scholarly journals Very similar cardiometabolic profile in the moderate and high cardiovascular risk classes: a population-based study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Chlabicz ◽  
J Jamolkowski ◽  
W Laguna ◽  
P Sowa ◽  
M Paniczko ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Population Based ◽  
Low Risk ◽  
Public Institution ◽  
Population Based Study ◽  
The Metabolic Syndrome ◽  
Cardiometabolic Profile

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Background Cardiovascular disease (CVD) is a major, worldwide problem and remain the dominant cause of premature mortality in the word. Simultaneously the metabolic syndrome is a growing problem. The aim of this study was to investigate the cardiometabolic profile among cardiovascular risk classes, and to estimate CV risk using various calculators. Methods The longitudinal, population-based study, was conducted in 2017-2020. A total of 931 individuals aged 20-79 were included. Anthropometric and biochemical profiles were measured according to a standardized protocols. The study population was divided into CV risk classes according to the latest recommendation. Comparisons variables between subgroups were conducted using Dwass-Steele-Critchlow-Fligner test. To estimate CV risk were used: the  Systematic Coronary Risk Estimation system, Framingham Risk Score and LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD). Results The mean age was 49.1± 15.5 years, 43.2% were male. Percentages of low-risk, moderate-risk, high-risk and very-high CV risk were 46.1%, 22.8%, 13.5%, 17.6%, respectively. Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants, whereas the low risk group differed significantly. In the moderate and high-risk groups, abdominal distribution of adipose tissue dominated with significantly elevated parameters of insulin resistance. Interestingly, estimating lifetime risk of myocardial infarction, stroke or CV death using LIFE-CVD calculator yielded similar results in moderate and high CV risk classes. Conclusion The participants belonging to moderate and high CV risk classes have a very similar unfavorable cardiometabolic profile which may result in the similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population. It would be advisable to consider combining the moderate and high risk classes into one high CV risk class, or it may be worth adding one of the parameters of abdominal fat distribution to the CV risk calculators as an expression of increased insulin resistance. Abstract Figure 1.

scholarly journals A Similar Lifetime CV Risk and a Similar Cardiometabolic Profile in the Moderate and High Cardiovascular Risk Populations: A Population-Based Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1584
Author(s):  
Małgorzata Chlabicz ◽  
Jacek Jamiołkowski ◽  
Wojciech Łaguna ◽  
Paweł Sowa ◽  
Marlena Paniczko ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Premature Mortality ◽  
Population Based ◽  
Pharmacological Management ◽  
Study Population ◽  
Perspective Model ◽  
European Society Of Cardiology ◽  
Cardiometabolic Profile

Background: Cardiovascular disease (CVD) is a major, worldwide problem that remains the dominant cause of premature mortality in the world, and increasing rates of dysglycaemia are a major contributor to its development. The aim of this study was to investigate the cardiometabolic profile among patients in particular cardiovascular risk classes, and to estimate their long term CV risk. Methods: A total of 931 individuals aged 20–79 were included. The study population was divided into CV risk classes according to the latest European Society of Cardiology recommendations. Results: Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants. Interestingly, estimating the lifetime risk of myocardial infarction, stroke or CV death, using the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people, yielded similar results in moderate and high CV risk classes. Conclusion: The participants who belonged to moderate and high CV risk classes had very similar unfavorable cardiometabolic profiles, which may result in similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population, who are often unaware of their situation. New prospective population studies are necessary to establish the true cardiovascular risk profiles in a changing society.

