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Find video protocols related to scientific articles indexed in Pubmed.
International Geographic Variation in Event Rates in Trials of Heart Failure With Preserved and Reduced Ejection Fraction.
Circulation
PUBLISHED: 11-20-2014
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-International geographic differences in outcomes may exist for clinical trials of heart failure and reduced ejection fraction (HF-REF), but there are few data for those with preserved ejection fraction (HF-PEF).
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Prognostic importance of temporal changes in resting heart rate in heart failure patients: an analysis of the CHARM program.
Eur. Heart J.
PUBLISHED: 11-05-2014
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Resting heart rate (HR) is a predictor of adverse outcome in patients with heart failure (HF). Whether changes in HR over time in patients with chronic HF are also associated with adverse outcome is unknown. We explored the relationship between changes in HR from a preceding visit, time-updated HR (i.e. most recent available HR value from a clinic visit) and subsequent outcomes in patients with chronic HF.
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Systolic and Diastolic Blood Pressure Changes in Relation With Myocardial Infarction and Stroke in Patients With Coronary Artery Disease.
Hypertension
PUBLISHED: 10-22-2014
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Excessively high and low achieved blood pressure (BP) may be associated with a bad outcome in patients with coronary artery disease, the J curve phenomenon. The effect of BP changes from baseline in relation with the subsequent risk of stroke and myocardial infarction (MI) is unknown. Of the 25 620 patients randomized in the Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) study, we selected 19 102 patients with coronary artery disease at baseline. BP at entry was 141/82 mm Hg, and its average decrease during follow-up was 7/6 mm Hg. BP entered the analysis as time-varying variable modeled with restricted cubic splines. After adjustment for several potential determinants of reverse causality, a change in BP from baseline by -34/-21 mm Hg (10th percentile) was associated with a lesser risk of stroke without any significant increase in the risk of MI. A rise in systolic/diastolic BP from baseline by 20/10 mm Hg (90th percentile) was associated with an increased risk of stroke, whereas the risk of MI increased with systolic BP and not with diastolic BP. In conclusion, in patients with coronary artery disease and initially free from congestive heart failure, a BP reduction from baseline over the examined BP range had little effect on the risk of MI and predicted a lower risk of stroke. An increase in systolic BP from baseline increased the risk of stroke and MI. The relationships of BP with risk were much steeper for stroke than for MI. A treatment-induced BP reduction over the explored range seems to be safe in patients with coronary artery disease.
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Influence of Hospitalization for Cardiovascular versus Noncardiovascular Reasons on Subsequent Mortality in Patients with Chronic Heart Failure Across the Spectrum of Ejection Fraction.
Circ Heart Fail
PUBLISHED: 10-17-2014
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-Noncardiovascular (non-CV) comorbidities may contribute to hospitalizations in patients with heart failure (HF). We examined the incidence of mortality following hospitalization for cardiovascular (CV) versus non-CV reasons in the CHARM Program.
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Evidence Relating Sodium Intake to Blood Pressure and CVD.
Curr Cardiol Rep
PUBLISHED: 10-10-2014
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Sodium is an essential nutrient, mostly ingested as salt (sodium chloride). Average sodium intake ranges from 3 to 6 g per day (7.5-15 g/day of salt) in most countries, with regional variations. Increasing levels of sodium intake have a positive association with higher blood pressure. Randomized controlled trials report a reduction in blood pressure with reducing sodium intake from moderate to low levels, which is the evidence that forms the basis for international guidelines recommending all people consume less than 2.0 g of sodium per day. However, no randomized trials have demonstrated that reducing sodium leads to a reduction in cardiovascular disease (CVD). In their absence, the next option is to examine the association between sodium consumption and CVD in prospective cohort studies. Several recent prospective cohort studies have indicated that while high intake of sodium (>6 g/d) is associated with higher risk of CVD compared to those with moderate intake (3 to 5 g/d), lower intake (<3 g/day) is also associated with a higher risk (despite lower blood pressure levels). However, most of these studies were conducted in populations at increased risk of cardiovascular disease. Current epidemiologic evidence supports that an optimal level of sodium intake is in the range of about 3-5 g/day, as this range is associated with lowest risk of CVD in prospective cohort studies. Randomized controlled trials, comparing the effect of low sodium intake to moderate intake on incidence of cardiovascular events and mortality, are required to truly define optimal intake range.
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Association of urinary sodium and potassium excretion with blood pressure.
N. Engl. J. Med.
PUBLISHED: 08-15-2014
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Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown.
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Predictors of early and late stroke following cardiac surgery.
CMAJ
PUBLISHED: 07-21-2014
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Much is known about the short-term risks of stroke following cardiac surgery. We examined the rate and predictors of long-term stroke in a cohort of patients who underwent cardiac surgery.
