tbuckley/cabot-search huggingface dataset:
Abstract MP25: The association between egg consumption, total serum cholesterol concentration, and cardiovascular disease incidence among American Indians: The Strong Heart Family Study
Authors: Weiyi Li, Amanda Fretts, Jessica Reese, Tauqeer Ali, Jason Umans, Shelley Cole, Ying Zhang
Journal: Circulation (2025)

Prior studies suggest associations between egg consumption, serum cholesterol levels, subclinical atherosclerosis and cardiovascular diseases (CVD). However, existing evidence remains controversial and limited. This study aimed to investigate the association between egg consumption, serum cholesterol profiles, subclinical atherosclerosis incidence, and CVD incidence among American Indians. The Strong Heart Family Study (SHFS) is a multicenter, family-based, prospective cohort study of CVD among American Indian communities. We evaluated SHFS participants at the baseline between 2001 and 2003 (n=2147). Carotid ultrasounds were used to detect plaque at baseline and follow-up examinations between 2006 and 2009, with a median follow-up of 5.3 years (Q1, Q3: 4.8, 6.4 years). We identified 422 incident CVD events through 2022, with a median follow-up of 20.2 years (Q1, Q3: 16.6, 21.1 years). General linear mixed models were used to evaluate the association between egg consumption and changes in serum total cholesterol, triglycerides, LDL-C, and HDL-C levels. The analysis revealed very weak associations, with respective regression coefficients of -0.06, 0.0004, -0.02, and -0.05, and corresponding P-values of 0.005, 0.68, 0.05, 0.01. These findings suggested that egg consumption had minimal impact on serum cholesterol levels. Shared frailty proportional hazards models were used to assess the association between egg consumption and subclinical atherosclerosis or CVD. We did not find a significant association between egg consumption and the development of carotid plaque. After adjusting for age, study site, hypertension, diabetes, and total caloric intake, the hazards ratios for incident CVD in the 2 nd , 3 rd , and 4 th quartiles of egg consumption were 0.77(95%CI: 0.56-1.05; P: 0.1), 0.74 (95%CI: 0.55-0.98; P: 0.04), and 1.12 (95%CI: 0.8-1.49; P: 0.42), compared to those in the 1 st quartile. Participants in the 3 rd quartile had a significantly lower risk of developing CVD. This study found weak associations between egg consumption and serum cholesterol levels in the SHFS. Moderate egg consumption was associated with a significantly lower risk of developing CVD compared to the lowest consumption in this population. This association was not observed in the group with the highest egg consumption. Moderate egg consumption appeared to be a way for low-income communities to obtain essential nutrients, particularly proteins, without burdening on the cardiovascular system.
Abstract P1173: Opportunities for Intervention: Mental Health and Cardiovascular Health Literacy in Women – Insights from the Research Goes Red Initiative
Authors: Asma Rayani, Ateh Stanislas Ketum, Faith Metlock, Jay Vadiya, Yaa Kwapong, Pamela Ouyang, Garima Sharma, Yvonne Commodore-Mensah
Journal: Circulation (2025)

Introduction: Cardiovascular health literacy (CVHL) is vital for managing cardiovascular risk. However, poor mental health can be a barrier, and there's a gap in understanding how mental health impacts CVHL in women. Hypothesis: We hypothesized that mental health has an association with cardiovascular health literacy. We further hypothesized that this would vary by younger age. Methods: We conducted a cross-sectional study using data from the Research Goes Red registry and SAFE HEART study. Women aged ≥18 completed questionnaires on cardiovascular health literacy (CVHL) and mental health. CVHL was assessed using a validated tool, with scores ranging 0-100. It included knowledge of CVD risk factors, exercise, diet, and therapeutic interventions. Psychological health risk was measured using the Perceived Stress Scale (PSS-4; score 1-16), Generalized Anxiety Disorder scale (GAD-2; score 1-6), and Patient Health Questionnaire (PHQ-2; score 0-6) for assessing depression. Stepwise linear regression models evaluated associations between mental health and