The Role of Markedly Elevated Cyst Carcinoembryonic Antigen in Risk-Stratifying Pancreatic Cysts.

Introduction: Carcinoembryonic antigen (CEA) level is currently being used in algorithms of commercially available pancreatic cyst fluid analysis platforms. However, the evidence to date on its role in risk stratification for mucinous lesions is heterogenous. We therefore sought to examine the relationship between the magnitude of CEA elevation and the structural and molecular properties of pancreatic cysts.

Association of Cardiologist Clinic Visits With Cardiovascular Primary Prevention Outcomes Among People With HIV From Underrepresented Racial and Ethnic Groups in the Southern United States.

Background: People with HIV (PWH) have elevated cardiovascular risk. Underrepresented racial and ethnic groups in the southern United States are disproportionately affected, yet whether cardiology care for this at-risk group improves blood pressure and lipid control or prevents cardiovascular events is unknown.

Methods And Results: We evaluated a cohort of PWH from underrepresented racial and ethnic groups who received HIV-related care at 4 centers in the southern United States during 2015 to 2018 with follow-up through 2020.

Performance of the pooled cohort equations and D:A:D risk scores among individuals with HIV in a global cardiovascular disease prevention trial: a cohort study leveraging data from REPRIEVE.

Background: Risk estimation is an essential component of cardiovascular disease prevention among people with HIV. We aimed to characterise how well atherosclerotic cardiovascular disease (ASCVD) risk scores used in clinical guidelines perform among people with HIV globally.

Methods: In this prospective cohort study leveraging REPRIEVE data, we included participants aged 40-75 years, with low-to-moderate traditional cardiovascular risk, not taking statin therapy.

Global Health Inequities in Electrophysiology Care: A State-of-the-Art Review.

This state-of-the-art review examines disparities in the diagnosis, management, and outcomes of cardiac arrhythmias globally. These arrhythmias include atrial fibrillation, ventricular tachyarrhythmias underlying sudden cardiac death, and bradyarrhythmias associated with sinus node and atrioventricular node disease. Arrhythmias in low- and middle-income countries often result in higher mortality rates due to complex and poorly documented risk factors, lack of clinical expertise among health care personnel, lack of sufficient infrastructure, and challenges in access to care.

Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis.

Background: Patients with abnormal (positive) exercise electrocardiography, but normal stress echocardiography (+ECG/-Echo), have an increased risk of adverse cardiovascular events compared with patients with a normal (negative) ECG and a normal stress Echo (-ECG/-Echo). However, it is unclear if +ECG/-Echo discordance is associated with a greater burden of subclinical coronary atherosclerosis.

Methods: Project Baseline Health Study participants who underwent a stress Echo and coronary artery calcium (CAC) scan were stratified by stress Echo result: -ECG/-Echo or +ECG/-Echo.

Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study.

Background: Preliminary data suggests that the burden of acute coronary syndrome (ACS) is high in Tanzania. After efforts to improve ACS care, we sought to describe ACS diagnosis rates, care processes, and outcomes in a Tanzanian Emergency Department (ED).

Methods: Adults presenting to a northern Tanzanian ED with acute chest pain or shortness of breath were enrolled from November 2020 to January 2023.

Taxing tobacco as a strategy to reduce consumption and increase public health benefits in Pakistan.

Background: Tobacco consumption poses a significant challenge to global health and contributes to the increase in noncommunicable diseases and premature deaths.

Aim: To investigate the potential impact of a 70% tobacco tax on consumption and government revenue in Pakistan.

Methods: We analysed secondary data from 2011 to 2022 (after imposition of a 70% excise tax) from the Pakistan Bureau of Statistics, Pakistan Social and Living Standard Survey, financial yearbooks and Federal Board of Revenue reports for tobacco consumption and government revenue.

Effect of a Multicomponent Intervention on Acute Myocardial Infarction Diagnosis and Treatment in Tanzania: The MIMIC Implementation Trial.

Background: In Tanzania, acute myocardial infarction (AMI) is under-diagnosed, and uptake of evidence-based care is sub-optimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC).

Methods: This single-arm pre-post trial was conducted in a northern Tanzanian emergency department (ED).

Pitavastatin, Procollagen Pathways, and Plaque Stabilization in Patients With HIV: A Secondary Analysis of the REPRIEVE Randomized Clinical Trial.

Importance: In a mechanistic substudy of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) randomized clinical trial, pitavastatin reduced noncalcified plaque (NCP) volume, but specific protein and gene pathways contributing to changes in coronary plaque remain unknown.

