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Ciccarone Articles

Ciccarone Center Research


Cardiovascular Risk Assessment

Landmark Articles

Focused update on the 2013-2014 cardiovascular disease prevention guidelines.
By: Abd TT, Misra S, Ojeifo O, Martin SS, Blumenthal RS, Foody J, Wong ND.
All men with vasculogenic erectile dysfunction require a cardiovascular workup.
By: Miner M, Nehra A, Jackson G, Bhasin S, Billups K, Burnett AL, et al.

This study supports the use of cardiovascular risk stratification and aggressive risk-factor management in all men with vasculogenic erectile dysfunction.

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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.
By: Blaha MJ, Silverman MG, Budoff MJ.
Subclinical atherosclerosis testing with CAC is currently superior to any combination of risk factors and serum biomarkers.
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Risk factors: new risk-assessment guidelines— more or less personalized?
By: Blaha MJ, Blumenthal RS.
The new ACC/AHA cardiovascular-risk guidelines feature updated equations for women, distinct equations for African-Americans, and include stroke prediction. However, the equations rely on the same traditional risk factors as previous versions, are driven predominantly by age, and curtail the intermediate-risk group, in which personalized risk assessment is recommended.
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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.
By: Kim J, McEvoy JW, Nasir K, Budoff MJ, Arad Y, Blumenthal RS, Blaha MJ.
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.
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Concepts and controversies: the 2013 American College of Cardiology/American Heart Association risk assessment and cholesterol treatment guidelines.
By: Martin SS, Blumenthal RS.
This editorial discusses the strengths and limitations of the new prevention guidelines.
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Incremental prognostic value of coronary artery calcium score versus CT angiography among symptomatic patients without known coronary artery disease.
By: Hulten E, Bittencourt MS, Ghoshhajra B, O’Leary D, Christman MP, Blaha MJ, Truong Q, Nelson K, Montana P, Steigner M, Rybicki F, Hainer J, Brady TJ, Hoffmann U, Di Carli MF, Nasir K, Abbara S, Blankstein R.
Among symptomatic patients with a CAC score of zero, a very low (1-2%) prevalence of potentially obstructive CAD can occur, although this finding was not associated with future coronary revascularization or adverse prognosis within two years.
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Modifiable lifestyle risks, cardiovascular disease, and all-cause mortality.
By: Ahmed HM, Blaha MJ, Blumenthal RS.
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Family history of coronary heart disease and the incidence and progression of coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA).
By: Pandey AK, Blaha MJ, Sharma K, Rivera J, Budoff MJ, Blankstein R, Al-Mallah M, Wong ND, Shaw L, Carr J, O’Leary D, Lima JA, Szklo M, Blumenthal RS, Nasir K.

A multiethnic, population-based study showed that a family history of premature CHD is associated with enhanced development and progression of subclinical disease, independent of other risk factors.

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Obstructive sleep apnea and diurnal non-dipping hemodynamic indices in patients at increased cardiovascular risk.
By: Seif F, Patel SR, Walia HK, Rueschman M, Bhatt DL, Blumenthal RS, Quan SF, Gottlieb DJ, Lewis EF, Patil SP, Punjabi NM, Babineau DC, Redline S, Mehra R.

We hypothesized increasing obstructive sleep apnea (OSA) severity would be associated with nondipping blood pressure (BP) in increased cardiovascular disease (CVD) risk. In patients at cardiovascular risk and moderate-to-severe OSA, increasing AHI and/or ODI were associated with increased odds of nondipping SBP and nondipping MAP. More severe levels of AHI and ODI also were associated with nondipping DBP. These results support progressive BP burden associated with increased OSA severity even in patients managed by cardiology specialty care.

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