43 results match your criteria: "The Methodist DeBakey Heart and Vascular Center[Affiliation]"

C-reactive protein levels and plaque regression with evolocumab: Insights from GLAGOV.

Am J Prev Cardiol

September 2020

Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Australia.

Article Synopsis
  • High sensitivity C-reactive protein (hsCRP) levels can predict plaque progression and cardiovascular risks in patients taking statins, while PCSK9 inhibitors like evolocumab further lower LDL cholesterol and improve heart health.
  • A clinical trial (GLAGOV) assessed the effects of evolocumab versus placebo over 78 weeks on coronary atherosclerosis in statin-treated patients, observing various levels of hsCRP.
  • Results showed no significant differences in plaque regression or composition among patients with different hsCRP levels, suggesting that inflammation does not impact the effectiveness of evolocumab in promoting plaque regression.
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Background: Incremental low-density lipoprotein (LDL) cholesterol lowering with the proprotein convertase subtilisin kexin type 9 inhibitor evolocumab regresses coronary atherosclerosis in statin-treated patients.

Objectives: The purpose of this study was to evaluate the effect of adding evolocumab to statin therapy on coronary plaque composition.

Methods: A total of 968 statin-treated coronary artery disease patients underwent serial coronary intravascular ultrasound imaging at baseline and following 76 weeks of treatment with placebo or evolocumab 420 mg monthly.

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Clinical Features: Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach.

Therapeutic Challenge: After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab.

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Handheld Echocardiography: Current State and Future Perspectives.

Circulation

November 2017

Cardiovascular Imaging Institute, Department of Cardiology, the Methodist DeBakey Heart and Vascular Center, Houston, TX (M.A.C.-P., W.A.Z.).

Echocardiography is the primary imaging modality for diagnosing cardiac conditions. Over the past 2 decades, technological advancements have resulted in the emergence of miniaturized handheld ultrasound equipment that is compact and battery operated, and handheld echocardiography can be readily performed at the point of care with reasonable image quality. The simplicity of use, availability at the patient's bedside, easy transportability, and relatively low cost have encouraged physicians to use these devices for prompt medical decision making.

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Background: Iliofemoral arterial disease can preclude transfemoral (TF) transcatheter aortic valve replacement (TF-TAVR). Transthoracic access by direct aortic or a transapical approach imparts a greater risk of complications and death than TF access. We hypothesized that subclavian/axillary arterial (SCA) access offers equivalent risks and outcomes as TF access.

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Lipoprotein(a) and coronary atheroma progression rates during long-term high-intensity statin therapy: Insights from SATURN.

Atherosclerosis

August 2017

Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, United States; Department of Medicine, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia. Electronic address:

Background & Aims: Lipoprotein(a) [Lp(a)] is a low-density lipoprotein (LDL)-like particle that associates with major adverse cardiovascular events (MACE). We examined relationships between Lp(a) measurements and changes in coronary atheroma volume following long-term maximally-intensive statin therapy in coronary artery disease patients.

Methods: Study of coronary atheroma by intravascular ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) used serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months.

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Introduction: In this article, we will review the clinical symptoms of dialysis access steal syndrome (DASS), evaluation, treatment options, and our approach and treatment algorithm.

Methods: We reviewed the literature discussing different aspects of DASS including its epidemiology, pathogenesis, clinical presentation, evaluation and management options.

Results: DASS is the most dreaded complication of access surgery.

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Importance: Reducing levels of low-density lipoprotein cholesterol (LDL-C) with intensive statin therapy reduces progression of coronary atherosclerosis in proportion to achieved LDL-C levels. Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors produce incremental LDL-C lowering in statin-treated patients; however, the effects of these drugs on coronary atherosclerosis have not been evaluated.

Objective: To determine the effects of PCSK9 inhibition with evolocumab on progression of coronary atherosclerosis in statin-treated patients.

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Background: Bromodomain and extra-terminal (BET) proteins regulate transcription of lipoprotein and inflammatory factors implicated in atherosclerosis. The impact of BET inhibition on atherosclerosis progression is unknown.

Methods: ASSURE was a double-blind, randomized, multicenter trial in which 323 patients with angiographic coronary disease and low high-density lipoprotein cholesterol (HDL-C) levels were randomized in a 3:1 fashion to treatment with the BET protein inhibitor RVX-208 200 mg or placebo for 26 weeks.

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Aims: The mitral annulus (MA) saddle shape is complex but vital for a normal functioning mitral apparatus. Although conventional parameters of MA geometry such as area and height are helpful, they fall short of describing its complex regional geometry.

Methods And Results: In this prospective study, novel parameters of MA curvature and torsion were derived from three-dimensional (3D) transoesophageal echocardiography.

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Background: The aim of this analysis was to examine the effects of icosapent ethyl (eicosapentaenoic acid ethyl ester, IPE) on high-sensitivity C-reactive protein (hsCRP) and lipid parameters in patients with metabolic syndrome, with and without stable statin therapy.

Methods: This post hoc exploratory analysis evaluated patients with metabolic syndrome treated with IPE 4 grams/day, IPE 2 grams/day, or placebo in phase 3, randomized, placebo-controlled studies entitled: MARINE [triglyceride (TG) levels ≥500 and ≤2000 mg/dL] and ANCHOR [TG levels ≥200 and <500 mg/dL, despite low-density lipoprotein cholesterol (LDL-C) control with stable statin therapy].

