scholarly journals Soluble ST2 Is Associated with All-Cause and Cardiovascular Mortality in a Population-Based Cohort: The Dallas Heart Study

2013 ◽  
Vol 59 (3) ◽  
pp. 536-546 ◽  
Author(s):  
Lu Q Chen ◽  
James A de Lemos ◽  
Sandeep R Das ◽  
Colby R Ayers ◽  
Anand Rohatgi
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Cardiovascular Mortality ◽  
Population Based ◽  
Low Risk ◽  
Cardiac Events ◽  
Risk Population ◽  
Soluble St2 ◽  
Heart Study ◽  
Dallas Heart Study

BACKGROUND ST2, part of the interleukin-1 receptor family, is released from cardiac myocytes under mechanical strain. Soluble ST2 (sST2) concentrations are associated with adverse cardiac events in high-risk cohorts. We evaluated the association of sST2 with all-cause and cardiovascular mortality in a large, low-risk population–based cohort. METHODS Plasma sST2 was measured in 3294 subjects from the Dallas Heart Study, a probability-based population cohort. We categorized participants into undetectable (reference group) or quartiles of detectable sST2 concentrations. Associations with all-cause and cardiovascular mortality were assessed over a median 8.3 years of follow-up. RESULTS sST2 concentrations were not significantly associated with most traditional risk factors, prevalent subclinical cardiovascular disease, or nonfatal cardiac events. However, a higher proportion of African Americans had detectable concentrations of sST2 than non–African Americans (44% vs 21%, respectively, P < 0.0001). In addition, sST2 concentrations were significantly associated with markers of inflammation. Increased sST2 was associated with increased all-cause mortality (Ptrend ≤ 0.0001) and cardiovascular mortality (Ptrend = 0.0004). In fully adjusted models, those in the highest quartile of detectable sST2 were at increased risk for all-cause death compared to those with undetectable sST2 concentrations (adjusted hazard ratio 2.1, 95% CI 1.4–3.2, P = 0.0009). CONCLUSIONS In a low-risk population, sST2 does not associate with traditional cardiovascular risk factors or nonfatal cardiovascular events but is higher in African Americans and is associated with increased all-cause and cardiovascular mortality. Further investigation is needed regarding the role of sST2 in risk prediction, particularly among African Americans.

Association of adiponectin in patatin-like phospholipase domain-containing 3 (PNPLA3) associated hepatic steatosis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 184-184
Author(s):  
Muhammad Shaalan Beg ◽  
Amit G. Singal ◽  
Colby Ayers ◽  
Sadia Saleem ◽  
Jorge A. Marrero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatic Steatosis ◽  
Hepatocellular Cancer ◽  
Population Based ◽  
Linear Regression Models ◽  
Nonalcoholic Fatty Liver ◽  
Heart Study ◽  
Qualitative Effect ◽  
Dallas Heart Study ◽  
The Impact

184 Background: The I148M polymorphism (rs738409) of the patatin-like phospholipase domain-containing 3 (PNPLA3) gene is strongly associated with hepatic triglyceride content (HTGC) and the development of nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH), which are themselves risk factors for hepatocellular cancer (HCC). Serum adiponectin affects insulin resistance and carcinogenesis and has also been associated with HTGC. Whether these risk factors are additive in predisposing to HTGC is unknown. We evaluated the impact of adiponectin and PNPLA3 genotypes on HTGC in a large community cohort. Methods: The Dallas Heart Study (DHS) is a multi-ethnic population based study of Dallas County residents. HTGC was quantified using H-MR spectroscopy. Univariate and multivariable logistic and linear regression models were generated to test the association between HTGC and log adiponectin stratified by PNPLA3 genotype (CC, CG and GG). Models were adjusted for age, gender, race, hypertension, diabetes, HOMA-IR and BMI. Results: There were 2,259 patients who had complete clinical, biochemical, imaging, and genotyping data and were included in this analysis. Median age was 44 and 47% were male. Race distribution was 48% Black, 32% White, and 18% Hispanic. The prevalences of PNPLA3 genotypes were 61% CC (wild type), 32% GC and 7% GG. The median concentration of adiponectin was 6.6 ug/ml. Adiponectin was an independent predictor HTCG across all genotypes after adjusting for covariates (CC b=-0.34, GC b=-0.42, GG b=-0.38, p<0.005 for each). HTGC decreased across gender and race-stratified quartiles of adiponectin for each PNPLA3 genotype, and the qualitative effect was greatest in the I148M homozygotes (table). Conclusions: Adiponectin is independently associated with hepatic steatosis across all three PNPLA3 genotypes. The combination of at-risk PNPLA3 genotypes and hypoadiponectemia is associated with a high risk of hepatic steatosis. Future studies will need to address downstream HCC risk and whether manipulation of adiponectin level may be of clinical benefit. [Table: see text]

