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Discrimination cardiovascular

Martin Reindl, Sebastian Johannes Reinstadler, Christina Tiller, Markus Kofler, Markus Theurl, Nora Klier, Katherina Fleischmann, Agnes Mayr, Benjamin Henninger, Gert Klug, Bernhard Metzler
BACKGROUND: The age, creatinine and ejection fraction (ACEF) score has originally been developed for risk stratification of patients undergoing elective cardiac surgery. In patients with stable coronary artery disease treated by percutaneous coronary intervention (PCI), the prognostic accuracy of ACEF could be further improved by modifying the original scoring system (called "modified ACEF" or "ACEF-MDRD"). We aimed to specifically adapt the ACEF score for risk assessment of ST-elevation myocardial infarction (STEMI) patients...
April 6, 2018: International Journal of Cardiology
Partho P Sengupta, Hemant Kulkarni, Jagat Narula
BACKGROUND: Myocardial relaxation is impaired in almost all cases with left ventricular diastolic dysfunction (LVDD) and is a strong predictor of cardiovascular and all-cause mortality. OBJECTIVES: This study investigated the feasibility of signal-processed surface electrocardiography (spECG) as a diagnostic tool for predicting the presence of abnormal cardiac muscle relaxation. METHODS: A total of 188 outpatients referred for coronary computed tomography (CT) angiography underwent an echocardiogram for assessment of LVDD...
April 17, 2018: Journal of the American College of Cardiology
Daniel G K Rasmussen, Tine W Hansen, Bernt J von Scholten, Signe H Nielsen, Henrik Reinhard, Hans-Henrik Parving, Martin Tepel, Morten A Karsdal, Peter K Jacobsen, Federica Genovese, Peter Rossing
OBJECTIVE: Type 2 diabetes is a common risk factor for the development of chronic kidney disease (CKD). Enhanced de novo collagen type VI (COL VI) formation has been associated with renal fibrosis and CKD. We investigated the hypothesis that PRO-C6, a product specifically generated during COL VI formation, is prognostic for adverse outcomes in patients with type 2 diabetes and microalbuminuria. RESEARCH DESIGN AND METHODS: In a prospective, observational study, we measured PRO-C6 in serum ( S -PRO-C6) and urine (U-PRO-C6) of 198 patients with type 2 diabetes and microalbuminuria without symptoms of coronary artery disease...
April 11, 2018: Diabetes Care
Jesse K Fitzpatrick, Beth E Cohen, Andrew Rosenblatt, Richard E Shaw, Nelson B Schiller
Left ventricular (LV) hypertrophy is strongly associated with increased cardiovascular morbidity and mortality. The 2-dimensional LV mass algorithms suffer from measurement variability that can lead to misclassification of patients with LV hypertrophy as normal, or vice versa. Among the 4 echocardiographic measurements required by the 2-dimensional LV mass algorithms, epicardial and endocardial area have the lowest interobserver variation and could be used to corroborate LV mass calculations. We sought cut-off values that are able to discriminate between elevated and normal LV mass based on endocardial or epicardial area alone...
March 13, 2018: American Journal of Cardiology
Wei Cai, Yan Dong, Lu Tian, Chun-Xia Cao, Xiu-Long Niu, Xin-Lin Liu, Jun-Xiang Liu, Wen-Jie Ji, Zhuoli Zhang, Xin Zhou, Yu-Ming Li
OBJECTIVES: To investigate the predictive value of four-dimensional (4D) strain echocardiography for major adverse cardiovascular events (MACE) in ST-elevation acute myocardial infarction (STEMI) patients. METHODS: Consecutive STEMI patients who underwent successful primary coronary interven tion (PCI) were enrolled and followed, with 2D and 4D strain echocardiography performed within 1 week after PCI. RESULTS: Twenty-six first MACE were recorded in 81 patients who finished a ∼3...
April 5, 2018: Cardiology
Stefano Cornara, Gabriele Crimi, Alberto Somaschini, Marco Cattaneo, Dominick J Angiolillo, Tullio Palmerini, Stefano De Servi
Systemic inflammation measured by high-sensitivity C reactive protein (CPR) is associated with increased risk of major adverse cardiovascular events (MACE). Recent clinical trials targeting CPR showed a reduction in MACE after an acute coronary syndrome (ACS). Inflammation could be linked to high platelet reactivity (HPR), which is an independent predictor of MACE in patients with ACS. We aimed to evaluate the impact of 1-month C-reactive Protein (CRP) levels on HPR in patients enrolled in the GEPRESS study...
