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Incident Myocardial Infarction (incident + myocardial_infarction)
Selected AbstractsAbdominal Aortic Calcification Detected on Lateral Spine Images From a Bone Densitometer Predicts Incident Myocardial Infarction or Stroke in Older WomenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2008John T Schousboe MD Abstract Among a cohort of elderly women, abdominal aortic calcification scored on baseline lateral spine densitometric images intended for vertebral fracture assessment was associated with subsequent myocardial infarction or stroke over a median 4-yr period, independent of clinical cardiovascular disease risk factors. Introduction: Cardiovascular disease (CVD) risk among older women is not adequately captured by traditional CVD risk factors. Lateral spine images obtained on bone densitometers for vertebral fracture assessment (VFA) can detect abdominal aortic calcification (AAC), an important marker of subclinical CVD. Our objective was to estimate the association between AAC scored on VFA images and subsequent myocardial infarction (MI) or stroke in elderly women. Materials and Methods: Among participants in a randomized controlled trial (women; age >75 yr) of clodronate versus placebo, those who sustained an MI or stroke during the median 4-yr follow-up study period were selected as cases (n = 408), and 408 controls were randomly selected from the remainder of the parent study population. Baseline VFA images were scored for AAC with a previously validated 24-point scale and a newer, simpler 8-point scale. Results: The OR of incident MI or stroke for those in the middle and top tertiles, respectively, compared with the bottom tertile of AAC score were 1.14 (95% CI, 0.79,1.66) and 1.74 (95% CI, 1.19,2.56) for the 24-point scale and 1.42 (95% CI, 0.98,2.05) and 1.77 (95% CI, 1.22,2.55) for the 8-point scale, adjusted for age, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, blood pressure, smoking, renal function, health status, and baseline diagnoses of diabetes mellitus, hypertension, angina, and prior stroke. Conclusions: AAC scored on VFA images is independently associated with incident MI or stroke. Because bone densitometry is indicated for all women ,65 yr of age, VFA imaging offers an opportunity to capture this CVD risk factor in postmenopausal women undergoing bone densitometry at very little additional cost. [source] Abdominal aortic calcification on vertebral morphometry images predicts incident myocardial infarctionJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2010Mark J Bolland Abstract Abdominal aortic calcification (AAC) measured on spine X-rays is an established risk factor for cardiovascular disease. We investigated whether AAC assessed using vertebral morphometry and a recently developed scoring system (AAC-8) is reliable and associated with cardiovascular risk factors or events. A total of 1471 healthy postmenopausal women and 323 healthy middle-aged and older men participated in 5 and 2,year trials of calcium supplements, respectively. AAC-8 was assessed on vertebral morphometry images at baseline and follow-up. In addition, 163 men also had coronary artery calcification measured using computed tomography. Cardiovascular events during the trials were independently adjudicated. We found strong inter- and intrameasurer agreement for AAC-8 (,,>,0.87). The prevalence of AAC increased with age (p,<,.01) in women and in men. AAC was associated with many established cardiovascular risk factors, with serum calcium in women (p,=,.002) and with higher coronary calcium scores in men (p,=,.03). Estimated 5,year cardiovascular risk increased with increasing AAC-8 score (p,<,.001) in women and in men. The presence of AAC independently predicted myocardial infarction (MI) in women [hazards ratio (HR),=,2.30, p,=,.007] and men (HR,=,5.32, p,=,.04), even after adjustment for estimated cardiovascular risk in women. In women, AAC independently predicted cardiovascular events (MI, stroke, or sudden death) (HR,=,1.74, p,=,.007), and changes in AAC-8 score over time were associated with MI and cardiovascular events, even after adjustment for estimated cardiovascular risk. In summary, scoring AAC on vertebral morphometric scans is a reproducible method of assessing cardiovascular risk that independently predicts incident MI and cardiovascular events, even after taking into account traditional cardiovascular risk factors. © 2010 American Society for Bone and Mineral Research [source] Variation in 