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2015

Ciccarone Center Research

All Ciccarone Research Articles

Use of the Frank-Starling mechanism during exercise is linked to exercise-induced changes in arterial load.
By: Chantler PD, Melenovsky V, Schulman SP, Gerstenblith G, Becker LC, Ferrucci L, Fleg JL, Lakatta EG, Najjar SS.
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Evidence of dependence of lipoprotein(a) on triglyceride and HDL metabolism.
By: Konerman M, Kulkarni K, Toth PP, Jones SR.

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Plaque composition and stenosis severity: is there any hope for plaque regression?
By: Al-Mallah MH, Nasir K.
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Potential use of coronary artery calcium progression to guide therapy and management of patients at risk for coronary artery disease.
By: McEvoy JW, Blaha MJ, Blumenthal RS, Jones SR, Nasir K.
This review examines the strengths and limitations of the existing data purporting to show an incremental prognostic benefit of looking at progression of CAC.
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Short-term effect of atorvastatin on carotid artery elasticity: a pilot study.
By: Ratchford EV, Gutierrez J, Lorenzo D, McClendon MS, Della-Morte D, DeRosa JT, Elkind MS, Sacco RL, Rundek T.
Short-term treatment with high-dose atorvastatin was associated with improvement in the carotid elasticity metrics. Carotid artery elasticity measured by B-mode ultrasound is a simple noninvasive measure of arterial wall function and may be a useful surrogate end point in clinical trials targeting individuals at increased risk for atherosclerosis.
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Comprehensive lipid management in the coronary artery disease patient.
By: Amin NP, Blaha MJ, Chow GV, Blumenthal RS, Ashen MD.

Low-density lipoprotein cholesterol (LDL-C) is the lipoprotein most implicated in atherosclerosis, and aggressive statin therapy remains the cornerstone of treatment. Adjunct therapies are often required to reach LDL-C goals, and recent studies have only fueled the debate over ezetimibe versus niacin. Alternate dosing regimens of high-potency statins can be used in those who cannot tolerate side effects. Residual risk may remain after LDL-C goals are achieved. Non–high-density lipoprotein cholesterol (non–HDL-C) must be calculated in patients with elevated triglycerides. Omega-3 fatty acids are most effective in lowering non–HDL-C. Low HDL-C levels can be raised with niacin, but clinical events may not be significantly reduced. Newer therapeutic targets, such as cholesteryl ester transfer protein (CETP) inhibitors, raise HDL-C and are being evaluated for safety and efficacy. Several ongoing, randomized controlled trials are investigating the relative efficacy of adjunctive therapies for reducing coronary heart disease events in high-risk patients.

Genome-wide association study for coronary artery calcification with follow-up in myocardial infarction.
By: O’Donnell CJ, Kavousi M, Smith AV, Kardia SL, Feitosa MF, Hwang SJ, Sun YV, Province MA, Aspelund T, Dehghan A, Hoffmann U, Bielak LF, Zhang Q, Eiriksdottir G, van Duijn CM, Fox CS, de Andrade M, Kraja AT, Sigurdsson S, Elias-Smale SE, Murabito JM, Launer LJ, van der Lugt A, Kathiresan S; CARDIoGRAM Consortium, Krestin GP, Herrington DM, Howard TD, Liu Y, Post W, et al.

Coronary artery calcification (CAC) detected by computed tomography is a noninvasive measure of coronary atherosclerosis, which underlies most cases of myocardial infarction (MI). We sought to identify common genetic variants associated with CAC and further investigate their associations with MI. SNPs in the 9p21 and PHACTR1 gene loci were strongly associated with CAC and MI, and there are suggestive associations with both CAC and MI of SNPs in additional loci. Multiple genetic loci are associated with development of both underlying coronary atherosclerosis and clinical events.

