tool to identify TOF patients suitable for TPVR post-TAP.
Non-steroidal Immune Modulating Therapies and Reduced Risk of Adverse Cardiovascular Events in Dermatomyositis and Polymyositis: A Cohort Study in the All of Us Research Program
Authors: Jill T Shah, Keya T Shah, Soutrik Mandal, Michael S Garshick, Alisa N Femia
Journal: Journal of the American Academy of Dermatology (2024)
Efficacy and safety of nail gutter therapy and topical timolol for treating epidermal growth factor receptor inhibitor-induced nail changes: a randomized, single-blind, intra-individual study
Authors: Isara Yenyuwadee, Sasitorn Yenyuwadee, Chuda Rujitharanawong, Charussri Leeyaphan, Sasima Eimpunth, Suthinee Ithimakin, Leena Chularojanamontri
Journal: Journal of the American Academy of Dermatology (2024)
Cutaneous melanoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
Authors: T Amaral, M Ottaviano, A Arance, C Blank, V Chiarion-Sileni, M Donia, R Dummer, C Garbe, J E Gershenwald, H Gogas, M Guckenberger, J Haanen, O Hamid, A Hauschild, C Höller, C Lebbé, R J Lee, G V Long, P Lorigan, E Muñoz Couselo, P Nathan, C Robert, E Romano, D Schadendorf, V Sondak, K P M Suijkerbuijk, A C J van Akkooi, O Michelin, P A Ascierto
Journal: Annals of Oncology (2024)
Abstract 4141749: Eplerenone: The New Standard in Heart Failure Management-Insights Into Improved Ejection Fraction and Reduced Mortality Compared to Spironolactone: A Systematic Review And Meta Analysis
Authors: Ashok Adhikari, Chandana Tadigotla, Ashwith Reddy Gaddam, Yogeshkumar Vaghamashi, Umang Gupta, Venkata Sai Abhilash Meda, Binay Panjiyar
Journal: Circulation (2024)

Background: Mineralocorticoid receptor antagonists namely, Spironolactone and Eplerenone, have been cornerstone therapies for reducing morbidity and mortality in patients with heart failure. However, the comparative efficacy and safety profiles of Spironolactone and Eplerenone in patients with heart failure and reduced ejection fraction have been largely unknown. Hypothesis: We hypothesize that Eplerenone is more efficacious and safer than Spironolactone in treating patients with heart failure and reduced ejection fraction. Methods: We conducted a comprehensive literature search in electronic databases such as PubMed, GoogleScholar, ScienceDirect, Cochrane library, PLOSONE and Clinicaltrial.gov, including studies published within the last 10 years.We used RevMan 5.4.1 version to make statistical calculations and random effects model to calculate the pooled mean difference(MD) and relative risk(RR) values with their corresponding 95% confidence intervals(CI). A p-value of &lt;0.005 was considered statistically significant. Results: A total of 1296 participants (Spironolactone:647 and Eplerenone:649) from three Randomized trials and three cohorts were included in this study. The mean age of participants were 59.74±12.47 and 60.35±10.99 years with 67.12% and 66.52% males along baseline Left Ventricular ejection fraction(LVEF) of 33.47±7.77 and 32.48±8.37% in spironolactone and eplerenone groups respectively. During follow-up, eplerenone improved LVEF(MD,2.96,95%CI:2.12-3.81,I2=0%,p=&lt;0.05), reduced Left Ventricular end systolic volume(MD,-11.50,95%CI:-14.98 to -8.03,I2=0%,p=&lt;0.05), Left Ventricular end diastolic volume(MD,-7.99,95%CI:-15.07 to -0.90,I2=0%,p=0.03) and all-cause mortality(RR,0.70,95%CI:0.52-0.93,I2=0,p=0.02). Although insignificant, eplerenone reduced cardiovascular death or hospitalization(RR,0.95,95%CI:0.79-1.15,I2=0,p=0.60) and safety outcomes like hyperkalemia(RR,0.70,95%CI:0.45-1.09,I2=0,p=0.12) and gynaecomastia(RR,0.18,95%CI:0.02-1.65,I2=71%,p=0.13). Conclusion: In patients with heart failure with reduced ejection fraction, compared to spironolactone, eplerenone showed superiority in improving Left ventricular ejection fraction, end systolic and diastolic volumes with all-cause mortality. Although statistically insignificant, eplerenone use reduced the cardiovascular death or hospitalization and adverse events like hyperkalemia and gynaecomastia in male patients. Further, clinical trials and research are necessary to confirm the above findings.
Abstract 4141715: Detection and Quantification of Myocardial Infarct with Four Different Histological Staining Techniques
Authors: Linnea Meier, Xiaobo Wu, Stefano Toldo, Robert Gourdie
Journal: Circulation (2024)

