scholarly journals Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1215
Author(s):  
Laura Barrubés ◽  
Nancy Babio ◽  
Pablo Hernández-Alonso ◽  
Estefania Toledo ◽  
Judith B. Ramírez Sabio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Research ◽  
Cardiovascular Risk ◽  
Longitudinal Studies ◽  
Smoking Status ◽  
Low Risk ◽  
High Cardiovascular Risk ◽  
Hazard Ratios ◽  
Score Range

Limited longitudinal studies have been conducted to evaluate colorectal cancer (CRC) incidence based on the updated 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations or other global lifestyle indices, and none in aged populations at high cardiovascular risk. We aimed to assess the association between CRC incidence and adherence to two emerging lifestyles indices (2018 WCRF/AICR score and another low-risk lifestyle (LRL) score comprising smoking status, alcohol consumption, physical activity, diet, and body mass index) in the Spanish PREvencion con DIeta MEDiterranea (PREDIMED) cohort. We studied 7216 elderly men and women at high cardiovascular risk. The 2018 WCRF/AICR and LRL scores were calculated. Multivariable Cox proportional regression models were fitted to estimate the HRs (hazard ratios) and 95% confidence intervals (CIs) for incident CRC events. During a median interquartile range (IQR) follow-up of 6.0 (4.4–7.3) years, 97 CRC events were considered. A significant linear association was observed between each 1-point increment in the WCRF/AICR score (score range from 0 to 7) and CRC risk (HR (95% CI) = 0.79 (0.63–0.99)). Similarly, each 1-point increment in the LRL score (score range from 0 to 5) was associated with a 22% reduction in CRC risk (0.78 (0.64–0.96)). Adhering to emergent lifestyle scores might substantially reduce CRC incidence in elderly individuals. Further longitudinal studies, which take different lifestyle indexes into account, are warranted in the future.

scholarly journals Prognostic value of myocardial perfusion scintigraphy in asymptomatic patients with diabetes mellitus at high cardiovascular risk: 5-year follow-up of the prospective multicenter BARDOT trial

2021 ◽  
Author(s):  
Federico Caobelli ◽  
◽  
Philip Haaf ◽  
Gianluca Haenny ◽  
Matthias Pfisterer ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Myocardial Perfusion ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Myocardial Perfusion Scintigraphy ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Perfusion Scintigraphy ◽  
High Cardiovascular Risk

Abstract Background The Basel Asymptomatic High-Risk Diabetics’ Outcome Trial (BARDOT) demonstrated that asymptomatic diabetic patients with an abnormal myocardial perfusion scintigraphy (MPS) were at increased risk of major adverse cardiovascular events (MACEs) at 2-year follow-up. It remains unclear whether this finding holds true even for a longer follow-up. Methods Four hundred patients with type 2 diabetes, neither history nor symptoms of coronary artery disease (CAD), were evaluated clinically and with MPS. Patients were followed up for 5 years. Major adverse cardiovascular events (MACEs) were defined as all-cause death, myocardial infarction, or late coronary revascularization. Results At baseline, an abnormal MPS (SSS ≥ 4 or SDS ≥ 2) was found in 87 of 400 patients (22%). MACE within 5 years occurred in 14 patients with abnormal MPS (16.1%) and in 22 with normal scan (1.7%), p = 0.009; 15 deaths were recorded. Patients with completely normal MPS (SSS and SDS = 0) had lower rates of MACEs than patients with abnormal scans (2.5% vs. 7.0%, p = 0.032). Patients with abnormal MPS who had undergone revascularization had a lower mortality rate and a better event-free survival from MI and revascularization than patients with abnormal MPS who had either undergone medical therapy only or could not be revascularized (p = 0.002). Conclusions MPS may have prognostic value in asymptomatic diabetic patients at high cardiovascular risk over a follow-up period of 5 years. Patients with completely normal MPS have a low event rate and may not need retesting within 5 years. Patients with an abnormal MPS have higher event rates and may benefit from a combined medical and revascularization approach.

