tbuckley/cabot-search huggingface dataset:
Abstract P1151: Varying Measures of Subclinical Carotid Arterial Injury and the Associations with Incident Cardiovascular Disease in Older Men: The British Regional Heart Study.
Authors: Atinuke Akinmolayan, Olia Papacosta, Lucy Lennon, Elizabeth Ellins, Julian Halcox, Peter Whincup, Goya Wannamethee
Journal: Circulation (2025)

Objectives Carotid intima-media thickness (CIMT) is reflective of arterial aging and injury. However, there are inconsistencies in the reported associations between CIMT measurements and CVD risk, specifically mean versus maximum CIMT, the role of carotid plaque location and quantity. This study explores the associations of these measures in older adults. Design A longitudinal analysis of data from the British Regional Heart Study, a prospective cohort study Participants 1315 men aged 71-92 years, without baseline coronary heart disease (CHD) or stroke Methods: Between 2010-2012, participants underwent follow-up, comprising of questionnaires, physical examination, and blood tests. CIMT and carotid plaque characteristics (location and quantity) were assessed using ultrasound. Cox proportional hazards models estimated multivariate-adjusted hazard ratios (HR) for incident CHD and stroke (fatal/non-fatal), based on CIMT and plaque features. Results: Over a median follow-up of 10.2 years, 108 incident CHD cases and 110 incident stroke cases (fatal/non-fatal) occurred. After adjusting for confounders (age, social class, smoking, exercise, alcohol intake, BMI, medications, comorbidities, blood pressure, cholesterol, CRP and NT-pro BNP), no significant associations were found between mean or maximum CIMT and CHD or stroke events (fatal/non-fatal). However, both mean and maximum CIMT were significantly associated with fatal CHD events (HR 1.38, CI 1.07-1.76 and HR 1.30, CI 1.02-1.61, respectively per standard deviation increase in CIMT). No significant association was observed with fatal stroke events. Stroke risk increased with increasing number of carotid plaques (HR 1.29, CI 1.04-1.61) which was seen for both fatal and non-fatal strokes. No association was seen with CHD. When examined by plaque location, plaques located in the common carotid artery (CCA) was associated with incident stroke events (HR 1.73, CI 1.06-2.83) and to a lesser extent with CHD (HR 1.48, CI 0.9-2.43). No associations were seen for other sites. Conclusion: In older men, mean and maximum CIMT are more associated with fatal CHD events than with non-fatal CHD. No significant association was found between CIMT (mean or maximum) and incident stroke events. However, the presence of carotid plaques, particularly in the CCA and in greater quantities, is strongly associated with an increased risk of stroke (fatal/non-fatal). These findings suggest that CVD risk varies according to measures of CIMT in older men.
Abstract P1155: Different Heart Failure Risk Factors Have Distinct Patterns of Preclinical Cardiac Dysfunction: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Jelani Grant, Sui Zhang, Amelia Wallace, Vijay Nambi, Justin Echouffo, Anum Minhas, Kunihiro Matsushita, Elizabeth Selvin, Christie Ballantyne, Josef Coresh, Amil Shah, Chiadi Ndumele
Journal: Circulation (2025)

Introduction: In individuals at risk for heart failure (HF), pre-clinical cardiac dysfunction is a target for preventive interventions. We hypothesized that different HF risk factors are associated with distinct patterns of cardiac dysfunction, with implications for underlying pathophysiology and approaches to screening and prevention. Methods: We conducted a cross-sectional analysis of 4,470 participants without prevalent HF from Visit 5 (2011-13) of the ARIC study with echocardiographic data, cardiac biomarker measurements (the N terminal pro-B-type natriuretic peptide [NT-proBNP] and high-sensitivity cardiac troponin T [hs-cTnT]) and data on HF risk factors (atherosclerotic cardiovascular disease [ASCVD], obesity, diabetes [DM], hypertension and chronic kidney disease [CKD]). Multivariable logistic regression was used to assess the associations of HF risk factors with different echocardiographic abnormalities and elevated cardiac biomarker levels, adjusted for age, sex, race, and other HF risk factors ( Table ). Results: The mean age was 76 years, with 58% women and 20% Black individuals. A total of 2,424 (54.2%) participants had abnormal echocardiographic measures, and 2,169 (48.5%) participants had elevated NT-proBNP or hs-TnT. Among HF risk factors, only ASCVD was independently associated with left ventricular (LV) systolic dysfunction (Table). In contrast, hypertension was associated with 4/4 indices of LV diastolic dysfunction, obesity 3/4 diastolic indices and CKD, ASCVD and DM with 2/4 diastolic indices. All risk factors were associated with increased LV filling pressures (average E/e'). Obesity was most strongly associated with LV hypertrophy among risk factors. All risk factors were associated with elevated hs-cTnT, but nominally inverse associations with NT-proBNP were seen for both diabetes and obesity. Conclusion: Different HF risk factors are associated with distinct patterns of preclinical cardiac dysfunction. Tailored approaches to screening and prevention may be needed to most effectively avert the onset of clinical HF for individuals with different risk factor profiles.
Abstract MP35: Community Prevalence of the Cardiovascular-Kidney-Metabolic (CKM) Syndrome: The Dallas Heart Study
Authors: Khaled Shelbaya, Yinun Zeleke, Victoria Lamberson, Yimin Yang, Colby Ayers, Ian Neeland, Anand Rohatgi, Parag Joshi, Amit Khera, James de Lemos, Amil Shah
Journal: Circulation (2025)

