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Kaptoge S, Seshasai SRK, Sun L, Walker M, Bolton T, Spackman S, Ataklte F, Willeit P, Bell S, Burgess S, Pennells L, Altay S, Assmann G, Ben-Shlomo Y, Best LG, Björkelund C, Blazer DG, Brenner H, Brunner EJ, Dagenais GR, Cooper JA, Cooper C, Crespo CJ, Cushman M, D'Agostino RB, Daimon M, Daniels LB, Danker R, Davidson KW, de Jongh RT, Donfrancesco C, Ducimetiere P, Elders PJM, Engström G, Ford I, Gallacher I, Bakker SJL, Goldbourt U, de La Cámara G, Grimsgaard S, Gudnason V, Hansson PO, Imano H, Jukema JW, Kabrhel C, Kauhanen J, Kavousi M, Kiechl S, Knuiman MW, Kromhout D, Krumholz HM, Kuller LH, Laatikainen T, Lowler DA, Meyer HE, Mukamal K, Nietert PJ, Ninomiya T, Nitsch D, Nordestgaard BG, Palmieri L, Price JF, Ridker PM, Sun Q, Rosengren A, Roussel R, Sakurai M, Salomaa V, Schöttker B, Shaw JE, Strandberg TE, Sundström J, Tolonen H, Tverdal A, Verschuren WMM, Völzke H, Wagenknecht L, Wallace RB, Wannamethee SG, Wareham NJ, Wassertheil-Smoller S, Yamagishi K, Yeap BB, Harrison S, Inouye M, Griffin S, Butterworth AS, Wood AM, Thompson SG, Sattar N, Danesh J, Di Angelantonio E, Tipping RW, Russell S, Johansen M, Bancks MP, Mongraw-Chaffin M, Magliano D, Barr ELM, Zimmet PZ, Knuiman MW, Whincup PH, Willeit J, Willeit P, Leitner C, Lawlor DA, Ben-Shlomo Y, Elwood P, Sutherland SE, Hunt KJ, Cushman M, Selmer RM, Haheim LL, Ariansen I, Tybjaer-Hansen A, Frikkle-Schmidt R, Langsted A, Donfrancesco C, Lo Noce C, Balkau B, Bonnet F, Fumeron F, Pablos DL, Ferro CR, Morales TG, Mclachlan S, Guralnik J, Khaw KT, Brenner H, Holleczek B, Stocker H, Nissinen A, Palmieri L, Vartiainen E, Jousilahti P, Harald K, Massaro JM, Pencina M, Lyass A, Susa S, Oizumi T, Kayama T, Chetrit A, Roth J, Orenstein L, Welin L, Svärdsudd K, Lissner L, Hange D, Mehlig K, Salomaa V, Tilvis RS, Dennison E, Cooper C, Westbury L, Norman PE, Almeida OP, Hankey GJ, Hata J, Shibata M, Furuta Y, Bom MT, Rutters F, Muilwijk M, Kraft P, Lindstrom S, Turman C, Kiyama M, Kitamura A, Yamagishi K, Gerber Y, Laatikainen T, Salonen JT, van Schoor LN, van Zutphen EM, Verschuren WMM, Engström G, Melander O, Psaty BM, Blaha M, de Boer IH, Kronmal RA, Sattar N, Rosengren A, Nitsch D, Grandits G, Tverdal A, Shin HC, Albertorio JR, Gillum RF, Hu FB, Cooper JA, Humphries S, Hill- Briggs F, Vrany E, Butler M, Schwartz JE, Kiyama M, Kitamura A, Iso H, Amouyel P, Arveiler D, Ferrieres J, Gansevoort RT, de Boer R, Kieneker L, Crespo CJ, Assmann G, Trompet S, Kearney P, Cantin B, Després JP, Lamarche B, Laughlin G, McEvoy L, Aspelund T, Thorsson B, Sigurdsson G, Tilly M, Ikram MA, Dorr M, Schipf S, Völzke H, Fretts AM, Umans JG, Ali T, Shara N, Davey-Smith G, Can G, Yüksel H, Özkan U, Nakagawa H, Morikawa Y, Ishizaki M, Njølstad I, Wilsgaard T, Mathiesen E, Sundström J, Buring J, Cook N, Arndt V, Rothenbacher D, Manson J, Tinker L, Shipley M, Tabak AG, Kivimaki M, Packard C, Robertson M, Feskens E, Geleijnse M, Kromhout D. Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation. Lancet Diabetes Endocrinol 2023; 11:731-742. [PMID: 37708900 PMCID: PMC7615299 DOI: 10.1016/s2213-8587(23)00223-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. METHODS For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961-2007, median latest follow-up years 1980-2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU. FINDINGS For participants with diabetes, we observed a linear dose-response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43-2·97) when diagnosed at 30-39 years, 2·26 (2·08-2·45) at 40-49 years, 1·84 (1·72-1·97) at 50-59 years, 1·57 (1·47-1·67) at 60-69 years, and 1·39 (1·29-1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier. INTERPRETATION Every decade of earlier diagnosis of diabetes was associated with about 3-4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes. FUNDING British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.
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Tschiderer L, Seekircher L, Izzo R, Mancusi C, Manzi MV, Baldassarre D, Amato M, Tremoli E, Veglia F, Tuomainen TP, Kauhanen J, Voutilainen A, Iglseder B, Lind L, Rundek T, Desvarieux M, Kato A, de Groot E, Aşçi G, Ok E, Agewall S, Beulens JWJ, Byrne CD, Calder PC, Gerstein HC, Gresele P, Klingenschmid G, Nagai M, Olsen MH, Parraga G, Safarova MS, Sattar N, Skilton M, Stehouwer CDA, Uthoff H, van Agtmael MA, van der Heijden AA, Zozulińska-Ziółkiewicz DA, Park HW, Lee MS, Bae JH, Beloqui O, Landecho MF, Plichart M, Ducimetiere P, Empana JP, Bokemark L, Bergström G, Schmidt C, Castelnuovo S, Calabresi L, Norata GD, Grigore L, Catapano A, Zhao D, Wang M, Liu J, Ikram MA, Kavousi M, Bots ML, Sweeting MJ, Lorenz MW, Willeit P. Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies. J Am Heart Assoc 2023:e027657. [PMID: 37301757 DOI: 10.1161/jaha.122.027657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/12/2023] [Indexed: 06/12/2023]
Abstract
Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I2=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I2=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I2=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.
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Affiliation(s)
- Lena Tschiderer
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Lisa Seekircher
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Maria V Manzi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine University of Milan Milan Italy
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | - Mauro Amato
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | | | | | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Bernhard Iglseder
- Department of Geriatric Medicine Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik Salzburg Austria
- Department of Geriatric Medicine Paracelsus Medical University Salzburg Austria
| | - Lars Lind
- Department of Medicine Uppsala University Uppsala Sweden
| | - Tatjana Rundek
- Department of Neurology University of Miami Miller School of Medicine Miami FL
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health Columbia University New York NY
- METHODS Core, Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1153 Paris France
| | - Akihiko Kato
- Blood Purification Unit Hamamatsu University Hospital Hamamatsu Japan
| | - Eric de Groot
- Imagelabonline and Cardiovascular Erichem the Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center-Academic Medical Centre Amsterdam the Netherlands
| | - Gülay Aşçi
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Ercan Ok
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Stefan Agewall
- Department of Clinical Sciences, Danderyd Hospital Division of Cardiology Karolinska Institutet Stockholm Sweden
- Institute of Clinical Sciences University of Oslo Oslo Norway
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | - Christopher D Byrne
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Hertzel C Gerstein
- Department of Medicine and Population Health Research Institute McMaster University Hamilton Ontario Canada
- Hamilton General Hospital Hamilton Ontario Canada
| | - Paolo Gresele
- Division of Internal and Cardiovascular Medicine, Department of Medicine and Surgery University of Perugia Perugia Italy
| | | | - Michiaki Nagai
- Department of Internal Medicine General Medicine and Cardiology, Hiroshima City Asa Hospital Hiroshima Japan
| | - Michael H Olsen
- Department of Internal Medicine, Holbaek Hospital University of Southern Denmark Odense Denmark
| | - Grace Parraga
- Department of Medical Biophysics, Robarts Research Institute Western University London ON Canada
| | - Maya S Safarova
- Department of Cardiovascular Medicine University of Kansas Medical Center Kansas City KS
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Michael Skilton
- Charles Perkins Centre, Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht Maastricht University Medical Centre Maastricht the Netherlands
| | - Heiko Uthoff
- Department of Angiology University Hospital Basel Basel Switzerland
| | - Michiel A van Agtmael
- Department of Internal Medicine Amsterdam University Medical Center, Vrije Universiteit Amsterdam the Netherlands
| | - Amber A van der Heijden
- Department of General Practice, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | | | - Hyun-Woong Park
- Division of Cardiology, Department of Internal Medicine Chungnam National University Sejong Hospital Sejong-si South Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, College of Medicine Konyang University Daejeon South Korea
- Department of Occupational and Environmental Medicine Konyang University Hospital Daejeon South Korea
| | - Jang-Ho Bae
- Heart Center, Konyang University Hospital Daejeon South Korea
- Department of Cardiology Konyang University College of Medicine Daejeon South Korea
| | - Oscar Beloqui
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Manuel F Landecho
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Matthieu Plichart
- Paris Cardiovascular Research Centre University Paris Descartes Paris France
- Fondation Santé Service, Hospital at Home Levallois-Perret France
| | | | | | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Clinical Physiology Sahlgrenska University Hospital, Region Västragötaland Gothenburg Sweden
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Samuela Castelnuovo
- Centro Dislipidemie, Aziende Socio Sanitarie Territoriali Grande Ospedale Metropolitano Niguarda Milan Italy
| | - Laura Calabresi
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
| | - Giuseppe D Norata
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Società Italiana per lo Studio dell'Aterosclerosi Center for the Study of Atherosclerosis, Bassini Hospital Cinisello Balsamo Italy
| | - Liliana Grigore
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Miao Wang
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - M Arfan Ikram
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands
| | - Michael J Sweeting
- Department of Health Sciences University of Leicester Leicester UK
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Matthias W Lorenz
- Klinik für Neurologie Krankenhaus Nordwest Frankfurt am Main Germany
- Department of Neurology Goethe University Frankfurt am Main Germany
| | - Peter Willeit
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
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Bahls M, Lorenz MW, Dörr M, Gao L, Kitagawa K, Tuomainen TP, Agewall S, Berenson G, Catapano AL, Norata GD, Bots ML, van Gilst W, Asselbergs FW, Brouwers FP, Uthoff H, Sander D, Poppert H, Hecht Olsen M, Empana JP, Schminke U, Baldassarre D, Veglia F, Franco OH, Kavousi M, de Groot E, Mathiesen EB, Grigore L, Polak JF, Rundek T, Stehouwer CDA, Skilton MR, Hatzitolios AI, Savopoulos C, Ntaios G, Plichart M, McLachlan S, Lind L, Willeit P, Steinmetz H, Desvarieux M, Ikram MA, Johnsen SH, Schmidt C, Willeit J, Ducimetiere P, Price JF, Bergström G, Kauhanen J, Kiechl S, Sitzer M, Bickel H, Sacco RL, Hofman A, Völzke H, Thompson SG. Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium. Eur J Prev Cardiol 2020; 27:234-243. [PMID: 31619084 PMCID: PMC7008553 DOI: 10.1177/2047487319877078] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/29/2019] [Indexed: 12/23/2022]
Abstract
AIMS Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear. METHODS AND RESULTS An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration (n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events. CONCLUSION Averaged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints.