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The mini-mental state examination, clinical factors, and motor vehicle crash risk.
J Am Geriatr Soc
PUBLISHED: 07-15-2014
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To examine the association between Mini-Mental State Examination (MMSE) score and motor vehicle crash (MVC) risk in a large cohort of community-dwelling participants with cardiovascular disease (CVD) or diabetes mellitus.
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Socioeconomic factors and use of secondary preventive therapies for cardiovascular diseases in South Asia: The PURE study.
Eur J Prev Cardiol
PUBLISHED: 06-20-2014
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The purpose of this study was to determine the association of socioeconomic factors on use of cardioprotective medicines in known coronary heart disease (CHD) or stroke in South Asia.
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Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study.
Circulation
PUBLISHED: 06-13-2014
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Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect.
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Incidental magnetic resonance diffusion-weighted imaging-positive lesions are rare in neurologically asymptomatic community-dwelling adults.
Stroke
PUBLISHED: 06-12-2014
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Incidental magnetic resonance diffusion-weighted imaging (DWI)-positive lesions, considered to represent small acute infarcts, have been detected in patients with cerebral small vessel diseases or cognitive impairment, but the prevalence in the community population is unknown.
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Modification of outcomes with aspirin or apixaban in relation to female and male sex in patients with atrial fibrillation: a secondary analysis of the AVERROES study.
Stroke
PUBLISHED: 06-10-2014
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The main objective of the present analysis was to assess the effect of treatment with aspirin compared with apixaban on ischemic stroke and major bleeding in women compared with men. Female patients with atrial fibrillation are at increased stroke risk compared with male patients, and the underlying reasons for higher risk are uncertain.
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Kidney function after off-pump or on-pump coronary artery bypass graft surgery: a randomized clinical trial.
JAMA
PUBLISHED: 06-03-2014
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Most acute kidney injury observed in the hospital is defined by sudden mild or moderate increases in the serum creatinine concentration, which may persist for several days. Such acute kidney injury is associated with lower long-term kidney function. However, it has not been demonstrated that an intervention that reduces the risk of such acute kidney injury better preserves long-term kidney function.
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Effects of basal insulin glargine and omega-3 fatty acid on cognitive decline and probable cognitive impairment in people with dysglycaemia: a substudy of the ORIGIN trial.
Lancet Diabetes Endocrinol
PUBLISHED: 06-02-2014
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Diabetes and non-diabetic dysglycaemia are risk factors for accelerated cognitive decline. In this planned substudy of the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial, we assessed whether normalising glucose with insulin glargine or administering omega-3 fatty acids in this population may slow this process or affect the development of cognitive impairment.
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Influence of previous heart failure hospitalization on cardiovascular events in patients with reduced and preserved ejection fraction.
Circ Heart Fail
PUBLISHED: 05-29-2014
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Hospitalization for acute heart failure (HF) is associated with high rates of subsequent mortality and readmission. We assessed the influence of the time interval between previous HF hospitalization and randomization in the Candesartan in Heart failure: Reduction in Mortality and morbidity (CHARM) trials on clinical outcomes in patients with both reduced and preserved ejection fraction.
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Association of cyclooxygenase-2 genetic variant with cardiovascular disease.
Eur. Heart J.
PUBLISHED: 05-05-2014
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A genetic variant (rs20417) of the PTGS2 gene, encoding for COX-2, has been associated with decreased COX-2 activity and a decreased risk of cardiovascular disease (CVD). However, this genetic association and the role of COX-2 in CVD remain controversial.
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Importance of persistent elevation of cardiac biomarkers in atrial fibrillation: a RE-LY substudy.
Heart
PUBLISHED: 05-02-2014
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To evaluate the prognostic importance of transient or persistent elevations of cardiac troponin-I (cTnI) and N-terminal-B-type natriuretic peptide (NT-proBNP) in atrial fibrillation (AF).
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Influence of Tea Consumption on Acute Myocardial Infarction in China Population: The INTERHEART China Study.
Angiology
PUBLISHED: 04-24-2014
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We assessed the association between tea consumption and acute myocardial infarction (AMI) using INTERHEART China data. Cases (n = 2909) and controls (n = 2947) were randomly selected and frequency matched by age and sex. Participants who drank tea ?4 cups/d had a significantly higher risk of AMI than tea nondrinkers; odds ratio (OR) was 1.29 (95% confidence interval [CI]: 1.03-1.61) compared with tea nondrinkers. A similar trend was found in green tea drinkers; OR was 1.52 (95% CI: 1.13-2.05) in the participants who drank 3 cups/d and 1.73 (95% CI: 1.35-2.22) in the participants who drank ?4 cups/d compared with tea nondrinkers. We also found that green tea consumption had a greater effect on females; OR was 2.80 (95% CI: 1.43-5.50) in females. In conclusion, we found that the risk of AMI increases as tea consumption increases. Further studies are needed to confirm this association.
