Abstract P186: Circulating Desphospho-uncarboxylated Matrix Gla Protein and the Risk of Coronary Heart Disease and Stroke

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Geertje W Dalmeijer ◽  
Yvonne T van der Schouw ◽  
Elke J Magdeleyns ◽  
Cees Vermeer ◽  
W. Monique M Verschuren ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Vitamin K ◽  
Stroke Risk ◽  
Matrix Gla Protein ◽  
Chd Risk ◽  
Increased Risk ◽  
Incident Cases

Background: Matrix Gla protein (MGP) is a vitamin K dependent protein and a potent inhibitor of vascular calcification. Desphospho-uncarboxylated MGP (dp-ucMGP) is a marker for vitamin K status with high dp-ucMGP concentration reflecting a low vitamin K status. High dp-ucMGP concentrations are thought to be associated with an increased risk of cardiovascular disease, but this has never been investigated in the general population. Objective: This study aimed to investigate the association of dp-ucMGP with incident coronary heart disease (CHD) or stroke in the general population. Design and Methods: A prospective case-cohort study with a representative baseline sample of 1406 participants and 1154 and 380 incident cases of CHD and stroke, respectively, was nested within the EPIC-NL study. Dp-ucMGP concentrations were measured by ELISA technique in baseline plasma samples. The incidence of fatal and non-fatal CHD and stroke was obtained by linkage to national registers. Cox proportional hazard models adapted for the case-cohort design were used to calculate hazard ratios (HRs) per standard deviation (SD) and per quartile of circulating dp-ucMGP levels, adjusted for cardiovascular risk factors. Results: This case-cohort study had an average follow-up of 11.5 years. Circulating dp-ucMGP levels were not associated with CHD risk with a HR per SD of 1.00 (95% CI: 0.93-1.07) and a HR Q4 vs Q1 of 0.94 (95% CI: 0.79-1.13) after multivariate adjustment. Circulating dp-ucMGP was not associated with stroke risk with a HR per SD of 0.98 (95% CI: 0.90-1.08) and a HR Q4 vs Q1 of 1.09 (95% CI: 0.78-1.51). Conclusion: This study does not support the hypothesis that high dp-ucMGP levels, reflecting a poor vitamin K status, are associated with increased CHD or stroke risk.

scholarly journals Impact of age on excess risk of coronary heart disease in patients with familial hypercholesterolaemia

Heart ◽  
2018 ◽  
Vol 104 (19) ◽  
pp. 1600-1607 ◽  
Author(s):  
Liv J Mundal ◽  
Jannicke Igland ◽  
Marit B Veierød ◽  
Kirsten Bjørklund Holven ◽  
Leiv Ose ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
Familial Hypercholesterolaemia ◽  
Age Groups ◽  
Primary Objective ◽  
Excess Risk ◽  
Hospital Death ◽  
Increased Risk ◽  
Incident Cases

ObjectiveThe primary objective was to study the risk of acute myocardial infarction (AMI) and coronary heart disease (CHD) in patients with familial hypercholesterolaemia (FH) and compare with the risk in the general population.MethodsPatients with an FH mutation but without prior AMI (n=3071) and without prior CHD (n=2795) were included in the study sample during 2001–2009. We obtained data on all AMI and CHD hospitalisations in Norway. We defined incident cases as first time hospitalisation or out-of-hospital death due to AMI or CHD. We estimated standardised incidence ratios (SIRs) with 95% CIs with indirect standardisation using incidence rates for the total Norwegian population stratified by sex, calendar year and 1 year age groups as reference rates.ResultsSIRs for AMI (95% CIs) were highest in the age group 25–39 years; 7.5 (3.7 to 14.9) in men and 13.6 (5.1 to 36.2) in women and decreased with age to 0.9 (0.4 to 2.1) in men and 1.8 (0.9 to 3.7) in women aged 70–79 years. Similarly, SIRs for CHD were highest among patients 25–39 years old; 11.1 (7.1–17.5) in men and 17.3 (9.6–31.2) in women and decreased 2.4 (1.4–4.2) in men and 3.2 (1.5–7.2) in women at age 70–79. For all age groups, combined SIRs for CHD were 4.2 (3.6–5.0) in men and 4.7 (3.9–5.7) in women.ConclusionPatients with FH are at severely increased risk of AMI and CHD compared with the general population. The highest excess risk was in the youngest group aged 25–39 years, in both sexes.

