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Ciccarone Articles

Ciccarone Center Research

Journal

Journal of the American College of Cardiology

Landmark Articles

Friedewald estimated versus directly measured low-density lipoprotein cholesterol and treatment implications.
By: Martin SS, Blaha MJ, Elshazly MB, Brinton EA, Toth PP, McEvoy JW, Joshi PH, Kulkarni KR, Mize PD, Kwiterovich PO, Defilippis AP, Blumenthal RS, Jones SR.
This study discovered that, compared with direct measurement, the Friedewald equation tends to underestimate low-density lipoprotein cholesterol (LDL-C) and, therefore, warrants additional evaluation in high-risk patients. Achieving non-high-density lipoprotein cholesterol (HDL-C) targets are important to reach in the secondary prevention setting.
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ASK NOT what CRP can do for you.
By: Blumenthal RS, Ndumele CE, Martin SS.

This editorial examines the extent to which measurements of vascular inflammation can improve cardiovascular risk prediction.

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Prevalence and prognostic significance of exercise-induced non-sustained ventricular tachycardia in asymptomatic volunteers: The Baltimore Longitudinal Study of Aging.
By: Marine JE, Shetty V, Chow GV, Wright J, Gerstenblith G, Najjar SS, Lakatta EG, Fleg JL.
This longitudinal cohort analysis suggests that brief asymptomatic runs of exercise-induced non-sustained ventricular tachycardia, in the absence of clinical heart disease, are not uncommon in men, older adults, and those with hypertension, but are not associated with increased mortality after adjusting for baseline risk factors. These findings do not necessarily apply to patients with known structural heart disease.
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Non-HDL cholesterol, guideline targets, and population percentiles for secondary prevention in a clinical sample of 1.3 million adults: the very large database of lipids (VLDL-2 Study).
By: Elshazly MB, Martin SS, Blaha MJ, Joshi PH, Toth PP, McEvoy JW, Al-Hijji MA, Kulkarni KR, Kwiterovich PO, Blumenthal RS, Jones SR.
There is significant patient-level discordance between non-HDL-C and LDL-C percentiles at lower values of LDL-C and higher triglycerides. Current non-HDL-C cut-points for high-risk patients should be lowered to match percentiles of LDL-C cut-points. Relatively small absolute reductions in non-HDL-C cut-points result in substantial reclassification of patients to higher treatment categories with potential implications for risk assessment and treatment.
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High-sensitivity C-reactive protein and cardiovascular disease: A resolute belief or an elusive link?
By: Yousuf O, Mohanty BD, Martin SS, Joshi PH, Blaha MJ, Nasir K, Blumenthal RS, Budoff MJ.
Although high-sensitivity C-reactive protein (hsCRP) is involved in the immunologic process that triggers vascular remodeling and plaque deposition and is associated with increased cardiovascular disease (CVD) risk, definitive randomized evidence for its role as a causative factor in atherothrombosis is lacking. This article reviews four distinct points from the literature to better understand the current state and application of hsCRP in clinical practice, and we highlight recommendations from societies and important considerations when using hsCRP to guide treatment decisions in the primary prevention setting.
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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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Patient- and trial-specific barriers to participation in cardiovascular randomized clinical trials.
By: Martin SS, Ou FS, Newby LK, Sutton V, Adams P, Felker GM, Wang TY.
This study quantitatively examined the association of patient- and trial-specific factors with participation in cardiovascular randomized clinical trials.
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Cigarette smoking is associated with increased mortality in both the presence and absence of coronary artery calcification.
By: McEvoy JW, Blaha MJ, Rivera JJ, Budoff MJ, Khan AN, Shaw LJ, Berman DS, Raggi P, Min JK, Rumberger JA, Callister TQ, Blumenthal RS, Nasir K.

The aim of this study was to further explore the interplay between smoking status, coronary artery calcium (CAC), and all-cause mortality. Smoking is a risk factor for death across the entire spectrum of subclinical coronary atherosclerosis. Smokers with any CAC had significantly higher mortality than smokers without CAC, a finding with implications for smokers undergoing lung cancer CT-based screening. However, the absence of CAC might not be as useful a "negative risk factor" in active smokers, because this group has mortality rates similar to nonsmokers with mild-to-moderate atherosclerosis.

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Mortality rates in smokers and nonsmokers in the presence or absence of coronary artery calcification.
By: McEvoy JW, Blaha MJ, Rivera JJ, Budoff MJ, Khan AN, Shaw LJ, Berman DS, Raggi P, Min JK, Rumberger JA, Callister TQ, Blumenthal RS, Nasir K.

The aim of this study was to further explore the interplay between smoking status, coronary artery calcium (CAC), and all-cause mortality. Smoking is a risk factor for death across the entire spectrum of subclinical coronary atherosclerosis. Smokers with any CAC had significantly higher mortality than smokers without CAC, a finding with implications for smokers undergoing lung cancer CT-based screening. However, the absence of CAC might not be as useful a "negative risk factor" in active smokers, because this group has mortality rates similar to nonsmokers with mild-to-moderate atherosclerosis.

Read on Pubmed