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Coronary Artery Disease: HELP
Articles from Vermont
Based on 67 articles published since 2008
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These are the 67 published articles about Coronary Artery Disease that originated from Vermont during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial Recognizing excellence in coronary artery disease: the Sobel Distinguished Scholarship Award. 2018

Dauerman, Harold L. ·Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #29394185.

ABSTRACT: -- No abstract --

2 Editorial The Sobel Distinguished Scholar in Coronary Artery Disease. 2017

Dauerman, Harold L. ·Division of Cardiology, Department of Medicine, University of Vermont, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #28403031.

ABSTRACT: -- No abstract --

3 Editorial Long Lesions, Hard Endpoints, and Intravascular Ultrasound. 2016

Dauerman, Harold L. ·University of Vermont College of Medicine, Burlington, Vermont. Electronic address: harold.dauerman@uvmhealth.org. ·JACC Cardiovasc Interv · Pubmed #27744038.

ABSTRACT: -- No abstract --

4 Editorial The elite scholar in Coronary Artery Disease. 2016

Dauerman, Harold L. ·College of Medicine, University of Vermont, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #26829454.

ABSTRACT: -- No abstract --

5 Editorial Distinguished scholarship in coronary artery disease. 2015

Dauerman, Harold L. ·Department of Medicine, University of Vermont College of Medicine, McClure 1 Cardiology, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #25647367.

ABSTRACT: -- No abstract --

6 Editorial Reconsidering the necessity of aspirin in stable coronary artery disease. 2014

Dauerman, Harold L. ·Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont. Electronic address: harold.dauerman@vtmednet.org. ·J Am Coll Cardiol · Pubmed #25277613.

ABSTRACT: -- No abstract --

7 Review β-Blockers in myocardial infarction and coronary artery disease with a preserved ejection fraction: recommendations, mechanisms, and concerns. 2018

Nambiar, Lakshmi / Meyer, Markus. ·Department of Medicine, Division of Cardiology, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #29432284.

ABSTRACT: β-Blockers are a recommended therapy in patients with acute myocardial infarction and coronary artery disease. β-Blockers markedly and unequivocally reduce mortality in patients with myocardial infarction and coronary artery disease with heart failure and a reduced ejection fraction. However, the mortality effects of β-blockers in patients with a preserved ejection fraction are not established even though they represent the majority of patients with coronary artery disease. In this review, we will assess the evidence basis of the recommendations for β-blockers in the US guidelines and discuss emerging concerns about the use of β-blockers and other heart rate-lowering medications in patients with a preserved ejection fraction that suggest that their long-term adverse outcomes may outweigh their antianginal benefits.

8 Review Meta-Analysis of Individual Patient Data of Sodium Bicarbonate and Sodium Chloride for All-Cause Mortality After Coronary Angiography. 2016

Brown, Jeremiah R / Pearlman, Daniel M / Marshall, Emily J / Alam, Shama S / MacKenzie, Todd A / Recio-Mayoral, Alejandro / Gomes, Vitor O / Kim, Bokyung / Jensen, Lisette O / Mueller, Christian / Maioli, Mauro / Solomon, Richard J. ·The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Community and Family Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Electronic address: jbrown@dartmouth.edu. · The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. · The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Community and Family Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. · Department of Cardiology, Virgen Macarena University Hospital, Seville, Spain. · Hospital São Lucas, PUCRS, Porto Alegre, Rio Grande do Sul, Brazil. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, University Hospital Basel, Petersgraben, Switzerland. · Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. · Fletcher Allen Health Care, University of Vermont School of Medicine, Burlington, Vermont. ·Am J Cardiol · Pubmed #27642111.

