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  • 1
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    Online Resource
    Troponin T, NT-proBNP, and venous thromboembolism: The Longitudinal Investigation of Thromboembolism Etiology (LITE)
    SAGE Publications ; 2014
    In:  Vascular Medicine Vol. 19, No. 1 ( 2014-02), p. 33-41
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 19, No. 1 ( 2014-02), p. 33-41
    Abstract: Increased levels of plasma troponins and natriuretic peptides are markers of cardiac dysfunction associated with increased risk of cardiovascular disease. Little information exists on cardiac dysfunction and occurrence of venous thromboembolism (VTE). In two prospective epidemiological cohorts, we tested the hypothesis that high-sensitivity troponin T (TnT) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are associated positively with VTE occurrence. The Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS) measured plasma TnT and NT-proBNP in 13,719 men or women with no history of venous thrombosis, coronary heart disease, or heart failure and followed them for approximately 10 years for VTE occurrence ( n=348 VTEs). In both ARIC and CHS, TnT was associated positively with incidence of total VTE and provoked VTE, but not with unprovoked VTE: age, race, and sex-adjusted hazard ratios for total VTE in the pooled analysis were 1.00, 0.85, 1.36, 1.51, and 1.98 ( p-trend 〈 0.0001) across five categories of TnT. In contrast, the association of NT-proBNP with VTE was positive in ARIC (hazard ratios approximately 2.5-fold for the highest versus lowest NT-proBNP quintiles), but non-existent in CHS.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X14520869
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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  • 2
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    Markers of vitamin D metabolism and incidence of clinically diagnosed abdominal aortic aneurysm: The Atherosclerosis Risk in Communities Study
    SAGE Publications ; 2018
    In:  Vascular Medicine Vol. 23, No. 3 ( 2018-06), p. 253-260
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 23, No. 3 ( 2018-06), p. 253-260
    Abstract: Little is known about whether markers of vitamin D metabolism are associated with the development of abdominal aortic aneurysm (AAA), though these markers have been linked to other cardiovascular diseases. We tested the hypotheses that risk of AAA is higher among individuals with low serum concentrations of 25-hydroxy vitamin D [25(OH)D] , and among those with elevated concentrations of calcium, fibroblast growth factor 23 (FGF23), phosphorus, and parathyroid hormone (PTH) using data from a cohort of black and white individuals with long-term follow-up. Markers of vitamin D metabolism were measured using serum collected in 1990–1992 from ARIC study participants (mean ± SD age 56.9 ± 5.7 years, 43.2% male, 23.9% black). A total of 12,770 participants were followed until 2011 for incident AAA. Multivariable-adjusted Cox regression models were used. A total of 449 incident AAA events occurred over a median follow-up of 19.7 years. For the association between serum calcium and risk of incident AAA there was evidence of interaction by sex ( p-interaction 0.02). Among women, in the fully adjusted model, the hazard ratio (95% confidence interval) comparing the highest to lowest quartile was 2.43 (1.25–4.73), whereas in men it was 1.01 (0.72–1.43). Not associated with risk of incident AAA were 25(OH)D, FGF23, phosphorus, and PTH. In this large prospective cohort, there was little evidence that markers of vitamin D metabolism are associated with risk of incident AAA. The positive association of calcium with AAA among women may warrant further investigation and replication in other populations.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X17751258
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 3
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    Online Resource
    Association of anger proneness, depression and low social support with peripheral arterial disease: the Atherosclerosis Risk in Communities Study
    SAGE Publications ; 2005
    In:  Vascular Medicine Vol. 10, No. 3 ( 2005-08), p. 199-206
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 10, No. 3 ( 2005-08), p. 199-206
    Abstract: There is mounting evidence to suggest that psychosocial factors, including anger proneness, depression and social isolation, are risk factors for cardiovascular disease. Nevertheless, evidence relating these factors to peripheral arterial disease (PAD) and intermittent claudication remains sparse. Using data from the Atherosclerosis Risk in Communities Study, we analyzed the relationship of psychosocial variables (Spielberger anger score, depression score from the Maastricht questionnaire, and a perceived social support scale) at study visit 2 with incident PAD (ankle-brachial index ≤0.9; a hospital discharge diagnosis of PAD, leg amputation, or leg revascularization procedures; or intermittent claudication). In 12 965 middle-aged adults with no prior history of PAD, 854 developed PAD over a mean follow-up time of 9.7 