Introduction: The recent AHA presidential advisory on Cardiovascular-Kidney-Metabolic Syndrome (CKM) proposed a novel staging scheme, but limited data exist regarding CKM stage prevalence in the community. Prior population-based studies have lacked subclinical imaging measures, and have not reported variability by age, gender, and race/ethnicity. Methods: We estimated the population prevalence of CKM stages in Dallas County, from among 2,817 participants in the population-sampled Dallas Heart Study who attended study Visit 1 (2000-2002). Participants underwent protocol measurement of body composition, lipids, fasting blood sugar, serum creatinine, NT-proBNP, hs-cTnT, urinary albumin and creatinine, coronary artery calcium by cardiac CT (CAC), and cardiac function and mass by cardiac MRI. These were used to operationalize the following CKM stages: 0 – no CKM risk factors; 1 – excess or dysfunctional adiposity (body mass index, waist circumference, and fasting blood glucose); 2 – metabolic risk factors (hypertriglyceridemia, hypertension, diabetes, metabolic syndrome) and chronic kidney disease; 3 – subclinical cardiovascular diseases (CAC, LV hypertrophy or dysfunction by cardiac MRI, elevated cardiac biomarkers (NT-proBNP or hs-cTnT), high AHA-PREVENT or KDIGO scores); 4 – prevalent cardiovascular diseases (coronary heart disease, heart failure, atrial fibrillation, stroke). We used sampling weights to estimate the prevalence of CKM stages in Dallas County in 2000-2002 overall and by age category (30-44, 45-59, 60-65 years), gender, and race/ethnicity. Results: Among the 2,817 participants with a mean age of 44±10 years, the sample weighted demographics were 50% women, 52% non-Hispanic White, 20% non-Hispanic Black, and 26% Hispanic race/ethnicity. Among Dallas County adults, only 10% were CKM Stage 0 (no risk factors). The weighted prevalence of CKM Stages 1 through 4 was 16%, 46%, 23%, and 5%, respectively ( Figure A) . CKM stage prevalence was similar between men and women, while CKM Stage 4 was more frequent among older individuals and among non-Hispanic Black compared with non-Hispanic White and Hispanic individuals ( Figure B ). Conclusion: The public health burden of CKM is substantial. Ninety percent of Dallas County residents in 2000-2002 had some form of CKM syndrome, nearly half demonstrated metabolic dysfunction (Stage 2), and nearly one-fourth had subclinical cardiovascular disease (Stage 3).
Abstract P1152: Association of the Alternative Healthy Eating Index with Coronary Artery Calcification Volume and Density: the Multi-Ethnic Study of Atherosclerosis
Authors: Ethan Cannon, Robyn McClelland, Alexis Wood, Matthew Budoff, Matthew Allison, Michael Criqui, David Jacobs, Pamela Lutsey
Journal: Circulation (2025)

