Abstract P368: Western and Prudent Diet Patterns are Associated With Risk of Developing Non-cancer Related Venous Thromboembolism

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
So Yun Yi ◽  
Lyn M Steffen ◽  
Pamela L Lutsey ◽  
Mary Cushman ◽  
Aaron R Folsom
Keyword(s):  
Venous Thromboembolism ◽  
Dietary Intake ◽  
Proportional Hazards ◽  
Western Diet ◽  
Atherosclerosis Risk In Communities ◽  
Diet Patterns ◽  
Phone Calls ◽  
Hazard Ratios ◽  
Diet Pattern ◽  
Prudent Diet

Background: Results are inconsistent from published studies about the association between dietary intake and risk of incident venous thromboembolism (VTE). Therefore we proposed to study the association between diet patterns and incident non-cancer related VTE. We hypothesized that a Western diet pattern is positively associated, and a Prudent diet pattern is inversely associated with incident non-cancer related VTE. Methods: In the Atherosclerosis Risk in Communities (ARIC) Study, 14,873 middle-aged men and women were followed for incident VTE over an average of 22 years between 1987 and 2015. VTE cases were ascertained via annual phone calls and community hospital surveillance. Hospital records were reviewed to validate cases. Dietary intake was assessed by food frequency questionnaire at baseline and year 6. The Western and the Prudent diet pattern scores were derived by principal components analysis. In separate proportional hazards regression analyses, associations of quintiles of the Western and the Prudent diet pattern scores with risk of developing non-cancer related VTE were examined, adjusting for demographic characteristics, lifestyle factors, body mass index, and diabetes. Results: Hazard ratios (95% confidence intervals) of incident non-cancer related VTE (n=634) across quintiles of the Prudent diet pattern score were 1.0 (reference), 0.99 (0.78-1.26), 0.79 (0.61-1.02), 0.66 (0.51-0.87), and 0.81 (0.61-1.07), p trend =0.01 (see Figure). Across quintiles of the Western diet pattern score, hazard ratios (95% CI) of incident non-cancer related VTE were 1.0 (reference), 1.14 (0.88-1.47), 1.20 (0.92-1.56), 1.10 (0.82-1.47), and 1.63 (1.17-2.28), p trend =0.02. Conclusions: In this community-based cohort, a Prudent diet pattern was associated with a lower risk of developing non-cancer related VTE, whereas higher risk was associated with a Western diet pattern.

scholarly journals Dietary Intake of Marine Polyunsaturated n-3 Fatty Acids and Risk of Recurrent Venous Thromboembolism

2019 ◽  
Vol 119 (12) ◽  
pp. 2053-2063 ◽  
Author(s):  
Trond Isaksen ◽  
Line H. Evensen ◽  
Sigrid K. Brækkan ◽  
John-Bjarne Hansen
Keyword(s):  
Fatty Acids ◽  
Venous Thromboembolism ◽  
Dietary Intake ◽  
Cox Regression ◽  
Risk Of Recurrence ◽  
Vein Thrombosis ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Recurrent Vte

Abstract Background Limited knowledge exists on the association between intake of long-chained n-3 polyunsaturated fatty acids (n-3 PUFAs) and risk of recurrence and all-cause mortality in patients with venous thromboembolism (VTE). Objectives This article investigates whether intake of marine n-3 PUFAs was associated with risk of recurrence and mortality in patients with incident VTE. Methods A total of 595 patients with incident VTE and available data on n-3 PUFA intake were derived from the Tromsø Study surveys 4 (1994–1995) and 6 (2007–2008). Weekly intake of n-3 PUFAs was categorized as low, medium, and high based on tertiles. Recurrent VTEs and all-cause mortality were registered up to December 31, 2016. Hazard ratios (HRs) were calculated using Cox regression models with the low intake category as reference. Results There were 98 recurrent VTEs and 227 deaths during follow-up. Overall, we found no association between intake of n-3 PUFAs and risk of recurrent VTE. However, inverse associations were found for high intakes in patients with unprovoked VTE (HR 0.45, 95% confidence interval [CI]: 0.20–1.01), cancer-free patients (HR 0.51, 95% CI: 0.27–0.95), and deep vein thrombosis (DVT) patients (HR 0.49, 95% CI: 0.24–0.97). The inverse associations were more evident when follow-up was restricted to the time after discontinuation of anticoagulant therapy. No association was observed between intake of n-3 PUFAs and mortality after incident VTE. Conclusion A high dietary intake of marine n-3 PUFAs was associated with lower risk of recurrent VTE after unprovoked index events, DVT, and in cancer-free patients.

