scholarly journals Modifiable Factors for Coronary Artery Disease, Myocardial Infarction, and Stroke: A Mendelian Randomisation Analysis (P15-006-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Tao Huang

Abstract Objectives We aimed to examine the causal associations of potentially risk factors, including lifestyle/dietary, cardiometabolic, and inflammatory factors, with risks of coronary artery disease (CAD), myocardial infarction (MI), and stroke. Methods We used single nucleotide polymorphisms (SNPs) associated with risk factors as instrumental variables to test the causal effect of risk factors on cardiovascular diseases using summary-level data from consortia. Results A total of 53 potentially risk factors were included. A Bonferroni corrected threshold of P = 0.00094 was considered to be significant. Genetically predicted higher BMI (odds ratio: 1.43, confidence interval: 1.26 to1.63 per 1 kg/m2, P = 7.64 × 10−8), smoking initiation (1.62, 1.42 to1.85 per year, P = 2.72 × 10−12), vitamin E (3.22, 1.81 to 4.63, P = 1.33 × 10−6). sIL-6R (1.63, 1.22 to 2.05, P = 0.0002), LDL (1.60, 1.46 to 1.75, P = 8.78 × 10−23), TC (1.48, 1.34 to 1.64, P = 1.14 × 10−13), TG (1.27, 1.13 to 1.43, P = 7.32 × 10−5), SBP (1.03, 1.02 to 1.05, P = 6.8 × 10−5), asthma (1.07, 1.05 to 1.09, P = 3.94 × 10−12), T2DM (1.12, 1.08 to 1.17, P = 4.37 × 10−8) were associated with higher risk of CAD; whilst, genetically predicted education (0.64, 0.55 to 0.75 per year, P = 2.68 × 10−8), and HDL (0.84, 0.76 to 0.92, P = 0.0003) were associated with lower risk of CAD. Similar results were observed for MI. In addition, atrial firillation (1.24, 1.18 to 1.30 P = 2.75 × 10−17), carotid artery plaque (1.24, 1.10 to 1.41, P = 0.0006), asthma (1.04 to 1.02, 1.06, P = 6.81 × 10−5), and T2DM (1.09, 1.04 to 1.14, P = 0.0002) were associated with higher risk of stroke per unit increase in log odds. We further observed suggestive associations of morning person, iron, fasting glucose, insulin, HbA1c, uric acid, and pulse pressure with CAD and suggestive associations of education, intelligence, Hcy, HDL, and pulse pressure with stroke. Conclusions Our results identified several modifiable factors as treatment targets for prevention of CAD, MI, or stroke. Funding Sources None. Supporting Tables, Images and/or Graphs

2018 ◽  
Author(s):  
Robyn E Wootton ◽  
Rebecca B Lawn ◽  
Louise A C Millard ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
...  

AbstractObjectivesTo investigate whether the association between subjective wellbeing (subjective happiness and life satisfaction) and physical health is causal.DesignWe conducted two-sample bidirectional Mendelian randomisation between subjective wellbeing and six measures of physical health: coronary artery disease, myocardial infarction, total cholesterol, HDL cholesterol, LDL cholesterol and body mass index (BMI).ParticipantsWe used summary data from four large genome-wide association study consortia: CARDIoGRAMplusC4D for coronary artery disease and myocardial infarction; the Global Lipids Genetics Consortium for cholesterol measures; the Genetic Investigation of Anthropometric Traits consortium for BMI; and the Social Science Genetics Association Consortium for subjective wellbeing. A replication analysis was conducted using 337,112 individuals from the UK Biobank (54% female, mean age =56.87, SD=8.00 years at recruitment).Main outcome measuresCoronary artery disease, myocardial infarction, total cholesterol, HDL cholesterol, LDL cholesterol, BMI and subjective wellbeing.ResultsThere was evidence of a causal effect of BMI on subjective wellbeing such that each 1 kg/m2 increase in BMI caused a 0.045 (95%CI 0.006 to 0.084, p=0.023) SD reduction in subjective wellbeing. Replication analyses provided strong evidence of an effect of BMI on satisfaction with health (β=0.034 (95% CI: −0.042 to −0.026) unit decrease in health satisfaction per SD increase in BMI, p<2-16). There was no clear evidence of a causal effect between subjective wellbeing and the other physical health measures in either direction.ConclusionsOur results suggest that a higher BMI lowers subjective wellbeing. Our replication analysis confirmed this finding, suggesting the effect in middle-age is driven by satisfaction with health. BMI is a modifiable determinant and therefore, our study provides further motivation to tackle the obesity epidemic because of the knock-on effects of higher BMI on subjective wellbeing.