ABSTRACT: We sought to examine the relation between sodium bicarbonate prophylaxis for contrast-associated nephropathy (CAN) and mortality. We conducted an individual patient data meta-analysis from multiple randomized controlled trials. We obtained individual patient data sets for 7 of 10 eligible trials (2,292 of 2,764 participants). For the remaining 3 trials, time-to-event data were imputed based on follow-up periods described in their original reports. We included all trials that compared periprocedural intravenous sodium bicarbonate to periprocedural intravenous sodium chloride in patients undergoing coronary angiography or other intra-arterial interventions. Included trials were determined by consensus according to predefined eligibility criteria. The primary outcome was all-cause mortality hazard, defined as time from randomization to death. In 10 trials with a total of 2,764 participants, sodium bicarbonate was associated with lower mortality hazard than sodium chloride at 1 year (hazard ratio 0.61, 95% confidence interval [CI] 0.41 to 0.89, p = 0.011). Although periprocedural sodium bicarbonate was associated with a reduction in the incidence of CAN (relative risk 0.75, 95% CI 0.62 to 0.91, p = 0.003), there exists a statistically significant interaction between the effect on mortality and the occurrence of CAN (hazard ratio 5.65, 95% CI 3.58 to 8.92, p <0.001) for up to 1-year mortality. Periprocedural intravenous sodium bicarbonate seems to be associated with a reduction in long-term mortality in patients undergoing coronary angiography or other intra-arterial interventions.

9 Review Novel oral anticoagulants in the management of coronary artery disease. 2016

McMahon, Sean R / Brummel-Ziedins, Kathleen / Schneider, David J. ·aCardiology Unit, Department of Medicine, Cardiovascular Research Institute bDepartment of Biochemistry, University of Vermont, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #27228186.

ABSTRACT: Despite advances in interventional and pharmacologic therapy, survivors of myocardial infarction remain at an increased risk of subsequent cardiovascular events. Initial pharmacological management includes both platelet inhibition and parenteral anticoagulation, whereas long-term pharmacological therapy relies on antiplatelet therapy for prevention of thrombotic complications. Biomarkers showing ongoing thrombin generation after acute coronary syndromes suggest that anticoagulants may provide additional benefit in reducing cardiovascular events. We review the pharmacokinetics of novel anticoagulants, clinical trial results, the role of monitoring, and future directions for the use of novel oral anticoagulants in the treatment of coronary artery disease. Clinical trials have shown that long-term use of oral anticoagulants decreases the risk of cardiovascular events, but they do so at a cost of an increased risk of bleeding. Future studies will need to identify optimal treatment combinations for selected patients and conditions that address both the appropriate combination of therapy and the appropriate dosage of each agent when used in combination.

10 Review Transition strategies from cangrelor to oral platelet P2Y12 receptor antagonists. 2016

Schneider, David J. ·Cardiology Unit, and Cardiovascular Research Institute, Department of Medicine, University of Vermont, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #26444255.

ABSTRACT: Cangrelor is the first parenteral antagonist of the platelet P2Y12 receptor. This direct-acting antagonist of the platelet P2Y12 receptor should be considered an adjunct to a percutaneous coronary intervention in patients who have not been adequately pretreated with platelet P2Y12 receptor antagonists at the time of the procedure. The use of cangrelor requires transition to an oral platelet P2Y12 receptor antagonist. Transition strategies have been developed on the basis of pharmacologic characteristics of platelet P2Y12 receptor antagonists, results of pharmacodynamic studies, and results from clinical trials. Cangrelor blocks the binding to the platelet P2Y12 receptor of the active metabolite of the thienopyridines, clopidogrel and prasugrel. The active metabolite of thienopyridines is present in blood for a short interval after administration. For this reason, clopidogrel should be administered after cangrelor is stopped. Prasugrel can be administered at the end of the cangrelor infusion or up to 30 min before cangrelor is stopped. Ticagrelor is also a reversible direct-acting antagonist of the platelet P2Y12 receptor. Because there is no interaction between ticagrelor and cangrelor, ticagrelor can be administered before or during the infusion of cangrelor.

11 Review Recent findings of long-chain n-3 polyunsaturated fatty acids (LCn-3 PUFAs) on atherosclerosis and coronary heart disease (CHD) contrasting studies in Western countries to Japan. 2015

Sekikawa, Akira / Doyle, Margaret F / Kuller, Lewis H. ·Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Electronic address: akira@pitt.edu. · Department of Pathology, University of Vermont, Burlington, VA. · Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. ·Trends Cardiovasc Med · Pubmed #25850978.

