The Correlation of Dyslipidemia with the Extent of Coronary Artery Disease in the Multiethnic Study of Atherosclerosis

Background.The extent of coronary artery calcium (CAC) improves cardiovascular disease (CVD) risk prediction. The association between common dyslipidemias (combined hyperlipidemia, simple hypercholesterolemia, metabolic Syndrome (MetS), isolated low high-density lipoprotein cholesterol, and isolated hypertriglyceridemia) compared with normolipidemia and the risk of multivessel CAC is underinvestigated.Objectives.To determine whether there is an association between common dyslipidemias compared with normolipidemia, and the extent of coronary artery involvement among MESA participants who were free of clinical cardiovascular disease at baseline.Methods.In a cross-sectional analysis, 4,917 MESA participants were classified into six groups defined by specific LDL-c, HDL-c, or triglyceride cutoff points. Multivessel CAC was defined as involvement of at least 2 coronary arteries. Multivariate Poisson regression analysis evaluated the association of each group with multivessel CAC after adjusting for CVD risk factors.Results.Unadjusted analysis showed that all groups except hypertriglyceridemia had statistically significant prevalence ratios of having multivessel CAC as compared to the normolipidemia group. The same groups maintained statistical significance prevalence ratios with multivariate analysis adjusting for other risk factors including Agatston CAC score [combined hyperlipidemia 1.41 (1.06–1.87), hypercholesterolemia 1.55 (1.26–1.92), MetS 1.28 (1.09–1.51), and low HDL-c 1.20 (1.02–1.40)].Conclusion.Combined hyperlipidemia, simple hypercholesterolemia, MetS, and low HDL-c were associated with multivessel coronary artery disease independent of CVD risk factors and CAC score. These findings may lay the groundwork for further analysis of the underlying mechanisms in the observed relationship, as well as for the development of clinical strategies for primary prevention.

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Ethnicity and cardiovascular risk factors

ESC CardioMed ◽

10.1093/med/9780198784906.003.0698_update_001 ◽

2018 ◽

pp. 2887-2892

Author(s):

Nizal Sarrafzadegan ◽

Farzad Masoudkabir

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Waist Circumference ◽

Black People ◽

South Asians ◽

Cvd Risk Factors ◽

White People ◽

Cvd Risk ◽

Artery Disease

Significant variation is evident among different ethnicities regarding the prevalence, awareness, severity, treatment, and complications of major cardiovascular disease (CVD) risk factors. Relative to white Europeans, stroke mortality is almost doubled in South Asians and Afro-Caribbeans; however, when coronary artery disease mortality is considered, it is high in South Asians and low in Afro-Caribbeans. Hypertension is more common, severe, and is associated with higher rates of morbidity and mortality in black people than white people. Diabetes is more prevalent and less controlled in South Asians which leads to a nearly fourfold higher cardiovascular mortality in South Asians than other ethnic groups. Furthermore, South Asians suffer from a highly atherogenic lipid profile. In contrast, black people are generally known for their higher high-density lipoprotein and lower triglyceride levels than white people which seem to play a major role in protecting them from coronary artery disease. For a given waist circumference, Asian, black, and Caucasian people show different levels of intra-abdominal adiposity and CVD risk. Hence, the joint definition from five major organizations in 2009 of the metabolic syndrome set ethnic-specific values of waist circumference to define central obesity. Black Caribbean men have the highest rates of current smoking among all ethnic groups in the United Kingdom while nearly all South Asian and black African women are never-smokers. Varied genetic and lifestyle-related risk factors and their interactions seem to be responsible for the ethnic differences in CVD risk factors. There is a clear need for ethnic-specific guidelines for diagnosis and treatment of major CVD risk factors to maximize the outcomes of preventive strategies.

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Cardiovascular Risk Factor Control and Lifestyle Factors in Young to Middle-Aged Adults with Newly Diagnosed Obstructive Coronary Artery Disease

Cardiology ◽

10.1159/000498891 ◽

2019 ◽

Vol 142 (2) ◽

pp. 83-90 ◽

Cited By ~ 3

Author(s):

Michael S. Garshick ◽

Georgeta D. Vaidean ◽

Anish Vani ◽

James A. Underberg ◽

Jonathan D. Newman ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Obstructive Coronary Artery Disease ◽