Increased risk of coronary heart disease among patients with idiopathic inflammatory myositis: a nationwide population study in Taiwan

Rheumatology ◽  
2019 ◽  
Vol 58 (11) ◽  
pp. 1935-1941 ◽  
Author(s):  
Meng-Yu Weng ◽  
Edward Chia-Cheng Lai ◽  
Yea-Huei Kao Yang
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Health Insurance ◽  
Cardiovascular Risk ◽  
General Population ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Idiopathic Myositis

Abstract Objective To evaluate the risk of incident coronary heart disease (CHD) among patients with DM and PM in a general population context. Methods We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database containing records covering the years from 2000 to 2010. DM and PM were confined for the purposes of this study to those aged ⩾18 years who were eligible for the Taiwan catastrophic illness certificate. The diagnoses, CHD outcomes and cardiovascular risk factors were identified from electronic claims data. We conducted two cohort analyses: CHD and DM, and CHD and PM, excluding for each analysis individuals with CHD already identified at baseline. Data for the comparison group was obtained from the Longitudinal Health Insurance database, comprising 1 million persons randomly sampled from the total beneficiaries during 2000. We estimated hazard ratios comparing myositis with comparison cohorts, adjusting for potential cardiovascular risk factors. Results A total of 1145 patients with idiopathic myositis were identified, along with 732 723 control patients aged ⩾18 years. The incidence rates of CHD were 15.1 in DM and 30.1 in PM per 1000 person-years, vs 8.4 and 10.5 per 1000 person-years in the comparison cohort. The adjusted hazard ratios for CHD in patients with idiopathic myositis were 2.21 (95% CI 1.64, 2.99) for DM and 3.73 (95% CI 2.83, 4.90) for PM. Conclusion Results of this general population-based cohort study suggest that DM and PM are associated with an increased risk of CHD.

scholarly journals RESULTS OF THE COMPLEX RISK FACTOR ASSESSMENT FOR THE CORONARY HEART DISEASE IN WORKING POPULATION

2018 ◽  
Vol 97 (4) ◽  
pp. 310-314 ◽  
Author(s):  
Sergey A. Maksimov ◽  
M. V. Tabakaev ◽  
A. N. Chigisova ◽  
G. V. Artamonova
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
White Collar ◽  
Blue Collar ◽  
Chd Risk ◽  
Working Groups ◽  
Total Burden ◽  
Chd Risk Factors

Material and methods. Three groups of men working in Kemerovo region were formed: 694 “white-collar”, 1674 “blue-collar” and 1612 “coal-miners”. To form the comparison group we used data from the Russian research ESSE-RF in the Kemerovo region (700 men). The following cardiovascular risk factors were assessed: hypercholesterolemia, hypertriglyceridemia, hyperglycemia, obesity, hypertension, smoking, and education level. The coronary heart disease (CHD) was diagnosed on the basis of ECG changes on the Minnesota code, Rose questionnaire, and myocardial infarction. According to the frequency of risk factors and their contribution to the probability of developing the coronary heart disease, there was calculated the total burden of CHD risk factors (Maksimov S.A. et al., 2015). Results .The burden of CHD risk factors in the general population up to 51 years accounts for 308 conventional units. There is a variety of risk factors frequency in the working groups, both inside the groups and in comparison with the general population. Consequently, there are differences in values of CHD risk factors burdens. The “blue-collar” burdens of CHD risk factors corresponding to the general population (304 conventional units). In “white-collar” and “miners” this parameter is lower, respectively, 266 and 259 conventional units. After 50 years, the total burden of CHD risk factors in the population increased to 472 conventional units (1.5 times). Differences of this index in the working groups to the general population after 50 years also increased. Conclusion. The working population is characterized by the low total burden of CHD risk factors compared with the general population. After 50 years, these differences increase, which indicates the deterioration of health with age, stimulates the individual to the termination of employment or the ongoing the work as the healthiest individuals. The lowest rates of CHD risk factors burden have been reported in “miners”, the average - in “white collar”, maximum - in “blue-collar”.

