American journal of preventive cardiology最新文献

{"title":"MONOTHERAPY EZETIMIBE-INDUCED RHABDOMYOLYSIS","authors":"","doi":"10.1016/j.ajpc.2024.100777","DOIUrl":"10.1016/j.ajpc.2024.100777","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Case Presentation</h3><div>A 62-year-old female with a past medical history of type one diabetes, coronary artery disease, hyperlipidemia, and previous statin-induced rhabdomyolysis presented with one month of worsening muscle pain. Two months ago, she was started on monotherapy ezetimibe 10mg daily. On presentation, labs were notable for creatine kinase of 2509 U/L (normal: 51-296 U/L) (figure 1), creatinine of 1.5 mg/dL with baseline 0.9 mg/dL (normal 0.6-1.0 mg/dL), and urinalysis with myoglobinuria. IV fluids and pain medications were started. Given normal autoimmune panel and thyroid labs with no other precipitating events, the decision was made to discontinue ezetimibe. Creatine kinase trended to normal levels of 186 U/L (figure 1) within 3 days of discontinuation. Her myalgias improved and she was started on a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor outpatient.</div></div><div><h3>Background</h3><div>Ezetimibe is often used in the setting of statin-induced myopathy. We report a rare case of monotherapy ezetimibe-induced rhabdomyolysis in a patient with previous history of rhabdomyolysis due to statins.</div></div><div><h3>Conclusions</h3><div>Previous cases in literature have reported combined ezetimibe/statin induced myopathy or rhabdomyolysis. However, monotherapy ezetimibe should also be considered in the differential for patients presenting with myopathy or rhabdomyolysis. More research needs to be performed in patients with previous myopathy due to statins to elucidate if they are at increased risk with ezetimibe as well. In these patients, PCSK9 inhibitors should be considered as an alternative treatment option.</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":"142422905","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":"CORRELATION BETWEEN THE AMERICAN HEART ASSOCIATION LIFE'S SIMPLE 7 AND LIFE'S ESSENTIAL 8 SCORES IN A COHORT OF AFRICAN AMERICAN ADULTS","authors":"","doi":"10.1016/j.ajpc.2024.100811","DOIUrl":"10.1016/j.ajpc.2024.100811","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>The American Heart Association (AHA) recently updated its Life's Simple 7 (LS7) cardiovascular health metric to Life's Essential 8 (LE8) by including sleep health and recognition of psychosocial influences on cardiovascular health. African American adults face psychosocial and structural factors affecting sleep and the achievement of optimal cardiovascular health; thus, we examined the correlation between LS7 and LE8 scores in a community sample of African American adults.</div></div><div><h3>Methods</h3><div>Demographic, behavioral (e.g., diet), and clinical (e.g., lipids) measures were collected from African American adults at 16 churches in Minnesota as part of a randomized controlled trial (FAITH! Trial) and an accompanying ancillary study (Heart Health+). We computed LS7 (range: 0-14) and LE8 scores (range: 0-100), indicating low to high cardiovascular health, as per AHA recommendations. Pearson correlation was used to assess the linear correlation between the two cardiovascular health scores.</div></div><div><h3>Results</h3><div>Participants (N=58) were predominantly female (67%), with a mean age of 54 (SD 12) years and high cardiometabolic risk (93% had overweight/obesity) (Table 1). Mean composite LS7 and LE8 scores were 6.7 [1.9] and 56.9 [11.6], respectively. Mean LE8 scores were highest for tobacco/nicotine exposure (84.1 [24.2]) and lowest for diet (30.3 [12.4]). LE8 was strongly correlated with LS7 (r=0.84, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>In African American adults, the new LE8 score correlates well with LS7, a well-established metric for measuring cardiovascular health. LE8 score may aid in monitoring tailored interventions that target psychosocial factors to enhance cardiovascular health in this population.