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Coronary Artery Disease: HELP
Articles from Lebanon
Based on 56 articles published since 2008
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These are the 56 published articles about Coronary Artery Disease that originated from Lebanon during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial Non-invasive imaging in suspected coronary artery disease: Choosing the right test from the first time. 2017

Dakik, Habib A. ·Division of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon. hd01@aub.edu.lb. ·J Nucl Cardiol · Pubmed #27681954.

ABSTRACT: -- No abstract --

2 Editorial Early post-stress LV dyssynchrony: a new marker for significant CAD. 2014

AlJaroudi, Wael. ·Division of Cardiovascular Disease, American University of Beirut Medical Center, Beirut, Lebanon, wa53@aub.edu.lb. ·J Nucl Cardiol · Pubmed #25145634.

ABSTRACT: -- No abstract --

3 Review Current Interventions for the Left Main Bifurcation. 2017

Rab, Tanveer / Sheiban, Imad / Louvard, Yves / Sawaya, Fadi J / Zhang, Jun Jie / Chen, Shao Liang. ·Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: srab@emory.edu. · Division of Cardiology, University of Turin, Turin, Italy. · Divsion of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France. · Division of Cardiology, American University of Beirut, Beirut, Lebanon. · Division of Cardiology, Nanjing Medical University, Nanjing, China. ·JACC Cardiovasc Interv · Pubmed #28473107.

ABSTRACT: Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores. As left main percutaneous coronary intervention gains acceptance, it is imperative to increase awareness for patient selection, risk scoring, intracoronary imaging, vessel preparation, and choice of stenting techniques that will optimize procedural and patient outcomes.

4 Review Review of cardiovascular imaging in the journal of nuclear cardiology in 2016: Part 2 of 2-myocardial perfusion imaging. 2017

Hage, Fadi G / AlJaroudi, Wael A. ·Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. fadihage@uab.edu. · Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. fadihage@uab.edu. · Division of Cardiovascular Medicine, Cardiovascular Imaging, Clemenceau Medical Center, P.O. Box 11-2555, Beirut, Lebanon. ·J Nucl Cardiol · Pubmed #28386817.

ABSTRACT: In 2016, the Journal of Nuclear Cardiology published many high-quality articles. Similar to previous years, we will summarize here a selection of the articles that were published in the Journal in 2016 to provide a concise review of the main advancements that have recently occurred in the field. In the first article of this two-part series we focused on publications dealing with positron emission tomography, computed tomography, and magnetic resonance. This review will place emphasis on myocardial perfusion imaging using single-photon emission-computed tomography summarizing advances in the field including in diagnosis, prognosis, and appropriate use.

5 Review Multi-modality imaging: Bird's eye view from the 2016 American Heart Association Scientific Sessions. 2017

AlJaroudi, Wael A / Lloyd, Steven G / Chaudhry, Farooq A / Hage, Fadi G. ·Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon. · Division of Cardiovascular Medicine, University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA. · Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Cardiovascular Medicine, University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA. fadihage@uab.edu. · Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. fadihage@uab.edu. ·J Nucl Cardiol · Pubmed #28205073.

ABSTRACT: This review summarizes key imaging studies that were presented in the American Heart Association Scientific Sessions 2016 related to the fields of nuclear cardiology, cardiac computed tomography, cardiac magnetic resonance, and echocardiography. This bird's eye view will inform readers about multiple studies from these different modalities. We hope that this general overview will be useful for those that did not attend the conference as well as to those that did since it is often difficult to get exposure to many abstracts at large meetings. The review, therefore, aims to help readers stay updated on the newest imaging studies presented at the meeting.

6 Review Cholesterol efflux capacity of high-density lipoprotein correlates with survival and allograft vasculopathy in cardiac transplant recipients. 2016

Javaheri, Ali / Molina, Maria / Zamani, Payman / Rodrigues, Amrith / Novak, Eric / Chambers, Susan / Stutman, Patricia / Maslanek, Wilhelmina / Williams, Mary / Lilly, Scott M / Heeger, Peter / Sayegh, Mohamed H / Chandraker, Anil / Briscoe, David M / Daly, Kevin P / Starling, Randall / Ikle, David / Christie, Jason / Rame, J Eduardo / Goldberg, Lee R / Billheimer, Jeffrey / Rader, Daniel J. ·Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri, USA. Electronic address: ali.javaheri@wustl.edu. · Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri, USA. · Division of Cardiology, Ohio State University, Columbus, Ohio, USA. · Icahn School of Medicine at Mount Sinai, New York, New York. · Brigham & Women׳s Hospital, Harvard University, Boston, Massachusetts, USA; Department of Medicine and Immunology, American University of Beirut, Beirut, Lebanon. · Brigham & Women׳s Hospital, Harvard University, Boston, Massachusetts, USA. · Children's Hospital Boston, Boston, Massachusetts, USA. · Cleveland Clinic, Cleveland, Ohio, USA. · Department of Biostatistics, Rho Federal Systems Division, Rho, Inc., Chapel Hill, North Carolina, USA. ·J Heart Lung Transplant · Pubmed #27498384.

ABSTRACT: BACKGROUND: Cardiac allograft vasculopathy (CAV) is a major cause of mortality after cardiac transplantation. High-density lipoprotein (HDL) cholesterol efflux capacity (CEC) is inversely associated with coronary artery disease. In 2 independent studies, we tested the hypothesis that reduced CEC is associated with mortality and disease progression in CAV. METHODS: We tested the relationship between CEC and survival in a cohort of patients with CAV (n = 35). To determine whether reduced CEC is associated with CAV progression, we utilized samples from the Clinical Trials in Organ Transplantation 05 (CTOT05) study to determine the association between CEC and CAV progression and status at 1 year (n = 81), as assessed by average change in maximal intimal thickness (MIT) on intravascular ultrasound. RESULTS: Multivariable Cox proportional hazard models demonstrated that higher levels of CEC were associated with improved survival (hazard ratio 0.26, 95% confidence interval 0.11 to 0.63) per standard deviation CEC, p = 0.002). Patients who developed CAV had reduced CEC at baseline and 1-year post-transplant. We observed a significant association between pre-transplant CEC and the average change in MIT, particularly among patients who developed CAV at 1 year (β = -0.59, p = 0.02, R CONCLUSION: Reduced CEC is associated with disease progression and mortality in CAV patients. These findings suggest the hypothesis that interventions to increase CEC may be useful in cardiac transplant patients for prevention or treatment of CAV.

7 Review Waterpipe smoking and risk of coronary artery disease. 2016

Almedawar, Mohamad Musbah / Walsh, Jason Leo / Isma'eel, Hussain A. ·aVascular Medicine Program, American University of Beirut Medical Centre, Beirut, Lebanon bDivision of Vascular Endothelium and Microcirculation, Department of Medicine III, TU Dresden, Dresden, Germany *Mohamad Musbah Almedawar and Jason Leo Walsh contributed equally to the writing of this article. ·Curr Opin Cardiol · Pubmed #27428005.

