bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract MP016: Glycated Albumin and Fructosamine May Not Overcome Limitations of HbA1c in the Setting of Chronic Kidney Disease
Authors: Jung Molly , Warren Bethany , Grams Morgan , Kwong Diana , Shafi Tariq , Coresh Josef , Rebholz Casey , Selvin Elizabeth
Published: March 2022

Introduction:
Alterations in red blood cell turnover in the setting of chronic kidney disease (CKD) may limit the interpretability of hemoglobin A1c (HbA1c) as a measure of diabetic glucose control. Where HbA1c is problematic, glycated albumin and fructosamine have been proposed as better markers of hyperglycemia. We investigated whether the associations of HbA1c, glycated albumin, and fructosamine with fasting glucose and HbA1c varied by CKD stage.

Methods:
We performed a cross-sectional analysis of 1,678 persons with diagnosed diabetes aged 65 years or older from the Atherosclerosis Risk in Communities Studies (list 5, 2011-2013). We compared Spearman’s rank correlation coefficients and root mean square error (RMSEs) for HbA1c, glycated albumin, and fructosamine with fasting glucose and HbA1c across CKD stages. CKD stages were defined using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR).

Results:
Mean age was 76 years, 54% (910 of 1,678) were female, and 29% (479 of 1,678) were black. The associations of HbA1c, glycated albumin, and fructosamine with fasting glucose were weaker (lower correlations and higher RMSEs) in persons with worse kidney function compared to those with preserved kidney function (Table). Both glycated albumin and fructosamine had stronger associations with HbA1c compared to fasting glucose and their associations with HbA1c were relatively similar across CKD stages.

Conclusions:
In persons with worse kidney function, HbA1c, glycated albumin, and fructosamine were all poorly correlated with fasting glucose. Yet the associations between glycated albumin and fructosamine with HbA1c were similar across CKD stages. Our data suggest that glycated albumin and fructosamine might not overcome limitations of HbA1c as a marker of hyperglycemia in older adults with CKD.
Abstract MP043: Pericardial Fat Thickness Increases With Greater Burden of Adverse Metabolic Factors Among Adults With Normal-range Body Mass Index: the Framingham Heart Study
Authors: Gona Philimon N , Lee Jane J , Oyama-Manabe Noriko , Salton Carol J , O’Donnell Christopher J , Manning Warren J , Chuang Michael L
Published: March 2022

Introduction:
Greater burden of pericardial fat is associated with increased body mass index (BMI). Obesity is associated with unfavorable metabolic characteristics such as hypertension, dyslipidemia, and glucose intolerance. We sought to determine whether increased pericardial fat thickness (PFT) was associated with unfavorable metabolic profile alone, in the absence of excess BMI.

Methods:
From the 1,794 Framingham Offspring cohort adults who underwent cardiac magnetic resonance (CMR), we identified 446 free of non-skin cancer and prevalent clinical cardiovascular disease (CVD) who had 18.5≤BMI<25.0 kg/m
2
and complete covariates. We calculated a metabolic score (MS) based on ATPIII criteria where 1 point was assigned for each of: a) fasting plasma glucose≥100 mg/dL or diabetes; b) SBP≥130 or DBP≥85 mm Hg or antihypertensive treatment; c) triglycerides≥150 mg/dL; d) HDL cholesterol <40(M)/<50(W) mg/dL or lipid-lowering treatment; e) HOMA-IR≥2.5; f) waist circumference ≥102(M)/ ≥88(W) cm. Participants were stratified as MS0 (no points), MS1 (1 point), MS2 (2 points) or MS3+ (≥3 points). PFT over the right ventricle (RV) was measured at the RV apex, at mid-ventricle and at maximal thickness from breathhold cine SSFP CMR in the 4-chamber view at end-diastole. The RV was selected because pericardial fat is commonly and well visualized over the RV. Analysis of covariance (ANCOVA), adjusted for sex, age, and BMI, was used to compare MS1, MS2 and MS3+ groups to the MS0 group. We further tested for linear trend across MS groups.

Results:
PFT increased with worsening metabolic score (see Table) at the fixed locations of the apical and mid-level RV, as well as at maximal PFT. On pairwise comparisons, only the MS3+ group had PFT that was consistently significantly greater than that of MS0 (all p<0.01).

Conclusions:
In a community-dwelling cohort, among participants who were free of cancer and clinical CVD and had normal-range or “healthy” BMI, worsening metabolic profile was associated with increased pericardial fat thickness.
Abstract MP046: Visceral Adipose Tissue but Not Subcutaneous Adipose Tissue Associates With Cholesterol Efflux Capacity in Psoriasis
Authors: Rivers Joshua P , Dey Amit K , Chaturvedi Abhishek , Chung Jonathan H , Kabbany Mohammad Tarek , Ahlman Mark A , Rodante Justin A , Joshi Aditya A , Harrington Charlotte L , Playford Martin P , Yao Jianhua , Powell-Wiley Tiffany M , Mehta Nehal N
Published: March 2022

Background:
Psoriasis (PSO), a chronic inflammatory disease associated with increased cardiovascular (CV) risk, provides an ideal model to study inflammatory atherogenesis in vivo. PSO is associated with impaired cholesterol efflux capacity (CEC) and increased cardiometabolic dysfunction including adipose tissue dysregulation. Recently, visceral adiposity (VAT) was shown to be associated with increased CV events. However, neither VAT nor subcutaneous adiposity (SAT) have been shown to be associated with CEC.

