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Reyes-Barrera J, Antonio-Villa NE, Posadas-Sánchez R, Vargas-Alarcón G, Medina-Urrutia AX. The dysfunctional adiposity index is a clinical surrogate of pericardial fat in adults without premature CVD: A sub-analysis of the GEA Mexican study control group. Nutr Metab Cardiovasc Dis 2024; 34:2002-2011. [PMID: 38664129 DOI: 10.1016/j.numecd.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/02/2024] [Accepted: 03/15/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND AND AIM The Dysfunctional Adiposity Index (DAI) is a clinical surrogate for evaluating adipose tissue functionality and cardiometabolic health. However, its association with Pericardial Fat Volume (PFV) has not been tested. The aim of this study was to evaluate DAI- PFV association, stratified by type 2 diabetes (T2D) status, and identify DAI thresholds for detecting increased PFV among patients without premature CVD. METHODS AND RESULTS Participants from the GEA-Mexican study underwent a computed tomography scan to measure PFV. Adjusted logistic regression analyses tested the association between DAI and PFV. AUROC curves evaluated DAI's ability to identify elevated PFV (≥57.57 cm³), and the Youden method determined DAI thresholds, along with diagnostic metrics. The study analyzed 997 participants (women: 55%; mean age: 54 ± 9 years; median PFV: 42 cm³ [IQR: 29-58]), with a 13% prevalence of T2D. DAI was positively associated with elevated PFV (OR: 1.33, 95% CI: 1.07-1.70), which was more pronounced among subjects with T2D (OR: 3.01, 95% CI: 1.41-6.40). DAI thresholds were established for all participants (>1.176), individuals without T2D (>1.003), and with T2D (>1.936), yielding sensitivities of 71%, 81%, and 57%, and specificities of 48%, 38%, and 75%, respectively. The adjusted logistic regression tied DAI thresholds to a 1.68-fold elevation in PFV for all, 2.06-fold for those without T2D, and 6.81-fold for those with T2D. CONCLUSION DAI was positively associated with increased PFV, particularly among participants with T2D. Established DAI thresholds demonstrated good diagnostic values for detecting increased PFV. DAI could serve as an accessible marker to identify PF in clinical settings.
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Affiliation(s)
- Juan Reyes-Barrera
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Ciudad de México, Mexico; Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | | | - Gilberto Vargas-Alarcón
- Department of Molecular Biology and Research Direction, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Aida X Medina-Urrutia
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
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Berkman AM, Andersen CR, Landstrom AP, Hildebrandt MAT, Gilchrist SC, Roth ME. Cardiovascular Disease in Childhood, Adolescent, and Young Adult Cancer Survivors: The Impact of Family History of Premature Heart Disease. J Adolesc Young Adult Oncol 2024; 13:548-556. [PMID: 38261412 DOI: 10.1089/jayao.2023.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Purpose: Childhood, adolescent, and young adult (CAYA) cancer survivors (age 0-39 years at diagnosis) are at increased risk of cardiovascular disease (CVD). Family history of early heart disease increases the risk of CVD in the general population; however, it is unknown whether this association is seen in CAYA cancer survivors. Methods: Self-report data from the National Health and Nutrition Examination Survey (2005-2018) were used to identify CAYA survivors (>5 years post-diagnosis). The risk of CVD based on family history status (parent or sibling with a diagnosis of heart attack or angina before age 50 years), personal sociodemographic factors, personal medical history factors, and personal behavioral risk factors was determined using logistic regression models. Results: Included were 95 CAYA survivors with CVD and 491 CAYA survivors without CVD. The odds of CVD were significantly higher in survivors with a first-degree family history of early heart disease (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.14-3.74). A history of diabetes (OR: 2.61, 95% CI: 1.41-4.84), hypertension (OR: 1.81, 95% CI: 1.04-3.16), and any smoking (OR: 2.19, 95% CI: 1.19-4.02) was also associated with higher odds of CVD in CAYA survivors. Reporting any physical activity in the past month was associated with lower odds (OR: 0.54, 95% CI: 0.30-0.97) of CVD. Conclusions: Family history of early heart disease was associated with increased odds of CVD in CAYA cancer survivors. Obtaining complete and accurate family history information is important both at time of diagnosis and throughout follow-up.
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Affiliation(s)
- Amy M Berkman
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Andrew P Landstrom
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Cell Biology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Michelle A T Hildebrandt
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention and Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael E Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Tannemann N, Erbel R, Nöthen MM, Jöckel KH, Pechlivanis S. Genetic polymorphisms affecting telomere length and their association with cardiovascular disease in the Heinz-Nixdorf-Recall study. PLoS One 2024; 19:e0303357. [PMID: 38743757 PMCID: PMC11093374 DOI: 10.1371/journal.pone.0303357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
Short telomeres are associated with cardiovascular disease (CVD). We aimed to investigate, if genetically determined telomere-length effects CVD-risk in the Heinz-Nixdorf-Recall study (HNRS) population. We selected 14 single-nucleotide polymorphisms (SNPs) associated with telomere-length (p<10-8) from the literature and after exclusion 9 SNPs were included in the analyses. Additionally, a genetic risk score (GRS) using these 9 SNPs was calculated. Incident CVD was defined as fatal and non-fatal myocardial infarction, stroke, and coronary death. We included 3874 HNRS participants with available genetic data and had no known history of CVD at baseline. Cox proportional-hazards regression was used to test the association between the SNPs/GRS and incident CVD-risk adjusting for common CVD risk-factors. The analyses were further stratified by CVD risk-factors. During follow-up (12.1±4.31 years), 466 participants experienced CVD-events. No association between SNPs/GRS and CVD was observed in the adjusted analyses. However, the GRS, rs10936599, rs2487999 and rs8105767 increase the CVD-risk in current smoker. Few SNPs (rs10936599, rs2487999, and rs7675998) showed an increased CVD-risk, whereas rs10936599, rs677228 and rs4387287 a decreased CVD-risk, in further strata. The results of our study suggest different effects of SNPs/GRS on CVD-risk depending on the CVD risk-factor strata, highlighting the importance of stratified analyses in CVD risk-factors.
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Affiliation(s)
- Nico Tannemann
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Markus M. Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Sonali Pechlivanis
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Asthma and Allergy Prevention, Neuherberg, Germany
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Posadas-Sánchez R, López-Uribe ÁR, Fragoso JM, Vargas-Alarcón G. Interleukin 6 polymorphisms are associated with cardiovascular risk factors in premature coronary artery disease patients and healthy controls of the GEA Mexican study. Exp Mol Pathol 2024; 136:104886. [PMID: 38290570 DOI: 10.1016/j.yexmp.2024.104886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 01/04/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND AND AIMS Interleukin-6 (IL-6) is an acute-phase protein that plays an important role in the inflammatory response, vascular inflammation, and atherosclerosis process. The study aimed to establish whether IL-6 gene polymorphisms and IL-6 concentrations are associated with premature coronary artery disease (pCAD) and cardiovascular risk factors. METHODS The IL-6 concentrations and the rs2069827, rs1800796, and rs1800795 IL-6 polymorphisms were determined in 1150 pCAD patients and 1083 healthy controls (coronary artery calcium equal to zero determined by tomography). RESULTS The IL-6 polymorphisms studied were not associated with pCAD, but they were associated with cardiovascular risk factors in patients and controls. In controls, under the dominant model, the rs1800795 C allele and the rs2069827 T allele were associated with a low risk of central obesity (OR = 0.401, p = 0.017 and OR = 0.577, p = 0.031, respectively), hypoalphalipoproteinemia (OR = 0.581, p = 0.027 and OR = 0.700, p = 0.014, respectively) and hypertriglyceridemia (OR = 0.575, p = 0.030 and OR = 0.728, p = 0.033, respectively). In pCAD, the rs1800795 C allele was associated with an increased risk of hypoalphalipoproteinemia (OR = 1.370, padditive = 0.025) and increased C-reactive protein (CRP) concentrations (OR = 1.491, padditive = 0.007). pCAD patients had significantly higher serum IL-6 concentrations compared to controls (p = 0.002). In the total population, individuals carrying the rs1800795 GC + CC genotypes had higher levels of IL-6 than carriers of the GG genotype (p = 0.025). In control individuals carrying the C allele (CG + CC), an inverse correlation was observed between IL-6 and HDL-cholesterol levels (p = 0.003). CONCLUSIONS In summary, the IL-6 polymorphisms were not associated with pCAD, however, they were associated with cardiovascular risk factors in pCAD patients and healthy controls. Individuals carrying the rs1800795 GC + CC genotypes had higher levels of IL-6 than carriers of the GG genotype.
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Affiliation(s)
| | - Ángel Rene López-Uribe
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - José Manuel Fragoso
- Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico; Research Direction, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
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Liu L, Peng J, Wang N, Wu Z, Zhang Y, Cui H, Zang D, Lu F, Ma X, Yang J. Comparison of seven surrogate insulin resistance indexes for prediction of incident coronary heart disease risk: a 10-year prospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1290226. [PMID: 38323107 PMCID: PMC10844492 DOI: 10.3389/fendo.2024.1290226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Background There were seven novel and easily accessed insulin resistance (IR) surrogates established, including the Chinese visceral adiposity index (CVAI), the visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC) and TyG-waist to height ratio (TyG-WHtR). We aimed to explore the association between the seven IR surrogates and incident coronary heart disease (CHD), and to compare their predictive powers among Chinese population. Methods This is a 10-year prospective cohort study conducted in China including 6393 participants without cardiovascular disease (CVD) at baseline. We developed Cox regression analyses to examine the association of IR surrogates with CHD (hazard ratio [HR], 95% confidence intervals [CI]). Moreover, the receiver operating characteristic (ROC) curve was performed to compare the predictive values of these indexes for incident CHD by the areas under the ROC curve (AUC). Results During a median follow-up period of 10.25 years, 246 individuals newly developed CHD. Significant associations of the IR surrogates (excepted for VAI) with incident CHD were found in our study after fully adjustment, and the fifth quintile HRs (95% CIs) for incident CHD were respectively 2.055(1.216-3.473), 1.446(0.948-2.205), 1.753(1.099-2.795), 2.013(1.214-3.339), 3.169(1.926-5.214), 2.275(1.391-3.719) and 2.309(1.419-3.759) for CVAI, VAI, LAP, TyG, TyG-BMI, TyG-WC and TyG-WHtR, compared with quintile 1. Furthermore, CVAI showed maximum predictive capacity for CHD among these seven IR surrogates with the largest AUC: 0.632(0.597,0.667). Conclusion The seven IR surrogates (excepted for VAI) were independently associated with higher prevalence of CHD, among which CVAI is the most powerful predictor for CHD incidence in Chinese populations.
