scholarly journals The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Niloofar Barzegar ◽  
Maryam Tohidi ◽  
Mitra Hasheminia ◽  
Fereidoun Azizi ◽  
Farzad Hadaegh
Keyword(s):  
Multivariate Analysis ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Significant Trend ◽  
Lipid Lowering ◽  
Tyg Index ◽  
Framingham Risk ◽  
Triglyceride Glucose Index ◽  
Increased Risk

Abstract Background To investigate whether the Triglyceride-Glucose index (TyG-index) is associated with increased risk of cardiovascular diseases (CVD)/coronary heart disease (CHD). Methods A total of 7521 Iranians aged ≥ 30 years (male = 3367) were included in the study. Multivariate Cox regression analyses (adjusted for age, gender, waist circumference, body mass index, educational level, smoking status, physical activity, family history of CVD, type 2 diabetes, hypertension, low and high density lipoprotein cholesterol, and lipid lowering drugs) were used to assess the risk of incident CVD/CHD across quintiles and for 1-standard deviation (SD) increase in the TyG-index. The cut off point for TyG-index was assessed by the minimum value of $$\sqrt {\left( {1 - sensitivity} \right)^{2} + \left( {1 - specificity} \right)^{2} }$$ 1 - s e n s i t i v i t y 2 + 1 - s p e c i f i c i t y 2 . We also examined the added value of the TyG-index in addition to the Framingham risk score when predicting CVD. Results During follow-up, 1084 cases of CVD (male = 634) were recorded. We found a significant trend of TyG-index for incident CVD/CHD in multivariate analysis (both Ps for tend ≤ 0.002). Moreover, a 1-SD increase in TyG-index was associated with significant risk of CVD/CHD in multivariate analysis [1.16 (1.07–1.25) and 1.19 (1.10–1.29), respectively]. The cut-off value of TyG-index for incident CVD was 9.03 (59.2% sensitivity and 63.2% specificity); the corresponding value of TyG-index for incident CHD was 9.03 (60.0% sensitivity and 62.8% specificity), respectively. Although no interaction was found between gender and TyG-index for CVD/CHD in multivariate analysis (both Ps for interaction > 0.085), the significant trend of TyG-index was observed only among females for incident CVD (P = 0.035). A significant interaction was found between age groups (i.e. ≥ 60 vs < 60 years) and TyG-index for CVD outcomes in the multivariate model (P-value for interaction = 0.046). Accordingly, a significant association between the TyG-index and outcomes was found only among the younger age group. Among the population aged < 60 the addition of TyG-index to the Framingham risk score (FRS) did not show improvement in the predictive ability of the FRS, using integrated discrimination improvement. Conclusion The TyG-index is significantly associated with increased risk of CVD/CHD incidence; this issue was more prominent among the younger population. However, adding TyG-index to FRS does not provide better risk prediction for CVD.

The utility of coronary artery calcium in non-gated high resolution CT thorax scans in predicting cardiac events as compared to the Framingham risk score: a retrospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Saluja ◽  
H Contractor ◽  
M Daniells ◽  
J Sobolewska ◽  
K Khan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Retrospective Study ◽  
Coronary Artery ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Cardiac Events ◽  
End Point ◽  
Framingham Risk ◽  
Good Concordance

