scholarly journals OP0122 SUBCLINICAL ATHEROSCLEROSIS OF FEMORAL ARTERIES IN RHEUMATOID ARTHRITIS. AN ULTRASOUND STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 80.1-81
Author(s):  
J. Medina ◽  
F. Aramburu ◽  
C. González Montagut ◽  
D. Sánchez ◽  
E. Loza
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Risk ◽  
Femoral Artery ◽  
Disease Risk ◽  
Subclinical Atherosclerosis ◽  
Cardiovascular Disease Risk ◽  
Carotid Plaques ◽  
Femoral Arteries ◽  
Eular Recommendations ◽  
Very High

Background:Cardiovascular morbidity and mortality is increased in patients with rheumatoid arthritis (RA). This cannot be entirely explained by traditional risk factors. Inflammation and autoimmunity may play a role in the cardiovascular risk excess. Subclinical atherosclerosis is associated with a risk comparable to established coronary heart disease. In RA it has been investigated by carotid artery ultrasound and carotid atherosclerotic plaques are more prevalent in RA patients than controls. EULAR recommendations for cardiovascular disease risk management consider that carotid ultrasound may be part of the risk evaluation in patients with RA. Recent studies in general population have shown that plaques in femoral arteries are more common and are associated with higher cardiovascular risk.Objectives:To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis and its ability to improve cardiovascular risk assessment in RA patients.Methods:Cross-sectional observational study of prevalence in 140 RA patients aged 40 to 65 years. Subclinical atherosclerosis was evaluated by carotid and femoral artery ultrasound.Results:Atherosclerotic plaques were found in 86.4% of RA patients (60.7% in carotid arteries and 78.6% in femoral arteries). Patients with plaques were older and more frequently past or present tobacco users. Femoral plaques were larger and more numerous than the carotid plaques and people with plaques in both locations had more extensive subclinical atherosclerotic disease (table). Only 7.9% of RA patients were considered as having very high cardiovascular risk by clinical factors, after carotid ultrasound this increased to 57.1% and after femoral ultrasound to 86.4%.Conclusion:Ultrasound examinations of the femoral artery in addition to the carotid artery increased the detection of subclinical atherosclerosis and determine a group of patients with higher intensity of atherosclerotic disease. Examinations of both arteries allowed a greater number of RA patients previously considered to have low to moderate cardiovascular risk to be classified as very high cardiovascular risk.References:[1]Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJL, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017 Jan;76(1):17–28.[2]Ambrosino P, Lupoli R, Di Minno A, Tasso M, Peluso R, Di Minno MND. Subclinical atherosclerosis in patients with rheumatoid arthritis. A meta-analysis of literature studies. Thromb Haemost. 2015 May;113(5):916–30.[3]Laclaustra M, Casasnovas JA, Fernández-Ortiz A, Fuster V, León-Latre M, Jiménez-Borreguero LJ, et al. Femoral and Carotid Subclinical Atherosclerosis Association With Risk Factors and Coronary Calcium: The AWHS Study. J Am Coll Cardiol. 2016 Mar 22;67(11):1263–74.TableOnly carotid plaquesn= 11Only femoral plaquesn= 36Femoral and carotid plaquesn= 74Number of carotid plaques per patient1,3 ± 0,5-2,5 ±2,0*Carotid plaques size (mm)1,63 ±0,20-2,08 ±0,69*Number of femoral plaques per patient-2,3 ±1,73,7 ± 2,9**Femoral plaque size (mm)-2,20 ± 0,593,10 ± 1,10**Total number of plaques per patient1,3 ± 0,52,3 ± 1,7*6,2 ± 4,3***†Results in mean ± sd. *p<0,05 vs only carotid plaques. **p<0,05 vs only femoral plaques. ***p<0,05 vs only carotid plaques and only femoral plaques.Disclosure of Interests:Julio Medina: None declared, Francisco Aramburu: None declared, Carmen González Montagut: None declared, Dolores Sánchez: None declared, Estíbaliz Loza Grant/research support from: Roche, Pfizer, Abbvie, MSD, Novartis, Gebro, Adacap, Astellas, BMS, Lylly, Sanofi, Eisai, Leo, Sobi

scholarly journals Predicting 10-year cardiovascular risk using WHO/ISH risk prediction chart among urban population in Salem