Hypothesis:
Increased VAT by CT is associated with a decrease in CEC independent of CV risk factors.

Methods:
Consecutively recruited PSO patients (N=76) underwent CT scans to measure abdominal adiposity. VAT and SAT volume was quantified from the level vertebral level T10 to pubic symphysis. CEC was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-laden macrophages. The relationship of VAT and SAT with CEC was analyzed using multivariable regression models (STATA 12).

Results:
The cohort had a low CV risk by FRS [median (IQR): 4.0 (2.0-7.0)], mild to moderate PSO [median (IQR): 5.2 (3.0-8.5)], overweight to obese with a mean BMI of 30, 40% were on statin treatment, and 40% were on systemic/biologic therapy for PSO. In unadjusted models VAT was inversely associated with CEC (beta = -0.41, p <0.001) while SAT was not significantly associated (beta = -0.12, p = 0.32). In fully adjusted models VAT retained inverse association with CEC (beta = -0.35, p = 0.04) while SAT remained insignificant (beta coefficient = 0.15, p-value = 0.43) (Table 1).

Conclusions:
VAT inversely associated with CEC while SAT showed no significant relationship suggesting that VAT may directly drive inflammatory HDL dysfunction while SAT may not. However, larger studies are needed to confirm these findings.
Abstract MP075: Profiles of Obese Depressed Adults in a Randomized Controlled Trial of Integrated Behavior Therapy
Authors: Ma Jun , Xiao Lan , LV Nan , Goldman Rosas Lisa , Snowden Mark , Lewis Megan A , Goldhaber-Fiebert Jeremy D , Venditti Elizabeth M , Lesser Lenard , Ward Elizabeth
Published: March 2022

Objective:
To identify distinct profiles of obese depressed patients in an ongoing trial that tests the effectiveness and implementation potential of an integrated care model in primary care combining standard behavioral weight loss treatment and problem solving therapy plus as-needed antidepressant(s).

Design and Methods:
Analysis of variance for continuous and Chi-square tests for categorical variables compared 4 domains (sociodemographic, behavioral, clinical and psychosocial characteristics) among 4 severity categories of obese depressed participants (i.e., body mass index [BMI]<35 kg/m
2
and Depression Symptom Checklist 20 [SCL20]<1.5; BMI<35 and SCL20≥1.5; BMI≥35 and SCL20<1.5; and BMI≥35 and SCL20≥1.5). Discriminant analysis identified combinations of characteristics that best differentiated these categories.

Results:
Participants (n=322) had baseline mean (SD) age of 50.4 (12.2) years, BMI of 36.7 (6.4) kg/m
2
, and SCL20 of 1.5 (0.5). Pairwise comparisons showed participants in the 4 categories had similar sociodemographic characteristics, but they differed significantly in the other 3 domains (Table). Discriminant analysis showed the combination of higher abdominal obesity, problems with usual activities (eg, work and family or leisure activities), higher anxiety, poorer self-reported mental health, and more obesity-related problems differentiated the highest from lowest severity category. The combination of lower abdominal obesity, more obese-related problems, and higher anxiety differentiated the 2 intermediate (lower obesity/high depression vs. high obesity/lower depression) categories.

Conclusions:
Discernable behavioral, clinical and psychosocial profiles reveal important variability according to comorbidity severity within a largely sociodemographically similar group of obese depressed adults. This insight may inform future analysis of heterogeneity of treatment effects and targeting of strategies to baseline participant profiles in a multicomponent intervention.
Abstract MP080: Contributions of Social, Behavioral, and Biological Factors to Racial Disparities in Incident Obesity: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Kershaw Kiarri N , Dutton Gareth , Goff David C , Gordon-Larsen Penny , Jacobs David , Kiefe Catarina , Lewis Cora E , Lloyd-Jones Donald M , Ning Hongyan , Shikany James , Sidney Stephen , Whitaker Kara
Published: March 2022

Background:
A combination of social, behavioral, and biological factors are hypothesized to account in large part for racial disparities in obesity, but few studies have shown this empirically. Thus, the goal of this study was to determine the extent to which these factors accounted for racial differences in the development of obesity in men and women over a 30-year period (mean follow-up 21.7 years).

Methods:
This study includes the 1,617 Black (743 men and 874 women) and 1,950 White (928 men and 1,022 women) CARDIA participants with complete data on all baseline covariates who were not obese at baseline (1985-1986; ages 18-30). A series of gender-stratified Cox proportional hazards models were run adjusting separately for socioeconomic, psychosocial, neighborhood, lifestyle, and physiological factors to determine the extent to which they explained race differences in incident obesity.

Results:
Among men, 36.9% of Whites and 43.7% of Blacks became obese over follow-up. In women, 33.7% of Whites and 60.3% of Blacks became obese. After adjusting for age and baseline BMI, Black men were 1.39 (95% confidence interval (CI): 1.19, 1.62) times more likely to become obese than White men (Table). Covariate adjustment reduced race differences by 34%; neighborhood factors were the strongest contributors. Black women were 1.63 (95% CI: 1.42, 1.88) times more likely to become obese than White women in the base model. This association was reduced by 57% in fully adjusted models. Lifestyle factors explained the largest proportion of the race difference, followed by individual-level socioeconomic factors and neighborhood conditions.

