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Ciccarone Articles

Ciccarone Center Research

Year

2012

Landmark Articles

Low free testosterone in HIV-infected men is not associated with subclinical cardiovascular disease.
By: Monroe AK, Dobs AS, Xu X, Palella FJ, Kingsley LA, Post WS, Witt MD, Brown TT.

Low testosterone (T) is associated with cardiovascular disease (CVD) and increased mortality in the general population; however, the impact of T on subclinical CVD in HIV disease is unknown. This study examined the relationships among free testosterone (FT), subclinical CVD, and HIV disease. Compared with HIV-uninfected men, HIV-infected men had lower FT, as well as more prevalent carotid lesions. In both groups, FT was not associated with CAC presence, log carotid IMT, or carotid lesion presence, suggesting that FT does not influence subclinical CVD in this population of men with and at risk for HIV infection.

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Lipoprotein(a) particle concentration and lipoprotein(a) cholesterol assays yield discordant classification of patients into four physiologically discrete groups.
By: Konerman M, Kulkarni K, Toth PP, Jones SR.
These findings suggest that the four Lipoprotein(a)-defined groups are physiologically discrete. Further investigation is warranted to assess which parameters among the four can be used to more accurately characterize Lp(a)-associated cardiovascular risk.
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The lipid/risk tightrope: 10 simple ways to optimize risk while waiting for the NCEP ATP IV guidelines.
By: Martin SS.
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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".
By: Wu KC, Gerstenblith G, Marine JE, Dalal D, Cheng A, Lima JA, Tomaselli GF, Weiss RG, Guallar E, Marbán E.

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Coronary artery calcium and primary prevention risk assessment: What is the evidence? An updated meta-analysis on patient and physician behavior.
By: Whelton SP, Nasir K, Blaha MJ, Gransar H, Metkus TS, Coresh J, Berman DS, Blumenthal RS.

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Associations of salivary cortisol levels with inflammatory markers: the Multi-Ethnic Study of Atherosclerosis.
By: DeSantis AS, DiezRoux AV, Hajat A, Aiello AE, Golden SH, Jenny NS, Seeman TE, Shea S.

Socioeconomic and psychosocial factors have been found to be associated with systemic inflammation. Although stress is often proposed as a contributor to these associations, no population studies have investigated the links between inflammation and biomarkers of stress. The current study examines associations between daily cortisol profiles and inflammatory markers interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor (TNF-a) in a population-based sample of 869 adults with repeat measures of cortisol over multiple days. Persons with higher levels of IL-6 had a less pronounced cortisol awakening response, a less steep daily decline, and higher cortisol area under the curve for the day with associations persisting after controls for risk factors and other cytokines. Persons with higher levels of TNF-a had lower cortisol levels upon waking, and flatter daily decline, although associations with decline were attenuated when controlling for inflammatory risk factors. Higher levels of IL-10 were associated with marginally flatter daily cortisol decline (p<.10). This study is the first to identify associations of basal cortisol activity and inflammatory markers in a population based sample. Findings are consistent with the possibility that HPA axis activity may mediate associations between psychosocial stressors and inflammatory processes. Additional prospective data are necessary to clarify the directionality of associations between cortisol and inflammatory markers.

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Health disparities in endocrine disorders: Biological, clinical, and nonclinical factors — an Endocrine Society Scientific Statement.
By: Golden SH, Brown A, Cauley JA, Chin MH, Gary-Webb TL, Kim C, Sosa JA, Sumner AE, Anton B.
There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.
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A national interactive Web-based physical activity intervention in women, evaluation of the American Heart Association Choose to Move program 2006-2007.
By: Lieber SB, Redberg RF, Blumenthal RS, Gandhi A, Robb KJ, Mora S.
In this national cohort of women, a 12-week Web-based intervention improved physical activity and quality of life measurements, resulting in higher short-term physical activity guideline compliance and better quality of life. Increasing use of this simple Web-based tool could improve physical activity and promote disease prevention.
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A point-by-point response to recent arguments against the use of statins in primary prevention.
By: Joshi PH, Chaudhari S, Blaha MJ, Jones SR, Martin SS, Post WS, Cannon CP, Fonarow GC, Wong ND, Amsterdam E, Hirshfeld JW, Blumenthal RS.
Early in 2012, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary-prevention statin trials. In selected at-risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at-risk individuals.
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Niacin and statin combination therapy for atherosclerosis regression and prevention of cardiovascular disease events: Reconciling the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Heal
By: Michos ED, Sibley CT, Baer JT, Blaha MJ, Blumenthal RS.
Despite substantial risk reductions targeting low-density lipoprotein cholesterol with statins, there remains significant residual risk as evidenced by incident and recurrent CVD events among statin-treated patients. Observational studies have shown that low levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased CVD risk. It remains unclear whether strategies aimed at increasing HDL-C in addition to background statin therapy will further reduce risk.
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