Prevalence Of Cardiovascular Disease Research Articles

The pattern of cardiovascular disease in River Nile State (October 2019-April 2020)

Background: The rise of cardiovascular diseases poses a significant global threat, not only in terms of morbidity and mortality but also due to their substantial economic burden. Understanding the specific patterns of CVDs within various populations is crucial for effective prevention, early diagnosis, and management. Objective: This study aimed to determine the pattern of cardiovascular disease using echocardiography in River Nile State. Methods: This prospective cross-sectional hospital-based study conducted from October 2019 to April 2020 aimed to ascertain the pattern of cardiovascular diseases using echocardiography in River Nile State. A sample of 1000 participants from Atbara Teaching Hospital, Atbara Complex, and Shendi Teaching Hospital was included. The study population comprised all Sudanese patients undergoing echocardiography in the region. Inclusion criteria involved patients presenting for echocardiography who consented to participate, while refusal to participate constituted exclusion criteria. Data collection involved obtaining written consent from patients and recording echocardiographic findings, including age, gender, and patterns of heart disease, using standardized data sheets. Results: The findings revealed a mean age of 72±6.8 years, with females comprising 64.7% of the sample. Hypertensive heart disease (31.5%) and valvular lesions (29.8%) emerged as the most prevalent cardiovascular diseases. Ischemic heart disease (11.2%), rheumatic heart disease (8.3%), and cardiomyopathy (5.7%) were also notable. Patterns of cardiovascular diseases showed significant associations with age and gender, with hypertensive heart disease and valvular lesions more prevalent in older age groups, while congenital heart disease was more prevalent among younger individuals (20–40 years). Conclusion: The study revealed that hypertensive heart disease (31.5%) and valvular lesions (29.8%) as the dominant CVD patterns. Focusing on these conditions with tailored prevention, early diagnosis, and management is crucial, especially for older individuals. Keywords: Cardiac diseases, Comorbidity, Nile State, Pattern.

Self-Supervised Machine Learning to Characterise Step Counts from Wrist-Worn Accelerometers in the UK Biobank.

Step count is an intuitive measure of physical activity frequently quantified in health-related studies; however, accurate step counting is difficult in the free-living environment, with error routinely above 20% in wrist-worn devices against camera-annotated ground truth. This study aims to describe the development and validation of step count derived from a wrist-worn accelerometer and assess its association with cardiovascular and all-cause mortality in a large prospective cohort. We developed and externally validated a self-supervised machine learning step detection model, trained on an open-source and step-annotated free-living dataset. 39 individuals will free-living ground-truth annotated step counts were used for model development. An open-source dataset with 30 individuals was used for external validation. Epidemiological analysis was performed using 75,263 UK Biobank participants without prevalent cardiovascular disease (CVD) or cancer. Cox regression was used to test the association of daily step count with fatal CVD and all-cause mortality after adjustment for potential confounders. The algorithm substantially outperformed reference models (free-living mean absolute percent error of 12.5%, versus 65-231%). Our data indicate an inverse dose-response association, where taking 6,430-8,277 daily steps was associated with 37% [25-48%] and 28% [20-35%] lower risk of fatal CVD and all-cause mortality up to seven years later, compared to those taking fewer steps each day. We have developed an open and transparent method that markedly improves the measurement of steps in large-scale wrist-worn accelerometer datasets. The application of this method demonstrated expected associations with CVD and all-cause mortality, indicating excellent face validity. This reinforces public health messaging for increasing physical activity and can help lay the groundwork for the inclusion of target step counts in future public health guidelines.

Predicting heart failure symptoms from the apnoea-hypopnoea index determined by full- night polysomnography.

