Abstract 147: The Role of Thrombin Generation in Cardiovascular Disease and Mortality - Results from the Population-based Gutenberg Health Study

Abstract Aims To assess the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in the general population and to investigate the associated cardiovascular burden and clinical outcome. Methods and Results The study sample comprised 15,010 individuals aged 35–74 years of the population-based Gutenberg Health Study. Subjects were classified into euglycaemia, prediabetes and T2DM according to clinical and metabolic (HbA1c) information. The prevalence of prediabetes was 9.5% (n = 1415) and of T2DM 8.9% (n = 1316). Prediabetes and T2DM showed a significantly increased prevalence ratio (PR) for age, obesity, active smoking, dyslipidemia, and arterial hypertension compared to euglycaemia (for all, P < 0.0001). In a robust Poisson regression analysis, prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PRprediabetes 1.20, 95% CI 1.07–1.35, P = 0.002) and represented as a risk factor for asymptomatic cardiovascular organ damage independent of traditional risk factors (PR 1.04, 95% CI 1.01–1.08, P = 0.025). Prediabetes was associated with a 1.5-fold increased 10-year risk for cardiovascular disease compared to euglycaemia. In Cox regression analysis, prediabetes (HR 2.10, 95% CI 1.76–2.51, P < 0.0001) and T2DM (HR 4.28, 95% CI 3.73–4.92, P < 0.0001) indicated for an increased risk of death. After adjustment for age, sex and traditional cardiovascular risk factors, only T2DM (HR 1.89, 95% CI 1.63–2.20, P < 0.0001) remained independently associated with increased all-cause mortality. Conclusion Besides T2DM, also prediabetes inherits a significant cardiovascular burden, which translates into poor clinical outcome and indicates the need for new concepts regarding the prevention of cardiometabolic disorders.

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P5361The diabetic continuum and its relation with cardiovascular disease: results from the population-based Gutenberg health study

European Heart Journal ◽

10.1093/eurheartj/ehx493.p5361 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

V. Schmitt ◽

A. Leuschner ◽

A. Pinto ◽

A. Schulz ◽

C. Juenger ◽

...

Keyword(s):

Cardiovascular Disease ◽

Population Based ◽

Health Study ◽

Gutenberg Health Study

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Vision-related quality of life considering both eyes: results from the German population-based Gutenberg Health Study (GHS)

Health and Quality of Life Outcomes ◽

10.1186/s12955-019-1158-1 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Stefan Nickels ◽

Alexander K. Schuster ◽

Heike Elflein ◽

Christian Wolfram ◽

Andreas Schulz ◽

...

Keyword(s):

Quality Of Life ◽

Population Based ◽

Health Study ◽

German Population ◽

Gutenberg Health Study ◽

Related Quality

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Development of DX-9065a, a novel direct factor Xa antagonist, in cardiovascular disease

Thrombosis and Haemostasis ◽

10.1160/th04-05-0289 ◽

2004 ◽

Vol 92 (12) ◽

pp. 1182-1193 ◽

Cited By ~ 5

Author(s):

John Alexander ◽

Christopher Dyke ◽

Robert Harrington ◽

Richard Becker

Keyword(s):

Cardiovascular Disease ◽

Thrombin Generation ◽

Circulatory System ◽

Factor Xa ◽

Pivotal Role ◽

Direct Factor ◽

Cellular Effects ◽

Potential Applications ◽

Pharmacologic Inhibitors

SummaryThe development of anticoagulants for treating patients with atherothrombotic disorders of the arterial circulatory system has focused, either directly or indirectly, on thrombin – a pleuripotential effector enzyme with prothrombotic and proinflammatory properties. The pivotal role of factor (f) Xa in thrombin generation, coupled with its direct cellular effects and widely recognized limitations of currently available anticoagulants, has led to the development of pharmacologic inhibitors of this important protease. The following review focuses on DX9065a – first in a class of direct, selective and reversible fXa antagonists – and its potential applications in the management of patients with cardiovascular disease.

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Atrial Fibrillation Manifestations Risk Factors and Sex Differences in a Population-Based Cohort (From the Gutenberg Health Study)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2018.03.028 ◽

2018 ◽

Vol 122 (1) ◽

pp. 76-82 ◽

Cited By ~ 4

Author(s):

Christina Magnussen ◽

Francisco M. Ojeda ◽

Philipp S. Wild ◽

Nils Sörensen ◽

Thomas Rostock ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Sex Differences ◽

Population Based ◽

Health Study ◽

Gutenberg Health Study

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The association of chronic anxiousness with cardiovascular disease and mortality in the community: results from the Gutenberg Health Study

Scientific Reports ◽

10.1038/s41598-020-69427-8 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Iris C. Reiner ◽

Ana N. Tibubos ◽

Antonia M. Werner ◽

Mareike Ernst ◽

Elmar Brähler ◽

...

