15 results on '"Pratik Sandesara"'
Search Results
2. Living in Food Deserts and Adverse Cardiovascular Outcomes in Patients With Cardiovascular Disease
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Heval M. Kelli, Jeong Hwan Kim, Ayman Samman Tahhan, Chang Liu, Yi‐An Ko, Muhammad Hammadah, Samaah Sullivan, Pratik Sandesara, Ayman A. Alkhoder, Fahad K. Choudhary, M. Mazen Gafeer, Keyur Patel, Saqib Qadir, Tené T. Lewis, Viola Vaccarino, Laurence S. Sperling, and Arshed A. Quyyumi
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cardiovascular disease ,death ,environment ,food desert ,myocardial infarction ,socioeconomic position ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Food deserts (FDs), defined as low‐income communities with limited access to healthy food, are a growing public health concern. We evaluated the impact of living in FDs on incident cardiovascular events. Methods and Results We recruited 4944 subjects (age 64±12, 64% male) undergoing cardiac catheterization into the Emory Cardiovascular Biobank. Using the US Department of Agriculture definition of FD, we determined whether their residential addresses had (1) poor access to healthy food, (2) low income, or (3) both (=FD). Subjects were prospectively followed for a median of 3.2 years for myocardial infarction (MI) and death. Fine and Gray's subdistribution hazard models for MI and Cox proportional hazard models for death/MI were used to examine the association between area characteristics (FD, poor access, and low income) and the rates of adverse events after adjusting for traditional risk factors. A total of 981 (20%) lived in FDs and had a higher adjusted risk of MI (subdistribution hazard ratio, 1.44 [95% CI, 1.06–1.95]) than those living in non‐FDs. In a multivariate analysis including both food access and area income, only living in a low‐income area was associated with a higher adjusted risk of MI (subdistribution hazard ratio, 1.40 [1.06–1.85]) and death/MI (hazard ratio, 1.18 [1.02–1.35]) while living in a poor‐access area was not significantly associated with either (subdistribution hazard ratio, 1.05 [0.80–1.38] and hazard ratio, 0.99 [0.87–1.14], respectively). Conclusions Living in an FD is associated with a higher risk of adverse cardiovascular events in those with coronary artery disease. Specifically, low area income of FDs, not poor access to food, was significantly associated with worse outcomes.
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- 2019
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3. High‐Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long‐Term Outcomes
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Ayman Samman Tahhan, Pratik Sandesara, Salim S. Hayek, Muhammad Hammadah, Ayman Alkhoder, Heval M. Kelli, Matthew Topel, Wesley T. O'Neal, Nima Ghasemzadeh, Yi‐An Ko, Mohamad Mazen Gafeer, Naser Abdelhadi, Fahad Choudhary, Keyur Patel, Agim Beshiri, Gillian Murtagh, Jonathan Kim, Peter Wilson, Leslee Shaw, Viola Vaccarino, Stephen E. Epstein, Laurence Sperling, and Arshed A. Quyyumi
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atherosclerosis ,coronary angiography ,coronary artery disease ,troponin ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundThe associations between high‐sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity. Methods and ResultsIn 3087 patients (aged 63±12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with ≥50% stenosis and the Gensini score. CAD progression was assessed in a subset of 717 patients who had undergone ≥2 coronary angiograms >3 months before enrollment. Patients were followed up for incident all‐cause mortality and incident cardiovascular events. Of the total population, 11% had normal angiograms, 23% had nonobstructive CAD, 20% had 1‐vessel CAD, 20% had 2‐vessel CAD, and 26% had 3‐vessel CAD. After adjusting for age, sex, race, body mass index, smoking, hypertension, diabetes mellitus history, and renal function, hsTnI levels were independently associated with the severity of CAD measured by the Gensini score (log 2 ß=0.31; 95% confidence interval, 0.18–0.44; P
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- 2018
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4. Myocardial Ischemia and Mobilization of Circulating Progenitor Cells