April 4, 2018: Platelets
Mayank Sardana, Darleen Lessard, Connie W Tsao, Nisha I Parikh, Bruce A Barton, Gregory Nah, Randell C Thomas, Susan Cheng, Nelson B Schiller, Jayashri R Aragam, Gary F Mitchell, Aditya Vaze, Emelia J Benjamin, Ramachandran S Vasan, David D McManus
BACKGROUND: Left atrial (LA) size, a marker of atrial structural remodeling, is associated with increased risk for atrial fibrillation (AF) and cardiovascular disease (CVD). LA function may also relate to AF and CVD, irrespective of LA structure. We tested the hypothesis that LA function index (LAFI), an echocardiographic index of LA structure and function, may better characterize adverse LA remodeling and predict incident AF and CVD than existing measures. METHODS AND RESULTS: In 1786 Framingham Offspring Study eighth examination participants (mean age, 66±9 years; 53% women), we related LA diameter and LAFI (derived from the LA emptying fraction, left ventricular outflow tract velocity time integral, and indexed maximal LA volume) to incidence of AF and CVD on follow-up...
March 30, 2018: Journal of the American Heart Association
Evangelos K Oikonomou, Sofia G Athanasopoulou, Polydoros N Kampaktsis, Damianos G Kokkinidis, Christos A Papanastasiou, Attila Feher, Richard M Steingart, Kevin C Oeffinger, Dipti Gupta
BACKGROUND: Long-term childhood cancer survivors (CCS) are at increased risk of adverse cardiovascular events; however, there is a paucity of risk-stratification tools to identify those at higher-than-normal risk. SUBJECTS, MATERIALS, AND METHODS: This was a population-based study using data from the Surveillance, Epidemiology, and End Results Program (1973-2013). Long-term CCS (age at diagnosis ≤19 years, survival ≥5 years) were followed up over a median time period of 12...
March 28, 2018: Oncologist
Milica Miljković, Aleksandra Stefanović, Nataša Bogavac-Stanojević, Sanja Simić-Ogrizović, Jerka Dumić, Darko Černe, Zorana Jelić-Ivanović, Jelena Kotur-Stevuljević
Inflammation, apoptosis and extracellular remodeling play significant roles in cardiovascular disease (CVD) underlying the major causes of mortality in renal patients. In 19 pre-dialysis patients, 21 dialysis patients and 20 control subjects, the concentrations of pentraxin-3, galectin-3, MMP-9 and TIMP-1 were determined by ELISA. CVD risk was calculated according to the Framingham risk score algorithm. Pentraxin-3 was increased in renal patients compared to healthy controls (p<0.001). In contrast, galectin-3 was reduced in hemodialysis patients compared to pre-dialysis patients and controls (p<0...
December 2017: Acta Clinica Croatica
Shuko Takahashi, Fumitaka Tanaka, Yuki Yonekura, Kozo Tanno, Masaki Ohsawa, Kiyomi Sakata, Makoto Koshiyama, Akira Okayama, Motoyuki Nakamura
BACKGROUND: Several types of cardiovascular diseases (CVDs) impair the physical and mental status. The purpose of this study was to assess the predictive ability of several cardiovascular biomarkers for identifying the incidence of disability as future recipients of public long-term care (LTC) service. METHODS: The subjects of this study were community-dwelling elderly individuals ≥ 65 years of age without a history of CVD (n = 5,755; mean age, 71 years). The endpoint of this study was official certification as a recipient of LTC...
2018: PloS One
Ellie Paige, Jessica Barrett, David Stevens, Ruth H Keogh, Michael J Sweeting, Irwin Nazareth, Irene Petersen, Angela M Wood
The benefits of using electronic health records for disease risk screening and personalized heathcare decisions are becoming increasingly recognized. We present a computationally feasible statistical approach to address the methodological challenges in utilizing historical repeat measures of multiple risk factors recorded in electronic health records to systematically identify patients at high risk of future disease. The approach is principally based on a two-stage dynamic landmark model. The first stage estimates current risk factor values from all available historical repeat risk factor measurements by landmark-age-specific multivariate linear mixed-effects models with correlated random-intercepts, which account for sporadically recorded repeat measures, unobserved data and measurements errors...
March 23, 2018: American Journal of Epidemiology
Stephanie J Frisbee, Sarah S Singh, Dwayne N Jackson, Kent A Lemaster, Samantha A Milde, J Kevin Shoemaker, Jefferson C Frisbee
BACKGROUND: Although the increased prevalence and severity of clinical depression and elevated cardiovascular disease risk represent 2 vexing public health issues, the growing awareness of their combined presentation compounds the challenge. The obese Zucker rat, a model of the metabolic syndrome, spontaneously develops significant depressive symptoms in parallel with the progression of the metabolic syndrome and, thus, represents a compelling model for study. The primary objective was to assess the impact on both cardiovascular outcomes, specifically vascular structure and function, and depressive symptoms in obese Zucker rats after aggressive treatment for cardiovascular disease risk factors with long-term exercise or targeted pharmacological interventions...
March 26, 2018: Journal of the American Heart Association
Richard S Saczkowski, Doug J A Brown, Riyad B Abu-Laban, Guy Fradet, Costas J Schulze, Nick D Kuzak
BACKGROUND: Extra-corporeal life support (ECLS) is a life-saving intervention for patients with hypothermia induced cardiac arrest or severe cardiovascular instability. However, its application is highly variable due to a paucity of data in the literature to guide practice. Current guidelines and recommendations are based on expert opinion, single case reports, and small case series. Combining all of the published data in a patient-level analysis can provide a robust assessment of the influence of patient characteristics on survival with ECLS...
