Progress in cardiovascular diseases最新文献

{"title":"Global longitudinal strain as an early marker of cardiac damage after cardiotoxic medications, a state-of-the-art review","authors":"Andrea Sartorio ,&nbsp;Luca Cristin ,&nbsp;Chiara Dal Pont ,&nbsp;Afshin Farzaneh-Far ,&nbsp;Simone Romano","doi":"10.1016/j.pcad.2025.01.001","DOIUrl":"10.1016/j.pcad.2025.01.001","url":null,"abstract":"<div><div>Ejection fraction (EF) is the principal parameter used clinically to assess cardiac function and provides prognostic information. However, significant myocardial damage can be present despite preserved EF. Recently, the measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel early marker of cardiac dysfunction. Cardiotoxicity is a frequent side effect of several drugs most notably those used in the treatment of cancer. Although oncology drugs remain the best known cardiotoxic medications, many other drugs can potentially affect LV function. The early recognition of LV dysfunction due to cardiotoxicity is important and of increasing clinical relevance particularly with the rapid pace of development of new drugs.</div><div>The aim of our review is to provide an overview of the current literature regarding utility of GLS to assess drug-induced myocardial damage. We propose that GLS is a sensitive early marker of myocardial dysfunction associated with the use of certain medications with high risk of cardiotoxicity. Thus, the use of this technique can potentially alert the clinician to myocardial toxicity before reductions in EF are seen.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 92-101"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974002","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":"Are ORBITA trials practice-changing?","authors":"Florian Zores ,&nbsp;Sanjay Kaul","doi":"10.1016/j.pcad.2025.03.005","DOIUrl":"10.1016/j.pcad.2025.03.005","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 3-4"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635039","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":"Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway","authors":"Atefe R. Tari ,&nbsp;Daniel E. Brissach ,&nbsp;Emma M.L. Ingeström ,&nbsp;Javaid Nauman ,&nbsp;Tristan Tyrell ,&nbsp;Carl Foster ,&nbsp;Kimberley Radtke ,&nbsp;John P. Porcari ,&nbsp;Stian Lydersen ,&nbsp;Leonard A. Kaminsky ,&nbsp;Jonathan Myers ,&nbsp;Tara L. Walker ,&nbsp;Jeff S. Coombes ,&nbsp;Dorthe Stensvold ,&nbsp;Ulrik Wisløff","doi":"10.1016/j.pcad.2024.11.004","DOIUrl":"10.1016/j.pcad.2024.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the cardiorespiratory fitness (CRF) levels needed to avoid the Grim Reaper (Death) among older adults. We hypothesized that an above average peak oxygen uptake (VO_2peak) is needed for 70–77-year-old men and women to delay the encounter with Death.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>General population of older adults in Norway.</div></div><div><h3>Participants</h3><div>788 women and 777 men aged 70–77 years.</div></div><div><h3>Intervention</h3><div>Clinical assessments, including a test of VO_2peak. Participants were categorised based on their baseline VO_2peak and changes after 1 year. This study explored associations between VO_2peak and 5-year all-cause mortality using Cox proportional hazard models.</div></div><div><h3>Main outcome measure</h3><div>All-cause mortality.</div></div><div><h3>Results</h3><div>Death caught up with 5.3 % of men and 3.7 % of women. Compared to unfit men and women, fewer men (Hazard Ratio [HR]: 0.34, 95 % Confidence Interval [CI] 0.15–0.78) and women (HR: 0.41, 95 % CI 0.17–0.98) classified as moderately fit encountered Death with no additional risk reduction among those classified as being more fit. It appears to be easier for the Grim Reaper to claim those in poorer physical condition, specifically VO_2peak levels &lt;26.5 mL/kg/min for men and 22.2 mL/kg/min for women (corresponding to ≥85 % of the observed age- and sex-specific average).