Relation of Intake of Saturated Fat to Atherosclerotic Risk Factors, Health Behaviors, Coronary Atherosclerosis, and All-Cause Mortality Among Patients Who Underwent Coronary Artery Calcium Scanning

2021 ◽  
Vol 138 ◽  
pp. 40-45
Author(s):  
Alan Rozanski ◽  
Yoav Arnson ◽  
Heidi Gransar ◽  
Sean W. Hayes ◽  
John D. Friedman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Health Behaviors ◽  
Coronary Artery Calcium ◽  
Coronary Atherosclerosis ◽  
Saturated Fat ◽  
All Cause Mortality ◽  
Atherosclerotic Risk Factors

Prognostic Value of Cardiac Risk Factors and Coronary Artery Calcium Screening for All-Cause Mortality

Radiology ◽  
2003 ◽  
Vol 228 (3) ◽  
pp. 826-833 ◽  
Author(s):  
Leslee J. Shaw ◽  
Paolo Raggi ◽  
Enrique Schisterman ◽  
Daniel S. Berman ◽  
Tracy Q. Callister
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Prognostic Value ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
All Cause Mortality

scholarly journals Young Obese Women with Polycystic Ovary Syndrome Have Evidence of Early Coronary Atherosclerosis

2007 ◽  
Vol 92 (12) ◽  
pp. 4609-4614 ◽  
Author(s):  
Rupal Shroff ◽  
Angela Kerchner ◽  
Michelle Maifeld ◽  
Edwin J. R. Van Beek ◽  
Dinesh Jagasia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Atherosclerosis ◽  
Polycystic Ovary ◽  
Fat Distribution ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Markers Of Inflammation ◽  
Increased Risk

Abstract Context: Polycystic ovary syndrome (PCOS) is associated with comorbidities that may contribute to increased risk of cardiovascular disease. PCOS is associated with increased risk of metabolic syndrome, dyslipidemia, and diabetes, but it remains unclear whether traditional cardiovascular (CV) risk factors can help predict coronary artery disease in this population. Objective: The objectives of the study were to detect early-onset subclinical coronary atherosclerosis (using coronary artery calcium as a marker) in young women with PCOS, compared with age- and body mass index-matched controls, and to compare traditional CV risk factors and inflammatory markers in the two groups. Design: This was a prospective case-control study. Setting: The study was conducted at a university hospital. Subjects: Twenty-four obese (body mass index ≥ 30 kg/m2) PCOS subjects and 24 obese controls participated. Outcome Measures: Coronary artery calcium, inflammatory markers (high-sensitivity C-reactive protein, IL-6, TNFα, adiponectin, leptin), fasting blood tests (glucose, lipids, insulin), and dual-energy x-ray absorptiometry scan for body fat distribution were measured. Results: Coronary artery calcium was detected in eight of 24 PCOS subjects (33%) and two of 24 controls (8%) (odds ratio 5.5, 95% confidence interval 1.03, 29.45, P < 0.03). Traditional CV risk factors did not differ significantly between the two groups, nor did markers of inflammation or adiposity, body fat distribution, or metabolic parameters with the exception of significantly lower quantitative insulin sensitivity check index (marker for insulin resistance) in the PCOS group (P < 0.05). Conclusions: Young, obese women with PCOS have a high prevalence of early asymptomatic coronary atherosclerosis, compared with obese controls. This increased risk is independent of traditional CV risk factors and novel markers of inflammation. These findings underscore the need to screen and aggressively counsel and treat these women to prevent symptomatic CV disease.

scholarly journals Predictors of Coronary Artery Calcium and Long‐Term Risks of Death, Myocardial Infarction, and Stroke in Young Adults

2021 ◽  
Author(s):  
Aamir Javaid ◽  
Joshua D. Mitchell ◽  
Todd C. Villines
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
All Cause Mortality

Background Coronary artery calcium (CAC) is well‐validated for cardiovascular disease risk stratification in middle to older–aged adults; however, the 2019 American College of Cardiology/American Heart Association guidelines state that more data are needed regarding the performance of CAC in low‐risk younger adults. Methods and Results We measured CAC in 13 397 patients aged 30 to 49 years without known cardiovascular disease or malignancy between 1997 and 2009. Outcomes of myocardial infarction (MI), stroke, major adverse cardiovascular events (MACE; MI, stroke, or cardiovascular death), and all‐cause mortality were assessed using Cox proportional hazard models, controlling for baseline risk factors (including atrial fibrillation for stroke and MACE) and the competing risk of death or noncardiac death as appropriate. The cohort (74% men, mean age 44 years, and 76% with ≤1 cardiovascular disease risk factor) had a 20.6% prevalence of any CAC. CAC was independently predicted by age, male sex, White race, and cardiovascular disease risk factors. Over a mean of 11 years of follow‐up, the relative adjusted subhazard ratio of CAC >0 was 2.9 for MI and 1.6 for MACE. CAC >100 was associated with significantly increased hazards of MI (adjusted subhazard ratio, 5.2), MACE (adjusted subhazard ratio, 3.1), stroke (adjusted subhazard ratio, 1.7), and all‐cause mortality (hazard ratio, 2.1). CAC significantly improved the prognostic accuracy of risk factors for MACE, MI, and all‐cause mortality by the likelihood ratio test ( P <0.05). Conclusions CAC was prevalent in a large sample of low‐risk young adults. Those with any CAC had significantly higher long‐term hazards of MACE and MI, while severe CAC increased hazards for all outcomes including death. CAC may have utility for clinical decision‐making among select young adults.

