Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.230.670
Filtrar
Mais filtros








Intervalo de ano de publicação
1.
J Sci Food Agric ; 102(1): 360-369, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34143446

RESUMO

BACKGROUND: Sowing date, seeding rate, and nitrogen (N) topdressing ratio have strong effects on grain yield (GY) and bread-making quality (BQ) in bread wheat. Simultaneous improvement in GY and BQ in bread wheat has long been a challenge due to the inverse relationship between GY and grain protein concentration (GPC). In this study, we investigated whether the GY and BQ of bread wheat sown on different dates could be improved simultaneously by optimizing the seeding rate and the N topdressing ratio. RESULTS: Delaying sowing beyond a certain period led to decreases in both GY and BQ. Optimizing the seeding rate and N topdressing ratio enhanced the N uptake during pre- and post-anthesis, as well as N remobilization during grain filling for all wheat plants sown on different dates, thereby increasing the GPC and the total N per grain (Ntot ). Consequently, grain protein composition was improved, resulting in an increased glutenin/gliadin ratio, sodium dodecyl sulfate-insoluble glutenin/total glutenin (i.e., glutenin polymerization index), and high-molecular-weight glutenin subunit/ low-molecular-weight glutenin subunit (HMW-GS/LMW-GS) ratio. Increased GPC and improved grain protein composition enhanced BQ. CONCLUSION: The mechanism underlying simultaneous improvement in GY and GPC as well as Ntot was the greater increase in N accumulation in grains per unit area relative to increases in GY, or total grain number per unit area. The GY and BQ can be improved simultaneously regardless of sowing date by optimizing the seeding rate and N topdressing ratio via enhanced N uptake and N remobilization into grains. © 2021 Society of Chemical Industry.


Assuntos
Pão/análise , Produção Agrícola/métodos , Nitrogênio/metabolismo , Sementes/metabolismo , Triticum/crescimento & desenvolvimento , Sementes/química , Sementes/crescimento & desenvolvimento , Fatores de Tempo , Triticum/química , Triticum/metabolismo
2.
J Med Virol ; 94(1): 380-383, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34403142

RESUMO

The durability of infection-induced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity has crucial implications for reinfection and vaccine effectiveness. However, the relationship between coronavirus disease 2019 (COVID-19) severity and long-term anti-SARS-CoV-2 immunoglobulin G (IgG) antibody level is poorly understood. Here, we measured the longevity of SARS-CoV-2-specific IgG antibodies in survivors who had recovered from COVID-19 1 year previously. In a cohort of 473 survivors with varying disease severity (asymptomatic, mild, moderate, or severe), we observed a positive correlation between virus-specific IgG antibody titers and COVID-19 severity. In particular, the highest virus-specific IgG antibody titers were observed in patients with severe COVID-19. By contrast, 74.4% of recovered asymptomatic carriers had negative anti-SARS-CoV-2 IgG test results, while many others had very low virus-specific IgG antibody titers. Our results demonstrate that SARS-CoV-2-specific IgG persistence and titer depend on COVID-19 severity.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/patologia , Imunoglobulina G/sangue , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
3.
Meat Sci ; 183: 108641, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34365254

RESUMO

The aim of this study was to investigate the course of glycogenolysis, ATP breakdown and fragmentation of myofibrillar proteins in the semitendinosus muscle of a progeny of Limousin×Holstein-Friesian (LMx) and Charolaise×Holstein-Friesian (CHx) (bulls and steers) and to describe the changes in the above parameters over time and its relationship with beef texture. The hypothesis that beef from bulls and steers of different crossbreeds required the same ageing time to achieve satisfactory tenderness was also tested. Cattle crossbreeding did not affect the amount of muscle glycogen, and castration did not differentiate it until 3 h post-mortem. The interaction between crossbreeding and castration was found, and the highest shear force values were observed in CHx bulls, whereas the lowest was in CHx steers. Beef obtained from CHx was found to be more predestined to short ageing, and LMx required longer ageing to achieve good tenderness. The R-values more strongly influenced subsequent beef texture than pH values.


