Abstract MP47: Associations Between Novel Biomarkers and Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Weihong Tang ◽  
Lu Yao ◽  
Ron C Hoogeveen ◽  
Alvaro Alonso ◽  
David J Couper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Risk ◽  
Aortic Aneurysms ◽  
Matrix Remodeling ◽  
Cross Sectional ◽  
Blood Concentrations ◽  
Abdominal Aortic ◽  
Novel Biomarkers ◽  
Aric Study

Introduction: Abdominal aortic aneurysms (AAA) are an important manifestation of vascular disease in older age and rupture of an AAA is associated with high mortality. Traditional atherosclerotic disease risk factors contribute to the etiology of AAA. Biomarkers for novel etiopathogenic mechanisms, including extracellular matrix remodeling and inflammation, have been assessed primarily in cross-sectional studies of AAA. The objective of this study was to prospectively assess the association between biomarkers for these novel mechanisms and clinical AAA during 24 years of follow-up in the ARIC study, a large, community-based cohort. Methods: Clinical AAAs were ascertained from baseline in 1987-1989 (45-64 years of age) to 2011 through hospital discharge codes, death codes, and Medicare outpatient claims. Over a maximum 24 years of follow-up, a total of 554 AAAs (85.3% whites) were identified. Using a nested case-cohort design, novel biomarkers, including MMP3, MMP9, IL6, IL1-beta, N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin, were measured at baseline (90% of sample) or Visit 2 (1990-1992, 10% of sample) in all AAAs and a random sample of 747 participants who were selected from baseline and matched with AAAs by age (≤55 and >55), race, and gender. The association of the biomarkers with the risk of future AAA was estimated using multivariable Cox proportional hazard models with weighting to adjust for the varying sampling fractions of cases and controls across strata. Results: MMP9, IL6, PIIINP, and osteopontin were significantly associated with future risk of AAA after adjusting for age, gender, race and field center (Table). The associations for PIIINP and osteopontin were no longer significant after further adjusting for other traditional risk factors for AAA. Conclusions: Blood concentrations of MMP9, IL6, and osteopontin measured in middle-age were risk markers for incident AAA. These results highlight the role of inflammation and extracellular remodeling in the development of AAA.

Abstract 032: Associations between Middle-age Risk Factors and Future Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Weihong Tang ◽  
Alvaro Alonso ◽  
Pamela L Lutsey ◽  
Frank A Lederle ◽  
Lu Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Middle Age ◽  
Disease Risk ◽  
Atherosclerotic Disease ◽  
Cross Sectional ◽  
Abdominal Aortic ◽  
Aric Study

Introduction: Abdominal aortic aneurysm (AAA) is an important manifestation of vascular disease in older age and rupture of an AAA is a life threatening condition. Traditional atherosclerotic disease risk factors, particularly male sex, smoking and hypertension, are known to contribute to the etiology of AAA. However, epidemiologic studies of AAA have often been cross-sectional, and few have employed a prospective cohort design, especially with long follow-up. The objective of this study was to prospectively assess the association between atherosclerotic disease risk factors and hospitalized AAA in 15,722 participants (68% whites) of the ARIC study, a large, community-based cohort. Methods: Risk factors were measured at baseline at 45-64 year of age. Clinical AAAs were ascertained through hospital discharge diagnoses or death certificates. Over 15 years of follow-up, a total of 265 AAAs (85.3% whites) were identified, including repair procedures, AAA rupture or dissection, and incidental detection. Multivariable Cox proportional hazard models were used to estimate the association of risk factors with the risk of future AAA. Results: Consistent with the literature from prospective studies, we identified age, male gender, white race, smoking, height, total and HDL cholesterols, triglycerides, white blood cell count, and hypertension as risk factors for AAA (Table). In addition, LDL-C, fibrinogen, and peripheral artery disease that were previously reported only in cross-sectional case-control studies were also strongly associated with AAA (Table). Body mass index, diabetes, and alcohol consumption were not associated with AAA occurrence. Conclusions: Several lifestyle and clinical variables measured in middle-age were strong risk factors for future AAA during a long follow-up.

scholarly journals The Association of Biomarkers of Inflammation and Extracellular Matrix Degradation With the Risk of Abdominal Aortic Aneurysm: The ARIC Study

Angiology ◽  
2018 ◽  
Vol 70 (2) ◽  
pp. 130-140 ◽  
Author(s):  
Weihong Tang ◽  
Lu Yao ◽  
Ron C. Hoogeveen ◽  
Alvaro Alonso ◽  
David J. Couper ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Matrix Metalloproteinase ◽  
Abdominal Ultrasound ◽  
Aortic Aneurysms ◽  
Blood Concentrations ◽  
Atherosclerosis Risk In Communities ◽  
Hazard Ratios ◽  
Abdominal Aortic ◽  
Aric Study