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Affiliation(s)
- Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Matthias W Lorenz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, University of Cambridge, UK
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Stefan Agewall
- Institute of Clinical Sciences, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Ullevål, Ullevål, Oslo, Norway
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, USA
| | - Alberico L Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Giuseppe D Norata
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Italy
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wiek van Gilst
- Department of Experimental Cardiology, University Medical Center Groningen, The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Institute of Cardiovascular Science, University College London, London, UK
- Health Data Research UK and Institute of Health Informatics, University College London, London, UK
| | - Frank P Brouwers
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing, Tutzing, Germany
| | - Holger Poppert
- Department of Neurology, Technical University Munich, Munich, Germany
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital and Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Jean Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Paris, France
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy
| | | | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric de Groot
- Imagelabonline and Cardiovascular, Erichem, The Netherlands
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Liliana Grigore
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
| | - Joseph F Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, USA
| | - Coen DA Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Michael R Skilton
- The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
| | - Apostolos I Hatzitolios
- Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki – AHEPA Hospital, Greece
| | - Christos Savopoulos
- Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki – AHEPA Hospital, Greece
| | - George Ntaios
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Matthieu Plichart
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | | | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
- METHODS Core, Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité (CRESS), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Paris, France
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Caroline Schmidt
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | | | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Clinical Physiology, Gothenburg, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Matthias Sitzer
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
- Department of Neurology, Klinikum Herford, Herford, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, USA
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology | Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
| | - Simon G Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Pennells L, Kaptoge S, Wood A, Sweeting M, Zhao X, White I, Burgess S, Willeit P, Bolton T, Moons KGM, van der Schouw YT, Selmer R, Khaw KT, Gudnason V, Assmann G, Amouyel P, Salomaa V, Kivimaki M, Nordestgaard BG, Blaha MJ, Kuller LH, Brenner H, Gillum RF, Meisinger C, Ford I, Knuiman MW, Rosengren A, Lawlor DA, Völzke H, Cooper C, Marín Ibañez A, Casiglia E, Kauhanen J, Cooper JA, Rodriguez B, Sundström J, Barrett-Connor E, Dankner R, Nietert PJ, Davidson KW, Wallace RB, Blazer DG, Björkelund C, Donfrancesco C, Krumholz HM, Nissinen A, Davis BR, Coady S, Whincup PH, Jørgensen T, Ducimetiere P, Trevisan M, Engström G, Crespo CJ, Meade TW, Visser M, Kromhout D, Kiechl S, Daimon M, Price JF, Gómez de la Cámara A, Wouter Jukema J, Lamarche B, Onat A, Simons LA, Kavousi M, Ben-Shlomo Y, Gallacher J, Dekker JM, Arima H, Shara N, Tipping RW, Roussel R, Brunner EJ, Koenig W, Sakurai M, Pavlovic J, Gansevoort RT, Nagel D, Goldbourt U, Barr ELM, Palmieri L, Njølstad I, Sato S, Monique Verschuren WM, Varghese CV, Graham I, Onuma O, Greenland P, Woodward M, Ezzati M, Psaty BM, Sattar N, Jackson R, Ridker PM, Cook NR, D'Agostino RB, Thompson SG, Danesh J, Di Angelantonio E. Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies. Eur Heart J 2019; 40:621-631. [PMID: 30476079 PMCID: PMC6374687 DOI: 10.1093/eurheartj/ehy653] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/03/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied. METHODS AND RESULTS Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms. CONCLUSION Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need.
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Affiliation(s)
- Lisa Pennells
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Angela Wood
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Mike Sweeting
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Xiaohui Zhao
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, UK
| | - Ian White
- MRC Clinical Trials Unit, University College London, 90 High Holborn, London, UK
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
- MRC Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
- Department of Neurology and Neurosurgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Thomas Bolton
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Karel G M Moons
- Epidemiology: Methodology, Julius Center Research Program Methodology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Department of Epidemiology, Julius Center Research Program Cardiovascular Epidemiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands
| | - Randi Selmer
- Division of Epidemiology, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, Norway
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, Hjartavernd Holtasmá¡ri 1, Kópavogur, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmýrarvegur 16, Reykjavik, Iceland
| | - Gerd Assmann
- Assmann-Foundation for Prevention, Gronowskistraße 33, Münster, Germany
| | - Philippe Amouyel
- Institut Pasteur de Lille, 1 rue du Professeur Calmette, Lille, France
| | - Veikko Salomaa
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | - Børge G Nordestgaard
- Department of Clinical Medicine, Copenhagen University Hospital, Blegdamsvej 3, Copenhagen, Denmark
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Neuenheimer Feld 581, Heidelberg, Germany
- University of Heidelberg, Grabengasse 1, Heidelberg, Germany
| | - Richard F Gillum
- Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue, Washington, DC, USA
| | - Christa Meisinger
- German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Ian Ford
- Institute of Health & Wellbeing, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK
| | - Matthew W Knuiman
- Faculty of Health and Medical Sciences, School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Perth, Western Australia, Australia
| | - Annika Rosengren
- Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, Gothenburg, Sweden
- Wallenberg Laboratory, Sahlgrenska University Hospital, Blå stråket 5, Gothenburg, Sweden
| | - Debbie A Lawlor
- Department of Social Medicine, University of Bristol, Bristol, UK
| | - Henry Völzke
- Institute of Community Medicine, University of Greifswald, Ellernholzstraße 1/2, Greifswald, Germany
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Rd, Southampton, UK
| | | | - Edoardo Casiglia
- Department of Medicine, University of Padova, 2 Via Giustiniani, Padova, Italy
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 1 Yliopistonranta, Kuopio, Finland
| | - Jackie A Cooper
- Centre for Cardiovascular Genetics, University College London, 5 University Street, London, UK
| | - Beatriz Rodriguez
- Department of Geriatric Medicine, University of Hawaii, 1960 East-West Road, Honolulu, HI, USA
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Ing 40, 5 tr, Uppsala, Sweden
| | | | - Rachel Dankner
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, USA
| | - Karina W Davidson
- Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, USA
| | - Robert B Wallace
- College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA, USA
| | - Dan G Blazer
- Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
| | - Cecilia Björkelund
- Department of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 16, Gothenburg, Sweden
| | - Chiara Donfrancesco
- Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Istituto Superiore di Sanità (ISS), 299 Viale Regina Elena, Rome, Italy
| | | | - Aulikki Nissinen
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Barry R Davis
- Department of Biostatistics, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, USA
| | - Sean Coady
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 31 Center Drive, Bethesda, MD, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK
| | - Torben Jørgensen
- Research Centre for Prevention and Health, 5 Øster Farimagsgade, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, Copenhagen, Denmark
- Aalborg University, Fredrik Bajers Vej 5, Aalborg, Denmark
| | - Pierre Ducimetiere
- Faculté de Médecine, Université Paris Descartes, 12 Rue de l'Ecole de Médecine, Paris, France
| | - Maurizio Trevisan
- CUNY School of Medicine, City College of New York, 160 Convent Ave, New York, NY, USA
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
| | - Carlos J Crespo
- School of Community Health, Portland State University, 506 SW Mill St, Portland, OR, USA
| | - Tom W Meade
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Marjolein Visser
- Department of Health Sciences, Vrije Universiteit Amsterdam, VU University Medical Center, De Boelelaan 1085, Amsterdam, the Netherlands
| | - Daan Kromhout
- Department of Epidemiology, University Medical Centre Groningen, University of Grogingen, Hanzeplein 1, Groningen, the Netherlands
| | - Stefan Kiechl
- Department of Neurology and Neurosurgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Makoto Daimon
- Faculty of Medicine, Yamagata University, 1-4-12 Kojirakawa-machi, Yamagata, Japan
| | - Jackie F Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, UK
| | | | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, the Netherlands
| | - Benoît Lamarche
- Pavillon Ferdinand-Vandry, Université Laval, 2440 Hochelaga, Quebec, Canada
| | - Altan Onat
- Department of Cardiology, Cerrahpaşa Faculty of Medicine, Istanbul University, Beyazıt, Fatih, Istanbul, Turkey
| | | | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, the Netherlands
| | - Yoav Ben-Shlomo
- Bristol Neuroscience, Bristol University, Queens Road, Bristol, UK
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, UK
| | - Jacqueline M Dekker
- The Institute for Health and Care Research, VU University Medical Center, De Boelelaan 1085, Amsterdam, the Netherlands
| | | | - Nawar Shara
- Department of Biostatistics and Bioinformatics, MedStar Health Research Institute, 6525 Belcrest Road, Hyattsville, MD, USA
| | - Robert W Tipping
- Clinical Biostatistics, Merck, 2000 Galloping Hill Road, Kenilworth, NJ, USA
| | - Ronan Roussel
- Centre de Recherche des Cordeliers, INSERM, 15 rue de l'Ecole de Médecine, Paris, France
| | - Eric J Brunner
- Institute of Epidemiology & Health, University College London, 1-19 Torrington Place, London, UK
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, 21 Arcisstraße, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Str. 29, Munich, Germany
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, Japan
| | - Jelena Pavlovic
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, the Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Centre Groningen, University of Grogingen, Hanzeplein 1, Groningen, the Netherlands
| | - Dorothea Nagel
- Klinikum der Universität München, Ludwig-Maximilians-Universität, 15 Marchioninistraße, Munich, Germany
| | - Uri Goldbourt
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Elizabeth L M Barr
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Australia
| | - Luigi Palmieri
- Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Istituto Superiore di Sanità (ISS), 299 Viale Regina Elena, Rome, Italy
| | - Inger Njølstad
- Department of Public Health, University of Tromsø, Hansine Hansens veg 18, Tromsø, Norway
| | - Shinichi Sato
- Chiba Prefectural Institute of Public Health, 666-2 Nito-no-machi Chuo-ku, Chiba, Japan
| | - W M Monique Verschuren
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, The Netherlands
| | - Cherian V Varghese
- Noncommunicable Diseases, Disability, Violence and Injury Prevention Department, World Health Organization, 20 Avenue Appia, Geneva 27, Switzerland
| | - Ian Graham
- School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | - Oyere Onuma
- Noncommunicable Diseases, Disability, Violence and Injury Prevention Department, World Health Organization, 20 Avenue Appia, Geneva 27, Switzerland
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL, USA
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, 75 George Street, Oxford, UK
- The George Institute for Global Health, University of New South Wales, 1 King Street Newtown, Sydney, Australia
| | - Majid Ezzati
- Faculty of Medicine, School of Public Health, Norfolk Place, St Mary's Campus, Imperial College London, London, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Seattle, WA, USA
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
| | - Rod Jackson
- Faculty of Medical and Health Sciences, University of Auckland, 261 Morrin Road, Auckland, New Zealand
| | - Paul M Ridker
- Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, USA
| | - Nancy R Cook
- Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, USA
| | - Ralph B D'Agostino
- Mathematics and Statistics Department, Boston University, 111 Cummington Mall, Boston, MA, USA
| | - Simon G Thompson
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
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5
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Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Correction: Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0204633. [PMID: 30235339 PMCID: PMC6147579 DOI: 10.1371/journal.pone.0204633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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7
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Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0191172. [PMID: 29649236 PMCID: PMC5896895 DOI: 10.1371/journal.pone.0191172] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/29/2017] [Indexed: 12/28/2022] Open
Abstract
AIMS Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
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Affiliation(s)
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Cambridge, United Kingdom
| | | | - Giuseppe Danilo Norata
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, UMR, Paris, France
| | - Irene Schmidtmann
- Institut fuer Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitaetsmedizin Mainz, Mainz, Germany
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Sathanur R. Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Coen D. A. Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joseph F. Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Moise Desvarieux
- Department of Epidemiology,Mailman School of Public Health,Columbia University, New York, United States of America
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Daniel Staub
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Cesare R. Sirtori
- Center of Dyslipidemias, Niguarda Ca’ Granda Hospital, Milano, Italy
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Oscar Beloqui
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Alfonso Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Liliana Grigore
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Stefan Blankenberg
- 2nd Department of Medicine, Johannes Gutenberg-Universität, Mainz, Germany
- Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | | | - Henry Völzke
- German Center for Cardiovascular Research (DZHK),partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Raffaele Izzo
- School of Medicine, Federico II University, Naples, Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Thapat Wannarong
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | | | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health,National Taiwan University, Taipei, Taiwan
| | - Jackie F. Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, Gothenburg University, Götheborg, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Elena Tremoli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
| | | | - Manuel F. Landecho
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Maria Rosvall
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Rafael Gabriel
- Escuela National de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Nicola de Luca
- School of Medicine, Federico II University, Naples, Italy
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eric de Groot
- Imagelabonline & Cardiovascular, Eindhoven and Lunteren, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - David N. Yanez
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Simon G. Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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8
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Appleton KM, Woodside JV, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets JB, Yarnell JWG, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson CC. A Role for Behavior in the Relationships Between Depression and Hostility and Cardiovascular Disease Incidence, Mortality, and All-Cause Mortality: the Prime Study. Ann Behav Med 2017; 50:582-91. [PMID: 26979997 PMCID: PMC4933737 DOI: 10.1007/s12160-016-9784-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits. Purpose These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality. Methods Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support. Results Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption. Conclusions These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.
