Abstract MP27: Saturated Fat Intake From Dairy Sources Is Associated With Reduced Cardiovascular Risk In Framingham Offspring Study Women

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mengjie Yuan ◽  
Richard Pickering ◽  
Martha Singer ◽  
Lynn L Moore
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Proportional Hazards ◽  
Dietary Assessment ◽  
Saturated Fat ◽  
Cox Proportional Hazards ◽  
Food Sources ◽  
Lipid Lowering ◽  
Cvd Risk ◽  
Diet Records

Introduction: While saturated fat (SFA) intake has long been considered as an important risk factor for cardiovascular disease (CVD), some evidence in recent years has called these findings into question. There is limited evidence examining the separate effects of SFAs from different food sources on cardiovascular risk. Objective: The goal of this study was to determine whether higher (vs. lower) intakes of SFA from dairy and non-dairy sources were associated with risk of incident cardiovascular disease. Methods: Data from 1991 adults, ages 30 and older, who were free of CVD at the time of baseline dietary assessment in the prospective Framingham Offspring Study were included in these analyses. Dairy and non-dairy SFA was assessed using 3-day diet records at exams 3 and 5; intakes were adjusted for body weight using the residual method. Subjects were followed from exam 5 to exam 9 for CVD events (median follow-up 16.9 years). Cox proportional hazards models were used to adjust for confounding by sex, age, BMI, physical activity, smoking (pack-years), non-dairy SFA (in dairy SFA models, and vice versa for non-dairy models), and time dependent occurrence of hypertension or use of lipid-lowering medications. Results: Subjects were classified into 3 categories of sex-specific intake of dairy SFA (<9, 9-<13, and ≥13 g/day for men; <6, 6-<9, ≥9 g/day for women) and non-dairy SFA (<15, 15-<18 and ≥18 g/day for men; <12, 12-<15, and ≥15 g/day for women). Women with moderate (vs. low) and high (vs. low) dairy SFA intakes had 56% (95% CI: 0.27-0.71) and 20% (95% CI: 0.56-1.14) lower CVD risks, respectively, while women consuming high (vs. low) non-dairy SFA had 22% (CI: 0.52-1.16) lower risks. Neither dairy-based SFA nor non-dairy SFA intake was associated with CVD occurrence in men. To determine whether the combined effects of SFA from dairy and non-dairy sources were associated with CVD risk, we cross-classified SFA intakes from the two sources (i.e., high/low dairy SFA intake: <9 vs. ≥9 g/day for men, <6 vs ≥6 g/day for women; high/low non-dairy SFA intake: <15 vs. ≥15 g/day for both men & women). Overall, subjects with higher intakes of dairy SFA combined with lower intakes of non-dairy SFA had the lowest risks of CVD (HR:0.73; 95% CI: 0.54-0.98). These effects were stronger in women (HR:0.60; 95% CI: 0.41-0.88), and non-statistically significant in men (HR: 0.88; 95% CI: 0.54-1.43). Women with higher combined intakes of SFA from both dairy and non-dairy sources still had 44% lower risks of CVD. However, higher intakes of SFA from non-dairy sources alone was not associated with CVD risk in either men or women. Conclusions: Saturated fats derived from dairy sources were associated with a reduced risk of incident CVD in women. For both men and women, those who had higher intakes of dairy-derived SFA combined with lower intakes of non-dairy SFA tended to have lower risks of CVD than those with lower intakes of SFA from both sources.

scholarly journals Differential Effects of Dietary Fats on Serum Lipids and Risks of Cardiovascular Disease and Diabetes in the Prospective Framingham Offspring Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1508-1508
Author(s):  
Mengjie Yuan ◽  
R Taylor Pickering ◽  
Martha Singer ◽  
Lynn l Moore
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Fats ◽  
Sensitivity Analyses ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Particle Sizes ◽  
Cvd Risk ◽  
Increased Risk

