European journal of preventive cardiology最新文献

{"title":"Advanced Prediction of Heart Failure Risk in Elderly Diabetic and Hypertensive Patients Using Nine Machine Learning Models and Novel Composite Indices: Insights from NHANES 2003-2016.","authors":"Qiyuan Bai, Hao Chen, Zhen Gao, Bing Li, Shidong Liu, Wentao Dong, Xuhua Li, Bing Song, Cuntao Yu","doi":"10.1093/eurjpc/zwaf081","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf081","url":null,"abstract":"<p><strong>Aim: </strong>As the global population ages, cardiovascular diseases, particularly heart failure (HF), have become leading causes of mortality and disability among elderly patients. Diabetes and hypertension are major risk factors for cardiovascular diseases, making this group especially vulnerable to heart failure. Current clinical tools for predicting HF risk are often complex, requiring extensive clinical parameters and laboratory tests, which limit their practical application. Therefore, a need exists for a predictive model that is both simple and effective in assessing heart failure risk in elderly patients with diabetes and hypertension.</p><p><strong>Methods and results: </strong>This study utilized data from the National Health and Nutrition Examination Survey (NHANES), spanning seven cycles from 2003 to 2016, including 71,058 subjects. The study focused on elderly patients (aged 65 and above) diagnosed with both diabetes and hypertension, ultimately including 1,445 participants. We examined seven novel composite indices: A Body Shape Index (ABSI), Atherogenic Index of Plasma (AIP), BARD score, Body Fat Percentage (BFP), Body Roundness Index (BRI), Fatty Liver Index (FLI), and Prognostic Nutritional Index (PNI). These indices were selected for their simplicity and ease of calculation from routine clinical assessments. The primary outcome was heart failure status, and data preprocessing included imputation for missing values using random forest algorithms. Various machine learning models were applied, including Random Forest, Logistic Regression, XGBoost, and others, with model performance assessed through metrics like accuracy, precision, recall, F1 score, and ROC AUC. The best-performing model was further analyzed using SHAP (SHapley Additive exPlanations) values to determine feature importance. The study found that the XGBoost model demonstrated superior performance across all evaluation metrics, with an AUC value of 0.96. Significant predictors of heart failure included BRI and PNI, which had the highest SHAP values, indicating their substantial influence on model predictions. The study also highlighted the robust predictive capabilities of AIP, particularly in assessing cardiovascular events in elderly patients.</p><p><strong>Conclusion: </strong>The study demonstrates that novel composite indices like ABSI, AIP, BARD score, Body Fat Percentage, BRI, FLI, and PNI have significant potential in predicting heart failure risk among elderly diabetic and hypertensive patients. These indices offer clinicians new tools for cardiovascular risk assessment that are simpler and potentially more effective in clinical practice. Future research should focus on validating these findings in different populations and exploring their longitudinal predictive power.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apolipoprotein C3, Triglycerides, and Cardiovascular Risk in Optimally Treated ACS Patients: The Critical Role of Mediation Analysis and Implications for Precision Primary Prevention.","authors":"Xiaoqun Xu, Houyong Zhu, Long Cai","doi":"10.1093/eurjpc/zwaf109","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf109","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of sarcopenia status and risk of incident cardiovascular disease.","authors":"Shuang Bing, Zhanchao Chen, Di Wu, Bo Yu, Hongbin Qiu, Yiying Zhang, Shanjie Wang","doi":"10.1093/eurjpc/zwaf115","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf115","url":null,"abstract":"<p><strong>Aims: </strong>Sarcopenia is an emerging risk factor for cardiovascular disease (CVD). However, previous studies did not take into consideration the cardiovascular impact of the changes in sarcopenia status. We investigated the relationship between changes in sarcopenia status and incident CVD.