Diabetes in treated hypertension is common and carries a high cardiovascular risk: results from a 28-year follow-up

2007 ◽  
Vol 25 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Torbj??rn Almgren ◽  
Lars Wilhelmsen ◽  
Ola Samuelsson ◽  
Anders Himmelmann ◽  
Annika Rosengren ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Cardiovascular Risk

scholarly journals AB0384 Rheumatic arthritis patients with very high cardiovascular risk: poor results in changes in lifestyle during follow-up

2018 ◽  
Author(s):  
N. Vegas-Revenga ◽  
V. Portilla ◽  
L.C. Domínguez-Casas ◽  
J.L. Martín-Varillas ◽  
B. Atienza-Mateo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Rheumatic Arthritis ◽  
Very High

Evaluating the sensitivity of the ACC/AHA pooled cohort risk calculator to predict atherosclerotic cardiovascular events within 10 years: how many events are we failing to predict?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Medina-Inojosa ◽  
V.K Somers ◽  
S Hayes ◽  
R Mankad ◽  
F Lopez-Jimenez
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Fasting Blood Glucose ◽  
Low Risk ◽  
P Value ◽  
Funding Source ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ideal Cardiovascular Health ◽  
Ascvd Risk

Abstract Background The ACC/AHA Pooled Cohort Equation (PCE) for atherosclerotic cardiovascular disease (ASCVD) has been recommended as the initial step in cardiovascular risk assessment. The sensitivity of this tool to detect those who will develop ASCVD within 10-years, while considering age and sex groups, has not been extensively studied. Methods Using the Rochester Epidemiology Project (REP) we evaluated a community-based cohort of consecutive patients that sought primary care in Olmsted County, MN, between the years 1998–2000 and were followed up through March 1st 2016. Inclusion criteria were ages 40–79 and complete data to calculate the PCE. We excluded those with known ASCVD, atrial fibrillation or heart failure. Criteria were similar to those used to derive the PCE. Events were validated in duplicate and included fatal and non-fatal myocardial infarction and ischemic stroke. Patient information was ascertained using the record linkage system of the REP. Follow-up was truncated at 10 years. We assessed the ASCVD predicted risk (categorized as low <5%, intermediate 5–9.9%, high 10–19.9%, and very high ≥20% risk) at baseline, in subjects having an ASCVD event within 10-years in the community across age (<65 years) and sex categories. We also categorized ideal cardiovascular health as ≥4 metrics [non-smoker, body mass index <25 kg/m2, and not having of elevated blood pressure (≥130/80 mmHg), LDL cholesterol (>100 mg/dL), or fasting blood glucose (>100 mg/dL), in the absence of a medical diagnosis or treatment]. Results We included 30,042 adults, mean ± SD age 48.5±12.2 years, 54% women, with a median follow-up of 16.5±5.3 years. There were 1,555 ASCVD events (5.2%) at 10 years of follow-up. The performance of the PCE was similar to what was described in the original report (0.78 vs 0.79). Overall, among those who suffered an ASCVD, 54% of women and 41% of men were not high risk as predicted by PCE (Figure 1A). Most women (73%) <65 years of age would had been considered low risk within 10-years before the event, and only 10% would have been considered to be high risks (Figure 1B). Nonetheless, women <65 years who had an ASCVD event and low 10-year predicted ASCVD risk by PCE were less likely to have ideal cardiovascular health [55 (0.40%) vs 3884 (28.39%), p-value<0.0001], when compared to women in the low risk category without an event. Conclusion The PCE fails to identify most women who will develop an ASCVD event, particularly women <65 years of age. These results underscore the importance of using additional information when estimating ASCVD risk among women and the need for better cardiovascular risk prediction tools. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Mayo Clinic

scholarly journals All-cause mortality following low-dose aspirin treatment for patients with high cardiovascular risk in remote Australian Aboriginal communities: an observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030034 ◽  
Author(s):  
Yuejen Zhao ◽  
Kanakamani Jeyaraman ◽  
Paul Burgess ◽  
Christine Connors ◽  
Steven Guthridge ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Outcome Measures ◽  
Low Dose ◽  
Aboriginal People ◽  
Univariate Analysis ◽  
High Cardiovascular Risk ◽  
Aboriginal Communities ◽  
All Cause Mortality ◽  
Benefit And Risk