Animal and human laboratory studies suggest that the pathogenesis of abdominal aortic aneurysms (AAAs) involves inflammation and degradation and remodeling of the extracellular matrix. This study prospectively assessed the association between biomarkers for these mechanisms and the presence of AAA during 24 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) study. The ARIC prospectively identified clinically diagnosed AAAs in 15 792 men and women from baseline in 1987 to 1989 to 2011 using hospital discharge codes and death records. Additional asymptomatic AAAs were detected by an abdominal ultrasound scan in 2011 to 2013. Matrix metalloproteinase (MMP)-3, MMP-9, interleukin 6 (IL-6), N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin were measured in blood samples collected between 1987 and 1992 in participants with AAA (544 clinically diagnosed AAAs and 72 ultrasound-detected AAAs) and a random sample of 723 participants selected from baseline and matched with AAAs by age, race and sex. Higher concentrations of MMP-9 and IL-6 were associated with future risk of clinically diagnosed AAA (hazard ratios [95% confidence intervals]: 1.55 [1.22-1.97] and 1.87 [1.48-2.35], respectively, comparing highest versus lowest tertiles) after multivariable adjustment ( P for trend < .001). Matrix metalloproteinase-9 was also associated with ultrasound-detected AAA. In conclusion, blood concentrations of MMP-9 and IL-6 measured in middle age predicted the risk of AAA during 24 years of follow-up.

Abstract P341: Associations between Middle-age Risk Factors and Risk of Asymptomatic Abdominal Aortic Aneurysm: the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Weihong Tang ◽  
Alvaro Alonso ◽  
Pamela L Lutsey ◽  
Frank Lederle ◽  
Lu Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Blood Cell ◽  
Cell Count ◽  
Middle Age ◽  
Blood Cell Count ◽  
Abdominal Aortic ◽  
Aric Study

Introduction: Abdominal aortic aneurysm (AAA) is an important cardiovascular disease in older adults and rupture of an AAA is associated with high mortality. Although traditional cardiovascular risk factors have been associated with the risk of AAA, their importance in the etiology of AAA is not well established, partly due to limited data for asymptomatic AAA from large prospective studies with a long follow up. The objective of this study was to prospectively assess the association between mid-life atherosclerotic disease risk factors and later-life asymptomatic AAA in the ARIC Study, a large, community-based cohort. Methods: Risk factors were measured at baseline, at 45-64 years of age, in 1987-1989. Abdominal aortic ultrasound was conducted in 2011-2013. Ultrasound images with maximal infrarenal abdominal aortic diameter (IAD) ≥ 28 mm were over-read by radiologists. Diagnosis of asymptomatic AAA was made in the over-reading based on IAD ≥ 30 mm. Participants who had a history of repair for abdominal aorta or were identified as clinical AAAs via previous hospital discharge diagnoses were excluded. Multivariable logistic regression models were used to estimate the association of baseline risk factors with AAA risk. Results: A total of 113 asymptomatic AAAs were ascertained in 5,904 participants (78% whites) who had an abdominal ultrasound exam (prevalence=1.9%). Age, male gender, white race, smoking, height, total, HDL, and LDL cholesterols, triglycerides, white blood cell count, and fibrinogen were risk factors for asymptomatic AAA (Table). BMI, diabetes, alcohol consumption, hypertension, and peripheral artery disease were not associated with AAA. In multivariable adjustment that included the significant risk factors, age, smoking, height, LDL or total cholesterol, white blood cell count, and fibrinogen remained independently associated with AAA risk (p<0.05). Conclusions: Several lifestyle and clinical variables measured in middle-age were associated with risk of asymptomatic AAA during a long follow up.

Abstract P038: Serum Calcium, 25-hydroxyvitamin D and Incidence of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Mary R Rooney ◽  
Weihong Tang ◽  
Aaron R Folsom ◽  
Erin D Michos ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Calcium ◽  
Aortic Aneurysms ◽  
Serum Concentrations ◽  
Atherosclerosis Risk In Communities ◽  
Hydroxyvitamin D ◽  
Abdominal Aortic ◽  
Atherosclerosis Risk ◽  
25 Hydroxyvitamin D

