| 1. |
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| 2. |
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| 3. |
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| 4. |
- Coignard, J, et al.
(författare)
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A case-only study to identify genetic modifiers of breast cancer risk for BRCA1/BRCA2 mutation carriers
- 2021
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1, s. 1078-
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. About 50 common variants have been shown to modify BC risk for mutation carriers. All but three, were identified in general population studies. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have so far been underpowered. We conduct a novel case-only genome-wide association study comparing genotype frequencies between 60,212 general population BC cases and 13,007 cases with BRCA1 or BRCA2 mutations. We identify robust novel associations for 2 variants with BC for BRCA1 and 3 for BRCA2 mutation carriers, P < 10−8, at 5 loci, which are not associated with risk in the general population. They include rs60882887 at 11p11.2 where MADD, SP11 and EIF1, genes previously implicated in BC biology, are predicted as potential targets. These findings will contribute towards customising BC polygenic risk scores for BRCA1 and BRCA2 mutation carriers.
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| 5. |
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| 6. |
- Figlioli, G, et al.
(författare)
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The FANCM:p.Arg658* truncating variant is associated with risk of triple-negative breast cancer
- 2019
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Ingår i: NPJ breast cancer. - : Springer Science and Business Media LLC. - 2374-4677. ; 5, s. 38-
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is a common disease partially caused by genetic risk factors. Germline pathogenic variants in DNA repair genes BRCA1, BRCA2, PALB2, ATM, and CHEK2 are associated with breast cancer risk. FANCM, which encodes for a DNA translocase, has been proposed as a breast cancer predisposition gene, with greater effects for the ER-negative and triple-negative breast cancer (TNBC) subtypes. We tested the three recurrent protein-truncating variants FANCM:p.Arg658*, p.Gln1701*, and p.Arg1931* for association with breast cancer risk in 67,112 cases, 53,766 controls, and 26,662 carriers of pathogenic variants of BRCA1 or BRCA2. These three variants were also studied functionally by measuring survival and chromosome fragility in FANCM−/− patient-derived immortalized fibroblasts treated with diepoxybutane or olaparib. We observed that FANCM:p.Arg658* was associated with increased risk of ER-negative disease and TNBC (OR = 2.44, P = 0.034 and OR = 3.79; P = 0.009, respectively). In a country-restricted analysis, we confirmed the associations detected for FANCM:p.Arg658* and found that also FANCM:p.Arg1931* was associated with ER-negative breast cancer risk (OR = 1.96; P = 0.006). The functional results indicated that all three variants were deleterious affecting cell survival and chromosome stability with FANCM:p.Arg658* causing more severe phenotypes. In conclusion, we confirmed that the two rare FANCM deleterious variants p.Arg658* and p.Arg1931* are risk factors for ER-negative and TNBC subtypes. Overall our data suggest that the effect of truncating variants on breast cancer risk may depend on their position in the gene. Cell sensitivity to olaparib exposure, identifies a possible therapeutic option to treat FANCM-associated tumors.
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| 7. |
- IVANOV, I, et al.
(författare)
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GROWTH OF EPITAXIAL ALN(0001) ON SI(111) BY REACTIVE MAGNETRON SPUTTER-DEPOSITION
- 1995
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Ingår i: JOURNAL OF APPLIED PHYSICS. - : AMER INST PHYSICS. - 0021-8979. ; 78:9, s. 5721-5726
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- 2H-AlN(0001) layers have been grown on Si(lll) by reactive magnetron sputtering from an Al target in Ar+N-2 gas mixtures at temperatures T-s=400-900 degrees C. Variations in reactive gas consumption, target voltage, and current-voltage characteristics ver
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| 8. |
- Adcox, K, et al.
(författare)
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Formation of dense partonic matter in relativistic nucleus-nucleus collisions at RHIC: Experimental evaluation by the PHENIX Collaboration
- 2005
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Ingår i: Nuclear Physics, Section A. - : Elsevier BV. - 0375-9474. ; 757:1-2, s. 184-283
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Forskningsöversikt (refereegranskat)abstract
- Extensive experimental data from high-energy nucleus-nucleus collisions were recorded using the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). The comprehensive set of measurements from the first three years of RHIC operation includes charged particle multiplicities, transverse energy, yield ratios and spectra of identified hadrons in a wide range of transverse momenta (PT), elliptic flow, two-particle correlations, nonstatistical fluctuations, and suppression of particle production at high PT. The results are examined with an emphasis on implications for the formation of a new state of dense matter. We find that the state of matter created at RHIC cannot be described in terms of ordinary color neutral hadrons.
