scholarly journals 13-year long-term associations between changes in traditional cardiovascular risk factors and changes in fibrinogen levels: The Coronary Artery Risk Development in Young Adults (CARDIA) study

2013 ◽  
Vol 226 (1) ◽  
pp. 214-219 ◽  
Author(s):  
Tochi M. Okwuosa ◽  
Oana Klein ◽  
Cheeling Chan ◽  
Nancy Swords Jenny ◽  
Pamela Schreiner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors

scholarly journals Prevalence of coronary artery calcification in young adults in UK

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
G Koulaouzidis
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Coronary Artery Calcification ◽  
Subclinical Atherosclerosis ◽  
Study Cohort ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis is a continuous process beginning early in life, with a long and clinically asymptomatic phase, before manifestations appear in middle and/or late adulthood. Coronary artery calcification (CAC) is a well-established marker of atherosclerosis; but the clinical validity of CAC in young adults (traditionally considered as a population group of low cardiovascular risk) remains unclear. Aim We aimed to assess the prevalence of CAC in a population of young individuals without previous history of coronary artery disease (CAD) in the UK and its association with conventional cardiovascular risk factors. Methods This analysis includes 4186 asymptomatic young individuals who underwent electron beam computed tomography (EBCT). Demographic information and the presence of cardiovascular risk factors were abstracted from referral letters and/or questionnaires completed by the patients prior to their tests. Individuals with previously documented CAD or chronic kidney disease were excluded. All EBCT CAC studies were performed using the same scanner (Imatron C300 Ultrafast computed tomography scanner, GE Healthcare, London, UK) and the same scanning protocol. Results The age (mean SD) of the study cohort was 40.5 ±3.6 years (range 26–45 years, 83.8% males). Hypertension, dyslipidemia, and diabetes mellitus (DM) were present in 15.5, 7.9, and 2.8% of individuals, respectively. Family history of premature CAD was present in 17% and 17.4% were smokers.  CAC was present in 21.8% of the cohort, while individuals with CAC comparing with those with CAC score 0 were males (95.2 vs. 80%, p < 0.002), older in age (41.4 3.2 vs. 40.3 3.7 years, p < 0.0001), with DM (5.5 vs. 25%, p < 0.0001), hypertension (22 vs. 13.7%, p < 0.0001), and dyslipidemia (14.8 vs. 6%, p < 0.0001). The prevalence of CAC score 0, 1–100, 101–400, 401–1000, >1000 were 78.2, 19, 2.1, 0.5, and 0.2%, respectively. The prevalence and distribution of CAC among various age groups are shown in Table 1. CAC was found in 24.8% of males (CAC score 1–100, 101–400, 400–1000, >1000 in 21.6, 2.5, 0.5, and 0.1%, respectively) and 6.6% of females (CAC score 1–100, 101–400, 400–1000, >1000 in 5.4, 0.6, 0.15 and 0.4%, respectively) (p < 0.0001). There was no statistical difference of mean CAC score between genders (males 13.8 72.7; females 11.8 142.4; p = 0.6). In multivariate analysis, the presence of CAC was associated with age (p< 0.0001), male gender (p< 0.0001), DM (p< 0.0001), hypertension (p< 0.0001), and dyslipidemia (p< 0.0001).  Conclusion   In a large cohort of asymptomatic young individuals, subclinical atherosclerosis (CAC score >0) was identified in approximately 20%. Assessment of CAC score is a useful clinical tool in young individuals, as it can confirm the presence of subclinical atherosclerosis.

Abstract P171: Hemoglobin A1c and Incident Albuminuria Among Individuals Without Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
April P Carson ◽  
Paul Muntner ◽  
Mercedes R Carnethon ◽  
Myron D Gross ◽  
Cora E Lewis
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Hemoglobin A1c ◽  
The United States ◽  
Continuous Variable ◽  
Urine Albumin ◽  
Increased Risk

Background: Higher hemoglobin A1c (HbA1c) has been associated with an increased risk of reduced estimated glomerular filtration rate <60 mls/min/1.73m2 among individuals without diabetes. However, it is unclear whether higher HbA1c in the non-diabetic glycemic range also is associated with an increased risk of albuminuria. This study investigated the association of HbA1c with incident albuminuria in a biracial cohort of middle-aged men and women without a history of diabetes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: The CARDIA Study is a prospective cohort study of 5,115 African-American and white adults, age 18-30 years at baseline (1985-86), from four field centers in the United States: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA. Participants with prevalent diabetes (defined as fasting glucose ≥126 mg/dL, 2-hour post-challenge glucose ≥ 200 mg/dL, HbA1c ≥ 6.5%, or used diabetes medications) or albuminuria (defined as a race- and sex-adjusted urine albumin-to-creatinine ratio ≥ 25 mg/g) at the year 20 examination (2005-06; baseline for this analysis) were excluded. This study included 2174 participants who had HbA1c measured at the year 20 examination and had urine albumin and creatinine measured at the year 25 examination (2010-11). Poisson regression with robust error variances was used to obtain risk ratios (RR) and 95% confidence intervals (CI) for the association of HbA1c, both as a continuous variable and dichotomous variable using its prediabetes cut-point, with albuminuria in unadjusted models and models adjusted for socio-demographics and cardiovascular risk factors. Results: During the follow-up period, 103 (4.7%) participants developed incident albuminuria. In unadjusted analyses, each 1% increase in HbA1c was associated with incident albuminuria (RR=2.55, 95% CI=1.48, 4.39). This association was attenuated and not statistically significant after adjustment for age, race, sex, and education (RR=1.68, 95% CI=0.98, 2.88) and further adjustment for cardiovascular risk factors (RR=1.42, 95% CI=0.81, 2.50). Additionally, individuals with HbA1c in the prediabetes range (5.7%-6.4%) had an increased risk of albuminuria (RR=1.59, 95% CI=1.04, 2.43) compared with those with HbA1c in the normal glycemic range (<5.7%) in the unadjusted model. However, this association was attenuated after adjustment for socio-demographics (RR=1.11, 95% CI=0.71, 1.72) and cardiovascular risk factors (RR=0.98, 95% CI=0.61, 1.55). Conclusions: After taking into account socio-demographics and traditional cardiovascular risk factors, HbA1c was not associated with incident albuminuria among individuals without diabetes.

scholarly journals Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

2021 ◽  
Vol 10 (6) ◽  
pp. 1314
Author(s):  
Rebeca Lorca ◽  
Isaac Pascual ◽  
Andrea Aparicio ◽  
Alejandro Junco-Vicente ◽  
Rut Alvarez-Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Young Women ◽  
Artery Dissection ◽  
Men And Women ◽  
High Prevalence

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

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