Aims: Patients with a low lifetime risk of coronary heart disease (CHD) are not completely free of events over 10 years. We evaluated predictors for CHD among "low lifetime risk" participants in the population-based Multi-Ethnic Study of Atherosclerosis (MESA).
Methods: MESA enrolled 6814 men and women aged 45-84 years who were free of baseline cardiovascular disease. Using established criteria of non-diabetic, non-smokers with total cholesterol ≤ 200 mg/dL, systolic BP ≤ 139 mmHg, and diastolic BP ≤ 89 mmHg at baseline, we identified 1391 participants with a low lifetime risk for cardiovascular disease. Baseline covariates were age, gender, ethnicity, HDL-C, C-reactive protein, family history of CHD, carotid intima-media thickness and coronary artery calcium (CAC). We calculated event rates and the number needed to scan (NNS) to identify one participant with CAC>0 and > 100.
Results: Over 10.4 years median follow-up, there were 33 events (2.4%) in participants with low lifetime risk. There were 479 participants (34%) with CAC>0 including 183 (13%) with CAC>100. CAC was present in 25 (76%) participants who experienced an event. In multivariable analyses, only CAC>100 remained predictive of CHD (HR 4.6; 95% CI: 1.6-13.6; p = 0.005). The event rates for CAC = 0, CAC>0 and CAC>100 were 0.9/1,000, 5.7/1,000, and 11.0/1000 person-years, respectively. The NNS to identify one participant with CAC>0 and > 100 were 3 and 7.6, respectively.
Conclusions: While 10-year event rates were low in those with low lifetime risk, CAC was the strongest predictor of incident CHD. Identification of individuals with CAC = 0 and CAC>100 carries significant potential therapeutic implications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.atherosclerosis.2016.01.017 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment of polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) in stormwater using polishing columns with biochar and granular activated carbon.
Chemosphere
January 2025
Department of Civil and Environmental Engineering, University of Maryland, College Park, MD, 20742, USA. Electronic address:
Polycyclic Aromatic Hydrocarbons (PAHs) and Polychlorinated Biphenyls (PCBs) are recalcitrant organic pollutants often detected in stormwater. Various stormwater control measures (SCMs) can remove PAHs and PCBs by filtration, adsorption, and biodegradation. However, dissolved PAHs and PCBs remain present in the treated outflow of SCMs.
View Article and Find Full Text PDFRecent Advances in Paper Conservation Using Nanocellulose and Its Composites.
Molecules
January 2025
Institute for Preservation and Conservation of Chinese Ancient Books, Fudan University Library, Fudan University, 220 Handan Road, Shanghai 200433, China.
Paper-based cultural relics experience aging and deterioration during their long-term preservation, which poses a serious threat to their lifetime. The development of conservation materials with high compatibility and low intervention has been expected to extend the lifetime of paper artifacts. As a new type of biological macromolecule, nanocellulose has been extensively utilized in paper conservation, attributed to its excellent paper compatibility, high optical transparency, outstanding mechanical strength, and large specific surface area with abundant hydroxyl groups.
View Article and Find Full Text PDFA Framework for Comprehensive Dairy Calf Health Investigations.
Animals (Basel)
January 2025
Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada.
The objective of this narrative review is to provide a systematic framework for veterinarians to investigate dairy calf health, focusing on critical control points and key performance indicators (KPIs) to address morbidity and mortality challenges in preweaned calves. Recommendations target prenatal maternal nutrition, heat stress abatement, and optimal calving management to minimize risks associated with perinatal mortality and preweaning morbidity. Further, comprehensive colostrum management is discussed to ensure excellent transfer of passive immunity, which includes prompt collection and feeding within two hours of birth at a volume of 8.
View Article and Find Full Text PDFExploring the impact of insurance switching on the cost-effectiveness of population genetic screening for familial hypercholesterolemia to US payers.
J Clin Lipidol
December 2024
University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, 301 Pharmacy Lane, Chapel Hill, NC 27599, USA.
Background: Widespread familial hypercholesterolemia screening requires a large upfront economic investment, but the health benefits and cost savings of cardiovascular disease prevention directed by screening occur over many years.
Objective: We evaluated the cost-effectiveness of population genetic screening for familial hypercholesterolemia compared to cascade testing to US payers while accounting for patient insurance switching between commercial and Medicare insurance.
Methods: We developed a hybrid decision-tree Markov model to assess genetic screening in 20-year-old adults over a lifetime horizon in which cohort members transitioned between commercial payers representing three commercial plans and Medicare.
Behavioural factors associated with cigarette quitting behaviour: an analysis of cross-sectional survey data collected in three low-income South African communities.
BMJ Open
January 2025
Health Economics and Epidemiology Research Office, Wits Health Consortium, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa.
Objective: To study the behavioural factors associated with sustained cigarette smoking cessation, and those associated with a current smoker attempting to quit, among current and former cigarette smokers living in low-income South African communities.
Setting: Three low-income areas in South Africa.
Design: In-person surveys with structured questions that asked respondents about their cigarette smoking and quitting behaviour, sociodemographic information and behavioural attributes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!