Sleep-disordered breathing (SDB) is closely related to cardiovascular diseases. The higher the apnoea-hypopnoea index (AHI), the higher the prevalence of cardiovascular diseases. Despite these findings suggesting a close link between SDB and heart failure, the relationship between the severity of SDB and the onset of heart failure symptoms in individuals without apparent heart failure symptoms (Heart Failure Stage A+B) remains poorly understood. Between December 2010 and June 2017, we conducted full-night polysomnography (PSG) at the Nippon Medical School Chiba Hokusoh Hospital, extracting patients who were at risk of heart failure (Stage A or B in the Heart Failure Guidelines). Using a median cut-off of AHI≥41.6 events/hour, we divided the patients into two groups and examined the composite endpoint of all-cause mortality plus hospitalization due to heart failure as the primary endpoint. We included 230 patients (mean age 63.0±12.5years, 78.3% males) meeting the selection criteria. When comparing the two groups, those with AHI<41.6 events/hour (L group, n=115) and those with AHI≥41.6 events/hour (H group, n=115), the H group had higher body mass index and higher serum triglyceride, and lower the frequency of acute coronary syndrome and lower estimated glomerular filtration rate than did the L group, but no other patient characteristics differed significantly. The H group had a significantly higher incidence of the composite endpoint than did the L group (10.6% vs. 2.6%, P=0.027). Factors associated with the composite endpoint were identified through multivariate analyses, with AHI, haemoglobin, and left atrial dimension emerging as significant factors (hazard ratio [HR]=1.02, 95% confidence interval [CI]=1.00-1.04, P=0.024; HR=0.71, 95% CI=0.54-0.94, P=0.017; and HR=1.10, 95% CI=1.03-1.18, P=0.006, respectively). Conversely, the minimum SpO2 during PSG (<80%) was not associated with the composite endpoint. In patients with SDB who are at risk of heart failure, severe SDB is associated with a high risk of all-cause mortality and the development of heart failure. Additionally, combining cardiac echocardiography and PSG data may improve risk stratification, offering potential assistance for early intervention. Further examination with a validation cohort is necessary.

Examining the relationship between Life’s Essential 8 and atherosclerotic cardiovascular disease among Adults in the United States: Insights from the National Health and Nutrition Examination Surveys (2017-2020)

The American Heart Association recently updated the assessment of cardiovascular health (CVH) with the Life&amp;rsquo;s Essential 8 (LE8) score. Our cross-sectional analytical study utilized data from 5042 adults in the United States (US) from the 2017 to 2020 NHANES surveys to examine the relationship between CVH assessed by LE8 metrics and the prevalence of atherosclerotic cardiovascular disease (ASCVD). Multivariate linear regressions were utilized to explore the relationship between CVH metrics and ASCVD, while linear probability models were used to predict ASCVD prevalence based on achieved LE8 scores. Controlling for relevant covariates revealed an inverse association between LE8 metrics and ASCVD prevalence. Improvements in LE8 were linked to a 29% reduction in ASCVD prevalence, with transitions to higher LE8 quartiles predicting a 4.8% reduction in ASCVD prevalence. Subgroup analysis indicated significant effects of age, education, and gender on ASCVD prevalence, with younger age, college education, and the female gender being associated with lower prevalence (P &lt; 0.05). Higher LE8 scores correlated with decreased ASCVD prevalence, while factors such as younger age, college education, and the female gender were also associated with lower ASCVD prevalence. Conversely, transitioning from married to divorced/widowed/separated status was linked to increased ASCVD prevalence (P &lt; 0.01).

Cardiometabolic factors and population risks of cardiovascular disease in community-dwelling adults with varied blood pressure statuses.

To examine the differential associations between cardiometabolic risk factors and cardiovascular disease (CVD), and to evaluate the population-attributable fractions (PAFs) for CVD among community-dwelling adults with varied blood pressure (BP) statuses. This prospective cohort study included participants without prevalent CVD from a subcohort of the China Patient-Centred Evaluative Assessment of Cardiac Events Million Persons Project. Participants were divided into four BP groups according to the American College of Cardiology/American Heart Association guidelines. The study exposure comprised the selected cardiometabolic risk factors, including waist circumference (WC), body mass index, (BMI) heart rate, fasting blood glucose (FBG), low-density lipoprotein cholesterol, and remnant cholesterol. The outcome was hospitalizations for CVD. Cox proportional hazard models were conducted, and the PAFs were calculated in the analysis. Among the 94 183 participants (39.0% were men, mean age: 54.2 years), 26.6% had Stage 1 hypertension and 30.8% had Stage 2 hypertension. A total of 6065 hospitalizations for CVD were captured after a median follow-up of 3.5 years. BP (per 1-standard deviation [SD]: hazard ratio [HR] 1.34, 95% confidence interval [CI] 1.29, 1.40), FBG (per 1-SD: HR 1.16, 95% CI 1.14, 1.19) and WC (per 1-SD: HR 1.41, 95% CI 1.36, 1.47) were three major contributors to CVD events. BP status significantly modified the associations of abdominal obesity, suboptimal BMI, suboptimal heart rate and abnormal FBG with CVD, with stronger associations with CVD observed in optimal BP groups compared to hypertensive groups (p for risk factor-by-BP group interaction <0.05). Participants with all cardiometabolic risk factors were at the highest risk for CVD, accounting for 35.6% (95% CI 30.0, 40.8) of the PAF for CVD. Among the risk factors, BP control explained the highest PAF for CVD (15.1%, 95% CI 8.2, 21.4) The overall PAFs of cardiometabolic risk factors for CVD were higher among the normotensive participants compared to the hypertensive participants. The awareness and control rates of hypertension were extremely low among Southern Chinese adults. BP status significantly modified the associations between cardiometabolic risk factors and CVD, and the overall PAFs for CVD were higher among people with normal BP. Dedicated efforts are needed to improve the management of cardiometabolic factors.

