American journal of preventive cardiology最新文献

{"title":"VENTRICULAR FIBRILLATION ARREST IN AN ELDERLY FEMALE DUE TO AMIODARONE-INDUCED ACQUIRED LONG-QT SYNDROME","authors":"","doi":"10.1016/j.ajpc.2024.100787","DOIUrl":"10.1016/j.ajpc.2024.100787","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Case Presentation</h3><div>We report the case of a 77-year-old female who presents after a LifeVest defibrillator shock. She had initially presented a month prior with new-onset heart failure and atrial fibrillation with rapid ventricular response. She was diagnosed with tachycardia-mediated cardiomyopathy. After three unsuccessful attempts at cardioversion, she was started on oral amiodarone 400mg twice a day. On discharge, she was prescribed oral amiodarone 200mg daily, along with entresto, metoprolol succinate, and empagliflozin.</div><div>She returned a month later after a shock at home. LifeVest interrogation demonstrated polymorphic ventricular tachycardia (VT)/ventricular fibrillation (VF) with prolonged QTc of 712 msec before VT/VF. Laboratory evaluation on admission within normal limits. Initial EKG showed sinus bradycardia with QTc 630 milliseconds (ms). The patient experienced recurrent TdP, requiring defibrillation three additional times while in the emergency department. Cardiac catheterization showed non-obstructive CAD. Amiodarone was held with improvement in her QTc to 398 ms. She was switched to mexiletine 150 mg TID, remained in sinus rhythm, and was discharged with a dual chamber pacemaker and defibrillator for secondary prevention.</div></div><div><h3>Background</h3><div>Due to age-related electrophysiological and structural changes, elderly individuals face an elevated risk of acquired long-QT syndrome (LQTS). Females are at a higher risk than males, with a 1-3% incidence of amiodarone-induced Torsades de Pointes (TdP). Older women taking amiodarone are especially susceptible to proarrhythmic effects, including QT interval prolongation, which can potentially lead to clinical complications.</div></div><div><h3>Conclusions</h3><div>Amiodarone is frequently utilized to treat atrial fibrillation refractory to cardioversion. However, current guidelines are based on studies conducted mainly on middle-aged men with minimal inclusion of women, especially older women, with a lack of sex-specific analysis and reporting. Women are prone to adverse drug reactions, and these reactions may be more severe due to doses that do not consider body weight differences. This can result in higher plasma levels and potential overdosage in women compared to men. Personalizing treatment by identifying sex differences in dosing, efficacy, and safety of cardiovascular drugs may help reduce the rate of adverse effects.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF CARDIOMETABOLIC DISORDERS ON THE DIAGNOSIS OF METABOLIC ASSOCIATED FATTY LIVER DISEASE (MAFLD) AMONG HOSPITALIZED PATIENTS: A 5-YEAR RETROSPECTIVE STUDY OF NIS DATABASE BETWEEN 2016-2020.","authors":"","doi":"10.1016/j.ajpc.2024.100785","DOIUrl":"10.1016/j.ajpc.2024.100785","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>Cardiometabolic disorders are health conditions that are associated with increased risk for cardiovascular events and sudden cardiac death in the US. However, only a few studies explored these health conditions on the increasing trend of MAFLD. This study aims to explore the impact of cardiometabolic disorders among patients diagnosed with MAFLD in US hospitals.</div></div><div><h3>Methods</h3><div>We used the NIS data of 2016-2020 period for this cross-sectional study. Our main outcome was MAFLD while predictors were cardiometabolic syndrome (hypertension, diabetes, CKD, dyslipidemia, obesity) with co-variates (race, age, sex). We did descriptive analysis, bivariate and multivariate logistic regressions to identify potential predictors associated with MAFLD.