Impact of Cardiovascular Risk Factors on the Occurrence of Cardiovascular Events in Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitides

Despite improvement in the prognosis of ANCA-associated vasculitides (AAVs), increased mortality, mainly from a cardiovascular origin, persists. We aimed to determine the role of cardiovascular risk factors (CVRFs) on the occurrence of major cardiovascular events (MACEs) in AAVs. Patients with AAVs were successively included in a prospective cohort study, which assessed CVRFs (defined by age >50 years in men and >60 years in women, personal history of cardiovascular disease, smoking status, obesity, diabetes, dyslipidemia, hypertension, and sedentary lifestyle), the use of glucocorticoids and immunosuppressive agents at baseline and during follow-up, and the occurrence of MACEs. One hundred and three patients were included, with a median follow-up time of 3.5 years. In the glucocorticoids and cyclophosphamide adjusted multivariate analysis, the occurrence of MACEs was associated with older age (p = 0.001, OR = 14.71, 95% CI (confidence interval) = 2.98–72.68), cardiovascular history (p = 0.007, OR (odds ratio) = 6.54, 95% CI = 1.66–25.71), sedentary lifestyle (p = 0.011, OR = 4.50, 95% CI = 1.42–14.29), hypertension (p = 0.017, OR = 5.04, 95% CI = 1.33–19.12), and dyslipidemia (p = 0.03, OR = 3.86, 95% CI = 1.14–13.09). The occurrence of MACEs was associated with the number of CVRFs (p < 0.001), but not with the use of glucocorticoids or cyclophosphamide (p = 0.733 and p = 0.339, respectively). The implementation of a screening and management program for modifiable CVRFs, particularly hypertension, sedentary lifestyle, and dyslipidemia, may be beneficial for AAV patients in order to reduce their cardiovascular risk.

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DYNAMICS OF CARDIOVASCULAR RISK FACTORS IN RAILWAY CREWS

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2018-3-53-58 ◽

2018 ◽

Vol 17 (3) ◽

pp. 53-58 ◽

Cited By ~ 3

Author(s):

E. N. Kazidaeva ◽

I. N. Sergunina ◽

Yu. L. Venevtseva

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Body Mass ◽

Age Of Onset ◽

Smoking Status ◽

Stabilization Of Parameters ◽

Brachiocephalic Arteries

Aim. To assess the prevalence of cardiovascular risk factors (RF) and dynamics over 4 years in locomotory crews.Material and methods. One hundred train drivers and assistants aged 25-59 y.o. (mean age — 43,8±10,3 y.) were investigated in-patient with 24 hour blood pressure (BP) monitoring, ultrasound Doppler of brachiocephalic arteries, standard biochemistry. Fifty three persons were assessed prospectively from 2013 to 2017 y.Results. BP increase (essential hypertension of I-II grades with mild or moderate hypertension) was found in 78 persons, with the mean duration — 10,4±4,3 years, and age of onset — 37,0±8,5 y.o. Most commonly, the dyslipidemiaswerefound:hypertriglyceridemiain59%,hypercholesterolemia in 44%. Smokers — 39%, overweight — 37%, obese — 41%. Correlational analysis revealed significant direct correlation of triglycerides with body mass index (r=0,35), with glucose tolerance disorder (r=0,22) and hypertension (r=0,22), however there was negative correlation with smoking status (r=-0,25). In patients with hypertension, aged 25-39 (n=18), comparing to the group with the none (n=22), there were significantly higher: body mass index, cholesterol level, triglycerides level and low density lipoproteideslevelwiththeabsenceofdifferenceinhighdensitylipoproteides, smoking prevalence and family anamnesis of cardiovascular diseases. In prospective follow-up the negative dynamics of lipid profile was found in males of 25-39 y.o., and morphological presentation — lesions in brachiocephalic arteries, at the age 40-49 y. with stabilization of parameters at the age 50-59 y.o. Mean group levels of systolic and diastolic BP at daytime and at night in both timepoints were within normotension range in all groups, corresponding to “non-dipper” type.Conclusion. Most prevalent RF in railway crews were dyslipidemia and obesity. The adequacy of therapy prescribed in all age strata makes it to regard the raise of BP as modifiable RF.