ABSTRACT: PURPOSE OF REVIEW: Smoking tobacco using a water pipe is becoming more prevalent globally, particularly amongst younger populations. In addition to its growing popularity, more evidence is emerging regarding associated harm, and several misconceptions exist concerning the likely adverse health effects of waterpipe smoking (WPS). It is timely, therefore, to examine the body of evidence linking WPS to coronary artery disease (CAD). Here, we review the direct evidence linking WPS to CAD and examine additional, indirect evidence of associated harm. We discuss the clinical and public health implications of the current evidence and provide suggestions for further research. RECENT FINDINGS: A multicentre case-control study in Lebanon has recently demonstrated an association between WPS and CAD. There are few prior studies making this direct link. However, a large body of evidence has emerged showing close similarities between WPS and cigarette smoking with regard to the toxicity of smoke and acute inflammatory and haemodynamic effects following exposure to it. SUMMARY: There are consistent similarities between WPS and cigarette smoking in regard to association with CAD, the nature of the smoke produced, and the acute haemodynamic effects and inflammatory responses that follow exposure. These findings justify both public health and clinical interventions to reduce WPS. Further studies are warranted to confirm a causal association between WPS and CAD.

8 Review The Safety and Benefit of Statins in Liver Cirrhosis: a Review. 2015

Souk, K / Al-Badri, M / Azar, S T. ·Endocrinology and Metabolism, American University of Beirut Medical Center, Beirut, Lebanon. · Internal Medicine, American University of Beirut Medical Center, New York, United States. ·Exp Clin Endocrinol Diabetes · Pubmed #26600051.

ABSTRACT: Dyslipidemia is a primary, major risk factor for coronary artery disease CAD. The prevalence of dyslipidemia had decreased over the past 30 years, which may in part be explained by the steady increase in the use of lipid-lowering drug therapy, especially statins. Cardiovascular risk has been shown to be greater in liver disease (20% in the liver cirrhosis vs. 12% in the general population), where statins can play an important role as a primary and secondary prevention for CAD. Given patients with chronic liver disease, especially liver cirrhosis are at risk of decreased hepatic clearance, there is concern that this patient population may be at higher risk for complications from statin therapy. Several retrospective studies showed that statin use in chronic liver disease and cirrhosis is safe, and even it was associated with lower mortality and lower rate of hepatic decompensation. This review discusses the safety and the different mechanisms where statins can decrease the rate of complications in liver cirrhosis, including portal hypertension, sepsis and the incidence of hepatocellular carcinoma.

9 Article Untargeted Mass Spectrometry Lipidomics identifies correlation between serum sphingomyelins and plasma cholesterol. 2019

Zalloua, Pierre / Kadar, Hanane / Hariri, Essa / Abi Farraj, Layal / Brial, Francois / Hedjazi, Lyamine / Le Lay, Aurelie / Colleu, Alexandre / Dubus, Justine / Touboul, David / Matsuda, Fumihiko / Lathrop, Mark / Nicholson, Jeremy K / Dumas, Marc-Emmanuel / Gauguier, Dominique. ·Lebanese American University, School of Medicine, Beirut, Lebanon. pierre.zalloua@lau.edu.lb. · University Paris Descartes, 15 rue de l'Ecole de Médecine, 75006, Paris, France. pierre.zalloua@lau.edu.lb. · Lebanese American University, Box 36, Byblos, PO, Lebanon. pierre.zalloua@lau.edu.lb. · University Paris Descartes, 15 rue de l'Ecole de Médecine, 75006, Paris, France. · Cordeliers Research Centre, INSERM UMRS 1138, SorbonneUniversity, 15 rue de l'école de médecine, 75006, Paris, France. · Institute of Cardiometabolism and Nutrition, University Pierre & Marie Curie, 91 boulevard de l'Hôpital, 75013, Paris, France. · Lebanese American University, School of Medicine, Beirut, Lebanon. · Institut de Chimie des Substances Naturelles, UPR2301, CNRS, Avenue de la Terrasse, 91198, Gif-sur-Yvette, France. · Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. · McGill University and Genome Quebec Innovation Centre, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada. · Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK. · University Paris Descartes, 15 rue de l'Ecole de Médecine, 75006, Paris, France. dominique.gauguier@crc.jussieu.fr. · Cordeliers Research Centre, INSERM UMRS 1138, SorbonneUniversity, 15 rue de l'école de médecine, 75006, Paris, France. dominique.gauguier@crc.jussieu.fr. · Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. dominique.gauguier@crc.jussieu.fr. · McGill University and Genome Quebec Innovation Centre, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada. dominique.gauguier@crc.jussieu.fr. ·Lipids Health Dis · Pubmed #30711004.

ABSTRACT: BACKGROUND: Lipoproteins are major players in the development and progression of atherosclerotic plaques leading to coronary stenosis and myocardial infarction. Epidemiological, genetic and experimental observations have implicated the association of sphingolipids and intermediates of sphingolipid synthesis in atherosclerosis. We aimed to investigate relationships between quantitative changes in serum sphingolipids, the regulation of the metabolism of lipoproteins (LDL, HDL), and endophenotypes of coronary artery disease (CAD). METHODS: We carried out untargeted liquid chromatography - mass spectrometry (UPLC-MS) lipidomics of serum samples of subjects belonging to a cross-sectional study and recruited on the basis of absence or presence of angiographically-defined CAD, and extensively characterized for clinical and biochemical phenotypes. RESULTS: Among the 2998 spectral features detected in the serum samples, 1328 metabolic features were significantly correlated with at least one of the clinical or biochemical phenotypes measured in the cohort. We found evidence of significant associations between 34 metabolite signals, corresponding to a set of sphingomyelins, and serum HDL cholesterol. Many of these metabolite associations were also observed with serum LDL and total cholesterol levels but not as much with serum triglycerides. CONCLUSION: Among patients with CAD, sphingolipids in the form of sphingomyelins are directly correlated with serum levels of lipoproteins and total cholesterol. Results from this study support the fundamental role of sphingolipids in modulating lipid serum levels, highlighting the importance to identify novel targets in the sphingolipid metabolic pathway for anti-atherogenic therapies.

10 Article Noncardiac Lebanese hospitalized adult patients' awareness of their coronary artery disease risk factors. 2018

Ghaddar, Fatima / Salameh, Pascale / Saleh, Nadine / Farhat, Firas / Chahine, Ramez / Lahoud, Nathalie / Hleyhel, Mira / Zeidan, Rouba K. ·Faculty of Public Health II, Lebanese University, Fanar, Lebanon, psalameh@ul.edu.lb. · National Institute of Public Health, Clinical Epidemiology and Toxicology, Faculty of Public Health, Lebanese University, Fanar, Lebanon, psalameh@ul.edu.lb. · Laboratory of Epidemiological and Clinical Research, Lebanese University, Beirut, Lebanon, psalameh@ul.edu.lb. · Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon. · Faculty of Public Health, La Sagesse University, Beirut, Lebanon. · CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon. ·Vasc Health Risk Manag · Pubmed #30510428.

