bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep characteristics in relation to cardiovascular disease incidence and mortality in individuals with diabetes
Authors: Chen Z , Liu B , Hu Y , Rimm E , Huang T , Sun Q 
Published: October 2024

Abstract

Background/Introduction
Evidence regarding the potential health effects of sleep characteristics among individuals with type 2 diabetes (T2D) is limited.

Purpose
We aimed to examine sleep characteristics in relation to subsequent risk of cardiovascular disease (CVD), including coronary heart disease (CHD), and stroke, and all-cause and cause-specific mortality among individuals with T2D.

Methods
We prospectively followed 21,902 men and women with T2D at baseline or diagnosed during follow-up (Nurses' Health Study: 1986-2018, Health Professionals Follow-Up Study: 1986-2018). Sleep characteristics, including sleep duration, snoring, sleep apnea, and sleep quality, were repeatedly assessed using self-reported questionnaires at baseline and follow-up. Associations of sleep characteristics with CVD risk and mortality were assessed using Cox proportional hazards models with adjustments for demographic, dietary and lifestyle factors, and medical history.

Results
During 170,355 and 196,458 person-years of follow-up in participants with T2D, there were 2,486 incident CVD events and 3,922 deaths, respectively. Compared with sleeping for 7-8 h/day, the multivariable-adjusted hazard ratios (HRs) of sleeping for ≤5 h/day were 1.21 (1.02, 1.45) for CVD incidence, 1.24 (1.20, 1.51) for CHD incidence, 1.40 (1.24, 1.58) for total mortality, 1.52 (1.20, 1.92) for CVD mortality, and 1.27 (1.01, 1.61) for other non-CVD and non-cancer mortality, while the HRs of ≥10 h/day were 1.42 (1.21, 1.66) for total mortality, and 1.63 (1.20, 2.10) for other non-CVD and non-cancer mortality. Furthermore, compared with participants without habitual snoring, those with habitual snoring had a 21%, 24%, 18%, and 33% higher risk for CVD incidence, CHD incidence, CVD mortality, and total mortality, respectively. Compared with participants without diagnosed sleep apnea, those with sleep apnea had a 27%-58% higher risk for CVD incidence, CVD mortality, and total mortality. In addition, lower habitual sleep quality, including sleep difficulties and restless sleep, was associated with a substantially higher risk of CVD, CHD, or CVD mortality. No associations were observed between sleep characteristics with risk of stroke and cancer mortality in individuals with T2D.

Conclusions
Short and long sleep durations as well as habitual snoring, sleep apnea, and lower sleep quality were independently associated with higher risks of CVD incidence and mortality, particularly CVD mortality in individuals with T2D.
Is there a gender difference in the effects of cardiovascular risk factors on the anatomical localization and severity of obstruction on coronary arteries?
Authors: Keser N , Korkmaz Y , Dogan S , Torun A , Yavuz S , Babaoglu M , Seker M , Erdem A , Orhan A L 
Published: October 2024

Abstract

Background
Whether there is a gender difference in the effects of traditional cardiovascular risk factors(CVRF) on the anatomical localization(AL) and severity(AS) of obstruction on coronary arteries(CA) remains unclear.

Purpose
In our study, we investigated whether there is a gender difference in the relationship between CVRF and obstruction on CA .

Methods
We included 978 patients(49.9% women, mean age: 61+10.3) with stable chest pain undergoing invasive coronary angiography between 2019-2021 who were recruited from the database of our clinic. We examined the gender difference in hypertension(HT), diabetes mellitus(DM), smoking, hyperlipidemia, previous history of CAD(H.CAD) and family history of premature CAD(F.CAD) and their correlation with the AL and AS of obstruction on CA in both gender.

