P11.26 CARDIOVASCULAR RISK IN THE VIEW OF INDIVIDUAL RISK FACTORS IN PATIENTS WITH MORE THAN 1 RISK FACTOR PRESENT

Abstract Background The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Design Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk. Methods A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years and 2 years after initiation of cancer therapy. Results At baseline, 893 patients (67.4%) presented at least 1 risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity and all-cause mortality [HR 1.79 (95% CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)]. Conclusions This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)

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Estimating the contribution of individual risk factors to disease in a person with more than one risk factor

Journal of Clinical Epidemiology ◽

10.1016/s0895-4356(02)00388-8 ◽

2002 ◽

Vol 55 (6) ◽

pp. 588-592 ◽

Cited By ~ 15

Author(s):

Patrick McElduff ◽

John Attia ◽

Ben Ewald ◽

Jill Cockburn ◽

Richard Heller

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Individual Risk ◽

Individual Risk Factors

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Contribution of Individual Risk Factor Changes to Reductions in Population Absolute Cardiovascular Risk

BioMed Research International ◽

10.1155/2014/626205 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Thomas Cochrane ◽

Rachel Davey ◽

Christopher Gidlow ◽

Zafar Iqbal ◽

Jagdish Kumar ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Risk Factor ◽

High Blood Pressure ◽

Individual Risk ◽

High Cholesterol ◽

Cvd Risk ◽

Individual Risk Factor ◽

One Year ◽

Individual Risk Factors

Background. Few studies have investigated individual risk factor contributions to absolute cardiovascular disease (CVD) risk. Even fewer have examined changes in individual risk factors as components of overall modifiable risk change following a CVD prevention intervention.Design. Longitudinal study of population CVD risk factor changes following a health screening and enhanced support programme.Methods. The contribution of individual risk factors to the estimated absolute CVD risk in a population of high risk patients identified from general practice records was evaluated. Further, the proportion of the modifiable risk attributable to each factor that was removed following one year of enhanced support was estimated.Results. Mean age of patients (533 males, 68 females) was 63.7 (6.4) years. High cholesterol (57%) was most prevalent, followed by smoking (53%) and high blood pressure (26%). Smoking (57%) made the greatest contribution to the modifiable population CVD risk, followed by raised blood pressure (26%) and raised cholesterol (17%). After one year of enhanced support, the modifiable population risk attributed to smoking (56%), high blood pressure (68%), and high cholesterol (53%) was removed.Conclusion. Approximately 59% of the modifiable risk attributable to the combination of high blood pressure, high cholesterol, and current smoking was removed after intervention.

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Hypertension is the Prominent Risk Factor in Cataract Patients

Medicina ◽

10.3390/medicina55080430 ◽

2019 ◽

Vol 55 (8) ◽

pp. 430 ◽

Cited By ~ 1

Author(s):

Ioanna Mylona ◽

Maria Dermenoudi ◽

Nikolaos Ziakas ◽

Ioannis Tsinopoulos

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Risk Factor ◽

Cataract Surgery ◽

Individual Risk ◽

Department Of Ophthalmology ◽

Significant Difference ◽

Almost All ◽

Individual Risk Factors ◽

The Impact

Background and objectives: The purpose of this study is to determine the impact of the most prominent cardiovascular and metabolic risk factors in patients undergoing cataract surgery. Materials and Methods: The study included 812 consecutive patients undergoing unilateral, uneventful cataract surgery by means of phacoemulsification, at the 2nd Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, Greece, during a calendar year. Patients were assessed for the type of cataract and the presence of three diseases, under pharmacological treatment, that have been reported as risk factors for the development of cataract (arterial hypertension, diabetes mellitus, and dyslipidemia). Results: There was a statistically significant difference between the types of cataract and individual risk factors (p < 0.001). Hypertension was the most frequentrisk factor, ranging from 43.8% in patients with subcapsular cataracts, 24.3% in patients with nuclear cataracts, 28.6% in patients with cortical cataracts, and 27.6% in patients with mixed type cataracts. There was a statistically significant difference as to the total number of risk factors per cataract type (p < 0.001); almost all patients with subcapsular cataracts had at least one risk factor (98.4%) while this percentage was 90.5% for patients with mixed cataracts, 85.7% for patients with cortical cataracts, and78.6% for patients with nuclear cataracts. Conclusions: Diabetes mellitus did not have a large incidence in our sample as a single risk factor, while hypertension did. This finding raises the importance of early detection of hypertension, a cardiovascular condition that typically progresses undetected for a number of years.

