278 results match your criteria: "MA (D.L.B.); and University of Texas Southwestern[Affiliation]"

Changes Over Time in Short-Term Stroke Outcomes by Race-Ethnicity.

Neurology

December 2024

From the Department of Epidemiology (L.D.L., E.C., M.K., M.A.S., L.B.M.), School of Public Health, and Stroke Program (L.D.L., D.L.B., D.B.Z., L.B.M.), University of Michigan, Ann Arbor.

Objectives: The objective of this study was to quantify trends (2008-2019) in stroke outcomes by race-ethnicity.

Methods: Patients with ischemic stroke from a population-based study were interviewed at 90 days to assess outcomes. Linear regression with multiple imputation and inverse probability weighting was used to model trends.

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Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis.

Circulation

November 2024

Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany (D.V., L.L., M.B., F.M.).

Article Synopsis
  • A meta-analysis of randomized, sham-controlled trials was conducted to evaluate the effectiveness and safety of catheter-based renal denervation (RDN) in treating hypertension, involving 10 trials with a total of 2,478 patients.
  • The study found that RDN significantly lowered both 24-hour and office systolic and diastolic blood pressure compared to sham procedures, without a notable difference in complications or changes in renal function.
  • Overall, RDN appears to be a safe and effective method for reducing blood pressure in patients with hypertension, although significant variability was noted among the studies analyzed.
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IGLON5 Frequency in Idiopathic REM Sleep Behavior Disorder: A Multicenter Study.

Neurol Neuroimmunol Neuroinflamm

November 2024

From the Montreal Neurological Institute and Department of Neurology and Neurosurgery (R.P.), Montréal, McGill University; Center for Advanced Research in Sleep Medicine (R.P., A.P., J.-F.G.), Hôpital du Sacré-Coeur de Montréal; Research Institute of the McGill University Health Centre (R.P., A.P., Z.G.-O.), Montreal, Quebec, Canada; Neurology and Medicine (N.V., L.K.F., J.A.F., O.A.R., W.S., B.F.B., A.M.), Mayo Clinic, Rochester, MN; Division of Neurology (N.V., E.K.S.L.), Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand; Department of Neurology (M.M.L., J.E.), Oregon Health & Science University; Department of Behavioral Neuroscience (M.M.L.); Department of Pulmonary and Critical Care Medicine; Oregon Institute of Occupational Health Sciences; Mental Illness Research Education and Clinical Center (M.M.L.); Neurology; National Center for Rehabilitative Auditory Research; Research Service (M.M.L., J.E.), VA Portland Health Care System, OR; Département of Psychology (J.-F.G.), Université du Québec à Montréal; Department of Human Genetics (Z.G.-O.), McGill University, Montréal, Québec, Canada; Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Neurology (A.Y.A.), Sleep Disorders Center, University of California, Los Angeles; Minnesota Regional Sleep Disorders Center (M.H., C.H.S.), and Departments of Psychiatry, Hennepin County Medical Center, and University of Minnesota Medical School; Minnesota Regional Sleep Disorders Center (M.H.), Hennepin County Medical Center, Minneapolis, MN; Washington University School of Medicine (J.M., A.A.D., Y.-E.S.J.), Saint Louis, MO; Barrow Neurological Institute (S.R.C.), Phoenix, AZ; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University, Redwood City, CA; Neurology and Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; and Neurology (E.H.D.), Mt. Sinai School of Medicine, New York.

Background And Objectives: Idiopathic/isolated REM sleep behavior disorder (iRBD) has been strongly linked to neurodegenerative synucleinopathies such as Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. However, there have been increasing reports of RBD as a presenting feature of serious and treatable autoimmune syndromes, particularly IGLON5. This study's objective was to investigate the frequency of autoantibodies in a large cohort of participants with iRBD.

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Since the 1960s, cardiologists have adopted several binary classification systems for acute myocardial infarction (MI) that facilitated improved patient management. Conversely, for chronic stable manifestations of myocardial ischemia, various classifications have emerged over time, often with conflicting terminology-eg, "stable coronary artery disease" (CAD), "stable ischemic heart disease," and "chronic coronary syndromes" (CCS). While the 2019 European guidelines introduced CCS to impart symmetry with "acute coronary syndromes" (ACS), the 2023 American guidelines endorsed the alternative term "chronic coronary disease.

