37 results match your criteria: "Department of Medicine Duke University Medical Center[Affiliation]"

Randomized Trials of Renal Denervation for Uncontrolled Hypertension: An Updated Meta-Analysis.

J Am Heart Assoc

August 2024

Division of Cardiovascular Medicine, Department of Medicine Henry Ford Health Detroit MI.

Article Synopsis
  • A meta-analysis was conducted to evaluate the effectiveness and safety of catheter-based renal denervation (RDN) in patients with uncontrolled hypertension, including those on and off antihypertensive medications.
  • The analysis included 15 randomized trials with a total of 2,581 patients, showing significant reductions in blood pressure for both groups, with larger decreases observed in those not taking medications.
  • RDN was found to be effective in lowering blood pressure while also demonstrating a good safety profile, confirming its potential as a treatment option for uncontrolled hypertension.
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Background: Shock-reduction implantable cardioverter-defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real-world studies investigating SRP and associated outcomes are limited.

Methods And Results: The BIOTRONIK CERTITUDE registry was linked with the Medicare database. We included all patients with an implantable cardioverter-defibrillator implanted between August 22, 2012 and September 30, 2021 in the United States.

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Article Synopsis
  • * A study analyzed insurance claims data of 5867 patients, revealing that those who adhered to positive airway pressure (PAP) therapy had fewer emergency department visits, hospitalizations, and lower healthcare costs compared to nonadherent patients.
  • * The findings emphasize the importance of diagnosing and managing OSA, showing that enhancing PAP therapy adherence can lead to both clinical and economic benefits for patients with atrial fibrillation.
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  • Transcatheter edge-to-edge repair (TEER) is a less invasive option for treating mitral regurgitation but carries higher long-term mortality and reintervention risks compared to surgery.
  • A survey of 201 patients showed a clear preference for TEER over surgery, even if it meant accepting greater risks of reintervention and hospitalizations.
  • For patients to prefer surgery over TEER, they would require significant functional improvement, equivalent to moving from class III to class I of the New York Heart Association classification over 5 years.
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Article Synopsis
  • There is ongoing uncertainty regarding the use of primary prevention implantable cardioverter-defibrillators (ICDs) in older patients with hypertrophic cardiomyopathy, emphasizing the need for clarity in treatment options.
  • A study analyzed data from patients who received ICDs between 2010 and 2016, noting an overall increase in ICD utilization across age groups, including those aged 65 and older.
  • Key risk factors for postdischarge mortality and hospitalization after ICD implantation in older patients included older age, severe heart failure symptoms, and low left ventricular ejection fraction, while a history of nonsustained ventricular tachycardia was particularly associated with hospitalizations for cardiac issues.*
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Background The interplay between branched-chain amino acid (BCAA) metabolism, an important pathway in adiposity and cardiometabolic disease, and visceral adipose depots such as hepatic steatosis (HS) and epicardial adipose tissue is unknown. We leveraged the PROMISE clinical trial with centrally adjudicated coronary computed tomography angiography imaging to determine relationships between adipose depots, BCAA dysregulation, and coronary artery disease (CAD). Methods and Results The PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial randomized 10 003 outpatients with stable chest pain to computed tomography angiography versus standard-of-care diagnostics.

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Background Homozygous familial hypercholesterolemia (HoFH) is a rare, treatment-resistant disorder characterized by early-onset atherosclerotic and aortic valvular cardiovascular disease if left untreated. Contemporary information on HoFH in the United States is lacking, and the extent of underdiagnosis and undertreatment is uncertain. Methods and Results Data were analyzed from 67 children and adults with clinically diagnosed HoFH from the CASCADE (Cascade Screening for Awareness and Detection) FH Registry.

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Background Women remain underrepresented in cardiology. We aimed to assess gender trends in research authorship, authorship in leading roles, mentorship, and research team diversity. Methods and Results We identified "cardiac and cardiovascular systems" journals from 2002 to 2020 using Journal Citation Reports 2019 (Web of Science, Clarivate Analytics).

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Background Women with atrial fibrillation (AF) demonstrate more AF-related symptoms and worse quality of life (QOL). Whether increased use of ablation in women reduces sex-related QOL differences is unknown. Sex-related outcomes for ablation versus drug therapy was a prespecified analysis in the CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial.

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The βAR is a prototypical G protein-coupled receptor (GPCR) known to orchestrate different cellular responses by the stimulation of specific signaling pathways. The best-established signaling pathways for the βAR are the canonical Gs pathway and the alternative β arrestin 2 (βarr2) pathway. Exploring each pathway separately remains a challenging task due to the dynamic nature of the receptor.

