tbuckley/cabot-search huggingface dataset:
Abstract 4112853: Trends in Statin Use for the Secondary Prevention of Atherosclerotic Cardiovascular Disease among U.S. Adults by Age, 1999-2020
Authors: Wang Junwen, Yuyang YE, Xuefeng CHEN, Xinru HU, Yong PENG
Journal: Circulation (2024)

Background: Current research focusing on trends in statin medication usage, particularly for different age groups, is limited. This study explored the change trends in statin usage from 1999 to 2020, with a specific focus on different age groups. Methods: Utilizing data from the National Health and Nutrition Examination Survey spanning the period from 1999 to 2020, our study included individuals aged 18 years and older diagnosed with atherosclerotic cardiovascular disease (ASCVD). Results: In the 18-44 years age group, usage changed from 18.34% (95% CI, 0.18 to 36.50) in 1999 to 16.63% (95% CI, 0.36 to 32.91) in 2020 (linear P value = 0.540, quadratic P value = 0.610) (Figure 1). For individuals aged 45-64 years, usage increased from 39.33% (95% CI, 29.62 to 49.05) in 1999 to 54.97% (95% CI, 47.10 to 662.83) in 2020 (linear P value &lt; 0.001, quadratic P value = 0.777) (Figure 1). In the group aged 65 years and older, usage increased from 35.17% (95% CI, 29.57 to 40.77) in 1999 to 60.62% (95% CI, 55.73 to 65.51) in 2010, and further to 68.62% (95% CI, 63.65 to 73.60) in 2020 (quadratic P value &lt; 0.001) (Figure 1). There was an interaction effect between statin usage trends and age (P for interaction &lt;0.001) (Figure 1). Conclusion: Overall, current health policies are effective for the use of statins for the secondary prevention of ASCVD. However, there was almost no improvement in statin usage within the 18-44 years age group. This highlights the need for greater focus on young ASCVD patients. Therefore, additional research is needed on statin use among young people.
Abstract 4112591: Delayed Migration of a Valve-in-Valve Transcatheter Aortic Valve Replacement
Authors: Katelyn Baggett, Francois Kaleta, Cameron Burmeister, Sandeep Jain, Mark Kozak, Matthew Nudy
Journal: Circulation (2024)

Introduction: Migration of a transcatheter aortic valve replacement (TAVR) is a rare, life-threatening complication that typically occurs during or shortly after the procedure. We present a unique case of an exceptionally rare, delayed migration of a valve-in-valve TAVR three years post-procedure that was subsequently treated with surgical explantation of the TAVR prosthesis and surgical aortic valve replacement (SAVR). Clinical Case: A 64-year-old male presented to an outpatient cardiology visit with one month of exertional dyspnea and near-syncopal episodes with a new diastolic murmur. Notable history included aortic regurgitation due to bicuspid aortic valve resulting in subcoronary implantation of a 27 mm Medtronic Freestyle stentless porcine bioprosthesis 20 years prior to presentation. Following the development of severe bioprosthetic regurgitation, a valve-in-valve TAVR with a 26 mm Edwards SAPIEN 3 Ultra was implanted 3 years prior to presentation with no evidence of stenosis or regurgitation on transthoracic echocardiograms completed 1 month and 1 year after implantation. Transesophageal echocardiogram now demonstrated migration of the TAVR valve into the left ventricular outflow tract 2 cm proximal to the surgical bioprosthesis. Severe eccentric transvalvular regurgitant flow through the surgical bioprosthesis and severe paravalvular regurgitation around the TAVR valve was seen with an unstable “rocking appearance”. No evidence of abscess or endocarditis was appreciated and blood cultures showed no growth. Following a short hospitalization, the patient underwent TAVR explantation and implantation of a 25 mm Edwards Inspiris Resilia stented bovine bioprosthesis with subsequent resolution of his symptoms. Discussion: Recognizing atypical presentations of TAVR complications such as delayed valve migration is facilitated by understanding key risk factors. This case highlights notable risk factors for TAVR migration including a valve-in-valve TAVR over a degenerative regurgitant bioprosthesis, decreased aortic annulus calcification resulting in suboptimal anchoring, the patient’s younger age, and the lack of a radiopaque marker on the stentless bioprosthesis which increases the potential for malpositioning.
Abstract 4112652: Impact of metabolic overweight/obesity phenotypes on clinical outcomes of patients with resectable non-small cell lung cancer in an Asian population
Authors: YI JEONG-EUN, Ji Hyung Hong
Journal: Circulation (2024)

