Accumulation of Deficits as a Key Risk Factor for Cardiovascular Morbidity and Mortality: A Pooled Analysis of 154 000 Individuals.

Abstract:

:Background Frailty is associated with higher mortality in individuals at high cardiovascular disease (CVD) risk. We hypothesize that frailty is a more important prognostic factor than CVD risk factors and aim to determine the prognostic value of a cumulative deficit frailty index in patients with or at high risk for CVD. Methods and Results We conducted an individual-level pooled analysis of participants with or at risk for CVD, recruited in 14 multicenter clinical trials. The cumulative deficit index was calculated as the proportion of 26 deficits exhibited. Individuals were categorized as nonfrail, prefrail, or frail if they had indexes of ≤0.1, >0.1 to 0.21, or >0.21, respectively. CVD risk was assessed using the Framingham score. Outcomes included CVD event (new or recurrent myocardial infarction, stroke, or heart failure) and mortality. We studied 154 696 patients (mean age, 70.8 years; 63% men) with median follow-up of 3.2 years. There were 17 535 CVD events and 15 067 deaths. The frail group (n=13 872) had higher risk of a CVD event (incidence rate ratio, 1.97; 95% CI, 1.85-2.08), all-cause mortality (hazard ratio, 1.91; 95% CI, 1.79-2.03), and CVD mortality (hazard ratio, 1.91; 95% CI, 1.77-2.05) than the nonfrail group (n=101 343). Associations remained unchanged after adjusting for CVD risk factors. The index statistically outperformed the Framingham score in its ability to discriminate CVD events (C-statistic, 0.60 [95% CI, 0.60-0.61] versus 0.58 [95% CI, 0.57-0.58], respectively; P<0.001). Conclusions In individuals with or at high risk of developing CVD, the cumulative deficit index is associated with increased CVD events and mortality, independent of CVD risk factors, and adds incremental prognostic value.

journal_name

J Am Heart Assoc

authors

Farooqi MAM,Gerstein H,Yusuf S,Leong DP

doi

10.1161/JAHA.119.014686

subject

Has Abstract

pub_date

2020-02-04 00:00:00

pages

e014686

issue

3

issn

2047-9980

journal_volume

9

pub_type

杂志文章
  • Is Transient Takotsubo Syndrome Associated With Cancer? Why, and With What Implications for Oncocardiology?

    abstract::See Article Cammann et al. ...

    journal_title:Journal of the American Heart Association

    pub_type: 评论,社论

    doi:10.1161/JAHA.119.013201

    authors: Angelini P,Uribe C

    更新日期:2019-08-06 00:00:00

  • Hemispheric Asymmetry of White Matter Hyperintensity in Association With Lacunar Infarction.

    abstract::Background White matter hyperintensities ( WMHs ) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric WMHs associated with lacunar infarcts. Methods and Results A total of 267 consecutive patients with small first-ever supratentorial infarcts (≤20 mm) were included. None had...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.118.010653

    authors: Ryu WS,Schellingerhout D,Ahn HS,Park SH,Hong KS,Jeong SW,Park MS,Choi KH,Kim JT,Kim BJ,Han MK,Lee J,Cha JK,Kim DH,Nah HW,Lee SJ,Cho YJ,Lee BC,Yu KH,Oh MS,Park JM,Kang K,Lee KB,Park TH,Park SS,Smith EE,

    更新日期:2018-11-20 00:00:00

  • Dipeptidyl Peptidase-4 Inhibition Potentiates Stimulated Growth Hormone Secretion and Vasodilation in Women.

    abstract:BACKGROUND:Diminished growth hormone (GH) is associated with impaired endothelial function and fibrinolysis. GH-releasing hormone is the primary stimulus for GH secretion and a substrate of dipeptidyl peptidase-4. We tested the hypothesis that dipeptidyl peptidase-4 inhibition with sitagliptin increases stimulated GH s...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/JAHA.117.008000

    authors: Wilson JR,Brown NJ,Nian H,Yu C,Bidlingmaier M,Devin JK

    更新日期:2018-02-25 00:00:00

  • A novel protein glycan biomarker and future cardiovascular disease events.

