Publications by authors named "Humphries K"

Background: Myocardial infarction with no obstructive coronary arteries (MINOCA), and ischemia with no obstructive coronary arteries (INOCA), are female-predominant conditions; clinical trials are lacking to guide medical management for the common underlying vasomotor etiologies. Data on long-term outcomes of (M)INOCA patients following attendance at a women's heart centre (WHC) are lacking.

Methods: Women diagnosed with MINOCA (n = 51) or INOCA (n = 112) were prospectively followed for 3 years at the Leslie Diamond WHC (LDWHC) in Vancouver.

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Systematic error, often referred to as bias is an inherent challenge in observational cardiovascular research, and has the potential to profoundly influence the design, conduct, and interpretation of study results. If not carefully considered and managed, bias can lead to spurious results, which can misinform clinical practice or public health initiatives and compromise patient outcomes. This methodological primer offers a concise introduction to the identification, evaluation, and mitigation of bias in observational cardiovascular research studies assessing the causal association of an exposure (or treatment) on an outcome.

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Ovarian aging is characterized by declines in follicular reserve and the emergence of mitochondrial dysfunction, reactive oxygen species production, inflammation, and fibrosis, which eventually results in menopause. Menopause is associated with increased systemic aging and the development of numerous comorbidities; therefore, the attenuation of ovarian aging could also delay systemic aging processes in women. Recent work has established that the anti-diabetic drug Canagliflozin (Cana), a sodium-glucose transporter 2 inhibitor, elicits benefits on aging-related outcomes, likely through the modulation of nutrient-sensing pathways and metabolic homeostasis.

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Article Synopsis
  • The introduction of high-sensitivity troponin (hsTnT) testing for emergency department patients with cardiac chest pain resulted in a significant reduction in length of stay, decreasing from approximately 464 minutes to 285 minutes.
  • The study included over 5,500 patients with cardiac chest pain, revealing a very low rate of missed major adverse cardiac events (MACE) at just 0.2%, indicating the safety of the new testing method.
  • No changes were observed in admission rates for both cardiac (around 24%) and noncardiac chest pain patients, while noncardiac cases remained stable in length of stay as well, underscoring the specific impact of hsTnT testing on cardiac chest pain
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  • The study investigates the best revascularization method for diabetic patients with multivessel disease who experience a non-ST-segment elevation myocardial infarction (NSTEMI), comparing coronary artery bypass grafting (CABG) and multivessel percutaneous coronary intervention (PCI).
  • It involves a large cohort of over 11,000 patients and reveals that CABG is linked to lower all-cause mortality than PCI, particularly in patients deemed potentially ineligible for CABG after a surgical consultation.
  • The results suggest that while CABG is generally more beneficial for these patients, the advantage is more pronounced when comparing CABG to a specific group of PCI patients who had a surgical consultation beforehand.
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Article Synopsis
  • The study aimed to analyze long-term outcomes in survivors of out-of-hospital cardiac arrest (OHCA) based on the cause of the arrest, particularly focusing on reversible vs. non-reversible etiologies.
  • Researchers examined data from the British Columbia Cardiac Arrest registry, categorizing patients by their OHCA cause and measuring outcomes like mortality and rehospitalization over three years.
  • Results indicated that survivors with reversible ischemic causes had the best outcomes, while those with reversible non-ischemic causes experienced the worst outcomes, highlighting the importance of identifying the underlying cause of cardiac arrests.
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Introduction: Cleft lip and/or palate (CL/P) affects 1 in 700 live births globally. Children born with CL/P and their families face various challenges throughout the child's development. Extant research is often limited by small numbers and single-centre data.

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Abnormal cardiac metabolism precedes and contributes to structural changes in heart failure. Low-level tragus stimulation (LLTS) can attenuate structural remodeling in heart failure with preserved ejection fraction (HFpEF). The role of LLTS on cardiac metabolism is not known.

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Background: Phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFK-2) is a critical glycolytic regulator responsible for upregulation of glycolysis in response to insulin and adrenergic signaling. PFKFB2, the cardiac isoform of PFK-2, is degraded in the heart in the absence of insulin signaling, contributing to diabetes-induced cardiac metabolic inflexibility. However, previous studies have not examined how the loss of PFKFB2 affects global cardiac metabolism and function.

