Cardiovascular Diseases Commons^™

Protein Consumption And Risk Of Cvd Among Us Adults: The Multi-Ethnic Study Of Atherosclerosis (Mesa), Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Students Publications

BACKGROUND: Although some randomized trials have reported beneficial effects of protein intake on cardiometabolic risk factors, evidence from prospective studies have not supported a strong link between protein intake and cardiovascular disease (CVD) risk. It is also unclear whether diversity in protein intake plays a role in CVD risk.

OBJECTIVE: We investigated prospective associations of (1) protein intake, overall and by food source and (2) diversity of protein sources with risk of CVD, coronary heart disease (CHD), and stroke.

METHODS: In a multi-ethnic cohort of 5879 U.S. adults (45-84 years), who were free of CVD at baseline, protein intake was …

Vital Exhaustion And Biomarkers Associated With Cardiovascular Risk: The Aric Study, Matthew R Deshotels, Mahmoud Al Rifai, Caroline Sun, Ali Agha, Elizabeth Selvin, B Gwen Windham, Viola Vaccarino, Erin D Michos, Hani Jneid, Glenn N Levine, Christopher Fagundes, Salim S Virani, Christie M Ballantyne, Vijay Nambi

Faculty, Staff and Students Publications

BACKGROUND: Vital exhaustion, defined as excessive fatigue, demoralization, and irritability due to chronic stress, is independently associated with cardiovascular disease (CVD).

OBJECTIVES: The purpose of this study was to examine the association of vital exhaustion with biomarkers associated with CVD risk in the ARIC (Atherosclerosis Risk In Communities) study.

METHODS: We examined the cross-sectional association of vital exhaustion (assessed using the Maastricht Vital Exhaustion Questionnaire [MVEQ]) with cardiac biomarker (high-sensitivity troponin T [hs-TnT], N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and high-sensitivity C-reactive protein (hs-CRP) levels in 11,542 ARIC study participants without CVD at ARIC visit 2 using multivariable logistic and linear …

Conservative Approach Versus Percutaneous Coronary Intervention In Patients With Spontaneous Coronary Artery Dissection From A National Population-Based Cohort Study, Chayakrit Krittanawong, Beatriz Castillo Rodriguez, Song Peng Ang, Yusuf Kamran Qadeer, Zhen Wang, Mahboob Alam, Samin Sharma, Hani Jneid

Faculty, Staff and Students Publications

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a rare and often underdiagnosed cause of acute coronary syndrome (ACS), predominantly affecting younger women without traditional cardiovascular risk factors. The management of SCAD remains a subject of debate, likely secondary to inconclusive evidence. This study aims to compare the clinical outcomes of SCAD patients treated with optimal medical therapy (OMT) versus those who underwent percutaneous coronary intervention (PCI) using a national population-based cohort.

METHODS: We conducted a retrospective analysis using the National Inpatient Sample (NIS) database from 2016 to 2020. The study included patients identified with SCAD using the ICD-10-CM (the International …

Digital, Social Micro-Interventions To Promote Physical Activity Among Midlife Adults With Elevated Cardiovascular Risk: An Ambulatory Feasibility Study With Momentary Randomization., Danielle Arigo, Leah M Schumacher, Kiri Baga, Jacqueline A Mogle

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing.

PURPOSE: This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512).

METHODS: Midlife adults (N = 30, MAge = 51, MBMI = 31.5 kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days …

The Impact Of Changes In Depression On Cardiovascular Outcomes In Patients With Coronary Heart Disease., Nishant Vatsa, Josiah Bennett, Sonika Vatsa, Alireza Rahbar, Daniel A Gold, Vardhmaan Jain, Matthew E Gold, Alexander Razavi, Adithya Yadalam, Shivang Desai, Muhammad Owais, Joy D Hartsfield, Yi-An Ko, Laurence Sperling, Viola Vaccarino, Puja K Mehta, Arshed A Quyyumi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Depression is associated with major adverse cardiovascular events (MACE). Whether longitudinal changes in depression affect MACE in patients with coronary heart disease (CHD) remains unknown.