Coronary Intervention ◽

Cvd Risk Factors ◽

Middle Aged ◽

Cvd Risk ◽

Aged Patients ◽

Artery Disease

Background: While progress in the prevention of cardiovascular disease (CVD) has been noted over the past several decades, there are still those who develop CVD earlier in life than others. Objective: We investigated traditional and lifestyle CVD risk factors in young to middle-aged patients compared to older ones with obstructive coronary artery disease (CAD). Methods: A retrospective analysis of patients with a new diagnosis of obstructive CAD undergoing coronary intervention was performed. Young to middle-aged patients were defined as those in the youngest quartile (n = 281, mean age 50 ± 6 years, 81% male) compared to the other three older quartiles combined (n = 799, mean age 69 ± 7.5 years, 71% male). Obstructive CAD was determined by angiography. Results: Young to middle-aged patients compared to older ones were more likely to be male (p < 0.01), smokers (21 vs. 9%, p < 0.001), and have a higher body mass index (31 ± 6 vs. 29 ± 6 kg/m2, p < 0.001). Younger patients were less likely to eat fruits, vegetables, and fish and had fewer controlled CVD risk factors (2.7 ± 1.2 vs. 3.0 ± 1.0, p < 0.001). Compared to older patients, higher levels of psychological stress (aOR 1.6, 95% CI 1.1–2.4), financial stress (aOR 1.8, 95% CI 1.3–2.5), and low functional capacity (aOR 3.3, 95% CI 2.4–4.5) were noted in the young to middle-aged population as well. Conclusion: Lifestyle in addition to traditional CVD risk factors should be taken into account when evaluating risk for development of CVD in a younger population.

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Expression of adiponectin and il-6 by local fat depots of the heart: relationship with the main risk factors for cardiovascular diseases

European Heart Journal ◽

10.1093/ehjci/ehaa946.1492 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

O.V Gruzdeva ◽

E Belik ◽

Y.U.A Dyleva ◽

D.A Borodkina ◽

E.G Uchasova ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Funding Source ◽

Mrna Levels ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Adiponectin Mrna ◽

Artery Disease

Abstract Introduction Previous studies have identified a number of pro-inflammatory and other markers potentially associated with atherogenesis, which are also expressed and produced by adipose tissue. Atherosclerosis is a multifactorial disease, in the development of which both unmodifiable factors (gender, age) and modifiable factors (smoking, dyslipidemia) contribute, and further study of the pathogenetic relationships of adipocytokines and CVD risk factors is necessary. Purpose To evaluate the features of the expression of adiponectin and IL-6 in the epicardial (EAT), perivascular (PVAT), subcutaneous adipose tissue (SAT) and its relationship with the main risk factors for CVD. Materials and methods The study included 84 patients with stable coronary artery disease (CAD) who were planning coronary artery bypass grafting (CABG). During the operation, adipose tissue (AT) biopsy samples were obtained. The expression of adiponectin and IL-6 genes was evaluated by the method of quantitative polymerase reaction in real time (PCR) depending on the presence or absence of CVD risk factors. Results It was found that adipocytes of EAT are characterized by the lowest expression of the adiponectin gene against the background of the maximum - IL-6. In men, the adiponectin mRNA level in EAT and PVAT is reduced (2.5 and 2.8 times). The expression of IL-6 in male patients is higher in SAT (3 times) and lower in PVAT than in women. The presence of dyslipidemia is associated with a decrease in the expression of both adiponectin in EAT and PVAT (2.7 and 3.6 times), and IL-6 in PVAT (2.3 times). People with arterial hypertension (AH) have lower levels of adiponectin in EAT and PVAT (2 and 1.8 times) with high levels of IL-6 in SAT and EAT (8 and 10.4 times). With an increase in the experience of hypertension for more than 20 years, adiponectin expression decreases in all types of AT with an increase in IL-6 in PVAT (2 times) and a decrease in SAT. Smoking is associated with increased adiponectin mRNA levels. Patients 51–59 years old are characterized by high expression of IL-6 in EAT and PVAT in comparison with parameters of other age groups. Conclusions The revealed decrease in the expression of adiponectin in EAT against the background of an increase in pro-inflammatory IL-6 can enhance atherogenesis, and in combination with risk factors such as male sex, the presence of dyslipidemia and hypertension contribute to the progression of coronary artery disease. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Russian Scientific Foundation no. 17-75-20026

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Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

Cardiology Research and Practice ◽

10.1155/2014/804751 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Okon Ekwere Essien ◽

Joseph Andy ◽

Victor Ansa ◽

Akaninyene Asuquo Otu ◽

Alphonsus Udoh

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Alcohol Use ◽

Cigarette Smoking ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Mean ◽

Artery Disease

Introduction. Death from coronary artery disease (CAD) has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD) risk factors in South South Nigeria.Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria.Results. CAD was diagnosed in 13 (1.6%) of 747 autopsies. They were predominantly males, urban residents, and of high social class with combination of CVD risk factors of hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activities, and obesity. The mean serum cholesterol of the clinical subjects was4.7±1.57 mmol/L and5.07±1.94 mmol/L for angina and myocardial infarction, respectively, which was higher than the mean total cholesterol for locality of 3.1 mmol/L.Conclusion. CAD and its risk factors are contributing to mortality and morbidity in South South Nigeria. These risk factors include hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activity, and obesity. Nigerians in this locality with CAD have raised serum lipids.