years, yielding an incidence rate of 6.8 per 1000 person years. A modest, monotonic dose-response, positive association between anger proneness and incident PAD was observed in a multivariable model: relative risk (RR) = 1.15 (95% confidence interval (CI) 0.99-1.38) in the moderate anger group and RR = 1.38 (95% CI 1.08-1.76) in the high anger group, compared with the low anger group. When compared with a low level of depressive symptoms, moderate and high levels of depressive symptoms were also associated with greater incident PAD, with multivariable RRs of 1.20 (95% CI 0.99-1.45) and 1.44 (95% CI 1.19-1.74) respectively. There was no association of perceived level of social support with the occurrence of PAD. Anger proneness and depressive symptoms may be associated with the occur-rence of PAD, as for other atherosclerotic syndromes. These findings may warrant confirmation in further studies and, if causal, could serve as a unique target for a PAD prevention trial.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1191/1358863x05vm622oa
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
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  • 4
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    Ankle—brachial index and hemostatic markers in the Atherosclerosis Risk in Communities (ARIC) study cohort
    SAGE Publications ; 2007
    In:  Vascular Medicine Vol. 12, No. 4 ( 2007-11), p. 267-273
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 12, No. 4 ( 2007-11), p. 267-273
    Abstract: To determine whether elevated levels of hemostatic and inflammatory markers [von Willebrand factor (vWF), fibrinogen, D-dimer, factor VII, factor VIII, PAI-1, tPA, beta-thromboglobulin (β-TG), CRP, and WBC count] are associated with increased peripheral arterial disease (PAD) prevalence, measured by low ABI, we studied 13,778 participants from the ARIC study in a cross-sectional analysis after adjustment for major cardiovascular risk factors. PAD was positively associated with fibrinogen, vWF, factor VIII, WBC count, D-dimer, β-TG, and CRP (p for trend 〈 0.05) but not with the other markers. Adjusted odds ratios for the highest versus the lowest quartile of fibrinogen in men and women, respectively, were 3.49 (95% CI 1.68—7.26) and 2.44 (95% CI 1.58—3.77); for vWF 2.36 (95% CI 1.36—4.07) and 1.45 (95% CI 1.00—2.10); for factor VIII 2.31 (95% CI 1.36—3.94) and 1.68 (95% CI 1.14—2.48). In a smaller subset, the sex and risk factor adjusted odds ratio for the highest versus the lowest quartile of D-dimer was 2.70 (95% CI 1.56—4.65), for β-TG was 1.80 (95% CI 1.12—2.88), and for CRP was 1.57 (95% CI 0.84—2.95). Plasma levels of hemostatic and inflammatory markers are elevated in PAD, suggesting these processes are involved in the pathophysiology of PAD.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X07082767
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
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  • 5
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    Association of Life’s Simple 7 with reduced clinically manifest abdominal aortic aneurysm: The ARIC study
    SAGE Publications ; 2019
    In:  Vascular Medicine Vol. 24, No. 3 ( 2019-06), p. 224-229
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 24, No. 3 ( 2019-06), p. 224-229
    Abstract: To optimize cardiovascular health, the American Heart Association (AHA) has recommended ‘Life’s Simple 7 (LS7)’. We tested the hypothesis that greater adherence to the LS7 cardiovascular risk metric is associated with reduced risk of developing abdominal aortic aneurysm (AAA). A total of 14,375 black and white participants aged 45–64 years at the baseline visit of the Atherosclerosis Risk in Communities (ARIC) study cohort were included in this analysis. A 14-point summary score for LS7 was calculated, and participants were classified as having poor (0–4), average (5–9), or ideal (10–14) cardiovascular health. We also counted the number of ideal components. Poisson regression was used to calculate incidence rates for AAA, and Cox regression to calculate hazard ratios adjusted for age, race, sex, and socioeconomic status. Over 25 years of follow-up, we identified 545 clinically manifest AAA events. Incident rates per 1000 person-years declined markedly across LS7 categories: 3.4 for the ‘poor’ category, 2.2 for ‘average’, and 0.9 for ‘ideal’. Compared to individuals in the ‘poor’ LS7 category, individuals in the ‘average’ category had a 52% lower AAA risk (95% CI: 37% to 63%) and those in the ‘ideal’ category had an 80% lower risk (95% CI: 72% to 86%). For every additional ideal component, there was a 28% lower risk of AAA (95% CI: 23% to 33%). Greater adherence to the AHA’s LS7 cardiovascular risk metric is associated with a reduced risk of clinically manifest AAA. These findings support the recommendation to follow LS7 for primary prevention of AAA.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X19829226
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 6
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    Online Resource
    Plasma Galectin-3 and Sonographic Measures of Carotid Atherosclerosis in the Atherosclerosis Risk in Communities Study
