Atherosclerosis Cardiovascular Disease Research Articles

Residual Risk of Atherosclerotic Cardiovascular Disease; Is It Possible to Eradicate?

Atherosclerosis Cardiovascular disease (ASCVD) remains the number one causes of death and disability worldwide. Treatment of major traditional risk factors, including low density lipoprotein–cholesterol, smoking cessation, controlling hypertension and diabetes, enhancing physical exercise etc. are the important measures of atherosclerotic risk reduction. An LDL centric approach to risk reduction, namely with statin for decades and proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) recently have served as the foundation of primary and secondary prevention and have led to significant improvement in cardiovascular outcome. However, a significant goal directed medically treated (GDMT) patients remain at a significantly elevated risk of having a major cardiovascular event that still remains unsolved. This is commonly referred to as residual risk. Beyond traditional risk factors, other drivers of residual risk have been postulated, these includes inflammatory, pro-thrombotic and metabolic factors.

Could Triglyceride-Glucose Index, a Predictor of Atherosclerosis, Be Associated with Retinal Vein Occlusion?

The triglyceride-glucose (TyG) index is a sign of atherosclerosis in cardiovascular diseases. The TyG index is thought to have clinical significance for the assessment of vascular damage. In this study we aimed to demonstrate the connection between the TyG index and retinal vein occlusion (RVO). This case-control observational study involved 492 participants aged 40-90, admitted to the ophthalmology outpatient clinic of our hospital. TyG index was calculated using the formula: ln(fasting TG [mg/dL] × fasting plasma glucose [mg/dL]/2). The RVO group included 387 patients (181 women and 206 men) and the control group included 115 patients (61 women and 54 men). The average patient age was 62.9±11.1 years in the RVO group and 56.7±8.7 years in the control group. The TyG index was higher in the RVO group (8.9±0.7) than in the control group (8.8±0.6). This difference was statistically significant (p=0.04). The correlation was statistically significant when evaluated according to age and sex by multivariate logistic regression analysis (odds ratio: 1.45, confidence interval: 1.03- 2.02, p=0.03). The TyG index is a novel atherogenicity index that is derived from routine blood tests and can be used to determine the risk of RVO in at-risk individuals with a simple calculation. Therefore, the TyG index could help as a reliable guide to identify individuals at RVO with high risk and initiate early intervention.

From metabolic to epigenetic: Insight into trained macrophages in atherosclerosis (Review).

Atherosclerosis (AS) is a chronic inflammatory disease caused by the deposition of lipoproteins and sequent immune responses. Within the atherosclerotic plaque, macrophages are the most abundant immune cells and play a great part as protagonists and promoters of AS. In the past decade, the concept of 'trained immunity' has emerged, which highlights the memory characteristics of innate immunity, thus opening up a new avenue of research. Evidence suggests that trained immunity may regulate the onset and progression of AS with trained macrophages playing an important and dynamic role in atherogenesis. The present review provided a summary of concepts related to trained immunity and its relationship with AS. Furthermore, different phenotypes of macrophages responding to various stimuli within the atherosclerotic plaque were presented, along with the complex mechanisms of metabolic and epigenetic reprogramming in the cells. Finally, several promising therapeutic approaches for AS cardiovascular disease were discussed, which may shed light on new clinical strategies.

Long‐term efficacy of washed microbiota transplantation in overweight patients

AbstractBackgroundFaecal microbiota transplantation holds promise in mitigating fat accumulation and improving obesity. This study aimed to evaluate the long‐term efficacy of washed microbiota transplantation (WMT) among overweight patients.MethodsThe clinical data pertaining to the treatment of patients with WMT were collected retrospectively. Compared alterations in body mass index (BMI), blood glucose, blood lipids and blood pressure prior to and following WMT treatment. Comprehensive efficacy evaluation and atherosclerosis cardiovascular disease (ASCVD) grading evaluation were carried out, with an analysis of gut microbiota composition before and after WMT.ResultsA total of 186 patients were included (80 overweight, 106 normal weight). WMT not only had the effect of improving overweight patients to the normal weight patients (p < .001), but also could significantly reduce BMI in the long term by restoring gut microbiota homeostasis (p < .001). In addition, the BMI improvement value of multi course was more significant than that of single course or double course. WMT had a significant ASCVD downgrade effect on the high‐risk and medium‐risk groups outside 1 year, while it did not increase the risk of upgrading ASCVD for low‐risk group.ConclusionsWMT could significantly reduce the BMI of overweight patients and still had an improvement effect in the long term.