    abstract:BACKGROUND:Glycosylated proteins partake in multiple cellular processes including inflammation. We hypothesized that GlycA, a novel biomarker of protein glycan N-acetyl groups, is related to incident cardiovascular disease (CVD), and we compared it with high-sensitivity C-reactive protein (hsCRP). METHODS AND RESULTS:...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/JAHA.114.001221

    authors: Akinkuolie AO,Buring JE,Ridker PM,Mora S

    更新日期:2014-09-23 00:00:00

  • Heart Rhythm Complexity Predicts Long-Term Cardiovascular Outcomes in Peritoneal Dialysis Patients: A Prospective Cohort Study.

    abstract::Background Cardiovascular disease is the leading cause of morbidity and mortality in patients with end-stage renal disease. Heart rhythm complexity analysis has been shown to be useful in predicting outcomes in various diseases; however, data on patients with end-stage renal disease are limited. In this study, we anal...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.119.013036

    authors: Tsai CH,Huang JW,Lin C,Ma HP,Lo MT,Liu LD,Lin LY,Lin CT,Hung CS,Peng CK,Lin YH

    更新日期:2020-01-21 00:00:00

  • Heart Rate Reserve in Fontan Patients: Chronotropic Incompetence or Hemodynamic Limitation?

    abstract::Background Patients with a Fontan circulation achieve lower peak heart rates ( HR ) during exercise. Whether this impaired chronotropic response reflects pathology of the sinoatrial node or is a consequence of altered cardiac hemodynamics is uncertain. We evaluated the adequacy of HR acceleration throughout exercise r...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.119.012008

    authors: Claessen G,La Gerche A,Van De Bruaene A,Claeys M,Willems R,Dymarkowski S,Bogaert J,Claus P,Budts W,Heidbuchel H,Gewillig M

    更新日期:2019-05-07 00:00:00

  • Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Optimal thromboprophylaxis after cardiac surgery is uncertain. This systematic review aimed to define the incidence and risk factors for deep vein thrombosis (DVT), fatal and nonfatal pulmonary embolism (PE), and assess whether venous thromboembolism (VTE) prophylaxis was effective in reducing VTE without co...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,meta分析,评审

    doi:10.1161/JAHA.115.002652

    authors: Ho KM,Bham E,Pavey W

    更新日期:2015-10-26 00:00:00

  • Death and Myocardial Infarction Following Initial Revascularization Versus Optimal Medical Therapy in Chronic Coronary Syndromes With Myocardial Ischemia: A Systematic Review and Meta-Analysis of Contemporary Randomized Controlled Trials.

    abstract::Background In chronic coronary syndromes, myocardial ischemia is associated with a greater risk of death and nonfatal myocardial infarction (MI). We sought to compare the effect of initial revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) plus optimal medical the...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.120.019114

    authors: Soares A,Boden WE,Hueb W,Brooks MM,Vlachos HEA,O'Fee K,Hardi A,Brown DL

    更新日期:2021-01-19 00:00:00

  • Peripheral arterial disease and risk of atrial fibrillation and stroke: the Multi-Ethnic Study of Atherosclerosis.

    abstract:BACKGROUND:Peripheral arterial disease (PAD) shares several risk factors with atrial fibrillation (AF), and persons with PAD have an increased risk of stroke. It is unclear if PAD is associated with an increased risk for AF and whether this potential association explains the increased risk of stroke observed in those w...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,多中心研究

    doi:10.1161/JAHA.114.001270

    authors: O'Neal WT,Efird JT,Nazarian S,Alonso A,Heckbert SR,Soliman EZ

    更新日期:2014-11-17 00:00:00

  • Remote Ischemic Perconditioning to Reduce Reperfusion Injury During Acute ST-Segment-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Remote ischemic conditioning (RIC) is a noninvasive therapeutic strategy that uses brief cycles of blood pressure cuff inflation and deflation to protect the myocardium against ischemia-reperfusion injury. The objective of this systematic review was to determine the impact of RIC on myocardial salvage index,...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,meta分析,评审

    doi:10.1161/JAHA.117.005522

    authors: McLeod SL,Iansavichene A,Cheskes S

    更新日期:2017-05-17 00:00:00

  • Impact of Beta-Blocker Initiation Timing on Mortality Risk in Patients With Diabetes Mellitus Undergoing Noncardiac Surgery: A Nationwide Population-Based Cohort Study.

