Abstract 11288: Breast Arterial Calcifications and Their Association With Cardiovascular Disease in the Prospect Cohort

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eva J Hendriks ◽  
Joline W Beulens ◽  
Willem P Mali ◽  
Yolanda van der Graaf ◽  
Pim A de Jong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Mortality ◽  
Arterial Calcification ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Medial Arterial Calcification

Introduction: Breast arterial calcifications (BAC) are a type of medial arterial calcification observed at mammography. They are more prevalent among diabetes patients and thought to be associated with increased cardiovascular risk, but high quality longitudinal studies are scarce. We aimed to investigate the association of BAC with risk of different types of cardiovascular outcomes. Methods: We performed a series of case-cohort studies nested within the PROSPECT-EPIC cohort, including a random subcohort (n = 1672), and incident cases of coronary heart disease (n=1050), stroke (n=399) peripheral artery disease (n=257), cardiovascular mortality (n=250), and type 2 diabetes (n=526). At baseline BAC was scored as absent, mild, moderate or severe by experienced radiologists. The average follow-up time was 12.0(±1.9) years. We calculated hazard ratios(HRs) using Cox proportional hazards models, adapted to the case-cohort design through Prentice-weighting and adjusting for traditional cardiovascular risk factors. Results: Of the women in the sub cohort with mammograms available (n=1540), 133 women (8.6%) had BAC in at least one breast. Grade was scored as mild in 75 women (4.9%), moderate in 39 women (2.5%) and severe in 19 women (1.2%). BAC presence was borderline significantly (0.05<p<0.10) associated with risk of coronary heart disease, stroke and cardiovascular mortality, with adjusted HR estimates ranging from 1.42 to 1.58. Much larger effect sizes were found for women with the most severe grade of BAC, as they had a HR of 3.43 (95% CI 1.85-6.37) for coronary heart disease, a HR of 3.19 (95% CI 1.52-6.72) for stroke, a HR of 2.92 (95%CI 1.02-8.35) for peripheral artery disease and a HR of 3.55 (95%CI 1.48-8.52) for cardiovascular mortality compared to women without BAC. Conclusions: BAC presence is modestly associated with cardiovascular disease, with an approximately 3-fold increased risk for the severest grade of BAC, independent of traditional risk factors. This indicates a possible contribution of a medial, non-atherosclerotic pathway to cardiovascular disease events. Whether BAC is a marker of medial arterial calcification in different vascular beds needs to be further investigated.

scholarly journals Cardiovascular Disease Risk Factors in HIV-Infected Adults in Nyeri County, Kenya

2021 ◽  
Vol 11 (5) ◽  
pp. 117-124
Author(s):  
Regina Kamuhu ◽  
Beatrice Mugendi ◽  
Judith Kimiywe
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
High Serum ◽  
Care Clinic ◽  
Obesity Class

Cardiovascular diseases (CVD) is currently second, after cancer, as the most frequent cause of death among HIV-positive subjects in areas of the world where Highly active anti-retroviral therapy (HAART) is widely available. The purpose of this study was to investigate cardiovascular disease markers in HIV-infected adults attending comprehensive care clinic in Nyeri Level- 5- Hospital. The results are based on a sample of 85 participants that randomly selected for an intervention study with two study arms. Descriptive statistics were used to analyze all study variables. Relationships between all and individual CVD risk factors were analyzed using Spearman’s correlation coefficient. Criterion for statistical significance was at p < 0.05 and 90% power of test. Twenty nine percent of the respondents were aged fifty years and above while 48.2% were between 40-49 years. Only 5.9% of the respondents smoked while 8.2% drunk alcohol. Twenty seven percent (27.1%) had low physical activity while 24.7% had obesity class I (30-34.9), 8.2% had obesity class II (35-39.9) while 1.5% had obesity class III (> 40). Another 31.8% were overweight (25-29.9). 28.2% had hypertension stage I (140-159) and another 11.8% had hypertension stage II (>160). Twenty two percent (22.4%) had high total cholesterol (>6.2), while 34.1% had high serum triglycerides (2.25-5.6) and another 4.7% had very high serum LDL-C (>4.91). Framingham’s risk score was used to determine the 10-year risk of developing a coronary heart disease. Majority of the participants (60%) had low (<10%) 10-year risk of coronary heart disease at the baseline. There is a high prevalence of hypertension and overweight/obesity among HIV+ patients. Key words: Cardiovascular risk factors, cardiovascular risk score, lipid profile, Framingham risk score.

