Family History Of Myocardial Infarction Research Articles

ASSOCIATION BETWEEN FAMILY HISTORY AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH PREMATURE ACUTE CORONARY SYNDROMES

ASSOCIATION BETWEEN FAMILY HISTORY AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH PREMATURE ACUTE CORONARY SYNDROMES

Correlation between a positive family risk score and peripheral artery disease in one case-control and two population-based studies

ObjectiveTo evaluate the association between a family history of cardiovascular and metabolic diseases or risk factors and the presence of peripheral artery disease (PAD). MethodsParticipants were recruited within one PAD case-control study (CAVASIC, n = 481) and two population-based studies (KORA-F3, n = 3118; KORA-F4, n = 1325). In the KORA studies, an ankle-brachial-index <0.9 and/or symptomatic claudication was defined as PAD. For myocardial infarction, stroke, diabetes mellitus, hypertension, PAD, and obesity, family risk scores (FamRS) were calculated taking into account the number and age of diseased parents and siblings and regressed on prevalent PAD or ankle-brachial-index. ResultsA significant association with PAD was found for family history of myocardial infarction and hypertension in a combined analysis of all studies and for family history of PAD in the case-control study. A combined family history score was derived from FamRS myocardial infarction, stroke, diabetes mellitus, hypertension and PAD. A positive family history of at least two and/or a strong positive family history of at least one of these diseases was found to be associated with increased risk of prevalent PAD in all three studies, even after adjustment for classical risk factors (OR = 1.93, 95%CI = [1.53–2.44], p = 2.6 × 10−8). ConclusionThe presence of a positive family history for cardiovascular and metabolic diseases or risk factors was shown to be associated with the presence of PAD. A FamRS calculation tool that considers age and family size can guide a physician to perform extended examinations to prevent complications and progression of PAD.

Ascending thoracic aortic aneurysms protect against myocardial infarctions.

There has been increasing evidence that ascending thoracic aortic aneurysms (TAAs) protect against atherosclerosis. However, there have been no studies examining the relationship between ascending TAAs and clinical endpoints of atherosclerosis, such as stroke or peripheral arterial disease. In this study, we aim to characterize the relationship between TAAs and a specific clinical endpoint of atherosclerosis, myocardial infarction (MI). We compared prevalence of coronary artery disease (CAD) and MIs in 487 patients who underwent surgical repair for ascending TAAs to 500 control patients who did not have an ascending TAA. Multivariate binary logistic regression was used to calculate the odds of having MI if a patient had an ascending TAA versus any of several MI risk factors. There was a significantly lower prevalence of CAD and MI in the ascending TAA group than in the control TAA group. The odds of having a MI if a patient had a MI risk factor were all > 1 (more likely to have a MI), with the lowest statistically significant odds ratio being 1.54 (age; p = 0.001) and the highest being 14.9 (family history of MI; p < 0.001). The odds ratio of having a MI if a patient had an ascending TAA, however, was near 0 at 0.05 (p < 0.001). This study provides evidence that ascending TAAs protect against MIs, adding further support to the hypothesis that ascending TAAs protect against atherosclerotic disease.

Coronary Artery Calcification and Family History of Myocardial Infarction in the Dallas Heart Study

