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Kido K, Bianco C, Caccamo M, Hashiguchi M, Choo LY, Sokos G. Sacubitril/Valsartan Does Not Change the Use and Dose of Loop Diuretics in Patients With Heart Failure With Reduced Ejection Fraction. J Pharm Pract 2024; 37:708-711. [PMID: 37191352 DOI: 10.1177/08971900231177202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Background: There is no standard approach for managing the use or dose of loop diuretics after initiating sacubitril/valsartan. Objective: To investigate longitudinal trends in loop diuretic therapy use and doses during the initial 6 months following sacubitril/valsartan initiation. Methods: This retrospective cohort study included adult patients who were initiated on sacubitril/valsartan in cardiology clinics. Inclusion criteria were patients diagnosed with heart failure with reduced ejection fraction (ejection fraction ≤40%) and initiated on sacubitril/valsartan in an outpatient setting. We investigated longitudinal trends in the prevalence of loop diuretic use and furosemide equivalent dose at baseline, 2 weeks, 1 month, 3 month and 6 months following sacubitril/valsartan initiation. Results: A total of 427 patients were included in the final cohort. Compared to the baseline loop diuretic use and dose, there were no significant longitudinal changes in the prevalence of loop diuretic use or the furosemide equivalent dose over the 6 months following sacubitril/valsartan initiation. The use of sacubitril/valsartan was not significantly associated with reductions in the use or dose of loop diuretics over a 6-month follow-up period. Conclusion: The use of sacubitril/valsartan did not significantly change the use or dose of loop diuretics over 6-month follow-up period. Initiation of sacubitril/valsartan may not need a pre-emptive loop diuretic dose reduction.
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Affiliation(s)
- Kazuhiko Kido
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Christopher Bianco
- Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, Morgantown, WV, USA
| | - Marco Caccamo
- Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, Morgantown, WV, USA
| | | | - Lyn Yuen Choo
- Clinical and Translational Science, West Virginia University, Morgantown, WV, USA
| | - George Sokos
- Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, Morgantown, WV, USA
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Kido K, Carey B, Caccamo M, Bianco C, Sokos G. Call to action for drug interactions between tirzepatide and heart failure guideline-directed medical therapy. J Am Pharm Assoc (2003) 2024; 64:169-173. [PMID: 37797920 DOI: 10.1016/j.japh.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/20/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND No drug interaction between the guideline-directed medical therapy (GDMT) for heart failure (HF) with reduced ejection fraction (HFrEF) and glucose-dependent insulinotropic polypeptide (GIP)-glucagon-like peptide-1 (GLP-1) agonists is currently indexed in available drug interaction databases or package inserts for tirzepatide, the first dual GIP/GLP-1 agonist. The objective of our case series is to present 3 patients with HF who required modification in GDMT regimens for HFrEF or loop diuretic therapy after tirzepatide initiation. CASE SUMMARY Three patients older than 60 years with HFrEF receiving GDMT agents (angiotensin receptor neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors) were initiated on tirzepatide for weight loss management. After initiating tirzepatide therapy, all 3 patients developed symptomatic hypotension. Two cases had acute kidney injury owing to tirzepatide's direct vasodilation, natriuresis, reduction in extracellular volume, and weight loss. GDMT regimens and diuretic therapy were significantly modified to improve these adverse reactions. PRACTICE IMPLICATIONS Clinicians must closely monitor vital signs and volume status after initiating tirzepatide for potential need to modify GDMT regimens. Authors request a call to action to index the drug interaction between GDMT agents and tirzepatide in major drug interaction databases for a potential hypotension or dehydration risk.
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Dongiovanni P, Meroni M, Aiello G, D’Amato A, Cenzato N, Casati S, Damiani G, Fenoglio C, Galimberti D, Grossi E, Prati D, Lamorte G, Bianco C, Valenti L, Soggiu A, Zapperi S, La Porta CAM, Del Fabbro M, Tartaglia GM. Salivary proteomic profile of young healthy subjects. Front Mol Biosci 2023; 10:1327233. [PMID: 38099196 PMCID: PMC10720708 DOI: 10.3389/fmolb.2023.1327233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
Background: The incidence of noncommunicable diseases (NCDs) has been rapidly ramped up worldwide. Hence, there is an urgent need to non-invasively detect NCDs possibly by exploiting saliva as a 'liquid biopsy' to identify biomarkers of the health status. Since, the absence of standardized procedures of collection/analysis and the lack of normal ranges makes the use of saliva still tricky, our purpose was to outline a salivary proteomic profile which features healthy individuals. Methods: We collected saliva samples from 19 young blood donors as reference population and the proteomic profile was investigated through mass-spectrometry. Results: We identified 1,004 proteins of whose 243 proteins were shared by all subjects. By applying a data clustering approach, we found a set of six most representative proteins across all subjects including Coronin-1A, F-actin-capping protein subunit alpha, Immunoglobulin J chain, Prosaposin, 78 kDa glucose-regulated protein and Heat shock 70 kDa protein 1A and 1B. Conclusion: All of these proteins are involved in immune system activation, cellular stress responses, proliferation, and invasion thus suggesting their use as biomarkers in patients with NCDs.
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Affiliation(s)
- P. Dongiovanni
- Medicine and Metabolic Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Meroni
- Medicine and Metabolic Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gilda Aiello
- Department of Human Science and Quality of Life Promotion, Telematic University San Raffaele, Rome, Italy
| | - A. D’Amato
- Department of Pharmaceutical Sciences, University of Milan, Milan, Italy
| | - N. Cenzato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - S. Casati
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - G. Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - C. Fenoglio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - D. Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Neurodegenerative Diseases Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E. Grossi
- Villa Santa Maria Foundation, Tavernerio, Italy
| | - D. Prati
- Biological Resource Center, Department of Transfusion Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G. Lamorte
- Biological Resource Center, Department of Transfusion Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C. Bianco
- Biological Resource Center, Department of Transfusion Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L. Valenti
- Biological Resource Center, Department of Transfusion Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A. Soggiu
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - S. Zapperi
- Department of Physics, Center for Complexity and Biosystems, University of Milan, Milan, Italy
| | - C. A. M. La Porta
- Department of Environmental Science and Policy, Center for Complexity and Biosystems, University of Milan, Milan, Italy
| | - M. Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- SC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G. M. Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- SC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Kido K, Fang W, Broscious R, Colvin BM, Kamal KM, Bianco C, Caccamo M, Felpel K, Sokos G. Evaluation of a pharmacist-provider collaborative clinic for treatment of iron deficiency in patients with heart failure. Am J Health Syst Pharm 2023; 80:1326-1335. [PMID: 37368751 PMCID: PMC10516710 DOI: 10.1093/ajhp/zxad149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE Intravenous iron therapy is recommended to improve symptoms and exercise tolerance in patients with heart failure (HF) with -reduced ejection fraction and iron deficiency (ID), but there are limited published data on the implementation of intravenous iron therapy in practice. A pharmacist-provider collaborative ID treatment clinic was established within an advanced HF and pulmonary hypertension service to optimize IV iron therapy. The objective was to evaluate the clinical impacts of the pharmacist-provider collaborative ID treatment clinic. METHODS A retrospective cohort study was performed to compare clinical outcomes among patients of the collaborative ID treatment clinic (the postimplementation group) and a cohort of patients who received usual care (the preimplementation group). The study included patients 18 years of age or older with diagnosed HF or pulmonary hypertension who met prespecified criteria for ID. The primary outcome was adherence to institutional intravenous iron therapy guidance. A key secondary outcome was ID treatment goal achievement. RESULTS A total of 42 patients in the preimplementation group and 81 in the postimplementation group were included in the study. The rate of adherence to the institutional guidance was significantly improved in the postimplementation group (93%) compared to the preimplementation group (40%). There was no significant difference in the ID therapeutic target achievement rate between the pre- and postimplementation groups (38% vs 48%). CONCLUSION Implementing a pharmacist-provider collaborative ID treatment clinic significantly increased the number of patients who adhered to intravenous iron therapy guidance compared to usual care.
