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Salvador D, Liv P, Norberg M, Pahud de Mortanges A, Saner H, Glisic M, Nicoll R, Muka T, Nyman E, Bano A, Näslund U. Changes in fasting plasma glucose and subclinical atherosclerosis: A cohort study from VIPVIZA trial. Atherosclerosis 2023:117326. [PMID: 37932189 DOI: 10.1016/j.atherosclerosis.2023.117326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND AND AIMS Studies on the influence of fasting plasma glucose (FPG) on the development of carotid plaque (CP) and intima media thickness (CIMT) mainly focused on single FPG measures. We investigated whether changes in FPG (ΔFPG) are associated with incident CP and CIMT change (ΔCIMT) over time. METHODS Analyses were based on information from 1896 participants from the VIPVIZA trial (Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention), with baseline and 3-year follow-up data on FPG, ultrasonographic CP (none or ≥1 lesion/s) and CIMT assessments. We studied the association between baseline FPG (prior to intervention) or 3-year ΔFPG (mmol/L) and incident CP (logistic regression) or ΔCIMT (linear regression). Analyses were adjusted for multiple potential confounders. RESULTS 1896 and 873 individuals, respectively, were included in the analysis on incident CP and ΔCIMT. Participants were 60 years old at baseline and 61% and 54% were females, in the CP and CIMT analyses, respectively. Every mmol/L increase in FPG was associated with an increased odds of incident CP (odds ratio: 1.42, 95% confidence interval [CI]: 1.17, 1.73), but there was no association with ΔCIMT (mean difference: 0.002 mm, 95% CI: -0.003, 0.008) after 3 years. Baseline FPG was not associated with incident CP nor ΔCIMT progression. CONCLUSIONS In middle-aged individuals with low to moderate risk for cardiovascular diseases, 3-year ΔFPG was positively associated with the risk of incident CP, but not with ΔCIMT. Single measures of FPG may not be sufficient in estimating cardiovascular risk among individuals with low to moderate risk.
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Affiliation(s)
- Dante Salvador
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Margareta Norberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Hugo Saner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
| | - Rachel Nicoll
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Epistudia, Bern, Switzerland
| | - Emma Nyman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Arjola Bano
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.
| | - Ulf Näslund
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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2
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Saydam CD. Subclinical cardiovascular disease and utility of coronary artery calcium score. IJC HEART & VASCULATURE 2021; 37:100909. [PMID: 34825047 PMCID: PMC8604741 DOI: 10.1016/j.ijcha.2021.100909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
ASCVD are the leading causes of mortality and morbidity among Globe. Evaluation of patients' comprehensive and personalized risk provides risk management strategies and preventive interventions to achieve gain for patients. Framingham Risk Score (FRS) and Systemic Coronary Risk Evaluation Score (SCORE) are two well studied risk scoring models, however, can miss some (20-35%) of future cardiovascular events. To obtain more accurate risk assessment recalibrating risk models through utilizing novel risk markers have been studied in last 3 decades and both ESC and AHA recommends assessing Family History, hs-CRP, CACS, ABI, and CIMT. Subclinical Cardiovascular Disease (SCVD) has been conceptually developed for investigating gradually progressing asymptomatic development of atherosclerosis and among these novel risk markers it has been well established by literature that CACS having highest improvement in risk assessment. This review study mainly selectively discussing studies with CACS measurement. A CACS = 0 can down-stratify risk of patients otherwise treated or treatment eligible before test and can reduce unnecessary interventions and cost, whereas CACS ≥ 100 is equivalent to statin treatment threshold of ≥ 7.5% risk level otherwise statin ineligible before test. Since inflammation, insulin resistance, oxidative stress, dyslipidemia and ongoing endothelial damage due to hypertension could lead to CAC, ASCVD linked with comorbidities. Recent cohort studies have shown a CACS 100-300 as a sign of increased cancer risk. Physical activity, dietary factors, cigarette use, alcohol consumption, metabolic health, family history of CHD, aging, exposures of neighborhood environment and non-cardiovascular comorbidities can determine CACs changes.