CVHL. Final adjusted models employed spline terms for PHQ-2 (scores 1, 2, 3), GAD-2 (scores 1, 2, 3), and PSS-4 (scores 4, 8, 12). Results: A total of 677 women were included in the analysis. Mean age 40.07 (SD15.30), 29.08% Black, and 64.1% employed. Our analysis revealed complex associations between mental health measures and cardiovascular health literacy (CVHL). Perceived stress (PSS-4) showed a non-linear relationship with CVHL (β=-2.64, 7.28, -5.72 for scores 4, 8, ≥12 respectively; all p&lt;0.05). Depression (PHQ-2) demonstrated a significant negative association at score 1 in the crude model (β=-6.51, 95% CI: -10.69, -2.34), which attenuated after adjustment. Anxiety (GAD-2) showed a significant positive association at scores ≥3 in the crude model (β=6.94, 95% CI: 2.06, 11.83), also attenuating after adjustment. Age ≥50 was consistently associated with higher CVHL scores across all models (β range: 10.49-13.3; all p&lt;0.001). Physical activity &lt;150 minutes/week showed a positive association (β=4.76, p&lt;0.05), but interacted negatively with BMI ≥25 (β=-7.12, p&lt;0.05). Financial strain was negatively associated with CVHL (β=-6.41, 95% CI: -9.16 to -3.67, p&lt;0.001). Conclusion: Mental health and CVHL show complex relationships, older age consistently predicting higher CVHL. Financial strain negatively impacts CVHL, highlighting the need for targeted interventions addressing both psychological and socioeconomic factors.
Abstract P2148: Adverse Childhood Experiences are Associated with Poor Sleep Among Racial and Ethnic Minoritized Patients with Recent Myocardial Infarction
Authors: Alexis Bartelloni, Stefany de Brito, Anais Hausvater, Nathaniel Smilowitz, Harmony Reynolds, Tanya Spruill
Journal: Circulation (2025)

Introduction: Disparities in sleep are well documented and may increase the risk of poor cardiovascular disease (CVD) outcomes in racial and ethnic minoritized groups. These groups are also more likely to report adverse childhood experiences (ACEs), which can impact sleep. The relationship between ACEs and sleep quality in adults with CVD, including those recovering from myocardial infarction (MI), is underexplored. Objective: To examine the association between ACEs and sleep quality in patients with recent MI. Methods: We analyzed baseline data from an ongoing longitudinal study of adults post-MI. Exposure to five ACEs was assessed (each yes/no): living with someone with chronic illness/disability, mental illness or substance abuse; parental separation/divorce; long-term financial problems. Sleep quality over the past 7 days was assessed with a single item rated 0–10, dichotomized as poor (0–3) vs. fair/good/excellent (4–10). Participants completed validated measures of anxiety, depressive symptoms and perceived stress. We used chi-square tests and linear regression to test associations between ACEs exposure and sleep quality. Results: The 161 participants (36.9% women, 34.4% from racial and ethnic minoritized groups, age 62±13 years) completed questionnaires at median 37.5 days post-MI (IQR=21–61). About half of participants (50.9%) reported ≥1 ACE and 21.7% reported poor sleep; these were somewhat more common among participants from minoritized groups vs. non-Hispanic White adults (≥1 ACE, 60.0% vs. 46.7%, p=0.08; poor sleep, 30.9% vs. 17.1%, p=0.04). Participants from minoritized groups with ≥1 ACE were more likely than those with no ACEs to report poor sleep (45.4% vs. 9.1%, p=0.006). This association was significant after adjusting for sociodemographic (age, sex, race/ethnicity, low income, marital status) and clinical (time since MI, diabetes, hypertension, body mass index) factors (B=-1.683, p=0.03), and was no longer significant when psychological factors (anxiety, depressive symptoms, perceived stress) were added (B=-1.344, p=0.10). There was no difference in poor sleep between non-Hispanic White participants who did vs. did not report ACEs in univariate (18.4% vs. 16.1%, p=0.80) or multivariate analyses (B=-0.054, p=0.91). Conclusions: ACEs exposure was associated with poorer self-reported sleep quality in MI patients from racial and ethnic minoritized groups. This association was mediated in part by effects of ACEs on psychological distress.