Automatic multi-label diagnosis of single-lead ECG using novel hybrid residual recurrent convolutional neural networks

Arrhythmia is a prevalent cardiovascular disease that can unveil various heart health issues. In recent times, the rise of wearable devices has garnered attention towards the advantages of portable single-lead ECG devices in heart health monitoring. Achieving end-to-end ECG automatic diagnosis through deep learning is essential due to the time-consuming and labour-intensive characteristics of manual diagnosis of ECG records. This paper presents the design of a hybrid residual recurrent convolutional neural network (HRRCNN) for automatically diagnosing single-lead ECG with multiple labels. Firstly, the convolutional layers and residual networks extract the spatial and short-term temporal features. Subsequently, a hybrid recurrent neural network (RNN) comprised of a double-layer bidirectional gated recurrent unit (GRU) and a bidirectional long short-term memory (LSTM) is employed to capture long and short-term temporal features. Finally, an output layer, comprising an attention layer and a fully connected layer, converts the extracted features into classification results. To evaluate the performance of HRRCNN, a dataset from the Shanghai First People’s Hospital Affiliated to Shanghai JiaoTong University(Shanghai General Hospital, SGH) is utilized. The experimental results demonstrate that HRRCNN achieves an accuracy of 95.08 %, F1-macro of 87.22 %, Sensitivity of 88.51 %, and a positive prediction rate of 86.13 %. Comparative analysis with existing methods underscores the superior performance of HRRCNN, thereby establishing its potential as an out-of-hospital heart health monitoring tool and an auxiliary tool in clinical settings.

The association between the triglyceride–glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study

BackgroundThe relationship between the triglyceride–glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes.MethodsWe used data from the 2003–2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted.ResultsThe study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes.ConclusionsA higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.

Evaluation of Socio-demographic Factors and Comorbidities in Adult Hemophilia Patients

Purpose: The association between socio-demographic factors and hemophilia status and the prevalence of comorbidities were evaluated. Material and Methods: Patients with hemophilia A (n=111) and B (n=24) who were filled a questionnaire form about their sociodemographic factors were included in our study. Factor and inhibitor levels, comorbidities, factor replacement therapies, hemophilic arthropathy, viral status and annual bleeding episodes were recorded. Results: Median age was 39 years in 135 hemophilia patients and 63.1 % of all the patients had severe hemophilia which was significantly higher among hemophilia A patients (p=0.002). Most of the patients (74.8%) were treated with prophylactic factor replacement therapy. Inhibitor status was positive in 8.9% of all patients. Unemployment rate was found 33.3%. Annual bleeding episodes were higher in patients who had a job. Most of the patients (60 %) were graduated from at least high school. The prevalence of cardiovascular disease, hypertension, diabetes mellitus and obesity were 6.7%; 17.8%, 13.3%, 11.9% respectively. Although there is no association between the obesity and annual bleeding episodes, right ankle was the most affected joint in overweight/obese patients. Conclusion: Age-related comorbidities and the relation of hemophilia status and social life are needed to be more investigated.

Cardiovascular calcification in hemodialysis patients: A Qatar-based prevalence and risk factors study.

Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of death due to the high prevalence of cardiovascular disease. Vascular calcification (VC) is predictive of cardiovascular disease and mortality. We conducted a study to evaluate the prevalence and risk factors for VC in dialysis patients in Qatar. This is a retrospective nationwide study including all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Calcifications were assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound. The study protocol was approved by the local medical research ethics committee (MRC-01-20-377). 842 HD patients were included in this study. Vascular calcifications (VC) were prevalent in 52.6% of patients. The main site of VC was Mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older and had more prevalence of diabetes mellitus (p = 0.001 and p = 0.006, respectively). There was no statistically significant difference between patients with calcifications and patients without calcifications regarding serum calcium, phosphorus, and PTH level. In multivariate analysis, age and diabetes significantly increased the risk factor for calcification (95% CI 1.033-1.065, p < 0.0001, and 95% CI 1.128-2.272, p < 0001, respectively). Moreover, higher vitamin D levels and higher doses of IV Alfacalcidol were significant risk factors for calcifications (95% CI 1.005-1.030, p < 0.007, and 95% CI 1.092-1.270, p < 0.0001, respectively). Our study found that vascular calcification was widespread among our dialysis population in Qatar. Implementing the practice of echocardiography in dialysis patients was extremely helpful and the most productive in detecting vascular calcification. Diabetes mellitus almost doubles the risk for vascular calcifications in dialysis patients. These results are beneficial in identifying risk factors for vascular calcification, which can help stratify dialysis patients' risk of cardiovascular disease and optimize prevention efforts.