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Evaluation Of Cardiovascular Risk Factors In Patients With Familial Hypercholesterolemia From The North-Eastern Area Of Romania

10.21203/rs.3.rs-61509/v5 ◽

2021 ◽

Author(s):

Cristiana-Elena Vlad ◽

Liliana Foia ◽

Laura Florea ◽

Irina-Iuliana Costache ◽

Andreea Covic ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Lipid Lowering ◽

The North ◽

North Eastern ◽

Lipid Lowering Agents ◽

North Eastern Part

Abstract Background. Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and non-traditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were:(a) to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b) to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents. Methods. This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH(SM score) were included.Results. 980 patients were examined and 61 (6.2%) were received the clinical diagnosis of FH. The mean age was 48.5±12.5 years, with more female patients than male patients (63.9% versus 36%). Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. The effective lipid-lowering drugs used were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new cardiovascular events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them. Conclusions. In patients with suspected FH, the lipid-lowering agents during the follow-up period delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.

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Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total Mortality in Patients with Stable Coronary Heart Disease: 10-Year Follow-up of the KAROLA Study

Clinical Chemistry ◽

10.1373/clinchem.2016.254755 ◽

2016 ◽

Vol 62 (7) ◽

pp. 982-992 ◽

Cited By ~ 17

Author(s):

Dhayana Dallmeier ◽

Hermann Brenner ◽

Ute Mons ◽

Wolfgang Rottbauer ◽

Wolfgang Koenig ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Total Mortality ◽

Growth Differentiation Factor 15 ◽

Stable Coronary Heart Disease

Abstract BACKGROUND This study considered whether baseline concentrations and 12-month changes of growth differentiation factor 15 (GDF-15) are associated with subsequent cardiovascular events (CVEs) and total mortality in patients with stable coronary heart disease. METHODS Baseline GDF-15 serum concentrations were measured in 1073 participants in a cardiac rehabilitation program (median follow-up 10 years). GDF-15 associations with subsequent CVE and total mortality were evaluated by Cox-proportional hazards models adjusting for well-established cardiovascular risk factors (Model 2), plus N-terminal probrain natriuretic peptide, high-sensitivity (hs) CRP, and hs cardiac troponin T (Model 3). RESULTS In our study population [84.7% men, mean age 59 years, median baseline GDF-15 1232 ng/L (interquartile range, 916, 1674)] we observed 190 CVE and 162 deaths. Compared to participants with GDF-15 <1200 ng/L, increased risk for death was found in participants with GDF-15 ≥1200 and ≤1800 ng/L [hazard ratio (HR) 1.68 (95% CI, 1.08–2.62)] and with GDF-15 >1800 ng/L [HR 1.73 (1.02–2.94)], even in Model 3. The 12-month relative median change was −16.7%. As compared to participants with 12-month relative changes between −20% and 20%, GDF-15 increments >20% were associated with: a) an HR of 1.84 (1.04–3.26) for CVE in Model 2, but found nonsignificant in Model 3; (b) an HR of 2.26 (1.32–3.86) for death even in Model 3. CONCLUSIONS GDF-15 at baseline is independently associated with subsequent CVE and 10-year total mortality. Twelve-month relative changes remained associated with subsequent CVE when adjusting for well-established cardiovascular risk factors, and with total mortality even after further adjustment for established cardiac biomarkers.

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The Influence of Cardiovascular Risk Factors and Hypogonadism on Cardiac Outcomes in an Aging Population of Beta-Thalassemia Patients

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd9010003 ◽

2021 ◽

Vol 9 (1) ◽

pp. 3

Author(s):

Umberto Barbero ◽

Matteo Ajassa ◽

Carmen Maria Gaglioti ◽

Antonio Piga ◽

Giovanni Battista Ferrero ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Thalassemia Major ◽

