scholarly journals A diet-related microsimulation modelling approach in the context of cardiovascular disease prevention: the ATTICA and GREECS epidemiological studies

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Kouvari ◽  
T Tsiampalis ◽  
C Chrysohoou ◽  
V Notara ◽  
E Georgousopoulou ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mediterranean Diet ◽  
Epidemiological Studies ◽  
Added Value ◽  
Total N ◽  
Individual Level ◽  
Coronary Syndrome ◽  
Funding Sources ◽  
Incidence And Mortality ◽  
Higher Weights

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The ATTICA study is supported by research grants from the Hellenic Cardiology Society [HCS2002] and the Hellenic Atherosclerosis Society [HAS2003]. Background/Introduction: Among all behaviors, nutrition makes the largest contribution to cardiovascular disease (CVD) morbidity across Europe. Purpose: The aim of the present work was to quantify the changes in 10-year CVD onset or recurrence or mortality, in relation to transitioning from low to higher level of adherence to Mediterranean diet. Methods: An individual-level microsimulation was created based on ATTICA (2002-2012, n = 3042 subjects free-of-CVD) and GREECS (2004-2014, n = 2172 patients with acute coronary syndrome (ACS)) studies (in total n = 5214). Eight scenarios regarding the proportion of participants and the size of improvement of level of adherence to Mediterranean diet were compared in terms of relative change in CVD incidence and mortality, as well as, the number of preventable CVD events and deaths. Results: Improving the level of adherence to the Mediterranean diet, even in 10% of the population, a significant relative percentage reduction was observed in the 10-year risk for CVD onset, recurrence and mortality, with the observed reductions being higher among women. In particular, at least 851 first CVD events, 374 recurrent CVD events and 205 CVD deaths per 100,000 of population could be averted or delayed. Additionally, Mediterranean diet clustering revealed that high consumption of fruits, vegetables, whole wheat products and legumes was more important than low consumption of meat and full fat dairy products against CVD. Conclusion: This microsimulation process confirms the added value of Mediterranean diet in primary and secondary CVD prevention having great achievements even with small modifications on a population basis, while challenges the orientation of a Mediterranean-diet intervention giving higher weights to plant-based part.

The role of triglycerides-glucose index to predict 10-year first and recurrent cardiovascular disease events: a sex-based analysis from ATTICA and GREECS prospective studies

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kouvari ◽  
D.B Panagiotakos ◽  
C Chrysohoou ◽  
V Notara ◽  
M Yannakoulia ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cox Regression ◽  
Liver Steatosis ◽  
Added Value ◽  
Funding Source ◽  
Classification Rate ◽  
Cox Regression Analysis ◽  
Coronary Syndrome

Abstract Background/Introduction Triglycerides-glucose index (TyG) has been used in apparently healthy individuals to define insulin resistance and liver steatosis. Additionally, findings from very recent studies challenge the use of this index as a predictor of cardiovascular disease (CVD) onset as well as a marker of atherosclerosis in patients with established CVD. Purpose To evaluate the association between TyG and 10-year first or recurrent fatal/non fatal CVD event. Methods The samples from two prospective epidemiological studies implemented in Greece were used. In particular, in ATTICA study, in 2001–02, 1,514 men and 1,528 women (>18 years) free of CVD, at baseline, living in greater Athens area, Greece, were enrolled and 10-year follow up was performed (2011–12) in 2,020 participants (n=317 cases). In GREECS study, in 2003–04 almost all consecutive 2,172 acute coronary syndrome (ACS) patients of 6 Greek hospitals were enrolled. In 2013–14, 10-year follow-up was performed in 1,918 participants. TyG was assessed at baseline using a standard formula. Results In ATTICA, ranking from 1st (i.e. <8.0) to 3rd TyG tertile (i.e. >8.6), 10-year first CVD incidence was 5.6%, 14.2% and 24.1% (p<0.001); the respective man-to-woman incidence ratio was 1.86, 1.17 and 1.19. In GREECS, ranking from 1st (i.e. <8.7) to 3rd TyG tertile (i.e. >9.3), 10-year recurrent CVD incidence was 35.3%, 43.2% and 35.9% (p=0.11); the respective man-to-woman incidence ratio was 1.08, 0.99 and 1.23. Multi-adjusted Cox regression analysis in ATTICA study revealed that participants assigned in the 3rd TyG tertile had about 77% higher CVD risk compared with their 1st tertile counterparts [Hazard Ratio (HR)=1.77, 95% Confidence Interval (95% CI) (1.06, 2.96), p=0.02]; sex-based stratified analysis revealed that this association remained significant only in women [HR=2.29 95% CI (1.20, 4.38), p=0.01] while in case of men this association was borderline significant [HR=1.70 95% CI (0.95, 3.35), p=0.10]. The total correct classification rate was around 83–85% in all models and similar with models adjusted separately for triglycerides or glucose levels. Using the area under the Receiver Operation Characteristic ROC) curve (AUC) analysis TyG had the best discriminative ability in both sexes with a small advantage in favor of women and minor discrepancies with the commonly used –triglycerides and glucose– biomarkers (Women: AUCTyG=0.694, AUCtriglycerides=0.678, AUCglucose=0.601 / Men: AUCTyG=0.662, AUCtriglycerides=0.634, AUCglucose=0.623). In case of GREECS study, no significant trends were observed. Conclusions The findings here suggest a predictive role of TyG against long-term CVD onset which comes in line with recent works; yet its added value against conventional markers such as glucose and triglycerides was not confirmed. Additionally, no significant prognostic effect of TyG against CVD recurrence was observed challenging its clinical use in secondary prevention spectrum. Funding Acknowledgement Type of funding source: Other. Main funding source(s): This work was supported by a research grant from Hellenic Atherosclerosis Society. The ATTICA study is supported by research grants from the Hellenic Cardiology Society [HCS2002] and the Hellenic Atherosclerosis Society [HAS2003].

Hyperuricemia as risk factor for cardiovascular disease – what’s new?

2020 ◽  
pp. 5-11
Author(s):  
Yu. V. Zhernakova
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Epidemiological Studies ◽  
Point Of View ◽  
Medical Society ◽  
High Cardiovascular Risk ◽  
Management Algorithm ◽  
Russian Medical

A significant number of epidemiological studies have shown that hyperuricemia is highly associated with the risk of developing cardiovascular disease, chronic kidney disease, and diabetes. In this connection, increased attention is required to monitor serum uric acid levels in patients, not only from a rheumatological point of view, but also with regard to reducing cardiovascular and renal risks. This article is a review of studies on the association of hyperuricemia with cardiovascular risk and a new consensus for the management of patients with hyperuricemia and high cardiovascular risk, published in december 2019 by a group of experts of the Russian Medical Society for Arterial Hypertension, which, among other things, includes a management algorithm of this category of patients.

scholarly journals High-Density Lipoproteins and Cardiovascular Disease: The Good, the Bad and the Future

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 857
Author(s):  
Josep Julve ◽  
Joan Carles Escolà-Gil
Keyword(s):  
Cardiovascular Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Epidemiological Studies ◽  
High Density ◽  
High Density Lipoproteins ◽  
Atherosclerotic Cardiovascular Disease ◽  
Plasma High Density ◽  
Low Levels

Epidemiological studies have shown that low levels of plasma high-density lipoprotein cholesterol (HDL-C) are associated with increased atherosclerotic cardiovascular disease (CVD) [...]

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