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Prugger C, Perier MC, Sabia S, Fayosse A, van Sloten T, Jouven X, Pentti J, Kivimäki M, Empana JP. Association between changes in cardiovascular health and the risk of multimorbidity: community-based cohort studies in the UK and Finland. Lancet Reg Health Eur 2024; 42:100922. [PMID: 38764806 PMCID: PMC11098950 DOI: 10.1016/j.lanepe.2024.100922] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/29/2024] [Accepted: 04/16/2024] [Indexed: 05/21/2024]
Abstract
Background Better cardiovascular health is associated with lower risk of various chronic diseases, but its association with multimorbidity is poorly understood. We aimed to examine whether change in cardiovascular health is associated with multimorbidity risk. Methods The primary analysis was conducted in the Whitehall II multiwave prospective cohort study (UK) and the validation analysis in the Finnish Public Sector cohort study (Finland). Change in cardiovascular health was assessed using the American Heart Association Life's Simple 7 (LS7) and Life's Essential 8 (LE8) at baseline and re-assessments, using objective measures in Whitehall II and self-reports and pharmacy claims in the Finnish Public Sector cohort study, respectively. Multimorbidity was defined as the presence of two or more of 12 chronic diseases during follow-up. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox's proportional hazard models with age as time scale, adjusting for sex, education, occupation, marital status, and ethnicity. Findings In the primary analysis among 9715 participants, mean age was 44.8 (standard deviation 6.0) years and 67.6% participants were men at baseline. During the median follow-up of 31.4 (interquartile range 26.8-32.3) years, 2751 participants developed multimorbidity. The hazard of multimorbidity decreased by 8% (HR 0.92, 95% CI 0.88-0.96) per ideal LS7 metric increment over 5 years and by 14% (HR 0.86, 95% CI 0.80-0.93) per ten points increase in LE8 score over 10 years. These findings were replicated in the validation analysis among 75,377 participants in terms of 4-year change in cardiovascular health. Interpretation Improvement in cardiovascular health was associated with lower multimorbidity risk in two community-based cohort studies. Interventions improving cardiovascular health of the community may contribute to multimorbidity prevention. Funding None.
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Affiliation(s)
- Christof Prugger
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Seestraße 73, 13347, Berlin, Germany
| | - Marie-Cécile Perier
- Université Paris Cité, Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, 75015, Paris, France
| | - Séverine Sabia
- Université Paris Cité, INSERM U1153, Epidemiology of Aging and Neurodegenerative Diseases, 10 avenue de Verdun, 75010, Paris, France
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Pl, London, Wc1E 7Hb, United Kingdom
| | - Aurore Fayosse
- Université Paris Cité, INSERM U1153, Epidemiology of Aging and Neurodegenerative Diseases, 10 avenue de Verdun, 75010, Paris, France
| | - Thomas van Sloten
- Department of Vascular Medicine, University Medical Centre Utrecht, Lundlaan 4, 3584 EA, Utrecht, the Netherlands
| | - Xavier Jouven
- Université Paris Cité, Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, 75015, Paris, France
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland
- Department of Public Health, University of Turku, Kiinamyllynkatu 8-10, 20520, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Kiinamyllynkatu 8-10, 20520, Turku, Finland
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, 00250, Helsinki, Finland
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, 17 Queen Square, WC1N 3AR, London, United Kingdom
- Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8, 00290, Helsinki, Finland
| | - Jean-Philippe Empana
- Université Paris Cité, Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, 75015, Paris, France
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Cavaillès C, Letellier N, Berr C, Samieri C, Empana JP, Tzourio C, Dartigues JF, Benmarhnia T, Dauvilliers Y, Jaussent I. The role of cardiovascular health and vascular events in the relationship between excessive daytime sleepiness and dementia risk. J Sleep Res 2024; 33:e14053. [PMID: 37822116 DOI: 10.1111/jsr.14053] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Many studies suggest a relationship between excessive daytime sleepiness (EDS) and dementia incidence, but the underlying mechanisms remain uncertain. The study aimed to investigate the role of cardiovascular burden in the relationship between EDS and dementia incidence over a 12-year follow-up in community-dwelling older adults. We performed analyses on 6171 subjects (aged ≥65 years) free of dementia and vascular disease at baseline. Participants self-reported EDS at baseline and an expert committee validated both prevalent and incident dementia. We defined cardiovascular burden by a low Cardiovascular Health score, constructed using the American Heart Association metrics, and incident vascular events. To explore the potential role of the cardiovascular burden in the relationship between EDS and dementia, we conducted mediation analyses with inverse odds ratio-weighted estimation, using multivariable-adjusted proportional hazard Cox and logistic regression models. Subjects with EDS had a higher risk of all-cause dementia (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.13-1.69) and dementia with vascular component (DVC) (HR 2.14, 95% CI 1.30-3.51), but not Alzheimer's disease (HR 1.18, 95% CI 0.93-1.51). Cardiovascular burden explained 5% (95% CI 4.1-5.2) and 11% (95% CI 9.7-11.3) of the relationship between EDS and all-cause dementia and DVC, respectively. These findings confirm that EDS may be implicated in the development of dementia and indicate a weaker than expected role of cardiovascular burden in the relationship between EDS and DVC.
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Affiliation(s)
- Clémence Cavaillès
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, La Jolla, California, USA
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Cecilia Samieri
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Philippe Empana
- Paris Descartes University, Faculty of Medicine, Paris, France; INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
| | - Christophe Tzourio
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-François Dartigues
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, La Jolla, California, USA
| | - Yves Dauvilliers
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
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Sutter W, Alsac JM, Ben Abdallah I, Michel C, Julia P, Empana JP, El Batti S. Treatment of Aortoiliac Occlusive Lesions by Aortic Robotic Surgery: Learning Curve and Midterm Outcome. Ann Vasc Surg 2024; 104:258-267. [PMID: 38593921 DOI: 10.1016/j.avsg.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUD The learning curve and midterm results of aortoiliac occlusive disease (AIOD) revascularization by robot-assisted laparoscopic (RAL) surgery may be known. METHODS A prospective single-center study was conducted in the vascular surgery department of Georges Pompidou European Hospital (Paris, France). Patients with AIOD treated by RAL from February 2014 to February 2019 were included. Demographic characteristics, past medical history, Trans-Atlantic Inter-Society Consensus (TASC) lesions classifications, mortality, primary and secondary patency, as well as complication rates were collected. Safety was analyzed by the cumulative sum control chart method with a conversion rate of 10%, operative time by cumulative average-time model, and primary and secondary patency by the Kaplan-Meier method. RESULTS Seventy patients were included, 18 (25.7%) with TASC C lesions and 52 (74.3%) with TASC D lesions. Before discharge, 14 (24.3%) patients had surgical complications. Among them, 10 (14.3%) required at least one reintervention. One (1.4%) patient died during the hospitalization. The learning curve in terms of safety (conversion rate) was 13 cases with an operating time of 220 minutes after 35 patients. During follow-up (median 37 months [21; 49]), 63 patients (91.3%) improved their symptoms, 53 (76.8%) became asymptomatic, and 3 graft limb occlusions occurred. The primary patency at 12, 24, 36, and 48 months was 94%, 92%, 92%, and 92%, respectively, while the secondary patency for the same intervals was 100%, 98.1%, 98.1%, and 98.1%, respectively. CONCLUSIONS Robotic surgery in AIOD revascularization seems safe and effective; allowing to treat patients with few comorbidities and severe lesions, in a dedicated center experienced in RAL, with excellent patency. Prospective clinical trials should be performed to confirm safety.
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Affiliation(s)
- Willy Sutter
- Integrative Epidemiology of Cardiovascular Diseases Team, Paris Cardiovascular Research Center- INSERM UMR-S 970, Paris, France; Université de Paris-Cité, Paris, France; Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Jean-Marc Alsac
- Université de Paris-Cité, Paris, France; Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Iannis Ben Abdallah
- Université de Paris-Cité, Paris, France; Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR-S 1140, Laboratoire de recherches Biochirurgicales de la Fondation Carpentier, Université de Paris-Cité, Paris, France
| | - Cassandre Michel
- Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Julia
- Université de Paris-Cité, Paris, France; Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Philippe Empana
- Integrative Epidemiology of Cardiovascular Diseases Team, Paris Cardiovascular Research Center- INSERM UMR-S 970, Paris, France
| | - Salma El Batti
- Université de Paris-Cité, Paris, France; Vascular Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR-S 1140, Laboratoire de recherches Biochirurgicales de la Fondation Carpentier, Université de Paris-Cité, Paris, France
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Saade Y, Deraz O, Chatzopoulou E, Rangé H, Boutouyrie P, Perier MC, Guibout C, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Recalled body silhouette trajectories over the lifespan and oral conditions in adulthood: A cross-sectional analysis of the Paris Prospective Study 3. Community Dent Oral Epidemiol 2024. [PMID: 38273719 DOI: 10.1111/cdoe.12946] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To examine the association between life-course body silhouette changes and oral conditions in adulthood. METHODS At study recruitment (2008-2012), 5430 adults underwent a full-mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life-course trajectories of body silhouettes were computed using group-based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression. RESULTS The final analysis included 4472 participants. Five body silhouette trajectories were established: lean-stable (30.0%), lean-increased (19.3%), moderate stable (18.1%), lean-marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean-increased trajectory were 58% more likely than those with a lean-stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides. CONCLUSIONS A life-course lean-increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood.
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Affiliation(s)
- Yara Saade
- Department of Periodontology, Université Paris Cité, Paris, France
- Rothschild Hospital, APHP, Paris, France
| | - Omar Deraz
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Eirini Chatzopoulou
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Hélène Rangé
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
- Department of Periodontology, Service of Odontology, University hospital of Rennes, University of Rennes 1, U.F.R. of Odontology, Paris, France
- INSERM, INRAE, University of Rennes 1 NUMECAN Institute (Nutrition Metabolisms and Cancer), Rennes, France
- FHU PaCeMM Paris Center for Microbiome Medicine, Paris, France
| | - Pierre Boutouyrie
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Catherine Guibout
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | | | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
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Javaudin F, Bougouin W, Fanet L, Diehl JL, Jost D, Beganton F, Empana JP, Jouven X, Adnet F, Lamhaut L, Lascarrou JB, Cariou A, Dumas F. Cumulative dose of epinephrine and mode of death after non-shockable out-of-hospital cardiac arrest: a registry-based study. Crit Care 2023; 27:496. [PMID: 38124126 PMCID: PMC10734153 DOI: 10.1186/s13054-023-04776-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Epinephrine increases the chances of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA), especially when the initial rhythm is non-shockable. However, this drug could also worsen the post-resuscitation syndrome (PRS). We assessed the association between epinephrine use during cardiopulmonary resuscitation (CPR) and subsequent intensive care unit (ICU) mortality in patients with ROSC after non-shockable OHCA. METHODS We used data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (capturing OHCA data located in the Greater Paris area, France) between May 2011 and December 2021. All adults with ROSC after medical, cardiac and non-cardiac causes, non-shockable OHCA admitted to an ICU were included. The mode of death in the ICU was categorized as cardiocirculatory, neurological, or other. RESULTS Of the 2,792 patients analyzed, there were 242 (8.7%) survivors at hospital discharge, 1,004 (35.9%) deaths from cardiocirculatory causes, 1,233 (44.2%) deaths from neurological causes, and 313 (11.2%) deaths from other etiologies. The cardiocirculatory death group received more epinephrine (4.6 ± 3.8 mg versus 1.7 ± 2.8 mg, 3.2 ± 2.6 mg, and 3.5 ± 3.6 mg for survivors, neurological deaths, and other deaths, respectively; p < 0.001). The proportion of cardiocirculatory death increased linearly (R2 = 0.92, p < 0.001) with cumulative epinephrine doses during CPR (17.7% in subjects who did not receive epinephrine and 62.5% in those who received > 10 mg). In multivariable analysis, a cumulative dose of epinephrine was strongly associated with cardiocirculatory death (adjusted odds ratio of 3.45, 95% CI [2.01-5.92] for 1 mg of epinephrine; 12.28, 95% CI [7.52-20.06] for 2-5 mg; and 23.71, 95% CI [11.02-50.97] for > 5 mg; reference 0 mg; population reference: alive at hospital discharge), even after adjustment on duration of resuscitation. The other modes of death (neurological and other causes) were also associated with epinephrine use, but to a lesser extent. CONCLUSIONS In non-shockable OHCA with ROSC, the dose of epinephrine used during CPR is strongly associated with early cardiocirculatory death. Further clinical studies aimed at limiting the dose of epinephrine during CPR seem warranted. Moreover, strategies for the prevention and management of PRS should take this dose of epinephrine into consideration for future trials.
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Affiliation(s)
- François Javaudin
- Paris Sudden Death Expertise Center, 75015, Paris, France.
- Emergency Department, Nantes University Hospital, 44000, Nantes, France.
- SAMU, 1 Quai Moncousu, 44093, Nantes Cedex1, France.
| | - Wulfran Bougouin
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- Medical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300, Massy, France
- AfterROSC Network, Paris, France
| | - Lucie Fanet
- Paris Sudden Death Expertise Center, 75015, Paris, France
| | - Jean-Luc Diehl
- Medical Intensive Care Unit, AP-HP, European Georges Pompidou Hospital, 75015, Paris, France
- Innovative Therapies in Hemostasis, INSERM 1140, Université Paris Cité, 75006, Paris, France
| | - Daniel Jost
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- BSPP (Paris Fire-Brigade Emergency-Medicine Department), 1 Place Jules Renard, 75017, Paris, France
| | - Frankie Beganton
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
| | - Jean-Philippe Empana
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
| | - Xavier Jouven
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- Cardiology Department, AP-HP, European Georges Pompidou Hospital, 75015, Paris, France
| | - Frédéric Adnet
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- SAMU de Paris, Necker University Hospital, Assistance Publique-Hôpitaux de Paris, 75015, Paris, France
| | - Lionel Lamhaut
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- SAMU de Paris, Necker University Hospital, Assistance Publique-Hôpitaux de Paris, 75015, Paris, France
| | - Jean-Baptiste Lascarrou
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- AfterROSC Network, Paris, France
- Medecine Intensive Reanimation, Nantes University Hospital, 44000, Nantes, France
| | - Alain Cariou
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- AfterROSC Network, Paris, France
- Medical Intensive Care Unit, AP-HP, Cochin Hospital, 75014, Paris, France
| | - Florence Dumas
- Paris Sudden Death Expertise Center, 75015, Paris, France
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015, Paris, France
- Emergency Department, AP-HP, Cochin-Hotel-Dieu Hospital, 75014, Paris, France
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Nambiema A, Lisan Q, Vaucher J, Perier MC, Boutouyrie P, Danchin N, Thomas F, Guibout C, Solelhac G, Heinzer R, Jouven X, Marques-Vidal P, Empana JP. Healthy sleep score changes and incident cardiovascular disease in European prospective community-based cohorts. Eur Heart J 2023; 44:4968-4978. [PMID: 37860848 PMCID: PMC10719494 DOI: 10.1093/eurheartj/ehad657] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND AIMS Evidence on the link between sleep patterns and cardiovascular diseases (CVDs) in the community essentially relies on studies that investigated one single sleep pattern at one point in time. This study examined the joint effect of five sleep patterns at two time points with incident CVD events. METHODS By combining the data from two prospective studies, the Paris Prospective Study III (Paris, France) and the CoLaus|PsyCoLaus study (Lausanne, Switzerland), a healthy sleep score (HSS, range 0-5) combining five sleep patterns (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnoea, and no excessive daytime sleepiness) was calculated at baseline and follow-up. RESULTS The study sample included 11 347 CVD-free participants aged 53-64 years (44.6% women). During a median follow-up of 8.9 years [interquartile range (IQR): 8.0-10.0], 499 first CVD events occurred (339 coronary heart disease (CHD) and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.76-0.89] per one-point increment in the HSS. After a median follow-up of 6.0 years (IQR: 4.0-8.0) after the second follow-up, 262 first CVD events occurred including 194 CHD and 72 stroke. After adjusting for baseline HSS and covariates, the risk of CVD decreased by 16% (HR 0.84, 95% CI 0.73-0.97) per unit higher in the follow-up HSS over 2-5 years. CONCLUSIONS Higher HSS and HSS improvement over time are associated with a lower risk of CHD and stroke in the community.
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Affiliation(s)
- Aboubakari Nambiema
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Quentin Lisan
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marie-Cecile Perier
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, APHP, DMU CARTE, Pharmacology, Paris, France
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | | | - Catherine Guibout
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Geoffroy Solelhac
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pedro Marques-Vidal
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
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Prugger C, Perier MC, Gonzalez-Izquierdo A, Hemingway H, Denaxas S, Empana JP. Incidence of 12 common cardiovascular diseases and subsequent mortality risk in the general population. Eur J Prev Cardiol 2023; 30:1715-1722. [PMID: 37294923 DOI: 10.1093/eurjpc/zwad192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/25/2023] [Accepted: 06/03/2023] [Indexed: 06/11/2023]
Abstract
BACKGROUND Incident events of cardiovascular diseases (CVDs) are heterogenous and may result in different mortality risks. Such evidence may help inform patient and physician decisions in CVD prevention and risk factor management. AIMS This study aimed to determine the extent to which incident events of common CVD show heterogeneous associations with subsequent mortality risk in the general population. METHODS AND RESULTS Based on England-wide linked electronic health records, we established a cohort of 1 310 518 people ≥30 years of age initially free of CVD and followed up for non-fatal events of 12 common CVD and cause-specific mortality. The 12 CVDs were considered as time-varying exposures in Cox's proportional hazards models to estimate hazard rate ratios (HRRs) with 95% confidence intervals (CIs). Over the median follow-up of 4.2 years (2010-16), 81 516 non-fatal CVD, 10 906 cardiovascular deaths, and 40 843 non-cardiovascular deaths occurred. All 12 CVDs were associated with increased risk of cardiovascular mortality, with HRR (95% CI) ranging from 1.67 (1.47-1.89) for stable angina to 7.85 (6.62-9.31) for haemorrhagic stroke. All 12 CVDs were also associated with increased non-cardiovascular and all-cause mortality risk but to a lesser extent: HRR (95% CI) ranged from 1.10 (1.00-1.22) to 4.55 (4.03-5.13) and from 1.24 (1.13-1.35) to 4.92 (4.44-5.46) for transient ischaemic attack and sudden cardiac arrest, respectively. CONCLUSION Incident events of 12 common CVD show significant adverse and markedly differential associations with subsequent cardiovascular, non-cardiovascular, and all-cause mortality risk in the general population.