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Affiliation(s)
- K M Appleton
- Department of Psychology, Bournemouth University, Poole, BH12 5BB, UK.
| | - J V Woodside
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - D Arveiler
- Department of Epidemiology and Public Health, University of Strasbourg, EA3430, Strasbourg, France
| | - B Haas
- Department of Epidemiology and Public Health, University of Strasbourg, EA3430, Strasbourg, France
| | - P Amouyel
- The Lille Monica Project, INSERM U744, Lille, France
| | - M Montaye
- The Lille Monica Project, INSERM U744, Lille, France
| | - J Ferrieres
- The Toulouse MONICA Project, INSERM UMR1027, Toulouse, France
| | - J B Ruidavets
- The Toulouse MONICA Project, INSERM UMR1027, Toulouse, France
| | - J W G Yarnell
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - F Kee
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - A Evans
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - A Bingham
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - P Ducimetiere
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - C C Patterson
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
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9
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Morange P, Scarabin P, Alessi M, Luc G, Arveiler D, Ferrieres J, Amouyel P, Evans A, Ducimetiere P, Juhan-Vague I. Association between TAFI antigen and Ala147Thr polymorphism of the TAFI gene and the angina pectoris incidence. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613387] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThrombin activatable fibrinolysis inhibitor (TAFI), a recently described inhibitor of fibrinolysis, has been hypothesized as playing a role in atherothrombosis. However, the evidence from retrospective studies, which have evaluated the role of TAFI in vascular risk, is conflicting.In a prospective cohort (the PRIME Study) of nearly 10 000 apparently healthy men recruited in France (Lille, Strasbourg, Toulouse) and Northern Ireland (Belfast), we measured baseline plasma concentration of TAFI antigen among 143 participants (81 from France and 62 from Ireland) who subsequently developed angina pectoris and among 286 age-matched participants who remained free of disease during the 5 years of follow-up. Genotyping of the Ala147Thr polymorphism located in the TAFI gene was performed using an allele specific PCR. In France, mean levels of TAFI were significantly higher at baseline among men who subsequently developed angina pectoris compared with their control subjects (119 versus 107 %; p = 0.02). The risk of future angina pectoris increased with increasing tertiles of TAFI (p = 0.02), such that men in the highest tertile at study entry had a 5-fold higher relative risk than those in the lowest tertile (95% confidence interval, 1.38 to 18.58) after controlling for the conventional cardiovascular risk factors. No such difference was observed in Northern Ireland. In France, Thr/Thr carriers of the Ala147Thr polymorphism were significantly more frequent in cases than in controls (p = 0.01) leading to a relative risk of angina pectoris of 2.7 (95%CI 1.2-5.8).Increase in plasma TAFI antigen levels is a risk factor for angina pectoris in France. Genotyping for the Ala147Thr polymorphism seems to be a reliable tool to assess the risk mediated by TAFI.
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10
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Liao X, Norata GD, Polak JF, Stehouwer CDA, Catapano A, Rundek T, Ezhov M, Sander D, Thompson SG, Lorenz MW, Balakhonova T, Safarova M, Grigore L, Empana JP, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Schminke U, Lind L, Willeit P, Yanez DN, Steinmetz H, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Iglseder B, Friera A, Xie W, Plichart M, Su TC, Srinivasan SR, Schmidt C, Tuomainen TP, Völzke H, Nijpels G, Willeit J, Franco OH, Suarez C, Zhao D, Ducimetiere P, Chien KL, Robertson C, Bergström G, Kauhanen J, Dörr M, Dekker JM, Kiechl S, Sitzer M, Bickel H, Sacco RL, Hofman A, Mathiesen EB, Gabriel R, Liu J, Berenson G, Kavousi M, Price JF. Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin? Eur J Prev Cardiol 2016; 23:1165-73. [DOI: 10.1177/2047487315625543] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/15/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Ximing Liao
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Giuseppe D Norata
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Italy
- SISA Centre for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Joseph F Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, USA
| | - Coen DA Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, The Netherlands
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, USA
| | - Marat Ezhov
- Atherosclerosis Department, Cardiology Research Centre, Moscow, Russia
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
- Department of Neurology, Technische Universität München, Germany
| | - Simon G Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, UK
| | - Matthias W Lorenz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | | | - Maya Safarova
- Atherosclerosis Department, Cardiology Research Centre, Moscow, Russia
| | - Liliana Grigore
- SISA Centre for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, France
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Centre for Population Health Sciences, University of Edinburgh, UK
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Germany
| | - Lars Lind
- Department of Medicine, Uppsala University, Sweden
| | - Peter Willeit
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, UK
- Department of Neurology, Medical University Innsbruck, Austria
| | - David N Yanez
- Department of Biostatistics, University of Washington, Seattle, USA
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, University of Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Alfonsa Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain
| | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sathanur R Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Austria
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Germany
- German Centrefor Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Jaqueline M Dekker
- Department of Epidemiology and Biostatistics, University Medical Centre, Amsterdam, The Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Austria
| | - Matthias Sitzer
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
- Department of Neurology, Klinikum Herford, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Germany
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, USA
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, University of Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Rafael Gabriel
- Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, USA
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jackie F Price
- Centre for Population Health Sciences, University of Edinburgh, UK
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11
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Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, Kavousi M, Dörr M, Stensland E, Ducimetiere P, Ronkainen K, Kiechl S, Sitzer M, Rundek T, Lind L, Liu J, Bergström G, Grigore L, Bokemark L, Friera A, Yanez D, Bickel H, Ikram MA, Völzke H, Johnsen SH, Empana JP, Tuomainen TP, Willeit P, Steinmetz H, Desvarieux M, Xie W, Schmidt C, Norata GD, Suarez C, Sander D, Hofman A, Schminke U, Mathiesen E, Plichart M, Kauhanen J, Willeit J, Sacco RL, McLachlan S, Zhao D, Fagerberg B, Catapano AL, Gabriel R, Franco OH, Bülbül A, Scheckenbach F, Pflug A, Gao L, Thompson SG. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care 2015; 38:1921-9. [PMID: 26180107 PMCID: PMC4580609 DOI: 10.2337/dc14-2732] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 06/20/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 population-based cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference in mean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97 mm across cohorts in people with diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between -0.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.
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Affiliation(s)
- Matthias W Lorenz
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Jackie F Price
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Christine Robertson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joseph F Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, MA
| | - Holger Poppert
- Department of Neurology, University Hospital of the Technical University of Munich, Munich, Germany
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marcus Dörr
- Department of Internal Medicine B/Cardiology, Greifswald University Clinic, Greifswald, Germany
| | - Eva Stensland
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | | | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Matthias Sitzer
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany Department of Neurology, Klinikum Herford, Herford, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Jing Liu
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Liliana Grigore
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy IRCCS MultiMedica, Milan, Italy
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Alfonsa Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - David Yanez
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Horst Bickel
- Department of Psychiatry, University Hospital of the Technical University of Munich, Munich, Germany
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University of Greifswald, Greifswald, Germany German Centre for Cardiovascular Research, Greifswald, Germany
| | - Stein Harald Johnsen
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Neurology and Neurophysiology, University Hospital of Northern Norway, Tromsø, Norway
| | | | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
| | - Helmuth Steinmetz
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY École des Hautes Études en Santé Publique, Paris, France INSERM U 738, Paris, France
| | - Wuxiang Xie
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Giuseppe D Norata
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Dirk Sander
- Department of Neurology, University Hospital of the Technical University of Munich, Munich, Germany Department of Neurology, Benedictus Hospital Tutzing and Feldafing, Feldafing, Germany
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Ellisiv Mathiesen
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Neurology and Neurophysiology, University Hospital of Northern Norway, Tromsø, Norway
| | - Matthieu Plichart
- INSERM U 970, Paris, France Gerontology Department, Broca Hospital, Paris, France
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Stela McLachlan
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Dong Zhao
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Björn Fagerberg
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Alberico L Catapano
- IRCCS MultiMedica, Milan, Italy Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Rafael Gabriel
- Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Alpaslan Bülbül
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Frank Scheckenbach
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Anja Pflug
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, Cambridge, U.K
| | - Simon G Thompson
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
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Majed B, Montaye M, Wagner A, Arveiler D, Ducimetiere P, Tafflet M, Ferrieres J, Ruidavets JB, Kee F, Evans A, Amouyel P, Prugger C, Empana JP. All-Cause Mortality up to and After Coronary Heart Disease and Stroke Events in European Middle-Aged Men. Stroke 2015; 46:1371-3. [DOI: 10.1161/strokeaha.115.008903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/27/2015] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The aim was to investigate prospectively the all-cause mortality risk up to and after coronary heart disease (CHD) and stroke events in European middle-aged men.
Methods—
The study population comprised 10 424 men 50 to 59 years of age recruited between 1991 and 1994 in France (N=7855) and Northern Ireland (N=2747) within the Prospective Epidemiological Study of Myocardial Infarction. Incident CHD and stroke events and deaths from all causes were prospectively registered during the 10-year follow-up. In Cox’s proportional hazards regression analysis, CHD and stroke events during follow-up were used as time-dependent covariates.
Results—
A total of 769 CHD and 132 stroke events were adjudicated, and 569 deaths up to and 66 after CHD or stroke occurred during follow-up. After adjustment for study country and cardiovascular risk factors, the hazard ratios of all-cause mortality were 1.58 (95% confidence interval 1.18–2.12) after CHD and 3.13 (95% confidence interval 1.98–4.92) after stroke.
Conclusions—
These findings support continuous efforts to promote both primary and secondary prevention of cardiovascular disease.
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Affiliation(s)
- Bilal Majed
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Michèle Montaye
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Aline Wagner
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Dominique Arveiler
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Pierre Ducimetiere
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Muriel Tafflet
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Jean Ferrieres
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Jean-Bernard Ruidavets
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Frank Kee
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Alun Evans
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Philippe Amouyel
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Christof Prugger
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
| | - Jean-Philippe Empana
- From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France (B.M., M.T., C.P., J.-P.E.); The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, UDSL, Lille, 5900, France (M.M., P.A.); The Strasbourg MONICA Project, Laboratoire d’Épidémiologie et de Santé Publique, EA 3430, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France (A.W., D.A.); INSERM
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Appleton K, Woodside J, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets J, Yarnell J, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson C. EPA-0229 - Association between depression and mortality depends on methodology used. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Appleton KM, Woodside JV, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets JB, Yarnell JWG, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson CC. Depression and mortality: artifact of measurement and analysis? J Affect Disord 2013; 151:632-638. [PMID: 23948631 DOI: 10.1016/j.jad.2013.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data. METHODS Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models. RESULTS Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost. LIMITATIONS Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied. CONCLUSIONS These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping.
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Affiliation(s)
- K M Appleton
- Psychology, DEC, Bournemouth University, Dorset BH12 5BB, United Kingdom.
| | - J V Woodside
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - D Arveiler
- The Strasbourg MONICA Project, Department of Epidemiology and Public Health, EA 3430, University of Strasbourg, Strasbourg, France
| | - B Haas
- The Strasbourg MONICA Project, Department of Epidemiology and Public Health, EA 3430, University of Strasbourg, Strasbourg, France
| | - P Amouyel
- The Lille Monica Project, INSERM U744, Lille, France
| | - M Montaye
- The Lille Monica Project, INSERM U744, Lille, France
| | - J Ferrieres
- The Toulouse MONICA Project, INSERM U558, Toulouse, France
| | - J B Ruidavets
- The Toulouse MONICA Project, INSERM U558, Toulouse, France
| | - J W G Yarnell
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - F Kee
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - A Evans
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - A Bingham
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - P Ducimetiere
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - C C Patterson
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
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Esquirol Y, Yarnell J, Ferrieres J, Evans A, Ruidavets JB, Wagner A, Dallongeville J, Arveiler D, Ducimetiere P, Amouyel P, Bingham A, Kee F. Impact of occupational physical activity and related tasks on cardiovascular disease: Emerging opportunities for prevention? Int J Cardiol 2013; 168:4475-8. [DOI: 10.1016/j.ijcard.2013.06.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 06/30/2013] [Indexed: 11/25/2022]
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Majed B, Tafflet M, Kee F, Haas B, Ferrieres J, Montaye M, Ruidavets JB, Arveiler D, Yarnell J, Amouyel P, Ducimetiere P, Empana JP. External validation of the 2008 Framingham cardiovascular risk equation for CHD and stroke events in a European population of middle-aged men. The PRIME study. Prev Med 2013; 57:49-54. [PMID: 23603213 DOI: 10.1016/j.ypmed.2013.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/05/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To test the applicability of the sex-specific 2008 Framingham general cardiovascular risk equation for coronary heart disease (CHD) and stroke in European middle-aged men from Ireland and France. METHODS In the PRIME study, 9638 healthy middle-aged men recruited in France and Ireland were surveyed for 10 years for the occurrence of first CHD and stroke events. The original Framingham equation, the partially calibrated Framingham equation (using the PRIME baseline survival at 10 years), and the completely calibrated Framingham equation (additionally using risk factor means calculated in PRIME) were assessed. Model fit (expected versus observed events) and discrimination ability were assessed using a modified Hosmer-Lemeshow Chi-square statistic and Harrell's c-index respectively. RESULTS The original (uncalibrated) Framingham equation overestimated by 1.94-fold the risk of CHD and stroke combined in PRIME, and by 2.23 and 1.42-fold in PRIME-France and PRIME-Ireland respectively. Adequate fit was found after complete calibration. However, discrimination ability of the Framingham equation was poor as shown by Harrell's c-index lower than 0.70. CONCLUSION The (completely) calibrated 2008 Framingham equation predicted accurate number of CHD and stroke events but discriminated poorly individuals at higher from those at lower event risk in a European population of middle-aged men.