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Muhammad Hammadah, Ayman Samman Tahhan, Ibhar Al Mheid, Kobina Wilmot, Ronnie Ramadan, Bryan R. Kindya, Heval M. Kelli, Wesley T. O'Neal, Pratik Sandesara, Samaah Sullivan, Zakaria Almuwaqqat, Malik Obideen, Naser Abdelhadi, Ayman Alkhoder, Pratik M. Pimple, Oleksiy Levantsevych, Kareem H. Mohammed, Lei Weng, Laurence S. Sperling, Amit J. Shah, Yan V. Sun, Brad D. Pearce, Michael Kutner, Laura Ward, J. Douglas Bremner, Jinhee Kim, Edmund K. Waller, Paolo Raggi, David Sheps, Viola Vaccarino, and Arshed A. Quyyumi
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coexpression of chemokine receptor 4 ,ischemia ,progenitor cell ,stromal‐derived factor ,vascular endothelial growth factor ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundThe response of progenitor cells (PCs) to transient myocardial ischemia in patients with coronary artery disease remains unknown. We aimed to investigate the PC response to exercise‐induced myocardial ischemia (ExMI) and compare it to flow mismatch during pharmacological stress testing. Methods and ResultsA total of 356 patients with stable coronary artery disease underwent 99mTc‐sestamibi myocardial perfusion imaging during exercise (69%) or pharmacological stress (31%). CD34+ and CD34+/chemokine (C‐X‐C motif) receptor 4 PCs were enumerated by flow cytometry. Change in PC count was compared between patients with and without myocardial ischemia using linear regression models. Vascular endothelial growth factor and stromal‐derived factor‐1α were quantified. Mean age was 63±9 years; 76% were men. The incidence of ExMI was 31% and 41% during exercise and pharmacological stress testing, respectively. Patients with ExMI had a significant decrease in CD34+/chemokine (C‐X‐C motif) receptor 4 (−18%, P=0.01) after stress that was inversely correlated with the magnitude of ischemia (r=−0.19, P=0.003). In contrast, patients without ExMI had an increase in CD34+/chemokine (C‐X‐C motif) receptor 4 (14.7%, P=0.02), and those undergoing pharmacological stress had no change. Plasma vascular endothelial growth factor levels increased (15%, P
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- 2018
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5. Marital Status and Outcomes in Patients With Cardiovascular Disease
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William M. Schultz, Salim S. Hayek, Ayman Samman Tahhan, Yi‐An Ko, Pratik Sandesara, Mosaab Awad, Kareem H. Mohammed, Keyur Patel, Michael Yuan, Shuai Zheng, Matthew L. Topel, Joy Hartsfield, Ravila Bhimani, Tina Varghese, Jonathan H. Kim, Leslee Shaw, Peter Wilson, Viola Vaccarino, and Arshed A. Quyyumi
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cardiovascular disease ,divorce ,marital status ,mortality ,never married ,socioeconomic position ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundBeing unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never‐married status affects outcomes in patients with cardiovascular disease has not been well characterized. Methods and ResultsA prospective cohort (inception period 2003–2015) of 6051 patients (mean age 63 years, 64% male, 23% black) undergoing cardiac catheterization for suspected or confirmed coronary artery disease was followed for a median of 3.7 years (interquartile range: 1.7–6.7 years). Marital status was stratified as married (n=4088) versus unmarried (n=1963), which included those who were never married (n=451), divorced or separated (n=842), or widowed (n=670). The relationship between marital status and primary outcome of cardiovascular death and myocardial infarction was examined using Cox regression models adjusted for clinical characteristics. There were 1085 (18%) deaths from all causes, 688 (11%) cardiovascular‐related deaths, and 272 (4.5%) incident myocardial infarction events. Compared with married participants, being unmarried was associated with higher risk of all‐cause mortality (hazard ratio [HR]: 1.24; 95% confidence interval [CI], 1.06–1.47), cardiovascular death (HR: 1.45; 95% CI, 1.18–1.78), and cardiovascular death or myocardial infarction (HR: 1.52; 95% CI, 1.27–1.83). Compared with married participants, the increase in cardiovascular death or myocardial infarction was similar for the participants who were divorced or separated (HR: 1.41; 95% CI, 1.10–1.81), widowed (HR: 1.71; 95% CI, 1.32–2.20), or never married (HR: 1.40; 95% CI, 0.97–2.03). The findings persisted after adjustment for medications and other socioeconomic factors. ConclusionsMarital status is independently associated with cardiovascular outcomes in patients with or at high risk of cardiovascular disease, with higher mortality in the unmarried population. The mechanisms responsible for this increased risk require further study.
