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  • Ovid Technologies (Wolters Kluwer Health)  (6)
  • 1
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    Abstract P230: Measures of Glycaemia (Fasting and 2 hr Glucose, Glycosylated Haemoglobin) in Relation to Incident Vascular Disease in Non-diabetic Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 129, No. suppl_1 ( 2014-03-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Introduction: Glycosylated haemoglobin (HbA 1c ) has recently been accepted for diagnosing diabetes in New Zealand. A 2 hour 75g oral glucose test was used previously and remains an alternative for diagnosis. Hypothesis: We assessed the hypothesis that HbA 1c would do at least as well as fasting and 2 hour glucose levels for predicting vascular events. Methods: Baseline data from a primary care cardiovascular disease (CVD) risk register of approximately 220,000 patients were prospectively linked to hospitalization, mortality and lab test data. There were 21,720 patients without a history of diabetes or CVD who had an HbA 1c and oral glucose tolerance test. We compared the prognostic value of HbA 1c and fasting and CVD or all-cause mortality using Cox proportional hazards regression. Results: The median follow-up time was 5 years (range 0 to 11). For HbA 1c values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the adjusted (age, gender and ethnicity) hazard ratios (with 95% confidence intervals) for diabetic hospitalisations were respectively: 1.45 (0.81-2.45), 1.00 (reference), 1.27 (1.01-1.63), 2.34 (1.88 -2.95), and 6.31 (5.10-7.94), respectively. Baseline HbA 1c was also related to risk of renal complications and retinopathy. For CVD, the hazard ratios (HR’s) were 0.95 (0.51-1.62), 1.00 (reference), 1.16 (0.95-1.42), 1.19 (0.98-1.46), and 1.32 (1.09-1.61), respectively. All associations remained significant after adjustment for the baseline fasting and 2 hour glucose levels. No HR’s were significant for all-cause mortality after adjusting for ethnicity. The associations between fasting glucose levels and the risk of CVD or death from any cause were not significant in models with adjustment for age, gender and ethnicity as well as HbA 1c . The association between the 2 hour glucose levels and the risk of diabetes was significant, but attenuated, in the model with adjustment for age, gender and ethnicity as well as HbA 1c . Conclusions: In conclusion, in people with no diabetes and no CVD, baseline HbA 1c was associated with subsequent diabetes, CVD, diabetic renal complications and retinopathy. HbA 1c was more strongly associated with these vascular complications than were fasting glucose and 2-hour glucose.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.p230
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 2
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    Abstract P331: Ethnic Differences in Glycoslation Indices in Non-Diabetic Adults: The Diabetes, Heart and Health Survey
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_1 ( 2015-03-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_1 ( 2015-03-10)
    Abstract: Objective: We examined whether there were ethnic differences in glycosylated haemoglobin concentrations, the glycation gap and haemoglobin glycation index in non-diabetic adults. Research design and methods: We studied 3,318 non-diabetic adults aged 35 to 74 years. Glycoslylated haemoglobin (HbA1c) levels were compared in 1,589 Europeans, 825 Maori, 689 Pacific and 226 Asians. The glycation gap was calculated using the residuals from the regression of HbA1c on mean fasting and 2 hour glucose levels and the haemoglobin glycation index using the residuals from the regression of HbA1c on fructosamine. Results: Mean ± SD HbA1c was 38.0 ± 4.57 mmol/mol. After adjusting for age and gender, mean (se) HbA1c was higher in Maori (38.6 mmol/mol (0.14)), Pacific (40.8 (0.16)) and Asians (37.9 (0.27)) compared with Europeans (36.5 (0.10)) (all P & lt 0.0001 vs. Europeans). In contrast, there was little difference in fructosamine levels between ethnic groups with 231.5 (0.63) μmol/L in Europeans, 230.7 (0.44) in Maori, 237.8 (1.16) in Asians (both P & gt 0.05 versus Europeans), and 232.7 (0.16) in Pacific (P & lt 0.05). After adjusting for age, sex, education, body mass index (BMI), systolic and diastolic blood pressure, fasting and post-glucose load glucose levels, cholesterol, triglycerides, HDL-cholesterol, physical exercise levels, total calorie intake and socioeconomic status, HbA1c levels were 37.0 (0.10) mmol/mol in Europeans, and remained higher in Maori (38.4 (0.13)), Pacific (40.0 (0.15)) and Asians (38.1 (0.25)) (all P & lt 0.001) compared to Europeans. The mean (se) age and gender adjusted glycation gap (based on fructosamine) was -1.50 (0.10) mmol/mol for Europeans, 0.66 (0.14) mmol/mol for Maori, 2.77 (0.16) mmol/mol for Pacific (Both (P & lt 0.0001 vs. Europeans), and -0.37 (0.27) mmol/mol in Asians (P =0.001 vs. Europeans. Similarly, the mean haemoglobin glycation index (based on mean glucose) was -1.34 (0.10) in Europeans, 0.41 (0.13) in Maori, 2.63 (0.15) in Pacific (both P & lt 0.0001 versus Europeans) and -0.45 (0.25) in Asians (P = 0.001 vs. Europeans). Conclusion: There were differences in HbA1c, the glycation gap and the haemoglobin glycation index between Europeans and Maori, Pacific and Asian non-diabetic adults, but there was little difference between ethnic groups for fructosamine. These differences could be due to heritable factors that may vary between the ethnic groups or may be related to high or low glycators.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_1.p331