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Affiliation(s)
- Li Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Jie Peng
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, China
| | - Ning Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenguo Wu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yerui Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Huiliang Cui
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Dejin Zang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaoping Ma
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Obstetrics and Gynecology, LiaoCheng People’s Hospital, Liaocheng, China
| | - Jianmin Yang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
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Torrico-Lavayen R, Vargas-Alarcón G, Riojas-Rodriguez H, Sánchez-Guerra M, Texcalac-Sangrador JL, Ortiz-Panozo E, Gutiérrez-Avila I, De Vizcaya-Ruiz A, Cardenas A, Posadas-Sánchez R, Osorio-Yáñez C. Long-term exposure to ambient fine particulate matter and carotid intima media thickness at bilateral, left and right in adults from Mexico City: Results from GEA study. CHEMOSPHERE 2023; 335:139009. [PMID: 37245594 DOI: 10.1016/j.chemosphere.2023.139009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/13/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND PM2.5 exposure has been associated with intima-media thickness (cIMT) increase. However, very few studies distinguished between left and right cIMT in relation to PM2.5 exposure. AIM To evaluate associations between chronic exposure to PM2.5 and cIMT at bilateral, left, and right in adults from Mexico City. METHODS This study comprised 913 participants from the control group, participants without personal or family history of cardiovascular disease, of the Genetics of Atherosclerosis Disease Mexican study (GEA acronym in Spanish), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. To assess the associations between chronic exposure to PM2.5 (per 5 μg/m3 increase) at different lag years (1-4 years) and cIMT (bilateral, left, and right) we applied distributed lag non-linear models (DLNMs). RESULTS The median and interquartile range for cIMT at bilateral, left, and right, were 630 (555, 735), 640 (550, 750), and 620 (530, 720) μm, respectively. Annual average PM2.5 exposure was 26.64 μg/m3, with median and IQR, of 24.46 (23.5-25.46) μg/m3. Results from DLNMs adjusted for age, sex, body mass index, low-density lipoproteins, and glucose, showed that PM2.5 exposure for year 1 and 2, were positively and significantly associated with right-cIMT [6.99% (95% CI: 3.67; 10.42) and 2.98% (0.03; 6.01), respectively]. Negative associations were observed for PM2.5 at year 3 and 4 and right-cIMT; however only year 3 was statistically significant [-2.83% (95% CI: 5.12; -0.50)]. Left-cIMT was not associated with PM2.5 exposure at any lag year. The increase in bilateral cIMT followed a similar pattern as that observed for right-cIMT, but with lower estimates. CONCLUSIONS Our results suggest different susceptibility between left and right cIMT associated with PM2.5 exposure highlighting the need of measuring both, left and right cIMT, regarding ambient air pollution in epidemiological studies.
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Affiliation(s)
- Rocio Torrico-Lavayen
- Departamento de Patología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, 14080, Mexico; Department of Environmental Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Gilberto Vargas-Alarcón
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, 14080, Mexico
| | | | | | | | - Eduardo Ortiz-Panozo
- Center of Population Health Research, National Institute of Public Health, Cuernavaca, Mexico; Department of Epidemiology, Harvard T.H. Chan School of Public Health. Boston, United States
| | - Iván Gutiérrez-Avila
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Andrea De Vizcaya-Ruiz
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA, United States
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States
| | - Rosalinda Posadas-Sánchez
- Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, 14080, Mexico
| | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, 04510, Mexico; Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación en Medicina Traslacional, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, 14080, Mexico.
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8
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Basdeki ED, Argyris AA, Efthymiou O, Athanasopoulou E, Sfikakis PP, Protogerou AD, Karatzi K. Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors. Nutrients 2023; 15:nu15041025. [PMID: 36839387 PMCID: PMC9967081 DOI: 10.3390/nu15041025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. METHODS Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). RESULTS Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: -3.28, 95% C.I.: -5.7 to -0.86), diastolic blood pressure (b: -1.85, 95% C.I.: -3.34 to -0.36), augmentation index (b: -3.17, 95% C.I.:-4.98 to 1.35) and left carotid intima media thickness (b: -0.03, 95% C.I.:-0.06 to -0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10-20% of daily total energy intake (dTEI) was inversely associated with Aix (b: -2.31, 95% C.I.:-4.05 to -0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). CONCLUSION SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.
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Affiliation(s)
- Eirini D. Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonios A. Argyris
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Efthymiou
- Department of Life Sciences, School of Sciences, European University of Cyprus, Nicosia 22006, Cyprus
| | - Elpida Athanasopoulou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros P. Sfikakis
- 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Athanase D. Protogerou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, 75 Iera Odos, 11855 Athens, Greece
- Correspondence:
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9
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Posadas-Sánchez R, Vargas-Alarcón G, Cardenas A, Texcalac-Sangrador JL, Osorio-Yáñez C, Sanchez-Guerra M. Long-Term Exposure to Ozone and Fine Particulate Matter and Risk of Premature Coronary Artery Disease: Results from Genetics of Atherosclerotic Disease Mexican Study. BIOLOGY 2022; 11:1122. [PMID: 35892978 PMCID: PMC9332787 DOI: 10.3390/biology11081122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022]
Abstract
(1) Background: Epidemiological studies have identified associations between fine particulate matter (PM2.5) and ozone exposure with cardiovascular disease; however, studies linking ambient air pollution and premature coronary artery disease (pCAD) in Latin America are non-existing. (2) Methods: Our study was a case−control analysis nested in the Genetics of Atherosclerotic Disease (GEA) Mexican study. We included 1615 participants (869 controls and 746 patients with pCAD), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. We defined pCAD as history of myocardial infarction, angioplasty, revascularization surgery or coronary stenosis > 50% diagnosed before age 55 in men and age 65 in women. Controls were healthy individuals without personal or family history of pCAD and with coronary artery calcification equal to zero. Hourly measurements of ozone and PM2.5 from the Atmospheric Monitoring System in Mexico City (SIMAT in Spanish; Sistema de Monitero Atmosférico de la Ciudad de México) were used to calculate annual exposure to ozone and PM2.5 in the study participants. (3) Results: Each ppb increase in ozone at 1-year, 2-year, 3-year and 5-year averages was significantly associated with increased odds (OR = 1.10; 95% CI: 1.03−1.18; OR = 1.17; 95% CI: 1.05−1.30; OR = 1.18; 95% CI: 1.05−1.33, and OR = 1.13; 95% CI: 1.04−1.23, respectively) of pCAD. We observed higher risk of pCAD for each 5 µg/m3 increase only for the 5-year average of PM2.5 exposure (OR = 2.75; 95% CI: 1.47−5.16), compared to controls. (4) Conclusions: Ozone exposure at different time points and PM2.5 exposure at 5 years were associated with increased odds of pCAD. Our results highlight the importance of reducing long-term exposure to ambient air pollution levels to reduce the burden of cardiovascular disease in Mexico City and other metropolitan areas.
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Affiliation(s)
| | - Gilberto Vargas-Alarcón
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (R.P.-S.); (G.V.-A.)
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA;
| | | | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación en Medicina Traslacional, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
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10
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Jiang H, Li L, Zhang L, Zang G, Sun Z, Wang Z. Role of endothelial cells in vascular calcification. Front Cardiovasc Med 2022; 9:895005. [PMID: 35928939 PMCID: PMC9343736 DOI: 10.3389/fcvm.2022.895005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Vascular calcification (VC) is active and regulates extraosseous ossification progress, which is an independent predictor of cardiovascular disease (CVD) morbidity and mortality. Endothelial cells (ECs) line the innermost layer of blood vessels and directly respond to changes in flow shear stress and blood composition. Together with vascular smooth muscle cells, ECs maintain vascular homeostasis. Increased evidence shows that ECs have irreplaceable roles in VC due to their high plasticity. Endothelial progenitor cells, oxidative stress, inflammation, autocrine and paracrine functions, mechanotransduction, endothelial-to-mesenchymal transition (EndMT), and other factors prompt ECs to participate in VC. EndMT is a dedifferentiation process by which ECs lose their cell lineage and acquire other cell lineages; this progress coexists in both embryonic development and CVD. EndMT is regulated by several signaling molecules and transcription factors and ultimately mediates VC via osteogenic differentiation. The specific molecular mechanism of EndMT remains unclear. Can EndMT be reversed to treat VC? To address this and other questions, this study reviews the pathogenesis and research progress of VC, expounds the role of ECs in VC, and focuses on the regulatory factors underlying EndMT, with a view to providing new concepts for VC prevention and treatment.
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Affiliation(s)
- Han Jiang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Lihua Li
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Lili Zhang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Guangyao Zang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhen Sun
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
- *Correspondence: Zhongqun Wang,
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11
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Duke NN, Jensen TM, Perreira KM, Hotz VJ, Harris KM. The Role of Family Health History in Predicting Midlife Chronic Disease Outcomes. Am J Prev Med 2021; 61:509-517. [PMID: 34229928 PMCID: PMC8818302 DOI: 10.1016/j.amepre.2021.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/13/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The generational relevance for determining disease risk for the leading causes of morbidity and mortality for U.S. adults is a source of debate. METHODS Data on 12,300 adults (Add Health Study Members) participating in Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (also known as Add Health) were merged with data from respondents' parents (n=2,013) participating in the Add Health Parent Study (2015-2017). Analyses beginning in January 2020 examined the concordance in lifetime occurrence of chronic conditions across 4 generations, including cardiovascular disease, diabetes, hypertension, hyperlipidemia, obesity, cancer, and depression and examined the associations between individual disease history and ones' family health history for the same condition. RESULTS Mean ages were 37.4 years for Add Health Study Members and 62.9 years for Add Health Parent Study mothers. The histories of mothers from the Add Health Parent Study on hyperlipidemia (AOR=1.61, 95% CI=1.04, 2.48), obesity (AOR=1.77, 95% CI=1.27, 2.48), and depression (AOR=1.87, 95% CI=1.19, 2.95) were significantly associated with increased odds of Add Health Study Member report of these conditions. Maternal great grandparent hyperlipidemia history was significantly associated with the Add Health Study Member hyperlipidemia (AOR=2.81, 95% CI=1.51, 5.21). Histories of diabetes in maternal grandfather (AOR=2.41, 95% CI=1.24, 4.69) and maternal great grandparent (AOR=3.05, 95% CI=1.45, 6.43) were significantly associated with Add Health Study Member diabetes. Each additional point in the Add Health Parent Study mothers' cardiometabolic risk factor index was associated with an 11% increase (incidence rate ratio=1.11, 95% CI=1.04, 1.19) in the expected count of cardiometabolic risk conditions for the Add Health Study Members. CONCLUSIONS Multigenerational health histories have value for quantifying the probability of diabetes, obesity, depression, and hyperlipidemia in early mid-adulthood. Family health history knowledge is relevant for health promotion and disease prevention strategies.