Abstract P2053: Social Vulnerability and Likelihood of Death at Home from Cardiovascular Disease in US Counties, 2016-2020
Authors: Ben Varghese, Hieu Truong, Laith Sorour
Journal: Circulation (2025)

Introduction: Areas where people disproportionately die at home from cardiovascular disease (CVD) are incompletely described. The United States (US) Centers for Disease Control and Prevention (CDC) developed the Social Vulnerability Index (SVI) using 16 US census measures clustered into four themes of vulnerability. The SVI and its themes may be utilized to score counties based on county-level social determinants of health. We conducted a county-level ecological study on the association of county SVI and its themes with CVD-related deaths occurring at home. Method: We used 2016–2020 CDC Wide-ranging Online Data for Epidemiologic Research data on county-level CVD-related (ischemic heart disease, heart failure, stroke, and hypertension) deaths in persons ≥18 years of age, and location of death (home, etc.), available for 92.4% of 3,226 US counties. The SVI and its themes (socioeconomic status [theme 1], household composition&amp;disability [theme 2], minority status&amp;language [theme 3], and housing type&amp;transportation [theme 4]) are scored from 0 to 1 (low to high vulnerability) based on their national percentile ranking. We grouped county-level SVI from 2018 into quartiles (Q1 [least] to Q4 [most vulnerable]). Due to overdispersion, we used negative binomial regression to estimate the likelihood of CVD-related deaths at home in Q4 vs Q1, offset by the total county CVD-related deaths. We reported rate ratios (RR [95% Confidence Interval], p-value). Results: CVD-related home death rates increased in a stepwise manner from SVI Q1 to Q4 (Fig). For overall SVI, the likelihood of death at home was 15% higher in Q4 vs Q1 (RR 1.15 [1.12–1.18], p&lt;0.0001). The greatest disparity was seen in theme 1, with Q4 vs Q1 having 27% higher likelihood of death at home (RR 1.27 [1.22–1.33], p&lt;0.0001). For theme 2, there was no statistically significant difference in the likelihood of death at home in Q4 vs Q1 (RR 0.98 [0.95–1.01], p=0.36). For theme 3, Q4 vs Q1 had 6% higher likelihood of death at home (RR 1.06 [1.03–1.09], p&lt;0.0001). For theme 4, Q4 vs Q1 had a 6% lower likelihood of death at home (RR 0.94 [0.91–0.97], p&lt;0.001). Conclusion: In US counties, higher social vulnerability was associated with a higher likelihood of CVD-related death at home, with the strength and direction of this association varying between the themes of vulnerability. SVI and its themes may be utilized to target interventions to improve access to hospital or hospice care.