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Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: results from the Asia Pacific Cohort Studies Collaboration

BMJ Open ◽

10.1136/bmjopen-2017-019335 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019335 ◽

Cited By ~ 12

Author(s):

Sanne A E Peters ◽

Xin Wang ◽

Tai-Hing Lam ◽

Hyeon Chang Kim ◽

Suzanne Ho ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Risk Factor ◽

Cohort Studies ◽

Cox Regression ◽

Population Based ◽

Asia Pacific ◽

Individual Risk ◽

Cvd Risk ◽

Individual Risk Factors

ObjectiveTo assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster.SettingAsia Pacific Cohort Studies Collaboration.ParticipantsIndividual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline.Outcome measuresClusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95% CIs for CVD associated with individual risk factors and risk factor clusters. Population-attributable fractions (PAFs) were calculated.ResultsDuring a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP–smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24% and 11%, respectively. For individuals with three risk factors, the BP–smoking–cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13% and 10%.ConclusionsRisk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.

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Association of antecedent cardiovascular risk factor levels and trajectories with cardiovascular magnetic resonance-derived cardiac function and structure

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-020-00698-w ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Roberto Lorbeer ◽

Susanne Rospleszcz ◽

Christopher L. Schlett ◽

Sophia D. Rado ◽

Barbara Thorand ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cardiac Function ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Individual Risk ◽

The Individual ◽

And Function ◽

Individual Risk Factors

Abstract Background The association of longitudinal trajectories of cardiovascular risk factors with cardiovascular magnetic resonance (CMR)-measures of cardiac structure and function in the community is not well known. Therefore we aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort. Methods We assessed conventional cardiovascular disease risk factors in 349 participants (143 women; aged 25–59 years) at three examination cycles (Exam 1 [baseline], at Exam 2 [7-years follow-up] and at Exam 3 [14-years follow-up]) of the KORA S4 cohort and related single-point measurements of individual risk factors and longitudinal trajectories of these risk factors to various CMR-measures obtained at Exam 3. Results High levels of diastolic blood pressure, waist circumference, and LDL-cholesterol at the individual exams were associated with worse cardiac function and structure. Trajectory clusters representing higher levels of the individual risk factors were associated with worse cardiac function and structure compared to low risk trajectory clusters of individual risk factors. Multivariable (combining different risk factors) trajectory clusters were associated with different cardiac parameters in a graded fashion (e.g. decrease of LV stroke volume for middle risk cluster β = − 4.91 ml/m2, 95% CI − 7.89; − 1.94, p < 0.01 and high risk cluster β = − 7.00 ml/m2, 95% CI − 10.73; − 3.28, p < 0.001 compared to the low risk cluster). The multivariable longitudinal trajectory clusters added significantly to explain variation in CMR traits beyond the multivariable risk profile obtained at Exam 3. Conclusions Cardiovascular disease risk factor levels, measured over a time period of 14 years, were associated with CMR-derived measures of cardiac structure and function. Longitudinal multivariable trajectory clusters explained a greater proportion of the inter-individual variation in cardiac traits than multiple risk factor assessed contemporaneous with the CMR exam.

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P468Pre-diabetes a new risk factor for stroke in non-valvular atrial fibrillation

EP Europace ◽

10.1093/europace/euaa162.300 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

L Kezerle ◽

M A Tsadok ◽

A Akriv ◽

B Feldman ◽

M Leventer-Roberts ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Risk Factor ◽