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Affiliation(s)
- Kazuhiko Kido
- West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Wei Fang
- West Virginia Center for Translational Science Institute, Morgantown, WV, USA
| | - Rachael Broscious
- Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA
| | - Bailey M Colvin
- Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA
| | - Khalid M Kamal
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Christopher Bianco
- Department of Medicine, West Virginia University Medicine, Morgantown, WV, USA
| | - Marco Caccamo
- Department of Medicine, West Virginia University Medicine, Morgantown, WV, USA
| | - Kevin Felpel
- Department of Medicine, West Virginia University Medicine, Morgantown, WV, USA
| | - George Sokos
- Department of Medicine, West Virginia University Medicine, Morgantown, WV, USA
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Gonuguntla K, Sattar Y, Faisaluddin M, Yasmin F, Alharbi AA, Alsaud A, Chobufo MD, Shaik A, Daggubati RB, Bianco C. IMPACT OF CORONARY BYPASS GRAFT MARKERS ON ANGIOGRAPHIC PROCEDURAL OUTCOMES: A META-ANALYSIS STUDY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Sattar Y, DeCicco D, Faisaluddin M, Almas T, Yasmin F, Alharbi A, Gonuguntla K, Khan MZ, Almas T, Chobufo MD, Daggubati R, Bianco C. Meta-Analysis on the Impact of Coronary Bypass Graft Markers on Angiographic Procedural Outcomes. Am J Cardiol 2023; 195:23-26. [PMID: 37001240 DOI: 10.1016/j.amjcard.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023]
Abstract
Utilization of radio-opaque coronary artery bypass graft markers is known to decrease the amount of contrast dye required to complete the procedure. The practice of marking bypass grafts varies significantly among surgeons. Limited data exist comparing the outcomes of percutaneous coronary intervention with and without coronary artery bypass graft (CABG) markers. We sought to explore the impact of proximal radio-opaque markers placed during CABG in subsequent percutaneous coronary intervention procedural risks. In our understanding of the current literature, this is the first meta-analysis conducted to evaluate the association between procedural angiographic metrics and CABG radio-opaque markers. We performed a query of MEDLINE and Scopus databases through August 2022 to identify relevant studies evaluating procedural metrics among patients with previous CABG with and without radio-opaque markers who underwent angiography. The primary outcomes of interest were fluoroscopy time, amount of contrast, and duration of angiography. We identified a total of 4 studies with 2,046 patients with CABG (CABG with markers n = 688, CABG without markers n = 1,518).2-5 Total fluoroscopy time was significantly reduced among patients with CABG markers compared with those with no markers (odds ratio [OR] -3.63, p <0.0001). The duration of angiography (OR -36.39, p >0.10) was reduced, although the result was not statistically significant. However, the amount of contrast utilization was significantly reduced (OR -33.41, p <0.0001). In patients who underwent CABG with radio-opaque markers, angiographic procedural metrics were improved, including reduced fluoroscopic time and the amount of contrast agent required compared with no markers.
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Witrick B, Annie F, Kimble W, Sokos G, Bianco C, Rinehart S, Dotson T, Hendricks B. Abstract P180: Disparities in Occurrence of Stroke Among Heart Failure Patients- A Case Control Study Evaluating Impact of Community Socioeconomic Distress Index. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Introduction:
Ischemic stroke is common complication among heart failure patients. Community-level socio-economic distress has been linked to adverse clinical outcomes in prior research. However, few to no studies have examined the relationship between neighborhood level socio-economic distress and stroke within a population of heart failure patients exclusively.
Hypothesis:
Odds of stroke among patients with heart failure are higher in neighborhoods with increased socio-economic distress, controlling for patient demographic and clinical comorbidities.
Methods:
Two separate cohorts of heart failure patients were assembled using ICD9/10 codes to identify all patients with a heart failure diagnosis seen at West Virginia University Hospital Systems (WVU Medicine) between 2008 and 2020 and Charleston Area Medical Center (CAMC) between 2017 and 2020. Cases were defined as heart failure patients with a diagnosis of ischemic stroke. Controls were defined as heart failure patients without a diagnosis of stroke and were matched to cases 4:1 on five-year age grouping and sex at birth. Distressed communities index (DCI) was linked to clinical data by patient zip code of residence. Neighborhoods with a DCI above 75 were classified as distressed, while those below were noted as non-distressed. Multivariable conditional logistic regression was used to identify significant associations at the 95% confidence level within each cohort separately.
Results:
In total there were 26,532 unique heart failure patients in the WVU Medicine cohort and 20,070 in the CAMC cohort. Of these, 10.3% (n=2,741) of the WVU Medicine cohort and 4.5% (n=900) of the CAMC cohort met the case definition of having had a diagnosis of stroke. Among patients in the WVU Medicine cohort with heart failure who experienced a stroke, 47.1% (n=1,291) were male and had an average age of 72.4 (± 12.9). In the CAMC cohort, among heart failure patients who experienced a stroke, 51.1% (n=460) were male and the average age was 70.9 (± 11.8). After controlling for demographics and clinical comorbidities, conditional logistic regression analyses identified a statistically significant association between neighborhood-level socio-economic distress in both the WVU Medicine cohort (OR = 1.31; 95% CI = 1.20 - 1.44) and the CAMC cohort (OR = 1.29; 95% CI = 1.027 - 1.454).
Conclusion:
Neighborhood-level socio-economic distress was associated with prevalence of stroke among heart failure patients. This is a critical finding for rural states, such as West Virginia, as it has the ability to inform placement of new satellite clinics among large hospital systems, or government funded clinics, such as federally qualified health centers, to address inequities in care for patients living in medically underserved communities.
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Affiliation(s)
- Brian Witrick
- West Virginia Clinical and Translational Science Institute, Morgantown, WV
| | - Frank Annie
- CAMC Health Education and Rsch, Charleston, WV
| | - Wes Kimble
- West Virginia Clinical and Translational Science Institute, Morgantown, WV
| | | | | | | | - Timothy Dotson
- West Virginia Clinical and Translational Science Institute, Morgantown, WV
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Avalon JC, Fuqua J, Deskins S, Miller T, Conte J, Martin D, Marano G, Yanamala N, Mills J, Bianco C, Patel B, Seetharam K, Raylman R, Sengupta PP, Hamirani YS. Quantitative single photon emission computed tomography derived standardized uptake values on 99mTc-PYP scan in patients with suspected ATTR cardiac amyloidosis. J Nucl Cardiol 2023; 30:127-139. [PMID: 35655113 DOI: 10.1007/s12350-022-02988-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 04/02/2022] [Indexed: 01/15/2023]
Abstract
Technetium-99 pyrophosphate scintigraphy (99mTc-PYP) provides qualitative and semiquantitative diagnosis of ATTR cardiac amyloidosis (ATTR-CA) using the Perugini scoring system and heart/contralateral heart ratio (H/CL) on planar imaging. Standardized uptake values (SUV) with quantitative single photon emission computed tomography (xSPECT/CT) can offer superior diagnostic accuracy and quantification through precise myocardial contouring that enhances assessment of ATTR-CA burden. We examined the correlation of xSPECT/CT SUVs with Perugini score and H/CL ratio. We also assessed SUV correlation with cardiac magnetic resonance (CMR), echocardiographic, and baseline clinical characteristics. Retrospective review of 78 patients with suspected ATTR-CA that underwent 99mTc-PYP scintigraphy with xSPECT/CT. Patients were grouped off Perugini score (Grade 0-1 and Grade 2-3), H/CL ratio (≥ 1.5 and < 1.5). Two cohorts were also created: myocardium SUVmax > 1.88 and ≤ 1.88 at 1-hour based off an AUC curve with 1.88 showing the greatest sensitivity and specificity. Cardiac SUV retention index was calculated as [SUVmax myocardium/SUVmax vertebrae] × SUVmax paraspinal muscle. Primary outcome was myocardium SUVmax at 1-hour correlation with Perugini grades, H/CL ratio, CMR, and echocardiographic data. Higher Perugini Grades corresponded with higher myocardium SUVmax values, especially when comparing Perugini Grade 3 to Grade 2 and 1 (3.03 ± 2.1 vs 0.59 ± 0.97 and 0.09 ± 0.2, P < 0.001). Additionally, patients with H/CL ≥ 1.5 had significantly higher myocardium SUVmax compared to patients with H/CL ≤ 1.5 (2.92 ± 2.18 vs 0.35 ± 0.60, P < 0.01). Myocardium SUVmax at 1-hour strongly correlated with ECV (r = 0.91, P = 0.001), pre-contrast T1 map values (r = 0.66, P = 0.037), and left ventricle mass index (r = 0.80, P = 0.002) on CMR. SUVs derived from 99mTc-PYP scintigraphy with xSPECT/CT provides a discriminatory and quantitative method to diagnose and assess ATTR-CA burden. These findings strongly correlate with CMR.
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Affiliation(s)
| | - Jacob Fuqua
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Seth Deskins
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Tyler Miller
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Justin Conte
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Daniel Martin
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - Gary Marano
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - Naveena Yanamala
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
| | - James Mills
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Brijesh Patel
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Karthik Seetharam
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Raymond Raylman
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - Partho P Sengupta
- Division of Cardiovascular Disease and Hypertension, Rutgers Robert Wood Johnson Medical School, 125 Patterson St, New Brunswick, NJ, 08901, USA
| | - Yasmin S Hamirani
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
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Osman M, Regner S, Osman K, Shahan C, Kheiri B, Kadiyala M, Sokos G, Sengupta PP, Shapiro MD, Michos ED, Bianco C. Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2022; 31:1719-1726. [PMID: 33826862 PMCID: PMC9836700 DOI: 10.1089/jwh.2020.8733] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Breast arterial calcification (BAC), which may be detected during screening mammography, is hypothesized to be a noninvasive imaging marker that may enhance cardiovascular risk assessment. Materials and Methods: In this systematic review and meta-analysis, we sought to assess the association between BAC and coronary artery disease (CAD) by conducting a meta-analysis. We conducted a literature search of PubMed, Scopus, Cochrane library, ClinicalTrials.gov, and conference proceedings, from inception through December 24, 2019. The outcome of interest was the presence of CAD in patients with BAC. This was reported as crude and adjusted odds ratio (OR). Results: A total of 18 studies comprising 33,494 women (mean age of 60.8 ± 3.7 years, 25% with diabetes, 57% with hypertension, and 21% with history of tobacco smoking) were included in the current meta-analysis. The prevalence of BAC among study participants was 10%. There was a statistically significant association between BAC and CAD (unadjusted OR 2.14; 95% confidence interval [CI] 1.63-2.81, p < 0.001, I2 = 76.5%). Moreover, adjusted estimates were available from 10 studies and BAC was an independent predictor of CAD (OR 2.39; 95% CI 1.68-3.41, p < 0.001, I2 = 61.7%). In the meta-regression analysis, covariates included year of publication, age, hypertension, diabetes mellitus, and history of tobacco smoking. None of these study covariates explained the heterogeneity across studies. Conclusions: BAC detected as part of screening mammography is a promising noninvasive imaging marker that may enhance CAD risk prediction in women. The clinical value of BAC for cardiovascular risk stratification merits further evaluation in large prospective studies.