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3
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Bhatraju PK, Cohen M, Nagao RJ, Morrell ED, Kosamo S, Chai XY, Nance R, Dmyterko V, Delaney J, Christie JD, Liu KD, Mikacenic C, Gharib SA, Liles WC, Zheng Y, Christiani DC, Himmelfarb J, Wurfel MM. Genetic variation implicates plasma angiopoietin-2 in the development of acute kidney injury sub-phenotypes. BMC Nephrol 2020; 21:284. [PMID: 32680471 PMCID: PMC7368773 DOI: 10.1186/s12882-020-01935-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/07/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We previously identified two acute kidney injury (AKI) sub-phenotypes (AKI-SP1 and AKI-SP2) with different risk of poor clinical outcomes and response to vasopressor therapy. Plasma biomarkers of endothelial dysfunction (tumor necrosis factor receptor-1, angiopoietin-1 and 2) differentiated the AKI sub-phenotypes. However, it is unknown whether these biomarkers are simply markers or causal mediators in the development of AKI sub-phenotypes. METHODS We tested for associations between single-nucleotide polymorphisms within the Angiopoietin-1, Angiopoietin-2, and Tumor Necrosis Factor Receptor 1A genes and AKI- SP2 in 421 critically ill subjects of European ancestry. Top performing single-nucleotide polymorphisms (FDR < 0.05) were tested for cis-biomarker expression and whether genetic risk for AKI-SP2 is mediated through circulating biomarkers. We also completed in vitro studies using human kidney microvascular endothelial cells. Finally, we calculated the renal clearance of plasma biomarkers using 20 different timed urine collections. RESULTS A genetic variant, rs2920656C > T, near ANGPT2 was associated with reduced risk of AKI-SP2 (odds ratio, 0.45; 95% CI, 0.31-0.66; adjusted FDR = 0.003) and decreased plasma angiopoietin-2 (p = 0.002). Causal inference analysis showed that for each minor allele (T) the risk of developing AKI-SP2 decreases by 16%. Plasma angiopoietin-2 mediated 41.5% of the rs2920656 related risk for AKI-SP2. Human kidney microvascular endothelial cells carrying the T allele of rs2920656 produced numerically lower levels of angiopoietin-2 although this was not statistically significant (p = 0.07). Finally, analyses demonstrated that angiopoietin-2 is minimally renally cleared in critically ill subjects. CONCLUSION Genetic mediation analysis provides supportive evidence that angiopoietin-2 plays a causal role in risk for AKI-SP2.
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Affiliation(s)
- Pavan K. Bhatraju
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA ,grid.34477.330000000122986657Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, USA
| | - Max Cohen
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Ryan J. Nagao
- grid.34477.330000000122986657Department of Bioengineering, University of Washington and Center for Cardiovascular Biology, Seattle, USA ,grid.34477.330000000122986657Institute of Stem Cell and Regenerative Medicine, University of Washington, Seattle, USA
| | - Eric D. Morrell
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Susanna Kosamo
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Xin-Ya Chai
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Robin Nance
- grid.34477.330000000122986657Department of Epidemiology, University of Washington, Seattle, USA
| | - Victoria Dmyterko
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Joseph Delaney
- grid.34477.330000000122986657Department of Epidemiology, University of Washington, Seattle, USA
| | - Jason D. Christie
- grid.25879.310000 0004 1936 8972Division of Pulmonary, Allergy, and Critical Care and Center for Clinical Epidemiology and Biostatistics, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Kathleen D. Liu
- grid.266102.10000 0001 2297 6811Divisions of Nephrology and Critical Care Medicine, University of California San Francisco, San Francisco, USA
| | - Carmen Mikacenic
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - Sina A. Gharib
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA
| | - W. Conrad Liles
- grid.34477.330000000122986657Department of Medicine, University of Washington, Seattle, USA
| | - Ying Zheng
- grid.34477.330000000122986657Department of Bioengineering, University of Washington and Center for Cardiovascular Biology, Seattle, USA ,grid.34477.330000000122986657Institute of Stem Cell and Regenerative Medicine, University of Washington, Seattle, USA
| | - David C. Christiani
- grid.38142.3c000000041936754XDepartments of Environmental Health and Epidemiology, Harvard TH Chan School of Public Health, Harvard University and Pulmonary and Critical Care Division, Cambridge, USA ,Department of Medicine, MA General Hospital/Harvard Medical School, Boston, USA
| | - Jonathan Himmelfarb
- grid.34477.330000000122986657Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, USA
| | - Mark M. Wurfel
- grid.34477.330000000122986657Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104 USA ,grid.34477.330000000122986657Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, USA
