tbuckley/cabot-search huggingface dataset:
Abstract P2075: Impact of a Minimally Processed Provegetarian Diet on LDL-cholesterol and Cardiovascular Risk Factors in Adults with Heterozygous Familial Hypercholesterolemia: a Randomized Controlled Feeding Trial
Authors: Jacob Lessard-Lord, Valerie Guay, Maryka Rancourt-Bouchard, Patrick Couture, Anne Gangloff, Jonatan Blais, Jean-Philippe Drouin-Chartier
Journal: Circulation (2025)

Introduction: Heterozygous familial hypercholesterolemia (HeFH) is a severe genetic disorder that accelerates atherosclerosis and leads to premature cardiovascular diseases (CVDs). Minimally processed provegetarian diets are recommended in dietary and clinical guidelines worldwide for their cardioprotective properties. However, the impact of such diet on LDL-cholesterol (LDL-C) and other CVD risk factors has not yet been assessed in fully controlled feeding settings among adults with HeFH. Hypothesis: We tested the hypothesis that a minimally processed provegetarian diet (MPVD) induces clinically significant improvements in plasma LDL-C levels (primary outcome) and other CVD risk factors compared to a standard American diet (SAD) among adults with HeFH. Methods: In this randomized, crossover, controlled feeding trial, 50 adults with genetically confirmed HeFH, free of cholesterol-lowering medication, consumed a MPVD and a SAD for 4 weeks each in a random order under fully controlled feeding conditions. Fasting plasma atherogenic lipid levels and other CVD risk factors were measured at the end of each diet. Results: Relative to the SAD, the MPVD induced a clinically significant reduction in LDL-C (−18.6%, 95% confidence interval (CI) −22.1%, −15.2%; P &lt;0.0001). Stratified analyses revealed no evidence of effect modification due to sex, LDL-receptor genotype, and BMI. However, a greater reduction of LDL-C was observed in older participants ( P diet*age =0.02) and in those with lower lipoprotein(a) levels ( P diet*Lp(a) =0.02). The MPVD also reduced apolipoprotein B (−15.2%, 95%CI −18.3%, −12.0%), non-HDL-C (−18.0%, 95%CI −21.0%, −14.8%), triglycerides (−8.6%, 95%CI −14.4%, −2.2%), and systolic (−2 mm Hg, 95%CI −3.3 mm Hg, 0.0 mm Hg) and diastolic (−2 mm Hg, 95%CI −3.4 mm Hg, −0.5 mm Hg) blood pressure. Overall, the MPVD reduced the 10-year risk of CVD by 1.55% ( P =0.03). Moreover, while the two diets were isocaloric and had the same macronutrient composition, the MPVD improved satiety compared to the SAD, with the effect being more important among men ( P diet*gender =0.03). Conclusion: This study demonstrates that, compared to a standard American diet, a minimally processed provegetarian diet induces clinically significant reductions in LDL-C and other CVD risk factors in adults with HeFH. It paves the way for developing precision nutrition strategies that incorporate gender-specific counseling and underscores the critical role of diet modification in HeFH management.
