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Cainzos-Achirica M, Quispe R, Mszar R, Dudum R, Al Rifai M, Erbel R, Stang A, Jöckel KH, Lehmann N, Schramm S, Schmidt B, Toth PP, Rana JS, Lima JAC, Doria de Vasconcellos H, Lloyd-Jones D, Joshi PH, Ayers C, Khera A, Blaha MJ, Greenland P, Nasir K. Coronary Artery Calcium Score to Refine the Use of PCSK9i in Asymptomatic Individuals: A Multicohort Study. J Am Heart Assoc 2022; 11:e025737. [PMID: 35943062 PMCID: PMC9496288 DOI: 10.1161/jaha.122.025737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background The value of coronary artery calcium (CAC) in the allocation of PCSK9i (proprotein convertase subtilisin/kexin type 9 inhibitors) among individuals without clinically evident atherosclerotic cardiovascular disease (ASCVD) is unknown for indications that do not require confirmed familial hypercholesterolemia. We aimed to assess the ability of CAC to stratify ASCVD risk under 3 non–familial hypercholesterolemia PCSK9i allocation paradigms. Methods and Results We included participants without clinically evident ASCVD from MESA (Multi‐Ethnic Study of Atherosclerosis), CARDIA (Coronary Artery Risk Development in Young Adults) study, DHS (Dallas Heart Study), and HNR (Heinz Nixdorf Recall) study. Three PCSK9i eligibility scenarios were defined: a broad scenario informed only by high low‐density lipoprotein cholesterol levels (N=567), a restrictive one combining higher low‐density lipoprotein cholesterol levels and presence of ≥2 additional risk factors (N=127), and a high‐risk scenario where individuals with subclinical organ damage or high estimated risk would be treated to achieve low‐density lipoprotein cholesterol <55 mg/dL (N=471). The high‐risk scenario had the highest ASCVD event rates (27.8% at 10 years). CAC=0 was observed in 35% participants in the broad scenario, 25% in the restrictive scenario, and 16% in the high‐risk scenario. In all, CAC=0 was associated with the lowest incident ASCVD rates at 5 and 10 years, and CAC burden was independently associated with ASCVD events adjusting for traditional risk factors. Conclusions CAC may be used to refine the allocation of PCSK9i, potentially leading to a more conservative use if CAC=0. The value of CAC testing is greater in scenarios that use low‐density lipoprotein cholesterol levels and/or traditional risk factors to define PCSK9i eligibility (CAC=0 present in 1 of 3–4 patients), whereas its prevalence is lower when allocation is informed by presence of noncoronary subclinical organ damage.
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Affiliation(s)
- Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston TX.,Center for Outcomes Research Houston Methodist Houston TX.,Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins Medical Institutions Baltimore MD
| | - Renato Quispe
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins Medical Institutions Baltimore MD
| | - Reed Mszar
- Center for Outcomes Research Yale School of Medicine New Haven CT
| | - Ramzi Dudum
- Division of Cardiovascular Medicine Stanford University Stanford CA
| | | | - Raimund Erbel
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany
| | - Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany.,Department of Epidemiology, School of Public Health Boston University Boston MA
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany
| | - Nils Lehmann
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany
| | - Sara Schramm
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany
| | - Börge Schmidt
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen University Duisburg-Essen Essen Germany
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins Medical Institutions Baltimore MD.,CGH Medical Center Sterling IL.,University of Illinois College of Medicine Peoria IL
| | - Jamal S Rana
- Divisions of Cardiology and Research Kaiser Permanente Northern California Oakland CA
| | - Joao A C Lima
- Division of Cardiovascular Imaging Johns Hopkins Medical Institutions Baltimore MD
| | | | - Donald Lloyd-Jones
- Departments of Preventive Medicine and Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Parag H Joshi
- Division of Cardiology, Department of Internal Medicine UT Southwestern Medical Center Dallas TX
| | - Colby Ayers
- Division of Cardiology, Department of Internal Medicine UT Southwestern Medical Center Dallas TX
| | - Amit Khera
- Division of Cardiology, Department of Internal Medicine UT Southwestern Medical Center Dallas TX
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins Medical Institutions Baltimore MD.,Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD
| | - Philip Greenland
- Departments of Preventive Medicine and Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston TX.,Center for Outcomes Research Houston Methodist Houston TX.,Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins Medical Institutions Baltimore MD
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2
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Qin L, Li L, Fan H, Gu Y, He W, Zhang K, Sun Y, Zhao W, Niu X, Wei C, Li L, Wang H. Longitudinal Associations Between Serum Bilirubin Level and Carotid Atherosclerosis Plaque in a Health Screening Population. Angiology 2022; 74:452-460. [PMID: 35759358 DOI: 10.1177/00033197221110966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to determine the relationship between bilirubin levels and carotid atherosclerosis (CAS) in the health screening population. After propensity score matching, this retrospective cohort study included 4360 subjects who underwent health examinations regularly in Hebei General Hospital between January 2010 and December 2019 and had no carotid plaque at baseline. After an average follow-up of 26.76 months, the main endpoint Cox regression analysis of carotid plaques was performed. After adjusting the confounding factors, Cox regression analysis showed that when serum total bilirubin (TBIL) and unconjugated bilirubin (UCB) increased by 1 standard deviation (SD), the risk of carotid plaque decreased by 7.30% (95% confidence interval (CI): 2.80-11.60%) and 15.70% (95% CI: 11.40-19.80%), respectively. When conjugated bilirubin (CB) increased by 1 SD, the risk of carotid plaques increased by 24.3% (95% CI: 19.7-29.0%). TBIL and UCB levels were negatively associated with CAS, and CB levels were positively associated with CAS.
