نتائج البحث - "Erin D. Michos"

1

Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States

المؤلفون: Allison G. Hays, Pensee Wu, Martha Gulati, S. Michelle Ogunwole, Mamas A. Mamas, Anum S. Minhas, Arthur J. Vaught, Di Zhao, Erin D. Michos

المصدر: Hypertension

مصطلحات موضوعية: Adult, Gestational hypertension, medicine.medical_specialty, Pregnancy Complications, Cardiovascular, Disease, 030204 cardiovascular system & hematology, Article, White People, Preeclampsia, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, Internal Medicine, medicine, Humans, Maternal health, 030212 general & internal medicine, reproductive and urinary physiology, Eclampsia, Obstetrics, business.industry, Hypertension, Pregnancy-Induced, medicine.disease, United States, female genital diseases and pregnancy complications, Black or African American, Increased risk, Socioeconomic Factors, Heart failure, Pregnancy induced, Female, business

الوصف: Women with pregnancy-induced hypertension, defined as gestational hypertension and preeclampsia/eclampsia, are at increased risk of long-term cardiovascular disease, but less is known about the spectrum of acute cardiovascular outcomes, especially across racial/ethnic groups. We evaluated the risk of cardiovascular events at delivery associated with gestational hypertension and preeclampsia/eclampsia, compared with no pregnancy-induced hypertension, overall and by race/ethnicity. We used the 2016 to 2018 National Inpatient Sample data.International Classification of Diseases,Tenth Revision, Clinical Modification codes identified delivery hospitalizations and clinical diagnoses. Using survey weights, cardiovascular events were examined using logistic regression by pregnancy-induced hypertension status, with subsequent stratification by race/ethnicity. Among 11 304 996 deliveries in 2016 to 2018, gestational hypertension occurred in 614 995 (5.4%) and preeclampsia in 593 516 (5.2%). Black women had higher odds for preeclampsia independent of underlying comorbidities (adjusted odds ratio, 1.45 [95% CI, 1.42–1.49]) and had the highest rates for several complications (peripartum cardiomyopathy, 506; heart failure, 660; acute renal failure, 953; and arrhythmias, 418 per 100 000 deliveries). After adjustment for socioeconomic factors and comorbidities, preeclampsia/eclampsia was associated with increased risk of cardiovascular events in women of all races/ethnicities. However, risk was highest among Asian/Pacific Islander women and lowest among Black women. In sum, while Black women were the most likely to experience preeclampsia, Asian/Pacific women were the most at risk for acute cardiovascular complications during delivery hospitalization.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::02c138eb1bb08dfbd4fb07c502cea55a
https://doi.org/10.1161/hypertensionaha.121.17104

2

Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study

المؤلفون: Michael Y. Tsai, Christie M. Ballantyne, Isha Lamba, John T. Wilkins, Seth S. Martin, Roger S. Blumenthal, Stephen J. Nicholls, Renato Quispe, Steven R. Jones, Rishi Puri, Anum Saeed, Sarah Nomura, Mohamed B. Elshazly, Erin D Michos, Joao A.C. Lima

المصدر: Eur Heart J

مصطلحات موضوعية: Adult, medicine.medical_specialty, Percentile, Apolipoprotein B, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Clinical Research, Risk Factors, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Young adult, Aged, Apolipoproteins B, biology, Cholesterol, business.industry, Proportional hazards model, Cholesterol, HDL, Hazard ratio, Middle Aged, Confidence interval, Primary Prevention, chemistry, Cardiovascular Diseases, biology.protein, Cardiology, Female, lipids (amino acids, peptides, and proteins), Cardiology and Cardiovascular Medicine, business