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| 9. |
- Adcox, K, et al.
(författare)
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PHENIX detector overview
- 2003
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Ingår i: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - 0167-5087. ; 499:2-3, s. 469-479
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Tidskriftsartikel (refereegranskat)abstract
- The PHENIX detector is designed to perform a broad study of A-A, p-A, and p-p collisions to investigate nuclear matter under extreme conditions. A wide variety of probes, sensitive to all timescales, are used to study systematic variations with species and energy as well as to measure the spin structure of the nucleon. Designing for the needs of the heavy-ion and polarized-proton programs has produced a detector with unparalleled capabilities. PHENIX measures electron and muon pairs, photons, and hadrons with excellent energy and momentum resolution. The detector consists of a large number of subsystems that are discussed in other papers in this volume. The overall design parameters of the detector are presented. (C) 2002 Elsevier Science B.V. All rights reserved.
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| 10. |
- Adler, SS, et al.
(författare)
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Bose-Einstein correlations of charged pion pairs in Au+Au collisions at root(NN)-N-s = 200 GeV
- 2004
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Ingår i: Physical Review Letters. - 1079-7114. ; 93:15
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Tidskriftsartikel (refereegranskat)abstract
- Bose-Einstein correlations of identically charged pion pairs were measured by the PHENIX experiment at midrapidity in Au+Au collisions at roots(NN)=200 GeV. The Bertsch-Pratt radius parameters were determined as a function of the transverse momentum of the pair and as a function of the centrality of the collision. Using the standard core-halo partial Coulomb fits, and a new parametrization which constrains the Coulomb fraction as determined from the unlike-sign pion correlation, the ratio R-out/R-side is within 0.8-1.1 for 0.25<<1.2 GeV/c. The centrality dependence of all radii is well described by a linear scaling in N-part(1/3), and R-out/R-side for similar to0.45 GeV/c is approximately constant at unity as a function of centrality.
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| 11. |
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| 12. |
- Adler, SS, et al.
(författare)
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Common suppression pattern of eta and pi(0) mesons at high transverse momentum in Au plus Au collisions at root SNN=200 GeV
- 2006
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Ingår i: Physical Review Letters. - 1079-7114. ; 96:20
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Tidskriftsartikel (refereegranskat)abstract
- Inclusive transverse momentum spectra of eta mesons have been measured within p(T)=2-10 GeV/c at midrapidity by the PHENIX experiment in Au+Au collisions at root s(NN) = 200 GeV. In central Au+Au the eta yields are significantly suppressed compared to peripheral Au+Au, d+Au, and p+p yields scaled by the corresponding number of nucleon-nucleon collisions. The magnitude, centrality, and p(T) dependence of the suppression is common, within errors, for eta and pi(0). The ratio of eta to pi(0) spectra at high p(T) amounts to 0.40 < R-eta/pi(0)< 0.48 for the three systems, in agreement with the world average measured in hadronic and nuclear reactions and, at large scaled momentum, in e(+)e(-) collisions.
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| 13. |
- Adler, SS, et al.
(författare)
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Deuteron and antideuteron production in Au+Au collisions at root s(NN)=200 GeV
- 2005
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Ingår i: Physical Review Letters. - 1079-7114. ; 94:12
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Tidskriftsartikel (refereegranskat)abstract
- The production of deuterons and antideuterons in the transverse momentum range 1.1 < p(T)< 4.3 GeV/c at midrapidity in Au+Au collisions at root s(NN) = 200 GeV has been studied by the PHENIX experiment at RHIC. A coalescence analysis, comparing the deuteron and antideuteron spectra with that of proton and antiproton, has been performed. The coalescence probability is equal for both deuterons and antideuterons and it increases as a function of p(T), which is consistent with an expanding collision zone. Comparing (anti)proton yields, (p) over bar /p = 0.73 +/- 0.01, with (anti)deuteron yields, (d) over bar /d = 0.47 +/- 0.03, we estimate that (n) over bar /n = 0.64 +/- 0.04. The nucleon phase space density is estimated from the coalescence measurement.
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| 14. |
- Adler, SS, et al.