Introduction: The Agatston score is a measure of coronary artery calcification (CAC) used to predict atherosclerotic cardiovascular disease (ASCVD) events. Notably, the score is upweighted for calcium density, despite evidence that density is inversely associated with cardiovascular disease after accounting for volume. Some studies have found associations between dietary components and the Agatston score, but none have evaluated diet in relation to CAC density and volume. Hypothesis: The Alternative Healthy Eating Index-2010 (AHEI), a measure of diet quality, is associated with lower CAC volume and higher CAC density. Methods: During the baseline exam of the Multi-Ethnic Study of Atherosclerosis, diet was assessed with a 120-item food frequency questionnaire from which the AHEI was derived. At the same exam, CAC was measured from computed tomography scans. In 3,099 participants with non-zero CAC volume, we modeled the associations of AHEI and natural log of Agatston score, natural log of volume, and density with linear regression. Models adjusted for age, sex, race/ethnicity, education, energy intake, cigarette smoking, and physical activity. We further adjusted for volume when density was the outcome and density when volume was the outcome. Results: The analytic sample included non-Hispanic White (45%), Black (23%), Hispanic (20%) and Chinese American (12%) individuals (mean age 66 years; 42% female). The median (Q1, Q3) Agatston score was 88 (22, 299) and volume was 85 mm 3 (25, 277). The mean (standard deviation [SD]) density score was 2.8 (0.7). After adjustment, the association of a one SD higher AHEI and Agatston score was not statistically significant (95% confidence interval [CI]: -0.10, 0.02; p=0.24). Conversely, in models assessing the relationship of AHEI with volume and density independent of one another, associations were significant (p=0.02 for volume; p=0.02 for density). A one SD higher AHEI was associated with a 0.05-unit lower log of volume (95% CI: -0.10, -0.01) and 0.02-unit higher density (95% CI: 0.00, 0.04). Conclusions : Our finding that higher AHEI was associated with lower CAC volume and higher CAC density aligns with research showing that diet is a risk factor for ASCVD. The null association with Agatston score appears to reflect the cancelling effects of the positive associations of density with higher AHEI and volume with lower AHEI, rather than the absence of a potential impact of dietary intake on subclinical atherosclerosis.
Abstract P1160: Gut Microbiota, Circulating Inflammatory Markers, and Cardiac Dysfunction In Women Living With HIV
Authors: Zheng Wang, Sanyog Shitole, Anjali Sharma, David Hanna, Brandilyn Peters-Samuelson, Tao Wang, Wendy Post, Alan Landay, kathleen weber, Audrey French, DANIEL MERENSTEIN, Sabina Haberlen, Alan Hinderliter, Igho Ofotokun, Claudia Martinez, Julie Schexnayder, Jason Lazar, Deborah Gustafson, Kathryn Anastos, Rob Knight, Robert Kaplan, Robert Burk, JORGE KIZER, Qibin Qi
Journal: Circulation (2025)

Introduction: The relationships among gut microbial alterations, host inflammation, and cardiac dysfunction remain understudied, particularly in the context of HIV. Hypothesis: We hypothesized that higher abundance of pro-inflammatory gut bacteria is associated with higher levels of host circulating inflammatory makers and cardiac dysfunction. Methods: We examined associations of gut microbial features (16S rRNA sequencing) with cardiac dysfunction (Echocardiography) in 973 women from the MACS/WIHS Combined Cohort Study. Cardiac dysfunction was defined as the presence of left ventricular systolic (LV ejection fraction&lt;54%) or diastolic (ASE 2016 criteria) dysfunction. In a subset (n=397), we further integrated cardiac dysfunction-associated microbial features (Shotgun metagenomics sequencing) with serum proteomic inflammatory markers (Olink platform inflammation panel) in relation to cardiac dysfunction. Results: The potentially pathogenic bacteria Streptococcus, Eggerthella and Anaeroglobus , were positively associated with cardiac dysfunction, while the beneficial genera Roseburia and Alistipes were linked to lower odds of cardiac dysfunction ( Fig. 1A ). Results were consistent in women with and without HIV. These cardiac dysfunction-associated bacteria were associated with a number of circulating proteomic inflammatory markers ( Fig. 1B ). For example, the pathogenic Streptococcus was positively associated with the pro-inflammatory cytokines IL-8 and IL-6, the chemokine MCP-3 (linked to immune response and atherosclerosis), and the inflammatory mediator OSM (associated with vascular inflammation and heart failure). Proteomic inflammatory scores were generated for each genus based on their specific inflammatory marker profiles. The inflammatory score for Streptococcus was significantly associated with cardiac dysfunction ( Fig. 1C ). Associations between bacterial genera and cardiac dysfunction were attenuated after further adjustment for specific microbial associated inflammatory markers ( Fig. 1D ). Conclusion: Among women living with or at risk of HIV, we identified gut microbial features associated with cardiac dysfunction, with certain microbiota-related inflammatory markers partially explaining these associations.
Abstract P1154: Childhood Parental Incarceration, Cardiovascular Health, and Subclinical CVD in Young Adults: the Future of Families and Cardiovascular Health Among Young Adults (FF-CHAYA) Study
Authors: Nicole Fields, Hongyan Ning, James Stein, Norrina Allen, Daniel Notterman, Donald Lloyd-Jones
Journal: Circulation (2025)

