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Primary Prevention CAD

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https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#1
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29754662/rationale-and-design-of-a-trial-to-personalize-risk-assessment-in-familial-coronary-artery-disease
#2
Thomas H Marwick, Kristyn Whitmore, Stephen J Nicholls, Tony Stanton, Geoffrey Mitchell, Andrew Tonkin, Christopher Blizzard, Amanda Neil, Catherine Jones, Gerald F Watts
BACKGROUND: The lifetime risk of coronary artery disease (CAD) is doubled in people with a family history of premature disease, yet this risk is not captured in most 5- or 10-year risk assessment algorithms. Coronary artery calcium scoring (CCS) is a marker of subclinical CAD risk, which has been shown in observational studies to provide prognostic information that is incremental to clinical assessment; is relatively inexpensive; and is performed with a small radiation dose. However, the use of CCS in guiding prevention is not strongly supported by guidelines...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29745255/pannexin-1-channels-on-endothelial-cells-mediate-vascular-inflammation-during-lung-ischemia-reperfusion-injury
#3
Ashish K Sharma, Eric J Charles, Yunge Zhao, Adishesh K Narahari, Pranav K Baderdinni, Miranda E Good, Ulrike M Lorenz, Irving L Kron, Douglas A Bayliss, Kodi S Ravichandran, Brant E Isakson, Victor E Laubach
Ischemia-reperfusion injury (IRI), which involves inflammation, vascular permeability, and edema, remains a major challenge after lung transplantation. Pannexin 1 (Panx1) channels modulate cellular ATP release during inflammation. This study tests the hypothesis that endothelial Panx1 is a key mediator of vascular inflammation and edema after IR and that IRI can be blocked by Panx1 antagonism. A murine hilar ligation model of IRI was utilized whereby left lungs underwent 1 hour of ischemia and 2 hours of reperfusion...
May 10, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29709892/comparing-the-consistency-and-performance-of-various-coronary-heart-disease-prediction-models-for-primary-prevention-using-a-national-representative-cohort-in-taiwan
#4
Kuo-Liong Chien, Hung-Ju Lin, Ta-Chen Su, Yun-Yu Chen, Pei-Chun Chen
BACKGROUND: Predicting future coronary artery disease (CAD) risk by model-based approaches can facilitate identification of high-risk individuals for prevention and management. Therefore, we compared the consistency and performance of various CAD models for primary prevention using 1 external validation dataset from a national representative cohort in Taiwan.Methods and Results:The 10 CAD prediction models were assessed in a validation cohort of 3559 participants (≥35 years old, 53...
April 27, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29655953/risk-factors-predisposing-to-acute-coronary-syndromes-in-young-women-%C3%A2-45-years-of-age
#5
Maciej Bęćkowski, Marek Gierlotka, Mariusz Gąsior, Lech Poloński, Tomasz Zdrojewski, Rafał Dąbrowski, Jarosław Karwowski, Ilona Kowalik, Wojciech Drygas, Hanna Szwed
BACKGROUND: Acute coronary syndromes (ACS) are rare in young women. The purpose of this study was to characterize risk factors (RF) predisposing to ACS in young women and evaluate possible age-related differences. METHODS AND RESULTS: We studied 1941 young women with ACS aged ≤45 years (≤45ACS) from the PL-ACS registry and compared them with two control groups: 4275 women aged 63-64 years with ACS (63-64ACS) from the PL-ACS registry and 1170 young healthy women aged ≤45 years (≤45H) without confirmed coronary artery disease (CAD), from two national, representative, cross-sectional population health surveys, NATPOL 2011 and WOBASZ...
April 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29655952/population-level-incidence-and-outcomes-of-myocardial-infarction-with-non-obstructive-coronary-arteries-minoca-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#6
Kevin R Bainey, Robert C Welsh, Wendimagegn Alemayehu, Cynthia M Westerhout, Dean Traboulsi, Todd Anderson, Neil Brass, Paul W Armstrong, Padma Kaul
BACKGROUND: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a known clinical conundrum with limited investigation. Using a large population-based cohort, we examined the incidence, demographic profile, use of evidence-based medicines (EBM) and clinical outcomes of MINOCA patients. METHODS: Patients hospitalized with a primary diagnosis of MI who underwent coronary angiography between 01/04/2002 and 31/03/2014 in Alberta, Canada, were included in the study...
April 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29521199/exercise-induced-cardioprotection-via-enos-a-putative-role-of-red-blood-cell-signaling
#7
Tatsiana Suvorava, Miriam M Cortese-Krott
Moderate exercise training is a key aspect of primary and secondary prevention strategies. Shear-induced upregulation of eNOS activity and function in the vascular endothelium is considered as one of the main molecular mechanisms of exercise-induced protection against myocardial ischemia/reperfusion (I/R) injury. It has been reported that levels of plasma nitrite, which are largely dependent on eNOS activity, were increased in healthy subjects after acute exercise, while this increase was abolished in coronary artery disease (CAD) patients...