Assuntos
Músculo Esquelético/química , Carne Vermelha/análise , Resistência ao Cisalhamento , Trifosfato de Adenosina/metabolismo , Animais , Bovinos , Manipulação de Alimentos/métodos , Glicogênio/análise , Hibridização Genética , Concentração de Íons de Hidrogênio , Masculino , Proteínas Musculares/metabolismo , Miofibrilas/química , Orquiectomia/veterinária , Fatores de Tempo
4.
Meat Sci ; 183: 108659, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34428606

RESUMO

The objective of this study was to evaluate the effect of aging period (0, 3, 6 or 9 weeks), aging temperature (2 versus 6 °C at 75% relative humidity, experiment 1) and relative humidity (70 versus 90% at 2 °C, experiment 2) on the sensory traits, oxidative stability and proteolysis of Belgian Blue beef. For each experiment, eight loins (M. longissimus thoracis et lumborum) from four animals (left and right side) were assigned to one of the two treatments (n = 4). Results showed no further tenderization after three weeks of aging, whereas metmyoglobin formation and lipid oxidation increased until nine weeks of aging (P < 0.05). During the nine weeks of aging, atypical flavor, odor and flavor intensity was affected (P < 0.05). This was accompanied by an increase of small peptides and other nitrogenous compounds. Aging temperature and relative humidity had only a very limited effect on the quality traits.


Assuntos
Manipulação de Alimentos/métodos , Carne Vermelha/análise , Animais , Bovinos , Feminino , Humanos , Umidade , Metamioglobina/análise , Músculo Esquelético/química , Odorantes , Oxirredução , Resistência ao Cisalhamento , Paladar , Temperatura , Fatores de Tempo
5.
Meat Sci ; 183: 108665, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34492481

RESUMO

Meat colour is an important attribute for consumer acceptance but there is an interval between colour grading and retail display. This experiment investigates the effect of time post-slaughter (5, 14 and 40 days) on colour and bloom depth (after 1 and 24 h) for beef carcasses graded AUS-MEAT colour 4 (MC 4). Sixteen carcasses were selected at grading, 8 carcasses were graded MC 4 and 8 as compliant colour (AUS-MEAT score 2 or 3). At 5 days post-slaughter, compliant loins had greater overall bloom depth and were more red than MC 4 loins. Bloom depth (24 h) increased with ageing time but reached maximum bloom at 14 days for both treatments. After ageing for 14 and 40 days, the bloom depth of MC 4 loin was no different to the 5 day aged compliant loins after 24 h on display. Colour at grading may not be a reliable measure of retail colour considering the changes post slaughter.


Assuntos
Cor , Manipulação de Alimentos/métodos , Carne Vermelha/normas , Animais , Austrália , Bovinos , Carne Vermelha/análise , Fatores de Tempo
7.
MMW Fortschr Med ; 163(20): 11, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34767200
8.
BMJ ; 375: e066534, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34759038

RESUMO

OBJECTIVE: To determine the use of epinephrine (adrenaline) before defibrillation for treatment of in-hospital cardiac arrest due to a ventricular arrhythmia and examine its association with patient survival. DESIGN: Propensity matched analysis. SETTING: 2000-18 data from 497 hospitals participating in the American Heart Association's Get With The Guidelines-Resuscitation registry. PARTICIPANTS: Adults aged 18 and older with an index in-hospital cardiac arrest due to an initial shockable rhythm treated with defibrillation. INTERVENTIONS: Administration of epinephrine before first defibrillation. MAIN OUTCOME MEASURES: Survival to discharge; favorable neurological survival, defined as survival to discharge with none, mild, or moderate neurological disability measured using cerebral performance category scores; and survival after acute resuscitation (that is, return of spontaneous circulation for >20 minutes). A time dependent, propensity matched analysis was performed to adjust for confounding due to indication and evaluate the independent association of epinephrine before defibrillation with study outcomes. RESULTS: Among 34 820 patients with an initial shockable rhythm, 9630 (27.6%) were treated with epinephrine before defibrillation, contrary to current guidelines. In comparison with participants treated with defibrillation first, participants receiving epinephrine first were less likely to have a history of myocardial infarction or heart failure, but more likely to have renal failure, sepsis, pneumonia, and receive mechanical ventilation before in-hospital cardiac arrest (P<0.0001 for all). Treatment with epinephrine before defibrillation was strongly associated with delayed defibrillation (median 3 minutes v 0 minutes). In propensity matched analysis (9011 matched pairs), epinephrine before defibrillation was associated with lower odds of survival to discharge (25.2% v 29.9%; adjusted odds ratio 0.81, 95% confidence interval 0.74 to 0.88; P<0.001), favorable neurological survival (18.6% v 21.4%; 0.85, 0.76 to 0.92; P<0.001), and survival after acute resuscitation (64.4% v 69.4%; 0.76, 0.70 to 0.83; P<0.001). The above findings were consistent in a range of sensitivity analyses, including matching according to defibrillation time. CONCLUSIONS: Contrary to current guidelines that prioritize immediate defibrillation for in-hospital cardiac arrest due to a shockable rhythm, more than one in four patients are treated with epinephrine before defibrillation, which is associated with worse survival.