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The cost implications of an early versus delayed invasive strategy in Acute Coronary Syndromes: the TIMACS study.
J Med Econ
PUBLISHED: 04-16-2014
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The Timing of Intervention in Acute Coronary Syndromes (TIMACS) trial demonstrated that early invasive intervention (within 24 hours) was similar to a delayed approach (after 36 hours) overall but improved outcomes were seen in patients at high risk. However, the cost implications of an early versus delayed invasive strategy are unknown.
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The relationship between estimated sodium and potassium excretion and subsequent renal outcomes.
Kidney Int.
PUBLISHED: 04-10-2014
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Patients are often advised to reduce sodium and potassium intake, but supporting evidence is limited. To help provide such evidence we estimated 24?h urinary sodium and potassium excretion in 28,879 participants at high cardiovascular risk who were followed for a mean of 4.5 years in the ONTARGET and TRANSCEND trials. The primary outcome was eGFR decline of 30% or more or chronic dialysis. Secondary outcomes were eGFR decline of 40% or more or chronic dialysis, doubling of serum creatinine or chronic dialysis, an over 5%/year loss of eGFR, progression of albuminuria, and hyperkalemia. Multinomial logit regression with multivariable fractional polynomials, adjusted for confounders, determined the association between urinary sodium and potassium excretion and renal outcomes, with death as a competing risk. The primary outcome occurred in 2,052 (7.6%) patients. There was no significant association between sodium and any renal outcome (primary outcome odds ratio 0.99; 95% CI 0.89-1.09 for highest [median 6.2?g/day] vs. lowest third [median 3.3?g/day]). Higher potassium was associated with lower odds of all renal outcomes (primary outcome odds ratio 0.74; 95% CI 0.67-0.82 for highest [median 2.7?g/day] vs. lowest third [median 1.7?g/day], except hyperkalemia nonsignificant. Thus, urinary potassium, but not sodium, excretion predicted clinically important renal outcomes. Our findings do not support routine low sodium and potassium diets for prevention of renal outcomes in people with vascular disease with or without chronic kidney disease.Kidney International advance online publication, 11 June 2014; doi:10.1038/ki.2014.214.
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Incremental value of left ventricular systolic and diastolic function to determine outcome in patients with acute ST-segment elevation myocardial infarction: the echocardiographic substudy of the OASIS-6 trial.
Echocardiography
PUBLISHED: 04-08-2014
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The echocardiographic substudy of the OASIS-6 trial evaluated the prognostic implications of left ventricle (LV) systolic and diastolic dysfunction early postacute ST-segment elevation myocardial infarction (STEMI) in patients treated with fondaparinux versus usual care.
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Elevated cholesteryl ester transfer protein (CETP) activity, a major determinant of the atherogenic dyslipidemia, and atherosclerotic cardiovascular disease in South Asians.
Eur J Prev Cardiol
PUBLISHED: 03-25-2014
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Why South Asians are at increased risk of premature atherosclerotic cardiovascular diseases compared with other ethnic groups is not fully understood. Atherogenic dyslipoproteinemia - hypertriglyceridemia, elevated numbers of low-density lipoprotein (LDL) particles and low high-density lipoprotein cholesterol (HDL-C) - is more common in South Asians but the mechanisms responsible have not been explicated. Here we examined whether the circulating lipid transfer protein, cholesteryl ester transfer protein (CETP), plays a role in the pathogenesis of the atherogenic dyslipoproteinemia among South Asians.
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Impact of telmisartan on cardiovascular outcome in hypertensive patients at high risk: a Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease subanalysis.
J. Hypertens.
PUBLISHED: 03-14-2014
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In the Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease, all patients were at high cardiovascular risk, and a substantial proportion were hypertensive. We performed a post-hoc analysis to explore the hypothesis that telmisartan has a differential action in hypertensive vs. nonhypertensive patients.
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Design and rationale of the TOTAL trial: a randomized trial of routine aspiration ThrOmbecTomy with percutaneous coronary intervention (PCI) versus PCI ALone in patients with ST-elevation myocardial infarction undergoing primary PCI.
Am. Heart J.
PUBLISHED: 03-01-2014
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A major limitation of primary percutaneous coronary intervention (PPCI) for the treatment of ST-elevation myocardial infarction (STEMI) is impaired microvascular perfusion due to embolization and obstruction of microcirculation with thrombus. Manual thrombectomy has the potential to reduce distal embolization and improve microvascular perfusion. Clinical trials have shown mixed results regarding thrombectomy.