Association between composite dietary antioxidant index and atherosclerosis cardiovascular disease in adults: A cross-sectional study

Background and aimThe objective of our study was to examine the association between composite dietary antioxidant index (CDAI) and atherosclerotic cardiovascular disease (ASCVD) in adults. Methods and resultsData was gathered from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018. To examine the connection between CDAI and ASCVD, multiple logistic regression analyses were performed. Restricted cubic splines were utilized to examine non-linear correlations, and the inflection point was identified using a two-piecewise linear regression approach. Subgroup analyses were performed to demonstrate stability of results. A total of 44,494 individuals were included in the study. The multivariate logistic regression model was fully adjusted and revealed an odds ratio of 0.968 (95% CI: 0.959–0.978; P < 0.001) for the correlation between CDAI and ASCVD. Furthermore, individuals in the highest quartile of CDAI exhibited a decreased risk of ASCVD compared to those in the lowest quartile [0.716 (0.652–0.787); P < 0.001]. Moreover, restricted cubic spline (RCS) analysis revealed non-linear relationship between CDAI and ASCVD, with inflection point at −0.387. The analysis of subgroups showed that the importance of CDAI remained consistent among various age, sex, race, body mass index (BMI), and physical activity. ConclusionsOur research revealed an inverse and non-linear relationship between CDAI and ASCVD in adults. The implications of these findings are significant for future studies and the formulation of dietary guidelines.

Ten-year atherosclerotic cardiovascular disease risk trajectories among women veteran cancer patients

Despite a higher risk of cardiovascular disease (CVD) events in women cancer survivors than their male counterparts, importance of female sex has been underestimated due to under-representation of women in clinical research and male dominant CVD risk models. This study examined ten-year Atherosclerosis Cardiovascular Disease (ASCVD) risk trajectories in women veterans diagnosed with the ten most common cancers—bladder, breast, colorectal, endometrial/uterine/cervix, leukemia, liver, lung and bronchium, Non-Hodgkin’s lymphoma, melanoma, and thyroid cancer—using United States (US) Veterans Affairs (VA) Electronic Health Records data. The study included 78,556 women veterans aged between 30 and 80 years from diverse backgrounds treated at VA hospitals with ≥2 complete outpatient visit records in the VA health care system between January 01, 2007 and December 31, 2017. A steep rise in ASCVD risk score trajectories post-cancer diagnosis was observed among women diagnosed with bladder, breast, liver, lung and thyroid cancer, melanoma, and Non-Hodgkin’s lymphoma, compared to pre-cancer diagnosis periods, as well as significantly elevated pre-cancer ASCVD risk among all patients with cancer, other than thyroid cancer, compared to the no cancer group (p < 0.0001). ASCVD risk monitoring is highly recommended to reduce adverse cardiovascular events for women diagnosed with cancer, survivors, and for women at risk of future cancer incidences.