</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":"142422916","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":"A VIRTUAL WEIGHT MANAGEMENT PROGRAM IS ASSOCIATED WITH WEIGHT LOSS, REDUCED WAIST CIRCUMFERENCE, AND INCREASED SATISFACTION FOR WOMEN WITH OBESITY AT RISK FOR CARDIOVASCULAR DISEASE","authors":"","doi":"10.1016/j.ajpc.2024.100733","DOIUrl":"10.1016/j.ajpc.2024.100733","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Obesity</div></div><div><h3>Background</h3><div>Obesity is a chronic, progressive, and relapsing health condition that increases cardiovascular disease (CVD) risk, yet management is challenging, and weight loss is typically not sustained. We hypothesized a Nurse Practitioner (NP)-led virtual weight management program will result in weight loss, reduced waist circumference (WC), and increased satisfaction for obese women at risk for CVD.</div></div><div><h3>Methods</h3><div>Women enrolled in an observational, single center study in the outpatient cardiology clinics in a large academic medical center in Southern California. Women with a BMI over 30 kg/m2 and at least one CVD risk factor were eligible. Measures included a digital-based weight-tracking application, a smart scale, a smart tape measure, and a satisfaction with the program survey. Thirty women were followed for eight weeks between January-March 2023. Each woman met twice on a virtual platform to receive dietary counseling using motivational interviewing and to establish weight goals with the NP. The women received booster texts every two weeks to submit weights and WC. Paired t-tests were used to compare mean scores pre-and post-intervention.</div></div><div><h3>Results</h3><div>Thirty women enrolled and 26 completed the program. Mean age was 54.0±13.4 years, and White (n=19, 73.2 %). There was a significant reduction in mean weight (6.4 lbs.±6.6 lbs; p &lt; 0.001; 3.2 %±2.9 body weight) and WC (3.0 in.±1.6; p &lt; 0.001) (Figure). Twenty-two women lost weight and reduced their BMI. Ninety two percent of women (n=24) were satisfied with the program.</div></div><div><h3>Conclusions</h3><div>This NP-led virtual weight management program resulted in the majority of women significantly reduce their weight and WC using novel self-monitoring technology in addition to behavioral counseling on lifestyle modifications. Utilizing smart scales for digital self-monitoring has the potential to offer a promising strategy for obese women at risk for CVD to achieve sustained weight loss.</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":"142422817","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":"EFFECTS OF CPAP USE IN PREVENTING ATRIAL FIBRILLATION RECURRENCE POST-ABLATION IN OSA PATIENTS","authors":"","doi":"10.1016/j.ajpc.2024.100732","DOIUrl":"10.1016/j.ajpc.2024.100732","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>With the escalating global prevalence of atrial fibrillation (AF) and its recognized link to obstructive sleep apnea (OSA), this study focuses on assessing the efficacy of continuous positive airway pressure (CPAP) therapy in reducing AF recurrence following catheter-based pulmonary vein isolation.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive systematic review and meta-analysis. The search was limited to English-language journal articles published from 2010 up to June 2023. Our search spanned various databases, targeting studies reporting AF recurrence post-ablation exclusively in patients diagnosed with OSA with AHI &gt; five. After stringent selection criteria, we applied the Mantel-Haenszel method for analysis, using the pooled relative risk (RR) as the core outcome measure.</div></div><div><h3>Results</h3><div>Data from Five studies with 1023 in total patients from three cohort studies and two intention-to-treat Randomized Control Trial was extracted. Both common effect and random effects models consistently demonstrated a substantial reduction in AF recurrence post-ablation attributed to CPAP intervention, yielding pooled RRs of 0.6075 and 0.6101, respectively. Patients who used CPAP showed 39.1% relative risk reduction (in the random effect model) of AF recurrence post-ablation compared to those who did not use CPAP. Heterogeneity analysis indicated moderate variability, and Egger's test suggested minimal risk of publication bias.