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Affiliation(s)
- Naomi N Duke
- Duke Department of Pediatrics, Division of General Pediatrics and Adolescent Health, & Duke Center for Childhood Obesity Research (DCCOR), & Department of Sociology, Duke University, Durham, North Carolina.
| | - Todd M Jensen
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Krista M Perreira
- Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - V Joseph Hotz
- Department of Economics, Duke University, Durham, North Carolina
| | - Kathleen Mullan Harris
- Carolina Population Center, & Department of Sociology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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12
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Lei MH, Wu YL, Chung SL, Chen CC, Chen WC, Hsu YC. Coronary Artery Calcium Score Predicts Long-Term Cardiovascular Outcomes in Asymptomatic Patients with Type 2 Diabetes. J Atheroscler Thromb 2021; 28:1052-1062. [PMID: 33162430 PMCID: PMC8560843 DOI: 10.5551/jat.59386] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aims:
Type 2 diabetes mellitus (T2DM) is no longer regarded as a coronary risk equivalent, and heterogeneity of cardiovascular risk exists, suggesting that further risk stratification should be mandatory. This study aimed to determine the prevalence and clinical predictors of coronary artery calcium (CAC) score, and evaluate the CAC score as a predictor of cardiovascular outcome in a large asymptomatic T2DM cohort.
Methods:
A total of 2,162 T2DM patients were recruited from a Diabetes Shared Care Network and the CAC score was measured. Cardiovascular outcomes were obtained for 1,928 patients after a follow-up of 8.4 years. Multiple regression analysis and Cox proportional hazard regression were applied to identify clinical predictors of CAC and calculate the incidence and hazard ratios (HRs) for all-cause mortality and cardiovascular events by CAC category.
Results:
Of the recruited patients, 96.8% had one or more risk factors. The distribution of CAC scores was as follows: CAC=0 in 24.2% of the patients, 0 <CAC ≤ 100 in 41.5%, 100 <CAC ≤ 400 in 20.3%, CAC >400 in 14.7%. The multivariable predictor of increased CAC included age (years) (odds ratio, 1.07; 95% confidence interval, 1.06–1.08), male sex (1.82; 1.54–2.17), duration (years) of T2DM (1.07; 1.05–1.09), and multiple risk factors (1.94; 1.28–2.95). Increasing severity of CAC was associated with higher all-cause or cardiac mortality and higher incident cardiovascular events. The HRs for cardiac death or major cardiac events in CAC >400 vs CAC=0 were 8.67 and 10.52, respectively (
p
<0.001)
Conclusion:
CAC scoring provides better prognostication of cardiovascular outcome than traditional risk factors in asymptomatic T2DM patients, and may allow identifying a high-risk subset for enhancing primary prevention.
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Affiliation(s)
- Meng-Huan Lei
- Division of Cardiology, Department of Internal Medicine, Lo-Tung Poh-Ai Hospital
| | - Yu-Lin Wu
- Department of Nursing, St. Mary's Junior College of Medicine, Nursing and Management
| | - Sheng-Liang Chung
- Division of Cardiology, Department of Internal Medicine, Lo-Tung Poh-Ai Hospital
| | - Chao-Chin Chen
- Division of Cardiology, Department of Internal Medicine, Lo-Tung Poh-Ai Hospital
| | - Wei-Cheng Chen
- Division of Cardiology, Department of Internal Medicine, Lo-Tung Poh-Ai Hospital
| | - Yu-Chen Hsu
- Division of Cardiology, Department of Internal Medicine, Lo-Tung Poh-Ai Hospital
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13
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Bruscato N, da Luz P, Werle B, Schvartzman P, Kesties J, Vivian L, de Carli W, Moriguchi E. Coronary artery calcification and dietary intake in asymptomatic men. Braz J Med Biol Res 2021; 54:e11371. [PMID: 34550273 PMCID: PMC8457685 DOI: 10.1590/1414-431x2021e11371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/07/2021] [Indexed: 11/21/2022] Open
Abstract
Dietary factors may influence the process of atherosclerosis and coronary artery calcification (CAC). This study assessed CAC and its association with dietary intake in asymptomatic men. We evaluated 150 asymptomatic men with mean age of 58.2±5.3 years. The dietary intake was assessed by the Food Consumption Register method. CAC was measured through multidetector computed tomography (MDCT) and assessed in accordance with the Agatston score. Modified Poisson regression model was used to estimate the effects of intake of different nutrients that are prevalent in moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals [95%CI]. An association was found between the intake of some nutrients and moderate/severe CAC. Lower carbohydrate intake (P=0.021) and higher lipid intake (P=0.006) were associated with moderate/severe CAC. After adjustment, the nutrients associated with the prevalence of moderate/severe CAC were carbohydrates (P=0.040), lipids (P=0.005), and saturated fatty acids (SFA) (P=0.013). A 1% increase in lipids and SFA intake caused an increase of 4% [95%CI: 1-7%] and 8% [95%CI: 2-14%] in the prevalence of moderate/severe CAC, respectively. A 1% increase of carbohydrate intake led to a 2% decrease in the likelihood of moderate/severe CAC [95%CI: 1-4%]. These conclusions showed that the higher intake of total lipids and SFA was associated with higher CAC scores, whereas higher carbohydrate intake was associated with lower CAC scores in asymptomatic men.
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Affiliation(s)
- N.M. Bruscato
- Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Pesquisa, Instituto Moriguchi: Centro de Estudos do Envelhecimento, Veranópolis, RS, Brasil
| | - P.L. da Luz
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - B.M. Werle
- Departamento de Pesquisa, Instituto Moriguchi: Centro de Estudos do Envelhecimento, Veranópolis, RS, Brasil
| | - P.R. Schvartzman
- Serviço de Radiologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - J. Kesties
- Departamento de Pesquisa, Instituto Moriguchi: Centro de Estudos do Envelhecimento, Veranópolis, RS, Brasil
| | - L. Vivian
- Departamento de Pesquisa, Instituto Moriguchi: Centro de Estudos do Envelhecimento, Veranópolis, RS, Brasil
| | - W. de Carli
- Associação Veranense de Assistência em Saúde, Veranópolis, RS, Brasil
| | - E.H. Moriguchi
- Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Pesquisa, Instituto Moriguchi: Centro de Estudos do Envelhecimento, Veranópolis, RS, Brasil
- Departamento de Medicina Interna, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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14
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Leventer-Roberts M, Gofer I, Barak Corren Y, Reis BY, Balicer R. Constructing data-derived family histories using electronic health records from a single healthcare delivery system. Eur J Public Health 2021; 30:212-218. [PMID: 31550373 DOI: 10.1093/eurpub/ckz152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In order to examine the potential clinical value of integrating family history information directly from the electronic health records of patients' family members, the electronic health records of individuals in Clalit Health Services, the largest payer/provider in Israel, were linked with the records of their parents. METHODS We describe the results of a novel approach for creating data-derived family history information for 2 599 575 individuals, focusing on three chronic diseases: asthma, cardiovascular disease (CVD) and diabetes. RESULTS In our cohort, there were 256 598 patients with asthma, 55 309 patients with CVD and 66 324 patients with diabetes. Of the people with asthma, CVD or diabetes, the percentage that also had a family history of the same disease was 22.0%, 70.8% and 70.5%, respectively. CONCLUSIONS Linking individuals' health records with their data-derived family history has untapped potential for supporting diagnostic and clinical decision-making.
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Affiliation(s)
- Maya Leventer-Roberts
- Clalit Research Institute, Tel Aviv, Israel.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilan Gofer
- Clalit Research Institute, Tel Aviv, Israel
| | - Yuval Barak Corren
- Predictive Medicine Group & Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.,Pediatrics Department, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ben Y Reis
- Predictive Medicine Group & Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Ran Balicer
- Clalit Research Institute, Tel Aviv, Israel.,Public Health Department, Ben-Gurion University of the Negev, Israel
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15
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Johansen MC, Gottesman RF, Kral BG, Vaidya D, Yanek LR, Becker LC, Becker DM, Nyquist P. Association of Coronary Artery Atherosclerosis With Brain White Matter Hyperintensity. Stroke 2021; 52:2594-2600. [PMID: 34000829 DOI: 10.1161/strokeaha.120.032674] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Michelle C Johansen
- Department of Neurology (M.C.J., R.F.G., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca F Gottesman
- Department of Neurology (M.C.J., R.F.G., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brian G Kral
- Department of Medicine, Division of Cardiology (B.G.K., L.C.B.), Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dhananjay Vaidya
- Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lisa R Yanek
- Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lewis C Becker
- Department of Medicine, Division of Cardiology (B.G.K., L.C.B.), Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Diane M Becker
- Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paul Nyquist
- Department of Neurology (M.C.J., R.F.G., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Medicine, Division of General Internal Medicine, GeneSTAR Research Program (B.G.K., D.V., L.R.Y., L.C.B., D.M.B., P.N.), Johns Hopkins University School of Medicine, Baltimore, MD
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16
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Christou GA, Deligiannis AP, Kouidi EJ. The role of cardiac computed tomography in pre-participation screening of mature athletes. Eur J Sport Sci 2021; 22:636-649. [PMID: 33517865 DOI: 10.1080/17461391.2021.1883125] [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: 10/22/2022]
Abstract
The overwhelming majority of sports-related sudden cardiac deaths in mature athletes is attributed to coronary artery disease (CAD). Coronary plaques of mature athletes appear to be more calcified compared to sedentary individuals and thus may be more stable and less likely to be associated with an acute coronary event. Cardiac computed tomography (CT), including unenhanced CT for coronary artery calcium scoring (CACS) and contrast-enhanced coronary CT angiography, is characterized by very high negative predictive value to rule out CAD. Cardiac CT has been shown to have additional diagnostic value for detection of CAD in athletes over and above exercise electrocardiogram. Moreover, measurement of CACS possibly enables a more precise cardiovascular risk stratification of mature athletes. The main advantage of cardiac CT is its noninvasive nature. Although cardiac CT appears to increase the overall cost of cardiac examinations, this additional cost is much lower than the cost of unnecessary invasive coronary angiographies that would be performed in case of false positive results of exercise electrocardiograms. Radiation exposure may not be a major concern for the application of this modality to pre-participation screening of athletes, since recent technical advancements have resulted in low radiation dose of cardiac CT.Highlights Coronary computed tomography angiography can be used in pre-participation screening of mature athletes to increase the negative predictive value for excluding coronary artery disease.The identification of coronary artery calcium score = 0 in an athlete can improve risk stratification, since this athlete can be reasonably managed as an individual with low cardiovascular risk.
