ORCID Profile
0000-0001-8257-7361
Current Organisations
University of Western Australia
,
Sir Charles Gairdner Hospital
,
Bond University
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Publications
The effect of vitamin K1 on arterial calcification activity in subjects with diabetes mellitus: a post hoc analysis of a double-blind, randomized, placebo-controlled trial
Publisher: Elsevier BV
Date: 2022
DOI: 10.1093/AJCN/NQAB306
Abstract: Coronary and aortic artery calcifications are generally slow to develop, and their burden predicts cardiovascular disease events. In patients with diabetes mellitus, arterial calcification is accelerated and calcification activity can be detected using 18F-sodium fluoride positron emission tomography (18F-NaF PET). We aimed to determine whether vitamin K1 supplementation inhibits arterial calcification activity in in iduals with diabetes mellitus. This was a post hoc analysis of the ViKCoVaC (effect of Vitamin-K1 and Colchicine on Vascular Calcification activity in subjects with Diabetes Mellitus) double-blind randomized controlled trial conducted in Perth, Western Australia. In iduals with diabetes mellitus and established coronary calcification (coronary calcium score > 10), but without clinical coronary artery disease, underwent baseline 18F-NaF PET imaging, followed by oral vitamin K1 supplementation (10 mg/d) or placebo for 3 mo, after which 18F-NaF PET imaging was repeated. We tested whether in iduals randomly assigned to vitamin K1 supplementation had reduced development of new 18F-NaF PET positive lesions within the coronary arteries and aorta. In total, 149 in iduals completed baseline and follow-up imaging studies. Vitamin K1 supplementation independently decreased the odds of developing new 18F-NaF PET positive lesions in the coronary arteries (OR: 0.35 95% CI: 0.16, 0.78 P = 0.010), aorta (OR: 0.27 95% CI: 0.08, 0.94 P = 0.040), and in both aortic and coronary arteries (OR: 0.28 95% CI: 0.13, 0.63 P = 0.002). In in iduals with diabetes mellitus, supplementation with 10 mg vitamin K1/d may prevent the development of newly calcifying lesions within the aorta and the coronary arteries as detected using 18F-NaF PET. Further long-term studies are needed to test this hypothesis.This trial was registered at anzctr.org.au as ACTRN12616000024448.
18 F-Sodium Fluoride Positron Emission Tomography Activity Predicts the Development of New Coronary Artery Calcifications
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-12-2020
DOI: 10.1161/ATVBAHA.120.315364
Abstract: The coronary calcium score (CCS) predicts cardiovascular disease risk in in iduals with diabetes mellitus, and rate of progression of CCS is an additional and incremental marker of risk. 18 F-sodium fluoride positron emission tomography ( 18 F-NaF PET) detects early and active calcifications within the vasculature. We aimed to ascertain the relationship between 18 F-NaF PET activity and CCS progression in patients with diabetes mellitus. We identified in iduals between 50 and 80 years with diabetes mellitus and no history of clinical coronary artery disease. Those with a CCS ≥10 were invited to undergo 18 F-NaF PET scanning and then repeat CCS years later. 18 F-NaF PET and CCS analysis were performed on a per-coronary and a per-patient level. We compared the proportion of CCS progressors in 18 F-NaF PET–positive versus 18 F-NaF PET–negative coronary arteries. Forty-one participants with 163 coronary arteries underwent follow-up CCS 2.8±0.5 years later. 18 F-NaF PET–positive coronary arteries (n=52) were more likely to be CCS progressors, compared with negative coronary arteries (n=111 86.5% versus 52.3%, P .001). Adjusting for baseline CCS, 18 F-NaF PET–positive disease was an independent predictor of subsequent CCS progression (odds ratio, 2.92 [95% CI, 1.32–6.45], P =0.008). All subjects (100%, 15/15) with ≥2 18 F-NaF–positive coronary arteries progressed in CCS. In subjects with diabetes mellitus, 18 F-NaF PET positivity at baseline, independently predicted the progression of calcifications within the coronary arteries 2.8 years later. These findings suggest 18 F-NaF PET may be a promising technique for earlier identification of patients at higher risk of cardiovascular events.