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Affiliation(s)
- Christof Prugger
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marie-Cécile Perier
- INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Diseases, Université Paris Cité, 56 rue Leblanc, 75015 Paris, France
| | - Arturo Gonzalez-Izquierdo
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
| | - Harry Hemingway
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
- British Heart Foundation Data Science Center, 215 Euston Road, NW1 2BE London, UK
| | - Jean-Philippe Empana
- INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Diseases, Université Paris Cité, 56 rue Leblanc, 75015 Paris, France
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Lisan Q, Marques-Vidal P, Hausler N, Danchin N, Boutouyrie P, Asselin A, Jouven X, Heinzer R, Empana JP. Obstructive sleep apnea, circulating microRNAs, and risk of cardiovascular disease. Sleep Med 2023; 109:1-3. [PMID: 37354730 DOI: 10.1016/j.sleep.2023.06.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE while obstructive sleep apnea is strongly associated with incident cardiovascular diseases (CVD), the underlying mechanisms remain to be elucidated. This study aimed to compare the patterns of microRNAs expression between OSA and control patients with and without incident CVD. METHODS 218 matched adult participants with and without OSA and with and without incident CVD were selected from two independent community-based prospective cohorts in France and Switzerland, and 168 microRNAs on average were detected per sample. OSA was diagnosed using the validated Berlin questionnaire in one study (Paris Prospective Study 3) and during a full-night polysomnography in the second study (HypnoLaus Study). RESULTS there were 78 OSA patients (39 with and 39 without CVD) and 140 controls (70 with and 70 without CVD). Participants were male in 54.6% (n = 119) and mean age was 58.7 years (±9.2). Of the 183 miRNAs screened, a mean 168 assays were detected per sample, and 129 in all samples. There was no pattern of blood microRNAs expression that discriminated OSA patients with and without CVD events. CONCLUSIONS this binational study failed to find any association between a large panel of microRNAs and OSA patients with and without incident CVD.
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Affiliation(s)
- Q Lisan
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France; Department of Head and Neck Surgery, Foch Hospital, Suresnes, France.
| | - P Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - N Hausler
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - N Danchin
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Cellular, Molecular and Physiological Mechanisms of Heart Failure', Paris, France
| | - A Asselin
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
| | - X Jouven
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
| | - R Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - J P Empana
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Team "Integrative Epidemiology of Cardiovascular Diseases", Paris, France
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9
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van Sloten TT, Climie RED, Deraz O, Périer MC, Valentin E, Fayosse A, Sabia S, Weiderpass E, Jouven X, Goldberg M, Zins M, Touvier M, Deschasaux-Tanguy M, Fezeu L, Hercberg S, Singh-Manoux A, Empana JP. Is the number of ideal cardiovascular health metrics in midlife associated with lower risk of cancer? Evidence from 3 European prospective cohorts. CMAJ Open 2023; 11:E774-E781. [PMID: 37607746 PMCID: PMC10449017 DOI: 10.9778/cmajo.20220175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Primordial prevention may be a relevant strategy for the prevention of cancer. Given the commonality of risk factors and mechanisms between cancer and cardiovascular disease, we examined the associations between the number of ideal cardiovascular health metrics in midlife and incident cancer. METHODS In 3 European cohorts (NutriNet-Santé and GAZEL, France; Whitehall II, United Kingdom), the number of ideal cardiovascular health metrics was determined at baseline (range 0-7). Follow-up for cancer events was until October 2020 (NutriNet-Santé), March 2017 (Whitehall II) and December 2015 (GAZEL). Cox regression was conducted in each cohort, and results were thereafter pooled using a random-effects model. RESULTS Data were available on 39 718 participants. A total of 16 237 were from NutriNet-Santé (mean age 51.3 yr; 28% men), 9418 were from Whitehall II (mean age 44.8 yr; 68% men) and 14 063 were from GAZEL (mean age 45.2 yr; 75% men). The median follow-up was 8.1 years in NutriNet-Santé, 29.6 years in Whitehall II and 24.8 years in GAZEL, and yielded a total of 4889 cancer events. A greater number of ideal cardiovascular health metrics was associated with a lower overall cancer risk in each cohort, with an aggregate hazard ratio (HR) per 1 increment in number of ideal metrics of 0.91 (95% confidence interval [CI] 0.88-0.93). This association remained after removal of the smoking metric (aggregate HR per unit increment in number of ideal metrics: 0.94, 95% CI 0.90-0.97), and site-specific analysis demonstrated a significant association with lung cancer. INTERPRETATION A greater number of ideal cardiovascular health metrics in midlife was associated with lower cancer risk, notably lung cancer. Primordial prevention of cardiovascular risk factors in midlife may be a complementary strategy to prevent the onset of cancer.
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Affiliation(s)
- Thomas T van Sloten
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Rachel E D Climie
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Omar Deraz
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Marie-Cécile Périer
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Eugenie Valentin
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Aurore Fayosse
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Séverine Sabia
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Elisabete Weiderpass
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Marcel Goldberg
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Marie Zins
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Mathilde Touvier
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Léopold Fezeu
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Serge Hercberg
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Archana Singh-Manoux
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Institut national de la santé et de la recherche médicale, (INSERM) Unité Mixte de Recherche (UMR) S970 (van Sloten, Deraz, Périer, Valentin, Jouven, Empana), Université Paris Cité, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine (van Sloten), Maastricht University Medical Center, Maastricht, the Netherlands; Menzies Institute for Medical Research (Climie), University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute (Climie), Melbourne, Australia; Centre for Research in Epidemiology and Statistics, INSERM, UMR 1153 (Fayosse, Sabia, Singh-Manoux), Université Paris Cité, Paris, France; Department of Epidemiology and Public Health (Sabia, Singh-Manoux), University College London, London, UK; International Agency for Research in Cancer (Weiderpass), Lyon, France; Population-based Cohorts Unit (Goldberg, Zins), INSERM, Unité Mixte de Service (UMS) 011, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France; Sorbonne Paris Nord University (Touvier, Deschasaux-Tanguy, Fezeu, Hercberg), INSERM, UMR 1153, Institut national de la recherche agronomique (INRAE) U1125, National Conservatory of Arts and Crafts, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center - University of Paris, Bobigny, France
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10
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Deraz O, Caceres B, Streed CG, Beach LB, Jouven X, Touvier M, Goldberg M, Zins M, Empana JP. Sexual Minority Status Disparities in Life's Essential 8 and Life's Simple 7 Cardiovascular Health Scores: A French Nationwide Population-Based Study. J Am Heart Assoc 2023:e028429. [PMID: 37195318 PMCID: PMC10382002 DOI: 10.1161/jaha.122.028429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Background A higher burden of cardiovascular disease risk factors has been reported in sexual minority populations. Primordial prevention may therefore be a relevant preventative strategy. The study's objectives are to estimate the associations of Life's Essential 8 (LE8) and Life's Simple 7 (LS7) cardiovascular health scores with sexual minority status. Methods and Results The CONSTANCES is a nationwide French epidemiological cohort study that recruited randomly selected participants older than 18 years in 21 cities. Sexual minority status was based on self-reported lifetime sexual behavior and categorized as lesbian, gay, bisexual, or heterosexual. The LE8 score includes nicotine exposure, diet, physical activity, body mass index, sleep health, blood glucose, blood pressure, and blood lipids. The previous LS7 score included 7 metrics without sleep health. The study included 169 434 cardiovascular disease-free adults (53.64% women; mean age, 45.99 years). Among 90 879 women, 555 were lesbian, 3149 were bisexual, and 84 363 were heterosexual. Among 78 555 men, 2421 were gay, 2748 were bisexual, and 70 994 were heterosexual. Overall, 2812 women and 2392 men declined to answer. In multivariable mixed effects linear regression models, lesbian (β=-0.95 [95% CI, -1.89 to -0.02]) and bisexual (β=-0.78 [95% CI, -1.18 to -0.38]) women had a lower LE8 cardiovascular health score compared with heterosexual women. Conversely, gay (β=2.72 [95% CI, 2.25-3.19]) and bisexual (β=0.83 [95% CI, 0.39-1.27]) men had a higher LE8 cardiovascular health score compared with heterosexual men. The findings were consistent, although of smaller magnitudes for the LS7 score. Conclusions Cardiovascular health disparities exist in sexual minority adults, particularly lesbian and bisexual women, who may represent a priority population for primordial cardiovascular disease prevention.
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Affiliation(s)
- Omar Deraz
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris France
| | - Billy Caceres
- Columbia University School of Nursing New York NY USA
| | - Carl G Streed
- Section of General Internal Medicine Boston University School of Medicine Boston MA USA
- Center for Transgender Medicine and Surgery Boston Medical Center Boston MA USA
| | - Lauren B Beach
- Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Xavier Jouven
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS) Bobigny France
| | - Marcel Goldberg
- Université Paris Cité, "Population-based Cohorts Unit," INSERM, Paris Saclay University Villejuif France
| | - Marie Zins
- Université Paris Cité, "Population-based Cohorts Unit," INSERM, Paris Saclay University Villejuif France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4) Paris France
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11
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Sedaghat S, Ji Y, Empana JP, Hughes TM, Mosley TH, Gottesman RF, Griswold M, Jack CR, Lutsey PL, van Sloten TT. Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life. Stroke 2023; 54:1280-1288. [PMID: 36951053 PMCID: PMC10133201 DOI: 10.1161/strokeaha.122.041374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/17/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Cardiovascular health may be used for prevention of cerebral vascular disease; however, data on the association of cardiovascular health across midlife and late-life with late-life cerebral vascular disease are lacking. Our aim was to examine whether midlife or late-life cardiovascular health as well as changes of cardiovascular health within midlife and between midlife and late-life were associated with prevalence of magnetic resonance imaging markers of cerebral vascular disease at late-life. METHODS Prospective cohort study including 1638 participants from the Atherosclerosis Risk in Communities Study who took part in 2 visits at midlife (mean ages, 53 and 59 years), and a late-life visit (mean age, 76 years). A cardiovascular health Life's Simple 7 score (range, 0-12/0-14, depending on diet availability) including 6 out of 7 items was calculated at each visit, with weight assigned to each item as poor (0), intermediate (1), or ideal (2). Participants underwent 3T brain magnetic resonance imaging scans in late-life visit. Outcomes were white matter hyperintensity volume, microbleeds, and lacunar, subcortical, and cortical infarcts at late-life. Linear and logistic regression models were used to assess the associations of cardiovascular health in midlife and late-life, and improvement of cardiovascular health within midlife, and from midlife to late-life with magnetic resonance imaging markers of cerebral vascular disease, adjusting for potential confounders. RESULTS A higher cardiovascular health in midlife, improvement of cardiovascular health within midlife, higher cardiovascular health at late-life, and improvement of cardiovascular health from midlife to late-life were associated with a lower prevalence of cerebral vascular disease markers. For example, improvement in cardiovascular health (per point) from midlife to late-life was associated with smaller white matter hyperintensity volume (β, -0.07 [95% CI, -0.10 to -0.04]) and lower odds of microbleeds (odds ratio, 0.93 [0.90-0.97]), lacunar (odds ratio, 0.93 [0.89-0.97]), subcortical (odds ratio, 0.93 [0.89-0.97]), and cortical infarcts (odds ratio, 0.92 [0.87-0.97]). CONCLUSIONS Improving cardiovascular health within midlife and from midlife to late-life may prevent development of cerebral vascular disease.
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Affiliation(s)
- Sanaz Sedaghat
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Yuekai Ji
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Jean-Philippe Empana
- Université de Paris, INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | | | - Thomas H Mosley
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, MS, USA
| | - Rebecca F Gottesman
- Stroke Branch, Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Michael Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Thomas T van Sloten
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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12
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Sedaghat S, Lutsey PL, Ji Y, Empana JP, Sorond F, Hughes T, Mosley TH, Gottesman RF, Knopman DS, Walker KA, Gudnason V, Launer LJ, van Sloten TT. Association of change in cardiovascular risk factors with incident dementia. Alzheimers Dement 2023; 19:1821-1831. [PMID: 36303296 PMCID: PMC10782572 DOI: 10.1002/alz.12818] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION We evaluated whether better cardiovascular health at midlife and improvement of cardiovascular health within midlife were associated with dementia risk. METHODS Two longitudinal population-based studies were used: Atherosclerosis Risk in Communities (ARIC) (n = 11,460/visits at ages 54 and 60), and Age, Gene/Environment Susceptibility (AGES)-Reykjavik (n = 3907/visit at age 51). A cardiovascular health score (range 0-12/0-14, depending on diet availability) including six/seven items was calculated at each visit, with weight assigned to each item as poor (0), intermediate (1), or ideal (2). Cardiovascular health was defined as low (score 0-4/0-5), intermediate (5-7/6-9), or high (8-12/10-14). Incident dementia was ascertained through linkage to health records and with neuropsychological examinations. RESULTS Midlife high compared to low cardiovascular health (hazard ratios [HRs]: for ARIC: 0.60 [95% confidence interval: 0.52, 0.69]); for AGES-Reykjavik: 0.83 [0.66, 0.99] and improvement of cardiovascular health score within midlife (HR per one-point increase: ARIC: 0.94 [0.92, 0.96]) were associated with lower dementia risk. DISCUSSION Better cardiovascular health at midlife and improvement of cardiovascular health within midlife are associated with lower dementia risk. HIGHLIGHTS Cardiovascular health and dementia were studied in two large cohort studies. Better cardiovascular health at midlife relates to lower dementia risk. Improvement of cardiovascular health within midlife relates to lower dementia risk. Promotion of cardiovascular health at midlife can help to reduce dementia risk.
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Affiliation(s)
- Sanaz Sedaghat
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Yuekai Ji
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Jean-Philippe Empana
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Farzaneh Sorond
- Department of Neurology, Feinberg School of Medicine, Northwestern University, IL, USA
| | | | - Thomas H Mosley
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, MS, USA
| | - Rebecca F Gottesman
- Stroke Branch, Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | | | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J Launer
- Laboratory for Epidemiology, Demography and Biometry of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Thomas T van Sloten
- School for Cardiovascular Diseases, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
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Welten SJGC, Remmelzwaal S, Blom MT, van der Heijden AA, Nijpels G, Tan HL, van Valkengoed I, Empana JP, Jouven X, Ågesen FN, Warming PE, Tfelt-Hansen J, Prescott E, Jabbari R, Elders PJM. Validation of the ARIC prediction model for sudden cardiac death in the European population: The ESCAPE-NET project: Predicting sudden cardiac death in European adults. Am Heart J 2023; 262:55-65. [PMID: 37084935 DOI: 10.1016/j.ahj.2023.03.018] [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: 11/01/2022] [Revised: 03/20/2023] [Accepted: 03/31/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Sudden cardiac death is responsible for 10-20% of all deaths in Europe. The current study investigates how well the risk of sudden cardiac death can be predicted. To this end, we validated a previously developed prediction model for sudden cardiac death from the Atherosclerosis Risk in Communities study (USA). METHODS Data from participants of the Copenhagen City Heart Study (CCHS) (n=9988) was used to externally validate the previously developed prediction model for sudden cardiac death. The model's performance was assessed through discrimination (C-statistic) and calibration by the Hosmer-Lemeshow goodness-of-fit (HL) statistics suited for censored data and visual inspection of calibration plots. Additional validation was performed using data from the Hoorn Study (N=2045), employing the same methods. RESULTS During ten years of follow-up of CCHS participants (mean age: 58.7 years, 56.2% women), 425 experienced SCD (4.2%). The prediction model showed good discrimination for sudden cardiac death risk (C-statistic: 0.81, 95% CI:0.79-0.83). Calibration was robust (HL statistic: p=0.8). Visual inspection of the calibration plot showed that the calibration could be improved. Sensitivity was 89.8%, and specificity was 60.6%. The positive and negative predictive values were 10.1% and 99.2%. Model performance was similar in the Hoorn Study (C-statistic: 0.81, 95% CI: 0.77-0.85 and the HL statistic: 1.00). CONCLUSION Our study showed that the previously developed prediction model in North American adults performs equally well in identifying those at risk for sudden cardiac death in a general North-West European population. However, the positive predictive value is low.
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Affiliation(s)
- Sabrina J G C Welten
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health behaviors & chronic diseases, Amsterdam, The Netherlands.
| | - Sharon Remmelzwaal
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Department of Epidemiology and Data Science, Amsterdam University Medical Center, location VU, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Marieke T Blom
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health behaviors & chronic diseases, Amsterdam, The Netherlands
| | - Amber A van der Heijden
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health behaviors & chronic diseases, Amsterdam, The Netherlands
| | - Giel Nijpels
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health behaviors & chronic diseases, Amsterdam, The Netherlands
| | - Hanno L Tan
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Netherlands Heart Institute, Utrecht, The Netherlands
| | - Irene van Valkengoed
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France; Sudden Cardiac Expertise Centre, Paris, France
| | - Xavier Jouven
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France; Sudden Cardiac Expertise Centre, Paris, France
| | - Frederik Nybye Ågesen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Peder Emil Warming
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.; Section of Forensic Genetics, Department of Forensic Medicine, Copenhagen University, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Reza Jabbari
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Petra J M Elders
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General practice, de Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Health behaviors & chronic diseases, Amsterdam, The Netherlands
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14
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van Sloten TT, Valentin E, Climie RE, Jouven X, Lemogne C, Goldberg M, Zins M, Empana JP. Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms. JAMA Psychiatry 2023; 80:342-349. [PMID: 36790776 PMCID: PMC9932942 DOI: 10.1001/jamapsychiatry.2022.5056] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 08/11/2022] [Accepted: 11/28/2022] [Indexed: 02/16/2023]
Abstract
Importance Cardiovascular health may be used for prevention of depressive symptoms. However, data on the association of cardiovascular health across midlife with depressive symptoms are lacking. Objective To evaluate whether better baseline cardiovascular health and improvement of cardiovascular health over time are associated with a lower risk of both incident depressive symptoms and unfavorable trajectories of depressive symptoms. Design, Setting, and Participants Participants without depressive symptoms were included from a prospective community-based cohort in France (GAZEL cohort). Cardiovascular health examinations occurred in 1990 and 1997 and assessment of depressive symptoms in 1997 and every 3 years thereafter until 2015. Data were analyzed from January to October 2022. Exposures Number of cardiovascular health metrics (smoking, body mass index, physical activity, diet, blood pressure, glucose, and cholesterol) at an intermediate or ideal level in 1997 (range, 0-7) and 7-year change in cardiovascular health between 1990 and 1997. Main Outcomes and Measures Primary outcome was incident depressive symptoms (20-item Center for Epidemiologic Studies-Depression Scale [CES-D] score of 17 or greater in men or 23 or greater in women); secondary outcome was trajectories of depressive symptoms scores. Trajectories included consistently low scores, moderately elevated scores, low starting then increasing scores, moderately high starting, increasing, then remitting scores, and moderately high starting then increasing scores. Results Of 6980 included patients, 1671 (23.9%) were women, and the mean (SD) age was 53.3 (3.5) years. During a follow-up spanning 19 years after 1997, 1858 individuals (26.5%) had incident depressive symptoms. Higher baseline cardiovascular health in 1997 and improvement in cardiovascular health over 7 years were each associated with lower risk of depressive symptoms (odds ratio [OR] per additional metric at intermediate or ideal level at baseline, 0.87; 95% CI, 0.84-0.91; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.91; 95% CI, 0.86-0.96). Also, better cardiovascular health was associated with lower risk of unfavorable depressive symptoms trajectories. Compared with the consistently low score trajectory, the lowest risks were observed for the low starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.70; 95% CI, 0.64-0.76; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.73; 95% CI, 0.68-0.79) and the moderately high starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.71; 95% CI, 0.64-0.79; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.71; 95% CI, 0.64-0.77). Conclusions and Relevance In this prospective community-based cohort study of adults, higher cardiovascular health was associated with a lower risk of depressive symptoms over time. Elucidating which set of cardiovascular factors may affect depression risk could be important for prevention.