Differences In Community and Academic Practice Patterns For Newly Diagnosed Myelodysplastic Syndromes (MDS) Patients In Minnesota: A Population Based Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2798-2798 ◽  
Author(s):  
Daniel Pease ◽  
Julie A Ross ◽  
Phuong L. Nguyen ◽  
Betsy Hirsch ◽  
Adina Cioc ◽  
...  
Keyword(s):  
High Risk ◽  
Supportive Care ◽  
Practice Patterns ◽  
Risk Group ◽  
Population Based ◽  
Low Risk ◽  
Risk Scores ◽  
First Year ◽  
Newly Diagnosed ◽  
Population Based Study

Abstract Introduction Expanding treatment options for MDS have changed therapeutic decision-making for clinicians. To better characterize therapeutic choices in newly diagnosed MDS, we report the practice patterns captured during the first year of MDS diagnosis for patients enrolled in our statewide population-based study. We highlight a comparison of treatment in community and academic centers. Methods Adults in Minnesota with MDS (AIMMS) is a statewide prospective population-based study conducted by the University of Minnesota (UMN), Mayo Clinic, and Minnesota Department of Health. Starting in April 2010, all newly diagnosed adult cases (ages 20+) of MDS were invited to participate. After patient enrollment, central review was performed consisting of independent hematopathology and cytogenetic review coupled with oncologist chart review assigning prognostic risk scores [International Prognostic Scoring System (IPSS) and IPSS-R (Revised)] and abstracting treatment exposures. All enrolled patients with one year follow-up were included in this analysis. Treatment was divided into supportive, active, transplant, or other. Supportive care included observation, growth factors, and transfusions. Active care included azacitidine, decitabine, lenalidomide, or 7+3 chemotherapy. Academic centers were defined as the UMN and Mayo Clinic; all other centers were designated as community based practices. Results The median patient age was 73 years, with 68% males. IPSS and IPSS-R risk scores were calculated for 100% and 97% of patients, respectively. Treatment choices stratified by IPSS risk group showed 89% low risk, 53% INT-1, 31% INT-2, and 13% high risk with supportive care; active and transplant strategies were utilized for 9% low risk, 44% INT-1, 64% INT-2, and 88% high risk. INT-1 in the community received 70% supportive treatment, in academic 35%. Active treatment for INT-1 was 30% in community and 45% in academic. Community INT-2 received supportive care in 45% of cases, in academic 23%. Transplants were limited to academic centers, with the highest rate in INT-2 at 34%. Among community diagnoses, 100% of high risk, 52% INT-2, 26% INT-1, and 13% low risk were referred to an academic center. Comparison of age <65 and 65+ years showed 83% of transplants occurred in those <65. INT-2/high risk group patients <65 received 95% active therapy or transplant, compared to 51% of those 65+. Discussion This prospective, population based study provides a well-defined patient cohort based on central review of pathologic and clinical data. Evaluation of practice patterns during the first year after diagnosis showed higher utilization of active and transplant treatment strategies as IPSS risk score increased. Further, compared to community, higher utilization occurred for patients at academic centers, suggesting more aggressive treatment in these settings. Age was also a predictor of treatment choice. In addition, referral patterns followed IPSS score. Whether these treatment differences are driven by patient preference and/or translate into improved disease control and decreased mortality requires continued prospective analysis and will be detailed in future reports. Disclosures No relevant conflicts of interest to declare.

scholarly journals Cardiovascular Risk estimates in ten years in the Brazilian population, a population-based study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Carvalho Malta ◽  
P Cisalpino ◽  
R Teixeira ◽  
I Eloah Machado ◽  
F Malta dos Santos ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Laboratory Data ◽  
Population Based ◽  
Brazilian Population ◽  
Population Based Study ◽  
Medium Risk ◽  
Low Cardiovascular Risk ◽  
Years Of Schooling