Coronary 18F-sodium fluoride PET detects high-risk plaque features on optical coherence tomography and CT-angiography in patients with acute coronary syndrome
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1016/J.ATHEROSCLEROSIS.2020.12.010
Abstract: Sixty-two prospectively recruited patients with acute coronary syndrome (ACS) underwent multi-vessel OCT, In 62 patients (age, mean ± standard deviation (SD) = 61 ± 9 years, 85% male) the coronary segments with elevated
Association between vitamin K1 intake and mortality in the Danish Diet, Cancer, and Health cohort
Publisher: Springer Science and Business Media LLC
Date: 30-09-2021
DOI: 10.1007/S10654-021-00806-9
Abstract: Reported associations between vitamin K 1 and both all-cause and cause-specific mortality are conflicting. The 56,048 participants from the Danish Diet, Cancer, and Health prospective cohort study, with a median [IQR] age of 56 [52–60] years at entry and of whom 47.6% male, were followed for 23 years, with 14,083 reported deaths. Of these, 5015 deaths were CVD-related, and 6342 deaths were cancer-related. Intake of vitamin K 1 (phylloquinone) was estimated from a food-frequency questionnaire (FFQ), and its relationship with mortality outcomes was investigated using Cox proportional hazards models. A moderate to high (87–192 µg/d) intake of vitamin K 1 was associated with a lower risk of all-cause [HR (95%CI) for quintile 5 vs quintile 1: 0.76 (0.72, 0.79)], cardiovascular disease (CVD)-related [quintile 5 vs quintile 1: 0.72 (0.66, 0.79)], and cancer-related mortality [quintile 5 vs quintile 1: 0.80 (0.75, 0.86)], after adjusting for demographic and lifestyle confounders. The association between vitamin K 1 intake and cardiovascular disease-related mortality was present in all subpopulations (categorised according to sex, smoking status, diabetes status, and hypertension status), while the association with cancer-related mortality was only present in current/former smokers (p for interaction = 0.002). These findings suggest that promoting adequate intakes of foods rich in vitamin K 1 may help to reduce all-cause, CVD-related, and cancer-related mortality at the population level.
The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia
Publisher: AMPCo
Date: 2018
DOI: 10.5694/MJA17.00132
Abstract: To determine the use of different anticoagulation therapies in rural Western Australia to establish whether remoteness from health care services affects the choice of anticoagulation therapy to gather preliminary data on anticoagulation therapy safety and efficacy. Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014-2015. Four hospitals serving two-thirds of the rural population of Western Australia. 609 patients with an indication for anticoagulation therapy recorded in their hospital discharge summary for index admission. Prescribing rates of anticoagulation therapies by indication for anticoagulation and distance of patient residence from their hospital. The primary safety outcome was re-hospitalisation with a major or clinically relevant non-major bleeding event the primary lack-of-efficacy outcome was re-hospitalisation for a thromboembolic event. The overall rates of prescription of NOACs and warfarin were similar (34% v 33%). A NOAC was prescribed more often than warfarin for patients with AF (56.0% v 42.2% of those who received an anticoagulant P < 0.001), but less often for patients with VTE (29% v 48% P < 0.001). Warfarin was prescribed for 38% of patients who lived locally, a NOAC for 31% (P = 0.013) for non-local patients, the respective proportions were 29% and 36% (P = 0.08). 69% of patients with AF and a CHA2DS2-VASc score ≥ 1 were prescribed anticoagulation therapy. Patients treated with NOACs had fewer bleeding events than patients treated with warfarin (nine events [4%] v 20 events [10%] P = 0.027). In rural WA, about one-third of patients with an indication for anticoagulation therapy receive NOACs, but one-third of patients with AF and at risk of stroke received no anticoagulant therapy, and may benefit from NOAC therapy.
Reel syndrome, a diagnostic conundrum: a case report
Publisher: Oxford University Press (OUP)
Date: 10-2021
Abstract: Pacemaker lead dislodgement and failure, related to device manipulation, is a rare complication of permanent pacemaker (PPM) insertion. Reel’s, Twiddler’s, and Ratchet syndrome are rare causes of pacemaker failure with varying mechanisms, defined by their classical lead and generator findings on chest X-ray imaging. Misleading patient presentations may be attributed to lead stimulation of surrounding structures. A 77-year-old female was admitted with abdominal wall pulsations, abdominal pain, and lower limb jerking 3 months following PPM insertion. Following exclusion of a ruptured abdominal aortic aneurysm, the presence of Reel syndrome was noted on the patient’s chest X-ray and the electrocardiogram showed inappropriate pacing. Deactivation of the pacemaker resulted in immediate symptom cessation and urgent repositioning of pacemaker leads was undertaken. This case highlights the importance of considering pacemaker complications causing non-cardiac symptomatology. Pacemaker lead stimulation of surrounding structures can present in an unconventional fashion, veiling the diagnosis. However, a structured approach to undifferentiated neuromuscular presentations in patients with PPMs should consider lead dislodgement as a differential diagnosis. Rapid recognition of lead dislodgement, device deactivation, and re-implantation or repositioning of the leads are critical in preventing potentially life-threatening complications.