Background: Metabolic syndrome and obesity are known to increase the incidence of lung cancer. We investigated the association between metabolic health and overweight/obesity phenotypes and clinical outcomes in patients with resectable non-small cell lung cancer (NSCLC). Methods: This large retrospective cohort study included adult patients who underwent curative upfront surgery for their stage IA-IIIB NSCLC at a tertiary university hospital from January 2010 to December 2020. They were classified into four phenotypes based on the combination of metabolic health status and body mass index categories: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obesity (MHO), metabolically unhealthy overweight/obesity (MUO). The primary outcomes were disease recurrence and death. Results: Of the 1,513 patients (342 with MHNW, 585 with MUNW, 122 with MHO, and 464 with MUO), patients with the phenotype of MHO were less likely to experience recurrence (MHO [13.1%] vs. MHNW [16.1%] vs. MUNW [22.9%] vs. MUO [19.2%], p = 0.018) and death (MHO [15.6%] vs. MHNW [24.6%] vs. MHUW [31.3%] vs. MUO [24.8%], p &lt; 0.001) compared to those with other 3 phenotypes. Similar results were observed in Kaplan-Meier curves for the primary outcomes according to the four phenotypes (all log-rank P &lt; 0.05). In multivariate Cox regression analyses, both MHO and MUO phenotypes did not increase the risk of recurrence compared to the MHNW phenotype and were associated with improved survival (MHO: adjusted hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.36-0.98, p = 0.040; MUO: adjusted HR 0.76, 95% CI 0.60-0.96, p = 0.022). Conclusions: After curative resection for NSCLC, regardless of metabolic health, patients with overweight/obesity were not at an increased risk of recurrence and paradoxically, had favorable overall survival.
Abstract 4112869: Development of a Sitosterolemia Risk Prediction Scale (SRPS): A Screening Tool
Authors: Poonam Tawde, Salim Mohammad
Journal: Circulation (2024)

Introduction: Sitosterolemia, a hereditary disorder marked by elevated plant sterol levels, presents diagnostic challenges due to its similarity to other lipid disorders. The development of the Sitosterolemia Risk Prediction Scale (SRPS) aims to address this by synthesising genetic, clinical, and dietary data into a coherent risk assessment model. Research Question: We propose that a structured risk scale, integrating diverse factors known to affect sitosterolemia, can significantly improve the accuracy of predicting the disorder. The SRPS is hypothesised to facilitate early detection and inform targeted interventions. Aim: The primary aim is to conceptualise and outline the SRPS, which categorises individuals into risk categories based on a point system reflecting genetic predispositions, clinical symptoms, dietary habits, and response to treatments. This scale seeks to enhance the clinical identification of sitosterolemia, promoting timely and personalised management strategies. Methods: A detailed table was generated to present the SRPS, categorising risk factors into genetic, clinical, dietary, and response to treatment. This innovative method allowed for the efficient synthesis and visualisation of complex data. Results: The SRPS table methodically organizes risk factors into low (0-2 points), moderate (3-5 points), and high (6+ points) categories. This stratification guides further diagnostic actions, ranging from exploring alternative causes of hyperlipidemia to necessitating comprehensive genetic and lipid analyses. Conclusion: The SRPS represents an innovative framework for assessing sitosterolemia risk, highlighting the potential benefits of integrating genetic, clinical, and dietary information. It further underscores the importance of a multifactorial approach in the early detection and management of sitosterolemia.
Abstract 4112620: Cardiomyocyte-specific Increases in Forkhead Box M1 (FoxM1) Expression May Promote Cardiomyocyte Proliferation and Improve Recovery from Myocardial Injury in Mice and Pigs
Authors: Yalin Wu, Yongyu Wang, Gregory Walcott, THANH NGUYEN, Yuji Nakada, Huilan Tan, Yu Jiang, Jianli Zhao, yanwen liu, Yang Zhou, Yajing Wang, Jianyi Zhang
Journal: Circulation (2024)