ABSTRACT: Background: Noncommunicable diseases are the leading cause of death in Lebanon, with cardiovascular diseases accounting for almost half of the annual deaths. Purpose: We aimed to determine awareness of noncardiac Lebanese hospitalized patients for their coronary artery disease risk factors, their level of adherence to medications or lifestyle modifications, and assess factors associated with awareness. Materials and methods: A cross-sectional study was conducted in 14 hospitals with a total of 382 patients. Levels of awareness were evaluated by the comparison of self-report with measurements and laboratory test results. Healthy behaviors and adherence to treatment were evaluated. Factors associated with better awareness were studied using multivariate regressions, while adherence to treatments and healthy lifestyle were described for the different risk factors and in the Framingham Risk Score categories. Results: Our work revealed a moderate-to-high level of awareness (58.7% for overweight/obesity, 75% for hypertension, 85.7% for diabetes, and 86.4% for dyslipidemia) among patients for most cardiovascular risk factors, but a low-to-moderate level of adherence for some interventions such as physical exercise, weight loss, and smoking cessation. Conclusion: The results emphasize on the importance of educational campaigns on healthy habits and screening to improve early diagnosis, increase patients' awareness of their risk factors, and, therefore, optimize primary prevention.

11 Article The effect of completeness of revascularization during CABG with single versus multiple arterial grafts. 2018

Schwann, Thomas A / Yammine, Maroun B / El-Hage-Sleiman, Abdul-Karim M / Engoren, Milo C / Bonnell, Mark R / Habib, Robert H. ·College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio. · Mercy Saint Vincent Medical Center, Toledo, Ohio. · Department of Internal Medicine, Outcomes Research Unit, Vascular Medicine Program, American University of Beirut, Beirut, Lebanon. · Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan. · Society of Thoracic Surgery Research Center, Chicago, Illinois. ·J Card Surg · Pubmed #30216551.

ABSTRACT: INTRODUCTION: Incomplete coronary revascularization is associated with suboptimal outcomes. We investigated the long-term effects of Incomplete, Complete, and Supra-complete revascularization and whether these effects differed in the setting of single-arterial and multi-arterial coronary artery bypass graft (CABG). METHODS: We analyzed 15-year mortality in 7157 CABG patients (64.1 ± 10.5 years; 30% women). All patients received a left internal thoracic artery to left anterior descending coronary artery graft with additional venous grafts only (single-arterial) or with at least one additional arterial graft (multi-arterial) and were grouped based on a completeness of revascularization index (CRI = number of grafts minus the number of diseased principal coronary arteries): Incomplete (CRI ≤ -1 [N = 320;4.5%]); Complete (CRI = 0 [N = 2882;40.3%]; reference group); and two Supra-complete categories (CRI = +1[N = 3050; 42.6%]; CRI ≥ + 2 [N = 905; 12.6%]). Risk-adjusted mortality hazard ratios (AHR) were calculated using comprehensive propensity score adjustment by Cox regression. RESULTS: Incomplete revascularization was rare (4.5%) but associated with increased mortality in all patients (AHR [95% confidence interval] = 1.53 [1.29-1.80]), those undergoing single-arterial CABG (AHR = 1.27 [1.04-1.54]) and multi-arterial CABG (AHR = 2.18 [1.60-2.99]), as well as in patients with 3-Vessel (AHR = 1.37 [1.16-1.62]) and, to a lesser degree, with 2-Vessel (AHR = 1.67 [0.53-5.23]) coronary disease. Supra-complete revascularization was generally associated with incrementally decreased mortality in all patients (AHR [CRI = +1] = 0.94 [0.87-1.03]); AHR [CRI ≥ +2] = 0.74 [0.64-0.85]), and was driven by a significantly decreased mortality risk in single-arterial CABG (AHR [CRI = +1] = 0.90 [0.81-0.99]; AHR [CRI ≥ +2] = 0.64 [0.53-0.78]); and 3-Vessel disease patients (AHR [CRI = +1] = 0.94 [0.86-1.04]; and AHR [CRI ≥ +2] = 0.75 [0.63-0.88]) with no impact in multi-arterial CABG (AHR [CRI = +1] = 1.07 [0.91-1.26]; AHR [CRI ≥ +2] = 0.93 [0.73-1.17]). CONCLUSIONS: Incomplete revascularization is associated with decreased late survival, irrespective of grafting strategy. Alternatively, supra-complete revascularization is associated with improved survival in patients with 3-Vessel CAD, and in single-arterial but not multi-arterial CABG.

12 Article Management of phrenic nerve palsy following cardiac surgery. 2018

El-Masri, Noura / Saj, Fatima / Wehbe, Tarek / Nasrallah, Georges / Ejbeh, Sarkis. ·The Lebanese University School of Medicine, Al-Hadath, Lebanon. · The Lebanese Canadian and The Notre Dame University Hospitals, Department of Hematology, Jounieh, Lebanon. · The Notre Dame University Hospital, Chief of Cardiothoracic Anesthesia, Jounieh, Lebanon. · The Notre Dame University Hospital, Chief of Cardiothoracic Surgery, Jounieh, Lebanon. ·J Card Surg · Pubmed #30014534.

ABSTRACT: Phrenic nerve palsy (PNP) is a potential complication of cardiac surgery. It may prolong ventilation and hospitalization and result in significant morbidity and mortality. The diagnosis and management of PNP following cardiac surgery is reviewed.

13 Article Incremental Value of Increasing Number of Arterial Grafts: The Effect of Diabetes Mellitus. 2018

Schwann, Thomas A / El Hage Sleiman, Abdul Karim M / Yammine, Maroun B / Tranbaugh, Robert F / Engoren, Milo / Bonnell, Mark R / Habib, Robert H. ·Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio; Department of Surgery, Mercy Saint Vincent Medical Center, Toledo, Ohio. Electronic address: thomas.schwann@utoledo.edu. · Department of Internal Medicine, Outcomes Research Unit, American University of Beirut, Beirut, Lebanon; Scholars in Health Research Program, American University of Beirut, Beirut, Lebanon. · Department of Surgery, Weill Cornell Medical College, New York, New York. · Department of Surgery, Mercy Saint Vincent Medical Center, Toledo, Ohio; Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan. · Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio. · The Society of Thoracic Surgeons Research Center, Chicago Illinois. ·Ann Thorac Surg · Pubmed #29408243.