Trends and Disparities in Treatment and Control of Atherosclerotic Cardiovascular Disease in US Adults, 1999 to 2018.

Although cardiovascular mortality continued declining from 2000 to 2019, the rate of this decrease decelerated. We aimed to assess the trends and disparities in risk factor control and treatment among US adults with atherosclerotic cardiovascular disease to find potential causes of the deceleration. A total of 55 ,021 participants, aged ≥20 years, from the 1999 to 2018 National Health and Nutrition Examination Survey were included, of which 5717 were with atherosclerotic cardiovascular disease. Risk factor control was defined as hemoglobin A1c <7%, blood pressure <140/90 mm Hg, and non-high-density lipoprotein cholesterol <100 mg/dL. The prevalence of atherosclerotic cardiovascular disease oscillated between 7.3% and 8.9% from 1999 to 2018. A significant increasing trend was observed in the prevalence of diabetes, obesity, heavy alcohol consumption, and self-reported hypertension within the population with atherosclerotic cardiovascular disease (Ptrend≤0.001). Non-high-density lipoprotein cholesterol <100 mg/dL increased from 7.1% in 1999 to 2002 to 15.7% in 2003 to 2006, before plateauing. Blood pressure control (<140/90 mm Hg) increased until 2011 to 2014, but declined to 70.1% in 2015 to 2018 (Ptrend<0.001, Pjoinpoint=0.14). Similarly, the proportion of participants achieving hemoglobin A1c control began to decrease after 2006 (Pjoinpoint=0.05, Ptrend=0.001). The percentage of participants achieving all 3 targets increased significantly from 4.5% to 18.6% across 1999 to 2018 (Ptrend=0.02), but the increasing trend decelerated after 2005 to 2006 (Pjoinpoint<0.001). Striking disparities in risk factor control and medication use persisted between sexes, and between different racial and ethnic populations. Worsened control of glycemia, blood pressure, obesity, and alcohol consumption, leveled lipid control, and persistent socioeconomic disparities may be contributing factors to the observed deceleration in decreasing cardiovascular mortality trends.

Prevalence of metabolic and cardiovascular diseases in Hidradenitis Suppurativa

Prevalence of metabolic and cardiovascular diseases in Hidradenitis Suppurativa

The association between weight loss medications and cardiovascular complications.

Obesity and its cardiovascular complications are major causes of morbidity and mortality. Little is known in real-world settings about the effect of newly approved antiobesity medications (AOMs) on cardiovascular complications among patients with obesity. This retrospective cohort study examined the association between newly approved AOM use and cardiovascular events among Medicare patients with obesity using data from 2020 to 2022. Patient age, gender, comorbidity scores, socioeconomic status, and baseline cardiovascular comorbidities were compared descriptively. Subgroup analysis compared variables by medication type. Relative risk and absolute risk of cardiovascular disease (CVD) events were estimated using Cox and Aalen regression models. The analysis included 5926 patients treated with semaglutide and tirzepatide, including Ozempic (5404 patients), Wegovy (375 patients), or Mounjaro (147 patients). Hypertension, type 2 diabetes, and hyperlipidemia were the most common comorbidities. For patients with AOMs, less incidence of heart failure (4.89% vs. 6.13%, p < 0.0001), atrial fibrillation (3.83% vs. 5.17%, p < 0.0001), arrhythmia (3.59% vs. 4.14%, p < 0.0153), and peripheral vascular disease (3.44% vs. 2.94%, p < 0.0395) was found versus patients without AOMs. Patients receiving AOMs showed an 8% risk reduction in any CVD. Protective effect on CVD was apparent over the first 375 days. Results suggest that utilization of AOMs effectively alleviates the high prevalence of CVD.

EFFECTS OF PTEROSTILBENE ON HEART AND LUNG OXIDATIVE STRESS PARAMETERS IN TWO EXPERIMENTAL MODELS OF CARDIOVASCULAR DISEASE: MYOCARDIAL INFARCTION AND PULMONARY ARTERIAL HYPERTENSION.

