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Bajracharya R, Kaaks R, Katzke V. Food Sources of Animal Protein in Relation to Overall and Cause-Specific Mortality-Causal Associations or Confounding? An Analysis of the EPIC-Heidelberg Cohort. Nutrients 2023; 15:3322. [PMID: 37571259 PMCID: PMC10421322 DOI: 10.3390/nu15153322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
While prior prospective iso-caloric substitution studies show a robust association between higher intake of animal protein and risk of mortality, associations observed for mortality risk in relation to major food sources of animal protein have been generally more diverse. We used the EPIC-Heidelberg cohort to examine if confounding, notably, by smoking, adiposity, or alcohol intake, could cause inconsistencies in estimated mortality hazard ratios (HR) related to intake levels of different types of meat and dairy products. Higher intakes of red or processed meats, and lower intakes of milk or cheese, were observed among current heavy smokers, participants with obesity, or heavy alcohol drinkers. Adjusting for age, sex, and total energy intake, risk models showed increased all-cause, cardiovascular, and cancer-related mortality with higher red or processed meat intakes (HR ranging from 1.25 [95% confidence interval = 1.15-1.36] to 1.76 [1.46-2.12] comparing highest to lowest tertiles), but reduced risks for poultry, milk, or cheese (HR ranging from 0.55 [0.43-0.72] to 0.88 [0.81-0.95]). Adjusting further for smoking history, adiposity indices, alcohol consumption, and physical activity levels, the statistical significance of all these observed was erased, except for the association of processed meat intake with cardiovascular mortality (HR = 1.36 [CI = 1.13-1.64]) and cheese intake with cancer mortality (HR = 0.86 [0.76-0.98]), which, however, were substantially attenuated. These findings suggest heavy confounding and provide little support for the hypothesis that animal protein, as a nutrient, is a major determinant of mortality risk.
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Affiliation(s)
| | | | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (R.B.); (R.K.)
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2
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D’Ecclesiis O, Pastore E, Gandini S, Caini S, Marvaso G, Jereczek-Fossa BA, Corrao G, Raimondi S, Bellerba F, Ciceri S, Latella M, Cavalcabò NDB, Bendinelli B, Saieva C, Fontana M, Gnagnarella P. Association between Alcohol Intake and Prostate Cancer Mortality and Survival. Nutrients 2023; 15:nu15040925. [PMID: 36839283 PMCID: PMC9965886 DOI: 10.3390/nu15040925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
We conducted a systematic review and meta-analysis to investigate the role of alcohol consumption with the prognosis of prostate cancer (PCa). Published reports were gathered on 15 October 2022, from PUBMED/MEDLINE and EMBASE. We found 19 independent eligible studies on the association between consumption of alcoholic beverages and the risk of fatal PCa (n = 5), PCa mortality (n = 5) in healthy subjects, and PCa patients' survival (n = 7) or surrogates thereof (n = 2). We used random effects meta-analysis to obtain a summary risk estimate (SRE) and 95% confidence intervals (95%CI) for incidence of fatal PCa and PCa mortality. The meta-analysis revealed no association between alcohol consumption and fatal prostate cancer incidence risk in healthy subjects with an indication for publication bias, but omitting the study that mainly increased the between-study heterogeneity, the SRE becomes significant (SRE 1.33, 95%CI 1.12-1.58), and the heterogeneity disappeared (I2 = 0%) with no indication of publication bias. No association of alcohol consumption was found with mortality risk in PCa patients (SRE 0.97, 95%CI 0.92-1.03) and PCa mortality risk in healthy subjects (SRE 1.03, 95%CI 0.82-1.30). In conclusion, this study suggests that there is some evidence of an association between high alcohol consumption and an increased risk of incidence of fatal prostate cancer in healthy subjects. Given the inconsistencies this result warrants further confirmation.