2018 ◽  
Vol 5 (12) ◽  
pp. 5228
Author(s):  
K. Premanandh ◽  
R. Shankar
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Smoking Status ◽  
Cardiovascular Disease Risk ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cvd Risk ◽  
Very High

Background: Coronary vascular disease (CVD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CVD prevention in resource-poor countries. The WHO /ISH risk prediction charts provide approximate estimates of cardiovascular disease risk in people who do not have established coronary heart disease, stroke or other atherosclerotic disease.Methods: A total of 280 subjects between 40 to 70 years of age were included in this cross sectional study. Eligible households was selected randomly (every 5th household) for the interview using systematic random sampling. Age, gender, smoking status, systolic blood pressure, presence or absence of diabetes and total serum cholesterol were used to compute the total CVD risk using WHO/ISH CVD risk prediction chart. The chart stratify an individual into low (<10%), moderate (10% to <20%), high (20% to <30%), and very high (>30%) risk groups.Results: Moderate and high CVD risk were 12.14% and 7.5% respectively. Of total study participants, 2.5% had very high risk (>40%). High risk (binge drinking) alcohol drinkers (p=0.04) and abdominal obesity (p=0.0001) were significantly associated with higher CVD risk. Higher prevalence of behavioral risk factors was also reported in our study population.Conclusions: A large proportion of the population is at moderate and high cardiovascular risk. Risk stratification and identification of individuals with a high risk for CHD who could potentially benefit from intensive primary prevention efforts are critically important in reducing the burden of CVD in India.

scholarly journals FRI0060 EVALUATION OF THE CARDIOVASCULAR RISK IN WOMEN WITH RHEUMATOID ARTHRITIS WITH DUPLEX STUDY OF THE CAROTID AND FEMORAL ARTERIES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 606.1-607
Author(s):  
N. De Carvalho Sacilotto ◽  
A. Ozela Augusto ◽  
D. Alves Lucena ◽  
M. Roberto Godoy ◽  
R. Duque de Almeida ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Disease ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Control Group ◽  
Atherosclerotic Plaques ◽  
Femoral Arteries

Background:The increasing of the cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is well know, even with the absence of traditional coronary risk factors. The ultrasound – duplex scan (USD) is a non invasive technique able to early detect atherosclerotic changes in the blood vessel, that gives the possibly to retard the development of symptomatic CVD.Objectives:To evaluate the cardiovascular (CVS) risk in patients with RA classificated as low risk by Framingham Score (FS), before and after the EULAR 1.5 multiplication factor and stratify with the carotid and femoral USD (intima-media thickness - IMT and atherosclerotic plaques - AP)Methods:Thirty-five female patients with RA and low CVS risk by FS and 35 healthy women with low CVS risk by FS (control group) were enrolled for the study. All of them submitted to carotid and femoral USDResults:The groups were homogenous by age and CVS comorbidities -Table 1. Mean age in the diagnosis was 44.57 years, mean disease duration was 12.11 years and mean disease activity was Disease Activity Score 28: 1,91 and Clinical Disease Activity Score: 6.176. In the RA patients group 46% showed changes in the carotid and/or femoral USD compared with 14% of the control group (p = 0,004) –Graphic 1. The USD with abnormalities in RA group 31% of the carotid USD and 81% of the femoral USD (p= 0,005) showed IMT and/or AP. After EULAR 1.5 multiplication factor, 66% remained low CVS risk. Where 35% of the RA patients showed changes in the carotid and/or femoral USD compared with 14% of the control group (p=0,07)Conclusion:The USD is able to early detect the CVD, special attention should be given to the femoral arteries, that are frequently affected. The Eular criteria is also effective and should be used in the clinical practiceReferences:[1]Mota LMH, Cruz BA, Brenol CV, et al. Diretrizes para o diagnóstico da artrite reumatoide.Rev. Bras. Reumatol 2013;53(2)[2]Charles-SchoemanC. Cardiovascular disease and Rheumatoid Arthritis: an update. CurrRheumatol Rep 2012;14(5): 455-62[3]Purcarea A, Sovaila S, Gheorghe A, et al. Cardiovascular disease risk scores in the current practice which to use in rheumatoid arthritis?Journal of Medicine and Life 2014;7(4):461-67[4]Agca R, Heslinga SC, Rollefstad S, etal.EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update.AnnRheumDis 2016[5]Abu-Shakra M, Polychuck I, Szendro G, et al. Duplex Study of the Carotidand Femoral Arteries of Patients with Rheumatoid Arthritis: A Controlled Study.Seminars in Arthritis and Rheumatism 2005;35(1):18-23[6]Freire CMV, Alcantara ML, Santos SN, etal. Recomendação para a Quantificação pelo Ultrassom da Doença Aterosclerótica das Artérias Carótidas e Vertebrais: Grupo de Trabalho do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia.ArqBrasCardiol: Imagem cardiovasc. 2015;28:e1- e64[7]Helck A, Bianda N, Canton G et al. Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging.Int J Cardiovasc Imaging 2015;31(8):1611-8[8]Lucatelli P, Fagnani C, Tarnoki AD, et al, Genetic influence on femoral plaque and its relationship with carotid plaque an international study.Int J Cardiovasc Imaging 2018;34(4):531-41[9]Cournot M, Bura A, Cambou JP, et al. Arterial Ultrasound Screening as a Tool for Coronary Risk Assessmente in Asymptomatic Men and Women.Angiology 2012;63(4):282-88[10]Peters MJ, Symmons DP, McCarey D, et al.Eular evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 2010;69:325-3Figure 1.Graphic 1: USD abnormalitiesIMT - intima-media thickness; AP atherosclerotic plaquesDisclosure of Interests:None declared