Abstract P2024: The Association of Cannabis Use with Risk of Mortality, Incident Stroke, and Incident Myocardial Infarction in a Minnesota Healthcare System, 2016-2023
Authors: Faye Norby, Natalie Scholz, Kamakshi Lakshminarayan, Traci Toomey, Pamela Lutsey, Darin Erickson
Journal: Circulation (2025)

Introduction: Daily cannabis use is now more common than daily alcohol use, but we lack a comprehensive understanding of the association of cannabis use with cardiovascular disease (CVD). We conducted a longitudinal analysis to assess the role of cannabis use associated with mortality, incident stroke, and incident myocardial infarction (MI). Methods: We included adult patients who received regular care (at least 2 outpatient visits in a 3-year span) from a large Minnesota healthcare system from 2016-2023. The baseline date was defined as the 2 nd qualifying visit, and variables were captured using ICD codes from medical records. Cannabis users were matched with up to four non-cannabis users by age, sex, race-ethnicity, baseline date, and days between the 1 st and 2 nd visit. Outcomes included incident stroke and MI obtained from inpatient admissions and mortality, which was obtained through linkage to state records. We used Cox proportional hazards models to assess the association between cannabis use and each outcome, adjusting for prevalent demographics and comorbidities at the time of the baseline date. Results: We matched 30,529 cannabis users to 121,623 non-cannabis users, with a mean (SD) age of 36 (15) years, 56% were male, and 71% were White race/ethnicity. During a mean (SD) follow-up of 3.9 (2.4) years, there were 5,425 deaths, 719 incident strokes, and 580 incident MIs (Table). After adjusting for potential confounders and mediators, the use of cannabis was associated with a higher risk of mortality [HR (95%CI): 1.41 (1.32, 1.53)], stroke [HR (95%CI): 1.25 (1.03, 1.53)] and MI [HR (95%CI): 1.53 (1.23, 1.88)] compared to non-users. Conclusion: Cannabis use was associated with an increased risk of mortality and CVD, even after fully adjusting for potential confounders and other substance use in this general healthcare system population. Given the increasing cannabis use in the US, more research is needed to understand the role of cannabis in CVD pathways and how increasing use alters CVD epidemiology.
Abstract P2143: Adverse Pregnancy Outcomes – Planning for Fourth Trimester Interventions to Promote Equitable Long-Term Cardiovascular Health
Authors: Salomon Roman Soto, Christina Blanchard, Jesse Rattan, Angelina Toluhi, Ayodeji Sanusi, Samantha Martin, Victoria Jauk, Lynda Ugwu, Ashley Battarbee, Akila Subramaniam, Alan Tita, Rachel Sinkey
Journal: Circulation (2025)

Introduction: Adverse pregnancy outcomes (APOs) are significantly associated with future cardiovascular disease and cardiovascular mortality and disproportionately affect women from minority racial and ethnic groups. Maternal and perinatal morbidity in the Southeast US is among the highest in the country, and cardiovascular disease (CVD) is the #1 cause of death in pregnant and nonpregnant patients. Therefore, we sought to define the contemporary epidemiology of APOs among pregnant and postpartum individuals at a major tertiary center in the Southeast US to plan a fourth-trimester cardiovascular disease intervention. We assessed the hypothesis that there is racial and ethnic variation in the epidemiology of APOs. Methods: We performed a retrospective study including pregnant/postpartum patients from a tertiary center between 2013 and 2018. The primary outcome was APO prevalence, defined as ≥1 of the following diagnoses during pregnancy or &lt;6 weeks postpartum: hypertensive disorders of pregnancy (HDP), preterm birth (PTB), diabetes, placental abruption, intrauterine fetal demise (IUFD), and small for gestational age (SGA) neonate. Secondary outcomes included trends in APO prevalence, and prevalence of and adjusted relative risks (aRR) of APOs by self-reported race/ethnicity. Results: Of 24,637 patients included in this study, all baseline characteristics significantly differed between groups. APOs occurred in 11,507 (47%) of pregnancies. Overall trends of HDP increased dramatically across the study period from 17% to 22% (p&lt;0.001). APO prevalence in Non-Hispanic Black, Non-Hispanic White, and Hispanic individuals were significantly different at 53%, 32%, and 12% (p&lt;0.001) (Figure). In adjusted analysis with Non-Hispanic White as a reference, Non-Hispanic Black individuals had an increased risk of APO aRR 1.03 (95% confidence interval (CI) 1.01-1.04), while Hispanic individuals had a reduced risk of APOs aRR 0.91 (95% CI 0.88-0.94). Hispanic individuals had an increased risk of diabetes aRR 1.73 (95% CI 1.51-1.94) while Non-Hispanic Black patients had an increased risk for IUFD aRR 1.33 (95% CI 1.05-1.60) and SGA aRR 1.32 (1.25-1.39). Conclusion: Nearly half of the patients in the study period experienced an APO with marked racial/ethnic disparities. As APOs are associated with future CVD - the #1 cause of death - these findings underscore an urgent need for timely fourth-trimester interventions to promote equitable cardiovascular health.