ABSTRACT: Recent long-term randomized clinical trials (RCTs) of long-chain n-3 polyunsaturated fatty acids (LCn-3 PUFAs) on coronary heart disease (CHD) among high-risk patients conducted in Western countries all failed to show their clinical benefits. In striking contrast, an RCT of LCn-3 PUFAs on CHD conducted in Japan, which is a combination of secondary and primary prevention, showed a significant 19% reduction. Potential reasons for this discrepancy are large differences in doses of LCn-3 PUFAs administered (300-900 mg/day in Western countries vs. 1800 mg/day in Japan) and background dietary intake of LCn-3 PUFAs (<300 mg/day in Western countries vs. >1000 mg/day in Japan). These observations suggest that higher doses of LCn-3 PUFAs than examined in RCTs in Western countries may be cardio-protective. Atherosclerosis is the major underlying cause of CHD. Recent observational studies and an RCT of LCn-3 PUFAs on atherosclerosis in Japan show that LCn-3 PUFAs are anti-atherogenic. In this brief review, we focus on recent epidemiological and clinical findings of LCn-3 PUFAs on atherosclerosis and CHD, contrasting studies in Western countries to those in Japan. We also discuss mechanisms of high-dose LCn-3 PUFAs on atherosclerosis.

12 Review The prognostic importance of weight loss in coronary artery disease: a systematic review and meta-analysis. 2014

Pack, Quinn R / Rodriguez-Escudero, Juan Pablo / Thomas, Randal J / Ades, Philip A / West, Colin P / Somers, Virend K / Lopez-Jimenez, Francisco. ·Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Cardiology, Department of Medicine, Baystate Medical Center, Springfield, MA. · Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN; Department of Medicine, Mount Sinai Medical Center, Miami, FL. · Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN. · Division of Cardiology, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, VT. · Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN. · Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN. Electronic address: Lopez@mayo.edu. ·Mayo Clin Proc · Pubmed #25199859.

ABSTRACT: OBJECTIVE: To assess the prognostic impact of weight loss on clinical outcomes in patients with coronary artery disease (CAD). METHODS: We performed a systematic review and meta-analysis of the prognostic effects of weight loss in patients with CAD on a composite outcome of all-cause mortality, cardiovascular mortality, and major adverse cardiac events considering studies published between January 1, 1964, and August 8, 2013. We considered weight loss "intentional" when it occurred in the presence of programmed therapeutic lifestyle changes and "observational" when no such intervention was specified. RESULTS: We searched 1218 abstracts, of which 12 studies with 14 cohorts met the inclusion criteria. A total of 35,335 patients (mean age, 64 years; 72% male; body mass index [BMI], 30; 3.2 years of follow-up) were included. Overall, weight loss was associated with a greater risk of the composite outcome (relative risk [RR], 1.30; 95% CI, 1.00-1.69; P=.05). However, heterogeneity was high (I(2)=90%) and was substantially explained by weight loss intentionality. Presumed intentional weight loss (4 cohorts) was associated with improved outcomes (RR, 0.67; 95% CI, 0.56-0.80; P<.001), whereas observational weight loss (10 cohorts) was associated with worsened outcomes (RR, 1.62; 95% CI, 1.26-2.08; P<.001; interaction P<.001). CONCLUSION: Whereas observational weight loss is associated with increased adverse cardiovascular events, intentional weight loss is associated with lower clinical events. These results suggest that the underlying mechanism of weight loss (ie, intentional or unintentional) affects its impact on subsequent risk in persons with known CAD.

13 Review New antithrombotic agents for the treatment of coronary artery disease: overview. 2012

Schneider, David J. ·Department of Medicine, Cardiovascular Research Institute, University of Vermont, Colchester, USA. david.schneider@uvm.edu ·Coron Artery Dis · Pubmed #22850479.

ABSTRACT: -- No abstract --

14 Review The treatment of obesity in cardiac rehabilitation. 2010

Ades, Philip A / Savage, Patrick D / Harvey-Berino, Jean. ·University of Vermont College of Medicine, Burlington, 05482, USA. philip.ades@vtmednet.org ·J Cardiopulm Rehabil Prev · Pubmed #20436355.