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Affiliation(s)
- Mohammed Osman
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Sean Regner
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Khansa Osman
- Department of Cardiology, Michigan Health Specialist, Michigan State University, Flint, Michigan, USA
| | - Cimmie Shahan
- Department of Cardiology, Division of Radiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Babikir Kheiri
- Department of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Madhavi Kadiyala
- Department of Cardiology, Michigan Health Specialist, Michigan State University, Flint, Michigan, USA
| | - George Sokos
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Partho P. Sengupta
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Michael D. Shapiro
- Department of Cardiology, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Erin D. Michos
- Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Christopher Bianco
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
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Osman M, Syed M, Kheiri B, Bianco C, Kalra A, Cigarroa JE, Mamas MA, Dawn Abbott J, Grines CL, Fonarow GC, Balla S. Age stratified sex-related differences in incidence, management, and outcomes of cardiogenic shock. Catheter Cardiovasc Interv 2022; 99:1984-1995. [PMID: 35391503 DOI: 10.1002/ccd.30177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/24/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is a lack of data on age-stratified sex differences in the incidence, treatment, and outcomes of cardiogenic shock (CS). We sought to study these differences from a contemporary database. METHODS Patients admitted with CS (2004-2018) were identified from the United States National Inpatient Sample. We compared CS (acute myocardial infarction-related cardiogenic shock [AMI-CS] and non-acute myocardial infarction-related cardiogenic shock [Non-AMI-CS]) incidence, management, and outcomes in males and females, stratified into four age groups (20-44, 45-64, 65-84, and ≥85 years of age). Propensity score matching (PSM) was used for adjustment. RESULTS A total of 1,506,281 weighted hospitalizations for CS were included (AMI-CS, 39%; Non-AMI-CS, 61%). Across all age groups, females had a lower incidence of CS compared with males. After PSM and among the AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 45-64 (28.5% vs. 26.3%) and 65-84 years (39.3% vs. 37.9%) (p < 0.01, for all). Among the Non-AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 20-44 (33.5% vs. 30.5%), 45-64 (35.1% vs. 31.9%), and 65-84 years (41.7% vs. 40.3%) (p < 0.01, for all). Similar age-dependent differences in the management of CS were also observed between females and males. CONCLUSIONS Females have a lower incidence of CS regardless of age. Significant disparities in the management and outcomes of CS were observed based on sex. However, these disparities varied by age and etiology of CS (AMI-CS vs. Non-AMI-CS) with pronounced disparity among females in the age range of 45-84 years.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.,Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Moinuddin Syed
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Babikir Kheiri
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Ankur Kalra
- Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Joaquin E Cigarroa
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, UK.,Division of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Jinnette Dawn Abbott
- Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cindy L Grines
- Division of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA
| | - Gregg C Fonarow
- Division of Cardiology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
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Gabriel A, Miller T, Bianco C, Sokos G, Caccamo M, Lagazzi L. A Rare Case of COVID-19 Induced Multisystem Inflammatory Syndrome in Adult (MIS-A) Requiring Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO). J Heart Lung Transplant 2022. [PMCID: PMC8988543 DOI: 10.1016/j.healun.2022.01.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction MIS-A is a rare COVID-19 induced condition defined by fever, new-onset severe cardiac illness, rash, encephalopathy, and elevated inflammatory markers in the setting of positive serum COVID-19 antibodies. This inflammatory cascade can cause significant biventricular dysfunction and subsequent cardiogenic shock. Patients with MIS-A can require temporary cardiac support including VA-ECMO. We present a case of a patient requiring VA-ECMO secondary to MIS-A induced heart failure and cardiogenic shock, with eventual myocardial recovery. Case Report 30-year-old male with type two diabetes was admitted with acute hypoxic respiratory failure, multiorgan failure, acute systolic biventricular heart failure, and COVID-19 infection four weeks prior. He was intubated and placed on vasopressors, antibiotics, and steroids for concerns for combined cardiogenic and septic shock. TTE noted global hypokinesis and 10-15% EF. EKG was sinus rhythm. He had mildly elevated troponins. Inflammatory markers including D-dimer, fibrinogen, and IL-6 were highly elevated. Despite antibiotics and supportive measures, the patient developed worsening hypoxia and hypotension. IVIG was also initiated, with deferral of plasmapheresis. At this time, MIS-A was suspected. The patient was approved for VA-ECMO as a means for bridging to cardiac recovery. He required VA-ECMO for four days, with ability to decannulate, extubate, and wean off vasopressors. COVID-19 antibody testing was positive. Infectious workup was negative, with the patient transitioned off antibiotics and steroid regimen after completing treatment course. Inflammatory markers improved. Repeat TTE noted 44% EF with improved biventricular function. Cardiac MRI one day later, noted 61% EF without evidence of scar, myocarditis, or perimyocarditis. He was discharged home after a total of 8 days of treatment with follow-ups scheduled. Summary This case highlights a severe presentation of MIS-A and showcases the benefit of VA-ECMO as a bridge to myocardial recovery. VA-ECMO has been shown to improve in-hospital survival and serve as a mechanism for cardiac recovery in acutely ill patients. Long-term cardiac effects and recovery rates post COVID-19 induced MIS-A remain unknown.
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Bianco C, Issaurat P, Vallet H. Désaturation et accident vasculaire cérébral chez une patiente âgée aux urgences : quand le foramen s’en mêle ! Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Miller T, Gabriel A, Bianco C, Hamirani YS. ACUTE EOSINOPHILIC MYOCARDITIS: AN ATYPICAL PRESENTATION DIAGNOSED BY COMBINED CARDIAC MAGNETIC RESONANCE IMAGING AND ENDOMYOCARDIAL BIOPSY WITH FULL RECOVERY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Thyagaturu HS, Bolton AR, Li S, Gonuguntla K, Kumar A, Bianco C, Balla S. Effect of Cocaine, Amphetamine and Cannabis Use Disorders on 30-day Readmissions of Patients with Heart Failure. Curr Probl Cardiol 2022:101189. [DOI: 10.1016/j.cpcardiol.2022.101189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 11/03/2022]
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15
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Lahan S, Bharadwaj A, Cheng R, Parwani P, Miller R, Cheung W, Bianco C, Kheiri B, Osman M, Mohamed M, Mamas M. In-Hospital Characteristics and 30-Day Readmissions for Acute Myocardial Infarction and Major Bleeding in Patients With Active Cancer. Am J Cardiol 2022; 166:25-37. [PMID: 34937657 DOI: 10.1016/j.amjcard.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/01/2022]
Abstract
There are limited data on readmission with ischemic and major bleeding events in patients with acute myocardial infarction (AMI) with active cancer. The purpose of our study was to evaluate in-hospital characteristics and 30-day readmission rates for recurrent AMI and major bleeding by cancer type in patients with AMI and active cancer. From 2016 through 2018, patients in the Nationwide Readmission Database admitted with AMI and underlying active colon, lung, breast, prostate, and hematological cancers were included. Thirty-day readmission for recurrent AMI and major bleeding were reported. Of 1,524,677 index hospitalizations for AMI, 35,790 patients (2.2%) had cancer (0.9% hematological; 0.5% lung; 0.4% prostate; 0.2% breast; and 0.1% colon). Compared with patients without cancer, patients with cancer were about 6 to 10 years older and had a higher proportion of atrial fibrillation, valvular heart disease, previous stroke, and a greater co-morbidity burden. Of all cancer types, only active breast cancer (adjusted odds ratios 1.82, 95% CI 1.11 to 2.98) was found to be significantly associated with elevated odds of readmission for major bleeding; no such association was observed for recurrent AMI. In conclusion, AMI in patients with breast cancer is associated with significantly greater odds of readmission for major bleeding within 30 days after discharge. Management of patients with concomitant AMI and cancer is challenging but should be based on a multidisciplinary approach and estimation of an individual patient's risk of major coronary thrombotic and bleeding events.