Dyslipidemias among workers in the Arctic zone of Russia

Introduction. Secondary hyperlipidemia plays an important role in the pathogenesis of atherosclerosis in cardiovascular diseases.&#x0D; Goal is to evaluate the blood lipid spectrum in working men in the Arctic zone of Russia to prevent the risk of developing cardiovascular complications.&#x0D; Materials and methods. We determined the blood lipid spectrum (triglycerides (TGL), total cholesterol (TC), low-density lipoproteins (LDL-C), and high-density lipoproteins (HDL-C), the type of dyslipidemia in two groups of men working in the Arctic (n=51) and the Subarctic (n=54) for 7.1±0.2 years and 6.4±0.6 years (p=0.45) with different working, living, and rest conditions.&#x0D; Results. TC in both groups was in the “borderline high” zone, and Q75 was in the “high” zone, HDL-C in Q75 was above the reference limit, Q25 in the first group was in the “borderline high” zone, in the second TC and HDL-C were normal. TGL parameters: in the first group Q75 is above normal, in the second group it is normal; LDL-C, respectively, in the range of the upper zone “norm” – the lower zone “high”, as well as normal. Lipid metabolism disorders were detected in 98 and 83.9% of men working in various climatic zones of the Arctic zone. Hypercholesterolemia and mixed dyslipidemia in the Arctic were found in 43.1% of those examined, respectively, and in the Subarctic – in 38.7 and 16.2%. An increase in HDL cholesterol was detected in 62.7% of those examined in the Arctic and in 29% of those examined in the Subarctic, respectively. The proportion of people with low HDL-C in the Arctic is 3.6 times less, with high THL – 8.1 times less (2% versus 16.1%), which determines the prevalence of the risk of developing cardiovascular complications in the Subarctic.&#x0D; Limitations. Men of physical and mental labour in the Arctic in an organized team, mental labour in the Subarctic in an urban environment.&#x0D; Conclusion. The results update the assessment of dyslipidemia in the Arctic zone of Russia, which will allow developing preventive measures to preserve the health of people working in extremely cold climates.

Sleep patterns and risks of incident cardiovascular disease and mortality among people with type 2 diabetes: a prospective study of the UK Biobank

BackgroundTo explore the relationship between sleep patterns and cardiovascular disease (CVD) incidence and mortality risk in a population with type 2 diabetes through a UK Biobank sample.MethodsA total of 6860 patients with type 2 diabetes were included in this study. Five sleep factors (including Chronotype, sleep duration, insomnia, daytime sleepiness, and snoring) were collected as a questionnaire. The calculation generates a sleep score of 0–5, and then three sleep patterns were defined based on the sleep scores: poor sleep pattern (0–2), Intermediate sleep pattern (3–4), and healthy sleep pattern (5). HRs and 95% confidence intervals were calculated by multivariate COX proportional risk model adjustment. Restricted cubic splines were used to validate linear associations between sleep scores CVD events.ResultsOur results found a reduced risk of CVD events in individuals with healthy sleep patterns compared to participants with poor sleep patterns. CVD Mortality (HR, 0.690; 95% CI 0.519–0.916), ASCVD (Atherosclerosis CVD) (HR, 0.784; 95% CI 0.671–0.915), CAD (Coronary Artery Disease) (HR, 0.737; 95% CI 0.618–0.879), PAD (Peripheral Arterial Disease) (HR, 0.612; 95% CI 0.418–0.896), Heart Failure (HR, 0.653; 95% CI 0.488–0.875). Restricted cubic spline responded to a negative linear correlation between sleep scores and CVD Mortality, ASCVD, CAD, PAD, and Heart Failure.ConclusionsHealthy sleep patterns are significantly associated with a reduced risk of CVD Mortality, ASCVD, CAD, PAD, and Heart Failure in the diabetes population.

Sex Differences in Glomerular Lesions, in Atherosclerosis Progression, and in the Response to Angiotensin-Converting Enzyme Inhibitors in the ApoE-/- Mice Model.

This study analyzes sex-based differences in renal structure and the response to the Angiotensin-Converting Enzyme (ACE) inhibitor enalapril in a mouse model of atherosclerosis. Eight weeks old ApoE-/- mice received enalapril (5 mg/kg/day, subcutaneous) or PBS (control) for an additional 14 weeks. Each group consisted of six males and six females. Females exhibited elevated LDL-cholesterol levels, while males presented higher creatinine levels and proteinuria. Enalapril effectively reduced blood pressure in both groups, but proteinuria decreased significantly only in females. Plaque size analysis and assessment of kidney inflammation revealed no significant sex-based differences. However, males displayed more severe glomerular injury, with increased mesangial expansion, mesangiolysis, glomerular foam cells, and activated parietal epithelial cells (PECs). Enalapril mitigated mesangial expansion, glomerular inflammation (particularly in the female group), and hypertrophy of the PECs in males. This study demonstrates sex-based differences in the response to enalapril in a mouse model of atherosclerosis. Males exhibited more severe glomerular injury, while enalapril provided renal protection, particularly in females. These findings suggest potential sex-specific considerations for ACE inhibitor therapy in chronic kidney disease and atherosclerosis cardiovascular disease. Further research is needed to elucidate the underlying mechanism behind these observations.