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Affiliation(s)
- Oriana D’Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Elisa Pastore
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
- Correspondence:
| | - Saverio Caini
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Giulia Marvaso
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Barbara A. Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Giulia Corrao
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Silvia Ciceri
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Marialetizia Latella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Nora de Bonfioli Cavalcabò
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Benedetta Bendinelli
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Calogero Saieva
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Miriam Fontana
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
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3
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[Risk Factors and Pathogenic Mechanism for Secondary Primary Lung Cancer
in Breast Cancer Patients: A Review]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2022; 25:750-755. [PMID: 36167461 PMCID: PMC9619345 DOI: 10.3779/j.issn.1009-3419.2022.101.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Breast cancer and lung cancer are the two most common malignancies in China. With the continuous improvement of breast cancer diagnosis and treatment technology, the survival time of breast cancer patients has been prolonged, and the number of breast cancer patients with second primary lung cancer (SPLC) has increased. In addition, breast cancer is the most common primary cancer in female patients with SPLC, and SPLC is the main cause of death in this population. More and more physicians pay attention to this clinical phenomenon. This paper summarized the risk and risk factors of SPLC in breast cancer patients, and elaborated its pathogenesis, in order to provide a theoretical basis for the clinical management of breast cancer patients and achieve accurate early intervention as soon as possible.
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Macke AJ, Petrosyan A. Alcohol and Prostate Cancer: Time to Draw Conclusions. Biomolecules 2022; 12:375. [PMID: 35327568 PMCID: PMC8945566 DOI: 10.3390/biom12030375] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 01/25/2023] Open
Abstract
It has been a long-standing debate in the research and medical societies whether alcohol consumption is linked to the risk of prostate cancer (PCa). Many comprehensive studies from different geographical areas and nationalities have shown that moderate and heavy drinking is positively correlated with the development of PCa. Nevertheless, some observations could not confirm that such a correlation exists; some even suggest that wine consumption could prevent or slow prostate tumor growth. Here, we have rigorously analyzed the evidence both for and against the role of alcohol in PCa development. We found that many of the epidemiological studies did not consider other, potentially critical, factors, including diet (especially, low intake of fish, vegetables and linoleic acid, and excessive use of red meat), smoking, family history of PCa, low physical activity, history of high sexual activities especially with early age of first intercourse, and sexually transmitted infections. In addition, discrepancies between observations come from selectivity criteria for control groups, questionnaires about the type and dosage of alcohol, and misreported alcohol consumption. The lifetime history of alcohol consumption is critical given that a prostate tumor is typically slow-growing; however, many epidemiological observations that show no association monitored only current or relatively recent drinking status. Nevertheless, the overall conclusion is that high alcohol intake, especially binge drinking, is associated with increased risk for PCa, and this effect is not limited to any type of beverage. Alcohol consumption is also directly linked to PCa lethality as it may accelerate the growth of prostate tumors and significantly shorten the time for the progression to metastatic PCa. Thus, we recommend immediately quitting alcohol for patients diagnosed with PCa. We discuss the features of alcohol metabolism in the prostate tissue and the damaging effect of ethanol metabolites on intracellular organization and trafficking. In addition, we review the impact of alcohol consumption on prostate-specific antigen level and the risk for benign prostatic hyperplasia. Lastly, we highlight the known mechanisms of alcohol interference in prostate carcinogenesis and the possible side effects of alcohol during androgen deprivation therapy.
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Affiliation(s)
- Amanda J. Macke
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Armen Petrosyan
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA;
- The Fred and Pamela Buffett Cancer Center, Omaha, NE 68198, USA
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Loeb S, Fu BC, Bauer SR, Pernar CH, Chan JM, Van Blarigan EL, Giovannucci EL, Kenfield SA, Mucci LA. Association of plant-based diet index with prostate cancer risk. Am J Clin Nutr 2021; 115:662-670. [PMID: 34791008 PMCID: PMC8895206 DOI: 10.1093/ajcn/nqab365] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Plant-based diets are associated with multiple health benefits and a favorable environmental impact. For prostate cancer, previous studies suggest a beneficial role of specific plant-based foods (e.g., tomatoes) and a potentially harmful role of specific animal-based foods (e.g., meat, dairy). However, less is known about plant-based dietary patterns. OBJECTIVES We sought to examine the relation between plant-based diet indices and prostate cancer risk, including clinically relevant disease. METHODS This was a prospective cohort study including 47,239 men in the Health Professionals Follow-Up Study (1986-2014). Overall and healthful plant-based diet indices were calculated from FFQs. Cox proportional hazards models were used to estimate HRs and 95% CIs to examine the risk of incident prostate cancer (total and by clinical category), among men ages <65 and ≥65 y. RESULTS Of the 47,239 men, 6655 men were diagnosed with prostate cancer over follow-up, including 515 with advanced-stage disease at diagnosis, 956 with lethal disease (metastasis or death), and 806 prostate cancer deaths. Greater overall plant-based consumption was associated with a significantly lower risk of fatal prostate cancer (HR: 0.81; 95% CI: 0.64, 1.01; P-trend = 0.04). In men aged <65, a higher plant-based diet index was associated with a lower risk of advanced, lethal, and fatal prostate cancer. Moreover, greater consumption of a healthful plant-based diet was associated with lower risks of total (HR: 0.84; 95% CI: 0.73, 0.98; P-trend = 0.046) and lethal prostate cancer (HR: 0.56; 95% CI: 0.34, 0.94; P-trend = 0.03) at age <65. There were no associations between overall or healthful plant-based diet indices with prostate cancer among men ≥65 y. Fewer than 1% of participants followed a strict vegetarian or vegan diet. CONCLUSIONS This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with a lower risk of aggressive forms of prostate cancer, with stronger benefit among men aged <65 y.
