scholarly journals Association between dietary choline and betaine intake and 10.6-year cardiovascular disease in adults

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahdieh Golzarand ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Cardiovascular Disease ◽  
Dietary Intake ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
United States Department ◽  
Third Wave ◽  
Food Category ◽  
Dietary Choline

Abstract Background Several studies have assessed the association between dietary choline and betaine and cardiovascular disease (CVD), but their results are inconsistent. The present study aimed to determine the association between dietary intake of choline and betaine and the risk of CVD in the general population over a 10.6-year period of follow-up. Methods The present cohort study was conducted on participants in the third wave of the Tehran Lipid and Glucose Study (2006–2008) and was followed-up until March 2018. Dietary intake of choline and betaine was calculated using the United States Department of Agriculture (USDA) database. Patients’ medical records were used to collect data on CVD. Results In this study, 2606 subjects with no previous CVD participated and were followed-up for a median of 10.6 years. During the follow-up periods, 187 incidences of CVD were detected. Results of the Cox proportional hazards regression indicated that neither energy-adjusted total choline nor betaine was associated with the incidence of CVD. Among individual choline forms, only higher intake of free choline (FC) was associated with a lower risk of CVD (HR: 0.64, 95% CI: 0.42–0.98). There was no significant association between each 10 mg/d increase in choline and betaine content of each food category and CVD. Conclusion Our investigation indicates no association between energy-adjusted total choline and betaine and a 10.6-year risk of CVD among adults. Besides, we found no relationship between individual choline forms (except FC) and CVD. We also found energy-adjusted choline and betaine obtained from food categories were not associated with the risk of CVD.

scholarly journals Association between Dietary Choline and Betaine Intake and 10.6-Year Cardiovascular Disease Outcomes and Mortality in Adults

2021 ◽  
Author(s):  
Mahdieh Golzarand ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Cardiovascular Disease ◽  
Dietary Intake ◽  
The United States ◽  
Food Sources ◽  
United States Department ◽  
Third Wave ◽  
Increased Risk ◽  
Dietary Choline ◽  
Cvd Mortality

Abstract Background: Several studies have assessed the association between dietary choline and betaine and cardiovascular disease (CVD) outcomes but their results are inconsistent. The present study aimed to determine the association between dietary intake of choline and betaine and risk of CVD events and mortality in the general population over a 10.6-year of follow-up. Methods: The present cohort study was conducted on participation in the third wave of the Tehran Lipid and Glucose Study (2006-2008) and was followed-up until March 2018. Dietary intake of choline and betaine was calculated using the United States Department of Agriculture (USDA) database. Data about CVD events and mortality were collected using patients’ medical records or death certification. Results: In this study, 2606 subjects with no previous CVD were participated and followed-up for a median of 10.6 years. During the follow-up periods, 183 incidences of CVD and 17 deaths were detected. Results of the multivariate analysis indicated neither per one standard deviation (SD) increase in dietary choline nor betaine associated with the incidence of CVD, CHD, stroke, and CVD mortality. There was no significant association between food sources of choline and CVD outcomes and mortality. When we assessed the relationship between dietary contributors betaine, per one SD increase in betaine content of fruit and vegetables and oils and fats significantly associated with increased risk of CVD mortality.Conclusion: Our investigation indicates no association between per one SD increase in choline and betaine and a 10.6-year risk of CVD events and mortality among adults. Besides, we found no relationship between significant food sources of choline and betaine and outcomes of interest.

P6355The behavior of atrial fibrillation in patients with heart failure hospitalization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Fukunaga ◽  
K Hirose ◽  
A Isotani ◽  
T Morinaga ◽  
K Ando
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Significant Difference ◽  
The Impact