Association of polymorphisms in androgen production, uptake, and conversion chain (APUC) genes with mortality of prostate cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 5528-5528
Author(s):  
Sean Thomas McSweeney ◽  
Anna Prizment ◽  
Nathan Pankratz ◽  
Corinne E Joshu ◽  
Elizabeth A. Platz ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Snp Array ◽  
Cox Proportional Hazards ◽  
Gain Of Function ◽  
Atherosclerosis Risk In Communities ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Aric Study

5528 Background: Genes involved in APUC may affect prognosis in PC. We tested the association of four SNPs involved in the APUC pathway: hydroxy-delta-5-steroid dehydrogenase, 3 beta-and steroid delta-isomerase 1 ( HSD3B1), 5α reductase enzyme ( SRD5A), and solute carrier organic ion ( SLCO2B1) with all-cause and PC mortality 596 in the Atherosclerosis Risk in Communities (ARIC) study. Methods: Between 1987 & 2015 596 men were diagnosed with PC. Median age at diagnosis was 70 (range 53-86) years; 21% of all PC patients were African American. After diagnosis, follow-up was median 8.4 years (max 26.7 years) until PrC death (N = 60), death from any cause (N = 253), or end of 2015. SNPs were genotyped using the Affymetrix Genome-Wide Human SNP Array 6.0 and imputed to the 1000 Genomes Phase 3 reference panel. To examine survival, we used Kaplan-Meier curves and Cox proportional hazards regression. Hazard ratios (HR) and 95% confidence intervals (CI) were adjusted for age, field center, stage and grade at diagnosis. We also controlled for confounding by ancestry by adjusting for genetic principal components. The analyses were conducted in all PrCa patients and in Whites PrCa patients only. Polymorphisms tested included rs1047303 (A = > C, also called 1245C); rs523349 (C = > G); and rs1789693 (A = > T) and rs12422149 (G = > A), located in the aforementioned genes. Results: The A allele for SLCO2B1 rs1789693 (A = > T) was significantly associated with an increased risk of PC mortality (versus T): multivariable-adjusted HRs (95%CI) were (2.06, 1.14-3.74; p = 0.02) and all-cause mortality (1.29, 1.00-1.66; p = 0.05) among Whites. The associations were similar when Whites and African-Americans were combined and when accounting for ancestry. The C allele for HSD3B1 rs1047303 (C = > A) was not statistically significantly associated with either PC or all-cause mortality in the whole cohort (which included localized disease), although HRs were increased for men diagnosed with stage 4 disease (n = 35) in both additive and dominant models. For carriers of the C allele (gain of function) versus AA, HRs were 5.32 (1.16-24.33; p = 0.03) and 6.13 (1.51-24.86; p = 0.01) for PC and all-cause mortality, respectively. All associations with SRDA2 (rs12422149) and SLCO2B1 (rs12422149) were not significant. Conclusions: The gain of function allele in HSD3B1 rs1047303 (1245C) was associated with increased PC and all-cause mortality in men diagnosed with metastatic PC, paralleling prior findings. Associations with SLCO2B1 SNP rs1789693 require validation in larger studies.

Abstract 015: Very-High Levels of HDL-C and Risks for CHD: The Lifetime Risk Pooling Project

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
John T Wilkins ◽  
Hongyan Ning ◽  
Alan R Dyer ◽  
Donald M Lloyd-Jones
Keyword(s):  
Proportional Hazards ◽  
Smoking Status ◽  
A Priori ◽  
Cox Proportional Hazards ◽  
Point Estimate ◽  
Atherosclerosis Risk In Communities ◽  
Cox Proportional Hazards Models ◽  
Chd Risk ◽  
Hazard Ratios ◽  
Very High

