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Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
EVIDENCE SUMMARY
PRP vs placebo. Three RCTs compared PRP with saline placebo injections and 2 found that PRP improved the Western Ontario and McMaster Universities Arthritis Index (WOMAC, a standardized scale assessing knee pain, function, and stiffness) by 40% to 70%; the third found 24% to 32% improvements in the EuroQol visual analog scale (EQ-VAS) scores at 6 months1-3 (TABLE1-12).
The first 2 studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity (baseline WOMAC scores about 50).1,2 Investigators in the first RCT injected PRP once in one subgroup and twice in another subgroup, compared with a single injection of saline in a third subgroup.1 They gave 3 weekly injections of PRP or saline in the second RCT.2
The third study enrolled mainly patients with early osteoarthritis (mean age early 50s, slightly more women). Investigators injected PRP 3 times in one subgroup and once (plus 2 saline injections) in another, compared with 3 saline injections, and evaluated patients at baseline and 6 months.3
PRP vs HA. Nine RCTs compared PRP with HA injections. Six studies (673 patients) found no significant difference; 3 studies (376 patients) found that PRP improved standardized knee assessment scores by 35% to 40% at 24-48 weeks.7,8,10 All studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity. In 7 RCTs, 4-6,9-12 investigators injected PRP or HA weekly for 3 weeks, in one RCT8 they gave 4 weekly injections, and in one7they gave 2 PRP injections separated by 4 weeks.
Three RCTs used the International Knee Documentation Committee (IKDC) score, considered the most reliable standardized scoring system, which quantifies subjective symptoms (pain, stiffness, swelling, giving way), activity (climbing stairs, rising from a chair, squatting, jumping), and function pre- and postintervention.5,9,12 All 3 studies using the IKDC found no difference between PRP and HA injections. Most RCTs used the WOMAC standardized scale, scoring 5 items for pain, 2 for stiffness, and 17 for function.1,2,4,6-8.10
Risk for bias
A systematic review13 that evaluated methodologic quality of the 3 studies comparing PRP with placebo rated 21,3 at high risk of bias and one2 at moderate risk. Another meta-analysis14 performed a quality assessment including 4 of the 9 RCTs,8-10,12 comparing PRP with HA and concluded that 3 had a high risk of bias; the fourth RCT had a moderate risk. No independent quality assessments of the other RCTs were available.4-7,11
RECOMMENDATIONS
The American Academy of Orthopaedic Surgeons doesn’t recommend for or against PRP injections because of insufficient evidence and strongly recommends against HA injections based on multiple RCTs of moderate quality that found no difference between HA and placebo.15
1. Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-364.
2. Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee arthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med. 2016;44:884-891.
3. Gorelli G, Gormelli CA, Ataoglu B, et al. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015;25:958-965.
4. Cole BJ, Karas V, Hussey K, et al. Hyaluronic acid versus platelet-rich plasma: a prospective double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 2016;45:339-346.
5. Filardo G, Di Matteo B, Di Martino A, et al. Platelet-rich intra-articular knee injections show no superiority versus viscosupplementation: a randomized controlled trial. Am J Sports Med. 2015;43:1575-1582.
6. Sanchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PGRF-endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy: J Arth and Related Surg. 2012;28:1070-1078.
7. Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee osteoarthritis injection choices: platelet-rich plasma (PRP) versus hyaluronic acid (a one-year randomized clinical trial). Clin Med Insights: Arth Musc Dis. 2015;8:1-8.
8. Cerza F, Carni S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822-2827.
9. Filardo G, Kon E, Di Martino B, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskeletal Disorders. 2012;13:229-236.
10. Vaquerizo V, Plasencia MA, Arribas I, et al. Comparison of intra-articular injections of plasma rich in growth factors (PGRF-endoret) versus durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy: J Arth and Related Surg. 2013;29:1635-1643.
11. Montanez-Heredia E, Irizar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritis knee pain: a randomized clinical trial in the context of the Spanish national health care system. Intl J Molec Sci. 2016;17:1064-1077.
12. Li M, Zhang C, Ai Z, et al. Therapeutic effectiveness of intra-knee articular injections of platelet-rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 25:1192-11966. (Article published in Chinese with abstract in English.)
13. Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Ortho Surg Res. 2017;12:16.
14. Laudy ABM, Bakker EWP, Rekers M, et al. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-672.
15. American Academy of Orthopaedic Surgeons. Clinical practice guideline on the treatment of osteoarthritis of the knee, 2nd ed. www.aaos.org/cc_files/aaosorg/research/guidelines/treatmentofosteoarthritisofthekneeguideline.pdf. Published May 2013. Accessed February 22, 2019.
EVIDENCE SUMMARY
PRP vs placebo. Three RCTs compared PRP with saline placebo injections and 2 found that PRP improved the Western Ontario and McMaster Universities Arthritis Index (WOMAC, a standardized scale assessing knee pain, function, and stiffness) by 40% to 70%; the third found 24% to 32% improvements in the EuroQol visual analog scale (EQ-VAS) scores at 6 months1-3 (TABLE1-12).