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Affiliation(s)
- Georgios A Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece.,MSc Sports Cardiology, St George's University of London, London, United Kingdom
| | - Asterios P Deligiannis
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia J Kouidi
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
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17
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Venkataraman P, Kawakami H, Huynh Q, Mitchell G, Nicholls SJ, Stanton T, Tonkin A, Watts GF, Marwick TH. Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease. JACC Cardiovasc Imaging 2021; 14:1206-1217. [PMID: 33454262 DOI: 10.1016/j.jcmg.2020.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor-based prediction alone in those with an family history of premature coronary artery disease (FHCAD). BACKGROUND The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance. METHODS A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%. RESULTS Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective. CONCLUSIONS Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.
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Affiliation(s)
- Prasanna Venkataraman
- Baker Heart and Diabetes Research Institute, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Hiroshi Kawakami
- Baker Heart and Diabetes Research Institute, Melbourne, Australia
| | - Quan Huynh
- Baker Heart and Diabetes Research Institute, Melbourne, Australia
| | | | | | - Tony Stanton
- The University of Queensland, Brisbane, Australia
| | | | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine, University of Western Australia, Perth, Australia
| | - Thomas H Marwick
- Baker Heart and Diabetes Research Institute, Melbourne, Australia; Monash University, Melbourne, Australia.
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Kiani R, Pouraliakbar H, Alemzadeh-Ansari MJ, Khademi A, Peighambari MM, Mohebbi B, Firouzi A, Zahedmehr A, Shakerian F, Hosseini Z, Rashidinejad A. The significance of coronary artery calcium score as a predictor of coronary artery stenosis in individuals referred for CT angiography. J Cardiovasc Thorac Res 2020; 12:203-208. [PMID: 33123326 PMCID: PMC7581835 DOI: 10.34172/jcvtr.2020.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/11/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population. Recent studies have found that coronary artery calcium score (CACS) is a strong independent predictor of CAD. Here we aimed to investigate the association between CACS and demographic, clinical, laboratory, and CT angiographic findings inpatients with suspected CAD. Methods: From June 2008 to August 2018, we retrospectively reviewed 219 consecutive patients suspected with CAD who were referred for CT angiography in Rajaie Cardiovascular, Medical, and Research Center. Medical records were reviewed, and relevant demographic, clinical, laboratory and imaging were collected. Results: A total of 219 patients with an average age of 62.64±12.39 were included. Twelve patients(5.5%) had normal coronary angiography, and 50.2% had mild CAD. An obstructive CAD was found in97 patients (44.3%). The median CACS was 76.4 (IQR, 13.0-289.1). The frequency of obstructive CAD was 28.1% in the CACS <100 group, and 67.0% in CACS >100 group (P < 0.001). On multiple logistic regression analysis, age (OR=1.04 [1.01-1.07], P = 0.006), CACS (OR= 4.31 [2.33-7.98], P < 0.001), and neutrophil to lymphocyte ratio (NLR) (OR = 0.82 [0.68-0.98], P = 0.027) were independent predictors of obstructive CAD. Conclusion: We found a direct association between higher CACS and obstructive patterns in coronary CT angiography. Our findings indicate that the possibility of the presence of obstructive CAD was higher among symptomatic patients with older age, lower NLR, and CACS >100.
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Affiliation(s)
- Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.,Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Ali Khademi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Mehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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19
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Lieb W, Song RJ, Vasan RS, Xanthakis V. Premature Parental Cardiovascular Disease and Subclinical Disease Burden in the Offspring. J Am Heart Assoc 2020; 9:e015406. [PMID: 32896212 PMCID: PMC7727015 DOI: 10.1161/jaha.119.015406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background Offspring of parents with premature cardiovascular disease (CVD) have an increased risk of developing subclinical and clinical CVD. It is unclear whether this association differs by vascular beds in the offspring or by the age cut points used to define premature parental CVD. Methods and Results Using 3 generations of Framingham Heart Study participants, we assessed prevalent coronary artery calcification, the progression of coronary artery calcification over 6.1 years (median), carotid intima media thickness and the ankle-brachial index in 1046 offspring of parents with premature CVD before age 70 years, in 1618 offspring with both parents free of CVD and in 923 offspring with parents with CVD after age 70 years. We used different age cut points (55, 60, 65, and 70 years) to define premature parental CVD. In multivariable-adjusted models, offspring of parents with premature CVD (onset before age 65 years) displayed greater odds for prevalent coronary artery calcification (odds ratio [OR], 1.81; 95% CI, 1.35-2.43), higher carotid intima media thickness (OR, 1.50; 95% CI, 0.92-2.44) and lower ankle-brachial index (OR, 1.89; 95% CI, 1.00-3.58). These associations were generally consistent across different age cut points used to define premature parental CVD. The association with the progression of coronary artery calcification was less consistent. Conclusions Parental premature CVD is associated with increased subclinical CVD burden in the offspring, with consistent relations across different vascular beds and for different age cut points used to define premature parental CVD. Future studies should evaluate whether screening for subclinical CVD traits is warranted in offspring with premature parental CVD.
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Affiliation(s)
- Wolfgang Lieb
- Framingham Heart Study Framingham MA.,Institute of Epidemiology Kiel University Kiel Germany
| | - Rebecca J Song
- Department of Epidemiology Boston University School of Public Health Boston MA
| | - Ramachandran S Vasan
- Framingham Heart Study Framingham MA.,Section of Preventive Medicine and Epidemiology Boston University School of Medicine Boston MA.,Department of Epidemiology Boston University School of Public Health Boston MA.,Boston University Center for Computing and Data Sciences Boston MA
| | - Vanessa Xanthakis
- Framingham Heart Study Framingham MA.,Section of Preventive Medicine and Epidemiology Boston University School of Medicine Boston MA.,Department of Biostatistics Boston University School of Public Health Boston MA
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20
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Chacko M, Sarma PS, Harikrishnan S, Zachariah G, Jeemon P. Family history of cardiovascular disease and risk of premature coronary heart disease: A matched case-control study. Wellcome Open Res 2020; 5:70. [PMID: 32518841 PMCID: PMC7256470 DOI: 10.12688/wellcomeopenres.15829.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Self-reported family history of cardiovascular disease (CVD) is an independent risk factor for future coronary heart disease (CHD) events. However, inclusion of family history of CVD in the traditional risk scores failed to improve risk prediction of CHD. It is proposed that family history of CVD may substantially increase the risk of CHD among younger individuals. Methods: We conducted a matched case-control study with 170 hospital-based premature CHD patients (<55 years in men and <65 years in women) from a tertiary care centre in Thiruvananthapuram, Kerala and age and sex matched community-based controls in 1:1 ratio. Conditional logistic regression analysis was conducted to assess the independent association of family history of cardiovascular disease (CVD) and premature CHD. We estimated McNemar's odds ratios and their 95 percent confidence intervals. Results: The prevalence of any family history of CVD and CHD in the control population was 24% and 21%, respectively. The family history of CVD was independently associated with premature CHD (odds ratio (OR) = 9.0; 95% confidence interval (CI) 4.7-17.3). There was a dose-response relationship between family history and premature CHD as the risk increased linearly with increase in number of affected family members. Conclusions: Family history of CVD is an independent risk factor for premature CHD. The risk of premature CHD increases linearly with increase in number of affected family members. Collecting family history beyond parental history of CVD is important for risk stratification. Targeting young individuals with family history of CVD for intensive risk reduction interventions may help to prevent future events.
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Affiliation(s)
- Manas Chacko
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - P. Sankara Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Sivadasanpillai Harikrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Geevar Zachariah
- Department of Cardiology, Mother Heart Care, Mother Hospital, Thrissur, Kerala, India
| | - Panniyammakal Jeemon
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
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21
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Arbab-Zadeh A, Fuster V. From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 74:1582-1593. [PMID: 31537269 DOI: 10.1016/j.jacc.2019.07.062] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 01/04/2023]
Abstract
The past decades have seen tremendous progress on elucidating mechanisms leading to acute coronary syndrome and sudden cardiac death. Pathology and imaging studies have identified features of coronary atherosclerosis that precede acute coronary events. However, many factors influence the risk of adverse events from coronary atherosclerotic disease and available data support our transition from focusing on individual "vulnerable plaque," coronary arterial stenosis, and inducible myocardial ischemia to understanding coronary heart disease as multifactorial, chronic disease. The concept of the vulnerable patient has evolved, with the atheroma burden, its metabolic activity, and the disposition to vascular thrombosis building a platform for assessing central aspects of coronary heart disease. In turn, this model has directed us to a focus on controlling the activity of atherosclerotic disease and on modifying the susceptibility of vascular thrombosis which has led to reduced morbidity and mortality from coronary heart disease.
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Affiliation(s)
- Armin Arbab-Zadeh
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Valentin Fuster
- Mount Sinai Heart Center, Icahn School of Medicine at Mount Sinai, New York, New York
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22
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Chacko M, Sarma PS, Harikrishnan S, Zachariah G, Jeemon P. Family history of cardiovascular disease and risk of premature coronary heart disease: A matched case-control study. Wellcome Open Res 2020; 5:70. [PMID: 32518841 PMCID: PMC7256470 DOI: 10.12688/wellcomeopenres.15829.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2020] [Indexed: 03/30/2024] Open
Abstract
Background: Self-reported family history of cardiovascular disease (CVD) is an independent risk factor for future coronary heart disease (CHD) events. However, inclusion of family history of CVD in the traditional risk scores failed to improve risk prediction of CHD. It is proposed that family history of CVD may substantially increase the risk of CHD among younger individuals. Methods: We conducted a matched case-control study with 170 hospital-based premature CHD patients (<55 years in men and <65 years in women) from a tertiary care centre in Thiruvananthapuram, Kerala and age and sex matched community-based controls in 1:1 ratio. Conditional logistic regression analysis was conducted to assess the independent association of family history of cardiovascular disease (CVD) and premature CHD. We estimated McNemar's odds ratios and their 95 percent confidence intervals. Results: The prevalence of any family history of CVD and CHD in the control population was 24% and 21%, respectively. The family history of CVD was independently associated with premature CHD (odds ratio (OR) = 9.0; 95% confidence interval (CI) 4.7-17.3). There was a dose-response relationship between family history and premature CHD as the risk increased linearly with increase in number of affected family members. Conclusions: Family history of CVD is an independent risk factor for premature CHD. The risk of premature CHD increases linearly with increase in number of affected family members. Collecting family history beyond parental history of CVD is important for risk stratification. Targeting young individuals with family history of CVD for intensive risk reduction interventions may help to prevent future events.
