Abstract 3482: Prevalence and Progression of Subclinical Atherosclerosis in Younger Adults with Low 10-Year Risk but High Lifetime Risk for Cardiovascular Disease: Findings from the CARDIA and MESA Studies

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jarett D Berry ◽  
Kiang Liu ◽  
Aaron R Folsom ◽  
Joseph F Polak ◽  
Cora E Lewis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Disease Burden ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Lifetime Risk ◽  
Younger Adults ◽  
Carotid Imt ◽  
Subclinical Disease

Objective : The Adult Treatment Panel (ATP) III recommends estimating 10-year risk for cardiovascular disease (CVD), but this strategy identifies few individuals age ≤ 50 years as high risk. Many individuals have a lifetime risk up to 70% despite a low 10-year risk (<10%) for CVD. We hypothesized that individuals with low 10-year/high lifetime risk would have a greater burden of subclinical atherosclerosis compared to individuals with low 10-year/low lifetime risk. Methods : We included individuals age ≤ 50 from two multiethnic NHLBI-sponsored studies designed to assess the importance of risk factors in the development of CVD [2988 from Coronary Artery Risk Development in Young Adults (CARDIA) study;1076 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA)]. The ATP III 10-year risk and lifetime risk for CVD were estimated for each participant, permitting stratification into three groups: low 10-year (<10%)/low lifetime (<39%) risk, low 10-year (<10%)/high lifetime risk (≥ 39%), and high 10-year risk (≥ 10%). Diabetics were considered to have high 10-year (≥ 10%) risk in all analyses. Baseline levels (CAC, IMT) and change in levels of subclinical atherosclerosis (CAC progression) were compared across the 3 risk strata for both cohorts. Results : As expected, those with high 10-year risk (≥ 10%) had the greatest burden of subclinical atherosclerosis in both studies. Among individuals with low 10-year risk (91% of all participants) in CARDIA, individuals with a high lifetime risk had significantly greater carotid IMT, higher CAC prevalence, and greater incidence of CAC progression compared to individuals with low lifetime risk (see table ). A remarkably similar pattern of results was observed in MESA. Conclusions : Individuals with low 10-year but high lifetime risk for CVD have a greater subclinical disease burden and greater incidence of atherosclerotic progression compared to individuals with low 10-year but low lifetime risk. Baseline Carotid Intima-Media Thickness (IMT), Coronary Artery Calcium (CAC) Prevalence and Progression among CARDIA Participants

scholarly journals Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

2021 ◽  
Author(s):  
Eliana Portilla-Fernández ◽  
Shih-Jen Hwang ◽  
Rory Wilson ◽  
Jane Maddock ◽  
W. David Hill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dna Methylation ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Association Studies ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

Abstract 17791: Yield of Different Approaches for Screening for Cardiovascular Disease in Asymptomatic Diabetics

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Timothy W Churchill ◽  
Carlos H Rassi ◽  
Carlos A Fernandes Tavares ◽  
Mateus G Fahel ◽  
Fabricia P Rassi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Carotid Plaque ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Coronary Plaque ◽  
Carotid Ultrasound ◽  
Asymptomatic Subjects ◽  
A Prospective Study

