Publications by authors named "Kirk U Knowlton"

Background: The contributions of genetic and environmental risk factors to hidradenitis suppurativa (HS) are both poorly understood.

Objective: To identify sequence variants that associate with HS and determine the contribution of environmental risk factors and inflammatory diseases to HS pathogenesis.

Methods: A genome-wide association meta-analysis of 4814 HS cases (Denmark: 1977; Iceland: 1266; Finland: 800; UK: 569; and US: 202) and 1.

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  • The study aims to investigate the genetic factors associated with accessory atrioventricular pathways (APs) and related heart rhythm disorders using a genome-wide association study (GWAS).
  • It involved analyzing genetic data from over 1,200,000 control individuals and 2,310 individuals with APs from multiple countries and various health databases.
  • Key findings revealed three significant genetic variants linked to APs, particularly in specific genes (CCDC141 and SCN10A), with implications for understanding conditions like paroxysmal supraventricular tachycardia (PSVT).
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  • The study investigates how different data sources (like electronic health records, insurance claims, and participant reports) contribute to analyzing clinical outcomes in a pragmatic randomized clinical trial (RCT) involving patients with atherosclerotic cardiovascular disease.
  • Conducted from April 2016 to June 2019, the ADAPTABLE study looked at the effects of daily aspirin doses on certain health events, while comparing participant data availability to enhance understanding of outcome rates.
  • The findings revealed a predominance of participant-reported and EHR data, with only a small percentage relying solely on claims data, indicating the need for further study on the varying contributions of each data source to overall clinical results.
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encodes for the Popeye domain-containing protein 2 which has an important role in cardiac pacemaking and conduction, due in part to its cAMP-dependent binding and regulation of TREK-1 potassium channels. Loss of in mice results in sinus pauses and bradycardia and morpholino knockdown of zebrafish results in atrioventricular (AV) block. We identified bi-allelic variants in in 4 families that presented with a phenotypic spectrum consisting of sinus node dysfunction, AV conduction defects and hypertrophic cardiomyopathy.

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Background: Periodic fasting was previously associated with greater longevity and a lower incidence of heart failure (HF) in a pre-pandemic population. In patients with coronavirus disease 2019 (COVID-19), periodic fasting was associated with a lower risk of death or hospitalization. This study evaluated the association between periodic fasting and HF hospitalization and major adverse cardiovascular events (MACEs).

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  • Short-term increases in fine particulate matter (PM) from wildfire smoke are linked to worse outcomes for asthma and COPD patients, with a study analyzing over 80,000 hospitalizations in Utah from 1999 to 2022.
  • The research found that asthma risk increased on the same day PM levels rose during both wildfire and winter inversion seasons, with notable differences in risk timing between adults and children.
  • While PM exposure was directly connected to asthma hospitalizations, its association with COPD was weak, and ozone levels had no significant impact on respiratory health outcomes.
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Autoimmune thyroid disease (AITD) is a common autoimmune disease. In a GWAS meta-analysis of 110,945 cases and 1,084,290 controls, 290 sequence variants at 225 loci are associated with AITD. Of these variants, 115 are previously unreported.

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Background: Statins can improve outcomes in high-risk primary prevention populations. However, application in clinical practice has lagged.

Objectives: The objective of this study was to compare an active vs a passive strategy (ie, usual care) to statin prescription for primary prevention of atherosclerotic cardiovascular disease (ASCVD).

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Background: The use of statins in patients with heart failure (HF) is controversial. In patients without HF, statins reduce atherosclerotic cardiovascular disease (ASCVD) risk, including HF-related events. However, in some large studies, no benefit was seen in statin-treated HF patients.

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The limitations of the explanatory clinical trial framework include the high expense of implementing explanatory trials, restrictive entry criteria for participants, and redundant logistical processes. These limitations can result in slow evidence generation that is not responsive to population health needs, yielding evidence that is not generalizable. Clinically integrated trials, which integrate clinical research into routine care, represent a potential solution to this challenge and an opportunity to support learning health systems.

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: Patient outcomes after percutaneous coronary intervention (PCI) have improved over the last 30 years due to better techniques, therapies, and care processes. This study evaluated contemporary predictors of post-PCI major adverse cardiovascular events (MACE) and summarized risk in a parsimonious risk prediction model. : The Cardiovascular Patient-Level Analytical Platform (CLiPPeR) is an observational dataset of baseline variables and longitudinal outcomes from the American College of Cardiology's CathPCI Registry and national claims data.

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  • * The study analyzed MI patients at Intermountain Health between 2001 and 2021, focusing on those who underwent coronary artery calcium (CAC) scans and had no SMRF, revealing that a majority had high CAC scores indicative of increased cardiovascular risk.
  • * Findings suggest that patients without SMRF but with high CAC prevalence could benefit from preventive treatments, highlighting the need for broader use of CAC scans to identify hidden at-risk populations for MI.
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  • Essential tremor (ET) is a common neurological disorder, but its biological causes are still not well understood.
  • A comprehensive study involving over 16,000 ET cases identified 12 genetic variants linked to the disorder, suggesting several potential causal genes, including CA3 and CPLX1.
  • The findings also reveal associations between ET and other conditions like Parkinson's disease, depression, and anxiety, which could lead to new therapeutic targets for treatment.
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We report a multi-ancestry genome-wide association study on liver cirrhosis and its associated endophenotypes, alanine aminotransferase (ALT) and γ-glutamyl transferase. Using data from 12 cohorts, including 18,265 cases with cirrhosis, 1,782,047 controls, up to 1 million individuals with liver function tests and a validation cohort of 21,689 cases and 617,729 controls, we identify and validate 14 risk associations for cirrhosis. Many variants are located near genes involved in hepatic lipid metabolism.

