tbuckley/cabot-search huggingface dataset:
Abstract P1008: A blood biomarker of accelerated aging associates with cardiometabolic biomarkers in response to weight-loss dietary interventions
Authors: Minghao Kou, Xiang Li, Yoriko Heianza, Lydia Bazzano
Journal: Circulation (2025)

Introduction: Weight-loss diets have shown protective effects on biological aging and cardiometabolic health. A novel epigenetic aging measure, DunedinPACE, is associated with cardiometabolic disorders. Studies examining the associations between DunedinPACE and cardiometabolic biomarkers in response to weight-loss dietary intervention are lacking. Hypothesis: Weight-loss dietary interventions may attenuate the associations between DunedinPACE and cardiometabolic biomarkers. Methods: We included 148 participants with obesity, who participated in a 12-month randomized weight-loss dietary intervention trial, the Study of Macronutrients and Heart Disease Risk (MACRO) trial. DunedinPACE was calculated by llumina EPIC array DNA methylation data from blood, reflecting biological aging at pre-intervention baseline, and pro-intervention 3- and 12-month follow-up. Generalized linear regression models and mixed effect models were used to assess the association between DunedinPACE and cardiometabolic biomarkers. A two-tailed P value of &lt;0.004 (0.05/12) was considered statistically significant after Bonferroni correction. Results: Prior to dietary intervention, every 10% higher DunedinPACE was significantly associated with worse levels of insulin (β: 0.202; standard error [SE]: 0.043; P&lt;0.001), homeostatic model assessment for insulin resistance (β: 0.170; SE: 0.037; P&lt;0.001), high-density lipoprotein cholesterol (β: -0.059; SE: 0.019; P=0.003), adiponectin (β: -0.153; SE: 0.047; P=0.001), and C-reactive protein (β: 0.172; SE: 0.055; P=0.002), adjusting for age, sex, race, and body mass index ( Table ). In response to weight-loss dietary interventions, most associations between DunedinPACE and cardiometabolic biomarkers were attenuated to insignificant levels (P&gt;0.004), except for C-reactive protein (β: 0.205; SE: 0.045; P&lt;0.001) and Ghrelin (β: -0.076; SE: 0.020; P&lt;0.001). Conclusions: Our findings indicate that DunedinPACE was associated with worse cardiometabolic biomarkers in obese people, while weight-loss dietary interventions might have beneficial effects in attenuating the associations.
Abstract P3012: Increased Circulating Concentrations of Soluble Cell Adhesion Molecules and Fibrin-D-Dimer in Adults with Periodontal Disease
Authors: Noah DeSouza, Samuel Ruzzene, Auburn Berry, Jared Greiner, Vinicius Pacheco Garcia, Kyle Diehl
Journal: Circulation (2025)

Periodontal disease, specifically periodontitis, is a progressive multidimensional inflammatory disease of the oral cavity. In addition to adverse oral health consequences, periodontitis is associated with increased risk of atherothrombotic cardiovascular disease and events. Importantly, periodontitis affects &gt;40% of adults in the United States over the age of 30 years. Despite improved management of many of the oral health consequences associated with periodontitis, factors that initiate and promote increased atherothrombotic risk and events are poorly understood. Elevated levels of circulating soluble cell adhesion molecules and fibrin D-dimer are markers of a proatherogenic vascular environment and strong prognostic indicators of atherothrombotic events. We tested the hypothesis that circulating levels of soluble cell adhesion molecules and fibrin D-dimer are elevated in adults with periodontitis, which, in turn, may contribute to the heightened risk of vascular disease and events in this population. Peripheral blood was collected from 26 middle-aged adults: 13 without periodontitis (9 M/4F; age: 49 + 3 yr; BMI: 28.5 + 0.9 kg/m 2 ) and 13 clinically diagnosed with periodontitis (7 M/6 F; 54 + 4 yr; 26.0 + 1.6 kg/m 2 ). All subjects were free of overt cardiovascular and metabolic disease. Plasma concentrations of extracellular soluble adhesion molecules (intracellular adhesion molecule-1 [sICAM-1], vascular adhesion molecule-1 [sVCAM-1], platelet endothelial cell adhesion molecule-1 [sPECAM-1] and E-selectin) and fibrin D-dimer were determined by immunoassay. sICAM-1 (265±14 vs 218±11 ng/mL), E-selectin (48±4 vs 36±3 ng/mL) and fibrin D-dimer (408±47 vs 278±31 ng/mL) were significantly higher (~25-50%) in adults with periodontitis. There were no significant group differences in either sVCAM-1 (595±38 vs 596±53 ng/mL) or sPECAM-1 (10±1 vs 9±1 ng/mL). Elevated circulating levels of sICAM and sE-selectin are sensitive biomarkers of vascular endothelial cell activation and adhesion and have been linked with increased risk of atherogenesis; in addition, elevated fibrin D-dimer is a direct indicator of thrombotic activity. Thus, the increased risk and prevalence of atherothrombotic events in adults with periodontitis may be mediated, in part, by increased expression of cell adhesion molecules and a prothrombotic environment as indicated by elevated soluble cell adhesion molecules and fibrin D-dimer levels.
Abstract P3015: Maintenance of Ideal Cardiovascular Health Among Latinos Over a Decade in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and National Health and Nutrition Examination Survey (NHANES)
Authors: Wenyan Ma, Ryung Kim, Carmen Isasi, Linda Gallo, Krista Perreira, Gabriela Trifan, Martha Daviglus, Amber Pirzada, Daniela Sotres-Alvarez, Christina Cordero, Frank Penedo, Robert Kaplan
Journal: Circulation (2025)