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Affiliation(s)
- Bilal Majed
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, UMR-S970 Paris, France.
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Prugger C, Luc G, Haas B, Morange PE, Ferrieres J, Amouyel P, Kee F, Ducimetiere P, Empana JP. Multiple biomarkers for the prediction of ischemic stroke: the PRIME study. Arterioscler Thromb Vasc Biol 2013; 33:659-66. [PMID: 23329137 DOI: 10.1161/atvbaha.112.300109] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To simultaneously evaluate 14 biomarkers from distinct biological pathways for risk prediction of ischemic stroke, including biomarkers of hemostasis, inflammation, and endothelial activation as well as chemokines and adipocytokines. METHODS AND RESULTS The Prospective Epidemiological Study on Myocardial Infarction (PRIME) is a cohort of 9771 healthy men 50 to 59 years of age who were followed up over 10 years. In a nested case-control study, 95 ischemic stroke cases were matched with 190 controls. After multivariable adjustment for traditional risk factors, fibrinogen (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.03-2.28), E-selectin (OR, 1.76; 95% CI, 1.06-2.93), interferon-γ-inducible-protein-10 (OR, 1.72; 95% CI, 1.06-2.78), resistin (OR, 2.86; 95% CI, 1.30-6.27), and total adiponectin (OR, 1.82; 95% CI, 1.04-3.19) were significantly associated with ischemic stroke. Adding E-selectin and resistin to a traditional risk factor model significantly increased the area under the receiver-operating characteristic curve from 0.679 (95% CI, 0.612-0.745) to 0.785 and 0.788, respectively, and yielded a categorical net reclassification improvement of 29.9% (P=0.001) and 28.4% (P=0.002), respectively. Their simultaneous inclusion in the traditional risk factor model increased the area under the receiver-operating characteristic curve to 0.824 (95% CI, 0.770-0.877) and resulted in an net reclassification improvement of 41.4% (P<0.001). Results were confirmed when using continuous net reclassification improvement. CONCLUSIONS Among multiple biomarkers from distinct biological pathways, E-selectin and resistin provided incremental and additive value to traditional risk factors in predicting ischemic stroke.
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Affiliation(s)
- Christof Prugger
- Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France.
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Di Angelantonio E, Gao P, Pennells L, Kaptoge S, Caslake M, Thompson A, Butterworth AS, Sarwar N, Wormser D, Saleheen D, Ballantyne CM, Psaty BM, Sundström J, Ridker PM, Nagel D, Gillum RF, Ford I, Ducimetiere P, Kiechl S, Koenig W, Dullaart RPF, Assmann G, D'Agostino RB, Dagenais GR, Cooper JA, Kromhout D, Onat A, Tipping RW, Gómez-de-la-Cámara A, Rosengren A, Sutherland SE, Gallacher J, Fowkes FGR, Casiglia E, Hofman A, Salomaa V, Barrett-Connor E, Clarke R, Brunner E, Jukema JW, Simons LA, Sandhu M, Wareham NJ, Khaw KT, Kauhanen J, Salonen JT, Howard WJ, Nordestgaard BG, Wood AM, Thompson SG, Boekholdt SM, Sattar N, Packard C, Gudnason V, Danesh J. Lipid-related markers and cardiovascular disease prediction. JAMA 2012; 307:2499-506. [PMID: 22797450 PMCID: PMC4211641 DOI: 10.1001/jama.2012.6571] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
CONTEXT The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated. OBJECTIVE To determine whether adding information on apolipoprotein B and apolipoprotein A-I, lipoprotein(a), or lipoprotein-associated phospholipase A2 to total cholesterol and high-density lipoprotein cholesterol (HDL-C) improves cardiovascular disease (CVD) risk prediction. DESIGN, SETTING, AND PARTICIPANTS Individual records were available for 165,544 participants without baseline CVD in 37 prospective cohorts (calendar years of recruitment: 1968-2007) with up to 15,126 incident fatal or nonfatal CVD outcomes (10,132 CHD and 4994 stroke outcomes) during a median follow-up of 10.4 years (interquartile range, 7.6-14 years). MAIN OUTCOME MEASURES Discrimination of CVD outcomes and reclassification of participants across predicted 10-year risk categories of low (<10%), intermediate (10%-<20%), and high (≥20%) risk. RESULTS The addition of information on various lipid-related markers to total cholesterol, HDL-C, and other conventional risk factors yielded improvement in the model's discrimination: C-index change, 0.0006 (95% CI, 0.0002-0.0009) for the combination of apolipoprotein B and A-I; 0.0016 (95% CI, 0.0009-0.0023) for lipoprotein(a); and 0.0018 (95% CI, 0.0010-0.0026) for lipoprotein-associated phospholipase A2 mass. Net reclassification improvements were less than 1% with the addition of each of these markers to risk scores containing conventional risk factors. We estimated that for 100,000 adults aged 40 years or older, 15,436 would be initially classified at intermediate risk using conventional risk factors alone. Additional testing with a combination of apolipoprotein B and A-I would reclassify 1.1%; lipoprotein(a), 4.1%; and lipoprotein-associated phospholipase A2 mass, 2.7% of people to a 20% or higher predicted CVD risk category and, therefore, in need of statin treatment under Adult Treatment Panel III guidelines. CONCLUSION In a study of individuals without known CVD, the addition of information on the combination of apolipoprotein B and A-I, lipoprotein(a), or lipoprotein-associated phospholipase A2 mass to risk scores containing total cholesterol and HDL-C led to slight improvement in CVD prediction.
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Prugger C, Luc G, Haas B, Arveiler D, Machez E, Ferrieres J, Ruidavets JB, Bingham A, Montaye M, Amouyel P, Yarnell J, Kee F, Ducimetiere P, Empana JP. Adipocytokines and the risk of ischemic stroke: the PRIME Study. Ann Neurol 2012; 71:478-86. [PMID: 22522440 DOI: 10.1002/ana.22669] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Adipocytokines are hormones secreted from adipose tissue that possibly link adiposity and the risk of cardiovascular disease, but limited prospective data exist on plasma adipocytokines and ischemic stroke risk. We investigated associations and predictive properties of 4 plasma adipocytokines, namely resistin, adipsin, leptin, and total adiponectin, with regard to incident ischemic stroke in the PRIME Study. METHODS A cohort of 9,771 healthy men 50 to 59 years of age at baseline was followed up over a period of 10 years. In a nested case-control study, 95 ischemic stroke cases were matched with 190 controls on age, study center, and date of examination. Hazard ratios (HRs) per standard deviation increase in plasma adipocytokine levels were estimated using conditional logistic regression analysis. The additive value of adipocytokines in stroke risk prediction was evaluated by discrimination and reclassification metrics. RESULTS Resistin (HR, 1.88; 95% confidence interval [CI], 1.16-3.03), adipsin (HR, 2.01; 95% CI, 1.33-3.04), and total adiponectin (HR, 1.53; 95% CI, 1.01-2.34), but not leptin, were independent predictors of ischemic stroke. The performance of a traditional risk factor model predicting ischemic stroke was significantly improved by the simultaneous inclusion of resistin, adipsin, and total adiponectin (c-statistic: 0.673 [95% CI, 0.631-0.766] vs 0.826 [95% CI, 0.792-0.892], p < 0.001; net reclassification improvement: 38.1%, p < 0.001). INTERPRETATION Higher plasma levels of resistin, adipsin, and total adiponectin were associated with an increased 10-year risk of ischemic stroke among healthy middle-aged men. Resistin, adipsin, and total adiponectin provided incremental value over traditional risk factors for the prediction of ischemic stroke risk.
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Affiliation(s)
- Christof Prugger
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S, France.
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Majed B, Arveiler D, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, Appleton K, Haas B, Kee F, Amouyel P, Ducimetiere P, Empana JP. Depressive symptoms, a time-dependent risk factor for coronary heart disease and stroke in middle-aged men: the PRIME Study. Stroke 2012; 43:1761-7. [PMID: 22517599 DOI: 10.1161/strokeaha.111.645366] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE To date, the association between depressive symptoms and the risk of cardiovascular diseases remains controversial. We investigated prospectively, within the same population, the time course of the association between baseline depressive symptoms and first stroke or coronary heart disease event. METHODS In the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study, a multicenter, observational, prospective cohort, 9601 men from France and Northern Ireland were surveyed for the occurrence of first coronary heart disease (n=647) and stroke events (n=136) over 10 years. At baseline, the fourth quartile of a 13-item modified Center for Epidemiological Studies questionnaire was used to define the presence of depressive symptoms. We sought the best time-dependent function to assess the association between depressive symptoms and outcomes. Thus, the hazard ratios were estimated by a Cox proportional hazard model after splitting the follow-up before and after 5 years of follow-up time periods. RESULTS Depressive symptoms at baseline were associated with coronary heart disease in the first 5 years of follow-up (hazard ratio, 1.43; 1.10-1.87) and with stroke in the second 5 years of follow up (hazard ratio, 1.96; 1.21-3.19) after adjustment for age, study centers, baseline socioeconomic factors, traditional vascular risk factors, and antidepressant treatment. The association was even stronger for ischemic stroke (n=108; hazard ratio, 2.48; 1.45-4.25). CONCLUSIONS The current study suggests that in healthy, European, middle-aged men, baseline depressive symptoms are associated with an increased risk of coronary heart disease in the short-term, and for stroke in the long-term.
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Affiliation(s)
- Bilal Majed
- INSERM U970, Paris Cardiovascular Research Center, Equipe 4: Epidémiologie cardiovasculaire et mort subite, 56 rue Leblanc, 75015 Paris, France.
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Blachier M, Dauvilliers Y, Jaussent I, Helmer C, Ritchie K, Jouven X, Tzourio C, Amouyel P, Besset A, Ducimetiere P, Empana JP. Excessive daytime sleepiness and vascular events: The Three City Study. Ann Neurol 2012; 71:661-7. [DOI: 10.1002/ana.22656] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 09/13/2011] [Accepted: 10/14/2011] [Indexed: 11/09/2022]
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Canouï-Poitrine F, Luc G, Mallat Z, Machez E, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, Yarnell J, Haas B, Arveiler D, Morange P, Kee F, Evans A, Amouyel P, Ducimetiere P, Empana JP. Systemic chemokine levels, coronary heart disease, and ischemic stroke events: the PRIME study. Neurology 2011; 77:1165-73. [PMID: 21849651 DOI: 10.1212/wnl.0b013e31822dc7c8] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To quantify the association between systemic levels of the chemokine regulated on activation normal T-cell expressed and secreted (RANTES/CCL5), interferon-γ-inducible protein-10 (IP-10/CXCL10), monocyte chemoattractant protein-1 (MCP-1/CCL2), and eotaxin-1 (CCL11) with future coronary heart disease (CHD) and ischemic stroke events and to assess their usefulness for CHD and ischemic stroke risk prediction in the PRIME Study. METHODS After 10 years of follow-up of 9,771 men, 2 nested case-control studies were built including 621 first CHD events and 1,242 matched controls and 95 first ischemic stroke events and 190 matched controls. Standardized hazard ratios (HRs) for each log-transformed chemokine were estimated by conditional logistic regression. RESULTS None of the 4 chemokines were independent predictors of CHD, either with respect to stable angina or to acute coronary syndrome. Conversely, RANTES (HR = 1.70; 95% confidence interval [CI] 1.05-2.74), IP-10 (HR = 1.53; 95% CI 1.06-2.20), and eotaxin-1 (HR = 1.59; 95% CI 1.02-2.46), but not MCP-1 (HR = 0.99; 95% CI 0.68-1.46), were associated with ischemic stroke independently of traditional cardiovascular risk factors, hs-CRP, and fibrinogen. When the first 3 chemokines were included in the same multivariate model, RANTES and IP-10 remained predictive of ischemic stroke. Their addition to a traditional risk factor model predicting ischemic stroke substantially improved the C-statistic from 0.6756 to 0.7425 (p = 0.004). CONCLUSIONS In asymptomatic men, higher systemic levels of RANTES and IP-10 are independent predictors of ischemic stroke but not of CHD events. RANTES and IP-10 may improve the accuracy of ischemic stroke risk prediction over traditional risk factors.
