scholarly journals Genetic Covariation between Serum γ-Glutamyltransferase Activity and Cardiovascular Risk Factors

2002 ◽  
Vol 48 (9) ◽  
pp. 1426-1431 ◽  
Author(s):  
John B Whitfield ◽  
Gu Zhu ◽  
John E Nestler ◽  
Andrew C Heath ◽  
Nicholas G Martin
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Environmental Factors ◽  
Cardiovascular Risk Factors ◽  
Model Fitting ◽  
Telephone Interviews ◽  
Risk Of Death ◽  
Likelihood Model ◽  
Sources Of Variation ◽  
Genetic And Environmental Factors

Abstract Background: Several studies have shown that variation in serum γ-glutamyltransferase (GGT) in the population is associated with risk of death or development of cardiovascular disease, type 2 diabetes, stroke, or hypertension. This association is only partly explained by associations between GGT and recognized risk factors. Our aim was to estimate the relative importance of genetic and environmental sources of variation in GGT as well as genetic and environmental sources of covariation between GGT and other liver enzymes and markers of cardiovascular risk in adult twin pairs. Methods: We recruited 1134 men and 2241 women through the Australian Twin Registry. Data were collected through mailed questionnaires, telephone interviews, and by analysis of blood samples. Sources of variation in GGT, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) and of covariation between GGT and cardiovascular risk factors were assessed by maximum-likelihood model-fitting. Results: Serum GGT, ALT, and AST were affected by additive genetic and nonshared environmental factors, with heritabilities estimated at 0.52, 0.48, and 0.32, respectively. One-half of the genetic variance in GGT was shared with ALT, AST, or both. There were highly significant correlations between GGT and body mass index; serum lipids, lipoproteins, glucose, and insulin; and blood pressure. These correlations were more attributable to genes that affect both GGT and known cardiovascular risk factors than to environmental factors. Conclusions: Variation in serum enzymes that reflect liver function showed significant genetic effects, and there was evidence that both genetic and environmental factors that affect these enzymes can also affect cardiovascular risk.

scholarly journals Are the Variants of the Circle of Willis Determined by Genetic or Environmental Factors? Results of a Twin Study and Review of the Literature

2018 ◽  
Vol 21 (5) ◽  
pp. 384-393 ◽  
Author(s):  
Bianka Forgo ◽  
Adam Domonkos Tarnoki ◽  
David Laszlo Tarnoki ◽  
Daniel Tamas Kovacs ◽  
Laszlo Szalontai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Cardiovascular Risk ◽  
Environmental Factors ◽  
Cardiovascular Risk Factors ◽  
Transcranial Doppler Sonography ◽  
Circle Of Willis ◽  
Significant Difference ◽  
Altered Blood ◽  
Mz Twins

Background: Anatomic variants of the circle of Willis (CW) are commonly observed in healthy subjects. Genetic and environmental factors influencing these variants remain unclear. Our aim was to assess the genetic and environmental background affecting variant CW phenotypes. Methods: A total of 122 adult healthy twins from the Hungarian Twin Registry (39 monozygotic (MZ) and 22 dizygotic (DZ) pairs, average age 49.7 ± 13.4 years) underwent Time-of-Flight magnetic resonance angiography and transcranial Doppler sonography. We investigated the anterior and posterior CW according to morphological categories. Prevalence and concordance rates of CW variants were calculated. MZ twins discordant for CW variants were analyzed for cardiovascular risk factors and altered blood flow. Results: Complete CW (45.0%) and bilaterally absent posterior communicating artery (PCoA) (22.5%) were the most prevalent variants in the anterior and posterior CW, respectively. There was no significant difference regarding the prevalence of variants across zygosity except for bilaterally hypoplastic PCoA (p = .02). DZ concordance was higher compared to MZ twins regarding morphological categories of the CW. Cardiovascular risk factors were not significantly associated with variant CW in MZ twins discordant to CW morphology. Flow parameters did not differ significantly among MZ twins discordant to CW variants. Conclusion: CW variants may not be determined by substantial genetic effects and are not influenced by altered blood flow in healthy individuals. Further investigations are needed to identify potential environmental factors affecting these variants.

scholarly journals Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study

2017 ◽  
Vol 25 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Andrea Milde Øhrn ◽  
Henrik Schirmer ◽  
Inger Njølstad ◽  
Ellisiv B Mathiesen ◽  
Anne E Eggen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Hazard Ratio ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Traditional Risk Factors