Abstract Background Cardiovascular diseases are the leading cause of morbidity and mortality, high health costs and significant economic losses. The Framingham score has been widely used to stratify the risk of the evaluated individuals, identifying those at higher risk for the implementation of prevention measures directed to this group. Objective Estimate the cardiovascular risk of developing cardiovascular event in 10 years, in the adult Brazilian population. Methods Cross-sectional study using laboratory data from da National Health Survey, 2014 and 2015, were used to calculate cardiovascular risk (CVR). Algorithms proposed by D`Agostino (2008) were used, based on the Framingham study, stratified by sex, was used. According to the guidelines of the Brazilian cardiology society, the following cutoff points for cardiovascular risk in 10 years were used: a) low CVR &lt;5%, medium CVR (5 to &lt; 20%) and high CVR (≥ 20%). The study estimated the general cardio vascular risk and the respective confidence intervals (95% CI). Results Most women 58.4% had low cardiovascular risk, 32.9% medium risk and 8.7% high risk. Among men, 36.5% had low cardiovascular risk, 41.9% medium risk and 21.6% high risk. The risk increased with age. The difference in CVR according to years of schooling was about five times, between high schooling (12 years of schooling and more) and (&lt;8 years of schooling) (3.2%: 95% CI 2.4 - 4.4 versus 15, 7%: 95% CI 13.5-18.3). Black women had a higher proportion in the highest risk group ( &gt; = 20%), 14.4% (95% CI 9.7-20.9), than white women, 7.3 (95% CI 5.8 - 9.1). The poor self-rated health showed the greatest difference, the population that self-rated with very good health 2.9% (95% CI 1.3-3.6) and very poor health 25.6% (12.7-45, 0). Conclusions The risk score is useful to support the prevention practices of these diseases, considering the clinical and epidemiological context. Key messages This is the first national population-based study to estimate RCV for the Brazilian adult population using laboratory data, being useful to identify the priority population for public health. Population with less education has a higher risk cardiovascular, and should be a priority for prevention actions in public health.

C-reactive protein, insulin resistance and risk of cardiovascular disease: a population-based study

2008 ◽  
Vol 15 (5) ◽  
pp. 594-598 ◽  
Author(s):  
Jørgen Jeppesen ◽  
Tine W. Hansen ◽  
Michael H. Olsen ◽  
Susanne Rasmussen ◽  
Hans lbsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Standard Deviation ◽  
Population Based ◽  
Hazard Ratio ◽  
C Reactive Protein ◽  
Standard Deviation Increase ◽  
Population Based Study ◽  
Reactive Protein

Background C-reactive protein (CRP), a marker of inflammation, and insulin resistance (IR), a metabolic disorder, are closely related. CRP and IR have both been identified as significant risk factors of cardiovascular disease (CVD) after adjustment for conventional CVD risk factors. It is not clear whether CRP predicts CVD independent of IR. Design Prospective population-based study. Methods Two thousand three hundred and fifty-seven Danish men and women, recruited from the general population, aged 41–72 years, without major CVD at baseline were studied. Traditional and new risk factors were recorded at baseline. CRP was determined by a high-sensitivity assay, and IR was determined by the homoeostasis model assessment (HOMA-IR) method. Results Over a median follow-up of 9.4 years, the incidence of the prespecified CV event, defined as the composite event of CV death, nonfatal ischaemic heart disease and nonfatal stroke, amounted to 222 cases. In Cox proportional-hazard models, adjusted for age, sex, smoking habit, total cholesterol, waist circumference, levels of triglycerides and high-density lipoprotein-cholesterol, systolic and diastolic blood pressures, physical activity and HOMA-IR, the hazard ratio (95% confidence interval) of a CV event was 1.33 (1.14–1.55; 0.001) per standard deviation increase in log-transformed CRP level. In the same model, the hazard ratio of a CV event was 1.11 (1.02–1.21; P < 0.05) per standard deviation increase in HOMA-IR level. Conclusion In a general Danish population free of major CVD at baseline, both CRP and IR were significantly related to risk of CVD.

Increased burden of cardiovascular risk among youth suicide attempters

2020 ◽  
pp. 1-9
Author(s):  
Yongqi Zhong ◽  
Steven Pham ◽  
Giovanna Porta ◽  
Antoine Douaihy ◽  
Anna Marsland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
Risk Score ◽  
Population Based ◽  
Suicide Attempters ◽  
Cardiovascular Risk Score ◽  
Increased Risk