Background: The cardiomyocytes (CMs) can not regenerate after myocardial infarction (MI) in adult mammals. FoxM1 is essential for cell proliferation. Targeted deletion of the Foxm1 in mice leads to serious cardiac proliferation defects and embryo death. The primary aim of this study was to demonstrate that the Specific Modified mRNA Translation System (SMRTs) can specifically overexpress FoxM1 in CMs and observe the benefits of overexpressing FoxM1 on myocardial repair in mice and pigs with myocardial injury. Methods: The FoxM1-CM SMRTs is composed of two modRNA constructs: one encoding L7Ae regulates the specific expression of FoxM1 on the other coding chain in CMs and inhibits its expression in non-cardiomyocytes through he CM-specific microRNAs miR-1 and miR-208 on L7Ae coding chain. Myocardial-specific expression of FoxM1-CM SMRTs and its proliferation-promoting effect were detected in hiPSC-CM (human-induced pluripotent stem cell-derived cardiomyocyte), mouse and pig models (days 3 after FoxM1-CM SMRTs treatment). In vivo experiments were conducted in both mouse and pigs with LAD (left anterior descending) ligation. The effects of FoxM1-CM SMRTs on cardiac function, MI size and hypertrophy in mice and pig models were detected after 4 weeks of FoxM1-CM SMRTs treatment. Results: FoxM1 was abundantly expressed in postmitotic CMs after transfection with the FoxM1-CM SMRTs, accompanied by activation of cell-cycle and proliferation markers (Ki67, PH3 and Aurora B kinase) and an increase in cell number. When the GFP-CM SMRTs was injected into mouse hearts with MI, GFP was only expressed in CMs, but not in non-CMs. Compared with the MI group, FoxM1-CM SMRTs significantly increased CM proliferation (days 3 after treatment administration in mice and pigs), improved left-ventricular ejection fractions (days 10 and 28 in both species) and hypertrophy, and reduced MI size (days 28 in both species). Conclusion: Intramyocardial injections of the FoxM1-CM SMRTs promoted CM proliferation, reduced MI size, and improved cardiac function in small and large mammals with acute myocardial infarction.
Abstract 4112716: The Trend In Racial Differences In Mortality Attributed To Congenital Heart Diseases In Infants In The United States From 2005 To 2019
Authors: Kwadwo Danso, Yaw Owusu, Chukwuemeka Aghasili, Yaa Karikari, Annette Ansong
Journal: Circulation (2024)