OBJECTIVES: The authors evaluated the hypothesis that increasing or persistent depression predicts MACE in patients with CHD.

METHODS: At baseline, 3,483 Emory Cardiovascular Biobank participants (median age 65.5 years, 31.6% female) completed the Patient Health Questionnaire 8 (PHQ8) for depression evaluation. At 1 year, 2,639 of these event-free participants repeated the questionnaire. Depression was defined as a PHQ8 score >9 and change in depressive symptoms (Δ" role="presentation"> PHQ8) was year 1 score minus baseline …

Temporal Variations In And Predictive Values Of Abg Results Prior To In-Hospital Cardiac Arrest, Mina Attin, Jie Rin, Chad Cross, Sidath Kapukotuwa, Ryan Shao, Peter G. Kaufmann, C.D. (Joey) Lin, Kim Arcoleo

Nursing Faculty Research

In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g., demographics, number and types of comorbidities). Arterial blood gas (ABG) analysis, one of the most common diagnostic tests for assessing and managing critically or acutely ill hospitalized patients, reflects pathophysiological changes associated with adverse events or complications, including IHCA. Yet the predictive and prognostic values of patterns of pre-arrest ABG parameters for IHCA have not been fully studied. The purpose of this retrospective pilot cohort study was to investigate temporal variations in …

Pediatric Cardiac Xenotransplantation And Expanded Access: Ethical Considerations, Daniel J Hurst, Christopher Bobier, Anthony Merlocco, Luz A Padilla, Daniel Rodger, David Cleveland, John D Cleveland

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Due to the current organ shortage waitlist, alternatives to allotransplantation are necessary. Xenotransplantation is currently being pursued as one such alternative in adults in need of kidney or heart transplantation. Cardiac xenotransplantation of genetically modified pig hearts has been conducted twice in adults under the United States Food and Drug Administration (FDA) expanded access criteria. Because of the shortage of transplantable hearts for children as well as the lack of mechanical circulatory support in this population, pediatric researchers are exploring FDA expanded access in high-risk neonates and infants who lack alternative options for survival. The adult cardiac xenotransplantation experience with …

Acute On Chronic Rheumatic Valvulitis, Natalie K Craik, Joseph Burns, Nirica Borges, Tam T Doan, Amy E Sanyahumbi, Edward J Hickey, Debra L Kearney, Ryan H Rochat, Eyal Muscal, Thomas Glenn

Faculty, Staff and Students Publications

An 11-year-old boy presented in distress with tachypnea, holosystolic murmur, and a gallop. Echocardiography revealed mitral valve thickening and severe regurgitation. He required valve replacement with pathology consistent with acute on chronic valvulitis. This case underscores the importance of considering rheumatic heart disease, despite no preceding suspicious history.

Trends In Gaps Of Care For Patients With Congenital Heart Disease: Implications For Social Determinants Of Health And Child Opportunity Index, Abbas H. Zaidi, Adam Alberts, Devyani Chowdhury, Claude Beaty, Benjamin Brewer, Ming Hui Chen, Sarah D. De Ferranti

Department of Surgery Faculty Papers

BACKGROUND: Lifelong continuity of care is essential for patients with congenital heart disease (CHD) to maximize health outcomes; unfortunately, gaps in care (GIC) are common. Trends in GIC and of social determinants of health factors contributing to GIC are poorly understood.

METHODS AND RESULTS: This retrospective cohort study included patients with CHD, aged 0 to 34 years, who underwent surgery between January 2003 and May 2020, followed up at a pediatric subspeciality hospital. Patients were categorized as having simple, moderate, and complex CHD based on 2018 American Heart Association and American College of Cardiology guidelines. Social determinants of health, such …

High-Sensitivity Cardiac Troponin [Hs-Ctn] As A Valuable Biomarker For Pulmonary Hypertension Risk Stratification: A Contemporary Review Of The Literature, Vijay Durga Pradeep Ganipineni, Sahas Reddy Jitta, Mohan Chandra Vinay Bharadwaj Gudiwada, Jaswanth Rao Jasti, Chaitra Janga, Bhavyasri Merugu, Revanth Reddy Bandaru, Srikanth Puli, Vikramaditya Samala Venkata, Advait Vasavada, Rupak Desai