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Affiliation(s)
- Lu Qin
- Graduate school, 12553Hebei Medical University, Shijiazhuang, China.,Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Lin Li
- Graduate school, 12553Hebei Medical University, Shijiazhuang, China.,Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Hongzhen Fan
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Yongsheng Gu
- Graduate school, 12553Hebei Medical University, Shijiazhuang, China.,Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Weiliang He
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Kaihua Zhang
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Yingru Sun
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Wannian Zhao
- Graduate school, 12553Hebei Medical University, Shijiazhuang, China.,Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Xiaoli Niu
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Ci Wei
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Litao Li
- Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
| | - Hebo Wang
- Graduate school, 12553Hebei Medical University, Shijiazhuang, China.,Department of Neurology, 117872Hebei General Hospital, Shijiazhuang, China
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3
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Rios J. Is the arterial echo-Doppler a useful tool in the detection of subclinical arteriosclerosis? VASCULAR INVESTIGATION AND THERAPY 2021. [DOI: 10.4103/2589-9686.333002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Hennig F, Geisel MH, Kälsch H, Lucht S, Mahabadi AA, Moebus S, Erbel R, Lehmann N, Jöckel KH, Scherag A, Hoffmann B. Air Pollution and Progression of Atherosclerosis in Different Vessel Beds-Results from a Prospective Cohort Study in the Ruhr Area, Germany. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:107003. [PMID: 33017176 PMCID: PMC7535085 DOI: 10.1289/ehp7077] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/23/2020] [Accepted: 09/04/2020] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Due to inconsistent epidemiological evidence on health effects of air pollution on progression of atherosclerosis, we investigated several air pollutants and their effects on progression of atherosclerosis, using carotid intima media thickness (cIMT), coronary calcification (CAC), and thoracic aortic calcification (TAC). METHODS We used baseline (2000-2003) and 5-y follow-up (2006-2008) data from the German Heinz Nixdorf Recall cohort study, including 4,814 middle-aged adults. Residence-based long-term air pollution exposure, including particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5), (PM10), and nitrogen dioxide (NO2) was assessed using chemistry transport and land use regression (LUR) models. cIMT was quantified as side-specific median IMT assessed from standardized ultrasound images. CAC and TAC were quantified by computed tomography using the Agatston score. Development (yes/no) and progression of atherosclerosis (change in cIMT and annual growth rate for CAC/TAC) were analyzed with logistic and linear regression models, adjusting for age, sex, lifestyle variables, socioeconomic status, and traffic noise. RESULTS While no clear associations were observed in the full study sample (mean age 59.1 (±7.6) y; 53% female), most air pollutants were marginally associated with progression of atherosclerosis in participants with no or low baseline atherosclerotic burden. Most consistently for CAC, e.g., a 1.5 μg/m3 higher exposure to PM2.5 (LUR) yielded an estimated odds ratio of 1.19 [95% confidence interval (CI): 1.03, 1.39] for progression of CAC and an increased annual growth rate of 2% (95% CI: 1%, 4%). CONCLUSION Our study suggests that development and progression of subclinical atherosclerosis is associated with long-term air pollution in middle-aged participants with no or minor atherosclerotic burden at baseline, while overall no consistent associations are observed. https://doi.org/10.1289/EHP7077.
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Affiliation(s)
- Frauke Hennig
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Marie Henrike Geisel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
- Research Group Clinical Epidemiology, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Hagen Kälsch
- Department of Cardiology, Alfried Krupp Hospital Essen, Essen, Germany
- Witten/Herdecke University, Witten, Germany
| | - Sarah Lucht
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Amir Abbas Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Susanne Moebus
- Center of Urban Epidemiology (Cue), Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - André Scherag
- Research Group Clinical Epidemiology, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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5
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Qin P, Shi J, Cao L, Li X, Lou Y, Wang C, Ma J, Wang L, Peng X, Chen H, Xu S, Zhao P, Hu D, Hu F. Low-Density Lipoprotein Cholesterol/High-Density Lipoprotein Cholesterol Ratio and Carotid Intima-Media Thickness: A Cohort Study in China. Lipids 2020; 56:59-68. [PMID: 32856731 DOI: 10.1002/lipd.12274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022]
Abstract
Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio may carry additional information and has been suggested as a better predictor for atherosclerosis progression and cardiovascular disease (CVD) than LDL-C and HDL-C alone. Therefore, we aim to explore the association between LDL-C/HDL-C ratio and high carotid intima-media thickness (CIMT) risk in a large Cohort in Beijing, China. This cohort study included 13,612 adults without high CIMT at first entry and who attended the baseline examination and at least one follow-up annual examination between 2009 and 2016. We used multivariable Cox regression to estimate hazard ratios (HR) with their 95% confidence intervals (CI) for the association between LDL-C/HDL-C ratio and risk of high CIMT. During 37,912 person-years of follow-up, 1996 (1268 men and 728 women) developed high CIMT. Compared with the first quartile of LDL-C/HDL-C ratio, the risk of high CIMT was significantly increased for the fourth quartile of LDL-C/HDL-C ratio (HR = 1.51, 95% CI: 1.29-1.78). We observed a significant association between LDL-C/HDL-C ratio and high CIMT risk comparing LDL-C/HDL-C ratio >2.78 with LDL-C/HDL-C ratio ≤2.78 and significant dose-response relationship between LDL-C/HDL-C ratio and risk of high CIMT. The restricted cubic spline showed a significant nonlinear association between LDL-C/HDL-C ratio and the risk of high CIMT (pnon-linearity = 0.009). We identify a significant association between LDL-C/HDL-C ratio and the risk of high CIMT in the Chinese Cohort study. Future studies are needed to evaluate the effectiveness of reducing LDL-C/HDL-C ratio treatment on the development of high CIMT.
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Affiliation(s)
- Pei Qin
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Jing Shi
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Liming Cao
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Xue Li
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Xiaotangshan Town, Changping, Beijing, 102200, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Xiaotangshan Town, Changping, Beijing, 102200, People's Republic of China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
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6
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Lou Y, Li X, Cao L, Qin P, Shi J, Zhang Y, Wang C, Ma J, Wang L, Peng X, Chen H, Xu S, Hu F, Zhao Y, Zhao P. LDL-cholesterol to HDL-cholesterol ratio discordance with lipid parameters and carotid intima-media thickness: a cohort study in China. Lipids Health Dis 2020; 19:141. [PMID: 32552893 PMCID: PMC7302368 DOI: 10.1186/s12944-020-01324-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/12/2020] [Indexed: 12/15/2022] Open
Abstract
Background The discordance of the low-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with alterative lipid parameters may explain the inconsistent association of CIMT with the LDL-C/HDL-C ratio. Therefore, this study aimed to explore the associations between LDL-C/HDL-C ratio discordance with alternative lipid parameters and elevated carotid intima-media thickness (CIMT) risk in a large cohort in Beijing, China. Methods In total, 13,612 adults who didn’t have elevated CIMT at baseline and who participated in at least one follow-up of annual examination between 2009 and 2016 were included in this cohort study. A multivariable Cox regression model was utilized to evaluate the associations of discordance of the LDL-C/HDL-C ratio with TC, TGs, LDL-C and HDL-C with elevated CIMT risk. Results During 37,999 person-years of follow-up, 2004 individuals (1274 men and 730 women) developed elevated CIMT. Among individuals with normal TC and TGs, 16.6 and 15.2% individuals had a discordantly high LDL-C/HDL-C ratio, respectively, and the risk of elevated CIMT increased by 1.54 (95% CI 1.33, 1.77) and 1.53 (95% CI 1.33, 1.76), respectively, comparing to individuals with a concordantly low LDL-C/HDL-C ratio. A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with LDL-C and HDL-C (P < 0.001). A low LDL-C/HDL-C ratio with discordantly normal HDL-C and high LDL-C (13.2% of individuals) had a 32% (HR = 1.32, 95% CI 1.11, 1.57) higher risk of elevated CIMT than concordantly low LDL-C and normal HDL-C. Sensitivity analysis by excluding CIMT developed in the first 2 years follow-up further confirmed the above results. Conclusions A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with TC, TGs, LDL-C and HDL-C Even a low LDL-C/HDL-C ratio with discordantly high LDL-C and normal HDL-C could also significantly increase CIMT risk. Individuals should maintain both the LDL-C/HDL-C ratio and LDL-C at normal levels to prevent elevated CIMT.