</div></div><div><h3>Results</h3><div>A total of 252,254,979 hospitalized patients were analyzed of which 112,375 patients were hospitalized with principal diagnosis of MAFLD/NAFLD. MAFLD were predominantly diagnosed in females (61.3%), individuals over 45 years (89.4%), white (78.4%), those with obesity (66.2%), without dyslipidemia (55.1%), with metabolic syndrome (98.8%), hypertension (66.2%), diabetes (80.4%) and chronic kidney disease (67.7%). Patients with obesity were two-fold likely to be diagnosed with MAFLD compared to patients with normal BMI. (aOR= 2.319 [95%CI 2.223-2.419], p&lt;.0001). Conversely patients with dyslipidemia were less likely to be diagnosed with MAFLD than those without dyslipidemia. (0.903 [0.870-0.936], p&lt;.0001). Patients with metabolic syndrome were four-fold likely to be diagnosed with MAFLD compared with non-metabolic syndrome patients. (4.353 [3.583-5.289], p&lt;.0001). Patients with hypertension had a marginal likelihood to be diagnosed with MAFLD compared to non-hypertensive patients. (1.044 [1.003-1.086], p=0.0348). Patients with diabetes or CKD were two-fold likely to be diagnosed with MAFLD compared with non-diabetic and non-CKD patients respectively. (2.439 [2.345-2.536], p&lt;.0001), (2.305 [2.206-2.409], p&lt;.0001). Patient of Hispanic descent were more likely to have MAFLD compared with patients of white descents. (1.169 [1.082-1.264], p&lt;.0001), while patients from black and Asian descent were less likely to have MAFLD respectively. (0.235 [0.219-0.251], p&lt;.0001), (0.651 [0.585-0.724], p&lt;.0001)</div></div><div><h3>Conclusions</h3><div>The results of this study contribute to the body of knowledge on the risk and pattern of MAFLD among patients with cardiometabolic disorders, emphasizing the complex interplay between sociodemographic and clinical factors. This further informs lifestyle modification, early detection and treatment of cardiometabolic disorders as preventive strategy for MAFLD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"HIGH AND INFLAMED\" A CURIOUS CASE OF CANNABIS-INDUCED RECURRENT MYOPERICARDITIS","authors":"","doi":"10.1016/j.ajpc.2024.100751","DOIUrl":"10.1016/j.ajpc.2024.100751","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Case Presentation</h3><div>A 27-year-old male with a history of presumed viral myopericarditis in 2021 presented with chest pain. He was found to have elevated troponin but coronary angiography was normal. On an echocardiogram, he was found to have a moderately thickened pericardium without effusion and a preserved LV systolic function. He was treated with indomethacin, prednisone, and colchicine however his symptoms recurred in 2023. An electrocardiogram (EKG) showed ST-segment elevation in I and aVL, with mild elevation across septal leads V2-V4. Troponin is 1.86, CPK of 206, and CRP of 5.5. A repeat echocardiogram revealed LVEF 55% Without pericardial effusion and no wall motion abnormalities. The patient clinically improved and was discharged on indomethacin 50 mg q8h to decrease dose by 25 mg per week, colchicine 0.6 mg bid for six weeks, and prednisone 40 mg for weeks with gradual taper.</div></div><div><h3>Background</h3><div>The United Nations estimated that around 192 million individuals aged 15 to 64 were using cannabis as of 2016(1). Over time, there has been a global trend towards decriminalizing and legalizing recreational cannabis (1). While the immediate impact of cannabis on heart rate is known to occur within 10 to 30 minutes of consumption (2), its long-term effects on cardiovascular health remain less understood due to regulatory constraints (3).</div><div>Emerging research suggests a potential connection between prolonged cannabis use and increased risk of cardiovascular diseases, although the precise mechanisms are not fully elucidated (4,5). Conditions like pericarditis and myocarditis, both heart inflammations, share similar symptoms and are diagnosed based on clinical observations, lab tests, and imaging.</div></div><div><h3>Conclusions</h3><div>Marijuana use has been linked to severe cardiovascular complications, such as myopericarditis. Therefore, healthcare professionals should maintain a high index of suspicion and routinely inquire about marijuana consumption in patients presenting with chest pain. Moreover, there is an apparent demand for further research to ascertain the most efficacious treatment modalities for myopericarditis induced by marijuana usage.