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- 2017
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6. Genetic Variation at the ADAMTS7 Locus is Associated With Reduced Severity of Coronary Artery Disease
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Kenneth Chan, Xiangyuan Pu, Pratik Sandesara, Robin N. Poston, Iain A. Simpson, Arshed A. Quyyumi, Shu Ye, and Riyaz S. Patel
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angiography ,atherogenesis ,coronary artery disease ,genetic association ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundGenome‐wide association studies identified ADAMTS7 as a risk locus for coronary artery disease (CAD). Functional studies suggest that ADAMTS7 may promote cellular processes in atherosclerosis. We sought to examine the association between genetic variation at ADAMTS7 and measures of atherosclerosis using histological, angiographic, and clinical outcomes data. Methods and ResultsThe lead CAD‐associated single‐nucleotide polymorphism rs3825807 at the ADAMTS7 locus was genotyped. The G allele (reduced ADAMTS7 function) was associated with a smaller fibrous cap (P=0.017) and a smaller percentage area of α‐actin (smooth muscle cell marker) in the intima (P=0.017), but was not associated with calcification or plaque thickness, following ex vivo immunohistochemistry analysis of human coronary plaques (n=50; mean age 72.2±11.3). In two independent cohorts (Southampton Atherosclerosis Study [n=1359; mean age 62.5±10.3; 70.1% men] and the Emory Cardiovascular Biobank [EmCAB; n=2684; mean age 63.8±11.3; 68.7% men]), the G allele was associated with 16% to 19% lower odds of obstructive CAD (Southampton Atherosclerosis Study: odds ratio, 0.81; 95% confidence interval, 0.67–0.98; EmCAB: odds ratio, 0.84; 95% confidence interval, 0.75–0.95) with similar effects for multivessel, left anterior descending, and proximal CAD. Furthermore, each copy of the G allele was associated with lower angiographic severity Gensini score (Southampton Atherosclerosis Study, P=0.026; EmCAB, P
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- 2017
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7. Primary Prevention of Cardiovascular Disease
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Danny J. Eapen, William M. Schultz, Robert E. Heinl, Nima Ghasemzadeh, Tina Varghese, Diana E. Kurian, Christina E. Mathai, Pratik Sandesara, Bryan R. Kindya, Marc P. Allard-Ratick, Neal K. Bhatia, Ijeoma Isiadinso, and Laurence Sperling
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. This article focuses on current guidelines for the primary prevention of CVD and addresses management of key risk factors. Dietary modification, weight loss, exercise, and tobacco use cessation are specific areas where focused efforts can successfully reduce CVD risk on both an individual and a societal level. Specific areas requiring management include dyslipidemia, hypertension, physical activity, diabetes, aspirin use, and alcohol intake. These preventive efforts have major public health implications. As the global population continues to grow, health care expenditures will also rise, with the potential to eventually overwhelm the health care system. Therefore it is imperative to apply our collective efforts on CVD prevention to improve the cardiovascular health of individuals, communities, and nations.
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- 2016
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8. EFFICACY AND SAFETY OF INTRAVASCULAR LITHOTRIPSY COMPARED TO ROTATIONAL ATHERECTOMY FOR CALCIFIED LEFT MAIN DISEASE
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Malika Elhage Hassan, Wissam A. Jaber, Sakolwat Montrivade, William Nicholson, and Pratik Sandesara
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Cardiology and Cardiovascular Medicine - Published
- 2023
9. Transcatheter Aortic Valve Replacement: Advances in Procedural Technology and Approaches
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John C, Lisko Iii, Nikoloz, Shekiladze, Pratik, Sandesara, and Chandan M, Devireddy
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Transcatheter Aortic Valve Replacement ,Technology ,Treatment Outcome ,Humans ,Aortic Valve Stenosis ,Embolic Protection Devices ,United States - Abstract
Transcatheter aortic valve replacement (TAVR) is now the dominant form of aortic valve replacement in the United States. Continued innovation has allowed the technique to be safe and democratized. New advances will increase the number of patients eligible to receive this therapy while increasing safety and efficiency. Herein, the authors review new TAVR technologies, approaches to valve deployment, and dedicated devices for cerebral embolic protection and vascular closure.