Objective: The long-term trends of cardiovascular health (CVH) in the US Hispanic/Latino population are incompletely understood. We aimed to assess CVH longitudinally using metrics based on the American Heart Association's Life's Essential 8 (LE8). To investigate the "Hispanic resilience" phenomenon, we compared Hispanic and non-Hispanic data from US-wide samples. Methods: We included HCHS/SOL enrollees aged 28 to 74 free of cardiovascular diseases at baseline (2008-2011, n=12,724) and at Visit 2 (2014-2017, n=9,246). We evaluated the weighted prevalence of meeting the ideal levels for five LE8 metrics repeatedly measured at both visits: nicotine exposure, body mass index (BMI), blood lipids, blood glucose, and blood pressure. We also assessed the prevalence of meeting multiple CVH metrics (defined as meeting four or five of the total five measured metrics) by demographic subgroups. Comparisons were made with data from corresponding timeframes from NHANES-Hispanics and NHANES-non-Hispanic Whites (NHW). Results: Over time, among Hispanics, the prevalence of meeting the blood lipid CVH metric increased (30.0% at baseline, 40.4% at Visit 2), while the prevalence of meeting the blood glucose metric decreased (47.6% to 39.1%). Nicotine exposure, BMI, and blood pressure metrics were unchanged. Among Hispanic/Latino backgrounds, South Americans consistently were most likely to meet multiple CVH metrics over time (18.4% to 18.5%), while Puerto Ricans showed the most improvement across time periods (9.9% to 14.0%). Both Hispanic males and females improved over time, with females having higher achievement of CVH metrics. US-born (i.e., 50 states/DC) Hispanics were more likely to meet most CVH metrics compared to those born outside the US. In comparison with NHANES, the prevalence of meeting the nicotine exposure metric was consistently higher in both HCHS/SOL and NHANES-Hispanics than in NHW. NHANES-NHW participants had a higher prevalence of meeting the BMI and blood lipid metrics compared to Hispanics in HCHS/SOL and NHANES. Across all Hispanic and NHW groups, there was a consistent trend of improvement in the blood lipid metric and a decline in the blood glucose metric. Conclusion: Across different metrics of CVH, Hispanics/Latinos have both advantages and disadvantages relative to NHW in the US. Across the US, among both Hispanics and NHW, blood lipids have improved over time, while the blood glucose component of CVH has worsened.
Abstract P1077: A comparison of outpatient cardiac rehabilitation access between rural and urban counties in Tennessee
Authors: Phoebe Tran, Benjamin Fogelson, Andrew Sorey, Robert Heidel, Raj Baljepally
Journal: Circulation (2025)