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Affiliation(s)
- Thomas T. van Sloten
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Eugénie Valentin
- Université Paris Cité, INSERM, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), UMR-S970, Paris, France
| | - Rachel E. Climie
- Université Paris Cité, INSERM, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), UMR-S970, Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
| | - Xavier Jouven
- Université Paris Cité, INSERM, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), UMR-S970, Paris, France
| | - Cedric Lemogne
- Institut de Psychiatrie et Neuroscience de Paris, Université Paris Cité, INSERM U1266, Paris, France
- Service de Psychiatrie de l’Adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris-Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Marie Zins
- Institut de Psychiatrie et Neuroscience de Paris, Université Paris Cité, INSERM U1266, Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), UMR-S970, Paris, France
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15
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Deraz O, Van Sloten T, Climie R, Debras C, Fezeu LK, Deschasaux-Tanguy M, Jouven X, Kesse-Guyot E, Galan P, Hercberg S, Touvier M, Empana JP. Person-centered and measured life's simple 7 cardiovascular health concordance and association with incident cardiovascular disease. Sci Rep 2023; 13:5247. [PMID: 37002422 PMCID: PMC10066211 DOI: 10.1038/s41598-023-32219-x] [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] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Person-centered cardiovascular health (CVH) may facilitate cardiovascular disease primordial prevention in low resources settings. The study aims to assess the validity of person-centered CVH compared to gold standard measured CVH by examining the concordance between person-centered vs. measured CVH together with their respective association with incident cardiovascular disease events (CVD). Life's Simple 7 (LS7) CVH metrics, including non-smoking, Body Mass Index, diet, physical activity, blood glycemia, blood pressure, and blood cholesterol were collected from 19,473 adults participating in the e-cohort NutriNet-Santé study from 2011 to 2014 and were followed until September 2020. Clinical examinations and blood analyses defined the measured biological metrics, while diagnoses, medication, or treatment for type 2 diabetes, hypertension, and hypercholesterolemia defined person-centered biological metrics. Declared behavioral metrics were common for both measured and person-centered CVH. The study included 18,714 CVD-free participants (mean age 51 years, 73% women), among whom 16.52% and 38.75% had 5-7 ideal LS7 metrics according to measured and person-centered CVH, respectively. Weighted concordance of person-centered and measured CVH was 0.87 [0.86; 0.88]. Over median follow-up of 8.05 years, 749 CVD events occurred. There was a 7% (HR 0.93 [0.88; 0.99]) and 13% (HR 0.87 [0.83; 0.92]) risk reduction of CVD risk by additional measured and person-centered ideal metrics, respectively. In conclusion, person-centered CVH may represent a reliable alternative to measured CVH.
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Affiliation(s)
- Omar Deraz
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Thomas Van Sloten
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rachel Climie
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Charlotte Debras
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Xavier Jouven
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Jean-Philippe Empana
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France.
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Weizman O, Empana JP, Blom M, Tan HL, Jonsson M, Narayanan K, Ringh M, Marijon E, Jouven X. Incidence of Cardiac Arrest During Sports Among Women in the European Union. J Am Coll Cardiol 2023; 81:1021-1031. [PMID: 36922087 DOI: 10.1016/j.jacc.2023.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 10/03/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Women represent a growing proportion of sports participants. Still, few original data regarding sudden cardiac arrest during sports (Sr-SCA) in women are available. OBJECTIVES The authors sought to assess the incidence, characteristics, and outcomes of women presenting with Sr-SCA. METHODS Data were analyzed from 3 population-based European registries (ESCAPE-NET 2020 Horizon Program) that prospectively and exhaustively collect every case of SCA: SDEC (Paris-Sudden Death Expertise Center), ARREST (AmsteRdam REsuscitation Studies), and SRCR (Swedish Register for Cardiopulmonary Resuscitation). Sr-SCA was defined as SCA during or ≤1 hour after cessation of sports activity. RESULTS Of 34,826 SCA between 2006 and 2017, 760 Sr-SCA (2.2%) were identified, including 54 in women. The average annual incidence of Sr-SCA in women in the 3 registries ranged from 0.10 per million (95% CI: 0.01-0.71 per million) to 0.38 per million (95% CI: 0.14-1.04 per million). Overall, the average annual incidence rate of Sr-SCA in women was 0.19 per million (95% CI: 0.14-0.24 per million), >10-fold lower compared with men (2.63 per million [95% CI: 2.45-2.83 per million]; P < 0.0001). When extrapolating to the total European population and accounting for age and sex, this yields 98 cases per year (95% CI: 72-123 cases per year) in women and 1,350 cases per year (95% CI: 1,256-1,451 cases per year) in men. Subject characteristics and circumstances of occurrence were similar in women vs men. Bystander response, time to defibrillation, and survival rate at hospital admission (58.8% vs 58.5%; P = 0.99) and 30 days did not differ significantly between women and men. CONCLUSIONS These findings emphasize the dramatically lower risk of Sr-SCA in women compared with men, despite similar subject characteristics. This should be considered in designing preparticipation screening strategies in the future.
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Affiliation(s)
- Orianne Weizman
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Marieke Blom
- Cardiology Department, Academic Medical Center, Amsterdam, the Netherlands
| | - Hanno L Tan
- Cardiology Department, Academic Medical Center, Amsterdam, the Netherlands
| | - Martin Jonsson
- Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Mattias Ringh
- Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France; Hôpital Européen Georges Pompidou, Paris, France.
| | - Xavier Jouven
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France; Hôpital Européen Georges Pompidou, Paris, France
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Empana JP, PERIER MC, Warming PE, Marijon E, Van Valkengoed I, Ågesen FN, Jabbari R, Prescott E, Climie R, Schwartz PJ, Tan HL, Tfelt-Hansen J, Jouven X. BASELINE AND CHANGE IN LIFE'S SIMPLE 7 CARDIOVASCULAR HEALTH SCORE AND RISK OF SUDDEN CARDIAC DEATH IN THE POPULATION. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02173-3] [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: 03/06/2023]
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Deraz O, Caceres BA, Streed CG, Beach LB, Jouven X, Touvier M, Goldberg M, Zins M, Empana JP. Abstract P189: Sexual Minority Status Disparities in Life’s Simple 7 and Life’s Essential 8 Cardiovascular Health Scores, a French Nationwide Population-Based Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/16/2023]
Abstract
A higher burden of cardiovascular disease risk factors has been reported in sexual minority populations (SM), such as lesbian, gay, bisexual, and non-heterosexual, compared to heterosexual populations. Therefore, primordial prevention, i.e., preventing risk factor onset in the first place, may be a relevant preventative strategy in this population. This study aimed to quantify the associations of SM status in each sex with Life’s Simple 7 (LS7) and Life’s Essential 8 (LE8) cardiovascular health (CVH) scores. The CONSTANCES study is a multicentric study that recruited randomly selected adults in 24 health examination centers in 21 cities in the French European territory. Sexual minority status was based on self-reported lifetime sexual behavior and categorized as lesbian, gay, bisexual, or heterosexual. The study included 169,434 CVD-free participants (53.64% women, mean age: 46.00 years). Among 90879 women, 555 were lesbian, 3149 bisexual, and 84363 heterosexual. Among 78555 men, 2421 were gay, 2748 bisexual, and 70994 heterosexual. Overall, 2812 women and 2392 men declined to answer. In women, the prevalence of high LS7 scores (12-14) ranged from 9.00% (declined to answer) to 12.38% (bisexual), whereas in men, it ranged from 4.06% (declined to answer) to 9.17% (gay). In multivariate analyses (Table 1), lesbian and bisexual women had lower LS7 score compared to heterosexual women. However, this was observed only among those who had never been pregnant (p for interaction <0.05). Conversely, gay and bisexual men living in urban areas had higher LS7 score compared to heterosexual men, while those living in rural areas had lower LS7 score than their heterosexual counterparts (p for interaction <0.05). Findings were consistent when using the LE8 score but with stronger effect sizes (Table 1). This study supports the presence of CVH disparities in sexual minority adults and may help identify vulnerable populations for prioritizing primordial CVD prevention.
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Affiliation(s)
- Omar Deraz
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Rsch Cntr, Integrative Epidemiology of cardiovascular disease (Team 4), Paris, France
| | - Billy A Caceres
- Columbia Univ Sch of Nursing, 560 West 168th Street, New York, NY
| | - Carl G Streed
- Section of General Internal Medicine, Boston Univ Sch of Medicine, Boston, Massachusetts, USA 4. Cntr for Transgender Medicine and Surgery, Boston Med Cntr, Boston, Massachusetts, USA., Boston, MA
| | - Lauren B Beach
- Dept of Med Social Sciences, Northwestern Univ Feinberg Sch of Medicine, Chicago, Illinois, USA., Chicago, IL
| | - Xavier Jouven
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Rsch Cntr, Integrative Epidemiology of cardiovascular disease (Team 4), Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord Univ, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Rsch Team (EREN), Epidemiology and Statistics Rsch Cntr, Univ of Paris (CRESS), Bobigny, France
| | - Marcel Goldberg
- Université Paris Cité, "Population-based Cohorts Unit", INSERM, Paris Saclay Univ, UVSQ", UMS 011, Villejuif, France
| | - Marie Zins
- Université Paris Cité, "Population-based Cohorts Unit", INSERM, Paris Saclay Univ, UVSQ", UMS 011, Villejuif, France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, UMR-S970, Paris Cardiovascular Rsch Cntr, Integrative Epidemiology of cardiovascular disease (Team 4), Paris, France
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Nambiema A, Lisan Q, Vaucher J, Perier MC, Boutouyrie P, Danchin N, Thomas F, Guibout C, Solelhac G, Heinzer R, Jouven X, Marques-Vidal P, Empana JP. Abstract 29: Change in Healthy Sleep Score and Incident Cardiovascular Disease: A Combined Analysis of Two Independent Community-Based Cohorts. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/15/2023]
Abstract
Introduction:
Evidence on the link between sleep habits and cardiovascular diseases (CVD) in the community predominantly relies on studies that have investigated only one sleep habit, measure at one timepoint. Therefore, this study examined the joint effect of five sleep habits at baseline and at follow-up with incident CVD events.
Hypothesis:
We assessed the hypothesis that change in sleep habits over time including improvement in sleep habits and maintenance of a high level of sleep habits are related to reduced CVD risk.
Methods:
We combined data from two large independent community-based cohorts, the Paris Prospective Study 3 (France) and the CoLaus/PsyCoLaus study (Switzerland), involving 11 347 participants in total, aged 53–64 and comprising 44.6% women, initially free from CVD at baseline (respectively 2008-2012 and 2003-2006). Information on participants’ sleep habits were collected twice (median time interval between the 2 time points=2.0; interquartile range [IQR]: 2.0-5.2) by validated questionnaires. A healthy sleep score (HSS) combining five sleep habits (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnea, and no frequent excessive daytime sleepiness) was calculated at baseline and follow-up. Each sleep habit was scored 1 point if optimal, otherwise 0 point. The score ranged from 0 to 5, reflecting the number of optimal sleep habits. Associations of HSS at baseline and the change in the score over time with CVD events (coronary heart disease, CHD, or stroke) were examined using Cox proportional hazard models.
Results:
During a median follow-up of 8.9 years (IQR: 8.0-10.0), 499 first CVD events occurred (339 CHD and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% per one-point increment in the HSS (hazard ratio, HR=0.82 [95% confidence interval, CI, 0.76-0.89]). At follow-up, 38% remained in stable high score (score≥3 at both time points, the median of the baseline HSS), 11% had a stable low HSS (score<3 at both time points), 22% increased their scores and 29% decreased their scores respectively. After a median follow-up of 8.1 years (IQR: 8.0-10.0) following the second measure of the HSS, a total of 308 first CVD events occurred (227 CHD and 86 stroke). After adjusting for the baseline HSS and covariates, the risk of CVD decreased by 13% (HR=0.87 [0.76-0.99]) per unit of change in HSS. In particular, compared to participants with a decreasing HSS, those with a high stable HSS had a 39% decrease in CVD risk (HR=0.61 [0.45-0.81]). If all participants in this study had achieved a HSS of four and five, 29% and 60% of new CVD could have been avoided, respectively.
Conclusions:
Higher HSS and increase in the HSS are associated with a lower risk of CHD and stroke in the community. This study supports the promotion of healthy sleep habits in the population and strong collaboration between sleep medicine and CVD medicine.
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Affiliation(s)
- Aboubakari Nambiema
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Quentin Lisan
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Julien Vaucher
- Dept of Medicine, Internal Medicine, Lausanne Univ Hosp and Univ of Lausanne, Lausanne, Switzerland
| | - Marie-Cécile Perier
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, PARIS, France
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Cellular, molecular and pathophysiological mechanisms of heart failure, Paris, France4Preventive and Clinical Investigation Cntr (IPC), Paris, France
| | - Nicolas Danchin
- Preventive and Clinical Investigation Cntr (IPC), Paris, France
| | | | - Catherine Guibout
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Geoffroy Solelhac
- Cntr for Investigation and Rsch in Sleep, Lausanne Univ Hosp and Univ of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Cntr for Investigation and Rsch in Sleep, Lausanne Univ Hosp and Univ of Lausanne, Lausanne, Switzerland
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Pedro Marques-Vidal
- Dept of Medicine, Internal Medicine, Lausanne Univ Hosp (CHUV) and Univ of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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Van Sloten T, Valentin E, Climie RE, Deraz O, Weiderpass E, Jouven X, Goldberg M, Zins M, Empana JP. Association of Midlife Cardiovascular Health and Subsequent Change in Cardiovascular Health With Incident Cancer. JACC CardioOncol 2023; 5:39-52. [PMID: 36875895 PMCID: PMC9982214 DOI: 10.1016/j.jaccao.2022.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 02/25/2023] Open
Abstract
Background The commonality of risk factors between cancer and cardiovascular disease suggests that primordial prevention (preventing the onset of risk factors) is a relevant strategy for cancer prevention. Objectives This study sought to examine the association between baseline and change in the cardiovascular health (CVH) score and incident cancer. Methods Using serial examinations of the GAZEL (GAZ et ELECTRICITE de France) study in France, we examined the associations between the American Heart Association's Life's Simple 7 CVH score (range: 0-to 14 [poor, intermediate, and ideal level of smoking, physical activity, body mass index, diet, blood pressure, diabetes status, or lipids]) in 1989/1990, their change over 7 years, and incident cancer and cardiac events up to 2015. Results The study population included 13,933 participants (mean age: 45.3 ± 3.4 years, 24% women). After a median follow-up of 24.8 years (Q1-Q3: 19.4-24.9 years), 2,010 participants had an incident cancer and 899 a cardiac event. The risk of cancer (any site) decreased by 9% (HR: 0.91; 95% CI: 0.88-0.93) per 1-point increase in the CVH score in 1989/1990 compared with a 20% (HR: 0.80; 95% CI: 0.77-0.83) risk reduction for cardiac events. The risk of cancer decreased by 5% (HR: 0.95; 95% CI: 0.92-0.99) per unit of change in the CVH score between 1989/1990 and 1996/1997 compared with a 7% risk reduction for cardiac events (HR: 0.93; 95% CI: 0.88-0.98). These associations remained after omitting the smoking metric from the CVH score. Conclusions Primordial prevention is a relevant strategy for the prevention of cancer in the population.
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Affiliation(s)
- Thomas Van Sloten
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Eugénie Valentin
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Rachel E. Climie
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
| | - Omar Deraz
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | | | - Xavier Jouven
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Marcel Goldberg
- Université de Paris, “Population-based Cohorts Unit,” Institut National de la Santé et de la Recherche Médicale, Paris Saclay University, Paris, France
| | - Marie Zins
- Université de Paris, “Population-based Cohorts Unit,” Institut National de la Santé et de la Recherche Médicale, Paris Saclay University, Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S970, PARis Cardiovascular research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Address for correspondence: Dr Jean-Philippe Empana, INSERM U970, Paris Cardiovascular Research Centre, Paris Descartes University, 56 Rue Leblanc, 75015 Paris, France.