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TEMPORAL TRENDS IN LIPOPROTEIN(A) TESTING AMONG UNITED STATES VETERANS FROM 2014-2023","authors":"","doi":"10.1016/j.ajpc.2024.100758","DOIUrl":"10.1016/j.ajpc.2024.100758","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Novel Biomarkers</div></div><div><h3>Background</h3><div>Elevated lipoprotein(a) [Lp(a)] is a genetically-determined, independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Multiple contemporary clinical practice guidelines endorse Lp(a) testing to refine risk stratification for ASCVD and guide clinical decision-making among high-risk patients. Changes in rates of testing and detection of elevated Lp(a) over time have not been well described.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using Veterans Affairs electronic health record data to evaluate temporal trends in Lp(a) testing from January 1, 2014 to December 31, 2023 among United States Veterans. We identified Veterans in each year who had a primary care or cardiology visit, an active medication filled, and no prior Lp(a) testing. We stratified testing rates based on demographic and clinical factors: age, sex, race and ethnicity, history of ASCVD, and neighborhood social vulnerability index (SVI) scores as defined by the Centers for Disease Control. The SVI incorporates variables such as employment, income, crowding, and education, with higher scores suggesting greater vulnerability. We classified elevated Lp(a) levels using three clinically meaningful thresholds: 50 mg/dL, 70 mg/dL and 90 mg/dL.</div></div><div><h3>Results</h3><div>Lp(a) testing increased nationally from 1 test per 10,000 eligible Veterans (558 tests) in 2014 to 9 tests per 10,000 (4,440 tests) in 2023. While testing increased across all groups, prevalent ASCVD was strongly associated with an increase in Lp(a) testing over time (Figure). Rates of testing increased less among those residing in neighborhoods with high social vulnerability compared with low social vulnerability. Rates of testing increased most among Asian Veterans but similarly across other racial and ethnic groups. The percent of elevated tests across clinically meaningful thresholds has remained stable over time.</div></div><div><h3>Conclusions</h3><div>We found a 9-fold increase in Lp(a) testing among US Veterans over the last decade, particularly among those with ASCVD, but the overall rate remains extremely low. The proportion of Veterans with elevated Lp(a) has remained steady, supporting the clinical utility of testing expansion. Efforts to increase testing among Veterans living in neighborhoods with high social vulnerability will be important to reduce emerging disparities as novel therapeutics to target Lp(a) become available.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotyping lipid profiles in type 2 diabetes: Risk association and outcomes from the Cardiovascular Health Study","authors":"","doi":"10.1016/j.ajpc.2024.100725","DOIUrl":"10.1016/j.ajpc.2024.100725","url":null,"abstract":"<div><h3>Aims</h3><p>To determine whether discrete lipid profiles (refer to as lipid phenotyping) can be used to stratify cardiovascular risk in individuals with type 2 diabetes.</p></div><div><h3>Methods and results</h3><p>Cardiovascular Health Study participants with diabetes and fasting lipid profiles at baseline (<em>n</em> = 866) were categorized separately by level of LDL cholesterol and HDL-C/Triglyceride (Tg) profiles (low Tg/high HDL-C; high Tg/low HDL-C; high Tg only or low HDL-C only). We performed Cox multivariate regression analysis to assess the risk of CVD mortality, incident myocardial infarction (MI), heart failure (HF), stroke, and composite MACE (MI, HF, stroke, and CVD mortality) associated with each lipid category. We also calculated risk estimates for MACE using lipid measures as continuous variables. In the fully adjusted model, the high triglyceride plus low HDL-C cholesterol phenotype demonstrated risk that was at least as high as the highest LDL-C sub-group phenotype for CVD mortality (Hazard ratio {HR} 1.58 vs 1.48), MI (HR 1.53 vs 1.58), HF (HR 1.47 vs 1.20), stroke (HR 2.02 vs 1.43), and MACE (HR 1.58 vs 1.38). When modeled continuously, the HR per SD for MACE was 1.12 (<em>p</em> = 0.03) for LDL-C and 1.19–1.20 (<em>p</em> &lt; 0.001) for triglycerides or remnant cholesterol.