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Jarauta E, Laclaustra M, Villa-Pobo R, Langarita R, Marco-Benedi V, Bea AM, León-Latre M, Casasnovas JA, Civeira F. Three Dimensional Carotid and Femoral Ultrasound is not Superior to Two Dimensional Ultrasound as a Predictor of Coronary Atherosclerosis Among Men With Intermediate Cardiovascular Risk. Eur J Vasc Endovasc Surg 2019; 59:129-136. [PMID: 31836509 DOI: 10.1016/j.ejvs.2019.07.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current cardiovascular disease (CVD) risk stratification scales, drawn up from traditional risk factors, have important limitations. The detection of subclinical atherosclerosis, by a non-invasive technique such as peripheral arteries ultrasound (US) may improve cardiovascular risk (CVR) stratification, especially in intermediate risk population. Our aim was to compare the predictive power of atherosclerotic plaques detected in carotid and femoral arteries by 2-dimensional (2D) vs. 3-dimensional (3D) US for positive coronary artery calcium score (CACS), used as a proxy for CVD, in a middle-aged sample with intermediate 10-year CVR (7.5-20%). METHODS To detect atherosclerotic plaques by 2D vs. 3D US scan of carotid and femoral arteries and comparison of their association with CACS obtained by computed tomography (CT) of subjects with intermediate CVR belonging to the Aragon Workers' Health Study. RESULTS 120 men were included, with a 10.4% average 10 years CVR. Forty-one (34.2%) participants had CACS ≥ 1. 90 participants (75%) had at least one plaque detected by 2D scan while 85 participants (70.8%) had at least a plaque detected by 3D US. Conventional CVR estimates c-statistic for CACS was .590. Although the variables most predicted of CACS ≥ 1 were those measured by 3D US (total plaque volume and mean of plaque density, c-statistics: .743 and .750 respectively), their predictive capacity was not statistically significantly different from the number of territories with plaque, measured either by 2D and 3D US (c-statistics .728 to .740 respectively). CONCLUSION Subclinical atherosclerosis measured by 2D and 3D US were better predictors of CACS ≥ 1 than CVR estimated by conventional guidelines. In our sample, 3D US did not show any significant advantages with respect to 2D US for the prediction of coronary atherosclerosis.
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Affiliation(s)
- Estíbaliz Jarauta
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain.
| | - Martin Laclaustra
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain; Fundación ARAID, Zaragoza, Spain
| | - Rosa Villa-Pobo
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Raquel Langarita
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Victoria Marco-Benedi
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana M Bea
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Montse León-Latre
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Jose A Casasnovas
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Fernando Civeira
- IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain; CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
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5
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Zhou J, Chen Y, Zhang Y, Wang H, Tan Y, Liu Y, Huang L, Zhang H, Ma Y, Cong H. Epicardial Fat Volume Improves the Prediction of Obstructive Coronary Artery Disease Above Traditional Risk Factors and Coronary Calcium Score. Circ Cardiovasc Imaging 2019; 12:e008002. [PMID: 30642215 DOI: 10.1161/circimaging.118.008002] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Recent studies have demonstrated the tremendous potential of epicardial fat volume (EFV) to predict obstructive coronary artery disease. We aimed to develop a new model to estimate pretest probability of obstructive coronary artery disease using traditional risk factors with coronary calcium score and EFV and compare it with proposed models in Chinese patients who underwent coronary computed tomography angiography. METHODS The new models were derived from 5743 consecutive patients using multivariate logistic regression and validated in an internal cohort using invasive coronary angiography as the outcome and an external cohort with clinical outcome data. Hosmer-Lemeshow goodness-of-fit test, area under the receiver operating characteristic curve, integrated discrimination improvement and net reclassification improvement were calculated to validate and compare the performance of models. RESULTS EFV improved prediction above conventional risk factors and coronary calcium score (area under the receiver operating characteristic curve increased from 0.856 to 0.874, integrated discrimination improvement 0.0487, net reclassification improvement 0.1181, P<0.0001 for all). The final model included 5 predictors: age, sex, symptom, coronary calcium score, and EFV. Good internal validation and external validation of the new model were achieved, with positive net reclassification improvement and integrated discrimination improvement, excellent area under the receiver operating characteristic curve and favorable calibration. Further, the new model demonstrated a better prediction of clinical outcome, resulting in a more cost-effective risk stratification to optimize decision-making of downstream diagnosis and treatment. CONCLUSIONS Addition of EFV to conventional risk factors and coronary calcium score offered a more accurate and effective estimation for pretest probability of obstructive coronary artery disease, which may help to improve initial management of stable chest pain.