Abstract Objectives Few studies have estimated the independent effects of butter and margarine on risk of cardiovascular disease (CVD). Our goal was to examine these effects as well as that of other fats and oils on risk of CVD and markers of cardiometabolic risk in subjects in the prospective Framingham Offspring Study. Methods Data from 2038 adults, who were free of CVD and diabetes through exam 5 were included. Intakes of butter, margarine, mayonnaise, oils, and shortening were assessed using 3-day diet records at exams 3 and 5. Concentrations of low-density lipoproteins (LDL), high-density lipoproteins (HDL), and their particle sizes were analyzed cross-sectionally at exam 5. Subjects were followed from exam 5 to 9 for incident CVD and type 2 diabetes (T2DM) (median follow-up, 16.9 years). Cox proportional hazards models were used to estimate risk of CVD and T2DM and generalized linear models were used to evaluate effects on other cardiometabolic outcomes, while adjusting for age, sex, pack-years of smoking, BMI, physical activity, intakes of other fats, hypertension and use of lipid-lowering medication. Intake of each type of dietary fat was categorized as low, moderate, or high using sensitivity analyses. Results Intake of &gt;5 g/day of butter (vs. non-consumers) had no effect on CVD risk but was associated with a non-statistically significant 24% lower risk of T2DM. In men, higher butter intake was linked with larger LDL and HDL particles sizes (P &lt; 0.01 for both) and a lower LDL: HDL ratio (P &lt; 0.01). Consuming &gt;7 g/day (vs. ≤2) of margarine was associated with a 48% (95% CI: 1.03–2.13) increased risk of CVD and a 68% (95% CI: 1.00–2.82) higher risk of T2DM in women. In men, higher margarine intake was associated with much weaker, non-statistically significant increased risks of CVD and T2DM. Finally, total intake of oils (&gt;7 vs. ≤2 g/day) was associated with a strong reduced risk of T2DM (HR: 0.55; 95% CI: 0.36–0.85) in men but not women. There was no effect of margarine or oils on lipid particle sizes in either men or women. Conclusions While butter intake had no adverse effect on risk of CVD in either men or women, it was beneficially associated with lipid profiles in men. In women, higher intakes of margarine but not butter were associated with increased risks of both CVD and T2DM. Finally greater oil consumption led to lower risks of T2DM in men. Funding Sources NHLBI National Dairy Council.

scholarly journals Added value of cardiovascular calcifications for prediction of recurrent cardiovascular events and cardiovascular interventions in patients with established cardiovascular disease

2021 ◽  
Author(s):  
Cilie C. van ’t Klooster ◽  
◽  
Yolanda van der Graaf ◽  
Hendrik M. Nathoe ◽  
Michiel L. Bots ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Valve ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Added Value ◽  
Cvd Risk ◽  
Major Cardiovascular Events ◽  
Cox Proportional Hazards Models ◽  
Cardiovascular Interventions

AbstractThe purpose is to investigate the added prognostic value of coronary artery calcium (CAC), thoracic aortic calcium (TAC), and heart valve calcium scores for prediction of a combined endpoint of recurrent major cardiovascular events and cardiovascular interventions (MACE +) in patients with established cardiovascular disease (CVD). In total, 567 patients with established CVD enrolled in a substudy of the UCC-SMART cohort, entailing cardiovascular CT imaging and calcium scoring, were studied. Five Cox proportional hazards models for prediction of 4-year risk of MACE + were developed; traditional CVD risk predictors only (model I), with addition of CAC (model II), TAC (model III), heart valve calcium (model IV), and all calcium scores (model V). Bootstrapping was performed to account for optimism. During a median follow-up of 3.43 years (IQR 2.28–4.74) 77 events occurred (MACE+). Calibration of predicted versus observed 4-year risk for model I without calcium scores was good, and the c-statistic was 0.65 (95%CI 0.59–0.72). Calibration for models II–V was similar to model I, and c-statistics were 0.67, 0.65, 0.65, and 0.68 for model II, III, IV, and V, respectively. NRIs showed improvement in risk classification by model II (NRI 15.24% (95%CI 0.59–29.39)) and model V (NRI 20.00% (95%CI 5.59–34.92)), but no improvement for models III and IV. In patients with established CVD, addition of the CAC score improved performance of a risk prediction model with classical risk factors for the prediction of the combined endpoint MACE+ . Addition of the TAC or heart valve score did not improve risk predictions.