ABSTRACT: Obesity is an independent risk factor for the development of coronary heart disease (CHD). At entry into cardiac rehabilitation (CR), more than 80% of patients are overweight and more than 50% have the metabolic syndrome. Yet, CR programs do not generally include weight loss programs as a programmatic component and weight loss outcomes in CR have been abysmal. A recently published study outlines a template for weight reduction based on a combination of behavioral weight loss counseling and an approach to exercise that maximized exercise-related caloric expenditure. This approach to exercise optimally includes walking as the primary exercise modality and eventually requires almost daily longer-distance exercise to maximize caloric expenditure. In addition, lifestyle activities such as stair climbing and avoidance of energy-saving devices should be incorporated into the daily routine. Risk factor benefits of weight loss and exercise training in overweight CHD patients are broad and compelling. Improvements in insulin resistance, lipid profiles, blood pressure, clotting abnormalities, endothelial-dependent vasodilatory capacity, and measures of inflammation such as C-reactive protein have all been demonstrated. Cardiac rehabilitation/secondary prevention programs can no longer ignore the challenge of obesity management in CHD patients. Individual programs need to develop clinically effective and culturally sensitive approaches to weight control. Finally, multicenter randomized clinical trials of weight loss in CHD patients with assessment of long-term clinical outcomes need to be performed.

15 Review Coronary revascularization in patients with type 2 diabetes and results of the BARI 2D trial. 2010

Sobel, Burton E. ·Department of Medicine, University of Vermont College of Medicine, University of Vermont, Colchester Research Facility, Colchester, Vermont 05446, USA. burton.sobel@uvm.edu ·Coron Artery Dis · Pubmed #20308880.

ABSTRACT: OBJECTIVES: This Perspective reviews the results of early and contemporary studies evaluating the safety and efficacy of coronary revascularization in patients with diabetes. It also addresses the implications of some of the data in the Bypass Angioplasty Revascularization Investigation in type 2 diabetes (BARI 2D) trial. METHODS: Review of the literature and discussion of the implications of results in the BARI 2D trial. RESULTS: Patients with diabetes benefit from revascularization by coronary thrombolysis, percutaneous transluminal coronary angioplasty, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG). However, with each intervention the benefit is less and the risks and complications are greater than in patients without diabetes. Revascularization for treatment of ST elevation myocardial infarction increases survival. When used for treatment of non-ST elevation myocardial infarction or unstable angina, it does not except in those at very high risk. In patients with chronic, symptomatic coronary artery disease, long-term mortality is comparable after CABG or PCI. However, the incidence of major adverse cardiac events is greater after PCI primarily because of the need for more subsequent revascularization procedures. Both interventions relieve symptoms, but neither improves survival except in patients at high risk. In patients with clinically stable chronic coronary disease, survival after CABG or PCI is comparable with that in patients treated with optimal medical therapy alone. Accordingly, evaluation for revascularization can be deferred until signs and symptoms worsen except in patients at high risk. In patients at high risk survival after promptly implemented CABG is greater than that with optimal medical therapy, especially when the diabetes is being treated with insulin sensitizing agents.

16 Review A perspective on the development of coronary revascularization. 2010

Sobel, Burton E. ·University of Vermont, Burlington, Vermont, USA. burton.sobel@uvm.edu ·Coron Artery Dis · Pubmed #20215966.

ABSTRACT: -- No abstract --

17 Clinical Trial Pharmacodynamic Effects When Clopidogrel is Given Before Cangrelor Discontinuation. 2015

Schneider, David J / Agarwal, Zubin / Seecheran, Naveen / Gogo, Prospero. ·Department of Medicine, Cardiology Unit and Cardiovascular Research Institute, University of Vermont, Burlington, Vermont. ·J Interv Cardiol · Pubmed #26381736.