Abstract P1072: Underutilization of Novel Guideline-Directed Medical Therapy in Patients with Heart Failure
Authors: Deepika Laddu, Manisha Cherupally, Raymond Kang, Ronald Ackermann, Amisha Wallia, David Liss, Sadiya Khan, Matthew OBrien
Journal: Circulation (2025)

Background: Guideline directed medical therapy (GDMT) for patients with heart failure (HF) now includes SGLT2i and ARNI regardless of ejection fraction. Despite strong evidence supporting these therapies, their utilization among HF patients remains unclear. This study used healthcare claims data to examine the utilization of GDMT in a contemporary cohort of newly diagnosed HF patients. Methods: We analyzed claims data from commercial and Medicare Advantage plans of a large national insurer to identify patients with incident HF, diagnosed in 2022. Patients were identified as having at least two outpatient claims or one inpatient HF claim, and 12 months of continuous enrollment prior to diagnosis. Pharmacy claims assessed prescription fill rates for novel and standard GDMT (including SGLT2i, ARNI, ACEI/ARB, BB, MRA, and GLP-1 RA). Results: The analytic cohort included 163,596 patients (49% male) diagnosed with new-onset HF, with two-thirds in the outpatient setting ( Table ). HF incidence was higher with older age, with over half of cases in adults aged ≥75 years. Comorbidities were prevalent, particularly hypertension (88%), diabetes (42%), and history of myocardial infarction (50%). Beta-blockers (55%) were most frequently used, while ACEi/ARB (24%) and MRAs (11%) were less commonly used. ARNI, SGLT2i and GLP-1 RA use remained low (5% each). Conclusion: In a privately insured sample with a new diagnosis of HF, use of novel GDMT was very low. Understanding treatment patterns by HF subtype and identifying gaps in GDMT utilization are critical for developing targeted strategies to improve HF management.
Abstract 069: Healthy Lifestyle and Risk of Cardiovascular Disease Incidence and Mortality Among Survivors with Stages I-III Colorectal Cancer
Authors: Mengxi Du, Qiang Liu, Alaina Bever, Yujia Lu, Jeffrey Meyerhardt, Andrew Chan, Frank Hu, Edward Giovannucci, Mingyang Song
Journal: Circulation (2025)

Introduction: Colorectal cancer (CRC) is a prevalent cancer and a leading cause of cancer deaths in the US. CRC survivors have a high risk of developing cardiovascular disease (CVD), which accounts for nearly 20% of their total mortality, likely due to shared risk factors including lifestyle. Hypothesis: We hypothesized that maintaining a healthy lifestyle after a CRC diagnosis is associated with a lower risk of CVD incidence and mortality. Methods: We analyzed data from 2,737 survivors with stages I-III CRC in the Nurses’ Health Study and Health Professional Follow-up Study. A lifestyle score, ranging from 0 to 5, was calculated for participants based on diet quality, smoking status, alcohol intake, physical activity, and body mass index. We calculated cumulative averaged scores before and after CRC diagnosis and used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence and mortality. We further examined changes in pre- and post-diagnostic lifestyle in relation to CVD outcomes and assessed potential effect modification by age, tumor characteristics, and medical history. Results: Over a median follow-up of 13.3 years after CRC diagnosis, we documented 449 incident CVD cases, including 201 coronary heart disease and 104 stroke cases, and 307 CVD-specific deaths. After adjustment for demographics, medical history, tumor characteristics, and pre-diagnostic lifestyle score, one unit increase in post-diagnostic score was associated with a 13% lower CVD incidence (HR [95% CI]: 0.87 [0.77-0.98]; p-trend: 0.03) and 29% lower CVD mortality (0.71 [0.61-0.83]; &lt;0.0001). When stratified by tumor stage, the inverse association with CVD incidence was observed for stage I (0.74 [0.60-0.92]) but not stages II-III CRC (1.12 [0.93-1.35]; p-interaction: 0.005); whereas no differential associations were found for CVD mortality. Survivors who maintained a healthy lifestyle (score ≥4) pre- and post-diagnosis had a 28% lower risk of CVD incidence (0.72 [0.57-0.92]) and a 48% lower risk of CVD mortality (0.52 [0.39-0.70]) compared to those with a constantly poor lifestyle (score &lt;4). Conclusions: In conclusion, a healthy lifestyle after CRC diagnosis was associated with a substantially lower risk of CVD incidence and mortality, highlighting the role of a healthy lifestyle in improving survivorship. These findings offer valuable insights for integrating lifestyle interventions into CRC oncology care.