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16
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Osman M, Benjamin MM, Balla S, Kheiri B, Bianco C, Sengupta PP, Daggubati R, Malla M, Liu SV, Mamas M, Patel B. Index Admission and Thirty-Day Readmission Outcomes of Patients With Cancer Presenting With STEMI. Cardiovasc Revasc Med 2022; 35:121-128. [PMID: 33888417 PMCID: PMC8521583 DOI: 10.1016/j.carrev.2021.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND National-level data of cancer patients' readmissions after ST-segment elevation myocardial infarction (STEMI) are lacking. OBJECTIVES The primary aim of this study was to compare the rates and causes of 30-day readmissions in patients with and without cancer. METHODS Among patients admitted with STEMI in the United States National Readmission Database (NRD) from October 2015-December 2017, we identified patients with the diagnosis of active breast, colorectal, lung, or prostate cancer. The primary endpoint was the 30-day unplanned readmission rate. Secondary endpoints included in-hospital outcomes during the index admission and causes of readmissions. A propensity score model was used to compare the outcomes of patients with and without cancer. RESULTS A total of 385,522 patients were included in the analysis: 5956 with cancer and 379,566 without cancer. After propensity score matching, 23,880 patients were compared (Cancer = 5949, No Cancer = 17,931). Patients with cancer had higher 30-day readmission rates (19% vs. 14%, p < 0.01). The most common causes for readmission among patients with cancer were cardiac (31%), infectious (21%), oncologic (17%), respiratory (4%), stroke (4%), and renal (3%). During the first readmission, patients with cancer had higher adjusted rates of in-hospital mortality (15% vs. 7%; p < 0.01) and bleeding complications (31% vs. 21%; p < 0.01), compared to the non-cancer group. In addition, cancer (OR 1.5, 95% CI 1.2-1.6, p < 0.01) was an independent predictor for 30-day readmission. CONCLUSIONS About one in five cancer patients presenting with STEMI will be readmitted within 30 days. Cardiac causes predominated the reason for 30-day readmissions in patients with cancer.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mina M. Benjamin
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Partho P. Sengupta
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Midhun Malla
- Division of Oncology, West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Stephen V. Liu
- Division of Oncology, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, United Kingdom,Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Brijesh Patel
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA,Corresponding author at: WVU Heart & Vascular Institute, West Virginia University, One Medical Center Drive, Box 8003, Morgantown, WV 26506., USA.
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Avalon JC, Fuqua J, Miller T, Deskins S, Wakefield C, King A, Inderbitzin-Brooks S, Bianco C, Veltri L, Fang W, Craig M, Kanate A, Ross K, Malla M, Patel B. Pre-existing cardiovascular disease increases risk of atrial arrhythmia and mortality in cancer patients treated with Ibrutinib. Cardiooncology 2021; 7:38. [PMID: 34798905 PMCID: PMC8603583 DOI: 10.1186/s40959-021-00125-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/09/2021] [Indexed: 12/31/2022]
Abstract
Background Ibrutinib is a Bruton’s tyrosine kinase inhibitor used in the treatment of hematological malignancies. The most common cardiotoxicity associated with ibrutinib is atrial arrhythmia (atrial fibrillation and flutter). It is known that patients with cardiovascular disease (CVD) are at an increased risk for developing atrial arrhythmia. However, the rate of atrial arrhythmia in patients with pre-existing CVD treated with ibrutinib is unknown. Objective This study examined whether patients with pre-existing CVD are at a higher risk for developing atrial arrhythmias compared to those without prior CVD. Methods A single-institution retrospective chart review of patients with no prior history of atrial arrhythmia treated with ibrutinib from 2012 to 2020 was performed. Patients were grouped into two cohorts: those with CVD (known history of coronary artery disease, heart failure, pulmonary hypertension, at least moderate valvular heart disease, or device implantation) and those without CVD. The primary outcome was incidence of atrial arrhythmia, and the secondary outcomes were all-cause mortality, risk of bleeding, and discontinuation of ibrutinib. The predictors of atrial arrhythmia (namely atrial fibrillation) were assessed using logistic regression. A Cox-Proportional Hazard model was created for mortality. Results Patients were followed for a median of 1.1 years. Among 217 patients treated with ibrutinib, the rate of new-onset atrial arrhythmia was nearly threefold higher in the cohort with CVD compared to the cohort without CVD (17% vs 7%, p = 0.02). Patients with CVD also demonstrated increased adjusted all-cause mortality (OR 1.9, 95% CI 1.06-3.41, p = 0.01) and decreased survival probability (43% vs 54%, p = 0.04) compared to those without CVD over the follow-up period. There were no differences in risk of bleeding or discontinuation between the two cohorts. Conclusions Pre-existing cardiovascular disease was associated with significantly higher rates of atrial arrhythmia and mortality in patients with hematological malignancies managed with ibrutinib.
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Affiliation(s)
| | - Jacob Fuqua
- West Virginia University School of Medicine, Morgantown, USA
| | - Tyler Miller
- West Virginia University School of Medicine, Morgantown, USA
| | - Seth Deskins
- West Virginia University School of Medicine, Morgantown, USA
| | | | - Austin King
- West Virginia University School of Medicine, Morgantown, USA
| | | | - Christopher Bianco
- West Virginia University Heart and Vascular Institute, Morgantown, WV, 26506, USA
| | - Lauren Veltri
- West Virginia University Mary Babb Randolph Cancer Institute, Morgantown, USA
| | - Wei Fang
- West Virginia Clinical and Translational Science Institute, Morgantown, USA
| | - Michael Craig
- West Virginia University Mary Babb Randolph Cancer Institute, Morgantown, USA
| | - Abraham Kanate
- West Virginia University Mary Babb Randolph Cancer Institute, Morgantown, USA
| | - Kelly Ross
- West Virginia University Mary Babb Randolph Cancer Institute, Morgantown, USA
| | - Midhun Malla
- West Virginia University Mary Babb Randolph Cancer Institute, Morgantown, USA
| | - Brijesh Patel
- West Virginia University Heart and Vascular Institute, Morgantown, WV, 26506, USA.
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Osman M, Syed M, Kheiri B, Bianco C, Kalra A, Cigarroa J, Mamas M, Abbott JD, Grines C, Fonarow G, Balla S. TCT-486 Age-Stratified Sex-Related Differences in Incidence, Management, and Outcomes of Cardiogenic Shock. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matetic A, Mohamed M, Miller RJH, Kolman L, Lopez-Mattei J, Cheung WY, Brenner DR, Van Spall HGC, Graham M, Bianco C, Mamas MA. Impact of cancer diagnosis on causes and outcomes of 5.9 million US patients with cardiovascular admissions. Int J Cardiol 2021; 341:76-83. [PMID: 34333019 DOI: 10.1016/j.ijcard.2021.07.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/11/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There are limited data on causes of cardiovascular (CV) admissions and associated outcomes among patients with different cancers. METHODS All CV admissions from the US National Inpatient Sample between October 2015 to December 2017 were stratified by cancer type as well as metastatic status. Multivariable logistic regression was performed to determine the adjusted odds ratios (aOR) of in-hospital mortality in different groups. RESULTS From 5,936,014 eligible CV admissions, cancer was present in 265,221 (4.5%) hospitalizations. There was significant variation in the admission diagnoses among the different cancers, with hematological malignancies being principally associated with heart failure (HF), lung cancer with atrial fibrillation (AF), and colorectal and prostate cancer with acute myocardial infarction (AMI). Admission with haemorrhagic stroke has the highest associated mortality across cancers (20.0-38.4%). In-hospital mortality was higher in cancer than non-cancer patients across most CV admissions (P < 0.001) with AF having the worst prognosis. Compared to group without any cancer, the greatest aOR of mortality was associated with lung cancer in AMI (aOR 2.32, 95% CI 2.18-2.47), ischemic stroke (aOR 2.21, 95%CI 2.08-2.34), AF (aOR 4.69, 95%CI 4.32-5.10) and HF (aOR 2.07, 95%CI 1.89-2.27). CONCLUSIONS The most common causes of CV admission to hospital vary in patients with different types of cancer, with AMI being most common in patients with colon cancer, HF in patients with hematological malignancies and AF in patients with lung cancer. Patients with cancer, particularly lung cancer, have greater mortality than non-cancer patients after admissions with a CV cause.
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Affiliation(s)
- Andrija Matetic
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK; Department of Cardiology, University Hospital of Split, Split, Croatia
| | - Mohamed Mohamed
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK
| | - Robert J H Miller
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | - Louis Kolman
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | - Juan Lopez-Mattei
- Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Winson Y Cheung
- Department of Medicine and Oncology, University of Calgary, Calgary, Canada
| | - Darren R Brenner
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Harriette G C Van Spall
- Division of Cardiology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Michelle Graham
- Division of Cardiology, University of Alberta, Edmonton, Canada
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK; Department of Cardiology, Thomas Jefferson University, Philadelphia, USA.