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Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA.
By: Yeboah J, Redline S, Johnson C, Tracy R, Ouyang P, Blumenthal RS, Burke GL, Herrington DM.
We assessed the association between sleep apnea, snoring, incident CV events and all-cause mortality in the Multi Ethnic Study of Atherosclerosis (MESA) cohort and concluded that sleep apnea, but not habitual snoring, was associated with high incident CV events and all-cause mortality in a multi-ethnic population-based study of adults free of clinical CV disease at baseline.
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Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high levels of coronary artery calcium are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, as compared to high CAC.
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Impact of lung transplantation on serum lipids in COPD.
By: Reed R, Hashmi S, Eberlein M, Iacono A, Netzer G, DeFilippis A, Girgis R, Toth P, Scharf S, Jones S.

Severe chronic obstructive pulmonary disease is associated with high HDL cholesterol (HDL-C). We sought to examine the effect of lung transplantation on lipid profiles in patients with COPD. In patients with COPD, lung transplantation results in reductions in the serum levels of HDL-C. These changes are not observed in patients undergoing lung transplantation for diagnoses other than COPD.

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Short-term effect of atorvastatin on carotid artery elasticity.
By: Ratchford EV, Gutierrez J, Lorenzo D, McClendon MS, Della-Morte D, DeRosa JT, Elkind MSV, Sacco RL, Rundek T.
Short-term treatment with high-dose atorvastatin was associated with improvement in the carotid elasticity metrics. Carotid artery elasticity measured by B-mode ultrasound is a simple noninvasive measure of arterial wall function and may be a useful surrogate end point in clinical trials targeting individuals at increased risk for atherosclerosis.
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Heat acclimation and exercise training interact when combined in an overriding and trade-off manner: physiologic-genomic linkage.
By: Kodesh E, Nesher N, Simaan A, Hochner B, Beeri R, Gilon D, Stern MD, Gerstenblith G, Horowitz M.
Combined heat acclimation (AC) and exercise training (EX) enhance exercise performance in the heat while meeting thermoregulatory demands. We suggest that concerted adjustments induced by AC and EX lead to enhanced metabolic and mechanical performance of the EXAC heart.
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Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC scores.
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Predicting and preventing cardiovascular disease in HIV-infected patients.
By: Post WS.
In the absence of specific randomized trials in the HIV-infected population, HIV-infected persons should be treated for cardiovascular risk factors according to current national guidelines for reducing risk, including those for aspirin use and for treatment of dyslipidemia, hypertension, and metabolic syndrome.
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Longitudinal predictors of progression of carotid atherosclerosis in rheumatoid arthritis.
By: Giles JT, Post WS, Blumenthal RS, Polak J, Petri M, Gelber AC, Szklo M, Bathon JM.
These prospective data provide evidence that inflammation is a contributor to the progression of subclinical atherosclerosis in rheumatoid arthritis and that it is potentially modified favorably by tumor necrosis factor inhibitors and detrimentally by glucocorticoids.
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Effects of physical activity on cardiovascular disease.
By: Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS.
This paper provides a comprehensive look at the benefits of increased physical activity on lipid changes, thrombotic, inflammatory factors, and measures of subclinical atherosclerosis.
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Addressing the debate: who should take statins?
By: Martin SS, Blumenthal RS.
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No justification for coronary CT angiography in low- to intermediate-risk individuals with coronary artery calcium score of 0.
By: Nasir K, Blaha MJ.
We review the rationale for non-contrast CT to risk stratify low-risk patients with atypical chest discomfort who have normal cardiac biomarkers.
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No justification for coronary CT angiography among low-intermediate risk individuals with CAC=0.
By: Blaha MJ, Nasir K.
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SATURN and AIM-HIGH: back down to planet earth.
By: Martin SS, Blumenthal RS.

The article discusses the Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) and the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) trial.