Background: Deaths from congenital heart disease (CHD) in children have been decreasing in the United States. We examined the differences in mortality trends between Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) infants. Methods: We retrospectively analyzed publicly available data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). The data was obtained from the linked birth/infant deaths from 2005 to 2019. We evaluated all infant deaths up to 1 year of age with the cause of death listed as CHD (International classification of diseases, 10 th revision (ICD-10) codes Q20-Q26 (except atrial septal defect, Q21.1 and patent ductus arteriosus, Q25. CHD infant mortality rate (IMR) was calculated per 100,000 live births. Race was ascertained based on death certificate reporting. Joinpoint regression was used to examine CHD-IMR by year, including stratification by NHB vs NHW, and neonatal vs postneonatal. The difference between NHB and NHW CHD-IMR was ascertained via the Mann-Whitney U test. P&lt;0.05 was considered statistically significant. Results: Out of 60,243,988 live births, there were 19,004 CHD-related infant deaths. The characteristics of the study population are displayed in Table 1. The overall CHD-IMR declined from 36.1 to 27.0 per 100,000 live births (25.2%) with an average annual percentage change (AAPC) of -2.1 [95% CI -2.6, -1.572] (Figure 1). The CHD-IMR was significantly higher in NHB than in NHW (40 vs 29.3; P&lt;0.0001) and this difference remained when the mortality rate was stratified by neonatal and post-neonatal periods. The CHD-IMR decreased significantly in NHW [AAPC: -2%; 95% CI: -2.5, -1.5%], but not in NHB [AAPC of -1.4%, 95% CI, -3.0, 0.3%]. The NHB-to-NHW CHD-IMR ratio, a measure of CHD-IMR disparity averaged 1.4 over the study period [AAPC: 0.8%; 95% CI: -0.2, 1.8%] (Figure 2). Conclusions: The CHD-IMR declined significantly for NHW, but not in NHB in the US from 2005 to 2019. The CHD-IMR was higher in NHB than in NHW. There was no significant change in the NHB-to-NHW CHD-IMR ratio, signifying no change in the disparity that exists between NHB and NHW IMR. These findings may have implications for patient care and public health policymaking. They lay the groundwork for additional studies to determine and understand the drivers behind these findings such as in prenatal diagnosis.
Abstract 4112546: Cannabis Legalization and Cardiovascular Hospitalizations: A Nationwide Difference-in-Differences Analysis
Authors: Samuel Slavin, Amy Mahar, Eric Secemsky, Robert Yeh, Murray Mittleman
Journal: Circulation (2024)

Background: Legal recreational cannabis sales (“legalization”) began earlier in the Western U.S. (January 2014) versus non-Western states (November 2018), providing a natural experiment to study its impact. Aim: To test the association between legalization and cardiovascular hospitalizations. Methods: Using the National Inpatient Sample (NIS), we performed a difference-in-differences analysis of the association between legalization and hospitalization rates for 6 cardiovascular diagnoses, a positive control (cannabis-related diagnoses), and 2 negative control diagnoses (opioid-related and urinary stones). We used survey-weighted Poisson regression modeling adjusted for age, sex, income, and race/ethnicity to estimate the relative change in hospitalization rates associated with each year of legalization. Results: Each year of legalization was associated with the following relative change in the hospitalization incidence rate ratio (cIRR) compared with regions that did not legalize: cannabis-related diagnoses [cIRR 1.138, 95% CI 1.066-1.214, p &lt; 0.001], atrial fibrillation/flutter (AF) [cIRR 1.023, 95% CI 1.010-1.035, p&lt;0.001], heart failure (HF) [cIRR 1.037, 95% CI 1.029-1.046, p &lt; 0.001], myocardial infarction (MI) [cIRR 1.031, 95% CI 1.014-1.048, p &lt; 0.001], ischemic stroke [cIRR 1.011, 95% CI 0.999-1.024, p=0.078], venous thromboembolism (VTE) [cIRR 1.009, 95% CI 0.999-1.020, p =0.066], and ventricular tachycardia (VT) [cIRR 1.019, 95% CI 0.993-1.046, p=0.161]. For falsification testing, there was no change in hospitalizations for urinary stones [cIRR 1.006, 95% CI 0.986-1.027, p = 0.535] or opioid-related diagnoses [cIRR 0.966, 95% CI 0.927-1.006, p = 0.091]. Conclusions: Recreational cannabis legalization was associated with increased hospitalizations for AF, HF, and MI. Further work is needed to replicate these findings in state-level analyses, ideally accounting for different cannabis formulations.
Abstract 4112775: Demographics and Cardiovascular Mortality Among Kaposi Sarcoma Patients in the United States: An Analysis of the SEER Database
Authors: Rozi Khan, Aman Goyal, Abdul Qahar Khan Yasinzai, Katharine Tracy, Amir Sohail, Shalini Ballur, Samuel Flesner, Ahmed Mahmood, Kalyani Ballur, Tamour Tareen, Pooja Sethi, Thomas Alexander, Asad Ullah
Journal: Circulation (2024)