Myocardial infarction (MI) and pulmonary artery hypertension (PAH) are two prevalent cardiovascular diseases. In both conditions, oxidative stress is associated with a worse prognosis. Pterostilbene (PTE), an antioxidant compound, has been studied as a possible therapy for cardiovascular diseases. This study aims to evaluate the effect of PTE on oxidative stress in the hearts of animals with myocardial infarction and in the lungs of animals with PAH. Male Wistar rats were used in both models. In the MI model, the experimental groups were sham, MI, and MI+PTE. In PAH model, the experimental groups were control, PAH, and PAH+PTE. Animals were exposed to MI through surgical ligation of the left coronary artery, or to PAH, by administration of monocrotaline (60 mg/kg). Seven days after undergoing cardiac injury, the MI+PTE animals were treated with PTE (100 mg/kg day) for 8 days. After this, the heart was collected for molecular analysis. The PAH+PTE animals were treated with PTE (100 mg/kg day) for 14 days, beginning 7 days after PAH induction. After this, the lungs were collected for biochemical evaluation. We found that PTE administration attenuated the decrease in ejection fraction and improved LV end-systolic volume in infarcted animals. In the PAH model, PTE improved pulmonary artery flow and decreased ROS levels in the lung. PTE administration promoted protective effects in terms of oxidative stress in two experimental models of cardiac diseases: MI and PAH. PTE also improved cardiac function in infarcted rats and pulmonary artery flow in animals with PAH.

Drivers of access to cardiovascular health care for rural Indigenous Peoples: a scoping review.

M&#257;ori (the Indigenous Peoples of Aotearoa New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD health care. Rural M&#257;ori experience additional barriers to treatment access, poorer health outcomes and a greater burden of CVD risk factors compared to Non-M&#257;ori and M&#257;ori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous Peoples in other nations impacted by colonisation. Given the scarcity of available literature, a systematic scoping review was conducted on literature exploring barriers and facilitators in accessing CVD health care for rural M&#257;ori and other Indigenous Peoples in nations impacted by colonisation. The review was underpinned by Kaupapa M&#257;ori Research methodology and was conducted utilising Arksey and O'Malley's (2005) methodological framework. A database search of MEDLINE (OVID), PubMed, Embase, SCOPUS, CINAHL Plus, Australia/New Zealand Reference Centre and NZResearch.org was used to explore empirical research literature. A grey literature search was also conducted. Literature based in any healthcare setting providing care to adults for CVD was included. Rural or remote Indigenous Peoples from New Zealand, Australia, Canada, and the US were included. Literature was included if it addressed cardiovascular conditions and reported barriers and facilitators to healthcare access in any care setting. A total of 363 articles were identified from the database search. An additional 19 reports were identified in the grey literature search. Following screening, 16 articles were included from the database search and 5 articles from the grey literature search. The literature was summarised using the Te Tiriti o Waitangi (Treaty of Waitangi) Framework principles: tino rangatiratanga (self-determination), partnership, active protection, equity and options. Themes elucidated from the literature were described as key drivers of CVD healthcare access for rural Indigenous Peoples. Key driver themes included input from rural Indigenous Peoples on healthcare service design and delivery, adequate resourcing and support of indigenous and rural healthcare services, addressing systemic racism and historical trauma, providing culturally appropriate health care, rural Indigenous Peoples' access to family and wellbeing support, rural Indigenous Peoples' differential access to the wider social determinants of health, effective interservice linkages and communication, and equity-driven and congruent data systems. The findings are consistent with other literature exploring access to health care for rural Indigenous Peoples. This review offers a novel approach to summarising literature by situating the themes within the context of equity and rights for Indigenous Peoples. This review also highlighted the need for further research in this area to be conducted in the context of Aotearoa New Zealand.

The association between triglyceride-glucose index and the likelihood of cardiovascular disease in the U.S. population of older adults aged ≥ 60 years: a population-based study

BackgroundThe association between the triglyceride-glucose (TyG) index and the likelihood of developing cardiovascular disease (CVD) in the general elderly population in the United States aged 60 and above is not well understood. The objective of our study was to examine the relationship between the TyG index and CVD likelihood in the general elderly population over 60 years of age in the United States.MethodsData for this cross-sectional study were sourced from the 2003–2018 National Health and Nutrition Examination Survey. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between the TyG index and the likelihood of CVD. Non-linear correlations were explored using restricted cubic splines.ResultsA total of 6502 participants were included, with a mean TyG index of 8.75 ± 0.01. The average prevalence of CVD was 24.31% overall. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 19.91%; Quartile 2: 21.65%; Quartile 3: 23.82%; Quartile 4: 32.43%). For CVD, a possible association between the TyG index and the odds of CVD was observed. Our findings suggest a nonlinear association between the TyG index and the odds of CVD. The threshold of 8.73 for the likelihood of CVD. Interaction terms were employed to assess heterogeneities among each subgroup, revealing a significant difference specifically in alcohol consumption. This suggests that the positive association between the TyG index and the likelihood of CVD is dependent on the drinking status of the participants.ConclusionA higher TyG index is linked to an increased likelihood of CVD in US adults aged ≥ 60 years. TyG index is anticipated to emerge as a more effective metric for identifying populations at early likelihood of CVD.