    abstract:BACKGROUND:Relevant clinical studies have been small and have not convincingly demonstrated whether the perioperative initiation of beta-blockers should be considered in patients with diabetes mellitus undergoing noncardiac surgery. METHODS AND RESULTS:In this nationwide propensity score-matched study, we included pat...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.116.004392

    authors: Chen RJ,Chu H,Tsai LW

    更新日期:2017-01-10 00:00:00

  • Predictive Value of 18F-Sodium Fluoride Positron Emission Tomography in Detecting High-Risk Coronary Artery Disease in Combination With Computed Tomography.

    abstract::Background Application of 18F-sodium fluoride (18F-NaF) positron emission tomography ( PET ) to coronary artery disease has attracted interest. We investigated the utility of 18F-NaF uptake for predicting coronary events and evaluated the combined use of coronary computed tomography (CT) angiography ( CCTA ) and 18F-N...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.118.010224

    authors: Kitagawa T,Yamamoto H,Nakamoto Y,Sasaki K,Toshimitsu S,Tatsugami F,Awai K,Hirokawa Y,Kihara Y

    更新日期:2018-10-16 00:00:00

  • Left Ventricular Hypertrophy Regression During Antihypertensive Treatment in an Outpatient Clinic (the Campania Salute Network).

    abstract:BACKGROUND:Regression of left ventricular (LV) hypertrophy (LVH) has been a goal in clinical trials. This study tests the external validity of results of clinical trials on LVH regression using a large registry from a tertiary care center, to identify phenotypes less likely to achieve regression of LVH. METHODS AND RE...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.116.004152

    authors: Lønnebakken MT,Izzo R,Mancusi C,Gerdts E,Losi MA,Canciello G,Giugliano G,De Luca N,Trimarco B,de Simone G

    更新日期:2017-03-08 00:00:00

  • Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure.

    abstract::Background The digital transformation of medical data provides opportunities to perform digital population health surveillance and identify people inadequately managed in usual care. We leveraged the electronic health records of a large health system to identify patients with markedly elevated blood pressure and chara...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.119.015033

    authors: Lu Y,Huang C,Mahajan S,Schulz WL,Nasir K,Spatz ES,Krumholz HM

    更新日期:2020-04-07 00:00:00

  • Regulator of G Protein Signaling 6 Facilities Cardiac Hypertrophy by Activating Apoptosis Signal-Regulating Kinase 1-P38/c-JUN N-Terminal Kinase 1/2 Signaling.

    abstract::Background Regulator of G protein signaling 6 ( RGS 6) is an important member of the RGS family and produces pleiotropic regulatory effects on cardiac pathophysiology. However, the role of RGS 6 protein in cardiomyocytes during angiotensin II - and pressure overload-induced cardiac hypertrophy remain unknown. Methods ...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.118.009179

    authors: Huang Z,Shu J,Jiang W,Jiang M,Lu Y,Dai H,Xu N,Yuan H,Cai J

    更新日期:2018-10-02 00:00:00

  • Effects of a Vegetarian Diet on Cardiometabolic Risk Factors, Gut Microbiota, and Plasma Metabolome in Subjects With Ischemic Heart Disease: A Randomized, Crossover Study.

    abstract::Background A vegetarian diet (VD) may reduce future cardiovascular risk in patients with ischemic heart disease. Methods and Results A randomized crossover study was conducted in subjects with ischemic heart disease, assigned to 4-week intervention periods of isocaloric VD and meat diet (MD) with individually designed...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.120.016518

    authors: Djekic D,Shi L,Brolin H,Carlsson F,Särnqvist C,Savolainen O,Cao Y,Bäckhed F,Tremaroli V,Landberg R,Frøbert O

    更新日期:2020-09-15 00:00:00

  • Delayed Time to Peak Velocity Is Useful for Detecting Severe Aortic Stenosis.

    abstract:BACKGROUND:Time to peak velocity (TPV) is an echocardiographic variable that can be easily measured and reflects a late peaking murmur, a classic physical finding suggesting severe aortic stenosis (AS). The aim of this study was to investigate the usefulness of TPV to evaluate AS severity. METHODS AND RESULTS:This stu...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.116.003907

    authors: Kamimura D,Hans S,Suzuki T,Fox ER,Hall ME,Musani SK,McMullan MR,Little WC

