Publications by authors named "Anna Bortnick"

There are limited and conflicting data on sex and urban-rural disparities in outcomes of patients with pulmonary embolism (PE) in the reproductive age group. Our object was to assess sex disparities in the reproductive age group cohort. All adult non-elective admissions in the reproductive age group (18-49 years) with a primary diagnosis of PE and with no missing sex/age data were identified using the National Inpatient Sample.

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ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality in the United States. Timely reperfusion with primary percutaneous coronary intervention is associated with improved outcomes. The Society for Cardiovascular Angiography & Interventions puts forth this expert consensus document regarding best practices for cardiac catheterization laboratory team readiness, arterial access with an algorithm to help determine proper arterial access in STEMI, and diagnostic angiography.

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There are similarities in the pathophysiologic mechanisms of atherosclerosis, calcific aortic valve disease (CAVD) and mitral annular calcification (MAC), however, medical treatment to slow or stop the progression of CAVD or MAC has been more elusive as compared to atherosclerosis. Atherosclerosis and CAVD share common demographic, clinical, protein, and genetic factors even more so than with MAC, which supports the possibility of shared medical therapies, though abrogating calcific extracellular vesicle shedding could be a common target for all three conditions. Herein, we summarize the overlapping and distinct pathways for further investigation, as well as key areas where additional research is needed.

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Article Synopsis
  • The field of interventional cardiology (IC) has seen significant advancements and improved training programs over the last 40 years, including accredited fellowship programs and subspecialty certification.
  • Despite these improvements, the application process for IC fellowships has been chaotic and inconsistent, causing stress and pressure on applicants due to competitive recruitment practices.
  • A task force from the Society for Cardiovascular Angiography & Interventions has initiated a grassroots movement to create a national Match system for IC fellowships, aiming to establish fairness and equity in the application process.
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Hypertensive disorders of pregnancy (HDP) complicate 13% to 15% of pregnancies in the United States. Historically marginalized communities are at increased risk, with preeclampsia and eclampsia being the leading cause of death in this population. Pregnant individuals with HDP require more frequent and intensive monitoring throughout the antepartum period outside of routine standard of care prenatal visits.

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Background And Aims: Matrix Gla protein (MGP) is an inhibitor of calcification that requires carboxylation by vitamin K for activity. The inactive form of MGP, dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP), has been associated with increased calcification. However, it is not known whether there is a longitudinal relationship between dephosphorylated-uncarboxylated matrix Gla protein levels and coronary and aortic calcification in large population cohorts.

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  • A study analyzed angiographic characteristics of patients with COVID-19 and STEMI using data from the North American COVID-19 Myocardial Infarction Registry, focusing on various angiographic outcomes.
  • Among 234 patients, 74% had one major blockage (culprit lesion), with significant cases of multivessel disease and stent thrombosis, complicating treatments.
  • One-third of the patients who underwent percutaneous coronary intervention (PCI) had unsuccessful outcomes linked to severe thrombus and poor blood flow, leading to higher in-hospital mortality rates for these cases.
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Several studies suggest differences in burnout and coping mechanisms between female and male physicians. We conducted an international, online survey exploring sex-based differences in the well-being of interventional cardiologists. Of 1251 participants, 121 (9.

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Background: Limited data exist regarding risk factors for aortic stenosis (AS). The plasma proteome is a promising phenotype for discovery of novel biomarkers and potentially causative mechanisms.

Objectives: The aim of this study was to discover novel biomarkers with potentially causal associations with AS.

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Background: Outcomes of individuals with adult congenital heart disease who are socioeconomically disadvantaged and cared for in cardio-obstetrical programs, are lacking.

Objective: This study aimed to describe the clinical characteristics, maternal pregnancy outcomes, and contraceptive uptake in individuals with adult congenital heart disease in an urban cardio-obstetrical program.

Study Design: Retrospective data were collected for individuals with adult congenital heart disease seen in the Maternal Fetal Medicine-Cardiology Joint Program at Montefiore Health System between 2015 and 2021 and compared using modified World Health Organization class I, II vs the modified World Health Organization class ≥II/III.