Abstract Background There is existing evidence to suggest a correlation between coronary artery calcification (CAC) measured using ECG-triggered chest computed tomography and cardiovascular disease. Further evidence has emerged to suggest a correlation between CAC measured using non-gated CT scans and cardiovascular disease. Herein, we sought to ascertain the utility of incidental findings of CAC on non-triggered high resolution CT (HRCT) thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease and Framingham risk score (FRS) in predicting cardiovascular events. Methods The Computerised Radiology Information Service (CRIS) database was manually searched to determine all HRCT scans performed in a single trust from 05/2015 to 05/2016. The reports issued by Radiologists and images of selected studies were reviewed. For patients with CAC, we calculated the calcium score for patients using the Agatston method. Clinical events were determined from the electronic medical record without knowledge of patients' CAC findings. For these patients, the Framingham Risk Score (FRS) was also calculated. The primary end point of the study was composite of all-cause mortality and cardiac events (non-fatal myocardial infarction, coronary revascularization, new atrial fibrillation or heart failure episode requiring hospitalization). Results We selected 300 scans from a total of approximately 2000 scans performed over this time. Data at follow up was available for 100% of the patients, with a median duration of follow up of 1.6 years. Moderate to severe CAC was found in 35% of people. Multivariable analysis showed good concordance between CAC and FRS in predicting composite clinical end point. The Odds Ratio for cardiac events in patients with moderate to severe CAC was 5.3 (p&lt;0.01) and for composite clinical end point was 3.4 (p&lt;0.01). This is similar to the OR predicted by the FRS: 4.8; p&lt;0.01 and 3.1; p&lt;0.01 respectively. Only 6.2% of patients with moderate to severe CAC were currently statin treated. Conclusion In this retrospective study of patients with respiratory disease attending for HRCT scanning, co-incidentally detected CAC predicts cardiac events, with good concordance with the FRS. The incidental finding of CAC on non-gated CT scanning should be reported with Agatston score calculation allowing consideration of intervention to mitigate cardiovascular risk and optimize. Further multi-centre prospective studies of this strategy, with a larger patient cohort should be conducted to clarify the utility of CAC as a prediction tool to modify cardiac risk. Funding Acknowledgement Type of funding source: None

scholarly journals Baseline Framingham risk score does not predict future ECG-derived QRS duration over an average of 3.3 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Elijah Stone ◽  
Yuling Zhou ◽  
Herbert Jelinek ◽  
Craig S. Mclachlan
Keyword(s):  
Cardiovascular Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Cross Sectional ◽  
Online Risk ◽  
Weak Association ◽  
Framingham Risk ◽  
Qrs Duration ◽  
Risk Parameters

Abstract Background Prolonged electrocardiogram (ECG) QRS duration has been associated with increased cardiovascular risk. It is unclear whether the main predictor of cardiovascular risk, the Framingham risk score also predicts short-term changes in ECG QRS duration. Our aim is to determine whether baseline Framingham risk score is associated with baseline or changes in QRS duration. Methods A retrospective cross-sectional analysis was performed using observational data obtained from two hundred two participants. Framingham risk score was calculated using an online risk calculator. QRS duration was obtained using a 10 s trace from a Welch Allyn PC-based 12-lead ECG system. Results Average follow-up duration was 3.3 ± 1.1 years. Mean QRS change was 1.8 ± 11.4 ms. Specifically, among two hundred two participants, there are 104 subjects with a greater QRS duration at follow-up, while 98 subjects had the same or a shorter follow-up QRS duration. Baseline Framingham risk score did not significantly predict an increase in QRSd with an odds ratio of 1.04 (P = 0.230). Regression analysis of QRS duration at baseline and Framingham risk at baseline had a weak association (R2 = 0.020; P = 0.043). The Framingham risk score at follow-up was likewise has a weak association with follow-up QRS duration (R2 = 0.045; P = 0.002). Conclusions Our results do not demonstrate a statistically significant association between Framingham risk parameters and future QRS duration changes over longitudinal time. QRS duration had variable changes between baseline and follow-up. This might suggest that a longer period of follow-up is required to document more stable increases in QRS duration associated with ventricular pathology. A larger population study is needed to confirm our observations.

Framingham risk score after risk-reducing salpingo-oophorectomy in women at risk for hereditary breast ovarian cancer: A controlled observational study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11048-11048
Author(s):  
T. M. Michelsen ◽  
S. Tonstad ◽  
A. A. Dahl ◽  
A. H. Pripp ◽  
C. G. Tropé ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Genetic Counseling ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Risk Profile ◽  
Hereditary Breast Ovarian Cancer ◽  
Framingham Risk ◽  
Chd Risk ◽  
Risk Reducing