</div></div><div><h3>Conclusion</h3><div>The Grim Reaper typically targets individuals with VO_2peak levels &lt;26.5 mL/kg/min/ and &lt;22.2 mL/kg/min when chasing male and female souls aged 70–77 years, respectively, reflecting his penchant for limited CRF. These data underscore the importance of maintaining or enhancing CRF throughout life, providing clear targets for clinicians in assessing patient CRF levels.</div><div>Trial registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT01666340</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 25-34"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788296","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":"Association of neighborhood median income to outcomes in hypertrophic cardiomyopathy","authors":"Raoul R. Wadhwa ,&nbsp;Rohan M. Desai ,&nbsp;Shilpa Rao ,&nbsp;Ala Alashi ,&nbsp;Bo Xu ,&nbsp;Susan Ospina ,&nbsp;Nicholas G. Smedira ,&nbsp;Maran Thamilarasan ,&nbsp;Zoran B. Popovic ,&nbsp;Milind Y. Desai","doi":"10.1016/j.pcad.2025.03.002","DOIUrl":"10.1016/j.pcad.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Neighborhood median household income (NMHI), a key social determinant of health, is being recognized as a major source of inequity in healthcare. Its impact on patients with hypertrophic cardiomyopathy (HCM) is uncertain.</div></div><div><h3>Objective</h3><div>We sought to study the association between NMHI and long-term outcomes of HCM patients.</div></div><div><h3>Methods</h3><div>This was an observation registry of 6368 HCM patients (median age 56 years, 58 % men, 83 % white, 32 % with ≥1 sudden death risk factor) who underwent a clinical evaluation at a tertiary care center between 2002 and 18. NMHI (US$) was calculated from each patient's zip code, using data from the US Census Bureau and Department of Housing &amp; Urban Development. The primary outcome was death, appropriate internal cardioverter defibrillator (ICD) discharge or heart transplant in follow up.</div></div><div><h3>Results</h3><div>Patients were categorized as obstructive (oHCM, <em>n</em> = 3827 or 60 %, 65 % symptomatic, median NMHI $51,600) and nonobstructive (nHCM, <em>n</em> = 2541 or 40 %, 73 % asymptomatic, median NMHI $53,700) using echocardiography. At a median of 6 years (interquartile range or IQR 2.91, 9.74), there were 998 (16 %) primary events (deaths = 939), with breakdown as follows: 599/3827 (16 %) in oHCM and 399/2541 (16 %) in nHCM, respectively. On multivariable Cox survival analysis, a higher NMHI was independently associated with improved long-term freedom from primary events (oHCM [Hazard ratio or HR 0.84 95 % Confidence Interval or CI 0.80–0.88] and nHCM [HR 0.95 95 % CI 0.91–9.97]), both <em>p</em> &lt; 0.01. On penalized spline analysis, the NMHI at which the hazard for primary events crossed 1 was ∼$52,000 for both oHCM and nHCM. In nHCM patients, NMHI greater than $52,000 was associated with improved longer-term freedom from primary events vs. those whose NMHI was lower than $52,000 (196/1398 [14 %] vs. 203/1143 [18 %], log-rank <em>p</em>-value&lt;0.01). Similarly, oHCM patients with NMHI greater than $52,000 had significantly improved longer-term freedom from primary events vs. those whose NMHI was lower than $52,000 (186/2067 [9 %] vs. 413/1760 [23 %] vs., log-rank <em>p</em>-value&lt;0.001).</div></div><div><h3>Conclusions</h3><div>NMHI, a marker of socioeconomic status, is independently associated with outcomes in patients with HCM. oHCM patients below the NMHI cutoff had significantly worse long-term outcomes vs. the nHCM patients similarly below the NMHI cutoff.