Results: Compared with placebo in patients with metabolic syndrome in MARINE (n=204) and ANCHOR (n=645), at the approved dose of 4 grams/day, IPE significantly lowered hsCRP levels 40.

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Sex-related differences of coronary atherosclerosis regression following maximally intensive statin therapy: insights from SATURN.

JACC Cardiovasc Imaging

October 2014

C5Research, Cleveland Clinic, Cleveland, Ohio; South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia. Electronic address:

Objectives: The study sought to explore sex-related differences in coronary atheroma regression following high-intensity statin therapy.

Background: Guidelines now recommend high-intensity statins in all individuals with atherosclerotic cardiovascular disease.

Methods: SATURN (Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin) employed serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months.

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Antiatherosclerotic effects of long-term maximally intensive statin therapy after acute coronary syndrome: insights from Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin.

Arterioscler Thromb Vasc Biol

November 2014

From the Department of Cardiovascular Medicine (R.P., S.E.N.) C5Research (R.P., S.E.N., M.S., S.J.N.), Cleveland Clinic, OH; Section of Cardiovascular Research, Baylor College of Medicine, and the Methodist DeBakey Heart and Vascular Center, Houston, TX (C.M.B.); Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (P.J.B.); INSERM Dyslipidaemia and Atherosclerosis Research Unit, Pitié-Salpetriere University Hospital, Paris, France (M.J.C.); West German Heart Center, Essen, Germany (R.E.); Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (P.L.); AstraZeneca, Wilmington, DE (J.S.R.); and South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia (K.U., Y.K., S.J.N.).

Objectives: Patients with acute coronary syndromes (ACS) display diffuse coronary atheroma instability and heightened risk of early and late recurrent coronary events. We compared the long-term antiatherosclerotic efficacy of high-intensity statins in patients with ACS when compared with stable disease.

Approach And Results: Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) used serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months.

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Objective: Although statins can induce coronary atheroma regression, this benefit has yet to be demonstrated in diabetic individuals. We tested the hypothesis that high-intensity statin therapy may promote coronary atheroma regression in patients with diabetes.

Research Design And Methods: The Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) used serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months.

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Cardiac and kidney markers for cardiovascular prediction in individuals with chronic kidney disease: the Atherosclerosis Risk in Communities study.

Arterioscler Thromb Vasc Biol

August 2014

From the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (K.M., Y.S., S.H.B., M.W., J.C.); Department of Medicine and Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison (B.C.A.); Department of Medicine, Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and the Methodist DeBakey Heart and Vascular Center, Houston, TX (R.C.H., C.M.B.); Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.D.S.).

Objective: Traditional predictors suboptimally predict cardiovascular disease (CVD) in individuals with chronic kidney disease (CKD). This study compared 5 nontraditional cardiac and kidney markers on the improvement of cardiovascular prediction among those with CKD.

Approach And Results: Among 8622 participants aged 52 to 75 years in the Atherosclerosis Risk in Communities (ARIC) Study, cardiac troponin T, N-terminal pro-B-type natriuretic peptide, cystatin C, β2-microglobulin, and β-trace protein were compared for improvement in predicting incident CVD after stratifying by CKD status (940 participants with CKD [kidney dysfunction or albuminuria]).

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Heparin monotherapy or bivalirudin during percutaneous coronary intervention in patients with non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease: results from the Evaluation of Drug-Eluting Stents and Ischemic Events registry.

Circ Cardiovasc Interv

June 2014

From the Department of Medicine, Division of Cardiology, New York University School of Medicine (S.B.); Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, NC (M.J.P.); Department of Cardiology, The Methodist DeBakey Heart and Vascular Center, Houston, TX (N.S.K.); and Department of Cardiology, Saint-Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine (D.J.C.).

Background: The use of bivalirudin versus unfractionated heparin monotherapy in patients without ST-segment-elevation myocardial infarction is not well defined.

Methods And Results: The study population consisted of patients enrolled in the Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) registry with either non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease, who underwent percutaneous coronary intervention with either unfractionated heparin or bivalirudin monotherapy. Propensity score matching was used to adjust for baseline characteristics.

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Aims: Various reports have raised the possibility of humoral immune responses as contributors for the progression of heart failure. Previous studies, however, have focused on the analysis of serum and documented circulating antibodies against a variety of cardiac proteins. However, there is little evidence on whether anti-cardiac antibodies are deposited in end-stage failing myocardium.

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Background: Simulation modules allow for the safe practice of certain techniques and are becoming increasingly important in the shift toward education for integrated vascular residents. There is an unquestionable need to standardize the evaluation of trainees on these simulation models to assure their impact and effectiveness. We sought to validate such an assessment tool for a basic open vascular technique.

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Volume Flow Measurements in Arteriovenous Dialysis Access in Patients with and without Steal Syndrome.

Int J Vasc Med

September 2013

Department of Cardiovascular Surgery, The Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, 6550 Fannin Street, Suite 1401 Houston, TX 77030, USA.

Introduction. Dialysis associated steal syndrome (DASS) constitutes a serious risk for patients undergoing vascular access operations. We aim to assess the measured volume flow using ultrasound in patients with clinically suspected steal syndrome and determine differences in flow among types of arteriovenous (AV) access.

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