</p><p><strong>Methods: </strong>Participants from two prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS) and the Health and Retirement Study (HRS) were included. Changes in sarcopenia status were assessed by sarcopenia status at the initial two surveys. CVD was ascertained by self-reported physician-diagnosed heart disease or stroke.</p><p><strong>Results: </strong>A total of 6,608 and 4,316 adults from CHARLS (mean age: 59.2 years, female: 53.6%) and HRS (mean age: 63.2 years, female: 60.2%) were analyzed, with a median follow-up of 5.0 years and 7.5 years, respectively. Meta-analysis showed a significant relationship between sarcopenia and CVD risk. Bidirectional MR analysis supported the robustness and causality, and no reverse association was found between CVD and sarcopenia. Compared with stable no sarcopenia participants, multivariable-adjusted incidence rate ratio (IRR) and 95% confidence interval (95% CI) for incident CVD in those who progressed from no sarcopenia to possible sarcopenia/sarcopenia were 1.29 (1.02-1.64) and 1.39 (1.11-1.74) in both cohorts. In contrast, sarcopenia participants who recovered to no sarcopenia/possible sarcopenia had lower incidence of CVD (CHARLS, IRR 0.61, 95% CI 0.43-0.87; HRS, IRR 0.20, 95% CI 0.11-0.39) than stable sarcopenia participants did.</p><p><strong>Conclusions: </strong>The progression of sarcopenia status increases the risk of CVD, while the recovery of sarcopenia status reduces the risk of incident CVD.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Thresholds of Diffuse Myocardial Fibrosis on Cardiovascular Magnetic Resonance.","authors":"Tin Mei Yeo, Thu-Thao Le, Jennifer Bryant, Vivian Lee, Redha Boubertakh, Roger Foo, Wenru Wang, Calvin W L Chin","doi":"10.1093/eurjpc/zwaf113","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf113","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Matters: Exploring Horizons in CVD Risk Assessment.","authors":"Lisa Pennells, Holly Pavey, Owen A Taylor","doi":"10.1093/eurjpc/zwaf073","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf073","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and elevated plasma glucose in heart valve calcification and disease: the Copenhagen General Population Study.","authors":"Morten Kaltoft, Shoaib Afzal, Børge G Nordestgaard, Per E Sigvardsen, Jørgen Tobias Kühl, Andreas Fuchs, Lars Køber, Klaus F Kofoed, Anne Langsted","doi":"10.1093/eurjpc/zwaf106","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf106","url":null,"abstract":"<p><strong>Aim: </strong>The only treatment available for aortic valve stenosis is valve replacement, which makes it important to identify modifiable risk factors. We tested the hypotheses that diabetes and elevated plasma glucose are associated with aortic and mitral valve calcification and aortic valve stenosis, and that these associations are explained partly by elevated plasma triglycerides, hypertension, and body mass index.</p><p><strong>Methods: </strong>In the Copenhagen General Population Study with 110,291 individuals, we evaluated risk of aortic valve stenosis and mitral valve regurgitation from health registers, and in a subset of 12,006 cardiac CT scanned individuals aortic and mitral valve calcification.</p><p><strong>Results: </strong>Of individuals with cardiac CT, 3018(25%) had aortic and 1521(13%) had mitral valve calcification. For individuals with versus without diabetes, the multivariable adjusted odds ratios were 1.67(95%:1.34-2.08) for aortic and 1.89(1.48-2.40) for mitral valve calcification. The corresponding hazard ratio was 1.71(1.44-2.03) for aortic valve stenosis.For individuals with glucose ≥6.6mmol/L(≥118mg/dL) versus ≤5.1mmol/L(≤92 mg/dL), the multivariable adjusted odds ratios were 1.27(1.07-1.52) for aortic and 1.44(1.18-1.77) for mitral valve calcification. The corresponding hazard ratio was 1.33(1.12-1.57) for aortic valve stenosis.In the relationship between diabetes and aortic valve stenosis, 4.8%(95%CI:0.5-11%) of the association was explained by plasma triglycerides, 19%(14-28%) by hypertension, and 27%(18-43%) by body mass index.</p><p><strong>Conclusions: </strong>Diabetes and elevated plasma glucose were associated with risk of aortic and mitral valve calcification and aortic valve stenosis. The risk of aortic valve stenosis was partly explained by elevated plasma triglycerides, hypertension, and body mass index.