Background: Whereas observational cohort data suggest the association between HDL-C and coronary heart disease (CHD) is inverse and linear, data are sparse at HDL-C values > 80mg/dL. Methods: We therefore pooled data from the NHLBI public-funded datasets of the Framingham, Framingham Offspring, and Atherosclerosis Risk in Communities studies. We used multivariable Cox Proportional-Hazards Models to adjust for age, systolic blood pressure, body mass index, smoking status, prevalent diabetes, non-HDL-C, antihypertension and lipid medication use. We calculated adjusted hazard ratios (HR) to assess the association between a priori strata of HDL-C (<30; >30-40; >40-50; >50-60; >60-70; >70-80; >80mg/dL) and CHD death and non-fatal myocardial infarction using HDL-C >40-50mg/dL as the referent. Results: Over 118,716 person*years of follow up, there were 562 events in 9,226 participants. As expected, hazard ratios for CHD events are greatest in the lowest category of HDL-C (HR 1.68, 95%CI: 1.31, 2.21) and there was generally a stepwise inverse trend in CHD hazards up to 80mg/dL. (See Figure) At HDL-C > 80mg/dL the hazard point estimate for CHD events was insignificantly higher (HR 0.52, 95% CI 0.29, 0.95) than the hazard observed at HDL-C >70-80mg/dl (HR 0.35, 95% CI 0.18-0.66). However, the hazard for CHD events for HDL-C > 80mg/dL was still significantly lower than the referent. Conclusions: These data suggest that the association between HDL-C and CHD risk may not be inverse and linear at HDL-C values > 80mg/dL. These data support investigation into qualitative differences in HDL molecules in individuals with very high levels of HDL-C.

Abstract 020: NT-proBNP, hs-Troponin T and Incident Venous Thromboembolism: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Pamela L Lutsey ◽  
Vijay Nambi ◽  
Mary Cushman ◽  
Susan R Heckbert ◽  
Christopher R DeFilippi ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Proportional Hazards ◽  
General Trend ◽  
Troponin T ◽  
Volume Overload ◽  
Race Model ◽  
Cox Proportional Hazards ◽  
Atherosclerosis Risk In Communities ◽  
Diabetes Status ◽  
Atherosclerosis Risk

Background: NT-pro B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin T (TnT) are important biomarkers for CHD and HF risk, but whether they are related to incidence of venous thromboembolism (VTE) is unknown. NT-proBNP is a marker of volume overload; volume overload may contribute to VTE risk via increased stasis and thrombogenesis. TnT might relate to VTE indirectly, as a marker of vascular inflammation or endothelial dysfunction. Hypotheses: NT-proBNP and TnT are associated positively with risk of incident VTE. Methods: Data from visit 4 (1996-1998) of the prospective population-based Atherosclerosis Risk in Communities study (n = 10,735; 53-74 yrs) were used. VTE events through 2005 were identified and validated by medical record review. Cox proportional hazards regression was used to explore the relation between the biomarkers and VTE. Model 1 adjusted for age, sex, and race. Model 2 additionally adjusted for HRT use, diabetes status, BMI, eGFR, CRP, aPTT and factor VIII. Results: A total of 227 incident VTE cases accrued over a median follow-up of 8.0 yrs. Relative to participants in the lowest quintile of NT-proBNP (≤26.7 pg/mL), those in the highest quintile (≥151.3 pg/mL) were at 2.28 (95% CI: 1.47-3.54) times greater risk of incident VTE (p-trend = 0.0002), adjusted via Model 1. This association was only slightly attenuated after adjustment in Model 2 [HR: 1.98 (95% CI: 1.25, 3.13); p-trend = 0.003]. The general trend was present for both unprovoked [HR: 1.62 (95% CI: 0.70, 3.75)] and provoked VTE [HR: 2.22 (95% CI: 1.28, 3.84)] in the fully-adjusted models, though power was low when stratifying by VTE type. Participants in the highest category (≥0.014 ug/L) of TnT were also at modestly greater risk of incident VTE in Model 1 [HR: 1.99 (95% CI: 1.23, 3.21); p-trend = 0.0002] and Model 2 [HR: 1.52 (95% CI: 0.89, 2.60); p-trend = 0.03], relative to those with undetectable TnT. The association was, however, present for only provoked VTE, with no evidence of a relation for unprovoked VTE. Discussion: In this large prospective cohort, both NT-proBNP and TnT were positively associated with risk of incident VTE. For NT-proBNP, the general trend was present for both provoked and unprovoked events, while for TnT the relation was isolated to provoked VTE events. Additional research is warranted to evaluate whether NT-proBNP and TnT are related to risk of VTE, or if the associations observed were the result of uncontrolled confounding.

scholarly journals The State of Diet Quality Globally: A Systematic Assessment of Worldwide Dietary Patterns Using the Global Dietary Database (P10-045-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Meghan O'Hearn ◽  
Fumiaki Imamura ◽  
Frederick Cudhea ◽  
Jennifer Onopa ◽  
Julia Reedy ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Diet Quality ◽  
Dietary Factors ◽  
Healthy Diet ◽  
Sub Saharan Africa ◽  
Individual Level ◽  
Diet Patterns ◽  
The World ◽  
Diet Pattern ◽  
Unhealthy Diet

