Synergistic and Non-synergistic Associations for Cigarette Smoking and Non-tobacco Risk Factors for Cardiovascular Disease Incidence in the Atherosclerosis Risk In Communities (ARIC) Study

Introduction: Cardiovascular disease (CVD) is the most common cause of death in nonalcoholic steatohepatitis (NASH). While these conditions share many cardio-metabolic risk factors including metabolic syndrome, diabetes and dyslipidemia, limited data exist on whether NASH is independently and prospectively associated with incident CVD beyond traditional risk factors. Fibrosis-4 (FIB-4) index is a scoring system based on platelet count, age, AST and ALT, shown to be comparable to magnetic resolution elastography for predicting advanced fibrosis in biopsy-proven NASH. We sought to evaluate the association of elevated FIB-4 with global CVD events and CVD mortality in the Atherosclerosis Risk in Communities (ARIC) Study Methods: We studied 5531 individuals, mean age of 76 (SD 5.2) years, 58% female, 22% black, at ARIC visit 5 (2011-2013). FIB-4 was categorized as low risk of advanced fibrosis for score <1.45, intermediate for 1.45-3.25 and high for >3.25. Cox regression was used to estimate the association of FIB-4 with time to first global CVD event (CHD, ischemic stroke or heart failure hospitalization) and CVD mortality adjusted for pooled cohort equation risk factors. Results: Over a median follow up of 6.2 (5.3-6.8) years, there were 1108 global CVD events and 457 CVD deaths. In adjusted models, compared to participants with low FIB-4 (<1.45), those with elevated FIB-4 >3.25, had significantly increased risk for global CVD events (HR 1.58, 95% CI 1.23-2.02) and CVD mortality (HR 1.70, 95% CI 1.16-2.50). Conclusions: In a large prospective cohort, presence of advanced liver fibrosis, as assessed by elevated FIB-4 index >3.25, was associated with increased risk for CVD events and CVD mortality, beyond traditional CVD risk factors. Future clinical trials of candidate medications under study for NASH should examine whether effective NASH treatment will impact CV outcomes.

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Endogenous Testosterone and its Relationship to Preclinical and Clinical Measures of Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-3934 ◽

2015 ◽

Vol 100 (4) ◽

pp. 1602-1608 ◽

Cited By ~ 36

Author(s):

Reshmi Srinath ◽

Sherita Hill Golden ◽

Kathryn A. Carson ◽

Adrian Dobs

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiac Mortality ◽

Cardiac Events ◽

Cvd Risk ◽

Cross Sectional ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

All Cause Mortality ◽

Aric Study

Context: Epidemiologic studies suggest that endogenous testosterone (T) levels in males may be implicated in cardiovascular disease (CVD), however further clarification is needed. Objective: We assessed the cross-sectional relationship between endogenous plasma T and mean carotid intima media thickness (cIMT), and the longitudinal relationship with incident clinical CVD events, cardiac mortality, and all-cause mortality using male participants in the Atherosclerosis Risk in Communities (ARIC) study. Design: This study involved a subset of men from visit 4 of the ARIC study. Setting: The study was conducted in a community based cohort. Participants: Males who provided a morning blood sample excluding those taking androgen therapy, with prevalent coronary heart disease (CHD), stroke, or heart failure (HF) (n = 1558). Intervention: None. Main Outcome Measures: Plasma T by liquid chromatography mass spectrometry and carotid IMT using high resolution B-mode ultrasound were obtained at visit 4. Incident CHD, HF, cardiac mortality, and all-cause mortality were identified by surveillance through 2010 (median 12.8 years). Results: Lower T was significantly associated with higher body mass index, greater waist circumference, diabetes, hypertension, lower HDL, and never smoking (P = 0.01). T was not associated with mean cIMT in unadjusted or adjusted analyses. Following multivariable adjustment, there was no association of quartile (Q) of T with incident CHD [hazard ratio (HR) = 0.87 (95% CI = 0.60–1.26) for Q1; 0.97 (95% CI = 0.69–1.38) for Q2; 0.97 (95% CI = 0.69–1.36) for Q3 compared to reference of Q4] or for incident HF [HR = 0.77 (95% CI = 0.46–1.29) for Q1; 0.72 (95% CI = 0.43–1.21) for Q2; 0.87 (95% CI = 0.53–1.42) for Q3 compared to reference of Q4]. Similarly there was no association of Q of T with mortality or cardiac-associated mortality. Conclusions: Low male plasma T is cross-sectionally associated with key CVD risk factors, but after adjustment there was no association with mean cIMT, incident cardiac events, or mortality. Our results are reassuring that neither high nor low T levels directly predict atherosclerosis, but are a marker for other cardiovascular risk factors.

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Risk factors for peripheral arterial disease incidence in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2004.11.024 ◽

2005 ◽

Vol 180 (2) ◽

pp. 389-397 ◽

Cited By ~ 112

Author(s):

Keattiyoat Wattanakit ◽

Aaron R. Folsom ◽

Elizabeth Selvin ◽

Beth D. Weatherley ◽

James S. Pankow ◽

...

Keyword(s):

Risk Factors ◽

Peripheral Arterial Disease ◽

Disease Incidence ◽

Arterial Disease ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Peripheral Arterial ◽

Aric Study

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Faculty Opinions recommendation of Lifetime Risk and Risk Factors for Abdominal Aortic Aneurysm in a 24-Year Prospective Study: The ARIC Study (Atherosclerosis Risk in Communities).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726956841.793535495 ◽

2017 ◽

Author(s):

Norman Hertzer

Keyword(s):

Risk Factors ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Prospective Study ◽

Lifetime Risk ◽

Atherosclerosis Risk In Communities ◽

Abdominal Aortic ◽

Atherosclerosis Risk ◽

Aric Study

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Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study

Neurology ◽

10.1212/wnl.0b013e31823efc42 ◽

2011 ◽

Vol 78 (2) ◽

pp. 102-108 ◽

Cited By ~ 56

Author(s):

D. C. Bezerra ◽

A. R. Sharrett ◽

K. Matsushita ◽

R. F. Gottesman ◽

D. Shibata ◽

...

Keyword(s):

Risk Factors ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

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Association of hemostatic variables with prevalent cardiovascular disease and asymptomatic carotid artery atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) Study Investigators.

Arteriosclerosis and Thrombosis A Journal of Vascular Biology ◽

10.1161/01.atv.13.12.1829 ◽

1993 ◽

Vol 13 (12) ◽

pp. 1829-1836 ◽

Cited By ~ 105

Author(s):

A R Folsom ◽

K K Wu ◽

E Shahar ◽

C E Davis

Keyword(s):

Cardiovascular Disease ◽

Carotid Artery ◽

Asymptomatic Carotid ◽

Atherosclerosis Risk In Communities ◽

Carotid Artery Atherosclerosis ◽

Atherosclerosis Risk ◽

Aric Study

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Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study

Heart ◽

10.1136/heartjnl-2017-311825 ◽

2017 ◽

Vol 104 (5) ◽

pp. 423-429 ◽

Cited By ~ 2

Author(s):

Brittany M Bogle ◽

Nona Sotoodehnia ◽

Anna M Kucharska-Newton ◽

Wayne D Rosamond

Keyword(s):

Risk Factors ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Disease Risk ◽

Ventricular Tachyarrhythmia ◽

Atherosclerosis Risk In Communities ◽

Vital Exhaustion ◽

Increased Risk ◽

Atherosclerosis Risk ◽

Aric Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

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