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  • The aging population is increasingly represented in cardiac procedures, making older adults the highest-risk patients for complications and mortality following complex interventions.
  • Structured risk assessments are essential for identifying which older patients will benefit from procedures versus those facing greater risks.
  • The conventional risk assessment methods focus on cardiovascular, physiological, and anatomical risks, but it’s suggested to add a fourth pillar: geriatric syndromes, since they can significantly impact overall risk.
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  • The text emphasizes the importance of a comprehensive risk assessment for older adults undergoing percutaneous coronary interventions, integrating geriatrics to improve patient outcomes in interventional cardiology.
  • It proposes forming a "geriatric" heart team that includes geriatric specialists alongside traditional heart team members to enhance risk evaluation and management for older patients.
  • The text also discusses goals of care, shared decision-making, and medication considerations for older adults, while identifying knowledge gaps and areas needing further research.
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COVID-19 infection triggers a heightened inflammatory response which in turn, increases thrombosis and thromboembolism. Microvascular thrombosis has been detected in various tissue beds which may account for some of the multi-system organ dysfunction associated with COVID-19. Additional research is needed to understand which prophylactic and therapeutic drug regimens are best for the prevention and treatment of thrombotic complications of COVID-19.

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Article Synopsis
  • The study investigates the impact of the COVID-19 pandemic and iodinated contrast shortage on the educational experience of first-year interventional cardiology (IC) fellows in the U.S. and Canada.
  • A survey of 111 fellows revealed that most worked long hours, predominantly in university programs, and had varied competencies with advanced procedures and technologies.
  • The results show significant gaps in training, particularly in intravascular imaging, complication management, and psychological support, along with high levels of stress among fellows.
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Background: Targeted temperature management (TTM) has been recommended after cardiac arrest (CA), however the specific temperature targets and cooling methods (intravascular cooling (IVC) versus surface cooling (SC)) remain uncertain.

Methods: PUBMED and EMBASE were searched until October 8, 2022 for randomized clinical trials (RCTs) investigating the efficacy of TTM after CA. The randomized treatment arms were categorized into the following 6 groups: 31.

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This review focuses on the maternal cardiovascular risk and outcomes of pregnancy in childhood, adolescent, and young adult cancer survivors who are achieving survival to their prime reproductive years. Childhood, adolescent, and young adult cancer survivors are a growing population and have increasing needs for reproductive care over decades of life. Female cancer survivors have an overall higher risk of maternal cardiovascular events compared to those without a history of cancer.

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Peripartum cardiomyopathy (PPCM) is idiopathic systolic congestive heart failure around pregnancy. Comparisons with matched controls are lacking. We investigated maternal characteristics and outcomes up to 12 months in a cohort admitted to Montefiore Health System in Bronx, New York 1999−2015 (n = 53 cases and n = 92 age and race-matched controls, >80% Black or Hispanic/Latina).

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Background: Aortic valve calcification (AVC) shares pathological features with atherosclerosis. Lipoprotein components have been detected in aortic valve tissue, including HDL (high-density lipoprotein). HDL measures have inverse associations with cardiovascular disease, but relationships with long-term AVC progression are unclear.

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As the average maternal age advances with increasing concurrent cardiovascular disease risk factors, more women are entering pregnancy with or at risk for various cardiovascular conditions. Although rare, pregnant patients may require various cardiac interventions in the catheterization laboratory. An understanding of indications for intervention in pregnant patients with conditions such as myocardial infarction, severe valvular disease, and cardiogenic shock is critical to optimizing both fetal and maternal outcomes.

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Background: Race and ethnicity are major considerations in the incidence, management, and long-term outcome of ST-elevation myocardial infarction (STEMI) in the United States, but there is limited existing comparative data.

Methods: We assembled a registry in a health system serving Bronx, NY of STEMI patients from 2008-2014 and analyzed differences in presentation, treatment and mortality between Hispanic/Latino (H/L), non-Hispanic Black (NHB) and non-Hispanic White (NHW). Upon discharge post-treatment for STEMI, all patients were followed for a median of 4.

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