In search of the vulnerable patient or the vulnerable plaque: 18F-sodium fluoride positron emission tomography for cardiovascular risk stratification
Publisher: Springer Science and Business Media LLC
Date: 03-04-0007
DOI: 10.1007/S12350-018-1360-2
Abstract: Cardiovascular disease (CVD) remains a leading cause of death. Preventative therapies that reduce CVD are most effective when targeted to in iduals at high risk. Current risk stratification tools have only modest prognostic capabilities, resulting in over-treatment of low-risk in iduals and under-treatment of high-risk in iduals. Improved methods of CVD risk stratification are required. Molecular imaging offers a novel approach to CVD risk stratification. In particular,
Optimizing arterial 18F-sodium fluoride positron emission tomography analysis
Publisher: Springer Science and Business Media LLC
Date: 23-03-2019
Coronary artery 18F-NaF PET analysis with the use of an elastic motion correction software
Publisher: Springer Science and Business Media LLC
Date: 25-01-2023
DOI: 10.1007/S12350-018-01587-7
Abstract: 18F-Sodium Fluoride Positron Emission Tomography (18F-NaF PET) is a novel molecular imaging modality with promise for use as a risk stratification tool in cardiovascular disease. There are limitations in the analysis of small and rapidly moving coronary arteries using traditional PET technology. We aimed to validate the use of a motion correction algorithm (eMoco) on coronary 18F-NaF PET outcome parameters. Patients admitted with an acute coronary syndrome underwent 18F-NaF PET and computed tomography coronary angiography. 18F-NaF PET data were analyzed using a diastolic reconstruction, an ungated reconstruction and the eMoco reconstruction. Twenty patients underwent 18F-NaF PET imaging and 17 patients had at least one positive lesion that could be used to compare PET reconstruction datasets. eMoco improved noise (the coefficient of variation of the blood pool radiotracer activity) compared to the diastolic dataset (0.09 [0.07 to 0.12] vs 0.14[0.11 to 0.17], p < .001) and marginally improved coronary lesion maximum tissue-to-background ratios compared to the ungated dataset (1.33 [1.05 to 1.48]vs 1.29 [1.04 to 1.40], p = .011). In this pilot dataset, the eMoco reconstruction algorithm for motion correction appears to have potential in improving coronary analysis of 18F-NaF PET by reducing noise and increasing maximum counts. Further testing in a larger patient dataset is warranted.
Vitamin K1 intake and incident diabetes in the Danish Diet Cancer and Health Study
Publisher: The Endocrine Society
Date: 26-05-2023
Abstract: Observational studies have reported lower risks of type 2 diabetes with higher vitamin K1 intake, but these studies overlook effect modification due to known diabetes risk factors. To identify subgroups that might benefit from vitamin K1 intake, we examined associations between vitamin K1 intake and incident diabetes overall and in subpopulations at risk of diabetes. Participants from the prospective cohort, the Danish Diet, Cancer, and Health Study, with no history of diabetes were followed up for diabetes incidence. The association between intake of vitamin K1, estimated from a food frequency questionnaire completed at baseline, and incident diabetes was determined using multivariable-adjusted Cox proportional-hazards models. In 54 787 Danish residents with a median (interquartile range) age of 56 (52-60) years at baseline, 6700 in iduals were diagnosed with diabetes during 20.8 (17.3-21.6) years of follow-up. Vitamin K1 intake was inversely and linearly associated with incident diabetes (P & .0001). Compared to participants with the lowest vitamin K1 intake (median:57 µg/d), participants with the highest intakes (median:191 µg/d) had a 31% lower risk of diabetes (HR 95% CI, 0.69 0.64-0.74) after multivariable adjustments. The inverse association between vitamin K1 intake and incident diabetes was present in all subgroups (namely, men and women, ever and never smokers, low and high physical activity groups, and in participants who were normal to overweight and obese), with differences in absolute risk between subgroups. Higher intake of foods rich in vitamin K1 was associated with a lower risk of diabetes. If the associations observed are causal, our results indicate that more cases of diabetes would be prevented in subgroups at higher risk (men, smokers, participants with obesity, and those with low physical activity).
