tbuckley/cabot-search huggingface dataset:
Abstract P1038: Blood Metabolomic Signatures of Incident Coronary Heart Disease in Racially and Ethnically Diverse Populations
Authors: Kai Luo, Taryn Alkis, Eun Hye Moon, Christie Ballantyne, Eric Boerwinkle, Clary Clish, Robert Gerszten, Megan Grove, Lifang Hou, Scott Hutton, Robert Kaplan, Rozenn Lemaitre, Donald Lloyd-Jones, Matthew Nayor, Kari North, Bruce Psaty, Laura Raffield, Stephen Rich, Jerome Rotter, Usman Tahir, Tao Wang, Kari Wong, Vanessa Xanthakis, Qibin Qi, Bing Yu
Journal: Circulation (2025)

Background: Metabolic perturbation has been characterized in coronary heart disease (CHD), yet the comprehensive metabolic fingerprint of incident CHD and potential racial/ethnical differences remain unclear. Hypothesis: Circulating metabolite alterations are associated with CHD risk, but associations vary across race/ethnicity. Methods: We included 22,566 CHD-free individuals of multi-ethnic groups from 7 studies in the Trans-Omics for Precision Medicine Program ( Fig.a ). Associations between metabolites (1245 named metabolites) and incident CHD were assessed by study/race-specific Cox proportional hazards regression. Results were pooled via random-effect meta-analyses. Results: Over an average of 7.5~17.0 yrs of follow-up 1124 incident CHD cases were recorded. We found that 280 metabolites were associated with incident CHD after adjusting for sociodemographic, behavioral factors, medications use, physical activity, and diet (FDR &lt; 0.05), with over 64% were independent of other major cardiometabolic traits ( Fig.b ). Over 90% of these metabolites showed positive associations, with strongest associations in metabolites of glycerolipids, phosphatidylethanolamine, fatty acids, lactoyl amino acid, histidine, aromatic amino acids, and branched amino acids ( Fig.b ). Race-specific analyses identified 70 metabolites presenting significant race/ethnicity differences (FDR&lt;0.05) in associations with CHD, with 34 being race/ethnicity specific metabolites that were not found in all participants (16 in Blacks, 11 in Whites and 7 in Hispanics; Fig.c-e ). For example, guanidinosuccinate, a known uremic toxin, was associated with increased risk of CHD only in US Hispanics, reinforcing the chronic kidney disease (CKD)-cardiovascular diseases continuum, especially for populations at high risk of CKD. Conclusion: Our study characterized the most comprehensive metabolic signatures of incident CHD and revealed substantial racial differences, further emphasizing the need of multi-ethnic resources to uncover metabolic perturbation underlying CHD.
Abstract P1137: The associations between maternal cardiovascular health scores during pregnancy and growth status of 0-2 years old infants: A birth cohort study
Authors: jiang bibo, Yujing Chen, Xiaonan Gu, Xuanqing He, Mengfan Li, Shuyue Huang, Li Cai
Journal: Circulation (2025)

Objective: Many maternal factors during pregnancy have been suggested to influence the physical development of offspring, while the overall effects haven’t been comprehensively evaluated. We aim to revise the Cardiovascular Health (CVH) metrics for pregnant women, a composite health indicator recommended and updated by the American Heart Association in 2022, and to explore its association with growth status within age 2 years based on a birth cohort. Methods: Pregnant women in 20-28 weeks of gestation were recruited in Guangzhou, China, from 2017 to 2018, and their offspring were followed up until 2 years old. Maternal behavioral factors were collected by standardized questionnaires, including diet, physical activity, nicotine exposure, and sleep. Maternal biochemical data were extracted from medical records, including weight, blood glucose, blood pressure, and blood lipid. Higher scores indicating better health (ranging from 0 to 100), three of the eight metrics were specifically adapted for pregnant women. Pre-pregnancy BMI and pregnancy weight gain were used to evaluate weight status. The Chinese Healthy Diet Index and the standard of the Chinese Guidelines for Gestational Diabetes Mellitus were applied to assess diet and blood glucose. Infants’ length and weight were repeatedly measured at 1, 3, 6, 8, 12, 18, and 24 months, and weight-for-length z-scores (WAZ), length-for-age z-scores (LAZ), body mass index z-scores (BAZ), and weight-for-age z-scores (WLZ) were calculated. The generalized estimating equation was conducted to explore the association between maternal CVH scores and infants’ growth status. Results: In 691 mother-child pairs, the average of CVH score was 67.02±9.52, with diet scoring the lowest (42.17±32.94). Approximately 3.47%, 85.82%, and 10.71% of mothers scored low (≤50), moderate (50-79), and high (≥80) in CVH levels, respectively. The CVH and health factor scores were positively correlated with family monthly income. Higher prenatal health behaviors and CVH scores were associated with increased LAZ, and health behavior, especially in sleep, was negatively associated with BAZ and WLZ of infants. Conclusion: This revised CVH score indicated a moderate overall health status for pregnant women, with dietary health warranting further improvement. Priority should be given to modifiable health behaviors during pregnancy, which showed a stronger and more stable association with the infant's physical growth.
Abstract P1066: Improved Access to Cardiovascular Care Reduces Ischemic Heart Disease Mortality in Rural Ohio
Authors: Suryasnata Bhowmik, Anjan Gupta
Journal: Circulation (2025)

Introduction: Ischemic heart disease (IHD) remains a leading cause of death globally, with its impact disproportionately higher in underserved regions, where access to specialist care is limited. In rural areas like Portage County, Ohio, geographic isolation and lack of local healthcare options have led to delayed treatment and poor outcomes. In 2016, a local catheterization (cath) lab, alongside comprehensive cardiovascular screening and prevention programs, was established to address the issue. Hypothesis: We assessed the hypothesis that the introduction of local specialist cardiovascular services would be associated with a reduction in crude death rates (CDRs) from IHD in Portage. Methods: This retrospective study analyzed CDRs for IHD (reported per 100,000) from the CDC WONDER database (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) from 2000 to 2019, stratified by age group. Hospital records provided data on angiograms performed from 2016 to 2022. We utilized linear regression and interrupted time series analysis to evaluate correlation between the intervention and CDR trends. As the study used publicly available secondary data and anonymized hospital records, no ethics approval was required. Results: From 2016 to 2019, over 3000 catheterizations were performed. During this period, a general decline in CDRs was observed across all age groups, especially in the older groups: in the 65-74 age group, rates dropped by 36% (294.2 in 2015 to 188.1 in 2019), while the 75-84 and 85+ age groups saw declines of 21% (817.1 to 648.6) and 28% (3715.6 to 2657.8), respectively. However, statistical significance (p&gt;0.05) was not reached due to limited post-intervention dataset. Conclusion: Early findings suggest that increasing access to specialist cardiovascular services may be associated with reduced IHD mortality in underserved regions like Portage. However, other factors like healthcare improvements, may have also influenced the results, and further analysis with a longer post-intervention period and comparison with control regions are needed to confirm these trends. These early results nonetheless offer insights into the potential of such specialist services to improve health outcomes in rural and underserved regions.
Abstract P3121: Temporal Changes in Blood and Fecal Metabolites and Fecal Microbiome After Bariatric Surgery
Authors: Yulu ZHENG, Kui Deng, Lei Wang, Charles Flynn, Wayne English, Jason Samuels, You Chen, Xiao-Ou Shu, Danxia Yu
Journal: Circulation (2025)

Background: Temporal changes in blood and fecal metabolites and fecal microbiome following bariatric surgery remain unclear. This study thus aimed to explore those intra-individual changes after bariatric surgery. Methods: Plasma and stool samples were collected from 62 patients who underwent first-time Roux-en-Y gastric bypass or sleeve gastrectomy at pre- and 3- and 12-month post-surgery. Global metabolite profiling and targeted short-chain fatty acid profiling were performed using LC-MS/MS. The microbiome was profiled by shotgun metagenomic sequencing. Paired Wilcoxon signed-rank tests and fold change (FC) were applied. Significant changes (FDR&lt;0.05 and FC&gt;1.5 or &lt;0.67) were categorized into three patterns: early changed, late sustained (i.e., significant when comparing 3-month post- to pre-surgery, which sustained comparing 12- to 3-month post-surgery); early changed, late reversed (significant opposite changes in both periods); early unchanged, late changed (only significant when comparing 12- to 3-month post-surgery). Results: Significant changes were observed in 274 plasma metabolites,143 fecal metabolites, and 102 microbial species. Major plasma metabolite changes involved sustained increases in primary bile acids and hemoglobin-related metabolites, and a decrease in tryptophan; reverses in ketone bodies, secondary bile acids, and fatty acids; late increases in lysophospholipids, benzoate, and energy-related metabolites, and a late decrease in long-chain fatty acids. Major fecal metabolite changes included sustained increases in medium- and long-chain fatty acids, and decreases in secondary bile acids and dipeptides; late increases in energy-related metabolites, and decreases in primary bile acids and sterols. Major microbial species changes were sustained increases in Streptococcus parasanguinis , S. salivarius , S. thermophilus , E. coli , and Klebsiella pneumoniae, and decreases in Agathobacter rectalis , Anaerobutyricum hallii , Dorea_A longicatena, Fusicatenibacter saccharivorans, and Roseburia inulinivorans ; reversed changes in Copromonas sp900066785 and Ruminococcus_D bicirculans ; and late increases in Agathobaculum butyriciproducens and Dysosmobacter butyriciproducens . Most changes did not differ significantly by surgical type or patient gender. Conclusions: Our findings indicate temporal changes in metabolites and microbiome following bariatric surgery, warranting further research on these changes and their link to long-term health outcomes.
Abstract P2036: Deciphering the Burden: Lead Exposure as a Major Contributor to Hypertensive Heart Disease Globally: A Global Analysis from 1990-2021
Authors: Juveriya Yasmeen, Nmair Alziadin, Hassaan Imtiaz, Paritaben Bhalodia, Anusha Parisapogu, Roopeessh Vempati, Naradasu Pranathi Royal, Vinay Kumar Gadamidi, Victor O. Adedara, Anjani Kumar Thota, Hardik Dineshbhai Desai
Journal: Circulation (2025)

Introduction: Lead exposure (LE) has been increasingly recognized as a significant risk factor for hypertensive heart disease (HHD), with no safe threshold identified for its adverse health effects. Persistent environmental contamination from sources such as old paint and industrial emissions continues to pose cardiovascular risks. Method: Using Burden of Disease Study 2021 tool, we estimated deaths and disability due to HHD attributable to LE by age, sex, year and location across the 204 countries and territories from 1990-2021. Results are shown in absolute counts and unadjusted rates (per 100,000). Results: From 1990 to 2021, the average annual percentage change (APC) in the absolute death count rose by 1.97%, disability-adjusted life years (DALYs) increased by 1.31%, and years lived with disability (YLDs) by 3%. Regionally, the highest increase in APC for deaths was observed in high-income countries at 3.54%, followed by high-SDI regions and South Asia, both at 2.95%. Regarding age, the highest number of deaths occurred in the 80-84 age group, totaling 216,409 (95% uncertainty interval: 179,011-244,186). The highest DALYs were noted in the 70-74 age group, at 3.3 million (2.8-3.7 million), and YLDs in the same age group were 178,655 (102,947-280,059). From 1990 to 2021, females saw higher total percentage changes (TPC) compared to males: deaths increased by 92% vs. 74%, DALYs by 57% vs. 43%, and YLDs by 170% vs. 134%. Conclusion: Deaths due to HHD attributable to LE accounted for 23.93% of all HHD related deaths globally in 2021. The persistent burden of HHD attributable to LE highlights a critical area for public health intervention. Reducing exposure to lead and mitigating its cardiovascular effects are imperative for global health security.
Abstract P1035: The Association between PREVENT 10-Year Overall Cardiovascular Disease Risk and Incident Fractures in Postmenopausal Women
Authors: Rafeka Hossain, Nicole Wright, Deepika Laddu, Kelley Gabriel, Shakia Hardy, Carolyn Crandall, Jane Cauley, Kristine Ensrud, Bernard Haring, Meryl LeBoff, JoAnn Manson, Ann Schwartz, Aladdin Shadyab, Nelson Watts
Journal: Circulation (2025)

Background: This study aimed to estimate the association between cardiovascular disease (CVD) risk and incident fracture in postmenopausal women. Methods: The study included data from women without a history of CVD enrolled in the Women’s Health Initiative, who had available CVD biomarker information at baseline necessary to compute a 10-year overall CVD risk using the PREVENT equation. Outcomes included self-reported any clinical, major osteoporotic (MOF-hip, spine, wrist, shoulder), and hip fractures. Women reporting anti-osteoporosis medications at baseline and pathologic fractures during follow-up were excluded. Hierarchical multivariable Cox proportional hazard models assessed the association of CVD risk with fracture and if the association was modified by race and ethnicity or body mass index (BMI). Results: Our study comprised 21,300 women (age: 63.7±7.3 years; non-Hispanic (NH) White: 48%; NH-Black: 33%). The mean 10-year overall CVD risk score was 9.3 ± 5.7, with 5,370 (25.2%), 4,169 (19.6%), 10,661 (50.0%), and 1,100 (5.2%) participants in the low (&lt;5.0%), borderline (5.0-7.4%), intermediate (7.5-19.9%, and high ≥20.0%) categories, respectively. A total of 9,399, 5,104, and 1,769 clinical, MOF, and hip fracture cases were reported over a mean follow-up of 17.1 ± 6.7 years. After full covariate adjustment (Model 4) and adjustment for factors significantly associated with fracture from stepwise modeling (Model 5), women with intermediate- and high- overall CVD risk scores had significantly higher risk for all fracture types, particularly hip fracture [Model 5 HR (95% CI) - intermediate: 2.43 (1.53, 3.87); high: 3.56 (2.01, 6.15)] (Table). Neither race and ethnicity nor BMI modified the association between overall CVD risk and fracture. Conclusion: In postmenopausal women, higher CVD risk scores significantly associated with a higher risk of incident fractures. Future studies assessing if management of CVD aids in fracture prevention in high-risk CVD populations based on PREVENT score is warranted.
Abstract P3124: Risk Factors of Atrial Fibrillation, Heart Failure and Their Co-occurrence in Postmenopausal Women: A Womens’s Health Initiative Study
Authors: Muhammad Baig, Ali Khan, Miremad Moafi-Madani, Joseph Larson, Michael LaMonte, Bing Lu, Nishant Shah, Mary Roberts, Charles Eaton
Journal: Circulation (2025)

Introduction: Heart failure (HF) and atrial fibrillation/flutter (AF) often cooccur in older adults, the risk factors for which are understudied and was the objective herein. Method: This prospective cohort study included 31,171 post-menopausal women from the Women’s Health Initiative (WHI) with adjudicated HF merged with Medicare database for AF ascertainment during median follow-up of 17 years. Participants were categorized into 4 groups: no incident AF or HF (n=22,578), with incident AF (n=1,123), with incident HF (n=1,004), and with both incident AF-HF (n=6,466). Baseline exposures evaluated were age, race, obesity, alcohol consumption, smoking, education, income, companionship, physical activity, hypertension, hyperlipidemia, diabetes, and coronary artery disease (CAD). Exposures were compared using multinomial logistic regression model to assess odds ratios (OR) and 95% confidence intervals (CI) for each factor adjusting for the others. The jointly defined referent group was absence of the exposure and no HF or AF. Result: AF had an incidence proportion of 24.3%, HF 24%, and both AFHF was 20.7%, which is 3.55 times the expected co-incidence. Participants had a mean age of 63.2 (6.9) years at baseline. The odd of incident AF, incident HF and both incident AFHF was higher with older age [OR, 95% CI AF: 1.06 (1.06, 1.07); HF: 1.07 (1.07, 1.09); both AFHF: 1.12 (1.11, 1.13)], obesity [OR, 95% CI AF: 1.26 (1.18, 1.34); HF: 1.55 (1.34, 1.79); both AFHF: 1.72 (1.50, 1.97)], past/ current smoker [OR, 95% CI AF: 1.25 (1.12, 1.39); HF: 2.26 (1.81, 2.81); both AFHF: 1.77 (1.41, 2.24)], higher alcohol std drink/week [OR, 95% CI AF: 1.01 (1.01, 1.02); HF 1.01 (0.99, 1.02); both AFHF: 1.02 (1.01, 1.03)], CAD [OR, 95% CI AF: 1.23 (1.03, 1.47); HF: 2.25 (1.69, 2.99); both AFHF: 2.16 (1.63, 2.86)] and hypertension [OR, 95% CI AF: 1.19 (1.12, 1.27); HF: 1.44 (1.24, 1.67); both AFHF: 1.640 (1.42, 1.88)]. Diabetes was associated with incident HF [OR, 95% CI 2.53 (2.08, 3.08)] and both incident AF-HF [OR, 95% CI 2.03 (1.65, 2.50)] but not with AF alone. Conclusion: Incident AF, HF are common in older women with their co-incidence 3.55 times higher than expected suggesting a common underlying pathophysiology. Obesity, alcohol consumption, past/ current smoker, hypertension and CAD are major risk factors for AF, HF and their co-occurrence. These findings underscore the importance of targeted interventions to manage these modifiable risk factors to prevent both conditions.
Abstract P1174: Endometriosis diagnosis, staging, and typology in relation to inflammatory cytokines
Authors: May Shaaban, Leslie Farland, Anna Pollack, Kathryn Rexrode, Rachael Hemmert, Madeline Paulsen, Jeanna Ryan, Emmanuel Adediran, Matt Peterson, Jessica Page, Karen Schliep
Journal: Circulation (2025)

Introduction: Endometriosis, affecting 11% of reproductive-aged persons, is characterized by ectopic endometrial tissue and chronic inflammation. Prior research suggests those with endometriosis have higher cardiovascular disease risk, but mechanisms remain elusive. The objective of this study is to assess whether endometriosis diagnosis, staging, and typology (superficial endometriosis (SE), ovarian endometriomas (OE), and deep infiltrating endometriosis (DE)) are associated with serum interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-) concentrations. Methods: The study analyzed data from 395 premenopausal persons in Utah undergoing gynecologic laparoscopy who participated in the NICHD ENDO study (2007–2009). Post-operative reports determined endometriosis typology (SE, OE, DE) and staging (minimal, mild, moderate, severe) using Revised American Society for Reproductive Medicine classification. Elevated serum cytokine concentrations were defined as IL-6 ≥2pg/mL, IL-8 ≥3pg/mL, and TNF- ≥7.5pg/mL. Generalized linear models generated adjusted prevalence ratios (aPR) 95% CI controlling for age, BMI, marital status, race/ethnicity, and serum cotinine. Results: Participants were on average 32 years (SD=7) at time of gynecologic laparoscopy/laparotomy, non-Hispanic white (79%), married (71%), mean BMI 28 (SD=8) and non-smokers (83% serum cotinine &lt;10ng/mL). Forty-two percent (n=166) were diagnosed with incident endometriosis. We found no differences among those with, compared to without, endometriosis and elevated IL-6, 12% vs 10%, aPR: 1.01 (0.97, 1.10), IL-8, 5% vs 8%, aPR: 0.99 (0.94, 1.04); and TNF, 16% vs 13%, aPR: 1.00 (0.96, 1.04). While there were no statistically significant associations between endometriosis staging or typology and cytokines, those with moderate to severe endometriosis had nonsignificant lower IL-6 and IL-8 (aPR: 0.61 [0.15, 2.52] and aPR: 0.74 [0.17, 3.20]) but higher TNF- (aPR: 1.27 [0.56, 2.84]), compared to no endometriosis. Individuals with OE and DE had nonsignificant trends of IL-6 and Il-8 (aPR: 0.86 [0.11, 2.52] and aPR: 0.93 [0.14, 6.43]) but higher TNF- (aPR: 1.93 [0.77, 4.84]). Conclusions: In summary, this study found no clear correlation between endometriosis diagnosis, staging, typology and inflammatory markers IL-6, IL-8, and TNF-. Whether endometriosis severity or typology is associated with TNF- should be explored in future studies with adequate power and more representative samples.
Abstract P2030: Association of Urinary Arsenic Concentration with Hypertension and Arterial Stiffness in Afro-Caribbean Adults
Authors: Rain Katz, Iva Miljkovic, Ryan Cvejkus, Victor Wheeler, Wan-Yee Tang, Alison Sanders, Aaron Barchowsky, Allison Kuipers
Journal: Circulation (2025)

Arsenic exposure is common throughout the world and is associated with cardiovascular disease (CVD). Blood pressure (BP) and arterial stiffening are sensitive measures of subclinical CVD that are common in the Afro-Caribbean Tobagonian population. However, little is known about arsenic exposure and its relationship to CVD in Tobago. We examined cross-sectional associations of urinary arsenic species and total urinary arsenic (TUA) with BP, hypertension, and arterial stiffness in Tobagonian adults. Concentrations of urinary dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), and inorganic arsenic (iAs) were quantified by inductively coupled plasma mass spectrometry in spot urine samples collected from a random subset of 965 participants from the Tobago Health Study. Arsenic concentrations below the limit of detection were imputed as LOD/√2. Total urinary arsenic (TUA) was calculated as the sum of DMA, MMA, and iAs and log-transformed; %DMA, %MMA, and %iAs were calculated as the proportion of DMA, MMA, and iAs in TUA. Participants underwent brachial-ankle pulse wave velocity (PWV) measurement and measurements of BP, height, and weight. Hypertension was defined as systolic BP≥130 mmHg, diastolic BP≥80 mmHg or use of anti-hypertensive medication. Multiple linear and logistic regressions were adjusted for log-transformed urinary creatinine (all models), age and sex (models 2 and 3), height and weight (model 3) and hypertension status (model 3 for PWV outcomes). Predictors were calculated for 805 individuals without missing data. The median age of this sample was 58 years (range 40-84); 48.2% were female and 72.9% had hypertension. Raw mean ± SD TUA was 16.6±17.6 ng/mL and mean (range) for proportions were: DMA: 80% (22-99%), MMA: 12% (0.2-41%), iAs: 6% (0.6-50%). In model 1, TUA, %DMA and %iAs were associated with higher SBP and greater odds of hypertension and %MMA was associated with lower SBP and lower odds of hypertension; associations were attenuated after adjusting for age and sex (Table). All predictors were associated with PWV in model 1; the association between greater %MMA and lesser PWV was independent of age, sex, height, weight and hypertension (Table). In a sample of Tobagonian adults, TUA was associated with increased BP and PWV. Further research is needed to fully understand the relationships between arsenic exposure and metabolism and CVD in Afro-Caribbean populations who are at high risk for both arsenic exposure and CVD.