scholarly journals Risk and Timing of Cardiovascular Disease After Androgen-Deprivation Therapy in Men With Prostate Cancer

2015 ◽  
Vol 33 (11) ◽  
pp. 1243-1251 ◽  
Author(s):  
Sean O'Farrell ◽  
Hans Garmo ◽  
Lars Holmberg ◽  
Jan Adolfsson ◽  
Pär Stattin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cardiovascular Disease ◽  
Androgen Deprivation Therapy ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Androgen Deprivation ◽  
Gnrh Agonists ◽  
Cvd Risk ◽  
Comparison Cohort ◽  
Using Data

Purpose Findings on the association between risk of cardiovascular disease (CVD) and the duration and type of androgen-deprivation therapy (ADT) in men with prostate cancer (PCa) are inconsistent. Methods By using data on filled drug prescriptions in Swedish national health care registers, we investigated the risk of CVD in a cohort of 41,362 men with PCa on ADT compared with an age-matched, PCa-free comparison cohort (n = 187,785) by use of multivariable Cox proportional hazards regression models. Results From 2006 to 2012, 10,656 men were on antiandrogens (AA), 26,959 were on gonadotropin-releasing hormone (GnRH) agonists, and 3,747 underwent surgical orchiectomy. CVD risk was increased in men on GnRH agonists compared with the comparison cohort (hazard ratio [HR] of incident CVD, 1.21; 95% CI, 1.18 to 1.25; and orchiectomy: HR, 1.16; 95% CI, 1.08 to 1.25). Men with PCa on AA were at decreased risk (HR of incident CVD, 0.87; 95% CI, 0.82 to 0.91). CVD risk was highest during the first 6 months of ADT in men who experienced two or more cardiovascular events before therapy, with an HR of CVD during the first 6 months of GnRH agonist therapy of 1.91 (95% CI, 1.66 to 2.20), an HR of CVD with AA of 1.60 (95% CI, 1.24 to 2.06), and an HR of CVD with orchiectomy of 1.79 (95% CI, 1.16 to 2.76) versus the comparison cohort. Conclusion Our results support that there should be a solid indication for ADT in men with PCa so that benefit outweighs potential harm; this is of particular importance among men with a recent history of CVD.

Abstract 17: Association of Race and Sex with Cardiovascular Disease and Non-Cardiovascular Disease Mortality: The REasons for Geographic and Racial Differences in Stroke study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Gabriel S Tajeu ◽  
Monika M Safford ◽  
George Howard ◽  
Rikki M Tanner ◽  
Paul Muntner
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Racial Differences ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Cvd Risk ◽  
Hazard Ratios ◽  
Stroke Study ◽  
Cvd Mortality