الوصف: Aims Emerging evidence suggests that remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease (ASCVD). We aimed to estimate RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) in patients without known ASCVD. Methods and results We pooled data from 17 532 ASCVD-free individuals from the Atherosclerosis Risk in Communities study (n = 9748), the Multi-Ethnic Study of Atherosclerosis (n = 3049), and the Coronary Artery Risk Development in Young Adults (n = 4735). RC was calculated as non-high-density lipoprotein cholesterol (non-HDL-C) minus calculated LDL-C. Adjusted Cox models were used to estimate the risk for incident ASCVD associated with log RC levels. We also performed discordance analyses examining relative ASCVD risk in RC vs. LDL-C discordant/concordant groups using difference in percentile units (>10 units) and clinically relevant LDL-C targets. The mean age of participants was 52.3 ± 17.9 years, 56.7% were women and 34% black. There were 2143 ASCVD events over the median follow-up of 18.7 years. After multivariable adjustment including LDL-C and apoB, log RC was associated with higher ASCVD risk [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.45–1.89]. Moreover, the discordant high RC/low LDL-C group, but not the low RC/high LDL-C group, was associated with increased ASCVD risk compared to the concordant group (HR 1.21, 95% CI 1.08–1.34). Similar results were shown when examining discordance across clinical cutpoints. Conclusions In ASCVD-free individuals, elevated RC levels were associated with ASCVD independent of traditional risk factors, LDL-C, and apoB levels. The mechanisms of RC association with ASCVD, surprisingly beyond apoB, and the potential value of targeted RC-lowering in primary prevention need to be further investigated.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d885eff24ffd630946eaa9cf9101cb20
https://doi.org/10.1093/eurheartj/ehab432

3

Further understanding of ideal cardiovascular health score metrics and cardiovascular disease

المؤلفون: Sadiya S. Khan, Erin D. Michos

المصدر: Expert Rev Cardiovasc Ther

الوصف: INTRODUCTION: The American Heart Association (AHA) introduced the construct of “cardiovascular health (CVH)”, to focus on primordial prevention to reduce the burden of cardiovascular disease (CVD). The CVH score includes 7 health and behavioral metrics (smoking, physical activity, body mass index, diet, total cholesterol, blood pressure, blood glucose), which are characterized as being ideal, intermediate, or poor. AREAS COVERED: In this review, we describe the utility of the CVH score for monitoring and promoting wellness, overall and by key sociodemographic groups, and for tracking of temporal trends. EXPERT COMMENTARY: Notably, the 7 factors are all modifiable, which differs from 10-year CVD risk scores that include non-modifiable components such as age, sex, and race. Numerous epidemiological studies have shown that achievement of a greater number of ideal CVH metrics is associated with lower incidences of CVD, cardiovascular mortality, and all-cause mortality. Longer duration of favorable CVH is associated with greater longevity and compressed morbidity. Nevertheless, the prevalence of favorable CVH is low, with

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::de8073f88c6b21ee6d44fdb8bd993557
https://doi.org/10.1080/14779072.2021.1937127

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4

The effects of vitamin D supplementation on types of falls

المؤلفون: Jennifer A. Schrack, Sarah L. Szanton, Erin D. Michos, Yurun Cai, David L. Roth, Edgar R. Miller, Christine M. Mitchell, Amanda L. Blackford, Lawrence J. Appel, Stephen P. Juraschek, Alice L. Sternberg, Amal A. Wanigatunga