</div></div><div><h3>Conclusions</h3><div>The findings highlight the potential of CPAP therapy in significantly curtailing AF recurrence among individuals with OSA, particularly in the context of post-ablation scenarios. CPAP's influence may extend to rectifying atrial structural and electrical remodeling, translating into a tangible decrease in AF recurrence rates.</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":"142422816","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":"STRESS CARDIOMYOPATHY AFTER DOWNHILL SKIING: A CASE REPORT","authors":"","doi":"10.1016/j.ajpc.2024.100798","DOIUrl":"10.1016/j.ajpc.2024.100798","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Heart Failure</div></div><div><h3>Case Presentation</h3><div>A 61-year-old female presented after a day of anxiety-filled downhill skiing, with 2 syncopal episodes in the ski lodge. The patient had an electrocardiogram (ECG) showing deep T-wave inversions in anterior leads, QTc 600 msec, troponin of 0.299 ng/mL (normal &lt;0.034 ng/mL), and BNP of 4,530 pg/mL (normal &lt;221 pg/mL). The patient was given intravenous magnesium, furosemide, and an infusion of lidocaine for polymorphic ventricular tachycardia seen on telemetry. A transthoracic echocardiogram (TTE) revealed reduced ejection fraction (LVEF) of 30-35% with akinesis of the apex, hypokinesis of all mid-apical myocardial segments, suspicious for takotsubo cardiomyopathy (TTC). The patient underwent a diagnostic coronary angiography revealing no signs of ischemic disease. On day 3 of hospitalization, the patient's ECG normalized with resolution of prolonged QTc, repeat TTE showed recovered LVEF of 50-55%, and was discharged home with complete cardiovascular recovery.</div></div><div><h3>Background</h3><div>TTC, also called stress cardiomyopathy or broken heart syndrome, is characterized by chest pain, ECG changes, transient apical “ballooning” of the left ventricle with mid-ventricular akinesis seen on TTE, and absence of obstructive coronary artery disease or plaque rupture. TTC is typically preceded by intense psychological or physical stress, diagnosed in 2% of patients presenting with acute myocardial infarction and has a 6% incidence for female patients, ages 50 and older. TTC has an in-hospital mortality from 0–8% and is thought to occur due to the negative inotropy effect of high levels of epinephrine on the largest density of β-adrenoceptors in the apical ventricular myocardium. As epinephrine levels return to normal, left ventricular function and apical wall motion return to baseline within days to weeks. At 6-month follow-up, women with TTC showed a better survival rate (97% vs 86%) and less major events such as death, reinfarction, or rehospitalization than women with CAD (8% vs 31%).</div></div><div><h3>Conclusions</h3><div>Our case highlights an inciting event of TTC with combined physical and emotional stress. Stress management, emotional regulation, and treatment of mood disorders, represent a crucial point to prevent TTC, reduce medical costs, and improve the long-term quality of life of patients.</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":"142422964","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":"STATIN RATES ONE YEAR AFTER OPPORTUNISTIC SCREENING FOR CORONARY ARTERY CALCIUM ON NON-GATED CHEST CT SCANS (NOTIFY-EXTEND PROJECT)","authors":"","doi":"10.1016/j.ajpc.2024.100804","DOIUrl":"10.1016/j.ajpc.2024.100804","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>Cardiovascular disease prevention is suboptimal, especially among high-risk individuals who would benefit from lipid-lowering therapy. The NOTIFY-1 project demonstrated that screening for incidental coronary artery calcium (CAC) on non-gated chest computed tomography (CT) scans with a deep-learning algorithm, followed by patient and clinician notification, significantly increased statin prescriptions at 6 months. NOTIFY-EXTEND assessed statin initiation and persistence in a larger sample at 12 months post-notification.