The first 2 studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity (baseline WOMAC scores about 50).1,2 Investigators in the first RCT injected PRP once in one subgroup and twice in another subgroup, compared with a single injection of saline in a third subgroup.1 They gave 3 weekly injections of PRP or saline in the second RCT.2
The third study enrolled mainly patients with early osteoarthritis (mean age early 50s, slightly more women). Investigators injected PRP 3 times in one subgroup and once (plus 2 saline injections) in another, compared with 3 saline injections, and evaluated patients at baseline and 6 months.3
PRP vs HA. Nine RCTs compared PRP with HA injections. Six studies (673 patients) found no significant difference; 3 studies (376 patients) found that PRP improved standardized knee assessment scores by 35% to 40% at 24-48 weeks.7,8,10 All studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity. In 7 RCTs, 4-6,9-12 investigators injected PRP or HA weekly for 3 weeks, in one RCT8 they gave 4 weekly injections, and in one7they gave 2 PRP injections separated by 4 weeks.
Three RCTs used the International Knee Documentation Committee (IKDC) score, considered the most reliable standardized scoring system, which quantifies subjective symptoms (pain, stiffness, swelling, giving way), activity (climbing stairs, rising from a chair, squatting, jumping), and function pre- and postintervention.5,9,12 All 3 studies using the IKDC found no difference between PRP and HA injections. Most RCTs used the WOMAC standardized scale, scoring 5 items for pain, 2 for stiffness, and 17 for function.1,2,4,6-8.10
Risk for bias
A systematic review13 that evaluated methodologic quality of the 3 studies comparing PRP with placebo rated 21,3 at high risk of bias and one2 at moderate risk. Another meta-analysis14 performed a quality assessment including 4 of the 9 RCTs,8-10,12 comparing PRP with HA and concluded that 3 had a high risk of bias; the fourth RCT had a moderate risk. No independent quality assessments of the other RCTs were available.4-7,11
RECOMMENDATIONS
The American Academy of Orthopaedic Surgeons doesn’t recommend for or against PRP injections because of insufficient evidence and strongly recommends against HA injections based on multiple RCTs of moderate quality that found no difference between HA and placebo.15
EVIDENCE SUMMARY
PRP vs placebo. Three RCTs compared PRP with saline placebo injections and 2 found that PRP improved the Western Ontario and McMaster Universities Arthritis Index (WOMAC, a standardized scale assessing knee pain, function, and stiffness) by 40% to 70%; the third found 24% to 32% improvements in the EuroQol visual analog scale (EQ-VAS) scores at 6 months1-3 (TABLE1-12).
The first 2 studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity (baseline WOMAC scores about 50).1,2 Investigators in the first RCT injected PRP once in one subgroup and twice in another subgroup, compared with a single injection of saline in a third subgroup.1 They gave 3 weekly injections of PRP or saline in the second RCT.2
The third study enrolled mainly patients with early osteoarthritis (mean age early 50s, slightly more women). Investigators injected PRP 3 times in one subgroup and once (plus 2 saline injections) in another, compared with 3 saline injections, and evaluated patients at baseline and 6 months.3
PRP vs HA. Nine RCTs compared PRP with HA injections. Six studies (673 patients) found no significant difference; 3 studies (376 patients) found that PRP improved standardized knee assessment scores by 35% to 40% at 24-48 weeks.7,8,10 All studies enrolled patients (mean age early 60s, approximately 50% women) with clinically and radiographically evaluated knee OA of mostly moderate severity. In 7 RCTs, 4-6,9-12 investigators injected PRP or HA weekly for 3 weeks, in one RCT8 they gave 4 weekly injections, and in one7they gave 2 PRP injections separated by 4 weeks.
Three RCTs used the International Knee Documentation Committee (IKDC) score, considered the most reliable standardized scoring system, which quantifies subjective symptoms (pain, stiffness, swelling, giving way), activity (climbing stairs, rising from a chair, squatting, jumping), and function pre- and postintervention.5,9,12 All 3 studies using the IKDC found no difference between PRP and HA injections. Most RCTs used the WOMAC standardized scale, scoring 5 items for pain, 2 for stiffness, and 17 for function.1,2,4,6-8.10
Risk for bias
A systematic review13 that evaluated methodologic quality of the 3 studies comparing PRP with placebo rated 21,3 at high risk of bias and one2 at moderate risk. Another meta-analysis14 performed a quality assessment including 4 of the 9 RCTs,8-10,12 comparing PRP with HA and concluded that 3 had a high risk of bias; the fourth RCT had a moderate risk. No independent quality assessments of the other RCTs were available.4-7,11
RECOMMENDATIONS
The American Academy of Orthopaedic Surgeons doesn’t recommend for or against PRP injections because of insufficient evidence and strongly recommends against HA injections based on multiple RCTs of moderate quality that found no difference between HA and placebo.15
1. Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-364.
2. Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee arthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med. 2016;44:884-891.
3. Gorelli G, Gormelli CA, Ataoglu B, et al. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015;25:958-965.
4. Cole BJ, Karas V, Hussey K, et al. Hyaluronic acid versus platelet-rich plasma: a prospective double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 2016;45:339-346.
5. Filardo G, Di Matteo B, Di Martino A, et al. Platelet-rich intra-articular knee injections show no superiority versus viscosupplementation: a randomized controlled trial. Am J Sports Med. 2015;43:1575-1582.
6. Sanchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PGRF-endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy: J Arth and Related Surg. 2012;28:1070-1078.
7. Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee osteoarthritis injection choices: platelet-rich plasma (PRP) versus hyaluronic acid (a one-year randomized clinical trial). Clin Med Insights: Arth Musc Dis. 2015;8:1-8.
8. Cerza F, Carni S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822-2827.
9. Filardo G, Kon E, Di Martino B, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskeletal Disorders. 2012;13:229-236.
10. Vaquerizo V, Plasencia MA, Arribas I, et al. Comparison of intra-articular injections of plasma rich in growth factors (PGRF-endoret) versus durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy: J Arth and Related Surg. 2013;29:1635-1643.
11. Montanez-Heredia E, Irizar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritis knee pain: a randomized clinical trial in the context of the Spanish national health care system. Intl J Molec Sci. 2016;17:1064-1077.
12. Li M, Zhang C, Ai Z, et al. Therapeutic effectiveness of intra-knee articular injections of platelet-rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 25:1192-11966. (Article published in Chinese with abstract in English.)
13. Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Ortho Surg Res. 2017;12:16.
14. Laudy ABM, Bakker EWP, Rekers M, et al. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-672.
15. American Academy of Orthopaedic Surgeons. Clinical practice guideline on the treatment of osteoarthritis of the knee, 2nd ed. www.aaos.org/cc_files/aaosorg/research/guidelines/treatmentofosteoarthritisofthekneeguideline.pdf. Published May 2013. Accessed February 22, 2019.
1. Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-364.
2. Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee arthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med. 2016;44:884-891.
3. Gorelli G, Gormelli CA, Ataoglu B, et al. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015;25:958-965.
4. Cole BJ, Karas V, Hussey K, et al. Hyaluronic acid versus platelet-rich plasma: a prospective double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 2016;45:339-346.
5. Filardo G, Di Matteo B, Di Martino A, et al. Platelet-rich intra-articular knee injections show no superiority versus viscosupplementation: a randomized controlled trial. Am J Sports Med. 2015;43:1575-1582.
6. Sanchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PGRF-endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy: J Arth and Related Surg. 2012;28:1070-1078.
7. Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee osteoarthritis injection choices: platelet-rich plasma (PRP) versus hyaluronic acid (a one-year randomized clinical trial). Clin Med Insights: Arth Musc Dis. 2015;8:1-8.
8. Cerza F, Carni S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822-2827.
9. Filardo G, Kon E, Di Martino B, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskeletal Disorders. 2012;13:229-236.
10. Vaquerizo V, Plasencia MA, Arribas I, et al. Comparison of intra-articular injections of plasma rich in growth factors (PGRF-endoret) versus durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy: J Arth and Related Surg. 2013;29:1635-1643.
11. Montanez-Heredia E, Irizar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritis knee pain: a randomized clinical trial in the context of the Spanish national health care system. Intl J Molec Sci. 2016;17:1064-1077.
12. Li M, Zhang C, Ai Z, et al. Therapeutic effectiveness of intra-knee articular injections of platelet-rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 25:1192-11966. (Article published in Chinese with abstract in English.)
13. Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Ortho Surg Res. 2017;12:16.
14. Laudy ABM, Bakker EWP, Rekers M, et al. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-672.
15. American Academy of Orthopaedic Surgeons. Clinical practice guideline on the treatment of osteoarthritis of the knee, 2nd ed. www.aaos.org/cc_files/aaosorg/research/guidelines/treatmentofosteoarthritisofthekneeguideline.pdf. Published May 2013. Accessed February 22, 2019.
EVIDENCE-BASED ANSWER:
Probably not, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence suggests it is no better than placebo.
Compared with saline placebo, platelet-rich plasma (PRP) injections may improve standardized scores for knee osteoarthritis (OA) pain, function, and stiffness by 24% to 70% for periods of 6 to 52 weeks in patients with early to moderate OA (strength of recommendation [SOR]: B, small randomized controlled trials [RCTs] with methodologic flaws).
Compared with hyaluronic acid (HA), PRP probably improves scores by a similar amount for periods of 8 to 52 weeks (SOR: B, multiple RCTs with conflicting results favoring no difference). However, since HA alone likely doesn’t improve scores more than placebo (SOR: B, RCTs of moderate quality), if both HA and PRP are about the same, then both are not better than placebo.
Submit Late-Breaking Abstracts
SVS is soliciting abstracts for a late-breaking session at the 2019 Vascular Annual Meeting. Preference will be given to prospective, multi-institutional trials and investigational device exemption studies. As the intent is to provide attendees with true “late-breaking” trial data, retrospective analyses will not be considered for this session. Abstracts must be submitted here by 3 p.m. Central Daylight Time, Wednesday, March 27. For more information, contact the SVS Education Department by email at [email protected].
SVS is soliciting abstracts for a late-breaking session at the 2019 Vascular Annual Meeting. Preference will be given to prospective, multi-institutional trials and investigational device exemption studies. As the intent is to provide attendees with true “late-breaking” trial data, retrospective analyses will not be considered for this session. Abstracts must be submitted here by 3 p.m. Central Daylight Time, Wednesday, March 27. For more information, contact the SVS Education Department by email at [email protected].