Abstract P2068: Prevalence of blood pressure control among adults with hypertrophic cardiomyopathy and hypertension
Authors: Katherine Goldrick, Soo Young Kim, Zachary Tenner, Mark Sherrid, Milla Arabadjian
Journal: Circulation (2025)

Introduction: Hypertension (HTN) occurs in ~50% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac disorder. Most individuals with HCM (~70%) have left ventricular outflow tract obstruction, precluding use of first- or second line anti-hypertensive agents. Little is known about the prevalence of blood pressure (BP) control among adults with HCM and HTN. Objectives: We sought to describe the prevalence of BP control among adults with HCM and HTN in a large clinical cohort. Methods: Data for this cross-sectional analysis was extracted from electronic health records of adults diagnosed with HCM (ICD codes I42.1/I42.2) who are treated for HTN and receive care in a large health system in New York. We conducted Wilcoxon-rank sum and Pearson chi-squared tests to compare demographic and clinical characteristics, and receipt of HCM specialty care (vs. not) between adults with and without controlled BP. Uncontrolled BP was defined as use of antihypertensive agents and systolic BP≥140 mmHg or diastolic BP ≥ 90mmHg. Results: Of 4,054 adults with HCM, 2,401 (59%) had HTN, 44% women, 69% Non-Hispanic (NH) white, 13% NH Black, 6.3% Hispanic/Latine. Adults with HCM and HTN were older, mean ± standard deviation, 69±15 vs 63±20 years, had higher body mass index (BMI), 28±7 vs 27±8, p&lt;0.001, and higher systolic and diastolic BP, 131/76 ±19/12 vs 128/75±20/11 mmHg, compared to those with HCM only. A higher proportion of adults with HCM and HTN were seen in a specialized HCM program, 50% vs 38%, p&lt;0.001, compared to adults with HCM only. Among adults with HCM and HTN, 824 (34%) had uncontrolled BP. Participants with uncontrolled BP were more likely to be older, 70±14 vs 68±16 years, p&lt;0.001, have a higher BMI, 29±9 vs 28±8, p&gt;0.001, and have co-morbid diabetes, 11% vs 8%, p&lt;0.001, compared to participants with controlled BP. BP control did not significantly differ between women and men. There was a higher proportion of NH Black and Hispanic/Latine participants among those with uncontrolled BP, compared to participants with controlled BP, 16% vs 11%, and 7.4% vs 5.7%, respectively, p&lt;0.001. Forty-seven % of participants with uncontrolled BP received HCM specialty care vs 51% of those with controlled BP, but the difference was not statistically significant. Conclusions: Over a third of adults with HCM and HTN had uncontrolled BP in this cohort. Findings highlight the need for focused strategies to improve BP control among this population.
Abstract P3061: Uncovering Neighborhood-Level Inequities in Access to Transthoracic Echocardiograms
Authors: Betsy Medina-Inojosa, Jose Medina-Inojosa, Nazanin Rajai, LaPrincess Brewer, Zachi Attia, Paul Friedman, Amir Lerman, Francisco Lopez-Jimenez
Journal: Circulation (2025)

Methods: From a sample cohort of 274,539 consecutive adults who sought care at Mayo Clinic between 2018-2022, we ascertained demographic and clinical information, including clinically indicated TTE within 15 days and up to a year after the index clinical visit. The Area Deprivation Index (ADI), a tool that captures neighborhood-level disadvantages that are linked to cardiovascular morbidity and outcomes, was extracted from the Neighborhood Atlas and ranked accordingly as state percentiles stratified in quintiles, with the highest values representing “most disadvantaged” areas. We performed non-parametric multivariate regression models that adjusted for cardiovascular risk factors expressed in odds ratio (OR) and 95% confidence interval (CI). Results: A total of 45,823 (16.9%) subjects had a TTE performed, with a mean age of 63±16 years, 48% were women, and 86% were non-Hispanic white. According to the TTE, 4% of subjects had LVSD, while 11% had a high probability of LVSD by AI-ECG. Median state ADI was 4 IQR (2-7). In the whole cohort, subjects residing in the most disadvantaged areas were less likely to have a TTE [OR 0.94 CI (0.91- 0.97)] see Fig. 1-A ; conversely, they were more likely to have LVSD by TTE [OR 1.80 CI (1.52-2.13)] see Fig. 1-B , and higher probability of LVSD by AI-ECG [OR 1.43 CI (1.36-1.51)] when compared to those with the least disadvantage see Fig. 1-C , independent of age, sex, and cardiovascular risk factors, p for trend&lt;0.001. Conclusion: Individuals living in socially disadvantaged areas were slightly less likely to have an echocardiogram despite a significantly higher likelihood of having an LVSD (suspected by AI-ECG and confirmed by TTE), independent of cardiovascular risk factors. Highlighting an important disparity in the diagnosis of LVSD.