Abstract Background Relationship between atrial fibrillation (AF) and heart failure (HF) is often compared with proverbial question of which came first, the chicken or the egg. Some patients showing AF at the HF admission result in restoration of sinus rhythm (SR) at discharge. It is not well elucidated that the restoration into SR during hospitalization can render the preventive effect for rehospitalization. Purpose To investigate the impact of restoration into SR during hospitalization for readmission rate of the HF patients showing AF. Methods We enrolled consecutive 640 HF patients hospitalized from January 2015 to December 2015. Patients data were retrospectively investigated from medical record. Patients showing atrial fibrillation on admission but unrecognized ever were defined as “incident AF”; patients with AF diagnosed before admission were defined as “prevalent AF”. Primary endpoint was a composite of death from cardiovascular disease or hospitalization for worsening heart failure. Secondary endpoints were death from cardiovascular disease, unplanned hospitalization related to heart failure, and any hospitalization. Results During mean follow up of 19 months, 139 patients (22%) were categorized as incident AF and 145 patients (23%) were categorized as prevalent AF. Among 239 patients showing AF on admission, 44 patients were discharged in SR (39 patients in incident AF and 5 patients in prevalent AF). Among incident AF patients, the primary composite end point occurred in significantly fewer in those who discharged in SR (19% vs. 42% at 1-year; 23% vs. 53% at 2-year follow-up, p=0.005). To compare the risk factors related to readmission due to HF with the cox proportional-hazards model, AF only during hospitalization [Hazard Ratio (HR)=0.37, p<0.01] and prevalent AF (HR=1.67, p=0.04) was significantly associated. There was no significant difference depending on LVEF. Conclusion Newly diagnosed AF with restoration to SR during hospitalization was a good marker to forecast future prognosis.

Abstract 16731: Early Onset of Menopause and Premature Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ruth Misha ◽  
Laura A Colangelo ◽  
Lucia Petito ◽  
Cora E Lewis ◽  
Pamela Schreiner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Black Women ◽  
Early Onset ◽  
White Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Age At Menarche

Introduction: Cardiovascular disease (CVD) is the leading cause of death in women and early onset of menopause before the age of 40 years has been identified as a risk enhancer for future CVD events. Quantifying the magnitude of risk for premature CVD among women with early menopause may inform and guide the intensity of sex-specific preventive strategies. Methods: We included all women in the Coronary Artery Risk Development in Young Adults (CARDIA) study who attended a follow-up exam after the age of 40 years, had available data on menopausal status, and had not experienced premature CVD before 40 years. We performed multivariable Cox proportional hazards regression to examine the relationship between early onset of menopause defined as <40 years and incident CVD (coronary heart disease, peripheral arterial disease, stroke, and heart failure) prior to the age of 65 years. We performed Cox proportional hazards models and adjusted for risk factors levels at baseline: age, race, age at menarche, years of education, smoking status, body mass index, diabetes, hypertension, and total cholesterol: high-density lipoprotein ratio. Results: Among 2136 women with mean age of 43.0 (SD 3.0), 9.1% reported premature menopause before the age of 40 years (4.5% in white and 13.9% in black women). Over a median follow-up of 14.0 (IQR 11.5, 16.9) years, 81 premature CVD events occurred. Incidence rate (95% CI) of CVD was 6.46 (2.43, 17.22) and 1.41 (0.92, 2.17) per 1,000 per person-years for white women with and without early onset menopause, respectively; 4.94 (2.66, 9.16) and 3.92 (2.94, 5.24) per 1,000 person-years for black women with and without early onset menopause (FIGURE). Conclusions: In a population-based sample, white women with early onset of menopause had a 3-fold higher rate of premature CVD events, independent of perimenopausal risk factor levels. Interventions to intensify CVD prevention in at-risk women are needed following early onset of menopause.

scholarly journals Extended Mortality Follow-up of a Cohort of 25,460 Workers Exposed to Acrylonitrile

2019 ◽  
Vol 188 (8) ◽  
pp. 1484-1492 ◽  
Author(s):  
Stella Koutros ◽  
Jay H Lubin ◽  
Barry I Graubard ◽  
Aaron Blair ◽  
Patricia A Stewart ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Proportional Hazards ◽  
Cox Regression ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Increased Risk ◽  
Total Cancer ◽  
Standardized Mortality Ratios

Abstract We extended the mortality follow-up of a cohort of 25,460 workers employed at 8 acrylonitrile (AN)-producing facilities in the United States by 21 years. Using 8,124 deaths and 1,023,922 person-years of follow-up, we evaluated the relationship between occupational AN exposure and death. Standardized mortality ratios (SMRs) based on deaths through December 31, 2011, were calculated. Work histories and monitoring data were used to develop quantitative estimates of AN exposure. Hazard ratios were estimated by Cox proportional hazards regression. All-cause mortality and death from total cancer were less than expected compared with the US population. We observed an excess of death due to mesothelioma (SMR = 2.24, 95% confidence interval (CI): 1.39, 3.42); no other SMRs were elevated overall. Cox regression analyses revealed an elevated risk of lung and bronchial cancer (n = 808 deaths; for >12.1 ppm-year vs. unexposed, hazard ratio (HR) = 1.43, 95% CI: 1.13, 1.81; P for trend = 0.05), lagged 10 years, that was robust in sensitivity analyses adjusted for smoking and co-exposures including asbestos. Death resulting from bladder cancer (for >2.56 ppm vs. unexposed, lagged 10-year HR = 2.96, 95% CI: 1.38, 6.34; P for trend = 0.02) and pneumonitis (for >3.12 ppm-year vs. unexposed, HR = 4.73, 95% CI: 1.42, 15.76; P for trend = 0.007) was also associated with AN exposure. We provide additional evidence of an association between AN exposure and lung cancer, as well as possible increased risk for death due to bladder cancer and pneumonitis.

