45 research outputs found
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The Effect of Salsalate Therapy on Endothelial Function in a Broad Range of Subjects
Background: Inflammation is fundamental to the development of atherosclerosis. We examined the effect of antiâinflammatory doses of salicylate on endotheliumâdependent vasodilation, a biomarker of cardiovascular risk, in a broad range of subjects. Methods and Results: We performed a randomized, doubleâblind, placeboâcontrolled crossover trial evaluating the effects of 4 weeks of highâdose salsalate (disalicylate) therapy on endotheliumâdependent flowâmediated and endotheliumâindependent vasodilation. Fiftyâeight subjects, including 17 with metabolic syndrome, 13 with atherosclerosis, and 28 healthy controls, were studied. Among all subjects, endotheliumâdependent flowâmediated vasodilation decreased after salsalate compared with placebo therapy (P=0.01), whereas nitroglycerinâmediated, endotheliumâindependent vasodilation was unchanged (P=0.97). Endotheliumâdependent flowâmediated vasodilation after salsalate therapy was impaired compared with placebo therapy in subjects with therapeutic salicylate levels (n=31, P0.2). Conclusions: Salsalate therapy, particularly when therapeutic salicylate levels are achieved, impairs endotheliumâdependent vasodilation in a broad range of subjects. These data raise concern about the possible deleterious effects of antiâinflammatory doses of salsalate on cardiovascular risk. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique Identifiers: NCT00760019 and NCT00762827
Electrocardiographic features of immune checkpoint inhibitor associated myocarditis.
BACKGROUND: Myocarditis is a highly morbid complication of immune checkpoint inhibitor (ICI) use that remains inadequately characterized. The QRS duration and the QTc interval are standardized electrocardiographic measures that are prolonged in other cardiac conditions; however, there are no data on their utility in ICI myocarditis.
METHODS: From an international registry, ECG parameters were compared between 140 myocarditis cases and 179 controls across multiple time points (pre-ICI, on ICI prior to myocarditis, and at the time of myocarditis). The association between ECG values and major adverse cardiac events (MACE) was also tested.
RESULTS: Both the QRS duration and QTc interval were similar between cases and controls prior to myocarditis. When compared with controls on an ICI (93±19 ms) or to baseline prior to myocarditis (97±19 ms), the QRS duration prolonged with myocarditis (110±22 ms, p
CONCLUSIONS: The QRS duration is increased in ICI myocarditis and is associated with increased MACE risk. Use of this widely available ECG parameter may aid in ICI myocarditis diagnosis and risk-stratification
COVID-19 Severity and Cardiovascular Outcomes in SARS-CoV-2-Infected Patients With Cancer and Cardiovascular Disease
BACKGROUND: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited.
OBJECTIVES: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF.
METHODS: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD
RESULTS: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all
CONCLUSIONS: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)
Maximum potential benefit of implantable defibrillators in preventing sudden death after hospital admission because of heart failure
Contribution of endothelin to pulmonary vascular tone under normoxic and hypoxic conditions
Risk of cardiovascular mortality with androgen deprivation therapy in prostate cancer: A secondary analysis of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Randomized Controlled Trial
BACKGROUND
For men with radiationâmanaged prostate cancer, there is conflicting evidence regarding the association between androgen deprivation therapy (ADT) and cardiovascular mortality (CVM), particularly among those who have with preexisting comorbidities. The objective of this study was to analyze the association between ADT and CVM across patient comorbidity status using prospectively collected data from a large clinical trial.
METHODS
In total, 1463 men were identified who were diagnosed with clinically localized, intermediateârisk/highârisk prostate cancer (T2bâT4, Gleason 7â10, or prostateâspecific antigen >10 ng/mL) from 1993 to 2001 and managed with either radiation therapy (RT) alone or RT plus ADT during the randomized Prostate, Lung, Colon, and Ovarian (PLCO) Cancer Screening Trial. Adjusted hazard ratios (aHRs) for causeâspecific mortality (prostate cancerâspecific mortality vs otherâcause mortalityâincluding the primary end point of CVM [death from ischemic heart disease, cerebrovascular accident, or other circulatory disease]) were determined using Fine and Gray competingârisk regression analysis and stratified by comorbidity history.
RESULTS
There was no difference in the risk of 5âyear CVM between ADT plus RT and RT alone (2.3% vs 3.3%, respectively; aHR, 0.69; 95% CI, 0.38â1.24; P = .21) overall or on subgroup analysis among men with a history of â„1 preexisting comorbidities (3.2% vs 5.3%, respectively; aHR, 0.83; 95% CI, 0.43â1.60; P = .58), â„2 preexisting comorbidities (6.9% vs 8.3%, respectively; aHR, 0.95; 95% CI, 0.40â2.25; P = .90), or cardiovascular disease/risk factors (3.6% vs 4.3%, respectively; aHR, 0.85; 95% CI, 0.44â1.65; P = .63). These results were all similar when each component of CVM was analyzed separatelyâeither cardiac, stroke, or other vascular mortality (P > .05).
CONCLUSIONS
This study provides prospectively collected evidence that the use of ADT plus RT, compared with RT alone, is not associated with an increased risk of CVM, even among subgroups of men who have preexisting comorbidities and cardiovascular disease.
In this secondary analysis of a prospective trial of 1463 men with radiationâtreated, localized, intermediateârisk/highârisk prostate cancer, 5âyear cardiovascular mortality is comparable between androgen deprivation therapy plus radiation therapy and radiation therapy alone (overall, 2.3% vs 3.3%, respectively), even among those who have preexisting comorbidities or cardiovascular disease