scholarly journals Prediction of subclinical coronary atherosclerosis in patients with high and very high cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Pogosova ◽  
NP Kachanova ◽  
YM Yufereva ◽  
OY Sokolova ◽  
IE Koltunov ◽  
...  
Keyword(s):  
Family History ◽  
Ct Angiography ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diagnostic Model ◽  
History Of ◽  
Hs Crp ◽  
Very High

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis has a long subclinical period. It’s early detection may offer a possibility of timely initiation of preventive interventions Purpose To develop a diagnostic rule for detection of patients (pts) with high probability of subclinical atherosclerosis among those with high or very high cardiovascular (CV) risk. Methods This cross-sectional study enrolled 52 pts (32 men [62%]), aged 40 to 65 years [mean age 54.6 ± 8.0]) with high or very high CV risk (5-9 and ≥10% by The Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT) angiography and calcium scoring. Traditional risk factors (RFs) (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose),  ankle-brachial index,  stress-test, carotid plaques according to ultrasound were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. Results All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n = 21) had any non-obstructive lesions or calcium score >0, pts in the control group (n = 31) had intact coronary arteries. The groups did not differ in age or gender. 26 multiple linear logistic models for any subclinical atherosclerosis were developed based on obtained diagnostic features. Taking into account R-square = 0.344 (p = 0.0008), the best fitting model was follows:  subclinical coronary atherosclerosis= -1.576 + 0.234 x SCORE ≥5%  + 0.541 x hs CRP >2 g/l + 0.015 x heart rate  (bpm) + 0.311 family history of premature CVD.  The developed algorithm had sensitivity of 63% and  specificity of 80%. Conclusions The created diagnostic model diagnostic model suggests the presence of subclinical coronary atherosclerosis in patients with high / very high CV risk with a high degree of probability. This easy-to-use method can be used in routine clinical practice to improve risk stratification and management choices in high-risk pts.

scholarly journals Prediction of Subclinical Coronary Atherosclerosis in Patients with High and Very High Cardiovascular Risk

Kardiologiia ◽  
2020 ◽  
Vol 60 (2) ◽  
pp. 75-82
Author(s):  
N. V. Pogosova ◽  
Y. M. Yufereva ◽  
N. P. Kachanova ◽  
V. A. Metelskaya ◽  
I. Y. Koltunov ◽  
...  
Keyword(s):  
Family History ◽  
Ct Angiography ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diagnostic Model ◽  
History Of ◽  
Hs Crp ◽  
Very High

Objective To develop a diagnostic rule for detection of patients (pts) with high probability of subclinical atherosclerosis among those with high or very high cardiovascular (CV) risk.Materials and Methods This cross-sectional study enrolled 52 pts (32 men [62 %]), aged 40 to 65 years [mean age 54.6±8.0]) with high or very high CV risk (5–9 and ≥10 % by The Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT) angiography and calcium scoring. Traditional risk factors (RFs) (family history of premature CVD, smoking, overweight / obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB / ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose), ankle-brachial index, stress-test, carotid plaques according to ultrasound were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality.Results All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n=21) had any non-obstructive lesions or calcium score >0, pts in the control group (n=31) had intact coronary arteries. The groups did not differ in age or gender. 26 multiple linear logistic models for any subclinical atherosclerosis were developed based on obtained diagnostic features. Taking into account R-square = 0.344 (p=0.0008), the best fitting model was follows: subclinical coronary atherosclerosis= –1.576 + 0.234 x SCORE ≥5 % + 0.541 x hs CRP >2 g / l +0.015 x heart rate (bpm) +0.311 family history of premature CVD. The developed algorithm had sensitivity of 63 % and specificity of 80 %.Conclusion The created diagnostic model diagnostic model suggests the presence of subclinical coronary atherosclerosis in patients with high / very high CV risk with a high degree of probability. This easy-to-use method can be used in routine clinical practice to improve risk stratification and management choices in high-risk pts.

scholarly journals An exploration of potential approaches to improve the diagnosis of subclinical atherosclerosis in patients with high cardiovascular risk

Kardiologiia ◽  
2019 ◽  
Vol 59 (11S) ◽  
pp. 53-62 ◽  
Author(s):  
N. V. Pogosova ◽  
Y. M. Yufereva ◽  
N. P. Kachanova ◽  
V. A. Metelskaya ◽  
I. Y. Koltunov ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Stiffness ◽  
Ct Angiography ◽  
Subclinical Atherosclerosis ◽  
Density Lipoprotein ◽  
Diagnostic Methods ◽  
Lipoprotein Cholesterol ◽  
History Of ◽  
Hs Crp ◽  
Very High