ObjectivesThis study aimed to investigate the independent and joint associations between family history of myocardial infarction (FH) and coronary artery calcification (CAC) with incident coronary heart disease (CHD). BackgroundFH and CAC are associated with each other and with incident CHD. It is not known whether FH retains its predictive value after CAC results are accounted for. MethodsAmong 2,390 participants without cardiovascular disease enrolled in the Dallas Heart Study, we assessed FH (myocardial infarction in a first-degree relative) and prevalent CAC by electron-beam computed tomography. The primary outcome, a composite of CHD-related death, myocardial infarction, and percutaneous or surgical coronary revascularization, was assessed over a mean follow-up of 8.0 ± 1.2 years. The individual and joint associations with the CHD composite outcome were determined for FH and CAC. ResultsThe mean age of the population was 44 ± 9 years; 32% had FH and 47% had a CAC score of 0. In multivariate models adjusted for traditional risk factors, FH was independently associated with CHD (adjusted hazard ratio: 2.6; 95% confidence interval: 1.6 to 4.2; p < 0.001). Further adjustment for prevalent CAC did not diminish this association (adjusted hazard ratio: 2.6; 95% confidence interval: 1.6 to 4.2; p < 0.001). FH and CAC were additive: CHD event rates in those with both FH and CAC were 8.8% vs. 3.3% in those with prevalent CAC alone (p < 0.001). CHD rates were 1.9% in those with FH alone compared with 0.4% in those with neither FH nor CAC (p < 0.017). Among subjects without CAC, FH characterized a group with a more unfavorable cardiometabolic profile. ConclusionsFH provided prognostic information that was independent of and additive to CAC. Among those with CAC, FH identified subjects at particularly high short-term risk, and, among those without it, selected a group with an adverse risk-factor profile.

Regional differences among female patients with heart failure from the Cardiac Insufficiency BIsoprolol Study in ELDerly (CIBIS-ELD)

The aim of our study was to examine regional differences in the demographics, etiology, risk factors, comorbidities and treatment of female patients with heart failure (HF) in the Cardiac Insufficiency BIsoprolol Study in ELDerly (CIBIS-ELD) clinical trial. One hundred and fifty-nine female patients from Germany and 169 from Southeastern (SE) Europe (Serbia, Slovenia and Montenegro) were included in this subanalysis of the CIBIS-ELD trial. Women comprised 54% of the study population in Germany and 29% in SE Europe. German patients were significantly older. The leading cause of HF was arterial hypertension in German patients, 71.7% of whom had a preserved ejection fraction. The leading etiology in SE Europe was the coronary artery disease; 67.6% of these patients had a reduced left ventricular ejection fraction (34.64 ± 7.75%). No significant differences were found in the prevalence of traditional cardiovascular risk factors between the two regions (hypertension, diabetes, hypercholesterolemia, smoking and family history of myocardial infarction). Depression, chronic obstructive pulmonary disease and malignancies were the comorbidities that were noted more frequently in the German patients, while the patients from SE Europe had a lower glomerular filtration rate. Compared with the German HF patients, the females in SE Europe received significantly more angiotensin converting enzyme inhibitors, loop diuretics and less frequently angiotensin receptor blockers and mineralocorticoid receptor antagonists. Significant regional differences were noted in the etiology, comorbidities and treatment of female patients with HF despite similar risk factors. Such differences should be considered in the design and implementation of future clinical trials, especially as women remain underrepresented in large trial populations.

Abstract P028: Fruit and Vegetable Consumption and the Risk of Heart Failure in Women

Background: Although numerous studies have investigated fruit and vegetable consumption in association with cardiovascular disease, a limited number of studies have investigated the association with heart failure specifically. The aim of this study was to assess the association between fruit and vegetable consumption and the incidence of heart failure among middle-aged and elderly women. Methods: In September 1997, 33,669 women (aged 49-83 y) from the Swedish Mammography Cohort free of cancer, CVD and diabetes at baseline completed a food-frequency questionnaire. Women were followed for incident heart failure (hospitalization or mortality of heart failure as the primary cause) through December 2011 using administrative health registries. Cox proportional hazard models were used to calculate relative risks (RR) and 95% confidence intervals (CI). In multivariable models we adjusted for age at baseline, educational level, smoking status, body mass index, physical activity, hypertension, diabetes, family history of myocardial infarction, alcohol consumption, total energy intake, and dietary supplement use. Results: During 13.1 years of follow-up (442,324 person-years), we identified 1407 incident cases of heart failure. Total fruit and vegetable consumption was inversely associated with the risk of heart failure (the multivariable-adjusted RR in the highest quintile compared to the lowest was 0.81 (95% CI: 0.68-0.97, p for trend=0.03). When investigating fruit and vegetables separately we observed a statistically significant lower risk for vegetables (RR: 0.82; 95% CI: 0.69-0.98, p for trend=0.10) but not for fruits (RR: 0.94; 95% CI: 0.79-1.12, p for trend=0.24). Conclusions: In this population-based prospective cohort study of women, higher total consumption of fruits and vegetables was inversely associated with the risk of heart failure.