Assuntos
Cardioversão Elétrica/mortalidade , Epinefrina/administração & dosagem , Parada Cardíaca/terapia , Adulto , Arritmias Cardíacas/complicações , Arritmias Cardíacas/mortalidade , Cardioversão Elétrica/métodos , Feminino , Parada Cardíaca/etiologia , Parada Cardíaca/mortalidade , Humanos , Masculino , Alta do Paciente/estatística & dados numéricos , Pontuação de Propensão , Sistema de Registros , Fatores de Tempo , Resultado do Tratamento
9.
Surg Clin North Am ; 101(6): 1023-1031, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34774265

RESUMO

Nonoperative management (NOM) of acute appendicitis is becoming more popular, especially in resource-strapped locations, to minimize hospital system costs. In uncomplicated cases of appendicitis, NOM can effectively treat the patient. It does carry a 39.1% risk of recurrence in 5 years, and operative management (OM) does not increase morbidity or risk of complication, so the authors recommend laparoscopic OM for uncomplicated appendicitis. For complicated cases of appendicitis, the authors recommend initial NOM with interval appendectomy in all patients. All appendicitis patients should undergo surveillance endoscopy if older than 40 years to rule out a contributing neoplasm.


Assuntos
Neoplasias do Apêndice/diagnóstico , Apendicite/terapia , Fatores Etários , Algoritmos , Antibacterianos/uso terapêutico , Apendicectomia/métodos , Apendicite/complicações , Apendicite/cirurgia , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Tomada de Decisão Clínica , Colonoscopia , Impacção Fecal/cirurgia , Humanos , Laparoscopia , Fatores de Tempo
10.
Surg Clin North Am ; 101(6): 1053-1065, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34774268

RESUMO

Laparoscopic cholecystectomy is a common operation; approximately 20 million Americans have gallstones, the most common indication. Surgeons who operate on the biliary tree must be familiar with the presentations and treatment options for acute and chronic biliary pathology. We focus on the difficult "bad" gallbladder. We explore the available evidence as to what to do when a gallbladder is too inflamed, too technically challenging, or a patient is too sick to undergo standard laparoscopic cholecystectomy. We discuss whether or not open cholecystectomy is a relevant tool and what can be done to manage common bile duct stones found unexpectedly intraoperatively.


Assuntos
Doenças da Vesícula Biliar/cirurgia , Colangiografia , Colecistectomia , Colecistectomia Laparoscópica , Colecistostomia , Coledocolitíase/cirurgia , Doenças da Vesícula Biliar/patologia , Humanos , Cuidados Intraoperatórios , Fatores de Tempo
11.
Gan To Kagaku Ryoho ; 48(11): 1381-1387, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34795131

RESUMO

AIM: We evaluated the safety and potential clinical impact of shortened ramucirumab infusion in Japanese patients from clinical studies. METHODS: Multivariate logistic regression analysis was used to assess any association between infusion rate and increased risk of an immediate infusion-related reaction(IRR). Population pharmacokinetic modeling was used to simulate concentration-time profiles and exposure parameters following a 30- or 60-minute infusion with ramucirumab. RESULTS: From 8 pooled ramucirumab clinical studies, 55 of 559(9.8%)Japanese patients experienced at least one immediate IRR(any grade). When grouped according to infusion rate quartile, the incidence of immediate any-grade IRR was similar across quartiles. Infusion rate was not significantly associated with an increased risk of an immediate IRR; odds ratio per 1 mg/min increase was 0.912, 95% confidence interval 0.724 to 1.149, p=0.436. Patients aged ≥65 years may have a reduced risk of an immediate IRR compared with those aged <65 years, and premedication use was also associated with a reduced risk. Ramucirumab pharmacokinetic profiles were comparable following a 30- or 60-minute infusion. CONCLUSIONS: A shortened infusion duration of ramucirumab is unlikely to affect the efficacy or safety profile in Japanese patients and may be clinically beneficial for patients and health care providers. CLINICAL TRIAL REGISTRATION: RAINBOW-NCT01170663, RAISE- NCT01183780, REACH-NCT01140347, REACH-2-NCT02435433, RAINFALL-NCT02314117, RANGE-NCT02426125, RELAY-NCT02411448, I4T-MC-JVCG-NCT01703091.