March 6, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29520604/estrogen-therapy-for-osteoporosis-in-the-modern-era
#8
REVIEW
V A Levin, X Jiang, R Kagan
Menopause predisposes women to osteoporosis due to declining estrogen levels. This results in a decrease in bone mineral density (BMD) and an increase in fractures. Osteoporotic fractures lead to substantial morbidity and mortality, and are considered one of the largest public health priorities by the World Health Organization (WHO). It is therefore essential for menopausal women to receive appropriate guidance for the prevention and management of osteoporosis. The Women's Health Initiative (WHI) randomized controlled trial first proved hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women...
May 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29503404/rationale-and-design-of-randomized-evaluation-of-aggressive-or-moderate-lipid-lowering-therapy-with-pitavastatin-in-coronary-artery-disease-real-cad-trial
#9
RANDOMIZED CONTROLLED TRIAL
Katsumi Miyauchi, Takeshi Kimura, Hiroaki Shimokawa, Hiroyuki Daida, Satoshi Iimuro, Hiroshi Iwata, Yukio Ozaki, Ichiro Sakuma, Yoshihisa Nakagawa, Kiyoshi Hibi, Takafumi Hiro, Yoshihiro Fukumoto, Seiji Hokimoto, Yasuo Ohashi, Hiroshi Ohtsu, Yasushi Saito, Masunori Matsuzaki, Ryozo Nagai
Large-scale clinical trials in patients in Western countries with coronary artery disease (CAD) have found that aggressive lipid-lowering therapy using high-dose statins reduces cardiovascular (CV) events further than low-dose statins. However, such evidence has not yet been fully established in Asian populations, including in Japan. The Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study addresses whether intensification of statin therapy improves clinical outcomes in Japanese patients with CAD...
March 30, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29450819/familial-hypercholesterolemia-cascade-screening-in-children-and-relatives-of-the-affected
#10
Nitika Setia, Renu Saxena, J P S Sawhney, Ishwar C Verma
OBJECTIVE: Familial Hypercholesterolemia (FH) is an inherited disorder of lipid metabolism characterized by very high low density lipoprotein (LDL) cholesterol since birth, resulting in premature atherosclerosis and coronary artery disease (CAD). Cascade screening of children and family members of proven FH individuals can identify more subjects who have high LDL cholesterol or the family mutation and appropriate intervention can reduce their risk of atherosclerosis and prevent its complications...
May 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29439299/recurrent-in-stent-restenosis-in-the-area-of-previous-stent-fracture-a-management-dilemma
#11
Udit Bhaskar Bhatnagar, Josh Rezkalla, Tomasz Stys, Adam Stys
Drug eluting stents (DES) have been increasingly being used for treatment of coronary artery disease (CAD) and have been shown to be very effective in prevention of primary in-stent restenosis (ISR). However DES have been increasingly associated with acute to subacute risk of stent fractures (SF). There is also a paucity of data about different management strategies for SF, especially in the long term. We present a case of recurrent ISR in an area of previous acute SF at the touchdown of saphenous venous graft (SVG) to first diagonal artery (D1)...
January 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/29404850/mabal-a-novel-deep-learning-architecture-for-machine-assisted-bone-age-labeling
#12
Simukayi Mutasa, Peter D Chang, Carrie Ruzal-Shapiro, Rama Ayyala
Bone age assessment (BAA) is a commonly performed diagnostic study in pediatric radiology to assess skeletal maturity. The most commonly utilized method for assessment of BAA is the Greulich and Pyle method (Pediatr Radiol 46.9:1269-1274, 2016; Arch Dis Child 81.2:172-173, 1999) atlas. The evaluation of BAA can be a tedious and time-consuming process for the radiologist. As such, several computer-assisted detection/diagnosis (CAD) methods have been proposed for automation of BAA. Classical CAD tools have traditionally relied on hard-coded algorithmic features for BAA which suffer from a variety of drawbacks...
February 5, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29325803/coronary-artery-disease-in-athletes-an-adverse-effect-of-intense-exercise
#13
REVIEW
Hélder Dores, Pedro de Araújo Gonçalves, Nuno Cardim, Nuno Neuparth
Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed...
January 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29325539/chinese-cervicocephalic-artery-dissection-study-ccads-rationale-and-protocol-for-a-multicenter-prospective-cohort-study
#14
Zhu Zhu, Yuyuan Xu, Yilong Wang, Zhenhua Zhou, Xiang Han, Aihua Liu, Jing Peng, Yi Xu, Luyao Wang
BACKGROUND: Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth. Findings from recent studies suggest it a "group of disease entities" with different underlying etiologies, presentations and prognosis, necessitating an integral study including various types of CAD to get a better understanding of this disease. In addition, Chinese patients with CAD are likely to carry different features from their western counterparts, which remains uncertain yet...