Results
Women were older(p&lt;0.001) with higher rates of HT (p=0.001) and DM(p=0.026) and higher TC, LDLC and HDLC levels respectively (rs) as (p=0.001, p=0.001, p=0.001). Whereas H.CAD and smoking rates were higher in men rs as (p=0.001, p=0.009).
The incidence of critical stenosis (≥70 obstruction) & intermediate lesions (50-69%) on all CA and Syntax scores were higher in men(p&lt;0,01).
In patients with HT, severe CAD was more prominent on circumflex (Cx)(p=0.029) and right coronary artery(RCA)(p=0.002) in women and on the proximal ( p=0.024) and mid portion of left anterior descending artery(LAD) (p=0.045) in men.
In patients with DM a statistically significant(ss) correlation was found between the presence of DM and AS in all vessels except for left main coronary artery (LMCA) in women (LAD prox:p=0.001; LAD mid:p=0.001; diagonal artery(Dg):p=0.003; Cx:p=0.001; RCA:p=0.001 ;LMCA:p&gt;0.05). However no such correlation was observed in men(p&gt;0.05).
In patients with H.CAD moderate/severe lesions were more common on proximal(p=0.013) and mid portions of LAD(p=0.021), on CX( p=0.006) and on RCA(p=0.016) in men and more common on the proximal portion of LAD(p=0.047), CX(p=0.014) and RCA(p=0.009) in women. For either smoking and F.CAD there was no such correlation in either gender (p&gt;0,05). As for blood lipid levels no correlation was observed between LDLC, HDLC and triglyceride levels and AL&AS in men(p&gt;0,05). However there was a negative, weak correlation between the HDLC levels and obstruction on LAD mid portion(r=-0.140; p=0.003); on Dg(r=-0.100; p=0.034) on CX (r=-0.154; p=0.001) and on RCA (r=-0.151; p=0.001) in women.

Conclusion
Major traditional CVRFs have a sex specific impact on AL and AS of obstruction on CA. In the era of precisıon medicine we need gender specific risk scoring systems taking these gender differences into account.
Cardiovascular risk prediction using metabolomic biomarkers and polygenic risk scores: a cohort study and modelling analyses
Authors: Ritchie S , Jiang X , Pennells L , Xu Y , Coffey C , Liu Y , Surendran P , Karthikeyan S , Lambert S , Danesh J , Butterworth A , Wood A , Kaptoge S , Di Angelantonio E , Inouye M 
Published: October 2024

Abstract

Background/Introduction
Metabolomic biomarker scores and polygenic risk scores (PRS) have shown promise for improving cardiovascular disease (CVD) prediction, but have not yet been evaluated in the context of current prediction models (SCORE2) and ESC recommendations for 10-year prediction of fatal and non-fatal CVD.

Purpose
To assess whether metabolomics biomarkers and PRSs can improve 10-year CVD risk prediction when added to SCORE2, and whether improvements are meaningful at ESC 2021 recommended risk thresholds for treatment consideration.

Methods
Metabolomics biomarker scores were constructed and compared to PRS and SCORE2 in 170,000 UK Biobank participants (5,096 incident CVD cases) aged 40–69 without previous CVD, diabetes, or lipid-lowering treatment. Improvement in risk discrimination when added to SCORE2 was assessed using Harrel’s C-index. Improvement in risk stratification following ESC guideline risk thresholds was assessed using categorical net reclassification. Population modelling was subsequently applied to estimate the impact on CVD prevention if applied at scale.

Results
Risk discrimination provided by SCORE2 (C-index: 0.718) was similarly improved by addition of metabolomic biomarker scores (ΔC-index: 0.011 [0.009–0.014]) and PRSs (ΔC-index 0.009; [0.007–0.012]). Addition of both metabolomic biomarker scores and PRSs to SCORE2 yielded the largest improvement risk discrimination, with ΔC-index 0.019 (0.016–0.022). Concomitant improvements in risk stratification were observed in categorical net reclassification index, with net case reclassification of 13.04% (11.67–14.41%). Modelling metabolic biomarker scores and PRSs for targeted risk-reclassification increased the number of CVD events prevented per 100,000 screened from 201 to 370 (ΔCVDprevented: 170 [158–182]) while essentially maintaining the number of statins prescribed per CVD event prevented.

Conclusions
Combining metabolomic biomarker scores and PRSs with SCORE2 moderately enhances prediction of first-onset CVD, and could have substantial population health benefit if applied at scale.
Trajectories of lipid profile during adolescence and risk of subclinical atherosclerosis in early adulthood: a two-decade population-based study
Authors: Esmaeili F , Tohidi M , Khalili D , Valizadeh M , Momeni Moghaddam A , Abdi A , Azizi F , Hadaegh F 
Published: October 2024

Abstract

Background/Introduction
Recent studies have shown the highest burdens of premature cardiovascular diseases (CVDs) in the Middle-eastern, and North Africa (MENA) region. The role of dyslipidemia, as a major metabolic disturbance, in the progression of subclinical atherosclerosis and subsequently premature CVDs, indicated by carotid intima-media thickness (cIMT), must not be overlooked, specifically in young adults.