Coronary artery disease--ignored in women or inherently more lethal in women?

1998 ◽  
Vol 7 (1) ◽  
pp. 77-79 ◽  
Author(s):  
KB Keller ◽  
L Lemberg
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Coronary Artery ◽  
Noninvasive Testing ◽  
Atypical Chest Pain ◽  
Artery Disease

The leading cause of death in women is cardiovascular disease. The major cardiovascular risk factors have a greater impact on women. The prognosis for women with CAD is worse than for men. Women frequently present with symptoms of heart disease at a much later age and have a greater frequency of atypical chest pain. Noninvasive testing is less reliable in women. Do these facts indicate that CAD is inherently a more lethal disease in women? Or is CAD, as some would suggest, traditionally ignored in women? Stay tuned!

scholarly journals D-dimer and the Risk of Stroke and Coronary Heart Disease

2017 ◽  
Vol 117 (03) ◽  
pp. 618-624 ◽  
Author(s):  
Leslie A. McClure ◽  
Suzanne E. Judd ◽  
Brett Kissela ◽  
George Howard ◽  
Monika M. Safford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Vascular Disease ◽  
Cardiovascular Risk Factors ◽  
Hazard Ratio ◽  
The Difference ◽  
D Dimer

SummaryD-dimer, a biomarker of coagulation, is higher in blacks than in whites and has been associated with stroke and coronary heart disease (CHD). It was our objective to assess the association of higher D-dimer with stroke and CHD in blacks and whites. REGARDS recruited 30,239 black and white participants across the contiguous US and measured baseline D-dimer in stroke (n=646) and CHD (n=654) cases and a cohort random sample (n=1,104). Cox models adjusting for cardiovascular risk factors determined the hazard ratio (HR) for increasing D-dimer for cardiovascular disease with bootstrapping to assess the difference in HR for CHD versus stroke by race. D-dimer was higher with increasing age, female sex, diabetes, hypertension, pre-baseline cardiovascular disease and higher C-reactive protein (CRP). Accounting for cardiovascular risk factors, each doubling of D-dimer was associated with increased stroke (hazard ratio [HR] 1.15; 95 % confidence interval [CI] 1.01, 1.31) and CHD (HR 1.27; 95 % CI 1.11, 1.45) risk. The difference in the HR between CHD and stroke was 0.20 (95 % CI >0.00, 0.58) for blacks and 0.02 (95 % CI –0.30, 0.27) for whites. CRP mediated 22 % (95 % CI 5 %, 41 %) of the association between D-dimer and CHD and none of the association with stroke. Higher D-dimer increased the risk of stroke and CHD independent of cardiovascular risk factors and CRP, with perhaps a stronger association for CHD versus stroke in blacks than whites. These findings highlight potential different pathophysiology of vascular disease by disease site and race suggesting potential further studies targeting haemostasis in primary prevention of vascular disease.

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

scholarly journals Correction to: Association between cholesterol efflux capacity and peripheral artery disease in coronary heart disease patients with and without type 2 diabetes: from the CORDIOPREV study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elena M. Yubero-Serrano ◽  
Juan F. Alcalá-Diaz ◽  
Francisco M. Gutierrez-Mariscal ◽  
Antonio P. Arenas-de Larriva ◽  
Patricia J. Peña-Orihuela ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Peripheral Artery Disease ◽  
Cholesterol Efflux ◽  
Peripheral Artery ◽  
Cholesterol Efflux Capacity ◽  
Artery Disease

An amendment to this paper has been published and can be accessed via the original article.