(författare)
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Double helicity asymmetry in inclusive midrapidity pi(0) production for polarized p+p collisions at root s=200 GeV
- 2004
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Ingår i: Physical Review Letters. - 1079-7114. ; 93:20: 202002
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Tidskriftsartikel (refereegranskat)abstract
- We present a measurement of the double longitudinal spin asymmetry in inclusive pi(0) production in polarized proton-proton collisions at roots=200 GeV. The data were taken at the Relativistic Heavy Ion Collider with average beam polarizations of 0.27. The measurements are the first in a program to study the longitudinal spin structure of the proton, using strongly interacting probes, at collider energies. The asymmetry is presented for transverse momenta 1-5 GeV/c at midrapidity, where next-to-leading-order perturbative quantum chromodynamic (NLO pQCD) calculations well describe the unpolarized cross section. The observed asymmetry is small and is compared to a NLO pQCD calculation with a range of polarized gluon distributions.
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| 15. |
- Adler, SS, et al.
(författare)
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Elliptic flow of identified hadrons in Au+Au collisions at root s(NN)=200 GeV
- 2003
-
Ingår i: Physical Review Letters. - 1079-7114. ; 91:18: 182301
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Tidskriftsartikel (refereegranskat)abstract
- The anisotropy parameter (v(2)), the second harmonic of the azimuthal particle distribution, has been measured with the PHENIX detector in Au+Au collisions at roots(NN)=200 GeV for identified and inclusive charged particle production at central rapidities (eta<0.35) with respect to the reaction plane defined at high rapidities (eta=3-4 ). We observe that the v(2) of mesons falls below that of (anti)baryons for p(T)>2 GeV/c, in marked contrast to the predictions of a hydrodynamical model. A quark-coalescence model is also investigated.
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| 16. |
- Adler, SS, et al.
(författare)
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Improved measurement of double helicity asymmetry in inclulsive midrapidity pi(0) production for polarized p+p collisions at root s=200 GeV
- 2006
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Ingår i: Physical Review D (Particles, Fields, Gravitation and Cosmology). - 1550-2368. ; 73:9
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Tidskriftsartikel (refereegranskat)abstract
- We present an improved measurement of the double helicity asymmetry for pi(0) production in polarized proton-proton scattering at root s=200 GeV employing the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). The improvements to our previous measurement come from two main factors: Inclusion of a new data set from the 2004 RHIC run with higher beam polarizations than the earlier run and a recalibration of the beam polarization measurements for the earlier run, which resulted in reduced uncertainties and increased beam polarizations. The results are compared to a Next to Leading Order (NLO) perturbative Quantum Chromodynamics (pQCD) calculation with a range of polarized gluon distributions.
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| 17. |
- Adler, SS, et al.
(författare)
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J/psi production from proton-proton collisions at root s=200 GeV
- 2004
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Ingår i: Physical Review Letters. - 1079-7114. ; 92:5
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Tidskriftsartikel (refereegranskat)abstract
- J/psi production has been measured in proton-proton collisions at roots=200 GeV over a wide rapidity and transverse momentum range by the PHENIX experiment at the Relativistic Heavy Ion Collider. Distributions of the rapidity and transverse momentum, along with measurements of the mean transverse momentum and total production cross section are presented and compared to available theoretical calculations. The total J/psi cross section is 4.0+/-0.6(stat)+/-0.6(syst)+/-0.4(abs) mub. The mean transverse momentum is 1.80+/-0.23(stat)+/-0.16(syst) GeV/c.
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| 18. |
- Adler, SS, et al.
(författare)
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J/psi production in Au-Au collisions at root s(NN)=200 GeV
- 2004
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 69:1
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Tidskriftsartikel (refereegranskat)abstract
- First results on charm quarkonia production in heavy ion collisions at the Relativistic Heavy Ion Collider (RHIC) are presented. The yield of J/psi's measured in the PHENIX experiment via electron-positron decay pairs at midrapidity for Au-Au reactions at roots(NN) = 200 GeV is analyzed as a function of collision centrality. For this analysis we have studied 49.3x10(6) minimum bias Au-Au reactions. We present the J/psi invariant yield dN/dy for peripheral and midcentral reactions. For the most central collisions where we observe no signal above background, we quote 90% confidence level upper limits. We compare these results with our J/psi measurement from proton-proton reactions at the same energy. We find that our measurements are not consistent with models that predict strong enhancement relative to binary collision scaling.
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| 19. |
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| 20. |
- Adler, SS, et al.