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Osman M, Syed M, Patibandla S, Sulaiman S, Kheiri B, Shah MK, Bianco C, Balla S, Patel B. Fifteen-Year Trends in Incidence of Cardiogenic Shock Hospitalization and In-Hospital Mortality in the United States. J Am Heart Assoc 2021; 10:e021061. [PMID: 34315234 PMCID: PMC8475696 DOI: 10.1161/jaha.121.021061] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background There is a lack of contemporary data on cardiogenic shock (CS) in-hospital mortality trends. Methods and Results Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the overall population and selected subgroups. Among a total of 563 949 644 hospitalizations during the period from January 1, 2004, to December 30, 2018, 1 254 358 (0.2%) were attributed to CS. There has been a steady increase in hospitalizations attributed to CS from 122 per 100 000 hospitalizations in 2004 to 408 per 100 000 hospitalizations in 2018 (Ptrend<0.001). This was associated with a steady decline in the adjusted trends of in-hospital mortality during the study period in the overall population (from 49% in 2004 to 37% in 2018; Ptrend<0.001), among patients with acute myocardial infarction CS (from 43% in 2004 to 34% in 2018; Ptrend<0.001), and among patients with non-acute myocardial infarction CS (from 52% in 2004 to 37% in 2018; Ptrend<0.001). Consistent trends of reduced mortality were seen among women, men, different racial/ethnic groups, different US regions, and different hospital sizes, regardless of the hospital teaching status. Conclusions Hospitalizations attributed to CS have tripled in the period from January 2004 to December 2018. However, there has been a slow decline in CS in-hospital mortality during the studied period. Further studies are necessary to determine if the recent adoption of treatment algorithms in treating patients with CS will further impact in-hospital mortality.
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Affiliation(s)
- Mohammed Osman
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
- Knight Cardiovascular InstituteOregon Health and Science UniversityPortlandOR
| | - Moinuddin Syed
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | | | - Samian Sulaiman
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Babikir Kheiri
- Knight Cardiovascular InstituteOregon Health and Science UniversityPortlandOR
| | - Mahek K. Shah
- Division of CardiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Christopher Bianco
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Sudarshan Balla
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
| | - Brijesh Patel
- Division of CardiologyWest Virginia University School of MedicineMorgantownWV
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Benjamin MM, Bianco C, Caccamo M, Sokos G, Kagiyama N, Shrestha S, Verzosa G, Sengupta PP. Non-invasive prediction of tissue Doppler-derived E/e' ratio using lung Doppler signals. Eur Heart J Cardiovasc Imaging 2021; 21:994-1004. [PMID: 32529205 DOI: 10.1093/ehjci/jeaa090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 11/15/2022] Open
Abstract
AIMS Lung Doppler signals (LDS) represent the radial movement of small pulmonary blood vessel walls, caused by pulse waves of cardiac origin. We sought to investigate the accuracy and prognostic value of LDS as a predictor of mitral valve early diastolic flow to annular velocity ratio (E/e'), in patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS We prospectively enrolled patients with ADHF (n = 99, mean age 65 ± 15 years, 61% males) who underwent echocardiographic and simultaneous LDS evaluation at hospital admission. Patients with hospital stay over 72 h underwent a repeat echocardiogram and LDS assessment before discharge. Patients were followed for the occurrence of short-term all-cause mortality and heart failure (HF) hospitalization. Predicted E/e' from LDS correlated with echocardiographic E/e' at admission and discharge (r = 0.67 and 0.83; P < 0.001 for both), respectively. Patients were dichotomized into two groups by the median predicted-E/e'. A high predicted-E/e' was associated with age, hypertension, anaemia, history of HF with preserved ejection fraction (EF), and chronic kidney disease. Over a median follow-up period of 7 months, 22 (22.2%) patients died and 23 (23.2%) patients were rehospitalized for HF. Kaplan-Meier analysis revealed a significantly lower event-free survival in high predicted-E/e' group HF patients with reduced EF (P = 0.0247). No significant differences were observed in HF rehospitalization rates between the two groups. CONCLUSION In this single-centre prospective study of patients with ADHF, LDS predicted echocardiographic E/e' measurements and showed prognostic value in predicting all-cause mortality in HF patients with a reduced EF.
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Affiliation(s)
- Mina M Benjamin
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Christopher Bianco
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Marco Caccamo
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - George Sokos
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Nobuyuki Kagiyama
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Sirish Shrestha
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Grace Verzosa
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
| | - Partho P Sengupta
- Division of Cardiology, West Virginia University Heart and Vascular Institute, 1 Medical Center Drive, Morgantown, WV 26505, USA
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22
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Kido K, Bianco C, Caccamo M, Fang W, Sokos G. Association of Body Mass Index With Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan. J Cardiovasc Pharmacol Ther 2021; 26:619-624. [PMID: 34138675 DOI: 10.1177/10742484211024441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Only limited data are available that address the association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction who are receiving sacubitril/valsartan. METHODS We performed a retrospective multi-center cohort study in which we compared 3 body mass index groups (normal, overweight and obese groups) in patients with heart failure with reduced ejection fraction receiving sacubitril/valsartan. The follow-up period was at least 1 year. Propensity score weighting was performed. The primary outcomes were hospitalization for heart failure and all-cause mortality. RESULTS Of the 721 patients in the original cohort, propensity score weighting generated a cohort of 540 patients in 3 groups: normal weight (n = 78), overweight (n = 181), and obese (n = 281). All baseline characteristics were well-balanced between 3 groups after propensity score weighting. Among our results, we found no significant differences in hospitalization for heart failure (normal weight versus overweight: average hazard ratio [AHR] 1.29, 95% confidence interval [CI] = 0.76-2.20, P = 0.35; normal weight versus obese: AHR 1.04, 95% CI = 0.63-1.70, P = 0.88; overweight versus obese groups: AHR 0.81, 95% CI = 0.54-1.20, P = 0.29) or all-cause mortality (normal weight versus overweight: AHR 0.99, 95% CI = 0.59-1.67, P = 0.97; normal weight versus obese: AHR 0.87, 95% CI = 0.53-1.42, P = 0.57; overweight versus obese: AHR 0.87, 95% CI = 0.58-1.32, P = 0.52). CONCLUSION We identified no significant associations between BMI and clinical outcomes in patients diagnosed with heart failure with a reduced ejection fraction who were treated with sacubitril/valsartan. A large-scale study should be performed to verify these results.
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Affiliation(s)
- Kazuhiko Kido
- Department of Clinical Pharmacy, 12355West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Christopher Bianco
- Division of Cardiology, Department of Medicine, 12355West Virginia University, Morgantown, WV, USA
| | - Marco Caccamo
- Division of Cardiology, Department of Medicine, 12355West Virginia University, Morgantown, WV, USA
| | - Wei Fang
- West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA
| | - George Sokos
- Division of Cardiology, Department of Medicine, 12355West Virginia University, Morgantown, WV, USA
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Kido K, Ghaffar YA, Lee JC, Bianco C, Shimizu M, Shiga T, Hashiguchi M. Meta-analysis comparing direct oral anticoagulants versus vitamin K antagonists in patients with left ventricular thrombus. PLoS One 2021; 16:e0252549. [PMID: 34086768 PMCID: PMC8177531 DOI: 10.1371/journal.pone.0252549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Current American College of Cardiology/American Heart Association guidelines for stroke or ST-elevation myocardial infarction recommend the use of oral vitamin K antagonists (VKAs) as a first-line anticoagulant. Although several studies have compared the use of direct oral anticoagulants (DOACs) to VKAs for left ventricular thrombus (LVT) anticoagulation therapy, they are small scale and have produced conflicting results. Thus, this meta-analysis was performed to aggregate these studies to better compare the efficacy and safety of DOACs with VKAs in patients with LVT. Cochrane Library, Google Scholar, MEDLINE, and Web of Science database searches through January 10, 2021 were performed. Eight studies evaluating stroke or systemic embolism (SSE), six studies for LVT resolution, and five studies for bleeding were included. There were no statistically significant differences in SSE (OR 0.89; 95% CI 0.46, 1.71; p = 0.73; I2 = 45%) and LVT resolution (OR 1.13; 95% CI 0.75, 1.71; p = 0.56; I2 = 1%) between DOAC and VKA (reference group) therapy. DOAC use was significantly associated with lower bleeding event rates compared to VKA use (OR 0.61; 95% CI 0.40, 0.93; p = 0.02; I2 = 0%). DOACs may be feasible alternative anticoagulants to vitamin K antagonists for LV thrombus treatment. Randomized controlled trials directly comparing DOACs with VKAs are needed.
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Affiliation(s)
- Kazuhiko Kido
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV, United States of America
- * E-mail:
| | - Yasir Abdul Ghaffar
- Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, WV, United States of America
| | - James C. Lee
- Department of Pharmacy Practice, University of Illinois Chicago College of Pharmacy, Chicago, IL, United States of America
| | - Christopher Bianco
- Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, WV, United States of America
| | - Mikiko Shimizu
- Department of Pharmaceutics and Pharmacometrics, School of Pharmacy, Shujitsu University, Okayama, Japan
| | - Tsuyoshi Shiga
- Department of Clinical Pharmacology and Therapeutics, The Jikei University School of Medicine, Tokyo, Japan
| | - Masayuki Hashiguchi
- Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, Tokyo, Japan
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Patel B, Bianco C, Sengupta PP. Early Tracking of Radiation-Induced Cardiotoxicity: Paradigm, Pragmatism, and Possibilities. JACC CardioOncol 2021; 3:290-293. [PMID: 34396336 PMCID: PMC8352235 DOI: 10.1016/j.jaccao.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Brijesh Patel
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Partho P. Sengupta
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia, USA
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Osman M, Balla S, Patibandla S, Kheiri B, Caccamo M, Bianco C, Sokos G. Regional Variation in the Adoption of Invasive Hemodynamic Monitoring for Cardiogenic Shock in the United States. Am J Cardiol 2021; 148:174-175. [PMID: 33667450 DOI: 10.1016/j.amjcard.2021.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia.