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 3
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    Longitudinal associations of blood pressure with aortic stiffness and pulsatility: the Atherosclerosis Risk in Communities Study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Hypertension Vol. 39, No. 5 ( 2021-05), p. 987-993
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 5 ( 2021-05), p. 987-993
    Abstract: To characterize the longitudinal relationships between blood pressure measured over 24 years and arterial stiffness in late life measured as pulse wave velocity (PWV). Methods: Carotid--femoral (cf) and femoral--ankle (fa) PWV were measured in 4166 adults at the visit 5 Atherosclerosis Risk in Communities study cohort examination (2011–2013). Participants were categorized into tertiles of PWV measurements. Blood pressure measurements were made at baseline (1987–1989), three subsequent triennial examinations, and visit 5. Results: Partial correlation coefficients between visit 5 cfPWV and SBP ranged from 0.13 for visit 1 SBP to 0.32 for visit 5 SBP. For visit 5 faPWV, correlations were ∼0 for visits 1 to 4 SBP, but was 0.20 for visit 5 SBP. Over 24 years of follow-up, those with higher average SBP were more likely to fall in the middle and upper tertiles of visit 5 cfPWV. Average pulse pressure and mean arterial pressure over 24 years had similar but weaker associations with cfPWV tertiles. DBP had no clear association with cfPWV. Blood pressure measurements were positively associated with faPWV tertiles only cross-sectionally at visit 5. Conclusion: Adult life-course measures of SBP, more so than mean arterial and pulse pressure, were associated with later life central arterial stiffness. By contrast, only contemporaneous measures of blood pressure were associated with peripheral arterial stiffness. Although arterial stiffness was only measured at later life, these results are consistent with the notion that elevated blood pressure over time is involved in the pathogenesis of arterial stiffening.
    Type of Medium: Online Resource
    ISSN: 0263-6352 , 1473-5598
    URL: Article
    DOI: 10.1097/HJH.0000000000002731
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2017684-3
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  • 4
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    Abstract P053: Glycated Hemoglobin in Relation to Incident Diabetes and Cardiovascular Disease in Non-diabetic Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 133, No. suppl_1 ( 2016-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Introduction: We compared the utility of glycated hemoglobin (HbA1c) and oral glucose tolerance (oGTT) in non-diabetic patients for identifying incident diabetes, all-cause mortality, cardiovascular disease (CVD) mortality, all-CVD events, coronary heart disease (CHD) events, ischaemic stroke events and diabetes microvascular complications. Hypothesis: HbA1c will provide the similar information to an oGTT. Methods: Data from a New Zealand community setting were prospectively linked to hospitalization, mortality, pharmaceutical and laboratory test results data. After applying exclusion criteria (prior laboratory diagnosis or history of drug treatment for diabetes or hospitalisation for diabetes or CVD event), there were 31,148 adults who had an HbA1c and 2-hr 75g oGTT. HbA1c was measured by ion-exchange high-performance liquid chromatography, and glucose using a commercial enzymatic method. We compared glycaemic measures and outcomes using multivariable Cox proportional hazards regression. Results: The median follow-up time was 4 years (range 0 to 13). The mean age was 57.6 years and 53.0% were male. After adjusting for other glycaemic measures (fasting glucose, 2-hr glucose and/or HbA1c where relevant) in addition to age, sex and ethnicity, the hazard ratios for incident diabetes, and diabetes complications of retinopathy, nephropathy and neuropathy were highest for 2-hr postchallenge glucose levels, followed by HbA1c and lastly by fasting plasma glucose. However, all-cause mortality was significantly associated with HbA1c concentrations only. CHD events were most strongly associated with HbA1c, followed by 2-hr glucose and circulatory complications showed stronger associations with HbA1c. Conclusion: HbA1c showed stronger associations with adverse outcomes compared to fasting glucose and provides a convenient alternative to an oGTT.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.133.suppl_1.p053
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
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  • 5
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    Icosapent Ethyl Reduces Ischemic Events in Patients With a History of Previous Coronary Artery Bypass Grafting: REDUCE-IT CABG