</div></div><div><h3>Methods</h3><div>The NOTIFY-1 project identified Stanford Healthcare patients without prior diagnosis of atherosclerotic cardiovascular disease (ASCVD) or statin therapy who underwent non-gated, non-contrast chest CT. Patients with CAC were identified via a deep-learning algorithm and initially randomized to notification (“early notification,” including their primary care clinicians) or usual care. Following completion of the project, patients in usual care who had not started statin therapy received a similar notification (“delayed notification”). The primary outcome of this follow-up study was statin prescription rates at 12 months. Secondary outcomes included discontinuation rates, cholesterol levels, cardiovascular testing, and outpatient encounters.</div></div><div><h3>Results</h3><div>There were 163 patients that received CAC notification, including 86 with early notification and 77 with delayed notification. Following notification, 75 participants (46%) were prescribed a statin within 6 months and 86 participants (53%) within 12 months. There were 117 participants (72%) that were either prescribed a statin or had a documented discussion regarding statin therapy within 12 months post-notification. Of participants prescribed a statin, 5% discontinued statin therapy within the 12-month follow-up period.</div><div>There was a significant decrease in low-density lipoprotein cholesterol (115.6 mg/dL to 90.6 mg/dL; p&lt;0.001) and triglyceride (106.2 mg/dL to 91.3 mg/dL; p=0.003) levels from baseline to 12 months post-notification. Additionally, we observed increased healthcare utilization in the post-notification period (Table 1).</div></div><div><h3>Conclusions</h3><div>Opportunistic screening and notification of CAC from non-gated chest CTs was associated with an increase in statin prescription rates that persisted at 12 months post-notification. Opportunistic screening for incidental CAC may be a powerful approach to motivating statin initiation and persistence.</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":"142422970","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":"OBICETRAPIB TARGETS ALL ATHEROGENIC LIPOPROTEINS BEYOND LDL-C","authors":"","doi":"10.1016/j.ajpc.2024.100752","DOIUrl":"10.1016/j.ajpc.2024.100752","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Kidney Disease</div></div><div><h3>Background</h3><div>Despite reductions in low-density lipoprotein cholesterol (LDL-C) with statin and non-statin lipid-lowering therapies, a large proportion of cardiovascular disease (CVD) risk remains. An investigation of 8 large CV outcome trials with statins demonstrated, on average, a relative risk reduction of 25%, leaving the majority of risk unaddressed. Residual risk is due in part to lipid components beyond LDL-C, such as LDL particle (-P) concentration, small dense (sd)LDL-C, and lipoprotein(a) [Lp(a)]. Obicetrapib is a cholesteryl ester transfer protein inhibitor under investigation for reducing atherogenic lipoproteins and CVD events.</div></div><div><h3>Methods</h3><div>ROSE1 (n=120) and ROSE2 (n=119) were phase II trials of obicetrapib on top of high-intensity statins for 8 or 12 weeks and TA-8995-203 (n=102) was a phase II trial of obicetrapib on top of atorvastatin 10/20 mg or rosuvastatin 5/10 mg for 8 weeks in Japanese participants. All trials enrolled men and women without CVD who had LDL-C &gt;70 mg/dL; all included a treatment arm of obicetrapib 10 mg monotherapy. Additionally, ROSE2 combined obicetrapib 10 mg with ezetimibe 10 mg. A complete lipid profile and apolipoprotein (Apo) B were measured in all trials. Additionally, Lp(a) was measured in ROSE1 and ROSE2, and sdLDL-C and nuclear magnetic resonance-assessed lipoprotein subfractions were analyzed in ROSE2.</div></div><div><h3>Results</h3><div>In addition to significantly lowering LDL-C by up to 50.8%, Apo B by up to 29.8%, and non-HDL-C by up to 44.4%, in ROSE2 obicetrapib 10 mg monotherapy compared to placebo significantly decreased total LDL-P, small LDL-P, and sdLDL-C by 54.8%, 92.7%, and 30.9%, respectively. A pooled analysis of Lp(a) demonstrated a placebo-corrected reduction of 57.1%. Obicetrapib plus ezetimibe also significantly reduced total LDL-P (-72.1%), small LDL-P (-95.4%), and sdLDL-C (-44.4%), beyond its significant effects on LDL-C (-63.4%), non-HDL-C (-55.6%), and Apo B (-34.4%). Obicetrapib had an adverse event profile similar to placebo, and it was nearly completely eliminated from circulation within 4 weeks after dosing.