scholarly journals Serum Urate and Incident Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0138067 ◽  
Author(s):  
Huifen Wang ◽  
David R. Jacobs ◽  
Angelo L. Gaffo ◽  
Myron D. Gross ◽  
David C. Goff ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Serum Urate ◽  
Incident Cardiovascular Disease

Abstract P107: Serum Urate Trajectories in Young Adulthood and Incident Cardiovascular Disease Events By Middle Age; The Coronary Artery Risk Development in Young Adults (cardia) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nagisa Morikawa ◽  
Michael P. Bancks ◽  
Yuichiro Yano ◽  
Masanori Kuwabara ◽  
Angelo L. Gaffo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Young Adulthood ◽  
Clinical Characteristics ◽  
Middle Age ◽  
Serum Urate ◽  
Hazard Ratios ◽  
Study Participants ◽  
Incident Cardiovascular Disease

Introduction: Higher levels of serum urate (UA) obtained on a single occasion have been shown to be associated with a higher risk of cardiovascular disease (CVD) events among middle-aged or older adults. However, little is known regarding UA trajectory patterns during young adulthood and their associations with CVD outcomes by middle age. Hypothesis: We hypothesize that higher UA trajectory is associated with a higher risk for CVD events compared to lower UA trajectories. Methods: We included data from 4845 CARDIA Study participants (mean age at the Year 20 exam 44.8±3.7 (37-55) years; 50.8% African American; 55.6% female). Sex-specific UA trajectories were assessed using group-based trajectory modeling (PROC TRAJ in SAS version 9.4) based on UA levels obtained at baseline (Year 0) and 10, 15, 20 years later. Covariates included age, sex, race, and clinical characteristics at Year 20 (body mass index, diabetes and creatinine). We estimated hazard ratios (HR) for CVD events (coronary heart disease, heart failure, and stroke) from Year 20 (2005-06) through 2017. Results: We identified 3 UA trajectories in men and 3 similar but lower UA trajectories in women, characterized by low-increasing (men: 30%; n=652, mean UA 5.1; women 43%, n=1191, mean UA 3.9), moderate-increasing (men: 52%; n=1290, mean UA 6.4; women 45%, n=1284, mean UA 5.0), and high-increasing UA (men: 17%; n=377, mean UA 8.0; women 12%, n=305, mean UA 6.4) (Figure 1). Sex-specific trajectories were pooled. Over a median follow-up of 10.9 years, 203 incident CVD events occurred. The adjusted HRs for CVD events were 0.98 (95%CI, 0.66-1.45) for the pooled moderate-increasing group and 1.77 (95%CI, 1.10-2.84) for the pooled high-increasing group compared to the pooled low-increasing group. Conclusions: High-increasing UA trajectory during young adulthood was associated with an greater risk of CVD events by middle age. Modeling UA trajectories may help identify young adults at higher risk for CVD events.

Abstract P447: Cellular Adhesion Molecules: Early Indicators of Subsequent Clinical Cardiovascular Disease Events in a Young Adult Population. The CARDIA Study.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Myron D Gross ◽  
Andrew O Odegaard ◽  
Suzette J Bielinski ◽  
Jose R Suarez-Lopez ◽  
J. Jeffrey Carr ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Adhesion Molecules ◽  
Cox Regression ◽  
Early Stage ◽  
Adult Population ◽  
Cellular Adhesion ◽  
Cellular Adhesion Molecules ◽  
Increased Risk

Background: Cellular adhesion molecules (CAM) have a central role in the accumulation of circulating leukocytes at sites of vascular injury, infection and/ inflammation, and have been associated with the development of atherosclerotic plaque and coronary artery disease in mature adults. Objective: To test the hypothesis that higher overall circulating CAM levels in young adults predict cardiovascular disease (CVD) events over the next 18 years. Method: We measured several circulating CAM molecules (ICAM-1, P-selectin, E-selectin and VCAM) in the Coronary Artery Risk Development in Young Adults (CARDIA) study at exam year 7 (1992-93, black and white men and women, CVD-free, mean age 32, range 25-37 years, n=2428) and monitored incident CVD events (n=70, including coronary heart disease, stroke, and heart failure, adjudicated based on medical records) through exam year 25, mean age of 50 years. We ranked each CAM in quintiles (coded 0-4) and summed the ranks across CAMs into an index to examine the association with incident CVD with Cox regression models. Results: Unadjusted cumulative CVD event rates were 1.6% (sum of CAM quartile ranks 0-8: 22 events in 1353 participants), 2.3% (sum of ranks 9-12: 29/813), and 7.3% (sum of ranks 13-16: 19/262). In proportional hazards regression analysis adjusted for year 7 age, sex, race, clinic, education, smoking, diet, physical activity, body mass index, blood pressure, blood lipids, and blood glucose, sum of ranks 13-16 were associated with a higher risk of CVD compared to the referent (rank sum 0-8) (See Table). Conclusion: High levels of circulating CAMs at an early stage of adulthood (mean age 32, range 25-37 years) were associated with an increased risk of incident CVD events. CAMs may be an early biomarker for development of subclinical CVD, even in CVD-free young adults with low atherosclerosis burden and decades prior to the development of clinical CVD.

Abstract 13676: Association of Plant-centered Diet Intake With Cardiovascular Disease and All-cause Mortality: Findings From the Coronary Artery Risk Development in Young Adults Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Lyn M Steffen ◽  
Pamela J SCHREINER ◽  
Daniel D Gallaher ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Diet Quality ◽  
Lower Risk ◽  
Multivariable Analysis ◽  
Parental History ◽  
Plant Foods ◽  
All Cause Mortality

Introduction: There is growing data regarding the potential for plant-centered diets to reduce risk for cardiovascular disease (CVD) and mortality. However, additional investigation is needed to strengthen and address inconsistencies in the existing evidence base. We examined the association between cumulative consumption of a plant-centered diet and a shift toward a more plant-centered diet and onset of CVD and all-cause mortality. Hypothesis: Nutritionally-rich plant-centered diets will be related to decreased risk of CVD and mortality. Methods: We included 4,926 black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, ages 18-30 years and free of CVD at baseline (1985-1986, exam year [Y0]) and followed until 2018. Diet was assessed through an interviewer-administered diet history at Y0, Y7, and Y20. A Priori Diet Quality Score (APDQS) was used to assess plant-centered diet quality, and high index scores were characterized by higher consumption of nutritionally-rich plant foods with limited consumption of meats and less healthful plant foods. Proportional hazards regression estimated the association of time-varying APDQS, which were cumulatively averaged over follow-up and 13-year change in APDQS (Y7-Y20) with CVD and all-cause mortality. The model was adjusted for sociodemographic factors, energy intake, parental history of CVD, smoking, and physical activity. Results: We documented 289 new CVD cases and 445 all-cause deaths during the median 32-years of follow up. In multivariable analysis, the highest quintile of cumulative APDQS was associated with a 52% lower risk of CVD (hazard ratio [HR]: 0.48, 95% CI: 0.28-0.81) compared with the lowest quintile of cumulative APDQS. Increased APDQS over 13 years was related to a 62% lower subsequent 12-year risk of CVD (95% CI: 0.18-0.78) when comparing extreme quintiles. The association for all-cause mortality was only apparent among high educational groups. Conclusions: Following a plant-centered, high-quality diet staring from young adulthood was associated with a lower risk of developing CVD and death by middle age. Our findings support the concept that a plant-centered diet may help prevent early CVD and death.

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.

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