Conclusions:
Racial disparities in incident obesity, and the extent to which these disparities were explained by baseline covariates, differ for men and women. Whereas substantial attenuation occurred after adjustment for a wide variety of baseline covariates, race differences in obesity incidence remained significant.
Abstract P002: The American Heart Association’s Life’s Simple 7 and Risk of Incident Atrial Fibrillation: the REasons for Geographic and Racial Differences in Stroke Study
Authors: Garg Parveen , O’Neal Wesley , Ogunsua Adedotun , Howard George , Soliman Elsayed , Cushman Mary
Published: March 2022

Background:
The American Heart Association has identified metrics of ideal cardiovascular (CV) health known as Life’s Simple 7 (LS7), including blood pressure, body mass index, cholesterol, cigarette smoking, diet, glucose, and physical activity, to target primary cardiovascular disease prevention. While poor control of these metrics are individually associated with a higher risk of atrial fibrillation (AF), the association of the combination of these metrics with incident AF has not been evaluated. We determined the relationship between LS7 and incident AF in a cohort of middle and older-aged adults.

Methods:
The REasons for Geographic And Racial Differences in Stroke Study is a biracial prospective study of 30,249 individuals. Eligible participants included those without AF who had data on all LS7 components at baseline and completed a follow-up exam 10 years later. An overall LS7 score was calculated as the sum of the LS7 component scores (0 to 2 points per component). This score was classified as inadequate (0-4), average (5-9), or optimum (10-14) CV health. Incident AF was identified at follow-up by either electrocardiogram or a self-reported medical history of a physician diagnosis.

Results:
9,576 participants (mean age=63; 57% women; 30% black) were included. In adjusted logistic regression analyses, optimum CV health (referent=poor) and each one point higher LS7 score were associated with a lower incident AF (Table). Associations did not differ by race or gender (interaction p-values of 0.51 and 0.49 respectively).

Conclusions:
Better CV health, as defined by the LS7 score, is associated with a reduction in the incidence of AF. Further study into whether efforts to improve the population’s CV health lower AF incidence is needed.
Abstract P012: Three Biological Age Estimates May Capture Distinct Aspects of Aging
Authors: Murabito Joanne M , Zhao Qiang , Levy Daniel , Benjamin Emelia J , Larson Martin G , Lunetta Kathryn L
Published: March 2022

Background:
Biological age (
BA
) may reflect an individual’s aging process better than chronological age (
CA
). The objective of our study was to construct BA measures from different types of biomarkers and test their associations with mortality and age-related disease in a community-based sample.

Methods:
We selected 6 clinical predictors that capture pulmonary, vascular, atherosclerosis, insulin sensitivity, inflammatory, and kidney domains of aging, and 9 inflammatory biomarkers measured in Framingham Heart Study Offspring cohort participants at exams 7 (1998-2001, N=3539, mean age 62±10) and 8 (2005-2008, N=3021, mean age 67±9). We used the Klemera-Doubal method to calculate a clinical variable BA and an inflammatory marker BA. We computed BA using DNA methylation (DNAm) data at exam 8 using Horvath’s method. For each of the measures we computed the difference (
ΔAge
) between BA and CA and modeled the effects of ΔAge after accounting for CA. We followed participants through 2014 for all-cause mortality (N=713), cardiovascular disease (CVD, N=412), coronary heart disease (CHD, N=223), stroke (N=129), and cancer (N=509).

Results:
Inflammatory and clinical ΔAge were correlated (=0.35, =0.33, for exams 7 and 8 respectively), and also across exams (inflammatory ΔAge exam 7 vs 8: =0.61; clinical ΔAge: =0.76). DNAm ΔAge was not significantly correlated with exam 8 inflammatory or clinical ΔAge. After adjusting for CA and sex, larger inflammatory and clinical ΔAge, corresponding to older BA than CA, was associated with significantly increased hazards of all-cause mortality, CVD, and CHD (Table). The clinical and inflammatory ΔAge were significant (p<0.05) in models containing both measures. DNAm ΔAge was associated with increased hazards of all-cause mortality, CVD, cancer, and stroke, and remained significant in a model for mortality that also included inflammatory ΔAge (p<0.05).

Conclusions:
Our findings suggest the three BA measures may be complementary in predicting risk for age-related disease.
Abstract P016: Left Ventricular Hypertrophy is Associated With Incident Dementia: The Atherosclerosis Risk in Communities - Neurocognitive Study
Authors: Norby Faye L , Chen Lin Y , Soliman Elsayed Z , Gottesman Rebecca F , Mosley Thomas H , Alonso Alvaro
Published: March 2022

Background:
Left ventricular hypertrophy (LVH) is most commonly an indicator of target organ damage due to hypertension and may serve as a marker for chronicity of blood pressure elevation and as an indicator of the long-term burden of vascular risk factors. We assessed whether LVH measured by 12-lead ECG was associated with incident dementia in the Atherosclerosis Risk in Communities – Neurocognitive Study (ARIC-NCS).

Methods:
Our analysis included 12,665 individuals (23% black race, 56% female, mean age 57) who attended visit 2 in 1990-92. Cornell voltage (SV3 + RaVL) was derived from 12-lead ECG at visit 2 (1990-92), visit 3 (1993-95) and visit 4 (1996-98) as a continuous variable, and the gender-specific Cornell voltage criteria (SV3 + RaVL > 28mm for men, and >22mm for women) was used to define LVH as a dichotomous variable. Incident dementia was defined using a validated algorithm consisting of a full neuropsychological assessment, interviews, informant interviews, hospital discharge codes, or diagnostic codes from death certificates. A cox proportional hazards model was used to evaluate the association between LVH and incident dementia. LVH and Cornell voltage were modeled as time-dependent variables and covariates were updated at each visit. Follow-up time was from baseline until date of dementia, end of follow-up, or the end of 2013, whichever came first.