Abstract P3168: Association Between Rurality and Socioeconomic Status on Acute Myocardial Infarction Hospitalization Among Medicare Beneficiaries
Authors: Fayz Quadri, Djhenne Dalmacy, Nitin Kanneganti, Abdullah Rabah, Jarett Berry, Yordanos Tiruneh
Journal: Circulation (2025)

Background: Higher cardiovascular mortality rates have been observed in rural compared to urban counties. The influence of socioeconomic status (SES) on this disparity remains poorly understood. Therefore, we aimed to characterize the association between rurality and hospitalization for acute myocardial infarction (AMI) across categories of SES. Methods: We included Medicare fee-for-service beneficiaries (aged 65 years or older) with prevalent hypertension (HTN) or diabetes (DM), followed from 2017 to 2021. Residential zip codes were categorized as metropolitan, micropolitan, small town, and rural using Rural Urban Commuting Area (RUCA) Codes. SES was determined at the participant level, with dual-eligible individuals (Medicare + Medicaid) classified as low SES. First hospitalization for AMI was determined from Medicare claims. The association between rurality and AMI hospitalization was assessed through Cox proportional hazards regression models adjusted for age, race, and sex, with additional models stratified by SES. Results: We included 25,915,862 participants (mean age 73; 45% male; 97.6% HTN; 41.6% DM; 75.5% metropolitan; 15.4% low SES). HTN prevalence and low SES prevalence were numerically similar across RUCA codes, but DM was slightly lower in rural areas (42% vs. 39%, metropolitan vs. rural). After 3.9 years follow-up, we observed 1,395,853 first AMI hospitalizations, with an overall event rate of 14.3 per 1,000 person-years. AMI rates were higher in rural vs. metropolitan zip codes (15.6 vs. 13.8 per 1,000 p-years) and low vs. not-low SES (21.6 vs. 13.1 per 1,000 p-years). In adjusted models, rurality was associated with an increased AMI risk. However, this association varied by SES status with the relative impact of rurality on AMI risk attenuated among low SES beneficiaries (see Table). Conclusions: Both rurality and low SES are associated with higher AMI hospitalization rates. However, the impact of rurality on AMI risk appears attenuated among low SES beneficiaries. Further research is needed to understand the mechanisms underlying the influence of rurality on AMI risk across varying SES strata.
Abstract MP36: Food and Nutrition Insecurity Impacts Cardiovascular Risk Factors Among Latina Women
Authors: Marcela Radtke, Lan Xiao, Wei-ting Chen, Michelle Hauser, Christopher Gardner, Megan Lewis, Patricia Rodriguez Espinosa, Elizabeth Venditti, Lisa Goldman Rosas
Journal: Circulation (2025)

Introduction: Nutrition security is an emerging concept that expands upon the definition of food security – consistent access to sufficient quantity and quality of food – to include prevention, management, and treatment of disease. There is limited evidence on how nutrition security is related to heart health, specifically in populations disproportionately impacted by cardiovascular disease risk, such as Latina women. Hypothesis: Latina women experiencing food and/or nutrition insecurity will have poorer indicators of Life’s Essential 8 compared to those with food and/or nutrition security. Methods: Vida Sana y Completa is randomized controlled trial of a multi-component Food is Medicine (FIM) intervention for Latina women with obesity (BMI&gt;30kg/m 2 ). This analysis uses survey data from baseline assessment (n=165). Food security status was assessed using the USDA 6-item screener and nutrition security status was assessed using the 4-item Nutrition Security Scale. Outcomes included vegetable and fruit intake, BMI, blood pressure (BP), and mental health. Within group differences by food and nutrition security status were performed using ANOVA with Fischer’s least significant difference and independent two-sample t-tests. Results: The majority (82%) reported food insecurity and approximately half (47%) reported nutrition insecurity. Women with very low or low food security consumed fewer vegetables compared to those with food security (1.7 vs. 2.1 vs. 3.0, respectively; p=0.02). Women with nutrition insecurity also consumed fewer servings of vegetables compared to participants with nutrition security (1.7 vs. 2.5; p=0.01). Systolic BP was higher among women with low food security, compared to participants with very low food security or participants with food security (p=0.01). Diastolic BP was higher for participants with low and very low food security compared to participants with food security (p=0.03). There was no difference in BP by nutrition security status. Participants with food and nutrition insecurity had more symptoms of depression and anxiety compared to participants with food and nutrition security(p&lt;0.05). There were no differences in daily servings of fruit or BMI by food and/or nutrition security status. Conclusion: Latina women with food and/or nutrition insecurity are at increased risk for cardiovascular disease. FIM interventions may effectively address food and/or nutrition insecurity, as well as Life’s Essential 8, to improve heart health.