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Affiliation(s)
- Manas Chacko
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - P. Sankara Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Sivadasanpillai Harikrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Geevar Zachariah
- Department of Cardiology, Mother Heart Care, Mother Hospital, Thrissur, Kerala, India
| | - Panniyammakal Jeemon
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
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23
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Pang J, Abraham A, Vargas-García C, Bates TR, Chan DC, Hooper AJ, Bell DA, Burnett JR, Schultz CJ, Watts GF. An age-matched computed tomography angiographic study of coronary atherosclerotic plaques in patients with familial hypercholesterolaemia. Atherosclerosis 2020; 298:52-57. [PMID: 32171980 DOI: 10.1016/j.atherosclerosis.2020.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolaemia (FH) is characterised by a high, but variable risk of premature coronary artery disease (CAD). Cardiac computed tomography angiography (CCTA) can be employed to assess subclinical coronary atherosclerosis. We investigated the features and distribution of coronary artery plaques in asymptomatic patients with and without genetically confirmed heterozygous FH. METHODS We undertook an aged-matched case-control study of asymptomatic phenotypic FH patients with (cases, M+) and without (controls, M-) an FH-causing mutation. Coronary atherosclerosis was assessed by CCTA and calcium scoring. Coronary segments were evaluated for global and vessel-level coronary plaques and degree of stenosis. RESULTS We studied 104 cases and 104 controls (mean age 49.9 ± 10.4 years), who had a similar spectrum of non-cardiovascular risk factors. Pre-treatment plasma LDL-cholesterol was higher in the M+ than M- group (7.8 ± 2.1 vs 6.2 ± 1.2 mmol/L, p<0.001). There was a greater proportion of patients with mixed and calcified plaque, as well as a higher coronary artery calcium score and segment stenosis score (all p<0.05), in the M+ compared with the M- group. M+ patients also had a significantly higher frequency of coronary artery calcium in the left main and anterior descending and right coronary arteries (all p<0.05), but not in the left circumflex. CONCLUSIONS Among patients with phenotypic FH, those with a genetically confirmed diagnosis had a higher frequency and severity of coronary atherosclerotic plaques, and specifically more advanced calcified plaques.
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Affiliation(s)
- Jing Pang
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Arun Abraham
- Department of Diagnostic Imaging, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Cristian Vargas-García
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Timothy R Bates
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia; Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Dick C Chan
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Amanda J Hooper
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia
| | - Damon A Bell
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - John R Burnett
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Carl J Schultz
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.
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24
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Coronary plaque tissue characterization in patients with premature coronary artery disease. Int J Cardiovasc Imaging 2020; 36:1003-1011. [PMID: 32078097 PMCID: PMC7228958 DOI: 10.1007/s10554-020-01794-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/11/2020] [Indexed: 12/22/2022]
Abstract
Premature coronary artery disease (CAD) studies rarely involve coronary plaque characterization. We characterize coronary plaque tissue by radiofrequency intravascular ultrasound (IVUS) in patients with premature CAD. From July 2015 to December 2017, 220 patients from the Department of Cardiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine with first occurrence of angina or myocardial infarction within 3 months were enrolled. Patients with premature CAD (n = 47, males aged < 55 years, and females aged < 65 years) or later CAD (n = 155) were retrospectively compared for cardiovascular risk factors, laboratory examination findings, coronary angiography data, gray-scale IVUS, and iMap-IVUS. The mean age was 53.53 ± 7.24 vs. 70.48 ± 8.74 years (p < 0.001). The groups were similar for traditional coronary risk factors except homocysteine (18.60 ± 5.15 vs. 17.08 ± 4.27 µmol/L, p = 0.043). After matching for baseline characteristics, LDL cholesterol (LDL-C) was higher for premature CAD than later CAD (2.50 ± 0.96 vs. 2.17 ± 0.80 mmol/L, p = 0.019). Before the matching procedure, the premature CAD group had shorter target lesion length [18.50 (12.60–32.00) vs. 27.90 (18.70–37.40) mm, p = 0.002], less plaque volume [175.59 (96.60–240.50) vs. 214.73 (139.74–330.00) mm3, p = 0.013] than the later CAD group. After the matching procedure, the premature CAD group appeared to be less plaque burden (72.69 ± 9.99 vs. 74.85 ± 9.80%, p = 0.005), and positive remodeling (1.03 ± 0.12 vs. 0.94 ± 0.18, p = 0.034), and lower high risk feature incidence (p = 0.006) than the later CAD group. At the plaque’s minimum lumen, premature CAD had more fibrotic (p < 0.001), less necrotic (p = 0.001) and less calcified areas (p = 0.012). Coronary plaque tissue was more fibrotic with less necrotic and calcified components in premature than in later CAD, and the range and degree of atherosclerosis were significantly lower.
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25
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Patil R, Satvic CM, Shetty L, Natraj Setty HS, Komma S, Jain A, Raghu TR, Manjunath CN. Clinical and angiographic profile of premature heart attack in patients with family history of premature coronary heart disease: A substudy of the PCAD registry (Registered under the Clinical Trials Registry of India [CTRI/2018/03/012544]). Res Cardiovasc Med 2020. [DOI: 10.4103/rcm.rcm_15_20] [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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26
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Pan W, Liang J, Tang H, Fang X, Wang F, Ding Y, Huang H, Zhang H. Differentially expressed microRNA profiles in exosomes from vascular smooth muscle cells associated with coronary artery calcification. Int J Biochem Cell Biol 2019; 118:105645. [PMID: 31733402 DOI: 10.1016/j.biocel.2019.105645] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/30/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The pathogenesis of coronary artery calcification (CAC) in coronary heart disease (CHD) is mediated by exosomes derived from vascular smooth muscle cells (VSMCs). However, little is known about their underlying mechanism. In this study, we aimed to investigate the differentially expressed miRNAs in VSMCs undergoing induced calcification. METHODS A cellular calcification model was established using the mouse VSMC line MOVAS-1. Calcium deposition was evaluated by Alizarin Red staining. Exosome sizes were determined by Nanoparticle Tracking Analysis (NTA), and exosome morphology was examined by transmission electron microscopy (TEM). The expression of exosome and calcification biomarkers was analyzed by quantitative real-time PCR (qPCR) and western blotting. Differential miRNA profiles were determined by deep sequencing and bioinformatics. Protein levels in VSMCs experiencing interference by a miR-324-3p inhibitor were detected by western blotting. RESULTS The MOVAS-1 calcification model was confirmed by Alizarin Red staining and expressional alteration of α-SMA, BMP-2, OPN, and MGP. Exosomes from the calcification model showed expression of exosomal biomarkers and regular exosome diameters, which caused significant calcification in MOVAS-1 cells. In total, 987 and 92 miRNAs were significantly upregulated and downregulated in exosomes from the cellular calcification model as compared with those from MOVAS-1 cells, respectively. Target genes of differential miRNAs were involved in various biological processes such as development, metabolism, and cellular component organization and biogenesis as well as multiple signaling pathways such as protein kinase B (AKT) signaling. The most differentially expressed miRNAs were validated by qPCR, which showed that mmu-let-7e-5p was downregulated and mmu-miR-324-3p was upregulated in exosomes from the MOVAS-1 cellular calcification model. The expression of IGF1R was increased, and the expressions of PIK3CA and MAP2K1 were reduced in MOVAS-1 transfected with a miR-324-3p inhibitor. CONCLUSION microRNA profiles were significantly altered in exosomes from VSMCs undergoing calcification.
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Affiliation(s)
- Wei Pan
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Jianwen Liang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Huili Tang
- Pediatric Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Xingrui Fang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Feng Wang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Yan Ding
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Hui Huang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
| | - Huanji Zhang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
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27
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Karnosová P, Mateřánková M, Seidlerová J, Mayer O, Filipovský J, Karnos V. Soluble RAGEs and cardiovascular risk factors in adult offspring of patients with premature coronary heart disease. Blood Press 2019; 29:87-94. [PMID: 31691578 DOI: 10.1080/08037051.2019.1685372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Advanced glycation end products (AGEs) are a heterogeneous group of highly oxidant compounds which can potentiate microvascular and macrovascular complications through the formation of irreversible cross-links between molecules in the basal membrane and also by engaging the receptor for AGEs (RAGE). Soluble receptor for AGEs (sRAGE) is suggested to have a protective role neutralizing the toxic action of AGEs. We aimed to investigate differences in plasma levels of sRAGE alongside with classic cardiovascular risk factors between offspring of patients with early onset of coronary heart disease (CHD) and healthy controls.Materials and methods: In a cross-sectional design, we examined 114 adult offspring of patients with premature CHD and 194 controls. Concentrations of soluble RAGE were quantified by ELISA methods. Aortic PWV was measured using Sphygmocor device. Multivariate logistic regressions were used to compare differences between the offspring and controls.Results: In the offspring group there were more men (p = 0.023), both groups had similar age (28.5 vs. 28.9 years; p = 0.51). After adjustment for covariates, we observed significantly higher aPWV (6.17 vs. 5.82 m s-1; p = 0.001) and lower sRAGE (1308.11 vs. 1475.59; p = 0.009) in the offspring group compared to controls. The significant determinants of the intergroup difference were sRAGE (p = 0.0017), aPWV (p = 0.011) and current smoking (p = 0.0053).Conclusion: Offspring of patients with early onset of CHD compared to age-matched healthy controls had significantly lower sRAGE levels suggesting a shift in the oxidative balance between stressors and defence mechanisms that may influence a higher cardiovascular risk in the future. The measurement of sRAGE might be a valuable predictor for more precise stratification of cardiovascular risk.