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Affiliation(s)
- F Canouï-Poitrine
- INSERM U970, The Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, Paris, F-75015, France.
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Empana JP, Tafflet M, Escolano S, Vergnaux AC, Bineau S, Ruidavets JB, Montaye M, Haas B, Czernichow S, Balkau B, Ducimetiere P. Predicting CHD risk in France: a pooled analysis of the D.E.S.I.R., Three City, PRIME, and SU.VI.MAX studies. ACTA ACUST UNITED AC 2011; 18:175-85. [PMID: 21450663 DOI: 10.1177/1741826710389354] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND We aimed to develop and validate a simple coronary heart disease (CHD) risk algorithm applicable to asymptomatic men and women in France, and to compare its accuracy with that of the last published version of the Framingham risk function for cardiovascular disease. DESIGN A pooled analysis of four French prospective general-population studies. METHODS The baseline and follow-up data from D.E.S.I.R., PRIME, Three City, and SU.VI.MAX studies were used. The 10-year CHD risk was estimated by the Cox proportional hazards model with candidate variables including age, gender, body mass index, waist circumference, family history of coronary heart disease, smoking status, diabetes status, systolic blood pressure, and total and high-density lipoprotein (HDL) cholesterol. RESULTS The study population included 22,256 subjects (61.4% men) aged (SD) 56.0 years (8.3) without a personal history of CHD at baseline. After a mean follow-up of 8.0 years (2.3), 788 first CHD events occurred, 726 in men and 62 in women. The final model included age, gender, age × gender interaction, current smoking status, diabetes status, systolic blood pressure, total and HDL cholesterol. Using this model, the number of predicted coronary events fitted that given by the 10-year Kaplan-Meier survival estimates within each decile of estimated risk (calibration). This model had fair discrimination: Harrell C-index, 0.7831 (95% CI: 0.7704-0.7957). For comparison, the recalibrated Framingham risk function had equivalent performances compared to the French risk equation. CONCLUSION Our 10-year French CHD risk equation based on traditional risk factors performed at least as well as the recalibrated Framingham cardiovascular disease risk function.
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Affiliation(s)
- J P Empana
- INSERM U970, Paris Cardiovascular Research Centre PARCC, 56 rue Leblanc, Paris, France.
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Borglykke A, Andreasen AH, Kuulasmaa K, Sans S, Ducimetiere P, Vanuzzo D, Ferrario MM, Palmieri L, Karvanen J, Tunstall-Pedoe H, Jorgensen T. Stroke risk estimation across nine European countries in the MORGAM project. Heart 2010; 96:1997-2004. [DOI: 10.1136/hrt.2010.207555] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Empana JP, Jouven X, Canouï-Poitrine F, Luc G, Tafflet M, Haas B, Arveiler D, Ferrieres J, Ruidavets JB, Montaye M, Yarnell J, Morange P, Kee F, Evans A, Amouyel P, Ducimetiere P. C-reactive protein, interleukin 6, fibrinogen and risk of sudden death in European middle-aged men: the PRIME study. Arterioscler Thromb Vasc Biol 2010; 30:2047-52. [PMID: 20651278 DOI: 10.1161/atvbaha.110.208785] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine prospectively the association of high-sensitivity C-reactive protein, interleukin 6, and fibrinogen with sudden death in asymptomatic European men. METHODS AND RESULTS Among the 9771 men from the Etude PRospective de l'Infarctus du Myocarde (PRIME) Study, 664 had a first coronary heart disease over 10 years, including 50 sudden deaths, 34 nonsudden coronary deaths, and 580 nonfatal coronary heart disease events. For each outcome, 2 matched controls, who were free of coronary heart disease at the index date, were randomly selected from the initial cohort (nested case control study design). There was a 3-fold increased risk (95% CI, 1.20 to 7.81) of sudden death between the upper and the lower third of interleukin 6 after adjustment for baseline confounders in conditional logistic regression analysis. Neither high-sensitivity C-reactive protein (hazard ratio(third versus first tertile)=1.27; 95% CI, 0.51 to 3.17) nor fibrinogen (hazard ratio(third versus first tertile)=1.90; 95% CI, 0.76 to 4.75) was associated with sudden death. For comparison, there was a 6-fold increased risk of nonsudden coronary death from the highest compared with the lowest tertile of fibrinogen and a trend toward an association with higher C-reactive protein and higher interleukin 6. All 3 inflammatory biomarkers were moderately, but significantly, associated with nonfatal coronary heart disease. CONCLUSIONS Interleukin 6, but not high-sensitivity C-reactive protein or fibrinogen, is an independent predictor of sudden death in asymptomatic European men.
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Affiliation(s)
- Jean-Philippe Empana
- Institut National de la Santé et de la Recherche Médicale, Unité 970, Paris Cardiovascular Research Center; Université Paris Descartes, Unité Mixte de Recherche en Santé 970, Paris, France .
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Fezeu L, Balkau B, Sobngwi E, Kengne AP, Vol S, Ducimetiere P, Mbanya JC. Waist circumference and obesity-related abnormalities in French and Cameroonian adults: the role of urbanization and ethnicity. Int J Obes (Lond) 2010; 34:446-53. [PMID: 20065972 PMCID: PMC2941697 DOI: 10.1038/ijo.2009.256] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the effect of urbanization and ethnicity on correlations between waist circumference (WC) and obesity-related cardiovascular risk factors. METHODS 1471 rural and urban Cameroonians, and 4185 French, from community-based studies, aged > or =25 years, not treated for hypertension, diabetes and dyslipidemia participated in this study. Slopes of obesity-related abnormalities with WC were compared using an interaction term between place of residence and WC. RESULTS Women in urban Cameroon and men in France had significantly higher WC and BMI relative to their gender counterparts. Urban Cameroonians had higher abdominal adiposity, but lower BP and better metabolic profile than the French. WC was positively associated to all the obesity-related abnormalities in the three sites except to FPG (both genders) and blood lipids (women) in rural Cameroon. A 5 cm larger WC was associated with a higher increment among urban than rural Cameroonians for diastolic blood pressure (DBP) (women, 1.95/0.63 mm Hg; men, 2.56/1.44 mm Hg), HOMA-IR (women, 0.11/0.05), fasting plasma glucose (FPG) (men, 0.09/-0.01 mmol/l) and triglycerides (women, 0.06/0.01 mmol/l; men, 0.09/0.03 mmol/l), all P<0.05. A 5 cm larger WC was associated with a higher increment among urban Cameroon than French people for DBP (women, 1.95/1.28 mm Hg, P<0.01; men, 2.56/1.49 mm Hg, P<0.01), but with a lower increment for HOMA-IR (women, 0.11/0.14, P<0.05), FPG (women, 0.05/0.09 mmol/l), total cholesterol (women, 0.07/0.11 mmol/l; men, 0.10/0.13 mmol/l) and triglycerides (women, 0.06/0.11 mmol/l; men, 0.09/0.13 mmol/l) all P<0.05. CONCLUSION Ethnicity and urbanization modify the association of WC with obesity-related metabolic abnormalities. WC cutoff points derived from Caucasians may not be appropriate for black Sub-Saharan Africans.
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Affiliation(s)
- L Fezeu
- INSERM U780-IFR69, Epidemiological and Biostatistical Research, Villejuif, France.
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Canouï-Poitrine F, Luc G, Bard JM, Ferrieres J, Yarnell J, Arveiler D, Morange P, Kee F, Evans A, Amouyel P, Ducimetiere P, Empana JP. Relative Contribution of Lipids and Apolipoproteins to Incident Coronary Heart Disease and Ischemic Stroke: The PRIME Study. Cerebrovasc Dis 2010; 30:252-9. [DOI: 10.1159/000319067] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 04/15/2010] [Indexed: 11/19/2022] Open
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Straczek C, Ducimetiere P, Barberger-Gateau P, Helmer C, Ritchie K, Jouven X, Carcaillon L, Amouyel P, Tzourio C, Empana JP. Higher Level of Systemic C-Reactive Protein Is Independently Predictive of Coronary Heart Disease in Older Community-Dwelling Adults: The Three-City Study. J Am Geriatr Soc 2009; 58:129-35. [DOI: 10.1111/j.1532-5415.2009.02625.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jackson D, White I, Kostis JB, Wilson AC, Folsom AR, Wu K, Chambless L, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Thompson SG, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Levy D, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Engström G, Berglund G, Loewel H, Koenig W, Hense HW, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Iso H, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Despres JP, Dagenais GR, Tunstall-Pedoe H, Lowe GDO, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Meade TW, Rudnicka A, Brennan P, Knottenbelt C, Cooper JA, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Lowe GDO, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Di Angelantonio E, Kaptoge S, Lewington S, Lowe GDO, Sarwar N, Thompson SG, Walker M, Watson S, White IR, Wood AM, Danesh J. Systematically missing confounders in individual participant data meta-analysis of observational cohort studies. Stat Med 2009; 28:1218-37. [PMID: 19222087 PMCID: PMC2922684 DOI: 10.1002/sim.3540] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154 012 participants in 31 cohorts.† Copyright © 2009 John Wiley & Sons, Ltd.
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Empana JP, Dauvilliers Y, Dartigues JF, Ritchie K, Gariepy J, Jouven X, Tzourio C, Amouyel P, Besset A, Ducimetiere P. Excessive daytime sleepiness is an independent risk indicator for cardiovascular mortality in community-dwelling elderly: the three city study. Stroke 2009; 40:1219-24. [PMID: 19246707 DOI: 10.1161/strokeaha.108.530824] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Excessive daytime sleepiness, one of the most frequent sleep complaints in the elderly, may affect survival, but inconsistent results have been observed in that population so far. We therefore estimated the risk of mortality for excessive daytime sleepiness (EDS) in community-dwelling elderly participating in the Three City Study. METHODS The Three City Study is a French population-based multicenter prospective study including 9294 subjects (60% women) aged >or=65 years at recruitment between 1999 to 2001. At baseline, 8269 subjects rated EDS and nocturnal sleep complaints as never, rare, regular, and frequent in response to an administered questionnaire and provided information on medication use for sleep or anxiety. Hazard ratios (HR) of EDS (regular or frequent) for mortality over 6 years were estimated by a Cox proportional hazard model. RESULTS At baseline, 18.7% of the study participants had regular or frequent EDS. After 6 years of follow-up, 762 subjects had died including 260 from cancer and 196 from cardiovascular disease. EDS was associated with a significant 33% increased risk of mortality (95% CI: 1.13 to 1.61) after adjustment for age, gender, study center, body mass index, previous cardiovascular disease, Mini Mental State Examination score, and cardiovascular risk factors. Further adjustment for current use of medication for sleep and for depressive symptoms slightly diminished the HRs. EDS was equally predictive of mortality in those who snored loudly and in those who did not. EDS was related to cardiovascular mortality but not to mortality attributable to cancer. CONCLUSIONS EDS might be independently associated with total and cardiovascular mortality in community-dwelling elderly.
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Affiliation(s)
- Jean-Philippe Empana
- INSERM U909, Cardiovascular Epidemiology and Sudden Death, Hôpital Paul Brousse, Villejuif cedex, France.