Results:
During a mean follow-up of 18 years, we identified 544 participants with LVH and 1195 incident dementia cases. LVH was associated with a higher risk of dementia: multivariable hazard ratio (HR) 1.91, 95% confidence interval (CI) 1.48-2.46 (Table). A 1-standard deviation increase in Cornell voltage (5 mm) was associated with a higher risk of dementia, HR (95% CI) = 1.10 (1.04-1.17).

Conclusion:
In this large population-based study, LVH measured in mid-life was associated with an increased risk of dementia. Additional research should confirm this association, and these results underscore the need for hypertension control to prevent subclinical brain injury.
Abstract P017: Migraine and Cognitive Function: baseline Findings From the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil
Authors: Baena Cristina P , Goulart Alessandra , Santos Itamar , Suemoto Claudia , Lotufo Paulo , Benseñor Isabela
Published: March 2022

Background:
Migraine and dementia are associated with higher vascular risk and both conditions have been linked with structural brain lesions. However, evidence on the possible association between migraine and cognitive performance is unclear. We aimed to analyze whether migraine is associated with cognitive performance within participants of the Brazilian Longitudinal Study of Adult Health, ELSA-Brasil.

Methods:
Inthis a cross-sectional analysis, we evaluated all participants without previous stroke, who were not taking medications that could impair cognitive performance and with complete data on cognitive tests or migraine at baseline assessment. Migraine based on International Headache Society classification was used as dependent variable in binary logistic models. The Consortium to Establish a Registry for Alzheimer’s disease scores for word list memory test (CERAD-WLMT), the semantic fluency test (SFT), and the Trail Making Test version B (TMTB) were categorized into poor cognitive performance as defined by a score below mean minus one standard deviation for a participant’s sex, age and educational-level group for memory and fluency tests and as a score above mean plus one standard deviation for the time to perform the Trail Making Test Version B.. Multivariate analyses were adjusted for marital status, alcohol consumption, smoking, physical activity, body-mass index, hypertension, diabetes mellitus and depression. In women we further adjusted for hormone replacement therapy.

Results:
We analyzed 4993 men(51.6 ±9.2 y) and 5028 women (51.9±8.9y ). Among those, there were 131 men( 2.6 %) and 926 women migraneurs (18.4%). The proportion of participants in the poor cognitive category did not differ significantly between migraneurs and non-migraneurs for men or women in any of the cognitive tests (p>0.072 for all). Fully adjusted OR (95%) for poor performance in men on immediate recall, late recall, recognition, verbal fluency, and TMTB were 1.02(0.60;1.72),1.15(0.69;1.91), 0.86(0.51;1.43), 1.08(0.51;1.43) and 1.75(0.64;1.82) respectively and in women 1.06(0.69; 1.62); 0.89 (0.61;1.29);1.25(0.81;1.95) and 1.72(1.07;2.77) respectively.

Conclusion:
Migraine was associated with poorer executive function in middle-aged women after multivariate adjustment including HRT. No association was found for middle-aged men, but this may be a consequence of the lower number of men with migraine compared to women.
Abstract P022: Sex and Racial Differences in Cardiovascular Disease Risk in Patients With Atrial Fibrillation
Authors: Alonso Alvaro , Chamberlain Alanna , Lutsey Pamela , MacLehose Richard , Norby Faye , O’Neal Wesley , Bengtson Lindsay , Chen Lin
Published: March 2022

Background:
Women and African Americans with atrial fibrillation (AF) experience higher rates of stroke compared to men and white AF patients, respectively. However, sex and race differences for cardiovascular outcomes other than stroke have not been specifically evaluated in patients with AF.

Methods:
We studied patients with AF in the Optum Clinformatics database between 2009 and 2015 with at least 6 months of enrollment before AF diagnosis. The Optum Clinformatics database includes medical and pharmacy claims and sociodemographic information on privately insured and Medicare Advantage enrollees throughout the US. Endpoints (hospitalizations for ischemic stroke, heart failure (HF), myocardial infarction (MI)) and covariates were defined using validated algorithms. Multivariable Cox models were used to study the association of race and sex with endpoints of interest.

Results:
The analysis included 380,636 eligible participants (mean age 73, women 45%). Of them, 82% were white, 9% African American, 7% Hispanic and 2% Asian American. During a mean follow-up of 23 months, 7,235 suffered ischemic stroke, 17,258 HF, and 5,585 MI. Crude rates of ischemic stroke and HF were higher in women than men, while men had higher rates of MI than women (Table). African Americans and Hispanics had higher rates of all studied outcomes than whites and Asian Americans. In models including age, sex, race, education and CHA
2
DS
2
-VASc score, women had higher risk of ischemic stroke and lower risk of HF and MI compared to men. Compared to whites, African Americans had 1.4 times the rate of HF and stroke, and 1.1 times the rate of MI, while Asian Americans had 16% lower rates of HF. No major differences were observed between rates in whites and Hispanics (Table).

Conclusion:
In a large insured population of patients with AF, we observed differences in rates of selected cardiovascular outcomes by sex and race. Additional research should explore the mechanisms underlying these differences and develop strategies to eliminate them.
Abstract P030: Recruitment and Effectiveness by Cohort in a Case Management Intervention Among American Indians and Alaska Natives with Diabetes
Authors: Pratte Katherine , Jiang Luohua , Beals Janette , Johnson Ann , Bullock Ann , Manson Spero
Published: March 2022

Introduction:
To determine the optimal strategies for effective large-scale implementation of evidence-based interventions, it is critical to investigate continued effectiveness as an intervention rolls out to large, diverse populations. The purpose of this study is to evaluate whether patient characteristics and intervention effectiveness differ by year of enrollment in a multi-year evidence-based translational intervention.