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Saikrishna Patibandla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Babikir Kheiri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon
| | - Marco Caccamo
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Christopher Bianco
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - George Sokos
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
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Avalon JC, Fuqua J, Deskins S, Miller T, Martin D, Marano G, Mills J, Bianco C, Hamirani Y. UTILIZING XSPECT/CT DERIVED STANDARDIZED UPTAKE VALUES TO BETTER QUANTIFY DISEASE BURDEN IN PATIENTS WITH TRANSTHYRETIN-RELATED AMYLOIDOSIS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02761-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Seekings AH, Warren CJ, Thomas SS, Mahmood S, James J, Byrne AMP, Watson S, Bianco C, Nunez A, Brown IH, Brookes SM, Slomka MJ. Highly pathogenic avian influenza virus H5N6 (clade 2.3.4.4b) has a preferable host tropism for waterfowl reflected in its inefficient transmission to terrestrial poultry. Virology 2021; 559:74-85. [PMID: 33839461 DOI: 10.1016/j.virol.2021.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Highly-pathogenic avian influenza virus (HPAIV) H5N6 (clade 2.3.4.4b) incurred into Europe in late 2017 and was predominantly detected in wild birds, with very few terrestrial poultry cases. Pekin ducks directly-infected with a UK virus (H5N6-2017) were donors of infection to investigate contact transmission to three recipient species: Ducks, chickens and turkeys. H5N6-2017 transmission to ducks was 100% efficient, but transmission to in-contact galliforme species was infrequent and unpredictable, thereby reflecting the European 2017-2018 H5N6 epidemiology. Although only two of 28 (7%) infected ducks died, the six turkeys and one chicken which became infected all died and displayed systemic H5N6-2017 dissemination, while pathogenesis in ducks was generally milder. Analysis of H5N6-2017 progeny in the contacts revealed no emergent polymorphisms in an infected duck, but the galliforme species included changes in the polymerase (PB2 A199T, PA D347A), matrix (M1 T218A) and neuraminidase genes (T88I). H5N6-2017 environmental contamination was associated with duck shedding.
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Affiliation(s)
- A H Seekings
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - C J Warren
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S S Thomas
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S Mahmood
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - J James
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - A M P Byrne
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S Watson
- Animal Sciences Unit, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - C Bianco
- Pathology Department, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - A Nunez
- Pathology Department, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - I H Brown
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S M Brookes
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - M J Slomka
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK.
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Osman M, Syed M, Balla S, Kheiri B, Faisaluddin M, Bianco C. A Meta-analysis of Intravenous Iron Therapy for Patients With Iron Deficiency and Heart Failure. Am J Cardiol 2021; 141:152-153. [PMID: 33259800 DOI: 10.1016/j.amjcard.2020.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/30/2022]
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Abstract
PURPOSE OF REVIEW Cancer and heart disease are the leading causes of mortality in the USA. Advances in cancer therapies, namely, the development and use of chemotherapeutic agents alone or in combination, are becoming increasingly prevalent. RECENT FINDINGS Many chemotherapeutic agents have been associated with adverse cardiovascular manifestations. The mechanisms of these sequelae remain incompletely understood. In particular, microtubule inhibitor (MTI) agents have been related to the development of heart failure, myocardial ischemia, and conduction abnormalities. At present, there are no guidelines for patients undergoing MTI therapy as it pertains to both preventative and mitigatory strategies for cardiovascular complications. We conducted a literature review focusing on content related to the use of MTIs and their effect on the cardiovascular system. MTIs have been associated with various forms of cardiotoxicity, and fatal cardiotoxicities are rare. The most well-described cardiotoxicities are brady- and tachyarrhythmias. The co-administration of anthracycline-based agents with MTIs can increase the risk of cardiotoxicity.
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Affiliation(s)
- Amogh M Joshi
- Department of Internal Medicine, Lehigh Valley Health Network, Allentown, PA, USA
| | - George S Prousi
- Department of Cardiology, University of South Carolina, Columbia, SC, USA
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr., Morgantown, WV, 26505, USA
| | - Midhun Malla
- Hematology and Oncology, West Virginia University, Morgantown, WV, USA
| | - Avirup Guha
- Department of Cardiology, Case Western University, Cleveland, OH, USA
| | - Mahek Shah
- Department of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brijesh Patel
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr., Morgantown, WV, 26505, USA.
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Kido K, Bianco C, Caccamo M, Fang W, Sokos G. Evaluating Sacubitril/Valsartan Dose Dependence on Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction. Ann Pharmacother 2021; 55:1069-1075. [PMID: 33384015 DOI: 10.1177/1060028020983522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Limited evidence is available regarding low (24/26 mg) and middle (49/51 mg) doses of sacubitril/valsartan. OBJECTIVES The purpose of this study was to investigate the effect of sacubitril/valsartan dose on heart failure (HF) hospitalization and mortality in patients with HF with reduced ejection fraction (HFrEF). METHODS A retrospective multicenter cohort study compared 3 doses of sacubitril/valsartan in patients with HFrEF. The coprimary outcomes were all-cause mortality and rehospitalization for HF. Propensity matching analysis was performed. RESULTS Of 721 eligible patients, propensity matching created a cohort with an effective sample size of 652 (24/26-mg group [n = 326], 49/51-mg group [n = 147], 97/103-mg group [n = 179]). The HF hospitalization rates were 29.14% in the 24/26-mg group, 19.51% in the 49/51-mg group, and 16.10% in the 97/103-mg group (24/26 vs 49/51 mg: HR = 1.56, 95% CI = 1.04-2.34; 24/26 vs 97/103 mg: HR = 1.79, 95% CI = 1.18-2.73; 49/51 vs 97/103 mg: HR = 1.15, 95% CI = 0.70-1.89). All-cause mortality rates were 29.63% in the 24/26-mg group, 17.58% in the 49/51-mg group, and 9.27% in the 97/103-mg group (24/26 vs 49/51 mg: HR = 1.67, 95% CI = 1.07-2.59; 24/26 vs 97/103 mg: HR = 2.56, 95% CI = 1.54-4.24; 49/51 vs 97/103 mg: HR = 1.54, 95% CI = 0.84-2.82). CONCLUSION AND RELEVANCE Sacubitril/valsartan 97/103- or 49/51-mg dose is associated with a lower mortality or hospitalization rate for HF in patients receiving sacubitril/valsartan compared with the 24/26-mg dose group.