March 23, 2018: Resuscitation
Brent A Williams, Kevin M Chagin, Lori D Bash, William E Boden, Sue Duval, F Gerry R Fowkes, Kenneth W Mahaffey, Mehul D Patel, Ralph B D'Agostino, Eric D Peterson, Michael W Kattan, Deepak L Bhatt, Marc P Bonaca
BACKGROUND AND AIMS: Risk stratification of patients with recent myocardial infarction (MI) for subsequent cardiovascular (CV) events helps identify patients most likely to benefit from secondary prevention therapies. This study externally validated a new risk score (TRS2˚P) for secondary events derived from the TRA2°P-TIMI 50 trial among post-MI patients from two large health care systems. METHODS: This retrospective cohort study included 9618 patients treated for acute MI at either the Cleveland Clinic (CC) or Geisinger Health System (GHS) between 2008 and 2013...
March 16, 2018: Atherosclerosis
Beatriz Villanueva, Antonio Arteaga, Alberto Maiz, Víctor A Cortés
BACKGROUND/OBJECTIVES: Abdominal obesity (AO) is associated with elevated risk for cardiovascular diseases; however, this association is less clear for non-obese people. We estimated the association of AO and cardiovascular risk factors (CVRF) and disease in non-obese adult individuals from Chile. SUBJECTS/METHODS: 5248 adults (15 years of age or older) of both sexes from the Chilean National Health Survey (October 2009 -September 2010, response rate 85%.) were included...
2018: PloS One
Huinan Yang, Chang Zhao, Rong Li, Chengxing Shen, Xiaoshu Cai, Li Sun, Chengfang Luo, Yuechao Yin
A prospective diagnosis method for coronary heart disease (CHD) using human urine based on surface-enhanced Raman spectroscopy (SERS) is proposed, and could provide valuable information for judging whether to perform percutaneous coronary intervention (PCI) in clinics. Here, urine samples from 87 patients with CHD, including patients with PCI before operation (degree of cardiovascular congestion above 70%) and without PCI (degree of cardiovascular congestion under 70%), and 20 healthy humans were measured using SERS...
March 26, 2018: Analyst
Muralidhar R Papireddy, Carl J Lavie, Abhizith Deoker, Hadii Mamudu, Timir K Paul
PURPOSE OF REVIEW: To review the landmark studies in predicting obstructive coronary artery disease (CAD) in symptomatic patients with stable chest pain and identify better prediction tools and propose a simplified algorithm to guide the health care providers in identifying low risk patients to defer further testing. RECENT FINDINGS: There are a few risk prediction models described for stable chest pain patients including Diamond-Forrester (DF), Duke Clinical Score (DCS), CAD Consortium Basic, Clinical, and Extended models...
March 24, 2018: Current Cardiology Reports
Tanja Stojkovic, Elka Stefanova, Ivan Soldatovic, Vladana Markovic, Iva Stankovic, Igor Petrovic, Federica Agosta, Sebastiano Galantucci, Massimo Filippi, Vladimir Kostic
OBJECTIVE: To determine frequency and type of cognitive disorders in cross-sectional analysis of a Parkinson's disease (PD) cohort, and explore its relations to motor symptoms, modifiable vascular risk factors and white matter lesions (WML) volume. METHODS: In a group of 133 PD patients, mild cognitive impairment (PD-MCI) and dementia (PDD) were diagnosed according to Movement Disorders Society Task Force criteria (level 2 for PD-MCI). Detailed motor measurements were applied, including rigidity, axial, bradykinesia, tremor and postural instability gait disorders (PIGD) scores...
March 23, 2018: Journal of Neurology
Chiara Arzilli, Alberto Aimo, Giuseppe Vergaro, Andrea Ripoli, Michele Senni, Michele Emdin, Claudio Passino
Background The Seattle heart failure model or the cardiac and comorbid conditions (3C-HF) scores may help define patient risk in heart failure. Direct comparisons between them or versus N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP) have never been performed. Methods Data from consecutive patients with stable systolic heart failure and 3C-HF data were examined. A subgroup of patients had the Seattle heart failure model data available. The endpoints were one year all-cause or cardiovascular death...
January 1, 2018: European Journal of Preventive Cardiology
Ahmed Bendary, Wael Tawfeek, Mohammed Mahros, Mohamed Salem
BACKGROUND: Left ventricular ejection fraction (LVEF) is fundamental for risk stratification after ST-segment elevation myocardial infarction (STEMI). However, it lacks discrimination power within normal range. Novel echocardiographic deformation parameters may be of benefit for those with post-MI preserved LVEF. OBJECTIVES: We hypothesized that semiautomated calculation of baseline global longitudinal strain (GLS) can identify high-risk group among patients with LVEF ≥ 50% following STEMI...
March 22, 2018: Echocardiography
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