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Prevalence and distribution of coronary artery calcium in a southeast asian cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The coronary artery calcium score (CACS) independently predicts the risk of cardiovascular disease and major adverse cardiovascular events. While previous studies have demonstrated regional and ethnic differences in coronary calcification, the distribution of CACS in Southeast Asian (SEA) adults has not been investigated.
Purpose
The aim of this study was to determine CACS distribution in a SEA cohort living in Singapore.
Methods
This study involved 4945 asymptomatic patients who underwent CT coronary angiography and calcium scoring as part of screening for cardiovascular disease. Similar to the MESA study, patients with diabetes were analyzed separately due an increased prevalence of coronary calcification. A nonparametric analytical approach was used to determine CACS distribution stratified by age, gender and ethnicity.
Results
A positive CACS was seen in 43.7% of the overall SEA cohort with a higher prevalence in males (45.2%) than females (36.7%). The onset and burden of coronary calcification was also earlier and more severe in male subjects. There were no significant differences in CACS distribution amongst the three major ethnic groups in our study (p = 0.177). The presence of coronary calcification (CACS >0) was associated with increasing age, male gender and hypertension. Ethnicity, dyslipidemia, smoking and a family history of coronary artery disease did not significantly affect the presence of CACS.
Conclusions
This study provides a reference CACS distribution in an asymptomatic SEA population. There were no significant differences in CACS distribution amongst the three major ethnic groups living in Singapore.
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Can cord blood lipid and lipoprotein levels inform LDL targets? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Current ESC dyslipidemia guidelines recommend lowering LDL targets to 1.4mmol/L (55mg/dL) for very high risk individuals. Lipid levels of newborns may provide insights into physiologic levels at the time of birth. There is limited data on cord blood lipids/lipoprotein levels in Asian populations. This study aims to describe cord blood lipid levels in a multi-ethnic Asian population.
Methods
We analyzed 563 (F = 275) anonymized residual cord serum samples for the measurement of cholesterol, triglycerides, dLDL and HDL on the Cobas c702 autoanalyzer and cLDL after exclusion of outliers (Tukey). Following tests for Gaussian distribution (Shapiro-Wilk) all data were log transformed. Gender differences were assessed by Mann-Whitney U test. dLDL was compared with cLDL (Passing-Bablok regression, Wilcoxon’s test, Bland-Altman plot). Statistical calculations were performed using MedCalc v20 (MedCalc software, Ostend, Belgium).
Results
There was no gender difference for cord cholesterol (p = 0.1781) and cLDL (p = 0.6186) and their values were: cholesterol (range:0.78-3.09mmol/L; mean:1.486; reference interval:0.92-2.42) and cLDL (range:0.19-1.85mmol/L; mean:0.60 ; reference interval:0.27-1.21). dLDL was higher in females (p = 0.0388) (range:0.17-1.84mmol/L; median:0.54; IQR:0.37,0.71; reference interval:0.22-1.26; 99th percentile 1.42) compared to males (range:0.16-1.19mmol/L; median:0.49; IQR:0.36,0.62; reference interval:0.21-0.98; 99th percentile 1.13). Cord dLDL values were significantly lower (p < 0.001) than cLDL; the difference (Bland-Altman) between dLDL and cLDL ranged from -0.2062-0.0141 mmol/L (mean -0.0960). Passing-Bablok regression analysis showed cLDL = 1.0465dLDL + 0.0695 with a correlation coefficient (Spearman) of 0.963 (p < 0.0001). Female triglycerides were lower (p < 0.0001) [range:0.11-0.82mmol/L; median:0.24; IQR:0.19,0.31; reference interval:0.11-0.64] than males [range:0.11-0.85mmol/L; median:0.28; IQR:0.21,0.38; reference interval:0.13-0.66]. HDL was higher in females [range:0.40-1.62mmol/L; median:0.75; IQR:0.62,0.93; reference interval:0.44-1.34] than males [range:0.33-1.29mmol/L; median:0.69; IQR:0.58,0.86; reference interval:0.43-1.16] (p = 0.005).
Conclusion
Contemporary cord blood lipid/lipoprotein values have been derived for our local multi-ethnic Asian population. Directly measured LDL, shows ESC guideline LDL targets are not lower than cord dLDL levels at the 99th percentile. However cLDL overestimates cord dLDL in this cohort of subjects.
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