Background: Longer travel distance and time to outpatient cardiac rehabilitation (OCR) are linked with lower OCR attendance despite OCR being significantly associated with reduced hospital readmission and mortality following a myocardial infarction. With contemporary research on rural-urban differences in proximity to OCR being limited, we examined whether travel distance and time to the closest OCR facility differed between rural and urban Tennessee counties. With there being a known lack of resources throughout the cardiovascular disease care continuum in rural areas, we hypothesized that rural Tennessee counties would have significantly greater travel distance and time to OCR than urban counties. Methods: To identify Tennessee OCR facilities, we supplemented an existing Tennessee Association of Cardiovascular and Pulmonary Rehabilitation OCR listing by data scraping Google Maps using keywords associated with OCR from the literature. Counties with Rural-Urban Continuum Codes 1-3 were classified as urban counties and codes 4-9 denoted rural counties. County-level mean travel distance and time to the closest facility were determined for each county and Wilcoxon rank-sum tests were performed to examine if mean travel distance/time differed significantly by rural/urban county status. Results: Twenty-three out of Tennessee’s 61 OCR facilities (37.7%) were in rural counties. Mean county-level travel distance to closest OCR was 16.6 miles (SD + 10.0 miles) and mean county-level travel time was 27.9 minutes (SD + 13.6 minutes). When examined by rural/urban county status, rural counties had slightly higher median of mean travel distance and time (15.4 miles, 28.9 minutes) compared to urban counties (12.9 miles, 23.2 minutes). However, the p-values for the distance and time comparisons between rural and urban counties were not statistically significant being 0.182 and 0.284 respectively. Conclusions: While &lt;40% of Tennessee’s OCR facilities were in rural counties, this did not correspond with significantly greater travel distance/time in rural versus urban counties, a contrast to what is usually observed for rural-urban distribution of services throughout the cardiovascular disease care continuum. With that said, additional efforts are warranted to help patients with actual or perceived high travel burden navigate the personal and structural factors precluding receiving OCR.
Abstract MP69: Nursing facility use and frailty index as indicators of reserve and resilience in adults with hospitalization for a cardiovascular event: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study
Authors: ENE ENOGELA, Lisandro Colantonio, Emily Levitan, Parag Goyal, Madeline Sterling, Monika Safford, Ying Wen, Mojisola Fasokun, Barrett Bowling
Journal: Circulation (2025)

Introduction: Reserve and resilience refer to the degree of robustness prior to, and the subsequent ability to recover from a health stressor. Frailty and nursing facility use (NFU) may characterize varying levels of physical reserve and resilience among individuals hospitalized for a cardiovascular event. Objective: To characterize older US adults who had a CVD hospitalization using novel indicators of reserve and resilience: nursing facility use and a frailty index. Methods: We analyzed data from 1,605 Black and White REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants with Medicare fee-for-service coverage who were age ≥65.5 years and had no NFU before an adjudicated myocardial infarction, heart failure, or stroke hospitalization in 2004-2019. Participants were grouped into mutually exclusive categories based on Medicare claims for NFU and vital status (i.e., alive without NFU, alive with NFU, and death) within 182 days and 183-365 days following discharge. We calculated a claims-based frailty index (index ranges from 0 to 1, with higher values indicating greater deficit accumulation) within 182 days before admission, and within 182 days and 183-365 days following discharge. Results: The mean age at admission was 77.4 years, 43.6% were female, and 30.4% were Black. Most participants were alive without NFU for 365 days post-discharge (64.9%), followed by those who died within 182 days following discharge (11.6%), and those who were alive with NFU within 182 days and alive without NFU in the 183-365 days following discharge (10.3%). Participants who were alive without NFU for 365 days post-discharge had the lowest frailty index in each assessment period (Figure) and were younger (mean age 76.5 years) versus the other groups (range 77.3-80.4 years). There were no substantial differences in subgroups defined by NFU and vital status post-discharge in analyses stratified by sex or race. Conclusion: NFU and frailty index identify older adults with varying levels of apparent reserve and resilience before and after a cardiovascular hospitalization.
Abstract 070: The Risk of Arrhythmias and Sudden Cardiac Arrest Associated with Methamphetamine, Cocaine, Opiate, and Cannabis Use: An Analysis of a Large Healthcare Claims Database
Authors: Faye Norby, Rob Walker, Wendy Wang, Darin Erickson, Pamela Lutsey
Journal: Circulation (2025)