Abstract 381: Ideal Cardiovascular Health and Cardiovascular Disease: Heterogeneity Across Event Phenotype and Contribution of Multiple Biomarkers

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Bamba Gaye ◽  
Muriel Tafflet ◽  
Dominique Arveil ◽  
Frank Kee ◽  
Alun Evans ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Mediating Effect ◽  
Blood Biomarkers ◽  
Disease Heterogeneity ◽  
Ideal Cardiovascular Health

Aims: To investigate whether or not the association between baseline cardiovascular health (CVH) and incident cardiovascular disease (CVD) differs by event phenotypes and to address the mediating effect of inflammatory and haemostatic blood biomarkers. Methods: The association of ideal CVH with outcomes was computed in 9312 middle-aged men from Northern Ireland and France (whole cohort) in multivariable Cox proportional hazards regression analysis. The mediating effect of baseline blood biomarkers was evaluated in a case control study nested within the cohort after 10 years of follow-up. Results: After a median follow-up of 10 years, 614 first CHD events and 117 first stroke events were adjudicated. Compared to those with poor CVH, those with an ideal CVH profile at baseline had a 72% lower risk of CHD (HR=0.28; 95% CI: 0.17; 0.46) and a 76% lower risk of stroke (HR=0.24; 95% CI: 0.06; 0.98). No heterogeneity was detected across main CHD and main stroke phenotypes. While significantly lower mean concentrations of hs-CRP, IL-6 (inflammatory markers), and fibrinogen, von Willbrandt factor (haemostatic factors) were noted in the controls with higher CVH status, the association of CVH with incident CHD was not attenuated upon adjustment for these biomarkers. Conclusion: these results support the universal promotion of ideal CVH for CVD in general and suggest that the lower risk of CHD associated with ideal CVH is independent from inflammatory and haemostatic biomarkers.

Risk-Based Intensive Blood Pressure Lowering and Prevention of Heart Failure: A SPRINT Post Hoc Analysis

Hypertension ◽  
2021 ◽  
Author(s):  
Rebecca J. Molsberry ◽  
Leah Rethy ◽  
Michael C. Wang ◽  
Rupal C. Mehta ◽  
Donald M. Lloyd-Jones ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Adverse Events ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Risk Category ◽  
Serious Adverse Events ◽  
Intensive Blood Pressure

The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated that intensive blood pressure (BP) lowering (target<120 mm Hg) was more effective in preventing heart failure (HF) compared with standard BP goals (target<140 mm Hg). However, intensive BP lowering also led to an increase in serious adverse events. We aimed to identify a subset of the clinical trial population who might derive the greatest benefit from intensive BP lowering for prevention of HF using a previously validated HF risk prediction model. SPRINT participants without prevalent cardiovascular disease were stratified into HF risk tertiles based on predicted HF risk. We performed Kaplan-Meier Survival analysis and multivariable Cox proportional hazards models to test the effect of intensive versus standard BP lowering on incident HF in each tertile of predicted HF risk. A total of 6911 individuals were included and 77 incident HF events occurred over a median follow-up time of 3.3 (interquartile range, 2.9–3.8) years. A reduction in risk of HF was observed among those randomized to intensive BP lowering in each risk tertile but was significant only in the highest HF risk category (risk tertile 1: hazard ratio, 0.86 [95% CI, 0.29–2.56]; risk tertile 2: 0.54 [0.23–1.30]; risk tertile 3: 0.46 [0.24–0.88]). Serious adverse events were frequent in all groups. While the short follow-up may lead to an underestimation of benefit in the lower predicted risk groups, prioritizing intensive BP lowering in those at highest predicted HF risk may help to reduce the high burden of HF in the United States.