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Empana JP, Lerner I, Perier MC, Guibout C, Jabre P, Bailly K, Andrieu M, Climie R, van Sloten T, Vedie B, Geromin D, Marijon E, Thomas F, Danchin N, Boutouyrie P, Jouven X. Ultrasensitive Troponin I and Incident Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2022; 42:1471-1481. [PMID: 36325900 DOI: 10.1161/atvbaha.122.317961] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To examine the association of ultrasensitive cTnI (cardiac troponin I) with incident cardiovascular disease events (CVDs) in the primary prevention setting. METHODS cTnI was analyzed in the baseline plasma (2008-2012) of CVD-free volunteers from the Paris Prospective Study III using a novel ultrasensitive immunoassay (Simoa Troponin-I 2.0 Kit, Quanterix, Lexington) with a limit of detection of 0.013 pg/mL. Incident CVD hospitalizations (coronary heart disease, stroke, cardiac arrhythmias, deep venous thrombosis or pulmonary embolism, heart failure, or arterial aneurysm) were validated by critical review of the hospital records. Hazard ratios were estimated per log-transformed SD increase of cTnI in Cox models using age as the time scale. RESULTS The study population includes 9503 participants (40% women) aged 59.6 (6.3) years. cTnI was detected in 99.6% of the participants (median value=0.63 pg/mL, interquartile range, 0.39-1.09). After a median follow-up of 8.34 years (interquartile range, 8.0-10.07), 516 participants suffered 612 events. In fully adjusted analysis, higher cTnI (per 1 SD increase of log cTnI) was significantly associated with CVD events combined (hazard ratio, 1.18 [1.08-1.30]). Among all single risk factors, cTnI had the highest discrimination capacity for incident CVD events (C index=0.6349). Adding log cTnI to the SCORE 2 (Systematic Coronary Risk Evaluation) risk improved moderately discriminatory capacity (C index 0.698 versus 0.685; bootstrapped C index difference: 0.0135 [95% CI, 0.0131-0.0138]), and reclassification of the participants (categorical net reclassification index, 0.0628 [95% CI, 0.023-0.102]). Findings were consistent using the US pooled cohort risk equation. CONCLUSIONS Ultrasensitive cTnI is an independent marker of CVD events in the primary prevention setting.
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Affiliation(s)
- Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Ivan Lerner
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Marie-Cécile Perier
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Catherine Guibout
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Patricia Jabre
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Karine Bailly
- Université Paris Cité, INSERM U1016, Cochin Institute, Platform CYBIO, France (K.B., M.A.)
| | - Muriel Andrieu
- Université Paris Cité, INSERM U1016, Cochin Institute, Platform CYBIO, France (K.B., M.A.)
| | - Rachel Climie
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.).,Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.C.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.C.)
| | - Thomas van Sloten
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.).,Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.v.S.)
| | - Benoit Vedie
- AP-HP, Department of Biochemistry, Tissue and Blood Samples Biobank, Georges Pompidou European Hospital, Paris, France (B.V., D.G.)
| | - Daniela Geromin
- AP-HP, Department of Biochemistry, Tissue and Blood Samples Biobank, Georges Pompidou European Hospital, Paris, France (B.V., D.G.)
| | - Eloi Marijon
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
| | - Frederique Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, Paris, France (P.B.)
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (J.-P.E., I.L., M.-C.P., C.G., P.J., R.C., T.v.S., E.M., X.J.)
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22
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Thibord F, Klarin D, Brody JA, Chen MH, Levin MG, Chasman DI, Goode EL, Hveem K, Teder-Laving M, Martinez-Perez A, Aïssi D, Daian-Bacq D, Ito K, Natarajan P, Lutsey PL, Nadkarni GN, de Vries PS, Cuellar-Partida G, Wolford BN, Pattee JW, Kooperberg C, Braekkan SK, Li-Gao R, Saut N, Sept C, Germain M, Judy RL, Wiggins KL, Ko D, O’Donnell CJ, Taylor KD, Giulianini F, De Andrade M, Nøst TH, Boland A, Empana JP, Koyama S, Gilliland T, Do R, Huffman JE, Wang X, Zhou W, Soria JM, Souto JC, Pankratz N, Haessler J, Hindberg K, Rosendaal FR, Turman C, Olaso R, Kember RL, Bartz TM, Lynch JA, Heckbert SR, Armasu SM, Brumpton B, Smadja DM, Jouven X, Komuro I, Clapham KR, Loos RJ, Willer CJ, Sabater-Lleal M, Pankow JS, Reiner AP, Morelli VM, Ridker PM, van Hylckama Vlieg A, Deleuze JF, Kraft P, Rader DJ, Lee KM, Psaty BM, Skogholt AH, Emmerich J, Suchon P, Rich SS, Vy HMT, Tang W, Jackson RD, Hansen JB, Morange PE, Kabrhel C, Trégouët DA, Damrauer SM, Johnson AD, Smith NL. Cross-Ancestry Investigation of Venous Thromboembolism Genomic Predictors. Circulation 2022; 146:1225-1242. [PMID: 36154123 PMCID: PMC10152894 DOI: 10.1161/circulationaha.122.059675] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/09/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a life-threatening vascular event with environmental and genetic determinants. Recent VTE genome-wide association studies (GWAS) meta-analyses involved nearly 30 000 VTE cases and identified up to 40 genetic loci associated with VTE risk, including loci not previously suspected to play a role in hemostasis. The aim of our research was to expand discovery of new genetic loci associated with VTE by using cross-ancestry genomic resources. METHODS We present new cross-ancestry meta-analyzed GWAS results involving up to 81 669 VTE cases from 30 studies, with replication of novel loci in independent populations and loci characterization through in silico genomic interrogations. RESULTS In our genetic discovery effort that included 55 330 participants with VTE (47 822 European, 6320 African, and 1188 Hispanic ancestry), we identified 48 novel associations, of which 34 were replicated after correction for multiple testing. In our combined discovery-replication analysis (81 669 VTE participants) and ancestry-stratified meta-analyses (European, African, and Hispanic), we identified another 44 novel associations, which are new candidate VTE-associated loci requiring replication. In total, across all GWAS meta-analyses, we identified 135 independent genomic loci significantly associated with VTE risk. A genetic risk score of the significantly associated loci in Europeans identified a 6-fold increase in risk for those in the top 1% of scores compared with those with average scores. We also identified 31 novel transcript associations in transcriptome-wide association studies and 8 novel candidate genes with protein quantitative-trait locus Mendelian randomization analyses. In silico interrogations of hemostasis and hematology traits and a large phenome-wide association analysis of the 135 GWAS loci provided insights to biological pathways contributing to VTE, with some loci contributing to VTE through well-characterized coagulation pathways and others providing new data on the role of hematology traits, particularly platelet function. Many of the replicated loci are outside of known or currently hypothesized pathways to thrombosis. CONCLUSIONS Our cross-ancestry GWAS meta-analyses identified new loci associated with VTE. These findings highlight new pathways to thrombosis and provide novel molecules that may be useful in the development of improved antithrombosis treatments.
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Affiliation(s)
- Florian Thibord
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Derek Klarin
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, 94550, USA
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Ming-Huei Chen
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Michael G. Levin
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kristian Hveem
- HUNT Research Center, Department of Public Health and Nursing, Norwegian University of Science and Technology, Forskningsvegen 2, Levanger, 7600, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Maris Teder-Laving
- Institute of Genomics, University of Tartu, Riia 23b, Tartu, Tartu, 51010, Estonia
| | - Angel Martinez-Perez
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
| | - Dylan Aïssi
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
| | - Delphine Daian-Bacq
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Kaoru Ito
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehirocho, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Girish N. Nadkarni
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Paul S. de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX, 77030, USA
| | | | - Brooke N. Wolford
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jack W. Pattee
- Division of Biostatistics, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
- Center for Innovative Design & Analysis and Department of Biostatistics & Informatics, Colorado School of Public Health, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Sigrid K. Braekkan
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Ruifang Li-Gao
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Noemie Saut
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
| | - Corriene Sept
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Marine Germain
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Renae L. Judy
- Surgery, University of Pennsylvania, 3401 Walnut Street, Philadelphia, PA, 19104, USA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Darae Ko
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- Section of Cardiovascular Medicine, Boston University School of Medicine, 85 East Newton Street, Boston, MA, 02118, USA
| | - Christopher J. O’Donnell
- Cardiology Section, Department of Medicine, VA Boston Healthcare System, Boston, MA, 02132, USA
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation, 1124 W Carson St., Torrance, CA, 90502, USA
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
| | - Mariza De Andrade
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Therese H. Nøst
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Jean-Philippe Empana
- Integrative Epidemiology of cardiovascular diseases, Université Paris Cité, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, Paris, 75015, France
- Department of Cardiology, APHP, Hopital Européen Georges Pompidou, 20 rue Leblanc, Paris, 75015, France
| | - Satoshi Koyama
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehirocho, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
| | - Thomas Gilliland
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
| | - Ron Do
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
- BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Jennifer E. Huffman
- MAVERIC, VA Boston Heathcare System, 2 Avenue de Lafayette, Boston, MA, 02111, USA
| | - Xin Wang
- 23andMe, Inc., 223 N Mathilda Ave, Sunnyvale, CA, 94086, USA
| | - Wei Zhou
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jose Manuel Soria
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
| | - Juan Carlos Souto
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
- Unit of Thrombosis and Hemostasis, Hospital de la Santa Creu i Sant Pau, St Quinti 89, Barcelona, 8041, Spain
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Jeffery Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Kristian Hindberg
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
| | - Frits R. Rosendaal
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Constance Turman
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Rachel L. Kember
- Psychiatry, University of Pennsylvania, 3401 Walnut Street, Philadelphia, PA, 19104, USA
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Julie A. Lynch
- VA Informatics & Computing Infrastructure, VA Salt Lake City Healthcare System, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
- Epidemiology, University of Utah, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Sebastian M. Armasu
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Ben Brumpton
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - David M. Smadja
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, 20 rue Leblanc, Paris, 75015, France
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, 4 avenue de l’Observatoire, Paris, 75270, France
| | - Xavier Jouven
- Integrative Epidemiology of cardiovascular diseases, Université Paris Descartes, Sorbonne Paris Cité, 56 rue Leblanc, Paris, 75015, France
- Paris Cardiovascular Research Center, Inserm U970, Université Paris Descartes, Sorbonne Paris Cité, 20 rue Leblanc, Paris, 75015, France
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Tokyo, 113-8655, Japan
| | - Katharine R. Clapham
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
| | - Ruth J.F. Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Cristen J. Willer
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Maria Sabater-Lleal
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Center for Molecular Medicine, Stockholm, 17176, Sweden
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Alexander P. Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Vania M. Morelli
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Astrid van Hylckama Vlieg
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
- Centre D’Etude du Polymorphisme Humain, Fondation Jean Dausset, 27 rue Juliette Dodu, Paris, 75010, France
| | - Peter Kraft
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Daniel J. Rader
- Departments of Medicine and Genetics and Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | | | | | | | | | | | - Kyung Min Lee
- VA Informatics & Computing Infrastructure, VA Salt Lake City Healthcare System, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Department of Health Systems and Population Heath, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Anne Heidi Skogholt
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, University of Paris, 185 rue Raymond Losserand, Paris, 75674, France
- UMR1153, INSERM CRESS, 185 rue Raymond Losserand, Paris, 75674, France
| | - Pierre Suchon
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
- C2VN, INSERM, INRAE, Aix-Marseille University, 27, bd Jean Moulin, Marseille, 13385, France
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, 3242 West Complex, Charlottesville, VA, 22908-0717, USA
| | - Ha My T. Vy
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Rebecca D. Jackson
- College of Medicine, Ohio State University, 376 W. 10th Ave, Columbus, OH, 43210, USA
| | - John-Bjarne Hansen
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Pierre-Emmanuel Morange
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
- C2VN, INSERM, INRAE, Aix-Marseille University, 27, bd Jean Moulin, Marseille, 13385, France
| | - Christopher Kabrhel
- Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA, 02114, USA
- Emergency Medicine, Harvard Medical School, Zero Emerson Place, Suite 3B, Boston, MA, 02114, USA
| | - David-Alexandre Trégouët
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Scott M. Damrauer
- Corporal Michael J. Crescenz Philadelphia VA Medical Center, 3900 Woodland Ave, Philadelphia, PA, 19104, USA
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Andrew D. Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, 98101, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, 98108, USA
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23
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Empana JP, Lerner I, Perier MC, Jabre P, Andrieu M, Climie RE, Van Sloten T, Vedie B, Geromin D, Marijon E, Danchin N, Thomas F, Boutouyrie P, Jouven X. Ultra-sensitive troponin-I and incident coronary heart disease, stroke, heart failure, cardiac arrhythmias, arterial aneurysms and venous thromboembolism hospitalizations. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/15/2022] Open
Abstract
Abstract
Background
Cardiac troponin I (cTnI) as measured by high-sensitive assays has been related to incident cardiovascular disease events (CVD) in the community. With the advent of ultra-sensitive assays, it is now possible to detect troponin I at very low concentration, far below the classical threshold of 1.9 pg/mL. However, the clinical relevance of these low concentrations for predicting CVD is largely unknown.
Purpose
To examine the association of cTnI as low as 0.013 pg/mL with incident cardiovascular disease events (CVDs) in the primary prevention setting.
Methods
cTnI was analyzed in the baseline plasma (2008–2012) of CVD free volunteers from the Paris Prospective Study III using for the first time a novel ultra-sensitive immunoassay (Simoa Troponin-I 2.0 Kit, Quanterix, Lexington) with a limit of detection (LOD) of 0.013 pg/mL. Incident CVD hospitalizations for coronary heart disease, stroke, arrhythmias, venous thromboembolism, arterial aneurysms and heart failure were validated by critical review of the hospital records. Hazard ratios were estimated per log-transformed standard deviation (SD) increase of cTnI in Cox models using age as the time scale. The added value (gain in discriminatory capacity) of cTnI for CVD risk prediction was examined by calculating the Harell's C-index boostraped difference of the SCORE 2 risk model with and without cTnI.
Results
There were 9503 CVD free participants (40% women) aged 59.6 (6.3) years at baseline. cTnI was detected in 99.6% of the participants (median value = 0.63 pg/mL, interquartile range [IQR] 0.39–1.09). After a median follow-up of 8.34 years (IQR, 8.0–10.07), 516 participants suffered 612 events. In fully-adjusted analysis, higher cTnI (per 1 SD increase of log cTnI) was significantly associated with CVD events combined (n=516, HR= 1.21; 1.06; 1.39). In univariate Cox analysis and compared to each single established risk factor, cTnI had the highest discrimination capacity for incident CVD events (C-index=0.6349) (Figure 1). Adding log cTnI to the SCORE 2 algorithm increased significantly albeit moderately discriminatory capacity (C-index 0.698 vs. 0.685; boostraped C index difference: 0.0135 (95% CI: 0.0131; 0.0138)).
Conclusion
cTnI concentrations as measured by a novel ultra-sensitive immunoassay is associated with a significant increased risk of incident CVD events in the primary prevention setting.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): ANR: French National Research AgencyEurope: Horizon 2020
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Affiliation(s)
- J P Empana
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - I Lerner
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M C Perier
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - P Jabre
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M Andrieu
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - R E Climie
- Menzies Research Institute , Hobart , Australia
| | - T Van Sloten
- Cardiovascular Research Institute Maastricht (CARIM) , Maastricht , The Netherlands
| | - B Vedie
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - D Geromin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - E Marijon
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - N Danchin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - F Thomas
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - P Boutouyrie
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - X Jouven
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
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24
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Diop IB, Balde D, Cavagna P, Adoubi A, Ikama MS, Suliman A, Hounkponou M, Empana JP, Camara Y, Mfeukeu-Kuate L, Toure C, Kabore H, Lubenga Y, Jouven X, Kingue S. Detection and characteristics of hypertension patients admitted in 37 cardiology departments from 17 Sub-Saharan African countries. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/13/2022] Open
Abstract
Abstract
Background
High blood pressure (BP) is a major risk factor for several common cardiovascular (CV) disease such as stroke, heart failure or chronic kidney disease. The Sub-Saharan Africa (SSA) should face the highest rate of hypertension worldwide with an overall prevalence estimation of 46%. Due to scarce resources and inadequate healthcare provision, SSA have scarce hard data on treatment and control of high BP.
Purpose
To assess the detection and characteristics of hypertension patients admitted in hospitalizations 17 SSA countries
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo, Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The February study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. Hypertension and severity of hypertension were defined according to 2018 ESC/ESH guidelines and BP was measured twice using standardized method. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10))
Results
The study involved 4360 patients. Hypertension was measured on 1906 (43.7%) patients at admission. Proportion of patients with high BP in hospital increased from 42.2% in 2016 to 52.2% in 2021 (p<0.05) and differed significantly across countries from 77.6% in Niger to 100% in Chad. Among hypertensive patients, men represented 59.6% of patients and mean of age was 59±15.1 years. Overall, 61.4% of patients were from low income countries. The mains causes of admission among hypertensive patients were heart failure (37.8%) and stroke (18.9%). Average of systolic BP was 159±29.3 mmHg and average of diastolic BP was 96.7±16mmHg. Overall, 760 (40.3%), 525 (27.8%) and 602 (31.9%) had grade 1, grade 2 and grade 3 hypertension respectively. History of CV disease was observed in 51.5% of patients. Thus, 70.4% of patients had at least one CV risk factor other than hypertension. Angiotensin converting enzyme inhibitors and diuretics was prescribed in 56.9% and 55.8% of patients respectively. The average amount of antihypertensive drugs prescribed in hospital was 2.09±1.18. Overall, 237 (12.4%), 295 (15.5%), 640 (33.6%) and 734 (38.5%) received respectively no drug, monotherapy, two-drug strategies and three and more drug strategies.
Conclusion
In patients admitted in cardiology departments, hypertension is a huge burden in SSA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I B Diop
- Fann Universitary Hospital , Dakar , Senegal
| | - D Balde
- University Hospital of Conakry, Cardiology , Conakry , Guinea
| | - P Cavagna
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - A Adoubi
- University Hospital of Bouake, Cardiology , Bouake , Côte d'Ivoire
| | - M S Ikama
- National University Hospital of Brazzaville, Marien Ngouabi University , Brazzaville , Congo
| | - A Suliman
- Shaab Teaching Hospital, Cardiology , Khartoum , Sudan
| | - M Hounkponou
- National University hospital of Hubert K. MAGA (CNHU-HKM) , Cotonou , Benin
| | - J P Empana
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - Y Camara
- University Hospital of Kati , Bamako , Mali
| | | | - C Toure
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - H Kabore
- Paul VI Medical Center , Ouagadougou , Burkina Faso
| | - Y Lubenga
- University Clinic of Kinshasa , Kinshasa , Congo (Democratic Republic of the)
| | - X Jouven
- European Georges Pompidou Hospital, AP-HP Centre, University of Paris , Paris , France
| | - S Kingue
- University of Yaoundé, Ministry of Public Health , Yaounde , Cameroon
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25
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Nambiema A, Lisan Q, Perier MC, Thomas F, Danchin N, Boutouyrie P, Jouven X, Empana JP. Healthy sleep score and incident cardiovascular diseases: the Paris Prospective Study III (PPS3). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Most studies on the association between sleep habits and cardiovascular disease (CVD) have focused on one single sleep dimension, essentially sleep duration and sleep apnea.
Purpose
To examine the joint effect of several dimensions of sleep habits with incident CVD in a community-based prospective cohort.