Trends in Serum Total Cholesterol and High Total Cholesterol Prevalence Among Royal Thai Army Personnel in Thailand, 2017-2022.

High total cholesterol (TC) is a robust-documented risk factor for atherosclerosis cardiovascular diseases. Approximately one-fourth (23.5%) of Thai civilians had high TC. However, the information on high TC among the Royal Thai Army (RTA) personnel is limited. The study aimed to identify the trends in serum TC and high TC prevalence among RTA personnel from 2017 to 2022. A serial cross-sectional study from 2017 to 2022 was conducted. A total of 318,353 active-duty RTA personnel aged 35-60 years were included in the study. High TC was defined as fasting TC ≥ 240 mg/dL. A multivariable log-binomial regression analysis was performed to investigate factors associated with high TC. The overall age- and sex-adjusted high TC prevalence was 26.3% in 2017 and dropped to 22.9% in 2020; then, it increased to 26.4% in 2022 (pfor quadratic trend <0.001). Younger-aged RTA personnel have significantly rising trends in sex-adjusted high TC prevalence over 6years. In the south, the age- and sex-adjusted high TC prevalence was 24.4% in 2017 and substantially rose to 33.6% in 2022 (pfor quadratic trend <0.001). Meanwhile, in the northeast, it rose by 3.6% over 6years. High body mass index, high blood pressure, and hyperglycemia were associated with high TC prevalence among this population. High TC was a common essential health issue among RTA personnel. Rising trends in mean serum TC and high TC prevalence from 2017 to 2022 were discovered, especially in younger participants and those residing in the south and northeast.

Association between visceral obesity and 10-year risk of first atherosclerotic cardiovascular diseases events among American adults: National Health and Nutrition Examination Survey.

In the United States, the relationship between visceral obesity and the risk of developing atherosclerosis cardiovascular disease (ASCVD) for the first time in 10 years is unclear. Data for this cross-sectional study came from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. We collected variable information related to 10-year ASCVD risk and visceral obesity reliable indicators [Visceral obesity index (VAI) and Lipid accumulation product (LAP)]. And we used multiple logistic regression to analyze the correlation of visceral obesity indicators (VAI and LAP) with 10-year ASCVD risk. In addition, we assessed the linear relationship between VAI or LAP and 10-year ASCVD risk by smoothing curve fitting. Finally, we conducted subgroup analysis and sensitivity analysis after excluding participants with extreme VAI and LAP values to ensure that we obtained accurate and reliable results. Our study included a total of 1,547 participants (mean age: 56.5 ± 10.1, 60% of males). The results of the multiple logistic regression showed that compared with participants with the lowest VAI in the 1st Quartile (≤0.79), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (1.30-2.14), and Q4 (≥2.15) were 2.58 (95% CI: 1.24-5.36, P = 0.011), 15.14 (95% CI: 6.93-33.05, P < 0.001), respectively. Compared with participants with the lowest LAP in the 1st Quartile (≤28.29), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (46.52-77.00), and Q4 (≥77.01) were 4.63 (95% CI: 2.18-9.82, P < 0.001), 16.94 (95% CI: 6.74-42.57, P < 0.001), respectively. Stratified analysis showed that the association between VAI or LAP and the first ASCVD event was more pronounced in males. Higher VAI or LAP scores are significantly associated with elevated 10-year ASCVD risk in adults aged 40 to 79 in the USA, which suggested that monitoring visceral obesity is crucial to reduce the risk of a first ASCVD event.

