Abstract:
BACKGROUND:Coronary heart disease and peripheral arterial disease (PAD) affect different vascular territories. Supplementing baseline findings with assays from stored serum, we compared their 20-year predictors. METHODS AND RESULTS:We randomly recruited 15 737 disease-free men and women aged 30 to 75 years across Scotland between 1984 and 1995 and followed them through 2009 for death and hospital diagnoses. Of these, 3098 developed coronary heart disease (19.7%), and 499 PAD (3.2%). Hazard ratios for 45 variables in the Cox model were adjusted for age and sex and for factors in the 2007 ASSIGN cardiovascular risk score. Forty-four of them were entered into parsimonious predictive models, tested by c-statistics and net reclassification improvements. Many hazard ratios diminished with adjustment and parsimonious modeling, leaving significant survivors. The hazard ratios were mostly higher in PAD. New parsimonious models increased the c-statistic and net reclassification improvements over ASSIGN variables alone but varied in their components and ranking. Coronary heart disease and PAD shared 7 of the 9 factors from ASSIGN: age, sex, family history, socioeconomic status, diabetes mellitus, tobacco smoking, and systolic blood pressure (but neither total nor high-density lipoprotein cholesterol); plus 4 new ones: NT-pro-BNP, cotinine, high-sensitivity C-reactive protein, and cystatin-C. The highest ranked hazard ratios for continuous factors in coronary heart disease were those for age, total cholesterol, high-sensitivity troponin, NT-pro-BNP, cotinine, apolipoprotein A, and waist circumference (plus 10 more); in PAD they were age, high-sensitivity C-reactive protein, systolic blood pressure, expired carbon monoxide, cotinine, socioeconomic status, and lipoprotein (a) (plus 5 more). CONCLUSIONS:The mixture of shared with disparate determinants for arterial disease in the heart and the legs implies nonidentical pathogenesis: cholesterol dominant in the former, and inflammation (high-sensitivity C-reactive protein, diabetes mellitus, smoking) in the latter.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Tunstall-Pedoe H,Peters SAE,Woodward M,Struthers AD,Belch JJFdoi
10.1161/JAHA.117.005967subject
Has Abstractpub_date
2017-09-18 00:00:00issue
9issn
2047-9980pii
JAHA.117.005967journal_volume
6pub_type
杂志文章,多中心研究abstract:BACKGROUND:Sedentary behaviors have been directly associated with all-cause mortality. However, little is known about different types of sedentary behaviors in relation to overall mortality. Our objective was to assess the association between different sedentary behaviors and all-cause mortality. METHODS AND RESULTS:I...
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abstract::Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have repor...
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abstract::Background Previous studies have demonstrated a possible association between the induction of coenzyme Q10 (CoQ10) after statin treatment and statin-induced myopathy. However, whether CoQ10 supplementation ameliorates statin-induced myopathy remains unclear. Methods and Results PubMed, EMBASE , and Cochrane Library we...
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journal_title:Journal of the American Heart Association
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pub_type: 杂志文章,多中心研究,随机对照试验
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doi:10.1161/JAHA.120.016623
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journal_title:Journal of the American Heart Association
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abstract::Background Active commuting is related to a higher level of physical activity but more exposure to ambient air pollutants. With the rather serious air pollution in urban China, we aimed to examine the association between active commuting and risk of incident cardiovascular disease in the Chinese population. Methods an...
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American Heart Association
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更新日期:2015-01-06 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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更新日期:2018-06-22 00:00:00