المصدر: J Am Geriatr Soc

الوصف: Background/objectives To assess whether vitamin D supplementation prevents specific fall subtypes and sequelae (e.g., fracture). Design Secondary analyses of STURDY (Study to Understand Fall Reduction and Vitamin D in You)-a response-adaptive, randomized clinical trial. Setting Two community-based research units. Participants Six hundred and eighty-eight participants ≥70 years old with elevated fall risk and baseline serum 25-hydroxyvitamin D levels of 10-29 ng/ml. Intervention 200 IU/day (control), 1000 IU/day, 2000 IU/day, or 4000 IU/day of vitamin D3. Measurements Outcomes included repeat falls and falls that were consequential, were injurious, resulted in emergency care, resulted in fracture, and occurred either indoors or outdoors. Results After adjustment for multiple comparisons, the risk of fall-related fracture was greater in the pooled higher doses (≥1000 IU/day) group compared with the control (hazard ratio [HR] = 2.66; 95% confidence interval [CI]:1.18-6.00). Although not statistically significant after multiple comparisons adjustment, time to first outdoor fall appeared to differ between the four dose groups (unadjusted p for overall difference = 0.013; adjusted p = 0.222), with risk of a first-time outdoor fall 39% lower in the 1000 IU/day group (HR = 0.61; 95% CI: 0.38-0.97; unadjusted p = 0.036; adjusted p = 0.222) and 40% lower in the 2000 IU/day group (HR = 0.60; 95%CI 0.38-0.97; p = 0.037; adjusted p = 0.222), each versus control. Conclusion Vitamin D supplementation doses ≥1000 IU/day might have differential effects on fall risk based on fall location and fracture risk, with the most robust finding that vitamin D doses between 1000 and 4000 IU/day might increase the risk of first time falls with fractures. Replication is warranted, given the possibility of type 1 error.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::33b7069c1191a1582f4457c1380099f5
https://doi.org/10.1111/jgs.17290

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5

Myocardial Injury in Severe COVID-19 Compared With Non–COVID-19 Acute Respiratory Distress Syndrome

المؤلفون: Jeffrey C. Trost, Jon R. Resar, Charles J. Lowenstein, Erin D. Michos, Rani K. Hasan, Eric P. Nolley, Allison G. Hays, Andreas S. Barth, Matthew J. Czarny, Lori J. Sokoll, Thomas S. Metkus, David R. Thiemann, Wendy S. Post

المصدر: Circulation

مصطلحات موضوعية: Male, medicine.medical_specialty, ARDS, Heart Injury, 030204 cardiovascular system & hematology, Severity of Illness Index, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Original Research Articles, Physiology (medical), Internal medicine, Severity of illness, Prevalence, medicine, Humans, Registries, 030212 general & internal medicine, Survival rate, Aged, Respiratory Distress Syndrome, biology, troponin, SARS-CoV-2, business.industry, Myocardium, Organ dysfunction, COVID-19, Middle Aged, medicine.disease, Respiration, Artificial, Troponin, Survival Rate, Heart Injuries, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, biology.protein, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Kidney disease, Cohort study

الوصف: Supplemental Digital Content is available in the text.
Background: Knowledge gaps remain in the epidemiology and clinical implications of myocardial injury in coronavirus disease 2019 (COVID-19). We aimed to determine the prevalence and outcomes of myocardial injury in severe COVID-19 compared with acute respiratory distress syndrome (ARDS) unrelated to COVID-19. Methods: We included intubated patients with COVID-19 from 5 hospitals between March 15 and June 11, 2020, with troponin levels assessed. We compared them with patients from a cohort study of myocardial injury in ARDS and performed survival analysis with primary outcome of in-hospital death associated with myocardial injury. In addition, we performed linear regression to identify clinical factors associated with myocardial injury in COVID-19. Results: Of 243 intubated patients with COVID-19, 51% had troponin levels above the upper limit of normal. Chronic kidney disease, lactate, ferritin, and fibrinogen were associated with myocardial injury. Mortality was 22.7% among patients with COVID-19 with troponin under the upper limit of normal and 61.5% for those with troponin levels >10 times the upper limit of normal (P

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f6ff571cf6dd6f563a108701e9a24ec2
https://doi.org/10.1161/circulationaha.120.050543

6

Vitamin D, Calcium Supplements, and Implications for Cardiovascular Health

المؤلفون: Erin D. Michos, Amir S. Heravi, Miguel Cainzos-Achirica, Lawrence J. Appel