Cannabis use and risk of atherosclerosis cardiovascular disease: a two-sample mendelian randomization study

Abstract Funding Acknowledgements Type of funding sources: None. Background Whether cannabis use causally associates with atherosclerotic cardiovascular disease (ASCVD) remains unknown. A genetic approach, using Mendelian randomization principles, can help make inferences on the association between a risk factor and a disease outcome when a clinical trial is impracticable for ethical reasons. Aims To estimate the effect of genetically determined cannabis use on risk of ASCVD, including coronary artery disease (CAD) and acute ischemic stroke (AIS). Methods Using two-sample Mendelian Randomization (MR), 65 independent (R2&amp;lt;0.2) genetic markers associating with "ever use of cannabis" in 184’765 European individuals were employed to estimate the causal association between cannabis use and risk of ASCVD. The genetic instruments were first used to test the causal association between cannabis use and CAD in 60’801 cases and 123’504 controls. Second, we explored the causal association between cannabis use and AIS in 34’217 cases and 406’111 controls. Genetic data for both outcomes predominantly comprised individuals from Caucasian origin. To triangulate genetic findings, we conducted a meta-analysis of observational studies reporting a link between cannabis use and ASCVD, CAD or AIS. Results Based on the genetic analysis, there was no evidence for a causal effect of cannabis use on the risk of CAD (OR=0.97, 95%CI 0.92-1.02, p-value=0.19) or AIS (OR=1.03, 95%CI 0.98-1.09, p-value=0.41). Sensitivity analyses, including MR-Egger, weighted median MR, Steiger filtering and multivariate MR analysis, yielded similar results, and no heterogeneity and directional pleiotropy were observed. Based on the meta-analysis of 6 observational studies for each outcome, ever use of cannabis was not associated with CAD (pooled OR=1.23, 95% CI 0.78-1.69), nor AIS (pooled OR=1.22, 95%CI 0.95-1.50). Conclusion Using a genetic approach recapitulating a clinical trial, we found no evidence in support of a causal effect between cannabis use and CAD or AIS.

Lipid profiles of people with human immunodeficiency virus with dyslipidemia after switching from efavirenz to dolutegravir.

Introduction: Human immunodeficiency virus (HIV) infection and the long-term use of antiretroviral therapy, especially efavirenz (EFV)-based regimens, impact lipid profiles due to insulin resistance and lead to a higher risk of metabolic diseases. Dolutegravir (DTG) is an integrase inhibitor with better lipid profiles than EFV. However, data on treatment experience in Thailand are limited. The primary outcome was lipid profile changes at 24 weeks after switching therapy. Methods: We conducted a prospective, open-label, cohort study in people with HIV aged ≥18 years who had undergone at least 6 months of EFV-based therapy, had HIV-1 ribonucleic acid levels &lt;50 copies/mL for ≥6 months before switching, and were diagnosed with dyslipidemia or had risk factors for atherosclerosis cardiovascular disease based on modified National Cholesterol Education Program Adult Treatment Panel III guidelines. Results: Sixty-four patients were enrolled. The mean age (standard deviation [SD]) was 48.20 ± 10.46 years, and 67.19% were male. At week 24, there were decreases from baseline in mean total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. However, mean body weight and waist circumference had increased. Conclusions: DTG resulted in better lipid profiles after switching from EFV-based therapy, suggesting that this switch could benefit patients with a high risk of cardiovascular disease. However, it is essential to note that weight gain and increased waist circumference were also observed.

Association of Major Adverse Cardiac Events and Beta-Blockers in Patients with and without Atherosclerotic Cardiovascular Disease: Long-Term Follow-Up Results of the T-SPARCLE and T-PPARCLE Registry in Taiwan