Purpose. The search for optimal approaches to the diagnosis of subclinical atherosclerosis using a wide range of traditional and psychosocial risk factors (RFs), as well as clinical and instrumental diagnostic methods in patients (pts) with high or very high cardiovascular (CV) risk. Methods. This cross-sectional study enrolled52 pts, aged 40 to 65 years with high or very high CV risk (5-9 and ≥10% by the Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT)angiography and calcium scoring. Traditional RFs (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose), ankle-brachial index, stress-test, carotid plaques according to ultrasound, arterial stiffness were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. Results. All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n=21) had any non-obstructive lesions or calcium score >0, pts in the control group (n=31) had intact coronary arteries. The groups did not differ in age or gender. It was found that patients with subclinical atherosclerosis significantly more often have a very high (≥10%) CV risk (42.9% vs.16.3%, p<0.05), a long (≥5 years) history of arterial hypertension (47.6% vs. 12.9% , p<0.01) and longer duration of antihypertensive therapy (61.9% vs. 29.0%, p<0.05), higher heart rate in rest (87. ± 14 vs. 77 ± 10 beats/min, p<0.01), increased arterial stiffness according to aortic pulse wave velocity (85.7% vs. 61.3%, p<0.05) and high level of hs-CRP (100% vs. 90.3%, p<0.05). Conclusion. Using in routine clinical practice of additional anamnestic (hypertension lasting ≥ 5 years and the intake of any antihypertensive drugs) and clinical-instrumental parameters (high heart rate in rest, hs CRP and arterial stiffness in pts with high and very high CV risk increases effectiveness of early detection of subclinical atherosclerosis.

5198HbA1C correlates subclinical atherosclerosis in non-diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
W.-T Wang ◽  
P.-F Hsu ◽  
Y.-J Wang ◽  
Y.-Z Ding ◽  
T.-L Liou ◽  
...  
Keyword(s):  
High Risk ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Smoking Habit ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Lipid Parameters

Abstract Objective We investigated the association of lipid parameters and coronary atherosclerosis related to normal blood sugar (BS) and impaired fasting glucose (IFG), and factors contributing to coronary atherosclerosis. Methods We analyzed 1209 non-diabetic subjects who underwent coronary computed tomography angiography (CCTA). Atherosclerotic plaque pattern severity and patterns were evaluated based on serum glucose values. The association between low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) and plaque patterns in non-diabetic subjects were also analyzed. Results Non-diabetic subjects (age: 58.6±9.7 years; 861 male) were enrolled. Higher glucose levels were correlated with a higher prevalence of mixed plaque, significant (>50% stenosis) high-risk plaque, and calcified plaque in non-diabetic patients. Although serum LDL-C levels were mostly controlled by statin use, atherosclerotic plaques progressed, with increasing A1c values. Multivariate logistic regression analysis showed that age, male gender and A1C were independently associated with the presence of significant mixed plaques after considering BMI, blood pressure, renal function, lipid parameters, uric acid, and smoking habit. Conclusions Although decreasing HDL-C and increasing TG correlated with the presence and severity of coronary atherosclerosis, increasing A1c is independently associated with the presence of high-risk plaque in non-diabetes even if LDL-C is controlled by statin therapy.

scholarly journals Independent role of low-density lipoprotein cholesterol in subclinical coronary atherosclerosis in the absence of traditional cardiovascular risk factors

2019 ◽  
Vol 20 (8) ◽  
pp. 866-872 ◽  
Author(s):  
Ki-Bum Won ◽  
Gyung-Min Park ◽  
Yu Jin Yang ◽  
Soe Hee Ann ◽  
Yong-Giun Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Abstract Aims Individuals without traditional cardiovascular risk factors (CVRFs) still experience adverse events in clinical practice. This study evaluated the predictors of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Methods and results A total of 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without CVRFs who underwent coronary computed tomographic angiography for a general health examination were analysed. The following were considered as traditional CVRFs: systolic/diastolic blood pressure ≥140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL; high-density lipoprotein cholesterol <40 mg/dL; body mass index ≥25.0 kg/m2; current smoking status; and previous medical history of hypertension, diabetes, and dyslipidaemia. Subclinical atherosclerosis, defined as the presence of any coronary plaque, was present in 20.6% cases; the incidences of non-calcified, calcified, and mixed plaque were 9.6%, 12.6%, and 2.6%, respectively. Multivariate regression analysis showed that LDL-C level [odds ratio (OR): 1.008; 95% confidence interval (CI): 1.001–1.015], together with age (OR: 1.101; 95% CI: 1.075–1.128) and male sex (OR: 5.574; 95% CI: 3.310–9.388), was associated with the presence of subclinical atherosclerosis (All P < 0.05). LDL-C level was significantly associated with an increased risk of calcified plaques rather than non-calcified or mixed plaques. Conclusion LDL-C, even at levels currently considered within normal range, is independently associated with the presence of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Our results suggest that a stricter control of LDL-C levels may be necessary for primary prevention in individuals who are conventionally considered healthy.