11048 Background: Risk-reducing salpingo-oophorectomy (RRSO) effectively prevents ovarian cancer in BRCA mutation carriers and in women at risk for hereditary breast-ovarian cancer. RRSO induces immediate menopause, which may increase the risk of coronary heart disease (CHD). Our aim was to determine CHD risk using Framingham risk score and examine factors associated with this risk in women who had undergone RRSO compared to population-based controls. Methods: A sample of 326 (65% of invited) women who underwent RRSO after genetic counseling from 1980–2005 provided completed questionnaires, physical measures, and blood samples. Controls were 1,630 age-matched controls from the Norwegian Nord-Trøndelag Health Study (HUNT-2) (1995- 97). Results: Mean age in both the RRSO and control groups at survey was 54.4 years. Mean follow-up after surgery was 6.5 years (SD 4.4). The RRSO group had a more favorable CHD risk profile (higher education, more physical activity, less smoking, lower total cholesterol, higher HDL cholesterol, lower systolic blood pressure and lower BMI) and lower Framingham total score compared to controls (p<0.05). In multiple logistic regression analyses RRSO was inversely associated with Framingham 10-year risk ≥5% (Odds Ratio 0.49, 95% CI [0.34, 0.71] p<0.001). Conclusions: In contrast to expectation, women at increased risk of hereditary breast ovarian cancer had a favorable CHD risk profile after RRSO compared to age-matched controls from the general population, and RRSO was associated with lower Framingham risk score. Follow-up time, self-selection of women seeking genetic counseling, changes in lifestyle after surgery and survival bias are possible explanations of this finding. No significant financial relationships to disclose.

scholarly journals The triglyceride-glucose index as a measure of insulin resistance and risk of obesity-related cancers

2019 ◽  
Vol 49 (1) ◽  
pp. 193-204 ◽  
Author(s):  
Josef Fritz ◽  
Tone Bjørge ◽  
Gabriele Nagel ◽  
Jonas Manjer ◽  
Anders Engeland ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Standard Deviation Increase ◽  
Cox Models ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Increased Risk ◽  
Males And Females ◽  
Surrogate Measure

Abstract Background The role of insulin resistance as a mediator in the association of body mass index (BMI) with site-specific cancer risk has, to our knowledge, never been systematically quantified. Methods Altogether 510 471 individuals from six European cohorts, with a mean age of 43.1 years, were included. We used the triglyceride glucose product (TyG index) as a surrogate measure for insulin resistance. We fitted Cox models, adjusted for relevant confounders, to investigate associations of TyG index with 10 common obesity-related cancers, and quantified the proportion of the effect of BMI mediated through TyG index on the log-transformed hazard ratio (HR) scale. Results During a median follow-up of 17.2 years, 16 052 individuals developed obesity-related cancers. TyG index was associated with the risk of cancers of the kidney HR per one standard deviation increase 1.13, 95% confidence interval: 1.07 to 1.20], liver (1.13, 1.04 to 1.23), pancreas (1.12, 1.06 to 1.19), colon (1.07, 1.03 to 1.10) and rectum (1.09, 1.04 to 1.14). Substantial proportions of the effect of BMI were mediated by TyG index for cancers of the pancreas (42%), rectum (34%) and colon (20%); smaller proportions for kidney (15%) and liver (11%). Little or no mediation was observed for breast (postmenopausal), endometrial and ovarian cancer. Results were similar for males and females, except for pancreatic cancer where the proportions mediated were 20% and 91%, respectively. Conclusions The TyG index was associated with increased risk of cancers of the digestive system and substantially mediated the effect of BMI, suggesting that insulin resistance plays a promoting role in the pathogenesis of gastrointestinal cancers.

scholarly journals Triglyceride–glucose index is associated with the risk of myocardial infarction: an 11-year prospective study in the Kailuan cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xue Tian ◽  
Yingting Zuo ◽  
Shuohua Chen ◽  
Qian Liu ◽  
Boni Tao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Surrogate Marker ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Increased Risk ◽  
The Mean ◽  
Adjusted Model ◽  
Multivariable Adjusted Model

Abstract Background The triglyceride–glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI. Methods A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models. Results During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77–2.45) and 1.58 (1.18–2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63–2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411). Conclusions Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.

scholarly journals Epicardial adipose tissue volume improves cardiovascular risk reclassification: the Framingham Risk Score example

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J A Sousa ◽  
M I Mendonca ◽  
M Santos ◽  
M Temtem ◽  
F Mendonca ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Epicardial Adipose Tissue ◽  
Major Adverse Cardiovascular Events ◽  
Net Reclassification Improvement ◽  
Framingham Risk ◽  
Asymptomatic Volunteers