scholarly journals Neighborhood social environment as risk factors to health behavior among African Americans: The Jackson Heart Study

2017 ◽  
Vol 45 ◽  
pp. 199-207 ◽  
Author(s):  
Xu Wang ◽  
Amy H. Auchincloss ◽  
Sharrelle Barber ◽  
Stephanie L. Mayne ◽  
Michael E. Griswold ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Health Behavior ◽  
Social Environment ◽  
Jackson Heart Study ◽  
Heart Study

Association of Lipoprotein-Associated Phospholipase A2 Mass and Activity with Coronary and Aortic Atherosclerosis: Findings from the Dallas Heart Study

2008 ◽  
Vol 54 (12) ◽  
pp. 1975-1981 ◽  
Author(s):  
Emmanouil S Brilakis ◽  
Amit Khera ◽  
Bilal Saeed ◽  
Subhash Banerjee ◽  
Darren K McGuire ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Large Population ◽  
Population Based ◽  
Aortic Atherosclerosis ◽  
Standard Deviation Increase ◽  
Plaque Instability ◽  
Aortic Plaque ◽  
Heart Study ◽  
Atherosclerosis Risk Factors ◽  
Dallas Heart Study

Abstract Background: Our aim was to characterize the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with coronary and aortic atherosclerosis in a large population-based study. Methods: Lp-PLA2 mass and activity were measured in 2171 subjects 30–65 years old participating in the Dallas Heart Study. We examined the association of Lp-PLA2 levels with 3 atherosclerosis phenotypes: coronary artery calcium (CAC) measured by electron-beam computed tomography and abdominal aortic plaque (AAP) and aortic wall thickness (AWT) measured by magnetic resonance imaging. Results: CAC and AAP were detected in 21% and 40% of subjects, respectively, and mean AWT (SD) was 1.70 (0.32) mm. In univariable analyses, Lp-PLA2 mass (but not activity) was higher in both men (P = 0.04) and women (P = 0.02) with detectable CAC. Lp-PLA2 mass and activity were higher (P = 0.004 and P = 0.01, respectively) and AWT was greater (P &lt; 0.001 and P = 0.02, respectively) in women with aortic atheroma, but not in men. After adjustment for traditional atherosclerosis risk factors and C-reactive protein concentrations, Lp-PLA2 mass and activity were not associated with AAP or AWT in either sex, but Lp-PLA2 mass remained modestly associated with detectable CAC only in men (odds ratio 1.20 per 1 standard deviation increase, 95% CI 1.01–1.42, P = 0.04). Conclusions: Although Lp-PLA2 mass was independently associated with CAC in men, it was not associated with AAP or AWT in men or with any of the atherosclerosis phenotypes in women. These findings suggest that if Lp-PLA2 independently influences clinical events, it does so by promoting atherosclerotic plaque instability rather than by stimulating atherogenesis.

Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tiffany M Powell ◽  
Colby R Ayers ◽  
James A de Lemos ◽  
Amit Khera ◽  
Susan G Lakoski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Weight Gain ◽  
Cardiovascular Risk Factors ◽  
Average Weight ◽  
Men And Women ◽  
Significant Weight Gain ◽  
Heart Study ◽  
Dallas Heart Study ◽  
The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

Abstract P026: Early Repolarization Pattern is Associated With Increased Left Ventricular Mass and Left Ventricular Hypertrophy: Results From the Dallas Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David A McNamara ◽  
Ari Bennett ◽  
Jarett D Berry ◽  
Mark S Link
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Left Ventricular ◽  
Percent Body Fat ◽  
Early Repolarization ◽  
Heart Study ◽  
Dallas Heart Study

