scholarly journals Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Janine E. van der Toorn ◽  
Oscar L. Rueda-Ochoa ◽  
Niels van der Schaft ◽  
Meike W. Vernooij ◽  
M. Arfan Ikram ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Mortality Risk ◽  
Cox Regression ◽  
Population Based ◽  
Arterial Calcification ◽  
Future Research ◽  
Rotterdam Study ◽  
Risk Profiles ◽  
Severe Calcification

Abstract Background Evidence has pointed towards differences in the burden of arteriosclerosis according to its location and sex. Yet there is a scarcity of population-based data on aggregated sex-specific cardiovascular risk profiles, instead of single risk factors, and mortality risk according to the location of arteriosclerosis. We assessed sex-specific cardiovascular risk profiles and mortality risk associated with arteriosclerosis. Methods From the population-based Rotterdam Study, 2357 participants (mean age 69 years, 53% women) underwent non-contrast computed tomography to quantify calcification, as a proxy for arteriosclerosis, in the coronary arteries (CAC), aortic arch (AAC), extracranial (ECAC) and intracranial carotid arteries (ICAC), vertebrobasilar arteries (VBAC), and aortic valve (AVC). Principal component analysis (PCA) of eight distinct cardiovascular risk factors was performed, separately for women and men, to derive risk profiles based on the shared variance between factors. We used sex-stratified multivariable logistic regression to examine the associations between PCA-derived risk profiles and severe calcification at different locations. We investigated the associations of severe calcification with mortality risk using sex-stratified multivariable Cox regression. Results PCA identified three cardiovascular risk profiles in both sexes: (1) anthropometry, glucose, and HDL cholesterol; (2) blood pressure; and (3) smoking and total cholesterol. In women, the strongest associations were found for profile 2 with severe ECAC and ICAC (adjusted OR [95% CI] 1.32 [1.14–1.53]) and for profile 3 with severe at all locations, except AVC. In men, the strongest associations were found for profile 2 with VBAC (1.31 [1.12–1.52]) and profile 3 with severe AAC (1.28 [1.09–1.51]). ECAC and AVC in women and CAC in men showed the strongest, independent associations with cardiovascular mortality (HR [95% CI] 2.11 [1.22–3.66], 2.05 [1.21–3.49], 2.24 [1.21–3.78], respectively). Conclusions Our findings further underline the existence of sex- and location-specific differences in the etiology and consequences of arteriosclerosis. Future research should unravel which distinct pathological processes underlie differences in risk profiles for arteriosclerosis.

Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample

2020 ◽  
Author(s):  
Pauline C. S. van Paridon ◽  
Marina Panova-Noeva ◽  
Philipp S. Wild ◽  
Rene van Oerle ◽  
Andreas Schulz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Mortality Risk ◽  
Tissue Factor Pathway Inhibitor ◽  
Population Based ◽  
Health Study ◽  
Activity Levels ◽  
Gutenberg Health Study ◽  
Tissue Factor Pathway

Abstract Objective Tissue factor pathway inhibitor (TFPI) is a potent anticoagulant protein in the extrinsic coagulation pathway. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and its association with cardiovascular disease (CVD) and total mortality. Methods Total TFPI activity was assessed in a selection of the population-based Gutenberg Health Study (n = 5,000). Statistical analysis was performed to identify the determinants for total TFPI activity as well as the associations with CVD and mortality. Results Multivariable linear regression analysis identified smoking (β 0.095 [0.054–0.136]) as a positive determinant for total TFPI activity, while diabetes (β –0.072 [–0.134 to –0.009]), obesity (β –0.063 [–0.101 to –0.024]), and history of coronary artery disease (CAD) were negatively associated with total TFPI activity, independent of age, sex, and the remaining cardiovascular risk factors. After adjustment for lipoprotein levels, the association between total TFPI activity levels and obesity and CAD was lost. The analysis additionally revealed a strong positive association between total TFPI activity levels and low-density lipoprotein (β 0.221 [0.204–0.237]). The Cox regression models revealed that a higher total TFPI activity, above 97.5th percentile of the reference group, was associated with an increased mortality risk (hazard ratio = 2.58 [95% confidence interval: 1.49–4.47]), independent of age, sex, and cardiovascular risk profile. Conclusion In the Gutenberg Health Study population-based cohort, the highest percentage of total TFPI correlated with an increased mortality risk. While elevated TFPI may reflect endothelial cell activation, the associations between total TFPI activity and obesity and CAD, points to additional mechanistic interactions.

