Publications by authors named "James De Lemos"
Background: Patients with a history of coronary revascularization are at a higher risk for subsequent cardiovascular events and all-cause mortality. Lowering LDL-cholesterol (LDL-C) levels post-revascularization significantly reduces these risks.
Methods: This analysis compared LDL-C-lowering therapies at baseline and over time among patients with and without prior coronary revascularization in the GOULD registry (a prospective multicenter cohort study).
Precision medicine aims to provide personalized clinical care guided by tools that reflect underlying pathophysiology. The need for such an approach has never been greater in cardiovascular medicine, given the large number of guideline-directed medical therapies available. However, progress has been modest to date with few precision tools available for clinicians.
View Article and Find Full Text PDFBackground: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are associated with cardiovascular outcomes and are recommended for measurement in type 2 diabetes (T2D). However, the effects of an intensive lifestyle intervention (ILI) targeting weight loss on cardiac biomarkers and the prognostic association of changes in these biomarkers with risk of adverse cardiovascular outcomes in T2D are not well-established.
Objectives: This study sought to evaluate the effects of an ILI on cardiac biomarkers and the association of changes in cardiac biomarkers with risk of cardiovascular outcomes in T2D.
High-density lipoprotein cholesterol efflux function may prevent brain amyloid beta deposition and neurodegeneration. However, the relevance of this finding has not been established in the diverse middle-aged population. We examined 1826 adults (47% Black adults) who participated in the Dallas Heart Study to determine associations between high-density lipoprotein (HDL) measures and brain structure and function.
View Article and Find Full Text PDFRenal denervation as an option for difficult to treat hypertension has been a concept for several decades, with recent U.S. FDA approval of new, minimally invasive devices.
View Article and Find Full Text PDFBackground: There are no shared decision-making frameworks for selecting blood pressure (BP) targets for individuals with hypertension. This study addressed whether results from the SPRINT (Systolic Blood Pressure Intervention Trial) could be tailored to individuals using predicted risks and simulated preferences.
Methods And Results: Among 8202 SPRINT participants, Cox models were developed and internally validated to predict each individual's absolute difference in risk from intensive versus standard BP lowering for cardiovascular events, cognitive impairment, death, and serious adverse events (AEs).
Background: Treating obesity may be a pathway to prevent and control hypertension. In the SURMOUNT-1 trial in people with obesity or overweight with weight-related complications, 72-week tirzepatide treatment led to clinically meaningful body weight and blood pressure reduction. Post hoc analyses were conducted to further explore the effects of tirzepatide on the pattern of blood pressure reduction and whether the effects were consistent across various subgroups.
View Article and Find Full Text PDFBackground: Hs-cTnT (cardiac troponin T measured with a highly sensitive assay) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) may identify adults with hypertension who derive greater cognitive benefits from lower systolic blood pressure targets.
Methods: In the SPRINT (Systolic Blood Pressure Intervention Trial) MIND study, participants were categorized as having both hs-cTnT and NT-proBNP in the lower 2 tertiles (n=4226), one in the highest tertile (n=2379), and both in the highest tertile (n=1506). We assessed the effect of intensive versus standard treatment on the composite of mild cognitive impairment (MCI) or probable dementia (PD) across biomarker categories.
Background: Previous studies have linked cardiovascular risk factors during midlife to cognitive function in later life. However, few studies have looked at the association between cardiac function, brain structure, and cognitive function and even less have included diverse middle-aged populations.
Objectives: The objective of this study was to determine associations between cardiac and brain structure and function in a multiethnic cohort of middle-aged adults.
Background: High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) provide complementary information regarding cardiovascular disease risk. The explanation for their distinct risk profiles is incompletely understood.
Methods And Results: hs-cTnI and hs-cTnT were measured in Dallas Heart Study participants.
Importance: Identification of individuals at high risk for atherosclerotic cardiovascular disease within the population is important to inform primary prevention strategies.
Objective: To evaluate the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors.
Design, Setting, And Participants: Individual-level analysis including data on cardiovascular biomarkers from 28 general population-based cohorts from 12 countries and 4 continents with assessments by participant age.
Objective: To evaluate the association between trimethylamine N-oxide (TMAO) and related metabolites with adverse cardiovascular events in a multiethnic urban primary prevention population.
Methods: We performed a case-control study of 361 participants of the Dallas Heart Study, including 88 participants with an incident atherosclerotic cardiovascular disease (ASCVD) event and 273 controls matched for age, sex, and body mass index without an ASCVD event during 12 years of follow-up (January 1, 2000, through December 31, 2015). Plasma levels of TMAO, choline, carnitine, betaine, and butyrobetaine were measured by mass spectrometry.
Article Synopsis
- Cardiogenic shock after acute myocardial infarction remains highly lethal, prompting researchers to analyze data from 16,337 cases across 440 centers to identify characteristics linked to lower mortality.
- The study found that centers with lower risk-adjusted in-hospital mortality rates typically had patients with fewer co-morbidities, performed more revascularizations, and showed better adherence to clinical processes.
- Despite the presence of some beneficial factors, not all low-mortality centers demonstrated these characteristics, indicating the complexity of treating cardiogenic shock and the challenges in evaluating outcomes in such cases.
Article Synopsis
- - Nighttime blood pressure (BP) is more closely linked to heart disease risk than daytime BP, yet its relationship with early heart disease indicators is not well understood.
- - A study involving 897 participants found that higher nighttime BP was significantly associated with increased levels of heart-related biomarkers, specifically NT-proBNP and hs-cTnT, indicating potential heart issues.
- - While both nighttime and daytime BP were linked to higher hs-cTnT levels, only nighttime BP showed a strong connection to NT-proBNP levels, suggesting it may be a more important factor in assessing cardiovascular health.
Background: Among individuals with hypertension and low diastolic blood pressure (DBP), the optimal BP target remains controversial due to concerns that BP lowering may reduce coronary perfusion. We determined the impact of intensive BP control among individuals with elevated systolic BP who have low DBP and elevated hs-cTnT (high-sensitivity cardiac troponin T) levels.
Methods And Results: A total of 8828 participants in SPRINT (Systolic Blood Pressure Intervention Trial) were stratified by baseline DBP.
Background: Hereditary transthyretin cardiac amyloidosis (ATTRv-CA) has a long latency phase before clinical onset, creating a need to identify subclinical disease. We hypothesized circulating transthyretin (TTR) and retinol binding protein 4 (RBP4) levels would be associated with carrier status and correlated with possible evidence of subclinical ATTRv-CA.
Methods: TTR and RBP4 were measured in blood samples from V122I carriers and age-, sex- and race-matched non-carrier controls (1:2 matching) among Dallas Heart Study participants (phases 1 (DHS-1) and 2 (DHS-2)).
Article Synopsis
- The study aims to find links between new plasma biomarkers and the occurrence or progression of coronary artery calcium (CAC), which can help understand heart disease development.
- It analyzed data from participants in the Dallas Heart Study over about 7 years, checking 31 biomarkers and their relationship with CAC changes.
- The key finding was that soluble intercellular adhesion molecule-1 (sICAM-1) was consistently associated with CAC changes, suggesting a link to inflammation in atherosclerosis, though further research is needed to clarify its role.
Background: A single, multitiered valve center designation has been proposed to publicly identify centers with expertise for all valve therapies. The correlation between transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (MTEER) procedures is unknown.
Objectives: The authors sought to examine the relationship between site-level volumes and outcomes for TAVR and MTEER.