</div></div><div><h3>Conclusions</h3><div>By reducing atherogenic lipoproteins beyond LDL-C, obicetrapib monotherapy on top of statins and in combination with ezetimibe represents a promising therapy to address residual lipoprotein-related risk for CVD on top of currently available LDL-C-lowering therapies.</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":"142422751","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":"PLANT-FORWARD CULINARY MEDICINE FOR THE PREVENTION OF CARDIOVASCULAR DISEASE FOR PRIMARY CARE RESIDENTS: A RANDOMIZED CONTROLLED TRIAL","authors":"","doi":"10.1016/j.ajpc.2024.100809","DOIUrl":"10.1016/j.ajpc.2024.100809","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Nutrition/Exercise</div></div><div><h3>Background</h3><div>In the United States, cardiovascular disease (CVD) is the leading cause of death, and nutrition is the leading risk factor. However, fewer than a third of internal medicine residents feel confident discussing nutrition with patients. “Culinary medicine,” by combining didactics with hands-on cooking instruction, empowers medical trainees to prevent and treat diet-related disease with their patients.</div></div><div><h3>Methods</h3><div>All 51 primary care residents at an academic medical center in New England participated in this randomized controlled study. Twenty-five residents were randomized to the intervention group and 26 to the control group. Both groups participated in 3 hours of cased-based learning, group discussion, lecture, and dietitian Q&amp;A sessions. The intervention group also received 1 hour of culinary medicine instruction in a “virtual teaching kitchen,” cooking together on Zoom and learning strategies for modifying recipes for heart-healthiness. The control group watched 1 hour of videos from the Nutrition Made Clear curriculum. Nutrition knowledge was assessed via multiple-choice questions. Confidence was measured on 6-point Likert scales. Attitudes were measured via a subscale of the Nutrition in Patient Care Survey (NIPS).</div></div><div><h3>Results</h3><div>NIPS subscale scores did not differ from baseline to immediate post in the control group (mean score 33.1 to 34.3, p=0.08) but did in the intervention group (34.7 to 36.1, p=0.04). Nutrition knowledge scores increased significantly from baseline to immediate post in both groups (mean % correct 53.6% to 93.7%, p=0.001 for control vs. 60.0% to 92.2%, p=0.001 for intervention). Percent of residents who felt confident providing patient-accessible dietary counseling for CVD increased significantly in the intervention group (8.3% to 52.2%, p=0.002) but did not in the control group (36.4% to 63.2%, p=0.453). At 8 weeks post, 96% of all residents reported implementing something they had learned from the curriculum into caring for patients, and their nutrition knowledge scores remained high. All residents said they would recommend the curriculum to colleagues and wanted additional nutrition education.</div></div><div><h3>Conclusions</h3><div>Both culinary medicine and didactics-only nutrition education can be feasible, well-received, and effective in improving nutrition knowledge. Culinary medicine may be superior in improving learners’ attitudes about nutrition and confidence in providing dietary counseling.</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":"142422914","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":"UTILIZATION OF PET/CT IN BREAST CANCER PATIENTS FOR SCREENING OF CARDIOVASCULAR DISEASE USING INCIDENTAL CORONARY CALCIUM: A SINGLE CENTER EXPERIENCE","authors":"","doi":"10.1016/j.ajpc.2024.100737","DOIUrl":"10.1016/j.ajpc.2024.100737","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Breast cancer has been associated with increased cardiovascular events and mortality. Strategies to improve primary prevention in this population are needed. PET/CT is an opportunity to have an initial screening for presence of atherosclerosis.