Faculty Bibliography
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73
Biochemical Markers of Bone Turnover and Risk of Incident Diabetes in Older Women: The Cardiovascular Health Study
OBJECTIVE:To investigate the relationship of osteocalcin (OC), a marker of bone formation, and C-telopeptide of type I collagen (CTX), a marker of bone resorption, with incident diabetes in older women. RESEARCH DESIGN AND METHODS/METHODS:The analysis included 1,455 female participants from the population-based Cardiovascular Health Study (mean [SD] age 74.6 [5.0] years). The cross-sectional association of serum total OC and CTX levels with insulin resistance (HOMA-IR) was examined using multiple linear regression. The longitudinal association of both markers with incident diabetes, defined by follow-up glucose measurements, medications, and ICD-9 codes, was examined using multivariable Cox proportional hazards models. RESULTS:= 0.031]), associations that were comparable in magnitude and approached or achieved statistical significance. CONCLUSIONS:In late postmenopausal women, lower OC and CTX levels were associated with similarly increased risks of insulin resistance at baseline and incident diabetes over long-term follow-up. Further research to delineate the mechanisms linking abnormal bone homeostasis and energy metabolism could uncover new approaches for the prevention of these age-related disorders.
PMCID:6105330
PMID: 30002202
ISSN: 1935-5548
CID: 3191882
Hyperlipidemia secondary to acitretin therapy for lamellar ichthyosis associated with a NIPAL4 mutation improves on a plant-based diet and relapses on a standard Western diet
Oral retinoids are commonly prescribed for many dermatological conditions and may induce hyperlipidemia. We document the case of a 35-year-old man taking acitretin for congenital lamellar ichthyosis associated with a homozygous deleterious mutation in NIPAL4 who developed retinoid-induced hyperlipidemia that responded dramatically to a whole-food plant-based (WFPB) diet. On presentation, his diet consisted of chicken, fish, low fat meats and dairy, grains, and some fruits and vegetables. He then adopted a WFPB diet without making changes to his medications. His serum lipid levels dropped and his exercise capacity improved. Five months later, after discontinuing the plant-based diet and returning to his baseline diet, his hyperlipidemia returned and persisted despite adjustments to his medications. After a year and a half, the patient again adopted a plant-based diet and his lipid levels fell sharply again. A WFPB diet helped improve and control serum lipid levels in a patient with retinoid-induced hyperlipidemia. Future interventions should focus on ways to help patients successfully adopt and maintain a WFPB diet, as increased adherence to a healthy lifestyle is associated with greater health benefits.
PMID: 29576363
ISSN: 2405-4577
CID: 3121862
Relationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study
Associations between bone mineral density and aortic valvular, aortic annular, and mitral annular calcification were investigated in a cross-sectional analysis of a population-based cohort of 1497 older adults. Although there was no association between continuous bone mineral density and outcomes, a significant association between osteoporosis and aortic valvular calcification in men was found.
PMCID:5537624
PMID: 28560501
ISSN: 1862-3514
CID: 3121822
Increased risk of stroke and mortality following new-onset atrial fibrillation during hospitalization
Aims/UNASSIGNED:The outcome of patients who develop new-onset atrial fibrillation (AF) during hospitalization is unknown, and the management of this patient population is not specifically addressed by current guidelines. We investigated the incidence of death and inhospital stroke among a large cohort of hospitalized inpatients who developed new-onset AF. Methods and results/UNASSIGNED:All patients ≥50 years of age admitted to a tertiary academic medical centre (20 April 2005 to 31 December 2011; n = 84 919) were studied. Demographic variables were compared among patients categorized as having new-onset, pre-existing, or no AF. A propensity-matched analysis was employed to compare outcomes by generalized estimating equations. Primary endpoints were all-cause 30-day and 1-year mortality and inhospital stroke. New-onset AF occurred in 1749 (2.1%) hospitalized patients. Among patients with new-onset AF, mortality at 30 days and 1 year was higher compared with patients without AF (at 30 days: OR 2.28, 95% CI 1.72-3.02, P < 0.0001; at 1 year: RR 1.53, 95% CI 1.36-1.73, P < 0.0001), and compared with patients with pre-existing AF at 30 days (OR 1.52, 95% CI 1.06-2.17, P = 0.02) -an effect that persisted as non-significant trend at 1 year (RR 1.14, 95% CI 0.98-1.34, P = 0.09). Risk of inhospital stroke was higher in patients with new-onset AF compared with patients without AF (OR 4.53, 95% CI 1.36-15.11, P = 0.02). Among patients with new-onset AF, the CHA2DS2-Vasc score correlated with incidence of inhospital stroke. Conclusion/UNASSIGNED:New-onset AF among hospitalized inpatients is independently associated with an increased incidence of stroke and mortality.