Beta Thalassemia ◽

Risk Equation ◽

Modifying Factors

Beta-thalassemia major (β-TM) is a hereditary genetic disease worsened by many comorbidities due to transfusion-related iron despite chelation therapy. Since there has recently been an increase in life expectancy of patients to up to 50 years old, which influences the prevalence of these diseases and the time span for traditional cardiovascular risk factors to play their role, this study aims to evaluate their distribution and prevalence in a population of thalassemia major patients and their relationship with observed cardiovascular events and potential modifying factors. One hundred and fifty-nine β-TM patients with at least 15 years of follow-up were included in this study. The mean age was 40.9 ± 8.4 years; 28% had diabetes mellitus and 62% had hypogonadism. The cardiovascular risk assessed using algorithms (CUORE and Pooled Cohort Risk Equation—PCRE) was low, but 3.8% of patients had at least one episode of heart failure, 35.9% showed early signs of heart failure, 22% received a diagnosis of diastolic dysfunction, and 21.4% showed supraventricular arrhythmias. Hypogonadism was shown to be related to the occurrence of cardiovascular events. The chronic accumulation of iron in the heart and the specific metabolic profile, mainly observed in patients with hypogonadism, allows us to define β-TM as a condition with a high level of cardiovascular risk from many points of view (iron-related myopathy, atherosclerosis and arrhythmias), which requires better stratification tools and a specific follow-up program.

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Evaluation of Cardiovascular Risk Factors in Patients With Familial Hypercholesterolemia From the North-eastern Area of Romania

10.21203/rs.3.rs-61509/v3 ◽

2020 ◽

Author(s):

Cristiana-Elena Vlad ◽

Liliana Foia ◽

Laura Florea ◽

Irina-Iuliana Costache ◽

Andreea Covic ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Lipid Lowering ◽

The North ◽

North Eastern ◽

Lipid Lowering Agents ◽

North Eastern Part

Abstract Background. Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and nontraditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were: (a)to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b)to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents.Methods. This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH (SM score) were included.Results. The 61 subjects with clinical diagnosis of FH (6.2% of all patients examined) recorded a mean age of 48.5±12.5 years, with more female patients than male patients. Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. As far as treatment was concerned, the effective lipid-lowering drugs were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new CV events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them.Conclusions. In patients with suspected FH, the lipid-lowering agents during the follow-up delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.

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Physical fitness is a modifiable predictor of early cardiovascular death: A 35-year follow-up study of 2014 healthy middle-aged men

European Journal of Preventive Cardiology ◽

10.1177/2047487318793459 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1655-1663 ◽

Cited By ~ 12

Author(s):

Kristian Engeseth ◽

Erik E Prestgaard ◽

Julian E Mariampillai ◽

Irene Grundvold ◽

Knut Liestol ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Physical Fitness ◽

Cardiovascular Risk Factors ◽

Middle Age ◽

Smoking Status ◽

Cardiovascular Death ◽

Middle Aged

Background Physical fitness has been shown to predict cardiovascular death during long-term follow-up. In the present study we aimed to investigate how physical fitness and other cardiovascular risk factors at middle-age influenced the risk of cardiovascular death during the early (0–11 years), intermediate (12–23 years) and late (24–35 years) parts of a 35-year observation period. Methods and results Age-adjusted physical fitness was calculated in 2014 apparently healthy, middle-aged men after maximal bicycle electrocardiogram-tests in 1972–1975 (Survey 1) and 1979–1982 (Survey 2). The men were assessed through 35 years after Survey 1, and 28 years after Survey 2 by Cox proportional hazards models. Low Survey 1 physical fitness was independently associated with increased risks of early and intermediate, but not late, cardiovascular death. Survey 1 to Survey 2 change in physical fitness, age, smoking status, systolic blood pressure and cholesterol impacted cardiovascular death risks in all periods. Family history of coronary heart disease impacted early and intermediate, but not late, cardiovascular death. Conclusions Most classical cardiovascular risk factors were strong predictors of early, intermediate and late cardiovascular death. Physical fitness measured at median age 50 years was independently associated with risk of early cardiovascular death, but the association weakened as time progressed. Change in physical fitness during middle-age impacted cardiovascular death risk in a full lifetime perspective. Thus, our data suggest that physical fitness is a modifiable cardiovascular risk factor with limited duration in contrast to the sustained impact of smoking, blood pressure and cholesterol on cardiovascular mortality.