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Affiliation(s)
- Jia Zhou
- Department of Cardiology (J.Z., Y.Z., Y.L., H.C.), Tianjin Chest Hospital, China.,Institute of Cardiovascular Diseases (J.Z., L.H., H.C.), Tianjin Chest Hospital, China
| | - Yundai Chen
- Department of Cardiology, General Hospital of Chinese People's Liberation Army (Y.C., Y.T.)
| | - Ying Zhang
- Department of Cardiology (J.Z., Y.Z., Y.L., H.C.), Tianjin Chest Hospital, China
| | - Hao Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health (H.W.).,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (H.W.)
| | - Yahang Tan
- Department of Cardiology, General Hospital of Chinese People's Liberation Army (Y.C., Y.T.).,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, China (Y.T.)
| | - Yujie Liu
- Department of Cardiology (J.Z., Y.Z., Y.L., H.C.), Tianjin Chest Hospital, China
| | - Lingyu Huang
- Institute of Cardiovascular Diseases (J.Z., L.H., H.C.), Tianjin Chest Hospital, China
| | - Hong Zhang
- Department of Radiology (H.Z., Y.M.), Tianjin Chest Hospital, China
| | - Yanhe Ma
- Department of Radiology (H.Z., Y.M.), Tianjin Chest Hospital, China
| | - Hongliang Cong
- Department of Cardiology (J.Z., Y.Z., Y.L., H.C.), Tianjin Chest Hospital, China.,Institute of Cardiovascular Diseases (J.Z., L.H., H.C.), Tianjin Chest Hospital, China
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6
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Pretransplant Cardiac Evaluation Using Novel Technology. J Clin Med 2019; 8:jcm8050690. [PMID: 31100854 PMCID: PMC6571765 DOI: 10.3390/jcm8050690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/11/2019] [Accepted: 05/14/2019] [Indexed: 12/03/2022] Open
Abstract
Hematopoietic stem-cell transplantation (HSCT) is a complex procedure that has been increasingly successful in treating malignant and nonmalignant conditions. Despite its effectiveness, it can be associated with potentially life-threatening adverse effects. New onset heart failure, ischemic disease, and arrhythmias are among the most notable cardiovascular complications post-HSCT. As a result, appropriate cardiac risk stratification prior to transplant could result in decreased morbidity and mortality by identifying patients with a higher probability of tolerating possible toxicities associated with HSCT. In this review, we aim to discuss the utility of cardiac screening using novel modalities of imaging technology in the pre-HSCT phase.