Keyword(s):

Cardiovascular Disease ◽

Health Study ◽

Gutenberg Health Study

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Association between faecal haemoglobin concentration and the risk of cardiovascular diseases among Taiwanese adults in a community-based screening cohort

BMJ Open ◽

10.1136/bmjopen-2019-032633 ◽

2020 ◽

Vol 10 (6) ◽

pp. e032633 ◽

Cited By ~ 1

Author(s):

Kuo-Liong Chien ◽

Ting-Yu Lin ◽

Chen-Yang Hsu ◽

Chang-Chuan Chan ◽

Tony Hsiu-Hsi Chen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Diseases ◽

Cardiovascular Events ◽

Reference Group ◽

Haemoglobin Concentration ◽

Population Based ◽

Trend Test ◽

Cohort Study Design

ObjectivesThe role of faecal haemoglobin as a colorectal cancer screening tool has been demonstrated. However, the association between the faecal haemoglobin concentration and the risk of cardiovascular disease events and deaths is still unclear.DesignCohort study design.SettingPopulation-based organised integrated service screening in Keelung City, TaiwanParticipantsA total of 33 355 healthy individuals aged over 40 years who were free of cardiovascular disease at study entry were followed up.Main outcomes and measuresNewly diagnosed cardiovascular disease events and deaths.ResultsAfter a median follow-up of 2.39 years, a total of 2768 participants developed cardiovascular events, and after a median follow-up of 8.43 years, 317 cases of cardiovascular deaths occurred. The risk of cardiovascular disease increased with baseline faecal haemoglobin in a dose–response manner, yielding a significant elevated risk of cardiovascular disease in parallel with the incremental concentration of faecal haemoglobin (adjusted HRs=1.04, 1.10, 1.40 and 1.23 for faecal haemoglobin concentrations of 1–19, 20–49, 50–99 and ≥100 ng/mL, trend test, p<0.0001, as compared with the reference group with undetectable faecal haemoglobin concentrations). A similar pattern was observed for the risk of cardiovascular disease deaths. In addition, the faecal haemoglobin improved the prediction performance of the model for the risk of cardiovascular diseases; the integrated discrimination improvement was 0.3% (p<0.001) for cardiovascular events and 0.1% (p=0.020) for cardiovascular deaths.ConclusionsOur data support that faecal haemoglobin concentrations may be associated with the risk of cardiovascular diseases. The biological mechanisms underlying the role of faecal haemoglobin as health outcomes should be investigated.

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No evidence for an association of plasma homocysteine levels and refractive error – Results from the population-based Gutenberg Health Study (GHS)

PLoS ONE ◽

10.1371/journal.pone.0231011 ◽

2020 ◽

Vol 15 (4) ◽

pp. e0231011

Author(s):

Stefan Nickels ◽

Henk J. Blom ◽

Andreas Schulz ◽

Lutz Joachimsen ◽

Thomas Münzel ◽

...

Keyword(s):

Refractive Error ◽

Population Based ◽

Plasma Homocysteine ◽

Health Study ◽

Gutenberg Health Study

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Cardiovascular health outcomes of mobbing at work: results of the population-based, five-year follow-up of the Gutenberg health study

Journal of Occupational Medicine and Toxicology ◽

10.1186/s12995-020-00266-z ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Karla Romero Starke ◽

Janice Hegewald ◽

Andreas Schulz ◽

Susan Garthus-Niegel ◽

Matthias Nübling ◽

...

Keyword(s):

Arterial Stiffness ◽

Cardiovascular Health ◽

Population Based ◽

Health Study ◽

Single Item ◽

Men And Women ◽

Gutenberg Health Study ◽

Increased Risk ◽

Study Population

Abstract Background The aim of this study was to determine if there is an increased risk of incident cardiovascular disease (CVD) resulting from workplace mobbing measured with two mobbing instruments in the Gutenberg Health Study. Methods In this prospective study, we examined working persons younger than 65 years for the presence of mobbing at baseline and at a 5-year follow-up using a single-item and a 5-item instrument. We used multivariate models to investigate the association between mobbing and incident CVD, hypertension, and change in arterial stiffness and further stratified the models by sex. Results After adjustment for confounders, mobbed workers appeared to have a higher risk of incident CVD than those not mobbed (single-item HR = 1.28, 95% CI 0.73–2.24; 5-item HR = 1.57, 95% CI 0.96–2.54). With the 5-item instrument, men who reported mobbing had a higher risk of incident CVD (HR = 1.77, 95% CI 1.01–3.09), while no association was observed for women (HR = 1.05, 95% CI 0.38–2.91). There was no difference in risks between men and women with the single-item instrument. No association between mobbing and incident hypertension and arterial stiffness was seen. Conclusions Our results show an indication of an increased risk of incident CVD for those mobbed at baseline when using the whole study population. Differences in risks between men and women when using the five-item instrument may be due to the instrument itself. Still, it is essential to detect or prevent workplace mobbing, and if present, to apply an intervention to halt it in order to minimize its adverse effects on CVD.

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