Hypothesis:
We hypothesize the patients recruited early may have a higher level of readiness to change their behaviors and achieve more improvements in their intervention outcomes than patients enrolled in later years.

Methods:
The Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project is an intensive case management intervention designed to reduce cardiovascular disease (CVD) risk among American Indian and Alaska Native patients with diabetes. SDPI-HH participants recruited from 2006 through 2008 were included (n=2,910). Baseline characteristics were compared by year of enrollment. We also evaluated the differences in improvements in CVD risk factors among participants recruited in different years.

Results:
The baseline characteristics of the three cohorts revealed significant differences in demographics, diabetes duration, health behaviors, level of motivation, and clinical measures. Improvements in 13 clinical and behavioral outcomes differed by enrollment year with the 2006 cohort having the greatest number of statistically significant improvements (Table 1). The 2006 cohort also had the highest rates of participant participation and retention.

Conclusions:
The SDPI-HH participants recruited later had fewer improvements in CVD risk factors, potentially due to the decline in participant motivation over the three years. Further investigation into ways to modify the intensive case management model to address differences in levels of motivation and participation is warranted to improve the prevention of chronic disease in Indian health.
Abstract P042: Coffee Intake and the Risk of Subclinical Myocardial Damage, Cardiovascular Events and All-cause Mortality
Authors: Florido Roberta , Ndumele Chiadi E , Daya Natalie , Chen Yuan , Blumenthal Roger S , Ballantyne Christie M , Rebholz Casey M , Michos Erin D , Klag Michael J , McEvoy John W , Selvin Elizabeth
Published: March 2022

Introduction:
Whether coffee intake is protective against cardiovascular disease (CVD) risk and mortality is controversial and putative mechanisms are incompletely understood, but prior studies may be confounded by a “healthy user” effect.

Hypothesis:
Habitual coffee consumption would not be associated with subclinical myocardial damage assessed using high-sensitivity cardiac troponin T (hs-cTnT), CVD events (coronary heart disease, heart failure or stroke) and all-cause mortality, after adjustment for rigorously measured confounders.

Methods:
We evaluated 11,281 ARIC participants free of CVD at baseline (Visit 2, 1990-1992). Coffee consumption was assessed via a modified food frequency questionnaire at Visit 2 and categorized according to number of cups/day. We used logistic regression models adjusted for demographic characteristics, smoking status and traditional CVD risk factors to test the cross-sectional associations with hs-cTnT, and adjusted Cox models for incident CVD events and mortality.

Results:
Mean age of participants was 57 years, 58% were women and 24% black. In cross-sectional analyses, compared to individuals reporting “almost never” having consumed coffee, no significant association was found between higher levels of coffee consumption and elevated hs-cTnT (OR for ≥6 cups/day vs. almost never 0.69; 95% CI 0.39, 1.21; Table). In prospective analyses, the association between coffee and incident CVD was not significant (HR for ≥6 cups/day vs. almost never: 1.15; 95% CI 0.99, 1.34; Table). Compared to almost never consuming coffee, 2-3 cups/day was associated with reduced risk of all-cause mortality and ≥6 cups/day with elevated risk of all-cause mortality (Table).

Conclusion:
In this bi-racial cohort of middle-aged adults, coffee intake was not associated with subclinical myocardial damage or CVD. However, moderate coffee consumption may be associated with a modestly reduced risk of all-cause mortality and very high coffee consumption with a mild increase in all-cause mortality.
Abstract P044: Male Sex Synergistically Interacts with Serum Corin on Metabolic Syndrome in Chinese Adults
Authors: Peng Hao , Zhang Qiu , Cai Xiaoqin , Chao Xiangqin
Published: March 2022

Background:
Metabolic syndrome is a key modifiable risk factor for cardiovascular disease (CVD). We previously found an increased level of serum corin in some metabolic disorders, such as diabetes, hypertension, dyslipidemia, and obesity. However, the association between serum corin and metabolic syndrome has not yet been studied in humans.

Methods:
We examined serum soluble corin using immunoassays for 2,498 Chinese adults free of CVD. Metabolic syndrome was defined as ≥ 3 components of the 5 metabolic abnormalities - raised blood pressure, increased triglycerides, reduced high density lipoprotein cholesterol, hyperglycemia, and central obesity. Logistic regression model was applied to examine the association of serum corin with metabolic syndrome adjusting for age, smoking, and drinking in men and women, respectively.

Results:
The mean age was 53 ± 9 years. Serum corin was significantly increased in participants with metabolic syndrome in both men (mean: 2457.8
vs
. 2126.6 pg/mL,
P
< 0.001) and women (mean: 1607.4
vs
. 1515.2 pg/mL,
P
< 0.001) compared with those without metabolic syndrome. Serum corin was significantly associated with metabolic syndrome in both genders but this association appeared stronger in men (OR = 1.69, 95%CI: 4.16-1.96,
P
< 0.001) than women (OR = 1.19, 95%CI: 1.06-1.33,
P
= 0.003). The OR of metabolic syndrome for participants with male sex and high corin (> median) was higher than the sum of ORs for those with either male sex or high corin only. About 42% (95%CI: 0.240-0.598) of metabolic syndrome risk could be attributed to the interaction between male sex and high corin.