Abstract P3006: Glycemia and Lipids Profiles Levels, Awareness and Control in the Adult Population: the Italian Health Examination Survey 2023-2024 - CUORE Project
Authors: BENEDETTA MARCOZZI, Cinzia Lo Noce, Anna Di Lonardo, Serena Vannucchi, teresa dipol, MARIA MORELLO, SERGIO BERNARDINI, DANIELA GALEONE, Paolo Bellisario, Luigi Palmieri, Chiara Donfrancesco
Journal: Circulation (2025)

Introduction: WHO recommends monitoring glycemic and lipid profiles in the population to control and prevent NCDs. The target for glycemic/diabetes is to halt the rise within 2025 (2010 as baseline). The Italian Ministry of Health (MoH) has strengthened prevention/health promotion and supported their periodic assessment through national health examination surveys (HESs), technically and financially supported by the Ministry of Health - National Centre for Disease Prevention and Control, and conducted within the CUORE Project. Hypothesis: The aim to monitor the achievement of the glycemia/diabetes WHO target and lipids profiles distribution in the Italian general population. Methods: In 2023 a new HES started including the assessment of fasting serum glycemia, total and HDL cholesterolemia and triglyceridemia. Up to now, data from random samples of residents in 12 Regions (of 20 regions) distributed in North, Centre and South of Italy and aged 35-74 years are available (1192 men, 1200 women). Glycemia and lipids profiles were assayed by a central lab. Elevated glycemia/diabetes (DM): glycemia ≥126 mg/dl and/or on medication. Elevated total cholesterol/hypercholesterolemia (HChol): total cholesterol ≥240 mg/dl and/or on medication. Results: Glycemia mean level was 97 mg/dl (95%CI: 96-98) in men and 91 mg/dl (90-92) in women; DM resulted 9% (6-12) and 7% (4-10) respectively. Among those with DM, about 2 in 10 men and 1 in 10 women were unaware; about 1 and 4 of 10 were aware but not on medication, respectively. Total cholesterol mean level was 194 mg/dl (192-196) in men and 203 (201-205) in women; HChol resulted 24% (18-31) and 29% (22-36) respectively. Mean level of HDL cholesterol was 49 mg/dl (49-50) in men and 60 mg/dl (59-61) in women; mean level of triglycerides was 116 mg/dl (112-120) and 93 mg/dl (91-96) respectively. Among those with HChol (men 25% - 21-30%; women 30% - 24-35%), about 2 in 10 men and 2 in 10 women were unaware; about 2 of 10 were aware but not on medication. Conclusions: Compared to 2008, these preliminary data showed a significant decrease of glycemia, total cholesterol and triglycerides mean values both in men and women, as well as of DM and HChol prevalence, but improvements on their awareness and control are still necessary.