</p></div><div><h3>Conclusions</h3><p>Participants with the high triglyceride/low HDL-C phenotype had equivalent or higher CVD risk than those with the high LDL-C phenotype. Further studies are necessary to determine whether lipid phenotyping accounts for the substantial CVD risk not explained by LDL cholesterol among individuals with type 2 diabetes.</p></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266666772400093X/pdfft?md5=34ecc037be6eeb164d07124684c133f3&pid=1-s2.0-S266666772400093X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EARLY METABOLIC IMBALANCE IN YOUNG ADULTS HAS VARIABLE IMPACT ON 35-YEAR MORTALITY RISK","authors":"","doi":"10.1016/j.ajpc.2024.100827","DOIUrl":"10.1016/j.ajpc.2024.100827","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>Early metabolic imbalance (EMI) is a hidden condition characterized by compensated insulin resistance, often accompanied by oxidative stress, subclinical inflammation, and hypoxia. Individuals with EMI have fasting glucose, triglycerides, hemoglobin A1c, and high-density lipoprotein cholesterol (HDL-C) values all within normal limits. Thus, EMI is undetected in routine screening for diabetes and cardiovascular risk. Previously, we reported that EMI is an independent risk factor for type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (CVD). <strong>Hypothesis:</strong> EMI in young adults increases the 35-year mortality risk compared with healthy, balanced metabolism.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The parent study began in 1985, enrolling 5,113 young adults ages 18-30, with study visits every five years for 35 years. For this retrospective analysis, the baseline exclusion criteria were fasting hyperglycemia, hypertriglyceridemia, low HDL-C, pregnancy, diabetes, or CVD; n=3,292. Cox proportional hazards regression analysis was performed using Stata 18.0 (StataCorp). The primary exposure variable was EMI, measured as the upper and lower halves of baseline homeostatic model assessment of insulin resistance v.2 (HOMA2-IR). The baseline covariates included other known causes of death. The primary outcome was time-to-incident mortality or censor. Mortality risk was measured as a Cox hazard ratio (HR) with 95% confidence interval (CI) and p-value. Each model met the assumption of proportional hazards.</div></div><div><h3>Results</h3><div>Over the 35-year follow-up period, 280 individuals died for a cumulative incidence of 8.5%. Cox Model 1 incorporated categorical HOMA2-IR (high/low) at baseline. Model 2 included the interaction between HOMA2-IR, sex, and race as a categorical variable (Table 1). Model 3 included the interaction variable from Model 2, along with other causes of death as covariates. As seen in Table 1, the Cox hazard ratios for EMI were modified by sex and race.</div></div><div><h3>Conclusions</h3><div>For young adults in CARDIA, EMI had a variable impact on 35-year mortality. The risk was modified by sex and race, even after adjusting for known risk factors. Further analysis is warranted.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATING MISINFORMATION REGARDING CARDIOVASCULAR DISEASE PREVENTION OBTAINED ON A POPULAR, PUBLICLY ACCESSIBLE ARTIFICIAL INTELLIGENCE MODEL (GPT-4)","authors":"","doi":"10.1016/j.ajpc.2024.100806","DOIUrl":"10.1016/j.ajpc.2024.100806","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Other: Artificial intelligence; Misinformation</div></div><div><h3>Background</h3><div>Misinformation regarding CVD prevention is prevalent on the internet and on social media. Chat-based artificial intelligence (AI) models such as ChatGPT have gained over 100 million users, are publicly accessible, and may provide appropriate information for simple CVD prevention topics. Whether these public AI models may propagate misinformation regarding CVD prevention is uncertain.