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Empana JP, Canoui-Poitrine F, Luc G, Juhan-Vague I, Morange P, Arveiler D, Ferrieres J, Amouyel P, Bingham A, Montaye M, Ruidavets JB, Haas B, Evans A, Ducimetiere P. Contribution of novel biomarkers to incident stable angina and acute coronary syndrome: the PRIME Study. Eur Heart J 2008; 29:1966-74. [DOI: 10.1093/eurheartj/ehn331] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Schunkert H, Götz A, Braund P, McGinnis R, Tregouet DA, Mangino M, Linsel-Nitschke P, Cambien F, Hengstenberg C, Stark K, Blankenberg S, Tiret L, Ducimetiere P, Keniry A, Ghori MJR, Schreiber S, El Mokhtari NE, Hall AS, Dixon RJ, Goodall AH, Liptau H, Pollard H, Schwarz DF, Hothorn LA, Wichmann HE, König IR, Fischer M, Meisinger C, Ouwehand W, Deloukas P, Thompson JR, Erdmann J, Ziegler A, Samani NJ. Repeated replication and a prospective meta-analysis of the association between chromosome 9p21.3 and coronary artery disease. Circulation 2008; 117:1675-84. [PMID: 18362232 DOI: 10.1161/circulationaha.107.730614] [Citation(s) in RCA: 316] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recently, genome-wide association studies identified variants on chromosome 9p21.3 as affecting the risk of coronary artery disease (CAD). We investigated the association of this locus with CAD in 7 case-control studies and undertook a meta-analysis. METHODS AND RESULTS A single-nucleotide polymorphism (SNP), rs1333049, representing the 9p21.3 locus, was genotyped in 7 case-control studies involving a total of 4645 patients with myocardial infarction or CAD and 5177 controls. The mode of inheritance was determined. In addition, in 5 of the 7 studies, we genotyped 3 additional SNPs to assess a risk-associated haplotype (ACAC). Finally, a meta-analysis of the present data and previously published samples was conducted. A limited fine mapping of the locus was performed. The risk allele (C) of the lead SNP, rs1333049, was uniformly associated with CAD in each study (P<0.05). In a pooled analysis, the odds ratio per copy of the risk allele was 1.29 (95% confidence interval, 1.22 to 1.37; P=0.0001). Haplotype analysis further suggested that this effect was not homogeneous across the haplotypic background (test for interaction, P=0.0079). An autosomal-additive mode of inheritance best explained the underlying association. The meta-analysis of the rs1333049 SNP in 12,004 cases and 28,949 controls increased the overall level of evidence for association with CAD to P=6.04x10(-10) (odds ratio, 1.24; 95% confidence interval, 1.20 to 1.29). Genotyping of 31 additional SNPs in the region identified several with a highly significant association with CAD, but none had predictive information beyond that of the rs1333049 SNP. CONCLUSIONS This broad replication provides unprecedented evidence for association between genetic variants at chromosome 9p21.3 and risk of CAD.
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Appleton KM, Woodside JV, Yarnell JWG, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrières J, Ruidavets JB, Ducimetiere P, Bingham A, Evans A. Depressed mood and dietary fish intake: direct relationship or indirect relationship as a result of diet and lifestyle? J Affect Disord 2007; 104:217-23. [PMID: 17475339 DOI: 10.1016/j.jad.2007.03.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Revised: 03/23/2007] [Accepted: 03/23/2007] [Indexed: 10/23/2022]
Abstract
Previous studies have suggested an association between depressed mood and the dietary intake of fish. In all cases, however, dietary fish intake has been considered at the exclusion of all other aspects of the diet. This analysis investigates associations between depressed mood and dietary fish intake, while also concurrently investigating intake of a number of other dietary components. The analysis is conducted on data from 10,602 men from Northern Ireland and France screened for inclusion into the PRIME cohort study. Depressed mood was assessed using a self-report questionnaire based on the Welsh Pure Depression sub-scale of the Minnesota Multiphasic Personality Inventory, diet was assessed using a Food Frequency Questionnaire, and limited demographics were also measured. Using regression, depressed mood is initially inversely associated with dietary fish intake. On inclusion of all other dietary variables, the strength of this relationship reduces but remains, and significant associations with a number of other foods are also found. On additional inclusion of all demographic variables, the strength of the above relationships again reduces, and associations with various measures of socio-economic status and education are also significant. These findings suggest that depressed mood is associated with fish intake both directly, and indirectly as part of a diet that is associated with depression and as part of a lifestyle that is associated with depression. Additional support for these conclusions is also provided in the pattern of associations between depressed mood and diet in the two countries. The relative contributions of fish intake to depressed mood both directly and indirectly are yet to be determined. However, while diet is not measured and until lifestyle can be adequately measured, the potential roles of diet and lifestyle in the association between depressed mood and dietary fish intake should not be ignored.
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Affiliation(s)
- K M Appleton
- School of Psychology, Queen's University Belfast, 18-30 Malone Road, Belfast, BT9 5BP, United Kingdom.
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Botton J, Heude B, Andre P, Bresson JL, Ducimetiere P, Charles MA. Relationship between gamma-glutamyltransferase and fat mass in a general population of 8–17 years old children. The FLVS II study. Diabetes & Metabolism 2007; 33:354-9. [PMID: 17652002 DOI: 10.1016/j.diabet.2007.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Accepted: 03/25/2007] [Indexed: 11/17/2022]
Abstract
AIM Elevated gamma-glutamyltransferase (GGT) is positively associated with severity of obesity in obese children and with increased BMI and waist circumference in general populations of adults. We aimed to study the relationships between GGT and anthropometric parameters in a general population of children. METHODS This cross-sectional study was conducted in 219 boys and 214 girls included in the Fleurbaix Laventie Ville Santé II study. Weight, height, four skinfolds and waist circumference were measured. We compared the means of GGT activity according to gender and Tanner stage, and according to overweight status (IOTF definition) and quartiles of anthropometric parameters. We then calculated partial Pearson correlations by gender between GGT and anthropometric parameters taking age and Tanner stage into account. RESULTS GGT activity was higher in boys than in girls as soon as puberty started (P<0.001). The higher difference was observed for Tanner stage III (GGT=10.2 UI/L, CI95% of mean (9.5, 11.1) vs. 7.8 UI/L (7.2, 8.4)). Anthropometric parameters were significantly associated with GGT, particularly waist circumference (r=0.28 in boys; r=0.24 in girls). After an additional adjustment for sum of skinfolds, this correlation disappeared in boys (r=0.06), and was still significant in girls (r=0.19). CONCLUSION In a general population of children, overweight and abdominal fat distribution were associated with increased GGT. As some studies have shown that GGT could predict the metabolic syndrome in children and type 2 diabetes in adults, the modest elevation of GGT observed in overweight children may be of pathophysiological importance in the long term.
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Affiliation(s)
- J Botton
- Inserm, U780, IFR69, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif, France; Faculté de médecine, université Paris-Sud, IFR69, 63, rue Gabriel-Péri, 94276 Le Kremlin-Bicêtre, France
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Danesh J, Erqou S, Walker M, Thompson SG, Tipping R, Ford C, Pressel S, Walldius G, Jungner I, Folsom AR, Chambless LE, Knuiman M, Whincup PH, Wannamethee SG, Morris RW, Willeit J, Kiechl S, Santer P, Mayr A, Wald N, Ebrahim S, Lawlor DA, Yarnell JWG, Gallacher J, Casiglia E, Tikhonoff V, Nietert PJ, Sutherland SE, Bachman DL, Keil JE, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Nordestgaard BG, Frikke-Schmidt R, Giampaoli S, Palmieri L, Panico S, Vanuzzo D, Pilotto L, Simons L, McCallum J, Friedlander Y, Fowkes FGR, Lee AJ, Smith FB, Taylor J, Guralnik J, Phillips C, Wallace R, Blazer D, Khaw KT, Jansson JH, Donfrancesco C, Salomaa V, Harald K, Jousilahti P, Vartiainen E, Woodward M, D'Agostino RB, Wolf PA, Vasan RS, Pencina MJ, Bladbjerg EM, Jorgensen T, Moller L, Jespersen J, Dankner R, Chetrit A, Lubin F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Bjorkelund C, Cremer P, Nagel D, Tilvis R, Strandberg T, Rodriguez B, Bouter LM, Heine RJ, Dekker JM, Nijpels G, Stehouwer CDA, Rimm E, Pai J, Sato S, Iso H, Kitamura A, Noda H, Goldbourt U, Salomaa V, Salonen JT, Nyyssönen K, Tuomainen TP, Deeg D, Poppelaars JL, Meade T, Cooper J, Hedblad B, Berglund G, Engstrom G, Döring A, Koenig W, Meisinger C, Mraz W, Kuller L, Selmer R, Tverdal A, Nystad W, Gillum R, Mussolino M, Hankinson S, Manson J, De Stavola B, Knottenbelt C, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Naito Y, Holme I, Nakagawa H, Miura H, Ducimetiere P, Jouven X, Crespo C, Garcia-Palmieri M, Amouyel P, Arveiler D, Evans A, Ferrieres J, Schulte H, Assmann G, Shepherd J, Packard C, Sattar N, Cantin B, Lamarche B, Després JP, Dagenais GR, Barrett-Connor E, Wingard D, Bettencourt R, Gudnason V, Aspelund T, Sigurdsson G, Thorsson B, Trevisan M, Witteman J, Kardys I, Breteler M, Hofman A, Tunstall-Pedoe H, Tavendale R, Lowe GDO, Ben-Shlomo Y, Howard BV, Zhang Y, Best L, Umans J, Onat A, Meade TW, Njolstad I, Mathiesen E, Lochen ML, Wilsgaard T, Gaziano JM, Stampfer M, Ridker P, Ulmer H, Diem G, Concin H, Rodeghiero F, Tosetto A, Brunner E, Shipley M, Buring J, Cobbe SM, Ford I, Robertson M, He Y, Ibanez AM, Feskens EJM, Kromhout D, Collins R, Di Angelantonio E, Kaptoge S, Lewington S, Orfei L, Pennells L, Perry P, Ray K, Sarwar N, Scherman M, Thompson A, Watson S, Wensley F, White IR, Wood AM. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. Eur J Epidemiol 2007; 22:839-69. [PMID: 17876711 DOI: 10.1007/s10654-007-9165-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 07/02/2007] [Indexed: 01/22/2023]
Abstract
Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.
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Ahluwalia N, Ferrieres J, Simon C, Dallongeville J, Ducimetiere P, Ruidavets J. Macronutrient intake patterns and overweight in a population‐based random sample in France. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a6-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Namanjeet Ahluwalia
- Epidemiology&Public HealthINSERM U558330 Ave de Grande Bretagne;, Hopital Paule de Viguier ‐ INSERM 558ToulouseFrance
| | - Jean Ferrieres
- EpidemiologyCHU‐Toulouse, INSERM U558, 37 Allées Jules GuesdeToulouseFrance
| | - Chantal Simon
- University School of Medicine, Louis Pasteur UniversityStrasbourgFrance
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Empana JP, Zureik M, Gariepy J, Courbon D, Dartigues JF, Ritchie K, Tzourio C, Alperovitch A, Ducimetiere P. The Metabolic Syndrome and the Carotid Artery Structure in Noninstitutionalized Elderly Subjects. Stroke 2007; 38:893-9. [PMID: 17272758 DOI: 10.1161/01.str.0000257983.62530.75] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background and Purpose—
In contrast to the young adult population, limited data are presently available regarding the epidemiology of the metabolic syndrome (MetS) and its relationship with cardiovascular disease risk in the elderly. We have investigated the frequency of the MetS and its association with the carotid artery structure in an elderly free-living population.
Methods—
The study population consists of 5585 French noninstitutionalized elderly men and women aged 65 to 85 years, free of diabetes, who participated in the multicenter Three City Study and who underwent ultrasound examination of the carotid arteries at baseline examination between March 1999 and March 2001. The MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.
Results—
The MetS was present in 12.1% of the study participants, with slightly higher rates in men. Subjects with the MetS had higher frequency of carotid plaques (odds ratio, 1.30; 95% CI, 1.09 to 1.55), higher intima-media thickness of the common carotid artery (odds ratio, 1.81; 95% CI, 1.37 to 2.41), and higher lumen diameter (odds ratio, 2.17; 95% CI, 1.61 to 2.94) (upper quintiles) after adjustment for other cardiovascular risk factors. This association was observed in both genders and in subjects without prevalent cardiovascular disease. Elevated blood pressure as defined in the MetS was the main determinant of the relations between the MetS and the carotid parameters, especially the lumen diameter.
Conclusions—
The present data suggest that noninstitutionalized elderly subjects with the MetS have altered structure of the carotid arteries.
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Affiliation(s)
- Jean-Philippe Empana
- INSERM U780, Cardiovascular Team, Paris XI University, Hôpital Paul Brousse, Villejuif cedex, France.