ABSTRACT: BACKGROUND: Multiarterial coronary grafting with two arterial grafts leads to improved survival compared with conventional single artery based on left internal thoracic artery to left anterior descending artery and saphenous vein grafts. We investigated whether extending arterial grafting to three or more arterial grafts further improves survival, and whether such a benefit is modified by diabetes mellitus. METHODS: We analyzed 15-year coronary artery bypass graft surgery mortality data in 11,931 patients (age 64.3 ± 10.5 years; 3,484 women [29.2%]; 4,377 [36.7%] with diabetes mellitus) derived from three US institutions (1994 to 2011). All underwent primary isolated left internal thoracic artery to left anterior descending artery grafting with at least two grafts: one artery (n = 6,782; 56.9%); two arteries (n = 3,678; 30.8%); or three or more arteries (n = 1,471; 12.3%). Long-term survival was estimated by Kaplan-Meier methods. Propensity score matching and comprehensive covariate adjustment (Cox regression) were used to derive long-term risk-adjusted hazard ratio (HR) with 95% confidence interval (CI) for increasing number of arterial grafts in the overall cohort and for diabetes and no-diabetes cohorts. RESULTS: Radial artery (94%) and right internal thoracic artery (6%) were used as additional arterial grafts. Multivariate analysis in all patients showed that diabetes was associated with decreased survival (HR 1.43, 95% CI: 1.34 to 53), whereas increasing number of arterial grafts was associated with decreased mortality (one artery HR 1.0 [reference]; two arteries HR 0.87, 95% CI: 0.80 to 0.95; and three arteries HR 0.83, 95% CI: 0.72 to 0.95). Pairwise comparisons also showed an incremental benefit of additional arterial grafts: two arteries versus one artery, HR 0.89 (95% CI: 0.80 to 0.98); and three arteries versus one artery, HR 0.80 (95% CI: 0.68 to 0.94). A three-artery versus two-artery survival advantage trend was also noted, but was not significant in either the overall study cohort (HR 0.90, 95% CI: 0.75 to 1.07), the diabetes cohort (HR 0.79, 95% CI: 0.60 to 1.03), or the no-diabetes cohort (HR 01.00, 95% CI: 0.79 to 1.26). Among diabetes patients, the survival advantage of two arteries versus one artery was modest (HR 0.96, 95% CI: 0.72 to 1.11), whereas it was significant for three arteries versus one artery (HR 0.74, 95% CI: 0.58 to 0.96). Analyses of propensity matched subcohorts were also consistent. CONCLUSIONS: Increasing number of arterial grafts improves long-term survival and supports extended use of arterial grafts in coronary artery bypass graft surgery, irrespective of diabetes status.

14 Article Myocardial infarction masquerading as myocarditis in a patient with factor V Leiden: unmasked with MR. 2017

Walsh, Jason Leo / Harris, Benjamin Howell Lole / Gharzuddine, Walid / Isma'eel, Hussain. ·American University of Beirut Medical Center, Beirut, Lebanon. · Department of Oncology, University of Oxford, Oxford, UK. ·BMJ Case Rep · Pubmed #28720694.

ABSTRACT: We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden.This case illustrates the value of MRI in differentiating acute MI from myocarditis when clinical suspicion is low, as in this young patient with atypical chest pain. Further, it demonstrates the value of MRI in detecting previous MIs and reinforces the importance of searching for precipitants of MI in young patients.

15 Article Association analyses based on false discovery rate implicate new loci for coronary artery disease. 2017

Nelson, Christopher P / Goel, Anuj / Butterworth, Adam S / Kanoni, Stavroula / Webb, Tom R / Marouli, Eirini / Zeng, Lingyao / Ntalla, Ioanna / Lai, Florence Y / Hopewell, Jemma C / Giannakopoulou, Olga / Jiang, Tao / Hamby, Stephen E / Di Angelantonio, Emanuele / Assimes, Themistocles L / Bottinger, Erwin P / Chambers, John C / Clarke, Robert / Palmer, Colin N A / Cubbon, Richard M / Ellinor, Patrick / Ermel, Raili / Evangelou, Evangelos / Franks, Paul W / Grace, Christopher / Gu, Dongfeng / Hingorani, Aroon D / Howson, Joanna M M / Ingelsson, Erik / Kastrati, Adnan / Kessler, Thorsten / Kyriakou, Theodosios / Lehtimäki, Terho / Lu, Xiangfeng / Lu, Yingchang / März, Winfried / McPherson, Ruth / Metspalu, Andres / Pujades-Rodriguez, Mar / Ruusalepp, Arno / Schadt, Eric E / Schmidt, Amand F / Sweeting, Michael J / Zalloua, Pierre A / AlGhalayini, Kamal / Keavney, Bernard D / Kooner, Jaspal S / Loos, Ruth J F / Patel, Riyaz S / Rutter, Martin K / Tomaszewski, Maciej / Tzoulaki, Ioanna / Zeggini, Eleftheria / Erdmann, Jeanette / Dedoussis, George / Björkegren, Johan L M / Anonymous3681104 / Anonymous3691104 / Anonymous3701104 / Schunkert, Heribert / Farrall, Martin / Danesh, John / Samani, Nilesh J / Watkins, Hugh / Deloukas, Panos. ·Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. · National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK. · Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK. · Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK. · MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. · NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. · William Harvey Research Institute, Barts &the London Medical School, Queen Mary University of London, London, UK. · Centre for Genomic Health, Queen Mary University of London, London, UK. · German Heart Center Munich, Clinic at Technische Universität München and Deutsches Zentrum für Herz- und Kreislauferkrankungen (DZHK), partner site Munich Heart Alliance, Munich, Germany. · CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UK. · Department of Medicine, Stanford University School of Medicine, Stanford, California, USA. · Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Department of Epidemiology and Biostatistics, Imperial College London, London, UK. · Department of Cardiology, Ealing Hospital, London North West Healthcare NHS Trust, Southall, UK. · Imperial College Healthcare NHS Trust, London, UK. · Molecular and Clinical Medicine, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK. · Pharmacogenomics Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK. · Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. · Cardiac Arrhythmia Service and Cardiovascular Research Center, Broad Institute of Harvard and Massachusetts Institute of Technology, Boston, Massachusetts, USA. · Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia. · Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. · Department of Clinical Sciences, Genetic &Molecular Epidemiology Unit, Lund University Diabetes Center, Skåne University Hospital, Lund University, Malmö, Sweden. · Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA. · Department of Public Health and Clinical Medicine, Unit of Medicine, Umeå University, Umeå, Sweden. · State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. · Institute of Cardiovascular Science, University College London,London, UK. · Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA. · Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. · Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. · Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. · Medical Clinic V (Nephrology, Rheumatology, Hypertensiology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. · Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany. · Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. · Estonian Genome Center, University of Tartu, Tartu, Estonia. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · Clinical Gene Networks AB, Stockholm, Sweden. · Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Lebanese American University, School of Medicine, Beirut, Lebanon. · Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. · Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. · Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. · Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. · Cardiovascular Science, National Heart and Lung Institute, Imperial College London, London, UK. · Mindich Child Health Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Farr Institute of Health Informatics, UCL, London, UK. · Bart's Heart Centre, St Bartholomew's Hospital, London, UK. · Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. · Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. · Division of Medicine, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. · Wellcome Trust Sanger Institute, Hinxton, UK. · Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany. · DZHK (German Research Centre for Cardiovascular Research), partner site Hamburg/Lübeck/Kiel, Lübeck, Germany. · University Heart Center Lübeck, Lübeck, Germany. · Department of Nutrition-Dietetics, Harokopio University, Athens, Greece. · Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden. · Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK. · Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia. ·Nat Genet · Pubmed #28714975.