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The association of Framingham and Reynolds risk scores with incidence and progression of coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
By: DeFilippis AP, Blaha MJ, Ndumele CE, Budoff MJ, Lloyd-Jones DM, McClelland RL, Lakoski SG, Cushman M, Wong ND, Blumenthal RS, Lima J, Nasir K.
Both the Framingham and Reynolds risk scores predict onset and progression of subclinical atherosclerosis. However, the Reynolds risk score may provide additional predictive information when discordance between the scoring systems exists.
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The association of the Framingham and Reynolds risk scores with incidence and progression of coronary artery calcium in MESA.
By: DeFilippis AP, Blaha MJ, Ndumele C, Budoff MJ, Lloyd-Jones D, McClelland RL, Lakoski SG, Cushman M, Wong ND, Blumenthal RS, Lima J, Nasir K.
This innovative study found that the Reynolds Risk Score was modestly better than the traditional Framingham risk score in predicting the incidence of new coronary calcification and the progression of existing calcification. This observation also applied to clinical events.
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Vascular imaging.
By: Ratchford EV.

Vascular imaging has now become routine in many echocardiography laboratories. With increasing recognition of the systemic nature of atherosclerosis, cardiologists are becoming more involved in imaging outside the heart both for clinical and research purposes.

Associations of salivary cortisol levels with metabolic syndrome and its components: the multi-ethnic study of atherosclerosis.
By: DeSantis AS, DiezRoux AV, Hajat A, Golden SH, Jenny NS, Sanchez BN, Shea S, Seeman TE.
Our findings do not support the hypothesis that differences in level or diurnal pattern of salivary cortisol output are associated with metabolic syndrome among persons without clinical diabetes.
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Electrocardiographic and clinical predictors separating atherosclerotic sudden cardiac death from incident coronary heart disease.
By: Soliman EZ, Prineas RJ, Case LD, Russell G, Rosamond W, Rea T, Sotoodehnia N, Post WS, Siscovick D, Psaty BM, Burke GL.
Sudden cardiac death and coronary heart disease have many risk factors in common, including hypertension, race/ethnicity, BMI, and heart rate, that have the potential to separate between the risks of both diseases. These results need to be validated in another cohort.
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QT-interval duration and mortality rate: results from the Third National Health and Nutrition Examination Survey.
By: Zhang Y, Post WS, Dalal D, Blasco-Colmenares E, Tomaselli GF, Guallar E.

Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.

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The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
By: Tison GH, Blaha MJ, Budoff MJ, Katz R, Rivera JJ, Bertoni AG, Wong ND, Blumenthal RS, Szklo M, Eng J, Tracy R, Nasir K.
The homeostasis model assessment of insulin resistance has a positive and graded association with extra-coronary calcification, but not independently of cardiovascular risk factors, particularly metabolic syndrome components.
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Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the multi-ethnic study of atherosclerosis.
By: Malik S, Budoff MJ, Katz R, Blumenthal RS, Bertoni AG, Nasir K, Szklo M, Barr RG, Wong ND.
Individuals with metabolic syndrome or diabetes have low risks for CHD when CAC or carotid intimal-medial thickness (CIMT) is not increased. Prediction of CHD and CVD events is improved by CAC more than by CIMT. Screening for CAC or CIMT can stratify risk in people with metabolic syndrome and diabetes and support the latest recommendations regarding CAC screening in those with diabetes.
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Statin therapy dose and risk of new-onset diabetes.
By: McEvoy JW.
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Making the case for selective use of statins in the primary prevention setting.
By: Minder CM, Blaha MJ, Tam LM, Munoz D, Michos ED, Kaul S, Blumenthal RS.
In this paper, we refute the incorrect view expressed by several members of the Archives editorial board in their “Less is More” column that lipid lowering is rarely indicated in the primary prevention setting.
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Electrocardiographic QT interval and mortality: A meta-analysis.
By: Zhang Y, Post WS, Blasco-Colmenares E, Dalal D, Tomaselli GF, Guallar E.
Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population have been unclear. We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population.
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Meta-analysis of genome-wide association studies from CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque.
By: Bis JC, Kavousi M, Francheschini N, Isaacs A, Abecasis GR, Schminke U, Post WS, Smith AV, et al.