Aims and Background: Kaposi sarcoma (KS) is a vascular neoplasm caused by human herpesvirus. Despite its significance, there is limited data regarding the causes and mortality factors associated with KS, particularly concerning cardiovascular mortality rates and specific influencing factors. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to gather data from 2000 to 2020. The primary endpoint was overall survival, assessed via log-rank analysis and Kaplan-Meier plots. Hazard ratios (HR) with 95% confidence intervals (CIs) were calculated using SAS v9.4, with significance set at p&lt;0.05. Results: We identified 8,247 patients with KS. Most were male (90.6%) and aged 40-59 years old (38.5%). Mortality data from KS showed that 56.3% of diagnosed patients were alive. Among those who died, 49.8% died of infectious causes, 11.4% died of cardiac causes, and the remaining died of other causes, such as leukemias and complications. Advanced age (&gt;80 years) vs. 0-19 year age group (HR: 2.263; 95% CI: 1.068-4.795; p=0.033), non-Hispanic Black race vs. non-Hispanic White race (HR 1.492; 95% CI: 1.369-1.627; p=0.001), and visceral involvement vs. cutaneous KS (HR 1.709; 95% CI: 1.487-1.963; p=0.001) were factors associated with increased mortality. Females had a slightly lower long-term survival than males (p&lt;0.001). Married individuals, higher incomes (≥$75,000), and urban areas of living had higher survival rates compared to widowed patients, lower-income patients (&lt;$75,000), and those in rural locations, respectively (p&lt;0.001, for all). In the subgroup analysis, females (24.3%; n=112) had significantly higher cardiac-related deaths than males (9.5%; n=297) (p&lt;0.0001). Cardiac-related deaths were highest in White patients (16.1%; n=279), followed by Hispanics (10.4%; n=79). Conclusions: Cardiac causes accounted for 11.4% of deaths. Various factors are associated with an increased mortality risk.
Differential contributions of the gut microbiota and metabolome to pathomechanisms in ulcerative colitis: an <i>in vitro</i> analysis
Authors: Jonas Poppe, Leen Boesmans, Sara Vieira-Silva, Lise Deroover, Raul Tito, Doris Vandeputte, Greet Vandermeulen, Vicky De Preter, Jeroen Raes, Severine Vermeire, Gwen Falony, Kristin Verbeke
Journal: Gut Microbes (2024)

The gut microbiota has been implicated in onset and progression of ulcerative colitis (UC). Here, we assess potential causal involvement of the microbiota and -associated fecal water (FW) metabolome in altering key functional parameters of the colonic epithelium. Fecal samples were collected from N = 51 healthy controls (HC), N = 36 patients with active UC (UC-A), and N = 41 subjects in remission N = 41 (UC-R). Using in vitro incubation experiments, the FW metabolome's impact on butyrate oxidation rates/gene expression and cell death (cytotoxicity) of HT-29 cells, cytokine production by PBMC, and barrier integrity of Caco2 monolayers was evaluated. The FW metabolome from patients and individuals hosting the Bacteroides 2 (Bact2) enterotype (69% of UC-A, 31% of UC-R, 3% of HC), characterized by lower levels of median- and short-chain fatty acids and furan compounds, left butyrate oxidation rates unaltered but affected associated gene expression profiles. UC patients/Bact2-carriers' FW lowered PBMC IL-8 production and increased IL-1β production. Patients' FW increased cytotoxicity, associated with sulfide compound levels. Bact2 carriers' FW, displaying higher levels of bile acids, lowered barrier function upon incubation of monolayers. The FW metabolome of patients and individuals hosting a dysbiotic microbiota could contribute to the disruption of functional processes of the colonic epithelium as observed in UC.
Grief-Specific Cognitive Behavioral Therapy vs Present-Centered Therapy
Authors: Rita Rosner, Jörn Rau, Anette Kersting, Winfried Rief, Regina Steil, Anna-Maria Rummel, Anna Vogel, Hannah Comtesse
Journal: JAMA Psychiatry (2024)