ABSTRACT: Genome-wide association studies (GWAS) in coronary artery disease (CAD) had identified 66 loci at 'genome-wide significance' (P < 5 × 10

16 Article Statin prescription strategies and atherogenic cholesterol goals attainment in Lebanese coronary artery disease patients. 2017

Lama, Soubra / Souraya, Domiati / Youssef, Fattouh. ·Department of Pharmacy Practice, Beirut Arab University, Beirut, Lebanon. l.soubra02@bau.edu.lb. · Department of Pharmacology and Therapeutics, Beirut Arab University, Beirut, Lebanon. · Department of Pharmacy Practice, Beirut Arab University, Beirut, Lebanon. ·Int J Clin Pharm · Pubmed #28523462.

ABSTRACT: Background Current guidelines recommend a low-density lipoprotein cholesterol goal of <1.8 mmol/L (<70 mg/dL) and a non high-density lipoprotein cholesterol (non-HDL-C) goal of <2.6 mmol/L (<00 mg/dL) for coronary artery disease (CAD) patients. Objective This study aimed to describe real-life statin prescription strategies and to assess their effectiveness in terms of LDL-C and non-HDL-C goals attainment in a cohort of CAD patients. Setting Outpatient cardiology specialty clinics located in main Lebanese cities. Methods This is a retrospective crosssectional study. Eligible patients were those who had established CAD, treated with statins and having complete follow-up lipid panel at least 3 months from statin prescription. The following statin prescription strategies were considered in data analysis: prescription of different intensity statin as monotherapy, prescription of a statin in combination with: a low fat diet, another lipid-altering agent and another lipidaltering agent plus a low fat diet. Main outcome measure LDL-C goal attainment for each of the statin prescription strategy. Results Of the 423 CAD statin-treated patients, only 38.5 and 36.6% attained their recommended LDL-C and non-HDL-C goals, respectively. Using a statin in combination with ezetimibe or with another lipid-altering agent plus a low fat diet were significantly associated with LDL-C and non-HDL-C goals attainment. Conclusion Improvement of statin prescription strategies, such as using regular and scheduled dosage of high-intensity statins and combining statin therapy with ezetimibe, is therefore required when managing patients with CAD.

17 Article First and second generation DESs reduce diabetes adverse effect on mortality and re-intervention in multivessel coronary disease: 9-Year analysis. 2017

Badour, Sanaa A / Dimitrova, Kamellia R / Kanei, Yumiko / Tranbaugh, Robert F / Hajjar, Mark M / Kabour, Ameer / Schwann, Thomas A / Alam, Samir / Badr, Kamal / Habib, Robert H. ·Department of Internal Medicine, Vascular Medicine Program and Outcomes Research Unit, American University of Beirut, Lebanon. · Divisions of Cardiology, Mount Sinai Beth Israel Medical Center, New York, NY, USA. · Cardiothoracic Surgery, Mount Sinai Beth Israel Medical Center, New York, NY, USA. · Division of Cardiology, Mercy Saint Vincent Medical Center, Toledo, OH, USA. · Department of Surgery, University of Toledo College of Medicine, Toledo, OH, USA. · Department of Internal Medicine, Vascular Medicine Program and Outcomes Research Unit, American University of Beirut, Lebanon. Electronic address: rh106@aub.edu.lb. ·Cardiovasc Revasc Med · Pubmed #28314676.

ABSTRACT: BACKGROUND/PURPOSE: Diabetes portends an increased risk of adverse early and late outcomes in patients undergoing PCI. In this study, we aimed to investigate if the adverse effect of diabetes mellitus (DM) on early and late PCI outcomes is reduced with drug-eluting (DES) compared to bare-metal (BMS) stents. METHODS/MATERIALS: We reviewed the Mount Sinai Beth Israel Hospital first PCI experience for multivessel coronary artery disease (CAD, 1998-2009). Patients were excluded if they had single-vessel CAD, emergency, no stent, prior bypass graft or myocardial infarction <24h. Diabetes-effect was derived from 9-year all-cause mortality and re-intervention risk-adjusted hazard ratios [AHR (95% confidence intervals)] for DES (N=2679; 48% three-vessel; 39% DM) and BMS (N=2651; 40% three-vessel; 33% DM) and then stratified based on stent (DES/BMS) and vessel disease (two/three). RESULTS: Diabetes-effect on mortality was lower for DES (AHR CONCLUSIONS: Our analysis of a large real-world PCI series indicates that diabetes is associated with worse 9-year mortality irrespective of stent type, albeit this is mitigated to varying degrees with DES, particularly in DES2 and in case of 2-vessel disease. A complementary stent-effect analysis confirmed DES-to-BMS and DES2-to-DES1 superiority in both diabetics and non-diabetics.

18 Article Snuggle T and protrusion (S-TAP) technique for coronary bifurcation stenting: A step-by-step angiographic and illustration demonstration. 2017

Dahdouh, Ziad / Fadel, Bahaa M / Roule, Vincent / Sarkis, Antoine / Grollier, Gilles. ·Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Interventional Cardiology, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: ziad_dahdouh@hotmail.com. · Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. · Department of Interventional Cardiology, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France. · Department of Cardiology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon. ·Cardiovasc Revasc Med · Pubmed #28254257.

ABSTRACT: T and small protrusion (TAP) is a stenting technique that is utilized for the management of coronary bifurcation lesions when using a two-stent strategy. This technique is also useful whenever stenting of a main vessel (MV) jeopardizes a side branch (SB) or when a sub-optimal result is encountered in a daughter vessel after starting with one-stent approach. The conversion from one-stent strategy to TAP could be achieved smoothly and often leads to good results. Technically, optimal positioning of the SB stent to achieve the required protrusion into the lumen of the MV remains a challenge. Toward that goal we propose an added step that involves inflating a balloon in the MV to serve as an anvil with simultaneous pullback of the SB stent, to be followed by stent deployment. We refer to this approach as the snuggle T and protrusion (S-TAP) technique owing to close contact between the SB stent and the MV balloon during simultaneous inflation. In this manuscript, we detail this interventional technique and provide a demonstrative case study.

19 Article Coronary Artery Bypass Graft Surgery Using the Radial Artery, Right Internal Thoracic Artery, or Saphenous Vein as the Second Conduit. 2017

Tranbaugh, Robert F / Schwann, Thomas A / Swistel, Daniel G / Dimitrova, Kamellia R / Al-Shaar, Laila / Hoffman, Darryl M / Geller, Charles M / Engoren, Milo / Balaram, Sandhya K / Puskas, John D / Habib, Robert H. ·Department of Cardiovascular Surgery, Mount Sinai Beth Israel, New York, New York. Electronic address: rft9008@med.cornell.edu. · Division of Cardiothoracic Surgery, University of Toledo Medical Center, Toledo, Ohio. · Division of Cardiothoracic Surgery, Mount Sinai St. Luke's, New York, New York. · Department of Cardiovascular Surgery, Mount Sinai Beth Israel, New York, New York. · Outcomes Research Unit and Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon. · Division of Anesthesia, Mercy Saint Vincent Medical Center, Toledo, Ohio. ·Ann Thorac Surg · Pubmed #28215422.