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Affiliation(s)
- Kazuhiko Kido
- West Virginia University School of Pharmacy, Morgantown, WV, USA
| | | | - Marco Caccamo
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Wei Fang
- West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA
| | - George Sokos
- West Virginia University School of Medicine, Morgantown, WV, USA
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31
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Chima NR, Osman M, Sokos GG, Bianco C, Caccamo M. Beyond the Diagnosis of Group IV Pulmonary Hypertension: Chronic Thromboembolic Pulmonary Hypertension Mimickers. JACC Case Rep 2020; 2:1999-2003. [PMID: 34317097 PMCID: PMC8299125 DOI: 10.1016/j.jaccas.2020.05.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 11/10/2022]
Abstract
We present 3 patients with similar clinical presentation of group IV pulmonary hypertension but with totally different diagnoses. This case series highlights the need to keep a broad differential diagnosis and to utilize more diverse imaging modalities for the diagnosis of group IV pulmonary hypertension. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Noor Rehman Chima
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Mohammed Osman
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - George G. Sokos
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Marco Caccamo
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
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Kido K, Bianco C, Caccamo M, Sokos G. Sacubitril/valsartan 24/26 Mg Dose Is A Predictor For Higher Mortality Rate In Patients With Heart Failure With Reduced Ejection Fraction Receiving Sacubitril/valsartan: Interim Results. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sokos GG, Bianco C, Caccamo MA, Kido K. Management of Heart Failure Care In Rural West Virginia: A Primary Care Perspective. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kido K, Bianco C, Caccamo M, Sokos G. Effect of Body Mass Index on Mortality In Patients with Heart Failure with Reduced Ejection Fraction Receiving Sacubitril/ Valsartan. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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35
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Harmon D, Regner S, Osman K, Shahan C, Kheiri B, Kadiyala M, Sokos G, Sengupta PP, Michos ED, Bianco C. Dramatic LDL-Cholesterol elevation with Ketogenic Diet: A Case Series. Am J Prev Cardiol 2020. [DOI: 10.1016/j.ajpc.2020.100053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Duff JP, Richey M, Holmes JP, Bianco C, Duff KP, Lawson B. Suspected collision trauma deaths in pied wagtails. Vet Rec 2020; 186:609-610. [PMID: 32527899 PMCID: PMC7365569 DOI: 10.1136/vr.m2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
| | - M Richey
- APHA Shrewsbury, Kendal Road, Shrewsbury SY1 4HD
| | - J P Holmes
- APHA Shrewsbury, Kendal Road, Shrewsbury SY1 4HD
| | - C Bianco
- APHA Lasswade, Bush Loan Road, Penicuik, Midlothian EH26 OPZ
| | - K P Duff
- Coventry University, Coventry CV1 2TU
| | - B Lawson
- Institute of Zoology, Zoological Society of London, London NW1 4RY
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Tokodi M, Shrestha S, Bianco C, Kagiyama N, Casaclang-Verzosa G, Narula J, Sengupta PP. Interpatient Similarities in Cardiac Function: A Platform for Personalized Cardiovascular Medicine. JACC Cardiovasc Imaging 2020; 13:1119-1132. [PMID: 32199835 PMCID: PMC7556337 DOI: 10.1016/j.jcmg.2019.12.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/31/2019] [Accepted: 12/19/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The authors applied unsupervised machine-learning techniques for integrating echocardiographic features of left ventricular (LV) structure and function into a patient similarity network that predicted major adverse cardiac event(s) (MACE) in an individual patient. BACKGROUND Patient similarity analysis is an evolving paradigm for precision medicine in which patients are clustered or classified based on their similarities in several clinical features. METHODS A retrospective cohort of 866 patients was used to develop a network architecture using 9 echocardiographic features of LV structure and function. The data for 468 patients from 2 prospective cohort registries were then added to test the model's generalizability. RESULTS The map of cross-sectional data in the retrospective cohort resulted in a looped patient network that persisted even after the addition of data from the prospective cohort registries. After subdividing the loop into 4 regions, patients in each region showed unique differences in LV function, with Kaplan-Meier curves demonstrating significant differences in MACE-related rehospitalization and death (both p < 0.001). Addition of network information to clinical risk predictors resulted in significant improvements in net reclassification, integrated discrimination, and median risk scores for predicting MACE (p < 0.05 for all). Furthermore, the network predicted the cardiac disease cycle in each of the 96 patients who had second echocardiographic evaluations. An improvement or remaining in low-risk regions was associated with lower MACE-related rehospitalization rates than worsening or remaining in high-risk regions (3% vs. 37%; p < 0.001). CONCLUSIONS Patient similarity analysis integrates multiple features of cardiac function to develop a phenotypic network in which patients can be mapped to specific locations associated with specific disease stage and clinical outcomes. The use of patient similarity analysis may have relevance for automated staging of cardiac disease severity, personalized prediction of prognosis, and monitoring progression or response to therapies.
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Affiliation(s)
- Márton Tokodi
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia; Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Sirish Shrestha
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Christopher Bianco
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Nobuyuki Kagiyama
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Grace Casaclang-Verzosa
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Jagat Narula
- Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Partho P Sengupta
- Division of Cardiology, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia.
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Bianco C, Sánchez-Cordón PJ, Verin R, Godinho A, Weyer U, Lesellier S, Spiropoulos J, Floyd T, Everest D, Núñez A. Investigation into the Pathology of Idiopathic Systemic Amyloidosis in Four Captive Badgers (Meles meles). J Comp Pathol 2020; 176:128-132. [PMID: 32359625 DOI: 10.1016/j.jcpa.2020.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/26/2022]
Abstract
Systemic idiopathic amyloidosis was described in four captive badgers (Meles meles). Two animals (B1 and B2) were not enrolled in any trial, while animals B3 and B4 took part in a vaccine efficacy study and had been challenged with Mycobacterium bovis. A full set of tissues was collected and processed routinely for histopathological, immunohistochemical and ultrastructural studies. Splenomegaly was found in three out of four animals. Histopathological evaluation revealed congophilic, permanganate-resistant systemic amyloid deposits in the tissues of all badgers. Animals B2 and B4 displayed a marked granulomatous response to amyloid within the spleen. Animals B1 and B2 also displayed clinicopathological findings suggestive of chronic kidney disease. Ultrastructural examination identified peculiar star-shaped arrays of amyloid. Immunohistochemical studies were unrewarding. Systemic amyloidosis should be considered among the differentials of wasting in captive badgers.
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Affiliation(s)
- C Bianco
- Pathology Department, Animal and Plant Health Agency, Lasswade, UK.
| | | | - R Verin
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy
| | - A Godinho
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - U Weyer
- Animal and Plant Health Agency, Weybridge, UK
| | - S Lesellier
- Animal and Plant Health Agency, Weybridge, UK
| | - J Spiropoulos
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
| | - T Floyd
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
| | - D Everest
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
| | - A Núñez
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
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Bianco C, Lesellier S, Barrat J, Richomme C, Boschiroli ML, Núñez A. Subclinical BCG-osis in a Captive Badger (Meles meles) with Lymphoma. J Comp Pathol 2020; 176:76-80. [PMID: 32359639 DOI: 10.1016/j.jcpa.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Abstract
Subclinical systemic dissemination of Bacillus Calmette-Guérin (BCG) is described in a captive badger (Meles meles) with lymphoma. An adult female European badger was vaccinated per os with BCG and after 8 weeks post-mortem examination identified marked lymphadenomegaly and multinodular hepatic lesions. The histopathology and immunohistochemistry confirmed a multicentric T-cell lymphoma, associated with high BCG bacterial load in numerous tissues. The histology did not identify BCG-associated lesions. The scenario suggested that the T-cell lymphoma likely favoured the dissemination of the BCG ('BCG-osis'). Given that lymphoma is rare in badgers, this neoplasm should not interfere with the efficacy of large-scale vaccination programmes.
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Affiliation(s)
- C Bianco
- Pathology Department, Animal and Plant Health Agency, Lasswade, UK.
| | - S Lesellier
- Animal and Plant Health Agency, Weybridge, UK
| | - J Barrat
- Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | - C Richomme
- Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | - M-L Boschiroli
- University Paris-Est, French Agency for Food, Environmental and Occupational Health and Safety, Laboratory for Animal Health, Maisons-Alfort, France
| | - A Núñez
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
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Osman M, Regner SR, Munir MB, Osman K, Benjamin M, Kheiri B, McCarthy P, Balla S, Bianco C. TARGETED TEMPERATURE MANAGEMENT IN SURVIVALS OF CARDIAC ARREST WITH NON-SHOCKABLE RHYTHMS: A META-ANALYSIS AND TRIAL SEQUENTIAL ANALYSIS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)30958-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bianco C, Hendricks B, Adeniran O, Finch C, Kimble W, Caccamo M, Sokos GG. SURVIVAL ADVANTAGE FOR OVERWEIGHT AND OBESE PATIENTS PERSISTS IN A RURAL HEART FAILURE PATIENT POPULATION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31636-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chima N, Osman M, Sokos GG, Bianco C, Caccamo M. PULMONARY ANGIO-SARCOMA THE GREAT CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION MIMICKER. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)33040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bianco C, Nunez A, Sanchez-Cordon P, Hansen R, Reid S, Jeckel S, Brown I, Thomas S, Poulos C, Brooks S. Pathology of Natural Highly Pathogenic Avian Influenza Viruses (HPAIV) H5N8 (2017) and HPAIV H5N6 (2018) Infection in Wild Birds in the UK. J Comp Pathol 2020. [DOI: 10.1016/j.jcpa.2019.10.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fletcher N, Bianco C, Mayers J, Skinner P, Hicks D, Brookes S, Brown I, Núñez A. Correspondence of Newcastle Disease Virulence with Virus Tropism In Ovo Using Immunohistochemistry. J Comp Pathol 2020. [DOI: 10.1016/j.jcpa.2019.10.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Ribosomes are universally important in biology and their production is dysregulated by developmental disorders, cancer, and virus infection. Although presumed required for protein synthesis, how ribosome biogenesis impacts virus reproduction and cell-intrinsic immune responses remains untested. Surprisingly, we find that restricting ribosome biogenesis stimulated human cytomegalovirus (HCMV) replication without suppressing translation. Interfering with ribosomal RNA (rRNA) accumulation triggered nucleolar stress and repressed expression of 1392 genes, including High Mobility Group Box 2 (HMGB2), a chromatin-associated protein that facilitates cytoplasmic double-stranded (ds) DNA-sensing by cGAS. Furthermore, it reduced cytoplasmic HMGB2 abundance and impaired induction of interferon beta (IFNB1) mRNA, which encodes a critical anti-proliferative, proinflammatory cytokine, in response to HCMV or dsDNA in uninfected cells. This establishes that rRNA accumulation regulates innate immune responses to dsDNA by controlling HMGB2 abundance. Moreover, it reveals that rRNA accumulation and/or nucleolar activity unexpectedly regulate dsDNA-sensing to restrict virus reproduction and regulate inflammation. (145 words)
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Affiliation(s)
- Christopher Bianco
- Department of Microbiology, NYU School of Medicine, New York, United States
| | - Ian Mohr
- Department of Microbiology, NYU School of Medicine, New York, United States.,Laura and Isaac Perlmutter Cancer Institute, NYU School of Medicine, New York, United States
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Finch C, Bianco C. CHF Order Set Improves Time to Hospital Readmission. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Potenski CJ, Epshtein A, Bianco C, Klein HL. Genome instability consequences of RNase H2 Aicardi-Goutières syndrome alleles. DNA Repair (Amst) 2019; 84:102614. [PMID: 30975634 DOI: 10.1016/j.dnarep.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 01/07/2023]
Abstract
The RNase H2 complex is a conserved heterotrimeric enzyme that degrades RNA:DNA hybrids and promotes excision of rNMPs misincorporated during DNA replication. Failure to remove ribonucleotides from DNA leads to genomic instability in yeast and humans. The monogenic Aicardi-Goutières syndrome (AGS) results from mutation in one of several genes, among which are those encoding the RNase H2 subunits. The complete cellular and genomic consequences of RNASEH2 mutations and the precise connection to disease remain unclear. To learn more about the effect of RNASEH2 mutations on the cell, we used yeast as a model of AGS disease. We have generated yeast strains bearing AGS-associated mutations in RNASEH2 genes. There is a range of disease presentation in patients bearing these RNASEH2 variants. Here we report on in vivo phenotypes of genomic instability, including mutation and recombination rates, and synthetic gene interactions. These phenotypes provide insight into molecular consequences of RNASEH2 mutations, and lay the groundwork for further study of genomic instability as a contributing factor to AGS disease.