Introduction: Recent studies have shown an association between early repolarization pattern (ERP) ECG morphology and sudden cardiac death. The role of left ventricular mass (LVM) as a potential mediator of ERP has not been well explored. Methods: Participants in the Dallas Heart Study who underwent an ECG and cardiac MRI (CMR) were assessed for ERP, defined as J-point elevation ≥1 mm in any 2 contiguous leads. We compared participants with and without ERP by age, gender, race/ethnicity, established cardiovascular risk factors of diabetes, hypertension and hyperlipidemia, lean body mass and percent body fat, and CMR-derived LVM, LVM/body surface area, and LVH defined by standard criteria, using Student’s T-tests and chi-squared tests where appropriate. Results: Of the 3,015 participants in our study, 276 (9.2%) had ERP. Participants with ERP were younger (43±9 vs 44±10 yrs, p=0.04), more prevalent in blacks than non-blacks (14 vs 5.0%, p<0.00001), and in men than women (18 vs 2.0%, p<0.00001). Baseline cardiovascular risk factors were not significantly different. Participants with ERP demonstrated higher lean body mass (59±10 vs 52±11 kg, p<0.00001) and lower percent body fat (27±8 vs 36±9%, p<0.00001). The presence of ERP was associated with greater LVM, increased LVM/body surface area, and the presence of LVH in the overall population and in analyses stratified by sex (Table 1). Conclusion: In a large, multi-ethnic cohort, ERP is associated with increased total LVM, increased LVM/body surface area, and LVH. These novel associations may provide insight into the biology of ERP. Further studies investigating the relationship of LVM and LVH with ERP are warranted.

Identifying low-risk chest pain in the emergency department without troponin testing: a validation study of the HE-MACS and HEAR risk scores

2021 ◽  
pp. emermed-2021-211669
Author(s):  
Fraser Todd ◽  
James Duff ◽  
Edward Carlton
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Limit Of Detection ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Low Risk ◽  
Risk Scores ◽  
Cardiac Events ◽  
Presenting Symptoms ◽  
Randomised Controlled

IntroductionPatients presenting to EDs with chest pain of possible cardiac origin represent a substantial and challenging cohort to risk stratify. Scores such as HE-MACS (History and Electrocardiogram-only Manchester Acute Coronary Syndromes decision aid) and HEAR (History, ECG, Age, Risk factors) have been developed to stratify risk without the need for troponin testing. Validation of these scores remains limited.MethodsWe performed a post hoc analysis of the Limit of Detection and ECG discharge strategy randomised-controlled trial dataset (n=629; June 2018 to March 2019; 8 UK hospitals) to calculate HEAR and HE-MACS scores. A <4% risk of major adverse cardiac events (MACE) at 30 days using HE-MACS and a score of <2 calculated using HEAR defined ‘very low risk’ patients suitable for discharge. The primary outcome of MACE at 30 days was used to assess diagnostic accuracy.ResultsMACE within 30 days occurred in 42/629 (7%) of the cohort. HE-MACS and HEAR scores identified 85/629 and 181/629 patients as ‘very low risk’, with MACE occurring in 0/85 and 1/181 patients, respectively. The sensitivities of each score for ruling out MACE were 100% (95% CI: 91.6% to 100%) for HE-MACS and 97.6% (95% CI: 87.7% to 99.9%) for HEAR. Presenting symptoms within these scores were poorly predictive, with only diaphoresis reaching statistical significance (OR: 4.99 (2.33 to 10.67)). Conventional cardiovascular risk factors and clinician suspicion were related to the presence of MACE at 30 days.ConclusionHEAR and HE-MACS show potential as rule out tools for acute myocardial infarction without the need for troponin testing. However, prospective studies are required to further validate these scores.