SVS is soliciting abstracts for a late-breaking session at the 2019 Vascular Annual Meeting. Preference will be given to prospective, multi-institutional trials and investigational device exemption studies. As the intent is to provide attendees with true “late-breaking” trial data, retrospective analyses will not be considered for this session. Abstracts must be submitted here by 3 p.m. Central Daylight Time, Wednesday, March 27. For more information, contact the SVS Education Department by email at [email protected].
VAM Registration and Housing Open Now
Registration and housing have officially opened for the 2019 Vascular Annual Meeting! This year’s event will be held on June 12-15 in National Harbor, Md., (near Washington, D.C.) As always, attendees will learn about cutting-edge vascular research, attend innovative education sessions, have the opportunity to network with other thought leaders in the field and do much more. You can find the link to register for VAM here.
Registration and housing have officially opened for the 2019 Vascular Annual Meeting! This year’s event will be held on June 12-15 in National Harbor, Md., (near Washington, D.C.) As always, attendees will learn about cutting-edge vascular research, attend innovative education sessions, have the opportunity to network with other thought leaders in the field and do much more. You can find the link to register for VAM here.
Registration and housing have officially opened for the 2019 Vascular Annual Meeting! This year’s event will be held on June 12-15 in National Harbor, Md., (near Washington, D.C.) As always, attendees will learn about cutting-edge vascular research, attend innovative education sessions, have the opportunity to network with other thought leaders in the field and do much more. You can find the link to register for VAM here.
Early career researchers win funding
John Krais, PhD, a researcher at Fox Chase Cancer Center in Philadelphia, has received a $75,000 grant from the Ovarian Cancer Research Alliance.
Dr. Krais received the 2-year grant to fund his investigation into DNA repair processes in BRCA1-mutant cancers, which will focus on the RNF168 protein.
Seven other early career researchers have joined the Parker Institute for Cancer Immunotherapy as part of the Parker Scholars, Parker Bridge Scholars, and Parker Fellows programs.
These researchers will receive a total of up to $3.1 million in funding to further their research on immunotherapies for cancers. Cécile Alanio, MD, PhD, a Parker Bridge Scholar at the University of Pennsylvania in Philadelphia, is researching the impact of infections on T cells in healthy patients with the goal of revealing new approaches to immunotherapy for cancer patients.
Kenneth Hu, PhD, a Parker Scholar at the University of California, San Francisco, plans to use single-cell profiling and microscopy to gain a better understanding of immune cells’ interactions in the tumor microenvironment.
Xihao (Sherlock) Hu, PhD, a Parker Scholar at the Dana-Farber Cancer Institute in Boston, plans to study the interactions between tumor antigens and tumor-infiltrating B cells.
Justin Eyquem, PhD, a Parker Fellow at the University of California, San Francisco, plans to use a genome-editing platform he developed to improve the function of chimeric antigen receptor (CAR) T cells in solid tumors.
Tijana Martinov, PhD, a Parker Scholar at Fred Hutchinson Cancer Research Center in Seattle, is seeking to produce T cells that can target multiple myeloma cells.
Sierra McDonald, a PhD candidate and Parker Scholar at the University of Pennsylvania, is investigating ways to improve responses to CAR T-cell therapy by studying the HMG-box family of proteins.
Roberta Zappasodi, PhD, of Memorial Sloan Kettering Cancer Center in New York, is transitioning from a Parker Scholar to a Parker Bridge Scholar. She previously characterized a population of immune-suppressive T cells. Now, she is working to determine how these cells can be used to improve the efficacy of checkpoint inhibition.
Movers in Medicine highlights career moves and personal achievements by hematologists and oncologists. Did you switch jobs, take on a new role, climb a mountain? Tell us all about it at [email protected], and you could be featured in Movers in Medicine.
John Krais, PhD, a researcher at Fox Chase Cancer Center in Philadelphia, has received a $75,000 grant from the Ovarian Cancer Research Alliance.
Dr. Krais received the 2-year grant to fund his investigation into DNA repair processes in BRCA1-mutant cancers, which will focus on the RNF168 protein.
Seven other early career researchers have joined the Parker Institute for Cancer Immunotherapy as part of the Parker Scholars, Parker Bridge Scholars, and Parker Fellows programs.
These researchers will receive a total of up to $3.1 million in funding to further their research on immunotherapies for cancers. Cécile Alanio, MD, PhD, a Parker Bridge Scholar at the University of Pennsylvania in Philadelphia, is researching the impact of infections on T cells in healthy patients with the goal of revealing new approaches to immunotherapy for cancer patients.
Kenneth Hu, PhD, a Parker Scholar at the University of California, San Francisco, plans to use single-cell profiling and microscopy to gain a better understanding of immune cells’ interactions in the tumor microenvironment.
Xihao (Sherlock) Hu, PhD, a Parker Scholar at the Dana-Farber Cancer Institute in Boston, plans to study the interactions between tumor antigens and tumor-infiltrating B cells.
Justin Eyquem, PhD, a Parker Fellow at the University of California, San Francisco, plans to use a genome-editing platform he developed to improve the function of chimeric antigen receptor (CAR) T cells in solid tumors.