Introduction: While diabetes has long been considered a coronary heart disease equivalent, there is increasing evidence to suggest that not all individuals with diabetes have cardiovascular disease, and it is unclear how best to risk stratify this population. We sought to compare the yield of testing for pre-clinical atherosclerosis with various approaches. Methods: A group of 98 asymptomatic subjects with type 2 diabetes mellitus (T2DM) without known coronary artery disease (CAD) were enrolled in a prospective study and underwent carotid ultrasound, exercise treadmill testing (ETT), coronary artery calcium (CAC) scoring, and coronary computed tomography angiography (CTA). CTA was used as the reference standard for CAD. Results: Of 98 subjects (average age 55±6, 64% female, 22 on insulin, mean A1c 7.3%), 43 (44%) had coronary plaque detectable on CTA, and 38 (39%) had CAC score > 0. By CTA, 16 (16%) had coronary stenosis ≥ 50%, including 3 subjects with CAC=0. Subjects with coronary plaque had greater prevalence of carotid plaque (58% vs. 38%, p=0.01) and greater carotid intima media thickness (0.80±0.20 mm vs. 0.70±0.11mm, p=0.02). However, 18 of the 55 subjects (33%) with normal CTA had carotid plaque. Eight subjects had a positive ETT, of whom 5 had ≥ 50% coronary stenosis and 2 had <50% stenosis, but there was no difference in METS achieved between subjects with and without plaque (8.2 vs. 8.7, p=0.19). Test characteristics of different imaging modalities for prediction of coronary plaque are shown in Figure 1. Conclusion: Among asymptomatic subjects with T2DM, a majority (56%) had no CAD by CTA. CAC was the most accurate screening modality for detection of CAD while ETT and carotid ultrasound had a limited sensitivity. Interestingly, 33% of subjects with normal CTA had carotid plaque. Further studies are needed to better characterize stroke risk in such patients and whether there is a role for screening for carotid plaque in diabetics without CAC or with normal CTA.

Common femoral artery intima-media thickness as marker for cardiovascular disease in asymptomatic adults

VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Giannoukas ◽  
Antoniou ◽  
Saleptsis ◽  
Baros ◽  
Griffin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Common Femoral Artery ◽  
Carotid Intima Media Thickness ◽  
Carotid Imt ◽  
Media Thickness ◽  
Similar Correlation ◽  
The Common

Background: The common carotid intima-media thickness (IMT) is considered as a marker of cardiovascular disease, while the value of the common femoral IMT is not well defined. The aim of the present study was to investigate the value of common femoral IMT alone or in combination with the common carotid IMT as a marker of cardiovascular disease in asymptomatic adults. Patients and Methods: Eighty-three individuals with no history of cardiovascular disease were subjected to IMT measurement of both common carotid and common femoral arteries with high-resolution ultrasonography. The Framingham Heart Study (FHS) risk score was calculated for each subject (according to gender) and was correlated with the carotid IMT, femoral IMT, and the combined IMT measured at both arterial sites. Results: The carotid and femoral IMT separately and in combination were found to be correlated with the FHS risk score, calculated based on either the total cholesterol or low density lipoprotein plasma levels (carotid IMT: r = 0.28, p = 0.035, and r = 0.35, p = 0.007, respectively, femoral IMT: r = 0.38, p = 0.003, and r = 0.43, p = 0.001, respectively, carotid-femoral IMT: r = 0.37, p = 0.005, and r = 0.46, p = 0.0001, respectively). In addition, femoral IMT was found to be correlated with the carotid IMT (r = 0.41, p = 0.001). Conclusions: Common carotid and common femoral IMT showed similar correlation with the FHS risk score. Additionally, the combination of IMT from both arterial sites was found to have similar correlation with the FHS risk score to carotid IMT alone.

scholarly journals Predictors of Subclinical Cardiovascular Disease in Women with Polycystic Ovary Syndrome: Interrelationship of Dyslipidemia and Arterial Blood Pressure

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Djuro Macut ◽  
Marina Bačević ◽  
Ivana Božić-Antić ◽  
Jelica Bjekić-Macut ◽  
Milorad Čivčić ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Clinical Markers ◽  
Ovary Syndrome ◽  
Arterial Blood