Introduction: Arrhythmogenic risks associated with substance use are poorly understood; existing studies are limited in scope or conducted in select populations. We conducted a longitudinal analysis to quantify the association of substance use with incident arrhythmias and sudden cardiac arrest (SCA) in a commercially insured population in the US. Methods: Using data from the MarketScan databases (2016-2022), we used ICD-10 codes to identify substances, outcomes, and covariates at each medical encounter. Substance users were matched with up to five non-substance users by age, sex, insurance enrollment date, and encounter date. Outcomes included atrial fibrillation (AF), ventricular tachycardia (VT), and a combined SCA/ventricular fibrillation (SCA/VF) outcome. We used Cox proportional hazards models to assess the association of each substance with each incident outcome, adjusting for demographics and comorbidities. Results: We matched 154,208 substance users to 697,869 non-users (mean age = 43 years; 46% female). Opiate and cannabis use were the most common (Table). During a mean follow-up of 2.1 years, there were 25,357 AF events, 6,351 VT events, and 2,095 SCA/VA events. After adjusting for potential confounders, the use of methamphetamines, cocaine, cannabis, and opiates was each associated with an increased risk of AF, with cannabis use having the highest risk of AF [HR: 1.84 (95% CI: 1.71, 1.98)] compared to matched non-users. All substances were associated with an increased risk of VT and SCA/VF, with cocaine use having the highest risk of SCA/VF [HR: 3.45 (95% CI: 2.77, 4.28)] compared to non-users. Conclusion: In this representative sample of commercially insured people, methamphetamine, cocaine, cannabis, and opiate use was each associated with a 1.5-3.5 times increased risk of developing arrhythmias. Given the ongoing drug crisis and increasing cannabis use in the US, understanding the association of substance use with arrhythmia risk will help better target arrhythmia prevention in these populations.
Abstract 076: Risk of Atherosclerotic Cardiovascular Disease and Heart Failure by Type 2 Diabetes Subtypes
Authors: Jithin Sam Varghese, Zhongyu Li, Aamna Soniwala, Mohammed Ali
Journal: Circulation (2025)

Introduction: Type 2 diabetes (T2D) appears to have subtypes with different trajectories of health. Compared to the mild obesity-related (MOD) and mild age-related (MARD) subtypes, the severe insulin-deficient (SIDD) subtype has higher HbA1c, reduced beta-cell function, younger age at diagnosis, and is consistently associated with a higher risk of diabetic retinopathy and neuropathy. However, little is known about the heterogeneity in risk for types of atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) by T2D subtype ( Figure 1 ). Methods: To describe the risks of ASCVD and HF by T2D subtypes, we analyzed electronic health records (EHRs) of newly diagnosed T2D from USA (2012-2023), defined using the SUPREME-DM phenotype, in the Epic Cosmos Research Platform (n = 727,076; 64.4 years [SD:13.3] and 52% female). Using previously validated models to identify subtypes in EHRs (AUC: 0.81-0.99, F1 score: 0.87-0.90), we classified T2D cases as SIDD (21.6%), MOD (23.8%), MARD (40.9%), and Mixed (13.7%). Six outcomes were defined using ICD-10-CM codes within five years after T2D diagnosis and included: severe ASCVD (non-ST [NSTEMI] and ST [STEMI] elevation myocardial infarction, unstable angina, stroke) and Heart Failure (preserved [HFpEF] and reduced [HFrEF] ejection fraction). We reported hazard ratios [HR] from Cox Proportional Hazards models adjusting for age, sex, and medications (statin, ACE/ARB, beta blockers). Results: Compared to MOD, SIDD was associated with higher hazards of NSTEMI (HR,1.68 [95%CI,1.61-1.75]), STEMI (HR, 1.48 [95%CI,1.40-1.56]), unstable angina (HR,1.41 [95%CI,1.34-1.48]), stroke (HR, 1.62 [95%CI,1.57-1.68]), HFrEF (HR, 1.36 [95%CI,1.32-1.41]) and HFpEF (HR, 1.10 [95%CI,1.07-1.13]) ( Figure 2 ). MARD had elevated hazards for NSTEMI (HR, 1.16 [95%CI,1.11-1.21]), STEMI (HR, 1.13 [95%CI,1.07-1.21]), stroke (HR, 1.20 [95%CI,1.16-1.25]) and angina [HR,1.07 [95%CI,1.01-1.13]), but lower hazards of HFpEF (HR, 0.72 [95%CI, 0.70-0.74]) and HFrEF (HR, 0.94 [95%CI, 0.91-0.97]) relative to MOD. The Mixed subtype had hazards similar to MARD for all outcomes. Conclusions: SIDD was associated with the highest risk of cardiovascular complications, relative to milder subtypes. These findings highlight the need to evaluate targeted prevention and treatment strategies tailored to this high-risk T2D subtype to reduce the burden of cardiovascular disease.
Abstract P1083: Religiosity and Risk of Heart Failure in the Southeastern United States
Authors: Taylar Dickson, Meng Xu, LaPrincess Brewer, Loren Lipworth, Deepak Gupta, Debra Dixon
Journal: Circulation (2025)