    更新日期:2016-10-22 00:00:00

  • Subclinical Longitudinal Change in Ankle-Brachial Index With Aging in a Community-Dwelling Population Is Associated With Central Arterial Stiffening.

    abstract::Background Aging is associated with a modest decline in ankle-brachial index (ABI); however, the underpinnings of this decline are not fully understood. The greater systolic ankle than brachial blood pressure, a normal ABI implies, is partially attributed to lower central than peripheral arterial stiffness. Hence, we ...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.118.011650

    authors: Oberdier MT,Morrell CH,Lakatta EG,Ferrucci L,AlGhatrif M

    更新日期:2019-08-06 00:00:00

  • Wide Complex Tachycardia Differentiation: A Reappraisal of the State-of-the-Art.

    abstract::The primary goal of the initial ECG evaluation of every wide complex tachycardia is to determine whether the tachyarrhythmia has a ventricular or supraventricular origin. The answer to this question drives immediate patient care decisions, ensuing clinical workup, and long-term management strategies. Thus, the importa...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.120.016598

    authors: Kashou AH,Noseworthy PA,DeSimone CV,Deshmukh AJ,Asirvatham SJ,May AM

    更新日期:2020-06-02 00:00:00

  • Heart rate at hospital discharge in patients with heart failure is associated with mortality and rehospitalization.

    abstract:BACKGROUND:Whether heart rate upon discharge following hospitalization for heart failure is associated with long-term adverse outcomes and whether this association differs between patients with sinus rhythm (SR) and atrial fibrillation (AF) have not been well studied. METHODS AND RESULTS:We conducted a retrospective c...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.114.001626

    authors: Laskey WK,Alomari I,Cox M,Schulte PJ,Zhao X,Hernandez AF,Heidenreich PA,Eapen ZJ,Yancy C,Bhatt DL,Fonarow GC,AHA Get With The Guidelines®‐Heart Failure Program.

    更新日期:2015-04-22 00:00:00

  • Trends in Diagnosis-Specific Work Disability Before and After Stroke: A Longitudinal Population-Based Study in Sweden.

    abstract:BACKGROUND:Although a stroke event often leads to work disability, diagnoses behind work disability before and after stroke are largely unknown. We examined the pre-event and postevent trends in diagnosis-specific work disability among patients of working age. METHODS AND RESULTS:We included all new nonfatal stroke ev...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.117.006991

    authors: Lallukka T,Ervasti J,Lundström E,Mittendorfer-Rutz E,Friberg E,Virtanen M,Alexanderson K

    更新日期:2018-01-04 00:00:00

  • Contemporary Risk Stratification After Myocardial Infarction in the Community: Performance of Scores and Incremental Value of Soluble Suppression of Tumorigenicity-2.

    abstract:BACKGROUND:Current American Heart Association/American College of Cardiology guidelines recommend the GRACE (Global Registry of Acute Coronary Events) and TIMI (Thrombolysis in Myocardial Infarction) scores to assess myocardial infarction (MI) prognosis. Changes in the epidemiological characteristics of MI and the avai...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.117.005958

    authors: Gerber Y,Weston SA,Enriquez-Sarano M,Jaffe AS,Manemann SM,Jiang R,Roger VL

    更新日期:2017-10-20 00:00:00

  • Variation in Practice Regarding Pretreatment With Dual Antiplatelet Therapy for Patients With Non-ST Elevation Myocardial Infarction.

    abstract:BACKGROUND:Despite guideline recommendations, a significant number of patients with non-ST elevation myocardial infarction (NSTEMI) do not receive dual antiplatelet therapy (DAPT) before angiography "pretreatment." While there may be valid clinical reasons to not pretreat, such as concern for bleeding or multivessel di...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,多中心研究

    doi:10.1161/JAHA.116.003576

    authors: Shafiq A,Valle J,Jang JS,Qintar M,Gosch K,Cohen DJ,Singh M,Bach R,Spertus JA

    更新日期:2016-06-10 00:00:00

  • Anti-remodeling and anti-fibrotic effects of the neuregulin-1β glial growth factor 2 in a large animal model of heart failure.

