Publications by authors named "A L Tonkin"

The impact of metabolic dysfunction-associated steatotic liver disease (MASLD), the preferred nomenclature for NAFLD, on cardiovascular health and mortality among older adults is uncertain. As such, we aimed to identify whether MASLD increases the risk of Major Adverse Cardiovascular Events (MACE) (a composite of fatal coronary heart disease [excluding heart failure], nonfatal myocardial infarction, or fatal or nonfatal ischemic stroke), Atrial Fibrillation (AF), or all-cause mortality in older adults, and whether aspirin attenuates these risks in individuals with MASLD. This is a non-prespecified post-hoc analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) randomized trial.

View Article and Find Full Text PDF

Cardiovascular disease (CVD) represents a major public health issue, claiming numerous lives. This study aimed to demonstrate the advantages of employing artificial intelligence (AI) models to improve the prediction of CVD risk using a large cohort of relatively healthy adults aged 70 years or more. In this study, deep learning (DL) models provide enhanced predictions (DeepSurv: C-index = 0.

View Article and Find Full Text PDF

Background: The risk-benefit balance of statin use in healthy older people is uncertain. We describe the baseline characteristics of the STAREE (Statins in Reducing Events in the Elderly) trial, which is a randomized, double-blind, placebo-controlled trial among community-dwelling older people; the trial evaluated the effect of atorvastatin 40 mg for the prevention of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction or stroke), and on disability-free survival (survival free of both dementia and persistent physical disability).

Methods And Results: STAREE enrolled people aged ≥70 years from 1583 general practices across Australia with no history of clinical cardiovascular disease, diabetes, or dementia.

View Article and Find Full Text PDF

Background: Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp[a]) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD). However, the relationship between Lp(a) level, LDL-C level, and ASCVD risk at different thresholds is not well defined.

Methods: A participant-level meta-analysis of 27 658 participants enrolled in 6 placebo-controlled statin trials was performed to assess the association of LDL-C and Lp(a) levels with risk of fatal or nonfatal coronary heart disease events, stroke, or any coronary or carotid revascularization (ASCVD).

View Article and Find Full Text PDF
Article Synopsis
  • Recent trials show that aspirin for preventing heart disease often leads to more bleeding risks than benefits, particularly in the general population.
  • This study analyzed data from the ASPREE trial, focusing on individuals with a high genetic risk for coronary artery disease (CAD).
  • Findings revealed that those in the highest genetic risk group experienced a significant reduction in CAD events with aspirin, without increased bleeding risk, suggesting aspirin may be beneficial for high-risk individuals.
View Article and Find Full Text PDF