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  • In patients with atherosclerotic cardiovascular disease, increased age is linked to higher risks of both ischemic and bleeding events, prompting a study on the effect of aspirin dosage based on age.
  • The ADAPTABLE trial involved nearly 15,100 participants who were randomly assigned to take either 81 mg or 325 mg of aspirin daily, with outcomes measured over an average follow-up of 26.2 months.
  • Results indicated that age did not significantly affect how aspirin dosage influenced clinical outcomes, suggesting that both doses are similarly effective for elderly and younger patients in preventing cardiovascular events.
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Importance: Recurrent pericarditis is a treatment challenge and often a debilitating condition. Drugs inhibiting interleukin 1 cytokines are a promising new treatment option, but their use is based on scarce biological evidence and clinical trials of modest sizes, and the contributions of innate and adaptive immune processes to the pathophysiology are incompletely understood.

Objective: To use human genomics, transcriptomics, and proteomics to shed light on the pathogenesis of pericarditis.

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  • - The study aimed to assess whether certain genetic variations in the GIP receptor might increase fracture risk or lower bone mineral density (BMD) in people managing obesity through weight loss.
  • - Researchers analyzed three specific gene variants and a group of predicted loss-of-function variants across a large population of up to 1.2 million participants, examining their correlation to different types of fractures and BMD measurements.
  • - The findings indicated that none of the examined gene variants were linked to a higher risk of fractures or lower BMD, suggesting that these genetic factors do not adversely affect bone health in the context of obesity treatment.
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Background: Coronary heart disease (CHD) is the leading cause of death in the world. Unfortunately, many of the key diagnostic tools for CHD are insensitive, invasive, and costly; require significant specialized infrastructure investments; and do not provide information to guide postdiagnosis therapy. In prior work using data from the Framingham Heart Study, we provided in silico evidence that integrated genetic-epigenetic tools may provide a new avenue for assessing CHD.

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  • Migraine is a complicated neurovascular condition with varying symptoms, traditionally studied as a single type in genome-wide association studies (GWAS), but this research focuses on two main subtypes: migraine with aura (MA) and migraine without aura (MO).
  • The study analyzed large datasets from six European populations, identifying four new gene variants associated with MA and classifying 13 variants for MO, highlighting a significant frameshift variant in PRRT2 linked to MA and epilepsy.
  • Additionally, testing on rare variants showed that loss-of-function mutations in SCN11A provide strong protection against migraine, while another variant affecting KCNK5 offers large protection against both migraine and brain aneurysms, suggesting new avenues for treatment.
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  • Clinicians recommend enteric-coated aspirin to reduce gastrointestinal bleeding for patients with coronary artery disease, despite evidence suggesting it may be less effective at inhibiting platelets than uncoated aspirin.
  • This study analyzed data from the ADAPTABLE trial, which involved over 15,000 patients with atherosclerotic cardiovascular disease, to compare the effectiveness and safety of enteric-coated versus uncoated aspirin.
  • The primary outcomes measured were the occurrence of major cardiovascular events and major bleeding incidents, with findings indicating the differences in these outcomes between the two aspirin formulations over approximately 26 months of follow-up.
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Background: Intermittent fasting may increase longevity and lower cardiometabolic risk. This study evaluated whether fasting modifies clinical risk scores for mortality [i.e.

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Many sequence variants have additive effects on blood lipid levels and, through that, on the risk of coronary artery disease (CAD). We show that variants also have non-additive effects and interact to affect lipid levels as well as affecting variance and correlations. Variance and correlation effects are often signatures of epistasis or gene-environmental interactions.

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Introduction: Long-chain omega-3 polyunsaturated fatty acids (OM3 PUFA) are commonly used for cardiovascular disease prevention. High-dose eicosapentaenoic acid (EPA) is reported to reduce major adverse cardiovascular events (MACE); however, a combined EPA and docosahexaenoic acid (DHA) supplementation has not been proven to do so. This study aimed to evaluate the potential interaction between EPA and DHA levels on long-term MACE.

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  • - The ADAPTABLE trial examined the effects of different doses of aspirin (81 mg vs 325 mg daily) on cardiovascular events and bleeding rates in patients with existing cardiovascular disease, finding no significant differences between the two doses.
  • - In a secondary analysis focusing on patients with chronic kidney disease (CKD), results showed that CKD patients had a higher risk of adverse cardiovascular outcomes and major bleeding, regardless of the aspirin dose they were taking.
  • - The study concluded that while CKD increased the risk for complications, the dosing of aspirin did not affect the risk of adverse events or bleeding in these patients.
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