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Affiliation(s)
- Yanmei Lou
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, People's Republic of China
| | - Xue Li
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Liming Cao
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Pei Qin
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Jing Shi
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Yanyan Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Yashuang Zhao
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
| | - Ping Zhao
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, People's Republic of China.
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7
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Simonetto C, Heier M, Rospleszcz S, Meisinger C, Then C, Seißler J, Peters A, Kaiser JC. Risk for cardiovascular events responds nonlinearly to carotid intima-media thickness in the KORA F4 study. Atherosclerosis 2020; 296:32-39. [PMID: 32005003 DOI: 10.1016/j.atherosclerosis.2020.01.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/02/2019] [Accepted: 01/15/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Risk assessment studies on the impact of carotid intima-media thickness (CIMT) on cardiovascular events (CVEs) often apply a linear relationship in Cox models of proportional hazards. However, CVEs are mostly induced through rupture of plaques driven by nonlinear mechanical properties of the arterial wall. Hence, the risk response might be nonlinear as well and should be detectable in CVE incidence data when associated with CIMT as surrogate variable for atherosclerotic wall degeneration. METHODS To test this hypothesis, we investigate the KORA F4 study comprising 2580 participants with CIMT measurements and 153 first CVEs (86 strokes and 67 myocardial infarctions). CIMT is only a moderate predictor of CVE risk due to confounding by attained age. Biological evidence suggests that age-related CIMT growth is not entirely connected with atherosclerosis. To explore the complex relations between age, CIMT and CVE risk, we apply linear and nonlinear models of both CIMT and dnCIMT, defined as deviation from a sex and age-adjusted normal value. RESULTS Based on goodness-of-fit and biological plausibility, threshold and logistic step models clearly reveal nonlinear risk response relations for vascular covariables CIMT and dnCIMT. The effect is more pronounced for models involving dnCIMT as novel risk factor, which is not correlated with age. CONCLUSIONS Compared to the standard approach of risk assessment with linear models involving CIMT, the application of excess dnCIMT with nonlinear risk responses leads to a more precise identification of asymptomatic high risk patients, especially at younger age.
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Affiliation(s)
- Cristoforo Simonetto
- Helmholtz Zentrum München, Institute of Radiation Medicine, 85764, Oberschleißheim, Germany
| | - Margit Heier
- Helmholtz Zentrum München, Institute of Epidemiology, 85764, Oberschleißheim, Germany
| | - Susanne Rospleszcz
- Helmholtz Zentrum München, Institute of Epidemiology, 85764, Oberschleißheim, Germany
| | - Christa Meisinger
- Helmholtz Zentrum München, Institute of Epidemiology, 85764, Oberschleißheim, Germany; Chair of Epidemiology, Ludwig-Maximilians-University München, UNIKA-T Augsburg, Augsburg, Germany
| | - Cornelia Then
- Diabetes Centre, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany
| | - Jochen Seißler
- Diabetes Centre, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany
| | - Annette Peters
- Helmholtz Zentrum München, Institute of Epidemiology, 85764, Oberschleißheim, Germany; Chair of Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
| | - Jan Christian Kaiser
- Helmholtz Zentrum München, Institute of Radiation Medicine, 85764, Oberschleißheim, Germany.
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8
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Hou Q, Li S, Gao Y, Tian H. Relations of lipid parameters, other variables with carotid intima-media thickness and plaque in the general Chinese adults: an observational study. Lipids Health Dis 2018; 17:107. [PMID: 29747638 PMCID: PMC5944024 DOI: 10.1186/s12944-018-0758-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/24/2018] [Indexed: 02/05/2023] Open
Abstract
Background It has been reported that non-high-density lipoprotein cholesterol (non-HDL-C) and lipid ratios, including total cholesterol (TC) / high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) / HDL-C, are better predictors for atherosclerosis than conventional lipid profiles. However, there have been few studies comparing the predictive values of different lipid parameters for early atherosclerosis. The aim of this study was to determine the relevant factors of carotid intima-media thickness (IMT) and plaque in the general Chinese adults and analyze the predictive values of different lipid parameters for carotid IMT and plaque. Methods We collected the demographics, anthropometrics, and laboratory data of 311 Chinese adults without the diagnoses of acute myocardial infarction, stroke, heart failure, peripheral arterial disease, end-stage renal disease or malignant tumor. The carotid IMT and the presence of carotid plaque were evaluated by high-resolution color Doppler ultrasonography. Results Based on the cutoff level of 0.9 mm, the percentage of people with a thickened IMT was 8.4%. And the percentage of people with carotid plaque was 15.8%. Among the lipid parameters, the levels of TC, non-HDL-C and LDL-C were more closely related to carotid IMT and plaque compared with other lipid parameters in the univariate analyses. In multivariate analyses, age, gender and systolic blood pressure (SBP) remained significantly with carotid IMT, whereas age, gender, diastolic blood pressure (DBP) and the TC level remained significantly with carotid plaque. Non-HDL-C level remained significantly with carotid plaque after adjusting for age, gender, waist-hip ratio (WHR), smoking, drinking, SBP and fasting plasma glucose (FPG). Conclusions Age, gender, SBP are important predictors for carotid IMT. Age, gender, DBP and TC are important predictors for carotid plaque. TC, LDL-C and non-HDL-C have greater predictive values for IMT and the presence of carotid plaque compared with other lipid parameters, among which TC has the greatest predictive value for the presence of carotid plaque. The predictive value of non-HDL-C for carotid IMT and plaque is not inferior to that of LDL-C.