ObjectivesTo evaluate the benefit and risk of low-dose acetylsalicylic acid (aspirin) in patients from remote Aboriginal communities in the Northern Territory, Australia.DesignRetrospective cohort study using primary care and hospital data routinely used for healthcare. Aspirin users and non-users were compared before and after controlling confounders by matching. Marginal structural models (MSM) were applied to ascertain the benefit and risk.SettingThe benefit and harm of aspirin were investigated in patients aged ≥18 years from 54 remote Aboriginal communities.ParticipantsNone had a previous cardiovascular event or major bleeds. Patients on anticoagulants or other antiplatelets were excluded.InterventionAspirin at a dose of 75–162 mg/day.Outcome measuresEndpoints were all-cause, cardiovascular mortality and incidences of cardiovascular events and major bleeds.Results8167 predominantly Aboriginal adults were included and followed between July 2009 and June 2017 (aspirin users n=1865, non-users n=6302, mean follow-up 4 years with hospitalisations 6.4 per person). Univariate analysis found material differences in demographics, prevalence of chronic diseases and outcome measures between aspirin users and non-users before matching. After matching, aspirin was significantly associated with reduced all-cause mortality (HR=0.45: 95% CI 0.34 to 0.60; p<0.001), but not bleeding (HR=1.13: 95% CI 0.39 to 3.26; p=0.820). After using MSMs to eliminate the effects of confounders, loss of follow-up and time dependency of treatment, aspirin was associated with reduced all-cause mortality (HR=0.60: 95% CI 0.47 to 0.76; p<0.001), independent of age (HR=1.06; p<0.001), presence of diabetes (HR=1.42; p<0.001), hypertension (HR=1.61; p<0.001) and alcohol abuse (HR=1.81; p<0.001). No association between aspirin and major bleeding was found (HR=1.14: 95% CI 0.48 to 2.73; p=0.765). Sensitivity analysis suggested these findings were unlikely to have been the result of unmeasured confounding.ConclusionAspirin was associated with reduced all-cause mortality. Bleeding risk was less compared with survival benefits. Aspirin should be considered for primary prevention in Aboriginal people with high cardiovascular risk.

Daily Sedentary Time and Risk of Cardiovascular Disease: The National FINRISK 2002 Study

2015 ◽  
Vol 12 (7) ◽  
pp. 904-908 ◽  
Author(s):  
Katja Borodulin ◽  
Anja Kärki ◽  
Tiina Laatikainen ◽  
Markku Peltonen ◽  
Riitta Luoto
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Leisure Time Physical Activity ◽  
Smoking Status ◽  
Sitting Time ◽  
Health Examination ◽  
Hazard Ratios ◽  
And Gender ◽  
Adjusted Model

Background:Daily sitting time may be a risk factor for incident cardiovascular disease (CVD); however, this has not yet been extensively studied. Our aim was to study the association of total sitting time with the risk of CVD.Methods:Participants (n = 4516, free of CVD at baseline) from the National FINRISK 2002 Study were followed for fatal and nonfatal CVD using national registers. Participants underwent a health examination and completed questionnaires, including total daily sitting time.Results:During a mean follow-up of 8.6 years, 183 incident CVD cases occurred. Sitting on a typical weekday, at baseline, was statistically significantly associated with fatal and nonfatal incident CVD. The hazard ratios (with 95% confidence intervals, CI) for the total amount of sitting were 1.05 (95% CI, 1.00–1.10) in the age and gender adjusted model and 1.06 (95% CI, 1.01–1.11) in the fully adjusted model, including age, gender, employment status, education, BMI, smoking status, leisure time physical activity, use of vegetables and fruit, alcohol use, blood pressure or its medication, and cholesterol or its medication.Conclusions:Our findings suggest that total amount of daily sitting is a risk factor for incident CVD. More research is needed to understand the etiology of sedentary behavior and CVD.