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The Cost Implications of Off-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery at One Year.
Ann. Thorac. Surg.
PUBLISHED: 02-25-2014
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The purpose of this study was to determine the cost implications of the Coronary Artery Bypass Graft Off or On Pump Revascularization Study (CORONARY) at 1 year.
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The population risks of dietary salt excess are exaggerated.
Can J Cardiol
PUBLISHED: 02-07-2014
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Policy positions on salt consumption (based largely on the association of sodium and blood pressure [BP]) has remained unchanged since the 1970s, until recently. However, this is beginning to change as new evidence emerges. The evidence supports a strong association of sodium with BP and cardiovascular disease events in hypertensive individuals, the elderly, and those who consume > 6 g/d of sodium. However, there is no association of sodium with clinical events at 3 to 6 g/day and a paradoxical higher rate of events at < 3 g/day. Therefore, until new evidence emerges, the optimal range of sodium consumption should be considered to be between 3 and 6 g/d. Population-wide sodium reduction is not justified in countries such as Canada.
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Rationale and design of the steroids in cardiac surgery trial.
Am. Heart J.
PUBLISHED: 01-30-2014
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Steroids may improve outcomes in high-risk patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CBP). There is a need\ for a large randomized controlled trial to clarify the effect of steroids in such patients.
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Sleep duration, snoring habits and risk of acute myocardial infarction in China population: results of the INTERHEART study.
BMC Public Health
PUBLISHED: 01-28-2014
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Less sleep time and snoring have been associated with cardiovascular disease (CVD) risk in Western populations; however, few studies have evaluated the different aspects of sleep duration and snoring frequency in relation to CVD, and this association has not been examined in China. The present study aimed to address the relation between sleep duration, snoring frequency and risk of acute myocardial infarction (AMI) in China population.
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Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial.
Diabetologia
PUBLISHED: 01-28-2014
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As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA1c level is close to normal.
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Analysing recurrent hospitalizations in heart failure: a review of statistical methodology, with application to CHARM-Preserved.
Eur. J. Heart Fail.
PUBLISHED: 01-24-2014
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Heart failure is characterized by recurrent hospitalizations, but often only the first event is considered in clinical trial reports. In chronic diseases, such as heart failure, analysing all events gives a more complete picture of treatment benefit. We describe methods of analysing repeat hospitalizations, and illustrate their value in one major trial.
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Mortality and morbidity in relation to changes in albuminuria, glucose status and systolic blood pressure: an analysis of the ONTARGET and TRANSCEND studies.
Diabetologia
PUBLISHED: 01-13-2014
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Urinary albumin excretion is a strong predictor of cardiovascular disease. It is uncertain whether improvement from microalbuminuria or deterioration from normoalbuminuria over time in patients with differing changes in glucose and BP change their cardiovascular risk.
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A Novel Method to Evaluate the Community Built Environment Using Photographs - Environmental Profile of a Community Health (EPOCH) Photo Neighbourhood Evaluation Tool.
PLoS ONE
PUBLISHED: 01-01-2014
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Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument.
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Gene-centric meta-analyses for central adiposity traits in up to 57,412 individuals of European descent confirm known loci and reveal several novel associations.
Hum. Mol. Genet.
PUBLISHED: 12-17-2013
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Waist circumference (WC) and waist-to-hip ratio (WHR) are surrogate measures of central adiposity that are associated with adverse cardiovascular events, type 2 diabetes, and cancer independent of body mass index (BMI). WC and WHR are highly heritable with multiple susceptibility loci identified to date. We assessed the association between SNPs and BMI-adjusted WC and WHR and unadjusted WC in up to 57,412 individuals of European descent from 22 cohorts collaborating with the NHLBIs Candidate Gene Association Resource (CARe) project. The study population consisted of women and men aged 20 to 80. Study participants were genotyped using the ITMAT/Broad/CARE array, which includes ?50,000 cosmopolitan tagged SNPs across ?2,100 cardiovascular-related genes. Each trait was modeled as a function of age, study site, and principal components to control for population stratification, and we conducted a fixed-effects meta-analysis. No new loci for WC were observed. For WHR analyses, three novel loci were significantly associated (P<2.4x10(-6)). Previously unreported rs2811337-G near TMCC1 was associated with increased WHR (?±SE,0.048±0.008, P=7.7x10(-9)) as was rs7302703-G in HOXC10 (?=0.044±0.008, P=2.9x10(-7)) and rs936108-C in PEMT (?=0.035±0.007, P=1.9x10(-6)). Sex-stratified analyses revealed two additional novel signals among females only, rs12076073-A near SHC1 (?=0.10±0.02, P=1.9x10(-6)), and rs1037575-A in ATBDB4 (?=0.046±0.01, P=2.2x10(-6)), supporting an already established sexual dimorphism of central adiposity-related genetic variants. Functional analysis using ENCODE and eQTL databases revealed that several of these loci are in regulatory regions or regions with differential expression in adipose tissue.