</div></div><div><h3>Methods</h3><div>We collected data from one institution from 2009-2021 of female patients with a first time diagnosis of breast cancer, undergoing PET/CT for cancer staging. We reviewed the primary images looking for presence or absence of coronary calcium and the scoped the official reports to assess if coronary calcium was reported. We registered variables including age, race, arterial age, hypertension, BMI, reporting of calcium score by radiologist, use of statin, LDL. Dichotomous variables are expressed in frequencies and percentage. For continuous variables we used mean and standard deviation.</div></div><div><h3>Results</h3><div>A total of 276 patients were identified. Mean age is 55 years old. Coronary calcium was present in 68 patients(24%). In those patients, the finding was mentioned for 5 patients(7.35%) in the radiologic report, mean LDL was 114 mg/dl, mean arterial age was 68 years old. Within the patients with coronary calcium, 27 patients had a calcium score &gt;100 A, the highest calcium score was 3,747.9 A, only 12 patients from this subset were in lipid lowering therapy. 208 patients did not have coronary calcification, absence of coronary calcifications was mentioned in only 10 patients; mean LDL was 105 mg/dL.</div></div><div><h3>Conclusions</h3><div>There is an under-reporting of coronary calcium burden in patients undergoing PET/CT for cancer staging which represents a missed opportunity for stronger primary prevention strategies in this population of patients with higher cardiovascular risk. Awareness of incidental findings of coronary atherosclerosis has the potential of improving cardiovascular outcomes.</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":"142422742","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":"A 5-YEAR TREND OF NON-ALCOHOLIC LIVER CIRRHOSIS AND CARDIOGENIC SHOCK IN HEART FAILURE PATIENTS","authors":"","doi":"10.1016/j.ajpc.2024.100814","DOIUrl":"10.1016/j.ajpc.2024.100814","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Heart Failure</div></div><div><h3>Background</h3><div>In heart failure (HF) patients, the intersection of non-alcoholic liver cirrhosis (NALC) and cardiogenic shock poses significant clinical challenges. Understanding the trends of these complications is essential for improving patient outcomes. This study examines the trend of NALC and its progression to cardiogenic shock among HF patients over a five-year period.</div></div><div><h3>Methods</h3><div>Data from the National Inpatient Sample (2016-2020) were analyzed to identify HF patients with NALC using ICD-10 codes. Trends were assessed using the Cochran-Armitage test for trend analysis and multivariable logistic regression to adjust for confounding factors. The year 2016 was the reference year for comparing data trends up to 2020. Outcomes are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and p-values.</div></div><div><h3>Results</h3><div>Out of 1,372,419 HF patients, 26,435 (1.9%) had NALC, with 1,180 (4.5%) experiencing cardiogenic shock with a mean age of 65 and predominantly male 59.3%. The rate of NALC among HF patients was 1.7% in 2016. By 2017, it increased to 2.0% (OR 1.2, 95% CI 1.20–1.31, p&lt;0.001), 2.2% in 2018 (OR 1.3, 95% CI 1.17–1.42, p&lt;0.001), 2.4% in 2019 (OR 1.5, 95% CI 1.31–1.60, p&lt;0.001), and 2.7% in 2020 (OR 1.6, 95% CI 1.47–1.79, p&lt;0.001), indicating an upward trend (trend p&lt;0.001). Cardiogenic shock rates in patients with NALC were 3.53% in 2016, increasing to 4.32% in 2017 (OR 1.2, 95% CI 0.83–1.83, p=0.3) compared to 3.1% in patients without NALC, 4.73% in 2018 (OR 1.3, 95% CI 0.85–2.1, p=0.2) compared to 4.5%, 6.93% in 2019 (OR 1.5, 95% CI 1.37–3.02, p&lt;0.001) compared to 5.6%, and 6.60% in 2020 (OR 1.6, 95% CI 1.25–2.88, p=0.003) compared to 6.4%, showing an increase trend (trend p&lt;0.001). Overall, Cardiogenic shock OR was 1.5 (95% CI 1.31–1.70, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>The study highlights the increasing trend of NALC and a concurrent increase in the rate of cardiogenic shock among patients with HF. This underscores the importance of vigilant monitoring and targeted intervention in effectively managing the HF population.</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":"142422829","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}