{"title":"Thromboembolism in the Complications of Long COVID-19.","authors":"Leilani A Lopes, Devendra K Agrawal","doi":"10.26502/fccm.92920317","DOIUrl":"https://doi.org/10.26502/fccm.92920317","url":null,"abstract":"<p><p>SARS-CoV-2 is a +ssRNA helical coronavirus responsible for the global pandemic caused by coronavirus disease 19 (COVID-19). Classical clinical symptoms from primary COVID-19 when symptomatic include cough, fever, pneumonia or even ARDS; however, they are limited primarily to the respiratory system. Long-COVID-19 sequalae is responsible for many pathologies in almost every organ system and may be present in up to 30% of patients who have developed COVID-19. Our review focuses on how long-COVID-19 (3 -24 weeks after primary symptoms) may lead to an increased risk for stroke and thromboembolism. Patients who were found to be primarily at risk for thrombotic events included critically ill and immunocompromised patients. Additional risk factors for thromboembolism and stroke included diabetes, hypertension, respiratory and cardiovascular disease, and obesity. The etiology of how long-COVID-19 leads to a hypercoagulable state are yet to be definitively elucidated. However, anti-phospholipid antibodies and elevated D-dimer are present in many patients who develop thromboembolism. In addition, chronic upregulation and exhaustion of the immune system may lead to a pro-inflammatory and hypercoagulable state, increasing the likelihood for induction of thromboembolism or stroke. This article provides an up-to-date review on the proposed etiologies for thromboembolism and stroke in patients with long-COVID-19 and to assist health care providers in examining patients who may be at a higher risk for developing these pathologies.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799789","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}
Khanh-Van Tran, Andreas Filippaios, Kamran Noorishirazi, Eric Ding, Dong Han, Fahimeh Mohagheghian, Qiying Dai, Jordy Mehawej, Ziyue Wang, Darleen Lessard, Edith Mensah Otabil, Alex Hamel, Tenes Paul, Matthew F Gottbrecht, Timothy P Fitzgibbons, Jane Saczynski, Ki H Chon, David D McManus
{"title":"False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management.","authors":"Khanh-Van Tran, Andreas Filippaios, Kamran Noorishirazi, Eric Ding, Dong Han, Fahimeh Mohagheghian, Qiying Dai, Jordy Mehawej, Ziyue Wang, Darleen Lessard, Edith Mensah Otabil, Alex Hamel, Tenes Paul, Matthew F Gottbrecht, Timothy P Fitzgibbons, Jane Saczynski, Ki H Chon, David D McManus","doi":"10.26502/fccm.92920314","DOIUrl":"10.26502/fccm.92920314","url":null,"abstract":"<p><p>Wrist-based wearables have been FDA approved for AF detection. However, the health behavior impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, we analyzed data from the Pulsewatch (NCT03761394) study, which randomized patients (≥50 years) with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. We employed linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. We developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"97-107"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862434","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}
S Nooti, V Rai, M M Radwan, F G Thankam, H Singh, Y S Chatzizisis, D K Agrawal
{"title":"Oxidized Low-density Lipoproteins and Lipopolysaccharides Augment Carotid Artery Plaque Vulnerability in Hypercholesterolemic Microswine.","authors":"S Nooti, V Rai, M M Radwan, F G Thankam, H Singh, Y S Chatzizisis, D K Agrawal","doi":"10.26502/fccm.92920338","DOIUrl":"https://doi.org/10.26502/fccm.92920338","url":null,"abstract":"<p><p>Atherosclerosis is a chronic inflammatory disease and hypercholesterolemia is a risk factor. This study aims to compare the potency of lipopolysaccharide (LPS) and oxidized low-density lipoproteins (oxLDL) to induce plaque formation and increase plaque vulnerability in the carotid artery of hypercholesterolemic Yucatan microswine. Atherosclerotic lesions at the common carotid artery junction and ascending pharyngeal artery were induced in