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7
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Ferencik M. Paradigms of Noninvasive Assessment of Coronary Atherosclerosis in Diabetic Patients: Insights From the PARADIGM Registry. JACC Cardiovasc Imaging 2018; 11:1472-1474. [PMID: 29778851 DOI: 10.1016/j.jcmg.2018.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon; and the Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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8
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Terentes-Printzios D, Vlachopoulos C, Xaplanteris P, Ioakeimidis N, Aznaouridis K, Baou K, Kardara D, Georgiopoulos G, Georgakopoulos C, Tousoulis D. Cardiovascular Risk Factors Accelerate Progression of Vascular Aging in the General Population: Results From the CRAVE Study (Cardiovascular Risk Factors Affecting Vascular Age). Hypertension 2017; 70:1057-1064. [PMID: 28923899 DOI: 10.1161/hypertensionaha.117.09633] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/10/2017] [Accepted: 08/18/2017] [Indexed: 12/22/2022]
Abstract
Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular risk. We hypothesized that the number of cardiovascular risk factors determines the progression of vascular aging. One hundred forty-two subjects (mean age 51.9 years, 94 men) without established cardiovascular disease were investigated in 2 examinations over a 2-year period. Subjects were classified at baseline according to their number of risk factors (from 0 to 2 and more). Subjects had determinations of carotid-femoral pulse wave velocity, aortic augmentation index, brachial flow-mediated dilatation, and common carotid intima-media thickness and their annual absolute changes were calculated. Subjects with more risk factors had a gradual higher annual progression of pulse wave velocity (0.092 m/s/y for 0, 0.152 m/s/y for 1, and 0.352 m/s/y for 2 and more; P=0.007). Patients with both hypertension and dyslipidemia have 4× higher annual progression rate compared with subjects without these risk factors (0.398 m/s/y versus 0.102 m/s/y). When only subjects 55 years old and under were considered, the progression rate of augmentation index was higher in subjects with more risk factors (1.15%/y versus 1.50%/y versus 2.99%/y, respectively; P=0.037). No association was found with the annual change of flow-mediated dilatation or carotid intima-media thickness. In the general population, increasing number of risk factors is associated with accelerated deterioration of specific indices of vascular aging, such as pulse wave velocity and augmentation index; in contrast, flow-mediated dilatation and carotid intima-media thickness are insensitive to such changes. Accordingly, the former may be more useful for gauging vascular aging.
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Affiliation(s)
- Dimitrios Terentes-Printzios
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Charalambos Vlachopoulos
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
| | - Panagiotis Xaplanteris
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Nikolaos Ioakeimidis
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Konstantinos Aznaouridis
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Katerina Baou
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Despina Kardara
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Georgios Georgiopoulos
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Christos Georgakopoulos
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
| | - Dimitrios Tousoulis
- From the Peripheral Vessels Unit, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece
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9
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Menezes AMB, da Silva CTB, Wehrmeister FC, Oliveira PD, Oliveira IO, Gonçalves H, Assunção MCF, de Castro Justo F, Barros FC. Adiposity during adolescence and carotid intima-media thickness in adulthood: Results from the 1993 Pelotas Birth Cohort. Atherosclerosis 2016; 255:25-30. [PMID: 27816805 PMCID: PMC5152614 DOI: 10.1016/j.atherosclerosis.2016.10.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/27/2016] [Accepted: 10/13/2016] [Indexed: 12/27/2022]
Abstract
Background and aims Although several studies have examined the association between adiposity and cardiovascular risk markers, few have explored the issue prospectively in young populations. We sought to test whether higher levels of body mass index (BMI) and subscapular skinfold at different stages of adolescence were associated with carotid intima-media thickness (cIMT) in young adulthood. Methods In a prospective cohort, we assessed BMI and subscapular skinfold at 11, 15 and 18 years and measured cIMT at 18 years in 3264 individuals. Traditional cardiovascular risk factors and fat mass-mediating effects on cIMT were also assessed. Results Both BMI and subscapular skinfolds were significantly associated with higher cIMT in a cummulative fashion: after controlling for confounders, males and females who persisted overweight/obese at all three assessments, had a mean higher cIMT (5.2 and 3.1 μm, respectively) compared to males and females with normal/healthy BMI at each evaluation (p < 0.001). Moreover, male and females that presented increased fatness in all assessments had a similar pattern of higher cIMT compared to normal/healthy fatness/skinfold at 18 years (mean cIMT 4.6 and 3.0 μm for males and females, respectively; p < 0.001). Associations between adiposity and cIMT were both direct and indirect. Indirect effects were chiefly mediated by fat mass and diastolic blood pressure. Conclusions Our results suggest adiposity exerts direct and indirect effects during adolescence that result in higher cIMT in young adulthood. High BMI and subscapular skinfolds during adolescence are associated with higher cIMT at 18 years. Adiposity exerts direct and indirect effects on cIMT. Indirect effects are chiefly mediated by fat mass and diastolic blood pressure.