Abstract P033: Alcohol and Incident Heart Failure among the Cohort of Swedish Men

Background: The relationship between alcohol intake and incident heart failure (HF) is complex. Compared with no alcohol consumption, heavy alcohol intake is associated with higher HF risk whereas light or moderate consumption may be associated with lower risk. Methods: We analyzed 34,581 men 45-79 years old with no history of HF, diabetes mellitus or myocardial infarction (MI) who were participants in the population-based Cohort of Swedish Men study. We excluded former drinkers. At baseline, participants reported how frequently they consumed specific alcoholic beverages in the past year and other characteristics. HF was defined as hospitalization for or death from HF (primary diagnosis), ascertained by Swedish inpatient and cause-of-death records from January 1, 1998 to December 31, 2011. Due to missing values for two covariates, we used Markov chain Monte Carlo multiple imputation to simulate 5 complete datasets. We used Cox proportional hazards models to estimate rate ratios and 95% confidence intervals, adjusting for age, total energy intake, education, body mass index, physical activity, a dietary component score, cigarette smoking, marital status, family history of MI before age 60, history of hypertension and history of high cholesterol. Results: At baseline, mean age was 58.6 years. There were 1592 incident cases of HF over the follow-up period. Compared with never drinkers, the multivariable-adjusted rate of HF was 19% lower among men who drank &lt;1 drink per week (rate ratio: 0.81, 95% confidence interval: 0.64, 1.04%). The multivariable-adjusted HF rate was similar among men who drank &lt;1 drink per week and men who drank ≥1 drink per week. Conclusions: Light-to-moderate drinking is associated with lower rate of HF compared with never drinking, but the association was not statistically significant.

Abstract P022: Chocolate Intake and Incidence of Heart Failure: Findings from the Cohort of Swedish Men (COSM)

Background: Several observational studies have found that moderate chocolate consumption is associated with a lower risk of incidence of stroke and myocardial infarction and beneficial effects on lipid metabolism and endothelial function. Randomized clinical trials have shown that chocolate reduces systolic and diastolic blood pressure. One study showed that moderate chocolate consumption is associated with a lower rate of heart failure (HF) in women, but there have been no studies to evaluate the association between chocolate intake and incidence of HF in men. Methods and Results: We conducted a prospective cohort study of 33,028 men 45-79 years old with no history of myocardial infarction, diabetes, or HF at baseline who were participants in the population-based Cohort of Swedish Men (COSM) study. Chocolate consumption was assessed through a self-administrated food frequency questionnaire. Participants were followed for HF hospitalization or mortality from January 1, 1998 to December 31, 2011 using record linkage to the Swedish inpatient and cause-of-death registries. During 14 years of follow up, 1350 men were hospitalized (n = 1256) or died from incident HF (n = 192). We used Cox proportional hazards models to compute multivariable-adjusted rate ratios accounting for age, total caloric intake, education, BMI, physical activity, cigarette smoking, alcohol consumption, family history of myocardial infarction, self-reported history of hypertension, and self-reported history of high cholesterol. Compared with subjects who reported no chocolate intake, the multivariable-adjusted rate ratio of HF was 0.90 (95% CI 0.75 - 1.08) for those consuming 1-3 servings per month, 0.88 (95% CI 0.72 - 1.08) for those consuming 1-2 servings per week, 0.69 (95% CI 0.51 - 0.93) for those consuming 3-6 servings per week, and 1.14 (95% CI 0.77 - 1.69) for those consuming and ≥1 servings per day (P for quadratic trend=0.02). Conclusions: In this large prospective cohort study, there was a J-shaped relationship between chocolate consumption and HF incidence. Moderate chocolate consumption was associated with a lower rate of HF hospitalization or death, but the protective association was not observed among individuals consuming one or more servings per day.