ABSTRACT: BACKGROUND: It is not clear whether radial artery (RA), right internal thoracic artery (RITA), or saphenous vein (SV) is the preferred second bypass graft during coronary artery bypass graft surgery using the left internal thoracic artery (LITA) in patients aged less or greater than 70 years. METHODS: Late survival data were collected for 13,324 consecutive, isolated, primary coronary artery bypass graft surgery patients from three hospitals. Cox regression analysis was performed on all patients grouped by age. RESULTS: Adjusted Cox regression showed overall better RA versus SV survival (hazard ratio [HR] 0.82, p < 0.001) and no difference in RITA versus SV survival (HR 0.95, p = 0.35). However, the survival benefit of RA versus SV was seen only in patients aged less than 70 years (HR 0.77, p < 0.001); and RITA patients aged less than 70 years also had a survival benefit compared with SV (HR 0.86, p = 0.03). There was no difference in survival for RA versus RITA across all ages. CONCLUSIONS: For patients aged less than 70 years, the optimal grafting strategy is using either RA or RITA as the second preferred graft. In patients aged 70 years or more, RA and RITA grafting should be used selectively. Multiple arterial grafting using either RA or RITA should be more widely utilized during coronary artery bypass graft surgery for patients less than 70 years of age.

20 Article No Association of Coronary Artery Disease with X-Chromosomal Variants in Comprehensive International Meta-Analysis. 2016

Loley, Christina / Alver, Maris / Assimes, Themistocles L / Bjonnes, Andrew / Goel, Anuj / Gustafsson, Stefan / Hernesniemi, Jussi / Hopewell, Jemma C / Kanoni, Stavroula / Kleber, Marcus E / Lau, King Wai / Lu, Yingchang / Lyytikäinen, Leo-Pekka / Nelson, Christopher P / Nikpay, Majid / Qu, Liming / Salfati, Elias / Scholz, Markus / Tukiainen, Taru / Willenborg, Christina / Won, Hong-Hee / Zeng, Lingyao / Zhang, Weihua / Anand, Sonia S / Beutner, Frank / Bottinger, Erwin P / Clarke, Robert / Dedoussis, George / Do, Ron / Esko, Tõnu / Eskola, Markku / Farrall, Martin / Gauguier, Dominique / Giedraitis, Vilmantas / Granger, Christopher B / Hall, Alistair S / Hamsten, Anders / Hazen, Stanley L / Huang, Jie / Kähönen, Mika / Kyriakou, Theodosios / Laaksonen, Reijo / Lind, Lars / Lindgren, Cecilia / Magnusson, Patrik K E / Marouli, Eirini / Mihailov, Evelin / Morris, Andrew P / Nikus, Kjell / Pedersen, Nancy / Rallidis, Loukianos / Salomaa, Veikko / Shah, Svati H / Stewart, Alexandre F R / Thompson, John R / Zalloua, Pierre A / Chambers, John C / Collins, Rory / Ingelsson, Erik / Iribarren, Carlos / Karhunen, Pekka J / Kooner, Jaspal S / Lehtimäki, Terho / Loos, Ruth J F / März, Winfried / McPherson, Ruth / Metspalu, Andres / Reilly, Muredach P / Ripatti, Samuli / Sanghera, Dharambir K / Thiery, Joachim / Watkins, Hugh / Deloukas, Panos / Kathiresan, Sekar / Samani, Nilesh J / Schunkert, Heribert / Erdmann, Jeanette / König, Inke R. ·Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. · DZHK (German Centre for Cardiovascular Research), partner site Hamburg-Lübeck-Kiel, Lübeck, Germany. · Estonian Genome Center, University of Tartu, Tartu, Estonia. · Institute of Molecular and Cell Biology, Tartu, Estonia. · Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine Stanford, Standford, California, USA. · Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA. · Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK. · Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK. · Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden. · Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland. · Department of Cardiology, Heart Hospital and University of Tampere School of Medicine, Tampere, Finland. · CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UK. · William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. · Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. · The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, USA. · Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere, Finland. · Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. · NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK. · Ruddy Canadian Cardiovascular Genetics Centre University of Ottawa Heart Institute, Ottawa, Canada. · Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Institute for Medical Informatics, Statistics and Epidemiology/Medical Faculty/University of Leipzig, Leipzig, Germany. · LIFE Research Center of Civilization Diseases, Leipzig, Germany. · Analytic and Translation Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA. · Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA. · Institut für Integrative und Experimentelle Genomik, Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany and University Heart Center Luebeck, Campus Lübeck, Lübeck, Germany. · Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Korea. · Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. · DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, München, Germany. · Department of Epidemiology and Biostatistics, Imperial College London, London, UK. · Department of Cardiology, Ealing Hospital National Health Service (NHS) Trust, Middlesex, UK. · Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. · Heart Center Leipzig, Cardiology, University of Leipzig, Leipzig, Germany. · Harokopio University Athens, Athens, Greece. · The Center for Statistical Genetics, Icahn School of Medicine at Mount Sinai, New York, USA. · The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, USA. · The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. · INSERM, UMRS1138, Centre de Recherche des Cordeliers, Paris, France. · Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, Uppsala, Sweden. · Duke University School of Medicine, Durham, North Carolina, USA. · Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, UK. · Cardiovascular Genetics and Genomics Group, Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. · Cleveland Clinic, Cleveland, Ohio, USA. · Boston VA Research Institute, Inc., Boston, Massachusetts, USA. · Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland. · Department of Clinical Physiology, University of Tampere School of Medicine, Tampere, Finland. · Zora Biosciences, Espoo, Finland. · Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden. · Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Department of Biostatistics, University of Liverpool, Liverpool, UK. · Second Department of Cardiology, University General Hospital Attikon, Athens, Greece. · Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. · Department of Health Sciences, University of Leicester, Leicester, UK. · Lebanese American University, School of Medicine, Beirut, Lebanon. · Harvard School of Public Health, Boston, Massachusetts, USA. · Imperial College Healthcare NHS Trust, London, UK. · Kaiser Permanente, Division of Research, Oakland, California, USA. · Department of Forensic Medicine, University of Tampere School of Medicine, Tampere, Finland. · Cardiovascular Science, National Heart and Lung Institute, Imperial College London, London, UK. · The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Synlab Academy, Synlab Services GmbH, Mannheim, Germany. · Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. · Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Hjelt Institute, University of Helsinki, Helsinki, Finland. · Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland. · Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. · Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. · Oklahoma Center for Neuroscience, Oklahoma City, Oklahoma, USA. · Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Medical Faculty, Leipzig, Germany. · Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK. · Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia. · Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA. ·Sci Rep · Pubmed #27731410.