(författare)
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Measurement of single electron event anisotropy in Au plus Au collisions at root s(NN)=200 GeV
- 2005
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 72:2
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Tidskriftsartikel (refereegranskat)abstract
- The transverse momentum dependence of the azimuthal anisotropy parameter v(2), the second harmonic of the azimuthal distribution, for electrons at midrapidity (vertical bar eta vertical bar < 0.35) has been measured with the PHENIX detector in Au+Au collisions at root s(NN) = 200 GeV. The measurement was made with respect to the reaction plane defined at high rapidities (vertical bar eta vertical bar = 3.1-3.9). From the result we have measured the v(2) of electrons from heavy flavor decay after subtraction of the v(2) of electrons from other sources such as photon conversions and Dalitz decay from light neutral mesons. We observe a nonzero single electron v(2) with a 90% confidence level in the intermediate-p(T) region. The precision of the present data set does not permit us to conclude definitively that heavy quarks exhibit thermalization with the transverse flow of the bulk matter.
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| 21. |
- Adler, SS, et al.
(författare)
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Measurement of transverse single-spin asymmetries for midrapidity production of neutral pions and charged hadrons in polarized p+p collisions at root s=200 GeV
- 2005
-
Ingår i: Physical Review Letters. - 1079-7114. ; 95
-
Tidskriftsartikel (refereegranskat)abstract
- Transverse single-spin asymmetries to probe the transverse-spin structure of the proton have been measured for neutral pions and nonidentified charged hadrons from polarized proton-proton collisions at midrapidity and root s = 200 GeV. The data cover a transverse momentum (pT) range 1.0-5.0 GeV/c for neutral pions and 0.5-5.0 GeV/c for charged hadrons, at a Feynman-x value of approximately zero. The asymmetries seen in this previously unexplored kinematic region are consistent with zero within errors of a few percent. In addition, the inclusive charged hadron cross section at midrapidity from 0.5 < P-T < 7.0 GeV/c is presented and compared to next-to-leading order perturbative QCD ( pQCD) calculations. Successful description of the unpolarized cross section above similar to 2 GeV/c suggests that pQCD is applicable in the interpretation of the asymmetry results in the relevant kinematic range.
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| 22. |
- Adler, SS, et al.
(författare)
-
Midrapidity direct-photon production in p+p collisions at root s=200 GeV
- 2005
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Ingår i: Physical Review D (Particles and Fields). - 0556-2821. ; 71:7
-
Tidskriftsartikel (refereegranskat)abstract
- A measurement of direct photons in p+p collisions at root s=200 GeV is presented. A photon excess above background from pi(0)->gamma+gamma, eta ->gamma+gamma and other decays is observed in the transverse momentum range 5.5 < p(T)< 7 GeV/c. The result is compared to a next-to-leading-order perturbative QCD calculation. Within errors, good agreement is found between the QCD calculation and the measured result.
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| 23. |
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| 24. |
- Adler, SS, et al.
(författare)
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Production of phi mesons at midrapidity in root S-NN=200 GeVAu+Au collisions at relativistic energies
- 2005
-
Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 72:1
-
Tidskriftsartikel (refereegranskat)abstract
- We present the results of phi meson production in the K+K- decay channel from Au+Au collisions at root s(NN) =200 GeV as measured at midrapidity by the PHENIX detector at Brookhaven National Laboratory's Relativistic Heavy Ion Collider. Precision resonance centroid and width values are extracted as a function of collision centrality. No significant variation from the Particle Data Group accepted values is observed, contrary to some model predictions. The phi transverse mass spectra are fitted with a linear exponential function for which the derived inverse slope parameter is seen to be constant as a function of centrality. However, when these data are fitted by a hydrodynamic model the result is that the centrality-dependent freeze-out temperature and the expansion velocity values are consistent with the values previously derived from fitting identified charged hadron data. As a function of transverse momentum the collisions scaled peripheral-to-central yield ratio R-CP for the phi is comparable to that of pions rather than that of protons. This result lends support to theoretical models that distinguish between baryons and mesons instead of particle mass for explaining the anomalous (anti) proton yield.
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| 25. |
- Adler, SS, et al.
