Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellu...Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellular adhesion molecule-1, interleukin-6, and monocyte chemoattractant protein-1 measured at examination cycle 7. Mitral annular calcium, aortic annular calcium, aortic sclerosis, and aortic stenosis were assessed by echocardiography at examination cycle 6. Logistic regression was used to examine the odds of valvular calcium per 1 unit increase in inflammation(ISUM), a summary statistic of all normalized deviates of the individual markers. Two thousand six hundred eighty-three participants(mean age 61±10 years; 52%women) were analyzed: 8.2%(n=216) had ≥1 calcified valve or annulus; 89 had mitral annular calcium, 78 had aortic annular calcium, 135 had aortic sclerosis, and 33 had aortic stenosis. Participants with valvular calcium were older and were more likely to have hypertension and diabetes mellitus. Participants with valve calcium had higher median levels of all markers. For each log unit increase in ISUM, after adjustment for age and gender, there was an associated 1.1-fold increased odds of ≥1 calcified valve(p=0.02); the odds ratios were no longer significant after adjustment for cardiovascular disease risk factors(odds ratio 1.0, 95%confidence interval 0.9 to 1.1). Similar results were obtained for the individual markers and the odds of ≥1 calcified valve. In conclusion, inflammatory markers were elevated in patients with valvular calcium. Our findings suggest that much of the observed association between systemic inflammatory markers and valvular calcium may be due to shared risk factors.展开更多
Background -Lifetime risk for atherosclerotic cardiovascular disease(CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown. Methods and Results -We included all Frami...Background -Lifetime risk for atherosclerotic cardiovascular disease(CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown. Methods and Results -We included all Framingham Heart Study participants who were free of CVD(myocardial infarction, coronary insufficiency, angina, stroke, claudication) at 50 years of age. Lifetime risks to 95 years of age were estimated for men and women, with death free of CVD as a competing event. We followed up 3564 men and 4362 women for 111 777 person-years; 1757 had CVD events and 1641 died free of CVD. At 50 years of age, lifetime risks were 51.7%(95%CI, 49.3 to 54.2) for men and 39.2%(95%CI, 37.0 to 41.4) for women, with median survivals of 30 and 36 years, respectively. With more adverse levels of single risk factors, lifetime risks increased and median survivals decreased. Compared with participants with ≥2 major risk factors, those with optimal levels had substantially lower lifetime risks(5.2%versus 68.9%in men, 8.2%versus 50.2%in women) and markedly longer median survivals( >39 versus 28 years in men, >39 versus 31 years in women). Conclusions -The absence of established risk factors at 50 years of age is associated with very low lifetime risk for CVD and markedly longer survival. These results should promote efforts aimed at preventing development of risk factors in young individuals. Given the high lifetime risks and lower survival in those with intermediate or high risk factor burden at 50 years of age, these data may be useful in communicating risks and supporting intensive preventive therapy.展开更多
Objectives We sought to determine the clinical factors and heritability associ ated with inflammation measured as circulating levels of soluble-intercellular adhesion molecule-1 (sICAM-1) in a community-based cohort. ...Objectives We sought to determine the clinical factors and heritability associ ated with inflammation measured as circulating levels of soluble-intercellular adhesion molecule-1 (sICAM-1) in a community-based cohort. Background Several prospective studies indicate that circulating sICAM-1 is predictive of future cardiovascular events. However, in some studies this predictive value is lost af ter multivariable adjustment for traditional cardiovascular disease (CVD) risk f actors. We addressed the heritability of sICAM-1 and its relation to CVD risk f actors in a community-based cohort. Methods We examined 3,295 subjects from the Framingham Heart Study and measured sICAM-1 levels. We then used linear and st epwise multivariable regression to determine predictors or sICAM-1 levels. Resu lts In age-and gender-adjusted regression models, increased sICAM-1 levels were positively associated with age, total/highdensity lipopro tein cholesterol, systolic blood pressure, body mass index (BMI), blood glucose, diabetes, smoking, and prevalent CVD. In stepwise multivariable regression mode ls, sICAM-1 levels remained associated with age, female gender, total/high-den sity lipoprotein cholesterol ratio, BMI, blood glucose, smoking, and prevalent C VD. The residual heritability of sICAM-1 was 24%. Conclusions In addition to p revalent CVD, established CVD risk factors and non-traditional ones such as BMI were associated with systemic inflammation as determined by sICAM-1 levels. Th ere also is significant heritability of sICAM-1, which suggests a genetic compo nent to systemic inflammation.展开更多