Background: Precise quantification of myocardial infarct size in therapeutic studies is a key prerequisite to ensure reliable and demonstrative results, and supports the rapid translation of findings into clinical practice. However, current quantification methods are often highly dependent on hand tracing and pose challenges that may impact accuracy, user ease, cost, and timeliness of image analysis. Here, we developed a semi-automatic color-based algorithm capable of infarct region detection and quantification with four different histological staining techniques. Methods: This model consists of an algorithm based on the unique digital color differences between normal and scarred regions of histological tissue. Typically, multicolored images contain pixels that consist of three colors: red, green and blue. We observed a pattern in the computational color code proportions between unscarred and scarred regions of cardiac tissues in various staining approaches. Therefore, with the aid of MATLAB software, employing a color threshold to these color combinations can potentially identify and isolate the infarct region. In this study, mouse cardiac tissue images from four histological staining methods (masson’s trichrome (MTS), hematoxylin and eosin (H&amp;E), 2,3,5-Triphenyltetrazolium chloride (TTC) and picrosirius red (PSR)) were included to demonstrate the performance of our algorithm. Results: The algorithm effectively identified and produced a clear visualization of scar tissue for the four staining techniques (Figure). Notably, using the MTS image as a reference (panel A), the algorithm could detect the infarct region in a similar heart structure on the H&amp;E image (panel B), which is infrequently used for fibrotic tissue assessment. The infarct region was also successfully extracted and masked. Further, we developed a user-friendly graphic interface to quantify the infarct area and potential volume if the entire heart is sectioned for analysis. Conclusion: In conclusion, we demonstrate that our algorithm is capable of accurately identifying and isolating cardiac infarct regions using color-based methods, as well as quantifying area and volumetric data from necrotic tissue.
Abstract 4141750: Catheter Ablation for AF Management in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis
Authors: Mehrdad Mahalleh, Hamidreza Soleimani, Mohammad Reza Pazoki, Saba Maleki, Parham Dastjerdi, Sahar Zafarmandi, Sima Shamshiri Khamene, Izat Mohammad Khawajah, Shehroze Tabassum, Rahul Bhardwaj, Jishanth Mattumpuram, Andrew Kaplan, Marmar Vaseghi, Ali Bozorgi, Kaveh Hosseini, Stylianos Tzeis
Journal: Circulation (2024)

Background: The latest guidelines advocate for catheter ablation (CA) over standard medical therapy (SMT) for managing atrial fibrillation (AF) in patients with heart failure with reduced ejection fraction (HFrEF). However, significant knowledge gaps exist regarding the effectiveness of CA vs. SMT in patients with heart failure with preserved ejection fraction (HFpEF). Methods: PubMed, Scopus, and Embase until February 2024 were systematically searched. Given the limited number of randomized studies, propensity score-matched observational studies comparing CA with SMT in AF patients with HFpEF were also included. The primary outcome was a composite endpoint of all-cause mortality and HF hospitalization. Results: Eight studies that enrolled 17,717 SMT and 2537 CA patients were included. CA was associated with a significantly lower risk of the composite endpoint of all-cause mortality and HF hospitalization (HR 0.69, 95% CI: 0.40-0.98). The risk of HF hospitalization (HR 0.48, 95% CI: 0.17-0.80), cardiovascular mortality (HR 0.27, 95% CI: -0.06-0.61), and AF recurrence (HR 0.53, 95% CI: 0.37-0.70) were also lower in the CA group. Conclusion: CA demonstrated significant cardiovascular morbidity and mortality benefits when compared to SMT in the HFpEF population.