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10(-8)). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events.

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Predictors of progression in atherosclerosis over 2 years in systemic lupus erythematosus.
By: Kiani AN, Post WS, Magder LS, Petri M.
Cardiovascular disease remains the major cause of death in systemic lupus erythematosus (SLE). We assessed the degree to which cardiovascular risk factors and disease activity were associated with 2-year changes in measures of subclinical atherosclerosis. Our data did not provide evidence of an association between measures of SLE disease activity (SLEDAI, anti-dsDNA, anti-phospholipid and treatment) and progression of subclinical atherosclerosis. Age and hypertension were associated with the progression of carotid IMT and plaque. Age, smoking and cholesterol were associated with progression of CAC.
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Hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased systemic inflammation.
By: Ndumele CE, Nasir K, Conceiçao RD, Carvalho JA, Blumenthal RS, Santos RD.
The goal of this study was to assess the independent and collective associations of hepatic steatosis, obesity, and the metabolic syndrome with elevated hsCRP levels. We evaluated 2,388 individuals without clinical cardiovascular disease between December 2004 and December 2006. Hepatic steatosis was diagnosed by ultrasound, and the metabolic syndrome was defined using National Heart, Lung, and Blood Institute criteria. We concluded that hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased odds of high hsCRP levels.
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Associations between C-reactive protein, coronary artery calcium, and cardiovascular events: implications for the JUPITER population from MESA, a population-based cohort study.
By: Blaha MJ, Budoff MJ, DeFilippis AP, Blankstein R, Rivera JJ, Agatston A, O’Leary DH, Lima J, Blumenthal RS, Nasir K.
The landmark Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial showed that some patients with LDL-cholesterol (LDL-C) <130 mg/dL and high-sensitivity C-reactive protein (hsCRP) concentrations of >2 mg/L benefit from treatment with rosuvastatin, although the absolute rates of cardiovascular events were low. In a population eligible for JUPITER, we established whether coronary artery calcium (CAC) might further stratify risk; additionally we compared hsCRP with CAC for risk prediction across the range of low and high hsCRP values. CAC further stratifies risk in patients eligible for JUPITER, and could be used to target subgroups of patients who are expected to derive the most, and the least, absolute benefit from statin treatment. Focusing of treatment on the subset of individuals with normal LDL-C and at least moderate subclinical atherosclerosis should allow for more appropriate allocation of resources.
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Sex-steroid hormones and electrocardiographic QT-interval duration: Findings from the Third National Health and Nutrition Examination Survey and the Multi-Ethnic Study of Atherosclerosis.
By: Zhang Y, Ouyang P, Post WS, Dalal D, Vaidya D, Blasco-Colmenares E, Soliman EZ, Tomaselli GF, Guallar E.
The association between physiologic levels of sex hormones and QT-interval duration in humans was evaluated using data from 727 men enrolled in the Third National Health and Nutrition Examination Survey and 2,942 men and 1,885 postmenopausal women enrolled in MESA. Testosterone, estradiol, and sex hormone-binding globulin levels were measured in serum and free testosterone was calculated from those values. The findings suggest that testosterone levels may explain differences in QT-interval duration between men and women and could be a contributor to population variability in QT-interval duration among men.
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Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: The multi-ethnic study of atherosclerosis.
By: Malik S, Budoff MJ, Katz R, Blumenthal RS, Bertoni AG, Nasir K, Szklo M, Barr RG, Wong ND.
While metabolic syndrome and diabetes generally confer a greater cardiovascular disease (CVD) risk, recent evidence suggests that these individuals have a wide range of risk. We evaluated whether screening for CAC and carotid intimal medial thickness (CIMT) can improve CVD risk stratification over traditional risk factors (RFs) in people with metabolic syndrome and diabetes. We concluded that individuals with metabolic syndrome or diabetes have low risks for CHD when CAC or CIMT is not increased. Prediction of CHD and CVD events are improved by CAC more than by CIMT. Screening for CAC or CIMT can stratify risk in people with metabolic syndrome and diabetes and support the latest recommendations regarding CAC screening in those with diabetes.