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Balkau B, Vierron E, Vernay M, Born C, Arondel D, Petrella A, Ducimetiere P. The impact of 3-year changes in lifestyle habits on metabolic syndrome parameters: the D.E.S.I.R study. ACTA ACUST UNITED AC 2006; 13:334-40. [PMID: 16926661 PMCID: PMC4764669 DOI: 10.1097/01.hjr.0000214614.37232.f0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effect of lifestyle changes in cohorts of free-living populations has been surprisingly little evaluated. DESIGN A longitudinal study. METHODS In the French Data from an Epidemiological Study on the Insulin Resistance (D.E.S.I.R) study of 1958 men and 2028 women, aged 30-65 years, the impact of 3-year changes in lifestyle habits (sporting activity, physical activity at home and at work, alcohol drinking, smoking) on metabolic syndrome parameters [insulin, glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic blood pressure, waist circumference] and on body mass index (BMI) were investigated. RESULTS In men, 3-year increases in sporting activity were associated with a lowering of insulin, glucose, systolic blood pressure and waist circumference (all P < 0.05). For women, the only effect was on lowering waist circumference (P < 0.03). Increases in physical activity at home were beneficially associated with HDL-cholesterol, triglycerides, waist circumference and BMI changes (all P < 0.05) in men, but had no apparent effect in women. Decreases in alcohol intake only had an effect in men, with decreases in HDL-cholesterol and systolic blood pressure (P < 0.05), whereas decreasing cigarette smoking in men was associated with significant increases in insulin, glucose, triglycerides, waist and BMI (P < 0.001), and in women HDL-cholesterol, waist circumference and BMI increased (P < 0.02). These results were mainly caused by those who had stopped smoking. CONCLUSIONS Increases in physical activity over the 3-year period were associated with beneficial effects on syndrome parameters, particularly in men. Smoking cessation and alcohol moderation produced mixed effects on these parameters.
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Kettaneh A, Heude B, Oppert JM, Scherer P, Meyre D, Borys JM, Ducimetiere P, Charles MA. Serum adiponectin is related to plasma high-density lipoprotein cholesterol but not to plasma insulin-concentration in healthy children: the FLVS II study. Metabolism 2006; 55:1171-6. [PMID: 16919535 DOI: 10.1016/j.metabol.2006.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 04/11/2006] [Indexed: 11/15/2022]
Abstract
Although low levels of plasma adiponectin were associated with an increase in cardiovascular risk in adults, few data investigated that relationship in children. The aim of this study was to investigate the relationship between plasma adiponectin and cardiovascular risk factors in healthy children. This cross-sectional population-based study was conducted in Fleurbaix and Laventie, 2 cities in the north of France. The main outcome measure was the correlations between plasma adiponectin and adiposity variables (the body mass index, the sum of 4 skinfolds, waist circumference [WC], and percent body fat [bioimpedance]), blood pressure, plasma glucose, triglycerides, high-density lipoprotein (HDL) cholesterol and insulin. In 398 children of both sexes, adiponectin was not significantly related to age and pubertal stage. In boys only, adiponectin correlated with WC (r = -0.19; P = .008) and body mass index (r = -0.15; P = .04) but not with other adiposity variables. After taking into account WC, adiponectin was positively correlated with HDL-cholesterol in boys (r = 0.14; P = .05) and girls (r = 0.25; P = .0004), but was not correlated with insulin and homeostasis model assessment index for insulin resistance in both sexes. These results suggest that, in apparently healthy children, adiponectin is related to the level of HDL-cholesterol independently of fat mass. The relationship between adiponectin and insulin resistance previously reported in obese or diabetic children was not apparent in these subjects and may therefore occur only at later age with fat accumulation.
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Affiliation(s)
- Adrien Kettaneh
- INSERM U 780, IFR 69, Faculté de Médecine Paris-Sud, 94800 Villejuif, France
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Abstract
BACKGROUND Experimental data suggest that zinc, copper, and magnesium are involved in carcinogenesis and atherogenesis. Few longitudinal studies have related these minerals to cancer or cardiovascular disease mortality in a population. METHODS Data from the Paris Prospective Study 2, a cohort of 4035 men age 30-60 years at baseline, were used to assess the association between serum zinc, copper, and magnesium and all-cause, cancer, and cardiovascular disease mortality. Serum mineral values measured at baseline were divided into quartiles and classified into low (1st quartile, referent group), medium (2nd-3rd quartiles), and high (4th quartile) values. During 18-year follow up, 339 deaths occurred, 176 as a result of cancer and 56 of cardiovascular origin. Relative risks (RRs) for each element were inferred using Cox's proportional hazard model after controlling for various potential confounders. RESULTS High copper values (4th quartile) were associated with a 50% increase in RRs for all-cause deaths (RR = 1.5; 95% confidence interval = 1.1-2.1), a 40% increase for cancer mortality (1.4; 0.9-2.2), and a 30% increase for cardiovascular mortality (1.3; 0.6-2.8) compared with low values (1st quartile). High magnesium values were negatively related to mortality with a 40% decrease in RR for all-cause (0.6; 0.4-0.8) and cardiovascular deaths (0.6; 0.2-1.2) and by 50% for cancer deaths (0.5; 0.3-0.8). Additionally, subjects with a combination of low zinc and high copper values had synergistically increased all-cause (2.6; 1.4-5.0) and cancer (2.7; 1.0-7.3) mortality risks. Similarly, combined low zinc and high magnesium values were associated with decreased all-cause (0.2; 0.1-0.5) and cancer (0.2; 0.1-0.8) mortality risks. CONCLUSIONS High serum copper, low serum magnesium, and concomitance of low serum zinc with high serum copper or low serum magnesium contribute to an increased mortality risk in middle-aged men.
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Affiliation(s)
- Nathalie Leone
- Unit 744 National Institute of Health and Medical Research (INSERM), Lille Pasteur Institute, Lille, France
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Lahlou-Laforet K, Alhenc-Gelas M, Pornin M, Bydlowski S, Seigneur E, Benetos A, Kierzin JM, Scarabin PY, Ducimetiere P, Aiach M, Guize L, Consoli SM. Relation of depressive mood to plasminogen activator inhibitor, tissue plasminogen activator, and fibrinogen levels in patients with versus without coronary heart disease. Am J Cardiol 2006; 97:1287-91. [PMID: 16635597 DOI: 10.1016/j.amjcard.2005.11.062] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Revised: 11/14/2005] [Accepted: 11/14/2005] [Indexed: 11/21/2022]
Abstract
The increased risk of coronary heart disease (CHD) associated with depression is well documented. We hypothesized that impaired fibrinolysis is involved in this link. To explore the association of depressive mood and/or vital exhaustion with various measurements of fibrinolysis activity, 231 men (40 to 65 years old; 123 without CHD and taking no medication and 108 with documented CHD), completed the Center of Epidemiologic Studies Depression Scale and the Maastricht Questionnaire for vital exhaustion. Using classic cut-off points (Center of Epidemiologic Studies Depression Scale score >or=17, Maastricht Questionnaire score >or=8), 6.5% and 9.8% of subjects without CHD and 38% and 48.1% of those with CHD were classified as depressed and exhausted, respectively. Patients with CHD were older, had a higher body mass index, and higher levels of total cholesterol, glucose, plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) antigen, and fibrinogen; 47% were treated for hypertension. Depressed subjects had higher levels of PAI-1 activity (p = 0.006) and exhausted patients had higher levels of PAI-1 activity (p = 0.011) and fibrinogen (p = 0.009). After adjusting for clinical condition (with or without CHD), smoking, hypertension, triglyceride concentration, and body mass index, PAI-1 activity remained higher in depressed subjects (p = 0.03). This association persisted after further adjustment for vital exhaustion or for t-PA antigen and fibrinogen levels. t-PA antigen and fibrinogen levels were not associated with depressive mood in multivariate analyses. No fibrinolytic variable was associated with vital exhaustion in multivariate analyses. In conclusion, depressive mood, but not vital exhaustion, is associated with higher levels of PAI-1 activity, suggesting a possible impairment of fibrinolysis and indicating a potential additional mechanism by which depressive mood may act as a cardiovascular risk factor.
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Affiliation(s)
- Khadija Lahlou-Laforet
- Department of C-L Psychiatry, Faculté de Médecine, Université Paris-Descartes, AP-HP, Hôpital Europeén Georges Pompidou, France.
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Danesh J, Lewington S, Thompson SG, Lowe GDO, Collins R, Kostis JB, Wilson AC, Folsom AR, Wu K, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi R, Vahtera E, Jousilahti P, Pekkanen J, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Arocha-Piñango CL, Rodriguez-Larralde A, Nagy E, Mijares M, Espinosa R, Rodriquez-Roa E, Ryder E, Diez-Ewald MP, Campos G, Fernandez V, Torres E, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Lind P, Loewel H, Koenig W, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Després JP, Dagenais GR, Tunstall-Pedoe H, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Rudnicka A, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Kromhout D, Dickinson A, Ireland B, Juzwishin K, Kaptoge S, Lewington S, Memon A, Sarwar N, Walker M, Wheeler J, White I, Wood A. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 2005; 294:1799-809. [PMID: 16219884 DOI: 10.1001/jama.294.14.1799] [Citation(s) in RCA: 460] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.
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Luc G, Bard JM, Lesueur C, Arveiler D, Evans A, Amouyel P, Ferrieres J, Juhan-Vague I, Fruchart JC, Ducimetiere P. Plasma cystatin-C and development of coronary heart disease: The PRIME Study. Atherosclerosis 2005; 185:375-80. [PMID: 16046222 DOI: 10.1016/j.atherosclerosis.2005.06.017] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 05/04/2005] [Accepted: 06/15/2005] [Indexed: 11/21/2022]
Abstract
The pathogenesis of ischemic coronary events involves degradation of the extracellular matrix in atherosclerotic lesions. The cysteine protease inhibitor cystatin-C may be involved in this phenomenon. The association of plasma cystatin-C with the incidence of myocardial infarction-coronary death and angina, was examined in a nested case-control (two controls per case) design within the prospective cohort study (Prospective Epidemiological Study of Myocardial Infarction (PRIME Study)) which included 9,758 men aged 50-59 years who were free of coronary heart disease (CHD) on entry and followed for a 5-year period. Three hundred and thirteen participants suffered myocardial infarction or coronary death (n = 159) or angina pectoris (n = 154) during follow-up. Cystatin-C was positively correlated with body mass index (BMI), low-density lipoprotein (LDL)-cholesterol, triglycerides and several inflammatory markers such as fibrinogen (r = 0.18), C-reactive protein (CRP) (r = 0.24), interleukin-6 (= 0.20), tumor necrosis factor-alpha (TNFalpha) (r = 0.27) and two TNFalpha receptors: TNFR1A (r = 0.43) and TNFR1B (r = 0.41); and negatively with high-density lipoprotein (HDL)-cholesterol (r = -0.25). After adjustment for traditional risk factors (age, diabetes, smoking, hypertension, BMI, triglycerides, LDL- and HDL-cholesterol), cystatin-C was significantly associated with the occurrence of the first ischemic coronary event. However, this association was no longer significant when CRP was included in the analysis. A decrease in glomerular filtration rate did not explain higher cystatin-C in cases than in controls. Cystatin-C appears to participate in the inflammatory phenomenon observed in the atherosclerotic process. Cystatin-C is not a more predictive risk marker of CHD than CRP or interleukin-6, but could be useful in detecting moderate chronic renal disease.
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Affiliation(s)
- Gérald Luc
- Department of Atherosclerosis, SERLIA-INSERM UR545, Institut Pasteur de Lille, 1, rue du Professeur Calmette, 59019 Lille Cedex, France and University Lille II, France.
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McCaughey C, Murray LJ, McKenna JP, Coyle PV, O'Neill HJ, Wyatt DE, Woodside JV, Yarnell JWG, Ducimetiere P, Bingham A, Amouyel P, Montaye M, Arveiler D, Haas B, Ferrieres J, Ruidavets JB. Lack of association between serological evidence of past Coxiella burnetii infection and incident ischaemic heart disease: nested case-control study. BMC Infect Dis 2005; 5:61. [PMID: 16033641 PMCID: PMC1185539 DOI: 10.1186/1471-2334-5-61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 07/20/2005] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Coxiella burnetii causes the common worldwide zoonotic infection, Q fever. It has been previously suggested that patients who had recovered from acute Q fever (whether symptomatic or otherwise) may be at increased risk of ischaemic heart disease. We undertook this study to determine if past infection with Coxiella burnetii, the aetiological agent of Q fever, is a risk factor for the subsequent development of ischaemic heart disease. METHODS A nested case-control study within the Prospective Epidemiological Study of Myocardial Infarction (PRIME). The PRIME study is a cohort study of 10,593 middle-aged men undertaken in France and Northern Ireland in the 1990s. A total of 335 incident cases of ischaemic heart disease (IHD) were identified and each case was matched to 2 IHD free controls. Q fever seropositivity was determined using a commercial IgG ELISA method. RESULTS Seroprevalence of Q fever in the controls from Northern Ireland and France were 7.8% and 9.0% respectively. No association was seen between seropositivity and age, smoking, lipid levels, or inflammatory markers. The unadjusted odds ratio (95% CI) for Q fever seropositivity in cases compared to controls was 0.95 (0.59, 1.57). The relationship was substantially unaltered following adjustment for cardiovascular risk factors and potential confounders. CONCLUSION Serological evidence of past infection with C. burnetii was not found to be associated with an increased risk of IHD.