Conclusions:
Serum corin is significantly and positively associated with metabolic syndrome and its individual components in Chinese adults. Male sex could synergistically interact with Corin on metabolic syndrome. The relationship between serum corin and metabolic syndrome warrants further investigation.
Abstract P045: The Association Between Cigarette Smoking and Cardiovascular Inflammation: The Genetic Epidemiology Network of Arteriopathy Study
Authors: Tibuakuu Martin , Kamimura Daisuke , Kianoush Sina , DeFilippis Andrew , Al Rifai Mahmoud , Butler Kenneth R , Mosley Thomas H , Hall Michael E , Blaha Michael J
Published: March 2022

Background:
To assist in the regulation of novel and existing tobacco products, there is a need to identify biomarkers of early cardiovascular damage following tobacco exposure. Our prior work suggests that inflammatory markers, in particular high-sensitivity C-reactive protein (hsCRP), may be sensitive markers of tobacco mediated cardiovascular damage. We aimed to further study the association of smoking and inflammation in a cohort with hsCRP and 11 other measures of inflammation associated with cardiovascular disease (CVD) risk.

Methods:
We conducted a cross-sectional analysis on 2,550 siblings diagnosed with essential hypertension prior to age 60 years. Cigarette smoking was assessed by status, intensity, pack-years, and time since quitting. We modeled each biomarker per standard deviation after natural log transformation and evaluated the association between smoking and biomarkers using generalized estimating equations (GEE) to account for intra-familial correlations. Models were adjusted for demographics and CVD risk factors.

Results:
The mean age of participants was 61±10 years; 64.5% were women and 54.4% African American. There were 12.2% current smokers and 32.2% former smokers. Compared to never smokers, current smokers had significantly higher levels of 8 inflammatory biomarkers (
Table
). In analyses of other smoking variables, there was a consistent association with hsCRP but not other biomarkers. HsCRP was positively associated with pack-years of cigarette smoked and inversely associated with time since quitting, but not with smoking intensity. There was a significant difference in hsCRP levels among current smokers by race (
p
for interaction=0.005). On average, hsCRP was higher among African American [0.445 (0.283, 0.606)] compared to White smokers [0.183 (0.011, 0.356)].

Conclusion:
Biomarkers of inflammation, especially hsCRP, may allow for early detection of cardiovascular injury due to cigarette smoking and could be useful for the study and regulation of emerging tobacco products.
Abstract P064: Associations Between Signs and Symptoms of Androgen Excess With Prediabetes and Diabetes in Hispanic/Latina Women of Reproductive Age in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Meyer Michelle L , Sotres-Alvarez Daniela , Steiner Anne , Cousins Larry , Talavera Gregory A , Cai Jianwen , Daviglus Martha L , Loehr Laura R
Published: March 2022

Background:
Androgen excess is a characteristic of polycystic ovary syndrome (PCOS). Signs and symptoms of androgen excess are associated with cardiometabolic risk factors and diabetes, however the characterization is incomplete among premenopausal women and high risk groups such as Hispanic/Latina women.

Methods:
HCHS/SOL is a community-based cohort study of 16,415 self-identified Hispanic/Latino adults from diverse backgrounds in the US at the baseline visit (2008-2011; 3,801 women age 18-44 years). This preliminary cross-sectional analysis is from 994 reproductive-aged women who attended the ongoing visit 2 (Oct. 2014-Sept. 2017) by Sept. 2016. Signs and symptoms of androgen excess included menstrual cycle irregularities, self-reported PCOS, and oral contraceptive use to regulate menstrual cycles or acne. Impaired fasting glucose (prediabetes) was defined as fasting glucose 100-125 mg/dL (excluding diabetes), and diabetes as fasting glucose ≥126 mg/dL, glucose post oral glucose tolerance test ≥200 mg/dL, or hemoglobin A1c ≥6.5%. Design-based estimates are presented and adjusted for site, age, Hispanic/Latina background, education, smoking status, and body mass index.

Results:
The mean age was 34 years. The prevalence of any sign or symptom of androgen excess was 28%, of which 19% self-reported having PCOS. Signs and symptoms of androgen excess was not significantly associated with the odds of prediabetes or diabetes (see table). Women self-reporting PCOS or oral contraceptive use to regulate cycles or acne had a higher odds of diabetes compared to those that did not, although not statistically significant.

Conclusion:
In this sample of Hispanic/Latina women, the association between signs and symptoms of androgen excess and the odds of prediabetes or diabetes were not statistically significant. Future analyses will include the whole cohort of reproductive-aged women that will improve statistical power and be critical to further characterize these relationships.
Abstract P066: Shot-term Exposure to Ambient Air Pollution and Circulating Biomarkers of Systemic Inflammation: The Framingham Heart Study
Authors: Li Wenyuan , Wilker Elissa H , Dorans Kirsten S , Rice Mary B , Ljungman Petter L , Schwartz Joel , Coull Brent A , Koutrakis Petros , Gold Diane R , Benjamin Emelia J , Vasan Ramachandran S , Mittleman Murray A
Published: March 2022

Introduction:
Exposure to air pollution has been positively associated with systemic inflammation. However, few large scale studies were conducted in regions with low levels of air pollution. We therefore studied the associations of air pollution with systemic inflammation biomarkers among participants in the Framingham Offspring and Third Generation cohorts in Greater Boston area.