Assuntos
Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica , Idoso , Ensaios Clínicos como Assunto , Humanos , Japão , Fatores de Tempo
12.
Nat Commun ; 12(1): 6379, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34737312

RESUMO

The short-term effectiveness of a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine was widely demonstrated. However, long term effectiveness is still unknown. Leveraging the centralized computerized database of Maccabi Healthcare Services (MHS), we assessed the correlation between time-from-vaccine and incidence of breakthrough infection between June 1 and July 27, the date of analysis. After controlling for potential confounders as age and comorbidities, we found a significant 1.51 fold (95% CI, 1.38-1.66) increased risk for infection for early vaccinees compared to those vaccinated later that was similar across all ages groups. The increased risk reached 2.26- fold (95% CI, 1.80-3.01) when comparing those who were vaccinated in January to those vaccinated in April. This preliminary finding of vaccine waning as a factor of time from vaccince should prompt further investigations into long-term protection against different strains.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/genética , Fatores de Tempo , Vacinação , Adulto Jovem
13.
J Prof Nurs ; 37(5): A1-A2, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34742534
14.
Circ Cardiovasc Qual Outcomes ; 14(11): e008242, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34749515

RESUMO

BACKGROUND: Despite its established benefit and strong endorsement in international guidelines, cardiac rehabilitation (CR) use remains low. Identifying determinants of CR referral and use may help develop targeted policies and quality improvement efforts. We evaluated the variation in CR referral and use across percutaneous coronary intervention (PCI) hospitals and operators. METHODS: We performed a retrospective observational cohort study of all patients who underwent PCI at 48 nonfederal Michigan hospitals between January 1, 2012 and March 31, 2018 and who had their PCI clinical registry record linked to administrative claims data. The primary outcomes included in-hospital CR referral and CR participation, defined as at least one outpatient CR visit within 90 days of discharge. Bayesian hierarchical regression models were fit to evaluate the association between PCI hospital and operator with CR referral and use after adjusting for patient characteristics. RESULTS: Among 54 217 patients who underwent PCI, 76.3% received an in-hospital referral for CR, and 27.1% attended CR within 90 days after discharge. There was significant hospital and operator level variation in in-hospital CR referral with median odds ratios of 3.88 (95% credible interval [CI], 3.06-5.42) and 1.64 (95% CI, 1.55-1.75), respectively, and in CR participation with median odds ratios of 1.83 (95% CI, 1.63-2.15) and 1.40 (95% CI, 1.35-1.47), respectively. In-hospital CR referral was significantly associated with an increased likelihood of CR participation (adjusted odds ratio, 1.75 [95% CI, 1.52-2.01]), and this association varied by treating PCI hospital (odds ratio range, 0.92-3.75) and operator (odds ratio range, 1.26-2.82). CONCLUSIONS: In-hospital CR referral and 90-day CR use after PCI varied significantly by hospital and operator. The association of in-hospital CR referral with downstream CR use also varied across hospitals and less so across operators suggesting that specific hospitals and operators may more effectively translate CR referrals into downstream use. Understanding the factors that explain this variation will be critical to developing strategies to improve CR participation overall.