First-In-Human Phase 1/2a Study of the First-In-Class CDK2/4/6 Inhibitor PF-06873600 Alone or with Endocrine Therapy in Patients with Breast Cancer
Authors: Timothy A. Yap, Jonathan W. Goldman, Shaveta Vinayak, Antoaneta Tomova, Erika Hamilton, Yoichi Naito, Antonio Giordano, Igor Bondarenko, Toshinari Yamashita, Li Zhou, Allison Moreau, Heather Neumann, Jessica Tougias, Feng Liu, Jennifer Park, Maria Delioukina, Komal Jhaveri
Journal: Clinical Cancer Research (2025)

Abstract Purpose: The discovery that cyclin E overexpression is a key CDK4/6 inhibitor resistance mechanism has reinvigorated interest in targeting CDK2, and simultaneous inhibition of CDK2/4/6 as a novel therapeutic approach. This first-in-human study assessed safety, tolerability, pharmacokinetics, pharmacodynamics and efficacy of PF-06873600, the first-in-class inhibitor of CDK2/4/6. Patients and Methods: Dose escalation included 78 patients with advanced breast cancer, triple negative breast cancer, or ovarian cancer who received oral PF-06873600 1–50 mg twice daily (BID) (Part 1A, n=51), or PF-06873600 with endocrine therapy (Part 1B, n=16; Part 1C n=11) to determine the recommended dose for expansion (RDE). Dose expansion (Part 2A, n=45; Part 2C, n=28) assessed preliminary antitumor activity, safety and tolerability at the RDE in combination with fulvestrant in patients with HR+/HER2– mBC. Pharmacodynamics and translational readouts were assessed by phosphorylated Rb and Ki67 in tumor biopsies and circulating tumor DNA (ctDNA). Results: The RDE of PF-06873600 was 25mg BID. During dose escalation, six of 42 (14.3%) evaluable patients had treatment-related dose-limiting toxicities. Most common all-causality adverse events (N=151) were nausea (62.9%), anemia (44.4%) and fatigue (43.7%). Reductions in Ki67-positive cells, pRb H-score, and ctDNA levels were observed. Three RECIST partial responses (PRs) were observed in Part 1. In Part 2A there were three PRs (objective response rate [ORR] 6.7%, 95% CI: 1.4–18.3%) and, in Part 2C, five PRs (ORR 22.7%, 95% CI: 7.8–45.4%). Conclusions: PF-06873600 demonstrated a benefit–risk profile consistent with the CDK4/6 inhibitor class of drugs, with preliminary clinical activity in HR+/HER2– mBC. ClinicalTrials.gov identifier: NCT03519178
Abstract P2093: Chronic Kidney Disease Severity and Incident Cognitive Impairment in Patients with Chronic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort
Authors: Zhijie Huang, Kristine Yaffe, Yang Pan, Changwei Li, mark unruh, Matthew Weir, Bernard Jaar, Panduranga Rao, Mahboob Rahman, Vallabh Shah, Jonathan Taliercio, Amanda Anderson, Katherine Mills, Lydia Bazzano, Jing Chen, Jiang He, Ana Ricardo, James Lash, Manjula Tamura, Tanika Kelly
Journal: Circulation (2025)

Background: Patients with chronic kidney disease (CKD) face a disproportionate burden of dementia compared to the general population. However, prospective associations between kidney function and cognitive impairment remain inconsistent and have not been exclusively evaluated in CKD. Methods: This analysis included 4,261 CKD patients from the Chronic Renal Insufficiency Cohort (CRIC). CKD severity was defined using standard estimated glomerular filtration rate (eGFR) and urinary protein to creatinine ratio (UPCR) thresholds. Global cognition and domains of verbal memory, attention/processing speed, and executive function were assessed longitudinally using the modified mini-mental status examination (3MS), Buschke Selective Reminding test, Trail Making Test A (TMTA), and Trail Making Test B (TMTB), respectively. For each test, impairment was defined as a score at least one standard deviation (SD) worse than the cohort mean at baseline. Cox proportional hazard models assessed associations between baseline CKD severity and time-to-cognitive impairment, adjusting for demographic and lifestyle risk factors, clinical measures, medications, and baseline cognition. Restricted cubic splines evaluated non-linear