Abstract PO3-27-05: Racioethnic and Ancestral Differences in Risk of Cardiometabolic Conditions and Cardiovascular Disease in Women Treated for Breast Cancer: the Pathways Heart Study

Abstract Background: Despite the established literature of racioethnic disparities in cardiovascular disease (CVD) in the general population, few studies have examined such differences in women after BC treatment, who are at higher risk due to cardiotoxic cancer treatment. Moreover, few prior studies have considered genetic similarity among the participants in the analyses, which can be objectively inferred to delineate the ancestral background of an individual. Methods: The Pathways Heart Study was established to investigate the incidence of cardiometabolic risk factors and CVD events in women with a history of BC at Kaiser Permanente Northern California (KPNC). The main study endpoints for this analysis were cardiometabolic risk factors (hypertension, diabetes, and dyslipidemia) and CVD events, identified by ICD and CPT codes from EHR. Prevalent conditions were identified within 3 years prior to the date of BC diagnosis, and incident conditions were from the date of BC diagnosis to December 31, 2021. Ethnicity was self-reported and classified as non-Hispanic White (NHW), non-Hispanic Black (NHB), Asian, Hispanic, other, or unknown. Global genetic ancestry was estimated to capture the proportion of continental ancestries genetically similar to the reference populations in Africa, Americas, Asia, and Europe from the 1000 Genome Project and Human Genome Diversity Project (HGDP), which, with the current lack of universally accepted labeling, are herein referred to as African, Native American, Asian, and European ancestry, respectively. Multivariable logistic and Cox proportional hazards regression models with all-cause mortality considered as competing risk were used to analyze the associations of race and ethnicity and genetic similarity with prevalent and incident cardiometabolic risk factors and CVD events. Results: Of the 4,071 women with BC in this analysis, 2,713 (66.6%) self-reported as NHW, 305 (7.5%) as NHB, 512 (12.6) as Asian, 447 (11.0%) as Hispanic, and 94 (2.3%) as other or unknown. NHB, Asian, and Hispanic women were more like to have prevalent diabetes than NHW women, the pattern of which persisted after BC diagnosis. Adjusted OR (95% CI) of risk of incident diabetes was 1.74 (1.21-2.49) for NHB, 3.63 (2.59-5.08) for Asian, and 2.19 (1.58-3.04) for Hispanic women, as compared to NHW. Analysis of genetic similarity revealed results consistent with self-reported race and ethnicity (sHR [95% CI] per 25% increment of African ancestry 1.19 [1.07-1.34], Asian ancestry 1.57 [1.44-1.72], and Native American ancestry 1.60 [1.29-2.00]), in comparison to European ancestry. For CVD risk, NHB women were more like to develop any prevalent and incident CVD than NHW women, particularly for ischemic heart disease (incident risk sHR=1.80 [1.10-2.94]). Genetic similarity analyses also showed higher risk of ischemic heart disease associated with African ancestry (incident risk per 25% increment, sHR=1.23 [1.06-1.43]). In contrast, Hispanic women were at lower risk of any incident CVD, serious CVD, arrhythmia, heart failure or cardiomyopathy, and ischemic heart disease. Similarly, lower risk of these CVD conditions was associated with Native American ancestry. Conclusions: Compared with women who self-reported as NHW, those self-reported as NHB, Asian, and Hispanic were at higher risk of diabetes prior to BC diagnosis and the elevated risk persisted after BC diagnosis. Moreover, Black women had higher risk of prevalent and incident CVD, whereas Hispanic women had lower risk of CVD, the latter of which might be related to the admixture of Native American ancestry. To our knowledge, this is the largest multi-ethnic study of disparities in CVD health in women post BC treatment, demonstrating corroborating findings between self-reported race and ethnicity and genetic similarity. The results highlight disparities in cardiometabolic risk factors and CVD among BC survivors that may warrant more research and clinical attentions. Citation Format: Song Yao, Haiyang Sheng, Peter Fiorica, Richard Cheng, Lucas Mendicino, Angela Omilian, Qianqian Zhu, Janise Roh, Cecile Laurant, Valerie Lee, Isaac Ergas, Carlos Iribarren, Jamal Rana, Mai Nguyen-Huynh, Eileen Rillamas-Sun, Dawn Hershman, Christine Ambrosone, Lawrence Kushi, Heather Greenlee, Marilyn Kwan. Racioethnic and Ancestral Differences in Risk of Cardiometabolic Conditions and Cardiovascular Disease in Women Treated for Breast Cancer: the Pathways Heart Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-27-05.