Abstract P190: Triggering of Coronary Heart Disease by Infection Type: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Logan Cowan ◽  
Pamela Lutsey ◽  
Jim Pankow ◽  
Kunihiro Matsushita ◽  
Junichi Ishigami ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Infection Type ◽  
Bloodstream Infections ◽  
Infection Frequency ◽  
Acute Infections ◽  
Chd Risk ◽  
Increased Risk ◽  
Infection Types ◽  
Tract Infections

Introduction: Acute infections are known triggers of coronary heart disease (CHD). It is unclear how the strength of the association varies by infection type. Hypothesis: We hypothesized that all acute infections increase CHD risk but the level of increased risk varies by infection type. Methods: Incident CHD (myocardial infarction and fatal CHD) cases were identified and adjudicated in the ARIC cohort. ARIC participants were linked to Medicare claims data. We used ICD-9 codes to identify 4 infection types based on infection frequency: cellulitis, pneumonia, urinary tract infections (UTI), and bloodstream infections. We used a case-crossover design and conditional logistic regression to compare infections among CHD cases 90 days before the event with two corresponding control periods 1 year and 2 years prior. The Wald test was used to assess differences between infection types. Results: A total of 1,312 CHD cases were identified. Among cases, 43 had cellulitis, 102 had pneumonia, 116 had a UTI, and 28 had a bloodstream infection within 90 days of the CHD event. All infection types were associated with higher CHD risk within 90 days of the infection; (odds ratios and 95% Cis) (cellulitis = 1.41 (0.93, 2.15), pneumonia = 5.60 (3.72, 8.43), UTI = 2.62 (1.92, 3.57), bloodstream infections = 4.77 (2.34, 9.71)) although cellulitis was not statistically significant (Figure). The association between infection and CHD was significantly stronger for pneumonia, UTI, and bloodstream infections compared to cellulitis (p<0.05). Pneumonia and bloodstream infections were stronger CHD triggers compared to UTI but only pneumonia reached statistical significance (p<0.05). Conclusions: Patients with pneumonia or bloodstream infections may be at particularly elevated CHD risk. Clinical trials of CHD preventive therapies during and immediately following infection to reduce the otherwise elevated CHD risk are needed. Healthcare providers should consider CHD risk during and immediately after infection and optimize preventive therapies.

Abstract P150: Association of Cholesterol Measures With Coronary Heart Disease Risk in Blacks and Whites in the Reasons for Geographic and Racial Differences in Stroke Study (regards)

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Neil Zakai ◽  
Jessica Minnier ◽  
Monika M Safford ◽  
Lisandro Colantonio ◽  
Marguerite M Irvin ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Total Cholesterol ◽  
Racial Differences ◽  
Cox Regression ◽  
Disease Risk ◽  
Point Estimate ◽  
Chd Risk ◽  
Increased Risk ◽  
Blacks And Whites

Introduction: Abnormal plasma lipid levels associate with coronary heart disease (CHD) risk. Race interaction for these associations are not established. Hypothesis: We hypothesized that the association of HDL, LDL, and triglyceride with CHD is stronger in whites versus blacks. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort recruited 30,283 black and white individuals aged 45+ from the contiguous U.S. from 2003-7. Participants were followed until December 31, 2016 for CHD events (i.e., myocardial infarction or CHD death), participants with history of CHD at baseline were excluded. Cox regression models were used to assess the association between baseline lipids and incident CHD events adjusting for traditional cardiovascular risk factors. Results: With 23,894 participants (57.8% white and 58.4% female, mean age 64.11± 9.32), over a median 9.9 years of follow-up, 1,487 CHD events occurred (615 among blacks). Overall, higher total Cholesterol, LDL cholesterol, and triglycerides were associated with increased risk of CHD in both blacks and whites with no evidence of a race interaction (Table 1). For HDL, the point estimate was more protective in whites (HR 0.90) than in blacks (HR 0.98), but the interaction was non-significant (p=0.15). However, when HDL was stratified into clinical categories (<40, 40-59, and ≥60), the reduction in point estimates was maintained among whites (HR 1.00, 0.88, and 0.74) but not among blacks (HR 1.00, 1.31, and 1.19) for HDL <40, 40-59, and ≥60 respectively, p-interaction 0.01. Conclusion: Total cholesterol, LDL, and triglycerides predict CHD risk equally in blacks and whites in the REGARDS study, however there is heterogeneity in the protective effect by race, especially when traditional clinical categories are used. In whites, higher HDL is associated with reduced risk, whereas in blacks the association is not maintained. These findings suggest that HDL levels are a more viable metric for white than blacks to predict CHD risk.