Abstract P320: Discordance of Framingham Risk Score and Reynolds Risk Score to Global Vascular Risk Score: Results from the Hispanic Community Health Study/Study of Latinos

Introduction: The Framingham Risk Score (FRS) is a coronary heart disease (CHD) risk model established using an ethnically homogeneous population that predicts 10-year hard CHD events, myocardial infarction (MI) and coronary death. The Reynolds Risk Score (RRS) and Global Vascular Risk Score (GVRS) are validated CHD risk models that, in addition to hard CHD events, predict stroke and other CHD outcomes. In addition to major CHD risk factors, RRS adds systemic inflammation and family history of MI as GVRS adds behavioral and anthropometric measures. This study aims to compare agreement of RRS and GVRS with FRS among Hispanic/Latino adults and to describe discordance in RRS and GVRS with FRS categories, by socio-demographic characteristics. Methods: HCHS/SOL is a population-based cohort study of Hispanics/Latinos in four US communities. The analytic sample includes 6,058 non-diabetic participants 45-74 years of age with no past history of CHD and stroke who underwent comprehensive baseline examination. 10-year hard CHD risk score was calculated; participants were categorized as low (&lt;10%), moderate (10-&lt;20%), and high (≥20%) risk. Kappa scores were calculated to compare agreement of RRS and GVRS with FRS. Socio-demographic characteristics of concordance and discordance were characterized overall; multinomial logistic regression models was used to examine age-sex-adjusted likelihood of in discordance by these factors. Results: Mean age of the participants was 55 (SE=0.15) years, 54.3% were women, 41% had family history of CHD, and 90% were foreign born. Overall, 4,805 (74%) had low FRS, 1,143 (24%) had moderate FRS, and 110 (2%) had high FRS. There was poor agreement between RRS and FRS (Kappa=0.16, P&lt;0.01) and fair agreement between GVRS and FRS (Kappa=0.36, P&lt;0.01). In age-sex-adjusted analyses, RRS and GVRS were both more likely to classify persons of moderate and high risk who are between the ages of 60-74; GVRS classified more moderate and high risk women than the FRS. RRS and GVRS discordance with FRS was not associated with nativity and length of time in US. Conclusion: Significant discordance was observed between RRS and GVRS compared to FRS. Among Hispanic/Latino adults, use of RRS or GVRS may be more inclusive in classifying older age adults and women at high 10-year CHD risk.

Family History of Myocardial Infarction Increases Risk of Renal Dysfunction in Middle Age

Background/Aims: Chronic kidney disease (CKD) is common in the general population, may lead to end-stage renal disease, and is most frequently found among males. Familial clustering of kidney diseases has been observed. We aimed to study a potential association between the family history of myocardial infarction (MI) and renal dysfunction. Methods: 22,297 males and 10,828 females, aged 33-60 years, from a population-based cohort study were studied. Estimated glomerular filtration rate (eGFR) was assessed by the CKD-EPI creatinine equation. Every participant filled in a self-administered questionnaire including family history. Heredity for MI was defined as mother or father having had MI and/or died from MI, and/or brother or sister having had MI. Binary logistic regression and multiple linear regression were used in the analyses. Results: Multiple linear regression revealed a significantly increased risk of renal dysfunction in those with a positive heredity for MI (the whole cohort p = 0.01, males p = 0.000, females p = 0.169). Binary logistic regression showed that males with heredity for MI with a mean age of 43 years have a 2 times higher risk (p = 0.02) of belonging to the group with GFR <45 ml/min/1.73 m² compared to those without heredity. For the whole cohort the increased risk was 1.6 times (p = 0.07). There was no significant association for females (p = 0.88). Conclusion: These findings demonstrate that a familial burden of MI is associated with renal dysfunction, in men, already in middle age. Genetic variants may underlie predisposition to CKD in those with heredity for MI.

Non-modifiable Factors of Coronary Artery Stenosis in Late Onset Patients with Coronary Artery Disease in Southern Iranian Population.