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- 2021
10. Abstract P047: Ideal Cardiovascular Health Score and Oxidative Stress
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Heval Mohamed Kelli, Chang Liu, Ayman Samman-Tahhan, Talal Alghamdi, Yi-An Ko, Fahad Choudhary, Vanessa Engineer, Muhammad Hammadah, Pratik Sandesara, Ibhar Al Mheid, Wesley O'Neal, Viola Vaccarino, Thomas Ziegler, Laurence Sperling, Michelle Lampl, Kenneth Brigham, Greg Martin, and Arshed Quyyumi
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Ideal cardiovascular health (CVH) promotion is effective for cardiovascular disease prevention. Whether increased CVH score improves oxidative stress is less clear. Our study examined the correlation between changes in ideal CVH status and oxidative stress. Hypothesis: Improvement in CVH score is correlated with changes in oxidative stress. Methods: A total of 569 actively working adult employees (51±11 years, 64% women, 21% Black) underwent a health partner-mediated lifestyle intervention. Serial counseling was delivered by a trained HP focused on promoting clinical self-knowledge and adoption of a healthier lifestyle, based on the subject’s personal schedule. Anthropometric, dietary and laboratory measurements were obtained at baseline and 1- and 2-year follow-up visits. Plasma levels of reduced (glutathione) and oxidized (cystine) aminothiols were measured by high performance liquid chromatography at baseline and follow-up to assess oxidative stress. Ratios of oxidized to reduced aminothiols (cystine/glutathione) were calculated. Linear mixed-effects model was used to examine the correlation between the changes in CVH score and changes in oxidative stress metrics overall 2 years follow-up. Results: Over 2-years, cystine (p=0.01) improved while cystine/glutathione (p=0.03) and glutathione (p Conclusion: Improvement in CVH with a lifestyle intervention was associated with early and sustained improvement in oxidative stress. Whether the impact of changes in CVH metrics on oxidative stress improves long-term morbidity and mortality needs further investigation in a controlled design.
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- 2018
11. Abstract P365: Effects of a Health Partner Intervention on Arterial Health
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Heval Mohamed Kelli, Robert Heinl, Jamal Hajjari, Samantha Noreen, Yi-An Ko, Muhammad Hammadah, Ayman Samman-Tahhan, Pratik Sandesara, Talal Alghamdi, Kaavya Chivukula, Frank Corrigan, Ibhar Al Mheid, Thomas Ziegler, Greg Gibson, Michelle Lampl, Kenneth Brigham, Viola Vaccarino, Greg Martin, and Arshed A Quyyumi
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Lifestyle modification is effective for cardiovascular disease prevention. Whether lifestyle intervention also preserves vascular health is less clear. Our study examined the role of a Health Partner-administered lifestyle intervention on vascular function. Hypothesis: Lifestyle intervention improves and preserves vascular function. Methods: A total of 711 university employees (48±11 years, 66% women, 22.5% Black) enrolled in a program that promoted healthier lifestyles at Emory University. Participants collaborated with a Health Partner to generate a personalized plan focused on achieving ideal health metrics. Anthropometric, laboratory and vascular function measurements were performed at baseline and at 1-year and 2-years of follow-up. Arterial stiffness was assessed by carotid-femoral pulse wave velocity and radial tonometry-derived central augmentation index. Microvascular function was assessed as digital reactive hyperemia index. Flow-mediated dilation was measured using ultrasound. The sample was divided into individuals within the lowest tertile and those in the upper two tertiles for vascular function at baseline. Paired t-test was used to assess the changes in vascular functions at 1 and 2 years of follow-up compared to baseline. Results: At each of the 1-year and 2-year follow-up visits, vascular function improved in the group within the abnormal tertile at baseline. Flow-mediated dilation increased by 1.6% and 2.0% (P Conclusion: A personalized, goal directed Health Partner intervention was associated with better vascular stiffness, endothelial and microvascular function in those with baseline abnormal values. These effects were evident at 1 year following enrollment and were sustained for 2 years. Whether the impact of Health Partner intervention on vascular function improves long-term morbidity and mortality needs further investigation in a controlled design.