(författare)
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Scaling properties of proton and antiproton production in root s(NN)=200 GeV Au+Au collisions
- 2003
-
Ingår i: Physical Review Letters. - 1079-7114. ; 91:17: 172301
-
Tidskriftsartikel (refereegranskat)abstract
- We report on the yield of protons and antiprotons, as a function of centrality and transverse momentum, in Au+Au collisions at rootS(NN)=200 GeV measured at midrapidity by the PHENIX experiment at the BNL Relativistic Heavy Ion Collider. In central collisions at intermediate transverse momenta (1.5
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| 26. |
- Adler, SS, et al.
(författare)
-
Single electrons from heavy-flavor decays in p + p collisions at root s=200 GeV
- 2006
-
Ingår i: Physical Review Letters. - 1079-7114. ; 96:3
-
Tidskriftsartikel (refereegranskat)abstract
- The invariant differential cross section for inclusive electron production in p+p collisions at root s=200 GeV has been measured by the PHENIX experiment at the BNL Relativistic Heavy Ion Collider over the transverse momentum range 0.4 <= p(T) <= 5.0 GeV/c in the central rapidity region (vertical bar eta vertical bar <= 0.35). The contribution to the inclusive electron spectrum from semileptonic decays of hadrons carrying heavy flavor, i.e., charm quarks or, at high p(T), bottom quarks, is determined via three independent methods. The resulting electron spectrum from heavy-flavor decays is compared to recent leading and next-to-leading order perturbative QCD calculations. The total cross section of charm quark-antiquark pair production is determined to be sigma(c (c) over bar) = 0.92 +/- 0.15(stat) +/- 0.54(syst) mb.
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| 27. |
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| 28. |
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| 29. |
- Chun, JS, et al.
(författare)
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Synchrotron x-ray diffraction and transmission electron microscopy studies of interfacial reaction paths and kinetics during annealing of fully-002-textured Al/TiN bilayers
- 2001
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Ingår i: Journal of Vacuum Science & Technology. A. Vacuum, Surfaces, and Films. - 0734-2101 .- 1520-8559. ; 19:1, s. 182-191
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Tidskriftsartikel (refereegranskat)abstract
- Dense fully-002-textured polycrystalline TiN layers, 110 nm thick with a N/TI ratio of 1.02+/-0.03, were grown on SiO2 by ultrahigh vacuum magnetically unbalanced magnetron sputter deposition at T-s = 450 degreesC in pure N-2 utilizing high N-2(+)/Ti Aux ratios and low energy (E-N2(+) = 20 eV) ion irradiation of the growing film. Al overlayers, 160 nm thick and possessing a strong 002 texture inherited from the underlying TiN, were then deposited at T-s = 100 degreesC without breaking vacuum. Synchrotron x-ray diffraction was used to follow interfacial reaction paths and kinetics during postdeposition annealing as a function of time (t(a) = 200 - 1200 s) and temperature (T-a = 500 - 580 degreesC). Changes in bilayer microstructure and microchemistry were investigated using transmission electron microscopy (TEM) and scanning TEM to obtain compositional maps of cross-sectional and plan-view specimens by energy dispersive x-ray analysis. The initial bilayer reaction step during annealing involves the formation of a continuous AIN interfacial layer which, due to local epitaxy with the TIN underlayer, grows with the metastable zinc-blende structure up to a thickness x similar or equal to3-5 nm, and with the wurtzite structure thereafter. Ti atoms released during AIN formation diffuse into the Al layer leading to supersaturation followed by the nucleation of dispersed regions of tetragonal Al3Ti with inherited 002 preferred orientation. The aluminide domains grow rapidly until they reach the free surface, thereafter growth is two dimensional as Al3Ti grains spread radially. The overall activation energy for Al3Ti formation and growth is 1.8+/-0.1 eV. In situ synchrotron x-ray diffraction analyses during thermal ramping show that the onset temperature for interfacial reactions was increased by more than 100 degreesC for fully dense completely 002-textured bilayers compared to Ill-textured bilayers deposited by conventional reactive sputter deposition. (C) 2001 American Vacuum Society.
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| 30. |
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| 31. |
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| 32. |
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| 33. |
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| 34. |
- Ferreira, MA, et al.