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Efficacy and Safety of Dabigatran Compared with Warfarin in Relation to Baseline Renal Function in Patients with Atrial Fibrillation: A RE-LY Trial Analysis.
Circulation
PUBLISHED: 12-09-2013
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Renal impairment increases the risk of stroke and bleeding in patients with atrial fibrillation. In the RE-LY trial dabigatran, with approximately 80% renal elimination, displayed superiority over warfarin for prevention of stroke and systemic embolism in the 150 mg dose, and significantly less major bleeding in the 110 mg dose in 18,113 patients with non-valvular atrial fibrillation. This pre-specified study investigates these outcomes in relation to renal function.
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Combination pharmacotherapy to prevent cardiovascular disease: present status and challenges.
Eur. Heart J.
PUBLISHED: 11-27-2013
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Combination pills containing aspirin, multiple blood pressure (BP) lowering drugs, and a statin have demonstrated safety, substantial risk factor reductions, and improved medication adherence in the prevention of cardiovascular disease (CVD). The individual medications in combination pills are already recommended for use together in secondary CVD prevention. Therefore, current information on their pharmacokinetics, impact on the risk factors, and tolerability should be sufficient to persuade regulators and clinicians to use fixed-dose combination pills in high-risk individuals, such as in secondary prevention. Long-term use of these medicines, in a polypill or otherwise, is expected to reduce CVD risk by at least 50-60% in such groups. This risk reduction needs confirmation in prospective randomized trials for populations for whom concomitant use of the medications is not currently recommended (e.g. primary prevention). Given their additive benefits, the combined estimated relative risk reduction (RRR) in CVD from both lifestyle modification and a combination pill is expected to be 70-80%. The first of several barriers to the widespread use of combination therapy in CVD prevention is physician reluctance to use combination pills. This reluctance may originate from the belief that lifestyle modification should take precedence, and that medications should be introduced one drug at a time, instead of regarding combination pills and lifestyle modification as complementary and additive. Second, widespread availability of combination pills is also impeded by the reluctance of large pharmaceutical companies to invest in development of novel co-formulations of generic (or mature) drugs. A business model based on mass approaches to drug production, packaging, marketing, and distribution could make the combination pill available at an affordable price, while at the same time providing a viable profit for the manufacturers. A third barrier is regulatory approval for novel multidrug combination pills, as there are few precedents for the approval of combination products with four or more components for CVD. Acceptance of combination therapy in other settings suggests that with concerted efforts by academics, international health agencies, research funding bodies, governments, regulators, and pharmaceutical manufacturers, combination pills for prevention of CVD in those with disease or at high risk (e.g. those with multiple risk factors) can be made available worldwide at affordable prices. It is anticipated that widespread use of combination pills with lifestyle modifications can lead to substantial risk reductions (as much as an 80% estimated RRR) in CVD. Heath care systems need to deploy these strategies widely, effectively, and efficiently. If implemented, these strategies could avoid several millions of fatal and non-fatal CVD events every year worldwide.
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Variation at the DPP4 locus influences apolipoprotein B levels in South Asians and exhibits heterogeneity in Europeans related to BMI.
Diabetologia
PUBLISHED: 11-12-2013
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Dyslipidaemia, a common feature of type 2 diabetes, is characterised by an increase in atherogenic particles, quantifiable through apolipoprotein B (ApoB) levels. Genetic studies of lipid levels have focused on Europeans; a study in South Asians could identify novel genes.
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The effect of ramipril and telmisartan on serum potassium and its association with cardiovascular and renal events: Results from the ONTARGET trial.
Eur J Prev Cardiol
PUBLISHED: 11-04-2013
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In the Ongoing Telmisartan Alone and in Combination with Ramipril Trial (ONTARGET), dual agent renin-angiotensin-aldosterone system (RAAS) blockade with angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) did not reduce the risk of renal and cardiovascular outcomes compared with the single use of either agent. Dual therapy however increased the incidence of hyperkalemia. We examined risk factors for hyper- and hyokalemia and hypothesized that both would be associated with worse cardiovascular and renal outcomes.
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Heart rate is associated with increased risk of major cardiovascular events, cardiovascular and all-cause death in patients with stable chronic cardiovascular disease: an analysis of ONTARGET/TRANSCEND.