Introduction: Coronary Artery disease (CAD) is influenced by genetic factors, environment and culture behavior. The aim of the present study was to evaluate some non-modifiable risk factors of coronary heart disease such as sex, age, family history and consanguineous marriage. Methods: This is a case-control study. The study population consisted of 200 fifteen or more years old. Data were collected on 200 patients with positive angiography and 200 control subjects with negative angiography. Positive angiography was defined as coronary diameter cut greater than 50%. Statistical analysis was conducted using SPSS 11.5. In this study, data were collected through a checklist. Logistic regression and stratification were used to determine the impact of age, gender, family history, and consanguinity on the risk of stenosis. Results: The percentage of men in patients and controls were 89% and 29%, respectively. As to gender, a significant association was found between patients and controls of CAD (CI 95%, 4.014-10.052, OR 6.352). Gender was determined as a risk factor for CAD. Family history of myocardial infarction did not show a significant effect on the artery stenosis. As to consanguinity of the parents, there was no significant association between patients and controls of CAD (P> 0.05). Conclusion: These researches show that ageing increases the risk of coronary heart stenosis; also, females are more than men protected against this disease. The impact of family history of myocardial infarction and consanguineous marriage were not associated with of CAD.

Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia

OBJECTIVETo investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.RESEARCH DESIGN AND METHODSParticipants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.RESULTSDuring a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8–8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6–14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5–17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00–1.04]), male sex (1.56 [1.08–2.25]), waist circumference (1.02 [1.02–1.03]), higher systolic blood pressure (1.01 [1.01–1.02]), higher HbA1c (%, 1.13 [0.97–1.31]/ mmol/mol, 1.01 [1.00–1.03]), and family history of myocardial infarction (1.38 [0.96–2.00]) predicted a recurrent cardiovascular event.CONCLUSIONSIndividuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient’s risk profile before the first event.

Differential Associations of Depressive Symptom Dimensions with Cardio-Vascular Disease in the Community: Results from the Gutenberg Health Study

A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD). In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n = 5000 Mid-Europeans aged 35–74 years from the Gutenberg Health Study (GHS). Only the somatic symptom dimension of depression was associated with CHD, biomarkers (inflammation, vascular function) and cardio-vascular risk factors. When multivariable adjustment was applied by demographic and cardiovascular risk factors, the weak associations of the somatic symptom dimension with the biomarkers disappeared. However, the associations of the somatic symptom dimension with CHD, myocardial infarction, obesity, dyslipidemia and family history of myocardial infarction remained. Both dimensions of depression were independently associated with a previous diagnosis of depression and distressed personality (type D). Thus, our results partly confirm current models: Somatic, but not cognitive-affective symptom dimensions are responsible for the association between depression and CHD, inflammation, vascular function and cardiovascular risk factors in the general population. However, our findings challenge the assumptions that somatic depression might be due to inflammation or vascular dysfunction as consequence of progressed atherosclerotic disease. They rather emphasize a close interplay with life-style factors and with a family history of MI.

The Role of Unknown Risk Factors in Myocardial Infarction

Background: Myocardial infarction (MI) also known as "heart attack", is the death of cardiac muscle resulting from ischemia. Objectives: To evaluate risk factors in myocardial infarction like age, sex, smoking, diabetes mellitus, hyperlipidemia, hypertension, positive family history, high level of cholesterol, stress and poor physical activity. Methods: This is a retrospective study on 163 myocardial infarction cases, conducted in the cardiology ward and CCU at a General Public Hospital, Baroda. Results: The majority of our patients were old men in the age range of 60 - 69 years. Amongst all patients 36.7% were smokers, 61.3% were type A personality group, 18.5% were active, 81.5% were physically inactive, 28.9% had hypertension, 23.3% were diabetic, 17.5% had hyperlipidemia and 33.2% had positive family history of myocardial infarction. Conclusions: Amongst people, to increase awareness regarding moderate physical activity, cessation of cigarette smoking, increased daily consumption of fruits and vegetables, as to tackle the problem and identifying the new risk factors for MI.