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Affiliation(s)
- Qingtao Hou
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yun Gao
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Kim D, Park W. The Inverse Relationship between Cardiorespiratory Fitness and Intima-Media Thickness with Prehypertensive Middle-Aged Women. TOHOKU J EXP MED 2017; 243:283-288. [PMID: 29238001 DOI: 10.1620/tjem.243.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Individuals with prehypertension have a greater risk of developing hypertension and cardiovascular disease than those with normal blood pressure. Good cardiorespiratory fitness has been associated with a reduced risk for cardiovascular diseases, but whether it is related to slower progression of early atherosclerosis is unclear. We evaluated 442 women, aged 40-60 years, with resting systolic blood pressure 120-139 mmHg and diastolic blood pressure 80-89 mmHg, defined as prehypertension in cross-sectional study. Blood glucose, blood lipids and carotid intima-media thickness (CIMT) were measured at rest. Cardiorespiratory fitness (VO2peak) was measured by respiratory gas exchange during a treadmill exercise test. Participants were divided into three cardiorespiratory fitness levels: low, moderate, and high. The prevalence of subclinical carotid atherosclerosis was defined as a mean carotid intima-media thickness greater than the 75th percentile. After adjustment for various confounders, a high cardiorespiratory fitness level was associated with significantly lower SBP, DBP and CIMT compared with low and moderate fitness (p < 0.05). After adjustment for established risk factors, high and moderate fitness were each associated with significantly lower odds ratios for carotid atherosclerosis 0.74 (95% CI 0.45-0.92) and 0.70 (95% CI 0.46-0.95), respectively, compared with low fitness. Our results indicate that good cardiorespiratory fitness is associated with a slower progression of early atherosclerosis in middle-aged women. These findings are important, because they emphasize that middle-aged women can be evaluated for cardiorespiratory fitness to estimate their future risk for atherosclerotic vascular diseases.
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Affiliation(s)
- Dokyung Kim
- Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Wonhah Park
- Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
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Brolin EB, Agewall S, Brismar TB, Caidahl K, Tornvall P, Cederlund K. Neither endothelial function nor carotid artery intima-media thickness predicts coronary computed tomography angiography plaque burden in clinically healthy subjects: a cross-sectional study. BMC Cardiovasc Disord 2015; 15:63. [PMID: 26148508 PMCID: PMC4494716 DOI: 10.1186/s12872-015-0061-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/29/2015] [Indexed: 12/03/2022] Open
Abstract
Background Cardiovascular risk assessment is usually based on traditional risk factors and risk assessment algorithms. However, a number of risk markers that might provide additional predictive power have been identified. Endothelial function determined by digital reactive hyperemia peripheral arterial tonometry (RH-PAT) and carotid artery intima-media thickness (IMT) have both been proposed as surrogate markers for coronary artery disease (CAD). We aimed to examine the ability of RH-PAT and IMT to predict coronary computed tomography angiography (CTA) plaque burden in clinically healthy subjects. Methods Fifty-eight clinically healthy volunteers (50–73 years old) underwent testing for RH-PAT and IMT as well as coronary CTA, including coronary artery calcium (CAC) scoring. Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic. The Mann–Whitney U-test was used to compare the groups with and without CAD and the Spearman test was used to test for correlation between variables. Results Twenty-five (43 %) subjects had normal coronary arteries, without any signs of atherosclerosis. The median (range) number of diseased segments was 1 (0–10), RH-PAT index 2.2 (1.4-4.9), IMT 0.70 (0.49-0.99) mm and CAC 4 (0–1882). There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098). As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001). Conclusions Neither evaluation of endothelial function by RH-PAT nor assessment of carotid artery IMT can reliably be used to predict coronary CTA plaque burden in clinically healthy subjects.
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Affiliation(s)
- Elin B Brolin
- Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. .,Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden.
| | - Stefan Agewall
- Department of Cardiology, Oslo University Hospital Ullevål; Institute of Clinical Sciences, University of Oslo, Oslo, Norway.
| | - Torkel B Brismar
- Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. .,Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden.
| | - Kenneth Caidahl
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden. .,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Per Tornvall
- Institution for Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
| | - Kerstin Cederlund
- Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. .,Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden.
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Perez L, Wolf K, Hennig F, Penell J, Basagaña X, Foraster M, Aguilera I, Agis D, Beelen R, Brunekreef B, Cyrys J, Fuks KB, Adam M, Baldassarre D, Cirach M, Elosua R, Dratva J, Hampel R, Koenig W, Marrugat J, de Faire U, Pershagen G, Probst-Hensch NM, de Nazelle A, Nieuwenhuijsen MJ, Rathmann W, Rivera M, Seissler J, Schindler C, Thiery J, Hoffmann B, Peters A, Künzli N. Air pollution and atherosclerosis: a cross-sectional analysis of four European cohort studies in the ESCAPE study. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:597-605. [PMID: 25625785 PMCID: PMC4455580 DOI: 10.1289/ehp.1307711] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 01/26/2015] [Indexed: 05/05/2023]
Abstract
BACKGROUND In four European cohorts, we investigated the cross-sectional association between long-term exposure to air pollution and intima-media thickness of the common carotid artery (CIMT), a preclinical marker of atherosclerosis. METHODS Individually assigned levels of nitrogen dioxide, nitrogen oxides, particulate matter ≤ 2.5 μm (PM2.5), absorbance of PM2.5 (PM2.5abs), PM10, PMcoarse, and two indicators of residential proximity to highly trafficked roads were obtained under a standard exposure protocol (European Study of Cohorts for Air Pollution Effects-ESCAPE study) in the Stockholm area (Sweden), the Ausburg and Ruhr area (Germany), and the Girona area (Spain). We used linear regression and meta-analyses to examine the association between long-term exposure to air pollution and CIMT. RESULTS The meta-analysis with 9,183 individuals resulted in an estimated increase in CIMT (geometric mean) of 0.72% (95% CI: -0.65%, 2.10%) per 5-μg/m3 increase in PM2.5 and 0.42% (95% CI: -0.46%, 1.30%) per 10-5/m increase in PM2.5abs. Living in proximity to high traffic was also positively but not significantly associated with CIMT. Meta-analytic estimates for other pollutants were inconsistent. Results were similar across different adjustment sets and sensitivity analyses. In an extended meta-analysis for PM2.5 with three other previously published studies, a 0.78% (95% CI: -0.18%, 1.75%) increase in CIMT was estimated for a 5-μg/m3 contrast in PM2.5. CONCLUSIONS Using a standardized exposure and analytical protocol in four European cohorts, we found that cross-sectional associations between CIMT and the eight ESCAPE markers of long-term residential air pollution exposure did not reach statistical significance. The additional meta-analysis of CIMT and PM2.5 across all published studies also was positive but not significant.