Clin Res Cardiol
PUBLISHED: 10-08-2013
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Heart rate was proposed as an emergent cardiovascular (CV) risk factor. Previous studies have shown associations between increased heart rate and CV risk in various populations. We aimed to evaluate the prognostic relevance of heart rate in a large contemporaneous medically optimized cohort of patients with stable chronic CV disease.
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Management and outcomes of major bleeding during treatment with dabigatran or warfarin.
Circulation
PUBLISHED: 09-30-2013
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The aim of this study was to compare the management and prognosis of major bleeding in patients treated with dabigatran or warfarin.
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Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study.
Circulation
PUBLISHED: 09-09-2013
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Atrial fibrillation is associated with increased mortality, but the specific causes of death and their predictors have not been described among patients on effective anticoagulant therapy.
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Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database.
Thromb. Haemost.
PUBLISHED: 09-05-2013
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In the RE-LY trial dabigatran 150 mg twice daily (D150) showed significantly fewer strokes, and 110 mg (D110) significantly fewer major bleeding events (MBE) compared to well-controlled warfarin in patients with atrial fibrillation (AF). The European (EU) label currently recommends the use of D150 in AF patients who are aged < 80 years without an increased risk for bleeding (e.g. HAS-BLED score <3) and not on concomitant verapamil. In other patients, D110 is recommended. In this post-hoc analysis of the RE-LY dataset, we simulated how dabigatran (n=6,004) would compare to well-controlled warfarin (n=6,022) used according to the EU label. "EU label simulated dabigatran treatment" was associated with significant reductions in stroke and systemic embolism (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.60-0.91), haemorrhagic stroke (HR 0.22; 95%CI 0.11-0.44), death (HR 0.86; 95%CI 0.75-0.98), and vascular death (HR 0.80; 95%CI 0.68-0.95) compared to warfarin. Dabigatran was also associated with less major bleeding (HR 0.85; 95%CI 0.73-0.98), life-threatening bleeding (HR 0.72; 95%CI 0.58-0.91), intracranial haemorrhage (HR 0.28; 95%CI 0.17-0.45), and "any bleeds" (HR 0.86; 95%CI 0.81-0.92), but not gastrointestinal major bleeding (HR 1.23; 95%CI 0.96-1.59). The net clinical benefit was significantly better for dabigatran compared to warfarin. In conclusion, this post-hoc simulation of dabigatran usage based on RE-LY trial dataset indicates that "EU label simulated dabigatran treatment" may be associated with superior efficacy and safety compared to warfarin, and are in support of the EU label and the 2012 European Society of Cardiology AF guideline recommendations. Thus, adherence to European label/guideline use results in a clinically relevant benefit for dabigatran over warfarin, for both efficacy and safety.
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Does hypoglycaemia increase the risk of cardiovascular events? A report from the ORIGIN trial.
Eur. Heart J.
PUBLISHED: 09-02-2013
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Hypoglycaemia caused by glucose-lowering therapy has been linked to cardiovascular (CV) events. The ORIGIN trial provides an opportunity to further assess this relationship.
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Prognostic Usefulness of Left Ventricular Hypertrophy by Electrocardiography in Patients With Atrial Fibrillation (from the Randomized Evaluation of Long-Term Anticoagulant Therapy Study).
Am. J. Cardiol.
PUBLISHED: 08-14-2013
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It is unknown whether left ventricular hypertrophy (LVH) diagnosis by electrocardiography improves risk stratification in patients with atrial fibrillation (AF). We investigated the prognostic impact of LVH diagnosis by electrocardiography in a large sample of anticoagulated patients with AF included in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Study. We defined electrographic LVH (ECG-LVH) by strain pattern or Cornell voltage (R wave in aVL plus S wave in V3) >2.0 mV (women) or >2.4 mV (men). LVH prevalence was 22.7%. During a median follow-up of 2.0 years, 303 patients developed a stroke, 778 died (497 from cardiovascular causes), and 140 developed a myocardial infarction. LVH was associated with a greater risk of stroke (1.99% vs 1.32% per year, hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.18 to 1.93, p <0.001), cardiovascular death (4.52% vs 1.80% per year, HR 2.56, 95% CI 2.14 to 3.06, p <0.0001), all-cause death (6.03% vs 3.11% per year, HR 1.95, 95% CI 1.68 to 2.26, p <0.0001), and myocardial infarction (1.11% vs 0.55% per year, HR 2.07, 95% CI 1.47 to 2.92, p <0.0001). In multivariate analysis, the prognostic value of LVH was additive to CHA2DS2-VASc score and other covariates. The category-free net reclassification index and integrated discrimination improvement increased significantly after adding LVH to multivariate models. In conclusion, our study demonstrates for the first time that ECG-LVH, a simple and easily accessible prognostic indicator, improves risk stratification in anticoagulated patients with AF.