المصدر: Journal of the American College of Cardiology. 77:437-449

الوصف: Vitamin D and calcium supplements are commonly used, often together, to optimize bone health. Multiple observational studies have linked low serum 25-hydroxyvitamin D concentrations with increased cardiovascular risk. However, subsequent randomized controlled trials (RCTs) failed to demonstrate cardiovascular benefit with vitamin D supplementation. Although vitamin D supplements do not appear to be harmful for cardiovascular health, the lack of benefit in RCTs should discourage their use for this purpose, favoring optimizing vitamin D status through healthy lifestyles such as specific foods and modest sunlight exposure. Furthermore, some (but not all) observational and RCT studies of calcium supplementation have suggested potential for cardiovascular harm. Therefore, calcium supplementation should be used cautiously, striving for recommended intake of calcium predominantly from food sources. In this review, the authors examine the currently available evidence investigating whether vitamin D and calcium supplements are helpful, harmful, or neutral for cardiovascular health.

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https://doi.org/10.1016/j.jacc.2020.09.617

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7

The Effects of Four Doses of Vitamin D Supplements on Falls in Older Adults

المصدر: Ann Intern Med

الوصف: Background Vitamin D supplementation may prevent falls in older persons, but evidence is inconsistent, possibly because of dosage differences. Objective To compare the effects of 4 doses of vitamin D3 supplements on falls. Design 2-stage Bayesian, response-adaptive, randomized trial. (ClinicalTrials.gov: NCT02166333). Setting 2 community-based research units. Participants 688 participants, aged 70 years and older, with elevated fall risk and a serum 25-hydroxyvitamin D [25-(OH)D] level of 25 to 72.5 nmol/L. Intervention 200 (control), 1000, 2000, or 4000 IU of vitamin D3 per day. During the dose-finding stage, participants were randomly assigned to 1 of the 4 vitamin D3 doses, and the best noncontrol dose for preventing falls was determined. After dose finding, participants previously assigned to receive noncontrol doses received the best dose, and new enrollees were randomly assigned to receive 200 IU/d or the best dose. Measurements Time to first fall or death over 2 years (primary outcome). Results During the dose-finding stage, the primary outcome rates were higher for the 2000- and 4000-IU/d doses than for the 1000-IU/d dose, which was selected as the best dose (posterior probability of being best, 0.90). In the confirmatory stage, event rates were not significantly different between participants with experience receiving the best dose (events and observation time limited to the period they were receiving 1000 IU/d; n = 308) and those randomly assigned to receive 200 IU/d (n = 339) (hazard ratio [HR], 0.94 [95% CI, 0.76 to 1.15]; P = 0.54). Analysis of falls with adverse outcomes suggested greater risk in the experience-with-best-dose group versus the 200-IU/d group (serious fall: HR, 1.87 [CI, 1.03 to 3.41]; fall with hospitalization: HR, 2.48 [CI, 1.13 to 5.46]). Limitations The control group received 200 IU of vitamin D3 per day, not a placebo. Dose finding ended before the prespecified thresholds for dose suspension and dose selection were reached. Conclusion In older persons with elevated fall risk and low serum 25-(OH)D levels, vitamin D3 supplementation at doses of 1000 IU/d or higher did not prevent falls compared with 200 IU/d. Several analyses raised safety concerns about vitamin D3 doses of 1000 IU/d or higher. Primary funding source National Institute on Aging.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ed4ec2d41c37c53e7ffc838b92823df2
https://doi.org/10.7326/m20-3812

8

Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania

المؤلفون: Brian S. Schwartz, Erin D. Michos, Jonathan Pollak, John W. McEvoy, Tara McAlexander, Jessie P. Buckley, Karen Bandeen-Roche