Background Unrecognized myocardial infarction (MI) is a frequent and intriguing entity associated with a similar risk of death as recognized MI. Previous studies have not fully addressed whether the poor prognosis is explained by traditional cardiovascular risk factors. We investigated whether electrocardiographically detected unrecognized MI was independently associated with cardiovascular events and death and whether it improved prediction for future MI in a general population. Design Prospective cohort study. Methods We studied 5686 women and men without clinically recognized MI at baseline in 2007–2008. We assessed the risk of future MI, stroke and all-cause mortality in persons with unrecognized MI compared with persons with no MI during 31,051 person-years of follow-up. Results In the unadjusted analyses, unrecognized MI was associated with increased risk of future recognized MI (hazard ratio 1.84, 95% confidence interval (CI) 1.15–2.96) and all-cause mortality (hazard ratio 1.78, 95% CI 1.21–2.61), but not stroke (hazard ratio 1.09, 95% CI 0.56–2.17). The associations did not remain significant after adjustment for traditional risk factors (hazard ratio 1.25, 95% CI 0.76–2.06 and hazard ratio 1.38, 95% CI 0.93–2.05) for MI and all-cause mortality respectively. Unrecognized MI did not improve risk prediction for future recognized MI using the Framingham Risk Score ( p = 0.96) or the European Systematic COronary Risk Evaluation ( p = 0.65). There was no significant sex interaction regarding any of the endpoints. Conclusion Electrocardiographic unrecognized MI was not significantly associated with future risk of MI, stroke or all-cause mortality in the general population after adjustment for the traditional cardiovascular risk factors, and it did not improve prediction of future MI.

scholarly journals Combined effect of menopause and cardiovascular risk factors on death and cardiovascular disease: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Li ◽  
Dong Zhao ◽  
Miao Wang ◽  
Jia-yi Sun ◽  
Jun Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Elevated Risk ◽  
Combined Effect ◽  
Age At Menopause ◽  
Risk Of Death

Abstract Background Observational studies suggest that early menopause is associated with increased risk of death and cardiovascular disease (CVD); however, the results of these studies have been inconsistently. We aimed to assess the association of menopause with death and CVD and whether this association was modified by cardiovascular risk factors. Methods The study population was women age 35–64 years living in two communities of Beijing who were enrolled in the Chinese Multi-provincial Cohort Study in 1992. Participants were followed until first cardiovascular event, death, or the end of follow-up (2018). Self-reported age at menopause was recorded. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of death and CVD after adjusting for baseline covariates of age, family history of CVD, and white blood cell count, as well as time-varying covariates of menopause, use of oral estrogen, and conventional risk factors. Additionally, we assessed the combined effect of age at menopause and risk factors on the primary endpoint. Results Of 2104 eligible women, 124 died and 196 had a first CVD event (33 fatal CVD and 163 non-fatal CVD). Compared with women who experienced menopause at age 50–51 years, the risk of death was higher in women with menopause at age 45–49 years (HR 1.99, 95% CI 1.24–3.21; P = 0.005), and the risk of ischemic stroke was higher in women with menopause at age < 45 years (HR 2.16, 95% CI 1.04–4.51; P = 0.04) and at age 45–49 years (HR 2.05, 95% CI 1.15–3.63; P = 0.01). Women who had menopause before age 50 years and at least one elevated risk factor at baseline had a higher risk of death (HR 11.10, 95% CI 1.51–81.41; P = 0.02), CVD (HR 3.98, 95% CI 1.58–10.01; P = 0.003), ischemic CVD (HR 4.53, 95% CI 1.63–12.62; P = 0.004), coronary heart disease (HR 8.63, 95% CI 1.15–64.50; P = 0.04), and stroke (HR 2.92, 95% CI 1.03–8.29; P = 0.04) than those with menopause at age 50–51 years and optimal levels of all risk factors. Conclusions Earlier menopause may predict death and ischemic stroke. Furthermore, there is a combined effect of earlier menopause and elevated risk factors on death and CVD.

QT interval, cardiovascular risk factors and risk of death in diabetes

2004 ◽  
Vol 27 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Massimo Veglio ◽  
A. Chinaglia ◽  
P. Cavallo-Perin
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Qt Interval ◽  
Risk Of Death

Abstract 16378: Growth Differentiation Factor-15 Independently Predicts 2 Year Mortality in Patients With Acute Coronary Syndrome: Observations From the A to Z Trial

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ethan C Kosova ◽  
James A de Lemos ◽  
Petr Jarolim ◽  
Jianping Guo ◽  
Eugene Braunwald ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Mortality Risk ◽  
Growth Differentiation Factor 15 ◽  
Inflammatory Biomarker ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Net Reclassification Improvement ◽  
Differentiation Factor