Methods:
We measured C-reactive protein (CRP), fibrinogen, interleukin 6 (IL6), and tumor necrosis factor receptor 2 (TNFR2) in 3943 participants living within 50 km of a central site monitor in Boston. We calculated the 1-, 2-, 3-, 5-, and 7-day moving averages of fine particulate matter (PM
2.5
), black carbon (BC), sulfate (SO
4
2-
), nitrogen oxides (NO
x
), and ozone (O
3
) prior to the exam visits. We used linear mixed effects models and linear regression models to evaluate repeated measures and cross-sectional associations respectively, adjusting for age, sex, individual and area level measures of socioeconomic position, lifestyle and clinical factors, time trend, and weather. We examined effect modification by age (>/≤ 65 years), sex, and diabetes history.

Results:
The mean age was 53(±14) years and 54% were women. PM
2.5
, BC, and SO
4
2-
were positively associated with CRP across multiple moving averages, and were statistically significant at 5-day moving averages: a 5 μg/m
3
higher PM
2.5
or a 0.5 μg/m
3
higher BC was associated with 3.9% (95% CI: 0.5, 7.3) or 5.3% (95% CI: 0.1, 10.9) higher CRP, respectively. Positive associations were observed for PM
2.5
, BC, and NO
x
with IL6; and for BC, SO
4
2-
, and O
3
with TNFR2. SO
4
2-
and O
3
were negatively associated with fibrinogen. Associations of BC and NO
x
with CRP and of BC with IL6 were of a larger magnitude among participants with diabetes than those without.

Conclusions:
In a region in compliance with current US-EPA regulation, we find positive associations of short-term exposure to ambient air pollution with CRP, IL6 and TNFR2 but not for fibrinogen.
Abstract P070: Glucose, Insulin, Insulin Resistance and Exposure to Ambient Air Pollution
Authors: Gondalia Rahul , Lamichhane Archana P , Holliday Katelyn M , Shih Regina A , Griffin Beth A , Wellenius Gregory A , Liao Duanping , Yanosky Jeffrey D , Madrigano Jaime , Stewart James D , Whitsel Eric A
Published: March 2022

Background:
Numerous studies suggest that long-term exposure to ambient particulate matter (PM) and nitrogen oxide (NOx) air pollution may be diabetogenic, but little is known about the effects of shorter-term exposures on markers of diabetes risk. Therefore, our objective was to determine whether short- and long-term ambient PM and NOx exposures are associated with glucose, insulin, and insulin resistance measures.

Methods:
We studied a stratified, random minority oversample of non-diabetic Women’s Health Initiative (WHI) clinical trials participants for whom estimates of fasting glucose, fasting insulin, insulin resistance, and geocoded address-specific daily mean concentrations of PM < 10 μm (PM
10
), PM < 2.5 μm (PM
2.5
), and NOx were available at screening and up to three follow-up visits between 1993-2004 (total n=4,019; mean age: 62.2 yr; 24% black; 12% Hispanic; 51% white). We measured insulin resistance using the homeostatic model assessment [HOMA], triglyceride to high-density lipoprotein cholesterol ratio, and the triglyceride-glucose index. We log-transformed the glucose, insulin, and insulin resistance measures, then used multi-level, mixed, longitudinal models weighted for sampling design / attrition and adjusted for sociodemographic, clinical, and meteorological covariates to estimate their associations with 2- and 365-day mean PM
10
and NOx and 365-day mean PM
2.5
concentrations.

Results:
Measures of glucose homeostasis decreased with short-term exposure to ambient PM
10
. For example, we found a -0.2% (95% confidence interval: -0.4%, 0.1%), -0.9% (-1.7%, -0.1%), and -1.1% (-2.0%, -0.3%) change in glucose, insulin, and HOMA per 10 μg/m
3
increase in the 2-day mean PM
10
concentration. In contrast, we found generally null results per 10 μg/m
3
increase in 365-day mean PM
10
concentration. Measures of glucose homeostasis similarly did not appear to be associated with short- and long-term increases in mean NOx or PM
2.5
concentrations.

Conclusion:
The findings suggest that responses to ambient exposure to PM
10
in women may be adaptive (i.e. capable of re-establishing normal glucose homeostasis and improving insulin sensitivity) over the short-term. Endoplasmic reticulum stress-response mechanisms involving decreases in protein misfolding may help explain this observed phenomena. Contrary to previous studies, results also suggest that sustained exposure to ambient PM and NOx has nominal influence on glucose homeostasis.
Abstract P074: Smoking Status and Incidence of Cancer After Myocardial Infarction: a 20-year Follow-up Study
Authors: Gerber Yariv , Lotan Katrin , Goldbourt Uri
Published: March 2022

Objectives:
We compared cancer incidence after acute myocardial infarction (MI) of never smokers, pre-MI quitters, post-MI quitters and persistent smokers, and assessed whether cigarette reduction among continued smokers is associated with lower cancer risk.

Methods:
Consecutive patients aged ≤65 years discharged from 8 hospitals in central Israel after first MI in 1992-3 were followed for cancer through 2013. Extensive data, including self-reported smoking habits, were obtained at the index hospitalization and 4 times during follow-up. Cox proportional hazards and Fine & Gray competing risks models were constructed to assess the hazard ratios (HRs) for cancer associated with baseline smoking categories. Smoking categories were also modeled as time-varying variables using extended Cox models.

