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Ciccarone Articles

Ciccarone Center Research

Journal

Circulation

Landmark Articles

Exercise blood pressure and future cardiovascular death in asymptomatic individuals.
By: Weiss SA, Blumenthal RS, Sharrett AR, Redberg RF, Mora S.
Individuals with exaggerated exercise BP tend to develop future hypertension. It is controversial whether they have higher risk of death from cardiovascular disease (CVD). We found that, in asymptomatic individuals, elevated exercise BP carried higher risk of CVD death but became nonsignificant after accounting for rest BP. However, Bruce stage 2 BP >180/90 mm Hg identified nonhypertensive individuals at higher risk of CVD death.
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Identifying patients at high risk of a cardiovascular event in the near future: current status and future directions: report of a national heart, lung, and blood institute working group.
By: Eagle KA, Ginsburg GS, Musunuru K, Aird WC, Balaban RS, Bennett SK, Blumenthal RS, Coughlin SR, Davidson KW, Frohlich ED, Greenland P, Jarvik GP, Libby P, Pepine CJ, Ruskin JN, Stillman AE, Van Eyk JE, Tolunay HE, McDonald CL, Smith SC Jr.
The National Heart, Lung, and Blood Institute convened a working group to provide basic and clinical research recommendations on the development of an integrated approach for identifying those individuals who are at high risk for a cardiovascular event, such as acute coronary syndromes (ACS) or sudden cardiac death in the “near term.” The participants reviewed current clinical cardiology practices for risk assessment and state-of-the-science techniques in several areas, including biomarkers, proteomics, genetics, psychosocial factors, imaging, coagulation, and vascular and myocardial susceptibility. This report presents highlights of these reviews and a summary of suggested research directions.
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The numbers are in – statins for the primary prevention of cardiovascular disease in women.
By: Duvernoy CS, Blumenthal R.
This study indicates that statin therapy among middle-aged and older women with low LDL-C but above average hsCRP achieves better outcomes than those previously observed in primary prevention trials that were conducted with less potent statins in individuals with overt hyperlipidemia. Clearly, the evidence base for statin therapy in asymptomatic middle-aged and older women with other risk factors is now much more compelling, thanks to the work of Mora and colleagues. We await publication of the formal cost-effectiveness analyses from the landmark JUPITER data set, as well as data on the long-term safety of high-potency statin therapy. In the meantime, clinicians will undoubtedly use the data by Mora et al to prescribe statin therapy much earlier for women who meet the entry criteria of the JUPITER study, and this change will improve cardiovascular outcomes in women.
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Integrative predictive model of coronary artery calcification in atherosclerosis.
By: McGeachie M, Ramoni RL, Mychaleckyj JC, Furie KL, Dreyfuss JM, Liu Y, Herrington D, Guo X, Lima JA, Post W, Rotter JI, Rich S, Sale M, Ramoni MF.
Many different genetic and clinical factors have been identified as causes or contributors to atherosclerosis. We present a model of preclinical atherosclerosis based on genetic and clinical data that predicts the presence of coronary artery calcification in healthy Americans of European descent 45 to 84 years of age in the MESA study. Our investigation of joint genetic and clinical factors associated with atherosclerosis shows predictive results for both cases, as well as enhanced performance for their combination.
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Engraftment, differentiation, and functional benefits of autologous cardiosphere-derived cells in porcine ischemic cardiomyopathy.
By: Johnston PV, Sasano T, Mills K, Evers R, Lee ST, Smith RR, Lardo AC, Lai S, Steenbergen C, Gerstenblith G, Lange R, Marbán E.

Cardiosphere-derived cells (CDCs) isolated from human endomyocardial biopsies reduce infarct size and improve cardiac function in mice. Safety and efficacy testing in large animals is necessary for clinical translation. Intracoronary delivery of CDCs in a preclinical model of postinfarct left ventricular dysfunction results in formation of new cardiac tissue, reduces relative infarct size, attenuates adverse remodeling, and improves hemodynamics. The evidence of efficacy without obvious safety concerns at 8 weeks of follow-up motivates human studies in patients after myocardial infarction and in chronic ischemic cardiomyopathy.

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