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Affiliation(s)
- Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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12
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Gronewold J, Bauer M, Lehmann N, Mahabadi AA, Kälsch H, Weimar C, Berger K, Moebus S, Jöckel KH, Erbel R, Hermann DM. Coronary artery calcification, intima-media thickness, and ankle-brachial index are complementary stroke predictors. Stroke 2014; 45:2702-9. [PMID: 25116876 DOI: 10.1161/strokeaha.114.005626] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Coronary artery calcification (CAC), a marker of coronary atherosclerosis, predicts stroke in addition to established risk factors. Whether CAC's predictive value can be improved by peripheral atherosclerosis markers, namely carotid intima-media thickness (CIMT) and ankle-brachial index (ABI), was unknown. METHODS A total of 3289 participants of the population-based Heinz Nixdorf Recall study (45-75 years; 48.8% men) without previous stroke or coronary heart disease were evaluated for incident stroke for 9.0±1.9 years. CAC, CIMT, and ABI were examined as stroke predictors. RESULTS Eighty-four strokes occurred during follow-up. In multivariable Cox proportional hazard regressions, CAC (hazard ratio, 1.45 [95% confidence interval, 1.11-1.88] per SD increase in ln(CAC+1); SD, 2.40), CIMT (1.34 [1.08-1.66] per SD increase; SD, 0.127 mm), and ABI (1.55 [1.32-1.82] per SD decrease; SD, 0.148) were associated with stroke in addition to established risk factors. When combined with each other, ln(CAC+1)'s hazard ratio remained similar when CIMT (1.41 [1.09-1.83]) was inserted into the multivariable model, but slightly decreased when ABI (1.31 [1.01-1.72]) or CIMT and ABI (1.29 [0.99-1.68]) were included. Although CAC alone did not significantly elevate the area under the curve in Harrell's c-statistics (by 0.009; P=0.379) in addition to established risk factors, the combination of CAC and ABI increased area under the curve (by 0.029; P=0.047), as did ABI (by 0.025; P=0.038) but not CIMT (by 0.002; P=0.795) alone. The combination of CAC and ABI also resulted in significant category-free net reclassification and integrated discrimination improvement. CONCLUSIONS CAC, CIMT, and ABI provide complementary information about stroke risk. ABI, which is distinctive in a small subpopulation, had the highest and CIMT, which is distributed across a larger range of values, had the lowest predictive value.
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Affiliation(s)
- Janine Gronewold
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Marcus Bauer
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Nils Lehmann
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Amir A Mahabadi
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Hagen Kälsch
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Christian Weimar
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Klaus Berger
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Susanne Moebus
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Karl-Heinz Jöckel
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Raimund Erbel
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.)
| | - Dirk M Hermann
- From the Departments of Neurology (J.G., C.W., D.M.H.) and Cardiology (M.B., A.A.M., H.K., R.E.), University Hospital Essen, Essen, Germany; Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany (N.L., S.M., K.-H.J.); and Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (K.B.).
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DeFina L, Radford N, Leonard D, Gibbons L, Khera A. Cardiorespiratory fitness and coronary artery calcification in women. Atherosclerosis 2014; 233:648-653. [DOI: 10.1016/j.atherosclerosis.2014.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/11/2013] [Accepted: 01/05/2014] [Indexed: 11/28/2022]
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Sinning C, Kieback A, Wild PS, Schnabel RB, Ojeda F, Appelbaum S, Zeller T, Lubos E, Schwedhelm E, Lackner KJ, Debus ES, Munzel T, Blankenberg S, Espinola-Klein C. Association of multiple biomarkers and classical risk factors with early carotid atherosclerosis: results from the Gutenberg Health Study. Clin Res Cardiol 2014; 103:477-85. [PMID: 24488175 DOI: 10.1007/s00392-014-0674-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 01/21/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND In the Gutenberg Health Study, a random sample of the population was scanned with vascular ultrasound for early atherosclerosis. A continuous classical risk marker model (waist circumference, HbA1c, LDL/HDL ratio, pack years and pulse pressure) was compared to a model of modern biomarkers (C-reactive protein, troponin I, N-terminal pro B-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin, and asymmetric dimethylarginine) with regard to the ability of ruling out abnormal intima-media thickness (IMT), respectively, carotid plaques. METHODS Data of the first consecutive 5,000 participants (aged 35-74 years; 2,540 men, 2,460 women) were analyzed. IMT was measured at both common carotid arteries using an edge detection system. Plaques were defined as protrusion of ≥1.5 mm in common, internal and external carotid artery. RESULTS For classical risk factors, in comparison to a model of six modern biomarkers, regarding the variable (a) IMT>0.85 mm negative and positive predictive value (NPV and PPV) were 0.98 and 0.16 for both the classical risk factor model and the biomarker model. The second variable (b) presence of plaque could be ruled out with an NPV of 0.84 and identified with a PPV of 0.61 for classical risk factors, and 0.84 and 0.58 for biomarkers, respectively. Values were calculated using logistic regression analysis. CONCLUSION Classical risk factors allow ruling out pathologic IMT and presence of carotid plaques in a population of primary prevention in a reliable way. Modern biomarkers performed almost equally well but did not provide further information.
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Affiliation(s)
- Christoph Sinning
- University Hospital Hamburg-Eppendorf, University Heart Center Hamburg, Hamburg, Germany,
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Relationship Between Carotid Disease on Ultrasound and Coronary Disease on CT Angiography. JACC Cardiovasc Imaging 2013; 6:1160-7. [DOI: 10.1016/j.jcmg.2013.06.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 05/31/2013] [Accepted: 06/28/2013] [Indexed: 11/23/2022]
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ZHAO QIAN, WU XINHUAI, CAI JIANMING, ZHAO XIHAI, ZHAO SHAOHONG, YANG LI, CAI ZULONG. Association between coronary artery calcium score and carotid atherosclerotic disease. Mol Med Rep 2013; 8:499-504. [DOI: 10.3892/mmr.2013.1521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/22/2013] [Indexed: 11/06/2022] Open
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Bauer M, Delaney JAC, Möhlenkamp S, Jöckel KH, Kronmal RA, Lehmann N, Mukamal KJ, Moebus S, Polak JF, Dragano N, Budoff MJ, Erbel R, McClelland RL. Comparison of factors associated with carotid intima-media thickness in the Multi-ethnic Study of Atherosclerosis (MESA) and the Heinz Nixdorf Recall Study (HNR). J Am Soc Echocardiogr 2013; 26:667-73. [PMID: 23611058 PMCID: PMC3694173 DOI: 10.1016/j.echo.2013.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND The measurement of carotid intima-media thickness (CIMT) is a valid method to quantify levels of atherosclerosis. The present study was conducted to compare the strengths of associations between CIMT and cardiovascular risk factors in two different populations. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) and the Heinz Nixdorf Recall Study (HNR) are two population-based prospective cohort studies of subclinical cardiovascular disease. All Caucasian subjects aged 45 to 75 years from these cohorts who were free of baseline cardiovascular disease (n = 2,820 in HNR, n = 2,270 in MESA) were combined. CIMT images were obtained using B-mode sonography at the right and left common carotid artery and measured 1 cm starting from the bulb. RESULTS In both studies, age, male sex, and systolic blood pressure showed the strongest association (P < .0001 for each) for a higher CIMT. The mean of mean far wall CIMT was slightly higher in MESA participants (0.71 vs 0.67 mm). Almost all significant variables were consistent between the two cohorts in both magnitude of association with CIMT and statistical significance, including age, sex, smoking, diabetes, cholesterol levels, and blood pressure. For example, the association with systolic blood pressure was (ΔSD = 0.011; 95% confidence interval, 0.0009 to 0.014) per mm Hg in MESA and (ΔSD = 0.010; 95% confidence interval, 0.005 to 0.021) per mm Hg in HNR. This consistency persisted throughout the traditional (Framingham) risk factors. CONCLUSIONS A comparison of the associations between traditional cardiovascular risk factors and CIMT across two culturally diverse populations showed remarkable consistency.
