Risk Factors and 20-Year Stroke Mortality in Men and Women in the Renfrew/Paisley Study in Scotland

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

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Sex-specific reference values and determinants of infra-renal abdominal aortic diameter among women and men from general population

European Heart Journal ◽

10.1093/ehjci/ehaa946.2841 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

F Zhu ◽

B Arshi ◽

M Ikram ◽

R De Knegt ◽

M Kavousi

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Reference Values ◽

Aortic Diameter ◽

Funding Source ◽

Men And Women ◽

Abdominal Aortic

Abstract Introduction Abdominal aortic diameter has shown to be a marker of adverse cardiovascular outcomes. Among the non-aneurysmal populations, studies regarding abdominal aortic diameter normal reference values are sparse. Moreover, data regarding the associations between cardiovascular risk factors and aortic diameter among men and women are limited. Purpose To establish age- and sex-specific distribution of the infra-renal abdominal aortic diameters among non-aneurysmal older adults from the general population and to investigate the associations between cardiovascular risk factors and aortic diameters in men and women. Methods From a population-based cohort, 4032 participants (mean age, 67.2 years; 60.4% women) with infra-renal diameter assessment and without history of cardiovascular disease were included. Mean and quantile values of diameters were calculated in different age groups. Multiple linear regression analysis was used to detect the association of cardiovascular risk factors with diameters in men and women. Results The mean crude diameter was larger in men [mean (SD): 19.5 (2.6) mm] compared to women [17.0 (2.4)mm] but after adjustment for body surface area (BSA), the differences were small. There was a non-linear relationship between age and diameter (p<0.001). After 66 years of age, the increase in diameter with increasing age was attenuated. After age 74 years in women and 71 years in men, the relationship between age and infra-renal aortic diameter was no longer statistically significant (Figure). Waist [standardized β (95% CI): 0.02 (0.0–0.04) in women and 0.03 (0.01–0.06) in men] and diastolic blood pressure [0.04 (0.02–0.05) in women and 0.02 (0.0–0.04) in men] were the risk factors for diameters in both sexes. Body mass index [0.02 (0.01–0.09)], systolic blood pressure [−0.01 (−0.02 to −0.01)], smoking status [0.21 (0.02–0.39)], cholesterol [−0.19 (−0.29 to −0.09)], and lipid-lowering medication [−0.47 (−0.71 to −0.23)] were significantly associated with aortic diameter only in women. Conclusion The differences in the crude abdominal aortic diameter between women and men diminished after taking into account the BSA. The abdominal aortic diameter increased steeply with advancing age and up to 66 years of age. However, after 74 years in women and 71 years in men, the diameter values reached a plateau. We also observed sex differences in the associations of cardiovascular risk factors with abdominal aortic diameter. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Netherlands Organization for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE)

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Risk factors for falls in a longitudinal population-based cohort study of Japanese men and women: The ROAD Study

Bone ◽

10.1016/j.bone.2012.10.020 ◽

2013 ◽

Vol 52 (1) ◽

pp. 516-523 ◽

Cited By ~ 28

Author(s):

Shigeyuki Muraki ◽

Toru Akune ◽

Yuyu Ishimoto ◽

Keiji Nagata ◽

Munehito Yoshida ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Population Based ◽

Japanese Men ◽

Men And Women ◽

The Road ◽

Risk Factors For Falls ◽

Road Study

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Lipoprotein(a) and Risk of Type 2 Diabetes

Clinical Chemistry ◽

10.1373/clinchem.2010.146779 ◽

2010 ◽

Vol 56 (8) ◽

pp. 1252-1260 ◽

Cited By ~ 99

Author(s):

Samia Mora ◽

Pia R Kamstrup ◽

Nader Rifai ◽

Børge G Nordestgaard ◽

Julie E Buring ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Men And Women ◽

Lipoprotein A ◽

Incident Type ◽

Reactive Protein ◽

Hb A1c ◽

Hormone Use

BACKGROUND Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein(a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass index, hemoglobin A1c (Hb A1c), C-reactive protein, and lipids. RESULTS Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2–5 vs quintile 1 of 0.87 (0.75–1.01), 0.80 (0.68–0.93), 0.88 (0.76–1.02), and 0.78 (0.67–0.91); P for trend 0.002. The association was stronger in nonfasting women, for whom respective HRs were 0.79 (0.58–1.09), 0.78 (0.57–1.08), 0.66 (0.46–0.93), and 0.56 (0.40–0.80); P for trend 0.001; P for interaction with fasting status 0.002. When we used Lp(a) ≥10 mg/L and Hb A1c <5% as reference values, the adjusted HRs were 1.62 (0.91–2.89) for Lp(a) <10 mg/L and Hb A1c <5%, 3.50 (3.06–4.01) for Lp(a)≥10 mg/L and Hb A1c 5%–<6.5%, and 5.36 (4.00–7.19) for Lp(a) <10 mg/L and Hb A1c 5%–<6.5%. Results were similar in nonfasting Danish men and women, for whom adjusted odds ratios were 0.75 (0.55–1.03), 0.64 (0.46–0.88), 0.74 (0.54–1.01), and 0.58 (0.42–0.79) for Lp(a) quintiles 2–5 vs quintile 1; P for trend 0.002. CONCLUSIONS Our results indicated that Lp(a) was associated inversely with risk of type 2 diabetes independently of risk factors, in contrast to prior findings of positive associations of Lp(a) with cardiovascular risk.

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