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The association of bone density and calcified atherosclerosis is stronger in women without dyslipidemia: The multi-ethnic study of atherosclerosis.
By: Jensky NE, Hyder JA, Allison MA, Wong N, Aboyans V, Blumenthal RS, Schreiner P, Carr JJ, Wassel CL, Ix JH, Criqui MH.
We tested whether the association between bone mineral density (BMD) and CAC varies according to dyslipidemia in community-living individuals. The inverse association of BMD with CAC proved stronger in women without dyslipidemia. These data argue against the hypothesis that dyslipidemia is the key factor responsible for the inverse association of BMD with atherosclerosis.
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Emerging therapeutic approaches for the management of diabetes mellitus and macrovascular complications.
By: Golden SH.
Type 2 DM affects an estimated 26 million people in the U.S. and is the 7th leading cause of death. While effective therapy can prevent or delay the complications that are associated with diabetes, according to the Center for Disease Control, 35% of Americans with DM are undiagnosed, and another 79 million Americans have blood glucose levels that greatly increase their risk of developing DM in the next several years. This article reviews established and emerging therapeutic approaches for managing DM and prevention of macrovascular complications.
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Impact of coronary computed tomographic angiography results on patient and physician behavior in a low-risk population.
By: McEvoy JW, Blaha MJ, Nasir K, Yoon YE, Choi EK, Cho IS, Chun EJ, Choi SI, Rivera JJ, Blumenthal RS, Chang HJ.
We studied asymptomatic patients from a large health-screening program. Our study population comprised 1,000 patients who underwent coronary CT angiography (CCTA) as part of a prior study and a matched control group of 1,000 patients who did not. We assessed medication use, secondary test referrals, revascularizations, and cardiovascular events at 90 days and 18 months. An abnormal screening CCTA result was predictive of increased aspirin and statin use at 90 days and 18 months, although medication use lessened over time. Screening CCTA was associated with increased invasive testing, without any difference in events at 18 months. Screening CCTA in asymptomatic adults should NOT be considered a justifiable test at this time.
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Electrocardiographic and clinical predictors separating atherosclerotic sudden cardiac death from incident coronary heart disease.
By: Soliman EZ, Prineas RJ, Case LD, Russell G, Rosamond W, Rea T, Sotoodehnia N, Post WS, Siscovick D, Psaty BM, Burke GL.
To identify specific ECG and clinical predictors that separate atherosclerotic SCD from incident CHD (non-fatal events and non-sudden death) in the combined cohorts of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. This analysis included 18,497 participants (58% females, 24% black individuals, mean age 58 years) who were initially free of clinical CHD. SCD and CHD have many risk factors in common. Hypertension, race/ethnicity, BMI, heart rate, QTc, abnormally inverted T wave in any ECG lead group and level of ST elevation in V2 have the potential to separate between the risks of SCD and CHD. These results need to be validated in another cohort.
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Predictors of coronary heart disease events among asymptomatic persons with low low-density lipoprotein cholesterol MESA (Multi-Ethnic Study of Atherosclerosis).
By: Blankstein R, Budoff MJ, Shaw LJ, Goff DC Jr, Polak JF, Lima J, Blumenthal RS, Nasir K.
Our aim was to identify risk factors for CHD events among asymptomatic persons with low (?130 mg/dl) LDL-C. Among persons with low LDL-C, older age, male sex, hypertension, diabetes, and low HDL-C are associated with adverse CHD events. Even after accounting for all such variables, the presence of CAC provided incremental prognostic value. These results may serve as a basis for deciding which patients with low LDL-C may be considered for more aggressive therapies. An elevated hsCRP was not predictive of events in this population of individuals with normal LDL-C.