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Affiliation(s)
| | | | | | - Paula Duarte Oliveira
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Isabel O Oliveira
- Dept of Physiology and Pharmacology, Federal University of Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Fernando C Barros
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Bertoni AG, Kramer H, Watson K, Post WS. Diabetes and Clinical and Subclinical CVD. Glob Heart 2016; 11:337-342. [PMID: 27741980 PMCID: PMC5125393 DOI: 10.1016/j.gheart.2016.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 11/21/2022] Open
Abstract
Diabetes mellitus is a major cardiovascular risk factor and its prevalence has been increasing globally. This review examines the contributions of the MESA (Multi-Ethnic Study of Atherosclerosis), a diverse American cohort (6,814 adults ages 45 to 84, recruited from 2000 to 2002, 50% female, 62% nonwhite) toward understanding the relationship between diabetes and clinical and subclinical cardiovascular disease. People with diabetes have a high burden of subclinical vascular disease as measured by coronary artery calcification (CAC), carotid artery intima-media thickness, valvular calcification, and alterations in left ventricular structure. CAC substantially improves cardiovascular risk prediction. Among adults with diabetes, 63% had CAC >0; above CAC >400 Agatston units the event rate was 4% annually, whereas an absence of CAC was a marker of a very low cardiovascular disease rate (0.4% to 0.1% annually). These stark differences in rates may have implications for screening and/or targeted prevention efforts based on CAC burden. MESA has also provided insight on diabetes epidemiology.
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Affiliation(s)
- Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Holly Kramer
- Department of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Karol Watson
- Division of Cardiology, Department of Medicine, The David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, USA
| | - Wendy S Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Machado-Silva W, Henriques AD, Souza GD, Gomes L, Ferreira AP, Brito CJ, Córdova C, Moraes CF, Nóbrega OT. Serum Immune Mediators Independently Associate with Atherosclerosis in the Left (But Not Right) Carotid Territory of Older Individuals. J Stroke Cerebrovasc Dis 2016; 25:2851-2858. [PMID: 27554076 DOI: 10.1016/j.jstrokecerebrovasdis.2016.07.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/26/2016] [Accepted: 07/30/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIM Disturbance in the carotid arteries strongly predicts cerebrovascular events and correlates with a systemic inflammatory milieu. We investigated the relationship of a profile of 10 circulating inflammatory mediators with measures of carotid intima-media thickness (cIMT) in elderly subjects, taking traditional risk factors into account. METHODS Clinical inspection for present and past chronic conditions and events, as well as biochemical and anthropometric measurements, was performed for patients in ambulatory setting. Scores of cIMT were obtained bilaterally in the distal common carotid artery wall. Serum concentrations of cytokines were assessed by bead-based, multiplexed flow cytometry immunoassays. RESULTS Correlation analysis between log-transformed cytokines levels implicated the mediators interleukin-1β (IL1β), IL6, IL8, IL10, and tumor necrosis factor-α (TNFα) (P ≤ .005) with scores of the left cIMT. Stepwise multivariate regression showed that TNFα, IL1β, and IL6 levels accounted for most of the variance in the cIMT scores. Comparison of cytokine levels across increasing tertiles of the left cIMT reproduced the positive association with TNFα and IL1β levels. CONCLUSION Five out of ten immune mediators independently correlated with cIMT of older subjects in a territory-sensitive manner. This possible contribution of immune mediators to an atherosclerotic process probably relates to the inflammaging process.