Methods
Between 2008 and 2011, 10,157 men and women aged 50 to 75 years were recruited in a preventive medical center. They underwent a standard physical examination coupled with standard biological tests, and provided information related to lifestyle, personal and family medical history, current health status, and medication use on questionnaires. Sleep habits were self-reported on validated questionnaires that assess sleep duration and insomnia complaints (Pittsburg questionnaire), early chronotype, sleep apnea (Berlin questionnaire) and subjective daytime sleepiness (Epworth questionnaire). Each sleep dimension was assigned 1 point if optimal and 0 point otherwise. A healthy sleep score ranging from 0 to 5 (the higher the better) and reflecting the number of optimal sleep dimensions was computed: early chronotype, sleep duration of 7–8 h/day, never/rarely insomnia, no sleep apnea, and no frequent excessive daytime sleepiness. The occurrence of incident CVD events including coronary heart disease and stroke was followed every two years up to September 2020, and events were validated after review of the medical records. The multivariable association between higher healthy sleep score and CVD events was examined in proportional hazard Cox regression analysis. Population-attributable fractions were calculated to estimate the proportion of CVD cases that could be prevented by healthier sleep habits.
Results
This study included 7203 participants (62% of men, mean age: 59.7 years±6.2) who were free of CVD at baseline and had complete data on sleep habits and covariates. Among them, 6.9% had a poor sleep score (healthy sleep score of 0 or 1), and 10.4% had an optimal sleep score (score= 5). After a median follow-up of 8 years, 275 participants had incident CVD events. After adjustment for age, sex, total alcohol consumption, socioprofessional categories, smoking status, body mass index, physical activity, family history of heart diseases, LDL and HDL cholesterol, and diabetes status, the risk of CVD decreased by 22% (HR=0.78 [95% CI: 0.71–0.86]) per 1 point increment in the healthy sleep score, and there was a 74% risk reduction in CVD risk (HR=0.26 [0.13–0.51]) between participants with the highest (score of 5) and those with the lowest (score of 0–1) healthy sleep score (Table 1). Under the hypothesis that all the participants would achieve an optimal sleep score of 5, 70.8% of incident CVD could be potentially avoided each year.
Conclusion(s)
In this community-based prospective cohort, a higher healthy sleep score combining 5 sleep dimensions was associated with a lower risk of CHD or stroke.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The National Research Agency (ANR), The Region Ile de France (Domaine d'Intérêt Majeur)
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Affiliation(s)
- A Nambiema
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - Q Lisan
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M C Perier
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - F Thomas
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - N Danchin
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - P Boutouyrie
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - X Jouven
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - J P Empana
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
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Le Floch E, Cosentino T, Larsen CK, Beuschlein F, Reincke M, Amar L, Rossi GP, De Sousa K, Baron S, Chantalat S, Saintpierre B, Lenzini L, Frouin A, Giscos-Douriez I, Ferey M, Abdellatif AB, Meatchi T, Empana JP, Jouven X, Gieger C, Waldenberger M, Peters A, Cusi D, Salvi E, Meneton P, Touvier M, Deschasaux M, Druesne-Pecollo N, Boulkroun S, Fernandes-Rosa FL, Deleuze JF, Jeunemaitre X, Zennaro MC. Identification of risk loci for primary aldosteronism in genome-wide association studies. Nat Commun 2022; 13:5198. [PMID: 36057693 PMCID: PMC9440917 DOI: 10.1038/s41467-022-32896-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Primary aldosteronism affects up to 10% of hypertensive patients and is responsible for treatment resistance and increased cardiovascular risk. Here we perform a genome-wide association study in a discovery cohort of 562 cases and 950 controls and identify three main loci on chromosomes 1, 13 and X; associations on chromosome 1 and 13 are replicated in a second cohort and confirmed by a meta-analysis involving 1162 cases and 3296 controls. The association on chromosome 13 is specific to men and stronger in bilateral adrenal hyperplasia than aldosterone producing adenoma. Candidate genes located within the two loci, CASZ1 and RXFP2, are expressed in human and mouse adrenals in different cell clusters. Their overexpression in adrenocortical cells suppresses mineralocorticoid output under basal and stimulated conditions, without affecting cortisol biosynthesis. Our study identifies the first risk loci for primary aldosteronism and highlights new mechanisms for the development of aldosterone excess.
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Affiliation(s)
- Edith Le Floch
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | | | - Casper K Larsen
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, 80336, Munich, Germany
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich (USZ) und Universität Zürich (UZH), Zürich, Switzerland
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, 80336, Munich, Germany
| | - Laurence Amar
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Unité Hypertension artérielle, Paris, France
| | - Gian-Paolo Rossi
- DMCS 'G. Patrassi' University of Padova Medical School, University Hospital, 35126, Padova, Italy
| | - Kelly De Sousa
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Stéphanie Baron
- Université Paris Cité, F-75006, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Physiologie, Paris, France
| | - Sophie Chantalat
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Benjamin Saintpierre
- Université Paris Cité, Institut Cochin, Genom'IC platform, INSERM, CNRS, 75014, Paris, France
| | - Livia Lenzini
- DMCS 'G. Patrassi' University of Padova Medical School, University Hospital, 35126, Padova, Italy
| | - Arthur Frouin
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | | | - Matthis Ferey
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | | | - Tchao Meatchi
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d'Anatomie Pathologique, Paris, France
| | | | - Xavier Jouven
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Cardiologie, Paris, France
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Daniele Cusi
- Institute of Biomedical Technologies National Research Council of Italy, Milan, Italy
- Bio4Dreams-Business Nursery for Life Sciences, Milan, Italy
| | - Erika Salvi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy
| | - Pierre Meneton
- UMR_1142, INSERM, Sorbonne Université, Université Paris 13, Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), 93017, Bobigny, France
| | | | | | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Xavier Jeunemaitre
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Maria-Christina Zennaro
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France.
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Lavignasse D, Lemoine S, Karam N, Gaye B, Bougouin W, Beganton F, Jabre P, Loeb T, Agostinucci JM, Dumas F, Lecarpentier E, Jost D, Cariou A, Marijon E, Empana JP, Jouven X. Does age influence out-of-hospital cardiac arrest incidence and outcomes among women? Insights from the Paris SDEC. Eur Heart J Acute Cardiovasc Care 2022; 11:293-302. [PMID: 35415752 DOI: 10.1093/ehjacc/zuac028] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/15/2022] [Indexed: 06/14/2023]
Abstract
AIMS Age and sex disparities in out-of-hospital cardiac arrest (OHCA) have been described. Reproductive age may have a protected effect on females vs. males, although results are conflicting. We aimed to clarify this using the Paris Sudden Death Expertise Centre (SDEC) registry. METHODS AND RESULTS The Paris SDEC registry collects OHCAs occurring in the Greater Paris Area. We included all OHCAs of presumed cardiac causes occurring between 2013 and 2018. Patients were divided into age groups: 1-13, 13-50, 50-75, and >75 years. Sex and age disparities in OHCA incidence and outcomes were analysed using multivariable negative binomial and logistic regression models. There were 19 782 OHCAs meeting inclusion criteria: 0.37% aged 1-13 years, 12.4% aged 13-50 years, 40.4% aged 50-75 years, and 46.9% aged >75 years. Adjusted incidence rate ratios (IRRs) in females vs. males were for the youngest to the older age groups: 1.29 [95% confidence interval (CI) 0.78-2.13], 0.54 [0.49-0.59], 0.60 [0.56-0.64], and 0.75 [0.67-0.84]. At reproductive age, females were more likely than males to have a return of spontaneous circulation [adjusted odds ratio (OR) 1.60 (1.27-2.02)], to be alive at hospital admission [OR: 1.49 (1.18-1.89)]. In both sexes, patients aged 13-50 years were more likely to survive at hospital discharge than those aged 50-75 years [males: OR 1.81 (1.49-2.20), females: 2.24 (1.54-3.25)]. However, at reproductive age, no sex disparity was observed in survival at hospital discharge [OR: 1.16 (0.75-1.80)]. CONCLUSION Incidence rate ratios were similar between pre- and post-menopausal aged patients. At reproductive age, no sex disparity in survival at hospital discharge was observed, suggesting that menopausal status may not influence OHCA occurrence and prognosis.
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Affiliation(s)
- Delphine Lavignasse
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Sabine Lemoine
- Brigade des Sapeurs-Pompiers de Paris (BSPP), 1 place Jules Renard, 75017 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Bamba Gaye
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Medical Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Noyer Lambert avenue, 91300 Massy, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Patricia Jabre
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Emergency Medical Services, SAMU 75, Necker Enfants Malades Hospital, APHP, 11 rue de Sèvres, 75015 Paris, France
| | - Thomas Loeb
- Emergency Medical Services, SAMU 92, Raymond Poincaré Hospital, APHP, 104, Raymond-Poincaré boulevard, 92380 Garches, France
| | - Jean-Marc Agostinucci
- Emergency Medical Services, SAMU 93, Hôpital Avicenne, APHP, 125 Stalingrad street, 93000 Bobigny, France
| | - Florence Dumas
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, 27 Faubourg Saint-Jacques, street 75014 Paris, France
| | - Eric Lecarpentier
- Emergency Medical Services, SAMU 94, Henri Mondor Hospital, APHP, 1 Gustave Eiffel street, 94000 Créteil, France
| | - Daniel Jost
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Alain Cariou
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Medical Intensive Care Unit, Hôpital Cochin Hospital, APHP, 27 Faubourg Saint-Jacques, street,75014 Paris, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center, University of Paris, INSERM Unit 970, 56 Leblanc street, 75015 Paris, France
- Department of Cardiology, European Georges Pompidou Hospital, APHP, 20 Leblanc street, 75015 Paris, France
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Lisan Q, Goldberg M, Lahlou G, Ozguler A, Lemonnier S, Jouven X, Zins M, Empana JP. Prevalence of Hearing Loss and Hearing Aid Use Among Adults in France in the CONSTANCES Study. JAMA Netw Open 2022; 5:e2217633. [PMID: 35713903 PMCID: PMC9206187 DOI: 10.1001/jamanetworkopen.2022.17633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Although hearing loss is common in the population worldwide, the prevalence of hearing loss and hearing aid use is not known. OBJECTIVE To estimate the prevalence of hearing loss and hearing aid use in the adult French population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the CONSTANCES cohort, a representative sample of the French population. Volunteers aged 18 to 75 years were recruited at 21 preventive health centers between January 1, 2012, and December 31, 2019. The present study included participants with audiometric data. MAIN OUTCOMES AND MEASURES The main outcomes were prevalence of hearing loss and disabling hearing loss overall and by sex and age group and prevalence of self-reported hearing aid use among those with disabling hearing loss. Hearing loss was defined as a pure-tone average (PTA) in the better ear of 20 dB or higher, and disabling hearing loss was defined as a PTA in the better ear of 35 dB or higher. RESULTS Of 200 870 participants in the CONSTANCES study, 186 460 had full audiometric data and were included in this study (mean [SD] age, 47.1 [13.5] years); 100 330 (53.8%) were female, and 86 130 (46.2%) were male. Of these participants, 24.8% (95% CI, 24.6%-25.0%) had hearing loss and 4.3% (95% CI, 4.2%-4.4%) had disabling hearing loss. The prevalence rates of hearing loss increased from 3.4% (95% CI, 2.8%-3.9%) at age 18 to 25 years to 73.3% (95% CI, 69.5%-77.2%) at age 71 to 75 years among men and from 4.4% (95% CI, 3.9%-5.0%) at age 18 to 25 years to 64.1% (95% CI, 59.7%-68.4%) at age 71 to 75 years among women. The prevalence of disabling hearing loss increased from 0.3% (95% CI, 0.2%-0.4%) among participants aged 18 to 25 years to 23.3% (95% CI, 20.7%-26.0%) among participants aged 71 to 75 years. Among the 8050 participants with disabling hearing loss, 36.8% (95% CI, 35.8%-37.9%) reported using hearing aids, including 56.7% (95% CI, 38.9%-74.4%) aged 18 to 25 years and 32.9% (95% CI, 26.8%-39.2%) aged 71 to 75 years. CONCLUSIONS AND RELEVANCE In this cohort study, hearing loss was prevalent in France, and the prevalence of hearing loss increased with age among both men and women. Hearing aids were underused, particularly among older individuals. These findings suggest that hearing loss prevention and screening in the French population are needed.
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Affiliation(s)
- Quentin Lisan
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Ghizlene Lahlou
- Assistance Publique–Hôpitaux de Paris Sorbonne Université, Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Département d’Oto-Rhino-Laryngologie, Unité Fonctionnelle Implants Auditifs, Paris, France
- Institut de l’Audition/Institut Pasteur, Équipe Technologies and Gene Therapy for Deafness, Paris, France
| | - Anna Ozguler
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Sylvie Lemonnier
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Xavier Jouven
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
- Department of Cardiology, European Hospital Georges Pompidou, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Marie Zins
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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Climie RE, Empana JP. Transition from adolescence to adulthood: Another window of opportunity for promoting primordial prevention. Int J Cardiol 2022; 356:106-107. [PMID: 35395287 DOI: 10.1016/j.ijcard.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia; Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative epidemiology of cardiovascular disease, Paris, France.
| | - Jean-Philippe Empana
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia
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30
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Warming PE, Ågesen FN, Lynge TH, Jabbari R, Smits RL, van Valkengoed IG, Welten SJ, van der Heijden AA, Elders PJ, Blom MT, Jouven X, Schwartz PJ, Albert CM, Beulens JW, Rutters F, Tan HL, Empana JP, Tfelt-Hansen J. Harmonization of the definition of sudden cardiac death in longitudinal cohorts of the European Sudden Cardiac Arrest network - towards Prevention, Education, and New Effective Treatments (ESCAPE-NET) consortium. Am Heart J 2022; 245:117-125. [PMID: 34936862 DOI: 10.1016/j.ahj.2021.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/16/2021] [Accepted: 12/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The burden of sudden cardiac death (SCD) in the general population is substantial and SCD frequently occurs among people with few or no known risk factors for cardiac disease. Reported incidences of SCD vary due to differences in definitions and methodology between cohorts. This study aimed to develop a method for adjudicating SCD cases in research settings and to describe uniform case definitions of SCD in an international consortium harmonizing multiple longitudinal study cohorts. METHODS The harmonized SCD definitions include both case definitions using data from multiple sources (eg, autopsy reports, medical history, eyewitnesses) as well as a method using only information from registers (eg, cause of death registers, ICD-10 codes). Validation of the register-based method was done within the consortium using the multiple sources definition as gold standard and presenting sensitivity, specificity, accuracy and positive predictive value. RESULTS Consensus definitions of "definite," "possible" and "probable" SCD for longitudinal study cohorts were reached. The definitions are based on a stratified approach to reflect the level of certainty of diagnosis and degree of information. The definitions can be applied to both multisource and register-based methods. Validation of the method using register-information in a cohort comprising 1335 cases yielded a sensitivity of 74%, specificity of 88%, accuracy of 86%, and positive predictive value of 54%. CONCLUSIONS This study demonstrated that a harmonization of SCD classification across different methodological approaches is feasible. The developed classification can be used to study SCD in longitudinal cohorts and to merge cohorts with different levels of information.
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Climie RE, Tafflet M, van Sloten T, de Lauzon-Guillain B, Bernard JY, Dargent-Molina P, Plancoulaine S, Lioret S, Jouven X, Charles MA, Heude B, Empana JP. Cardiovascular Health at Age 5 Years: Distribution, Determinants, and Association With Neurodevelopment. Front Pediatr 2022; 10:827525. [PMID: 35479759 PMCID: PMC9035843 DOI: 10.3389/fped.2022.827525] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Early childhood may represent an opportune time to commence primordial prevention of cardiovascular disease (CVD, i.e., prevention of risk factors onset), but epidemiological evidence is scarce. We aimed to examine the distribution and parental and early life determinants of ideal cardiovascular health (CVH) in children up to 5 years and to compare the level of cognitive development between children with and without ideal CVH at age 5 years. METHODS Using data from the Etude sur les déterminants pré et post natals précoces du Développement psychomoteur et de la santé de l'Enfant (EDEN) study, a French population-based mother-child cohort study, CVH was examined in children at 5 years of age based on the American Heart Association CVH metrics (ideal body mass index, physical activity, diet, blood pressure, cholesterol and glucose levels, and passive smoking, considered in sensitivity analysis only). Children were categorized as having ideal (five to six ideal metrics) or non-ideal CVH (<5 ideal metrics). Intelligence quotient (IQ) at age 5 years was assessed using the French version of the Wechsler Preschool and Primary Scale of Intelligence. RESULTS Among the 566 children (55% boys), only 34% had ideal CVH. In fully adjusted logistic regression, boys compared to girls (OR = 1.77, 95% CI 1.13-2.78), children with intermediate (1.77, 1.05-2.98) or ideal (2.58, 1.38-4.82) behavioral CVH at age 3 years and children who spent < 30 min/day watching television (1.91, 1.09-3.34) at age 3 years were more likely to have ideal CVH at age 5 years. At age 5 years, there was a significant 2.98-point difference (95% CI 0.64-5.32) in IQ between children with and without ideal biological CVH after adjusting for confounders. CONCLUSION This study highlights that only a third of children aged 5 years had ideal CVH and identified modifiable determinants of ideal CVH and is suggestive of an association between CVH and neurodevelopment at a young age.