Introduction: Black Americans have higher rates of cardiovascular disease (CVD) mortality compared with whites. Differences in sociodemographic, psychosocial, CVD, and other risk factors may explain increased mortality risk. Methods: We analyzed data from 29,015 REasons for Geographic and Racial Differences in Stroke study participants to determine factors that may explain the higher hazard ratio for CVD and non-CVD mortality in blacks compared with whites. Cause of death was adjudicated by trained investigators. Within age-sex sub-groups, we used Cox proportional hazards regression with progressive adjustment to estimate black:white hazard ratios. Results: Overall, 41.0% of participants were black, and 54.9% were women. Over a mean follow-up of 7.1 years (maximum 12.3 years), 5,299 participants died (1,797 CVD and 3,502 non-CVD deaths). Among participants < 65 years of age, the age and region adjusted black:white hazard ratio for CVD mortality was 2.28 (95% CI: 1.68-3.10) and 2.32 (95% CI: 1.80-3.00) for women and men, respectively, and for participants ≥ 65 was 1.54 (95% CI: 1.30-1.82) and 1.35 (95% CI: 1.16-1.57) for women and men, respectively ( Table ). The higher black:white hazard ratios for CVD mortality were no longer statistically significant after multivariable adjustment, with the largest attenuation occurring with sociodemographic and CVD risk factor adjustment. Among participants < 65 years of age, the age and region adjusted black:white hazard ratios for non-CVD mortality were 1.51 (95% CI: 1.24-1.85) and 1.76 (95% CI: 1.46-2.13) for women and men, respectively, and for participants ≥ 65 was 1.12 (95% CI: 1.00-1.26) and 1.34 (95% CI: 1.20-1.49) for women and men, respectively. The higher black:white hazard ratios for non-CVD mortality were attenuated after adjustment for sociodemographics. Conclusions: Black:white differences are larger for CVD than non-CVD causes of death. The increased CVD mortality for blacks compared with whites is primarily explained by sociodemographic and CVD risk factors.

Abstract P256: Stability of Obesity and Metabolic Health and the Risk of Cardiovascular Disease

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Todd Sponholtz ◽  
Justin B Echouffo-Tcheugui ◽  
Ramachandran S Vasan
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cox Proportional Hazards ◽  
Metabolic Health ◽  
Lipid Lowering ◽  
Cvd Risk ◽  
High Blood Glucose ◽  
Coronary Insufficiency ◽  
Metabolically Healthy

Introduction: Metabolic syndrome (MetSyn) reportedly confers higher risk of cardiovascular disease (CVD) than its individual components. Although typically defined as a binary exposure, each of its component factors can vary over time. Little is known about whether CVD risk differs according to MetSyn stability. Methods: We defined longitudinal states of obesity and metabolic health among 2,952 Framingham Offspring Study participants for whom we had sufficient data to define MetSyn at ≥4 exams between Exams 2 (1979-1983) and 9 (2011-2014). Obesity was defined as BMI ≥30 kg/m 2 , high triglycerides as ≥150 mg/dL/taking lipid-lowering medication, low HDL as <40 mg/dL for males/ <50 mg/dL for females; high blood pressure as systolic blood pressure ≥130 mm Hg/diastolic blood pressure ≥85 mm Hg/taking antihypertensive medication, and high blood glucose as ≥100 mg/dL/taking antidiabetic medication. Metabolic health was defined as having <2 metabolic conditions. Obesity and metabolic health were classified as unstable if there was a change from one state to the other in ≥33% of observations occurring before a CVD event or end of follow-up, stable obese/metabolically unhealthy if not unstable and >50% of observations were classified as stable obese/metabolically unhealthy, or stable non-obese/metabolically healthy otherwise. CVD was defined as any of the following coronary death, myocardial infarction, coronary insufficiency, angina pectoris, stroke, transient ischemic attack, intermittent claudication, or congestive heart failure. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) using Cox proportional hazards regression with age as the time scale. Results: We classified 332 participants (11.3%) as having unstable metabolic health, and 130 (4.4%) as having unstable obesity. We observed 1,206 events in 75,673 person-years of follow-up (median 30 years). Participants classified as stable metabolically unhealthy had the highest CVD risk (HR 1.77, 95% CI 1.47, 2.13, compared to stable metabolically healthy). Stable obesity was associated with a 48% (95% CI 24, 80) increase in CVD risk relative to stable non-obese. Unstable metabolic health and obesity were associated with moderate increases in risk compared to stable metabolically healthy and stable non-obese (HRs: 1.32, 95% CI 1.03, 1.71 and 1.25, 95% CI 0.88, 1.77, respectively). There was no interaction between obesity- and metabolic health stability (p interaction =0.23). Conclusions: In our sample, stability of obesity and of metabolic health influenced CVD risk, with the highest risk of CVD observed among stable metabolically unhealthy participants. Instability of both obesity and metabolic health convey a risk intermediate between the stable obese/metabolically healthy and stable non-obese/metabolically unhealthy conditions.