ABSTRACT: In recent years, genome-wide association studies have identified 58 independent risk loci for coronary artery disease (CAD) on the autosome. However, due to the sex-specific data structure of the X chromosome, it has been excluded from most of these analyses. While females have 2 copies of chromosome X, males have only one. Also, one of the female X chromosomes may be inactivated. Therefore, special test statistics and quality control procedures are required. Thus, little is known about the role of X-chromosomal variants in CAD. To fill this gap, we conducted a comprehensive X-chromosome-wide meta-analysis including more than 43,000 CAD cases and 58,000 controls from 35 international study cohorts. For quality control, sex-specific filters were used to adequately take the special structure of X-chromosomal data into account. For single study analyses, several logistic regression models were calculated allowing for inactivation of one female X-chromosome, adjusting for sex and investigating interactions between sex and genetic variants. Then, meta-analyses including all 35 studies were conducted using random effects models. None of the investigated models revealed genome-wide significant associations for any variant. Although we analyzed the largest-to-date sample, currently available methods were not able to detect any associations of X-chromosomal variants with CAD.

21 Article Antithrombotic Medication Use and Misuse Among Patients with Intracranial Hemorrhage: A 16-Year, Lebanese, Single-Center Experience. 2016

Fahed, Elie / Ghauche, Jessica / Rahme, Ralph / Okais, Nabil / Samaha, Elie / Nohra, Georges / Rizk, Tony / Maarrawi, Joseph / Menassa-Moussa, Lina / Moussa, Ronald. ·Department of Neurosurgery, Hôtel-Dieu de France, Saint-Joseph University, Beirut, Lebanon. · Department of Radiology, Hôtel-Dieu de France, Saint-Joseph University, Beirut, Lebanon. · Department of Neurosciences, Virginia Commonwealth University School of Medicine - Inova Campus, Falls Church, Virginia, USA. · Department of Neurosurgery, Hôtel-Dieu de France, Saint-Joseph University, Beirut, Lebanon. Electronic address: ronald_moussa@hotmail.com. ·World Neurosurg · Pubmed #27521729.

ABSTRACT: OBJECTIVE/BACKGROUND: The use of antithrombotic medication (ATM) frequently is reported in patients with intracranial hemorrhage (ICH) and is associated with increased mortality. Unfortunately, ATMs sometimes are prescribed and/or used inappropriately. We sought to determine the rate of ATM misprescription/misuse among patients with ICH in a single-center retrospective study. METHODS: All patients admitted with ATM-related ICH in 1998-2014 were included. Charts were reviewed and demographic, clinical, and radiologic variables were recorded. The type of ATM, dose, and duration of treatment were analyzed critically. The adequacy of ATM prescription/use was assessed in light of the recommendations and guidelines of the American Heart Association, American Stroke Association, and French National Authority for Health, in effect at the time of admission. RESULTS: A total of 106 patients with mean age 68 years were identified. Aspirin (53.8%) was the most commonly used drug, followed by oral anticoagulants (31.1%) and clopidogrel (22.6%). In only 80 patients (75.5%), the use of ATM was in line with contemporary guidelines. In the remaining 26 (24.5%), the use of ATMs was inappropriate, including bad drug combination, wrong dose, poor indication, wrong drug class, and/or incorrect treatment duration. CONCLUSIONS: In this Lebanese cohort of patients with ICH, the 24.5% rate of ATM misprescription and/or misuse is highly alarming and the origin of this problem is likely multifactorial. Immediate measures should be undertaken, and efforts should be focused on regaining tight control of ATM prescription and fulfillment, ensuring good patient education, and offering more vigilant oversight on physician licensure.

22 Article Effects of Blood Transfusion on Cause-Specific Late Mortality After Coronary Artery Bypass Grafting-Less Is More. 2016

Schwann, Thomas A / Habib, Joseph R / Khalifeh, Jawad M / Nauffal, Victor / Bonnell, Mark / Clancy, Christopher / Engoren, Milo C / Habib, Robert H. ·Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio; Mercy Saint Vincent Medical Center, Toledo, Ohio. · Department of Internal Medicine, Outcomes Research Unit and Vascular Medicine Program, American University of Beirut, Beirut, Lebanon. · Department of Internal Medicine, Outcomes Research Unit and Vascular Medicine Program, American University of Beirut, Beirut, Lebanon; Department of Medicine, Johns Hopkins Medical Institutes, Baltimore, Maryland. · Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio. · Mercy Saint Vincent Medical Center, Toledo, Ohio; Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan. · Department of Internal Medicine, Outcomes Research Unit and Vascular Medicine Program, American University of Beirut, Beirut, Lebanon. Electronic address: rh106@aub.edu.lb. ·Ann Thorac Surg · Pubmed #27344276.

ABSTRACT: BACKGROUND: Red blood cell transfusion after coronary artery bypass graft surgery has been associated with increased late all-cause death. Yet, whether this association is, first, independent of the packed red blood cells and perioperative morbidity association, and second, of a cardiac versus noncardiac etiology remains unknown. METHODS: We analyzed patients undergoing coronary artery bypass graft surgery at two Ohio hospitals (n = 6,947) from 1994 to 2007. Salvage operations and patients with preoperative renal failure were excluded. Long-term outcomes and leading cause of death (cardiac, noncardiac, all cause) were derived from the US Social Security Death Index and later from Ohio Department of Health Death Index. Fifteen-year mortality cumulative incidence functions were compared for transfusion groups (yes, n = 2,540; no, n = 4,806) overall, and then stratified based on perioperative complications status (yes, n = 2,638; no, n = 4,708). Comprehensive, 32 covariates, risk-adjusted transfusion effects were estimated by competing risk regression. Results were confirmed by propensity score adjusted analysis. RESULTS: Perioperative transfusions and complications occurred in 33.9% and 35.2% of patients, respectively. In all, 3,108 deaths (48.1%) have been documented (median time to death, 7.43 years). Both transfusion rates (25.6% versus 49.1%, p < 0.001) and deaths (58.2% versus 38.5%, p < 0.001) were more frequent among complications patients. Red blood cells transfusion increased intermediate to late mortality risk overall (15-year adjusted hazard ratio [AHR] 1.21, 95% confidence interval [CI]: 1.11 to 1.31), and for complications (AHR 1.24, 95% CI: 1.11 to 1.39) and no complications (AHR 1.16, 95% CI: 1.03 to 1.31). The increased mortality was true for cardiac and noncardiac etiologies (AHR 1.19, 95% CI: 1.03 to 1.36, and AHR 1.14, 95% CI: 1.01 to 1.29, respectively). Red blood cell transfusion increased mostly cardiac deaths (AHR 1.38, 95% CI: 1.14 to 1.66) among the complications group, and noncardiac mortality (AHR 1.24, 95% CI: 1.05 to 1.47) for the no complications group. A parallel propensity matched sensitivity analysis confirmed these findings. CONCLUSIONS: Perioperative red blood cells transfusion is associated with significant adverse late death effects among both complicated patients and noncomplicated patients, principally seen between 0 and 5 years postoperatively, and is driven by both increased cardiovascular and noncardiovascular mortality. Further studies are needed to elucidate the mechanisms behind these findings, including their potential dose dependence.