Beta-blockers are widely used, but the benefit is now challenged in patients at risk of atherosclerotic cardiovascular disease (ASCVD) in the present coronary reperfusion era. We aimed to identify the risk factors of a major adverse cardiac event (MACE) and the long-term effect of beta-blockers in two large cohorts in Taiwan. Two prospective observational cohorts, including patients with known atherosclerosis cardiovascular disease (T-SPARCLE) and patients with at least one risk factor of ASCVD but without clinically evident ASCVD (T-PPARCLE), were conducted in Taiwan. The primary endpoint is the time of first occurrence of a MACE (cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, and cardiac arrest with resuscitation). Between December 2009 and November 2014, with a median 2.4 years follow-up, 11,747 eligible patients (6921 and 4826 in T-SPARCLE and T-PPARCLE, respectively) were enrolled. Among them, 273 patients (2.3%) met the primary endpoint. With multivariate Cox PH model analysis, usage of beta-blocker was lower in patients with MACE (42.9% vs. 52.4%, p < 0.01). In patients with ASCVD, beta-blocker usage was associated with lower MACEs (hazard ratio 0.72; p < 0.001), but not in patients without ASCVD. The event-free survival of beta-blocker users remained higher during the follow-up period (p < 0.005) of ASCVD patients. In conclusion, in ASCVD patients, reduced MACE was associated with beta-blocker usage, and the effect was maintained during a six-year follow-up. Prescribing beta-blockers as secondary prevention is reasonable in the Taiwanese population.

Millet shell polyphenols ameliorate atherosclerosis development by suppressing foam cell formation

Polyphenols are bioactive compounds that occur naturally in plants, and they are widely used for disease prevention and health maintenance. In present study, the effects of millet shell polyphenols (MSPs) in thwarting atherosclerosis were explored. The results found that MSPs effectively inhibited the ability of macrophages to phagocytose lipids, and reduced the secretion of inflammatory factors IL-1β and TNF-α by obstructing the expression of STAT3 and NF-κB in macrophages. Eventually, MSPs hindered the formation of macrophage-derived foam cells. On the other hand, MSPs promoted the transformation of HASMCs from synthesis to contraction by regulating the gene expression levels of smooth muscle myosin heavy chain (SMMHC), desmin (DES), smoothelin (SMTN) and elastin (ELN). Lipid phagocytosis inhibited along with this process, thereby reducing the formation of smooth muscle cell-derived foam cells. In addition, experiments in ApoE−/− mice also showed that MSPs increased high-density lipoprotein cholesterol (HDL-C). Collectively, MSPs play a role in preventing atherosclerosis by impeding foam cell production. This study offers an integrative strategy for thwarting plaque formation in the early stages of atherosclerosis in cardiovascular disease.

Associations between residential greenness and the predicted 10-year risk for atherosclerosis cardiovascular disease among Chinese adults

BackgroundExposure to build environments, especially residential greenness, offers benefits to reduce the development of atherosclerotic cardiovascular diseases (ASCVD). The 10-year ASCVD risk is a useful indicator for long-term ASCVD risk, but the evidence on the association and potential pathway of residential greenness in mitigating its development remains unclear. ObjectivesThis study aimed to investigate the associations between residential greenness and the 10-year predicted ASCVD risks, and potentially mediation effect on this association by air pollution, body mass index (BMI) and physical activity (PA). MethodsThe baseline of the China Multi-Ethnic Cohort (CMEC) study, enrolling 99,556 adults during 2018–2019, was used in this cross-sectional study. The participants' 10-year ASCVD risks were predicted as low-, moderate-, and high-risk groups, based on the six risk factors: age, smoking, hypertension, low-density lipoprotein cholesterol (LDL-C), high high-density lipoprotein cholesterol (HDL-C), and high total cholesterol (TC). The 3-year mean value within the circular buffer of 500 m and 1000 m of Enhanced Vegetation Index (EVI500m and EVI1000m) were used to assess greenness exposure. Multiple logistic regression was used to evaluate the association between residential greenness and the 10-year ASCVD risks. Stratified analyses by sex, age and smoking status were performed to identify susceptible populations. Causal mediation analysis was used to explore the mediation effects of air pollution, BMI and PA. ResultsA total of 75,975 participants were included, of which 17.9 % (n = 13,614) and 5.6 % (n = 4253) had the moderate and high 10-year ASCVD risks, respectively. Compared to the low-risk group, each interquartile increase in EVI500m and EVI1000m reduced the ASCVD risk of the moderate-risk group by 4 % (OR = 0.96 [0.94, 0.98]) and 4 % (OR = 0.96 [0.94, 0.98]), respectively; and reduced the risk of the high-risk group by 8 % (OR = 0.92 [0.90, 0.96]) and 7 % (OR = 0.93 [0.90, 0.97]), respectively. However, the increased greenness did not affect the ASCVD risk of the high-risk group when compared to the moderate-risk group. Effects of residential greenness on the ASCVD risk were stronger in women than in men (p < 0.05), and were not observed in those aged ≥55. PA and BMI partially mediated the association between greenness and the 10-year ASCVD risk. ConclusionsASCVD prevention strategies should be tailored to maximize the effectiveness within the groups with different ASCVD risks, better at early stages when the ASCVD risk is low.