Abstract P120: Women With Menopause After Age 45 and Take Hormone Therapy After Age 60 Increase the Risk of Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Dongshan Zhu ◽  
Hsin-Fang Chung ◽  
Annette Dobson ◽  
Nirmala Pandeya ◽  
Gita Mishra
Keyword(s):  
Cardiovascular Disease ◽  
Hormone Therapy ◽  
Postmenopausal Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
Natural Menopause ◽  
Individual Level ◽  
Age At Menopause ◽  
Increased Risk

Introduction: Evidence from clinical trials and observational studies on the relationship between menopausal hormone therapy (MHT) and cardiovascular disease (CVD) risk has been discordant. Hypothesis: We hypothesized that the association between MHT and risk of CVD might be affected by both age at menopause and age when initiated MHT. Methods: We harmonised and pooled individual-level data from 15 studies across five countries/regions (Australia, Scandinavia, USA, Japan, and UK). Postmenopausal women who had reported their MHT status (user or non-user) and CVD status (occurred or not, including coronary heart disease (CHD) and stroke) were included. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for the association between MHT use and incident CVD. We stratified the analyses by age when initiated MHT and age at natural menopause to examine the interaction between MHT, age initiated MHT, and age at menopause on incident CVD. Results: Overall, 190 625 postmenopausal women were included. We identified 10 601 incident CVD events, including 7615 CHD and 3543 strokes. Around 39% (74 585) women were MHT users. Compared to non-users of MHT, women who were MHT users had 10% higher risk of incident CVD (HR 1.10, 95% CI 1.06-1.14), with HR (95% CI) of (1.15, 1.10-1.20) for CHD and (1.02, 0.96-1.09) for stroke. After stratifying by age at natural menopause, women who experienced menopause after age 45 years and took MHT had around 15% higher risk of CHD, while the significant association with incident stroke was only observed in women who had menopause after 55 years (1.16, 1.01-1.33). After a further stratification by age initiated MHT, we found the significant associations between MHT users and incident CVD were only observed in women who experienced menopause after age 45 years and took MHT at age 60 years or old (Table 1). Conclusions: Postmenopausal women who experienced natural menopause after age 45 years and took MHT after age 60 years had increased risk of incident CVD.

scholarly journals A Meta-analysis of Vitamin K Status and Cardiovascular Disease (OR33-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
M Kyla Shea ◽  
Daniel Weiner ◽  
Gregory Matuszek ◽  
Sarah Booth ◽  
Kathryn Barger
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Vitamin K ◽  
Cardiovascular Health ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Objectives Evidence suggests low vitamin K status may be associated with an increased cardiovascular disease (CVD) risk in people with CVD risk factors. The objective of this study was to summarize the association between vitamin K status and CVD, overall and according to baseline CVD risk, by conducting a participant-level meta-analysis using data from the Framingham Offspring Study, the Health, Aging, and Body Composition Study (Health ABC), and the Multi-ethnic Study of Atherosclerosis (MESA). Methods Circulating phylloquinone (vitamin K1), measured from baseline fasting blood samples, was categorized as ≤0.5 nM, >0.5 - ≤1.0 nM and >1.0 nM. CVD was defined as confirmed ischemic heart disease, angina, resuscitated cardiac arrest, fatal or non-fatal myocardial infarction or stroke. Multivariable Cox proportional hazards models were used to evaluate the association between circulating phylloquinone and incident CVD overall and stratified according to baseline CVD risk factors. Results Among the 3622 participants (mean (SD) baseline age 65 (11), 45% men, 65% white), there were 785 CVD events over a median of 13.0 years. Overall the risk for CVD did not differ significantly according to circulating phylloquinone categories [HR(95%CI) for CVD, compared to plasma phylloquinone >1.0 nM: ≤0.5 nM = 1.15 (0.96–1.38); >0.5 - ≤1.0 nM = 0.99 (0.84–1.18)]. However, lower circulating phylloquinone was associated with higher incident CVD risk in those with diabetes, with a normal BMI, and in women (Table). Conclusions Overall, we did not detect any significant differences in CVD risk across circulating phylloquinone categories in community-dwelling adults. However, low circulating phylloquinone was associated with a higher CVD risk among certain sub-groups, but additional studies are needed to clarify if improving vitamin K status will benefit the cardiovascular health of certain segments of the population. Funding Sources Supported by NHLBI R21HL133421 and the USDA ARS Cooperative Agreement (58‐1950‐7‐707). Supporting Tables, Images and/or Graphs