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Affiliation(s)
- Rachel E Climie
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Menzies Institute for Medical Research, University of Tasmanian, Hobart, TAS, Australia.,Sports Cardiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Muriel Tafflet
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Thomas van Sloten
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Blandine de Lauzon-Guillain
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Patricia Dargent-Molina
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sabine Plancoulaine
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Xavier Jouven
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Marie-Alines Charles
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Jean-Philippe Empana
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France
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Grave C, Gabet A, Empana JP, Puymirat E, Tuppin P, Danchin N, Olié V. Care management and 90-day post discharge mortality in patients hospitalized for myocardial infarction and COVID-19: A French nationwide observational study. Arch Cardiovasc Dis 2022; 115:37-47. [PMID: 34952827 PMCID: PMC8666304 DOI: 10.1016/j.acvd.2021.11.002] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Concomitant or cured coronavirus disease 2019 (COVID-19) in patients with myocardial infarction (MI) may lead to difficulties in acute care management and impair prognosis. AIMS To describe and compare the characteristics, care management and 90-day post discharge outcomes of patients hospitalized for MI who did not have COVID-19 with those of patients with concomitant or previous hospital-diagnosed COVID-19. METHODS This population-based French study included all patients hospitalized for MI in France (30 December 2019 to 04 October 2020) from the French National Health Data System. Outcomes were described for each COVID-19 group and compared using adjusted logistic regression analysis. RESULTS Among 55,524 patients hospitalized for MI, 135 had previous hospital-diagnosed COVID-19 and 329 had concomitant COVID-19. Patients with previous hospital-diagnosed COVID-19 had more personal history of cardiovascular diseases than those without concomitant/previous confirmed COVID-19. In-hospital and 90-day post discharge mortality rates of patients with previous COVID-19 were 8.1% and 4.0%, respectively, compared with 3.5% and 3.0% in patients without concomitant/previous confirmed COVID-19 (odds ratio [OR]adjin-hospital 1.83, 95% confidence interval [CI] 0.97-3.46; ORadjpostdischarge 0.77, 95% CI 0.28-2.13). Patients with concomitant COVID-19 had more personal history of cardiovascular diseases, but also a poorer prognosis than their no concomitant/no previous confirmed COVID-19 counterparts; they presented excess cardiac complications during hospitalization (ORadj 1.62, 95% CI 1.29-2.04), in-hospital mortality (ORadj 3.31, 95% CI 2.32-4.72) and 90-day post discharge mortality (ORadj 2.09, 95% CI 1.24-3.51). CONCLUSIONS In-hospital and 90-day post discharge mortality of patients hospitalized for MI who had previous hospital-diagnosed COVID-19 did not seem to differ from those hospitalized for MI alone. Conversely, concomitant COVID-19 and MI carried a poorer prognosis extending beyond the hospital stay. Special attention should be given to patients with simultaneous COVID-19 and MI, in terms of acute care and secondary prevention.
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Affiliation(s)
- Clémence Grave
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France,Corresponding author. Santé Publique France (French Public Health Agency), 12, rue du Val d’Osne, 94415 Saint-Maurice cedex, France
| | - Amélie Gabet
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
| | - Jean-Philippe Empana
- Inserm, UMR-S970, department of epidemiology, Paris Cardiovascular Research Centre, université Paris Descartes, 75015 Paris, France
| | - Etienne Puymirat
- Department of cardiology, hôpital Européen Georges-Pompidou, université Paris-Descartes, AP–HP, 75015 Paris, France
| | - Philippe Tuppin
- Caisse Nationale de l’Assurance Maladie (French National Health Insurance), 75020 Paris, France
| | - Nicolas Danchin
- Department of cardiology, hôpital Européen Georges-Pompidou, université Paris-Descartes, AP–HP, 75015 Paris, France
| | - Valérie Olié
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
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Deraz O, Rangé H, Boutouyrie P, Chatzopoulou E, Asselin A, Guibout C, Van Sloten T, Bougouin W, Andrieu M, Vedié B, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Oral Condition and Incident Coronary Heart Disease: A Clustering Analysis. J Dent Res 2021; 101:526-533. [PMID: 34875909 DOI: 10.1177/00220345211052507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor oral health has been linked to coronary heart disease (CHD). Clustering clinical oral conditions routinely recorded in adults may identify their CHD risk profile. Participants from the Paris Prospective Study 3 received, between 2008 and 2012, a baseline routine full-mouth clinical examination and an extensive physical examination and were thereafter followed up every 2 y until September 2020. Three axes defined oral health conditions: 1) healthy, missing, filled, and decayed teeth; 2) masticatory capacity denoted by functional masticatory units; and 3) gingival inflammation and dental plaque. Hierarchical cluster analysis was performed with multivariate Cox proportional hazards regression models and adjusted for age, sex, smoking, body mass index, education, deprivation (EPICES score; Evaluation of Deprivation and Inequalities in Health Examination Centres), hypertension, type 2 diabetes, LDL and HDL serum cholesterol (low- and high-density lipoprotein), triglycerides, lipid-lowering medications, NT-proBNP and IL-6 serum level. A sample of 5,294 participants (age, 50 to 75 y; 37.10% women) were included in the study. Cluster analysis identified 3,688 (69.66%) participants with optimal oral health and preserved masticatory capacity (cluster 1), 1,356 (25.61%) with moderate oral health and moderately impaired masticatory capacity (cluster 2), and 250 (4.72%) with poor oral health and severely impaired masticatory capacity (cluster 3). After a median follow-up of 8.32 y (interquartile range, 8.00 to 10.05), 128 nonfatal incident CHD events occurred. As compared with cluster 1, the risk of CHD progressively increased from cluster 2 (hazard ratio, 1.45; 95% CI, 0.98 to 2.15) to cluster 3 (hazard ratio, 2.47; 95% CI, 1.34 to 4.57; P < 0.05 for trend). To conclude, middle-aged individuals with poor oral health and severely impaired masticatory capacity have more than twice the risk of incident CHD than those with optimal oral health and preserved masticatory capacity (ClinicalTrials.gov NCT00741728).
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Affiliation(s)
- O Deraz
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France
| | - H Rangé
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - P Boutouyrie
- Université de Paris, INSERM U970, Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, Paris, France
| | - E Chatzopoulou
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - A Asselin
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - C Guibout
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - T Van Sloten
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht, The Netherlands
| | - W Bougouin
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - M Andrieu
- Université de Paris, Cochin Institute, Platform CYBIO, INSERM U1016, Paris, France
| | - B Vedié
- AP-HP, Georges Pompidou European Hospital, Department of Biochemistry, Tissue and Blood Samples Biobank, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - N Danchin
- Preventive and Clinical Investigation Center, Paris, France
| | - X Jouven
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France.,AP-HP, Georges Pompidou European Hospital, Department of Cardiology, Paris, France
| | - P Bouchard
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - J P Empana
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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34
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Grave C, Gabet A, Puymirat E, Empana JP, Tuppin P, Danchin N, Olié V. Myocardial infarction throughout 1 year of the COVID-19 pandemic: French nationwide study of hospitalization rates, prognosis and 90-day mortality rates. Arch Cardiovasc Dis 2021; 114:768-780. [PMID: 34840126 PMCID: PMC8600551 DOI: 10.1016/j.acvd.2021.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
Background Studies reported a decrease in hospital admissions for myocardial infarction (MI) in early 2020 as a result of the coronavirus disease 2019 (COVID-19) crisis, mainly restricted to the beginning of the pandemic. Aims To describe national trends in hospital admissions for MI in 2020, and to compare patient characteristics, in-hospital prognosis and 90-day mortality between patients who had an MI in 2020 and those admitted in 2017–2019. Methods All patients hospitalized for MI in France from 2017 to 2020 were selected from the national hospital discharge database. Analyses compared temporal trends in MI admissions, in-hospital cardiac complications and mortality rates in 2020 versus 2017–2019. Results In 2020, 94,747 patients were hospitalized for MI, corresponding to a 6% decrease in MI admissions compared with 2017–19. This decrease was larger during the first lockdown (–24%; P < 0.0001) than during the second lockdown (–8%; P < 0.0001). Reductions in MI admissions were more pronounced and longer among patients with non-ST-segment elevation MI, older people and women. An increase in ST-segment elevation MI admissions was observed between lockdowns (+4%; P = 0.0005). Globally, and after adjustment for age, sex and calendar year, in-hospital and 90-day post-discharge mortality rates did not differ in 2020 versus 2017–19: incidence rate ratio (IRR)adjin-hospital 1.03, 95% confidence interval (CI) (0.98–1.08); IRRadj90-daypost-discharge 1.06, 95% CI (0.98–1.13). Conclusions In 2020, a significant decrease in MI admissions was observed, and was marked at the beginning of the year. This highlights the need to disseminate public information on the importance of maintaining care and regular medical follow-up. The effect of the COVID-19 crisis on acute and 3-month outcomes of patients hospitalized for MI appears limited. Nevertheless, monitoring of chronic MI complications and the impact on non-hospitalized patients should continue.
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Affiliation(s)
- Clémence Grave
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France.
| | - Amélie Gabet
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
| | - Etienne Puymirat
- Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris-Descartes, 75015 Paris, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM, UMR-S970, Integrative Epidemiology of Cardiovascular Disease Team, Paris Cardiovascular Research Centre, 75015 Paris, France
| | - Philippe Tuppin
- Caisse Nationale de l'Assurance Maladie (French National Health Insurance), 75020 Paris, France
| | - Nicolas Danchin
- Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris-Descartes, 75015 Paris, France
| | - Valérie Olié
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
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Raynaud M, Aubert O, Divard G, Reese PP, Kamar N, Yoo D, Chin CS, Bailly É, Buchler M, Ladrière M, Le Quintrec M, Delahousse M, Juric I, Basic-Jukic N, Crespo M, Silva HT, Linhares K, Ribeiro de Castro MC, Soler Pujol G, Empana JP, Ulloa C, Akalin E, Böhmig G, Huang E, Stegall MD, Bentall AJ, Montgomery RA, Jordan SC, Oberbauer R, Segev DL, Friedewald JJ, Jouven X, Legendre C, Lefaucheur C, Loupy A. Dynamic prediction of renal survival among deeply phenotyped kidney transplant recipients using artificial intelligence: an observational, international, multicohort study. Lancet Digit Health 2021; 3:e795-e805. [PMID: 34756569 DOI: 10.1016/s2589-7500(21)00209-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/22/2021] [Accepted: 08/17/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Kidney allograft failure is a common cause of end-stage renal disease. We aimed to develop a dynamic artificial intelligence approach to enhance risk stratification for kidney transplant recipients by generating continuously refined predictions of survival using updates of clinical data. METHODS In this observational study, we used data from adult recipients of kidney transplants from 18 academic transplant centres in Europe, the USA, and South America, and a cohort of patients from six randomised controlled trials. The development cohort comprised patients from four centres in France, with all other patients included in external validation cohorts. To build deeply phenotyped cohorts of transplant recipients, the following data were collected in the development cohort: clinical, histological, immunological variables, and repeated measurements of estimated glomerular filtration rate (eGFR) and proteinuria (measured using the proteinuria to creatininuria ratio). To develop a dynamic prediction system based on these clinical assessments and repeated measurements, we used a Bayesian joint models-an artificial intelligence approach. The prediction performances of the model were assessed via discrimination, through calculation of the area under the receiver operator curve (AUC), and calibration. This study is registered with ClinicalTrials.gov, NCT04258891. FINDINGS 13 608 patients were included (3774 in the development cohort and 9834 in the external validation cohorts) and contributed 89 328 patient-years of data, and 416 510 eGFR and proteinuria measurements. Bayesian joint models showed that recipient immunological profile, allograft interstitial fibrosis and tubular atrophy, allograft inflammation, and repeated measurements of eGFR and proteinuria were independent risk factors for allograft survival. The final model showed accurate calibration and very high discrimination in the development cohort (overall dynamic AUC 0·857 [95% CI 0·847-0·866]) with a persistent improvement in AUCs for each new repeated measurement (from 0·780 [0·768-0·794] to 0·926 [0·917-0·932]; p<0·0001). The predictive performance was confirmed in the external validation cohorts from Europe (overall AUC 0·845 [0·837-0·854]), the USA (overall AUC 0·820 [0·808-0·831]), South America (overall AUC 0·868 [0·856-0·880]), and the cohort of patients from randomised controlled trials (overall AUC 0·857 [0·840-0·875]). INTERPRETATION Because of its dynamic design, this model can be continuously updated and holds value as a bedside tool that could refine the prognostic judgements of clinicians in everyday practice, hence enhancing precision medicine in the transplant setting. FUNDING MSD Avenir, French National Institute for Health and Medical Research, and Bettencourt Schueller Foundation.
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Affiliation(s)
- Marc Raynaud
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France
| | - Olivier Aubert
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Gillian Divard
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Peter P Reese
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Renal Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Nassim Kamar
- Université Paul Sabatier, INSERM, Department of Nephrology and Organ Transplantation, CHU Rangueil & Purpan, Toulouse, France
| | - Daniel Yoo
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France
| | - Chen-Shan Chin
- Deep Learning in Medicine and Genomics, DNAnexus, San Francisco, CA, USA
| | - Élodie Bailly
- Nephrology and Immunology Department, Bretonneau Hospital, Tours, France
| | - Matthias Buchler
- Nephrology and Immunology Department, Bretonneau Hospital, Tours, France
| | - Marc Ladrière
- Nephrology Dialysis Transplantation Department, University of Lorraine, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Moglie Le Quintrec
- Department of Nephrology, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Michel Delahousse
- Department of Transplantation, Nephrology and Clinical Immunology, Foch Hospital, Suresnes, France
| | - Ivana Juric
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Nikolina Basic-Jukic
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Marta Crespo
- Department of Nephrology, Hospital del Mar Barcelona, Spain
| | - Helio Tedesco Silva
- Hospital do Rim, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kamilla Linhares
- Hospital do Rim, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Gervasio Soler Pujol
- Unidad de Trasplante Renopancreas, Centro de Educacion Medica e Investigaciones Clinicas Buenos Aires, Buenos Aires, Argentina
| | - Jean-Philippe Empana
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France
| | - Camilo Ulloa
- Kidney Transplantation Department, Clinica Alemana de Santiago, Santiago, Chile
| | - Enver Akalin
- Renal Division Montefiore Medical Centre, Kidney Transplantation Program, Albert Einstein College of Medicine, NY, USA
| | - Georg Böhmig
- Division of Nephrology and Dialysis, Department of Medicine III, General Hospital Vienna, Vienna, Austria
| | - Edmund Huang
- Department of Medicine, Division of Nephrology, Comprehensive Transplant Centre, Cedars Sinai Medical Centre, Los Angeles, CA, USA
| | - Mark D Stegall
- William J von Liebig Centre for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA
| | - Andrew J Bentall
- William J von Liebig Centre for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA
| | | | - Stanley C Jordan
- Department of Medicine, Division of Nephrology, Comprehensive Transplant Centre, Cedars Sinai Medical Centre, Los Angeles, CA, USA
| | | | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John J Friedewald
- Kidney Transplantation Department, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Xavier Jouven
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Cardiology Department, European Georges Pompidou Hospital, Paris, France
| | - Christophe Legendre
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Carmen Lefaucheur
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Alexandre Loupy
- Paris Translational Research Centre for Organ Transplantation, INSERM, PARCC, Université de Paris, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
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Empana JP, Boutouyrie P, Lemogne C, Jouven X, van Sloten TT. Microvascular Contribution to Late-Onset Depression: Mechanisms, Current Evidence, Association With Other Brain Diseases, and Therapeutic Perspectives. Biol Psychiatry 2021; 90:214-225. [PMID: 34325805 DOI: 10.1016/j.biopsych.2021.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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] [Received: 12/09/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
Depression is common in older individuals and is associated with high disability and mortality. A major problem is treatment resistance: >50% of older patients do not respond to current antidepressants. Therefore, new effective interventions for prevention and treatment of depression in older individuals need to be developed, which requires a better understanding of the mechanisms underlying depression. The pathophysiology of depression is multifactorial and complex. Microvascular dysfunction may be an early and targetable mechanism in the development of depression, notably depression that initiates in late life (late-onset depression). Late-onset depression commonly co-occurs with other diseases or syndromes that may share a microvascular origin, including apathy, cognitive impairment, dementia, and stroke. Together, these disabilities may all be part of one large phenotype resulting from global cerebral microvascular dysfunction. In this review, we discuss the pathophysiology of microvascular dysfunction-related late-onset depression, summarize recent epidemiological evidence on the association between cerebral microvascular dysfunction and depression, and indicate potential drivers of cerebral microvascular dysfunction. We also propose the hypothesis that depression may be a manifestation of a larger phenotype of cerebral microvascular dysfunction, highlight potential therapeutic targets and interventions, and give directions for future research.
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Affiliation(s)
- Jean-Philippe Empana
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France
| | - Xavier Jouven
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Thomas T van Sloten
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France; School for Cardiovascular Diseases Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
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37
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Lisan Q, van Sloten T, Boutouyrie P, Laurent S, Danchin N, Thomas F, Guibout C, Perier MC, Dagnelie P, Henry RM, Schram MT, Heinzer R, Marques-Vidal P, van der Kallen CJ, Crijns HJ, van Greevenbroek M, Reesink K, Köhler S, Sastry M, Jouven X, Stehouwer CDA, Empana JP. Sleep Apnea is Associated With Accelerated Vascular Aging: Results From 2 European Community-Based Cohort Studies. J Am Heart Assoc 2021; 10:e021318. [PMID: 34308679 PMCID: PMC8475690 DOI: 10.1161/jaha.120.021318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background The mechanisms underlying the association between obstructive sleep apnea (OSA) and cardiovascular disease may include accelerated vascular aging. The aim was to compare the magnitude of vascular aging in patients with high versus low risk of OSA. Methods and Results In 2 community-based studies, the PPS3 (Paris Prospective Study 3) and the Maastricht Study, high risk of OSA was determined with the Berlin questionnaire (a screening questionnaire for OSA). We assessed carotid artery properties (carotid intima-media thickness, Young's elastic modulus, carotid-femoral pulse wave velocity, carotid pulse wave velocity, carotid diameter using high precision ultrasound echography), and carotid-femoral pulse wave velocity (in the Maastricht Study only). Regression coefficients were estimated on pooled data using multivariate linear regression. A total of 8615 participants without prior cardiovascular disease were included (6840 from PPS3, 62% men, mean age 59.5±6.2 years, and 1775 from the Maastricht Study, 51% men, 58.9±8.1 years). Overall, high risk of OSA prevalence was 16.8% (n=1150) in PPS3 and 23.8% (n=423) in the Maastricht Study. A high risk of OSA was associated with greater carotid intima-media thickness (β=0.21; 0.17-0.26), Young's elastic modulus (β=0.21; 0.17-0.25), carotid-femoral pulse wave velocity (β=0.24; 0.14-0.34), carotid pulse wave velocity (β=0.31; 0.26-0.35), and carotid diameter (β=0.43; 0.38-0.48), after adjustment for age, sex, total cholesterol, smoking, education level, diabetes mellitus, heart rate, and study site. Consistent associations were observed after additional adjustments for mean blood pressure, body mass index, or antihypertensive medications. Conclusions These data lend support for accelerated vascular aging in individuals with high risk of OSA. This may, at least in part, underlie the association between OSA and cardiovascular disease.
