Publications by authors named "Rajat Deo"
Measures from affinity-proteomics platforms often correlate poorly, challenging interpretation of protein associations with genetic variants (pQTL) and phenotypes. Here, we examined 2,157 proteins measured on both SomaScan 7k and Olink Explore 3072 across 1,930 participants with genetic similarity to European, African, East Asian, and Admixed American ancestry references. Inter-platform correlation coefficients for these 2,157 proteins followed a bimodal distribution (median r=0.
View Article and Find Full Text PDFBackground: Deep learning methods on standard, 12-lead electrocardiograms (ECG) have resulted in the ability to identify individuals at high-risk for the development of atrial fibrillation. However, the process remains a "black box" and does not help clinicians in understanding the electrocardiographic changes at an individual level. we propose a nonparametric feature extraction approach to identify features that are associated with the development of atrial fibrillation (AF).
View Article and Find Full Text PDFBackground: Biological age can be quantified by composite proteomic scores, called aging clocks. We investigated whether biological age acceleration (a discrepancy between chronological and biological age) in midlife and late-life is associated with cognitive function and risk of dementia.
Methods: We used two population-based cohort studies: Atherosclerosis Risk in Communities (ARIC) Study and Multi-Ethnic Study of Atherosclerosis (MESA).
Background: To measure the aging process before a cancer diagnosis, we developed the first cancer-specific proteomic aging clock (CaPAC) and examined its association with cancer risk in the Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis (MESA) studies.
Methods: Using the SomaScan assay, ARIC measured 4,712 proteins in plasma samples collected in 1990-92 from 3,347 participants who developed cancer over follow-up until 2015 and 7,487 who remained cancer-free, all aged 46-70. We constructed CaPAC0 using elastic net regression among two-thirds randomly selected cancer-free participants (N=4,991, training set) and calculated age acceleration for CaPAC0 (CaPAA0) as residuals of CaPAC0 on chronological age in all remaining ARIC participants.
Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.
N Engl J Med
February 2025
Article Synopsis
- The EMPA-KIDNEY trial examined the effects of empagliflozin, an SGLT2 inhibitor, on patients with chronic kidney disease at risk for progression, assessing outcomes during and after the trial.
- A total of 6609 patients were randomized, with 4891 participating in a follow-up period after the trial where they were observed for an additional 2 years, without trial medication but allowed to use other SGLT2 inhibitors.
- Results showed that fewer primary outcome events (like kidney disease progression or cardiovascular death) occurred in the empagliflozin group (26.2%) compared to the placebo group (30.3%), suggesting lasting benefits of the drug even after the trial ended. *
Brugada Syndrome Risk Stratification: Selecting the Population of Interest.
J Am Coll Cardiol
November 2024
Key Points: Machine learning and large-scale proteomics led to a 16-protein secondary cardiovascular risk model in patients with CKD. Hepatic fibrosis and liver X receptor activation represented biologic pathways that link kidney disease and risk of secondary cardiovascular events. An understanding of the circulating proteins associated with secondary cardiovascular events may help to identify novel therapeutic targets.
View Article and Find Full Text PDFBackground: Biological age may be estimated by proteomic aging clocks (PACs). Previous published PACs were constructed either in smaller studies or mainly in white individuals, and they used proteomic measures from only one-time point. In this study, we created de novo PACs and compared their performance to published PACs at 2 different time points in the Atherosclerosis Risk in Communities (ARIC) study of white and black participants (around 75% white and 25% black).
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the long-term risk of damage to the right coronary artery (RCA) after patients undergo radiofrequency ablation (RFA) for atrial flutter related to the cavotricuspid isthmus (CTI).
- A comparison was made between patients who had CTI RFA and those who only received ablation for atrial fibrillation (AF), with coronary angiography performed afterward to evaluate any differences in RCA stenosis.
- Results indicate that there were no significant differences in the incidence or severity of RCA stenoses between the two groups, suggesting that CTI RFA does not increase the risk of RCA damage in the long term.
Background: Cardiac implantable electronic device (CIED) procedures can cause significant postoperative pain. Opioid use for postoperative pain is associated with risk of persistent use. The benefits of pectoral nerve (PECs) blocks have been established for other chest wall surgeries, but adoption in electrophysiology has been limited.