Circulating Concentrations of the Novel Adipokine Chemerin Are Associated with Cardiovascular Disease Risk in Rheumatoid Arthritis

2014 ◽  
Vol 41 (9) ◽  
pp. 1746-1754 ◽  
Author(s):  
Patrick H. Dessein ◽  
Linda Tsang ◽  
Angela J. Woodiwiss ◽  
Gavin R. Norton ◽  
Ahmed Solomon
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Abdominal Obesity ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Endothelial Activation ◽  
Angiopoietin 2

Objective.Depending on physiological context, the adipokine chemerin can reduce or enhance cardiovascular risk. We investigated whether chemerin concentrations represent cardiovascular disease risk in rheumatoid arthritis (RA).Methods.We assessed ELISA-determined chemerin concentrations and those of 4 early endothelial activation molecules as well as angiopoietin 2, which mediates angiogenesis and thereby contributes to advanced atherosclerosis, the common carotid artery intima-media thickness (cIMT), and carotid artery plaque by ultrasound in 236 patients (114 black and 122 white) with RA. Relationships were identified in potential confounder and mediator-adjusted mixed regression models.Results.Mean (SD) chemerin and median (interquartile range) angiopoietin 2 concentrations were 114 (35) ng/ml and 2560 (2044–3341) pg/ml, respectively; the mean (SD) cIMT was 0.708 (0.110) mm, and 40.3% of patients had plaque. Chemerin concentrations were not related to those of early endothelial activation molecules, but associated with those of angiopoietin 2 [β SE = 0.002 (0.0004), p < 0.0001] and plaque [OR 1.006 (95% CI 1.00–1.013), p = 0.05] in all patients. The presence of major conventional cardiovascular risk factors, generalized and abdominal obesity, and RA severity markers modified the independent chemerin-cardiovascular risk relations (interaction p < 0.05). Consequently, chemerin concentrations were associated with cIMT in those with but not without overweight or generalized obesity and abdominal obesity [β SE = 0.001 (0.0003), p = 0.005 and 0.001 (0.0001), p = 0.001 vs −0.001 (0.0004), p = 0.2 and −0.0002 (0.0004), p = 0.6, respectively], and with plaque in those without but not with generalized obesity [OR 1.008 (95% CI) 1.000–1.016, p = 0.03 vs 1.003 (0.990–1.017), p = 0.6, respectively]. The β (SE) for the chemerin-intima-media thickness relations in patients with overweight or generalized obesity and abdominal obesity were larger than in those without these characteristics (p < 0.0001 and = 0.04, respectively).Conclusion.Chemerin is associated with endothelial activation and atherosclerosis in RA. Adiposity influences the chemerin-atherosclerotic phenotype relations in RA.