Study Groups ◽

Individual Risk ◽

Historical Cohort ◽

Kaplan Meier ◽

Increased Risk ◽

Individual Risk Factors

Abstract Funding Acknowledgements Pfizer Israel Background Diabetes mellitus is a well-established independent risk factor for embolic complications in patients with non-valvular atrial fibrillation (NVAF). The association between prediabetes and risk of ischemic stroke, however, has not been studied separately in patients with NVAF. Purpose To evaluate whether pre-diabetes is associated with increased risk of stroke and death in patients with NVAF Methods We conducted a prospective, historical cohort study using the Clalit Health Services (CHS) electronic medical records database. The study population included all CHS members ≥ 21 years old, with a first diagnosis of NVAF between January 1 2010 to December 31 2016 and a minimal follow-up period of 1 year. We compared three groups of patients: prediabetes, those with established DM, and normoglycemic individuals Results A total of 44,451 cases were identified. The median age was 75 years and 52.5% were women. During a mean follow up of 38 months, the incidence of stroke per 100 person-years in the three study groups was: 1.14 in non-diabetics, 1.40 in pre-diabetics and 2.15 in diabetics. In both univariate and multivariate analyses, pre-diabetes was associated with an increased risk of stroke compared with non-diabetics (Adjusted Hazard Ratio (HR) = 1.19 {95% CI 1.01-1.4}) even after adjusting for CHA2DS2-VASC individual risk factors and use of oral anti-coagulants while diabetes conferred an even higher risk (vs non-diabetics { HR = 1.56, 95% CI ;1.37 - 1.79}). The risk for mortality was higher for diabetics (HR =1.47, 95% CI ;1.41, 1.54}) but not for pre-diabetics (HR = 0.98 ,CI 95%; 0.92 - 1.03). Conclusion: In this observational cohort of patients with incident newly diagnosed patients with NVAF, pre-diabetes was associated with an increased risk of stroke even after accounting for other recognized risk factors. Abstract Figure. Kaplan-Meier for stroke-free survival

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The Role of Fructose as a Cardiovascular Risk Factor: An Update

Metabolites ◽

10.3390/metabo12010067 ◽

2022 ◽

Vol 12 (1) ◽

pp. 67

Author(s):

Stefan-Sebastian Busnatu ◽

Teodor Salmen ◽

Maria-Alexandra Pana ◽

Manfredi Rizzo ◽

Tiziana Stallone ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cardiovascular Risk ◽

High Body Mass Index ◽

Nutritional Risk ◽

Individual Risk ◽

Alcoholic Fatty Liver ◽

Added Sugars ◽

Lifestyle Risk Factors ◽

Lifestyle Risk

There is increasing presence of fructose in food and drinks, and some evidence suggests that its higher consumption increases cardiovascular risk, although the mechanisms still remain not fully elucidated. Cardiovascular diseases (CVD) are still responsible for one-third of deaths worldwide, and therefore, their prevention should be assessed and managed comprehensively and not by the evaluation of individual risk factor components. Lifestyle risk factors for CVD include low degree of physical activity, high body mass index, alcohol consumption, smoking, and nutritional factors. Indeed, nutritional risk factors for CVD include unhealthy dietary behaviors, such as high intake of refined foods, unhealthy fats, added sugars, and sodium and a low intake of fruits, vegetables, whole grains, fiber, fish, and nuts. Even though there is no definitive association between CVD incidence and high consumption of total sugar, such as sucrose and fructose, there is, however, evidence that total sugars, added sugars, and fructose are harmfully associated with CVD mortality. Since high fructose intake is associated with elevated plasma triglyceride levels, as well as insulin resistance, diabetes hyperuricemia, and non-alcoholic fatty liver disease, further longitudinal studies should be conducted to fully elucidate the potential association between certain sugars and CVD.

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MANAGEMENT OF ENDOCRINE DISEASE: Cardiovascular risk assessment, thromboembolism, and infection prevention in Cushing’s syndrome: a practical approach

Acta Endocrinologica ◽

10.1530/eje-20-1309 ◽

2021 ◽

Vol 184 (5) ◽

pp. R207-R224 ◽

Cited By ~ 1

Author(s):

Elena V Varlamov ◽

Fabienne Langlois ◽

Greisa Vila ◽

Maria Fleseriu

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cushing’S Syndrome ◽

Clinical Care ◽

Urinary Free Cortisol ◽

Cushing's Syndrome ◽

Individual Risk ◽

Pneumocystis Jiroveci ◽

Free Cortisol ◽

Individual Risk Factors

Cushing’s syndrome (CS) is associated with increased mortality that is driven by cardiovascular, thromboembolic, and infection complications. Although these events are expected to decrease during disease remission, incidence often transiently increases postoperatively and is not completely normalized in the long-term. It is important to diagnose and treat cardiovascular, thromboembolic, and infection complications concomitantly with CS treatment. Management of hyperglycemia/diabetes, hypertension, hypokalemia, hyperlipidemia, and other cardiovascular risk factors is generally undertaken in accordance with clinical care standards. Medical therapy for CS may be needed even prior to surgery in severe and/or prolonged hypercortisolism, and treatment adjustments can be made based on disease pathophysiology and drug-drug interactions. Thromboprophylaxis should be considered for CS patients with severe hypercortisolism and/or postoperatively, based on individual risk factors of thromboembolism and bleeding. Pneumocystis jiroveci pneumonia prophylaxis should be considered for patients with high urinary free cortisol at the initiation of hypercortisolism treatment.

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