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Affiliation(s)
- Petra Karnosová
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Markéta Mateřánková
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jitka Seidlerová
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Otto Mayer
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jan Filipovský
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Václav Karnos
- Department of Surgery, University Hospital in Pilsen, Pilsen, Czech Republic
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28
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Saba L, Biswas M, Suri HS, Viskovic K, Laird JR, Cuadrado-Godia E, Nicolaides A, Khanna NN, Viswanathan V, Suri JS. Ultrasound-based carotid stenosis measurement and risk stratification in diabetic cohort: a deep learning paradigm. Cardiovasc Diagn Ther 2019; 9:439-461. [PMID: 31737516 PMCID: PMC6837906 DOI: 10.21037/cdt.2019.09.01] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Stroke is in the top three leading causes of death worldwide. Non-invasive monitoring of stroke can be accomplished via stenosis measurements. The current conventional image-based methods for these measurements are not accurate and reliable. They do not incorporate shape and intelligent learning component in their design. METHODS In this study, we propose a deep learning (DL)-based methodology for accurate measurement of stenosis in common carotid artery (CCA) ultrasound (US) scans using a class of AtheroEdge system from AtheroPoint, USA. Three radiologists manually traced the lumen-intima (LI) for the near and the far walls, respectively, which served as a gold standard (GS) for training the DL-based model. Three DL-based systems were developed based on three types of GS. RESULTS IRB approved (Toho University, Japan) 407 US scans from 204 patients were collected. The risk was characterized into three classes: low, moderate, and high-risk. The area-under-curve (AUC) corresponding to three DL systems using receiver operating characteristic (ROC) analysis computed were: 0.90, 0.94 and 0.86, respectively. CONCLUSIONS Novel DL-based strategy showed reliable, accurate and stable stenosis severity index (SSI) measurements.
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Affiliation(s)
- Luca Saba
- Department of Radiology, A.O.U., Cagliari, Italy
| | - Mainak Biswas
- Department of Computer Science and Engineering, JIS University, Agarpara, Kolkata, India
| | | | - Klaudija Viskovic
- Department of Radiology and Ultrasound University Hospital for Infectious Diseases, Zagreb, Croatia
| | - John R. Laird
- Heart and Vascular Institute, Adventist, St. Helena Hospital, Napa Valley, CA, USA
| | | | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre, London, UK
- Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - N. N. Khanna
- Cardiology Department, Indraprastha Apollo Hospitals, New Delhi, India
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, India
| | - Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
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29
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Chiva-Blanch G, Padró T, Alonso R, Crespo J, Perez de Isla L, Mata P, Badimon L. Liquid Biopsy of Extracellular Microvesicles Maps Coronary Calcification and Atherosclerotic Plaque in Asymptomatic Patients With Familial Hypercholesterolemia. Arterioscler Thromb Vasc Biol 2019; 39:945-955. [DOI: 10.1161/atvbaha.118.312414] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Heterozygous familial hypercholesterolemia (FH) is the most common genetic disorder associated with premature atherosclerotic cardiovascular disease. Circulating microvesicles (cMV) are released when cells are activated. We investigated whether cMV could provide information on coronary calcification and atherosclerosis in FH patients.
Approach and Results—
Eighty-two patients (mean of 44±9 years old) with molecular diagnosis of heterozygous FH and asymptomatic cardiovascular disease were investigated. Atherosclerotic plaque characterization was performed by computed tomography angiography, and Agatston coronary calcium score and plaque composition sum were calculated. cMV were quantified by flow cytometry using AV (annexin V) and cell surface-specific antibodies. Of the 82 FH patients, 48 presented atherosclerotic plaque. Patients with atherosclerosis were men and older in a higher percentage than patients without atherosclerotic plaque. FH patients with atherosclerotic plaque showed higher levels of total AV
+
cMV, cMV AV
+
from platelet origin, from granulocytes and neutrophils, and cMV AV
+/−
from endothelial cells than FH-patients without atherosclerotic plaque. Plaque composition sum correlated with platelet- and endothelial-derived cMV, and Agatston coronary calcium score correlated with granulocyte-, platelet-, and endothelial-derived cMV. Receiver operating characteristic curve analyses indicated that the cluster of platelet-, granulocyte-, neutrophil, and endothelial-derived cMV considered together, added significant predictive value to the specific SAFEHEART (Spanish Familial Hypercholesterolaemia Cohort Study) risk equation for plaque presence (area under the curve=0.866, 95% CI, 0.775–0.958;
P
<0.0001,
P
=0.030 for the increment of the area under the curve).
Conclusions—
Endothelial-, granulocyte-, neutrophil- and platelet-derived cMV discriminate and map coronary atherosclerotic plaque and calcification in asymptomatic patients with FH. Liquid biopsy of cMV may be a surrogate biomarker of coronary atherosclerotic plaque burden in FH patients.
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Affiliation(s)
- Gemma Chiva-Blanch
- From the Cardiovascular Science Institute – ICCC; IIB-Sant Pau, Hospital de Sant Pau, Barcelona, Spain (G.C.-B., T.P., J.C., L.B.)
| | - Teresa Padró
- From the Cardiovascular Science Institute – ICCC; IIB-Sant Pau, Hospital de Sant Pau, Barcelona, Spain (G.C.-B., T.P., J.C., L.B.)
- CiberCV, Institute Carlos III, Madrid, Spain (T.P., L.B.)
| | - Rodrigo Alonso
- Nutrition Department, Clínica las Condes, Santiago de Chile, Chile (R.A.)
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (R.A., L.P.d.I., P.M.)
| | - Javier Crespo
- From the Cardiovascular Science Institute – ICCC; IIB-Sant Pau, Hospital de Sant Pau, Barcelona, Spain (G.C.-B., T.P., J.C., L.B.)
| | - Leopoldo Perez de Isla
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (R.A., L.P.d.I., P.M.)
- Cardiology Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain (L.P.d.I.)
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain (R.A., L.P.d.I., P.M.)
| | - Lina Badimon
- From the Cardiovascular Science Institute – ICCC; IIB-Sant Pau, Hospital de Sant Pau, Barcelona, Spain (G.C.-B., T.P., J.C., L.B.)
- CiberCV, Institute Carlos III, Madrid, Spain (T.P., L.B.)
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30
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Dudum R, Dzaye O, Mirbolouk M, Dardari ZA, Orimoloye OA, Budoff MJ, Berman DS, Rozanski A, Miedema MD, Nasir K, Rumberger JA, Shaw L, Whelton SP, Graham G, Blaha MJ. Coronary artery calcium scoring in low risk patients with family history of coronary heart disease: Validation of the SCCT guideline approach in the coronary artery calcium consortium. J Cardiovasc Comput Tomogr 2019; 13:21-25. [PMID: 30935842 PMCID: PMC6663654 DOI: 10.1016/j.jcct.2019.03.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/29/2019] [Accepted: 03/25/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The Society of Cardiovascular Computed Tomography (SCCT) recommends consideration of coronary artery calcium (CAC) scoring among individuals with a family history (FH) of coronary heart disease (CHD) and atherosclerotic cardiovascular disease (ASCVD) risk <5%. No dedicated study has examined the prognostic significance of CAC scoring among this population. METHODS The CAC Consortium is a multi-center observational cohort study from four clinical centers linked to long-term follow-up for cause-specific mortality. All CAC scans were physician referred and performed in patients without a history of CHD. Our analysis includes 14,169 patients with ASCVD scores <5% and self-reported FH of CHD. RESULTS This cohort had a mean age of 48.1 (SD 7.4), was 91.3% white, 47.4% female, had an average ASCVD score of 2.3% (SD 1.3), and 59.4% had a CAC = 0. The event rate for all-cause mortality was 1.2 per 1000 person-years, 0.3 per 1000 person-years for CVD-specific mortality, and 0.2 per 1000 person-years for CHD-specific mortality. In multivariable Cox proportional hazard models, those with CAC>100 had a 2.2 (95% CI 1.5-3.3) higher risk of all-cause mortality, 4.3 (95% CI 1.9-9.5) times higher risk of CVD-specific mortality, and a 10.4 (95% CI 3.2-33.7) times higher risk of CHD-specific mortality compared to individuals with CAC = 0. The NNS to detect CAC >100 in this sample was 9. CONCLUSION In otherwise low risk patients with FH of CHD, CAC>100 were associated with increased risk of all-cause and CHD mortality with event rates in a range that may benefit with preventive pharmacotherapy. These data strongly support new SCCT recommendations regarding testing of patients with a family history of CHD.
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Affiliation(s)
- Ramzi Dudum
- Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology and Neuroradiology, Charité, Berlin, Germany
| | | | - Zeina A Dardari
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Olusola A Orimoloye
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Matthew J Budoff
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Daniel S Berman
- Department of Nuclear Cardiology/Cardiac Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Rozanski
- Department of Medicine, St. Luke's Roosevelt Hospital Center, New York, NY, USA
| | - Michael D Miedema
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, MN, USA
| | - Khurram Nasir
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA; Center for Outcomes Research & Evaluation, Yale School of Medicine, New Haven, CT, USA
| | - John A Rumberger
- Department of Cardiovascular Imaging, Princeton Longevity Center, Princeton, NJ, USA
| | - Leslee Shaw
- Department of Radiology and Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Seamus P Whelton
- Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | | | - Michael J Blaha
- Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
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31
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Sohrabi B, Separham A, Habibolahi H, Enamzadeh E, Ghamari B, Karkon Shayan F. Prediction of clinical outcomes of patients treated with percutaneous coronary intervention for ST-Elevation myocardial infarction using familial history of premature coronary artery disease. JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2018. [DOI: 10.15171/jarcm.2018.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: ST-elevation myocardial infarction (STEMI) is a relatively common cause of mortality among patients. The effects of risk factors as predictors of mortality in patients has been shown in different studies. The present study was performed aiming to evaluate the association between a family history of premature coronary artery diseases (CADs) with clinical outcomes among patients treated with percutaneous coronary intervention (PCI) for STEMI. Methods: This descriptive-analytical study was conducted in Shahid Madani Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, on 200 patients with STEMI with a PCI. 100 out of these 200 patients had a family history of premature CAD. Patients were followed up within 48 hours after PCI, as well as one year after admission, and the secondary outcomes including myocardial infarction (MI), heart failure, ventricular arrhythmias (VAs), pulmonary edema, and death were evaluated. Results: The mean age of the patients with positive and negative family history of premature CAD was 56.37 ± 8.20 and 61.72 ± 7.42 years, respectively. The mean age of the patients with a family history of a premature CAD was significantly lower than that of patients without a family history of a premature CAD (P = 0.001). There was no significant difference in the frequency of CAD risk factors, angiographic findings, and its complications, ST-segment resolution and frequency of secondary outcomes during 48 hours and one year after admission between the study groups (P > 0.050). Conclusion: The present study showed that a family history of premature CAD does not predict the clinical outcomes in patients treated with PCI for STEMI which should be validated across future studies.