Background. Women with polycystic ovary syndrome (PCOS) could develop subclinical atherosclerosis during life.Purpose. To analyze cardiovascular risk (CVR) factors and their relation to clinical markers of cardiovascular disease (CVD) in respect to their age.Material and Methods. One hundred women with PCOS (26.32±5.26years, BMI:24.98±6.38 kg/m2) were compared to 50 respective controls. In all subjects, total cholesterol (TC), HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, resp.), and carotid intima-media thickness (CIMT) were analyzed in respect to their age and level of androgens.Results. PCOS over 30 years had higher WHR (P=0.008), SBP (P<0.001), DBP (P<0.001), TC (P=0.028), HDL-C (P=0.028), LDL-C (P=0.045), triglycerides (P<0.001), TC/HDL-C (P<0.001), and triglycerides/HDL-C (P<0.001) and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P=0.005and 0.036, resp.). TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P=0.045and 0.034, resp.).Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure.

scholarly journals Hubungan ear lobe crease dengan penyakit jantung koroner

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Jacqueline A. Fuzairi ◽  
Dewi U. Djafar ◽  
Agnes L. Panda
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Case Control ◽  
Control Group ◽  
Media Thickness ◽  
Artery Disease

Abstract: Cardiovascular disease is a huge burden in terms of mortality, disability, and morbidity in this day. Prevention of cardiovascular disease is based on the physical signs. Waist circumference, Ankle Brachial Index (ABI) and Carotid Intima Media Thickness (CIMT) are useful to recognize occult atherosclerosis, so as ear lobe crease. However, medics have less attention about examination of ear lobe crease for detection of coronary artery disease. This study aimed to determine the relation of ear lobe crease and coronary artery disease. This was an analytical observational study with a case control design. The results showed that there were 45 samples for control group and 45 samples for case group. The statistical analysis showed the X2 = 21.78 with a p value <0,001 which indicated that there was a significant correlation between Ear Lobe Crease and Coronary Artery Disease. The OR = 8.9% (95% CI 3.4 -23.3) meant that if a person had ear lobe crease, the possibility of coronary artery disease was 8.9 times higher than a person without ELC. Conclusion: There was a significant correlation between Ear Lobe Crease and Coronary Artery Disease.Keywords: ear lobe crease, coronary artery diseaseAbstrak: Penyakit Kardiovaskular merupakan penyebab utama kematian, kecacatan dan kesakitan saat ini. Deteksi penyakit kardiovaskular sebagai tindakan pencegahan dapat dilihat melalui pemeriksaan fisik. Pengukuran lingkar pinggang, Ankle Brachial Index (ABI), dan Carotid Intima Media Thickness (CIMT) sangat berguna untuk penanda aterosklerosis subklinis, begitu pula dengan Ear Lobe Crease. Namun sampai saat ini, pemeriksaan Ear Lobe Crease untuk menilai penyakit jantung koroner kurang mendapat perhatian petugas medis. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner. Metode: Penelitian ini dilakukan menggunakan metode penelitian analitik observasional dengan case control. Hasil penelitian: Sampel penelitian terdiri dari 45 orang untuk kelompok kontrol dan 45 orang untuk kelompok kasus. Berdasarkan uji X2 diperoleh X2 = 21,78 dengan p < 0,001. Hasil ini menunjukkan bahwa adanya hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner (p < 0,001). Dalam uji ini, juga diperoleh OR = 8,9 (95% CI: 3,4 – 23,3). Odd Ratio (OR) ini menyatakan bahwa bila seseorang ditemukan adanya ELC, maka orang tersebut berisiko 8,9 kali mendapat Penyakit Jantung Koroner dibanding dengan orang tanpa ELC. Simpulan: Terdapat hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner.Kata kunci: ear lobe crease, penyakit jantung koroner.

scholarly journals 1145Obesity-related changes in metabolomic profiles in youth

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Toby Mansell ◽  
Matthew Sabin ◽  
Zoe McCallum ◽  
Markus Juonala ◽  
David Burgner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Childhood And Adolescence ◽  
Metabolic Dysfunction ◽  
Metabolomic Profile ◽  
Early Effect ◽  
Analogous Data ◽  
The Relationship