Background: Few studies have prospectively examined associations of parental incarceration during childhood with offspring cardiovascular health (CVH). We assessed: (1) associations between parental incarceration and subclinical cardiovascular disease (subCVD) in young adulthood, and (2) whether associations were mediated by CVH. Methods: Data are from the FF-CHAYA Study, an ancillary study of the Future of Families and Child Wellbeing Study. Incarceration of mothers and fathers as well as the number of times the father was incarcerated (never, once, ≥2 times) was collected via interviews at birth and ages 1, 5, and 9y. Carotid intima-media thickness (IMT) was measured at age 22 using B-mode ultrasound and analyzed as a continuous or dichotomous (high IMT ≥75 th percentile) outcome. In linear and logistic regression models, covariates included age, sex, race, mother’s poverty level, young adult’s arrest history, and CVH (Life’s Essential 8 score at age 22). Attenuation by adjustment and formal mediation analyses were performed to understand how much of the association between parental incarceration and subCVD was explained by CVH. Results: Among 1,372 participants, 54% identified as female, 51% as Black, 27% as Hispanic, 17% as non-Hispanic White, and 4% as Other or Mixed; 278 (20.3%) experienced incarceration of a parent prior to age 9y. Most parental incarceration was paternal (n=222; 79.9%); 106 (47.7%) reported their father was incarcerated once and 116 (52.3%) reported their father was incarcerated ≥2 times. Parental incarceration was associated with higher mean-mean (Model 2: b= 0.86; 95% CI: 0.05, 1.67) and mean-max cIMT (b=0.94; 95% CI: 0.06, 1.82) but was attenuated and nonsignificant after adjustment for CVH (Model 3). There was significant mediation by CVH (22.3% and 25.7% for mean-mean and mean-max cIMT, respectively, P &lt; 0.05). Paternal incarceration ≥2 or more times (versus never) was associated with high mean-mean (OR=1.66; 95% CI: 1.01, 2.73) and mean-max (OR=2.05; 95% CI: 1.25, 3.36) IMT. Conclusions: In these young adults, the association between parental incarceration and subCVD was partially mediated by CVH, suggesting that promotion of CVH earlier in life may lessen future CVD risk, although other pathways may also be important. Further, a greater number of paternal incarcerations was associated with developing high IMT suggesting that targeted interventions may help mitigate future CVD risk among this vulnerable population.
Abstract P1036: ABO Blood Type, Plasma Proteomic Profile, and Risk of Chronic Disease
Authors: Chengyong Jia, Yanbo Zhang, Kai Luo, robert kaplan, Thomas Rohan, Qibin Qi
Journal: Circulation (2025)

Background: ABO blood type has been related to cardiometabolic diseases, but the underlying mechanism is not well-understood. Hypothesis: O blood group has lower risks of cardiometabolic diseases, and a cardiometabolic favorable plasma proteomic profile compared to non-O blood group. Methods: In ~500,000 participants from the UK Biobank, we examined associations of ABO blood type (O [43%] vs. non-O blood group) with 37 non-cancer diseases both cross-sectionally and prospectively. In a subsample with plasma proteomics data ( n = 44,562), we examined whether O-type-related proteins mediate the associations between O blood type and diseases. Results: O blood type was associated with six diseases in both cross-sectional and prospective analyses ( FDR &lt; 0.05). Compared to non-O blood group, O blood group had lower risks of venous thromboembolism (VTE; HR = 0.75 [95% CI: 0.72–0.78]), peripheral artery disease (0.93 [0.88–0.98]), coronary artery disease (CAD; 0.96 [0.93–0.98]), diabetes (0.93 [0.90–0.96]) and vasculitis (0.85 [0.75–0.96]), and a higher risk of peptic ulcer (1.08 [1.02–1.13]; Figure 1A ). Out of 2911 proteins, 198 and 184 proteins were positively and negatively associated with O blood type, respectively; and these proteins were enriched in 30 KEGG pathways ( Figure 1B ). By constructing O-enriched protein pathway scores, we found that 13 and 6 scores were negatively associated with risks of diabetes and VTE, respectively, and seven scores were positively associated with risk of peptic ulcer ( Figure 1C; FDR &lt; 0.05). Further mediation analyses revealed that certain protein pathways such as mucin O-glycan or glycosaminoglycan biosynthesis potentially mediated the negative associations of O blood type with VTE, diabetes, and CAD, while infection-related pathways potentially mediated the positive association between O blood type and peptic ulcer. Conclusions: O blood type is associated with lower risks of multiple cardiometabolic diseases. Circulating proteins may potentially link O blood type and these diseases.
Abstract MP32: Cardiovascular Risk Factors and Predicted Risks Across Asian American, Native Hawaiian and other Pacific Islander Subgroups: The PANACHE Study
Authors: Rishi Parikh, Alan Go, Joan Lo, Andrew Ambrosy, Thida Tan, Stacey Alexeeff, Connor Howick, Yihe Daida
Journal: Circulation (2025)

