Abdominal obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction

2020 ◽  
Vol 27 (18) ◽  
pp. 1944-1952 ◽  
Author(s):  
Hanieh Mohammadi ◽  
Joel Ohm ◽  
Andrea Discacciati ◽  
Johan Sundstrom ◽  
Kristina Hambraeus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Heart Disease ◽  
Waist Circumference ◽  
Confidence Interval ◽  
Abdominal Obesity ◽  
Hazard Ratio ◽  
Atherosclerotic Cardiovascular Disease ◽  
First Myocardial Infarction

Background The association between abdominal obesity and recurrent atherosclerotic cardiovascular disease after myocardial infarction remains unknown. Objective The purpose of this study was to investigate the prevalence of abdominal obesity and its association with recurrent atherosclerotic cardiovascular disease in patients after a first myocardial infarction. Design and methods In this register-based observational cohort, 22,882 patients were identified from the national Swedish Web-system for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) registry at a clinical revisit 4–10 weeks after their first myocardial infarction 2005–2014. Patients were followed for recurrent atherosclerotic cardiovascular disease defined as non-fatal myocardial infarction, coronary heart disease death, non-fatal or fatal ischaemic stroke. Univariate and multivariable-adjusted Cox regression models were used to calculate hazard ratios and 95% confidence intervals in quintiles of waist circumference as well as three categories of body mass index including normal weight, overweight and obesity. Results The majority of patients had abdominal obesity. During a median follow-up time of 3.8 years, 1232 men (7.3%) and 469 women (7.9%) experienced a recurrent atherosclerotic cardiovascular disease event. In the univariate analysis, risk was elevated in the fifth quintile (hazard ratio 1.22, 95% confidence interval 1.07–1.39) compared with the first. In the multivariable-adjusted analysis, risk was elevated in the fourth and fifth quintiles (hazard ratio 1.21, confidence interval 1.03–1.43 and hazard ratio 1.25, confidence interval 1.04–1.50), respectively. Gender-stratified analyses showed similar associations in men, while U-shaped associations were observed in women and the body mass index analyses. Conclusions Abdominal obesity was common in post-myocardial infarction patients and larger waist circumference was independently associated with recurrent atherosclerotic cardiovascular disease, particularly in men. We recommend utilising waist circumference to identify patients at increased risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction.

Systemic lupus erythematosus is a risk factor for cardiovascular disease: a nationwide, population-based study in Korea

Lupus ◽  
2018 ◽  
Vol 27 (13) ◽  
pp. 2050-2056 ◽  
Author(s):  
S Y Lim ◽  
E H Bae ◽  
K-D Han ◽  
J-H Jung ◽  
H S Choi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Lupus Erythematosus ◽  
Hazard Ratio ◽  
Systemic Lupus

Objective To investigate the incidence and clinical significance of cardiovascular disease in systemic lupus erythematosus patients. Methods We included systemic lupus erythematosus patients ( n = 18,575) without previous cardiovascular disease and age- and sex-matched individuals without systemic lupus erythematosus (controls; n = 92,875) from the Korean National Health Insurance Service database (2008–2014). Both cohorts were followed up for incident cardiovascular disease and death until 2015. Results During follow up, myocardial infarction occurred in 203 systemic lupus erythematosus patients and 325 controls (incidence rate: 1.76 and 0.56 per 1000 person-years, respectively), stroke occurred in 289 patients and 403 controls (incidence rate: 2.51 and 0.70 per 1000 person-years, respectively), heart failure occurred in 358 patients and 354 controls (incidence rate 3.11 and 0.61 per 1000 person-years, respectively), and death occurred in 744 patients and 948 controls (incidence rate 6.54 and 1.64 per 1000 person-years, respectively). Patients with systemic lupus erythematosus had higher risks for myocardial infarction (hazard ratio: 2.74, 95% confidence interval: 2.28–3.37), stroke (hazard ratio: 3.31, 95% confidence interval: 2.84–3.86), heart failure (hazard ratio: 4.60, 95% confidence interval: 3.96–5.35), and cardiac death (hazard ratio: 3.98, 95% confidence interval: 3.61–4.39). Conclusions Here, systemic lupus erythematosus was an independent risk factor for cardiovascular disease, thus cardiac assessment and management are critical in systemic lupus erythematosus patients.