ABSTRACT: OBJECTIVE: To determine whether initiation of clopidogrel before discontinuation of cangrelor would impact on the recovery of platelet reactivity. BACKGROUND: The active metabolite of clopidogrel cannot bind to P2Y12 when cangrelor occupies the receptor. Pharmacodynamic studies have shown that this interaction is avoided when clopidogrel is given at the end of the cangrelor infusion. We found that antiplatelet effects of another thienopyridine, prasugrel, were apparent when prasugrel was administered 0.5 hour before cangrelor was stopped. METHODS: Platelet function studies (light transmission aggregometry, VerifyNow, and flow cytometry) were performed on blood from patients with stable coronary artery disease who were taking aspirin when a loading dose of clopidogrel (600 mg) was given during a cangrelor infusion (0.5 and 1 hour before cangrelor was stopped). Results were compared with those obtained when clopidogrel was given immediately after cangrelor was stopped. RESULTS: Administration of clopidogrel 0.5 and 1 hour before discontinuation of the cangrelor infusion did not prevent recovery of platelet reactivity more effectively than administration at the end of the infusion. CONCLUSION: Our results support the previously established strategy of administering clopidogrel immediately after discontinuation of cangrelor. Earlier administration increases the recovery of platelet function.

18 Clinical Trial N-terminal pro-B-type natriuretic peptide and stroke risk: the reasons for geographic and racial differences in stroke cohort. 2014

Cushman, Mary / Judd, Suzanne E / Howard, Virginia J / Kissela, Brett / Gutiérrez, Orlando M / Jenny, Nancy S / Ahmed, Ali / Thacker, Evan L / Zakai, Neil A. ·From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.) · Departments of Epidemiology and Medicine, University of Alabama at Birmingham (S.E.J., V.J.H., O.M.G., A.A., E.L.T.) · Department of Neurology, University of Cincinnati, OH (B.K.) · and Department of Medicine, Veterans Affairs Medical Center, Birmingham, AL (A.A.). ·Stroke · Pubmed #24757103.

ABSTRACT: BACKGROUND AND PURPOSE: Improved identification of those at risk of stroke might improve prevention. We evaluated the association of the cardiac function biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) with stroke risk in the 30 239 black and white participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. METHODS: During 5.4 years of follow-up after enrollment in 2003 to 2007, NT-proBNP was measured in baseline blood samples of 546 subjects with incident ischemic stroke and 956 without stroke. RESULTS: NT-proBNP was higher with older age and in those with heart disease, kidney disease, atrial fibrillation, and lower low-density lipoprotein-cholesterol. Adjusting for age, race, sex, income, education, and traditional stroke risk factors, there was an increased risk of stroke across quartiles of NT-proBNP; participants with NT-proBNP in the top versus the bottom quartile had a hazard ratio of 2.9 (95% confidence interval, 1.9-4.5). There was no impact of added adjustment for kidney function and heart failure. Among pathogenetic stroke subtypes, the association was largest for cardioembolic stroke, with a hazard ratio of 9.1 (95% confidence interval, 2.9-29.2). Associations did not differ by age, sex, or race, or after excluding those with baseline heart failure or atrial fibrillation. Predicted stroke risk was more accurate in 27% of participants if NT-proBNP was considered after traditional stroke risk factors (P<0.001). CONCLUSIONS: NT-proBNP was a major independent risk marker for stroke. Considering this and other data for stroke, coronary disease, and atrial fibrillation, the clinical use of NT-proBNP measurement in primary prevention settings should be considered.

19 Clinical Trial Effects on platelet function of a direct acting antagonist of coagulation factor Xa. 2012

Ringwala, Sukit M / Dibattiste, Peter M / Schneider, David J. ·Cardiovascular Unit and Cardiovascular Research Institute, University of Vermont, 111 Colchester Ave, Burlington, VT, 05401, USA. sukit.ringwala@vtmednet.org ·J Thromb Thrombolysis · Pubmed #22528328.