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. 23 ( 2021-12-07), p. 1845-1855
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. 23 ( 2021-12-07), p. 1845-1855
    Abstract: Despite advances in surgery and pharmacotherapy, there remains significant residual ischemic risk after coronary artery bypass grafting surgery. Methods: In REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial), a multicenter, placebo-controlled, double-blind trial, statin-treated patients with controlled low-density lipoprotein cholesterol and mild to moderate hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or placebo. They experienced a 25% reduction in risk of a primary efficacy end point (composite of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina) and a 26% reduction in risk of a key secondary efficacy end point (composite of cardiovascular death, myocardial infarction, or stroke) when compared with placebo. The current analysis reports on the subgroup of patients from the trial with a history of coronary artery bypass grafting. Results: Of the 8179 patients randomized in REDUCE-IT, a total of 1837 (22.5%) had a history of coronary artery bypass grafting, with 897 patients randomized to icosapent ethyl and 940 to placebo. Baseline characteristics were similar between treatment groups. Randomization to icosapent ethyl was associated with a significant reduction in the primary end point (hazard ratio [HR], 0.76 [95% CI, 0.63–0.92] ; P =0.004), in the key secondary end point (HR, 0.69 [95% CI, 0.56–0.87]; P =0.001), and in total (first plus subsequent or recurrent) ischemic events (rate ratio, 0.64 [95% CI, 0.50–0.81]; P =0.0002) compared with placebo. This yielded an absolute risk reduction of 6.2% (95% CI, 2.3%–10.2%) in first events, with a number needed to treat of 16 (95% CI, 10–44) during a median follow-up time of 4.8 years. Safety findings were similar to the overall study: beyond an increased rate of atrial fibrillation/flutter requiring hospitalization for at least 24 hours (5.0% vs 3.1%; P =0.03) and a nonsignificant increase in bleeding, occurrences of adverse events were comparable between groups. Conclusions: In REDUCE-IT patients with a history of coronary artery bypass grafting, treatment with icosapent ethyl was associated with significant reductions in first and recurrent ischemic events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01492361.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.121.056290
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 6
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    Whole Genome Sequence Analysis of the Plasma Proteome in Black Adults Provides Novel Insights Into Cardiovascular Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. 5 ( 2022-02), p. 357-370
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. 5 ( 2022-02), p. 357-370
    Abstract: Plasma proteins are critical mediators of cardiovascular processes and are the targets of many drugs. Previous efforts to characterize the genetic architecture of the plasma proteome have been limited by a focus on individuals of European descent and leveraged genotyping arrays and imputation. Here we describe whole genome sequence analysis of the plasma proteome in individuals with greater African ancestry, increasing our power to identify novel genetic determinants. Methods: Proteomic profiling of 1301 proteins was performed in 1852 Black adults from the Jackson Heart Study using aptamer-based proteomics (SomaScan). Whole genome sequencing association analysis was ascertained for all variants with minor allele count ≥5. Results were validated using an alternative, antibody-based, proteomic platform (Olink) as well as replicated in the Multi-Ethnic Study of Atherosclerosis and the HERITAGE Family Study (Health, Risk Factors, Exercise Training and Genetics). Results: We identify 569 genetic associations between 479 proteins and 438 unique genetic regions at a Bonferroni-adjusted significance level of 3.8×10 -11 . These associations include 114 novel locus-protein relationships and an additional 217 novel sentinel variant-protein relationships. Novel cardiovascular findings include new protein associations at the APOE gene locus including ZAP70 (sentinel single nucleotide polymorphism [SNP] rs7412-T, β=0.61±0.05, P =3.27×10 -30 ) and MMP-3 (β=-0.60±0.05, P =1.67×10 -32 ), as well as a completely novel pleiotropic locus at the HPX gene, associated with 9 proteins. Further, the associations suggest new mechanisms of genetically mediated cardiovascular disease linked to African ancestry; we identify a novel association between variants linked to APOL1-associated chronic kidney and heart disease and the protein CKAP2 (rs73885319-G, β=0.34±0.04, P =1.34×10 -17 ) as well as an association between ATTR amyloidosis and RBP4 levels in community-dwelling individuals without heart failure. Conclusions: Taken together, these results provide evidence for the functional importance of variants in non-European populations, and suggest new biological mechanisms for ancestry-specific determinants of lipids, coagulation, and myocardial function.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.121.055117
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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