Abstract Background Suicide and cardiovascular disease rank among the leading causes of disability and premature mortality worldwide. Young adult suicide attempters are at increased risk of mortality from cardiovascular disease even compared to those with major depressive disorder suggesting an increased burden of cardiovascular risk factors. We compared the cardiovascular risk burden between youth attempters and other high-risk individuals. Methods Participants were from the Collaborative Psychiatric Epidemiology Surveys (CPES), a U.S. population-based study, aged 18–30 years [suicide attempt (SA): n = 303; suicidal ideation (SI): n = 451; controls: n = 3671]; and psychiatric inpatients admitted for a SA (n = 38) or SI (n = 40) and healthy controls (n = 37) aged 15–30 years. We computed a cardiovascular risk score and high- and low-risk latent classes based on risk factors of high blood pressure, obesity, and smoking. Results Suicide attempters showed an increased cardiovascular risk score (CPES: B = 0.43, 95% confidence interval (CI) 0.31–0.54, p < 0.001; inpatient sample: B = 1.61, 95% CI 0.53–2.68, p = 0.004) compared to controls. They were also more likely to be classified in the high cardiovascular risk group (CPES: odds ratio (OR) 3.36, 95% CI 1.67–6.78, p = 0.001; inpatient sample: OR 9.89, 95% CI 1.38–85.39, p = 0.03) compared to those with SI (CPES: OR 1.15, 95% CI 0.55–2.39, p = 0.71; inpatient sample: OR 1.91, 95% CI 0.25–15.00, p = 0.53). Conclusions Youth attempters show an increased burden for cardiovascular risk compared to other high-risk individuals in inpatient and population-based samples. Clinicians should pay particular attention to cardiovascular risk factors among suicide attempters in order to reduce their risk for cardiovascular events.

P3402Validation of the SCORE O.P. for prediction of cardiovascular disease mortality in a large population of elderly individuals

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Andexlinger ◽  
J Fritz ◽  
M Edlinger ◽  
H Concin ◽  
G Nagel ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Large Population ◽  
Risk Function ◽  
Low Risk ◽  
Healthy Individuals ◽  
Operating Characteristics ◽  
Observed Score ◽  
Austrian Population

Abstract Background Estimation of absolute cardiovascular risk in apparently healthy individuals, using SCORE (Systematic COronary Risk Evaluation) is recommended by the ESC guidelines on cardiovascular disease (CVD) prevention in clinical practice. Recently, the SCORE system has been extended by the SCORE O.P. aiming to improve estimates of cardiovascular risk specifically in older persons (65 years and older). Purpose The aim of this study was to validate the SCORE O.P. in an Austrian population of 34,909 healthy individuals aged between 65 and 80 years which were prospectively followed for a minimum of 10 years. Methods Predicted fatal CVD and coronary heart disease (CHD) event rates within 10 years were calculated using the “SCORE O.P. risk function for low risk regions” and compared to the actually observed rates, thereby assessing calibration. In addition, predicted probabilities were plotted against observed mortality by deciles of predicted risk. Regarding discrimination, receiver operating characteristics (ROC) analysis and corresponding c-statistics were used. Results In 14,586 males, 1,509 deaths from CVD (10.4%) and 847 deaths from CHD (5.8%) occurred within 10 years of follow-up. SCORE O.P. predicted 1,699 fatal CVD (11.7%) and 872 CHD (6.0%) events. In male high risk individuals (10th decile), SCORE O.P. overestimated mortality from CVD and CHD. C-statistics were 0.68 (95% CI 0.67–0.70) for CVD and 0.67 (0.65–0.69) for CHD. In 20,323 females, 1,340 deaths from CVD (6.6%) and 672 deaths from CHD (3.3%) were observed. SCORE O.P. predicted 1,232 fatal CVD (6.1%) and 539 CHD events (2.7%). In female high risk individuals (8–10th deciles), SCORE O.P. underestimated mortality from CVD and CHD. C-statistics were 0.77 (0.75–0.78) for CVD and 0.77 (0.75–0.79) for CHD. Conclusion With regard to overall accuracy, the SCORE O.P. performed considerably well in this elderly Austrian population. However, in high-risk individuals, cardiovascular risk was overestimated for males and underestimated for females. SCORE O.P. was able to discriminate high-risk from low-risk individuals, better in women than in men.

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