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Ciccarone Articles

Ciccarone Center Research

Topic

Markers of Thrombosis, Myocardial Injury, Wall Stress

Landmark Articles

Role of troponin in patients with chronic kidney disease and suspected acute coronary syndromes: a systematic review.
By: Stacy SR, Suarez-Cuervo C, Berger Z, Wilson LM, Yeh HC, Bass EB, Michos ED.
In chronic kidney disease patients suspected of having acute coronary syndromes, troponin levels can aid in identifying patients with a poor prognosis, but the diagnostic utility is limited by varying estimates of sensitivity and specificity.
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Prognostic value of cardiac troponins in chronic kidney disease patients without a suspected acute coronary syndrome: a systematic review.
By: Michos ED, Wilson LM, Yeh HC, Berger Z, Suarez-Cuervo C, Stacy SR, Bass EB.
In chronic kidney disease patients without suspected acute coronary syndromes, troponin elevations were associated with worse prognosis.
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Troponin elevations only detected with a high-sensitivity assay: Clinical correlations and prognostic significance.
By: Korley FK, Schulman SP, Sokoll LJ, DeFilippis AP, Stolbach AI, Bayram JD, Saheed MO, Omron R, Fernandez C, Lwin A, Cai SS, Post WS, Jaffe AS.

With clinical use of high-sensitivity troponin I (hsTnI), more frequent troponin elevations will occur. However, the burden and implications of these elevations are not well understood. The authors quantified the prevalence of elevated hsTnI in patients presenting with possible acute coronary syndrome (ACS) who do not have elevated troponin with a current generation assay (cardiac troponin I [cTnI]) and determined the association of these newly detected elevations with a composite of all-cause mortality and subsequent cardiac hospitalization. On the initial sample, 9% to 11% of subjects without cTnI elevation had hsTnI elevation. Although the majority of the patients with these newly detected hsTnI elevations did not have ACS, they had a higher risk for all-cause mortality and subsequent cardiac hospitalization.

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Effects of physical activity on cardiovascular disease.
By: Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS.
Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. We review recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease. There is a strong correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, HDL increase, change in LDL particle size, increase in tissue plasminogen activator activity, and decrease in CAC. Further research is needed to elucidate the effect on inflammatory markers and intima-media thickness.
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Effects of physical activity on cardiovascular disease.
By: Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS.
This paper provides a comprehensive look at the benefits of increased physical activity on lipid changes, thrombotic, inflammatory factors, and measures of subclinical atherosclerosis.
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Association of SNPs on chromosome 9p21.3 with platelet reactivity: A potential mechanism for increased vascular disease.
By: Musunuru K, Post WS, Herzog W, Shen H, O’Connell JR , Peyser PA, Faraday N, Shuldiner AR, Mitchell BD.

Genome-wide association studies have identified a locus on chromosome 9p21.3 to be strongly associated with myocardial infarction/coronary artery disease and ischemic stroke. To gain insights into the mechanisms underlying these associations, we hypothesized that single nucleotide polymorphisms (SNPs) in this region would be associated with platelet reactivity across multiple populations. Results suggest that risk alleles at 9p21.3 locus may have pleiotropic effects on myocardial infarction/coronary artery disease and stroke risk, possibly through their influence on platelet reactivity.

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Use of nonsteroidal anti-inflammatory drugs in patients with cardiovascular disease: a cautionary tale.
By: Amer M, Bead VR, Bathon J, Blumenthal RS, Edwards DN.
Potentially, all nonsteroidal anti-inflammatory drugs (NSAIDs) possess a fair risk of adverse effects on gastrointestinal, cardiovascular, and renal systems. Until more evidence for safety via randomized trials is available, we recommend caution in prescribing COX-1 and 2 inhibitors for musculoskeletal disorders in patients with existing gastrointestinal or cardiovascular conditions.
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