Abstract Objectives Healthy diet patterns are a global priority to reduce undernutrition and chronic disease. Prior work suggests that healthy and unhealthy diet patterns are distributed and changing independently across the world. Our objective was to characterize current healthy and unhealthy diet patterns by age, sex, education, residence and country using the 2015 Global Dietary Database (GDD). Methods The GDD 2015 evaluates dietary intake based on 1137 surveys-years of systematically identified national and subnational individual-level diet surveys worldwide from 185 countries (97.5% of the global population). Dietary intake estimates and their uncertainty were generated for 15 dietary factors using a Bayesian hierarchical model including the individual-level data, country-level food availability data, and other covariates. Two types of diet patterns were assessed: one reflecting greater intake of 11 healthy dietary items; and the other, lower intake of 4 unhealthy dietary items. Mean intake of each dietary factor was divided into quintiles. Quintiles were assigned an ordinal score and scores were summed to generate each pattern, scaled from 0–100. Higher scores correspond to healthier diets for each age-sex-country-year-education-residence stratum. Results In 2015, the global mean score was 48 [95% UI: 39–58] for the healthy diet pattern (Fig 1) and 51 [32–69] for the unhealthy diet pattern (Fig 2). Healthy vs unhealthy diet pattern scores across the 41,040 global strata annually were not strongly interrelated (r < -0.4). Western (54 [45–63]) and Latin American (63 [53–72]) regions had highest scores for the healthy diet pattern but lowest for the unhealthy diet pattern (37 [19, 54]; 27 [13, 42], respectively). Asia (57 [40–76]) and Sub-Saharan Africa (57 [34–76]) had the highest unhealthy diet pattern scores but lowest healthy diet pattern scores (42 [33, 52]; 41 [30, 53], respectively). Healthy diet pattern scores were generally higher in urban areas and among more educated strata, while unhealthy diet pattern scores were higher in rural areas and in less educated strata. Conclusions These novel data provide quantitative estimates of the specific heterogeneity in diet patterns across the world, providing the best estimates to date to inform policies and priorities for reducing the health and economic burdens of poor diet quality. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals C-reactive protein and venous thromboembolism

2009 ◽  
Vol 102 (10) ◽  
pp. 615-619 ◽  
Author(s):  
Pamela L. Lutsey ◽  
Brad C. Astor ◽  
Mary Cushman ◽  
Aaron R. Folsom
Keyword(s):  
Venous Thromboembolism ◽  
Hormone Replacement ◽  
Hazard Ratio ◽  
C Reactive Protein ◽  
Atherosclerosis Risk In Communities ◽  
Reactive Protein ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Aric Study

SummaryThe role of inflammation in the causation of venous thromboembolism (VTE) is uncertain. In 10,505 participants of the Atherosclerosis Risk in Communities (ARIC) Study, we assessed the association of the systemic inflammation marker, elevated C-reactive protein (CRP), with incidence of VTE (n=221) over a median of 8.3 years of follow-up. Adjusted for age, race, and sex, the hazard ratios of VTE across quintiles of CRP were 1.0, 1.61, 1.16, 1.56, and 2.31 (p for trend p<0.0007). For CRP above the upper 10 percentile (≥8.55 mg/L), compared with the lowest 90% of CRP values, the hazard ratio of VTE was 2.07 (95% CI 1.47, 2.94). Further adjustment for baseline hormone replacement therapy, diabetes, and body mass index attenuated the hazard ratios only slightly. For example, the adjusted hazard ratio of VTE was 1.76 (95% CI 1.23, 2.52) for CRP above versus below the 90th percentile. In conclusion, this prospective, populationbased study suggests elevated CRP is independently associated with increased risk of VTE.

scholarly journals High Prudent diet factor score predicts lower relapse hazard in early multiple sclerosis

2020 ◽  
pp. 135245852094308
Author(s):  
Steve Simpson-Yap ◽  
Wendy H Oddy ◽  
Bruce Taylor ◽  
Robyn M Lucas ◽  
Lucinda J Black ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dietary Intake ◽  
Dietary Patterns ◽  
Proportional Hazards ◽  
Factor Score ◽  
Cox Proportional Hazards ◽  
Omega 3 ◽  
Relapse Risk ◽  
Supplement Use ◽  
Prudent Diet