Cardiac biomarkers for cardiovascular risk prediction among women and men from the general population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Zhu ◽  
B Arshi ◽  
E Aribas ◽  
MA Ikram ◽  
MK Ikram ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Predictive Value ◽  
Troponin T ◽  
Cardiac Biomarkers ◽  
C Statistic ◽  
Cardiovascular Risk Prediction ◽  
Traditional Risk Factors

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): the Erasmus Medical Center and Erasmus University Rotterdam; the Netherlands Organization for Health Research and Development (ZonMw); Purpose To evaluate the sex-specific predictive value of two cardiac biomarkers; N-terminal pro B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin T (hs-cTnT), alongside traditional cardiovascular risk factors, for 10-year cardiovascular risk prediction in general population. Methods A total of 5430 participants (mean age 68.1 years; 59.9% women) free of cardiovascular disease (CVD), with blood sample measurements between 1997 and 2001 were included. We developed a ‘base’ model using cardiovascular risk factors used in the Pooled Cohort Equation (includes age, sex, systolic blood pressure, treatment of hypertension, total and high-density lipoprotein cholesterol levels, smoking, and diabetes) and then extended the ‘base’ model with NT-proBNP or hs-cTnT. These models were developed for coronary heart disease (CHD), stroke, and heart failure (HF) and also for composite CVD outcomes. To evaluate biomarkers’ added predictive value, c-statistic, and net reclassification improvement index (NRI) for events and non-events were calculated. NRI was calculated using cutoffs of 5%, 7.5% and 20% to categorize participants as low, borderline, intermediate, or high risk. Results Adding NT-proBNP to the ‘base’ model significantly improved c-statistic for all outcomes (increases ranged between 0.012-0.047), with the largest improvement in HF [0.026 (95% CI, 0.013, 0.040) for women and 0.047 (95% CI, 0.026, 0.069) for men]. Adding hs-TnT to ‘base’ model increased the c-statistic for CHD in women by 0.040 (95% CI, 0.013, 0.067) and for HF in men by 0.032 (95% CI, 0.005, 0.059). Improvments in reclassification by both biomarkers were mostly limited to modest improvemetns in reclassification of non-events [largest non-event NRI for global CVD in women (NT-proBNP: 11.8%; hs-cTnT: 10.5%) and for HF in men (NT-proBNP: 9.6%; hs-cTnT: 8.4%)]. Conclusion NT-proBNP improved model performance for prediction of all cardiovascular outcomes, in particular for HF, beyond traditional risk factors for both women and men. Hs-cTnT showed modest added predictive value beyond traditional risk factors for CHD among women and for HF among men. Imropovements in reclassification by both biomarkers were modest and not clinically relevant. Improvements of 10-year risk predictions Events Adding NT-proBNP Adding troponin T Delta c-statistic* Event NRI, % Non-event NRI, % Delta c-statistic* Event NRI, % Non-event NRI, % WomenASCVD Global CVD 0.012 (0.004, 0.020) 0.018 (0.010, 0.026) -1.7 (-5.0, 1.5)-0.8 (-3.8, 2.2) 5.4 (3.5, 7.2)11.8 (9.6, 14.1) 0.028 (0.009, 0.048)0.025 (0.009, 0.040) -0.4 (-7.1, 6.2)2.9 (-2.4, 8.3) 6.9 (3.9, 9.9)10.5 (7.3, 13.8) MenASCVD Global CVD 0.016 (0.005, 0.027)0.023 (0.012, 0.033) 0.7 (-2.3, 3.7)-0.3 (-3.0, 2.4) 5.2 (3.2, 7.2)7.2 (4.9, 9.4) 0.007 (-0.002, 0.016)0.011 (0.000, 0.021) -1.1 (-5.0, 2.7)-1.6 (-6.0, 2.8) 4.0 (1.2, 6.9)6.4 (3.1, 9.7) ASCVD comprises coronary heart disease and stroke; Global CVD comprises coronary heart disease, stroke and heart failure.

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

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