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Affiliation(s)
- Conall McCaughey
- Regional Virus Laboratory, Royal Hospitals, Grosvenor Road, Belfast BT12 6BA, UK
| | - Liam J Murray
- Department of Epidemiology and Public Health, Mulhouse Building, Queen's University of Belfast, BT12 6BJ, UK
| | - James P McKenna
- Regional Virus Laboratory, Royal Hospitals, Grosvenor Road, Belfast BT12 6BA, UK
| | - Peter V Coyle
- Regional Virus Laboratory, Royal Hospitals, Grosvenor Road, Belfast BT12 6BA, UK
| | - Hugh J O'Neill
- Regional Virus Laboratory, Royal Hospitals, Grosvenor Road, Belfast BT12 6BA, UK
| | - Dorothy E Wyatt
- Regional Virus Laboratory, Royal Hospitals, Grosvenor Road, Belfast BT12 6BA, UK
| | - Jayne V Woodside
- Department of Medicine, Mulhouse Building, Queen's University of Belfast BT12 6BJ, UK
| | - John WG Yarnell
- Department of Epidemiology and Public Health, Mulhouse Building, Queen's University of Belfast, BT12 6BJ, UK
| | - Pierre Ducimetiere
- INSERM U258, Epidemiologie cardio-vasculaire et metabolique, Hopital Paul Brousse, 94807 Villejuif Cedex, France
| | - Annie Bingham
- INSERM U258, Epidemiologie cardio-vasculaire et metabolique, Hopital Paul Brousse, 94807 Villejuif Cedex, France
| | | | | | | | - Bernadette Haas
- Laboratoire d'Epidémiologie et de Santé Publique, Strasbourg, France
| | - Jean Ferrieres
- INSERM U558, Faculté de Médicine Purpan, Toulouse, France
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Morange PE, Tregouet DA, Frere C, Luc G, Arveiler D, Ferrieres J, Amouyel P, Evans A, Ducimetiere P, Cambien F, Tiret L, Juhan-Vague I. TAFI gene haplotypes, TAFI plasma levels and future risk of coronary heart disease: the PRIME Study. J Thromb Haemost 2005; 3:1503-10. [PMID: 15978108 DOI: 10.1111/j.1538-7836.2005.01486.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the association of thrombin-activatable fibrinolysis inhibitor (TAFI) gene polymorphisms with the risk of coronary heart disease (CHD) and with TAFI levels measured by a newly developed enzyme-linked immunosorbent assay (ELISA) (TAFI-1B1), shown to be a reliable method for detecting quantitative variations in circulating TAFI. PATIENTS/METHODS Six polymorphisms (C-2599G, G-438A, Ala147Thr, Thr325Ile, C + 1542G and T + 1583A) were genotyped and baseline plasma concentrations of TAFI were measured in a nested case-control design as part of the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. Participants from France and Northern Ireland who had developed a CHD event during a 5-year follow-up (n = 321) were compared with 645 population- and age-matched control subjects. RESULTS In France, the Thr147 allele was more frequent in cases than in controls (0.41 vs. 0.32; P = 0.02), whereas the reverse was observed in Northern Ireland (0.33 vs. 0.38; P = 0.19) (P = 0.01 for interaction). No other polymorphism was associated with CHD risk. Consistent with the results derived from the single-locus analysis, haplotype analysis revealed that the haplotype carrying the Thr147 allele was associated with increased risk of CHD in France while the reverse tended to hold in the Northern Ireland population. Single-locus and haplotype analyses revealed that two polymorphisms, C-2599G and Ala147Thr (or T + 1583A that is in nearly complete association with it), had additive effects on TAFI levels and explained >18% of TAFI variability. This effect was homogeneous in France and Northern Ireland, and in cases and controls who exhibited similar TAFI levels. CONCLUSIONS Thrombin-activatable fibrinolysis inhibitor gene polymorphisms are strongly associated to plasma TAFI levels, but the relation to CHD risk is less clear.
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Affiliation(s)
- P E Morange
- INSERM U626, Hematology Laboratory, Faculty of Medicine, CHU Timone, Marseille, France
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Empana JP, Sykes DH, Luc G, Juhan-Vague I, Arveiler D, Ferrieres J, Amouyel P, Bingham A, Montaye M, Ruidavets JB, Haas B, Evans A, Jouven X, Ducimetiere P. Contributions of Depressive Mood and Circulating Inflammatory Markers to Coronary Heart Disease in Healthy European Men. Circulation 2005; 111:2299-305. [PMID: 15867179 DOI: 10.1161/01.cir.0000164203.54111.ae] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Data on the possible association between depressive disorders and inflammatory markers are scarce and inconsistent. We investigated whether subjects with depressive mood had higher levels of a wide range of inflammatory markers involved in coronary heart disease (CHD) incidence and examined the contribution of these inflammatory markers and depressive mood to CHD outcome.
Methods and Results—
We built a nested case-referent study within the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study of healthy middle-aged men from Belfast and France. We considered the baseline plasma sample from 335 future cases (angina pectoris, nonfatal myocardial infarction, coronary death) and 670 matched controls (2 controls per case). Depressive mood characterized men whose baseline depression score (13-item modification of the Welsh depression subscale) was in the fourth quartile (mean score, 5.75; range, 4 to 12). On average, men with depressive mood had 46%, 16%, and 10% higher C-reactive protein, interleukin-6, and intercellular adhesion molecule-1 levels, respectively, independently of case-control status, social characteristics, and classic cardiovascular risk factors; no statistical difference was found for fibrinogen. The odds ratios of depressive mood for CHD were 1.35 (95% CI, 1.05 to 1.73) in univariate analysis and 1.50 (95% CI, 1.04 to 2.15) after adjustment for social characteristics and classic cardiovascular risk factors. The latter odds ratio remained unchanged when each inflammatory marker was added separately, and in this analysis, each inflammatory marker contributed significantly to CHD event risk.
Conclusions—
These data support an association of depressive mood with inflammatory markers and suggest that depressive mood is related to CHD even after adjustment for these inflammatory markers.
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Affiliation(s)
- J P Empana
- INSERM Avenir, Epidemiology of Sudden Death in the Population, Villejuif, France.
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Abstract
BACKGROUND Abdominal (visceral) and overall obesity are both related to coronary heart disease mortality risk; however, the relative contribution of these 2 components of fat deposit in the etiology of sudden death is unknown. METHODS AND RESULTS We used the data from 7079 asymptomatic men of the Paris Prospective Study I who were free of ischemic heart disease and who were 43 to 52 years of age at first clinical examination between 1967 and 1972. Body mass index (BMI) and sagittal abdominal diameter (SAD) were measured at baseline and used as markers of overall and abdominal obesity. During a follow-up of 23 years, there were 118 sudden deaths and 192 fatal myocardial infarctions. After adjustment for baseline level of cardiovascular risk factors, trunk subcutaneous fat, and thoracic diameter, the ratio of the fifth over the first quintile of SAD was 2.6 (95% CI 1.0 to 6.7) and 2. 6 (95% CI 1.3 to 5.1) for sudden death and fatal myocardial infarction, respectively, and the risk of sudden death increased proportionally with SAD level. The corresponding ratios for BMI were 2.0 (95% CI 1.1 to 3.8) and 1.0 (95% CI 0.6 to 1.7), respectively. Compared with men with low SAD (first tertile) and normal BMI (<25 kg/m2), men with elevated SAD (third tertile) were at increased risk of sudden death but not of fatal myocardial infarction, whether they were of normal weight (multivariate adjusted relative risk 3. 0 [95% CI 1.3 to 6. 9]) or overweight (BMI > or =25 kg/m2; 1.9 [95% CI 1.0 to 3.9]). CONCLUSIONS In asymptomatic French middle-aged men, larger SAD was associated with a particularly increased risk of sudden death, independent of BMI level and known cardiovascular risk factors.
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Affiliation(s)
- J P Empana
- INSERM Avenir-U258, Epidemiology of Sudden Death in the Population, Hopital Paul Brousse, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif, France.
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Morange PE, Tiret L, Saut N, Luc G, Arveiler D, Ferrieres J, Amouyel P, Evans A, Ducimetiere P, Cambien F, Juhan-Vague I. TLR4/Asp299Gly, CD14/C-260T, plasma levels of the soluble receptor CD14 and the risk of coronary heart disease: The PRIME Study. Eur J Hum Genet 2004; 12:1041-9. [PMID: 15367917 DOI: 10.1038/sj.ejhg.5201277] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
TLR4 and CD14 are two components of the LPS receptor complex, which are considered to play a key role in the pathogenesis of atherosclerosis. TLR4/Asp299Gly and CD14/C-260T polymorphisms are thought to modulate the activity of this complex. The aim of the study was to examine the association between the TLR4/Asp299Gly and CD14/C-260T polymorphisms, plasma levels of the soluble receptor CD14 (sCD14), and the incidence of coronary heart disease (CHD) in a prospective cohort (the PRIME Study) of 9758 healthy men aged 50-59 years recruited in France and Northern Ireland. A nested case-control design was used, comparing the 249 participants who developed a CHD event during the 5-year follow-up with 492 population- and age-matched control subjects. The two polymorphisms were genotyped and baseline plasma concentrations of sCD14 were measured. None of the two polymorphisms, or sCD14 levels, either considered alone or in combination, were associated with the risk of CHD. The CD14/C-260T allele was associated with increased plasma concentrations of soluble thrombomodulin and vascular cell adhesion molecule-1 and, to a lesser extent, sCD14. No relationship was observed between the TLR4 polymorphism and, any of the inflammatory and endothelial markers measured. The TLR4/Asp299Gly and CD14/C-260T polymorphisms and plasma sCD14 concentrations do not appear as significant predictors of the risk of CHD in healthy individuals.
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Affiliation(s)
- P E Morange
- Hematology Laboratory, CHU Timone, Inserm U626, Faculty of Medicine, Marseille, France
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Zureik M, Galan P, Bertrais S, Mennen L, Czernichow S, Blacher J, Ducimetiere P, Hercberg S. D2-6 Effets d’une supplémentation quotidienne sur sept ans en vitamines et minéraux antioxydants, à des doses nutritionnelles, sur les altérations vasculaires (Étude SUVIMAX). Rev Epidemiol Sante Publique 2004. [DOI: 10.1016/s0398-7620(04)99185-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Morange PE, Simon C, Alessi MC, Luc G, Arveiler D, Ferrieres J, Amouyel P, Evans A, Ducimetiere P, Juhan-Vague I. Endothelial Cell Markers and the Risk of Coronary Heart Disease. Circulation 2004; 109:1343-8. [PMID: 15023872 DOI: 10.1161/01.cir.0000120705.55512.ec] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Tissue factor pathway inhibitor (TFPI), von Willebrand factor (vWF), and thrombomodulin (TM) are 3 major hemostatic regulatory molecules synthesized by endothelium. Data from epidemiological studies aiming to evaluate the relation between plasma levels of these molecules and the development of coronary heart disease (CHD) are sparse or contradictory.
Methods and Results—
We examined the association between these endothelial-cell markers and the incidence of fatal or nonfatal myocardial infarction (hard CHD) and stable or unstable angina (angina pectoris) in a prospective cohort (the PRIME Study) of nearly 10 000 healthy men recruited in France and Northern Ireland. We measured baseline plasma concentration of the free form of TFPI (f-TFPI), vWF, and the soluble form of TM (sTM) among 296 participants who subsequently developed CHD over the 5-year follow-up (158 with hard CHD and 142 with angina pectoris) and in 563 control subjects by use of a nested case-control design. Individuals with plasma vWF levels in the highest quartile showed a 3.04-fold increase in the risk of hard CHD compared with those in the lowest quartile (95% CI, 1.59 to 5.80). Individuals with f-TFPI levels below the 10th percentile had a 2.13-fold increased risk of hard CHD compared with those with levels above it (95% CI, 1.08 to 4.18). The risk for both molecules persisted after control for inflammatory parameters. Individuals with vWF levels in the highest quartile and f-TFPI levels below the 10th percentile presented a 6.9-fold increased risk of hard CHD compared with those with vWF levels in the lowest quartile and f-TFPI levels above the 10th percentile (95% CI, 1.3 to 37.8).
Conclusions—
vWF and f-TFPI plasma levels were independent risk factors for hard CHD events.
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Affiliation(s)
- P E Morange
- Department of Hematology, Faculty of Medicine, INSERM U626, Marseilles, France
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