relations of both eGFR and UPCR with cognitive impairment. Results: Among CRIC participants with a mean age 59.6 years and median follow-up of 14.7 years, we observed significant, dose-response associations between increasing CKD severity, based on both eGFR and UPCR, and incident global cognitive impairment. Compared to those with stage G2 CKD (eGFR=60-89), patients with stage G4/G5 CKD (eGFR&lt;30) had a 36% increased risk of cognitive impairment (HR=1.36; 95% CI=1.00, 1.86; P linear =0.03). Similarly, patients with UPCR&gt;500 mg/g had a 26% increased risk compared to those with UPCR&lt;150 mg/g (HR=1.26; 95% CI=0.99, 1.59; P linear =0.04). Increased CKD severity based on eGFR was significantly associated with attention impairment (G4/G5 vs. G2 HR=1.49; 95% CI=1.03, 2.14; P linear =0.04). Spline analyses revealed linear relationships between declining eGFR and impairment in global cognition (P=0.007) and attention (P=0.005), and between increasing UPCR and impairment in attention (P=0.015) and executive function (P=0.036; Figure ). No evidence of non-linear relationships were observed. Conclusion: More severe CKD, reflected by lower eGFR and higher UPCR, was prospectively associated with impairment in global cognition and specific cognitive domains.
Abstract P3037: Racial and Ethnic Disparities in Cardiovascular Outcomes and the Role of Physical Activity and Sleep as Mediators: 2011-2020 National Health and Nutrition Examination Survey
Authors: Christy Rodriguez, Samuel Gledhill, William Xiao, Bunmi Ogungbe
Journal: Circulation (2025)

Background: Cardiovascular Disease (CVD) - including coronary artery disease, heart failure, stroke, and hypertension - disproportionately affects Black and Hispanic populations. However, the mediating role of physical activity and sleep in these disparities has not been fully explored. Objectives: To examine the extent to which physical activity and sleep mediate the relationship between race/ethnicity and cardiovascular outcomes among adults aged 35 and older. Methods: We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. CVD outcomes were defined as self-reported diagnosis of coronary heart disease, heart failure, or stroke. Physical activity was assessed using a self-reported survey, minutes/week of physical activity were categorized as poor (&lt;1 min/week), intermediate (1-149 min/week), or ideal (≥150 min/week) based on recommended guidelines. Sleep was evaluated using self-reported trouble sleeping (yes/no). Survey-weighted logistic regression models were fitted, and mediation analyses (separate models for each racial/ethnic group) were conducted. Results: Among a sample of 19,714 participants, the mean age was 55.7 years old (SD: 11.5), 53% female. Both sleep and physical activity as exposures were significantly associated with CVD outcomes. Sleep trouble was associated with increased odds of CVD (OR = 1.45, 95% CI: 1.24, 1.70, Table), with varying effects across racial/ethnic groups. This association was highest among non-Hispanic Asian adults (OR = 2.36, 95% CI: 1.37, 4.07), followed by Hispanic (OR = 2.16, 95% CI: 1.73, 2.70), non-Hispanic Black (OR = 1.40, 95% CI: 1.04, 1.88), and non-Hispanic White (OR = 1.38, 95% CI: 1.12, 1.68) groups. Both intermediate (OR = 0.67, 95% CI: 0.53, 0.83) and ideal (OR = 0.63, 95% CI: 0.53, 0.76) physical activity levels were associated with lower odds of CVD compared to poor activity levels. Mediation analysis showed significant indirect effects of sleep trouble for all groups. For physical activity, significant indirect effects were observed across all racial/ethnic groups for both intermediate and ideal levels, among non-Hispanic White, and non-Hispanic Black adults. Conclusion: Our findings suggest that physical activity and sleep play an important role in the relationship between race and ethnicity and cardiovascular outcomes. Interventions on improving sleep quality and increasing physical activity should be tailored.