Interpretation of Serum Troponin Elevation

Interpretation of Serum Troponin Elevation

Abstract P081: Markers of Endothelial Function and Peripheral Arterial Disease among Women

Introduction: Markers of endothelial function may be associated with increased risk for cardiovascular disease; however, prospective data for peripheral arterial disease (PAD) are limited. We evaluated the hypothesis that serum markers of endothelial dysfunction are associated with an increased risk of PAD among women. Methods: We conducted a nested case-control study within an ongoing prospective cohort of U.S. female nurses (Nurses’ Health Study). Among 32,826 NHS participants who provided blood samples in 1989-1990, after excluding those who had myocardial infarction, coronary heart disease, stroke, or carotid artery surgery prior to the PAD diagnosis, we included all incident PAD cases that occurred between 1990 and 2008 and were confirmed by medical records. Each case was individually matched with three eligible controls using risk-set sampling, by age, smoking, date of blood draw, and fasting status. We evaluated the association between serum levels of soluble intercellular adhesion molecule (ICAM-1), E-selectin, and the risk of PAD, using conditional logistic regression analysis. Results: Complete biomarker data from 1990 was available for 144 cases and 431 controls. After accounting for matching factors, baseline ICAM-1 levels were associated with higher risk of PAD (RR for highest (T3) vs. lowest (T1) tertile=1.75, 95% CI: 1.05-2.90). The association was attenuated and no longer significant (RR T3 vs. T1=1.37, 95% CI: 0.75-2.49) after adjusting for serum levels of HDL and LDL-cholesterol, family history of myocardial infarction, relative weight, reported aspirin and cholesterol-lowering medication use, hypertension and diabetes diagnoses, physical activity, and pack-years of smoking. Additional adjustment for CRP levels further attenuated the relative risk (RR T3 vs. T1= 1.24, 95% CI: 0.67-2.29). We did not observe any significant association between baseline E-selectin levels and the risk of PAD (multivariate- and CRP-adjusted RR T3 vs. T1=0.93, 95% CI: 0.54-1.59). Conclusions: There was no association between ICAM-1 and E-selectin and subsequent PAD in this cohort of U.S women.

Vascular Risk Factors, Cardiovascular Disease, and Restless Legs Syndrome in Women

BackgroundPrevious studies evaluating the association of cardiovascular disease and vascular risk factors with restless legs syndrome showed inconsistent results, especially for the potential relation between various vascular risk factors and restless legs syndrome. We therefore aimed to analyze the relationships between vascular risk factors, prevalent cardiovascular disease, and restless legs syndrome. MethodsThis is a cross-sectional study of 30,262 female health professionals participating in the Women's Health Study (WHS). Restless legs syndrome was defined according to diagnostic criteria of the International Restless Legs Study Group. Information on vascular risk factors (diabetes, hypertension, hypercholesterolemia, body mass index [BMI], alcohol, smoking, exercise, and family history of myocardial infarction) was self-reported. Cardiovascular disease events (coronary revascularization, myocardial infarction, and stroke) were confirmed by medical record review. Prevalent major cardiovascular disease was defined as nonfatal stroke or nonfatal myocardial infarction. Logistic regression models were used to evaluate the association between vascular risk factors, prevalent cardiovascular disease, and restless legs syndrome. ResultsOf the 30,262 participants (mean age: 63.6 years), 3624 (12.0%) reported restless legs syndrome. In multivariable-adjusted models, BMI (odds ratio [OR] for BMI≥35 kg/m2, 1.35; 95% confidence interval [CI], 1.17-1.56), diabetes (OR, 1.19; 95% CI, 1.04-1.35), hypercholesterolemia (OR, 1.17; 95% CI, 1.09-1.26), smoking status (OR for≥15 cigarettes/day, 1.41; 95% CI, 1.19-1.66), and exercise (OR for exercise≥4 times/week, 0.84; 95% CI, 0.74-0.95) were associated with restless legs syndrome prevalence. We found no association between prevalent cardiovascular disease (major cardiovascular disease, myocardial infarction, and stroke) and restless legs syndrome prevalence. Women who underwent coronary revascularization had a multivariable-adjusted OR of 1.39 (1.10-1.77) for restless legs syndrome. ConclusionsIn this large cohort of female health professionals, various vascular risk factors are associated with the prevalence of restless legs syndrome. We could not confirm the results of previous reports indicating an association between prevalent cardiovascular disease and restless legs syndrome.