Association between dietary inflammatory index and atherosclerosis cardiovascular disease in U.S. adults.

To evaluate the association between dietary inflammatory index (DII) and Atherosclerotic cardiovascular disease (ASCVD) among U.S. adults. We collected data from National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Adults who reported complete information to diagnose ASCVD and calculate DII were included. We used three models to differentially adjust the covariates, including age, sex, race or ethnicity, education level, smoking status, poverty, insurance, body mass index, hyperlipemia, hypertension, and diabetes. Logistic regression was used to estimate the Odds Ratio (OR) and 95% confidence interval (95% CI) for ASCVD grouped by DII deciles. We additionally conducted spline smoothing with the generalized additive model (GAM) and the log-likelihood ratio to examine the non-linear relationship between DII and ASCVD. If exists, the segmented linear regression will be used to detect the cutoff point. The subgroup analyses were stratified by various atherosclerotic cardiovascular diseases (i.e., CHD, angina, heart attack, and stroke) and sex. A total of 48,733 participants (mean age, 47.13 ± 0.19 years) with 51.91% women were enrolled, of which 5,011 were diagnosed with ASCVD. In the crude model, participants in the five highest deciles (D6, 7, 8, 9, and 10) of DII score had a significantly higher risk of having ASCVD compared to those in the first decile. In the fully adjusted model, those in the tenth decile [OR = 1.47, 95% CI = (1.18,1.84)] of DII had a significantly increased risk of ASCVD compared to the first decile. Notably, when DII is above 3, the ASCVD risk increased by 41% for each one increase in DII [OR = 1.41, 95% CI = (1.15,1.73)]. This relationship was more pronounced in females. Our study revealed a positive and non-linearly association between DII and ASCVD in U.S. adults. This relationship was more pronounced in females. The findings provide a reference for future research and diet recommendations.

Association between weight change and the predicted 10-year risk for atherosclerosis cardiovascular disease among U.S. older adults: data from National Health and Nutrition Examination Survey 1999-2018.

It remains controversial regarding the association between weight change and cardiovascular disease risk in older adults (aged ≥60 years). This study aimed to evaluate the association between weight change and the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risks in older adults. This study used data from the National Health and Nutrition Examination Survey (NHANES). Older adults aged 60-79 years who were free of self-reported ASCVD at the time of the NHANES interview were included. Data were collected from January 1999 to December 2018 and analyzed in March 2022. We focused on the associations between weight change and the 10-year ASCVD risks with the percentage change in weight during short-term (1 year) and long-term (10 years), which categorized as moderate to high weight loss (≥10%), small weight loss (5.1-9.9%), stable weight (±5%), small weight gain (5.1-9.9%), and moderate to high weight gain (≥10%). The number of participants was 1,867 (mean age 67.49 years; 42.10% female) for the long-term interval (10 years) in our analysis, and 1894 for the short-term interval (1 years). We only observed an inverse association between long-term weight loss and the 10-year ASCVD risk in fully adjusted model (loss ≥ 10%: β = 2.52, 95%CI = 0.98, 4.05; loss 5.1% ~ 9.9%: β = 2.99, 95% CI = 1.30, 4.68), but all intervals of weight gain ≥5% were not significant associated with higher risk than stable weight. However, in the subgroup analyses, the association between long-term weight loss and the 10-year ASCVD risk was not significant in old-old (aged 75-79), obesity (BMI ≥ 35 kg/m2), intentional weight loss, moderate physical activity and diabetics. Older adults (aged 60-79 years) with weight loss >5% over the past 10 years have excess predicted 10-year ASCVD risk. Our study supports the benefits of stable weight in promoting cardiovascular health in older adults.