ABSTRACT: Because novel direct acting anticoagulants are being tested in the secondary prevention of cardiovascular events, we assessed potential effects of a direct acting antagonist of Factor Xa on platelet function. Blood from patients with known coronary artery disease who were treated with aspirin but no other antithrombotic agent was spiked in vitro with rivaroxaban alone or in combination with a direct acting P2Y12 antagonist (cangrelor). To limit cofounding effects of anticoagulants and to enable interaction between coagulation factors, blood was anticoagulated only with a specific inhibitor of Factor XIIa, corn trypsin inhibitor. Polymerization of fibrin was prevented with the peptide GPRP. Activation of platelets was determined with the use of flow cytometry in response to lipidated tissue factor, thrombin, the collagen mimetic convulxin, and adenosine diphosphate (ADP). Rivaroxaban inhibited the activation of platelets induced by tissue factor and to a lesser extent activation induced by thrombin, effects that were accentuated when combined with cangrelor. Rivaroxaban did not attenuate convulxin-induced activation of platelets; however, a limited but consistent attenuation of ADP-induced platelet activation was seen with blood anticoagulated with rivaroxaban. Effects of rivaroxaban on ADP-induced platelet activation were not mediated by thrombin, tissue factor, or platelet-leukocyte aggregation. In conclusion, rivaroxaban attenuated in vitro the activation of platelets mediated by thrombin. In light of the pivotal role of thrombin in platelet activation after rupture of an atherosclerotic plaque, rivaroxaban should attenuate platelet activation in vivo, an effect that is accentuated by combination with a P2Y12 antagonist.

20 Article Genome-wide association study of homocysteine in African Americans from the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Coronary Artery Risk in Young Adults study. 2018

Raffield, Laura M / Ellis, Jaclyn / Olson, Nels C / Duan, Qing / Li, Jin / Durda, Peter / Pankratz, Nathan / Keating, Brendan J / Wassel, Christina L / Cushman, Mary / Wilson, James G / Gross, Myron D / Tracy, Russell P / Rich, Stephen S / Reiner, Alex P / Li, Yun / Willis, Monte S / Lange, Ethan M / Lange, Leslie A. ·Department of Genetics, University of North Carolina, Chapel Hill, NC, 27599, USA. laura_raffield@unc.edu. · Department of Genetics, University of North Carolina, Chapel Hill, NC, 27599, USA. · Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, 05405, USA. · Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, 55455, USA. · Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA. · Department of Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, 05405, USA. · Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, 39216, USA. · Department of Biochemistry, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, 05405, USA. · Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA. · Department of Epidemiology, University of Washington, Seattle, WA, 98195, USA. · Department of Biostatistics, University of North Carolina, Chapel Hill, NC, 27599, USA. · Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA. · Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA. ·J Hum Genet · Pubmed #29321517.

ABSTRACT: Homocysteine (Hcy) is a heritable biomarker for CVD, peripheral artery disease, stroke, and dementia. Little is known about genetic associations with Hcy in individuals of African ancestry. We performed a genome-wide association study for Hcy in 4927 AAs from the Jackson Heart Study (JHS), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Coronary Artery Risk in Young Adults (CARDIA) study. Analyses were stratified by sex and results were meta-analyzed within and across sex. In the sex-combined meta-analysis, we observed genome-wide significant evidence (p < 5.0 × 10

21 Article Should Diabetes Be a Contraindication to Bilateral Internal Mammary Artery Grafting? 2018

Iribarne, Alexander / Westbrook, Benjamin M / Malenka, David J / Schmoker, Joseph D / McCullough, Jock N / Leavitt, Bruce J / Weldner, Paul W / DeSimone, Joseph / Kramer, Robert S / Quinn, Reed D / Olmstead, Elaine M / Klemperer, John D / Sardella, Gerald L / Ross, Cathy S / DiScipio, Anthony W / Anonymous491112. ·Department of Surgery, Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: alexander.iribarne@hitchcock.org. · Department of Surgery, Section of Cardiac Surgery, Catholic Medical Center, Manchester, New Hampshire. · Department of Medicine, Section of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. · Department of Surgery, Section of Cardiac Surgery, University of Vermont Medical Center, Burlington, Vermont. · Department of Surgery, Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. · Department of Surgery, Section of Cardiac Surgery, Central Maine Medical Center, Lewiston, Maine. · Department of Surgery, Section of Cardiac Surgery, Maine Medical Center, Portland, Maine. · Department of Surgery, Section of Cardiac Surgery, Eastern Maine Medical Center, Bangor, Maine. · Department of Surgery, Section of Cardiac Surgery, Concord Hospital, Concord, New Hampshire. ·Ann Thorac Surg · Pubmed #29223418.

