Abstract P260: Can Metabolic Syndrome Predict the Incidence of Silent Myocardial Infarction? An Analysis From the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yong Shen ◽  
Stephanie Filipp ◽  
Matthew J Gurka ◽  
Mark D DeBoer ◽  
Thomas A Pearson
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Severity Score ◽  
Smoking Status ◽  
Heart Diseases ◽  
Significant Risk ◽  
Predictive Tool ◽  
Aric Study ◽  
The Impact ◽  
Silent Myocardial Infarction

Introduction: Diabetes patients are at risk for clinical Myocardial Infarction (MI) and have a larger proportion being silent Myocardial Infarction. However, less is known about the impact of Metabolic Syndrome (MetS, also known as prediabetes) on the incidence of silent MI. Here, we studied whether the degree of MetS severity can be predictive for future risk of silent MI. Methods: 12,527 ARIC study participants who are free of coronary heart diseases (CHD) and diabetes at baseline (1987-1989) were included for the analysis. Silent MI was determined by ECG serial changes of MI without prior clinical history of MI. A continuous MetS severity score was formulated from the integration of MetS components to assess its prediction for future silent MI and clinical MI. Results and Conclusions: 458 participants (3.7%, 458 of 12,527) developed clinical MI and 87 (0.7%, 87 of 12,527) were diagnosed with silent MI until ARIC visit 4 (1996-1998). Within the 10 years follow-up period, gender, smoking status, MetS components (waist circumference, blood pressure, HDL cholesterol) and the integrated MetS severity score were identified as significant risk factors for the incidence of both silent MI and clinical MI. Participants with MetS had a significant adjusted HR for incident silent MI (HR = 1.98, 95% CI: [1.30, 3.02], p=0.0015) as compared to clinical MI (HR = 1.67, 95% CI: [1.39, 2.00], p<0.0001). The 10-year risk scoring equations of silent MI and clinical MI were constructed as a multivariate predictive tool based on MetS severity score. In conclusion, higher MetS severity score is associated with further risk of both clinical and silent MI, identifying the potential clinical application of MetS severity score in MI prevention.

scholarly journals Prevalence of carotid artery disease in patients with metabolic syndrome

2020 ◽  
Vol 12 ◽  
Author(s):  
Tatjana Deleva-Stoshevska
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Significant Risk ◽  
Adequate Treatment ◽  
Effective Prevention ◽  
Linear Probe ◽  
Artery Disease ◽  
The Impact

There is a growing body of scientific evidence on the impact of metabolic syndrome (MetS) on the progression of atherosclerosis, imposing the need for research of the association of MetS with carotid artery disease (CAD) as a significant risk factor for cerebrovascular insult (CVI) and transient ischemic attack (TIA). The aim of the study was to determine the prevalence of CAD as a risk factor for CVI and TIA in subjects with MetS. Material and methods: A cross-sectional study was performed including a total of 118 subjects, 65 men, 53 women, with MetS according to NCEP ATP III criteria that were analyzed clinically, biochemically and ultrasonographically in the City General Hospital "8th September" - Skopje in the period from January 2017 to January 2018. Waist circumference, blood pressure, glycemia, triglycerides, and HDL cholesterol were determined according to standard routine protocols. The evaluation of the extracranial carotid trunk was done with a Color Doppler Duplex sonography with a linear probe of 7.5MHz. CAD assessment was performed using Ultrasound Consensus Criteria for Carotid Stenosis. An objective neurological assessment of the existence of CVI and TIA was performed by a standard protocol for neurological examination and brain CT results from medical history were reviewed. Results: The prevalence of CAD in this study was 77 subjects (65.25%), of which 35 subjects (29.66%) had symptomatic CAD, 17 subjects (48.57%) had CVI, 18 subjects (51.43%) had TIA. Regarding the degree of carotid artery stenosis (CAS) in the total number of subjects with MetS and CAD, no subjects with normal findings were registered, 16 subjects had stenosis <50% , 29 subjects had stenosis 50-69% , 23 subjects had stenosis 70-99% , while 9 subjects had occlusion. Conclusion: The results obtained in this study have shown that asymptomatic CAD is dominant in patients with MetS, which further imposed the need for timely extracranial ultrasonographic evaluation of the carotid trunk. This would achieve both effective prevention and adequate treatment of CVI and TIA, thereby reducing morbidity and mortality from cerebrovascular events which has a great health and socioeconomic significance.

scholarly journals Independent Effects of Metabolic Syndrome and Air Pollution (PM2.5) on Atherosclerosis in Modernizing China

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Woo KS ◽  
◽  
Timothy KCY ◽  
Chook P ◽  
Hu YJ ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Air Pollution ◽  
Hong Kong ◽  
Waist Circumference ◽  
Smoking Status ◽  
Direct Interaction ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Imt ◽  
The Impact