BACKGROUND: Growth Differentiation Factor-15 (GDF-15) is an inflammatory biomarker upregulated in the setting of myocardial stress that we and others have shown to have potential prognostic value in cardiovascular (CV) disease. However, any role for GDF-15 along with traditional CV risk factors and biomarkers in predicting long term mortality after ACS remains investigational. METHODS: We measured the plasma concentration of GDF-15 after stabilization of ACS in 4,179 patients (pts) presenting with UA/NSTEMI or STEMI enrolled in the A to Z Trial. Established, pre-specified cutoffs of GDF-15 (<1200, 1200-1800, and >1800 ng/L) were used for analysis. Outcomes were followed through the end of the study (median 2 years). RESULTS: Pts with GDF-15 >1800 ng/L had significantly higher 2 year mortality rates than those with levels of 1200-1800 or <1200 ng/L (14.8%, 9.7%, and 3.2%, respectively; P<0.001, Fig-1A). After adjusting for age, sex, hypertension, diabetes, renal function, STEMI vs NSTEACS, heart failure, B-type natriuretic peptide (BNP) and C-reactive protein (CRP), pts with GDF-15 >1800 ng/L were at a significantly higher risk of death at 2yr (HR 1.88; 95% CI, 1.25-2.83) compared to those with GDF-15 levels <1200 ng/L. Even in pts with low baseline BNP levels (<80 pg/mL), a GDF-15 level >1800 ng/L was associated with higher mortality risk compared with pts with levels of 1200-1800 or <1200 ng/L (11.8%, 7.9%, and 3.0% respectively; P<0.001, Fig-1B). Addition of GDF-15 to a model including traditional cardiovascular risk factors, BNP, and CRP resulted in significant net reclassification improvement (P<0.001). CONCLUSIONS: GDF-15 obtained in patients with established CAD stabilized after ACS is independently associated with increased mortality at 2 yrs. GDF-15 identifies additional mortality risk not currently captured by cardiovascular risk factors, BNP, or CRP. This finding supports GDF-15 as a potential aid for prognostic assessment in patients with ACS.

Renal function and attributable risk of death and cardiovascular hospitalization in patients with cardiovascular risk factors from a registry-based cohort

2016 ◽  
Vol 34 (11) ◽  
pp. 2266-2273 ◽  
Author(s):  
Maria Tellez-Plaza ◽  
Domingo Orozco-Beltran ◽  
Vicente Gil-Guillen ◽  
Salvador Pita-Fernandez ◽  
Jorge Navarro-Pérez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Attributable Risk ◽  
Risk Of Death

scholarly journals The impact of modern cardiovascular risk factors associated with metabolic syndrome on long-term outcome

2015 ◽  
Vol 10 (4) ◽  
pp. 380-387
Author(s):  
Gabriel Cristian BEJAN ◽  
◽  
Liviu Nicolae GHILENCEA ◽  
Mihaela Adela IANCU ◽  
Mihaela Daniela BALTĂ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Apo B ◽  
Long Term Outcome ◽  
Factors Associated ◽  
Risk Of Death ◽  
The Impact

Metabolic syndrome is also called insulin resistance syndrome or catecholamine excess syndrome and is a cluster of cardiometabolic factors that result in increased incidence of cardiovascular disease and diabetes type 2. Due to sedentary lifestyle and hypercaloric diet with an increased content of saturated fat and carbohydrates that characterizes modern life style of the population, especially in urban areas, the prevalence of metabolic syndrome is increasing, thus becoming a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, aged between 48 and 83 years, who have determined the prevalence of modern cardiovascular risk factors such as hs CRP, serum uric acid, 24-hour proteinuria, serum fibrinogen and the ratio of apo B/apo A1, associated with the metabolic syndrome. The study was conducted separately by gender in the sense that we followed prevalence of these modern risk factors associated with metabolic syndrome in both genders, women and men. We also watched the influence of risk factors related to lifestyle on metabolic syndrome. Finally, we determined the correlation of these factors with the risk of death from cardiovascular disease to observe their influence on the prognosis of metabolic syndrome.

scholarly journals N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort

2021 ◽  
Author(s):  
Christian O’Donnell ◽  
Melanie D. Ashland ◽  
Elena C. Vasti ◽  
Ying Lu ◽  
Andrew Y. Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Hospital Mortality ◽  
Cardiovascular Risk Factors ◽  
Natriuretic Peptide ◽  
Fold Increase ◽  
Cardiac Events ◽  
Risk Of Death ◽  
Increased Risk

Background Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality. Methods and Results In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%; P <0.001) and shorter median time to death (7 versus 9 days; P <0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%; P <0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest ( P <0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34). Conclusions Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.

scholarly journals Depression and mortality in a high-risk population

2002 ◽  
Vol 181 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Melanie Abas ◽  
Matthew Hotopf ◽  
Martin Prince
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cognitive Decline ◽  
Cardiovascular Risk Factors ◽  
Controlled Trial ◽  
High Risk Population ◽  
Risk Of Death ◽  
History Of ◽  
Antidepressant Use ◽  
Randomised Controlled

BackgroundIt is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables.AimsTo measure the effect of depression on mortality after controlling for cognitive decline, cardiovascular risk factors and antidepressant use.MethodA prospective cohort study derived from data from a multi-centre randomised controlled trial of moderate hypertension. Atotal of2584 participants, aged 65–75 years at study entry, were followed up for 11 years.ResultsDepression on the SelfCARE-D scale was associated with mortality after controlling for gender. After controling for cardiovascular risk factors, cognitive decline and anti-depressant use, depression continued to have a modest effect (hazard ratio⩵l.43; 95% CI 1.03–1.98). Depression in males and in people aged under 70 years significantly increased the risk of death.ConclusionsDepression was associated with mortality only after controlling for gender. There was a modest but robust association between depression and mortality that was not explained by confounding by cardiovascular risk factors, cognitive decline or history of antidepressant use.

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