24 hemostatic genes and associations with non-fatal myocardial infarction and ischemic strokeJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2008N. L. SMITH Summary., Background:, Arterial thrombosis involves platelet aggregation and clot formation, yet little is known about the contribution of genetic variation in fibrin-based hemostatic factors to arterial clotting risk. We hypothesized that common variation in 24 coagulation,fibrinolysis genes would contribute to risk of incident myocardial infarction (MI) or ischemic stroke (IS). Methods:, We conducted a population-based, case,control study. Subjects were hypertensive adults and postmenopausal women 30,79 years of age, who sustained a first MI (n = 856) or IS (n = 368) between 1995 and 2002, and controls matched on age, hypertension status, and calendar year (n = 2689). We investigated the risk of MI and IS associated with (i) global variation within each gene as measured by common haplotypes and (ii) individual haplotypes and single nucleotide polymorphisms (SNPs). Significance was assessed using a 0.2 threshold of the false discovery rate q -value, which accounts for multiple testing. Results:, After accounting for multiple testing, global genetic variation in factor (F) VIII was associated with IS risk. Two haplotypes in FVIII and one in FXIIIa1 were significantly associated with increased IS risk (all q -values < 0.2). A plasminogen gene SNP was associated with MI risk. All are new discoveries not previously reported. Another 24 tests had P -values < 0.05 and q -values > 0.2 in MI and IS analyses, 23 of which are new and hypothesis generating. Conclusions:, Apart from the association of FVIII variation with IS, we found little evidence that common variation in the 24 candidate fibrin-based hemostasis genes strongly influences arterial thrombotic risk, but our results cannot rule out small effects. [source] Association of Common CRP Gene Variants with CRP Levels and Cardiovascular EventsANNALS OF HUMAN GENETICS, Issue 6 2005D. T. Miller Summary C-reactive protein (CRP) is a well-documented marker of atherosclerotic cardiovascular disease risk. We resequenced CRP to identify a comprehensive set of common SNP variants, then studied and replicated their association with baseline CRP level among apparently healthy subjects in the Women's Health Study (WHS; n = 717), Pravastatin Inflammation/CRP Evaluation trial (PRINCE; n = 1,110) and Physicians' Health Study (PHS; n = 509) cohorts. The minor alleles of four SNPs were consistently associated in all three cohorts with higher CRP, while the minor alleles of two SNPs were associated with lower CRP (p < 0.05 for each). Single marker and haplotype analysis in all three cohorts were consistent with functional roles for the 5,-flanking triallelic SNP ,286C>T>A and the 3,-UTR SNP 1846G>A. None of the SNPs associated with higher CRP were associated with risk of incident myocardial infarction (MI) or ischemic stroke in a prospective, nested case-control study design from the PHS cohort (610 case-control pairs). One SNP, ,717A>G, was unrelated to CRP levels but associated with decreased risk of MI (p = 0.001). Taken together, these data imply significant interactions between both genetic and environmental contributions to the increased CRP levels that predict a greater risk of future atherothrombotic events in epidemiological studies. [source] Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case,control analysisBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2009Y.B. Brauchli Summary Background, Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce. Objectives, To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis-free population. Methods, We conducted an inception cohort study with a nested case,control analysis within the U.K.-based General Practice Research Database. The study population encompassed 36 702 patients with a first-time recorded diagnosis of psoriasis 1994,2005, matched 1 : 1 to psoriasis-free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs). Results, Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1·66 (95% CI 1·03,2·66) compared with patients without psoriasis, while the OR for patients aged , 60 years was 0·99 (95% CI 0·77,1·26). The adjusted ORs of developing MI for patients of all ages with , 2 or > 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69,8·91) and 1·39 (95% CI 0·43,4·53), with a similar finding for stroke and TIA. Conclusions, The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease. [source] | ||||||||||