Abstract P378: Higher Non-exercise Estimated Cardiorespiratory Fitness in Midlife is Associated With Lower Risk of Cardiovascular Disease and Mortality in Later Life: The Framingham Heart Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Joowon Lee ◽  
Ramachandran S Vasan ◽  
Vanessa Xanthakis
Keyword(s):  
Cardiovascular Disease ◽  
Cardiorespiratory Fitness ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Health Indicators ◽  
Later Life ◽  
Cox Proportional Hazards ◽  
All Cause Mortality

Introduction: Studies have demonstrated that higher cardiorespiratory fitness (CRF) is associated with a lower risk of cardiovascular disease (CVD) and mortality. However, exercise CRF test is not routinely performed in clinical settings because it requires specialized equipment and trained personnel. Therefore, non-exercise estimated CRF (eCRF) using easily accessible health indicators in clinical practice may be a time- and cost-effective alternative for evaluating fitness. Hypothesis: We hypothesized that higher eCRF in midlife will be associated with a lower risk of CVD and all-cause mortality in later life. Methods: We evaluated 2,501 Framingham Offspring cohort participants (mean age 65 yrs., 52% women). We used a longitudinal non-exercise algorithm that includes age, sex, body mass index, waist circumference, resting heart rate, physical activity, and smoking status. We then used SAS PROC TRAJ to identify sex-specific latent patterns of eCRF (low, moderate, and high eCRF categories) between exam 2 and 8 (1979-2008). Multivariable Cox proportional hazards regression models were used to relate the long-term trajectories of eCRF to incident CVD and all-cause mortality on follow-up. Results: We identified three distinct trajectories of eCRF (Low [n=268, 10.7%] vs. moderate [n=1,273, 50.9%] vs. high [n=960, 38.4%]). Overall, 265 participants developed CVD and 429 died during 10 years of median follow-up. Participants in the “high eCRF” group were at lower risk of CVD and all-cause mortality compared to those in the “low eCRF” group, after adjustment for potential confounders ( Table ). Conclusions: Our findings suggest that lower eCRF during midlife may be a marker of risk of CVD and mortality in older adulthood.

Abstract 17220: Treatment Persistence and Discontinuation With Rivaroxaban, Dabigatran and Warfarin for Stroke Prevention in Patients With Non-valvular Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Craig Coleman ◽  
Muralikrishna Tangirala ◽  
Thomas Evers
Keyword(s):  
Atrial Fibrillation ◽  
Proportional Hazards ◽  
Cohort Analysis ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Hospital Death ◽  
Treatment Persistence ◽  
Diagnosis Codes ◽  
Cox Proportional Hazards Models

Introduction: Continuous use of oral anticoagulant (OAC) therapy is essential for reducing the risk of stroke in patients with non-valvular atrial fibrillation. To date, no single study has compared persistence and discontinuation rates between rivaroxaban, dabigatran and warfarin users. Hypothesis: To compare persistence and discontinuation rates between rivaroxaban, dabigatran and warfarin users with non-valvular atrial fibrillation. Methods: A retrospective cohort analysis of the United States MarketScan claims databases was performed. This included adult patients newly initiated on rivaroxaban, dabigatran or warfarin between 1 November 2011 and 31 December 2013 with a baseline CHA2DS2-VASc score ≥2, ≥2 atrial fibrillation diagnosis codes (427.31) and ≥6 months of continuous medical and pharmacy benefits prior to OAC initiation (index date). Propensity score matching was performed in a two-step process to match patients on rivaroxaban with dabigatran 1:1 and with warfarin 1:1. Patients were followed until the earliest of in-hospital death, end of continuous enrolment or end of study period. Persistence was defined as absence of refill gap of >60 days. Discontinuation was defined as no additional refill for >90 days and through end of follow-up. Cox proportional hazards models were estimated to examine hazard ratios (HRs) of OAC non-persistence and discontinuation. Results: A total of 32,634 patients were included (N=10,878/OAC group). At 3 months’ follow-up, treatment persistence was 79.2%, 69.6% and 70.9% for rivaroxaban, dabigatran and warfarin users, respectively, dropping to 70.2%, 57.8% and 58.8% after 6 months, 60.1%, 44.7% and 42.0% after 1 year and 50.4%, 30.6% and 26.5% after 2 years. On regression, rivaroxaban use was associated with a decreased hazard of non-persistence compared with dabigatran (HR=0.64; 95% confidence interval [CI] 0.62-0.67) and warfarin (HR=0.62; 95% CI 0.59-0.64), and a decreased rate of discontinuation versus dabigatran (HR=0.61; 95% CI 0.58-0.64) and warfarin (HR=0.65; 95% CI 0.62-0.68). Conclusions: This matched patient analysis indicated significantly higher persistence and lower discontinuation rates with rivaroxaban compared with dabigatran and warfarin.