January 11, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29319564/genetics-in-the-prevention-and-management-of-coronary-artery-disease
#15
Robert Roberts
PURPOSE OF REVIEW: The current review is to describe the genetic risk variants that have been discovered predisposing to coronary artery disease (CAD) and how they are utilized to stratify for risk of CAD. RECENT FINDINGS: Over 90 genetic risk variants have been discovered that predispose to risk for CAD. SUMMARY: The total genetic risk burden for CAD is proportional to the number of risk variants inherited and can be combined into a single number referred to as the genetic risk score (GRS)...
May 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29281605/trends-in-cardiovascular-risk-profiles
#16
REVIEW
Samir Kapadia
Outcomes for patients with coronary artery disease (CAD) have improved in the past 20 years likely due to advances in clinical care such as angiotensin-converting enzyme inhibitors, antiplatelet agents, and reduced time to cardiac cauterization procedures. But how have the risk factors for CAD changed in the past 2 decades? Analysis of nearly 4,000 patients with ST-elevation myocardial infarction (STEMI) at a tertiary care center found that patients presenting with acute STEMI are younger and more obese than in the past...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29018039/the-ocean-lifeguard-drowning-prevention-paradigm-how-and-where-do-lifeguards-intervene-in-the-drowning-process
#17
William Koon, Ali Rowhani-Rahbar, Linda Quan
Drowning is a global health problem that can be addressed with multiple strategies including utilisation of lifeguards in recreational swim areas. However, few studies have described lifeguard prevention activities. We conducted a retrospective analysis using lifeguard activity data collected in real time with a Computer-Aided-Dispatch (CAD) system to characterise the nature of lifeguard primary and secondary drowning prevention at a popular ocean beach in California. Preventative actions constituted the majority (232 065/423 071; 54...
October 10, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28986061/adverse-cardiovascular-outcomes-in-atrial-fibrillation-validation-of-the-new-2mace-risk-score
#18
Marija Polovina, Dijana Đikić, Ana Vlajković, Matej Vilotijević, Ivan Milinković, Milika Ašanin, Miodrag Ostojić, Andrew J S Coats, Petar M Seferović
BACKGROUND: In addition to thromboembolism, atrial fibrillation (AF) may also predispose to major adverse cardiovascular events (MACE) attributable to coronary artery disease (CAD), including myocardial infarction (MI). The 2MACE score (2 points - Metabolic syndrome and Age≥75years, 1 point - MI/revascularization, Congestive heart failure/ejection-fraction <40%, and thrombo-Embolism) was recently proposed to help identify AF patients at risk of MACE. We assessed the predictive validity of the 2MACE score for MACE occurrence in AF patients free of CAD at baseline...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28974431/adenovirotherapy-delivering-cytokine-and-checkpoint-inhibitor-augments-car-t-cells-against-metastatic-head-and-neck-cancer
#19
Amanda Rosewell Shaw, Caroline E Porter, Norihiro Watanabe, Kiyonori Tanoue, Andrew Sikora, Stephen Gottschalk, Malcolm K Brenner, Masataka Suzuki
In solid tumors, chimeric antigen receptor (CAR)-modified T cells must overcome the challenges of the immunosuppressive tumor microenvironment. We hypothesized that pre-treating tumors with our binary oncolytic adenovirus (CAd), which produces local oncolysis and expresses immunostimulatory molecules, would enhance the antitumor activity of HER2-specific CAR T cells, which alone are insufficient to cure solid tumors. We tested multiple cytokines in conjunction with PD-L1-blocking antibody and found that Ad-derived IL-12p70 prevents the loss of HER2...
November 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28965093/quantifying-sociodemographic-and-income-disparities-in-medical-therapy-and-lifestyle-among-symptomatic-patients-with-suspected-coronary-artery-disease-a-cross-sectional-study-in-north-america
#20
Joseph A Ladapo, Adrian Coles, Rowena J Dolor, Daniel B Mark, Lawton Cooper, Kerry L Lee, Jonathan Goldberg, Michael D Shapiro, Udo Hoffmann, Pamela S Douglas
OBJECTIVES: To evaluate potential gaps in preventive medical therapy and healthy lifestyle practices among symptomatic patients with suspected coronary artery disease (CAD) seeing primary care physicians and cardiologists and how gaps vary by sociodemographic characteristics and baseline cardiovascular risk. DESIGN: Cross-sectional study assessing potential preventive gaps. PARTICIPANTS: 10 003 symptomatic outpatients evaluated by primary care physicians, cardiologists or other specialists for suspected CAD...
September 29, 2017: BMJ Open
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