Purpose
To examine the impact of early-life lipid profile trajectories in adolescence on subclinical atherosclerosis, evidenced by cIMT in adulthood.

Methods
In this trajectory analysis, with 1006 participants (472 male, mean age=14.72±3.23 years), latent class growth modeling, particularly Group-based multi-trajectory modeling (GBMTM) was used to analyze the heterogeneity in the longitudinal lipid alterations (total cholesterol [TC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and non-HDL-C). The trajectories were named based on direction (rising/decreasing) and slopes of the associated trends in lipid alterations (stable/ slow/ rapid). The association between lipid trajectories, and cIMT values, both as continuous and categorical variables, were evaluated using multivariate regression analysis adjusted for age, sex, body mass index, and systolic blood pressure at the baseline, as well as antihypertensive and lipid-lowering drug use, smoking, physical activity, and desired lipid parameter at the nearest survey to cIMT measurement.

Results
During a median follow-up of 17.6 years, the "Rising" trajectories of TC, TG, LDL-C, and non-HDL-C were linked to elevated cIMT values (in the fully-adjusted model beta-coefficients [βs]=0.08 [-0.01,0.14], 0.11 [0.05,0.17], 0.13 [0.05,0.21], and 0.12 [0.06,0.18], respectively). The "Rapid-Rising" trajectories of TG, LDL-C, and non-HDL-C notably amplified the risk (in the fully-adjusted model odds ratios (OR)=2.05 [1.46-2.75], 1.99 [1.35-2.92], and 2.02 [1.45-2.77], respectively). Conversely, the "Decreasing" trajectories of TC, LDL-C, and TG were associated with lower cIMT measures (βs =-0.09 [-0.16,-0.03], -0.11 [-0.17,-0.01], and -0.08 [-0.14,-0.02], respectively); also "Decreasing" trajectories of TC and LDL-C lowered the risk by at least 30% in the fully-adjusted model (ORs=0.59 [0.39-0.81] and 0.68 [0.41-1.02], respectively). While HDL-C "Rapid-Decreasing" trajectory doubled the risk of elevated cIMT (OR=1.98 [1.47-2.68]).

Conclusion
The findings showed the unfavorable trajectory alterations in all lipid parameters were significantly associated with higher cIMT values, underscoring the need for sustained efforts to monitor lipid levels from early adolescence.
Predicting atrial fibrillation within 7 years follow-up using machine learning models
Authors: Tsarapatsani K H , Biros D , Tsakanikas V , Sakellarios A , Trampisch H J , Rudolf H , Matsopoulos G K , Fotiadis D I 
Published: October 2024

Abstract

Background
The prevalence of atrial fibrillation (AF), the most common type of cardiac arrhythmia, has increased globally. AF is also the leading cardiac factor for several cardiovascular and cerebrovascular events. Early prediction and treatment of AF prevents major cardiovascular and cerebrovascular events.

Purpose
Our objective is to predict AF risk within 7-years follow-up using only twelve basic factors and applying machine learning (ML) models.

Methods
Data from the German epidemiological trial on ankle brachial index (getABI) were utilized in this work. GetABI includes 6,457 patients with mean age of 72.53 years. 3,985 individuals were assessed for AF of which 393 patients suffered from AF at 7-years follow-up. The feature selection was initially done manually, ending up in 45 features. The 10 best features were extracted from this dataset according to the SHAP (SHapley Additive exPlanations) values. The final features were body mass index, sensitive CRP, cholesterol, LDL-cholesterol, troponin I, NT-pro-BNP, glomerular filtration rate, ratio of triglycerides and HDL-cholesterol, gamma-GT, heart rate, including age and sex as major factors. The handling of missing values was achieved by SimpleImputer, estimating the mean values. XGBoost and Random Forest predicted AF. Logistic Regression was also used as a baseline model. The data were split into training and test set and ML models were applied for 100 iterative runs, extracting results with mean values.

Results
XGBoost was the most accurate model, predicting the AF with 71.19 % mean accuracy, 66.37 % mean sensitivity and 75.61 % mean specificity. Figure 1 depicts the performance of all models. Additionally, Receiver Operating Characteristic Curve (ROC) and Area Under Curve (AUC) for each model are presented in Figure 2. XGBoost also outperformed all the others models, achieving the highest mean AUC value, equal to 70.99 %. Contrariwise, logistic regression had the lowest overall performance.