Abstract Background Obesity during childhood and adolescence is linked to subclinical atherosclerosis, metabolic dysfunction and later cardiovascular disease. Adults with obesity have metabolomic profiles that predict cardiovascular disease and mortality. Analogous data from children with obesity are sparse. Here, we aimed to investigate i) the relationship between the severity of obesity (determined by the percentage above the 95th BMI-centile (%&gt;95th BMI-centile)) and metabolomic profiles, ii) the effect of changes in the severity of obesity on the metabolomic profile and iii) the relationship between obesity-related metabolites and subclinical atherosclerosis outcomes. Methods Participants from the Childhood Overweight Biorepository of Australia (COBRA) cohort had %&gt;95th BMI-centile and NMR metabolomic profile (Nightingale, Finland) from fasted blood analysed at two time-points (mean interval of 5.5 years). At the follow-up visit, subclinical atherosclerosis phenotypes (carotid elasticity, carotid intima-media thickness, and pulse-wave velocity) were assessed. Results There were 98 participants who attended both visit 1 (mean %&gt;95th BMI-centile 134.6±19.0) and visit 2 (mean %&gt;95th BMI-centile 130.7±26.2). Higher absolute, and increasing severity, of obesity between visits were associated with increased phenylalanine, tyrosine, GlycA (a marker of chronic inflammation), and pyruvate, in both sexes (estimated increases of 0.14-0.18 standard deviations per 10% BMI-centile at visit 2, and 0.15-0.25 per 10% increase in BMI-centile between visits). There was modest evidence for a relationship between lower alanine and higher carotid elasticity. Conclusions In children with obesity, the overall severity of obesity and changes in obesity severity were associated with a metabolomic pattern that in adults is predictive of cardiovascular disease. In children, these metabolites were not related subclinical atherosclerosis; these relationships may become manifest with increasing age. Key messages There is evidence for an early effect of severe obesity on metabolomic profiles in childhood and adolescence.

scholarly journals Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiu-Shong Liu ◽  
Chia-Ing Li ◽  
Yuh-Cherng Guo ◽  
Chih-Hsueh Lin ◽  
Wen-Yuan Lin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystatin C ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Carotid Imt ◽  
Low Hdl ◽  
Hs Crp

Abstract Background Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis.

scholarly journals Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels

2020 ◽  
Vol 9 (5) ◽  
pp. 1422 ◽  
Author(s):  
Marco Gentile ◽  
Arcangelo Iannuzzi ◽  
Francesco Giallauria ◽  
Antonello D’Andrea ◽  
Elio Venturini ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Carotid Imt

Background: atherosclerotic process inexorably advances in patients reaching low-density lipoprotein cholesterol (LDL-C) targets. An attractive hypothesis is that lipoprotein particles (very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL)), could contribute to residual risk. The present study aims to investigate the relationship between carotid intima-media thickness (IMT) and different lipoprotein subfractions in a cohort of healthy postmenopausal women. Methods: 75 postmenopausal women, at LDL-C target levels without overt cardiovascular disease, underwent biochemical analyses (including subfraction assay of plasma lipoproteins) and carotid ultrasound examination. Results: a statistically significant correlation between VLDL and carotid IMT (p < 0.001) was found. No significant correlation was found between carotid IMT and LDL-C (p = 0.179), IDL-C (p = 0.815), high-density lipoprotein (HDL) (p = 0.855), and LDL score (p = 0.240). Moreover, IMT is significantly correlated to LDL particle diameter (p = 0.044). After adjusting for age, systolic blood pressure, body mass index, smoking habits, glucose plasma concentration, and Lipoprotein(a) (Lpa) levels, multivariate analysis showed that women in the third tertile of VLDL-C, compared with those in the first tertile, were significantly associated to the highest IMT (p = 0.04). Conclusions: in this cohort of postmenopausal women, VLDL-C was significantly associated to carotid IMT, independent of main cardiovascular risk factors. These findings pave the way for targeting circulating concentrations of VLDL-C to reduce cardiovascular events in patients with target LDL-C levels.

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