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Affiliation(s)
| | | | - Gleim Dias Souza
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | - Lucy Gomes
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | | | | | - Cláudio Córdova
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | - Clayton Franco Moraes
- Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil; Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
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Coronary artery calcium scores and cardiovascular risk factors in 31,545 asymptomatic Korean adults. Int J Cardiovasc Imaging 2016; 32 Suppl 1:139-45. [DOI: 10.1007/s10554-016-0892-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/05/2016] [Indexed: 11/27/2022]
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13
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Hepatic fat content is a determinant of metabolic phenotypes and increased carotid intima-media thickness in obese adults. Sci Rep 2016; 6:21894. [PMID: 26902311 PMCID: PMC4763213 DOI: 10.1038/srep21894] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/03/2016] [Indexed: 01/22/2023] Open
Abstract
Individuals with metabolically healthy obesity (MHO) are at relatively low risk for the development of metabolic abnormalities and subclinical atherosclerosis. This study aims to examine whether hepatic fat accumulation determines metabolic phenotype of obesity and associated with subclinical atherosclerosis. A total of 485 obese adults (aged 40–65 years) who received magnetic resonance spectroscopy were divided into metabolically abnormally obesity (MAO) and MHO groups according to metabolic status. MHO individuals had lower levels of intrahepatic triglyceride (IHTG) content and carotid intima-media thickness (CIMT) than MAO individuals. In multivariable linear regression analyses, IHTG content was independently associated with metabolic syndrome components and CIMT. Based on receiver operating characteristic curve analysis, the IHTG content displayed a higher area under the curve (AUC) for detecting the MAO phenotype (AUC = 0.70, 95%CI = 0.65–0.75) and increased CIMT (AUC = 0.60, 95%CI = 0.54–0.66) than BMI, waist circumference, and body fat percent. MHO individuals were 1.9 times (p < 0.001) more likely to have metabolic syndrome per 1 SD change in IHTG content in multivariable-adjusted models. Likewise, the risk for high CIMT increased 29% per 1 SD change in IHTG content [OR (95% CI):1.29(1.01–1.64)]. These findings suggest that hepatic fat is a potential predictor of metabolically unhealthy obesity phenotype and subclinical atherosclerosis.
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Pérez de Ciriza C, Moreno M, Restituto P, Bastarrika G, Simón I, Colina I, Varo N. Circulating osteoprotegerin is increased in the metabolic syndrome and associates with subclinical atherosclerosis and coronary arterial calcification. Clin Biochem 2014; 47:272-8. [PMID: 25218813 DOI: 10.1016/j.clinbiochem.2014.09.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/06/2014] [Accepted: 09/01/2014] [Indexed: 12/17/2022]
Abstract
CONTEXT The relationship between osteoprotegerin (OPG) a glycoprotein related to bone metabolism and the metabolic syndrome (MS) has not been established. OBJECTIVE The aim of this study is to evaluate OPG concentration in patients with MS and its association with subclinical atherosclerosis and coronary arterial calcification (CAC). MATERIALS/METHODS The study included 238 asymptomatic patients. MS was diagnosed according to the NCEP/ATPIII guidelines. OPG was measured by ELISA. All subjects underwent ultrasonography of the common carotid arteries to measure intima-media thickness (IMT) and evaluate the presence of atheroma plaques. In a subgroup (n=39) CAC was quantified by ECG-triggered cardiac computed tomography. Adipose tissue was excised from 25 patients and OPG expression by RT-PCR and immunohistochemistry was studied. RESULTS Patients with the MS (n=60) had higher OPG than patients without (n=178) (p<0.05). OPG correlated with IMT (r=0.2, p=0.005) and patients with atheroma plaques had higher OPG (p=0.008) and also those with coronary artery calcification (p<0.05). OPG expression was confirmed in adipose tissue (n=12) and the expression was significantly higher in patients with MS than in those without (p=0.003). CONCLUSIONS This study shows that OPG may potentially be a biomarker for cardiovascular risk/damage in the MS and identifies adipose tissue as a potential source of OPG.
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Affiliation(s)
| | - María Moreno
- Clinical Chemistry Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Patricia Restituto
- Clinical Chemistry Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gorka Bastarrika
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Isabel Simón
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Inmaculada Colina
- Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Nerea Varo
- Clinical Chemistry Department, Clínica Universidad de Navarra, Pamplona, Spain.
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