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Affiliation(s)
- Bahram Sohrabi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Department of Cardiology, School of medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Habibolahi
- Department of Cardiology, School of medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elgar Enamzadeh
- Department of Cardiology, School of medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behnaz Ghamari
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Karkon Shayan
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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32
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Brunham LR, Lynch K, English A, Sutherland R, Weng J, Cho R, Wong GC, Anis AH, Francis GA, Khan NA, McManus B, Wood D, Walley KR, Leipsic J, Humphries KH, Hoens A, Krahn AD, John Mancini GB, Pimstone S. The design and rationale of SAVE BC: The Study to Avoid CardioVascular Events in British Columbia. Clin Cardiol 2018; 41:888-895. [PMID: 29635745 DOI: 10.1002/clc.22959] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/20/2018] [Accepted: 03/30/2018] [Indexed: 11/05/2022] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is highly heritable, particularly when it occurs at a young age. The screening of individuals with premature ASCVD, although often recommended, is not routinely performed. Strategies to address this gap in care are essential. We designed the Study to Avoid CardioVascular Events in British Columbia (SAVE BC) as a prospective, observational study of individuals with a new diagnosis of very premature ASCVD (defined as age ≤ 50 years in males and age ≤ 55 years in females) and their first-degree relatives (FDRs) and spouses. FDRs and spouses will undergo screening for cardiovascular (CV) risk factors and subclinical ASCVD using a structured screening algorithm. All subjects will be followed longitudinally for ≥10 years. The overall goal of SAVE BC is to evaluate the yield of a structured screening program for identifying individuals at risk of premature ASCVD. The primary objectives of SAVE BC are to identify and follow index cases with very premature ASCVD and their FDRs and to determine the diagnostic yield of a structured screening program for these individuals. We will collect data on CV risk factors, medication use, CV events, and healthcare costs in these individuals. SAVE BC will provide insight regarding approaches to identify individuals at risk for premature ASCVD with implications for prevention and treatment in this population.
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Affiliation(s)
- Liam R Brunham
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Kelsey Lynch
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Amy English
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Rory Sutherland
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Jian Weng
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Raymond Cho
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Graham C Wong
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Aslam H Anis
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Center for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, Canada
| | - Gordon A Francis
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Nadia A Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Center for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, Canada
| | - Bruce McManus
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada.,Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, Canada
| | - David Wood
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Keith R Walley
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Jonathon Leipsic
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Karin H Humphries
- Center for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, Canada.,BC Centre for Improved Cardiovascular Health, Vancouver, Canada
| | - Alison Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Andrew D Krahn
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - G B John Mancini
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Simon Pimstone
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
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33
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Rationale and design of a trial to personalize risk assessment in familial coronary artery disease. Am Heart J 2018; 199:22-30. [PMID: 29754662 DOI: 10.1016/j.ahj.2017.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/13/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The lifetime risk of coronary artery disease (CAD) is doubled in people with a family history of premature disease, yet this risk is not captured in most 5- or 10-year risk assessment algorithms. Coronary artery calcium scoring (CCS) is a marker of subclinical CAD risk, which has been shown in observational studies to provide prognostic information that is incremental to clinical assessment; is relatively inexpensive; and is performed with a small radiation dose. However, the use of CCS in guiding prevention is not strongly supported by guidelines. Showing definitive evidence of the efficacy and cost-effectiveness of CCS is therefore of importance. STUDY DESIGN The proposed randomized controlled trial of the use of CCS will be targeted to 40- to 70-year-old first-degree relatives of patients with CAD onset <60 years old or second-degree relatives of patients with onset <50 years old. Control patients will undergo standard risk scoring and be blinded to CCS results. In the intervention group, primary prevention in patients undergoing CCS will be informed by this score. At 3 years, effectiveness will be assessed on change in plaque volume at computed tomography coronary angiography, the extent of which has been strongly linked to outcome. SUMMARY The CAUGHT-CAD trial will provide evidence to inform the guidelines regarding the place of CCS in decision making regarding primary prevention of patients with a family history of premature disease.
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34
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4550] [Impact Index Per Article: 758.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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35
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Two-year Follow-up of Patients With Unstable Angina/Non-ST Segment Elevation Myocardial Infarction Undergoing Early Invasive Strategy: Predictors of Normal or Near-Normal Coronary Angiography and Mortality. Crit Pathw Cardiol 2018; 17:47-52. [PMID: 29432377 DOI: 10.1097/hpc.0000000000000108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Predictors of normal or near-normal coronary angiography (NONCAG) in patients with unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) and their importance regarding the prognosis are not understood. Accordingly, we determined these predictors as well as mortality risk factors at 2-year follow-up of UA/NSTEMI patients managed by the early invasive strategy. METHODS We prospectively studied consecutive patients with UA/NSTEMI managed with the early invasive strategy at Tehran Heart Center, in 1-year period. Echocardiography was performed before coronary angiography (CAG) for all the patients. Baseline characteristics, laboratory parameters, echocardiographic findings, invasive treatment modalities, and survival status after 2 years of follow-up were collected. We identified the predictors of NONCAG in the first phase of the study and then the risk factors of mortality in the second phase. RESULTS In the study period, 298 patients including 211 (71%) males, with the age of 59.31 ± 10.72 years were enrolled. The following factors were predictors of NONCAG: the female sex (P < 0.001); negative family history of CAD (P = 0.028); Thrombolysis in Myocardial Infarction (TIMI) risk score (P < 0.001); and early transmitral flow velocity/mean mitral annular velocity (E/E'mean) (P = 0.003). The following items were significant protective factors against mortality: percutaneous coronary intervention (PCI) (P = 0.012), age (P = 0.001), and E/E'mean (P = 0.020). CONCLUSION Patients' baseline characteristics as well as echocardiographic data could help in predicting those with NONCAG and PCI can be considered as the treatment of strategy with the most protection against mortality.
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36
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Osawa K, Nakanishi R, Budoff M. Coronary Artery Calcification. Glob Heart 2018; 11:287-293. [PMID: 27741976 DOI: 10.1016/j.gheart.2016.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 07/26/2016] [Accepted: 08/01/2016] [Indexed: 11/28/2022] Open
Abstract
Coronary artery calcification (CAC) is an established marker of subclinical atherosclerosis and an independent predictor of future coronary heart disease in the asymptomatic primary prevention population, particularly in the intermediate risk cohort. CAC also helps in reclassifying those patients and their risk of cardiovascular events into higher or lower risk categories. MESA (Multi-Ethnic Study of Atherosclerosis) is a National Heart, Lung, and Blood Institute-sponsored population-based medical research study involving 6,814 men and women from 6 U.S. communities without a medical history of clinical cardiovascular disease. The evidence from this population cohort revealed that CAC scoring was independently predictive and highly effective at risk stratification of major adverse cardiac events. This review provides available data based on MESA. We focus on the utility of CAC for cardiovascular disease risk stratification of individuals, and we describe its diagnostic value in identifying patients at risk.
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Affiliation(s)
- Kazuhiro Osawa
- Los Angeles Biomedical Research Institute at Harbor, University of California-Los Angeles, Los Angeles, CA, USA
| | - Rine Nakanishi
- Los Angeles Biomedical Research Institute at Harbor, University of California-Los Angeles, Los Angeles, CA, USA
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute at Harbor, University of California-Los Angeles, Los Angeles, CA, USA.
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37
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Blaha MJ, Yeboah J, Al Rifai M, Liu K, Kronmal R, Greenland P. Providing Evidence for Subclinical CVD in Risk Assessment. Glob Heart 2018; 11:275-285. [PMID: 27741975 DOI: 10.1016/j.gheart.2016.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 10/20/2022] Open
Abstract
When the MESA (Multi-Ethnic Study of Atherosclerosis) began, the Framingham risk score was the preferred tool for 10-year global coronary heart disease risk assessment; however, the Framingham risk score had limitations including derivation in a homogenous population lacking racial and ethnic diversity and exclusive reliance on traditional risk factors without consideration of most subclinical disease measures. MESA was designed to study the prognostic value of subclinical atherosclerosis and other risk markers in a multiethnic population. In a series of landmark publications, MESA demonstrated that measures of subclinical cardiovascular disease add significant prognostic value to the traditional Framingham risk variables. In head-to-head studies comparing these markers, MESA established that the coronary artery calcium score may be the single best predictor of coronary heart disease risk. Results from MESA have directly influenced recent prevention guidelines including the recommendations on risk assessment and cholesterol-lowering therapy. The MESA study has published its own risk score, which allows for the calculation of 10-year risk of coronary heart disease before and after knowledge of a coronary artery calcium score.
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Affiliation(s)
- Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD, USA.
| | - Joseph Yeboah
- Department of Internal Medicine/Cardiology, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Mahmoud Al Rifai
- Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kiang Liu
- Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Kronmal
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Philip Greenland
- Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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38
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Khera A, Joshi P. What's a Malignant Family History?: You'll Know It When You See It. JACC Cardiovasc Imaging 2017; 10:1136-1138. [PMID: 28109931 DOI: 10.1016/j.jcmg.2016.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Amit Khera
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Parag Joshi
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
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39
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Coronary Plaque Burden and Adverse Plaque Characteristics Are Increased in Healthy Relatives of Patients With Early Onset Coronary Artery Disease. JACC Cardiovasc Imaging 2017; 10:1128-1135. [DOI: 10.1016/j.jcmg.2016.10.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 12/15/2022]
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40
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Early coronary calcifications are related to cholesterol burden in heterozygous familial hypercholesterolemia. J Clin Lipidol 2017; 11:704-711.e2. [DOI: 10.1016/j.jacl.2017.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/11/2017] [Accepted: 03/27/2017] [Indexed: 12/12/2022]
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41
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6130] [Impact Index Per Article: 875.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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42
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Fareed M, Afzal M. Increased cardiovascular risks associated with familial inbreeding: a population-based study of adolescent cohort. Ann Epidemiol 2016; 26:283-92. [PMID: 27084548 DOI: 10.1016/j.annepidem.2016.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 01/03/2023]
Abstract
PURPOSE Cardiovascular diseases are the leading cause of mortality and morbidity among humans worldwide. We aimed to estimate the effect of familial inbreeding on cardiovascular risks. METHODS The study was conducted during April 2014 through June 2014, and a total of 587 adolescent subjects (male = 270, female = 317; 11-18 years of age) were recruited from five Muslim populations viz., Gujjar and Bakarwal (n = 130), Mughal (n = 111), Malik (n = 114), Syed (n = 108), and Khan (n = 124). Wright's path relationship method was used for calculating the coefficient of inbreeding (F). Anthropometric and physiological parameters were estimated using standard methods. RESULTS We observed higher mean values for major physiological traits among the inbred subjects in comparison with the non-inbred groups of five different populations. Our study suggests that inbreeding and sex are the key factors affecting cardiovascular profile. Multivariate analysis of covariance revealed inbreeding as a major source of variation for cardiovascular risks, dominating over other factors causing greater variability in the physiological traits. The magnitude of cardiovascular risks shows an increase with the increase in the values of coefficient of inbreeding (i.e., from F = 0.00 to F = 0.125). The abnormal levels of systolic blood pressure (SBP; range 140-159 mm Hg) and fasting blood glucose (FBG; range 101-126 mg per dL) show persuasive increase with an upsurge in the homozygosity level (i.e., coefficient of inbreeding). CONCLUSIONS Our comprehensive assessment presents the deleterious consequence of inbreeding on cardiovascular profile. This study can be used as fact-sheet for framing the heath policies and hence can play a vital role in genetic counseling strategies for transforming the public opinion regarding the practice of consanguinity and its associated risks.