Abstract Introduction Epicardial adipose tissue (EAT) volume can be noninvasively detected by CT and has been suggested to predict major adverse cardiovascular events (MACE). Framingham Risk Score is one of a number of scoring systems used to determine an individual's chances of developing cardiovascular disease, hence identifying who is most likely to benefit from prevention. Objectives The purpose of this study was to determine net reclassification improvement (NRI) and improved risk prediction based on EAT volume, in comparison to a traditionally known cardiovascular risk score, such as the Framingham. Methods 895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9±7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. For NRI assessment, EAT volume as a continuous variable was added to the Framingham Risk Score. Results After 3.7 median years of follow-up, 27 patients developed a MACE. Using NRI, the net proportion of events (netNRIe) that assigned a higher risk was 33.3% (better reclassified), and the net ratio of non-events (netNRIne) was 24.7%, resulting in a net reclassification index (netNRI) of 58.0%. When the new marker was included in the model, 58.0% of patients were better reclassified. In our work, a total of 33.3% of patients who suffered events (n=27) were correctly reclassified and assigned a higher risk. Conclusion EAT volume results in a high reclassification rate in an asymptomatic, low-risk population, demonstrating the benefit of this marker beyond traditional risk assessment models. Our study supports its application, especially in carefully selected individuals. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Framingham Risk Score for Cardiovascular Disease: Application to Jordanian Community; A cross sectional study

2021 ◽  
Author(s):  
shereen Arabiyat ◽  
odate tadros ◽  
Tamara Al-daghastani ◽  
Deema Jaber
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Risk Score ◽  
Cardiac Event ◽  
Framingham Risk Score ◽  
Lipid Lowering ◽  
Framingham Score ◽  
Event Risk ◽  
Framingham Risk ◽  
Significant Difference

Objective: The aim of this study is to assess the protective measures taken by the Jordanian population in order to decrease the risk of the first cardiovascular event using Framingham score risk classification to assess cardiac event risk. Methods: Several nationally representative models of adult Jordanians were recruited in this study. Demographic data and anthropometric parameters were documented. Framingham risk score was calculated. Accordingly, cardiac event risk has been determined. Google form was created to generate a survey. Social media was utilized to extend the survey. Key findings: As expected, taking lipid lowering medications has decreased the Framingham score significantly, patients with high HDL value have lower Framingham score. Significant difference in Framingham score between diploma and patients with high school or less education level p-value 0.043. There was a significant difference in Framingham score between nonsmokers and sometimes smokers. The study revealed that 90% of the participants were having low risk for developing CVD, 5% were at intermediate risk and 5% were at high risk for developing CVD. This was expected as the average age was between 20-30 years. Conclusion: This study presented no advantage and even some harm because of consuming daily low-dose aspirin in some groups of people formerly thought to benefit from such treatment. This new piece of information applies to patients who do not have identified cardiovascular disease. If you have not had one of the above situations or events and are older than 70 years, younger than 40 years, or at higher danger of bleeding because of a medical condition or treatments, you should not consume aspirin for principal prevention of heart disease. If you are between 40 and 70 years old, at decreased risk of bleeding, and thought to be at increased risk of heart disease, you might get advantage from using aspirin.

Are Physical Fitness and CRP Related to Framingham Risk Score in HIV+ Adults?

2020 ◽  
pp. 155982762090434
Author(s):  
John E. Lewis ◽  
Jillian Poles ◽  
Eleanor Garretson ◽  
Eduard Tiozzo ◽  
Sharon Goldberg ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Risk Score ◽  
Aerobic Capacity ◽  
Muscular Strength ◽  
Framingham Risk Score ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Framingham Risk ◽  
Increased Risk ◽  
Multiple Biomarkers

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). The Framingham Risk Score (FRS) predicts a 10-year CVD risk. Its relationships to physical fitness and C-reactive protein (CRP) are not well established. The current aim is to determine the links between FRS, physical fitness, and CRP in PLWH. Methods. Participants (n = 87) were assessed on multiple biomarkers. The FRS was calculated with the respective variables. Other variables that correlated significantly with FRS were entered into a regression equation to determine their relationship to FRS. Results. The FRS for men was more than twice that for women (12.8 vs 6.0, P < .001). Men were more fit than women, but most participants were not fit. Aerobic capacity was predictive of FRS in men, but not in women, and muscular strength was not predictive of FRS. Women had more than double the CRP compared with men (7.9 vs 3.5 mg/L, P < .01), and it was unrelated to FRS. Conclusions. In men, aerobic capacity was significantly predictive of FRS, but muscular strength and CRP were unrelated to FRS in both genders. These results do not conclusively demonstrate that physical fitness and CRP are related to FRS in PLWH.

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