Assuntos
Reabilitação Cardíaca , Intervenção Coronária Percutânea , Teorema de Bayes , Planos de Seguro Blue Cross Blue Shield , Hospitais , Humanos , Michigan/epidemiologia , Intervenção Coronária Percutânea/efeitos adversos , Encaminhamento e Consulta , Estudos Retrospectivos , Fatores de Tempo
16.
Ann Ital Chir ; 92: 589-591, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795115

RESUMO

OBJECTIVE: To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019(COVID-19) who developed bowel perforation. MATERIALS AND METHODS: This case series was conducted in Emergency Department of AORN Sant'Anna and S. Sebastiano located in Caserta. All patients resulted positive to SARS-Cov-2 in nasopharyngeal swabs whith a positive laboratory test for SARS-CoV-2 from real time reverse transcription polymerase chain reaction(RT-PCR) as well as bowel perforation which was identified by abdominal CT, from September 2020 to December 2020. RESULTS: A total of five patients were identified with Bowel perforation occurred despite all patients being on anticoagulation. All patients were Italian, predominantly male(four patients) with an average age of 60 years and the most common comorbidity was hypertension, diabetes and obesity. DISCUSSION: Bowel perforation in COVID-19 is clinically significant with high morbidity and mortality. In our series 40% of patients who were diagnosed of bowel perforation died. Average time to death after bowel perforation diagnosis was 6 days. CONCLUSION: We describe a case series of COVID-19 patients who developed bowel perforation. KEY WORDS: Covid-19, Bowel perforation.


Assuntos
COVID-19 , Perfuração Intestinal , Comorbidade , Humanos , Perfuração Intestinal/epidemiologia , Perfuração Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores de Tempo
17.
Am J Cardiol ; 161: 1-11, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34794605

RESUMO

Described herein are clinical and cardiac morphologic findings in 12 patients (age 43 to 70 years) (7 men) who underwent orthotopic heart transplantation (OHT) because of severe heart failure (HF) resulting from a single large discrete acute myocardial infarct that healed and was associated with severe narrowing of only one major epicardial coronary artery. Most myocardial infarcts are associated with severe narrowing of >1 major epicardial coronary artery and result in smaller myocardial infarcts. Another unusual feature was the total infarction of the ventricular septum in 3 of the 12 patients.


Assuntos
Oclusão Coronária/complicações , Vasos Coronários/diagnóstico por imagem , Insuficiência Cardíaca/etiologia , Transplante de Coração , Infarto do Miocárdio/diagnóstico , Adulto , Idoso , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico , Progressão da Doença , Eletrocardiografia , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Pericárdio , Índice de Gravidade de Doença , Síndrome , Fatores de Tempo
18.
Am J Cardiol ; 161: 19-25, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34794614

RESUMO

The optimal length of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains debated. Current guidelines recommend individualized treatment with consideration of risk scores. We sought to evaluate the degree of agreement in treatment recommendations and the ability to predict ischemic and bleeding complications of the PRECISE-DAPT (predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy) and DAPT scores. Consecutive patients receiving 12 months of DAPT were grouped based on score treatment recommendation at the time of PCI: PRECISE-DAPT prolonged or shortened (PRECISE DAPT <25 vs ≥25) and DAPT prolonged or shortened (DAPT ≥2 vs <2). One-year ischemic and bleeding outcomes were compared for each group. In 451 patients, the PRECISE-DAPT and DAPT score recommendations were concordant in 56.7% of patients (Cohen's kappa for agreement of k = 0.139, 95% confidence interval 0.065 to 0.212). There was no difference in composite major adverse cardiovascular and cerebrovascular events between patients with high versus low PRECISE-DAPT or DAPT scores. In patients with a high PRECISE-DAPT score versus a low score, there was an increased incidence of 1-year all-cause mortality (2.13% vs 0%, p = 0.04) and an increase in bleeding (Bleeding Academic Research Consortium ≥3a: 17.0% vs 2.8%; p <0.001; Bleeding Academic Research Consortium 3b/c and 5: 8.5% vs 1.4%; p = 0.001). There were no differences in rates of mortality or bleeding for patients with high versus low DAPT scores. In conclusion, when applied at the baseline, the PRECISE-DAPT and DAPT scores frequently make discordant DAPT duration recommendations. The PRECISE-DAPT, but not the DAPT score, demonstrated associations with all-cause mortality and bleeding in patients prescribed 12 months of DAPT after PCI.