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Article Synopsis
  • This study looked at how certain heart problems after surgery might lead to strokes in patients who didn't have heart issues before.
  • Out of over 251,000 patients who had non-heart surgeries, a small number developed a heart problem called postoperative atrial fibrillation (POAF), which made their stroke risk higher.
  • The research found that giving these patients blood-thinning medicine after surgery could help prevent strokes linked to POAF.
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Article Synopsis
  • Recent studies have shown that colchicine may lower the risk of major cardiovascular events in patients with coronary artery disease, but its effects on peripheral artery disease (PAD) is unclear.
  • The researchers conducted two "emulated" trials comparing colchicine to non-steroidal anti-inflammatory drugs (NSAIDs) in patients with gout and PAD, using data from Medicare patients over a 12-year period.
  • The results indicated no significant difference in the risk of major adverse events between the colchicine and NSAID groups, suggesting that colchicine might not have a marked impact on lowering these risks in PAD patients.
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Article Synopsis
  • * Recent studies have raised concerns about this 12-month regimen, suggesting adjustments based on patients' bleeding or ischemic risks, arguing some may benefit from shorter or longer durations.
  • * Several strategies to modify DAPT practices, such as de-escalating to less potent medications or shortening therapy, have shown to reduce bleeding risks without significantly increasing cardiovascular issues, yet the 12-month recommendation remains unchanged in guidelines.
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Article Synopsis
  • * A meta-analysis included 78,607 patients from 11 trials, revealing that SGLT2i reduced MACE by 9%, primarily due to lower rates of cardiovascular death rather than incidents of myocardial infarction or stroke.
  • * Results showed consistent benefits from SGLT2i in patients with diabetes, heart failure, and chronic kidney disease, suggesting wide applicability for improving heart-related outcomes among these populations.
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Do patients benefit from omega-3 fatty acids?

Cardiovasc Res

February 2024

Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, NewYork 10029-5674, NY, USA.

Article Synopsis
  • * While prescription-grade EPA-only formulations have demonstrated significant reductions in cardiovascular events for high-risk patients, mixtures of EPA and docosahexaenoic acid (DHA) have largely failed in effective prevention.
  • * The distinct clinical benefits of EPA over DHA and other O3FAs may stem from their unique biological properties, which influence various cardiovascular mechanisms beyond just lowering lipids.
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Validation of the RBD Symptom Severity Scale in the North American Prodromal Synucleinopathy Consortium.

Neurology

February 2024

From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada.

Background And Objectives: REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment. The International RBD Study Group developed the RBD Symptom Severity Scale (RBDSSS) to assess symptom severity for clinical or research use. We assessed the psychometric and clinimetric properties of the RBDSSS in participants enrolled in the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD.

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Article Synopsis
  • * While there is evidence linking triglycerides to cardiovascular risk, therapies aimed at lowering triglycerides, like omega-3 fatty acids, have produced mixed results in outcomes.
  • * Icosapent ethyl, a specific form of omega-3, has shown promising evidence in reducing cardiovascular risk in patients with high triglyceride levels who are also on statin therapy.
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Article Synopsis
  • The study investigated the long-term prognosis of patients suspected of having acute coronary syndrome (ACS) based on serial high-sensitivity troponin-I (hsTnI) measurements during hospitalization from 2012 to 2019.
  • A total of 20,609 individuals were analyzed, revealing that those with persistently elevated hsTnI levels had the highest mortality rates (8.0% within 30 days and 11.1% within 365 days), while those with normal levels had much lower rates (0.5% and 2.6%, respectively).
  • Changes in hsTnI concentration, particularly rising levels, could indicate higher mortality risk, especially for those with more than a 50%
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Article Synopsis
  • * The study proposes using machine learning to create adaptive predictive models, termed computational trial phenomaps, which can help optimize participant selection based on predicted treatment benefits.
  • * Results from simulations of two cardiovascular trials show that this approach could have significantly reduced trial sizes while maintaining similar treatment effects, suggesting improved efficiency in RCT enrollment.
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Article Synopsis
  • Randomized controlled trials (RCTs) are crucial for evidence-based medicine but require significant resources, prompting the need for more efficient enrollment methods.
  • The study proposes a machine learning approach to improve RCT enrollment by using adaptive predictive enrichment and computational trial phenomaps to identify candidates based on their potential treatment benefits.
  • Simulations of two large cardiovascular trials showed this method could reduce trial sizes by approximately 15-18% while maintaining the integrity of study outcomes, indicating a more efficient way to conduct RCTs.
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Frequency of Orthostatic Hypotension in Isolated REM Sleep Behavior Disorder.