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Affiliation(s)
| | - Benjamin C Fu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Scott R Bauer
- Department of Medicine and Urology, UCSF; Division of General Internal Medicine, San Francisco, CA, USA
| | - Claire H Pernar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - June M Chan
- Departments of Epidemiology and Biostatistics, and Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Erin L Van Blarigan
- Departments of Epidemiology and Biostatistics, and Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Stacey A Kenfield
- Departments of Epidemiology and Biostatistics, and Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Chen Z, Ma Y, Hua J, Wang Y, Guo H. Impacts from Economic Development and Environmental Factors on Life Expectancy: A Comparative Study Based on Data from Both Developed and Developing Countries from 2004 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8559. [PMID: 34444306 PMCID: PMC8391297 DOI: 10.3390/ijerph18168559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022]
Abstract
Both economic development level and environmental factors have significant impacts on life expectancy at birth (LE). This paper takes LE as the research object and selects nine economic and environmental indicators with various impacts on LE. Based on a dataset of economic and environmental indicators of 20 countries from 2004 to 2016, our research uses the Pearson Correlation Coefficient to evaluate the correlation coefficients between the indicators, and we use multiple regression models to measure the impact of each indicator on LE. Based on the results from models and calculations, this study conducts a comparative analysis of the influencing mechanisms of different indicators on LE in both developed and developing countries, with conclusions as follow: (1) GDP per capita and the percentage of forest area to land area have a positive impact on LE in developed countries; however, they have a negative impact on LE in developing countries. Total public expenditure on education as a percentage of GDP and fertilizer consumption have a negative impact on LE in developed countries; however, they have a positive impact on LE in developing countries. Gini coefficient and average annual exposure to PM2.5 have no significant effect on LE in developed countries; however, they have a negative impact on LE in developing countries. Current healthcare expenditures per capita have a negative impact on LE in developed countries, and there is no significant impact on LE in developing countries. (2) The urbanization rate has a significant positive impact on LE in both developed countries and developing countries. Carbon dioxide emissions have a negative impact on LE in both developed and developing countries. (3) In developed countries, GDP per capita has the greatest positive impact on LE, while fertilizer consumption has the greatest negative impact on LE. In developing countries, the urbanization rate has the greatest positive impact on LE, while the Gini coefficient has the greatest negative impact on LE. To improve and prolong LE, it is suggested that countries should prioritize increasing GDP per capita and urbanization level. At the same time, countries should also work on reducing the Gini coefficient and formulating appropriate healthcare and education policies. On the other hand, countries should balance between economic development and environmental protection, putting the emphasis more on environmental protection, reducing environmental pollution, and improving the environment's ability of self-purification.
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Affiliation(s)
- Zhiheng Chen
- College of Northeast Asian Studies, Jilin University, No. 2699 Qianjin Street, Changchun 130012, China;
| | - Yuting Ma
- College of Biological and Agricultural Engineering, Jilin University, No. 5988 Renmin Street, Changchun 130022, China; (Y.M.); (J.H.); (Y.W.)
| | - Junyi Hua
- College of Biological and Agricultural Engineering, Jilin University, No. 5988 Renmin Street, Changchun 130022, China; (Y.M.); (J.H.); (Y.W.)
| | - Yuanhong Wang
- College of Biological and Agricultural Engineering, Jilin University, No. 5988 Renmin Street, Changchun 130022, China; (Y.M.); (J.H.); (Y.W.)
| | - Hongpeng Guo
- College of Biological and Agricultural Engineering, Jilin University, No. 5988 Renmin Street, Changchun 130022, China; (Y.M.); (J.H.); (Y.W.)