Abstract P345: Prediction of Cardiovascular Disease Events and Death using Multiple Biomarkers in African Americans: the Jackson Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Solomon K Musani ◽  
Ramachandran Vasan ◽  
Aurelian Bidulescu ◽  
Jung Lee ◽  
Gregory Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African Americans ◽  
High Sensitivity ◽  
Serum Cortisol ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Risk Reclassification ◽  
Heart Study ◽  
Traditional Risk Factors

Background: The usefulness of biomarkers from different biologic pathways for predicting cardiovascular disease (CVD) events among African Americans is not well understood. Methods: We evaluated prospectively 3,102 Jackson Heart Study participants (mean age 54 years; 64% women) with data on a panel of 9 biomarkers representing inflammation (high sensitivity C - reactive protein), adiposity (adiponectin, leptin), neurohormonal activation (B-type natriuretic peptide [BNP], aldosterone, and cortisol); insulin resistance (HOMA-IR); and endothelial function (endothelin and homocysteine). We used Cox proportional hazard regression to relate the biomarker panel to the incidence of CVD (stroke, coronary heart disease, angina, heart failure and intermittent claudication) adjusting for standard CVD risk factors. Results: On follow-up (median 8.2 years), 224 participants (141 women) experienced a first CVD event, and 238 (140 women) died. Circulating concentrations of aldosterone, BNP and HOMA-IR were associated with CVD (multivariable-adjusted hazard ratios [HR] and 95% confidence interval [CI] per standard deviation (SD) increase in log-biomarker) were, respectively 1.15, (95% CI 1.01-1.30, p=0.016), 1.97, (95% CI 1.22-2.41, p<0.0001), and 1.30, (95% CI 1.10-1.52, p=0.0064). Blood cortisol and homocysteine were associated with death (HR per SD increment log-biomarker, respectively, 1.17, (95% CI 1.01-1.35, p=0.042), and 1.24, (95% CI 1.10-1.40, pvalue=0.0005). Biomarkers improved risk reclassification by 0.135; 0.120 of which was gained in classification of participants that experienced CVD events and 0.015 from participants that did not. Also, biomarkers marginally increased the model c-statistic beyond traditional risk factors. Conclusions: In our community-based sample of African Americans, circulating aldosterone, BNP and HOMA-IR predicted CVD risk, whereas serum cortisol and homocysteine predicted death. However, the incremental yield of biomarkers over traditional risk factors for risk prediction was minimal.

Abstract 5085: Cardiovascular Risk Factors and Coronary Atherosclerosis in Retired National Football League Players: Implications for Coronary Risk of Large Body Size in Athletes

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alice Y Chang ◽  
Shannon J FitzGerald ◽  
John Cannaday ◽  
Song Zhang ◽  
Amit Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Size ◽  
Coronary Atherosclerosis ◽  
National Football League ◽  
Large Body ◽  
Physically Active ◽  
The Metabolic Syndrome ◽  
Heart Study ◽  
Community Controls ◽  
Dallas Heart Study

A high prevalence of obesity exists among national football league (NFL) players as classified by body mass index (BMI). It has not been established whether this elevated BMI is associated with a greater prevalence of cardiovascular (CV) risk factors or coronary artery disease in former NFL players as in non-athletes. This study compared CV risk factors and subclinical coronary atherosclerosis among retired NFL players versus community controls. The design was a case-control study of retired NFL players against matched controls from the population-based Dallas Heart Study (DHS) and a second physically active sample from the Aerobics Center Longitudinal Study (ACLS). CV risk factors were assessed by survey and health screening visit. Coronary atherosclerosis was determined with computed tomography measurements of coronary artery calcium (CAC). 201 NFL players completed measurements of CAC. Compared to DHS men, retired NFL players had a significantly lower prevalence of diabetes, hypertension, a sedentary lifestyle and the metabolic syndrome, yet a higher prevalence of impaired fasting glucose and hyperlipidemia. However, there was no significant difference in the prevalence of positive CAC (46 v 48.3%, p=0.69) or the distribution across subgroups of CAC (0 –10, 10 –100, 100 – 400, 400+, p=0.11) between the retired NFL players and DHS men. These results were not significantly different when controlling for ethnicity or linemen status. When compared to physically active controls (ACLS), retired NFL players had a greater BMI, waist size and prevalence of the metabolic syndrome, but no difference in other CV risk factors or CAC scores. Conclusions: Despite their large body size, former NFL players do not have a greater prevalence of CV risk factors or amount of CAC than community controls when matched by BMI and/or age. Age and hyperlipidemia, not body size, were the most significant predictors of subclinical coronary atherosclerosis among retired NFL players. This research has received full or partial funding support from the American Heart Association, AHA National Center. CV Risk Factors, Retired NFL Players versus Dallas Heart Study Participants

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