Tijana Martinov, PhD, a Parker Scholar at Fred Hutchinson Cancer Research Center in Seattle, is seeking to produce T cells that can target multiple myeloma cells.
Sierra McDonald, a PhD candidate and Parker Scholar at the University of Pennsylvania, is investigating ways to improve responses to CAR T-cell therapy by studying the HMG-box family of proteins.
Roberta Zappasodi, PhD, of Memorial Sloan Kettering Cancer Center in New York, is transitioning from a Parker Scholar to a Parker Bridge Scholar. She previously characterized a population of immune-suppressive T cells. Now, she is working to determine how these cells can be used to improve the efficacy of checkpoint inhibition.
Movers in Medicine highlights career moves and personal achievements by hematologists and oncologists. Did you switch jobs, take on a new role, climb a mountain? Tell us all about it at [email protected], and you could be featured in Movers in Medicine.
John Krais, PhD, a researcher at Fox Chase Cancer Center in Philadelphia, has received a $75,000 grant from the Ovarian Cancer Research Alliance.
Dr. Krais received the 2-year grant to fund his investigation into DNA repair processes in BRCA1-mutant cancers, which will focus on the RNF168 protein.
Seven other early career researchers have joined the Parker Institute for Cancer Immunotherapy as part of the Parker Scholars, Parker Bridge Scholars, and Parker Fellows programs.
These researchers will receive a total of up to $3.1 million in funding to further their research on immunotherapies for cancers. Cécile Alanio, MD, PhD, a Parker Bridge Scholar at the University of Pennsylvania in Philadelphia, is researching the impact of infections on T cells in healthy patients with the goal of revealing new approaches to immunotherapy for cancer patients.
Kenneth Hu, PhD, a Parker Scholar at the University of California, San Francisco, plans to use single-cell profiling and microscopy to gain a better understanding of immune cells’ interactions in the tumor microenvironment.
Xihao (Sherlock) Hu, PhD, a Parker Scholar at the Dana-Farber Cancer Institute in Boston, plans to study the interactions between tumor antigens and tumor-infiltrating B cells.
Justin Eyquem, PhD, a Parker Fellow at the University of California, San Francisco, plans to use a genome-editing platform he developed to improve the function of chimeric antigen receptor (CAR) T cells in solid tumors.
Tijana Martinov, PhD, a Parker Scholar at Fred Hutchinson Cancer Research Center in Seattle, is seeking to produce T cells that can target multiple myeloma cells.
Sierra McDonald, a PhD candidate and Parker Scholar at the University of Pennsylvania, is investigating ways to improve responses to CAR T-cell therapy by studying the HMG-box family of proteins.
Roberta Zappasodi, PhD, of Memorial Sloan Kettering Cancer Center in New York, is transitioning from a Parker Scholar to a Parker Bridge Scholar. She previously characterized a population of immune-suppressive T cells. Now, she is working to determine how these cells can be used to improve the efficacy of checkpoint inhibition.
Movers in Medicine highlights career moves and personal achievements by hematologists and oncologists. Did you switch jobs, take on a new role, climb a mountain? Tell us all about it at [email protected], and you could be featured in Movers in Medicine.
Get ready for the Big Easy
CHEST 2019 will be in New Orleans, Louisiana, this year, October 19-23. Here are a few ways to be engaged leading up to the meeting.
Submit Abstracts and Case Reports
Do you have original investigative research to share? There’s still some time to submit your abstracts and case reports for presentation at CHEST 2019 through Friday, March 15. If accepted, all abstracts and case reports will be published as submitted in an online CHEST® journal abstract supplement. No corrections will be made once submission is complete.
View submission details (https://chestmeeting.chestnet.org/abstracts-and-case-reports/)
Call for Moderators
CHEST is currently requesting moderators to facilitate discussions, questions, and answers within assigned sessions on-site at CHEST 2019 in New Orleans. Moderators will be notified June to September of their acceptance as a moderator.
View complete details (https://docs.google.com/forms/d/e/1FAIpQLSdSWFSyKAeIjfyYgGRF6km_95znba63bx6iM9TWl08gpdqzEQ/viewform)
CHEST Challenge 2019
US-based CHEST fellows-in-training - does your fellowship have what it takes to win CHEST Challenge 2019? CHEST Challenge is a fun and exciting competition in which CHEST fellows-in-training compete against programs around the country for honor and prizes! The first round of the competition consists of two parts: social media challenges and online quiz. The aggregate score for both of these components will be used to identify the top three highest scoring teams. These top three teams will then be invited to send three fellows each to the CHEST Challenge Championship, a Jeopardy-style game show that takes place live during the CHEST Annual Meeting.
See the rules and how to participate. (chestchallenge.org)
Apply for CHEST Foundation Grants
The CHEST Foundation has awarded more than $10 million in grant funding to nearly 800 recipients worldwide for clinical research and community service. Each year, the CHEST Foundation offers grants to worthy research candidates, generous community service volunteers, and distinguished scholars in a field of expertise.