Background: Air Pollution (AP) and metabolic syndrome (MS) are important global health hazards of the 21st century, in mainland China in particular, and AP has been associated with increased prevalence of cardiovascular diseases, and stroke. Methods: To evaluate the impact of metabolic syndrome on AP-related atherogenesis, 1557 Han Chinese adults (mean age 47.2±11.8 years, male 47%) in Hong Kong, Macau, Pun Yu, Yu County (Shanxi coalmine) and 3-Gorges (Yangtze River) were studied. Cardiovascular risk profiles and metabolic syndrome (IDF criteria) were evaluated. PM2.5 (satellite sensor modeling), and atherosclerotic surrogates, brachial reactivity (FMD) and carotid Intima-media thickness (IMT) (ultrasound), were measured. Results: The yearly PM2.5 concentration ranged from 34.0μg/m³ in Hong Kong to 93.8μg/m³ in 3-Gorges Territories. MS was diagnosed in 340 subjects (21.8%). Smoking status, gender and PM2.5 were similar in the MS cohort versus those without MS. Blood pressures (SBP and DBP), waist circumference, triglycerides and glucose were higher, but high-density lipidcholesterol was lower in the MS cohort, compared to the other subjects. Brachial FMD was significantly lower and carotid IMT significantly higher (0.70±0.13 mm, 95% CI 0.68-0.71 mm vs. 0.63mm±0.14mm, 95% CI 0.62-0.64 mm) in the MS cohort than those without (P<0.0001). On multivariate regression, PM2.5 was not related to MS development, but was significantly related to carotid IMT in both no MS (beta=0.234, P<0.0001) and MS cohorts (beta=0.245, p<0.0001), independent of age, SBP, and waist circumference. There was no direct interaction between PM2.5 and MS. Conclusions: Both AP and MS have independent impacts on atherogenic processes in China, with significant implications for atherosclerosis prevention.

The Prevalence of Metabolic Syndrome in an NHANES Population.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5589-5589
Author(s):  
Christopher Hollenbeak ◽  
Eldon Spackman ◽  
Matthew J. Page ◽  
Rami Ben-Joseph3 ◽  
Todd Williamson3
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Metabolic Syndrome ◽  
Acute Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Congestive Heart Failure ◽  
Smoking Status ◽  
Clinical Measures ◽  
Actual Prevalence ◽  
The U.S

Abstract Metabolic syndrome (MetS) is a constellation of metabolic risk factors that can lead to diabetes, cardiovascular events, and other complications. MetS is recognized by several standards-setting bodies, including the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). In this study, we used a nationally representative set of data to create a model to predict the prevalence of MetS in a population from demographic information. Data for this study were from the National Health and Nutrition Examination Survey (NHANES) data set, a nationwide probability sample survey designed to collect information on the health and nutritional status of the U.S. population through interviews and direct physical examinations. NHANES 2001–2002 includes data for 11,039 persons, of which 2,605 had information necessary for identification of metabolic syndrome. A weighted logistic regression model was used to determine the effects of gender, age, ethnicity, and smoking status on the prevalence of MetS based on IDF and NCEP-ATP III criteria. Estimated coefficients were then used to predict the prevalence of MetS conditional on the demographic characteristics of the population. In addition, the model predicts the one-year risk of acute myocardial infarction and stroke as well as the prevalence of coronary heart disease, congestive heart failure, and type 2 diabetes among those with MetS. Values were calculated based on the population age 18 and over as reported by the U.S. Census combined with the NHANES 2001–2002 means for the other demographic variables (gender, mean age, ethnicity, smoking status). The model was validated using an earlier NHANES cohort (1999–2000). Table 1 presents the prevalence of MetS based on the two definitions and the percentage of each population exceeding the risk thresholds for each of the five MetS components. The estimated rate of metabolic syndrome in the U.S. is 25.0% according to the NCEP-ATP III definition and 41.3% according to the IDF definition, a difference most likely attributable to the smaller waist circumference listed by the IDF definition. The complications are not consistently higher for either group as defined by NCEP-ATP III or IDF. The model validation shows how well the model predicts MetS prevalence in the NHANES 1999–2000 data. The predicted prevalence using demographics from NHANES 1999–2000 and following the NCEP-ATP III definition was 24.7% compared to an actual prevalence of 23.1%. Using the IDF definition the prevalence was predicted to be 40.9% and the actual prevalence was 39.2%. For both definitions predictions were within the 95% probability range suggested by the model. In a disease where actual clinical measures are required for diagnosis, it is possible to model and predict the prevalence of MetS using fundamental demographic data. Therefore, this model will be useful for healthcare providers and decision makers in estimating the prevalence of MetS when clinical measures are absent. Table 1. Prevalence of Metabolic Syndrome and Its Components NCEP-ATP III IDF * Annual Risk, ** Prevalence Prevalence 25.0% 41.3% Components High Waist Circumference 88.5% 100% High Triglycerides 83.3% 65.5% Low HDL Cholesterol 82.0% 58.5% High Blood Pressure 62.7% 72.9% High Fasting Plasma Glucose 76.4% 66.0% Complications Acute Myocardial Infarction * 0.4% 0.8% Stroke * 0.8% 0.6% Coronary Heart Disease ** 4.8% 5.0% Congestive Heart Failure ** 4.0% 3.6% Diabetes ** 24.0% 20.6%

scholarly journals The impact of frequency, pattern, intensity, and type of alcohol consumption, and its combined effect with smoking on inflammation, lipid profile, and the risk of myocardial infarction

