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Risk Reclassification

Suli Huang, Ziquan Lv, Yi Guo, Lu Li, Yanwei Zhang, Li Zhou, Binyao Yang, Shuang Wu, Ying Zhang, Changhui Xie, Shanshan Li, Jinquan Cheng
Circulating microRNAs (miRNAs) are emerging as novel disease biomarkers. Using a miRNA microarray, we previously showed that the whole blood level of let-7e-5p was significantly higher in ischemic stroke patients than in control subjects. However, the association between let-7e-5p expression and the occurrence of ischemic stroke remains unknown. In this study, we validated the expression levels of let-7e-5p in two case-control populations using miRNA TaqMan assays and further investigated the potential targets of let-7e-5p...
2016: PloS One
Aki S Havulinna, Marko Sysi-Aho, Mika Hilvo, Dimple Kauhanen, Reini Hurme, Kim Ekroos, Veikko Salomaa, Reijo Laaksonen
OBJECTIVE: Ceramides are molecular lipids implicated in apoptosis, inflammation, obesity, and insulin resistance. An earlier study reported that ceramides were associated with fatal outcome among patients with coronary heart disease. Here, we examined whether ceramides are associated with major adverse cardiovascular events (MACEs) among apparently healthy individuals. APPROACH AND RESULTS: FINRISK 2002 is a population-based risk factor survey, which recruited men and women aged 25 to 74 years...
October 20, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Fernando Lanas, Pamela Serón, Sergio Muñoz, Paula Margozzini, Teresa Puig
OBJECTIVES: Obesity is an important determinant of cardiovascular risk. However, the optimal measure and cutoffs in Latin America are not defined. We sought to assess the relationship between body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) with risk factor prevalence and estimated coronary heart disease (CHD) risk and to assess if recommended cutoffs apply to the Chilean population. STUDY DESIGN AND SETTING: Data from 2,200 men and 3,216 women from the Chilean Health Survey 2009-2010 were analyzed...
October 17, 2016: Journal of Clinical Epidemiology
Zahir H Alshehry, Piyushkumar A Mundra, Christopher K Barlow, Natalie A Mellett, Gerard Wong, Malcolm J McConville, John Simes, Andrew M Tonkin, David R Sullivan, Elizabeth H Barnes, Paul J Nestel, Bronwyn A Kingwell, Michel Marre, Bruce Neal, Neil R Poulter, Anthony Rodgers, Bryan Williams, Sophia Zoungas, Graham S Hillis, John Chalmers, Mark Woodward, Peter J Meikle
BACKGROUND: -Clinical lipid measurements do not show the full complexity of the altered lipid metabolism associated with diabetes or cardiovascular disease. Lipidomics enables the assessment of hundreds of lipid species as potential markers for disease risk. METHODS: -Plasma lipid species (310) were measured by a targeted lipidomic analysis with liquid chromatography electrospray ionisation-tandem mass spectrometry on a case-cohort (n=3,779) subset from the ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) trial...
October 18, 2016: Circulation
Yoichiro Otaki, Tetsu Watanabe, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Tetsuro Shishido, Takuya Miyamoto, Tsuneo Konta, Yoko Shibata, Hidenori Sato, Ryo Kawasaki, Makoto Daimon, Yoshiyuki Ueno, Takeo Kato, Takamasa Kayama, Isao Kubota
BACKGROUND: Oxidative stress is a major cause of cardiovascular disease. Superoxide dismutase-1 (SOD1) is an antioxidant that protects against oxidative stress. Deoxyribonucleic acid (DNA) variations such as single nucleotide polymorphism (SNP) or haplotypes within the SOD gene are reportedly associated with the development of cardiovascular disease. However, it remains to be determined whether SOD1 variability is associated with cardiovascular or all-cause mortality in the general population...
2016: PloS One
Michael Olsen, Sara Greve, Marie Blicher, Ruan Kruger, Thomas Sehestedt, Susanne Rasmussen, Julie Vishram, Pierre Boutouyrie, Stephane Laurent
OBJECTIVE: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular (CV) risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pressure and previously published equations. The aim of this study was to investigate whether ePWV could predict CV events independently of traditional cardiovascular risk factors and/or cfPWV...
September 2016: Journal of Hypertension
Hong Guo, Fengyu Sun, Ye Tian
OBJECTIVE: The interankle systolic blood pressure (SBP) difference has been found to predict the risk for overall and cardiocerebrovascular events; however, few studies have evaluated the association between the interankle SBP difference and stroke. Our study aimed to determine whether the interankle SBP difference is associated with prevalent stroke in a Chinese adult population. DESIGN AND METHOD: This cross-sectional study included 1485 participants aged ≥35 years in the framework of the China Hypertension Survey...