hypercholesterolemic Yucatan microswine at 5-6 months of age with balloon angioplasty. LPS or oxLDL were administered intraluminally at the site of injury after occluding the arterial flow temporarily. Pre-intervention ultrasound (US), angiography, and optical coherence tomography (OCT) were done at baseline and just before euthanasia to assess post-op parameters. The images from the US, OCT, and angiography in the LPS and the oxLDL-treated group showed increased plaque formation with features suggestive of unstable plaque, including necrotic core, thin fibrous caps, and a signal poor region more with oxLDL compared to LPS. Histomorphology of the carotid artery tissue near the injury corroborated the presence of severe lesions in both LPS and oxLDL-treated pigs but more in the oxLDL group. Vascular smooth muscle and endothelial cells treated with LPS and oxLDL showed increased folds changes in mRNA transcripts of the biomarkers of inflammation and plaque vulnerability compared to untreated cells. Collectively, the results suggest that angioplasty-mediated intimal injury of the carotid arteries in atherosclerotic swine with local administration of LPS or ox-LDL induces vulnerable plaques compared to angioplasty alone and oxLDL is relatively more potent than LPS in inducing vulnerable plaque.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 4","pages":"273-294"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421630/pdf/nihms-1920665.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996740","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}
Abhishek Rajendra Potnis, S. Potwar, B. Aironi, Dwarkanath Vivekanand Kulkarni, U. E. Jadhav, Gaurish Omprakash Sawant
{"title":"Do Post-Operative Electrocardiographic (ECG) Changes Indicate any Underlying Graft Problem after CABG? Correlation of Early Post-Operative ECG Changes with CT Coronary Angiography (CTCA)","authors":"Abhishek Rajendra Potnis, S. Potwar, B. Aironi, Dwarkanath Vivekanand Kulkarni, U. E. Jadhav, Gaurish Omprakash Sawant","doi":"10.26502/fccm.92920323","DOIUrl":"https://doi.org/10.26502/fccm.92920323","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohsin Ahmed, Sayeedur Rahman Khan, Aminur Razzaque, M. Arifur Rahman, S. Islam, Mainul Islam, Monwarul Islam AKM, Mohammad Ullah Firoze, Md. Matiur Rahman, T. Ahmad, Kudrat-E-Khuda Cm, Shiblee Sa
{"title":"Molecular Analysis of CYP2C19 Alleles and Clopidogrel Resistance Among Bangladeshi Patients with Acute Coronary Syndrome","authors":"Mohsin Ahmed, Sayeedur Rahman Khan, Aminur Razzaque, M. Arifur Rahman, S. Islam, Mainul Islam, Monwarul Islam AKM, Mohammad Ullah Firoze, Md. Matiur Rahman, T. Ahmad, Kudrat-E-Khuda Cm, Shiblee Sa","doi":"10.26502/fccm.92920321","DOIUrl":"https://doi.org/10.26502/fccm.92920321","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Peri-Coronary Sinus Flutter: A Unique Form of an Atypical Atrial Flutter. A Case Report","authors":"A. Ziakos, H. Greiss, Angelis Sezenias, A. Sause","doi":"10.26502/fccm.92920307","DOIUrl":"https://doi.org/10.26502/fccm.92920307","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Myocarditis in COVID-19 Patients: A Cross-Sectional Study","authors":"","doi":"10.26502/fccm.92920316","DOIUrl":"https://doi.org/10.26502/fccm.92920316","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Ravikumar, Ravindra S Kiwalkar, R. H. S., Beerakayala Lokesh, Dhammdeep C. Dabhade
{"title":"Dapagliflozin and Sitagliptin Combination Therapy: An Overview of Clinical Utility in Type 2 Diabetes Mellitus with Multiple Cardiovascular Risk Factors","authors":"L. Ravikumar, Ravindra S Kiwalkar, R. H. S., Beerakayala Lokesh, Dhammdeep C. Dabhade","doi":"10.26502/fccm.92920319","DOIUrl":"https://doi.org/10.26502/fccm.92920319","url":null,"abstract":"Cardiovascular disease remains the leading cause of mortality in patients with diabetes. Control of multiple cardiovascular risk factors in patients with type 2 diabetes mellitus often leads to substantial reduction in adverse cardiovascular events. Newer antihyperglycemic agents at several randomized