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

scholarly journals AB0258 CAROTID INTIMA-MEDIA THICKNESS AND SERUM BIOMARKERS IN PARAGUAYAN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1428.2-1428
Author(s):  
V. Valinotti ◽  
A. Paats ◽  
R. Acosta ◽  
L. Roman ◽  
I. Acosta-Colman ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Disease Duration ◽  
Subclinical Atherosclerosis ◽  
High Sensitivity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Serum Biomarkers ◽  
Carotid Plaques ◽  
Media Thickness ◽  
Hs Crp

Background:The mechanism of increased cardiovascular risk in RA is not well understood and is independent of traditional CV risk factors. Intima-media thickness of the common carotid wall measured by ultrasonogram is a safe and useful biomarker of early stage atherosclerosis that correlates with coronary involvement; and it correlates with severity and duration of disease. Several studies have shown a relationship between inflammation markers, endothelial dysfunction markers, and carotid involvement. (1)Objectives:To determine the presence of inflammation biomarkers and its relationship with subclinical atherosclerosis measured by carotid ultrasound, and with the clinical characteristics in patients with established Rheumatoid Arthritis (RA)Methods:Descriptive, cross sectional, prospective study, in a Paraguayan cohort of patients with RA meeting ACR/EULAR2010 criteria. This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the National Sciences and Technology Council (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, homocysteine, apolipoprotein, fibrinogen, and high sensitivity-CRP levels) and carotid ultrasound evaluation by a trained specialist, to evaluate subclinical atherosclerosis. Subclinical atherosclerosis was defined as carotid intima-media thickness (CIMT) >0,9mm and/or presence of carotid plaques. All patients signed informed consent. SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous, and p ≤ 0.05 for statistical significance.Results:100 patients were included, 87% were women, mean disease duration 130.9±102.64 months, 77% were RF positive, and 84.4% were ACPA positive, 43.4% had bone erosions, mean ESR-DAS28 was 3,42±1,1; 30% had remission criteria. 39% had extra-articular manifestations.Elevated serum biomarkers were found: fibrinogen >400 mg/dL 88.2%, high sensitivity-CRP (hs-CRP) >5mg/dL 42.9%, endothelin >2 ng/mL 20%, alpha-TNF >15,6 pg/mL 13.1%, E-selectin >79,2 ng/mL 6%. 25.3% had CIMT >0,9 mm and mean CIMT was 0.68±0.25mm. 27.14% had carotid plaques. Patients with CIMT>1mm had higher frequency of family history of arterial hypertension (p=0.006), greater mean disease duration (p=0.0007), hip circumference (p=0.014), blood pressure (SBP p=0.038, DBP p=0.027), HAQ levels (p=0,019) and hs-CRP levels (p=0.013), also lower mean height (p=0,04); while carotid plaques were related to higher homocysteine (p=0.026) and hs-CRP levels (p=0.024).Conclusion:A considerable percentage of patients had subclinical atherosclerosis. Patients with CIMT>0,9mm had a longer disease duration, higher HAQ levels, hip circumference, as well as higher BP. High levels of hs-CRP were more frequently related to the presence of subclinical atherosclerosisReferences:[1]Aday, A. targeting residual inflammatory risk: a shifting paradigm for atherosclerotic disease. Frontiers in cardiovascular medicine. 2019. 6:16.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6403155/pdf/fcvm-06-00016.pdfDisclosure of Interests:None declared

scholarly journals Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Naïve

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

Abstract P375: Vascular Age Versus Calendar Age as Surrogate for Atherosclerotic Burden and Cardiovascular Disease Risk

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Specific Reference ◽  
Communication Tool ◽  
Vascular Age

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.

Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
First Degree Relatives ◽  
Age And Sex

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

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