scholarly journals Plant-based diets and incident cardiovascular disease and all-cause mortality in African Americans: A cohort study

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003863
Author(s):  
Leah J. Weston ◽  
Hyunju Kim ◽  
Sameera A. Talegawkar ◽  
Katherine L. Tucker ◽  
Adolfo Correa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Black Americans ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
African American Adults ◽  
Education And Health ◽  
Cox Proportional Hazards Models ◽  
Heart Study ◽  
All Cause Mortality

Background Prior studies have documented lower cardiovascular disease (CVD) risk among people with a higher adherence to a plant-based dietary pattern. Non-Hispanic black Americans are an understudied group with high burden of CVD, yet studies of plant-based diets have been limited in this population. Methods and findings We conducted an analysis of prospectively collected data from a community-based cohort of African American adults (n = 3,635) in the Jackson Heart Study (JHS) aged 21–95 years, living in the Jackson, Mississippi, metropolitan area, US, who were followed from 2000 to 2018. Using self-reported dietary data, we assigned scores to participants’ adherence to 3 plant-based dietary patterns: an overall plant-based diet index (PDI), a healthy PDI (hPDI), and an unhealthy PDI (uPDI). Cox proportional hazards models were used to estimate associations between plant-based diet scores and CVD incidence and all-cause mortality. Over a median follow-up of 13 and 15 years, there were 293 incident CVD cases and 597 deaths, respectively. After adjusting for sociodemographic characteristics (age, sex, and education) and health behaviors (smoking, alcohol intake, margarine intake, physical activity, and total energy intake), no significant association was observed between plant-based diets and incident CVD for overall PDI (hazard ratio [HR] 1.06, 95% CI 0.78–1.42, p-trend = 0.72), hPDI (HR 1.07, 95% CI 0.80–1.42, p-trend = 0.67), and uPDI (HR 0.95, 95% CI 0.71–1.28, p-trend = 0.76). Corresponding HRs (95% CIs) for all-cause mortality risk with overall PDI, hPDI, and uPDI were 0.96 (0.78–1.18), 0.94 (0.76–1.16), and 1.06 (0.86–1.30), respectively. Corresponding HRs (95% CIs) for incident coronary heart disease with overall PDI, hPDI, and uPDI were 1.09 (0.74–1.61), 1.11 (0.76–1.61), and 0.79 (0.52–1.18), respectively. For incident total stroke, HRs (95% CIs) for overall PDI, hPDI, and uPDI were 1.00 (0.66–1.52), 0.91 (0.61–1.36), and 1.26 (0.84–1.89) (p-trend for all tests > 0.05). Limitations of the study include use of self-reported dietary intake, residual confounding, potential for reverse causation, and that the study did not capture those who exclusively consume plant-derived foods. Conclusions In this study of black Americans, we observed that, unlike in prior studies, greater adherence to a plant-based diet was not associated with CVD or all-cause mortality.