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher intakes of dietary dicarbonyl compounds are associated with lower risk of cardiovascular disease.","authors":"Ana-Lucia Mayén, Kim Maasen, Claudia Hana, Viktoria Knaze, Jean Scheijen, Simone J P M Eussen, Philippe Vangrieken, Charlotte Debras, Jessica Blanco, Christina C Dahm, Krasimira Aleksandrova, Matthias B Schulze, Lucia Dansero, Giovanna Masala, Salvatore Panico, Sabina Sieri, Marcela Guevara, Conchi Moreno Iribas, Dafina Petrova, Carmen Santiuste, Raul Zamora-Ros, Yvonne T van der Schouw, Elom Aglago, Inge Huybrechts, Heinz Freisling, Casper Schalkwijk, Mazda Jenab","doi":"10.1093/eurjpc/zwaf060","DOIUrl":"10.1093/eurjpc/zwaf060","url":null,"abstract":"<p><strong>Aims: </strong>Dicarbonyl compounds such as methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG) are present in numerous foods. They are pro-inflammatory and pro-oxidative, but their potential role in cardiovascular disease (CVD) development has been scarcely studied. We explored associations between dietary dicarbonyls with fatal and non-fatal CVD.</p><p><strong>Methods and results: </strong>We conducted a case-cohort analysis based on 32 873 subjects drawn from 346 055 participants of the multi-national prospective EPIC cohort. Cases (15 863 subjects) were CVD-free at baseline and later developed CVD [coronary heart disease (CHD) and/or stroke] with non-fatal (n CVD = 17 837; n CHD = 12 003; n stroke = 6791; not mutually exclusive) and/or fatal (n CVD = 2894; n CHD = 2284; n stroke = 908) outcomes. Dietary intake of dicarbonyl compounds was estimated using country-specific questionnaires linked to a food composition database of dicarbonyl compounds. Multivariable prentice weighted Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for incident non-fatal and fatal CVD. The main food sources of dicarbonyl compounds include cereals, sugar and confectionaries, coffee, fruits, and vegetables. Higher dietary dicarbonyl intakes were inversely associated with non-fatal CVD (per 1 SD increase, GO: HR = 0.95, 95% CI 0.92-0.98; 3-DG: HR = 0.95, 95% CI 0.92-0.98), fatal CVD (MGO: HR = 0.92, 95% CI 0.87-0.97; GO: HR = 0.91, 0.86-0.96; 3-DG: HR = 0.93, 0.86-0.99), non-fatal CHD (3-DG: HR = 0.95, 0.92-0.99), non-fatal stroke (MGO: HR = 0.93, 95% CI 0.90-0.96; GO: HR = 0.90, 95% CI 0.86-0.95; 3-DG: HR = 0.92, 95% CI 0.89-0.96), and fatal CHD (MGO: HR = 0.94, 95% CI 0.88-0.99; GO: HR = 0.92, 0.86-0.98; 3-DG: HR = 0.89, 0.82-0.96).</p><p><strong>Conclusion: </strong>Higher intakes of dietary MGO, GO, and 3-DG intake are associated with lower risk of non-fatal or fatal CVD. Further research is required to confirm these findings, assess circulating levels of dicarbonyls, and explore potential underlying mechanisms for their observed CVD risk associations.</p><p><strong>Lay summary: </strong>Dicarbonyl compounds are known to promote oxidative stress, inflammation, endothelial dysfunction, and vascular complications. They are formed endogenously in the body as a byproduct in glucose metabolism but are also present in some foods during food preparation and processing. We studied the role of three major dicarbonyl compounds coming from foods on cardiovascular diseases using data from the prospective EPIC cohort, which includes over 520 000 participants from 10 European countries.We observed that higher consumption of dietary dicarbonyl compounds resulted in a lower risk of non-fatal or fatal CVD.Our findings highlight the need to better understand the roles of these dietary compounds along with their potential underlying mechanisms of action.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Cardiovascular Prevention: Cost-Effective Cholesterol Lowering for Statin-Intolerant Patients in Australia and the UK.","authors":"Jedidiah I Morton, Danny Liew, Gerald F Watts, Sophia Zoungas, Stephen J Nicholls, Padraig Dixon, Zanfina Ademi","doi":"10.1093/eurjpc/zwaf114","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf114","url":null,"abstract":"<p><strong>Background: </strong>Approximately 1 in 11 people are intolerant to statins. There have been no studies evaluating the cost-effectiveness of early intervention for primary prevention of cardiovascular disease (CVD) with three non-statin drugs (ezetimibe, proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i; inclisiran and evolocumab), and bempedoic acid). We aimed to evaluate the cost-effectiveness of these therapies when initiated at age 40 years.