The CHEST Foundation is accepting grant applications now through April 8, 2019, in the following areas:
• CHEST Foundation Community Service Grant Honoring D. Robert McCaffree, MD, Master FCCP – Up to $15,000 (multiple recipients selected)*
• The GlaxoSmithKline Distinguished Scholar in Respiratory Health – $150,000*
• CHEST Foundation Research Grant in Asthma – $15,000 – $30,000*
• CHEST Foundation Research Grant in Chronic Obstructive Pulmonary Disease – $25,000 – $50,000*
• CHEST Foundation Research Grant in Cystic Fibrosis – $15,000 – $30,000*
• CHEST Foundation Research Grant in Lung Cancer – $50,000 – $100,000*
• CHEST Foundation Research Grant in Nontuberculous Mycobacteria Diseases – $30,000 – $60,000*
• CHEST Foundation Research Grant in Pulmonary Arterial Hypertension – $25,000 – $50,000*
• CHEST Foundation Research Grant in Pulmonary Fibrosis – $25,000 – $50,000*
• CHEST Foundation Research Grant in Venous Thromboembolism – $15,000 – $30,000*
• CHEST Foundation Research Grant in Women’s Lung Health – $10,000*
*Amount contingent on funding.
Learn more on how to apply now. (https://foundation.chestnet.org/grants/apply-for-a-grant/)
CHEST 2019 will be in New Orleans, Louisiana, this year, October 19-23. Here are a few ways to be engaged leading up to the meeting.
Submit Abstracts and Case Reports
Do you have original investigative research to share? There’s still some time to submit your abstracts and case reports for presentation at CHEST 2019 through Friday, March 15. If accepted, all abstracts and case reports will be published as submitted in an online CHEST® journal abstract supplement. No corrections will be made once submission is complete.
View submission details (https://chestmeeting.chestnet.org/abstracts-and-case-reports/)
Call for Moderators
CHEST is currently requesting moderators to facilitate discussions, questions, and answers within assigned sessions on-site at CHEST 2019 in New Orleans. Moderators will be notified June to September of their acceptance as a moderator.
View complete details (https://docs.google.com/forms/d/e/1FAIpQLSdSWFSyKAeIjfyYgGRF6km_95znba63bx6iM9TWl08gpdqzEQ/viewform)
CHEST Challenge 2019
US-based CHEST fellows-in-training - does your fellowship have what it takes to win CHEST Challenge 2019? CHEST Challenge is a fun and exciting competition in which CHEST fellows-in-training compete against programs around the country for honor and prizes! The first round of the competition consists of two parts: social media challenges and online quiz. The aggregate score for both of these components will be used to identify the top three highest scoring teams. These top three teams will then be invited to send three fellows each to the CHEST Challenge Championship, a Jeopardy-style game show that takes place live during the CHEST Annual Meeting.
See the rules and how to participate. (chestchallenge.org)
Apply for CHEST Foundation Grants
The CHEST Foundation has awarded more than $10 million in grant funding to nearly 800 recipients worldwide for clinical research and community service. Each year, the CHEST Foundation offers grants to worthy research candidates, generous community service volunteers, and distinguished scholars in a field of expertise.
The CHEST Foundation is accepting grant applications now through April 8, 2019, in the following areas:
• CHEST Foundation Community Service Grant Honoring D. Robert McCaffree, MD, Master FCCP – Up to $15,000 (multiple recipients selected)*
• The GlaxoSmithKline Distinguished Scholar in Respiratory Health – $150,000*
• CHEST Foundation Research Grant in Asthma – $15,000 – $30,000*
• CHEST Foundation Research Grant in Chronic Obstructive Pulmonary Disease – $25,000 – $50,000*
• CHEST Foundation Research Grant in Cystic Fibrosis – $15,000 – $30,000*
• CHEST Foundation Research Grant in Lung Cancer – $50,000 – $100,000*
• CHEST Foundation Research Grant in Nontuberculous Mycobacteria Diseases – $30,000 – $60,000*
• CHEST Foundation Research Grant in Pulmonary Arterial Hypertension – $25,000 – $50,000*
• CHEST Foundation Research Grant in Pulmonary Fibrosis – $25,000 – $50,000*
• CHEST Foundation Research Grant in Venous Thromboembolism – $15,000 – $30,000*
• CHEST Foundation Research Grant in Women’s Lung Health – $10,000*
*Amount contingent on funding.
Learn more on how to apply now. (https://foundation.chestnet.org/grants/apply-for-a-grant/)
CHEST 2019 will be in New Orleans, Louisiana, this year, October 19-23. Here are a few ways to be engaged leading up to the meeting.
Submit Abstracts and Case Reports
Do you have original investigative research to share? There’s still some time to submit your abstracts and case reports for presentation at CHEST 2019 through Friday, March 15. If accepted, all abstracts and case reports will be published as submitted in an online CHEST® journal abstract supplement. No corrections will be made once submission is complete.
View submission details (https://chestmeeting.chestnet.org/abstracts-and-case-reports/)
Call for Moderators
CHEST is currently requesting moderators to facilitate discussions, questions, and answers within assigned sessions on-site at CHEST 2019 in New Orleans. Moderators will be notified June to September of their acceptance as a moderator.