View Article and Find Full Text PDFRationale & Objective: Matrix metalloproteinase 2 (MMP-2) plays an important role in the development of fibrosis, the final common pathway of chronic kidney disease (CKD). This study aimed to assess the relationship between repeated measures of MMP-2 and CKD progression in a large, diverse prospective cohort.
Study Design: In a prospective cohort of Chronic Renal Insufficiency Cohort (CRIC) participants (N = 3,827), MMP-2 was measured at baseline.
Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) and dementia disproportionately burden patients with chronic kidney disease (CKD). The association between CHIP and cognitive impairment in CKD patients is unknown.
Methods: We conducted time-to-event analyses in up to 1452 older adults with CKD from the Chronic Renal Insufficiency Cohort who underwent CHIP gene sequencing.
Article Synopsis
- Epicardial access is important during ventricular tachycardia ablation, and the study compares two methods: traditional ConvEpi access and a newer method called EpiCO, which involves puncturing coronary venous branches.
- The study included 153 patients and found that both methods had similar success rates, but ConvEpi was quicker and associated with more complications, especially significant bleeding.
- Overall, EpiCO access showed a decrease in major complications and bleeding compared to ConvEpi, suggesting it might be a safer option for patients.
Article Synopsis
- The document outlines guidelines for diagnosing and managing cardiac arrhythmias in athletes, given the rise in sports participation among youth and adults.
- It highlights the importance of expert risk assessments based on athlete symptoms to ensure safe return to sports while minimizing restrictions.
- Key topics covered include treatment strategies, shared decision-making, emergency planning, and recommendations for future research in managing these conditions.
Background And Aims: Incident heart failure (HF) among individuals with chronic kidney disease (CKD) incurs hospitalizations that burden patients and health care systems. There are few preventative therapies, and the Pooled Cohort equations to Prevent Heart Failure (PCP-HF) perform poorly in the setting of CKD. New drug targets and better risk stratification are urgently needed.
View Article and Find Full Text PDFKey Points: Integrated analysis of proteome and metabolome identifies modules associated with CKD progression and kidney failure. Ephrin transmembrane proteins and podocyte-expressed CRIM1 and NPNT emerged as central components and warrant experimental and clinical investigation.
Background: Proteins and metabolites play crucial roles in various biological functions and are frequently interconnected through enzymatic or transport processes.
Background: Premature ventricular complexes (PVCs) are common and associated with worse outcomes in patients with heart failure. Class 1C antiarrhythmic drugs (AADs) effectively suppress PVCs, but guidelines currently restrict their use in structural heart disease.
Objectives: This study aimed to assess the safety and efficacy of class 1C AADs in patients with nonischemic cardiomyopathy (NICM) and implantable cardioverter-defibrillators (ICDs).
Article Synopsis
- * In a study of 3789 AIS patients, 300 had cTn measurements; those with a rising pattern had a significantly higher risk of 7-day mortality and unfavorable discharge compared to those with falling or stable levels.
- * The findings suggest that monitoring cTn patterns in AIS patients can help predict mortality risk and guide clinical decision-making.
Background: Long-term rhythm monitoring to detect atrial fibrillation (AF) following a cryptogenic stroke (CS) is well established. However, the burden of organized atrial arrhythmias in this population is not well defined.
Objective: The purpose of this study was to assess the incidence and risk factors for organized atrial arrhythmias in patients with CS.
Background: Targeting non-pulmonary vein triggers (NPVTs) after pulmonary vein isolation may reduce atrial fibrillation (AF) recurrence. Isoproterenol infusion and cardioversion of spontaneous or induced AF can provoke NPVTs but typically require vasopressor support and increased procedural time.
Objective: The purpose of this study was to identify risk factors for the presence of NPVTs and create a risk score to identify higher-risk subgroups.
Background Cardiovascular complications after acute ischemic stroke (AIS) can be related to chronic/comorbid cardiac conditions or acute disruption of the brain-heart autonomic axis (stroke-heart syndrome). Women are known to be more vulnerable to certain stress-induced cardiac complications, such as Takotsubo cardiomyopathy. We investigated sex differences in cardiac troponin (cTn) elevation, cardiac events, and outcomes after AIS.
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