Abstract PO5-12-03: Cardiovascular Toxicities in Breast Cancer Survivors

Abstract Background: Chemotherapy, despite its effectiveness, presents drawbacks in breast cancer patients due to its side effects. Fatigue, hair loss, nausea, and anemia are among the many symptoms associated with chemotherapy. Moreover, chemotherapy can lead to cardiovascular diseases, including cardiac arrhythmias, hypertension, heart failure, heart attacks, and cardiomyopathy, particularly with the use of anthracyclines and HER-2-targeted agents. Risk factors such as weight, age, race, comorbidities (e.g., obesity, diabetes, hyperlipidemia), and radiation exposure further increase these risks. Despite these potential complications, guidelines are just emerging aiming to prevent these cardiovascular complications in breast cancer patients. Untreated cardiovascular abnormalities can have long-term effects on breast cancer survivors. Our aim is to analyze the relationships between breast cancer treatment and cardiovascular abnormalities, examining associations with various factors, including race, BMI, and age in a majority Hispanic cohort of breast cancer survivors. Methods: retrospective, single institution study data from a total of 53 patients treated with chemotherapy with either anthracyclines and/or HER 2 directed therapy with curative intent between 2018-2020. Our analysis included basic demographic information, menopausal status, breast cancer type, treatment types, use of cardio-protective medications, and cardiovascular effects (both pre-existing and developed during treatment). Results: Our sample of 50 women primarily comprised Hispanic individuals (73%), most of whom were postmenopausal (86%), with an average age of 63 years (range 35-86). Among the breast cancer types identified, 35 were hormone-positive, 8 were HER-2 positive, and 10 were triple negative. 72% of the patients received adjuvant hormonal therapy. 18% of the population received anthracycline-based treatment, 8% received Her 2 directed therapy and 2 % received Immune check point inhibitors. Radiation therapy was administered to 50% of the patients. The most prevalent cardiovascular disease observed was hypertension, affecting 62% of patients, followed by type 2 diabetes (38%), hyperlipidemia (34%), stroke (8%), and heart attack (6%). The predominant cardioprotective medications used were ACE inhibitors/ARBs (48%), followed by statins (46%), beta-blockers (20%), aspirin (16%), and GLP-1 agonists (14%). Conclusion: Our analysis revealed a high prevalence of cardiovascular conditions among breast cancer survivors treated with chemotherapy in a majority Hispanic cohort of patients. This population has been linked to higher risk of developing comorbidities such as diabetes, obesity and hypertension. Further analysis evaluating risk factors and implementation of treatment strategies to minimize adverse effects is needed in this population. Citation Format: Victoria Ayodele, Emily Sherry, Marcela Mazo-Canola. Cardiovascular Toxicities in Breast Cancer Survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-03.

PHYSICAL ACTIVITY IS ASSOCIATED WITH IMPROVED SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN THE UK BIOBANK

INTRODUCTION &amp; AIM Physical activity (PA) is known to be associated with a decreased risk of all-cause and cardiovascular mortality in apparently healthy adults. The association between PA and risk of death for individuals with prevalent cardiovascular disease (CVD) at baseline is less well understood. Therefore, the aim of this study was to determine the association between PA levels and survival in individuals with prevalent CVD at baseline. METHODS A survival analysis involving 38,291 UK Biobank participants with prevalent CVD at baseline was conducted. Physical activity was assessed using accelerometry-calibrated PA which measures total energy expended in PA. Prevalent CVD, all-cause mortality, and CVD mortality were determined through ICD-10 codes and data linkage through death and hospital records. Cox proportional hazard models were used to estimate the risk of all-cause, overall cardiovascular, and specific CVD category mortality for quartiles of PA after adjusting for known confounders. RESULTS There were 6,540 all-cause deaths and 3,559 cardiovascular deaths with median follow up time of 11.98 years. The risk of all-cause and overall cardiovascular mortality reduced with increasing dose of PA (highest vs lowest PA; HR = 0.70, 95% CI: 0.64 - 0.76 and 0.70, 95% CI: 0.62 - 0.79, respectively). Those in the highest quartile of PA had a 41% reduced risk of dying from cerebrovascular disease and a 38% reduced risk of dying from and hypertensive diseases (including hypertensive heart disease with heart failure). CONCLUSION Higher levels of PA are associated with lower risk of all-cause and overall cardiovascular mortality in individuals with prevalent CVD at baseline. These findings highlight the importance of PA in secondary prevention of cardiovascular disease.