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Affiliation(s)
- Quentin Lisan
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France.,Department of Otolaryngology-Head and Neck Surgery Foch HospitalSchool of MedicineUniversity Paris Saclay Paris France
| | - Thomas van Sloten
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Pierre Boutouyrie
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France.,Department of Medicine Service of Internal Medicine Lausanne University Hospital and University of Lausanne Switzerland
| | - Stéphane Laurent
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France.,Department of Medicine Service of Internal Medicine Lausanne University Hospital and University of Lausanne Switzerland
| | - Nicolas Danchin
- Department of Cardiology and Cardiovascular Research Institute MaastrichtMaastricht University Medical Center Maastricht Netherlands.,Department of Biomedical EngineeringMaastricht University Medical Centre Maastricht the Netherlands
| | - Frédérique Thomas
- Department of Biomedical EngineeringMaastricht University Medical Centre Maastricht the Netherlands
| | - Catherine Guibout
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France
| | - Marie-Cécile Perier
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France
| | - Pieter Dagnelie
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands.,AP-HP Department of PharmacologyGeorges Pompidou European Hospital Paris France
| | - Ronald M Henry
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Raphaël Heinzer
- MHeNs School for Mental Health and Neuroscience Maastricht University Maastricht the Netherlands.,Department of Respiratory Medicine Maastricht University Medical Centre Maastricht The Netherlands
| | - Pedro Marques-Vidal
- MHeNs School for Mental Health and Neuroscience Maastricht University Maastricht the Netherlands
| | - Carla J van der Kallen
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Harry J Crijns
- Preventive and Clinical Investigation Center Paris France
| | - Marleen van Greevenbroek
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Koen Reesink
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,AP-HP Department of Cardiology Georges Pompidou European Hospital Paris France
| | - Sebastian Köhler
- Department of EpidemiologyMaastricht University Medical Centre Maastricht the Netherlands
| | - Manuel Sastry
- Center for Investigation and Research in SleepLausanne University Hospital and University of Lausanne Switzerland
| | - Xavier Jouven
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France.,Department of Cardiology and Cardiovascular Research Institute MaastrichtMaastricht University Medical Center Maastricht Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular DiseasesMaastricht University Maastricht the Netherlands.,Department of Internal MedicineMaastricht University Medical Centre Maastricht the Netherlands
| | - Jean-Philippe Empana
- INSERM UMR 970 Integrative Epidemiology of Cardiovascular Diseases University of Paris Paris France
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38
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Letellier N, Ilango SD, Mortamais M, Tzourio C, Gabelle A, Empana JP, Samieri C, Berr C, Benmarhnia T. Socioeconomic inequalities in dementia risk among a French population-based cohort: quantifying the role of cardiovascular health and vascular events. Eur J Epidemiol 2021; 36:1015-1023. [PMID: 34308532 PMCID: PMC8542549 DOI: 10.1007/s10654-021-00788-8] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/08/2021] [Indexed: 12/29/2022]
Abstract
This study aimed to investigate the role of cardiovascular health (CVH) and vascular events as potential contributors to socioeconomic inequalities in dementia using causal mediation analyses. We used data from the Three-City Cohort, a French population-based study with 12 years of follow-up, with active search of dementia cases and validated diagnosis. Individual socioeconomic status was assessed using education, occupation and income. A CVH score as defined by the American Heart Association and incident vascular events were considered separately as mediators. We performed multi-level Cox proportional and Aalen additive hazard regression models to estimate the total effects of socioeconomic status on dementia risk. To estimate natural direct and indirect effects through CVH and vascular events, we applied two distinct weighting methods to quantify the role of CVH and vascular events: Inverse Odds Ratio Weighting (IORW) and Marginal Structural Models (MSM) respectively. Among 5581 participants, the risk of dementia was higher among participants with primary education (HR 1.60, 95%CI 1.44–1.78), blue-collar workers (HR 1.62, 95%CI 1.43–1.84) and with lower income (HR 1.23, 95%CI 1.09–1.29). Using additive models, 571 (95% CI 288–782) and 634 (95% CI 246–1020) additional cases of dementia per 100 000 person and year were estimated for primary education and blue-collar occupation, respectively. Using IORW, the CVH score mediate the relationship between education or income, and dementia (proportion mediated 17% and 26%, respectively). Yet, considering vascular events as mediator, MSM generated indirect effects that were smaller and more imprecise. Socioeconomic inequalities in dementia risk were observed but marginally explained by CVH or vascular events mediators.
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Affiliation(s)
- Noémie Letellier
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
| | - Sindana D Ilango
- School of Public Health, San Diego State University, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Marion Mortamais
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Christophe Tzourio
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Audrey Gabelle
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Center, Paris, France
| | - Cécilia Samieri
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
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39
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Climie RE, Heude B, Empana JP. Weight Gain Prevention and Cardiovascular Disease: A Complex Lifelong but Achievable Process. Arterioscler Thromb Vasc Biol 2021; 41:2328-2329. [PMID: 34196218 DOI: 10.1161/atvbaha.121.316595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rachel E Climie
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, France (R.E.C., J.-P.E.).,Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.E.C.)
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, France (B.H.)
| | - Jean-Philippe Empana
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, France (R.E.C., J.-P.E.)
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40
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Chatzopoulou E, Rangé H, Deraz O, Boutouyrie P, Perier MC, Guibout C, Thomas F, Andrieu M, Bailly K, Vedie B, Danchin N, Jouven X, Bouchard P, Empana JP. Poor Masticatory Capacity and Blood Biomarkers of Elevated Cardiovascular Disease Risk in the Community: The Paris Prospective Study III. Arterioscler Thromb Vasc Biol 2021; 41:2225-2232. [PMID: 34039017 DOI: 10.1161/atvbaha.121.316085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Eirini Chatzopoulou
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.)
| | - Hélène Rangé
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.)
| | - Omar Deraz
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Pierre Boutouyrie
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.).,Université de Paris, INSERM U970, Cellular, molecular and pathophysiological mechanisms of heart failure, Paris, France (P.B.)
| | - Marie-Cécile Perier
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Catherine Guibout
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Frédérique Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Muriel Andrieu
- Université de Paris, INSERM U1016, Cochin Institute, Platform CYBIO, Paris, France (M.A., K.B.)
| | - Karine Bailly
- Université de Paris, INSERM U1016, Cochin Institute, Platform CYBIO, Paris, France (M.A., K.B.)
| | - Benoît Vedie
- AP-HP, Department of biochemistry, Tissue and blood samples biobank, Georges Pompidou European Hospital, France (B.V.)
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Xavier Jouven
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | | | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
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41
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Garnier S, Harakalova M, Weiss S, Mokry M, Regitz-Zagrosek V, Hengstenberg C, Cappola TP, Isnard R, Arbustini E, Cook SA, van Setten J, Calis JJA, Hakonarson H, Morley MP, Stark K, Prasad SK, Li J, O'Regan DP, Grasso M, Müller-Nurasyid M, Meitinger T, Empana JP, Strauch K, Waldenberger M, Marguiles KB, Seidman CE, Kararigas G, Meder B, Haas J, Boutouyrie P, Lacolley P, Jouven X, Erdmann J, Blankenberg S, Wichter T, Ruppert V, Tavazzi L, Dubourg O, Roizes G, Dorent R, de Groote P, Fauchier L, Trochu JN, Aupetit JF, Bilinska ZT, Germain M, Völker U, Hemerich D, Raji I, Bacq-Daian D, Proust C, Remior P, Gomez-Bueno M, Lehnert K, Maas R, Olaso R, Saripella GV, Felix SB, McGinn S, Duboscq-Bidot L, van Mil A, Besse C, Fontaine V, Blanché H, Ader F, Keating B, Curjol A, Boland A, Komajda M, Cambien F, Deleuze JF, Dörr M, Asselbergs FW, Villard E, Trégouët DA, Charron P. Genome-wide association analysis in dilated cardiomyopathy reveals two new players in systolic heart failure on chromosomes 3p25.1 and 22q11.23. Eur Heart J 2021; 42:2000-2011. [PMID: 33677556 PMCID: PMC8139853 DOI: 10.1093/eurheartj/ehab030] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/13/2020] [Accepted: 01/14/2021] [Indexed: 12/31/2022] Open
Abstract
AIMS Our objective was to better understand the genetic bases of dilated cardiomyopathy (DCM), a leading cause of systolic heart failure. METHODS AND RESULTS We conducted the largest genome-wide association study performed so far in DCM, with 2719 cases and 4440 controls in the discovery population. We identified and replicated two new DCM-associated loci on chromosome 3p25.1 [lead single-nucleotide polymorphism (SNP) rs62232870, P = 8.7 × 10-11 and 7.7 × 10-4 in the discovery and replication steps, respectively] and chromosome 22q11.23 (lead SNP rs7284877, P = 3.3 × 10-8 and 1.4 × 10-3 in the discovery and replication steps, respectively), while confirming two previously identified DCM loci on chromosomes 10 and 1, BAG3 and HSPB7. A genetic risk score constructed from the number of risk alleles at these four DCM loci revealed a 3-fold increased risk of DCM for individuals with 8 risk alleles compared to individuals with 5 risk alleles (median of the referral population). In silico annotation and functional 4C-sequencing analyses on iPSC-derived cardiomyocytes identify SLC6A6 as the most likely DCM gene at the 3p25.1 locus. This gene encodes a taurine transporter whose involvement in myocardial dysfunction and DCM is supported by numerous observations in humans and animals. At the 22q11.23 locus, in silico and data mining annotations, and to a lesser extent functional analysis, strongly suggest SMARCB1 as the candidate culprit gene. CONCLUSION This study provides a better understanding of the genetic architecture of DCM and sheds light on novel biological pathways underlying heart failure.
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Affiliation(s)
- Sophie Garnier
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
| | - Magdalena Harakalova
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Michal Mokry
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Laboratory of Clinical Chemistry and Haematology, University Medical Center, Heidelberglaan 100, Utrecht, the Netherlands
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands
| | - Vera Regitz-Zagrosek
- Institute of Gender in Medicine and Center for Cardiovascular Research, Charite University Hospital, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Berlin, Germany
| | - Christian Hengstenberg
- Department of Internal Medicine, Division of Cardiology, Medical University of Vienna, Austria
- Department of Internal Medicine, Medical University of Regensburg, Germany
| | - Thomas P Cappola
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard Isnard
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
- Cardiology Department, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Stuart A Cook
- National Heart and Lung Institute, Imperial College London, London, UK
- National Heart Centre Singapore, Singapore
- Duke-NUS, Singapore
| | - Jessica van Setten
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jorg J A Calis
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hakon Hakonarson
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael P Morley
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus Stark
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Sanjay K Prasad
- National Heart Centre Singapore, Singapore
- Royal Brompton Hospital, London, UK
| | - Jin Li
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Declan P O'Regan
- Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - Maurizia Grasso
- Centre for Inherited Cardiovascular Diseases—IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- IBE, Faculty of Medicine, LMU Munich, Germany
- Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Thomas Meitinger
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- IBE, Faculty of Medicine, LMU Munich, Germany
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jean-Philippe Empana
- Université de Paris, INSERM, UMR-S970, Integrative Epidemiology of cardiovascular disease, Paris, France
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- IBE, Faculty of Medicine, LMU Munich, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg University, Mainz 55101, Germany
| | - Melanie Waldenberger
- Research unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Kenneth B Marguiles
- Penn Cardiovascular Institute and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christine E Seidman
- Department of Medicine and Genetics Harvard Medical School, Boston, MA, USA
- Brigham & Women's Cardiovascular Genetics Center, Boston, MA, USA
| | - Georgios Kararigas
- Department of Physiology, Faculty of Medicine, University of Iceland, Vatnsmýrarvegur 16, 101 Reykjavík, Iceland
| | - Benjamin Meder
- Institute for Cardiomyopathies Heidelberg, Heidelberg University, Germany
- Stanford Genome Technology Center, Department of Genetics, Stanford Medical School, CA, USA
| | - Jan Haas
- Institute for Cardiomyopathies Heidelberg, Heidelberg University, Germany
| | - Pierre Boutouyrie
- Université de Paris, INSERM, UMR-S970, Integrative Epidemiology of cardiovascular disease, Paris, France
- Cardiology Department, APHP, Georges Pompidou European Hospital, Paris, France
| | | | - Xavier Jouven
- Université de Paris, INSERM, UMR-S970, Integrative Epidemiology of cardiovascular disease, Paris, France
- Cardiology Department, APHP, Georges Pompidou European Hospital, Paris, France
| | - Jeanette Erdmann
- Medizinische Klinik und Poliklinik, Universitätsmedizin der Johannes-Gutenberg Universität Mainz, Mainz, Germany
| | | | - Thomas Wichter
- Dept. of Cardiology and Angiology, Niels-Stensen-Kliniken Marienhospital Osnabrück, Heart Centre Osnabrück/Bad Rothenfelde, Osnabrück 49074, Germany
| | - Volker Ruppert
- Klinik für Innere Medizin-Kardiologie UKGM GmbH Standort Marburg Baldingerstrasse, Marburg, Germany
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy
| | - Olivier Dubourg
- Université de Versailles-Saint Quentin, Hôpital Ambroise Paré, AP-HP, Boulogne, France
| | - Gérard Roizes
- Institut de Génétique Humaine, UPR 1142, CNRS, Montpellier, France
| | | | | | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Jean-Noël Trochu
- Université de Nantes, CHU Nantes, CNRS, INSERM, l’institut du thorax, Nantes 44000, France
| | - Jean-François Aupetit
- Département de pathologie cardiovasculaire, Hôpital Saint-Joseph-Saint-Luc, Lyon, France
| | - Zofia T Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Marine Germain
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux 33000, France
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Daiane Hemerich
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ibticem Raji
- AP-HP, Département de Génétique, Centre de Référence Maladies Cardiaques Héréditaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Delphine Bacq-Daian
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Carole Proust
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux 33000, France
| | - Paloma Remior
- Department of Cardiology, Hospital Universitario Puerta de Hierro, CIBERCV, Madrid, Spain
| | - Manuel Gomez-Bueno
- Department of Cardiology, Hospital Universitario Puerta de Hierro, CIBERCV, Madrid, Spain
| | - Kristin Lehnert
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Renee Maas
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Ganapathi Varma Saripella
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- SLU Bioinformatics Infrastructure (SLUBI), PlantLink, Department of Plant Breeding, Swedish University of Agricultural Sciences, Almas Allé 8, 750 07 Uppsala, Sweden
| | - Stephan B Felix
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Steven McGinn
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Laëtitia Duboscq-Bidot
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
| | - Alain van Mil
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Céline Besse
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Vincent Fontaine
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
| | - Hélène Blanché
- Laboratory of Excellence GENMED (Medical Genomics)
- Centre d'Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Flavie Ader
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- APHP, UF Cardiogénétique et Myogénétique, service de Biochimie métabolique, Hôpital universitaire Pitié-Salpêtrière Paris, France
- Faculté de Pharmacie Paris Descartes, Département 3, Paris 75006, France
| | - Brendan Keating
- Division of Transplantation, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Angélique Curjol
- AP-HP, Département de Génétique, Centre de Référence Maladies Cardiaques Héréditaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Michel Komajda
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
- Cardiology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | | | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry 91057, France
- Laboratory of Excellence GENMED (Medical Genomics)
- Centre d'Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
- Health Data Research UK and Institute of Health Informatics, University College London, London, UK
| | - Eric Villard
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
| | - David-Alexandre Trégouët
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux 33000, France
- Laboratory of Excellence GENMED (Medical Genomics)
| | - Philippe Charron
- Sorbonne Université, INSERM, UMR-S1166, Research Unit on Cardiovascular Disorders, Metabolism and Nutrition, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris 75013, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris 75013, France
- Cardiology Department, APHP, Pitié-Salpêtrière Hospital, Paris, France
- AP-HP, Département de Génétique, Centre de Référence Maladies Cardiaques Héréditaires, Hôpital Pitié-Salpêtrière, Paris, France
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Reese PP, Aubert O, Naesens M, Huang E, Potluri V, Kuypers D, Bouquegneau A, Divard G, Raynaud M, Bouatou Y, Vo A, Glotz D, Legendre C, Lefaucheur C, Jordan S, Empana JP, Jouven X, Loupy A. Assessment of the Utility of Kidney Histology as a Basis for Discarding Organs in the United States: A Comparison of International Transplant Practices and Outcomes. J Am Soc Nephrol 2021; 32:397-409. [PMID: 33323474 PMCID: PMC8054891 DOI: 10.1681/asn.2020040464] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/28/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Many kidneys donated for transplant in the United States are discarded because of abnormal histology. Whether histology adds incremental value beyond usual donor attributes in assessing allograft quality is unknown. METHODS This population-based study included patients who received a deceased donor kidney that had been biopsied before implantation according to a prespecified protocol in France and Belgium, where preimplantation biopsy findings are generally not used for decision making in the allocation process. We also studied kidneys that had been acquired from deceased United States donors for transplantation that were biopsied during allocation and discarded because of low organ quality. Using donor and recipient characteristics, we fit multivariable Cox models for death-censored graft failure and examined whether predictive accuracy (C index) improved after adding donor histology. We matched the discarded United States kidneys to similar kidneys transplanted in Europe and calculated predicted allograft survival. RESULTS In the development cohort of 1629 kidney recipients at two French centers, adding donor histology to the model did not significantly improve prediction of long-term allograft failure. Analyses using an external validation cohort from two Belgian centers confirmed the lack of improved accuracy from adding histology. About 45% of 1103 United States kidneys discarded because of histologic findings could be accurately matched to very similar kidneys that had been transplanted in France; these discarded kidneys would be expected to have allograft survival of 93.1% at 1 year, 80.7% at 5 years, and 68.9% at 10 years. CONCLUSIONS In this multicenter study, donor kidney histology assessment during allocation did not provide substantial incremental value in ascertaining organ quality. Many kidneys discarded on the basis of biopsy findings would likely benefit United States patients who are wait listed.