Low ADAMTS13 Activity Is a Strong Risk Factor for Ischemic Stroke: A Prospective Cohort Study - the Rotterdam Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 113-113 ◽  
Author(s):  
Michelle Alida Helena Sonneveld ◽  
Moniek de Maat ◽  
Marileen L.P. Portegies ◽  
Albert Hofman ◽  
Peter L Turecek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Adamts13 Activity ◽  
Rotterdam Study ◽  
Advisory Committees ◽  
Cox Proportional Hazard Regression

Abstract Introduction.ADAMTS13 has antithrombotic properties because it cleaves Von Willebrand factor (VWF) in smaller, less active multimers. Low ADAMTS13 activity may therefore increase the risk of arterial thrombosis, including ischemic stroke. We prospectively studied the association between ADAMTS13 activity, VWF antigen (VWF:Ag) levels and ischemic stroke in the Rotterdam Study, a population-based cohort study among subjects ≥ 55 years. Methods.We included 5941 individuals without a history of stroke or TIA. Blood was drawn at baseline and ADAMTS13 activity (expressed as % of normal plasma) was measured using the FRETS-VWF73 assay and VWF:Ag levels by ELISA. All individuals were followed for development of stroke or TIA. The association between ADAMTS13 activity, VWF:Ag levels and ischemic stroke were assessed by Cox proportional hazard regression analysis. Results.Over an average follow-up time of 9.5 years, 461 participants suffered from a stroke, 306 of which definitely classified as ischemic. After adjustment for cardiovascular risk factors, individuals with ADAMTS13 activity in the lowest quartile had a higher risk of ischemic stroke (HR 1.65, 95% CI 1.16 – 2.32) than those in the reference highest quartile. In individuals with low ADAMTS13 activity and high VWF:Ag levels the risk of ischemic stroke risk was 3.5 fold increased (HR 3.51, 95% CI 1.60 – 7.70). Conclusions.In this large prospective population study, low ADAMTS13 activity predicts the risk of ischemic stroke, independently of age, sex, and established cardiovascular risk factors. This risk was even higher in individuals with both low ADAMTS13 activity and high VWF antigen levels. Figure 1 Figure 1. Disclosures Turecek: Baxter Innovations GmbH, Vienna, Austria: Employment. Rottensteiner:Baxter Innovations GmbH: Employment. Scheiflinger:Baxter Innovations GmbH: Employment. Leebeek:CSL Behring and Baxter: Membership on an entity's Board of Directors or advisory committees.

scholarly journals The epidemiology of Lp-PLA2: Distribution and correlation with cardiovascular risk factors in a population-based cohort

2007 ◽  
Vol 190 (2) ◽  
pp. 388-396 ◽  
Author(s):  
Margaretha Persson ◽  
Jan-Åke Nilsson ◽  
Jeanenne J. Nelson ◽  
Bo Hedblad ◽  
Göran Berglund
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Population Based

A population-based study of associations between preeclampsia and later cardiovascular risk factors

2014 ◽  
Vol 211 (6) ◽  
pp. 657.e1-657.e7 ◽  
Author(s):  
Ingvild V. Alsnes ◽  
Imre Janszky ◽  
Michele R. Forman ◽  
Lars J. Vatten ◽  
Inger Økland
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Population Based Study

scholarly journals Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction

2021 ◽  
Author(s):  
Jan-Per Wenzel ◽  
Ramona Bei der Kellen ◽  
Christina Magnussen ◽  
Stefan Blankenberg ◽  
Benedikt Schrage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Diastolic Dysfunction ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Left Ventricular ◽  
Health Study ◽  
Common Finding

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

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