Objective: To use targeted discovery proteomics and transcriptomics approaches to interrogate biological pathways beyond low-density lipoprotein cholesterol (LDL-C), relating statin outcomes to reduce NCP volume and promote plaque stabilization among people with HIV (PWH).

Design, Setting, And Participants: This was a post hoc analysis of the double-blind, placebo-controlled, REPRIEVE randomized clinical trial.

Prognosis of patients with nonspecific electrocardiogram findings in a Tanzanian emergency department.

Background: Nonspecific electrocardiogram (ECG) findings are associated with increased morbidity and mortality in high-income settings. ECGs are increasingly available in emergency departments (EDs) in low- and middle-income countries (LMICs), however the prognostic value of nonspecific ECG findings in resource-limited settings, particularly in sub-Saharan Africa, remains unclear.

Objective: To assess the association between nonspecific ECG findings and 30-day mortality among patients presenting with chest pain and shortness of breath to a Tanzanian ED.

Impact of prior cholecystectomy on diagnosis and outcomes of choledochal cyst resection in adults.

Introduction: The diagnosis of choledochal cysts in the adult population is complicated by the expected physiologic dilation of the common bile duct after cholecystectomy. We aimed to compare patients who underwent choledochal cyst resection based on cholecystectomy status.

Methods: A retrospective analysis was conducted of patients who underwent choledochal cyst resection between 1/1/1998-12/31/2021.

Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer.

Effective antiretroviral therapy (ART) is now nearly ubiquitous. However, the survival benefits conferred with ART contribute to an aging human immunodeficiency virus (HIV) population and increased risk of chronic diseases, like atherosclerotic cardiovascular disease (ASCVD). Furthermore, HIV is a known risk enhancer of ASCVD and acknowledged as such in the current 2018 AHA/ACC Blood Cholesterol guidelines [1].

1- and 2-year outcomes and predictors of weight loss after gastric sleeve to Roux-en-Y gastric bypass conversion: a retrospective cohort study.

Background: Sleeve gastrectomy to Roux-en-Y bypass conversion is a commonly performed procedure, yet data are limited on outcomes and their predictors. The purpose of this study is to characterize the long-term outcomes of patients after sleeve-to-bypass conversion and identify predictors of post-conversion outcomes.

Methods: We performed a retrospective cohort study of patients who underwent sleeve-to-bypass conversion for obesity across four hospitals from 06/2017 to 04/2023.

Procedural characteristics of coronary angiography in patients with anomalous aortic origin of a coronary artery.

Background: Anomalous coronary arteries (ACA) are seen in 1-5 % of patients undergoing coronary angiography, and their presence may increase procedural difficulty. We aimed to compare procedural outcomes of coronary angiography in ACA patients by anatomy and prior knowledge of the ACA.

Methods: This was a single-center review of ACA patients undergoing coronary angiography between October 2013 and February 2022.

Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.

Background: Although the incidence of acute myocardial infarction (AMI) is rising in sub-Saharan Africa, the uptake of evidence-based care for the diagnosis and treatment of AMI is limited throughout the region. In Tanzania, studies have revealed common misdiagnosis of AMI, infrequent administration of aspirin, and high short-term mortality rates following AMI.

Objective: This study aims to evaluate the implementation and efficacy outcomes of an intervention, the Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC), which was developed to improve the delivery of evidence-based AMI care in Tanzania.

Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.

Background: Coronary plaque is common among people with HIV (PWH) with low-to-moderate traditional atherosclerotic cardiovascular disease (ASCVD) risk.

Objectives: The purpose of this study was to determine the association of high-sensitivity cardiac troponin T (hs-cTnT) levels with coronary plaque characteristics and evaluate if hs-cTnT improves identification of these features beyond traditional ASCVD risk factors among PWH.

Methods: Among PWH receiving stable antiretroviral therapy with low-to-moderate ASCVD risk and no known history of ASCVD, hs-cTnT levels and measures of plaque by coronary computed tomography angiography were assessed.

Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension.

Background: Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypertension (HTN) is important to improve the primary prevention efforts for this high-risk population. We sought to assess important patient-level correlates (eg, race) and inter-facility variations in antihypertension medication prescriptions and BP control among Veterans living with HIV (VLWH) and HTN.

Pitavastatin Is Well-Tolerated With no Detrimental Effects on Physical Function.

Background: Little is known about the potential benefits or harms of statins on physical function among people with human immunodeficiency virus (PWH).

Methods: REPRIEVE was a double-blind randomized controlled trial evaluating pitavastatin for primary prevention of major adverse cardiovascular events in PWH. Time to complete 10 chair rises, 4-m gait speed, grip strength, and a modified short physical performance test were assessed annually for up to 5 years in the ancillary study PREPARE and analyzed using linear mixed models.