Low Endothelial Shear Stress Is Associated With High-Risk Coronary Plaque Features and Microcalcification Activity
Publisher: Elsevier BV
Date: 11-2021
Use of cardiovascular imaging in risk restratification of the diabetic patient
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-12-2020
The effect of Vitamin-K1 and Colchicine on Vascular Calcification Activity in subjects with Diabetes Mellitus (ViKCoVaC): A double-blind 2x2 factorial randomized controlled trial
Publisher: Springer Science and Business Media LLC
Date: 06-04-2021
DOI: 10.1007/S12350-021-02589-8
Abstract: There is currently no treatment for attenuating progression of arterial calcification. 154 patients with diabetes mellitus and coronary calcification, as detected using computed tomography (CT), were randomized to one of four treatment groups (placebo lacebo, vitamin-K 149 subjects completed follow-up (vitamin-K In patients with type 2 diabetes, neither vitamin-K ACTRN12616000024448.
Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 17-08-2021
Abstract: Dietary vitamin K (K 1 and K 2 ) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations. In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K 1 and vitamin K 2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models. Among 53 372 Danish citizens with a median (interquartile range) age of 56 (52–60) years, 8726 in iduals were hospitalized for any ASCVD during 21 (17–22) years of follow‐up. Compared with participants with the lowest vitamin K 1 intakes, participants with the highest intakes had a 21% lower risk of an ASCVD‐related hospitalization (hazard ratio, 0.79 95% CI: 0.74–0.84), after multivariable adjustments for relevant demographic covariates. Likewise for vitamin K 2 , the risk of an ASCVD‐related hospitalization for participants with the highest intakes was 14% lower than participants with the lowest vitamin K 2 intake (hazard ratio, 0.86 95% CI, 0.81–0.91). Risk of ASCVD was inversely associated with diets high in vitamin K 1 or K 2 . The similar inverse associations with both vitamin K 1 and K 2 , despite very different dietary sources, highlight the potential importance of vitamin K for ASCVD prevention.
Is breast arterial calcification associated with coronary artery disease? A systematic review and meta-analysis
Publisher: Public Library of Science (PLoS)
Date: 28-07-2020
Ischaemic Stroke and the Echocardiographic Bubble Study
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.HLC.2018.07.007
Abstract: Patent foramen ovale (PFO) is a potential mechanism for paradoxical embolism in cryptogenic ischaemic stroke or transient ischaemic attack (TIA). PFO is typically demonstrated with agitated saline ("bubble study", BS) during echocardiography. We hypothesised that the BS is frequently requested in patients that have a readily identifiable cause of stroke, that any PFO detected is likely incidental, and its detection often does not alter management. This was a retrospective observational study of patients with recent ischaemic stroke/TIA referred for a BS. Patient demographics, stroke risk factors, vascular/cerebral imaging results and transoesophageal echocardiogram (TOE) reports were recorded. A "modified" Risk of Paradoxical Embolism (RoPE) score was calculated. Change in management was defined as antiplatelet/anticoagulant therapy alteration or referral for PFO closure. Bubble Study complications were recorded. Among 715 patients with ischaemic stroke/TIA referred for a BS, 8.7% had atrial fibrillation and 9.2% had carotid stenosis ≥70%. At least three stroke risk factors were present in 39.3% and only 47.1% of patients screened had a "modified" RoPE score of >5. A PFO was detected in 248 patients of whom only 31% (77/248) had a subsequent change in management. Of BS performed, 1/924 patients (0.1%) suffered a TIA as a complication. The echocardiographic BS is frequently performed in patients that have a readily identifiable cause of stroke and whose PFO unlikely relates to the stroke/TIA. Bubble Study findings resulted in a change in management in the minority. The procedure is safe but the complication rate warrants informed consent.
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No related grants have been discovered for Jamie Bellinge.