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Affiliation(s)
- Peter P. Reese
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Olivier Aubert
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Department of Kidney Transplantation, Necker Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Maarten Naesens
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Edmund Huang
- Division of Nephrology, Department of Medicine, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, California
| | - Vishnu Potluri
- Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Dirk Kuypers
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Antoine Bouquegneau
- Department of Nephrology, Dialysis and Transplantation, Centre Hospitalier Universitaire de Liege, Liege, Belgium
| | - Gillian Divard
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Marc Raynaud
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Yassine Bouatou
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Ashley Vo
- Division of Nephrology, Department of Medicine, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, California
| | - Denis Glotz
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Department of Nephrology and Kidney Transplantation, Saint-Louis Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Christophe Legendre
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Department of Kidney Transplantation, Necker Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Carmen Lefaucheur
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Department of Nephrology and Kidney Transplantation, Saint-Louis Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Stanley Jordan
- Division of Nephrology, Department of Medicine, Comprehensive Transplant Center, Cedars Sinai Medical Center, West Hollywood, California
| | - Jean-Philippe Empana
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Xavier Jouven
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Cardiology and Heart Transplant Department, Pompidou Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Alexandre Loupy
- Université de Paris, Institut National de la Santé et de la Recherche Médicale U970, Paris Translational Research Centre for Organ Transplantation, Paris, France,Department of Kidney Transplantation, Necker Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
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43
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Affiliation(s)
- Rachel Climie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Valentin Fuster
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.,Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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44
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Hamieh N, Kab S, Zins M, Blacher J, Meneton P, Empana JP, Hoertel N, Limosin F, Goldberg M, Melchior M, Lemogne C. Depressive symptoms and non-adherence to treatable cardiovascular risk factors' medications in the CONSTANCES cohort. Eur Heart J Cardiovasc Pharmacother 2020; 7:280-286. [PMID: 33200205 DOI: 10.1093/ehjcvp/pvaa124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/28/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022]
Abstract
AIMS Depression is associated with increased risk of cardiovascular disease (CVD) and the role of poor medical adherence is mostly unknown. We studied the association between depressive symptoms and non-adherence to medications targeting treatable cardiovascular risk factors in the CONSTANCES population-based French cohort. METHODS AND RESULTS We used CONSTANCES data linked to the French national healthcare database to study the prospective association between depressive symptoms (assessed at inclusion with the Center for Epidemiological Studies Depression scale) and non-adherence to medications (less than 80% of trimesters with at least one drug dispensed) treating type 2 diabetes, hypertension, and dyslipidaemia over 36 months of follow-up. Binary logistic regression models were adjusted for socio-demographics, body mass index, and personal history of CVD at inclusion. Among 4998 individuals with hypertension, 793 with diabetes, and 3692 with dyslipidaemia at baseline, respectively 13.1% vs. 11.5%, 10.5% vs. 5.8%, and 29.0% vs. 27.1% of those depressed vs. those non-depressed were non-adherent over the first 18 months of follow-up (15.9% vs. 13.6%, 11.1% vs. 7.4%, and 34.8% vs. 36.6% between 19 and 36 months). Adjusting for all covariates, depressive symptoms were neither associated with non-adherence to medications for hypertension, diabetes, and dyslipidaemia over the first 18 months of follow-up, nor afterwards. Depressive symptoms were only associated with non-adherence to anti-diabetic medications between the first 3-6 months of follow-up. CONCLUSION Non-adherence to medications targeting treatable cardiovascular risk factors is unlikely to explain much of the association between depressive symptoms and CVD at a population level. Clinicians are urged to search for and treat depression in individuals with diabetes to foster medications adherence.
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Affiliation(s)
- Nadine Hamieh
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris F75012, France
| | - Sofiane Kab
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.,Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Jacques Blacher
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,AP-HP, Centre-Université de Paris, Hôtel-Dieu Hospital, Hypertension and Cardiovascular Prevention Unit, Paris, France
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Team 4 Integrative Epidemiology of Cardiovascular Diseases, Paris, France
| | - Nicolas Hoertel
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Corentin-Celton, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, France
| | - Frederic Limosin
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Corentin-Celton, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.,Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris F75012, France
| | - Cedric Lemogne
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Hôtel-Dieu, Service de psychiatrie de l'adulte, Paris, France
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45
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Bruno RM, Nilsson PM, Engström G, Wadström BN, Empana JP, Boutouyrie P, Laurent S. Early and Supernormal Vascular Aging: Clinical Characteristics and Association With Incident Cardiovascular Events. Hypertension 2020; 76:1616-1624. [PMID: 32895017 DOI: 10.1161/hypertensionaha.120.14971] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Pulse wave velocity is an established marker of early vascular aging but may also help identifying individuals with supernormal vascular aging. We tested the hypothesis that individuals with the largest difference (Δ-age) between chronological and vascular age show the lowest rate of cardiovascular events and may thus be defined as supernormal vascular aging. Vascular age was defined as the predicted age in the best fitting multivariable regression model including classical risk factors and treatment and pulse wave velocity, in a subset of the Reference Values for Arterial Stiffness Collaboration Database (n=3347). Δ-age was then calculated as chronological age minus vascular age, and the 10th and 90th percentiles were used to define early (Δ-age<-5.7 years), normal (Δ-age -5.7 to 6.8 years) and supernormal vascular aging (Δ-age>6.8 years). The risk for fatal and nonfatal cardiovascular events associated with vascular aging categories was investigated in the Malmö Diet and Cancer Study cohort (n=2642). In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events), Δ-age was significantly (P<0.01) and inversely associated with cardiovascular events. Compared with normal vascular aging, supernormal vascular aging had lower risk (hazard ratio, 0.59 [95% CI, 0.41-0.85]), whereas early vascular aging had higher risk (hazard ratio, 2.70 [95% CI, 1.55-4.70]) of cardiovascular events, in particular coronary events. There was no significant association with all-cause mortality. This study represents the first validation of the clinical significance of the supernormal vascular aging concept, based on prospective data. Its further characterization may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.
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Affiliation(s)
- Rosa Maria Bruno
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.)
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Benjamin Nilsson Wadström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.)
| | - Pierre Boutouyrie
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
| | - Stephane Laurent
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
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46
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Vulser H, Lemogne C, Boutouyrie P, Côté F, Perier MC, Van Sloten T, Hoertel N, Danchin N, Limosin F, Jouven X, Empana JP. Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis. Prev Med 2020; 135:106050. [PMID: 32156564 DOI: 10.1016/j.ypmed.2020.106050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/08/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 02/07/2023]
Abstract
Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.
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Affiliation(s)
- Hélène Vulser
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France.
| | - Cédric Lemogne
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Pharmacology, Paris, France
| | - Francine Côté
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, Necker Enfants Malades Hospital, Department of Hematology, Institut Imagine, INSERM U1183 CNRS ERL 8254, Laboratory of Excellence GR-Ex, Paris, France
| | - Marie-Cécile Perier
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
| | - Thomas Van Sloten
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nicolas Hoertel
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Nicolas Danchin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France; Preventive and Clinical Investigation Center, Paris, France
| | - Frédéric Limosin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Xavier Jouven
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France
| | - Jean-Philippe Empana
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
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47
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Lisan Q, van Sloten T, Climie RE, Boutouyrie P, Guibout C, Thomas F, Danchin N, Jouven X, Empana JP. Sleep apnoea is associated with hearing impairment: The Paris prospective study 3. Clin Otolaryngol 2020; 45:681-686. [PMID: 32329188 DOI: 10.1111/coa.13557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/13/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Hearing impairment (HI) is a leading impairment worldwide, and identifying modifiable risk factors of HI may have major public health implications. The aim of this study was to investigate the association between obstructive sleep apnoea (OSA) and HI. DESIGN Observational longitudinal study (the Paris Prospective Study 3). SETTING Population-based. PARTICIPANTS Volunteers aged 50-75 years and consulting at a preventive medical centre were included between 2008 and 2012. 6797 participants were included in the present analysis. MAIN OUTCOME MEASURES Audiometry testing was performed in both ears in all participants, and HI was defined by a pure-tone average (PTA) >25 decibels (dB) hearing level in the better ear. RESULTS Obstructive sleep apnoea (estimated by the Berlin questionnaire) was present in 18.6% (n = 1267) and HI in 13.9% (n = 947) of the participants. Mean age was 59.5 years (SD 6.2) and 63.5% were male (n = 4317). In multiple logistic regression modelling, OSA was significantly associated with a 1.21-increased odds of HI (95% confidence interval 1.01-1.44). Several sensitivity analyses supported this finding. CONCLUSION Obstructive sleep apnoea is associated with a 21% increased odds of HI. These results support active screening of HI in subjects with OSA, and future studies should evaluate whether the treatment of OSA can delay the onset of HI.
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Affiliation(s)
- Quentin Lisan
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France.,Department of Head and Neck Surgery, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Thomas van Sloten
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France.,Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rachel E Climie
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France.,Baker Heart and Diabetes Institute, Melbourne, Vic, Australia.,Menzies Institute for Medical Research, University of Tasmanian, Hobart, TAS, Australia
| | - Pierre Boutouyrie
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France.,Department of Pharmacology, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Catherine Guibout
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France
| | | | - Nicolas Danchin
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,Preventive and Clinical Investigation Center, Paris, France.,Department of Cardiology, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Xavier Jouven
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France.,Department of Cardiology, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Jean-Philippe Empana
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France.,UMR-S970, Integrative Epidemiology of Cardiovascular disease Team, Paris Cardiovascular Research Center, INSERM, Paris, France
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48
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Loupy A, Coutance G, Bonnet G, Van Keer J, Raynaud M, Aubert O, Bories MC, Racapé M, Yoo D, Duong Van Huyen JP, Bruneval P, Taupin JL, Lefaucheur C, Varnous S, Leprince P, Guillemain R, Empana JP, Levine R, Naesens M, Patel JK, Jouven X, Kobashigawa J. Identification and Characterization of Trajectories of Cardiac Allograft Vasculopathy After Heart Transplantation: A Population-Based Study. Circulation 2020; 141:1954-1967. [PMID: 32363949 DOI: 10.1161/circulationaha.119.044924] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient mortality. Little is known about the prototypes of CAV trajectories at the population level. We aimed to identify the different evolutionary profiles of CAV and to determine the respective contribution of immune and nonimmune factors in CAV development. METHODS Heart transplant recipients were from 4 academic centers (Pitié-Salpêtrière and Georges Pompidou Hospital, Paris, Katholieke Universiteit Leuven, and Cedars-Sinai, Los Angeles; 2004-2016). Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessments of clinical, histological, and immunologic parameters. The main outcome was a prediction for CAV trajectory. We identified CAV trajectories by using unsupervised latent class mixed models. We then identified the independent predictive variables of the CAV trajectories and their association with mortality. RESULTS A total of 1301 patients were included (815 and 486 in the European and US cohorts, respectively). The median follow-up after transplantation was 6.6 (interquartile range, 4-9.1) years with 4710 coronary angiographies analyzed. We identified 4 distinct profiles of CAV trajectories over 10 years. The 4 trajectories were characterized by (1) patients without CAV at 1 year and nonprogression over time (56.3%), (2) patients without CAV at 1 year and late-onset slow CAV progression (7.6%), (3) patients with mild CAV at 1 year and mild progression over time (23.1%), and (4) patients with mild CAV at 1 year and accelerated progression (13.0%). This model showed good discrimination (0.92). Among candidate predictors assessed, 6 early independent predictors of these trajectories were identified: donor age (P<0.001), donor male sex (P<0.001), donor tobacco consumption (P=0.001), recipient dyslipidemia (P=0.009), class II anti-human leukocyte antigen donor-specific antibodies (P=0.004), and acute cellular rejection ≥2R (P=0.028). The 4 CAV trajectories manifested consistently in the US independent cohort with similar discrimination (0.97) and in different clinical scenarios, and showed gradients for overall-cause mortality (P<0.001). CONCLUSIONS In a large multicenter and highly phenotyped prospective cohort of heart transplant recipients, we identified 4 CAV trajectories and their respective independent predictive variables. Our results provide the basis for a trajectory-based assessment of patients undergoing heart transplantation for early risk stratification, patient monitoring, and clinical trials. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04117152.
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Affiliation(s)
- Alexandre Loupy
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Kidney Transplant Department (A.L., O.A.), Necker Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Guillaume Coutance
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, France (G.C., S.V., P.L.)
| | - Guillaume Bonnet
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Cardiology and Heart Transplant Department (G.B., M.-C.B., R.G., J.-P.E., X.J.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Jan Van Keer
- Departments of Cardiology (J.V.K.), University Hospitals Leuven, Katholieke Universiteit Leuven, Belgium
| | - Marc Raynaud
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.)
| | - Olivier Aubert
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Kidney Transplant Department (A.L., O.A.), Necker Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Marie-Cécile Bories
- Cardiology and Heart Transplant Department (G.B., M.-C.B., R.G., J.-P.E., X.J.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Maud Racapé
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.)
| | - Daniel Yoo
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.)
| | | | - Patrick Bruneval
- Pathology Department (P.B.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Jean-Luc Taupin
- Laboratory of Immunology and Histocompatibility, AP-HP, Saint Louis Hospital, Paris, France (J.-L.T.)
| | - Carmen Lefaucheur
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.)
| | - Shaida Varnous
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, France (G.C., S.V., P.L.).,INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France (S.V., P.L.)
| | - Pascal Leprince
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, France (G.C., S.V., P.L.).,INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France (S.V., P.L.)
| | - Romain Guillemain
- Cardiology and Heart Transplant Department (G.B., M.-C.B., R.G., J.-P.E., X.J.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Cardiology and Heart Transplant Department (G.B., M.-C.B., R.G., J.-P.E., X.J.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Ryan Levine
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.L., J.K.P., J.K.)
| | - Maarten Naesens
- Microbiology, Immunology, and Transplantation and of Nephrology(M.N.), University Hospitals Leuven, Katholieke Universiteit Leuven, Belgium.,Renal Transplantation (M.N.), University Hospitals Leuven, Katholieke Universiteit Leuven, Belgium
| | - Jigneh K Patel
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.L., J.K.P., J.K.)
| | - Xavier Jouven
- Université de Paris, INSERM, Paris Translational Research Centre for Organ Transplantation, France (A.L., G.C., G.B., M. Raynaud, O.A., M. Racapé, D.Y., C.L., J.-P.E., X.J.).,Cardiology and Heart Transplant Department (G.B., M.-C.B., R.G., J.-P.E., X.J.), Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Jon Kobashigawa
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.L., J.K.P., J.K.)
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49
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Hamieh N, Meneton P, Zins M, Goldberg M, Wiernik E, Empana JP, Limosin F, Melchior M, Lemogne C. Hostility, depression and incident cardiac events in the GAZEL cohort. J Affect Disord 2020; 266:381-386. [PMID: 32056903 DOI: 10.1016/j.jad.2020.01.164] [Citation(s) in RCA: 2] [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: 07/09/2019] [Revised: 11/25/2019] [Accepted: 01/28/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Psychological factors such as hostility and depression have been associated with cardiovascular disease. However, their role in predicting incident cardiac events independently one of another is not clear. METHODS Among 10,304 GAZEL middle-aged workers free of cardiovascular diseases in 1993, 581 incident cardiac events were validated from 1994-2014. Hostile traits (cognitive hostility, behavioral hostility, irritability and negativism) were assessed with the Buss and Durkee Hostility Inventory at baseline. Depressive symptoms were assessed at baseline and every three years with the Center for Epidemiological Studies Depression scale. We used Cox proportional hazards models to calculate hazard ratios (HR) of hostile traits for incident cardiac events adjusting for baseline self-reported socio-demographics and family history of coronary heart diseases (model 1), then additionally for time-dependent depressive symptoms (either as a binary or continuous variable) (model 2) and for yearly self-reported modifiable cardiovascular risk factors (physical activity, smoking, body mass index, diabetes, dyslipidemia and hypertension) (model 3). RESULTS In Model 1, the only hostile trait associated with incident cardiac events was irritability (HR for one interquartile range: 1.16, 95% confidence interval: 1.02-1.32). This association was no longer statistically significant when further adjusting for depressive symptoms. Depressive symptoms, in turn, remained significant predictors of cardiac events with HRs ranging from 1.40-1.49 (binary). LIMITATIONS Hostility traits were measured only once. CONCLUSIONS Depressive symptoms might explain the association between irritability and cardiac events and should therefore be prioritized in interventions aiming to prevent cardiovascular disease. Further research is needed to identify the mechanisms underlying this association.
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Affiliation(s)
- Nadine Hamieh
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, F75012, Paris, France.
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Marie Zins
- Université de Paris, Faculty of Medicine, Paris, France; INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marcel Goldberg
- Université de Paris, Faculty of Medicine, Paris, France; INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Emmanuel Wiernik
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | | | - Frederic Limosin
- Université de Paris, Faculty of Medicine, Paris, France; AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, F75012, Paris, France
| | - Cedric Lemogne
- Université de Paris, Faculty of Medicine, Paris, France; AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris
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50
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Cseh D, Climie RE, Offredo L, Guibout C, Thomas F, Zanoli L, Danchin N, Sharman JE, Laurent S, Jouven X, Boutouyrie P, Empana JP. Type 2 Diabetes Mellitus Is Independently Associated With Decreased Neural Baroreflex Sensitivity: The Paris Prospective Study III. Arterioscler Thromb Vasc Biol 2020; 40:1420-1428. [PMID: 32188272 DOI: 10.1161/atvbaha.120.314102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Impaired baroreflex function is an early indicator of cardiovascular autonomic imbalance. Patients with type 2 diabetes mellitus (T2D) have decreased baroreflex sensitivity (BRS), however, whether the neural BRS (nBRS) and mechanical component of the BRS is altered in those with high metabolic risk (HMR, impaired fasting glucose and metabolic syndrome) or with overt T2D, is unknown. We examined this in a community-based observational study, the Paris Prospective Study III (PPS3). Approach and Results: In 7626 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and RR [time elapsed between two successive R waves] intervals) and mechanical BRS were measured by high-precision carotid echotracking. The associations between overt T2D or HMR as compared with subjects with normal glucose metabolism and nBRS or mechanical BRS were quantified using multivariable linear regression analysis. There were 319 subjects with T2D (61±6 years, 77% male), 1450 subjects with HMR (60±6 years, 72% male), and 5857 subjects with normal glucose metabolism (59±6 years, 57% male). Compared with normal glucose metabolism, nBRS was significantly lower in HMR subjects (β=-0.07 [95% CI, -0.12 to -0.01]; P=0.029) and in subjects with T2D (β=-0.18 [95% CI, -0.29 to -0.07]; P=0.002) after adjustment for confounding and mediating factors. Subgroup analysis suggests significant and independent alteration in mechanical BRS only among HMR patients who had both impaired fasting glucose and metabolic syndrome. CONCLUSIONS In this community-based study of individuals aged 50 to 75, a graded decrease in nBRS was observed in HMR subjects and patients with overt T2D as compared with normal glucose metabolism subjects.
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Affiliation(s)
- Domonkos Cseh
- From the Department of Physiology, Semmelweis University, Budapest, Hungary (D.C.)
| | - Rachel E Climie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.E.C.).,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Lucile Offredo
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Catherine Guibout
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Frédérique Thomas
- Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.)
| | - Luca Zanoli
- University of Catania, Catania, Italy (L.Z.)
| | - Nicolas Danchin
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Stéphane Laurent
- Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Xavier Jouven
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Pierre Boutouyrie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
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