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Affiliation(s)
- Marcus Bauer
- Department of Cardiology, University of Duisburg-Essen, Essen, Germany
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Bauer M, Hoffmann B, Möhlenkamp S, Lehmann N, Moebus S, Roggenbuck U, Berg C, Kälsch H, Mahabadi AA, Kara K, Jöckel KH, Erbel R. [Distribution of carotid intima media thickness in men and women with and without coronary heart disease. Cross-sectional data of the Heinz Nixdorf Recall Study]. Herz 2012. [PMID: 23179052 DOI: 10.1007/s00059-012-3718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to introduce population-based sex and age-stratified distributions of carotid intima media thickness (CIMT), to compare fixed cut-off and percentile values for subjects with and without known coronary heart disease (CHD) and to describe CIMT percentiles. METHODS Between 2000 and 2003, a total of 4,814 subjects aged 45-75 years were recruited into the Heinz Nixdorf recall study (HNR). Ultrasound examination of extracranial arteries was performed and the CIMT was measured manually over a distance of 1 cm proximal to the bulb in the common carotid artery (CCA). Both sides were measured and the average of the right and left artery were calculated (mean CIMT). RESULTS The CIMT was measured for 1,749 men and 1,802 women without prevalent CHD and 177 men and 50 women with prevalent CHD. Mean CIMT values were higher in men compared to women (men 0.71 ± 0.14 mm vs. women 0.65 ± 0.11 mm, p ≤ 0.0001) and in subjects with CHD compared to those without (men with and without CHD: 0.76 ± 0.14 mm and 0.70 ± 0.14 mm, p ≤ 0.0001, respectively; women with and without CHD: 0.73 ± 0.15 mm and 0.64 ± 0.11 mm, p ≤ 0.0001, respectively). In men the mean CIMT increased from 0.62 ± 0.10 mm in the youngest (45-49 years old) up to 0.79 ± 0.13 mm in the highest age group (≥ 70 years) (0.57 ± 0.08 mm up to 0.71 ± 0.12 mm in women, p ≤ 0.0001 for both). CONCLUSIONS Compared to international studies similar CIMT distributions were found in this study using both continuous and percentile distributions. However, lower CIMT values were observed in older participants, which can be explained by exclusion of carotid plaque formation in CIMT measurements.
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Affiliation(s)
- M Bauer
- Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstrasse 55, Essen, Germany.
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Non-invasive assessments reveal that more than half of randomly selected middle-aged individuals have evidence of subclinical atherosclerosis: a DanRisk substudy. Int J Cardiovasc Imaging 2012; 29:301-8. [DOI: 10.1007/s10554-012-0091-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/27/2012] [Indexed: 01/07/2023]
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Hermann DM, Gronewold J, Lehmann N, Seidel UK, Möhlenkamp S, Weimar C, Kälsch H, Moebus S, Jöckel KH, Erbel R, Bauer M. Intima-media thickness predicts stroke risk in the Heinz Nixdorf Recall study in association with vascular risk factors, age and gender. Atherosclerosis 2012; 224:84-9. [PMID: 22809448 DOI: 10.1016/j.atherosclerosis.2012.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 04/16/2012] [Accepted: 06/13/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Individual risk stratification requires reliable information on preexisting vascular disease. The intima-media thickness of the common carotid artery (CIMT) is a non-invasively accessible marker of atherosclerosis, which can be used for risk evaluation. METHODS In a sample of 3669 initially stroke-free subjects aged 45-75 years belonging to the population-based Heinz Nixdorf Recall cohort, the predictive value of CIMT for incident stroke was evaluated over 85.3 ± 17.4 months in addition to established risk factors. RESULTS In a multivariable Cox regression analysis with traditional cardiovascular risk factors including age, gender, systolic blood pressure, LDL and HDL, diabetes, body mass index, smoking and CIMT, CIMT was a moderate stroke predictor (hazard ratio = 1.20 per 0.1 mm, 95% confidence interval = 1.01-1.44; p = 0.043), additional to e.g. age (1.46 per 5 years, 1.21-1.75; p < 0.001), systolic blood pressure (1.16 per 10 mm Hg, 1.04-1.30; p = 0.008) and current smoking (1.93, 1.12-3.31; p = 0.014). CIMT was associated with stroke risk in subjects above but not below 65 years. CIMT predicted stroke events in men, but not women. CIMT discriminated stroke incidence specifically in subjects belonging to the highest Framingham risk score tercile. CONCLUSIONS CIMT is a moderate independent stroke predictor, which discriminates stroke incidence in subjects at high vascular risk.
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Affiliation(s)
- Dirk M Hermann
- Department of Neurology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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Lambrechtsen J, Gerke O, Egstrup K, Sand NP, Nørgaard BL, Petersen H, Mickley H, Diederichsen ACP. The relation between coronary artery calcification in asymptomatic subjects and both traditional risk factors and living in the city centre: a DanRisk substudy. J Intern Med 2012; 271:444-50. [PMID: 22092933 DOI: 10.1111/j.1365-2796.2011.02486.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate the association between the risk factor for living in the city centre as a surrogate for air pollution and the presence of coronary artery calcification (CAC) in a population of asymptomatic Danish subjects. DESIGN AND SUBJECTS A random sample of 1825 men and women of either 50 or 60 years of age were invited to take part in a screening project designed to assess risk factors for cardiovascular disease (CVD). Noncontrast cardiac computed tomography was performed on all subjects, and their Agatston scores were calculated to evaluate the presence of subclinical coronary atherosclerosis. The relationship between CAC and several demographic and clinical parameters was evaluated using multivariate logistic regression. RESULTS A total of 1225 individuals participated in the study, of whom 250 (20%) were living in the centres of major Danish cities. Gender and age showed the greatest association with the presence of CAC: the odds ratio (OR) for men compared with women was 3.2 [95% confidence interval (CI) 2.5-4.2; P < 0.0001], and the OR for subjects aged 60 versus those aged 50 years was 2.2 (95% CI 1.7-2.8; P < 0.0001). Other variables independently associated with the presence of CAC were diabetes and smoking with ORs of 2.0 (95% CI 1.1-3.5; P = 0.03) and 1.9 (95% CI 1.4-2.5, P < 0.0001), respectively. The adjusted OR for subjects living in city centres compared to those living outside was 1.8 (95% CI 1.3-2.4; P = 0.0003). CONCLUSION Both conventional risk factors for CVD and living in a city centre are independently associated with the presence of CAC in asymptomatic middle-aged subjects.