2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.


2021 ◽  
Author(s):  
Daniel Hui ◽  
Christopher S. Thom ◽  
Kimberly Lorenz ◽  
Scott M. Damrauer ◽  
Themistocles L. Assimes ◽  
...  

An inverse correlation between stature and risk of coronary artery disease (CAD) has been observed in several epidemiologic studies, and recent Mendelian randomization (MR) experiments have suggested evidence that this association may be causal. However, the extent to which the effect estimated by MR can be explained by established cardiovascular risk factors is unclear, with a recent report suggesting that lung function traits could fully explain the height-CAD effect. To clarify this relationship, we utilized the largest set of genetic instruments for human stature to date, comprising >2,000 genetic variants for height and CAD. In univariable analysis, we confirmed that a one standard deviation decrease in height (~6.5 cm) was associated with a 12.0% increase in the risk of CAD, consistent with previous reports. In multivariable analysis accounting for effects from up to 12 established risk factors, we observed a >3-fold attenuation in the causal effect of height on CAD susceptibility (3.7%, p = 2.1x10-2). We observed minimal effects of lung function traits on CAD risk in our analyses, indicating that these traits are unlikely to explain the residual association between height and CAD risk. In sum, these results suggest that height does not add meaningful clinical impact on CAD risk prediction beyond established risk factors.


2004 ◽  
Vol 3 (3) ◽  
pp. 19-21
Author(s):  
S Regmi ◽  
R Malla ◽  
S Rajbhandari ◽  
MB KC ◽  
D Sharma ◽  
...  

Coronary Artery disease (CAD) remains a major health problem. Stable angina, unstable angina and myocardial infarction are the major manifestations of CAD. This study is aimed to assess the coronary artery profile in these groups and its relation to the major conventional risk factors and the distribution of the disease in differant ethnic group of Napalase population.


Author(s):  
Mariana Garcia ◽  
Zakaria Almuwaqqat ◽  
Kasra Moazzami ◽  
An Young ◽  
Bruno B. Lima ◽  
...  

Background Black patients tend to develop coronary artery disease at a younger age than other groups. Previous data on racial disparities in outcomes of myocardial infarction (MI) have been inconsistent and limited to older populations. Our objective was to investigate racial differences in the outcome of MI among young and middle‐aged patients and the role played by socioeconomic, psychosocial, and clinical differences. Methods and Results We studied 313 participants (65% non‐Hispanic Black) <61 years old hospitalized for confirmed type 1 MI at Emory‐affiliated hospitals and followed them for 5 years. We used Cox proportional‐hazard models to estimate the association of race with a composite end point of recurrent MI, stroke, heart failure, or cardiovascular death after adjusting for demographic, socioeceonomic status, psychological, and clinical risk factors. The mean age was 50 years, and 50% were women. Compared with non‐Black patients, Black patients had lower socioeconomic status and more clinical and psychosocial risk factors but less angiographic coronary artery disease. The 5‐year incidence of cardiovascular events was higher in Black (35%) compared to non‐Black patients (19%): hazard ratio (HR) 2.1, 95% CI, 1.3 to 3.6. Adjustment for socioeconomic status weakened the association (HR 1.3, 95% CI, 0.8–2.4) more than adjustment for clinical and psychological risk factors. A lower income explained 46% of the race‐related disparity in outcome. Conclusions Among young and middle‐aged adult survivors of an MI, Black patients have a 2‐fold higher risk of adverse outcomes, which is largely driven by upstream socioeconomic factors rather than downstream psychological and clinical risk factors.


Author(s):  
Dr. Jitendra Kodilkar ◽  
Dr Jeetendra Singh ◽  
Dr. Akash Berad ◽  
Dr. Mayur Babras ◽  
Dr. Imran Pinjari ◽  
...  