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7
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Bhattacharya R, Zekavat SM, Uddin MM, Pirruccello J, Niroula A, Gibson C, Griffin GK, Libby P, Ebert BL, Bick A, Natarajan P. Association of Diet Quality With Prevalence of Clonal Hematopoiesis and Adverse Cardiovascular Events. JAMA Cardiol 2021; 6:1069-1077. [PMID: 34106216 DOI: 10.1001/jamacardio.2021.1678] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Clonal hematopoiesis of indeterminate potential (CHIP), the expansion of somatic leukemogenic variations in hematopoietic stem cells, has been associated with atherosclerotic cardiovascular disease. Because the inherited risk of developing CHIP is low, lifestyle elements such as dietary factors may be associated with the development and outcomes of CHIP. Objective To examine whether there is an association between diet quality and the prevalence of CHIP. Design, Setting, and Participants This retrospective cohort study used data from participants in the UK Biobank, an ongoing population-based study in the United Kingdom that examines whole-exome sequencing data and survey-based information on health-associated behaviors. Individuals from the UK Biobank were recruited between 2006 and 2010 and followed up prospectively with linkage to health data records through May 2020. The present study included 44 111 participants in the UK Biobank who were age 40 to 70 years, had data available from whole-exome sequencing of blood DNA, and were free of coronary artery disease (CAD) or hematologic cancer at baseline. Exposures Diet quality was categorized as unhealthy if the intake of healthy elements (fruits and vegetables) was lower than the median of all survey responses, and the intake of unhealthy elements (red meat, processed food, and added salt) was higher than the median. Diets were classified as healthy if the intake of healthy elements was higher than the median, and the intake of unhealthy elements was lower than the median. The presence of CHIP was detected by data from whole-exome sequencing of blood DNA. Main Outcomes and Measures The primary outcome was CHIP prevalence. Multivariable logistic regression analysis was used to examine the association between diet quality and the presence of CHIP. Multivariable Cox proportional hazards models were used to assess the association of incident events (acute coronary syndromes, coronary revascularization, or death) in each diet quality category stratified by the presence of CHIP. Results Among 44 111 participants (mean [SD] age at time of blood sample collection, 56.3 [8.0] years; 24 507 women [55.6%]), 2271 individuals (5.1%) had an unhealthy diet, 38 552 individuals (87.4%) had an intermediate diet, and 3288 individuals (7.5%) had a healthy diet. A total of 2507 individuals (5.7%) had CHIP, and the prevalence of CHIP decreased as diet quality improved from unhealthy (162 of 2271 participants [7.1%]) to intermediate (2177 of 38 552 participants [5.7%]) to healthy (168 of 3288 participants [5.1%]; P = .003 for trend). Compared with individuals without CHIP who had an intermediate diet, the rates of incident cardiovascular events progressively decreased among those with CHIP who had an unhealthy diet (hazard ratio [HR], 1.52; 95% CI, 1.04-2.22) and those with CHIP who had a healthy diet (HR, 0.99; 95% CI, 0.62-1.58) over a median of 10.0 years (interquartile range, 9.6-10.4 years) of follow-up. Conclusions and Relevance This cohort study suggests that an unhealthy diet quality may be associated with a higher prevalence of CHIP and higher rates of adverse cardiovascular events and death independent of CHIP status.
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Affiliation(s)
- Romit Bhattacharya
- Cardiovascular Research Center, Massachusetts General Hospital, Boston.,Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Seyedeh Maryam Zekavat
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Cardiovascular Research Center, Massachusetts General Hospital, Boston.,Yale School of Medicine, New Haven, Connecticut
| | - Md Mesbah Uddin
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Cardiovascular Research Center, Massachusetts General Hospital, Boston
| | - James Pirruccello
- Cardiovascular Research Center, Massachusetts General Hospital, Boston.,Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Abhishek Niroula
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christopher Gibson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gabriel K Griffin
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.,Epigenomics Program, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Peter Libby
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin L Ebert
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexander Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, Boston.,Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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