Introduction: Serum concentrations of calcium and 25-hydroxyvitamin D [25(OH)D] may potentially contribute to the development of abdominal aortic aneurysms (AAA), likely predominately through established AAA risk factors such as hypertension and inflammation. To date, no prospective epidemiologic studies have examined the association between calcium and 25(OH)D and AAA risk. Hypothesis: We hypothesized that 20-year risk of AAA is higher among individuals with elevated serum calcium and among those with low serum of 25(OH)D. Methods: Serum calcium and 25(OH)D were measured in Atherosclerosis Risk in Communities (ARIC) study participants without prior AAA and who attended visit 2 (1990-92) (N=13,452). Serum calcium was corrected for serum albumin. AAA events were identified through 2011 via annual follow-up phone calls for hospitalized AAAs, and through Medicare for both hospitalized and outpatient AAAs. Multi-variable Cox proportional hazards models were used. Calcium was modeled as quartiles and 25(OH)D as <10, 10-<20, 20-<30, ≥30 ng/ml. Additionally, sex-stratified analysis was conducted. Results: The participants were mean±SD age 57±6y, 44% men and 75% white. Mean serum concentrations were 9.2±0.4 mg/dl for calcium and 24.3±8.5 ng/ml for 25(OH)D. Over a median 19.7 years of follow-up, 484 AAA cases were identified. High serum calcium was associated with an increased incidence of AAA [HR Q4 v Q1=1.60 (95% CI: 1.24-2.08)] after adjustment for demographics and with additional adjustment for height, weight and smoking [1.39 (1.05-1.82)], but not after other CVD risk factors were controlled for [1.20 (0.91-1.58)]. In the fully adjusted model, a sex-interaction was present [p-value sex*calcium interaction=0.03], whereby the association was present in women [2.28 (1.20-4.34)] not men [1.05 (0.75-1.47)]. Those with 25(OH)D ≥30 ng/ml vs. <10 ng/ml had a HR for AAA of 1.54 (1.03-2.29) after demographic adjustment, but the association was attenuated with further adjustment for height, weight and smoking [1.24 (0.82-1.88)]. No sex-25(OH)D interaction was detected. As such, stratified results are not presented. Conclusions: In this large prospective cohort, there was little evidence that markers of vitamin D metabolism are associated with risk of incident AAA. The positive association of calcium with AAA among women may warrant further investigation and replication in other populations.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

scholarly journals POS1015 ANTI-TNF DRUGS AND CARDIOVASCULAR EVENTS IN PATIENTS WITH SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 775.2-776
Author(s):  
C. W. S. Chan ◽  
P. H. LI ◽  
C. S. Lau ◽  
H. Y. Chung
Keyword(s):  
Risk Factors ◽  
Psoriatic Arthritis ◽  
Cardiovascular Events ◽  
Clinical Information ◽  
Incidence Rates ◽  
Major Adverse Cardiovascular Events ◽  
Cross Sectional ◽  
Cerebrovascular Events ◽  
Cardiovascular Morbidity And Mortality

Background:Cardiovascular (CVS) diseases are the leading cause of death worldwide and patients with rheumatic diseases have an increased CVS risk including stroke and myocardial infarction (MI) (1-3). CVS risk factors and CVS events are common in SpA (4). Delineating the CVS risk and the association with medications in patients with SpA would be useful.Objectives:The objective of this study was to delineate the CVS risk and the association with medications in patients with SpA.Methods:Patients with SpA and patients with non-specific back pain (NSBP) were identified in rheumatology and orthopedics clinics respectively. Clinical information and CVS events were retrieved. Incidence rates were calculated. Association analysis was performed to determine the CVS risk of SpA and other modifiable risk factors.Results:A total of 5046 patients (SpA 2616 and NSBP 2430) were included from eight centers. Over 56 484 person-years of follow-up, 160 strokes, 84 MI and 262 major adverse cardiovascular events (MACE) were identified. Hypercholesterolemia was more prevalent in SpA (SpA 34.2%, NSBP 28.7%, P<0.01). Crude incidence rates of stroke and MI were higher in SpA patients. SpA was associated with a higher risk of MACE (HR 1.66, 95%CI 1.22-2.27, P<0.01) and cerebrovascular events (HR 1.42, 95%CI 1.01-2.00, p=0.04). The use of anti-tumor necrosis factor (TNF) drugs was associated with a reduced risk of MACE (HR 0.37, 95%CI 0.17-0.80, P=0.01) and cerebrovascular events (HR 0.21, 95%CI 0.06-0.78, P=0.02).Conclusion:SpA is an independent CVS risk factor. Anti-TNF drugs were associated with a reduced CVS risk in these patients.References:[1]Crowson CS, Liao KP, Davis JM, 3rd, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013;166(4):622-8 e1.[2]Verhoeven F, Prati C, Demougeot C, Wendling D. Cardiovascular risk in psoriatic arthritis, a narrative review. Joint Bone Spine. 2020;87(5):413-8.[3]Liew JW, Ramiro S, Gensler LS. Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis. Best Pract Res Clin Rheumatol. 2018;32(3):369-89.[4]Molto A, Etcheto A, van der Heijde D, Landewe R, van den Bosch F, Bautista Molano W, et al. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study. Ann Rheum Dis. 2016;75(6):1016-23.Disclosure of Interests:None declared.

scholarly journals THU0254 Risk factors for back pain in a cross sectional and in a one-year follow up study in nurses

2001 ◽  
Author(s):  
M Brzosko ◽  
I Fiedorowicz-Fabrycy ◽  
J Fliciñski ◽  
H Przepiera-Bêdzak ◽  
K Prajs
Keyword(s):  
Risk Factors ◽  
Back Pain ◽  
Cross Sectional ◽  
Follow Up Study ◽  
One Year
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