September 2016: Journal of Hypertension
Eric S Orwoll, Jodi Lapidus, Patty Y Wang, Liesbeth Vandenput, Andrew Hoffman, Howard Fink, Gail A Laughlin, Maria Nethander, Östen Ljunggren, Andreas Kindmark, Mattias Lorentzon, Magnus Karlsson, Dan Mellström, Anthony Kwok, Sundeep Khosla, Timothy Kwok, Claes Ohlsson
Measurement of serum testosterone (T) levels is recommended in the evaluation of osteoporosis in older men and estradiol (E2) and sex hormone binding globulin (SHBG) levels are associated with the rate of bone loss and fractures, but the clinical utility of sex steroid and SHBG measurements for the evaluation of osteoporosis in men has not been examined. To evaluate whether measurements of T, E2 and/or SHBG are useful for the prediction of fracture risk or the rate of bone loss in older men, we analyzed longitudinal data from 5487 community-based men participating in the MrOS Study in the US, Sweden and Hong Kong...
October 18, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Holly Depinet, Karen Copeland, Joseph Gogain, Halim Hennes, Norman A Paradis, Rebecca Andrews-Dickert, Cheryl W Vance, David S Huckins
BACKGROUND: The diagnosis of pediatric acute appendicitis can be difficult. Although scoring systems such as the Pediatric Appendicitis Score (PAS) are helpful, they lack adequate sensitivity and specificity as standalone diagnostics. When used for risk stratification, they often result in large percentages of moderate-risk patients requiring further diagnostic evaluation. METHODS: We applied a biomarker panel (the APPY1 Test) that has high sensitivity and negative predictive value (NPV) to patients with PAS in the moderate-risk range (3-7) and reclassified those patients with a negative result to the low-risk group...
August 10, 2016: American Journal of Emergency Medicine
Kei Mizuno, Takahiro Inoue, Hidefumi Kinoshita, Toshifumi Yano, Hiroaki Kawanishi, Hideki Kanda, Naoki Terada, Takashi Kobayashi, Tomomi Kamba, Yoshiki Mikami, Taizo Shiraishi, Yoshiko Uemura, Yukihiro Imai, Gen Honjo, Tomoyuki Shirase, Kazuhiro Okumura, Mutsushi Kawakita, Keiji Ogura, Yoshiki Sugimura, Tadashi Matsuda, Osamu Ogawa
OBJECTIVE: Active surveillance has emerged as an alternative to immediate treatment in men with favorable-risk prostate cancer; however, consensus about defining the appropriate candidates is still lacking. To examine the factors predicting unfavorable pathology among active surveillance candidates, we assessed low-risk radical prostatectomy specimens. METHODS: This retrospective study included 1753 men who had undergone radical prostatectomy at six independent institutions in Japan from 2005 to 2011...
October 15, 2016: Japanese Journal of Clinical Oncology
Nobuyuki Kagiyama, Hiroyuki Okura, Yuya Matsue, Tomoko Tamada, Koichiro Imai, Ryotaro Yamada, Teruyoshi Kume, Akihiro Hayashida, Yoji Neishi, Kiyoshi Yoshida
BACKGROUND: Various unfavorable echocardiographic findings other than apical ballooning, such as right ventricular involvement, mitral regurgitation, left ventricular outflow tract obstruction, and left ventricular thrombus, occur in takotsubo cardiomyopathy. Occasionally, these findings are observed simultaneously in a single patient. This study was performed to investigate the prevalence and characteristics of patients with multiple unfavorable echocardiographic findings in takotsubo cardiomyopathy and their associations with adverse outcomes...
October 11, 2016: Journal of the American Society of Echocardiography
Ye-Li Wang, Woon-Puay Koh, Jian-Min Yuan, An Pan
AIMS: To assess the association between liver enzymes and the risk of type 2 diabetes (T2D) in a Chinese population. METHODS: A nested case-control study comprising 571 T2D cases and 571 matched controls was conducted within the Singapore Chinese Health Study. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) were quantified in baseline plasma collected from them, while γ-glutamyltransferase (GGT) was assayed among 255 T2D cases with baseline hemoglobin A1c <6...