ABSTRACT: BACKGROUND: This study evaluates the influence of bilateral internal mammary artery (BIMA) versus single internal mammary artery (SIMA) grafting on postoperative morbidity and long-term survival among diabetic patients undergoing coronary artery bypass grafting (CABG). METHODS: A multicenter, retrospective analysis of 47,984 consecutive CABGs performed from 1992 to 2014 at 7 medical centers was conducted. Among the study population, 1,482 CABGs with BIMA were identified, and 1,297 BIMA patients were propensity-matched to 1,297 SIMA patients. The study cohort for this analysis, drawn from matched data, included 430 diabetic patients: 217 SIMA and 213 BIMA. The primary endpoint was long-term survival. Secondary endpoints included postoperative morbidity, length of stay, and in-hospital mortality. RESULTS: The median duration of follow-up was 9.3 (range, 4.3 to 13.9) years. Among propensity-matched diabetic patients, there was no significant difference in age, body mass index, or major baseline comorbidities. The groups were also well matched on the number of diseased coronary arteries and number of distal anastomoses performed. There was no difference in the rate of mediastinitis or sternal dehiscence (p = 0.503) or in-hospital mortality (p = 0.758) between groups. Both groups had a similar median length of stay of 5 (range, 4 to 7) days. Diabetic patients who received a BIMA had significantly improved long-term survival when compared with SIMA patients (hazard ratio 0.75 [95% confidence interval 0.57 to 0.98], p = 0.034). CONCLUSIONS: Among diabetics undergoing CABG, use of BIMA grafting does not result in increased in-hospital morbidity or mortality and confers a long-term survival advantage when compared with SIMA grafting. Thus, diabetic patients should be considered for BIMA grafting more frequently.

22 Article What do we tell patients with coronary artery disease about marijuana use? 2018

Khadanga, Sherrie / Ades, Philip A. ·Department of Medicine, Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington, Vermont, USA. ·Coron Artery Dis · Pubmed #28984637.

ABSTRACT: -- No abstract --

23 Article Adipokines and severity and progression of coronary artery calcium: Findings from the Rancho Bernardo Study. 2017

Larsen, Britta A / Laughlin, Gail A / Cummins, Kevin / Barrett-Connor, Elizabeth / Wassel, Christina L. ·Department of Family Medicine & Public Health, University of California, San Diego, CA, USA. Electronic address: blarsen@ucsd.edu. · Department of Family Medicine & Public Health, University of California, San Diego, CA, USA. · Division of Global Public Health, University of California, San Diego, CA, USA; School of Social Work, San Diego State University, San Diego, CA, USA. · Department of Pathology and Laboratory Medicine, University of Vermont, Berlington, VT, USA. ·Atherosclerosis · Pubmed #28825974.

ABSTRACT: BACKGROUND AND AIMS: Adipokines are known to predict cardiovascular events, yet their association with coronary artery calcium (CAC), a surrogate marker of coronary atherosclerosis and risk factor for cardiovascular disease (CVD), is unclear. We aimed at assessing the association between adipokines and the severity and progression of CAC in healthy older adults, and at exploring potential modification by gender. METHODS: 409 men and women from the Rancho Bernardo Study with no known CVD underwent a chest computed tomography scan to determine baseline CAC severity; 329 returned 4.5 years later for a repeat scan to evaluate CAC progression. Adipokines (IL-6, adiponectin, leptin, and TNF-α) were measured from baseline blood samples. Ordinal linear and logistic regression models were used to determine the association of each adipokine with baseline severity and future progression of CAC. RESULTS: Adjusting for age and sex, IL-6 and leptin were associated with greater odds of increasing CAC severity (OR = 1.63, 95% CI 1.22-2.19; OR = 1.19, 95% CI 0.99-1.43, respectively, per SD). The association with IL-6 remained significant in models further adjusted for lifestyle, body size, CVD risk factors, and body fat distribution. Adiponectin was associated with CAC progression (OR = 0.68, 95% CI 0.51-0.92 in fully adjusted models). This was modified by sex, with protective effects seen for men (OR = 0.57, 95% CI 0.38-0.85), but not for women (OR = 0.93, 95% CI 0.67-1.32; p-for-interaction = 0.04). CONCLUSIONS: IL-6 and leptin predicted greater CAC severity while adiponectin predicted lower odds of CAC progression. More research is needed to explore biological mechanisms, including differences by sex.