scholarly journals Genetic Predisposition to Low-Density Lipoprotein Cholesterol May Increase Risks of Both Individual and Familial Alzheimer's Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Jiang-Shan Tan ◽  
Meng-Jin Hu ◽  
Yan-Min Yang ◽  
Yue-Jin Yang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Family History ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
History Of ◽  
Mr Study

Background: Previous observational studies provided conflicting results on the association between low-density lipoprotein cholesterol (LDL-C) level and the risk of Alzheimer's disease (AD).Objective: We used two-sample Mendelian randomization (MR) study to explore the causal associations between LDL-C level and the risks of individual, paternal, maternal, and family history of AD.Methods: Summary-level genetic data for LDL-C were acquired from results of the UK Biobank GWAS. Corresponding data for paternal, maternal, and family history of AD were obtained from the NHGRI-EBI Catalog of human genome-wide association studies. Data for individual AD were obtained from the MR-Base platform. A two-sample MR study was performed to explore the causal association between LDL-C level and the risks of individual, paternal, maternal, and family history of AD.Results: Genetically predicted LDL-C was positively associated with individual [Odds ratio (OR) = 1.509, 95% confidence interval (CI) = 1.140–1.999; P = 4.0 × 10−3], paternal [OR = 1.109, 95% CI = 1.053–1.168; P = 9.5 × 10−5], maternal [OR = 1.132, 95% CI = 1.070–1.199; P = 2.0 × 10−5], and family history of AD [OR = 1.124, 95% CI = 1.070–1.181; P = 3.7 × 10−6] in inverse variance weighted analysis. After performing weighted median and MR-Egger analysis, consistent results were observed. There was no horizontal pleiotropy in the two-sample MR analysis.Conclusions: High level of LDL-C may increase the risks of both individual and familial AD. Decreasing the LDL-C to a reasonable level may help to reduce the related risk.

scholarly journals Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

2020 ◽  
Author(s):  
Haofei Hu ◽  
Mijie Guan ◽  
Zhuangsen Chen ◽  
Yang Wu ◽  
Qijun Wan
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Incident Diabetes ◽  
Family History Of Diabetes ◽  
Drinking Status ◽  
History Of ◽  
The Relationship

Abstract Background: Previous studies have revealed that chronic kidney disease (CKD) is one of major risk factors of insulin resistance and diabetes. However, there are few investigations of the correlations between the estimated glomerular filtration rate (eGFR) and incident diabetes, especially in Chinese population. This study was taken to explore the relationship between eGFR and incident diabetes in a large cohort in Chinese community population. Methods: The present study was a retrospective cohort study. A total of 199,435 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were eGFR measured at baseline and incident diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association between eGFR and incident diabetes. Generalized additive model was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. Result: After adjusting gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes, result showed eGFR was negatively associated with incident diabetes (HR=0.987, 95%CI (0.984, 0.989)). A J shape relationship was detected between eGFR and incident diabetes, which had an inflection point of eGFR was 97.967 mL/min-1·(1.73 m2)-1. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.999 (0.994,1.004) and 0.977 (0.974,0.981), respectively. Subgroup analysis showed, the stronger association can be found in the population with FPG<6.1mmol/L, BMI<24kg/m2, SBP<140mmHg, DBP<90mmHg, HDL in middle level and family history without diabetes. The same trend was also seen in men and in the population with never or ever smoking. Conclusion: eGFR is independently associated with incident diabetes. The relationship between eGFR and incident diabetes is also non-linear. eGFR was strong negatively related to incident diabetes when eGFR is above 97.967 mL/min-1·(1.73 m2)-1.