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Shared genetic architecture between neuroticism, coronary artery disease and cardiovascular risk factors

Translational Psychiatry ◽

10.1038/s41398-021-01466-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kristin Torgersen ◽

Shahram Bahrami ◽

Oleksandr Frei ◽

Alexey Shadrin ◽

Kevin S. O’ Connell ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Genome Wide Association Study ◽

Molecular Genetic ◽

Elastic Fiber ◽

Fiber Formation ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Artery Disease

AbstractNeuroticism is associated with poor health, cardiovascular disease (CVD) risk factors and coronary artery disease (CAD). The conditional/conjunctional false discovery rate method (cond/conjFDR) was applied to genome wide association study (GWAS) summary statistics on neuroticism (n = 432,109), CAD (n = 184,305) and 12 CVD risk factors (n = 188,577–339,224) to investigate genetic overlap between neuroticism and CAD and CVD risk factors. CondFDR analyses identified 729 genomic loci associated with neuroticism after conditioning on CAD and CVD risk factors. The conjFDR analyses revealed 345 loci jointly associated with neuroticism and CAD (n = 30), body mass index (BMI) (n = 96) or another CVD risk factor (n = 1–60). Several loci were jointly associated with neuroticism and multiple CVD risk factors. Seventeen of the shared loci with CAD and 61 of the shared loci with BMI are novel for neuroticism. 21 of 30 (70%) neuroticism risk alleles were associated with higher CAD risk. Functional analyses of the genes mapped to the shared loci implicated cell division, nuclear receptor, elastic fiber formation as well as starch and sucrose metabolism pathways. Our results indicate polygenic overlap between neuroticism and CAD and CVD risk factors, suggesting that genetic factors may partly cause the comorbidity. This gives new insight into the shared molecular genetic basis of these conditions.

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Ethnicity and cardiovascular risk factors

ESC CardioMed ◽

10.1093/med/9780198784906.003.0698 ◽

2018 ◽

pp. 2887-2892

Author(s):

Nizal Sarrafzadegan ◽

Farzad Masoudkabir

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Waist Circumference ◽

Black People ◽

South Asians ◽

Cvd Risk Factors ◽

White People ◽

Cvd Risk ◽

Artery Disease

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Abstract 13224: Which White Cell Subtypes Predict the Presence of Coronary Artery Disease in High Risk Patients Over 55 Years Old?

Circulation ◽

10.1161/circ.132.suppl_3.13224 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Issada Trakarnwijitr ◽

Bobby V Li ◽

Heath Adams ◽

Jamie Layland ◽

John Garlick ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

High Risk ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Lymphocyte Ratio ◽

High Risk Patients ◽

Risk Patients ◽

Artery Disease

Introduction: Inflammation has an important role in initiation and progression of coronary artery disease (CAD). Different white cell count (WCC) subtypes may reflect different mechanisms of this complex disease, and may be valuable clinically in risk stratification and detection of patients with CAD. Studies on the correlation between WCC subtypes and CAD have yielded conflicting results. Hypothesis: We hypothesized that WCC subtypes are associated with the presence of CAD in high-risk patients over 55 years old. Methods: We analyzed 622 patients over the age of 55 from the BRAVEHEART and MINACS cohort who were referred for coronary angiogram at our institution. Univariate and multivariate logistic regression models were used to compare different WCC subtypes as predictors of presence of CAD, defined as ≥50% stenosis of 1 or more coronary arteries. We adjusted for age, sex and conventional cardiac risk factors. Results: On univariate analysis, patients with CAD had significantly more CVD risk factors compared to control patients. Markers associated with CAD were lower lymphocytes (tertile 2 OR 0.61, 95% CI 0.39-0.98, p=0.040, tertile 3 OR 0.70, 95% CI 0.44-1.12, p=0.139), and higher monocytes (tertile 3 OR 2.51, 95% CI 1.45-4.34, p=0.001), neutrophil-lymphocyte ratio (NLR) (OR 1.70, 95% CI 1.07-2.68, p=0.024), and monocyte-lymphocyte ratio (MLR) (tertile 3 OR 2.62, 95% CI 1.61-4.26, p<0.001). After adjustment for CVD risk factors, lower lymphocytes (tertile 2 OR 0.40, 95% CI 0.22-0.73, p=0.003, tertile 3 OR 0.50, 95% CI 0.27-0.93, p=0.028), and higher monocytes (tertile 3 OR 2.38, 95% CI 1.23-4.61, p=0.010), NLR (tertile 3 OR 1.91, 95% CI 1.08-3.38, p=0.025), and MLR (tertile 3 OR 2.26, 95% CI 1.23-4.14, p=0.009) were associated with CAD. Conclusions: In high-risk patients over 55 years old, lower lymphocytes, and higher monocytes, NLR and MLR were associated with angiographically determined CAD independent of other risk factors. Monocytes and MLR were the strongest correlates of CAD in high-risk patients over 55. Whether these can be used as biomarkers of CAD in high risk patients warrants further study.

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