Prolonged grief disorder (PGD) is included as a new diagnosis in international classification systems. Treatments following a cognitive behavioral model are most effective, but comparisons with active control treatments are scarce.
Gut microbial metabolism of bile acids modifies the effect of Mediterranean diet interventions on cardiometabolic risk in a randomized controlled trial
Authors: Peipei Gao, Ehud Rinott, Danyue Dong, Zhendong Mei, Fenglei Wang, Yuxi Liu, Omer Kamer, Anat Yaskolka Meir, Kieran M. Tuohy, Matthias Blüher, Michael Stumvoll, Meir J. Stampfer, Iris Shai, Dong D. Wang
Journal: Gut Microbes (2024)

Bile acids (BAs) undergo extensive microbial metabolism in the gut and exert hormone-like functions on physiological processes underlying metabolic risk. However, the extent to which gut BA profiles predict cardiometabolic risk and explain individual responses to dietary interventions in humans is still unclear. In the DIRECT-PLUS Trial, we conducted a multi-omics analysis of 284 participants randomized into three groups: healthy dietary guidelines and two Mediterranean diet (MedDiet) groups. We longitudinally measured 44 fecal BAs using liquid chromatography-mass spectrometry, the gut microbiome through shotgun metagenomic sequencing, and body adiposity and serum lipids at baseline, 6, and 18 months. Fecal levels of 14 BAs, such as lithocholic acid and ursodeoxycholic acid, were prospectively associated with body mass index (BMI) and serum lipid profiles (false discovery rate [q]<0.05). Baseline fecal BA levels significantly modified the beneficial effects of the MedDiet; for example, BMI reduction induced by MedDiet interventions was more pronounced in individuals with lower 12-dehydrocholic acid levels (q-interaction <0.001). We confirmed that the gut microbiome is a major modifier of the secondary BA pool in humans. Furthermore, the association of fecal BAs with body adiposity and serum lipids varied significantly in individuals with different abundances of gut microbes carrying BA metabolism enzymes, e.g. several Ruminococcus spp. In summary, our study identifies novel predictive biomarkers for cardiometabolic risk and offers new mechanistic insights to guide personalized dietary interventions.
Melt Electrowriting of Polyhydroxyalkanoates for Enzymatically Degradable Scaffolds
Authors: Magdalena Z. Gładysz, Didi Ubels, Marcus Koch, Armin Amirsadeghi, Frederique Alleblas, Sander van Vliet, Marleen Kamperman, Jeroen Siebring, Anika Nagelkerke, Małgorzata K. Włodarczyk‐Biegun
Journal: Advanced Healthcare Materials (2024)

Melt electrowriting (MEW) enables precise scaffold fabrication for biomedical applications. With a limited number of processable materials with short and tunable degradation times, polyhydroxyalkanoates (PHAs) present an interesting option. Here, poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and a blend of PHBV and poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (PHBV+P34HB) are successfully melt electrowritten into scaffolds with various architectures. PHBV+P34HB exhibits greater thermal stability, making it a superior printing material compared to PHBV in MEW. The PHBV+P34HB scaffolds subjected to enzymatic degradation show tunable degradation times, governed by enzyme dilution, incubation time, and scaffold surface area. PHBV+P34HB scaffolds seeded with human dermal fibroblasts (HDFs), demonstrate enhanced cell adherence, proliferation, and spreading. The HDFs, when exposed to the enzyme solutions and enzymatic degradation residues, show good viability and proliferation rates. Additionally, HDFs grown on enzymatically pre-incubated scaffolds do not show any difference in behavior compared those grown on control scaffolds. It is concluded that PHAs, as biobased materials with enzymatically tunable degradability rates, are an important addition to the already limited set of materials available for MEW technology.