Coronary Risk Factors in Adolescents Related to Their Knowledge of Familial Coronary Heart Disease and Hypercholesterolemia: The Muscatine Study

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 444-451
Author(s):  
Linda E. Muhonen ◽  
Richard P. Nelson ◽  
Trudy L. Burns ◽  
Ronald M. Lauer
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Density Lipoprotein ◽  
Apolipoprotein A1 ◽  
Lipoprotein Cholesterol ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
High Cholesterol ◽  
Parental History ◽  
History Of

Objective. To determine the utility of a school-based questionnaire, to identify adolescents with adverse coronary risk factor levels. Design. In Muscatine, IA, students (9th through 12th grade) completed a questionnaire providing medical history information about first- and second-degree relatives. Anthropometric measures were obtained and blood pressure, lipid, lipoprotein, and apolipoprotein levels were determined. Results. A history of parental coronary heart disease (CHD) was rare and a history of parental high cholesterol frequently was unknown; however, when known, a history of high cholesterol or early (30 to 55 years of age) or later (&gt;55 years of age) CHD (myocardial infarction, coronary bypass, or death from a heart attack) in grandfathers enriched the identification of adolescents with adverse coronary risk factors. Parental history of CHD was associated with an increased risk for high body mass index and low apolipoprotein A1 levels in their children. Grandfather history of early or later CHD was associated with an increased risk for low apolipoprotein A1 and high density lipoprotein cholesterol levels and high body mass index in their grandchildren. Students with positive grandfather histories of high cholesterol had higher total cholesterol, low density lipoprotein cholesterol, apolipoprotein B, and low density lipoprotein cholesterol to high density lipoprotein cholesterol ratios. Grandmother histories, because most were negative, did not help identify adolescents in this population with adverse coronary risk factors. Conclusions. A parental history of CHD as well as a grandfather history of high cholesterol or CHD enriches the identification of children with adverse coronary risk factor levels. The positive predictive values associated with using a school-based history obtained from adolescents, many with the aid of their parents, are small and many adolescents do not know their family history. It is essential that pediatricians inquire about parental and especially grandparental medical histories in accordance with the National Cholesterol Education Program guidelines to help identify children at highest familial risk. The importance of determining parental and grandparental histories of CHD or hypercholesterolemia should be emphasized to families who are uncertain of their histories to identify children and adolescents who require a physician's care. It is also important for pediatricians to remind their colleagues who care for patients with premature ischemic heart disease to refer their progeny for pediatric care so that their lipids and lipoproteins may be screened and counseling provided.

Migraine in Children: Association With Primary and Familial Dyslipoproteinemias

PEDIATRICS ◽  
1986 ◽  
Vol 77 (3) ◽  
pp. 316-321
Author(s):  
Charles J. Glueck ◽  
Stephen R. Bates
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Degree Relative ◽  
Presumptive Diagnosis ◽  
History Of ◽  
Premature Myocardial Infarction ◽  
Disproportionate Number ◽  
Severe Migraine ◽  
Cerebral Vascular

We studied lipids and lipoprotein cholesterols in 39 children (26 boys, 13 girls) with severe migraine, to examine the hypothesis that primary and familial lipoprotein abnormalities might be associated with or predispose children to the migraine syndrome. Each of the children, 4 to 20 years of age, had severe migraine, leading to pediatric neurologic referral and therapy. Twenty-five of the 39 probands (64%) had a first degree relative with severe migraine, and 18% had a second degree relative with severe migraine. In 11 of the 39 kindreds (28%), there was a family history of premature myocardial infarction and/or cerebral vascular accident (&lt;age 55 years), involving one grandparent from each of ten kindreds and one parent in the 11th kindred. In nine of the 26 boys, low-density lipoprotein cholesterol (LDL-C) levels were greater than or equal to the age-, sex-, race-specific 90th percentile, and in three of these nine children, there was at least one additional first degree relative also having a primary top decile LDL-C level, consistent with the presumptive diagnosis of familial hypercholesterolemia. The finding of more than three times as many boys with migraine headache having top decile LDL-C than expected (9 v 2.6) was significant (x2 = 17.5, P &lt;.01). Also, there were six boys having bottom decile levels of high-density lipoprotein cholesterol (HDL-C); all six came from kindreds with at least one first degree relative also having bottom decile HDL-C. The finding of more than two times as many boys with migraine having bottom decile HDL-C than expected (6 v 2.6) was significant (x2 = 4.94, P &lt; .05). Of the 13 female pediatric probands, two had top decile LDL-C and two had bottom decile HDL-C and came from families with at least one additional first degree family relative also having a primary and similar dyslipoproteinemia. Our observations suggest that the clinical diagnosis of severe migraine in childhood should lead to measurement of lipids and lipoprotein cholesterols, particularly in boys, because they represent a cohort with a disproportionate number of hyper-β- and hypo-α-lipoproteinemic subjects. We speculate that primary and familial lipoprotein abnormalities, particularly those involving high levels of LDL-C and/or low levels of HDL-C, may be etiologically related to migraine, perhaps related to platelet hyperaggregability, and/or increased likelihood of cerebral vascular instability.

Sign in / Sign up

Export Citation Format

Share Document