Polygenic Risk Score to Identify Subclinical Coronary Heart Disease Risk in Young Adults

2021 ◽  
Author(s):  
Quinn S. Wells ◽  
Minoo Bagheri ◽  
Aaron W. Aday ◽  
Deepak K. Gupta ◽  
Christian M. Shaffer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Young Adults ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Atherosclerosis ◽  
Modifiable Risk Factors ◽  
C Statistic ◽  
Integrated Discrimination Improvement

Background: Polygenic risk scores (PRS) may enhance risk stratification for coronary heart disease among young adults. Whether a coronary heart disease PRS improves prediction beyond modifiable risk factors in this population is not known. Methods: Genotyped adults aged 18 to 35 years were selected from the CARDIA study (Coronary Artery Risk Development in Young Adults; n=1132) and FOS (Framingham Offspring Study; n=663). Systolic blood pressure, total and HDL (high-density lipoprotein) cholesterol, triglycerides, smoking, and waist circumference or body mass index were measured at the visit 1 exam of each study, and coronary artery calcium, a measure of coronary atherosclerosis, was assessed at year 15 (CARDIA) or year 30 (FOS). A previously validated PRS for coronary heart disease was computed for each subject. The C statistic and integrated discrimination improvement were used to compare Improvements in prediction of elevated coronary artery calcium between models containing the PRS, risk factors, or both. Results: There were 62 (5%) and 93 (14%) participants with a coronary artery calcium score >20 (CARDIA) and >300 (FOS), respectively. At these thresholds, the C statistic changes of adding the PRS to a risk factor–based model were 0.015 (0.004–0.028) and 0.020 (0.001–0.039) in CARDIA and FOS, respectively. When adding risk factors to a PRS-based model, the respective changes were 0.070 (0.033–0.109) and 0.051 (0.017–0.079). The integrated discrimination improvement, when adding the PRS to a risk factor model, was 0.027 (−0.006 to 0.054) in CARDIA and 0.039 (0.0005–0.072) in FOS. Conclusions: Among young adults, a PRS improved model discrimination for coronary atherosclerosis, but improvements were smaller than those associated with modifiable risk factors.

Abstract 12: Volume of Calcium in the Descending Thoracic Aorta Predicts All Cause Mortality Beyond Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Isac C Thomas ◽  
Matthew A Allison ◽  
Nketi I Forbang ◽  
Erin D Michos ◽  
WT Longstreth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Thoracic Aorta ◽  
Coronary Artery Calcium ◽  
Regression Models ◽  
Cardiac Ct ◽  
Descending Thoracic Aorta ◽  
Predictive Values ◽  
Ethnic Study ◽  
All Cause Mortality

Introduction: Coronary artery calcium (CAC) volume and density differentially predict incident cardiovascular disease (CVD), with CAC density inversely associated with these outcomes. Whether similar associations exist between descending thoracic aortic calcium (DTAC) volume and density and all cause mortality (ACM) are unknown. We hypothesized that DTAC volume and density predict ACM independently of CAC. Methods: The Multi-Ethnic Study of Atherosclerosis enrolled 6,814 participants free of clinical CVD at baseline and followed them for incident adverse events. Cardiac CT at baseline visualized the segment of the descending thoracic aorta posterior to the heart. Only participants with prevalent DTAC were included (necessary to evaluate DTAC density). DTAC and CAC volumes were natural log transformed to adjust for skewness. Cox regression models estimated the associations of DTAC volume and density with ACM after adjustment for age, gender, ethnicity, CVD risk factors, statin use, and CAC volume and density. The incremental predictive values of DTAC volume and density were evaluated by area under receiver operating characteristic (AUC) curves. Results: Of the total cohort, 1,850 participants (27%) had prevalent DTAC and 491 deaths occurred over 10.3 years. In separate regression models, DTAC volume was independently associated with ACM after adjustment for CAC volume (HR 1.21 [95% CI 1.09-1.35]) and additional adjustment for CAC density (1.18 ([1.06-1.32]). After the same adjustments, DTAC density was not significantly associated with ACM (0.94 [0.84-1.06]). The AUC for the base Model 1 (risk factors + CAC volume) was 0.706 (0.680-0.732), which increased to 0.716 (0.690-0.742) with the addition of DTAC volume in Model 2 (p=0.03 compared to Model 1). Further addition of DTAC density in Model 3 did not improve the AUC significantly (0.717 [0.692-0.743], p=0.23 compared to Model 2). Conclusions: In a cohort free of baseline clinical CVD, DTAC visualized on cardiac CT was common. When DTAC was present, DTAC volume (but not density) was independently associated with ACM. DTAC volume also significantly improved ACM risk prediction beyond risk factors and CAC volume.

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