Assuntos
Síndrome Coronariana Aguda/terapia , Terapia Antiplaquetária Dupla/métodos , Intervenção Coronária Percutânea , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/epidemiologia , Sistema de Registros , Medição de Risco/métodos , Idoso , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Inibidores da Agregação Plaquetária/administração & dosagem , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
19.
Am J Cardiol ; 161: 26-35, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34794615

RESUMO

The long-term prognostic significance of a coronary artery calcium (CAC) score of 0 is poorly defined in younger adults. We evaluated this among participants aged 45 to 55 years from the Multi-Ethnic Study of Atherosclerosis, and assessed whether additional biomarkers can identify subgroups at increased absolute risk. We included 1,407 participants (61% women) without diabetes or severe hypercholesterolemia, with estimated 10-year risk <20% and CAC = 0. We evaluated all and hard cardiovascular disease (CVD) events, overall and among subjects with each of the following: high-sensitivity C-reactive protein levels ≥2 mg/L, homocysteine ≥10 µmol/L, high-sensitivity cardiac troponin T ≥95th percentile, lipoprotein (a) >50 mg/dl, triglycerides ≥175 mg/dl, apolipoprotein B ≥130 mg/dl, albuminuria, thoracic aortic calcium, aortic valve calcium (AVC), mitral annular calcium, ankle-brachial index <0.9, any carotid plaque, and maximum internal carotid artery intima-media thickness (ICA-IMT) ≥1.5 mm. Median follow-up was 16 years, and overall CVD event rates were low (4% at 15 years). For most exposures evaluated, rates of all CVD events were <6 per 1,000 person-years, except for ICA-IMT ≥1.5 mm (6.43) and AVC (13.8). The number needed to screen to detect ICA-IMT ≥1.5 mm was 8, and 84 for AVC. Among participants with borderline/intermediate risk or premature family history, hard CVD event rates were <7 per 1,000 for most exposures, except for ICA-IMT ≥1.5 mm (8.25), albuminuria (8.30), and AVC (13.47). Nonsmokers and those with ICA-IMT <1.5 mm had very low rates. In conclusion, our results demonstrate a favorable long-term prognosis of CAC = 0 among adults aged ≤55 years, particularly among nonsmokers. ICA-IMT testing could be considered for further risk assessment in adults ≤55 years with CAC = 0 and uncertain management.


Assuntos
Aterosclerose/diagnóstico , Cálcio/metabolismo , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/metabolismo , Grupos Étnicos , Aterosclerose/etnologia , Aterosclerose/metabolismo , Espessura Intima-Media Carotídea , Doença da Artéria Coronariana/etnologia , Doença da Artéria Coronariana/metabolismo , Vasos Coronários/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Prognóstico , Fatores de Tempo , Estados Unidos/epidemiologia
20.
Am J Cardiol ; 161: 42-50, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34794617

RESUMO

Plasma proteomic profiling may aid in the discovery of novel biomarkers upstream of the development of atrial fibrillation (AF). We used data from the Atherosclerosis Risk in Communities study to examine the relation between large-scale proteomics and incident AF in a cohort of older-aged adults in the United States. We quantified 4,877 plasma proteins in Atherosclerosis Risk in Communities participants at visit 5 (2011-2013) using an aptamer-based proteomic profiling platform. We used Cox proportional hazards models to assess the association between protein levels and incident AF, and explored relation of selected protein biomarkers using annotated pathway analysis. Our study included 4,668 AF-free participants (mean age 75 ± 5 years; 59% female; 20% Black race) with proteomic measures. A total of 585 participants developed AF over a mean follow-up of 5.7 ± 1.7 years. After adjustment for clinical factors associated with AF, N-terminal pro-B-type natriuretic peptide (NT-proBNP) was associated with the risk of incident AF (hazard ratio, 1.82; 95% CI, 1.68 to 1.98; p, 2.91 × 10-45 per doubling of NT-proBNP). In addition, 36 other proteins were also significantly associated with incident AF after Bonferroni correction. We further adjusted for medication use and estimated glomerular filtration rate and found 17 proteins, including angiopoietin-2 and transgelin, that remained significantly associated with incident AF. Pathway analyses implicated the inhibition of matrix metalloproteases as the top canonical pathway in AF pathogenesis. In conclusion, using a large-scale proteomic platform, we identified both novel and established proteins associated with incident AF and explored mechanistic pathways of AF development.


Assuntos
Aterosclerose/sangue , Fibrilação Atrial/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Proteômica/métodos , Medição de Risco/métodos , Aterosclerose/complicações , Aterosclerose/epidemiologia , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Biomarcadores/sangue , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Precursores de Proteínas , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA