tbuckley/cabot-search huggingface dataset:
Abstract P2072: Lipoprotein(a) Levels in Premature Versus Non-Premature Atherosclerotic Cardiovascular Disease: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Matthew Belanger, Jelani Grant, Sui Zhang, Seth Martin, Kunihiro Matsushita, Salim Virani, Roger Blumenthal, Ron Hoogeveen, Eric Boerwinkle, Christie Ballantyne, Joseph Coresh, Chiadi Ndumele
Journal: Circulation (2025)

Background: Lipoprotein(a) [Lp(a)] is a causal, predominantly genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD). Approximately 20-30% of the global population have Lp(a) levels in the atherogenic range, with prospective data demonstrating a dose-response association of Lp(a) levels with ASCVD risk. However, there are relatively limited data characterizing the relationship between Lp(a) and premature ASCVD in epidemiologic cohort studies. Methods: We evaluated participants in the ARIC study with available Lp(a) measurements, collected at ARIC Visit 4 (1996-98). We used continuous follow-up and adjudication for ASCVD events (nonfatal myocardial infarction, fatal coronary heart disease, or ischemic stroke) from 1987 through 2021 to categorize participants as having had premature ASCVD events (events by age &lt;55 for men, &lt;65 for women), non-premature ASCVD events (age ≥55 for men, ≥65 for women), or no ASCVD events. Lp(a) levels were categorized according to previously established cutpoints: &lt;30, ≥30 to &lt;50, ≥50 to &lt;100, and ≥100 mg/dL and compared across those with non-premature ASCVD, premature ASCVD, and no ASCVD. Elevated Lp(a) was defined as ≥30 mg/dL, and multivariable-adjusted logistic regression models were used to assess the association of elevated Lp(a) with ASCVD status. Results: Among 8,236 participants (mean age 58 yrs, 71% female, 24% Black adults), those with premature ASCVD had the highest median Lp(a) levels (17.7 mg/dL), followed by non-premature ASCVD (14.4 mg/dL), and no ASCVD (13.6 mg/dL) (p = 0.002) ( Table ). Elevated Lp(a) levels were found in 40.8% of participants with premature ASCVD, compared with 34.1% in non-premature ASCVD, and 30.8% without ASCVD (p &lt;0.001). Participants with premature ASCVD had the highest odds of elevated Lp(a) relative to those with no ASCVD (OR: 1.39 [95% CI: 1.09-1.77]), while participants with non-premature ASCVD had a lesser, but still significantly higher odds of elevated Lp(a), compared to those with no ASCVD (OR: 1.16 [1.02-1.31]). Conclusion: Among ARIC study participants, premature ASCVD is associated with the highest prevalence and odds of elevated Lp(a). These findings reinforce the importance of the broader adoption of current guidelines that recommend systematic screening for elevated Lp(a) among individuals with premature ASCVD.
Abstract P2064: Comparing East and South Asian population-specific blood pressure trajectories and their associations with cardiovascular disease risk
Authors: So Mi Cho, Sarah Urbut, Yunfeng Ruan, Aarushi Bhatnagar, Shriienidhie Ganesh, Whitney Hornsby, Romit Bhattacharya, Michael Honigberg, Stephen Juraschek, Eugene Yang, Daichi Shimbo, Pradeep Natarajan
Journal: Circulation (2025)

Introduction: Cardiovascular disease (CVD) risk differs across Asian subgroups possibly due to differences in hypertension burden. We characterized lifetime blood pressure (BP) trajectories for East and South Asian individuals and compared their age-specific associations with lifetime CVD risk. Methods: Using UK Biobank primary care data, we identified 148,872 individuals with BP measurements since age 18 years. For each sex and self-identified ethnicity, life course BP trajectories were fitted as a function of age. We determined associations of time-averaged young adulthood (age 18-39), middle-age (age 40-64), and later-life (age ≥65) systolic BP (SBP) and diastolic BP (DBP) with incident atherosclerotic CVD risk using sex and antihypertensive-adjusted logistic regression. Results: Of 148,872 UK adults (54% women), 376 (0.3%) identified as East Asian, 3077 (2.1%) as South Asian, 143,575 (96.4%) as White European, and 1844 (1.2%) as African or Black. The predicted SBP/DBP [95% CI] at age 30 years was 108 [103-114] / 68 [65-71] mmHg for East Asian and 114 [110-118] / 72 [71-73] mmHg for South Asian individuals. By age 40, South Asian individuals were projected to reach SBP of 130.0 mmHg, whereas East Asian individuals reached the equivalent SBP by age 49. Among South Asian individuals, each standard deviation increase in young adulthood SBP associated with a higher atherosclerotic CVD risk with an odds ratio (OR) [95% CI] of 1.41 [1.12-1.75] but not among East Asians ( P interaction =0.01). Midlife SBP associated with peripheral artery disease among South Asian individuals (OR [95% CI]: 2.08 [1.51-2.88]), and with ischemic stroke among East Asian individuals (3.84 [1.08-5.07]). Later-life SBP associated with myocardial infarction risk by 1.52 [1.15-1.92]-fold among South Asian and ischemic stroke by 2.50 [1.06-3.80]-fold among East Asian individuals. Conclusions: East and South Asian individuals exhibit distinct BP trajectories that age-differentially associate with incident CVD. Disaggregating Asian subgroups may inform tailored hypertension screening and management.
Abstract P3167: Area-level Social Determinants of Health Are Associated with Earlier Age of Heart Failure Onset: A Cluster Analysis in the Get With The Guidelines Heart Failure Registry
Authors: Xiaoning Huang, Faraz Ahmad, Nilay Shah, Clyde Yancy, Gregg Fonarow, Sadiya Khan, Lucia Petito
Journal: Circulation (2025)

Background: Area-level social determinants of health (SDOH) are associated with earlier onset of heart failure (HF). However, the extent to which adverse SDOH cluster in geographic communities and contribute to earlier onset of HF, particularly among minoritized populations, is not known. Methods: Patients hospitalized with new-onset HF in the Get With The Guidelines-HF Registry (2017-19) were included. K-means clustering identified 4 groups of patient 5-digit residential zip code areas with similar area-level SDOH (education, income, employment, housing quality, healthcare access, and environmental factors). Linear regression adjusted for sex, region, and year of admission examined associations between area-level SDOH groups and age of HF onset overall and stratified by self-identified race and ethnicity. Results: The 74,616 patients with new-onset HF belonging to one of the 4 area-level SDOH clusters differed had substantial heterogeneity in patient-level demographic and HF characteristics ( Table ). Mean (SD) age of HF onset was universally lowest in C3, ranging from 60.8y in NHB to 67.2y in NH Asian. Even within area-level SDOH clusters, racial and ethnic differences in HF onset age persisted. In the highest income cluster (C1), NHB patients and Hispanic patients had earlier age of HF onset (by 11.3 [95% CI 10.6, 12.1] and 7.9 [7.1, 8.7] y, respectively) compared with NHW patients. Conclusions: Areas with adverse SDOH experience greater burden of and earlier HF onset with pervasive and widespread racial and ethnic disparities in age of incident HF hospitalization. Incorporating area-level SDOH measures may improve identification of HF risk. Disparities in age of HF onset persisted in areas with more favorable SDOH, suggest that structural and systemic factors continue to perpetuate health inequalities. Identifying at-risk communities and designing multi-level interventions are needed to equitably prevent or delay HF onset.
Abstract P3159: Long-term and recurrent antibiotic use during early life is associated with incident cardiovascular disease during adulthood
Authors: Shuqi Zhu, Ying Hu, Xuan Wang, Hao Ma, Yoriko Heianza, Zhaoxia Liang, Lu Qi
Journal: Circulation (2025)

Background: Long-term antibiotic use during adulthood has been associated with a high risk of cardiovascular disease (CVD) in adults. However, it remains unclear whether antibiotic use during early life is related to incident adulthood CVD risk. Methods: We analyzed the associations of long-term or recurrent antibiotic use (LRAU) during early life and incident CVD events based on a large cohort of 151541 participants in the UK Biobank, using cox proportional hazards models. Results: During a median of 12.2 years of follow-up, 9444 total CVD incidents were documented, including 7272 coronary heart disease cases and 2,641 stroke cases. In the fully adjusted model, LRAU during early life was significantly associated with a higher risk of total CVD events and coronary heart disease (CHD), with a hazard ratio of 1.19 (95% confidence interval, 1.12–1.26) and 1.22 (1.14-1.31) respectively. LRAU during early life was not significantly associated with stroke. In addition, LRAU during early life showed significant multiplicative interactions with women (P for multiplicative interaction = 0.035) and hypertension at baseline (P for multiplicative interaction &lt; 0.001) on the risk of CVD was observed. Stronger associations were found in women and individuals with hypertension than their counterparts. Moreover, we found that LRAU during early life ranked higher in relative strength than lifestyle factors apart from smoking in predicting CVD. Conclusions: LRAU during early life is associated with a higher risk of CVD during adulthood. The associations are stronger among women and individuals with hypertension at baseline.
Abstract P2065: A Comparative Study Of Social Determinants, Hypertension, And Life Essential Factors In Alabama And Colorado From The 2021 Behavioral Risk Factor Surveillance System
Authors: Chibuike Chukwunyere, Kevin Owuor
Journal: Circulation (2025)

Background: Hypertension is an important modifiable risk factor for cardiovascular disease, which disproportionately impacts racial/ethnic minorities in the US. Currently, Equity in Prevention of Hypertension (EPIPHANY, 2024) a program funded by the American Heart Association(AHA) is focusing on and engaging the Black belt of Alabama to mitigate hypertension by targeting adults with prehypertension, a new strategy to reduce the prevalence of hypertension. This project was meant to test the hypothesis of no difference in the risk of hypertension between two US States and to generate evidence for implementation. Objective: To compare the social determinant of health (SDOH), hypertension, and the AHA life's essential factors among adults in Colorado and Alabama in the 2021 Behavioral Risk Factor Surveillance System (BRFSS) Methodology: This was a cross-sectional survey of adults enrolled in the US 2021 BRFSS study. Data analysed compared Colorado and Alabama to determine the essential life factors among the two states. Elevated blood pressure (hypertension) and the included variables were based on the answers from the diagnosis of the healthcare professional given to the participants in the US BRFSS 2021. Data analysis used regression and risk ratios from the BRFSS WEAT to calculate the logistic regression and adjusted odds ratios (CDC, 2024). Results: In 2021, the racial proportion of adults with hypertension in Alabama was 41.8% for White vs 48.4% for the Black population (overall proportion=42.6 %), while in Colorado, 27.6% of White vs 36.1% of the Black adult population had hypertension(Overall proportion=25.9%) [Figure 1]. Compared to Colorado, AL has 1.83 times higher AOR of hypertension (p&lt;0.0001). Fruit consumption, physical activity, and disability status significantly differed between Alabama and Colorado (p&lt;0.0001)[Table 1, Figure 2]. Surprisingly, there was no difference in healthcare access between AL and CO (0.7872) [Table 1] Conclusion: Though Colorado has the lowest prevalence of hypertension in the United States, disparities still persist. However, Alabama demonstrated much higher disability status, lack of physical activity, and consumption of vegetables and fruits of &lt;1 time/day (p&lt;0.0001). Recommendations: The high burden of hypertension among ethnic minorities deserve attention and more evidence can be assessed to further understand the enabling factors that led to CO having the lowest proportion of hypertension.
Abstract P3043: Circulating Omega-3 Polyunsaturated Fatty Acids and Early Type 2 Diabetes Risk Phenotypes: Longitudinal Analyses in the PROspective Metabolism and ISlet cell Evaluation (PROMISE) Cohort
Authors: Ji-Eun Chon, Nagam Anna Yehia, Ravi Retnakaran, Stewart Harris, Adam Metherel, Vasanti Malik, Richard Bazinet, Anthony Hanley
Journal: Circulation (2025)

Background: Literature on omega-3s and T2D risk has been heterogenous; however, most prior studies have used self-reported dietary intake or short-term supplementation regimens. Thus, further investigation is needed to assess longitudinal associations of circulating omega-3 with early T2D risk phenotypes. Objective: Assess longitudinal associations of circulating omega-3s with changes in insulin sensitivity (IS) and β-cell function (BCF) in the PROMISE cohort. Methods: Adults at-risk for T2D underwent four assessments over 9 years (n=472); blood samples were collected to determine insulin and glucose concentrations, and an OGTT was conducted. Baseline serum omega-3s (ALA, EPA, DPAn-3, DHA) were measured using gas chromatography-flame ionization detection. OGTT values were used to calculate validated IS (HOMA2-%S, ISI) and BCF (IGI/IR, ISSI-2) indices. Generalized estimating equations (GEE) analysis assessed the association between baseline omega-3s (mol%) with longitudinal change in IS and BCF indices after covariate adjustment. Results: Significant positive correlations were shown between EPA and DHA with IS measures (HOMA2-%S: EPA, r=0.18, DHA, r=0.23, all p&lt;0.001; ISI: EPA, r=0.15, p&lt;0.01, DHA, r=0.19, p&lt;0.001) and between DHA and BCF indices (IGI/IR, r=0.14, p&lt;0.01; ISSI-2, r=0.1, p&lt;0.05). In adjusted GEE models, baseline EPA and DHA were positively associated with longitudinal change in IS (HOMA2-%S, p&lt;0.001; ISI , p&lt;0.01), and BCF (IGI/IR, p&lt;0.05) ( Figure ) . Conclusions: Circulating omega-3s (specifically EPA and DHA) were positively associated with IS and BCF, which are important early T2D risk phenotypes. These findings add to growing evidence of the potential role omega-3s have in T2D primary prevention.
Abstract P1093: Race, Sex, and SES Differences in Heart Failure Incidence: A Cross-Cohort Collaboration
Authors: Miremad Moafi-Madani, Tiffany Hsieh, Chanelle Howe, Mary Roberts, Norrina Allen, Michael LaMonte, David Jacobs, Emily Levitan, Nancy Min, Anna Kucharska-Newton, Wayne Rosamond, Vanessa Xanthakis, JORGE KIZER, Faraz Ahmad, Daniel Forman, James Newburg, Charles Eaton
Journal: Circulation (2025)

Background: Health disparities regarding heart failure (HF) incidence by age, race, sex at birth, socioeconomic status (SES) and their intersections remain under-researched. Methods: We harmonized data from nine cohorts (WHI, FOHS, ARIC, Health ABC, REGARDS, CARDIA, JHS, CHS, and MESA). We performed a descriptive study of the cohort calculating incidence rates (IR) and incidence rate ratios (IRR). Age was defined at time zero for each cohort. Participants who identified as Black or white were included. SES was categorized as low or high based on both an educational attainment of some college/vocational training or less and an income, using household size and Official Poverty Measure (OPM) less than 200%. We stratified by age (≤65 vs. &gt;65 years) and evaluated IRs and IRRs, standardized by age (using 10-year intervals), sex, and race, depending on the comparison. Results: A total of 9700 incident HF cases occurred among 96000 participants free of HF at baseline followed up for a median of 13.7 years. Black participants had a slightly lower overall incidence of HF than Whites (IRR: 0.93, 95% CI: 0.89-0.97). We observed a higher risk of HF among Black participants≤65 years of age (IRR: 1.22, 95% CI: 1.14-1.31) compared to Whites. Conversely, Black individuals &gt;65 years of age had a lower incidence than Whites (IRR: 0.75, 95% CI: 0.71-0.80). Women had a lower incidence of HF than men (IRR: 0.66, 95% CI: 0.63-0.68), overall and in age strata. Low, as compared to high SES individuals had a higher incidence of HF (IRR: 1.67, 95% CI: 1.60-1.74. Among those ≤65, low SES Black men (IRR: 2.16, 95% CI: 1.81, 2.56) and low SES White men (IRR: 1.60, 95% CI: 1.35,1.91) had the highest incidence rate of HF compared to high SES White men. Conclusion: Both Black and White low SES groups are at the highest HF risk. Effect modification by age is apparent for race differences but a limitation of present descriptive analysis is that competing risk of death is not accounted for. 10-year cumulative incidence risk and its differences based on race, sex, and/or SES by accounting for competing risk of death are planned.
Abstract P3158: Sex-specific association patterns of childhood maltreatment across TyG and TyG-BMI indices in young adults
Authors: Shanshan Wang, Shuqin Li, Ruoyu Li, Min Mu, Yuhui Wan
Journal: Circulation (2025)

Background: There is a high prevalence of childhood maltreatment (CM) among adults with cardiometabolic diseases. However, there is limited information available on the specific patterns of association between CM (cumulative CM, subtype, threat- and deprivation-based CM and co-occurrence) with cardiometabolic health indicators in young adults. Aims: To investigate the patterns of association between CM and cardiometabolic health indicators, including the triglyceride glucose (TyG) index and the TyG-body mass index (TyG-BMI), in a sex-specific manner among young adults. Methods: This cross-sectional study included 817 young adults from the University Student Cohort in Anhui Province, conducted in September 2022. Spearman correlations and linear regressions were used to test the association of cumulative CM, five subtypes of CM - physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect - as well as the threat- and deprivation-based CM and co-occurrence (two or more subtypes of CM) with respect to the TyG index and the TyG-BMI index, in a sex-specific analysis. Results: Cumulative CM was associated with TyG index ( β = 0.06, 95% CI = 0.00 - 0.12). In contrast, none of the CM variables was associated with TyG-BMI index. We revealed profound sex-specific differences, with associations between cumulative CM and TyG index ( β = 0.10, 95% CI = 0.01 - 0.18), between emotional neglect and TyG index ( β = 0.10, 95% CI = 0.00 - 0.20), and between deprivation-based CM and TyG index ( β = 0.09, 95% CI = 0.00 - 0.18) in men only. Also, only men showed an association between deprivation-based CM and TyG-BMI index ( β = 3.06, 95% CI = 0.35 - 5.77). Conclusions: This study indicates that cumulative CM, emotional neglect and deprivation-based CM may be associated with poorer cardiometabolic health in young adults, with these associations being much stronger in men than in women.
Abstract P3030: Associations of Co-Existing Hypertension and Diabetes with Mortality Risk in US Adults: A Prospective Analysis of the 1999-2018 National Health and Nutrition Examination Surveys
Authors: Ye Yuan, Carmen Isasi, Tala Al-Rousan, Arnab Ghosh, Pricila Mullachery, Priya Palta, Nour Makarem
Journal: Circulation (2025)

Introduction: Hypertension (HTN) and type 2 diabetes (T2D) prevalence is on the rise resulting in an increasing number of US adults living with multiple cardiometabolic morbidities. The association of co-existing HTN and T2D with mortality risk has not been quantified. Hypothesis: Co-existing HTN and T2D are associated with higher all-cause and cardiovascular mortality risk compared to having either condition alone or neither condition, and associations vary by sex, race and ethnicity. Methods: Participants were 48,727 adults from the 1999-2018 National Health and Nutrition Examination Surveys (NHANES). Blood pressure and glycemic indicators were used to categorize participants into 4 groups: 1) neither condition, 2) HTN only, 3) T2D only, 4) co-existing HTN and T2D. Mortality was ascertained using the National Death Index. Kaplan-Meier curves and multivariable Cox proportional hazards models evaluated associations with mortality. Results: Overall, 50.1% of participants had neither condition, 38.4% had hypertension alone, 2.8% had T2D alone, and 8.7% had both. During a median follow up of 9.2y, there were 7,734 total deaths, of which 2,013 were CVD deaths. Compared to having neither condition, co-existing HTN and T2D were associated with &gt;2-fold and ~3-fold higher all-cause and CVD mortality risk (HR(95%CI): 2.46 (2.45, 2.47) and 2.97 (2.94, 3.00), respectively). Compared to having T2D or HTN only, co-existing T2D and HTN status was associated with up to 82% and 93% higher all-cause and CVD mortality risk. In stratified analyses, associations were stronger in females vs. males (p-interaction&lt;0.01), and differential associations were observed by race and ethnicity (p-interaction&lt;0.01) (Figure). Conclusions: The co-existence of HTN and T2D substantially increases all-cause and CVD mortality risk. Findings underscore the critical need for multilevel contextual interventions that address multiple cardiometabolic morbidities to extend lifespan and address chronic disease inequities in the US population.
Abstract P3155: Socio-Demographic Disparities in the Management Modalities of Pulmonary Embolism Amongst COVID-19 Patients: A Retrospective Population-Based Study
Authors: Urvish Patel, Dhrumil Chhaganbhai Sakariya, Naga Sai Ragha Manpreet Kondamuri, Enrique Paredes Romero, Kainat Asif, Vishal Kalmani, Rithi Prasannakumary, MohammedAfzal Yerrababugari, Nidhi Khinvasara, Siddhi Savoiverekar, Ritu Agarwal, Malavika Sajeev, Jay Vyasa, Tarun Parvataneni
Journal: Circulation (2025)

Introduction: Pulmonary embolism (PE) affects 60 to 70 persons per 100,000 people and causes about 7 million DALYs worldwide, making it an economically onerous handicap condition in the US. COVID-19's hypercoagulation and pro-inflammatory condition increase PE risk (OR 4.4 and RR 3.1) compared to non-COVID-19 individuals. Few studies have examined modalities and disparities in use. Aims: The study's main goal was to calculate the utilization rate and predictors of utilization of PE therapy modalities (tPA/thrombolytics, mechanical thrombectomy [MT], and surgical thrombectomy [ST]), and treatment disparities in COVID-19 patients in the US. Methods: We performed a retrospective cross-sectional observational study of a nationwide inpatient sample (year 2020) in adult hospitalizations with PE to identify patients with COVID-19. ICD-10 codes were used. Using SAS 9.4, we ran a univariate analysis using the chi-square test and multivariate survey logistic regression analysis to calculate adjusted OR and 95% CI. Results: Of 172,630 PE hospitalizations, 3124 patients had COVID-19. PE patients with COVID-19 were younger (mean age 60 vs 66) with the age group of 18-44 (2.54% vs &gt;65-year-old 1.36%), male (1.99% vs female 1.63%), and Hispanics (4.47% vs African Americans 2.71% vs White 1.35%) in comparison to non-COVID-19. PE with COVID-19 had a higher prevalence of obesity (30.72% vs 29.6%) and diabetic mallitus (12.8% vs 9.76%). Utilization of tPA (3.36% vs 3.14%), MT (7.04% vs 5.58%), and ST (0.32% vs 0.19%) were higher amongst PE with COVID-19. tPA use was higher amongst young [OR 1.47 (95%CI 1.01-2.14), females (1.54, 1.17-2.04), and patients with diabetes mellitus (1.73, 1.18-2.53). MT use was higher amongst young (1.46, 1-2.12), African Americans (1.8, 1.45-2.24) and Hispanics (2.99, 2.06-4.35) (compared to White), patients with cardiogenic shock (3.06, 1.91-4.90), ischemic stroke (3.33, 1.55-7.15), diabetes mellitus (1.29, 1.01-1.63), and obesity (2.54, 2.15-3.0). ST use was higher amongst COVID-19 (7.48, 1.94-28.88), males (17.54, 3.5-83.33), patients with AFib (7.49, 1.68-33.49), and obesity (4.75, 1.37-16.51). Conclusion: Management discrepancies among PE patients with COVID-19 include younger age, male, African American, and Hispanic, with ischemic stroke, AFib, obesity, and diabetes using more. To reduce socio-demographic differences in COVID-19 pulmonary embolism care, personalized management techniques, and equitable healthcare resources should be developed.