23 Article The reproducibility and prognostic value of serial measurements of heart rate response to regadenoson during myocardial perfusion imaging. 2016

Andrikopoulou, Efstathia / AlJaroudi, Wael A / Farag, Ayman / Lester, Davis / Patel, Hiren / Iskandrian, Ami E / Hage, Fadi G. ·Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. · Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. · Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon. · Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. fadihage@uab.edu. · Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. fadihage@uab.edu. · University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1720 2nd AVE S, Birmingham, AL, 35294, USA. fadihage@uab.edu. ·Eur J Nucl Med Mol Imaging · Pubmed #27079736.

ABSTRACT: PURPOSE: The heart rate response (HRR, percentage change from baseline) to regadenoson during myocardial perfusion imaging (MPI) can provide incremental prognostic value in patients with known or suspected coronary artery disease. Our purpose was to evaluate the variability and prognostic value of HRR on serial measurements. METHODS: We studied 648 consecutive patients (61 ± 11 years, 48 % with diabetes) who underwent two regadenoson MPI studies (16 ± 9 months between studies). HRR <30 % was defined as abnormal. All-cause mortality was determined by chart review and verified using the US Social Security Death Master File. RESULTS: HRR was well correlated between the two studies (intraclass correlation coefficient 0.72, 95 % CI 0.67 - 0.76) with no systematic bias (mean difference 0.88 %, p = 0.2) or proportional bias (p = 0.5) by Bland-Altman analysis in all patients and in those with normal MPI on both studies. Of the 308 patients (48 %) with normal baseline HRR (HRR-1), 33 % had developed a blunted HRR on the second MPI study (HRR-2). Older age, male gender, end-stage renal disease, and abnormal baseline left ventricular ejection fraction were independent predictors of a new-onset abnormal HRR. During a mean follow-up of 2.4 ± 1.2 years, 55 patients (8.5 %) died. Patients with a blunted HRR-1 had increased mortality risk irrespective of their HRR-2 (p = 0.9, log-rank test). Among patients with normal HRR-1, a blunted HRR-2 was an independent predictor of all-cause mortality beyond clinical and traditional MPI data (hazard ratio 2.83, 95 % CI 1.14 - 7.03). Finally, patients with a normal HRR-1 and HRR-2 had the lowest event rate, while those with any abnormal HRR had an increased risk of death (hazard ratio 2.5, 95 % CI 1.2 - 5.4). CONCLUSION: There was good correlation in the HRR to regadenoson on serial measurements without systematic or proportional biases. Patients with consistently normal HRR had the best prognosis.

24 Article Review of Cardiovascular Imaging in the Journal of Nuclear Cardiology in 2015-Part 2 of 2: Myocardial perfusion imaging. 2016

Hage, Fadi G / AlJaroudi, Wael A. ·Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, UK. · Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, UK. · Division of Cardiovascular Medicine, Cardiovascular Imaging, Clemenceau Medical Center, P.O.Box 11-2555, Beirut, Lebanon. wjaroudi@hotmail.com. ·J Nucl Cardiol · Pubmed #26892251.

ABSTRACT: In 2015, the Journal of Nuclear Cardiology (®) published many high-quality articles. In this series, we will summarize key articles that have appeared in the Journal last year to provide for the interested reader a quick review of the advancements that have recently occurred in the field. In the first article of this 2-part series, we concentrated on publications dealing with plaque imaging, cardiac positron emission tomography, computed tomography, and magnetic resonance. This review will focus on myocardial perfusion imaging summarizing advances in the field including in diagnosis, prognosis, and appropriate use.

25 Article Characterizing redescriptions using persistent homology to isolate genetic pathways contributing to pathogenesis. 2016

Platt, Daniel E / Basu, Saugata / Zalloua, Pierre A / Parida, Laxmi. ·Computational Biology Center, IBM T. J. Watson Research Center, 1101 Kitchawan Rd., Yorktown Hgts, 10598, NY, USA. watplatt@us.ibm.com. · Department of Mathematics, Purdue University, 150 N. University St., West Lafayette, 47907, IN, USA. sbasu@math.purdue.edu. · Graduate Studies and Research, Lebanese American University, P.O. Box 13-5053, Chouran Beirut, 1102 2801, Lebanon. pierre.zalloua@lau.edu.lb. · Department of Environmental Health, Harvard University, 401 Park Drive, Boston, MA, USA. pierre.zalloua@lau.edu.lb. · Computational Biology Center, IBM T. J. Watson Research Center, 1101 Kitchawan Rd., Yorktown Hgts, 10598, NY, USA. parida@us.ibm.com. ·BMC Syst Biol · Pubmed #26819062.

ABSTRACT: BACKGROUND: Complex diseases may have multiple pathways leading to disease. E.g. coronary artery disease evolves from arterial damage to their epithelial layers, but has multiple causal pathways. More challenging, those pathways are highly correlated within metabolic syndrome. The challenge is to identify specific clusters of phenotype characteristics (composite phenotypes) that may reflect these different etiologies. Further, GWAS seeking to identify SNPs satisfying multiple composite phenotype descriptions allows for lower false positive rates at lower α thresholds, allowing for the possibility of reducing false negatives. This may provide a window into the missing heritability problem. METHODS: We identify significant phenotype patterns, and identify fuzzy redescriptions among those patterns using Jaccard distances. Further, we construct Vietoris-Rips complexes from the Jaccard distances and compute the persistent homology associated with those. The patterns comprising these topological features are identified as composite phenotpyes, whose genetic associations are explored with logistic regression applied to pathways and to GWAS. RESULTS: We identified several phenotypes that tended to be dominated by metabolic syndrome descriptions, and which were distinct among the combinations of metabolic syndrome conditions. Among SNPs marking the RAAS complex, various SNPs associated specifically with different groups of composite phenotypes, as well as distinguishing between the composite phenotypes and simple phenotypes. Each of these showed different genetic associations, namely rs6693954, rs762551, rs1378942, and rs1133323. GWAS identified SNPs that associated with composite phenotypes included rs12365545, rs6847235, and rs701319. Eighteen GWAS identified SNPs appeared in combinations supported in composite combinations with greater power than for any individual phenotype. CONCLUSIONS: We do find systematic associations among metabolic syndrome variates that show distinctive genetic association profiles. Further, the systematic characterization involves composite phenotype descriptions that allow for combined power of individual phenotype GWAS tests, yielding more significance for lower individual thresholds, permitting the exploration of SNPs that would otherwise show as false negatives.

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