</p><p><strong>Methods: </strong>We used a published microsimulation model populated with 108 statin-intolerant individuals. The model simulated the ageing of individuals from 40 to 85 years. We calculated the incremental cost-effectiveness ratio (ICER) when non-statin lipid lowering strategies were initiated at age 40 years compared to no intervention until a cardiovascular event. ICERs were compared to Australian and UK cost-effectiveness thresholds of 28,000 AUD and 25,000 GBP per QALY gained, respectively. We adopted each countries national healthcare system perspective (2022 AUD/GBP) and discounted health economic results by 5% annually for Australia and 3.5% annually for the UK.</p><p><strong>Results: </strong>At current prices in Australia, ezetimibe was cost-effective in 34/108 (31.4%) individuals simulated; bempedoic acid in 17/108 (15.7%); bempedoic acid and ezetimibe in combination in 14/108 (13.0%); whilst inclisiran and evolocumab were not cost-effective in any individuals. Corresponding numbers for the UK were 98/108 (90.7%); 5/108 (4.6%); 11/108 (10.2%); 0/108 (0.0%); and 0/108 (0.0%). Cost-effectiveness of bempedoic acid was predominantly among individuals with an LDL-C of at least 4.0 mmol/L and systolic blood pressure of at least 140 mmHg in Australia and 5.0mmol/L and 160 mmHg in the UK, respectively.</p><p><strong>Conclusion: </strong>Ezetimibe and bempedoic acid, both alone and in combination, are cost-effective for long-term primary prevention of CVD in a range of people with statin-intolerance, depending on their baseline risk of CVD.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared and distinct pathways from anxiety disorder and depression to cardiovascular disease: a UK Biobank prospective cohort study.","authors":"Shinya Nakada, Carlos Celis-Morales, Jill P Pell, Frederick K Ho","doi":"10.1093/eurjpc/zwaf110","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf110","url":null,"abstract":"<p><strong>Aims: </strong>Although anxiety disorder and depression increase the risk of cardiovascular disease, few studies have examined their underlying mechanisms systematically, particularly contrasting the difference between the two of them. Our study aimed to examine the extent to which lifestyle, physical and metabolic factors mediate the associations of anxiety disorder and depression with incident CVD.</p><p><strong>Methods: </strong>A prospective cohort study was conducted using UK Biobank. Anxiety disorder, depression, and incident CVD were ascertained through linkage to hospital and death records. A causal mediation analysis was performed for anxiety disorder and depression, separately examining multiple potential lifestyle, physical, and metabolic mediators. Cox proportional hazard models and log-linear models were used to derive indirect effect estimates and proportions mediated.</p><p><strong>Results: </strong>A total of 254,695 participants were included. Both anxiety disorder (HR 1.62, 95% CI 1.15-2.13) and depression (HR 2.15, 95% CI 1.75-2.64) were associated with CVD after adjusting for sociodemographic confounders. Among lifestyle and physical factors, the strongest mediators were current smoking and higher waist-hip ratio which accounted for 11.9% and 13.4% of the excess risk from anxiety disorder, and 17.3% and 14.0% from depression, respectively. The strongest metabolic mediators were systolic blood pressure for anxiety disorder (10.4%) and CRP (10.8%) for depression. Systolic blood pressure was the weakest mediator for depression (4.3%).</p><p><strong>Conclusions: </strong>Lifestyle and physical pathways to incident CVD may be common to both anxiety disorder and depression, but shared metabolic pathways seem unlikely. Our findings inform which risk factors to target among people with anxiety disorder or depression in order to reduce their higher risk of developing CVD.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Personalized Prevention: The Role of ECG in Cardiovascular Risk Prediction for Type 2 Diabetes.","authors":"Arnaud Bisson, Denis Angoulvant","doi":"10.1093/eurjpc/zwaf111","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf111","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}