scholarly journals Longitudinal Plasma Kallikrein Levels and their Association with the Risk of Cardiovascular Disease Outcomes in Type 1 Diabetes in DCCT/EDIC

2020 ◽  
Author(s):  
Ada Admin ◽  
Miran A Jaffa ◽  
Ionut Bebu ◽  
Deirdre Luttrell ◽  
Barbara H Braffett ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Major Adverse Cardiovascular Events ◽  
Plasma Kallikrein ◽  
Cvd Risk ◽  
20 Nm ◽  
Adjusted Model

We determined the relationship between plasma kallikrein and cardiovascular disease (CVD) outcomes as well as major adverse cardiovascular events (MACE) in the DCCT/EDIC-cohort of type 1 diabetes (T1D). Plasma kallikrein levels were measured longitudinally in 693 subjects at DCCT baseline (1983-1989), mid-point of DCCT (1988-1991), end of DCCT (1993), and EDIC years 4-6 (1997-1999), 8-10 (2001-2003), and 11-13 (2004-2006). Cox proportional hazards regression models assessed the association between plasma kallikrein levels and the risk of CVD. In unadjusted models, higher plasma kallikrein levels were associated with higher risk of any CVD during DCCT/EDIC (HR=1.16 per 20 nM higher levels of plasma kallikrein; p=0.0177) as well as over the EDIC-only period (HR=1.22; p=0.0024). The association between plasma kallikrein levels and the risk of any CVD remained significant during the EDIC follow-up after adjustment for age and mean HbA1c (HR=1.20; p=0.0082) and in the fully adjusted model for other CVD risk factors (HR=1.17; p=0.0330). For MACE, higher plasma kallikrein levels were associated with higher risk in unadjusted (HR=1.25; p=0.0145), minimally adjusted (HR=1.23; p=0.0417, and fully adjusted (HR=1.27; p=0.0328) models during EDIC-only. These novel findings indicate that plasma kallikrein level associates with the risk of any CVD and MACE in T1D individuals.

scholarly journals Compositional Features of HDL Particles Interact with Albuminuria to Modulate Cardiovascular Disease Risk

2019 ◽  
Vol 20 (4) ◽  
pp. 977
Author(s):  
James Corsetti ◽  
Stephan Bakker ◽  
Ronald Gansevoort ◽  
Eke Gruppen ◽  
Margery Connelly ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Disease Risk ◽  
Interaction Analysis ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
Disease Study ◽  
Baseline Screening

Lipoproteins containing apolipoprotein B modify associations of elevated urinary albumin excretion (UAE) with cardiovascular disease (CVD). Additionally, it is known that elevated UAE alters high-density lipoprotein functionality. Accordingly, we examined whether HDL features might also modify UAE-associated CVD. Multivariable Cox proportional-hazards modeling was performed on participants of the PREVEND (Prevention of Renal and Vascular Endstage Disease) study at the baseline screening with standard lipid/lipoprotein analyses and, three-to-four years later (second screen), with nuclear magnetic resonance lipoprotein analyses focusing on HDL parameters including HDL particle (HDL-P) and apolipoprotein A-I concentrations. These were used with UAE and derived measures of HDL apoA-I content (apoA-I/HDL-C and apoA-I/HDL-P) in risk models adjusted for gender, age, apoB, diabetes, past CVD history, CRP and GFR. Interaction analysis was also performed. Baseline screening revealed significant associations inverse for HDL-C and apoA-I and direct for apoA-I/HDL-C. The second screening demonstrated associations inverse for HDL-P, large HDL-P, medium HDL-P, HDL size, and apoA-I/HDL-P. Significant interactions with UAE included apoA-I/HDL-C at the baseline screening, and apoA-I/HDL-P and medium HDL-P but not apoA-I/HDL-C at the second screening. We conclude that features of HDL particles including apoA-I/HDL-P, indicative of HDL apoA-I content, and medium HDL-P modify associations of elevated UAE with CVD risk.

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