scholarly journals P16‐25: Effects of statins and steroids on stroke and coronary artery disease among patients with interstitial lung disease and pulmonary fibrosis: A general population study

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 458-458
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Interstitial Lung Disease ◽  
General Population ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
Population Study ◽  
General Population Study ◽  
Artery Disease

scholarly journals Effects of statins and steroids on coronary artery disease and stroke in patients with interstitial lung disease and pulmonary fibrosis: A general population study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259153
Author(s):  
Jun-Jun Yeh ◽  
Cheng-Li Lin ◽  
Nai-Hua Hsu ◽  
Chia-Hung Kao
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Interstitial Lung Disease ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
General Population Study ◽  
Oral Steroids ◽  
Artery Disease ◽  
Statin Use

Purpose To determine the effects of statins and steroids on the risk of coronary artery disease (CAD) and stroke in patients with interstitial lung disease and pulmonary fibrosis (ILD-PF). Methods We retrospectively enrolled patients with ILD-PF who were using statins (statin cohort, N = 11,567) and not using statins (nonstatin cohort, N = 26,159). Cox proportional regression was performed to analyze the cumulative incidence of CAD and stroke. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of CAD and stroke were determined after sex, age, and comorbidities, as well as the use of inhaler corticosteroids (ICSs), oral steroids (OSs), and statins, were controlled for. Results Compared with those of patients without statin use, the aHRs (95% CIs) of patients with statin use for CAD and ischemic stroke were 0.72 (0.65–0.79) and 0.52 (0.38–0.72), respectively. For patients taking single-use statins but not ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.72 (0.65–0.79)/0.69 (0.61–0.79) and 0.54 (0.39–0.74)/0.50 (0.32–0.79), respectively. For patients using ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.71 (0.42–1.18)/0.74 (0.64–0.85) and 0.23 (0.03–1.59)/0.54 (0.35–0.85), respectively. Conclusions The findings demonstrate that statin use, either alone or in combination with OS use, plays an auxiliary role in the management of CAD and ischemic stroke in patients with ILD-PF.

scholarly journals Familial Hypercholesterolemia in the Danish General Population: Prevalence, Coronary Artery Disease, and Cholesterol-Lowering Medication

2012 ◽  
Vol 97 (11) ◽  
pp. 3956-3964 ◽  
Author(s):  
Marianne Benn ◽  
Gerald F. Watts ◽  
Anne Tybjaerg-Hansen ◽  
Børge G. Nordestgaard
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
General Population ◽  
Familial Hypercholesterolemia ◽  
Odds Ratio ◽  
Premature Coronary Artery Disease ◽  
Cholesterol Lowering ◽  
General Population Study ◽  
Lipid Clinic ◽  
Artery Disease

Context: The diagnosis of familial hypercholesterolemia (FH) can be made using the Dutch Lipid Clinic Network criteria. This employs the personal and family history of premature coronary artery disease and hypercholesterolemia and the presence of a pathogenic mutation in the low-density lipoprotein receptor (LDLR) and apolipoprotein B (APOB) genes. Objective: We employed this tool to investigate the prevalence of FH and the associations between FH and coronary artery disease and cholesterol-lowering medication in the Copenhagen General Population Study. Setting: The study was of an unselected, community-based population comprising 69,016 participants. Main Outcome Measures: FH (definite/probable) was defined as a Dutch Lipid Clinic Network score higher than 5. Coronary artery disease was myocardial infarction or angina pectoris. Results: The prevalence of FH was 0.73% (one in 137). Of participants with FH, 20% had an LDLR or APOB mutation. The prevalence of coronary artery disease among FH participants was 33%. Only 48% of subjects with FH admitted to taking cholesterol-lowering medication. The odds ratio for coronary artery disease off cholesterol-lowering medication was 13.2 (10.0–17.4) in definite/probable FH compared with non-FH subjects, after adjusting for age, gender, body mass index, hypertension, metabolic syndrome and diabetes, and smoking. The corresponding adjusted odds ratio for coronary artery disease in FH subjects on cholesterol-lowering medication was 10.3 (7.8–13.8). Conclusion: The prevalence of FH appears to be higher than commonly perceived in a general population of white Danish individuals, with at least half of affected subjects not receiving cholesterol-lowering medication. The very high risk of coronary artery disease irrespective of use of medication reflects the extent of underdiagnosis and undertreatment of FH in the community and primary care.

scholarly journals Genetically Predicted Type 2 Diabetes Mellitus Liability, Glycated Hemoglobin and Cardiovascular Diseases: A Wide-Angled Mendelian Randomization Study

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1644
Author(s):  
Bowen Liu ◽  
Amy M. Mason ◽  
Luanluan Sun ◽  
Emanuele Di Angelantonio ◽  
Dipender Gill ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
General Population ◽  
Mendelian Randomization ◽  
Causal Effects ◽  
Disease Outcomes ◽  
Artery Disease ◽  
Diagnosed Diabetes

