Plasma lipidomic profiles in two large independent cohorts improve upon conventional risk factors to predict cardiovascular events

Abstract BACKGROUND The objective of this study was to investigate the predictive power of a high-sensitivity cardiac troponin I (hs-cTnI) assay for cardiovascular events and mortality in a large population of older community dwellers. METHODS Blood was collected from 5764 individuals (age 66–98 years) during the period of 2002–2006 and the outcome as to all-cause death and incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) followed up to 10 years. hs-cTnI (Abbott) was measured in serum to assess the association of this marker with CVD, CHD and death, and finally, to compare the results with conventional risk factors by multivariable statistical analysis. RESULTS The median (interquartile range) concentrations of hs-cTnI were 8.4 ng/L (5.6–14.2 ng/L) and 5.3 ng/L (3.8–8.1 ng/L) in men (2416) and women (3275), respectively, and the concentrations increased linearly with age. Outcomes as to all-cause death and incidence of CVD and CHD were significantly associated with increasing concentrations of hs-cTnI beginning well below the 99th percentile concentrations. The associations with outcome remained after adjustments for conventional risk factors and were similar in men and women. CONCLUSIONS Our findings suggest that hs-cTnI reflects the status of the myocardium even in seemingly healthy individuals and that the measurements of hs-cTnI may be useful for primary prediction of heart disease; this should form the basis for future prospective clinical trials for determining whether measuring hs-cTnI can be used in the prevention of CVD/CHD.

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Two Unconventional Risk Factors for Major Adverse Cardiovascular Events in Subjects with Sexual Dysfunction: Low Education and Reported Partner's Hypoactive Sexual Desire in Comparison with Conventional Risk Factors

Journal of Sexual Medicine ◽

10.1111/j.1743-6109.2012.02947.x ◽

2012 ◽

Vol 9 (12) ◽

pp. 3227-3238 ◽

Cited By ~ 8

Author(s):

Giulia Rastrelli ◽

Giovanni Corona ◽

Alessandra D. Fisher ◽

Antonio Silverii ◽

Edoardo Mannucci ◽

...

Keyword(s):

Risk Factors ◽

Sexual Dysfunction ◽

Sexual Desire ◽

Cardiovascular Events ◽

Major Adverse Cardiovascular Events ◽

Low Education ◽

Conventional Risk Factors

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Contribution of cardio-ankle vascular index to prediction of cardiovascular events in the adult urban population: data from the ESSE-RF study (Tomsk)

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2021-2967 ◽

2021 ◽

Vol 20 (5) ◽

pp. 2967

Author(s):

A. R. Zairova ◽

A. N. Rogoza ◽

E. V. Oshchepkova ◽

E. B. Yarovaya ◽

V. A. Kutsenko ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Events ◽

Urban Population ◽

Population Data ◽

Cardiovascular Death ◽

Risk Criterion ◽

Composite Endpoints ◽

Conventional Risk Factors

Aim. To determine the role of cardio-ankle vascular index (CAVI) in predicting cardiovascular events (CVEs) in adult Russian population using model of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study (Tomsk).Material and methods. We analyzed the data of 1342 people aged 25-64 (4,3±11,6) years, in whom arterial stiffness was assessed as part of the ESSE-RF study using the vascular screening system VaSeraVS-1500, followed by phone contacts, on average, 4,7 years later. We studied the prognostic role of CAVI in relation to primary composite (cardiovascular death, nonfatal myocardial infarction (MI) or stroke) and secondary composite (all CVEs) endpoints.Results. We revealed that prior myocardial infarction or stroke (n=52) is associated with an increase in CVE incidence from 2,3 to 11,5% (p=0,0003) and from 5% to 23% (p<0,001) for primary and secondary composite endpoints, respectively. In a group of 1290 people (without prior MI or stroke), CAVI was significantly higher in men than in women: 7,4±1,4 vs 7,1±1,3 (p=0,002), despite more young age: 45,4±11,8 vs 48,0±11,3 years (p<0,001). The risk criterion for CVE was CAVI >7,8 (relative risk (RR): 5,06; 95% confidence interval (CI): 2,32-11,06) (p<0,001) and (RR: 3,95; 95% CI: 2,37-6,58) (p<0,001), which retains its predictive value when adjusted for conventional risk factors (RR: 3,13; 95% CI: 1,26-7,75) (p=0,014) and (RR: 2,16; 95% CI: 1,18-3,98) (p=0,013) — primary and secondary composite endpoints, respectively.Conclusion. CAVI has a significant independent value in predicting CVEs in Tomsk adult urban population aged 25-64 years. To clarify the cardiovascular risk, vascular screening with identifying CAVI should be carried out during preventive and screening examinations for men over 35 and women over 45.

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Strength of Fibroblast Growth Factor 23 as a Cardiovascular Risk Predictor in Chronic Kidney Disease Weaken by ProBNP Adjustment

American Journal of Nephrology ◽

10.1159/000497125 ◽

2019 ◽

Vol 49 (3) ◽

pp. 203-211 ◽

Cited By ~ 4

Author(s):

Insa E. Emrich ◽

Vincent Brandenburg ◽

Alexander B. Sellier ◽

Johanna Schauerte ◽

Johanna Wiedenroth ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Chronic Kidney Disease ◽

Growth Factor ◽

Kidney Disease ◽

Cardiovascular Events ◽

Fibroblast Growth Factor 23 ◽

Cardiovascular Effects ◽

Fibroblast Growth ◽

Conventional Risk Factors

Background: Various epidemiological studies linked high fibroblast growth factor 23 (FGF23) levels with cardiovascular events in chronic kidney disease (CKD). It remains enigmatic whether high FGF23 exerts adverse cardiovascular effects, or whether it reflects detrimental effects of residual confounders. Earlier studies adjusted for CKD-mineral bone disease (CKD-MBD) regulators of FGF23 rather than for recently discovered non-CKD-MBD regulators, among which iron deficiency and heart failure are of particular importance. Moreover, they used c-terminal FGF23 (cFGF23) assays rather than more specific intact FGF23 (iFGF23) assays. Methods: The CARE FOR HOMe study analyzed plasma ferritin, iFGF23, cFGF23 and N-terminal proBNP (NT-proBNP) along with conventional risk factors, among 575 CKD G2-G4 patients to determine the interaction between FGF23, its non-CKD-MBD regulators, and incident cardiovascular events in CKD patients. The participants were followed up for 5.1 ± 2.1 years for the occurrence of atherosclerotic events and hospitalization for acute decompensated heart failure. Results: cFGF23 correlated strongly with high iFGF23 (r = 0.607), fairly with high NT-proBNP (r = 0.453) and weakly with low ferritin (r = –0.207); correlation coefficients of iFGF23 with NT-proBNP and ferritin were numerically lower. In Kaplan-Meier analyses, both endpoints were predicted by cFGF23 and iFGF23. In Cox regression models, cFGF23 remained an outcome predictor after adjustment for conventional risk factors and ferritin. This prediction was largely eliminated when further adjusting for NT-proBNP. iFGF23 was less consistently associated with adverse outcome in partly adjusted models, and failed to predict outcome in fully adjusted models. Conclusion: In summary, iron deficiency and heart failure affect plasma FGF23. As adjustment for NT-proBNP virtually eliminates the association between plasma FGF23 and predefined outcome, we speculate that high FGF23, rather than exerting detrimental cardiovascular effects, mirrors prevalent heart disease.

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