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Evaluation of Cardiovascular Risk Factors in Patients with Familial Hypercholesterolemia from the North-Eastern Area of Romania

10.21203/rs.3.rs-61509/v4 ◽

2020 ◽

Author(s):

Cristiana-Elena Vlad ◽

Liliana Foia ◽

Laura Florea ◽

Irina-Iuliana Costache ◽

Andreea Covic ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Lipid Lowering ◽

The North ◽

North Eastern ◽

Lipid Lowering Agents ◽

North Eastern Part

Abstract Background. Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and non-traditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were:(a) to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b) to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents.Methods. This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH(SM score) were included.Results. 980 patients were examined and 61 (6.2%) were received the clinical diagnosis of FH. The mean age was 48.5±12.5 years, with more female patients than male patients (63.9% versus 36%). Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. The effective lipid-lowering drugs used were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new CV events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them.Conclusions. In patients with suspected FH, the lipid-lowering agents during the follow-up period delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.

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Prediction of Cerebrovascular and Cardiovascular Events in Patients With Subclinical Carotid Atherosclerosis

Journal of Investigative Medicine ◽

10.2310/jim.0b013e31816204ab ◽

2008 ◽

Vol 56 (1) ◽

pp. 32-40 ◽

Cited By ~ 16

Author(s):

Manfredi Rizzo ◽

Egle Corrado ◽

Giuseppe Coppola ◽

Ida Muratori ◽

Salvatore Novo

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Chlamydia Pneumoniae ◽

Carotid Atherosclerosis ◽

Older Age ◽

Markers Of Inflammation ◽

Progression Of Atherosclerosis

BackgroundSeveral studies have suggested that inflammation and infection may be important for accelerated progression of atherosclerosis, but few data are available on subjects with early stages of atherosclerosis.Methods and ResultsWe included, in a prospective 5-year follow-up study, 150 patients with subclinical carotid atherosclerosis, evaluating at baseline all established traditional cardiovascular risk factors (eg, older age, male sex, obesity, hypertension, diabetes, smoking, family history of coronary artery disease, and dyslipidemia); 2 markers of inflammation, fibrinogen, and high-sensitivity C-reactive protein (CRP); and the seropositivity to Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus. After follow-up, cardiovascular and cerebrovascular events were registered in the 19% of patients, and the increment in CRP levels (in quintiles) was significantly associated with ischemic stroke (P = 0.0253), acute myocardial infarction (P = 0.0055), cardiovascular or cerebrovascular death (P = 0.0145), and the presence of any event (P = 0.0064). Most traditional cardiovascular risk factors (eg, older age, hypertension, diabetes, and dyslipidemia) were significantly associated with the events but only in the unadjusted analysis; in fact, at logistic regression analysis, among all baseline variables, only elevated CRP levels showed a predictive role (odds ratio, 7.0; 95% confidence interval, 2.2-18.4; P = 0.0247).ConclusionsOur findings suggest that elevated CRP concentrations may significantly influence the occurrence of cerebrovascular and cardiovascular events in patients with baseline subclinical carotid atherosclerosis. Notably, null findings were obtained by viral and bacteria titers, suggesting a greater role of inflammation (and not of infection) in the progression of atherosclerosis in our cohort. However, further studies are needed to evaluate the therapeutic implications in this category of patients.

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Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania

Lipids in Health and Disease ◽

10.1186/s12944-020-01428-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Cristiana-Elena Vlad ◽

Liliana Foia ◽

Laura Florea ◽

Irina-Iuliana Costache ◽

Andreea Covic ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Events ◽

Lipid Lowering ◽

The North ◽

North Eastern ◽

Lipid Lowering Agents ◽

North Eastern Part

Abstract Background Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and non-traditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were: (a) to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b) to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents. Methods This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH(SM score) were included. Results Nine hundred-eighty patients were examined and 61 (6.2%) were received the clinical diagnosis of FH. The mean age was 48.5±12.5 years, with more female patients than male patients (63.9% versus 36%). Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. The effective lipid-lowering drugs used were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new cardiovascular events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them. Conclusions In patients with suspected FH, the lipid-lowering agents during the follow-up period delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.

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