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 16-22"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627344","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":"Assorted topics in cardiovascular disease 2025: Novel insights in prevention, diagnosis, and treatment","authors":"Leandro Slipczuk","doi":"10.1016/j.pcad.2025.03.008","DOIUrl":"10.1016/j.pcad.2025.03.008","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 1-2"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695022","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":"Stepping up physical activity and fitness is needed for longevity","authors":"Carl J. Lavie ,&nbsp;Fabian Sanchis-Gomar ,&nbsp;Andre La Gerche ,&nbsp;Jari A. Laukkanen","doi":"10.1016/j.pcad.2025.03.012","DOIUrl":"10.1016/j.pcad.2025.03.012","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 61-62"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695026","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":"Non-atherosclerotic coronary causes of myocardial infarction in women","authors":"Abhishek Chaturvedi ,&nbsp;Naga Vaishnavi Gadela ,&nbsp;Kriti Kalra ,&nbsp;Parul Chandrika ,&nbsp;Olga Toleva ,&nbsp;Fernando Alfonso ,&nbsp;Nieves Gonzalo ,&nbsp;Hayder Hashim ,&nbsp;Waiel Abusnina ,&nbsp;Kalyan R. Chitturi ,&nbsp;Itsik Ben-Dor ,&nbsp;Jacqueline Saw ,&nbsp;Natalia Pinilla-Echeverri ,&nbsp;Ron Waksman ,&nbsp;Hector M. Garcia-Garcia","doi":"10.1016/j.pcad.2025.01.008","DOIUrl":"10.1016/j.pcad.2025.01.008","url":null,"abstract":"<div><div>Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms. Recent advancements in invasive and noninvasive imaging techniques and physiological testing allow for distinguishing these mechanisms from each other, providing a definitive diagnosis and tailored treatment. This review summarizes the existing literature on the non-atherosclerotic coronary causes of MI with a focus on evidence pertaining to women, offering a basis for future studies.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 78-91"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070536","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":"Resting heart rate – The forgotten risk factor? Comparison of resting heart rate and hypertension as predictors of all-cause mortality in 692,217 adults in Asia and Europe","authors":"Chi Pang Wen ,&nbsp;Chien Hua Chen ,&nbsp;Javaid Nauman ,&nbsp;Jackson Pui Man Wai ,&nbsp;Min Kuang Tsai ,&nbsp;Jun-Han Lee ,&nbsp;Ta-Wei David Chu ,&nbsp;Emma Maria Lovisa Ingestroem ,&nbsp;Hong Yi Chiou ,&nbsp;Chih Cheng Hsu ,&nbsp;Christopher Wen ,&nbsp;Xifeng Wu ,&nbsp;Atefe R. Tari ,&nbsp;Ulrik Wisloff","doi":"10.1016/j.pcad.2025.01.007","DOIUrl":"10.1016/j.pcad.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Resting Heart Rate (RHR) is commonly viewed as a reflection of underlying co-morbidities and not an independent risk factor. Here we compared whether high RHR (80–99 beats/min) and hypertension (blood pressure, BP ≥140/90 mmHg) independently predict all-cause mortality in 692,217 adults from Asia and Europe.</div></div><div><h3>Methods</h3><div>Taiwan MJ cohort constituted of 636,064 adults (1994–2017) and the HUNT cohort of 56,153 Norwegian adults (1995–1997). Both cohorts were followed for about 25 years. We report adjusted hazard ratios (HRs) for all-cause mortality, and life expectancy were calculated.</div></div><div><h3>Results</h3><div>The prevalence of high RHR changed little between those aged 20–29 years (21.2 %) and ≥ 70 years (25.2 %, ns.), whereas hypertension prevalence increased from 4.5 % to 57.3 %, respectively. We observed similar all-cause mortality among those with a high RHR and a normal BP and those with hypertension and normal RHR of 60–69 beats/min. We observed higher all-cause mortality among those with normal BP (≤120/80 mmHg) but high RHR than among those with hypertension and normal RHR. All-cause mortality risk associated with hypertension was not significant for those &lt;40 years of age, whereas risk associated with high RHR remained significant across all age groups. Reductions in life expectancy was larger among individuals with normal BP, but high RHR (10.29 years, 95 % CI 8.09–12.49) compared with those with hypertension but normal RHR (5.53 years, 95 % CI 3.57–7.59).