View complete details (https://docs.google.com/forms/d/e/1FAIpQLSdSWFSyKAeIjfyYgGRF6km_95znba63bx6iM9TWl08gpdqzEQ/viewform)
CHEST Challenge 2019
US-based CHEST fellows-in-training - does your fellowship have what it takes to win CHEST Challenge 2019? CHEST Challenge is a fun and exciting competition in which CHEST fellows-in-training compete against programs around the country for honor and prizes! The first round of the competition consists of two parts: social media challenges and online quiz. The aggregate score for both of these components will be used to identify the top three highest scoring teams. These top three teams will then be invited to send three fellows each to the CHEST Challenge Championship, a Jeopardy-style game show that takes place live during the CHEST Annual Meeting.
See the rules and how to participate. (chestchallenge.org)
Apply for CHEST Foundation Grants
The CHEST Foundation has awarded more than $10 million in grant funding to nearly 800 recipients worldwide for clinical research and community service. Each year, the CHEST Foundation offers grants to worthy research candidates, generous community service volunteers, and distinguished scholars in a field of expertise.
The CHEST Foundation is accepting grant applications now through April 8, 2019, in the following areas:
• CHEST Foundation Community Service Grant Honoring D. Robert McCaffree, MD, Master FCCP – Up to $15,000 (multiple recipients selected)*
• The GlaxoSmithKline Distinguished Scholar in Respiratory Health – $150,000*
• CHEST Foundation Research Grant in Asthma – $15,000 – $30,000*
• CHEST Foundation Research Grant in Chronic Obstructive Pulmonary Disease – $25,000 – $50,000*
• CHEST Foundation Research Grant in Cystic Fibrosis – $15,000 – $30,000*
• CHEST Foundation Research Grant in Lung Cancer – $50,000 – $100,000*
• CHEST Foundation Research Grant in Nontuberculous Mycobacteria Diseases – $30,000 – $60,000*
• CHEST Foundation Research Grant in Pulmonary Arterial Hypertension – $25,000 – $50,000*
• CHEST Foundation Research Grant in Pulmonary Fibrosis – $25,000 – $50,000*
• CHEST Foundation Research Grant in Venous Thromboembolism – $15,000 – $30,000*
• CHEST Foundation Research Grant in Women’s Lung Health – $10,000*
*Amount contingent on funding.
Learn more on how to apply now. (https://foundation.chestnet.org/grants/apply-for-a-grant/)
CHEST updates guidelines on PAH
The American College of Chest Physicians® (CHEST) has published updates to the evidence-based guidelines on therapy for pulmonary arterial hypertension (PAH). In the latest evidence-based guideline, Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report, experts provide 78 evidence-based recommendations for appropriate use in treating patients with PAH.
“New recommendations and ungraded consensus-based statements were developed in this update based on new studies that were published since the 2014 guidelines. In addition, an evidence-based and consensus-driven treatment algorithm was created to guide the clinician through an organized approach to management,” says CHEST Pulmonary Arterial Hypertension Guidelines Committee Co-Chair, Deborah Jo Levine, MD, FCCP.
As part of the guideline development process, the panel updated the systematic review on the same clinical questions and criteria. Based on the results of the systematic review, the panel developed two new recommendations about pharmacologic therapy for PAH:
•For treatment-naive patients with PAH who are World Health Organization (WHO) functional class II and III, we suggest initial combination therapy with ambrisentan and tadalafil to improve 6-minute walk distance (6MWD).
•For stable or symptomatic patients with PAH on background therapy with ambrisentan, we suggest the addition of tadalafil to improve 6MWD.
The complete guideline article is free to view in the Online First section of the journal CHEST®.
The American College of Chest Physicians® (CHEST) has published updates to the evidence-based guidelines on therapy for pulmonary arterial hypertension (PAH). In the latest evidence-based guideline, Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report, experts provide 78 evidence-based recommendations for appropriate use in treating patients with PAH.
“New recommendations and ungraded consensus-based statements were developed in this update based on new studies that were published since the 2014 guidelines. In addition, an evidence-based and consensus-driven treatment algorithm was created to guide the clinician through an organized approach to management,” says CHEST Pulmonary Arterial Hypertension Guidelines Committee Co-Chair, Deborah Jo Levine, MD, FCCP.
As part of the guideline development process, the panel updated the systematic review on the same clinical questions and criteria. Based on the results of the systematic review, the panel developed two new recommendations about pharmacologic therapy for PAH:
•For treatment-naive patients with PAH who are World Health Organization (WHO) functional class II and III, we suggest initial combination therapy with ambrisentan and tadalafil to improve 6-minute walk distance (6MWD).
•For stable or symptomatic patients with PAH on background therapy with ambrisentan, we suggest the addition of tadalafil to improve 6MWD.
The complete guideline article is free to view in the Online First section of the journal CHEST®.
The American College of Chest Physicians® (CHEST) has published updates to the evidence-based guidelines on therapy for pulmonary arterial hypertension (PAH). In the latest evidence-based guideline, Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report, experts provide 78 evidence-based recommendations for appropriate use in treating patients with PAH.
“New recommendations and ungraded consensus-based statements were developed in this update based on new studies that were published since the 2014 guidelines. In addition, an evidence-based and consensus-driven treatment algorithm was created to guide the clinician through an organized approach to management,” says CHEST Pulmonary Arterial Hypertension Guidelines Committee Co-Chair, Deborah Jo Levine, MD, FCCP.