</div></div><div><h3>Methods</h3><div>This study was performed in March 2024 using the subscription-based version of GPT-4 (OpenAI, USA). Prompts regarding six CVD prevention topics (statin therapy and muscle-side effects, dementia, and liver disease; fish oil; supplements; and low-density lipoprotein-cholesterol and heart disease) were posed. Prompts were framed in two tones: a neutral tone and a misinformation-prompting tone. The misinformation-prompting tone requested specific arguments and scientific references to support misinformation. Each tone and topic was prompted in a different chatbot instance. Each response was reviewed by a board-certified cardiologist specializing in preventive cardiology at a tertiary care center. If a response had multiple bullet-points with individual scientific references, each bullet-point was graded separately. Responses were graded as appropriate (accurate content and references), borderline (minor inaccuracies or references published &gt;20 years ago), or inappropriate (inaccurate content and/or references, including non-existent references).</div></div><div><h3>Results</h3><div>For the six prompts posed with a neutral tone, all responses lacked scientific references and were graded as appropriate (100%). For all six prompts posed with a misinformation-prompting tone, each response consisted of multiple discrete bullet-points with a scientific reference for each individual point. Of 31 bullet-points across the six topics obtained using a misinformation-prompting tone, 32.2% (10/31) were graded as appropriate, 19.4% (6/31) were graded as borderline, and 48.4% (15/31) were graded as inappropriate.</div></div><div><h3>Conclusions</h3><div>In this exploratory study, GPT-4 – a popular and publicly accessible chat-based AI model – was easily prompted to support CVD prevention misinformation. Misinformation-supporting arguments and scientific references were inappropriate due to inaccurate content and/or references nearly 50% of the time. Robust research efforts and policies are needed to study and prevent AI-enabled propagation of misinformation regarding CVD prevention.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF WEIGHT REDUCTION AND METABOLIC PARAMETERS IN HIV COHORT UNDERGOING TREATMENT WITH GLP-1 RECEPTOR AGONISTS AT A LARGE PUBLIC NYC/HHC+ HOSPITAL IN NEW YORK CITY","authors":"","doi":"10.1016/j.ajpc.2024.100788","DOIUrl":"10.1016/j.ajpc.2024.100788","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Obesity</div></div><div><h3>Background</h3><div>Individuals living with HIV who undergo prolonged combined antiretroviral therapy (cART) may experience weight gain as a potential side effect. Many of these individuals are prescribed GLP-1 receptor agonists (RA), which are recognized for their ability to reduce weight. However, there is uncertainty regarding whether cART could serve as a confounding factor, potentially influencing the effectiveness of GLP-1 RA treatment and impeding the attainment of desired outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted, reviewing electronic medical records of 239 HIV-positive patients on GLP-1 RA. After applying criteria, 180 patients were analyzed, all on GLP-1 RA for at least 12 weeks. Multivariate logistic regression was used, assessing weight loss, BMI, HbA1c change, and association between weight loss and cART.</div></div><div><h3>Results</h3><div>Out of 180 participants, 51.67% were male and 48.33% were female, with a mean age of 58.2 (SD +/- 11.09). 82% of participants had diabetes mellitus II type (DMT2). The mean duration of GLP-1 RA treatment was 25.38 months (SD +/- 18.5). Semaglutide was used by 50.5%, liraglutide by 4%, and dulaglutide by 45.5%. Weight gain was observed in 29.4%, weight loss under 5 kg in 34.4%, 5-10 kg loss in 15%, and over 10 kg loss in 21.11%. Mean weight reduction was 2.5 kg (SD +/- 12.5), HbA1c reduction was 1.03% (SD +/- 2.3), and BMI reduction was 0.76 (SD +/- 12.4). No significant association was found between GLP duration and weight reduction. Dolutegravir/Lamivudine showed less weight reduction compared to other cART regimens (OR=0.36, CI 0.13 – 0.97, p=0.044).