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Affiliation(s)
- J Lambrechtsen
- Department of Cardiology, Svendborg Hospital, Svendborg.
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Salem S, Bruck H, Bahlmann FH, Peter M, Passlick-Deetjen J, Kretschmer A, Steppan S, Volsek M, Kribben A, Nierhaus M, Jankowski V, Zidek W, Jankowski J. Relationship between magnesium and clinical biomarkers on inhibition of vascular calcification. Am J Nephrol 2012; 35:31-9. [PMID: 22179063 DOI: 10.1159/000334742] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 10/29/2011] [Indexed: 01/24/2023]
Abstract
BACKGROUND Arteriosclerosis and cardiovascular disease are strongly associated with vascular calcification. Hyperphosphatemia is an essential risk factor for increased vascular calcification. End-stage renal disease (ESRD) patients could serve as an in vivo model for accelerated calcification. This study focuses on the most likely protective effects of magnesium ion (Mg(2+)) on phosphate-induced vascular calcification ex vivo/in vitro. Furthermore, plasma Mg(2+) concentrations of ESRD and healthy controls were investigated for association with surrogate parameters of vascular calcification in vivo. METHODS Aortic segments of male Wistar-Kyoto rats were incubated and the phosphate concentration of the medium was elevated. The aortic segments were incubated in the absence and presence of MgCl(2); tissue calcification was quantified by different methods. Serum Mg(2+) concentrations of patients with chronic kidney disease (CKD stage 5; ESRD) and patients without CKD (controls) were associated with carotid intima media thickness (IMT) and aortic pulse wave velocity (PWV) as surrogate parameter for arteriosclerosis and arterial stiffening. RESULTS Incubation of aortic segments in the presence of β-glycerophosphate and NaH(2)PO(4) caused an increased tissue Ca(2+) deposition compared to control conditions. This increased amount of Ca(2+) in the aortic rings was significantly decreased in the presence of Mg(2+). In CKD patients, but not in controls, magnesium serum concentration was associated with the IMT of the carotid arteries. In addition, CKD patients with higher magnesium serum concentration had a significantly lower PWV. DISCUSSION AND CONCLUSION Elevated phosphate concentrations in the culture media induce ex vivo/in vitro medial calcification in intact rat aortic rings in the presence of alkaline phosphatase. Mg(2+) ions reduced ex vivo/in vitro vascular calcification despite increased phosphate concentration. This hypothesis is additionally based on the fact that CKD patients with high Mg(2) serum levels had significantly lower IMT and PWV values, which may result in a lower risk for cardiovascular events and mortality in these patients. Therefore, Mg(2+) supplementation may be an option for treatment and prevention of vascular calcification resulting in a reduction of cardiovascular events in CKD patients.
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Affiliation(s)
- Silvia Salem
- Charité, Medical Clinic IV, University of Berlin, Germany
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KRÖGER KNUT, LEHMANN NILS, RAPPAPORT LISA, PERREY MAREIKE, SOROKIN ALEXEY, BUDDE THOMAS, HEUSCH GERD, JÖCKEL KARLHEINZ, THOMPSON PAULD, ERBEL RAIMUND, MÖHLENKAMP STEFAN. Carotid and Peripheral Atherosclerosis in Male Marathon Runners. Med Sci Sports Exerc 2011; 43:1142-7. [DOI: 10.1249/mss.0b013e3182098a51] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sinning C, Wild PS, Echevarria FMO, Wilde S, Schnabel R, Lubos E, Herkenhoff S, Bickel C, Klimpe S, Gori T, Münzel TF, Blankenberg S, Espinola-Klein C. Sex differences in early carotid atherosclerosis (from the community-based Gutenberg-Heart Study). Am J Cardiol 2011; 107:1841-7. [PMID: 21481827 DOI: 10.1016/j.amjcard.2011.02.318] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 02/07/2011] [Accepted: 02/07/2011] [Indexed: 01/09/2023]
Abstract
The objectives of this study were to describe gender differences in intima-media thickness (IMT) in a community-based population study and to define normal IMT values for healthy men and women. In total, 4,814 participants (aged 35 to 74 years; 2,433 men, 2,381 women) from the Gutenberg-Heart Study (GHS) were included. IMT was measured at both common carotid arteries using an edge detection system. Median IMT was 0.62 mm (25th percentile 0.55, 75th percentile 0.70) in women and 0.65 mm (25th percentile 0.57, 75th percentile 0.75) in men and was significantly associated with age (p <0.0001). On multivariate analysis, advanced age, smoking, and arterial hypertension were positively associated with higher IMT in men and women. A subgroup of 1,025 subjects without cardiovascular risk factors or previous cardiovascular disease was analyzed to define normal IMT values. Nomograms were calculated according to age and gender. For each age group, IMT >95th percentile was defined as abnormal. In this subgroup, gender differences in IMT became nonsignificant at older ages. At the age of 35 years, IMT was 0.71 mm in men and 0.61 mm in women at the 95th percentile. In comparison, at the age of 74 years, IMT at the 95th percentile was 0.90 mm in men and 0.89 mm in women. In conclusion, men had higher carotid IMT than women, but predictors of early carotid atherosclerosis were similar across genders. In young subjects without cardiovascular risk factors, normal values for IMT were lower in women compared with men. In contrast, in older subjects, gender differences in IMT became nonsignificant.
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Affiliation(s)
- Christoph Sinning
- Department of Medicine 2, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Guimarães Henriques JC, Kreich EM, Helena Baldani M, Luciano M, Cezar de Melo Castilho J, Cesar de Moraes L. Panoramic radiography in the diagnosis of carotid artery atheromas and the associated risk factors. Open Dent J 2011; 5:79-83. [PMID: 21760860 PMCID: PMC3134975 DOI: 10.2174/1874210601105010079] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 02/08/2011] [Accepted: 02/21/2011] [Indexed: 11/22/2022] Open
Abstract
Atherosclerosis is a serious chronic disease, responsible for thousands of deaths worldwide and is characterized by thickening and loss of elasticity of the arterial walls, associated with the presence of atheromatous plaques. Various risk factors act directly on predisposition to the disease, among which the following are pointed out: diabetes mellitus, arterial hypertension and inadequate diet and eating habits. More recent researches have elucidated new risk factors acting in the development of this disease, such as, for example: periodontitis, chronic renal disease and menopause. The panoramic radiograph, commonly used in dental practice, makes it possible to see calcified atherosclerotic plaques that are eventually deposited in the carotid arteries. The aim of this review article was to emphasize the dentist’s important role in the detection of carotid artery atheromas in panoramic radiographs and the immediate referral of patients affected by these calcifications to doctors. In addition, the study intended to guide the dentist, especially the dental radiologist, with regard to differential diagnosis, which should be made taking into consideration particularly the triticeal cartilage when it is calcified.