Neurology

December 2023

Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada.

Background And Objectives: Although orthostatic hypotension (OH) can be an early feature of autonomic dysfunction in isolated REM sleep behavior disorder (iRBD), no large-scale studies have examined the frequency of OH in iRBD. In this study, we prospectively evaluated the frequency of OH in a large multicenter iRBD cohort.

Methods: Participants 18 years or older with video polysomnogram-confirmed iRBD were enrolled through the North American Prodromal Synucleinopathy consortium.

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Background: Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes.

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Article Synopsis
  • The OCEAN(a)-Outcomes trial is investigating if lowering Lp(a) levels can reduce cardiovascular events in patients who have had a myocardial infarction or PCI and have high Lp(a) levels (≥200 nmol/L).
  • This study analyzed data from 3,142 patients aged 18-85 with previous MI or PCI, measuring Lp(a) between 2000 and 2019, finding that 12.3% had elevated Lp(a).
  • Results showed a significantly higher rate of major cardiovascular events in patients with elevated Lp(a) compared to those without, suggesting that high Lp(a) is linked to increased cardiovascular risk.
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Article Synopsis
  • The study aimed to create a risk assessment tool for identifying type 2 diabetes (T2D) patients at higher risk of kidney disease progression, focusing on those who may benefit from SGLT2 inhibitors like dapagliflozin.
  • The research analyzed data from over 41,000 T2D patients, identifying eight key predictors of kidney disease progression and validating the model, showing strong predictive accuracy.
  • Results indicated that while dapagliflozin's relative risk reduction was consistent across risk categories, patients with higher baseline risk experienced a greater absolute reduction in kidney disease progression over time.
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Article Synopsis
  • * Finding the right balance of platelet inhibition based on individual patient factors and their specific heart conditions is a significant challenge for healthcare providers.
  • * The Academic Research Consortium is working to clarify the different methods of adjusting antiplatelet therapy (like de-escalation and escalation) and aims to standardize the terminology used in this field.
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Article Synopsis
  • Icosapent ethyl (IPE) has been shown to reduce ischemic events significantly, such as heart attacks, in statin-treated patients with atherosclerosis or diabetes, but the mechanisms behind these benefits were unclear.* -
  • The EVAPORATE trial indicated that IPE lowers plaque burden, and this study aimed to evaluate its effects on coronary physiology through fractional flow reserve computed tomography (FFRCT) in patients.* -
  • Results indicated that IPE improved mean distal segment FFRCT values over time compared to placebo, suggesting significant benefits in coronary physiology, although changes in translesional FFRCT were not statistically significant.*
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The safety and efficacy of lentivirus-mediated gene therapy was recently demonstrated in five male patients with Fabry disease-a rare X-linked lysosomal storage disorder caused by gene mutations that result in multiple end-organ complications. To evaluate the risks of clonal dominance and leukemogenesis, which have been reported in multiple gene therapy trials, we conducted a comprehensive DNA insertion site analysis of peripheral blood samples from the five patients in our gene therapy trial. We found that patients had a polyclonal integration site spectrum and did not find evidence of a dominant clone in any patient.

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Somatic Variants in SVIL in Cerebral Aneurysms.

Neurol Genet

December 2022

Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Background And Objectives: While somatic mutations have been well-studied in cancer, their roles in other complex traits are much less understood. Our goal is to identify somatic variants that may contribute to the formation of saccular cerebral aneurysms.

Methods: We performed whole-exome sequencing on aneurysm tissues and paired peripheral blood.

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Background: Heuristic biases are increasingly recognized, and potentially modifiable, contributors to patient care and outcomes. Left digit bias is a cognitive bias where continuous variables are categorized by their left-most digit. The impact of this heuristic bias applied to patient age on quality of care in heart failure has not been explored.

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Patient selection for long-term secondary prevention with ticagrelor: insights from PEGASUS-TIMI 54.

Eur Heart J

December 2022

TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Aim: In patients with prior myocardial infarction (MI) on aspirin, the addition of ticagrelor reduces ischaemic risk but increases bleeding risk. The simultaneous assessment of baseline ischaemic and bleeding risk may assist clinicians in selecting patients who are most likely to have a favourable risk/benefit profile with long-term ticagrelor.

Methods And Results: PEGASUS-TIMI 54 randomized 21 162 prior MI patients, 13 956 of which to the approved 60 mg dose or placebo and who had all necessary data.

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