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Ciccarone Center Research

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ASCVD (Atherosclerotic Cardiovascular Disease)

Landmark Articles

Cardiovascular disease risk prediction and its integration into clinical practice.
By: Abd TT, Blaha MJ, Blumenthal RS, Joshi PH.
The authors highlighted measures of risk prediction and made suggestions on how to integrate these into a busy clinical practice.
Landmark lipid-lowering trials in the primary prevention of cardiovascular disease.
By: Chrispin J, Martin SS, Hasan RK, Joshi PH, Minder CM, McEvoy JW, Kohli P, Johnson AE, Wang L, Blaha MJ, Blumenthal RS.
Over the past 25?years, lipid-lowering therapies have been developed that are proven to not only lower cholesterol, but also to decrease adverse cardiovascular events and CVD mortality. This review highlights some key clinical trials encompassing several classes of lipid-lowering medications that have provided clinicians with an evidence-based framework for managing their patients’ cardiovascular risk.
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Absolute coronary artery calcium score is the best predictor of non-calcified plaque involvement in patients with low calcium scores (1–100).
By: Tam LM, Joonseok K, Blumenthal RS, Nasir K, Al-Mallah MH, Blaha MJ.
This study looked at the predictors on non-calcified plaque in persons with mild coronary calcification.
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Platelet COX-1-independent TxA2 generation in patients with acute coronary syndromes.
By: DeFilippis AP, Oloyede OS, Andrikopoulou E, Saenger AK, Palachuvattil JM, Fasoro YA, Guallar E, Blumenthal RS, Kickler TK, Jaffe AS, Gerstenblith G, Schulman SP, Rade JJ.

Aspirin's therapeutic action is via inhibition of platelet cyclooxygenase 1 (COX-1) thromboxane A2 (TxA2) production. The aim of this study was to evaluate TxA2 production, in the absence of platelet COX-1 activity, in coronary atherosclerotic heart disease patients with and without atherothrombotic myocardial infarction (MI). Differences in TxA2 production, in the absence of platelet COX-1 activity, between those with vs. without atherothrombotic MI were not observed when TxA2 generation was assessed on 11-dehydro-TxB2 production alone (polyclonal ELISA or LC-MS/MS), but differences were observed when TxA2 generation was assessed using 11-dehydro-TxB2 plus 11-dehydro-2,3-dinor-TxB2 (monoclonal ELISA). These findings highlight important differences between different commercially available assays for TxA2 generation and suggest that 11-dehydro-2,3-dinor-TxB2 may be critical to the biology of atherothrombosis. 

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Discordance: Can we capitalize on it to better personalize atherosclerosis treatment?
By: Nasir K, Martin SS, Virani S.
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Localization of myocardial scar in patients with cardiomyopathy and left bundle branch block using electrocardiographic Selvester QRS scoring.
By: Wieslander B, Wu KC, Loring Z, Andersson LG, Frank TF, Gerstenblith G, Tomaselli GF, Weiss RG, Wagner GS, Ugander M, Strauss DG.
This study describes the diagnostic performance of electrocardiographic criteria based on the Selvester QRS scoring system, first in localizing myocardial scar and second in screening for any non-septal scar in patients with strictly defined left bundle branch block.
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Which serum cholesterol markers should I use to lower my patient’s cardiovascular risk?
By: Makadia S, Harrington C, Blumenthal RS.
We reviewed the strengths and limitations of LDL-C, non-HDL-C, apolipoprotein B, and advanced lipoprotein testing in cardiovascular risk prediction.
Right, but not left, bundle branch block is associated with large anteroseptal scar.
By: Strauss DG, Loring Z, Selvester RH, Gerstenblith G, Tomaselli G, Weiss RG, Wagner GS, Wu KC.
This study concluded that right bundle branch block patients have significantly greater scar size than left bundle branch block patients.
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Progression of coronary calcium and incident CHD events: MESA (Multi-Ethnic Study of Atherosclerosis).
By: Budoff MJ, Young R, Lopez VA, Kronmal RA, Nasir K, Blumenthal RS, Detrano RC, Bild DE, Guerci AD, Liu K, Shea S, Szklo M, Post W, Lima J, Bertoni A, Wong ND.
This study concluded that progression of coronary artery calcium (CAC) is associated with an increased risk for future heart disease events, even after controlling for other potentially confounding factors.
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Coronary artery disease is under-diagnosed and under-treated in advanced lung disease.
By: Reed RM, Eberlein M, Girgis RE, Hashmi S, Iacono A, Jones SP, Netzer G, Scharf S.

Coronary artery disease is a potentially treatable comorbidity observed frequently in both chronic obstructive pulmonary disease and interstitial lung disease. The prevalence of angiographically proven coronary artery disease in advanced lung disease is not well described. We sought to characterize the treatment patterns of coronary artery disease complicating advanced lung disease and to describe the frequency of occult coronary artery disease in this population. Coronary artery disease is common in patients with advanced lung disease attributable to chronic obstructive pulmonary disease or interstitial lung disease and is under-diagnosed. Guideline-recommended cardioprotective medications are suboptimally utilized in this population.

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