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Bauer M, Moebus S, Möhlenkamp S, Dragano N, Nonnemacher M, Fuchsluger M, Kessler C, Jakobs H, Memmesheimer M, Erbel R, Jöckel KH, Hoffmann B. Urban particulate matter air pollution is associated with subclinical atherosclerosis: results from the HNR (Heinz Nixdorf Recall) study. J Am Coll Cardiol 2011; 56:1803-8. [PMID: 21087707 DOI: 10.1016/j.jacc.2010.04.065] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 04/07/2010] [Accepted: 04/12/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association of long-term residential exposure to fine particles with carotid intima-media thickness (CIMT). BACKGROUND Experimental and epidemiological evidence suggest that long-term exposure to air pollution might have a causal role in atherogenesis, but epidemiological findings are still inconsistent. We investigate whether urban particulate matter (PM) air pollution is associated with CIMT, a marker of subclinical atherosclerosis. METHODS We used baseline data (2000 to 2003) from the HNR (Heinz Nixdorf Recall) study, a population-based cohort of 4,814 participants, 45 to 75 years of age. We assessed residential long-term exposure to PM with a chemistry transport model and measured distance to high traffic. Multiple linear regression was used to estimate associations of air pollutants and traffic with CIMT, adjusting for each other, city of residence, age, sex, diabetes, and lifestyle variables. RESULTS Median CIMT of the 3,380 analyzed participants was 0.66 mm (interquartile range 0.16 mm). An interdecile range increase in PM(2.5) (4.2 μg/m(3)), PM(10) (6.7 μg/m(3)), and distance to high traffic (1,939 m) was associated with a 4.3% (95% confidence interval [CI]: 1.9% to 6.7%), 1.7% (95% CI: -0.7% to 4.1%), and 1.2% (95% CI: -0.2% to 2.6%) increase in CIMT, respectively. CONCLUSIONS Our study shows a clear association of long-term exposure to PM(2.5) with atherosclerosis. This finding strengthens the hypothesized role of PM(2.5) as a risk factor for atherogenesis.
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Affiliation(s)
- Marcus Bauer
- Department of Cardiology, West German Heart Center Essen, University Hospital, University of Duisburg-Essen, Essen, Germany
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van Dijk R, Virmani R, von der Thüsen J, Schaapherder A, Lindeman J. The natural history of aortic atherosclerosis: A systematic histopathological evaluation of the peri-renal region. Atherosclerosis 2010; 210:100-6. [DOI: 10.1016/j.atherosclerosis.2009.11.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 10/30/2009] [Accepted: 11/10/2009] [Indexed: 11/29/2022]
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Davis PH, Dawson JD, Blecha MB, Mastbergen RK, Sonka M. Measurement of aortic intimal-medial thickness in adolescents and young adults. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:560-565. [PMID: 20350682 PMCID: PMC2851193 DOI: 10.1016/j.ultrasmedbio.2010.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 12/21/2009] [Accepted: 01/13/2010] [Indexed: 05/29/2023]
Abstract
Atherosclerosis begins in childhood in the distal abdominal aorta and later involves the carotid arteries. Noninvasive screening to detect these lesions may allow early intervention. Ultrasound images of the distal 10 mm of the aorta were obtained after an 8-h fast and were analyzed by an automated program to determine the mean far wall intimal-medial thickness (IMT). The results were compared with the mean carotid IMT obtained concurrently. The mean age of the 313 males and 322 females imaged was 20.4 years (SD 5.6) and 61 participants had a second study to assess reproducibility. The mean aortic IMT was 0.63 mm (SD 0.14) for males and 0.61 mm (SD 0.13) for females while the mean carotid IMT was 0.50 (SD 0.04) mm and 0.49 (SD 0.04) mm, respectively. Images were analyzed in 95% of participants. Intra-subject reproducibility for the mean aortic IMT had a coefficient of variation of 18% with a mean absolute difference of 0.12 mm (SD 0.10). For carotid IMT, the results were 3% and 0.02 mm (SD 0.01), respectively. Aortic IMT can be measured in normal adolescents and young adults with low rates of missing data and reasonable reproducibility. Aortic IMT increased with age at a greater rate than carotid IMT.
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Affiliation(s)
- Patricia H Davis
- Department of Neurology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
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Clinical prediction of obstructive coronary disease in patients referred for coronary CTA: "low-hanging fruit" or still a "risky business"? J Cardiovasc Comput Tomogr 2010; 3:392-3. [PMID: 20083059 DOI: 10.1016/j.jcct.2009.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 11/11/2009] [Indexed: 11/22/2022]
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Busnelli M, Froio A, Bacci ML, Giunti M, Cerrito MG, Giovannoni R, Forni M, Gentilini F, Scagliarini A, Deleo G, Benatti C, Leone BE, Biasi GM, Lavitrano M. Pathogenetic role of hypercholesterolemia in a novel preclinical model of vascular injury in pigs. Atherosclerosis 2009; 207:384-90. [DOI: 10.1016/j.atherosclerosis.2009.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 05/05/2009] [Accepted: 05/16/2009] [Indexed: 01/17/2023]
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De Meyer T, Rietzschel ER, De Buyzere ML, Langlois MR, De Bacquer D, Segers P, Van Damme P, De Backer GG, Van Oostveldt P, Van Criekinge W, Gillebert TC, Bekaert S. Systemic telomere length and preclinical atherosclerosis: the Asklepios Study. Eur Heart J 2009; 30:3074-81. [DOI: 10.1093/eurheartj/ehp324] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hotline update of clinical trials and registries presented at the German Cardiac Society Meeting 2009. Clin Res Cardiol 2009; 98:413-9. [PMID: 19468779 PMCID: PMC3085771 DOI: 10.1007/s00392-009-0027-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 04/28/2009] [Indexed: 12/03/2022]
Abstract
This review article gives an overview on a number of novel clinical trials and registries in the field of cardiovascular medicine. Key presentations made at the 75th annual meeting of the German Cardiac Society, held in Mannheim, Germany, in April 2009 are reported. The data were presented by leading experts in the field with relevant positions in the trials and registries. These comprehensive summaries should provide the readers with the most recent data on diagnostic and therapeutic developments in cardiovascular medicine similar as previously reported (Rosenkranz et al. in Clin Res Cardiol 96:457–468, 9; Maier et al. in Clin Res Cardiol 97:356–363, 3).
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