scholarly journals Diet Quality and Risk of Parkinson Disease: A Prospective Study and a Meta-Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1442-1442
Author(s):  
Yi-Hsuan Liu ◽  
Gordon Jensen ◽  
Muzi Na ◽  
Diane Mitchell ◽  
G Craig Wood ◽  
...  
Keyword(s):  
Cohort Study ◽  
Parkinson Disease ◽  
Diet Quality ◽  
Proportional Hazards ◽  
Agricultural Research ◽  
Living Arrangement ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
United States Department

Abstract Objectives Several dietary components have been shown to be neuroprotective against risk of neurodegeneration. We thus examined the associations between diet quality and risk of Parkinson disease (PD) in a prospective cohort study and a meta-analysis. Methods Included in the cohort study were 3653 participants (1519 men and 2134 women; mean age: 81.5 years) in the Geisinger Rural Aging Study longitudinal cohort in Pennsylvania. Diet quality was assessed using a validated dietary screening tool containing 25 food- and behavior-specific questions in 2009 (baseline). Potential PD cases were identified using electronic health records based on ICD10 code (G20) and PD-related treatments. Incident PD cases were defined as being diagnosed after 1 year of follow-up and receiving PD-related medication treatments. Hazard ratios (HRs) and 95% confidence intervals (CIs) across diet quality tertiles were calculated using cox proportional hazards models after adjusting for age, sex, race, educational level, smoking, oral health, obesity and living arrangement. We further performed a meta-analysis by pooling our study with four published papers on this topic. Random-effects model was utilized to calculate the pooled risk ratios and 95% CIs. Results During a mean of 6.94 years of follow-up, 47 incident PD cases were documented. Having high diet quality at baseline was associated with lower PD risk (p-trend = 0.02). The adjusted HR was 0.39 (95% CI: 0.17–0.89) for the highest vs the lowest diet quality tertiles. The meta-analysis including 140,617 individuals also showed that adherence to a healthy dietary pattern was associated with lower risk of incident PD (pooled risk ratio = 0.64; 95% CI: 0.49–0.83). Conclusions Having high diet quality was associated with lower future risk of PD. Funding Sources United States Department of Agriculture, Agricultural Research Service agreement.

scholarly journals Metabolic Syndrome, Its Components and Risk of Cardiometabolic Multimorbidity: Findings From the UK Biobank Cohort

2021 ◽  
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cardiometabolic Disease ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Previous Diagnosis ◽  
The Uk

Abstract Background: Metabolic syndrome (MetS) and its components have been acknowledged as risk factors for a single cardiometabolic disease, but their relationship with the risk of cardiometabolic multimorbidity is unclear. The present study aimed to prospectively investigate the association of MetS and its components with the risk of cardiometabolic multimorbidity.Methods: In this prospective cohort study, we analyzed data of 353,427 participants from the UK Biobank. Participants with a previous diagnosis of cardiometabolic disease or those with missing data on the items of MetS were not eligible. Cardiometabolic multimorbidity was defined as the co-existence of two and more conditions of type 2 diabetes, coronary heart disease (CHD), and stroke. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the relationship between MetS, components of MetS and cardiometabolic multimorbidity. Results: During a median of 8.9 years of follow-up, 3389 participants developed the cardiometabolic multimorbidity. Compared with individuals without MetS, individuals with MetS had a three times higher risk of developing cardiometabolic multimorbidity (adjusted HR: 3.02, 95% CI: 2.82-3.24). The accumulation of MetS components was associated, in a dose-response manner, with the risk of cardiometabolic multimorbidity (P for trend <0.0001). For the temporal sequences in the development of cardiometabolic diseases, the corresponding HRs (95% CIs) for individuals with ≥4 metabolic abnormalities were 1.57 (1.47-1.68) for cardiovascular disease only, 10.27 (7.62-13.84) for cardiovascular disease with subsequent diabetes, 25.34 (21.95-29.24) for diabetes only, and 42.97 (21.19-87.13) for diabetes with subsequent cardiovascular disease.Conclusions: MetS was independently associated with the risk of cardiometabolic multimorbidity, and the risk substantially increased with a greater number of MetS components. Our findings highlight the importance of screening and treatment of MetS in the prevention of cardiometabolic multimorbidity.

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