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Reliability of hypothalamic-pituitary-adrenal axis assessment methods for use in population-based studies.
By: Golden SH, Wand GS, Malhotra S, Kamel I, Horton K.
Population-based studies have been hampered in exploring hypothalamic-pituitary-adrenal axis (HPA) activity as a potential explanatory link between stress-related and metabolic disorders due to their lack of incorporation of reliable measures of chronic cortisol exposure. The purpose of this review is to summarize current literature on the reliability of HPA axis measures and to discuss the feasibility of performing them in population-based studies.
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Sex differences in subclinical atherosclerosis by race/ethnicity in the multi-ethnic study of atherosclerosis.
By: Kim C, Diez-Roux AV, Nettleton JA, Polak JF, Post WS, Siscovick DS, Watson KE, Vahratian AM.
Sex differences in CVD mortality are more pronounced among non-Hispanic whites than other racial/ethnic groups, but it is unknown whether this variation is present in the earlier subclinical stages of disease. The authors examined racial/ethnic variation in sex differences in CAC and cIMT at baseline in 2000-2002 among participants (n = 6,726) in MESA using binomial and linear regression. Models adjusted for risk factors in several stages: age, traditional cardiovascular disease risk factors, behavioral risk factors, psychosocial factors, and adult socioeconomic position. In conclusion, coronary artery calcification is differentially patterned by sex across racial/ethnic groups.
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Calcium score reclassification: how should baseline risk be measured?
By: McEvoy JW, Nasir K, Blumenthal RS.
A coronary artery score measurement to reclassify persons to either a low or high risk category has implications for preventive therapy strategies for patients in the broad intermediate cardiac risk category that need to be tested in a prospective, randomized manner.
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The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
By: Tison GH, Blaha MJ, Budoff MJ, Katz R, Rivera JJ, Bertoni AG, Wong ND, Blumenthal RS, Szklo M, Eng J, Tracy R, Nasir K.
We hypothesized that insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA-IR), is independently associated with prevalent and incident extra-coronary calcification (ECC). We concluded that HOMA has a positive and graded association with ECC, but not independently of cardiovascular risk factors, particularly metabolic syndrome components.
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Impaired fasting glucose and the risk of incident diabetes mellitus and cardiovascular events in an adult population: MESA (Multi-Ethnic Study of Atherosclerosis).
By: Yeboah J, Bertoni AG, Herrington DM, Post WS, Burke GL.
The purpose of the study was to assess the cardiovascular risk of impaired fasting glucose (IFG). The associations between IFG, incident type 2 diabetes mellitus (T2DM), and CV events remains unclear. The MESA study included participants who were 45 to 84 years or age and free of clinical CV disease at baseline. Having IFG was not independently associated with an increased short-term risk for incident CV events. These data reiterate the importance of intervention for persons with IFG to reduce their incidence of T2DM.
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Preventive cardiology: past, present, and future.
By: Blaha MJ, Gluckman TJ, Blumenthal RS.
The majority of improvement in rates of mortality from CVD since 1960 has been the result of prevention strategies and not treatment of acute CVD. Prevention occurs at three levels: primordial, primary, and secondary. National guidelines direct population-based and individual-based preventive care. This chapter offers an easy to remember memory tool that facilitates comprehensive preventive care: The Ciccarone Center ABCDE approach.
Metabolically benign obesity: a wolf in sheep’s clothing.
By: McEvoy JW, Blaha MJ, Nasir K.
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Exercise for restoring health and preventing vascular disease.
By: Stewart KJ, Ratchford EV, Williams MA.
Individuals with heart disease can benefit greatly from exercise training and other aspects of cardiac rehabilitation and secondary prevention programs. Exercise training plays a critical role as a primary treatment of patients with peripheral arterial disease, with the goal of improving quality of life and functional capacity.