controlled trials have demonstrated their cardiovascular safety along with reduction in cardiovascular outcomes in type 2 diabetes mellitus with or without heart failure. Sodium-glucose cotransporter 2 inhibitors and dipeptidyl peptidase-4 inhibitors reported to have positive CV outcomes; especially, combination therapy with dapagliflozin and sitagliptin seem to be suitable therapeutic option. However, data upon the fixed-dose combination of these agents is limited. This review discusses the rationale and clinical utility of combination therapy with dapagliflozin and sitagliptin in improving glycemic control and reducing cardiovascular events in patients with type 2 diabetes mellitus with multiple cardiovascular risk factors.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69346975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Råmunddal, A. Rawshani, B. Redfors, P. Pétursson, O. Angerås, G. Hirlekar, D. Ioanes, J. Odenstedt, C. Dworeck, S. Völz, A. Myredal
{"title":"Angiographic Findings in Unstable Angina and Prediction of 1-Year Risk of Recurrent Acute Coronary Syndrome or Death: A Nationwide Machine Learning Study","authors":"T. Råmunddal, A. Rawshani, B. Redfors, P. Pétursson, O. Angerås, G. Hirlekar, D. Ioanes, J. Odenstedt, C. Dworeck, S. Völz, A. Myredal","doi":"10.26502/fccm.92920330","DOIUrl":"https://doi.org/10.26502/fccm.92920330","url":null,"abstract":"Background: We studied whether machine learning could predict survival, risk of future acute coronary syndrome (ACS) and coronary angiographic (CAG) findings in patients with unstable angina (UA). We also studied whether high-sensitivity troponin levels within normal range can predict the presence of obstructive coronary lesions, risk of future ACS and death. Methods: We used the SWEDEHEART registry to include patients admitted to the coronary care unit due to chest pain, with normal high-sensitivity cardiac troponin T or I (hs-cTnI, hs-cTnT), who underwent CAG and did not receive a final diagnosis of acute myocardial infarction (AMI). We studied CAG findings on segmental level, developed machine learning models predicting the risk of ACS or death within 1-year, and angiographic findings. The latter model predicted CAG resulting in interventions (any) or eliciting further assessments after CAG. Models for ACS and death included 130 candidate predictors and models for angiographic findings included 110 predictors. Results: We included 9’314 patients; 1-year rate of death was 0.9% (n=78) and ACS was 2.7% (n=251). A total of 5455 (61.5%) of CAG resulted in no intervention and no further assessment afterwards, with 40% without significant stenosis. There was a strong association between hs-cTnI (within normal range) and severity of coronary atherosclerosis; e.g 32.4% in patients with hs-cTnI 26-35 ng/L had >50% stenosis in segment 6, as compared with 12.6% in those with hs-cTnI 0-5 ng/L. All segments displayed similar associations with troponin levels. Among 17 predictors for atherosclerosis, hs-cTnI was the strongest predictor of having >50% stenosis in the left anterior descending artery (LAD). Mortality increased at hs-cTnI levels above 10 ng/L for men, but not women. Age and sex adjusted hazard ratio for hs-cTnI 25-35 vs hs-TnI 0-5 was 5.73 (2.14-15.35) for 1-year mortality. No association was noted for hs-cTnT. The strongest predictors of 1-year mortality were C-reactive protein, body mass index, estimated glomerular filtration rate.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Mendonça, M. Santos, M. Temtem, Débora Sá, F. Sousa, E. Henriques, S. Freitas, S. Borges, M. Rodrigues, G. Guerra, A. Drumond, A. C. Sousa, R. Palma Reis
{"title":"Synergy among Genes and Genes-Environment on Coronary Artery Disease Risk and Prognosis","authors":"M. Mendonça, M. Santos, M. Temtem, Débora Sá, F. Sousa, E. Henriques, S. Freitas, S. Borges, M. Rodrigues, G. Guerra, A. Drumond, A. C. Sousa, R. Palma Reis","doi":"10.26502/fccm.92920332","DOIUrl":"https://doi.org/10.26502/fccm.92920332","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}