24 Article Association of ectopic fat with abdominal aorto-illiac and coronary artery calcification in african ancestry men. 2017

Kuipers, Allison L / Zmuda, Joseph M / Carr, J Jeffrey / Terry, James G / Nair, Sangeeta / Cvejkus, Ryan / Bunker, Clareann H / Patrick, Alan L / Wassel, Christina L / Miljkovic, Iva. ·Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: kuipers@pitt.edu. · Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. · Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA. · Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago. · Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA. ·Atherosclerosis · Pubmed #28651187.

ABSTRACT: BACKGROUND AND AIMS: There is strong evidence that fat accumulating in non-adipose sites, "ectopic fat", is associated with cardiovascular disease (CVD), including vascular calcification. Most previous studies of this association have assessed only a single ectopic fat depot. Therefore, our aim was to assess the association of total, regional, and ectopic fat with abdominal aorto-illiac calcification (AAC) and coronary artery calcification (CAC) in 798 African ancestry men. METHODS: Participants (mean age 62) were from the Tobago Bone Health Study cohort. Adiposity was assessed via clinical examination, dual x-ray absorptiometry, and computed tomography (CT). Ectopic fat depots included: abdominal visceral adipose tissue (VAT), liver attenuation, and calf intermuscular adipose tissue (IMAT). Vascular calcification was assessed by CT and quantified as present versus absent. Associations were tested using multiple logistic regression adjusted for traditional cardiovascular risk factors. Models of ectopic fat were additionally adjusted for total body fat and standing height. RESULTS: All adiposity measures, except VAT, were associated with AAC. Lower liver attenuation or greater calf IMAT was associated with 1.2-1.3-fold increased odds of AAC (p < 0.03 for both), though calf IMAT was a stronger predictor than liver attenuation (p < 0.001) when entered in a single model. No ectopic fat measure was associated with CAC. CONCLUSIONS: Greater adiposity in the skeletal muscle and liver, but not in the visceral compartment, was associated with increased odds of AAC in African ancestry men. These results highlight the potential importance of both quantity and location of adiposity accumulation throughout the body.

25 Article Routine CT angiography to detect severe coronary artery disease prior to transcatheter aortic valve replacement. 2017

Chava, S / Gentchos, G / Abernethy, A / Leavitt, B / Terrien, E / Dauerman, H L. ·University of Vermont Larner College of Medicine, Burlington, VT, USA. · University of Vermont Larner College of Medicine, Burlington, VT, USA. harold.dauerman@uvmhealth.org. · Division of Cardiology, University of Vermont Medical Center, 111 Colchester Avenue, McClure 1, Burlington, VT, 05401, USA. harold.dauerman@uvmhealth.org. ·J Thromb Thrombolysis · Pubmed #28646403.

ABSTRACT: Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis. The analysis was confined to four segments: left main and three proximal to mid major coronaries to maximize myocardial territory at risk. Coronary assessment was performed using standard reconstructed ECG phases from pre-TAVR chest CTA on a Philips 256 iCT scanner. Nearly ¾ of patients were ≥75 years old, 57% were female, half were diabetic and 45% had prior PCI. By ICA, 49% had significant coronary calcification. The incidence of severe proximal to mid vessel CAD by ICA was 39%. Similarly, a third of patients required PCI prior to TAVR. CTA was unable to exclude severe proximal to mid vessel CAD in 88% of patients in all four segments: non-diagnostic CTA readings were mainly due to calcification (60%) or motion artifact (28%). Non-diagnostic coronary CTA readings ranged from 25 to 72% according to segment analyzed: only the left main segment had diagnostic quality CTA in the majority of patients (p < 0.01). PCI is performed frequently prior to TAVR based upon invasive coronary angiographic assessment. Routine chest CTA algorithms do not provide adequate diagnostic information to exclude severe CAD, primarily due to severe coronary calcification in the TAVR population.

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