2016: BMJ Open Diabetes Research & Care
John R Benson, Ismail Jatoi, Masakazu Toi
The heterogeneous nature of ductal carcinoma in situ has been emphasised by data for breast-cancer screening that show substantial increases in the detection of early-stage non-invasive breast cancer but no noteworthy change in the incidence of invasive and distant metastatic disease. Indolent non-progressive forms of ductal carcinoma in situ are managed according to similar surgical strategies as high-risk disease, with extent of resection dictated by radiological and pathological estimates of tumour dimensions...
October 2016: Lancet Oncology
Xiaoqing Bu, Hao Peng, Chongke Zhong, Tan Xu, Tian Xu, Yanbo Peng, Chung-Shiuan Chen, Jinchao Wang, Zhong Ju, Qunwei Li, Deqin Geng, Yingxian Sun, Dongsheng Zhang, Jintao Zhang, Jing Chen, Yonghong Zhang, Jiang He
BACKGROUND AND PURPOSE: Antiphosphatidylserine antibodies (aPS) have been associated with the risk of ischemic stroke. However, it remains unclear whether aPS will influence clinical outcomes in patients with acute ischemic stroke. METHODS: A total of 3013 patients with acute ischemic stroke recruited from 26 hospitals across China from August 2009 to May 2013 were included in the study The primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke...
October 11, 2016: Stroke; a Journal of Cerebral Circulation
Y Su, J Leung, D Hans, B Aubry-Rozier, T Kwok
: The thresholds of trabecular bone score (TBS) require validation for clinical application in older Chinese people. The lower threshold of TBS significantly improved the accuracy of prediction by bone mineral density-based osteoporosis status for major osteoporotic fracture in older Chinese men. INTRODUCTION: Trabecular bone score (TBS) is a relatively new indicator of skeletal fragility. Its clinical application warrants further investigations. Our aim was to validate and recommend practical thresholds of TBS for fracture prediction in older Chinese people...
October 11, 2016: Osteoporosis International
Matthias Heringlake, Efstratios I Charitos, Kira Erber, Astrid Ellen Berggreen, Hermann Heinze, Hauke Paarmann
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is an emerging humoral marker for risk stratification in cardiovascular disease. Cardiac-surgery-associated acute kidney injury (CSA-AKI), an important complication in patients undergoing cardiac surgery, is associated with poor prognosis. The present secondary analysis of an observational cohort study aimed to determine the role of GDF-15 in predicting CSA-AKI compared with the Cleveland-Clinic Acute Renal Failure (CC-ARF) score and a logistic regression model including variables associated with renal dysfunction...
October 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Christian T Ruff, Robert P Giugliano, Eugene Braunwald, Sabina A Murphy, Karen Brown, Petr Jarolim, Michele Mercuri, Elliott M Antman, David A Morrow
Importance: Treatment decisions in atrial fibrillation (AF) are based on clinical assessment of risk. The CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age 65-74 [1 point] or ≥75 years [2 points], diabetes mellitus, and stroke, transient ischemic attack or thromboembolism [2 points]-vascular disease, and sex category [female]) risk score is pragmatic and widely used but has only moderate discrimination. Objective: To develop and test a cardiovascular biomarker score for indication of risk in patients with AF...
October 5, 2016: JAMA Cardiology
Tavia E Evans, Michael J O'Sullivan, Marius de Groot, Wiro J Niessen, Albert Hofman, Gabriel P Krestin, Aad van der Lugt, Marileen L P Portegies, Peter J Koudstaal, Daniel Bos, Meike W Vernooij, M Arfan Ikram
BACKGROUND AND PURPOSE: The presence of subclinical vascular brain disease, including white matter lesions and lacunar infarcts, substantially increases the risk of clinical stroke. White matter microstructural integrity is considered an earlier, potentially better, marker of the total burden of vascular brain disease. Its association with risk of stroke, a focal event, remains unknown. METHODS: From the population-based Rotterdam Study, 4259 stroke-free participants (mean age: 63...
October 4, 2016: Stroke; a Journal of Cerebral Circulation
Pamela L Lutsey, Christina M Parrinello, Jeffrey R Misialek, Andy N Hoofnagle, Clark M Henderson, Thomas J Laha, Erin D Michos, John H Eckfeldt, Elizabeth Selvin
BACKGROUND: Quantifying the variability of biomarkers is important, as high within-person variability can lead to misclassification of individuals. Short-term variability of important markers of vitamin D metabolism is relatively unknown. METHODS: A repeatability study was conducted in 160 Atherosclerosis Risk in Communities study participants (60% female, 28% black, mean age 76 years). Fasting serum was drawn at 2 time points, a median of 6 (range 3-13) weeks apart...
September 30, 2016: Clinical Chemistry
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