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- 2017
12. Abstract MP076: Angiographic Coronary Artery Disease Severity and Risk of Mental and Conventional Stress Induced Myocardial Ischemia
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Muhammad Hammadah, Naser Abdelhadi, Shuyang Fang, Zakaria Almuwaqqat, Ayman Alkhoder, Mazen Ghafeer, Hawkins C Gay, Ijeoma Ibeanu, Wesley T O’Neal, Samah Sullivan, Ayman Samman Tahhan, Heval Mohamed Kelli, Levantsevych Oleksiy, Malik Obideen, Pratik Pimple, Pratik Sandesara, ibhar almheid, Kobina Wilmot, Ronnie Ramadan, Amit J Shah, J. Douglas Bremner, Paolo Raggi, David Sheps, Arshed Quyyumi, and Viola Vaccarino
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medicine.medical_specialty ,Myocardial ischemia ,business.industry ,Stress induced ,medicine.disease ,Coronary artery disease ,Increased risk ,Physiology (medical) ,Internal medicine ,Mental stress ,medicine ,Cardiology ,Anxiety ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular outcomes - Abstract
Background: Mental stress induced myocardial ischemia (MSIMI) is linked to increased risk of adverse cardiovascular outcomes, but its mechanisms are thought to be different from those of conventional stress-induced ischemia (CSIMI). Specifically, whether MSIMI is associated with more severe underlying obstructive coronary artery disease (CAD) is unclear. We investigated the association between angiographically-defined CAD severity and both MSIMI and CSIMI with a hypothesis that, CAD severity will be linked to CSIMI, but not MSIMI. Methods: A total of 273 patients with stable CAD, aged 51±7 years, 49% female, who survived a myocardial infarction (MI) within the past 8 months (median 167±52 days) were enrolled in the Myocardial Infarction and Mental Stress 2 (MIMS-2) study. The coronary angiogram performed during the index MI hospitalization was used to assess CAD severity. Coronary artery obstruction was assessed by counting the number of diseased vessels with 70% stenosis (DV70%) and using the Gensini Score (GS) after correcting for revascularized vessels. Patients underwent 99mTc sestamibi myocardial perfusion imaging during mental stress, using a public speaking task, and during conventional stress test, using exercise or pharmacological stress. MSIMI and CSIMI were defined as a new or worsening impairment in myocardial perfusion using a 17-segment model. Results: A total of 68 (26%) patients developed CSIMI, while 46 (17%) developed MSIMI. Median DV70% and GS were 0 (0-1), and 3 (0-12), respectively. Using logistic regression models, and after adjustment for age, gender, hypertension, hyperlipidemia and diabetes, obstructive CAD was associated with increased risk of CSIMI [OR(95%CI) of 1.54 (1.02 - 2.31) for DV70% and 1.25 (1.03-1.53), for GS], but not MSIMI [OR(95%CI) of 0.93 (0.56 - 1.53) for DV70%, and 0.94 (0.75-1.18) for GS]. Conclusion: Although CSIMI is linked to underlying coronary obstruction, MSIMI is independent of CAD severity among post- MI patients. Other mechanisms are likely responsible for MSIMI post MI.
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- 2017
13. MARKERS OF KIDNEY FUNCTION AND THE RISK FOR ADVERSE EVENTS IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION
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Pratik Sandesara, Sanjay Venkatesh, Wesley O'Neal, and Sameer Arora
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medicine.medical_specialty ,business.industry ,Volume overload ,Renal function ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Internal medicine ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,Adverse effect ,business ,Heart failure with preserved ejection fraction ,Kidney disease - Abstract
Recent evidence suggests that volume overload in patients with heart failure with preserved ejection fraction (HFpEF) is partially related to chronic kidney disease (CKD). Therefore, we examined the influence of CKD on outcomes in patients with HFpEF. We examined the relationship between markers of
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- 2019
14. CIRCULATING SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR LEVELS PREDICT MORTALITY IN SUBJECTS WITHOUT OBSTRUCTIVE CORONARY ARTERY DISEASE
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Nabil Sabbak, Ahmed AlBadri, Ayman Samman Tahhan, Pratik Sandesara, Ayman Alkhoder, Salim Hayek, Heval M. Kelli, Mohamad Mazen Gafeer, Naser Abdelhadi, Belal Kaseer, Yi-An Ko, Keyur Patel, Fahad Choudhary, Sonali Kumar, Jamal Hajjari, Arti Patel, Murtuza Jafri, Muaaz Choudhary, Laila Hasnain, Vanessa Engineer, Saqib Qadir, Arianna Sidoti, Laurence Sperling, Puja K. Mehta, and Arshed Quyyumi
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Coronary artery disease ,medicine.medical_specialty ,Endocrinology ,business.industry ,Urokinase Plasminogen Activator ,Internal medicine ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Receptor - Published
- 2018
15. RISK OF ADVERSE OUTCOMES ASSOCIATED WITH ATRIAL FIBRILLATION SUBTYPES IN HEART FAILURE WITH PRESERVED EJECTION FRACTION
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Wesley T. O'Neal, Elsayed Z. Soliman, Pratik Sandesara, and Sanjay Venkatesh
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medicine.medical_specialty ,business.industry ,Adverse outcomes ,Atrial fibrillation ,medicine.disease ,Increased risk ,Internal medicine ,Cardiology ,Medicine ,In patient ,Cardiology and Cardiovascular Medicine ,Heart failure with preserved ejection fraction ,business ,Adverse effect - Abstract
Atrial fibrillation (AF) is associated with an increased risk for adverse events in patients with heart failure with preserved ejection fraction (HFpEF), but it is currently unknown if differences exist in patients with paroxysmal versus sustained AF. We examined the risk of adverse outcomes
- Published
- 2018
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