Association of baseline c-reactive protein with incident cancer and survival in cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11052-11052
Author(s):  
K. H. Allin ◽  
S. E. Bojesen ◽  
B. G. Nordestgaard
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
General Population ◽  
Cancer Patients ◽  
Early Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hazard Ratios ◽  
Incident Cancer

11052 Background: We tested the hypothesis that baseline plasma levels of C-reactive protein (CRP) associate with risk of incident cancer in the general population, and early death in cancer patients. Methods: 10,408 individuals from the Danish general population, who had CRP measured at baseline, were followed for up to 16 years; 1,624 developed cancer and of these, 998 died during follow-up. Follow-up was 100% complete. We excluded individuals with a cancer diagnosis at baseline. Results: Baseline CRP levels >3 vs. <1 mg/L were associated with multifactorially adjusted hazard ratios of 1.3 (95% CI, 1.0–1.6) for cancer of any type, of 2.2 (1.0–4.6) for lung cancer, of 1.9 (0.8–4.6) for colorectal cancer, and of 0.7 (0.4–1.4) for breast cancer. Corresponding hazard ratios for the highest vs. the lowest quintile of baseline CRP levels were 1.3 (1.0–1.6), 2.1 (1.2–3.8), 1.7 (0.8–3.2), and 0.9 (0.5–1.7), respectively. Multifactorially adjusted hazard ratios for early death in cancer patients were 1.8 (1.2–2.7) for CRP >3 vs. <1 mg/L and 1.4 (1.1–1.7) for the highest vs. the lowest quintile. Elevated CRP levels associated with early death in cancer patients with localized disease, but not in cancer patients with metastases (interaction; P=.03). Conclusions: Elevated levels of CRP in cancer-free individuals are associated with increased risk of cancer of any type, of lung cancer, and possibly of colorectal cancer. Moreover, elevated levels of baseline CRP associate with early death after a diagnosis of any cancer, particularly in patients without metastases. No significant financial relationships to disclose.

scholarly journals DYNAMICS OF CARDIOVASCULAR RISK FACTORS IN RAILWAY CREWS

2018 ◽  
Vol 17 (3) ◽  
pp. 53-58 ◽  
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.

785 Sodium–glucose cotransporter 2 inhibitors in real-life patients at high cardiovascular risk

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Arturo Cesaro ◽  
Fabio Fimiani ◽  
Felice Gragnano ◽  
Elisabetta Moscarella ◽  
Giovanni Signore ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Event ◽  
Cardiovascular Risk ◽  
Ejection Fraction ◽  
Real World ◽  
High Cardiovascular Risk ◽  
Sodium Glucose Cotransporter ◽  
Risk Patients ◽  
Tract Infections

Abstract Sodium-glucose cotransporter 2 inhibitors (SGLT2i), were recently approved in the USA and the EU for the treatment of adults with symptomatic heart failure with reduced ejection fraction (HFrEF). These drugs currently play a prominent role in the treatment algorithm for HFrEF [ejection fraction ≤40%], and international guidelines considered they as first-line drugs. However, data on the use of SGLT2i in real-world practice lack. We aim at providing data on SGLT2i in high cardiovascular risk patients in the real-world setting. We have retrospectively evaluated high cardiovascular risk patients treated with SGLT2i according to Italian national regulation, and collected 1-year outcomes. The primary objective of the study is to generate real-world data about clinical characteristics, major adverse cardiovascular events (MACE), hospitalizations for heart failure, and adverse event in patients receiving canagliflozin, empagliflozin, dapagliflozin, ertugliflozin from our cohort. Ninety-three patients with diabetes treated with SGLT2i were retrospectively enrolled. At 1-year follow-up, the rate of hospitalization was 10.7%, the MACE events occurred in 6.4% of patients; of these, 4.3% had a myocardial infarction, and 2.1% had a stroke/TIA, the rate of urinary tract infections was 5.3% while no major adverse event occurred. In conclusion, in a real-world study including patients with high and very high cardiovascular risk, SGLT2i showed to be safe, with no major adverse events occurring at follow-up.

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