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Diet and kidney disease in high-risk individuals with type 2 diabetes mellitus.
JAMA Intern Med
PUBLISHED: 08-14-2013
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Type 2 diabetes mellitus and associated chronic kidney disease (CKD) have become major public health problems. Little is known about the influence of diet on the incidence or progression of CKD among individuals with type 2 diabetes.
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The effects of apixaban on hospitalizations in patients with different types of atrial fibrillation: insights from the AVERROES trial.
Eur. Heart J.
PUBLISHED: 07-25-2013
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The aim of this study was to evaluate the effects of apixaban, a novel oral factor Xa inhibitor, on the need for cardiovascular hospitalization.
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Dabigatran compared with warfarin in patients with atrial fibrillation and symptomatic heart failure: a subgroup analysis of the RE-LY trial.
Eur. J. Heart Fail.
PUBLISHED: 07-09-2013
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We evaluated the effects of dabigatran compared with warfarin in the subgroup of patients with previous symptomatic heart failure (HF) in the RE-LY trial.
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Heart rate and blood pressure interactions in the development of erectile dysfunction in high-risk cardiovascular patients.
Eur J Prev Cardiol
PUBLISHED: 07-01-2013
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Erectile dysfunction (ED) is associated with cardiovascular risk factors as elevated systolic blood pressure (SBP), resting high heart rate (HR), and endothelial dysfunction and predicts cardiovascular events. However, the interaction between high HR and SBP and the development of ED remains unclear.
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Dabigatran versus warfarin: effects on ischemic and hemorrhagic strokes and bleeding in Asians and non-Asians with atrial fibrillation.
Stroke
PUBLISHED: 06-06-2013
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Intracranial hemorrhage rates are higher in Asians than non-Asians, especially in patients receiving warfarin. This randomized evaluation of long-term anticoagulation therapy subgroup analysis assessed dabigatran etexilate (DE) and warfarin effects on stroke and bleeding rates in patients from Asian and non-Asian countries.
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Is the superiority of apoB over non-HDL-C as a marker of cardiovascular risk in the INTERHEART study due to confounding by related variables?
J Clin Lipidol
PUBLISHED: 05-21-2013
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Patients with increased numbers of cholesterol-depleted apolipoprotein B (apoB) particles frequently have multiple other abnormalities, which might confound the comparison of apoB and non-high-density-lipoprotein-cholesterol (non-HDL-C) as markers of cardiovascular risk.
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Prospective Urban Rural Epidemiology (PURE) study: Baseline characteristics of the household sample and comparative analyses with national data in 17 countries.
Am. Heart J.
PUBLISHED: 04-29-2013
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The PURE study was established to investigate associations between social, behavioural, genetic, and environmental factors and cardiovascular diseases in 17 countries. In this analysis we compare the age, sex, urban/rural, mortality, and educational profiles of the PURE participants to national statistics.
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Effects of nonpersistence with medication on outcomes in high-risk patients with cardiovascular disease.
Am. Heart J.
PUBLISHED: 04-29-2013
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The impact of nonpersistence on events and of events on persistence is unclear. We studied the effects of nonpersistence on outcomes and events on nonadherence in a randomized placebo controlled trial in 40 countries on 25,620 patients.
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Secretory Phospholipase A2-IIA and Cardiovascular Disease: A Mendelian Randomization Study.