</div></div><div><h3>Conclusions</h3><div>We observed expected positive outcomes linked to GLP-1 RA use, leading to improvements in the metabolic profiles of individuals living with HIV on cART. Further analysis is needed to investigate the relationship between weight and improvements in metabolic parameters with different cART regimens. Additionally, it's important to examine potential sex and racial disparities in response to GLP-1 RA therapy among people living with HIV on cART.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DISCREPANCIES IN AMI MORTALITY IN THE US SOUTHERN BORDER REGION 1999-2020","authors":"","doi":"10.1016/j.ajpc.2024.100735","DOIUrl":"10.1016/j.ajpc.2024.100735","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD in Special Populations</div></div><div><h3>Background</h3><div>The US-Mexican border region (BR) faces distinct demographic and health challenges. Analyzing premature acute myocardial infarction (AMI) mortality disparities can inform targeted health strategies.</div></div><div><h3>Methods</h3><div>Mortality data for premature AMI (&lt;55y men, &lt;65y women) from 1999-2019 were extracted from CDC death certificate data. ANOVA tests were done for race &amp; BR, and for Hispanic origin &amp; BR. Join point regression with tests for parallelism was applied to significant ANOVA subsets to analyze time trends.</div></div><div><h3>Results</h3><div>ANOVA revealed significantly higher mortality rates for Hispanics in the BR. Join point regression indicated parallel downtrends in mortality for non-Hispanics in both areas with an average annual percentage change (AAPC) of –2.4916 (p&lt;0.05). Hispanic mortality trended up in the BR (AAPC = +1.2886, p&lt;0.05) and down in the non-BR (AAPC = -1.1370, p&lt;0.05). The parallelism test was refuted for Hispanic groups, with two observed trends in the non-BR: significant downtrend with an annual percentage change (APC) of -2.7949 (p&lt;0.05) from 1999-2009 and no significant change post-2009.</div></div><div><h3>Conclusions</h3><div>Hispanic groups in the US-Mexican border region face higher premature AMI mortality rates. AMI mortality trended down improved for non-Hispanic groups and Hispanic groups in the non-BNR, while Hispanic border region rates are consistently rising worsening despite improvements in myocardial infarction treatment standards. This highlights the need to further investigate specific challenges and methods to improve in cardiovascular health post myocardial infarction care faced by Latinx communities in the US-Mexican border region.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LIPOPROTEIN(A) AND CARDIOVASCULAR RISK. A RETROSPECTIVE COHORT STUDY FROM NYC/HHC+ PUBLIC HOSPITAL IN NEW YORK CITY","authors":"","doi":"10.1016/j.ajpc.2024.100759","DOIUrl":"10.1016/j.ajpc.2024.100759","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>Lipoprotein(a) [Lp(a)] is a independent genetic risk factor for cardiovascular disease with heritability rates ranging from 70% to 90%. Our study aimed to compare demographic and clinical characteristics in patients with normal vs. abnormal Lp(a).</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review at Jacobi Medical Center from August 2020 to September 2023 and we identified 78 patients with available Lp(a) measurement.</div></div><div><h3>Results</h3><div>Among 78 patients, 32 (41.03%) were female, and 46 (58.97%) were male. 32 patients had abnormal Lp(a) (&gt;75 nmol/L) with a mean of 143.35 nmol/L, mean BMI of 30.34 and median age of 53.5 years. Abnormal Lp(a) correlated with higher LDL levels (111.01 vs. 91.23 mg/dL; p=0.044). Increased Lp(a) was more prevalent among African Americans. No significant association was found between abnormal Lp(a) and aortic or mitral valve calcifications. In the cohort with abnormal Lp(a) levels, the prevalence of heart failure with preserved ejection fraction (HFpEF) was 100%, while the presence of heart failure with reduced ejection was notably lower at 24% (p=0.008). The demographic and clinical characteristics are presented in Table 1.</div></div><div><h3>Conclusions</h3><div>Our study found no significant difference in comorbidities between both groups but did show a correlation with elevated LDL. HFpEF was more prevalent among patients with abnormal Lp(a).</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}