Introduction: Cardiovascular disease (CVD) risk varies substantially across racial and ethnic groups, especially among disaggregated Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) subpopulations. We describe differences in the prevalence of CVD risk factors and predicted CVD risk among a large, diverse population of AANHPI adults living in California and Hawai’i. Methods: We identified 2,653,007 adults within Kaiser Permanente Northern California and Hawaii from 2012-2022 aged ≥30 years with no prior myocardial infarction, stroke, heart failure or atrial fibrillation. CVD risk factors were ascertained using validated diagnosis codes, ambulatory measurements, and dispensed medications in the electronic health record. We calculated the 10-year predicted risk of CVD events using the American Heart Association base PREVENT-CVD equations. Prevalence estimates and means were standardized to the overall age and sex distribution using parametric g-computation. Results: Mean (SD) age was 49 (15) years and ranged from 41 (12) years in South Asian to 55 (16) years in Japanese adults. 53% were women overall, ranging from 48% in Native Hawaiian/Pacific Islander to 64% in Korean adults. Compared to non-Hispanic White adults, all AANHPI subgroups had higher prevalences of diabetes and dyslipidemia and lower prevalence of smoking, the latter except Native Hawaiian/Pacific Islander adults ( Figure ). There were notable differences across AANHPI subgroups in the prevalence of hypertension (12% in Chinese to 30% in Filipino adults), obesity (11% in Vietnamese to 41% in Native Hawaiian/Pacific Islander adults), and diabetes (5% in Chinese to 14% in Native Hawaiian/Pacific Islander adults. Filipino, Native Hawaiian/Pacific Islander, Vietnamese, and other Southeast Asian adults lived in neighborhoods with higher deprivation indices. Based on PREVENT-CVD risk estimates, Filipino, Native Hawaiian/Pacific Islander, South Asian and other Southeast Asian populations had higher standardized 10-year CVD risks. Conclusions: We found considerable variation in traditional CVD risk factors and predicted CVD risk across disaggregated AANHPI subgroups in a contemporary population with no prior CVD. Further research is needed to investigate potential differences in mediating pathways to the development of CVD across AANHPI subgroups. There is also a need to examine non-traditional structural and social factors that may uniquely affect AANHPI populations.
Abstract P2010: Extra-Coronary Calcification and Risk of Incident Cardiovascular Disease in Adults 75 and Older: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Siyu Zou, Hairong Liu, Yejin Mok, Abhishek Gami, Lin Yee Chen, Matthew Budoff, Michael Blaha, Kunihiro Matsushita
Journal: Circulation (2025)

Background: The coronary artery calcium (CAC) score is one of the most potent predictors of cardiovascular disease (CVD). During a CAC scan, extra-coronary calcification (ECC) can be simultaneously measured, but the independent prognostic value is unknown in adults aged 75 and older. Methods: We studied 1,831 ARIC participants at visit 7 (mean age 80.4 [SD 4.2] years, 62% female, 20% black) without prevalent CVD. We quantified ECC (Agatston score) at five specific sites: aortic valve calcification (AVC), aortic valve ring calcification (AVR), mitral valve calcification (MVC), ascending aorta calcification (ASA), and descending aorta calcification (DSA). We ran multivariable Cox models with total CVD events (composite of adjudicated myocardial infarction, stroke, and heart failure) as the outcome. Results: Over a mean follow-up of 2.6 years, 113 incident CVD events occurred. The prevalence of ECC&gt;0 varied by site: AVC (45%), ARC (86%), MVC (47%), ASA (25%), and DSA (89%). After adjusting for traditional CVD risk factors (Model 1 in Table), prevalence of each ECC was associated with incident CVD events (e.g., hazard ratio 1.30, [95%CI 1.09-1.56] for AVC). However, after further adjustment for the CAC score (Model 2 in Table), only AVC remained significant (hazard ratio 1.22 [1.02-1.47]). When adding each ECC into the base model with traditional risk factors and CAC score, AVC, but not other ECCs, significantly improved CVD risk prediction (Δc-statistic 0.014 [95%CI 0.001 to 0.033] from c-statistic of 0.703 to 0.718). Conclusion: Of ECCs measured, AVC was particularly robustly associated with incident CVD and improved CVD prediction beyond CAC score in the 75-and-older population. Our findings suggest the value of quantifying ECC when CAC scan was performed in this population.