Epidemiology, morbidity and mortality in Behçet’s disease: a cohort study using The Health Improvement Network (THIN)

Rheumatology ◽  
2020 ◽  
Vol 59 (10) ◽  
pp. 2785-2795 ◽  
Author(s):  
Tom Thomas ◽  
Joht Singh Chandan ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
George Gkoutos ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Venous Thrombosis ◽  
Ischaemic Heart Disease ◽  
Thromboembolic Disease ◽  
Age And Gender ◽  
Increased Risk ◽  
And Gender

Abstract Objectives The epidemiology of Behçet’s disease (BD) has not been well characterized in the UK. Evidence on the risk of cardiovascular disease, thromboembolic disease and mortality in patients with BD compared with the general population is scarce. Methods We used a large UK primary care database to investigate the epidemiology of BD. A retrospective matched cohort study was used to assess the following outcomes: risk of cardiovascular, thromboembolic disease and mortality. Controls were selected at a 1:4 ratio (age and gender matched). Cox proportional hazard models were used to derive adjusted hazard ratios (aHR). Results The prevalence of BD was 14.61 (95% CI 13.35–15.88) per 100 000 population in 2017. A total of 1281 patients with BD were compared with 5124 age- and gender-matched controls. There was significantly increased risk of ischaemic heart disease [aHR 3.09 (1.28–7.44)], venous thrombosis [aHR 4.80 (2.42–9.54)] and mortality [aHR 1.40 (1.07–1.84)] in patients with BD compared with corresponding controls. Patients with BD were at higher risk of pulmonary embolism compared with corresponding controls at baseline [adjusted odds ratio 4.64 (2.66–8.09), P &lt; 0.0001]. The majority of patients with pulmonary embolism and a diagnosis of BD had pulmonary embolism preceding the diagnosis of BD, not after (87.5%; n = 28/32). Conclusion BD has a higher prevalence than previously thought. Physicians should be aware of the increased risk of developing ischaemic heart disease, stroke/transient ischaemic attack and deep venous thrombosis in patients with BD at an earlier age compared with the general population. Risk of embolism in patients with BD might vary across the disease course.

scholarly journals Gender Differences in Risks of Coronary Heart Disease and Stroke in Patients with Type 2 Diabetes Mellitus and Their Association with Metabolic Syndrome in China

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mei-Fang Yao ◽  
Jie He ◽  
Xue Sun ◽  
Xiao-Li Ji ◽  
Yue Ding ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Type 2 Diabetes Mellitus ◽  
Heart Disease ◽  
Stroke Risk ◽  
Chinese Women ◽  
Chd Risk

Coronary heart disease (CHD) and stroke are common complications of type 2 diabetes mellitus (T2DM). We aimed to explore the differences in the risks of CHD and stroke between Chinese women and men with T2DM and their association with metabolic syndrome (MS). This study included 1514 patients with T2DM. The Asian Guidelines of ATPIII (2005) were used for MS diagnosis, and the UKPDS risk engine was used to evaluate the 10-year CHD and stroke risks. Women had lower CHD risk (15.3% versus 26.3%), fatal CHD risk (11.8% versus 19.0%), stroke risk (8.4% versus 10.3%), and fatal stroke risk (1.4% versus 1.6%) compared with men with T2DM (p<0.05–0.001). The CHD risk (28.4% versus 22.6%, p<0.001) was significantly higher in men with MS than in those without MS. The CHD (16.2% versus 11.0%, p<0.001) and stroke risks (8.9% versus 5.8%, p<0.001) were higher in women with MS than in those without MS. In conclusion, our findings indicated that Chinese women with T2DM are less susceptible to CHD and stroke than men. Further, MS increases the risk of both these events, highlighting the need for comprehensive metabolic control in T2DM.

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