المصدر: J Am Coll Cardiol

الوصف: Background Growing literature linking unconventional natural gas development (UNGD) to adverse health has implicated air pollution and stress pathways. Persons with heart failure (HF) are susceptible to these stressors. Objectives This study sought to evaluate associations between UNGD activity and hospitalization among HF patients, stratified by both ejection fraction (EF) status (reduced [HFrEF], preserved [HFpEF], not classifiable) and HF severity. Methods We evaluated the odds of hospitalization among patients with HF seen at Geisinger from 2008 to 2015 using electronic health records. We assigned metrics of UNGD activity by phase (pad preparation, drilling, stimulation, and production) 30 days before hospitalization or a frequency-matched control selection date. We assigned phenotype status using a validated algorithm. Results We identified 9,054 patients with HF with 5,839 hospitalizations (mean age 71.1 ± 12.7 years; 47.7% female). Comparing 4th to 1st quartiles, adjusted odds ratios (95% confidence interval) for hospitalization were 1.70 (1.35 to 2.13), 0.97 (0.75 to 1.27), 1.80 (1.35 to 2.40), and 1.62 (1.07 to 2.45) for pad preparation, drilling, stimulation, and production metrics, respectively. We did not find effect modification by HFrEF or HFpEF status. Associations of most UNGD metrics with hospitalization were stronger among those with more severe HF at baseline. Conclusions Three of 4 phases of UNGD activity were associated with hospitalization for HF in a large sample of patients with HF in an area of active UNGD, with similar findings by HFrEF versus HFpEF status. Older patients with HF seem particularly vulnerable to adverse health impacts from UNGD activity.

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https://doi.org/10.1016/j.jacc.2020.10.023

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9

Evaluation and Management of Patients With Stable Angina: Beyond the Ischemia Paradigm

المؤلفون: Jacqueline Latina, Armin Arbab-Zadeh, Steven R. Jones, Roger S. Blumenthal, Jeffrey C. Trost, Abdulhamied Alfaddagh, Michael J. Blaha, William E. Boden, Joao A.C. Lima, Valentin Fuster, Richard A. Ferraro, Garima Sharma, Erin D. Michos, William S. Weintraub

المصدر: Journal of the American College of Cardiology. 76:2252-2266

الوصف: Coronary heart disease is a chronic, systemic disease with a wide range of associated symptoms, clinical outcomes, and health care expenditure. Adverse events from coronary heart disease can be mitigated or avoided with lifestyle and risk factor modifications, and medical therapy. These measures are effective in slowing the progression of atherosclerotic disease and in reducing the risk of thrombosis in the setting of plaque disruptions. With increasing effectiveness of prevention and medical therapy, the role of coronary artery revascularization has decreased and is largely confined to subgroups of patients with unacceptable angina, severe left ventricular systolic dysfunction, or high-risk coronary anatomy. There is a compelling need to allocate resources appropriately to improve prevention. Herein, we review the scientific evidence in support of medical therapy and revascularization for the management of patients with stable coronary heart disease and discuss implications for the evaluation of patients with stable angina and public policy.

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https://doi.org/10.1016/j.jacc.2020.08.078

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10

Sex‐stratified analysis of the safety of percutaneous left atrial appendage occlusion

المؤلفون: Babikir Kheiri, Mohamad Alkhouli, Sudarshan Balla, Ramesh Daggubati, Brijesh Patel, Akram Kawsara, Muhammad Bilal Munir, Erin D. Michos, Mohammed Osman

المصدر: Catheterization and Cardiovascular Interventions. 97:885-892

الوصف: OBJECTIVES AND BACKGROUND There is insufficient current evidence about whether sex impacts outcomes of percutaneous left atrial appendage occlusion (LAAO). The aim of this study was to investigate the association between sex and short-term outcomes of LAAO. METHODS Patients who were hospitalized and underwent LAAO from October 2015 to December 2017 in the National Readmission Database were queried. The primary endpoint of interest was major in-hospital adverse events. Secondary endpoints included, 30-day readmission rate, nonhome discharge, and cost of hospitalization. Propensity score matching (1:1) was performed to compare the outcomes among women and men. RESULTS A total of 9,281 patients were included in the current analysis [women = 3,659 (39%); men = 5,622 (61%)]. Comparing women to men, women had lower prevalence of diabetes mellitus (30.6% vs 35.7%, p

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bbc7691bb05efdcf0fe99937947a53e1
https://doi.org/10.1002/ccd.29282

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