As part of the guideline development process, the panel updated the systematic review on the same clinical questions and criteria. Based on the results of the systematic review, the panel developed two new recommendations about pharmacologic therapy for PAH:
•For treatment-naive patients with PAH who are World Health Organization (WHO) functional class II and III, we suggest initial combination therapy with ambrisentan and tadalafil to improve 6-minute walk distance (6MWD).
•For stable or symptomatic patients with PAH on background therapy with ambrisentan, we suggest the addition of tadalafil to improve 6MWD.
The complete guideline article is free to view in the Online First section of the journal CHEST®.
CHEST reaccredited by Society for Simulation in Healthcare
The American College of Chest Physicians (CHEST) received reaccreditation from the Society for Simulation in Healthcare (SSH) for the 2018-2023 term in the areas of Teaching/Education, Assessment, and Research. In 2013, CHEST became the first and only medical specialty society to achieve SSH accreditation, a distinction that continues today. Currently, CHEST joins over 125 SSH-accredited programs worldwide, including universities, hospitals, and medical education companies.
The reaccreditation process was the result of months of preparation on behalf of CHEST Simulation Program staff, CHEST Accreditation staff, CHEST Outcomes staff, as well as CHEST’s Live Learning Domain Task Force chairs and other education leadership. This culminated in mid-November at a face-to-face on-site interview with site reviewers representing SSH and CHEST Simulation Program faculty and staff and CHEST leadership. Throughout the process, CHEST was given the opportunity to highlight the unique and innovative ways in which we are utilizing simulation-based education to provide greater clinical insights to enhance patient care.
We recognize that this isn’t only an every-4-year commitment, but it is resultant of the ongoing efforts from a group of dedicated individuals. Thank you to all whose contributions ensured our success!
The American College of Chest Physicians (CHEST) received reaccreditation from the Society for Simulation in Healthcare (SSH) for the 2018-2023 term in the areas of Teaching/Education, Assessment, and Research. In 2013, CHEST became the first and only medical specialty society to achieve SSH accreditation, a distinction that continues today. Currently, CHEST joins over 125 SSH-accredited programs worldwide, including universities, hospitals, and medical education companies.
The reaccreditation process was the result of months of preparation on behalf of CHEST Simulation Program staff, CHEST Accreditation staff, CHEST Outcomes staff, as well as CHEST’s Live Learning Domain Task Force chairs and other education leadership. This culminated in mid-November at a face-to-face on-site interview with site reviewers representing SSH and CHEST Simulation Program faculty and staff and CHEST leadership. Throughout the process, CHEST was given the opportunity to highlight the unique and innovative ways in which we are utilizing simulation-based education to provide greater clinical insights to enhance patient care.
We recognize that this isn’t only an every-4-year commitment, but it is resultant of the ongoing efforts from a group of dedicated individuals. Thank you to all whose contributions ensured our success!
The American College of Chest Physicians (CHEST) received reaccreditation from the Society for Simulation in Healthcare (SSH) for the 2018-2023 term in the areas of Teaching/Education, Assessment, and Research. In 2013, CHEST became the first and only medical specialty society to achieve SSH accreditation, a distinction that continues today. Currently, CHEST joins over 125 SSH-accredited programs worldwide, including universities, hospitals, and medical education companies.
The reaccreditation process was the result of months of preparation on behalf of CHEST Simulation Program staff, CHEST Accreditation staff, CHEST Outcomes staff, as well as CHEST’s Live Learning Domain Task Force chairs and other education leadership. This culminated in mid-November at a face-to-face on-site interview with site reviewers representing SSH and CHEST Simulation Program faculty and staff and CHEST leadership. Throughout the process, CHEST was given the opportunity to highlight the unique and innovative ways in which we are utilizing simulation-based education to provide greater clinical insights to enhance patient care.
We recognize that this isn’t only an every-4-year commitment, but it is resultant of the ongoing efforts from a group of dedicated individuals. Thank you to all whose contributions ensured our success!
In Memoriam
CHEST has been notified of the following deaths.
We extend our sincere condolences.
Faroque A. Khan, MBBS
Venessa Holland, MD, FCCP
CHEST has been notified of the following deaths.
We extend our sincere condolences.
Faroque A. Khan, MBBS
Venessa Holland, MD, FCCP
CHEST has been notified of the following deaths.
We extend our sincere condolences.
Faroque A. Khan, MBBS
Venessa Holland, MD, FCCP
Ready for universal hepatitis C testing?
Poor asthma control during pregnancy trims live birth rates. Fluorouracil beats other actinic keratosis treatments in a head-to-head trial. And vitamin C for sepsis? Experts take sides in a sharp debate.
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Poor asthma control during pregnancy trims live birth rates. Fluorouracil beats other actinic keratosis treatments in a head-to-head trial. And vitamin C for sepsis? Experts take sides in a sharp debate.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Poor asthma control during pregnancy trims live birth rates. Fluorouracil beats other actinic keratosis treatments in a head-to-head trial. And vitamin C for sepsis? Experts take sides in a sharp debate.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Thyroid Hormones Predict Readmission After Aortic Surgery
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.