(1) Aim: To investigate the causal effects of T2DM liability and glycated haemoglobin (HbA1c) levels on various cardiovascular disease outcomes, both in the general population and in non-diabetic individuals specifically. (2) Methods: We selected 243 variants as genetic instruments for T2DM liability and 536 variants for HbA1c. Linear Mendelian randomization analyses were performed to estimate the associations of genetically-predicted T2DM liability and HbA1c with 12 cardiovascular disease outcomes in 367,703 unrelated UK Biobank participants of European ancestries. We performed secondary analyses in participants without diabetes (HbA1c < 6.5% with no diagnosed diabetes), and in participants without diabetes or pre-diabetes (HbA1c < 5.7% with no diagnosed diabetes). (3) Results: Genetically-predicted T2DM liability was positively associated (p < 0.004, 0.05/12) with peripheral vascular disease, aortic valve stenosis, coronary artery disease, heart failure, ischaemic stroke, and any stroke. Genetically-predicted HbA1c was positively associated with coronary artery disease and any stroke. Mendelian randomization estimates generally shifted towards the null when excluding diabetic and pre-diabetic participants from analyses. (4) Conclusions: This genetic evidence supports causal effects of T2DM liability and HbA1c on a range of cardiovascular diseases, suggesting that improving glycaemic control could reduce cardiovascular risk in a general population, with greatest benefit in individuals with diabetes.

scholarly journals Coronary Artery Disease Is Under-diagnosed and Under-treated in Advanced Lung Disease

2012 ◽  
Vol 125 (12) ◽  
pp. 1228.e13-1228.e22 ◽  
Author(s):  
Robert M. Reed ◽  
Michael Eberlein ◽  
Reda E. Girgis ◽  
Salman Hashmi ◽  
Aldo Iacono ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lung Disease ◽  
Artery Disease

Comorbidities of Psoriatic Arthritis — Metabolic Syndrome and Prevention: A Report from the GRAPPA 2010 Annual Meeting

2012 ◽  
Vol 39 (2) ◽  
pp. 437-440 ◽  
Author(s):  
SIBA P. RAYCHAUDHURI
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Psoriatic Arthritis ◽  
Coronary Artery ◽  
General Population ◽  
Annual Meeting ◽  
Artery Disease

Psoriatic arthritis (PsA) is associated with serious comorbidities such as increased cardiovascular risk, hypertension, depression, and reduced quality of life. Patients with psoriasis have been observed to have an increased incidence of metabolic syndrome compared with the general population; recently, this has also been observed in patients with PsA. This review focuses on the comorbidities associated with PsA, with an emphasis on risks of coronary artery disease and metabolic syndrome. We also discuss the development of a comprehensive approach for the management of comorbidities of PsA. The review summarizes a presentation at the 2010 annual meeting of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis).

scholarly journals Relationship of lipoprotein-associated apolipoprotein C-III with lipid variables and coronary artery disease risk: The EPIC-Norfolk prospective population study

2018 ◽  
Vol 12 (6) ◽  
pp. 1493-1501.e11 ◽  
Author(s):  
Julian C. van Capelleveen ◽  
Sang-Rok Lee ◽  
Rutger Verbeek ◽  
John J.P. Kastelein ◽  
Nicholas J. Wareham ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Population Study ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Apolipoprotein C ◽  
Artery Disease ◽  
Relationship Of

Markers of subclinical cardiac disease associate with thresholds for pre-diabetes and diabetes in the general population: data from the ACE 1950 Study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Myhre ◽  
M Lyngbakken ◽  
T Berge ◽  
R Roysland ◽  
E Aagaard ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
General Population ◽  
Cardiac Disease ◽  
Cardiac Injury ◽  
Left Ventricular ◽  
Funding Source ◽  
Total Study Population ◽  
Increased Risk ◽  
Artery Disease

Abstract Background Diabetes mellitus (DM) is associated with increased risk of left ventricular (LV) remodeling and incident heart failure. However, the associations between dysglycemia and subclinical cardiac disease in middle-aged subjects recruited from the general population are not established. Purpose To assess the associations of dysglycemia and diagnostic DM thresholds with indices of subclinical cardiac injury and dysfunction in the general population. Methods We included participants born in 1950 from the Akershus Cardiac Examination 1950 Study with available biomarker measurements (n=3,688). We used regression models and restricted cubic splines (knots selected from lowest Akaike Information Criterion) to assess the association between glycated hemoglobin A1c (HbA1c) and cardiac troponin T (cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and echocardiographic parameters. We classified participants with self-reported diagnosis of DM or HbA1c ≥6.5% (48 mmol/L) as DM, participants with HbA1c 5.7–6.5% as pre-DM, and participants with HbA1c &lt;5.7% (39 mmol/mol) as no-DM. Results Mean age was 63.9±0.7 years, mean body mass index (BMI) 27.2±4.4 kg/m2, and 1,795 participants (49%) were women. DM was classified in 380 participants (10%), pre-DM in 1,630 participants (44%) and no-DM in 1,678 participants (46%). Increasing HbA1c concentrations were associated with younger age, male sex, obesity, hypercholesterolemia, hypertension, and established coronary artery disease in adjusted analyses. In models adjusted for age, sex, BMI, smoking, hypertension, atrial fibrillation, coronary artery disease and renal function, greater HbA1c was associated with increasing logcTnT and logCRP concentrations, decreasing logNT-proBNP concentrations and worse global longitudinal strain and E/e' (p&lt;0.001 for all). LV mass index was not associated with HbA1c in adjusted models (p=0.23). All five associations were non-linear in the total study population (p&lt;0.001 for non-linearity for all) with robust, linear associations in the pre-DM range of HbA1c, also in adjusted models, and attenuated associations in the no-DM and DM range (Figure 1). Conclusion We found robust, linear associations between HbA1c and indices of subclinical cardiac injury and dysfunction among participants classified as pre-DM, while associations were more attenuated among participants with DM. Preventive measures for cardiovascular disease should be considered also in patients with dysglycemia and HbA1c below the established cutoff for DM. Figure 1. P-values for overall trend Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Akserhus University Hospital

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