Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes

Study Overview
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Brief Summary
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Cardiovascular disease (CVD) is an important public health problem that affects millions of people worldwide. Associations between risk factors, such as smoking, dyslipidaemia or hypertension, and prevalent CVD are well documented. However, few studies have investigated associations with onset of disease. The initial manifestation of CVD, for example an episode of unstable angina, is important because it influences the prognosis, the quality of life and the management of disease. Furthermore, the extent to which social deprivation, alcohol consumption or atrial fibrillation affects presentation of CVD is poorly understood and deserves further consideration. Most previous studies have considered CVD as a single entity. However, differences in aetiology between coronary phenotypes suggest that risk factors may not be shared across specific coronary phenotypes and their relative importance is likely to differ for each phenotype. Gaining knowledge of these differences could provide insights into the pathophysiology of specific forms of CVD and could eventually lead to modification of recommendations for patient management and disease prevention. We propose to use the linkage of the national registry of coronary events to general practice records in the Clinical Practice Research Database (CPRD), to investigate whether demographic, behavioral, and clinico-metabolic risk factors differentially influence the onset of specific types of CVD.

Official Title
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Cardiovascular Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes: a CALIBER Proposal Using Linked GPRD-MINAP-HES Data

Conditions
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Ischemic Stroke, Heart Diseases, Cardiovascular Diseases, Acute Myocardial Infarction, Unstable Angina, Chronic Stable Angina, Cerebrovascular Accident, Subarachnoid Hemorrhage, Transient Ischemic Attack, Abdominal Aortic Aneurysm, Peripheral Arterial Disease, Sudden Coronary Death, Ventricular Arrhythmia, Sudden Death, Cardiac Arrest, Heart Failure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged ≥30yrs old Registered in CPRD practices in England consenting to data linkage ≥1 year of up-to-standard pre-study follow-up Exclusion Criteria: History of any of the CVD endpoints considered before study follow-up initiation.

Ages Eligible for Study
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Minimum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CALIBER Healthy Cohort<br>We will report findings from the CALIBER (CArdiovascular disease research using Linked BEspoke studies and Electronic Records) collaboration where we linked primary care data (from the General Practice Research Database [GPRD]) to three further sources of electronic health records: the Myocardial Ischemia National Audit Project registry (MINAP),cause specific discharge data from Hospital Episodes Statistics (HES) and cause specific mortality from the Office for National Statistics (ONS). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First presentation of cardiovascular disease, as specified in description | First occurrence of the following fatal or non-fatal cardiovascular outcomes: acute myocardial infarction, unstable angina, stable angina, ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, transient ischemic attack, abdominal aortic aneurysm, peripheral arterial disease, sudden cardiac death, heart failure | Study follow-up will commence on the earliest date on which a patient fulfils the criteria for study inclusion within the period between 1st January 1997 and 25th March 2010 (maximum of 13 years after enrolment). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Non CVD specific deaths | Death from non CVD, that is, excluding deaths related to the primary endpoints. | Same as for primary outcomes (maximum of 13 years after follow-up start) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Vascular diseases, Peripheral occlusive diseases, Sudden coronary death, Ventricular arrhythmia, Sudden cardiac death, Cardiac arrest, Heart failure, Heart diseases, Cardiovascular diseases, Coronary heart disease not otherwise specified, Cerebrovascular disorders, Brain diseases, Central nervous system diseases, Nervous system diseases, Atherosclerosis, Arteriosclerosis, Pathologic processes, Acute myocardial infarction, Myocardial infarction, Myocardial ischemia, Infarction, Necrosis, Unstable angina, Chronic stable angina, Stable angina, Angina pectoris, Chest pain, Pain, Signs and symptoms, Ischemia, Ischemic stroke, Hemorrhagic stroke, Stroke, Subarachnoid hemorrhage, Transient ischemic attack, Abdominal aortic aneurysm, Aneurysm, Aortic aneurysm, Aortic aneurysm, abdominal, Aortic diseases, Peripheral arterial diseases, Peripheral vascular diseases