Conclusion
ML models, specifically XGBoost, achieved accurate AF prediction in 3,985 individuals utilizing only twelve clinical-routine data.Evaluation results of each used model.ROC curve and AUC value of each model.
Myocardial determinants of Functional limitation in advanced Fabry cardiomyopathy
Authors: Guida G , Attanasio A , Disabato G , Tondi L , Paglione G , Castelvecchio S , Iannotta M , Bandera F , Spagnolo P , Guazzi M , Lombardi M , Camporeale A , Piepoli M F 
Published: October 2024

Abstract

Background
Cardiac involvement in Fabry Disease (FD) manifests as left ventricular hypertrophy (LVH) often complicated by myocardial fibrosis and/or inflammation. Both LVH and advanced tissue alterations can be non-invasively detected and quantified by cardiac magnetic resonance (CMR) with Late Gadolinium Enhancement (LGE). Impairment in functional capacity has been previously reported in FD patients. However, there is limited data regarding the determinants of myocardial alterations in exercise intolerance in FD.

Methods
Among 190 consecutive FD patients referred for CMR, 41 simultaneously performed a cardiopulmonary exercise test (CPET) to evaluate functional capacity. All patients underwent an extensive CMR protocol to provide a detailed evaluation of cardiac morphology and function, including multiparametric tissue characterization. CPET parameters were compared between patients with advanced Fabry cardiomyopathy (Group B), characterized by hypertrophy, inflammation, and fibrosis, and FD patients without irreversible cardiac damage (Group A).

Results
Group B patients were older compared to Group A (57.0 years vs 33.5 years, p&lt;0.001), had a greater LVH (LVMI: 117 g/sqm vs 76.5 g/sqm, p&lt;0.001; LVMWT 17 vs 10 mm, p&lt;0.001). LV ejection fraction was preserved in both groups but Group B patients had a lower peak VO2 value compared to group A (17.8 ml/kg/min vs 21.9 ml/kg/min, p=0.025), a lower (but not significant) percent-predicted peak VO2. A negative linear correlation was identified between the LGE extension (expressed as % of LV mass) and peak VO2 (r=-0.553, p=0.014). This correlation remained consistent even after excluding patients under chronic beta-blocker therapy (r=-0.678, p=0.045). No significant correlation between LV mass and peak VO2 was found.

Conclusions
in patients with FD, the presence of advanced tissue alterations detected by LGE is associated with reduced functional capacity (low peak VO2) despite preserved LV ejection fraction, with a significant negative correlation.
Association of lifes essential 8 and mortality among adults with and without CVD
Authors: Kobo O , Kaur G , Gulati M , Mamas M 
Published: October 2024

Abstract

Background
Differences in the American Heart Association’s Life’s Essential 8 (LE8) score and its association with mortality based on the presence of clinically prevalent cardiovascular disease (CVD) has not been assessed previously.

Methods
Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018 was utilized to calculate LE8 scores among adult patients, stratified by the presence of existing CVD. Health metrics were further divided into health behaviors and health factors. Scores were also evaluated based on sex, age, race/ethnicity, and socioeconomic status. Cox proportional hazard models were used to evaluate the association between the levels of cardiovascular health (CVH) and risk of all-cause and cardiovascular mortality.

Results
25,359 patients were included in the analysis, of which 10.2% had known CVD. Individuals with known CVD had lower overall CVH (55.9 vs. 65.8, p &lt;0.001), health behaviors (60.6 vs. 67.9, p &lt;0.001), and health factors (51.3 vs. 63.8, p &lt;0.001) scores. The lower CVH scores in those with prior CVD persisted after stratification by sex, age, race/ethnicity, and socioeconomic status. When assessing the association of CVH metrics with mortality, for every 10-point increase in LE8 score, there was a significant reduction (17%-27%) in all-cause and CV mortality in those with and without CVD.

Conclusions
Individuals with known CVD have lower CVH metric scores. Overall, the LE8 score is able to predict future CV outcomes in both individuals with and without CVD and highlights the importance of effective implementation strategies that target health factors and behaviors in primary and secondary prevention populations.
LE8 score in relation to cardiovascular disease and mortality in individuals with diabetes
Authors: Li W , Xing A , Xu W , Guo L , Gao X , Zhou S , Drouin-Chartier J P , Wu S , Chen Z 
Published: October 2024

Abstract

Background
Evidence regarding the potential health effects of Life’s Essential 8 (LE8) score among individuals with type 2 diabetes (T2D) is limited.

Purpose
We aimed to examine the associations of LE8 score with risk of cardiovascular disease (CVD) and mortality, among individuals with T2D.