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Affiliation(s)
- Mohd Fareed
- Human Genetics and Toxicology Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
| | - Mohammad Afzal
- Human Genetics and Toxicology Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
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43
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Qanitha A, de Mol BA, Pabittei DR, Mappangara I, van der Graaf Y, Dalmeijer GW, Burgner DP, Uiterwaal CS. Infections in early life and premature acute coronary syndrome: A case-control study. Eur J Prev Cardiol 2016; 23:1640-8. [PMID: 27006417 DOI: 10.1177/2047487316640656] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/03/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infections in young children may affect the vasculature and initiate early atherosclerosis. Whether infections experienced in childhood play a part in adult clinical cardiovascular disease remains unclear. We investigated the association between infections in early life and the occurrence of premature coronary heart disease. METHODS We conducted a population-based case-control study of 153 patients with a first acute coronary syndrome before the age of 56 years and 153 age- and sex-matched controls. Any history of severe infections in childhood and adolescence was obtained, together with clinical and laboratory measurements and other cardiovascular risk factors. We developed an infection score for the overall burden of early life infections. Conditional logistic regression was used to assess the associations. RESULTS Infections experienced in early life increased the risk of acquiring acute coronary syndrome at a young age with an odds ratio (OR) of 2.67 (95% confidence interval (CI) 1.47-4.83, p = 0.001). After adjustments for traditional risk factors, lifestyle, dietary patterns, socio-economic status and parental history of cardiovascular events, these associations remained significant and changed only slightly. There was an indication for an interaction between infections in early life and current cardiovascular risk (Framingham Risk Score (FRS); p-interaction = 0.052). Within participants with a low FRS (<10%), the OR of early life infection for acute coronary syndrome was 1.49 (95% CI 0.72-3.08, p = 0.283); within participants with an intermediate FRS (10-20%), the OR was 4.35 (95% CI 1.60-11.84, p = 0.004); and within participants with a high FRS (>20%), the OR 10.00 (95% CI 1.21-82.51, p = 0.032). CONCLUSION Infections in early life may partly explain premature coronary heart disease in adulthood and may potentiate traditional cardiovascular risk factor effects.
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Affiliation(s)
- Andriany Qanitha
- Department of Cardio-thoracic Surgery, Academic Medical Centre, University of Amsterdam, the Netherlands Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
| | - Bastianus Ajm de Mol
- Department of Cardio-thoracic Surgery, Academic Medical Centre, University of Amsterdam, the Netherlands
| | - Dara R Pabittei
- Department of Cardio-thoracic Surgery, Academic Medical Centre, University of Amsterdam, the Netherlands Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
| | - Idar Mappangara
- Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
| | - Yolanda van der Graaf
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands
| | - Geertje W Dalmeijer
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands
| | - David P Burgner
- Department of Paediatrics, University of Melbourne, Australia
| | - Cuno Spm Uiterwaal
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands
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Guan S, Tang Z, Fang X, Wu X, Liu H, Wang C, Hou C. Prevalence of hyperuricemia among Beijing post-menopausal women in 10 years. Arch Gerontol Geriatr 2016; 64:162-6. [PMID: 26906723 DOI: 10.1016/j.archger.2016.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of this study was to explore the trend and risk factors of the prevalence of hyperuricemia among post-menopausal women in Beijing over a ten years period. METHOD This research was based on two cross-sectional surveys in post-menopausal women in Beijing. A total of 1881 post-menopausal women were included. Subjects answered a questionnaire and underwent a physical examination and blood test. Serum uric acid >357 μmol/L was diagnosed as hyperuricemia, and another diagnosis criterion (serum uric acid >416 μmol/L) was applied in these women. RESULTS Serum uric acid levels and hyperuricemia prevalence increased remarkably in the 10-year period. The prevalence of hyperuricemia increased more than 2-fold after being adjusted by age. Multivariate logistic regression models revealed hyperuricemia associated with age, education level, urban residents, alcohol consumption, hypertension, obesity, and dyslipidemia. With the increasing number of traditional cardiovascular risk factors (including hypertension, obesity, diabetes, and dyslipidemia), the risk of hyperuricemia increased significantly, and the accumulative effect of the factors on the risk of hyperuricemia was determined. CONCLUSION The prevalence of hyperuricemia was high and exhibited a remarkable, increasing trend in Beijing community-based, post-menopausal women. Better management of relative factors could help to prevent further increases in the burden of hyperuricemia in post-menopausal women in this region.
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Affiliation(s)
- Shaochen Guan
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
| | - Zhe Tang
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
| | - Xianghua Fang
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China.
| | - Xiaoguang Wu
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
| | - Hongjun Liu
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
| | - Chunxiu Wang
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
| | - Chengbei Hou
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory for Neurodegenerative Disease of Ministry of Education, China
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Mulders TA, Taraboanta C, Franken LC, van Heel E, Klass G, Forster BB, Arad Y, Boekholdt SM, Groenink M, Fröhlich J, Guerci AD, Stroes ES, Pinto-Sietsma SJ. Coronary artery calcification score as tool for risk assessment among families with premature coronary artery disease. Atherosclerosis 2016; 245:155-60. [DOI: 10.1016/j.atherosclerosis.2015.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 12/01/2015] [Accepted: 12/04/2015] [Indexed: 01/07/2023]
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Hecht HS. Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 2016; 8:579-596. [PMID: 25937196 DOI: 10.1016/j.jcmg.2015.02.006] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/01/2015] [Accepted: 02/05/2015] [Indexed: 02/06/2023]
Abstract
Coronary artery calcium scanning (CAC) has emerged as the most robust predictor of coronary events in the asymptomatic primary prevention population, particularly in the intermediate-risk cohort. Every study has demonstrated its superiority to risk factor-based paradigms, e.g., the Framingham Risk Score, with outcome-based net reclassification indexes ranging from 52.0% to 65.6% in the intermediate-risk, 34.0% to 35.8% in the high-risk, and 11.6% to 15.0% in the low-risk cohorts. CAC improves medication and lifestyle adherence and is cost-effective in specified populations, with the ability to effectively stratify the number needed to treat and scan for different therapeutic strategies and patient cohorts. Data have emerged clearly demonstrating the worse prognosis associated with increasing CAC on serial scans, suggesting a potential role for evaluating residual risk and treatment success or failure. CAC is also strongly associated with the development of stroke and congestive heart failure.
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Affiliation(s)
- Harvey S Hecht
- Icahn School of Medicine at Mount Sinai, New York, New York.
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47
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2015; 133:e38-360. [PMID: 26673558 DOI: 10.1161/cir.0000000000000350] [Citation(s) in RCA: 3744] [Impact Index Per Article: 416.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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48
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de Carvalho Cantarelli MJ, Castello HJ, Gonçalves R, Gioppato S, de Freitas Guimarães JB, Ribeiro EKP, Vardi JCF, Maksud D, Navarro EC. Preditores independentes de doença arterial coronária multiarterial: resultados do Registro Angiocardio. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rbci.2015.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Weber LA, Cheezum MK, Reese JM, Lane AB, Haley RD, Lutz MW, Villines TC. Cardiovascular Imaging for the Primary Prevention of Atherosclerotic Cardiovascular Disease Events. CURRENT CARDIOVASCULAR IMAGING REPORTS 2015; 8:36. [PMID: 26301038 PMCID: PMC4534502 DOI: 10.1007/s12410-015-9351-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Traditional cardiovascular risk factors have well-known limitations for the accurate assessment of individual cardiovascular risk. Unlike risk factor-based scores which rely on probabilistic calculations derived from population-based studies, coronary artery calcium (CAC) scoring, and carotid ultrasound allow for the direct visualization and quantification of subclinical atherosclerosis with the potential for a more accurate, personalized risk assessment and treatment approach. Among strategies used to guide preventive management, CAC scoring has consistently and convincingly outperformed traditional risk factors for the prediction of adverse cardiovascular events. Moreover, several studies have demonstrated the potential of CAC testing to improve precision for the use of more intensive pharmacologic therapies, such as aspirin and statins, in patients most likely to derive benefit, as compared to atherosclerotic cardiovascular disease risk calculators. By comparison to CAC, the role of carotid ultrasound for the measurement of carotid intima-media thickness (CIMT) remains less well-elucidated but may be significantly improved with the inclusion of plaque screening and novel three-dimensional measurements of plaque volume and morphology. Despite significant evidence supporting the ability of non-invasive atherosclerosis imaging (particularly CAC) to guide preventive management, imaging remains an under-utilized strategy among current guidelines and clinical practice. Herein, we review evidence regarding CAC and carotid ultrasound for patient risk classification, with a comparison of these techniques to currently advocated traditional risk factor-based scores.
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Affiliation(s)
- Lauren A. Weber
- />Cardiology Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
| | - Michael K. Cheezum
- />Departments of Medicine and Radiology (Cardiovascular Division), Brigham and Women’s Hospital, Non-Invasive Cardiovascular Imaging Program, Boston, MA 02115 USA
| | - Jason M. Reese
- />Cardiology Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
| | - Alison B. Lane
- />Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
| | - Ryan D. Haley
- />Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
| | - Meredith W. Lutz
- />Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
| | - Todd C. Villines
- />Cardiology Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 USA
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Liu J, Wang H, Zhao H, Liu H, Li L, Zhou Y. Arterial stiffness is increased in healthy subjects with a positive family history of hypertension. Clin Exp Hypertens 2015; 37:622-6. [PMID: 26114350 DOI: 10.3109/10641963.2015.1036061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jinbo Liu
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
| | - Hongyu Wang
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
| | - Hongwei Zhao
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
| | - Huan Liu
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
| | - Lihong Li
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
| | - Yingyan Zhou
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , PR China
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