Background: To assess risk factors for coronary artery disease and their correlation with thyroid hormone profile amongst women with ST segment elevation in acute myocardial infarction. Method: A total number of 78 females having ST elevation myocardial infarction diagnosed through detailed clinical history and ECG evaluations were included after they satisfy the eligibility criteria. Patients were subsequently evaluated for presence of risk factors of ischemic heart disease such age, marital status, parity, and menopause, use of oral contraceptives, family history, obesity, diabetes mellitus, hypertension, hypercholesterolemia and hypertriglyceridemia. Their thyroid hormone profiles (T3, T4, TSH) were done and were correlated with risk factors for ischemic heart disease. Result: A total 78 patient included in the study. Most of the study population belongs to the age group of 40 to 50 years (43.6 %). Hypertension was the most common clinical features amongst study population (59%) followed by Diabetes (50%). most of the study population had Normal Thyroid status (57.69%) followed by Hypothyroidism (25.64%) and Hyperthyroidism (16.67%). and SERUM TSH is the most sensitive test for evaluation. Diabetes Mellitus was statistically significant risk factor (p value <0.05) in patients with STEMI with different levels of thyroid. Conclusion: Patients with coronary artery disease especially in the presence of other risk factors should be screened for diabetes and also for thyroid dysfunction as in our study cases of Hypothyroidism was seen in 25.64% of the population under study. Hence it can be postulated that hypothyroidism may be a predictor for myocardial injury in STEMI. Here we recommend that tests for thyroid disorders in acute coronary syndrome can give predictor for risk of morbidity and mortality in those subjects. These results also may warrant further larger study to investigate whether reversing the hypothyroidism could benefit the STEMI patients. Keywords: STEMI- ST segment elevation myocardial infarction, MI- Myocardial Infarction, Hyperthyroidism, Hypothyroidism, TSH- Thyroid Stimulating Hormone


Author(s):  
Negar Omidi ◽  
Saeed Sadeghian ◽  
Mojtaba Salarifar ◽  
Arash Jalali ◽  
Seyed Hesameddin Abbasi ◽  
...  

Background: Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide. We sought to evaluate the correlation between the severity of coronary artery disease (CAD) and conventional coronary artery risk factors in a large cohort of patients with ACS. Methods: This study included all patients admitted to the coronary care unit with a diagnosis of ACS between 2003 and 2017. The patients were divided into 2 groups: 1) unstable angina and 2) myocardial infarction. The aims of this study were to evaluate the effects of the risk factors and extension of coronary artery stenosis in patients with ACS according to the Gensini score. Results: Of a total 40 319 patients who presented with ACS, 18 862 patients (mean age =60.4±11.14 y, male: 67.2%) underwent conventional coronary angiography and met our criteria to enter the final analysis. The median of the Gensini score was 50 (25–88) in the study population. The multivariable analysis showed that age, sex, diabetes mellitus, hypertension, dyslipidemia, family history, cigarette smoking, opium consumption, and myocardial infarction increased the risk of positive Gensini scores. All the aforementioned risk factors, except cigarette smoking and opium consumption, increased the severity of stenosis in those with positive Gensini scores. The strongest relationship was seen vis-à-vis myocardial infarction, sex, and diabetes mellitus. Conclusion: Our findings suggest that age, sex, diabetes mellitus, dyslipidemia, hypertension, family history, and myocardial infarction have significant effects on the severity of CAD. The obesity paradox in relation to CAD should be taken into consideration and needs further investigation in patients with ACS.


2014 ◽  
Vol 15 (2) ◽  
pp. 135-140
Author(s):  
NS Neki

Coronary artery disease (CAD) - which includes coronary atherosclerotic disease, myocardial infarction (MI), acute coronary syndrome and angina - is the most prevalent form of cardiovascular disease and is the largest subset of this mortality. Coronary artery disease (CAD) is a leading cause of death of women and men  worldwide. CAD’s impact on women traditionally has been underappreciated due to higher rates at younger ages in men. Microvascular coronary disease disproportionately affects women. Women have unique risk factors for CAD, including those related to pregnancy and autoimmune disease.DOI: http://dx.doi.org/10.3329/jom.v15i2.20687 J MEDICINE 2014; 15 : 135-140


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