    SAGE Publications ; 2019
    In:  Angiology Vol. 70, No. 1 ( 2019-01), p. 47-55
    Details
    In: Angiology, SAGE Publications, Vol. 70, No. 1 ( 2019-01), p. 47-55
    Abstract: Galectin-3 is a β-galactoside-binding lectin that plays a role in the regulation of several conditions that are associated with atherosclerosis. The goal of this cross-sectional study was to assess the association of plasma galectin-3 concentrations with sonographic measures of carotid atherosclerosis in the Atherosclerosis Risk in Communities study. Linear regression was used to determine the difference and 95% confidence intervals (CIs) for carotid intima–media thickness (cIMT) by categorical and continuous representations of galectin-3. Logistic regression was used to determine the odds ratio and 95% CI, separately, for dichotomized cIMT (75th percentile = 0.9 mm) and carotid plaque and/or shadowing. Compared to those in the first quintile of galectin-3, those in the fifth quintile of galectin-3 level had higher cIMT (mean difference: 0.020 mm after multivariable adjustment; P trend = .04). Moreover, compared to those in the lowest galectin-3 quintile, those in the highest galectin-3 quintile had higher odds of carotid plaque/and or shadowing (odds ratio 1.13 after multivariable adjustment; P trend = .014). Higher levels of galectin-3 are associated with greater carotid atherosclerosis. Our findings provide support for the role of inflammatory biomarkers in the pathogenesis of atherosclerosis and suggest galectin-3 as a possible target for intervention in the prevention or management of atherosclerotic disease.
    Type of Medium: Online Resource
    ISSN: 0003-3197 , 1940-1574
    URL: Article
    DOI: 10.1177/0003319718780772
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 7
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    Online Resource
    The ARIC Carotid MRI Study of Blood Cellular Markers: An Inverse Association of Monocyte Myeloperoxidase Content With Peripheral Arterial Disease
    SAGE Publications ; 2011
    In:  Angiology Vol. 62, No. 3 ( 2011-04), p. 237-244
    Details
    In: Angiology, SAGE Publications, Vol. 62, No. 3 ( 2011-04), p. 237-244
    Abstract: We evaluated the association of blood monocyte and platelet activation markers with the risk of peripheral artery disease (PAD) in a multicenter study of atherosclerosis among African American and Caucasian patients. Flow cytometric analysis of blood cells was performed in 1791 participants (209 cases with PAD and 1582 noncases) from the cross-sectional Atherosclerosis Risk in Communities Carotid Magnetic Resonance Imaging ([MRI] ARIC Carotid MRI) Study to assess platelet glycoproteins IIb and IIIa, P-selectin, CD40 ligand, platelet—leukocyte aggregates, monocyte lipopolysaccharide receptor, toll-like receptors (TLRs) 2 and 4, P-selectin glycoprotein ligand 1, cyclooxygenase 2, and myeloperoxidase. Multivariate regression analyses evaluated the association of cellular markers with the risk of PAD. After adjusting for age, race, and gender, platelet CD40L, and monocyte myeloperoxidase (mMPO) levels were significantly lower (P 〈 .001), and monocyte TLR-4 levels were higher (P = .03) in patients with PAD. With additional adjustments for conventional risk factors, mMPO remained inversely and independently associated with the risk of PAD (odds ratio [OR]: 0.35, P = .01).
    Type of Medium: Online Resource
    ISSN: 0003-3197 , 1940-1574
    URL: Article
    DOI: 10.1177/0003319710385336
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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  • 8
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    Glycemia (hemoglobin A 1c ) and incident venous thromboembolism in the Atherosclerosis Risk in Communities cohort study
    SAGE Publications ; 2013
    In:  Vascular Medicine Vol. 18, No. 5 ( 2013-10), p. 245-250
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 18, No. 5 ( 2013-10), p. 245-250
    Abstract: Diabetes has been inconsistently associated with increased risk of venous thromboembolism (VTE) and there is little direct evidence on the associations of glycemia levels with VTE. We used data from the Atherosclerosis Risk in Communities study to test the hypothesis that glycemia, as measured by hemoglobin A 1c (A 1c ), is positively associated with VTE. Participants aged 45–64 years ( n = 12,298) had A 1c measured in 1990 and were followed for incident VTE ( n = 345) through 2005. Because A 1c is affected by diabetes treatment, analyses were stratified by history of diagnosed diabetes. Owing to evidence of non-linearity, we categorized A 1c according to clinical cut-points: 〈 5.7, 5.7–6.4, and ≥6.5% in those with no diagnosed diabetes; 〈 7.0 and ≥7.0% in those with diagnosed diabetes. After adjustment for potential confounders, the hazard ratios (95% CIs) for VTE across increasing A 1c categories were 1 (referent), 1.02 (0.77, 1.35) and 0.72 (0.41, 1.29) for those without diagnosed diabetes, and 1.30 (0.77, 2.17) and 1.41 (0.95, 2.09) for those with diagnosed diabetes. To explore the relation, we employed various models to adjust for potential confounding variables and modeled A 1c as tertiles. We consistently found elevated hazard ratios in those with diagnosed diabetes, though the association was not statistically significant in every model. Hazard ratios in those without diagnosed diabetes were close to 1. In conclusion, our results are mildly suggestive that diagnosed diabetes and high levels of glucose, per se, may increase the risk of VTE. Elevated glucose was not related to VTE in those without diagnosed diabetes.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X13506764