</div></div><div><h3>Conclusions</h3><div>Our data clearly demonstrate that elevated RHR should be considered as an independent risk factor for all-cause mortality. The observation that elevated RHR in young adulthood to middle age (20–50 years of age) served as better predictor of all-cause mortality than hypertension calls for a paradigm shift particularly among these age groups, and we suggest it is time that RHR should be regarded as a vital clinical sign measured and evaluated at all clinical visits.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 35-44"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082717","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":"Unlocking insights: Clinical associations from the largest 6-minute walk test collection via the my Heart Counts Cardiovascular Health Study, a fully digital smartphone platform","authors":"Daniel Seung Kim ,&nbsp;Narayan Schuetz ,&nbsp;Anders Johnson ,&nbsp;Alexander Tolas ,&nbsp;Sriya Mantena ,&nbsp;Jack W. O'Sullivan ,&nbsp;Steven G. Hershman ,&nbsp;Jonathan N. Myers ,&nbsp;Jeffrey W. Christle ,&nbsp;Marily Oppezzo ,&nbsp;Eleni Linos ,&nbsp;Fatima Rodriguez ,&nbsp;C. Mikael Mattsson ,&nbsp;Matthew T. Wheeler ,&nbsp;Abby C. King ,&nbsp;Herman A. Taylor Jr ,&nbsp;Euan A. Ashley","doi":"10.1016/j.pcad.2025.01.010","DOIUrl":"10.1016/j.pcad.2025.01.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The six-minute walk test (6MWT) is a prognostic sub-maximal exercise test used clinically as a measure of functional capacity. With the emergence of advanced sensors, 6MWTs are being performed remotely via smartphones and other devices. The &lt;em&gt;My Heart Counts Cardiovascular Health Study&lt;/em&gt; is a smartphone application that serves as a digital platform for studies of human cardiovascular health, and has been used to perform 30,475 6MWTs on 8922 unique participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;As our 30,475 6MWTs represent the largest such collection of data available, we sought to identify associations with measured demographic and clinical variables with 6MWT distance at enrollment and separately determine if use of the &lt;em&gt;My Heart Counts&lt;/em&gt; smartphone application led to changes in 6MWT distance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and results&lt;/h3&gt;&lt;div&gt;We present the public data release of our 30,475 6MWTs and the launch of a webpage-based data viewer of summary-level statistics, to compare the functional capacity of an individual by their age, gender, height, weight, and disease status (&lt;span&gt;&lt;span&gt;https://mhc-6mwts.streamlit.app&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;). Using multivariable regression, we report associations of demographic and clinical variables with baseline 6MWT distance (&lt;em&gt;N&lt;/em&gt; = 3606), validating prior associations with age, male gender, height, and baseline physical activity level with 6MWT distance. We also report associations of 6MWT baseline distance with employment status (+12.4 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;4.9 m, &lt;em&gt;P&lt;/em&gt; = 0.011) and feeling depressed (−3.65 m, &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;0.79 m, &lt;em&gt;P&lt;/em&gt; &lt; 0.001). We separately found that cardiovascular disease status was significantly associated with decreased 6MWT distance for atrial fibrillation (−24.9 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;7.8 m, &lt;em&gt;P&lt;/em&gt; = 0.0013), peripheral artery disease (−41.7 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;12.5 m, &lt;em&gt;P&lt;/em&gt; &lt; 0.001), and pulmonary arterial hypertension (−76.3 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;24.8 m, &lt;em&gt;P&lt;/em&gt; = 0.0022). Heart failure was associated with decreased 6MWT distance but was not statistically significant (−25.5 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;14.5 m, &lt;em&gt;P&lt;/em&gt; = 0.078). In a subset of participants who conducted repeat 6MWTs separated by at least 1 week but no greater than 3 months (&lt;em&gt;N&lt;/em&gt; = 1129), we found that use of the &lt;em&gt;My Heart Counts&lt;/em&gt; app was associated with a statistically significant increase in 6MWT distance (+17.5 m &lt;span&gt;&lt;math&gt;&lt;mo&gt;±&lt;/mo&gt;&lt;/math&gt;&lt;/span&gt;7.85 m, &lt;em&gt;P&lt;/em&gt; &lt; 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;We validate previously identified associations from clinic-performed 6MWTs, demonstrating the utility of a mobile method in collecting 6MWT data for clinicians and researchers. We also demonstrate that use of the &lt;em&gt;My Heart Counts&lt;/em&gt; app is associated with small, but significant increa","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 45-52"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070540","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":"Waist to hip ratio modifies the cardiovascular risk of lipoprotein (a): Insights from MESA","authors":"Muhammad Imtiaz Ahmad ,&nbsp;Parag A. Chevli ,&nbsp;Saeid Mirzai ,&nbsp;Rishi Rikhi ,&nbsp;Harpeet Bhatia ,&nbsp;Neha Pagidipati ,&nbsp;Roger Blumenthal ,&nbsp;Alexander C. Razavi ,&nbsp;Kathleen Ruddiman ,&nbsp;Jared A. Spitz ,&nbsp;Khurram Nasir ,&nbsp;Michael D. Shapiro","doi":"10.1016/j.pcad.2025.03.001","DOIUrl":"10.1016/j.pcad.2025.03.001","url":null,"abstract":"<div><h3>Aims</h3><div>To assess if adiposity measures such as waist-to-hip ratio (WHR) modify the relationship of lipoprotein (a) [Lp(a)] with atherosclerotic cardiovascular disease (ASCVD).</div></div><div><h3>Methods</h3><div>4652 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) were grouped as follows: Lp(a) &lt; 50 mg/dl and WHR &lt;90th percentile(pct) (reference); Lp(a) &lt; 50 mg/dl and WHR ≥90th pct; Lp(a) ≥ 50 mg/dl and WHR &lt;90th pct; and Lp(a) ≥50 mg/dl and WHR ≥90th pct. Cox proportional hazard models assessed the relationship of Lp(a) and WHR with time to ASCVD events.</div></div><div><h3>Results</h3><div>Compared to the reference group, isolated elevated Lp(a) ≥ 50 mg/dl or WHR ≥90th pct were not significantly associated with risk of ASCVD (hazard ratio (HR), 1.15, 95 % confidence interval (CI): 0.94–1.39) and (HR, 1.14, 95 % CI: 0.92–1.41), respectively. In contrast, the combination of elevated Lp(a) ≥50 mg/dl and WHR ≥90th pct was associated with ASCVD risk (HR, 2.34, 95 % CI: 1.61–3.40). Lp(a) ≥50 mg/dl was not significantly associated with ASCVD risk in the 1st and 2nd tertile of WHR (HR, 1.06, 95 % CI: 0.72–1.48and HR, 1.08, 95 % CI: 0.79–1.48, respectively). However, Lp(a) ≥50 mg/dl was significantly associated with ASCVD risk in the highest tertile of WHR (HR, 1.60, 95 % CI: 1.23–2.09). (Interaction <em>p</em> = 0.01). Body mass index (BMI) and Lp(a) combinations resulted in similar greater risks of ASCVD in the highest risk category (HR, 1.33, 95 % CI: 1.00–1.77), without a significant interaction (<em>p</em> = 0.99).</div></div><div><h3>Conclusions</h3><div>In MESA, WHR significantly modifies the risk of ASCVD associated with Lp(a). Measures of abdominal adiposity may further refine the cardiovascular risk in individuals with elevated Lp(a).</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"89 ","pages":"Pages 5-12"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627346","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}