Interpretation of Serum Troponin Elevation

Interpretation of Serum Troponin Elevation

Association between Hysterectomy with Ovarian Preservation and Cardiovascular Disease in a Norwegian Population-Based Sample

Background/Aims: Some previous studies have reported that hysterectomy predicts increased prevalence of cardiovascular diseases, but the findings are disputed. We aimed to examine associations between hysterectomy and cardiovascular disease in a Norwegian cross-sectional health study. Methods: The data were obtained from the population-based cross-sectional Nord-Trøndelag Health Study (The HUNT-2 Study). Of 46,709 invited females, 35,280 (76%) participated; 939 (3%) reported hysterectomy without oophorectomy (exposed women). Each exposed woman was age-matched with four randomly chosen women (n = 3,756) without hysterectomy or oophorectomy. Oophorectomy and hysterectomy status was self-reported by the women. Hazard ratio for cardiovascular diseases was calculated by Cox regression analyses with hysterectomy as a time-dependent covariate. Results: Median time since hysterectomy was 14 years (range 0–56 years). We calculated a significantly larger cumulative probability of cardiovascular diseases after hysterectomy with a hazard ratio of 1.92, 95% CI (1.51–2.38) after adjustments for cardiovascular risk factors (diabetes, age, use of hormonal replacement therapy and positive family history of myocardial infarction). Conclusion: Women had a significantly increased risk of cardiovascular diseases after hysterectomy compared to age-matched controls. Studies with longitudinal design and confirmed medical outcome data are needed.

Abstract 19316: Family History of Cardiovascular Disease in a First Degree Relative is Associated with High Risk Profile, but not Healthier Lifestyle

Background: Family history (FH) of premature cardiovascular disease (CVD) and stroke is a risk factor for personal CVD. Engagement in healthy lifestyle behaviors and preventative health screenings may lessen risk. Objective: To compare CVD risk profiles, lifestyle behaviors, and health screening practices of rural Kentucky residents with and without high-risk FH and examine the association of FH with personal CVD diagnosis. Methods: Data were obtained from 687 participants (77% female; age 49 ± 13 years) who completed a FH questionnaire. High-risk FH was defined as having one or more first degree relatives with a history of myocardial infarction (MI) or stroke before age 60 years. CVD risk profile was assessed using the Framingham 10-year risk score for CVD. MOS-Specific Adherence Scale items on activity and diet were used to assess lifestyle behaviors, with unhealthy behavior defined as the response “none of the time” on the 4-point Likert scale. Screening was determined by asking about frequency of blood pressure, glucose, and cholesterol checks by a health professional. Self-reported diagnosis of MI, heart failure, and stroke was used to assess personal CVD. Differences in CVD risk profile, lifestyle behaviors, and screening between those with and without high-risk FH were evaluated using independent samples t-test or Chi square tests. Logistic regression was used to assess the association of FH with personal CVD, controlling for gender, age, and diabetes. Results: A total of 36.8% had a high-risk FH. Those with a high-risk FH had significantly worse CVD risk profiles than those without ( p = .001). The only significant difference in lifestyle behaviors was greater adherence to a low saturated/trans fat diet among persons with high-risk FH compared to those without (80.6% vs. 73.7%, p = .04); no significant differences in screening practices were found. Participants with high-risk FH had a 2.5 times greater odds of personal CVD diagnosis (95% CI 1.4 - 2.5, p = .002). Conclusion: Despite having greater personal risk and worse CVD risk profiles than those without, individuals with a high-risk FH of MI or stroke had similar lifestyle and screening behaviors. Robust preventative interventions are needed to promote effective risk-reduction for high risk individuals.