Abington Jefferson Health Papers

Background: Pulmonary hypertension (PH) can lead to cardiac failure, thereby signif- icantly affecting life expectancy and quality of life. Due to inadequate disease surveillance and risk assessment, clinical challenges persist despite advances in diagnosis and treatment. We aimed to review the potential of high-sensitivity cardiac troponin (hs-cTn) as a biomarker for predicting outcomes in PH patients. Methods: A thorough examination of the PubMed and Google Scholar databases was conducted through March 2023. Studies involving adult PH patients and hsTn as a prognostic indicator of outcomes such as mortality, hospitalization, and disease progression were included, after screening their titles and abstracts. …

Comparative Outcomes Of Transcatheter Versus Surgical Aortic Valve Replacement In Elderly Patients With Severe Symptomatic Aortic Stenosis: A Systematic Review, Omar Hamodat, Saif Almuzainy, Salma Nizar

Journal of the Saudi Heart Association

Objectives: Aortic stenosis is the most common valvular heart disease globally; while transcatheter aortic valve replacement (TAVR) has proven to be a competitive alternative to surgical aortic valve replacement (SAVR) and revolutionized treatment, its safety and efficacy has yet to be comprehensively assessed against SAVR for certain subsets of aortic stenosis patients; therefore, this study aims to systematically analyze all the available clinical evidence from randomized clinical trials on TAVR versus SAVR among intermediate and low-risk patients with severe symptomatic aortic stenosis.

Methodology: We performed a systematic review of the randomized controlled trials (RCT), studies comparing TAVR and …

Soprano: Macitentan In Patients With Pulmonary Hypertension Following Left Ventricular Assist Device Implantation, Robert P. Frantz, Shashank S. Desai, Gregory Ewald, Veronica Franco, Antoine Hage, Evelyn M. Horn, Shane J. Larue, Michael A. Mathier, Stacy Mandras, Myung H. Park, Ashwin K. Ravichandran, Joel D. Schilling, I-Wen Wang, Ronald Zolty, Gabriela Gomez Rendon, Mark A. Rocco, Mona Selej, Carol Zhao, J. Eduardo Rame

Jefferson Hospital Staff Papers and Presentations

Macitentan is a dual endothelin receptor antagonist (ERA) approved for treating pulmonary arterial hypertension (PAH). SOPRANO evaluated the efficacy and safety of macitentan versus placebo in pulmonary hypertension (PH) patients after left ventricular assist device (LVAD) implantation. SOPRANO was a phase 2, multicenter, double-blind, randomized, placebo-controlled, parallel-group study. Patients with an LVAD implanted within the prior 90 days who had persistent PH (i.e., mean pulmonary arterial pressure ≥25 mmHg, pulmonary artery wedge pressure [PAWP] ≤18 mmHg, and pulmonary vascular resistance [PVR] >3 Wood units [WU]) were randomized (1:1) to macitentan 10 mg or placebo once daily for 12 weeks. The …

Meta-Analysis Comparing Oral Anticoagulant Monotherapy Versus Dual Antithrombotic Therapy In Patients With Atrial Fibrillation And Stable Coronary Artery Disease, Mushood Ahmed, Areeba Ahsan, Aimen Shafiq, Raheel Ahmed, Mahboob Alam, Pierre Sabouret, Jamal S Rana, Gregg C Fonarow

Faculty, Staff and Students Publications

BACKGROUND: Oral anticoagulants (OACs) are routinely used for the management of atrial fibrillation (AF) while antiplatelet agents are used in coronary artery disease (CAD). However, data regarding the comparative clinical outcomes of OAC monotherapy versus dual antithrombotic therapy (anticoagulant plus antiplatelet agent) in patients with AF and stable CAD are limited.