Introduction: Greater religiosity, or degree of involvement in religious activities, associates with better CV health profiles. Yet, studies of the association between religiosity and incident CV events have yielded mixed results. The southeastern US is characterized by strong religious practice but has among the highest rates of incident heart failure (HF). The relationship between religiosity and incident HF is not well characterized, particularly among low-income populations. Methods: We studied 23,893 Black or White Southern Community Cohort Study participants (median age 53 years, 70% Black, 64% women, 70% annual household income &lt;$15k) without prevalent HF or CAD at enrollment (2002-2009). Religiosity, defined by religious service attendance, was ascertained at enrollment via a single item adapted from the Duke University Religion Index. Incident HF was determined using Centers for Medicare and Medicaid Services Research Identifiable Files (ICD-9/-10 codes 428.x or I50, I110) through December 31, 2016. We quantified the association of religious attendance with incident HF via Cox models adjusted for demographics, HF risk factors (HTN, HLD, DM, BMI, CVA), health behaviors (smoking, alcohol, physical activity, DASH diet), socioeconomic (income, education, employment, neighborhood deprivation, rurality) and psychosocial factors (marital status, social support, depressive symptoms, anti-depressant use). Results: Religious service attendance was common: &gt;1/week (24%), 1/week (27%), &lt;1/week (33%), and never (15%). Participants attending &gt;1/week were more likely to be older and female, had relatively higher SES and more comorbidities, but better health behaviors and psychosocial support. HF developed in 6081 participants (25%; median 10-yr follow-up). Adjusting for demographics and HF risk factors, attendance &gt;1/week associated with lower HF risk (HR 0.88 [0.82,0.94] and HR 0.92 [0.84,1.00] compared to &lt;1/week or never, respectively). Attendance 1/week compared to &lt;1/week showed similar association (HR 0.91 [0.85, 0.97]). Further adjustment for health behaviors, socioeconomic and psychosocial factors attenuated the association to non-significance. There was no interaction between religiosity and race. Conclusion: Greater frequency of religious service attendance associated with lower incident HF risk adjusting for demographics and HF risk factors; however, this association attenuated with adjustment for health behaviors, socioeconomic and psychosocial factors.
Abstract MP73: Long-Term Effects of Physical Activity, Sleep, and Screen-Time on Hypertension Incidence in Adolescents – ABCD Study
Authors: Augusto Cesar Ferreira De Moraes, Ethan Hunt, Denver Brown, Jacob Szeszulski, Gabrielli De Mello, Marcus Vinicius Nascimento-Ferreira
Journal: Circulation (2025)

Background: Hypertension is a critical risk factor for cardiovascular diseases with a high prevalence in pediatric populations. However, the long-term effects of physical activity, sleep, and screen time on hypertension incidence in adolescents remain unclear. Research Questions: How do long-term physical activity, sleep, and screen time influence the incidence of hypertension in adolescents within the Adolescent Brain Cognitive Development (ABCD) Study? Aims: i) Investigate the long-term effects of physical activity, sleep patterns, and screen time on hypertension incidence in adolescents using Fitbit and self-reports. Methods: Our analysis involved 1,702 adolescents (51.5% boys) from the ABCD study across 21 US cities, followed prospectively from 2018-2020 (T0) to 2020-2022 (T1), focusing on those with complete data on physical activity, sleep, screen time, and covariates (sex, age, waist circumference and social determinants). Hypertension was defined according to AAP guidelines. Movement behaviors were categorized as ≥ 60 minutes of moderate to vigorous physical activity daily, ≤ 2 hours of recreational screen time, and 9-11 hours of sleep. We estimated hypertension incidence and relative risks, examining the individual and joint additive effects of movement behaviors. Results: At the T0, the mean age was 11.9 years, increasing to 14.1 years at T1. Adolescents who did not meet the screen time recommendations had higher hypertension prevalence (1.9%) and incidence (4.0%) compared to those who met the guideline (1.0% prevalence; 1.7% incidence). No significant differences were observed for sleep guideline adherence. Physical activity guideline adherence was associated with higher hypertension incidence (4.7% vs. 3.1%), but not prevalence (1.2% vs. 2.7%). Meeting two or more components of the 24-hour movement behavior guidelines was associated with significantly reduced hypertension risk (RR 0.31, 95% CI 0.09-0.98). Conclusions: High screen time and not meet physical activity guideline are linked to increased hypertension risk in adolescents. Adhering two or more 24-hour movement behavior recommendations reduces this risk of hypertension, emphasizing the need for comprehensive and combined lifestyle interventions to promote cardiovascular health.