    abstract:BACKGROUND:Neuregulin-1β (NRG-1β) is a growth factor critical for cardiac development and repair with therapeutic potential for heart failure. We previously showed that the glial growth factor 2 (GGF2) isoform of NRG-1β improves cardiac function in rodents after myocardial infarction (MI), but its efficacy in a large a...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.113.000773

    authors: Galindo CL,Kasasbeh E,Murphy A,Ryzhov S,Lenihan S,Ahmad FA,Williams P,Nunnally A,Adcock J,Song Y,Harrell FE,Tran TL,Parry TJ,Iaci J,Ganguly A,Feoktistov I,Stephenson MK,Caggiano AO,Sawyer DB,Cleator JH

    更新日期:2014-10-23 00:00:00

  • Pulmonary vascular and right ventricular reserve in patients with normalized resting hemodynamics after pulmonary endarterectomy.

    abstract:BACKGROUND:Patients with normalized mean pulmonary artery pressure (mPAP) after pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) do not always regain normal exercise capacity. We evaluated right ventricular function, its interaction with both pulsatile and resistive afterload, an...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.114.001602

    authors: Claessen G,La Gerche A,Dymarkowski S,Claus P,Delcroix M,Heidbuchel H

    更新日期:2015-03-23 00:00:00

  • Aging Impairs Mitochondrial Function and Mitophagy and Elevates Interleukin 6 Within the Cerebral Vasculature.

    abstract::Background The blood-brain barrier (BBB) is critical for cerebrovascular health. Although aging impairs the integrity of the BBB, the mechanisms behind this phenomenon are not clear. As mitochondrial components activate inflammation as mitochondria become dysfunctional, we examined how aging impacts cerebrovascular mi...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.120.017820

    authors: Tyrrell DJ,Blin MG,Song J,Wood SC,Goldstein DR

    更新日期:2020-12-01 00:00:00

  • Obstructive sleep apnea and progression of coronary artery calcium: the multi-ethnic study of atherosclerosis study.

    abstract:BACKGROUND:Obstructive sleep apnea (OSA) is a common condition associated with cardiovascular disease. Its potential effect on progression of subclinical atherosclerosis is not well understood. We tested the hypothesis that self-reported OSA is associated with progression of coronary artery calcium (CAC). We also evalu...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.114.001241

    authors: Kwon Y,Duprez DA,Jacobs DR,Nagayoshi M,McClelland RL,Shahar E,Budoff M,Redline S,Shea S,Carr JJ,Lutsey PL

    更新日期:2014-09-26 00:00:00

  • Comparison of Reperfusion Strategies for ST-Segment-Elevation Myocardial Infarction: A Multivariate Network Meta-analysis.

    abstract::Background We systematically reviewed trials comparing different reperfusion strategies for ST-segment-elevation myocardial infarction and used multivariate network meta-analysis to compare outcomes across these strategies. Methods and Results We identified 31 contemporary trials in which patients with ST-segment-elev...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.119.015186

    authors: Fazel R,Joseph TI,Sankardas MA,Pinto DS,Yeh RW,Kumbhani DJ,Nallamothu BK

    更新日期:2020-06-16 00:00:00

  • Carnosine Supplementation Mitigates the Deleterious Effects of Particulate Matter Exposure in Mice.

    abstract::Background Exposure to fine airborne particulate matter ( PM 2.5) induces quantitative and qualitative defects in bone marrow-derived endothelial progenitor cells of mice, and similar outcomes in humans may contribute to vascular dysfunction and the cardiovascular morbidity and mortality associated with PM 2.5 exposur...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章

    doi:10.1161/JAHA.119.013041

    authors: Abplanalp W,Haberzettl P,Bhatnagar A,Conklin DJ,O'Toole TE

    更新日期:2019-07-02 00:00:00

  • Mortality Benefit of Alirocumab: A Bayesian Perspective.

    abstract::Background The ODYSSEY OUTCOMES (Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome) trial demonstrated that alirocumab reduced major cardiovascular events. However, because of the hierarchical testing strategy used for the multiple outcomes examined, the observed reduction in all-cause mortality was...

    journal_title:Journal of the American Heart Association

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/JAHA.119.013170

    authors: Labos C,Brophy JM,Sniderman A,Thanassoulis G

    更新日期:2019-10-15 00:00:00