PMID: 27207814
ISSN: 1532-2092
CID: 3121802
Journal of geriatric cardiology : JGC. 2017:14(5):375-378.DOI: 10.11909/j.issn.1671-5411.2017.05.003
A plant-based diet and heart failure: case report and literature review
PMCID:5466944
PMID: 28630617
ISSN: 1671-5411
CID: 3121832
Recurrent Stress Cardiomyopathy During COPD Exacerbation: Are Beta-adrenergic Agonists Only to Blame?
Takotsubo cardiomyopathy (TCM) is a variant of stress-induced cardiomyopathy, characterized by transient left ventricular dysfunction that may be associated with emotional or physical triggers. We present the case of a 51-year-old Caucasian female with severe chronic obstructive pulmonary disease (COPD) who presented with syncope and was found to have her second lifetime episode of stress-induced cardiomyopathy. Eight months prior, she had been admitted with a COPD exacerbation and was found to have left ventricular (LV) dysfunction with ejection fraction (EF) of 22% attributed to TCM with subsequent normalization of her left ventricular function. Recurrence of stress-induced cardiomyopathy associated with COPD is a rare phenomenon and its presentation raises the possibility of a common underlying mechanism.
PMCID:5429155
PMID: 28507838
ISSN: 2168-8184
CID: 3121852
Outcomes of </=6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation: A meta-analysis and meta-regression
BACKGROUND: The benefit of </=6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of 40 was identified, effects were obtained with random models. RESULTS: Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between
PMCID:5207602
PMID: 28033306
ISSN: 1536-5964
CID: 2429992
Culprit-lesion only versus complete multivessel percutaneous intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized trials
BACKGROUND:ST-segment elevation myocardial infarction (STEMI) in patients with concomitant multivessel (MV) coronary artery disease (CAD) is associated with poor outcomes. Percutaneous coronary intervention (PCI) of the culprit-lesion only (CLO) as compared with a MV PCI approach to revascularization remains uncertain. Our objective is to gain a better understanding of the efficacy and safety of CLO as compared with MV PCI in patients with STEMI by conducting an updated meta-analysis. METHODS:A comprehensive search of PubMed, CENTRAL, EMBASE, The Cochrane Central Register, the ClinicalTrials.gov Website, and Google Scholar databases of randomized controlled trials (RCTs) was performed. RESULTS:Seven RCTs were included, enrolling a total of 2006 patients. We found that there was a significant reduction in major adverse cardiovascular events (MACE) (OR, 0.62; 95% CI, 0.43-0.90), cardiovascular mortality (OR, 0.46; 95% CI, 0.27-0.80), and repeat revascularization (RRV) (OR, 0.39; 95% CI, 0.30-0.51) favoring MV over the CLO approach for patients undergoing primary PCI. The number needed to treat in order to prevent one CV mortality, RRV, or MACE event is 47, 11, and 16 patients, respectively. No differences were observed between MV vs. CLO PCI for subsequent myocardial infarction (OR, 0.74; 95% CI, 0.40-1.39), all-cause mortality (OR, 0.78; 95% CI, 0.53-1.15), non-cardiovascular mortality (OR, 1.35; 95% CI, 0.74-2.48), all-bleeding events (OR, 0.82; 95% CI, 0.40-1.65), contrast-induced nephropathy (OR, 0.72; 95% CI, 0.33-1.54), and stroke (OR, 1.28; 95% CI, 0.47-3.46). CONCLUSIONS:MV PCI significantly reduces the rate of MACE, CV mortality, and RRV without significant harm as compared to CLO PCI.
PMID: 27390938
ISSN: 1874-1754
CID: 2980452
Angina rapidly improved with a plant-based diet and returned after resuming a Western diet
PMCID:4921549
PMID: 27403146
ISSN: 1671-5411
CID: 3121812
INTRAVENOUS DILTIAZEM, AS COMPARED TO INTRAVENOUS METOPROLOL, FOR ATRIAL FIBRILLATION/FLUTTER IS ASSOCIATED WITH INCREASED ADMISSION FROM THE EMERGENCY DEPARTMENT [Meeting Abstract]
ISI:000375188701630
ISSN: 0735-1097
CID: 3121712
