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Ciccarone Center Research
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- Meet the Authors
Nonfatal outcomes in the primary prevention of atherosclerotic cardiovascular disease: is all-cause mortality really all that matters?Read on Pubmed
This article clearly shows that major nonfatal cardiovascular outcomes are very important to take into account when designing primary prevention guidelines.
Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.Read on Pubmed
Subclinical atherosclerosis testing with CAC is currently superior to any combination of risk factors and serum biomarkers.
Critical review of high-sensitivity C-reactive protein and coronary artery calcium for the guidance of statin allocation: head-to-head comparison of the JUPITER and St. Francis Heart Trials.Read on Pubmed
This analysis looks at the strengths and limitations of two large trials of statin therapy based on persons with an elevated hsCRP, CAC score, or both.
Dyslipidemia, coronary artery calcium, and incident atherosclerotic cardiovascular disease: implications for statin therapy from the multi-ethnic study of atherosclerosis.Read on Pubmed
CAC scoring can help match statin therapy to absolute atherosclerotic CVD risk.
Response to letter regarding article, "combined cardiac magnetic resonance imaging and C-reactive protein levels identify a cohort at low risk for defibrillator firings and death".
Coronary artery calcium and primary prevention risk assessment: What is the evidence? An updated meta-analysis on patient and physician behavior.
Regional coronary endothelial function is closely related to local early coronary atherosclerosis in patients with mild coronary artery disease: pilot study.
There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease.
How accurate are 3 risk prediction models in US women?
We review the strengths and limitations of the Reynolds Risk Score and the Framingham risk estimates for myocardial infarction (MI) prediction and for major CVD event prediction.
Combined cardiac magnetic resonance imaging and C-reactive protein levels identify a cohort at low risk for defibrillator firings and death.
Annually, ~80,000 Americans receive guideline-based primary prevention implantable cardioverter-defibrillators (ICDs), but appropriate firing rates are low. In a cohort of primary prevention ICD candidates, combining a myocardial heterogeneity index with an inflammatory biomarker identified a subgroup with a very low risk for adverse cardiac events, including ventricular arrhythmias. This novel approach warrants further investigation to confirm its value as a clinical risk stratification tool.
Comparison of exercise treadmill testing with cardiac computed tomography angiography among patients presenting to the emergency room with chest pain: the Rule Out Myocardial Infarction Using Computer-Assisted Tomography (ROMICAT) study.
Although patients with a high number of clinical risk factors are more likely to have obstructive coronary artery disease, those who are young or who would be expected to have a very high exercise capacity are unlikely to have coronary stenosis and therefore may benefit from initial treadmill testing instead of CTA.
Common genetic variation in the 3’-BCL11B gene desert is associated with carotid-femoral pulse wave velocity and excess cardiovascular disease risk: the AortaGen Consortium.
Carotid-femoral pulse wave velocity (CFPWV) is a heritable measure of aortic stiffness that is strongly associated with increased risk for major cardiovascular disease events. Common genetic variation in a locus in the BCL11B gene desert that is thought to harbor 1 or more gene enhancers is associated with higher CFPWV and increased risk for cardiovascular disease. Elucidation of the role this novel locus plays in aortic stiffness may facilitate development of therapeutic interventions that limit aortic stiffening and related cardiovascular disease events.
Genome-wide association study for coronary artery calcification with follow-up in myocardial infarction.
Coronary artery calcification (CAC) detected by computed tomography is a noninvasive measure of coronary atherosclerosis, which underlies most cases of myocardial infarction (MI). We sought to identify common genetic variants associated with CAC and further investigate their associations with MI. SNPs in the 9p21 and PHACTR1 gene loci were strongly associated with CAC and MI, and there are suggestive associations with both CAC and MI of SNPs in additional loci. Multiple genetic loci are associated with development of both underlying coronary atherosclerosis and clinical events.
Randomized clinical trial of aspirin and simvastatin for pulmonary arterial hypertension: ASA-STAT.
Pulmonary arterial hypertension (PAH) is a progressive disease that causes exercise limitation, heart failure, and death. We performed a randomized, double-blind, placebo-controlled 2×2 factorial clinical trial to determine the safety and efficacy of aspirin and simvastatin in patients with PAH. Neither aspirin nor simvastatin had a significant effect on the 6-minute walk distance, although patients randomized to simvastatin tended to have a lower 6-minute walk distance at 6 months. These results do not support the routine treatment of patients with PAH with these medications.
Letter regarding “Pathogenesis of sudden unexpected death in a clinical trial of patients with myocardial infarction and left ventricular dysfunction, heart failure, or both.