Abstract P2076: Association of High-Density Lipoprotein Cholesterol, Apolipoprotein E and A1 Concentrations With Fetal Growth, Maturation, and Placental Insufficiency
Authors: Rikke Mohr Lytsen, Sofie Nielsen, Anne-Sophie Sillesen, Anna Axelsson, Ruth Ottilia Birgitta Voegg, PIA KAMSTRUP, Kasper Iversen, Henning Bundgaard, Ruth Frikke-Schmidt
Journal: Circulation (2025)

Introduction: Cholesterol is important for fetal growth and is in fetal life mainly carried by high density lipoprotein (HDL) cholesterol enriched with apolipoprotein E (apoE). The fetus is dependent on maternal/placental transport of cholesterol until de novo synthesis increases at 19 weeks of gestation. The association between HDL cholesterol concentrations and fetal growth, maturation, and placental insufficiency remains uncertain. Hypothesis: We hypothesized that HDL cholesterol, apoE, and apolipoproteinA1 (apoA1) concentrations are associated with fetal growth, maturation, and placental insufficiency. Methods: To examine this we used data from the Copenhagen Baby Heart and COMPARE studies including more than 12,600 umbilical cord blood samples and 360 corresponding venous samples at birth, with follow-up at 2 months. Results: HDL cholesterol concentrations correlated significantly with apoE and apoA1 at birth in both cord blood (Spearman’s correlation: 0.48 for apoE and 0.67 for apoA1, p-values &lt;0.001) and venous blood (0.58 for apoE and 0.71 for apoA1, p-values&lt;0.001) and at two months of age in venous blood (Spearman’s correlation: 0.18 for apoE (p=0.003) and 0.87 for apoA1(p&lt;0.001)). From birth to two months of age venous blood concentrations of HDL cholesterol and apoA1 increased while apoE decreased (p&lt;0.001). Gestational age adjusted HDL cholesterol and apoE concentrations in cord blood at birth were positively associated with birth weight (p&lt;0.001), while apoA1 was only marginally significant (p=0.05). The clinical classification of intrauterine growth/maturation; small, appropriate, and large for gestational age, showed a significant, stepwise increase in cord blood for HDL cholesterol and apoE concentrations, but not for apoA1, from small to large for gestational age (p for trend &lt;0.001). Multifactorially adjusted odds ratios (95% CI) for cord concentrations of HDL cholesterol, apoE, and apoA1 below the 20 th percentile among newborns exposed to placental insufficiency was 1.39 (1.17-1.66) for HDL cholesterol, 1.47 (1.23-1.76) for apoE, and 1.19 (0.99-1.43) for apoA1. Conclusions: HDL cholesterol and apoE at birth are positively associated with intrauterine growth and maturation. Placental insufficiency increases risk of having low HDL cholesterol and apoE concentrations at birth, suggesting these lipid traits as markers of placental health.