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Background: Heart disease is the leading cause of premature death for women in Canada. Ischemic heart disease is categorized as myocardial infarction (MI) with no obstructive coronary artery disease (MINOCA), ischemia with no obstructive coronary arteries (INOCA), and atherosclerotic obstructive coronary artery disease (CAD) with MI (MI-CAD) or without MI (non-MI-CAD). This study aims to study the prevalence of traditional and nontraditional ischemic heart disease risk factors and their relationships with (M)INOCA, compared to MI-CAD and non-MI-CAD in young women.

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Background: An analytical benchmark for high-sensitivity cardiac troponin (hs-cTn) assays is to achieve a coefficient of variation (CV) of ≤ 10.0 % at the 99th percentile upper reference limit (URL) used for the diagnosis of myocardial infarction. Few prospective multicenter studies have evaluated assay imprecision and none have determined precision at the female URL which is lower than the male URL for all cardiac troponin assays.

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Objectives: This study aimed to establish whether hypothermia was present in patients who required a blood transfusion and underwent a urology procedure, as well as identify staff knowledge and understanding.

Patients And Methods: A staff survey was conducted with respondents from a range of clinical settings, with some staff working across more than one area. A retrospective review of 46 medical records was conducted between January 2021 and July 2022.

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Background: Phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFK-2) is a critical glycolytic regulator responsible for upregulation of glycolysis in response to insulin and adrenergic signaling. PFKFB2, the cardiac isoform of PFK-2, is degraded in the heart in the absence of insulin signaling, contributing to diabetes-induced cardiac metabolic inflexibility. However, previous studies have not examined how the loss of PFKFB2 affects global cardiac metabolism and function.

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Importance: The association between changes in atherosclerotic plaque induced by lipid-lowering therapies (LLTs) and reduction in major adverse cardiovascular events (MACEs) remains controversial.

Objective: To evaluate the association between coronary plaque regression assessed by intravascular ultrasound (IVUS) and MACEs.

Data Sources: A comprehensive, systematic search of publications in PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was performed.

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A healthy heart adapts to changes in nutrient availability and energy demands. In metabolic diseases like type 2 diabetes (T2D), increased reliance on fatty acids for energy production contributes to mitochondrial dysfunction and cardiomyopathy. A principal regulator of cardiac metabolism is 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFK-2), which is a central driver of glycolysis.

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Objective: We investigated sex differences in 1-year survival in a cohort of patients who survived out-of-hospital cardiac arrest (OHCA) to hospital discharge. We hypothesized that female sex is associated with higher 1-year posthospital discharge survival.

Methods: A retrospective analysis of linked data (2011-2017) from clinical databases in British Columbia (BC) was conducted.

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SIRT3 is a longevity factor that acts as the primary deacetylase in mitochondria. Although ubiquitously expressed, previous global SIRT3 knockout studies have shown primarily a cardiac-specific phenotype. Here, we sought to determine how specifically knocking out SIRT3 in cardiomyocytes (SIRTcKO mice) temporally affects cardiac function and metabolism.

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Aim: Longer emergency medical system cardiopulmonary-resuscitation-to-return of-spontaneous-circulation (EMS CPR-to-ROSC) interval has been associated with worse hospital discharge outcomes after out-of-hospital cardiac arrest (OHCA). We hypothesized that this association extends post-discharge in hospital survivors. We investigated whether pre-arrest co-morbidities influence the duration of resuscitation.

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Background: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction (MI) in young to middle-aged women.

Objectives: We aim to define the long-term natural history of SCAD.

Methods: We performed a multicenter, prospective, observational study of patients with nonatherosclerotic SCAD presenting acutely from 22 North American centers.

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Article Synopsis
  • Previous studies indicated that older adults are less protected by seat belts against fatal injuries, but this research aims to understand how age affects seat belt protection against severe injuries and torso injuries.
  • Using data from the Crash Outcome Data Evaluation System, researchers analyzed the effectiveness of seat belts for different age groups in reducing risks of fatal injuries, severe injuries (MAIS 3+), and torso injuries through a matched cohort design.
  • Findings revealed that while seat belts significantly reduce the risk of fatal injuries for all ages, their effectiveness in preventing serious injuries and torso injuries decreases as age increases, with notably lower protection for those aged 75 and older.
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