(författare)
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Genome-wide association and transcriptome studies identify target genes and risk loci for breast cancer
- 2019
-
Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 10:1, s. 1741-
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Tidskriftsartikel (refereegranskat)abstract
- Genome-wide association studies (GWAS) have identified more than 170 breast cancer susceptibility loci. Here we hypothesize that some risk-associated variants might act in non-breast tissues, specifically adipose tissue and immune cells from blood and spleen. Using expression quantitative trait loci (eQTL) reported in these tissues, we identify 26 previously unreported, likely target genes of overall breast cancer risk variants, and 17 for estrogen receptor (ER)-negative breast cancer, several with a known immune function. We determine the directional effect of gene expression on disease risk measured based on single and multiple eQTL. In addition, using a gene-based test of association that considers eQTL from multiple tissues, we identify seven (and four) regions with variants associated with overall (and ER-negative) breast cancer risk, which were not reported in previous GWAS. Further investigation of the function of the implicated genes in breast and immune cells may provide insights into the etiology of breast cancer.
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| 35. |
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| 36. |
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| 37. |
- Gall, D, et al.
(författare)
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Electronic structure of ScN determined using optical spectroscopy, photoemission, and ab initio calculations
- 2001
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Ingår i: Physical Review B. Condensed Matter and Materials Physics. - 1098-0121 .- 1550-235X. ; 63:12
-
Tidskriftsartikel (refereegranskat)abstract
- Experimental and ab initio computational methods are employed to conclusively show that ScN is a semiconductor rather than a semimetal, i.e., there is a gap between the N 2p and the Sc 3d bands. Previous experimental investigators reported, in agreement with band structure calculations showing a band overlap of 0.2 eV, that ScN is a semimetal while others concluded that it is a semiconductor with a band gap larger than 2 eV. We have grown high quality, single crystalline ScN layers on MgO(001) and on TiN(001) buffer layers on MgO(001) by ultrahigh vacuum reactive magnetron sputter deposition. ScN optical properties were determined by transmission, reflection, and spectroscopic ellipsometry while in-situ x-ray and ultraviolet valence band photoelectron spectroscopy were used to determine the density of stares (DOS) below the Fermi level. The measured DOS exhibits peaks at 3.8 and 5.2 eV stemming from the N 2p bands and at 15.3 eV due to the N 2s bands. The imaginary part of the measured dielectric function epsilon (2) consists of two primary features due to direct X- and Gamma -point transitions at photon energies of 2.7 and 3.8 eV, respectively. For comparison, the ScN band structure was calculated using an nb initio Kohn-Sham approach which treats the exchange interactions exactly within density-functional theory. Calculated DOS and the complex dielectric function are in good agreement with our ScN valence-band photoelectron spectra and measured optical properties. respectively. We conclude, combining experimental and computational results, that ScN is a semiconductor with an indirect Gamma -X bandgap of 1.3 +/- 0.3 eV and a direct X-point gap of 2.4 +/- 0.3 eV.
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Vaduganathan, M, et al.
(författare)
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Sudden Death After Hospitalization for Heart Failure With Reduced Ejection Fraction (from the EVEREST Trial)
- 2018
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Ingår i: Am J Cardiol. - : Elsevier BV. - 1879-1913. ; 122:2, s. 255-260
-
Tidskriftsartikel (refereegranskat)abstract
- Patients with chronic heart failure with reduced ejection fraction (HFrEF) benefit from medical and device therapies targeting sudden cardiac death (SCD). Contemporary estimates of SCD risk after hospitalization for heart failure are limited. We describe the incidence, timing, and clinical predictors of SCD after hospitalization for HFrEF (30 baseline covariates (including treatment randomization, demographics, comorbid conditions, natriuretic peptides, ejection fraction, and medical and device therapies) to identify predictors of 1-year SCD. Of the 4,024 trial patients discharged alive (97%), there were 268 who experienced SCD (7%) and 703 who experienced non-SCD (17%) during median follow-up of 9.9 months. Implantable cardioverter defibrillator use at baseline was 14.5%. Estimates of SCD at 1, 3, 6, and 12 months were 0.8%, 2.3%, 4.1%, and 7.4%, respectively. Most patients were readmitted before SCD (n = 147, 55%). Male gender, black race, diabetes mellitus, and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use were potential predictors of 1-year SCD after hospitalization for HFrEF (all p <0.10); however, this final model demonstrated poor discrimination (C-statistic 0.57). In conclusion, in the EVEREST trial, patients hospitalized for HFrEF faced risks of 1-year postdischarge SCD of 7%, which accrued gradually over time, and were balanced with high competing risks of nonsudden death (17%). Traditional clinical characteristics fail to adequately predict SCD risk. Further data are needed to identify patients at greatest relative risk for SCD (compared with non-SCD) after hospitalization for HFrEF.
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| 43. |
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