Results:
Overall, 1,486 cancer-free participants at baseline were studies (mean±SD age, 54±8 years; 81% male). Smokers were younger than nonsmokers and more likely to be male and of lower socioeconomic status. Over a median follow-up of 21.4 years, 273 incident cancers were diagnosed. Baseline smoking was associated with ~40% increased risk of cancer; ~25% after accounting for death as a competing event. Taking changes in smoking during follow-up into account, the increased risk was largely confined to persistent smokers, whereas the risk in post-MI quitters was close to that of never smokers (Figure). Among patients who continued smoking after MI, each reduction of 10 cigarettes relative to pre-MI consumption was associated with an adjusted HR of 0.86 (95% CI: 0.74-1.00).

Conclusions:
Smoking cessation either before or after MI is associated with lower risk of cancer. Reducing consumption among persistent smokers appears also to be beneficial.
Abstract P090: Non-Hospital Factors Exacerbate Racial Disparities in In-Hospital Outcomes Among Patients with Coronary Artery Disease
Authors: Sergeev Alexander V
Published: March 2022

Background:
Racial disparities in coronary artery disease (CAD) can worsen patient outcomes. While a number of studies have investigated racial disparities in CAD risk factors, the underlying mechanisms of racial disparities in the treatment outcomes in hospitalized CAD patients remain unclear.

Hypothesis:
We hypothesized that racial disparities in in-hospital CAD mortality are, at least partially, attributed to non-hospital factors that are external to quality of in-hospital care.

Methods:
We conducted a retrospective cohort study of in-hospital mortality in 9,128,116 hospitalized CAD patients (mean±SD age 72.4±13.0 years; 56.7% males) over a five-year time period. Multivariable logistic regression was used to obtain adjusted odds ratios (aOR) for in-hospital death in relation to patients’ race, adjusting for major clinical and demographic covariates.

Results:
A total of 349,688 deaths occurred among 9,128,116 hospitalized CAD cases (3.8% mortality). Mortality in patients admitted through the emergency department was higher than in non-emergency admissions (4.3% vs. 2.8%, p<0.001). Deceased patients had more severe comorbidities than patients who were discharged alive: mean Elixhauser-Walraven comorbidity scores were 10.6±7.7 and 4.9±6.5, respectively (p<0.001), with higher scores indicating a more severe comorbidity status. African Americans were more likely to experience an emergency admittance than any other racial group, with 79.8% of African Americans admissions being through emergency department, compared to 70.9% of Asians admissions and 70.3% of Caucasians admissions (p<0.001, ANOVA with post-hoc analysis and correction for multiple comparisons). Asians had higher Elixhauser-Walraven scores (5.8±6.8) than African Americans (5.4±7.1) and Caucasians (5.0±6.5) (p<0.01). However, when adjusted for multiple confounders, African Americans were less likely to die than patients of other races (aOR = 0.91, 95% CI 0.90-0.92, p<0.001).

Conclusion:
Racial disparities in in-hospital mortality for CAD patients do exist. These disparities are attributed to several factors, including the non-hospital factors external to quality of in-hospital care, such as lack of access to a high-quality primary care resulting in emergency admissions with more severe forms of CAD and severe comorbidities.
Abstract P100: Heritability of Atrial Fibrillation
Authors: Weng Lu-Chen , Choi Seung Hoan , Klarin Derek , Loh Po-Ru , Chaffin Mark , Roselli Carolina , Hulme Olivia , Smith J. Gustav , Kathiresan Sekar , Lunetta Kathryn , Dupuis Josée , Newton-Cheh Chris , Benjamin Emelia J , Ellinor Patrick T , Lubitz Steven A
Published: March 2022

Background:
Atrial fibrillation (AF) is a common and heritable arrhythmia associated with substantial morbidity. Previous reports have implicated over 30 genes and 16 loci in the pathogenesis of AF, but the genetic architecture of the arrhythmia has not been systematically characterized.

Methods:
We assessed AF heritability in 120,286 unrelated individuals of European ancestry (2,981 with AF) from the population-based UK Biobank. We ascertained AF based on self-reported disease history and/or billing codes from medical record data. To validate the phenotype definition, we examined genetic associations with AF for variants at known susceptibility loci reported in prior independent genome-wide association studies. We then estimated the proportion of AF variance explained by additive genetic variation (heritability) using a variance components method (BOLT-REML) based on ~800,000 independent high quality imputed variants with minor allele frequencies (MAF) ≥ 1%. We further evaluated the heritability of AF by sex, allele frequency, and established AF loci from association studies (+/- 500 kb of a top associated variant). All analyses were adjusted for baseline age, sex, array, and 15 principal components of ancestry.

Results:
The average age was higher in AF cases than in referents (62.3 years vs. 56.8 years), and more AF cases were male (69% vs. 47%). We observed expected associations between genetic variation and AF, validating our AF definition. The heritability of AF was 22.3% (95% confidence interval [CI] 15.8%-28.8%), and no substantive difference was observed between males and females. We observed that the AF variance was mainly explained by common variants with MAF ≥ 5% (20.6%, 95%CI 15.2%-25.9%) rather than low-frequency variants with MAF between 1%-<5% (0%, 95%CI 0.0%-0.06%). Only 4.7% (95%CI 3.7%-5.7%) of AF variance was explained by known AF susceptibility loci.

Conclusions:
Using a population-based sample of European ancestry, we observed that a substantial proportion of variance in AF risk is attributable to additive genetic variation. AF variance is predominantly accounted for by common variants. Only a small proportion of AF variance is attributable to known AF loci. Our findings suggest that further genetic discovery, with an emphasis on common variation, is warranted to understand the causal genetic basis of AF.