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Ciccarone Articles

Ciccarone Center Research


Cardiovascular Risk Assessment

Landmark Articles

Short and lifetime cardiovascular risk estimates: same wine, different bottles. Do we have the COURAGE to abandon risk scores?
By: Nasir K, Blaha MJ.
This editorial examines the shortcomings of traditional cardiovascular risk assessment scores.
Read on Pubmed
Relation between self-reported physical activity level, fitness, and cardiometabolic risk.
By: Minder CM, Shaya GE, Michos ED, Keenan TE, Blumenthal RS, Nasir K, Carvalho JA, Conceição RD, Santos RD, Blaha MJ.
Self-reported physical activity level and directly measured fitness are moderately correlated, and the latter is more strongly associated with a protective cardiovascular risk profile.
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Association between resting heart rate and inflammatory biomarkers (high-sensitivity C-reactive protein, interleukin-6, and fibrinogen): from the Multi-Ethnic Study of Atherosclerosis.
By: Whelton SP, Narla V, Blaha MJ, Nasir K, Blumenthal RS, Jenny NS, Al-Mallah MH, Michos ED.
Heart rate (HR) at rest is associated with adverse cardiovascular events; however, the biologic mechanism for the relation is unclear. An increased HR at rest was associated with a higher level of inflammation among an ethnically diverse group of subjects without known cardiovascular disease.
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Are we moving towards concordance on the principle that lipid discordance matters?
By: Martin SS, Michos ED.

The paper addresses the underappreciated concept of discordance between different lipid and lipoprotein measures in individual patients. The investigators address the prevalence of such discordance and its association with long-term incidence of coronary events.

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Polypill therapy, subclinical atherosclerosis, and cardiovascular events — implications for the use of preventive pharmacotherapy: MESA (Multi-Ethnic Study of Atherosclerosis).
By: Bittencourt MS, Blaha MJ, Blankstein R, Budoff M, Vargas JD, Blumenthal RS, Agatston AS, Nasir K.
The authors conclude that avoidance of polypill therapy in individuals with subclinical atherosclerosis could allow for a more selective use of the treatment and, as a result, avoidance of treatment in those who are unlikely to benefit.
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All-cause mortality in asymptomatic persons with extensive Agatston scores above 1000.
By: Patel J, Blaha MJ, McEvoy JW, Qadir S, Tota-Maharaj R, Shaw LJ, Rumberger JA, Callister TQ, Berman DS, Min JK, Raggi P, Agatston AA, Blumenthal RS, Budoff MJ, Nasir K.
Increasing calcified plaque in coronary arteries continues to predict a graded decrease in survival among patients with extensive Agatston score > 1000 with no apparent upper threshold.
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Heart disease and stroke statistics — 2014 update: a report from the American Heart Association.
By: Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
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Beyond BMI: the "metabolically healthy obese" phenotype and its association with clinical/subclinical cardiovascular disease and all-cause mortality: a systematic review.
By: Roberson LL, Aneni EC, Maziak W, Agatston A, Feldman T, Rouseff M, Tran T, Blaha MJ, Santos RD, Sposito A, Al-Mallah MH, Blankstein R, Budoff MJ, Nasir K.

This review analyzed the literature that has examined the burden of CVD and all-cause mortality in the metabolically healthy obese population.

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Dyslipidemia, coronary artery calcium, and incident atherosclerotic cardiovascular disease: implications for statin therapy from the multi-ethnic study of atherosclerosis.
By: Martin SS, Blaha MJ, Blankstein R, Agatston A, Rivera JJ, Virani SS, Ouyang P, Jones SR, Blumenthal RS, Budoff MJ, Nasir K.
CAC scoring can help match statin therapy to absolute atherosclerotic CVD risk.
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The risk discussion: A key virtue of the 2013 ACC/AHA cholesterol treatment guidelines.
By: Martin SS, Stone NJ, Blumenthal RS.