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Background: Venous thromboembolism (VTE) affects approximately 1-2 individuals per 1000 annually and is associated with an increased risk for pulmonary hypertension, postthrombotic syndrome, and recurrent VTE.

Objective: To determine risk factors, incidence, treatments, and outcomes of VTE through a 2-year surveillance program initiated in Durham County, North Carolina (population approximately 280,000 at time of study).

Patients/methods: We performed a retrospective analysis of data actively collected from three hospitals in Durham County during the surveillance period.

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Background Although technological advances to pump design have improved survival, left ventricular assist device (LVAD) recipients experience variable improvements in quality of life. Methods for optimizing LVAD support to improve quality of life are needed. We investigated whether acoustic signatures obtained from digital stethoscopes can predict patient-centered outcomes in LVAD recipients.

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Background There is an open Centers for Medicare and Medicaid Services National Coverage Decision for Transcatheter Mitral Valve Repair (TMVr) and a recent multisociety consensus document suggesting that TMVr centers should achieve prespecified mitral valve replacement or repair (MVRr). Yet, little is known about the MVRr volume-TMVr outcome relationship. Methods and Results Using Centers for Medicare and Medicaid Services administrative claims from January 1, 2016 to December 31, 2018, we computed the Pearson correlation coefficient and performed multivariable hierarchical modeling to estimate the MVRr volume to TMVr outcome relationship for mortality and heart failure hospitalization.

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The roles of mitochondrial dysfunction in carcinogenesis remain largely unknown. The effects of PTEN-induced putative kinase 1 (PINK1)-dependent mitophagy on the pathogenesis of multiple myeloma (MM) are determined. The levels of the PINK1-dependent mitophagy markers and parkin RBR E3 ubiquitin protein ligase ( in CD138 plasma cells are reduced in patients with MM and correlate with clinical outcomes in myeloma patients.

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Peritoneal adhesion occurs in a majority of patients following abdominal surgery and can result in significant side effects and complications. Current strategies to minimize adhesions involve the use of nontargeted anatomical barriers that are either inefficient in protecting injured areas or lacking the adequate residence time to prevent adhesions. Herein, the development of a biologically targeted photo-crosslinkable nanopatch (pCNP) is reported that can prevent postsurgical adhesion.

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Background When patients require readmission after a recent myocardial infarction (MI), returning to the discharging (index) hospital may be associated with better outcomes as a result of greater continuity in care. However, little evidence exists to answer this frequent patient question. Methods and Results Among Medicare patients aged ≥65 years discharged home alive post-MI from 491 US hospitals in the ACTION (Acute Coronary Treatment Intervention Outcomes Network) Registry, we compared reason for readmission, duration of rehospitalization, and 30-day mortality between patients readmitted to the index versus nonindex hospital within 30 days of index MI discharge.

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Background Although recommended in the guidelines, the safety of chronic P2Y inhibitor therapy in patients with chronic kidney disease ( CKD ) after an acute myocardial infarction ( MI ) is not well studied. Methods and Results The TRANSLATE -ACS (Treatment with ADP Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study included 11 108 MI patients treated with percutaneous coronary intervention and discharged alive on a P2Y inhibitor from 233 US hospitals. We compared rates of GUSTO (Global Use of Strategies to Open Occluded Arteries) severe/moderate bleeding and premature discontinuation of P2Y inhibitor by 1 year after MI among patients with varying CKD severity.

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Hepatitis B virus (HBV) reactivation may occur with high risk immunosuppression, such as anti-cluster of differentiation (CD)20 antibodies (Abs). Appropriate HBV prophylaxis during anti-CD20 Ab therapy averts hepatitis, chemotherapy disruption, and death. Serologic evidence of prior HBV exposure is present in one in nine veterans in the Veterans Health Administration (VHA).

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Radiation injury to the lung is the result of acute and chronic free radical formation, and there are currently few effective means of mitigating such injury. Studies in rodents indicate that superoxide dismutase mimetics may be effective in this regard; however, studies in humans or large animals are lacking. We hypothesized that post-exposure treatment with the lipophilic mitochondrial superoxide dismutase mimetic, MnTnHex-2-PyP (hexyl), would reduce radiation-induced pneumonitis and fibrosis in the lungs of nonhuman primates.

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Objective: A weight loss maintenance trial involving weight loss prior to randomization is challenging to implement due to the potential for dropout and insufficient weight loss. We examined rates and correlates of non-initiation, dropout, and insufficient weight loss during a weight loss maintenance trial.

Methods: The MAINTAIN trial involved a 16-week weight loss program followed by randomization among participants losing at least 4 kg.

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