Abstract P509: Olive Oil Consumption and Risk of Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Marta Guasch ◽  
Gang Liu ◽  
Yanping Li ◽  
Laura Sampson ◽  
Joann E Manson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Confidence Interval ◽  
Olive Oil ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Mediterranean Populations ◽  
Dairy Fat ◽  
Incident Cases

Background: Olive oil intake has been associated with lower risk of cardiometabolic risk factors in Mediterranean populations, but little is known about these associations in the U.S. population, where olive oil intake is relatively low. Objectives: To examine whether olive oil intake is associated with total Cardiovascular Disease (CVD), coronary heart disease (CHD) and stroke risk. Methods: We included 63,867 women from the Nurses’ Health Study (1990 to 2014) and 35,512 men from the Health Professionals Follow-up Study (1990 to 2014) who were free of cancer, heart disease, and stroke at baseline. Diet was assessed using food frequency questionnaires at baseline and then every 4 years. Cumulative average of intake was used in the primary analysis. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. Results: During 24 years of follow-up, we documented 10,240 incident cases of CVD, including 6,270 CHD cases and 3,970 stroke cases. After adjusting for major diet and lifestyle factors, compared with non-consumers, those with higher olive oil intake (>1/2 tablespoon/d or > 7g/d) had 15% lower risk of total CVD [pooled hazard ratio (95% confidence interval): 0.85 (0.77, 0.93)] and 21% lower risk of CHD [pooled hazard ratio (95% confidence interval): 0.79 (0.70, 0.89)]. No significant associations were observed for total stroke or ischemic stroke. We estimated that replacing 5g of margarine, butter, mayonnaise, or dairy fat with the equivalent amount of olive oil was associated with 5-7% lower risk of total CVD and CHD. No significant associations were observed when olive oil was compared with other plant oils combined (corn, safflower, soybean and canola oil). Conclusions: Higher olive oil intake was associated with a lower risk of CHD and total CVD in two large prospective cohorts of U.S. men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil might lead to a lower risk for CHD and CVD.

scholarly journals Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

BMJ ◽  
2020 ◽  
pp. m2297 ◽  
Author(s):  
Xiaoyan Cai ◽  
Yunlong Zhang ◽  
Meijun Li ◽  
Jason HY Wu ◽  
Linlin Mai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
Confidence Interval ◽  
Absolute Risk ◽  
Meta Analysis ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Objective To evaluate the associations between prediabetes and the risk of all cause mortality and incident cardiovascular disease in the general population and in patients with a history of atherosclerotic cardiovascular disease. Design Updated meta-analysis. Data sources Electronic databases (PubMed, Embase, and Google Scholar) up to 25 April 2020. Review methods Prospective cohort studies or post hoc analysis of clinical trials were included for analysis if they reported adjusted relative risks, odds ratios, or hazard ratios of all cause mortality or cardiovascular disease for prediabetes compared with normoglycaemia. Data were extracted independently by two investigators. Random effects models were used to calculate the relative risks and 95% confidence intervals. The primary outcomes were all cause mortality and composite cardiovascular disease. The secondary outcomes were the risk of coronary heart disease and stroke. Results A total of 129 studies were included, involving 10 069 955 individuals for analysis. In the general population, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.13, 95% confidence interval 1.10 to 1.17), composite cardiovascular disease (1.15, 1.11 to 1.18), coronary heart disease (1.16, 1.11 to 1.21), and stroke (1.14, 1.08 to 1.20) in a median follow-up time of 9.8 years. Compared with normoglycaemia, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 7.36 (95% confidence interval 9.59 to 12.51), 8.75 (6.41 to 10.49), 6.59 (4.53 to 8.65), and 3.68 (2.10 to 5.26) per 10 000 person years, respectively. Impaired glucose tolerance carried a higher risk of all cause mortality, coronary heart disease, and stroke than impaired fasting glucose. In patients with atherosclerotic cardiovascular disease, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.36, 95% confidence interval 1.21 to 1.54), composite cardiovascular disease (1.37, 1.23 to 1.53), and coronary heart disease (1.15, 1.02 to 1.29) in a median follow-up time of 3.2 years, but no difference was seen for the risk of stroke (1.05, 0.81 to 1.36). Compared with normoglycaemia, in patients with atherosclerotic cardiovascular disease, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 66.19 (95% confidence interval 38.60 to 99.25), 189.77 (117.97 to 271.84), 40.62 (5.42 to 78.53), and 8.54 (32.43 to 61.45) per 10 000 person years, respectively. No significant heterogeneity was found for the risk of all outcomes seen for the different definitions of prediabetes in patients with atherosclerotic cardiovascular disease (all P>0.10). Conclusions Results indicated that prediabetes was associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease. Screening and appropriate management of prediabetes might contribute to primary and secondary prevention of cardiovascular disease.