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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  • 9
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    No Association Found Between Midlife Seropositivity for Infection and Subsequent Cognitive Decline: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)
    SAGE Publications ; 2020
    In:  Journal of Geriatric Psychiatry and Neurology Vol. 33, No. 1 ( 2020-01), p. 15-21
    Details
    In: Journal of Geriatric Psychiatry and Neurology, SAGE Publications, Vol. 33, No. 1 ( 2020-01), p. 15-21
    Abstract: Infections of herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), Helicobacter pylori, and Chlamydia pneumoniae may play a role in cognitive decline via systemic inflammation. We hypothesized that Atherosclerosis Risk in Communities study participants who were seropositive in midlife for antibodies to HSV-1, CMV, H pylori, or C pneumoniae would have an accelerated rate of cognitive decline over 20 years. Atherosclerosis Risk in Communities performed a case-cohort study involving a stratified random sample of participants tested for serum immunoglobulin G antibodies to the pathogens of interest. We conducted a longitudinal study using this cohort. Cognitive change was measured using Z scores from the Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF) Tests administered at visits 2 (1990-1992), 4 (1996-1998), and 5 (2011-2013). Linear regression models with generalized estimating equations and inverse probability of attrition weights were used to evaluate associations between infection and cognitive performance. Four hundred twenty-six participants were analyzed, of which 3% were seronegative for all 4 infections, 14% seropositive for one, 33% and 34% seropositive for 2 and 3, respectively, and 16% seropositive for all infections. At baseline, test scores were significantly lower for participants seropositive for H pylori and C pneumoniae. After baseline covariate adjustment, the rate of decline in DWR, DSS, WF, and global Z scores did not differ significantly by infection status for any of the 4 infections. There was also no significant association between the number of infections for which participants were seropositive and cognitive decline. Our study provides no evidence supporting a longitudinal relationship between seropositivity and cognitive decline.
    Type of Medium: Online Resource
    ISSN: 0891-9887 , 1552-5708
    URL: Article
    DOI: 10.1177/0891988719856692
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 10
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    The Association of Biomarkers of Inflammation and Extracellular Matrix Degradation With the Risk of Abdominal Aortic Aneurysm: The ARIC Study
    SAGE Publications ; 2019
    In:  Angiology Vol. 70, No. 2 ( 2019-02), p. 130-140
    Details
    In: Angiology, SAGE Publications, Vol. 70, No. 2 ( 2019-02), p. 130-140
    Abstract: Animal and human laboratory studies suggest that the pathogenesis of abdominal aortic aneurysms (AAAs) involves inflammation and degradation and remodeling of the extracellular matrix. This study prospectively assessed the association between biomarkers for these mechanisms and the presence of AAA during 24 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) study. The ARIC prospectively identified clinically diagnosed AAAs in 15 792 men and women from baseline in 1987 to 1989 to 2011 using hospital discharge codes and death records. Additional asymptomatic AAAs were detected by an abdominal ultrasound scan in 2011 to 2013. Matrix metalloproteinase (MMP)-3, MMP-9, interleukin 6 (IL-6), N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin were measured in blood samples collected between 1987 and 1992 in participants with AAA (544 clinically diagnosed AAAs and 72 ultrasound-detected AAAs) and a random sample of 723 participants selected from baseline and matched with AAAs by age, race and sex. Higher concentrations of MMP-9 and IL-6 were associated with future risk of clinically diagnosed AAA (hazard ratios [95% confidence intervals]: 1.55 [1.22-1.97] and 1.87 [1.48-2.35], respectively, comparing highest versus lowest tertiles) after multivariable adjustment ( P for trend 〈 .001). Matrix metalloproteinase-9 was also associated with ultrasound-detected AAA. In conclusion, blood concentrations of MMP-9 and IL-6 measured in middle age predicted the risk of AAA during 24 years of follow-up.
    Type of Medium: Online Resource
    ISSN: 0003-3197 , 1940-1574
    URL: Article
    DOI: 10.1177/0003319718785278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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