Task Progress:
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All aims have been accomplished. Because this section will be made publicly available, a modified selection from "main findings" is reproduced here.
1). DEFINED HOW TO QUANTIFY PROGRESSION OF CAC: The most common clinical definition of >15% per year, which is used by NASA flight surgeons, is too sensitive to the baseline CAC and frequently gives erroneous information, especially in patients with low baseline levels of CAC (for example an increase of 1 to 2, 10 to 11, or 100 to 101 reflect a 100%, 10%, and 1% change, but would still reflect the same absolute change in CAC). Different methods can result in divergent classification in up to 30% of individuals. Although we could not define the "best" score, the Hokanson method, based on the square root of the change in CAC, seemed to be the most robust, and will be utilized in other publications. This paper has been accepted in the Journal of the American College of Cardiology (JACC): Imaging; Paixao ARM...Levine BD et al. Disagreement Between Different Definitions of Coronary Artery Calcium Progression. JACC: Imaging, 2014, in press.
2). MADE THE NOVEL, CLINICALLY IMPORTANT OBSERVATION THAT THE FINAL CAC SCORE, RATHER THAN A MEASURE OF DISEASE PROGRESSION IS THE MOST IMPORTANT PIECE OF INFORMATION FOR PREDICTING CLINICAL EVENTS. So if serial CAC scanning is performed by flight surgeons, the latest scan should be used for risk assessment; knowledge of the change in CAC leading to this subsequent score will provide no independent prognostic information. This new finding obviates the need for complex calculations regarding rate of progression, and emphasizes that risk for future events depends mainly on the overall atherosclerotic burden, not on how fast the diseases progresses. Radford NB...Levine BD et al. Baseline Value, Follow-Up Value and Progression Rate of Coronary Artery Calcification Score and Risk of Incident Cardiovascular Disease Events. Submitted JAMA 08/2014
3). HIGHER DEGREES OF FITNESS MITIGATE THE EFFECT OF CAC AT ANY AGE OR LEVEL OF CAC. DeFina LF...Levine BD et al. Cardiorespiratory Fitness, Coronary Artery Calcium and Cardiovascular Disease Events. To be presented at American Heart Association meetings 2014; referenced as Circulation 2014; abstract in press.
4). DEVELOPED THE ASTRO-CHARM (Cardiovascular Health and Risk Modification). This score is the only system available which quantifies global cardiovascular risk in a relatively young population like the astronaut corps, using routine clinical information plus a CAC score. The final results from Astro-CHARM, including the functional calculator were delivered to NASA and the Human Research Program (HRP) in February 2014, and is actively being used by flight surgeons now.
5). DEMONSTRATED THAT INCREASED FITNESS PROTECTS AGAINST THE DEVELOPMENT OF DIABETES IN PATIENTS ON STATINS. Radford NB...Levine BD et al. Impact of Fitness on Incident Diabetes from Statin Use in Primary Prevention. Submitted Mayo Clinic Proceedings 07/2014.
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Abstracts for Journals and Proceedings
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DeFina LF, Leonard D, Willis B, Barlow CE, Radford NB, Khera A, Levine BD. "Cardiorespiratory Fitness, Coronary Artery Calcium and Cardiovascular Disease Events." American Heart Association Scientific Sessions 2014, Chicago, Illinois, November 15-19, 2014. Circulation. 2014 Nov 25;130(Suppl 2):A20477. http://circ.ahajournals.org/content/130/Suppl_2/A20477.abstract ; accessed 9/7/2020. , Nov-2014
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Articles in Other Journals or Periodicals
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Radford NB, DeFina LF, Barlow CE, Kerr A, Chakravorty R, Khera A, Levine BD. "Impact of Fitness on Incident Diabetes from Statin Use in Primary Prevention." Mayo Clinic Proceedings. In press, as of September 2014. , Sep-2014
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Articles in Peer-reviewed Journals
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Radford NB, DeFina LF, Barlow CE, Lakoski SG, Leonard D, Paixao AR, Khera A, Levine BD. "Progression of CAC score and risk of incident CVD." JACC Cardiovasc Imaging. 2016 Dec;9(12):1420-9. Epub 2016 Jun 29. http://dx.doi.org/10.1016/j.jcmg.2016.03.010 ; PubMed PMID: 27372023 (NOTE: previously reported in August 2014 as "submitted" and later in June 2016 as Epub) , Dec-2016
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Articles in Peer-reviewed Journals
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Radford NB, DeFina LF, Barlow CE, Kerr A, Chakravorty R, Khera A, Levine BD. "Effect of fitness on incident diabetes from statin use in primary prevention." Atherosclerosis. 2015 Mar;239(1):43-9. Epub 2014 Dec 23. http://dx.doi.org/10.1016/j.atherosclerosis.2014.12.051 ; PubMed PMID: 25568952 , Mar-2015
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Articles in Peer-reviewed Journals
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Radford NB, DeFina LF, Leonard D, Barlow CE, Willis BL, Gibbons LW, Gilchrist SC, Khera A, Levine BD. "Cardiorespiratory fitness, coronary artery calcium and cardiovascular disease events in a cohort of generally healthy, middle aged men: Results from the Cooper Center Longitudinal Study." Circulation. 2018 May 1;137(18):1888-95. Epub 2018 Jan 17. https://doi.org/10.1161/CIRCULATIONAHA.117.032708 ; PubMed PMID: 29343464 , May-2018
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Articles in Peer-reviewed Journals
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DeFina LF, Radford NB, Barlow CE, Willis BL, Leonard D, Haskell WL, Farrell SW, Pavlovic A, Abel K, Berry JD, Khera A, Levine BD. "Association of all-cause and cardiovascular mortality with high levels of physical activity and concurrent coronary artery calcification." JAMA Cardiol. 2019 Feb;4(2):174-81. https://doi.org/10.1001/jamacardio.2018.4628 ; PubMed PMID: 30698608 , Feb-2019
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Articles in Peer-reviewed Journals
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Hansen AB, Lawley JS, Rickards CA, Howden EJ, Sarma S, Cornwell WK 3rd, Amin SB, Mugele H, Marume K, Possnig C, Whitworth LA, Williams MA, Levine BD. "Reducing intracranial pressure by reducing central venous pressure: Assessment of potential countermeasures to spaceflight associated neuro-ocular syndrome." J Appl Physiol (1985). 2021 Feb 1;130(2):283-9. https://doi.org/10.1152/japplphysiol.00786.2020 ; PMID: 33270516
, Feb-2021
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Articles in Peer-reviewed Journals
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Paixao ARM, Chakravorty R, Khera A, LeonardD, DeFina LF, Barlow CE, Radford NB, Levine BD. "Disagreement between different definitions of coronary artery calcium progression." Journal of the American College of Cardiology: Cardiovascular Imaging. 2015 Jun;8(6):743-4. Epub 2014 Nov 12. http://dx.doi.org/10.1016/j.jcmg.2014.07.019 ; PubMed PMID: 25457766 , Jun-2015
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Awards
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Levine BD. "Dill Lecture at American College of Sports Medicine Meetings, May 2014." May-2014
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Awards
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Levine B. "Association of American Physicians, April 2014." Apr-2014
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Awards
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Levine B. "Best Doctors, Dallas, January 2014." Jan-2014
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Awards
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Levine B. "Fellow, American Physiological Society, Cardiovascular Section, December 2013." Dec-2013
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Awards
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Levine B. "Hermann Rahn Memorial Lecture, University of Buffalo, June 2013." Jun-2013
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