Statin Therapy for The Primary Prevention of Cardiovascular Disease: Pros

Cardiovascular disease (CVD) is the leading cause of death worldwide. Dyslipidemia is one of the causes of cardiovascular disease with a contributor to plaque formation.Statins are a class of drugs that lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase. The purpose of statin therapy is to reduce the risk of cardiovascular and associated morbidity and mortality. Statins have a significant impact on reducing atherosclerosis cardiovascular disease. However, primary prevention of ASCVD using statins is debated although statins have several advantages. This review describes the pros of using statins as primary prevention of cardiovascular disease .A comprehensive electronic search was conducted using PubMed, Google Scholar, and ScienceDirect. The search was limited to English-language publications from 2002 to 2021. Hand-searching of relevant journals and reference lists was also performed. It is found that statins can lower cholesterol levels to prevent the formation of atherosclerosis, which then progresses to cardiovascular disease. Recognizing the presence of coronary artery calcium with imaging strategies can guide the initiation of therapy in young adults. Statins have pleiotropic effects to prevent cardiovascular, cost effective, safe, effective, and well tolerated. On the other hand, statins are still debated in older adults. Statins are a primary preventive consideration to reduce morbidity and mortality due to cardiovascular disease.&#x0D; Keywords: statin, atherosclerosis, primary prevention, and cardiovascular disease

Clinical significance of undetectable high sensitivity cardiac troponin I (hs-TnI) in Thai individuals with low cardiovascular risk

Abstract Introduction The long term prognosis of individuals who has undetectable hs-TnI is poorly defined in low cardiovascular risk. We aim to examine whether undetectable hs-TnI individuals have better cardiovascular outcomes in low cardiovascular risk population. Methods Data of low cardiovascular risk population (&amp;lt;7.5%) who has no established of atherosclerosis cardiovascular disease (ASCVD) was derived from the Electricity Generating Authority of Thailand (EGAT) study in 2007–2009 survey. High sensitivity cardiac troponin I was measured by using the Abbott ARCHITECT i2000 SR assay. We categorized level of hs-TnI into undetectable hs-TnI (&amp;lt;1.9 ng/L), low hs-TnI, intermediate and more hsTnI by gendered specific cut-off. The low cardiovascular risk population was classified into extremely low risk (&amp;lt;5%) and low risk (5–7.5%). Major cardiovascular event (MACE) and all-cause mortality were collected until 31st December 2019. Survival analysis and subgroup analysis were performed. Results A total of 3,442 participants were eligible. Mean age was 43.6 years-old, 65.5% male, hs-TnI was detected 79.8%, median hs-cTnI was 2.6 ng/L (2,3.6). During median time followed-up 10.3 years, 52 events (1.5%) of MACE and 60 events (1.7%) of all-cause mortality occurred. After adjusted for conventional risk factors, hs-cTnI significantly associated with incidence of MACE (HR 1.03 95% CI 1.02–1.04, p-value &amp;lt;0.001). Compared with intermediate and more hs-TnI group, undetectable hs-TnI and low hs-TnI had 79% and 52% lower incidence of MACE (HR 0.21, 95% CI (0.05–0.79) and HR 0.48, 95% CI (0.23–1.0), p-value for trend 0.04. Subgroup analysis, incidence of MACE remained higher either extremely low or low CV risk compared with those undetectable hs-TnI. (P for interact 0.83) Conclusion Among individuals with low cardiovascular risk, hs-TnI testing can provide risk prognostication. Undetectable hs-TnI could be as a negative risk marker for adverse cardiovascular events. Funding Acknowledgement Type of funding sources: None.