文摘Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellular adhesion molecule-1, interleukin-6, and monocyte chemoattractant protein-1 measured at examination cycle 7. Mitral annular calcium, aortic annular calcium, aortic sclerosis, and aortic stenosis were assessed by echocardiography at examination cycle 6. Logistic regression was used to examine the odds of valvular calcium per 1 unit increase in inflammation(ISUM), a summary statistic of all normalized deviates of the individual markers. Two thousand six hundred eighty-three participants(mean age 61±10 years; 52%women) were analyzed: 8.2%(n=216) had ≥1 calcified valve or annulus; 89 had mitral annular calcium, 78 had aortic annular calcium, 135 had aortic sclerosis, and 33 had aortic stenosis. Participants with valvular calcium were older and were more likely to have hypertension and diabetes mellitus. Participants with valve calcium had higher median levels of all markers. For each log unit increase in ISUM, after adjustment for age and gender, there was an associated 1.1-fold increased odds of ≥1 calcified valve(p=0.02); the odds ratios were no longer significant after adjustment for cardiovascular disease risk factors(odds ratio 1.0, 95%confidence interval 0.9 to 1.1). Similar results were obtained for the individual markers and the odds of ≥1 calcified valve. In conclusion, inflammatory markers were elevated in patients with valvular calcium. Our findings suggest that much of the observed association between systemic inflammatory markers and valvular calcium may be due to shared risk factors.
文摘Background -Lifetime risk for atherosclerotic cardiovascular disease(CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown. Methods and Results -We included all Framingham Heart Study participants who were free of CVD(myocardial infarction, coronary insufficiency, angina, stroke, claudication) at 50 years of age. Lifetime risks to 95 years of age were estimated for men and women, with death free of CVD as a competing event. We followed up 3564 men and 4362 women for 111 777 person-years; 1757 had CVD events and 1641 died free of CVD. At 50 years of age, lifetime risks were 51.7%(95%CI, 49.3 to 54.2) for men and 39.2%(95%CI, 37.0 to 41.4) for women, with median survivals of 30 and 36 years, respectively. With more adverse levels of single risk factors, lifetime risks increased and median survivals decreased. Compared with participants with ≥2 major risk factors, those with optimal levels had substantially lower lifetime risks(5.2%versus 68.9%in men, 8.2%versus 50.2%in women) and markedly longer median survivals( >39 versus 28 years in men, >39 versus 31 years in women). Conclusions -The absence of established risk factors at 50 years of age is associated with very low lifetime risk for CVD and markedly longer survival. These results should promote efforts aimed at preventing development of risk factors in young individuals. Given the high lifetime risks and lower survival in those with intermediate or high risk factor burden at 50 years of age, these data may be useful in communicating risks and supporting intensive preventive therapy.
文摘Objectives We sought to determine the clinical factors and heritability associ ated with inflammation measured as circulating levels of soluble-intercellular adhesion molecule-1 (sICAM-1) in a community-based cohort. Background Several prospective studies indicate that circulating sICAM-1 is predictive of future cardiovascular events. However, in some studies this predictive value is lost af ter multivariable adjustment for traditional cardiovascular disease (CVD) risk f actors. We addressed the heritability of sICAM-1 and its relation to CVD risk f actors in a community-based cohort. Methods We examined 3,295 subjects from the Framingham Heart Study and measured sICAM-1 levels. We then used linear and st epwise multivariable regression to determine predictors or sICAM-1 levels. Resu lts In age-and gender-adjusted regression models, increased sICAM-1 levels were positively associated with age, total/highdensity lipopro tein cholesterol, systolic blood pressure, body mass index (BMI), blood glucose, diabetes, smoking, and prevalent CVD. In stepwise multivariable regression mode ls, sICAM-1 levels remained associated with age, female gender, total/high-den sity lipoprotein cholesterol ratio, BMI, blood glucose, smoking, and prevalent C VD. The residual heritability of sICAM-1 was 24%. Conclusions In addition to p revalent CVD, established CVD risk factors and non-traditional ones such as BMI were associated with systemic inflammation as determined by sICAM-1 levels. Th ere also is significant heritability of sICAM-1, which suggests a genetic compo nent to systemic inflammation.