Michael V Holmes, Tabassome Simon, Holly J Exeter, Lasse Folkersen, Folkert W Asselbergs, Montse Guardiola, Jackie A Cooper, Jutta Palmen, Jaroslav A Hubacek, Kathryn F Carruthers, Benjamin D Horne, Kimberly D Brunisholz, Jessica L Mega, Erik P A van Iperen, Mingyao Li, Maarten Leusink, Stella Trompet, Jeffrey J W Verschuren, G Kees Hovingh, Abbas Dehghan, Christopher P Nelson, Salma Kotti, Nicolas Danchin, Markus Scholz, Christiane L Haase, Dietrich Rothenbacher, Daniel I Swerdlow, Karoline B Kuchenbaecker, Eleonora Staines-Urias, Anuj Goel, Ferdinand van 't Hooft, Karl Gertow, Ulf de Faire, Andrie G Panayiotou, Elena Tremoli, Damiano Baldassarre, Fabrizio Veglia, Lesca M Holdt, Frank Beutner, Ron T Gansevoort, Gerjan J Navis, Irene Mateo Leach, Lutz P Breitling, Hermann Brenner, Joachim Thiery, Dhayana Dallmeier, Anders Franco-Cereceda, Jolanda M A Boer, Jeffrey W Stephens, Marten H Hofker, Alain Tedgui, Albert Hofman, André G Uitterlinden, Vera Adamkova, Jan Piťha, N Charlotte Onland-Moret, Maarten J Cramer, Hendrik M Nathoe, Wilko Spiering, Olaf H Klungel, Meena Kumari, Peter H Whincup, David A Morrow, Peter S Braund, Alistair S Hall, Anders G Olsson, Pieter A Doevendans, Mieke D Trip, Martin D Tobin, Anders Hamsten, Hugh Watkins, Wolfgang Koenig, Andrew N Nicolaides, Daniel Teupser, Ian N M Day, John F Carlquist, Tom R Gaunt, Ian Ford, Naveed Sattar, Sotirios Tsimikas, Gregory G Schwartz, Debbie A Lawlor, Richard W Morris, Manjinder S Sandhu, Rudolf Poledne, Anke H Maitland-van der Zee, Kay-Tee Khaw, Brendan J Keating, Pim van der Harst, Jackie F Price, Shamir R Mehta, Salim Yusuf, Jaqueline C M Witteman, Oscar H Franco, J Wouter Jukema, Peter de Knijff, Anne Tybjaerg-Hansen, Daniel J Rader, Martin Farrall, Nilesh J Samani, Mika Kivimäki, Keith A A Fox, Steve E Humphries, Jeffrey L Anderson, S Matthijs Boekholdt, Tom M Palmer, Per Eriksson, Guillaume Paré, Aroon D Hingorani, Marc S Sabatine, Ziad Mallat, Juan P Casas, Philippa J Talmud.
J. Am. Coll. Cardiol.
PUBLISHED: 04-24-2013
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This study sought to investigate the role of secretory phospholipase A2 (sPLA2)-IIA in cardiovascular disease.
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Rationale and design of the Primary pREvention strategies at the community level to Promote Adherence of treatments to pREvent cardiovascular diseases trial number (CTRI/2012/09/002981).
Am. Heart J.
PUBLISHED: 03-25-2013
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Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality in low-income countries including India. There is a need for effective, low-cost methods to prevent CVDs in rural India. One strategy is to identify and implement interventions at high-risk individuals using community health workers (CHWs). There is a paucity of CHW-based CVD intervention trials from low-income countries.
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The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients in the RE-LY Trial.
J. Am. Coll. Cardiol.
PUBLISHED: 03-11-2013
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Analyze the impact of dabigatran plasma concentrations, patient demographics and ASA use on frequencies of ischemic strokes/systemic emboli and major bleeds in atrial fibrillation patients .
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Left Atrial Appendage Occlusion Study II (LAAOS II).
Can J Cardiol
PUBLISHED: 01-25-2013
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Occlusion of the left atrial appendage (LAA) is a potential alternative to anticoagulation for patients with atrial fibrillation (AF); however, evidence of its safety and efficacy is lacking. The Left Atrial Appendage Occlusion Study II (LAAOS II) explored the feasibility of a definitive trial of LAA occlusion for stroke prevention in AF.
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Balancing the benefits and risks of 2 doses of dabigatran compared with warfarin in atrial fibrillation.
J. Am. Coll. Cardiol.
PUBLISHED: 01-10-2013
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This study sought to compare the net clinical benefit of dabigatran 110 mg bid and 150 mg bid with that of warfarin in patients with atrial fibrillation (AF).
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Causal relationship between adiponectin and metabolic traits: a Mendelian randomization study in a multiethnic population.
PLoS ONE
PUBLISHED: 01-01-2013
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Adiponectin, a secretagogue exclusively produced by adipocytes, has been associated with metabolic features, but its role in the development of the metabolic syndrome remains unclear.
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Excess of rare variants in non-genome-wide association study candidate genes in patients with hypertriglyceridemia.
Circ Cardiovasc Genet
PUBLISHED: 12-01-2011
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Rare variant accumulation studies can implicate genes in disease susceptibility when a significant burden is observed in patients versus control subjects. Such analyses might be particularly useful for candidate genes that are selected based on experiments other than genome-wide association studies (GWAS). We sought to determine whether rare variants in non-GWAS candidate genes identified from mouse models and human mendelian syndromes of hypertriglyceridemia (HTG) accumulate in patients with polygenic adult-onset HTG.
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Urinary sodium and potassium excretion and risk of cardiovascular events.
JAMA
PUBLISHED: 11-24-2011
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The precise relationship between sodium and potassium intake and cardiovascular (CV) risk remains uncertain, especially in patients with CV disease.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.