2019 ◽  
Author(s):  
Ritienne Attard ◽  
Philip Dingli ◽  
Carine J. M. Doggen ◽  
Karen Cassar ◽  
Rosienne Farrugia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Alcohol Consumption ◽  
Lipid Profile ◽  
Smoking Status ◽  
Alcoholic Beverage ◽  
Combined Effect ◽  
Pattern Frequency ◽  
Increased Risk ◽  
Hs Crp ◽  
The Impact

Abstract Aim To determine the risk of myocardial infarction (MI) associated with pattern, frequency, and intensity of alcohol consumption, type of alcoholic beverage, and the combined effect of alcohol and smoking on risk of MI, inflammation, and lipid profile. Method A total of 423 cases with a first MI and 465 controls from the Maltese Acute Myocardial Infarction (MAMI) Study were analysed. Data was collected through an extensive interviewer-led questionnaire, along with measurements of various blood parameters. Medians and the Mann–Whitney test were used to assess effect of different drinking patterns, frequency, intensity, and smoking and drinking combinations on hs-CRP and lipid profile. Odds ratios, adjusted for the conventional risk factors of MI (AdjORs), were calculated as an estimate of the relative risk of MI. Results Regular alcohol consumption protected against MI [AdjOR 0.6 (95% CI 0.4–0.9)] while daily binge drinking increased risk [AdjOR 5.0 (95% CI 1.6–15.0)] relative to regular drinkers who did not binge drink. Whereas moderate weekly consumption of wine protected against MI, high weekly consumption of beer conveyed a deleterious effect. Alcohol consumption decreased risk of MI independent of smoking status. Frequent alcohol consumption was associated with higher HDL-, non-HDL-, total cholesterol and triglycerides, and lower hs-CRP. Total and HDL-cholesterol increased and BMI decreased with increasing quantity of weekly alcohol consumption relative to the non-regular drinkers. The effect of smoking on lipid profile and hs-CRP was less pronounced in current drinkers than in those who were non-regular drinkers. Conclusion The protective effect of alcohol consumption was dependent on the pattern, frequency, type, and intensity of alcohol consumed. Alcohol modified the effects of smoking on the lipid profile. Regular drinking attenuated the effect of smoking on hs-CRP and lipid profile.

scholarly journals 1462. The protective effect of pneumococcal vaccination on cardiovascular disease in adults: A systematic review and meta-analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Fawziah Marra ◽  
Angel Zhang ◽  
Emma Gillman ◽  
Katherine Bessai ◽  
Kamalpreet Parhar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Protective Effect ◽  
Risk Reduction ◽  
Cardiovascular Event ◽  
Meta Analysis ◽  
Significant Risk ◽  
Pneumococcal Vaccination ◽  
The Impact ◽  
Research Grant

Abstract Background Epidemiological studies suggest a link between pneumococcal infection and an adverse cardiovascular outcome such as myocardial infarction. Therefore, studies have evaluated the protective effect of the 23-valent polysaccharide pneumococcal vaccination (PPV23), but results have varied. We conducted a meta-analysis to summarize the available evidence on the impact of PPV23 on cardiovascular disease Methods A literature search from January 1946 to September 2019 was conducted in Embase, Medline and Cochrane. All studies evaluating PPV23 compared to a control (placebo, no vaccine or another vaccine) for any cardiovascular events including myocardial infarction (MI), heart failure, cerebrovascular events were included. Risk ratios (RRs) were pooled using random effects models. Results Eighteen studies were included, with a total of 716,108 participants. Vaccination with PPV23 was associated with decreased risk of any cardiovascular event (RR: 0.91;95% CI: 0.84-0.99), and MI (RR of 0.88; 95% CI:0.79-0.98) in all age groups, with a significant effect in those 65 years and older, but not in the younger age group. Similarly, PPV23 vaccine was associated with significant risk reduction in all-cause mortality in all ages (RR: 0.78; 95%CI: 0.68-0.88), specifically in those aged 65 years and older (RR: 0.71; 95%CI: 0.60-0.84). A significant risk reduction in cerebrovascular disease was not observed following pneumococcal vaccination. Conclusion Polysaccharide pneumococcal vaccination decreases the risk of a cardiovascular event, specifically acute MI in the vaccinated population, particularly those 65 years of age and older. It would be highly beneficial to vaccinate the population who is at greater risk for cardiovascular diseases. Disclosures Fawziah Marra, BSc (Pharm), PharmD, Pfizer Inc (Research Grant or Support) Nirma Khatri Vadlamudi, BA, BS, MPH, Pfizer Inc (Research Grant or Support)

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