Abstract P030: Association of Ideal Cardiovascular Health and Plasminogen Activator Inhibitor-1 From Early Adulthood to Middle Age: the Coronary Artery Risk Development in Young Adults Study

Abstract

Background: Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease (CVD). Therefore identification of biomarkers that may mediate risk between CVH and CVD may offer novel approaches in CVD prevention. One potential biomarker is plasminogen activator inhibitor-1 (PAI-1), which has been associated with increased risk of CVD. The aim of this study is to assess the relationship between CVH scores and PAI-1 levels from young adulthood to mid-life. Methods: Plasma PAI-1 levels were measured in a subset of randomly selected participants (n=1200) from the Coronary Artery Risk Development in Young Adults (CARDIA) study at year 7 (Y7) and Y20. Among them, 911 participants at Y7 and 830 participants at Y20 had available data on CVH status. We calculated CVH scores (range 0-14) and categorized as low (0-7), moderate (8-11), and high (12-14). We performed multivariable linear regression to study the association of CVH and PAI-1 at Y7 and Y20 after adjustment for age, sex, race, education, and center. Results: At Y7, participants (mean age 32.3±3.5 years) had a mean CVH score of 11.1 (±1.8) and mean PAI-1 level of 20.0 ng/mL (±21.2) with an adjusted correlation coefficient of -0.29 (p<0.0001) (TABLE) . By Y20, mean CVH score of the participants had declined to 10.1 (±2.3) and mean PAI-1 level had increased to 36.2 ng/mL (±37.1) with an adjusted correlation coefficient of -0.46 (p<0.0001). Among participants with high, moderate, and low CVH, PAI-1 levels were higher at Y20 compared to Y7 (high: 14.7 to 18.0 ng/mL, moderate: 23.9 to 36.9 ng/mL, low: 27.3 to 64.6 ng/mL). At both Y7 and Y20, mean level of PAI-1 was significantly higher in participants with moderate or low CVH (compared with high CVH). Conclusion: Higher CVH score is associated with lower plasma levels of PAI-1 from young adulthood to mid-life. PAI-1 levels increased among all CVH categories with aging; however, participants with high CVH had the smallest increase in PAI-1 and PAI-1 levels remained lower than even young adults with moderate or low CVH.