METHODS: A comprehensive search of major databases including PubMed/MEDLINE, Cochrane Library, and Embase was performed from inception to September 1, 2024 to identify randomized control trials (RCTs) that compared OAC monotherapy with dual antithrombotic therapy in patients with AF and stable CAD. The risk ratios (RRs) were estimated with …

Multicohort Epigenome-Wide Association Study Of All-Cause Cardiovascular Disease And Cancer Incidence: A Cardio-Oncology Approach, Arce Domingo-Relloso, Angela L Riffo-Campos, Naisi Zhao, Guillermo Ayala, Karin Haack, Carlos Manterola, Dorothy A Rhoades, Jason G Umans, M Daniele Fallin, Miguel Herreros-Martinez, Marina Pollan, Eric Boerwinkle, Elizabeth A Platz, Miranda R Jones, Jan Bressler, Roby Joehanes, Calen P Ryan, Juan R Gonzalez, Daniel Levy, Daniel W Belsky, Shelley A Cole, Dominique S Michaud, Ana Navas-Acien, Maria Tellez-Plaza

Faculty, Staff and Student Publications

BACKGROUND: Emerging evidence reveals a complex relationship between cardiovascular disease (CVD) and cancer, which share common risk factors and biological pathways.

OBJECTIVES: The aim of this study was to evaluate common epigenetic signatures for CVD and cancer incidence in 3 ethnically diverse cohorts: Native Americans from the SHS (Strong Heart Study), European Americans from the FHS (Framingham Heart Study), and European Americans and African Americans from the ARIC (Atherosclerosis Risk In Communities) study.

METHODS: A 2-stage strategy was used that included first conducting untargeted epigenome-wide association studies for each cohort and then running targeted models in the union set of …

Metagenomic Study Of The Mesa: Detection Of Gemella Morbillorum And Association With Coronary Heart Disease, Kent D Taylor, Alexis C Wood, Jerome I Rotter, Xiuqing Guo, David M Herrington, W Craig Johnson, Wendy S Post, Russell P Tracy, Stephen S Rich, Shaista Malik

Faculty, Staff and Students Publications

BACKGROUND: Inflammation is a feature of coronary heart disease (CHD), but the role of proinflammatory microbial infection in CHD remains understudied.

METHODS AND RESULTS: CHD was defined in the MESA (Multi-Ethnic Study of Atherosclerosis) as myocardial infarction (251 participants), resuscitated arrest (2 participants), and CHD death (80 participants). We analyzed sequencing reads from 4421 MESA participants in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine program using the PathSeq workflow of the Genome Analysis Tool Kit and a 65-gigabase microbial reference. Paired reads aligning to 840 microbes were detected in >1% of participants. The association of the …

Blood Pressure During Hospital Stay For Delivery And Risk For Postpartum Readmission For Hypertension, Kaitlyn Taylor, Sai S. Pochana, Andrew Chapple, Maureen Dempsey, Elizabeth F. Sutton

School of Medicine Faculty Publications

OBJECTIVE: To evaluate the association of changes in peripartum blood pressure (BP) with risk for postpartum readmission for hypertension. METHODS: We conducted a retrospective cohort study of birthing individuals delivering from January 1, 2017, to March 1, 2020, in Louisiana. We identified patients with postpartum readmission for hypertension (readmission within 30 days of delivery) and compared BP and clinical and sociodemographic characteristics with those of patients who were not readmitted for hypertension. Patients were also grouped by their BP at both admission for delivery and 36 hours postpartum: systolic below 130 mm Hg and diastolic below 80 mm Hg, systolic …

Prevalence Of Cardiometabolic Risk Factors In Women: Insights From The Houston Heartreach Study, Arjun R Raghuram, Matthew W Segar, Stephanie Coulter, Joseph G Rogers

The Texas Heart Institute Journal

BACKGROUND: Cardiovascular disease is the leading cause of death among women in the United States. Past research has highlighted the importance of the relationship between female-specific demographics and traditional risk factors. The present analysis aimed to identify the prevalence of modifiable risk factors in women attending a community cardiovascular health screening.