Use of melatonin supplements and risk of type 2 diabetes and cardiovascular diseases in the USA: insights from three prospective cohort studies

Use of melatonin supplements has been increasing substantially in both children and adults in the USA; however, their long-term cardiometabolic effects remain unclear. We aimed to assess the associations between regular use of melatonin supplements and the risk of developing type 2 diabetes or cardiovascular disease in adults. In this study, we included individuals from three US cohorts: the Nurses' Health Study (women only), the Health Professionals Follow-up Study (men only), and the Nurses' Health Study II (women only). Women aged 25-55 years and men aged 45-75 years at baseline, who had no diagnosis of cancer at baseline, and who responded to the question about melatonin supplement use (yes or no) were included. We excluded baseline prevalent cardiovascular disease and baseline prevalent type 2 diabetes for the main analyses. The main outcomes were cardiovascular disease and type 2 diabetes incidence. In secondary analyses, we stratified by duration of rotating night shift work in the Nurses' Health Study and Nurses' Health Study II to examine whether the associations with melatonin supplement use differed by rotating night shift work. For the cardiovascular disease analysis, we included 67 202 women from the Nurses' Health Study (follow-up 1998-2019, mean age at baseline: 63·6 years [SD 7·1]), 26 629 men from the Health Professionals Follow-up Study (1998-2020, 62·9 years [8·8], and 65 241 women from the Nurses' Health Study II (2003-19, 48·2 years [4·7]). Follow-up for incident type 2 diabetes was from 1998 to June 30, 2021, for the Nurses' Health Study; 2003 to Jan 31, 2023, for the Nurses' Health Study II; and from 1998 to Jan 31, 2020, for the Health Professionals' Follow-up Study. Melatonin supplement use in the study cohorts doubled over recent decades from less than 2% in 1998-2007 to 4% or higher in 2014-15 (4·0% in men and 5·3% in women). We documented 16 917 incident cardiovascular disease events during 2 609 068 person-years of follow-up and 12 730 incident cases of type 2 diabetes during 2 701 830 person-years of follow-up. In a pooled analysis of the three cohorts, comparing users with non-users of melatonin supplements, the pooled multivariable-adjusted hazard ratios were 0·94 (95% CI 0·83-1·06, p=0·32) for cardiovascular disease and 0·98 (0·86-1·12, p=0·80) for type 2 diabetes. In secondary analyses, melatonin supplement use appeared to attenuate the positive association between long-term shift work (>5 years) and risk of cardiovascular disease (pinteraction=0·013) among the female nurses. With up to 23 years of follow-up of three large prospective cohorts of middle-aged and older men and women, self-reported melatonin supplement use was not associated with risk of type 2 diabetes or cardiovascular disease. Further research is warranted to assess if melatonin supplement use could mitigate the potential risks of type 2 diabetes and cardiovascular disease associated with rotating night shift work. US National Institutes of Health.

Pyroptosis inhibitors MCC950 and VX-765 mitigate myocardial injury by alleviating oxidative stress, inflammation, and apoptosis in acute myocardial hypoxia

Acute myocardial infarction (AMI) is a prevalent cardiovascular disease with high morbidity and mortality rates worldwide. Pyroptosis is an inflammatory form of programmed cell death that has been linked to various pathological conditions. However, its exact contribution to the onset and progression of heart injury in AMI has not yet fully elucidated. Herein, we established mouse AMI model by ligating the left anterior descending artery and performed transcriptome analysis during the early phase of AMI. Mouse HL-1 and human AC-16 cardiomyocytes were subjected to hypoxia to simulate ischemic injury in vitro. Our results revealed a significant activation of the inflammatory response at 3 h post-ligation, as confirmed by RNA sequencing. We identified the occurrence of NLRP3 inflammasome-mediated pyroptosis in the cardiac tissues of human cases with AMI, as well as in mouse models of AMI and hypoxia-induced cardiomyocytes, using immunohistochemistry staining and Western blotting assays. Concurrently, pharmacological inhibition of NLRP3 inflammasome-mediated pyroptosis with MCC950 and VX-765 effectively decreased hypoxia-induced cardiomyocytes injury, while mitigating myocardial oxidative stress, apoptosis and inflammation caused by hypoxia. Moreover, the circulating levels of gasdermin D (GSDMD), the pyroptosis executor, were remarkably elevated in the plasma of mice with early AMI and in the supernatant of hypoxia-exposed cardiomyocytes in a time-dependent manner using ELISA and Western blotting. Furthermore, the change in circulating GSDMD positively correlated with Creatine Kinase-MB (CK-MB) in the plasma of early-stage AMI mouse. In summary, these findings indicated a critical role for NLRP3 inflammasome-mediated pyroptosis in the progression of AMI, the administration of MCC950 and VX-765 may be attractive candidate therapeutic approaches for cardiac injury caused by acute hypoxia or even AMI. Additionally, the circulating GSDMD exhibits potential as a newly diagnostic biomarker for AMI.