Methods
We prospectively followed 19,915 Chinese participants with T2D at baseline or diagnosed during follow-up (Kailuan Study: 2006-2020), who were free of CVD at diagnosis of diabetes. Diet, lifestyle, and health conditions were repeatedly assessed every 2 years. The LE8 score (range, 0-100), was calculated based on 8 components: diet quality, physical activity, smoking status, sleep health, BMI, blood lipids, blood glucose, and blood pressure. We used time-varying cox models to model the associations.

Results
During a median follow-up of 11.5 years in participants with T2D, there were 3,295 incident CVD cases and 3,123 deaths. Higher LE8 score was associated with lower risk of CVD incidence and total mortality among participants with diabetes. The multivariate-adjusted hazard ratios and 95%CIs for the highest quintile of LE8 score compared with the lowest quintile were 0.56 (0.53, 0.59) for CVD incidence, 0.57 (0.53, 0.62) for heart disease incidence, 0.53 (0.49, 0.57) for stroke incidence, and 0.73 (0.69, 0.78) for total mortality (all p trend&lt;0.001). Furthermore, compared with participants with stable or decreased LE8 score after diabetes diagnosis, those with increased LE8 score had 17%-42% lower risk of CVD incidence, heart disease incidence, stroke incidence, and total mortality. These associations persisted in subgroup analysis stratified by age, sex, BMI, smoking status, alcohol intake, family history of diabetes and CVD, and follow-up time.

Conclusions
Higher LE8 score was associated with a substantially lower risk of CVD incidence and total mortality among adults with T2D. These findings further support the tremendous benefit of adhering to a high CVH, defined as the LE8 in reducing the subsequent burden of cardiovascular complications and improving overall health in individuals with T2D.Main TableMain Figure
Progress in understanding the genetic underpinning of coronary artery disease: from genotype to phenotype
Authors: Sa D , Mendonca M , Serrao M , Sousa F , Abreu G , Henriques E , Freitas S , Rodrigues M , Borges S , Guerra G , Ornelas I , Drumond A , Sousa A C , Palma Dos Reis R 
Published: October 2024

Abstract

Background
The functional dissection of genetic risk opens the door to strategies for pharmacological manipulation of molecular and cellular processes implicated in human diseases, including coronary artery disease (CAD).

Aim
To assess the relationship between a set of single nucleotide polymorphisms previously associated with CAD and coronary artery calcium (CAC) score in an asymptomatic population from Portugal.

Methods
Prospective study in a cohort of 1,284 subjects aged 59.3±8.9 years, 73.6% males without apparent CAD. The CAC score was performed by cardiac computed tomography and reported as Agatston units according to the Hoff nomogram. Anthropometric, conventional, and biochemical risk factors were evaluated. Thirty-three single nucleotide polymorphisms were genotyped by TaqMan real-time PCR. Bivariate and multivariate logistic regression analysis estimated variables associated with the CAC score.

Results
After bivariate analysis, PHACTR1 rs1332844 C&gt;T, a downstream regulator of the endothelin-1 gene, showed a significant association with CAC score (p=0.015), together with CDKN2B-AS1 variants rs4977574 A&gt;G in the locus 9p21.3 (p=0.002) and rs1333049 G&gt;C (p=0.010). MTHFD1L gene encodes a mitochondrial enzyme responsible for homocysteine remethylating in methionine, and rs6922269 G&gt;A showed protection against artery calcification (p=0.013). After multivariate logistic regression, PHACTR1 rs1332844 (CT+TT) (p=0.009) and CDKN2B-AS1 rs4977574 A&gt;G (GG) (p=0.002) remained in the equation as independently associated with arterial calcification, together with male sex (p=0.039), age (p&lt;0.0001), hypertension (p=0.001), diabetes (p&lt;0.0001), smoking status (p&lt;0.0001) and obesity (p=0.020). MTHFD1L rs6922269 AA also remained as significant protection from arterial calcification (p=0.027).

Conclusion
The present work showed two genetic variants, PHACTR1 and CDKN2B-AS1, linked to arterial wall calcification, herewith clinical and environmental risk factors. MTHFD1L showed protection. Understanding the genetic basis of vessel calcification can enable lifestyle changes or pharmacologic therapy to attenuate risk before the disease becomes clinic. More research in this field is critical to understanding the genetic basis of CAD through an intermediate phenotype, coronary arterial wall calcification.