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Affiliation(s)
- Catherine J Potenski
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY 10016, USA
| | - Anastasiya Epshtein
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY 10016, USA
| | - Christopher Bianco
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - Hannah L Klein
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY 10016, USA.
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Bogdándi V, Ida T, Sutton TR, Bianco C, Ditrói T, Koster G, Henthorn HA, Minnion M, Toscano JP, van der Vliet A, Pluth MD, Feelisch M, Fukuto JM, Akaike T, Nagy P. Speciation of reactive sulfur species and their reactions with alkylating agents: do we have any clue about what is present inside the cell? Br J Pharmacol 2019; 176:646-670. [PMID: 29909607 PMCID: PMC6346080 DOI: 10.1111/bph.14394] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/18/2018] [Accepted: 06/05/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND PURPOSE: Posttranslational modifications of cysteine residues represent a major aspect of redox biology, and their reliable detection is key in providing mechanistic insights. The metastable character of these modifications and cell lysis-induced artifactual oxidation render current state-of-the-art protocols to rely on alkylation-based stabilization of labile cysteine derivatives before cell/tissue rupture. An untested assumption in these procedures is that for all cysteine derivatives, alkylation rates are faster than their dynamic interchange. However, when the interconversion of cysteine derivatives is not rate limiting, electrophilic labelling is under Curtin-Hammett control; hence, the final alkylated mixture may not represent the speciation that prevailed before alkylation. EXPERIMENTAL APPROACH Buffered aqueous solutions of inorganic, organic, cysteine, GSH and GAPDH polysulfide species were used. Additional experiments in human plasma and serum revealed that monobromobimane can extract sulfide from the endogenous sulfur pool by shifting speciation equilibria, suggesting caution should be exercised when interpreting experimental results using this tool. KEY RESULTS In the majority of cases, the speciation of alkylated polysulfide/thiol derivatives depended on the experimental conditions. Alkylation perturbed sulfur speciation in both a concentration- and time-dependent manner and strong alkylating agents cleaved polysulfur chains. Moreover, the labelling of sulfenic acids with dimedone also affected cysteine speciation, suggesting that part of the endogenous pool of products previously believed to represent sulfenic acid species may represent polysulfides. CONCLUSIONS AND IMPLICATIONS We highlight methodological caveats potentially arising from these pitfalls and conclude that current derivatization strategies often fail to adequately capture physiological speciation of sulfur species. LINKED ARTICLES This article is part of a themed section on Chemical Biology of Reactive Sulfur Species. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.4/issuetoc.
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Affiliation(s)
- Virág Bogdándi
- Department of Molecular Immunology and ToxicologyNational Institute of OncologyBudapestHungary
| | - Tomoaki Ida
- Department of Environmental Medicine and Molecular ToxicologyTohoku University Graduate School of MedicineSendaiJapan
| | - Thomas R Sutton
- Clinical and Experimental Sciences, Faculty of MedicineUniversity Hospital Southampton NHS Foundation Trust, University of SouthamptonSouthamptonUK
| | | | - Tamás Ditrói
- Department of Molecular Immunology and ToxicologyNational Institute of OncologyBudapestHungary
| | - Grielof Koster
- Clinical and Experimental Sciences, Faculty of MedicineUniversity Hospital Southampton NHS Foundation Trust, University of SouthamptonSouthamptonUK
| | - Hillary A Henthorn
- Department of Chemistry and Biochemistry, Materials Science Institute, Institute of Molecular BiologyUniversity of OregonEugeneORUSA
| | - Magda Minnion
- Clinical and Experimental Sciences, Faculty of MedicineUniversity Hospital Southampton NHS Foundation Trust, University of SouthamptonSouthamptonUK
| | - John P Toscano
- Department of ChemistryJohns Hopkins UniversityBaltimoreMDUSA
| | - Albert van der Vliet
- Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of MedicineUniversity of VermontBurlingtonVTUSA
| | - Michael D Pluth
- Department of Chemistry and Biochemistry, Materials Science Institute, Institute of Molecular BiologyUniversity of OregonEugeneORUSA
| | - Martin Feelisch
- Clinical and Experimental Sciences, Faculty of MedicineUniversity Hospital Southampton NHS Foundation Trust, University of SouthamptonSouthamptonUK
| | - Jon M Fukuto
- Department of ChemistrySonoma State UniversityRohnert ParkCAUSA
| | - Takaaki Akaike
- Department of Environmental Medicine and Molecular ToxicologyTohoku University Graduate School of MedicineSendaiJapan
| | - Péter Nagy
- Department of Molecular Immunology and ToxicologyNational Institute of OncologyBudapestHungary
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Rubio RM, Depledge DP, Bianco C, Thompson L, Mohr I. RNA m 6 A modification enzymes shape innate responses to DNA by regulating interferon β. Genes Dev 2018; 32:1472-1484. [PMID: 30463905 PMCID: PMC6295168 DOI: 10.1101/gad.319475.118] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/12/2018] [Indexed: 12/21/2022]
Abstract
In this study, Rubio et al. researched how the dynamic genome-wide landscape of m6A-modified mRNAs impacts virus infection and host immune responses. They show that type I interferon (IFN) production triggered by dsDNA or human cytomegalovirus (HCMV) is controlled by the cellular m6A methyltrasferase subunit METTL14 and ALKBH5 demethylase, and their results demonstrate that responses to nonmicrobial dsDNA in uninfected cells are regulated by enzymes controlling m6A epitranscriptomic changes. Modification of mRNA by N6-adenosine methylation (m6A) on internal bases influences gene expression in eukaryotes. How the dynamic genome-wide landscape of m6A-modified mRNAs impacts virus infection and host immune responses remains poorly understood. Here, we show that type I interferon (IFN) production triggered by dsDNA or human cytomegalovirus (HCMV) is controlled by the cellular m6A methyltrasferase subunit METTL14 and ALKBH5 demethylase. While METTL14 depletion reduced virus reproduction and stimulated dsDNA- or HCMV-induced IFNB1 mRNA accumulation, ALKBH5 depletion had the opposite effect. Depleting METTL14 increased both nascent IFNB1 mRNA production and stability in response to dsDNA. In contrast, ALKBH5 depletion reduced nascent IFNB1 mRNA production without detectably influencing IFN1B mRNA decay. Genome-wide transcriptome profiling following ALKBH5 depletion identified differentially expressed genes regulating antiviral immune responses, while METTL14 depletion altered pathways impacting metabolic reprogramming, stress responses, and aging. Finally, we determined that IFNB1 mRNA was m6A-modified within both the coding sequence and the 3′ untranslated region (UTR). This establishes that the host m6A modification machinery controls IFNβ production triggered by HCMV or dsDNA. Moreover, it demonstrates that responses to nonmicrobial dsDNA in uninfected cells, which shape host immunity and contribute to autoimmune disease, are regulated by enzymes controlling m6A epitranscriptomic changes.
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Affiliation(s)
- Rosa M Rubio
- Department of Microbiology, New York University School of Medicine, New York, New York 10016, USA
| | - Daniel P Depledge
- Department of Microbiology, New York University School of Medicine, New York, New York 10016, USA
| | - Christopher Bianco
- Department of Microbiology, New York University School of Medicine, New York, New York 10016, USA
| | - Letitia Thompson
- Department of Microbiology, New York University School of Medicine, New York, New York 10016, USA
| | - Ian Mohr
- Department of Microbiology, New York University School of Medicine, New York, New York 10016, USA.,Laura and Isaac Perlmutter Cancer Institute, New York University School of Medicine, New York, New York 10016, USA
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Farrugia M, Bianco C, Sambamoorthi U, Mattes M. Radiation Associated Hypertension in Patients Undergoing Prostate Irradiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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