Background: Dietary patterns and their association with subsequent clinical course have not been well studied in early multiple sclerosis (MS). Objectives: To describe dietary patterns in people in 5 years following first clinical demyelination and assess associations with MS conversion and relapse. Methods: This study included baseline food frequency questionnaire dietary intake (entry to the Ausimmune Study) and 5-year follow-up; iterated principal factor analysis was applied. MS conversion and relapse risks were assessed by Cox proportional hazards models, adjusted for age, sex, study site, education, body mass index (BMI), smoking and omega-3 supplement use. Results: In cases with a first clinical diagnosis of central nervous system (CNS) demyelination, we identified three major dietary patterns, ‘Prudent’, ‘High-Vegetable’ and ‘Mixed’, explaining 43%, 37% and 24% of diet variance in dietary intake, respectively. Fruits, vegetables, fish, wholegrains and nuts loaded highly on the Prudent pattern, starchy vegetables and legumes on the High-Vegetable pattern, and meats and alcohol on the Mixed pattern. Diet factor scores were not associated with MS conversion risk. Those with baseline Prudent scores above the median had significantly lower relapse risk (adjusted hazard ratio = 0.54, 95% confidence interval (CI) 0.37, 0.81) with some evidence of a plateau effect. Conclusion: Prudent diet factor score above the median was prospectively associated with lower relapse risk in the 5 years following the first clinical demyelinating event.

scholarly journals Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto–Med Randomized Trial

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 967
Author(s):  
Matthew J. Landry ◽  
Anthony Crimarco ◽  
Dalia Perelman ◽  
Lindsay R. Durand ◽  
Christina Petlura ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Randomized Clinical Trials ◽  
Secondary Analysis ◽  
Critical Factor ◽  
Detailed Examination ◽  
Diet Patterns ◽  
Time Points ◽  
Study Results ◽  
Wide Range ◽  
Diet Pattern

Adherence is a critical factor to consider when interpreting study results from randomized clinical trials (RCTs) comparing one diet to another, but it is frequently not reported by researchers. The purpose of this secondary analysis of the Keto–Med randomized trial was to provide a detailed examination and comparison of the adherence to the two study diets (Well Formulated Ketogenic Diet (WFKD) and Mediterranean Plus (Med-Plus)) under the two conditions: all food being provided (delivered) and all food being obtained by individual participants (self-provided). Diet was assessed at six time points including baseline (x1), week 4 of each phase when participants were receiving food deliveries (x2), week 12 of each phase when participants were preparing and providing food on their own (x2), and 12 weeks after participants completed both diet phases and were free to choose their own diet pattern (x1). The adherence scores for WFKD and Med-Plus were developed specifically for this study. Average adherence to the two diet patterns was very similar during both on-study time points of the intervention. Throughout the study, a wide range of adherence was observed among participants—for both diet types and during both the delivery phase and self-provided phase. Insight from this assessment of adherence may aid other researchers when answering the important question of how to improve behavioral adherence during dietary trials. This study is registered at clinicaltrials.gov NCT03810378.

scholarly journals Sex-Specific Associations between Blood Pressure and Risk of Atrial Fibrillation Subtypes in the Tromsø Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1514
Author(s):  
Hilde Espnes ◽  
Jocasta Ball ◽  
Maja-Lisa Løchen ◽  
Tom Wilsgaard ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Pressure Management ◽  
Reference Models ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Increased Risk

The aim of this study was to explore sex-specific associations between systolic blood pressure (SBP), hypertension, and the risk of incident atrial fibrillation (AF) subtypes, including paroxysmal, persistent, and permanent AF, in a general population. A total of 13,137 women and 11,667 men who participated in the fourth survey of the Tromsø Study (1994–1995) were followed up for incident AF until the end of 2016. Cox proportional hazards regression analysis was conducted using fractional polynomials for SBP to provide sex- and AF-subtype-specific hazard ratios (HRs) for SBP. An SBP of 120 mmHg was used as the reference. Models were adjusted for other cardiovascular risk factors. Over a mean follow-up of 17.6 ± 6.6 years, incident AF occurred in 914 (7.0%) women (501 with paroxysmal/persistent AF and 413 with permanent AF) and 1104 (9.5%) men (606 with paroxysmal/persistent AF and 498 with permanent AF). In women, an SBP of 180 mmHg was associated with an HR of 2.10 (95% confidence interval [CI] 1.60–2.76) for paroxysmal/persistent AF and an HR of 1.80 (95% CI 1.33–2.44) for permanent AF. In men, an SBP of 180 mmHg was associated with an HR of 1.90 (95% CI 1.46–2.46) for paroxysmal/persistent AF, while there was no association with the risk of permanent AF. In conclusion, increasing SBP was associated with an increased risk of both paroxysmal/persistent AF and permanent AF in women, but only paroxysmal/persistent AF in men. Our findings highlight the importance of sex-specific risk stratification and optimizing blood pressure management for the prevention of AF subtypes in clinical practice.

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