Socioeconomic status predicts second cardiovascular event in 29,226 survivors of a first myocardial infarction

2018 ◽  
Vol 25 (9) ◽  
pp. 985-993 ◽  
Author(s):  
Joel Ohm ◽  
Per H Skoglund ◽  
Andrea Discacciati ◽  
Johan Sundström ◽  
Kristina Hambraeus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Socioeconomic Status ◽  
Secondary Prevention ◽  
Marital Status ◽  
Preventive Treatment ◽  
Disposable Income ◽  
Atherosclerotic Cardiovascular Disease ◽  
One Year ◽  
First Myocardial Infarction

Background Risk assessment post-myocardial infarction needs improvement, and risk factors derived from general populations apply differently in secondary prevention. The prediction of subsequent cardiovascular events post-myocardial infarction by socioeconomic status has previously been poorly studied. Design Swedish nationwide cohort study. Methods A total of 29,226 men and women (27%), 40–76 years of age, registered at the standardised one year revisit after a first myocardial infarction in the secondary prevention quality registry of SWEDEHEART 2006–2014. Personal-level data on socioeconomic status measured by disposable income and educational level, marital status, and the primary endpoint, first recurrent event of atherosclerotic cardiovascular disease, defined as non-fatal myocardial infarction or coronary heart disease death or fatal or non-fatal stroke were obtained from linked national registries. Results During the mean 4.1-year follow-up, 2284 (7.8%) first recurrent manifestations of atherosclerotic cardiovascular disease occurred. Both socioeconomic status indicators and marital status were associated with the primary endpoint in multivariable Cox regression models. In a comprehensively adjusted model, including secondary preventive treatment, the hazard ratio for the highest versus lowest quintile of disposable income was 0.73 (95% confidence interval 0.62–0.83). The association between disposable income and first recurrent manifestation of atherosclerotic cardiovascular disease was stronger in men as was the risk associated with being unmarried (tests for interaction P < 0.05). Conclusions Among one year survivors of a first myocardial infarction, first recurrent manifestation of atherosclerotic cardiovascular disease was predicted by disposable income, level of education and marital status. The association between disposable income and first recurrent manifestation of atherosclerotic cardiovascular disease was independent of secondary preventive treatment but further study on causal pathways is needed.

scholarly journals Association between body mass index and 1-year outcome after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D.W Kim
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
Cardiac Death ◽  
Funding Source ◽  
Group Iii ◽  
End Point ◽  
Group I

Abstract Background Beneficial effects of overweight and obesity on mortality after acute myocardial infarction (AMI) have been described as “Body Mass Index (BMI) paradox”. However, the effects of BMI is still on debate. We analyzed the association between BMI and 1-year major cardiocerebrovascular events (MACCE) after AMI. Methods and findings Among 13,104 AMI patients registered in an Institute of Health in Korea between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group I; &lt;22 kg/m2, 22 ≤ Group II &lt;26 kg/m2, Group III; ≥26 kg/m2). The primary end point was a composite of cardiac death (CD), myocardial infarction (MI), target vessel revascularization (TVR), and cerebrovascular events at 1 year. Over the median follow-up of 12 months, the composite of primary end point occurred more frequently in the Group I patients than in the Group III patients (primary endpoint: adjusted hazard ratio [aHR], 1.290; 95% confidence interval [CI] 1.024 to 1.625, p=0.031). Especially, cardiac death in MACCE components played a major role in this effect (aHR, 1.548; 95% confidence interval [CI] 1.128 to 2.124, p=0.007). Conclusions Higher BMI appeared to be good prognostic factor on 1-year MACCE after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Research of Korea Centers for Disease Control and Prevention and the Korea Health Technology R&D Project, Ministry of Health & Welfare (HI13C1527), Republic of Korea.

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