METHODS: Data collected between 2011 and 2019 were obtained from the Houston HeartReach Registry. Participants were classified as having or not having each of 4 traditional cardiometabolic risk factors: hypertension, diabetes, body mass index indicating overweight or obesity, and dyslipidemia. Differences in prevalence were compared using the Pearson χ2 …

Which Endocrine Disorder Does This Ecg Suggest?, Muhammad Mohsin Zafar, Muhammad Asad Hanif

Transformative Medicine

No abstract provided.

Thrombectomy For Stroke With Large Infarct On Noncontrast Ct: The Tesla Randomized Clinical Trial, Writing Committee For The Tesla Investigators, Albert J Yoo, Osama O Zaidat, Sunil A Sheth, Ansaar T Rai, Santiago Ortega-Gutierrez, Curtis A Given, Syed F Zaidi, Ramesh Grandhi, Hugo Cuellar, Maxim Mokin, Jeffrey M Katz, Amer Alshekhlee, Muhammad A Taqi, Sameer A Ansari, Adnan H Siddiqui, Nobl Barazangi, Joey D English, Alberto Maud, Jawad Kirmani, Rishi Gupta, Dileep R Yavagal, Jason Tarpley, Dhruvil J Pandya, Marshall C Cress, Sushrut Dharmadhikari, Kaiz S Asif, Tareq Kass-Hout, Ajit S Puri, Nazli Janjua, Aniel Q Majjhoo, Aamir Badruddin, Randall C Edgell, Rakesh Khatri, Larry Morgan, Anmar Razak, Alicia Zha, Priyank Khandelwal, Nils Mueller-Kronast, Dennis J Rivet, Thomas Wolfe, Brian Snelling, Ali Sultan-Qurraie, Shao-Pow Lin, Rajkamal Khangura, Alejandro M Spiotta, Parita Bhuva, Sergio Salazar-Marioni, Eugene Lin, Abdul R Tarabishy, Edgar A Samaniego, Murali K Kolikonda, Mouhammad A Jumaa, Vivek K Reddy, Pankaj Sharma, Olvert A Berkhemer, Pieter-Jan Van Doormaal, Adriaan C G M Van Es, Wim H Van Zwam, Bart J Emmer, Ludo F Beenen, Charles B L M Majoie, Nancy Buderer, Michelle A Detry, Anna Bosse, Todd L Graves, Christina Saunders, Lucas Elijovich, Ashutosh Jadhav, Mary Patterson, Hannah Slight, Kristine Below, Sami Al Kasab, Tesla Investigators

Faculty, Staff and Student Publications

Importance: Recent large infarct thrombectomy trials used heterogeneous imaging modalities and time windows for patient selection. Noncontrast computed tomographic (CT) scan is the most common stroke imaging approach. It remains uncertain whether thrombectomy is effective for patients with large infarcts identified using noncontrast CT alone within 24 hours of stroke onset.

Objective: To evaluate the effect of thrombectomy in patients with a large infarct on a noncontrast CT scan within 24 hours of onset.

Design, setting, and participants: Open-label, blinded-end point, bayesian-adaptive randomized trial with interim analyses for early stopping (futility or success) or population enrichment, which was conducted at …

Target Heart Rate Formulas For Exercise Stress Testing: What Is The Evidence?, Omar Almaadawy, Barry F Uretsky, Chayakrit Krittanawong, Yochai Birnbaum

Faculty, Staff and Students Publications

Exercise stress testing (EST) is commonly used to evaluate chest pain, with some labs using 85% of age-predicted maximum heart rate (APMHR) as an endpoint for EST. The APMHR is often calculated using the formula 220-age. However, the accuracy of this formula and 85% APMHR as an endpoint may be questioned. Moreover, failing to reach 85% APMHR (known as chronotropic insufficiency) may also indicate poor cardiovascular prognosis, but measurements, such as percentage heart rate reserve (%HRR), maximum rate pressure product (MRPP), and the maximum metabolic equivalent of tasks (METs) reached during EST may provide better prediction of cardiovascular outcomes than …