Datasheet1_The effect of non-optimal lipids on the progression of coronary artery calcification in statin-naïve young adults: results from KOICA registry.docx

BackgroundDespite the importance of attaining optimal lipid levels from a young age to secure long-term cardiovascular health, the detailed impact of non-optimal lipid levels in young adults on coronary artery calcification (CAC) is not fully explored. We sought to investigate the risk of CAC progression as per lipid profiles and to demonstrate lipid optimality in young adults.MethodsFrom the KOrea Initiative on Coronary Artery calcification (KOICA) registry that was established in six large volume healthcare centers in Korea, 2,940 statin-naïve participants aged 20–45 years who underwent serial coronary calcium scans for routine health check-ups between 2002 and 2017 were included. The study outcome was CAC progression, which was assessed by the square root method. The risk of CAC progression was analyzed according to the lipid optimality and each lipid parameter.ResultsIn this retrospective cohort (mean age, 41.3 years; men 82.4%), 477 participants (16.2%) had an optimal lipid profile, defined as triglycerides 60 mg/dl. During follow-up (median, 39.7 months), CAC progression was observed in 434 participants (14.8%), and more frequent in the non-optimal lipid group (16.5% vs. 5.7%; p ConclusionNon-optimal lipid levels were significantly associated with the risk of CAC progression in young adults, even at low-risk. Screening and intervention for non-optimal lipid levels, particularly triglycerides, from an early age might be of clinical value.</p

The occurrence of adverse cardiac event according to cardiac CT and myocardial SPECT.

<p>The occurrence of adverse cardiac event according to cardiac CT and myocardial SPECT.</p

CONSORT diagram of the study population selection.

<p>CCTA, coronary computed tomographic angiography; SPECT, single-photon emission computed tomography; CAD, coronary artery disease.</p

Kaplan-Meier survival curves for adverse cardiac events from combined cardiac CT and SPECT information.

<p>Event-free survival curves stratified by (A) coronary artery calcium score (CACS) of 400 and presence or absence of perfusion defect (PD), (B) diameter stenosis (DS) of 50% and presence or absence of PD, (C) presence of plaque in 3 or more segments of the coronary tree and presence or absence of PD, and (D) presence of non-calcified plaque (NCP) or mixed plaque (MP) in 2 or more segments of the coronary tree and presence or absence of PD.</p

Improved prediction of adverse cardiac events with integration of cardiac computed tomography (CT) and single-photon emission computed tomography (SPECT).

<p>Comparison of the annual event rate according to (A) increasing coronary artery calcium score (CACS), (B) worsening diameter stenosis (DS), (C) presence of non-calcified plaque (NCP), (D) mixed plaque (MP), and (E) calcified plaque (CP) between patients with and without perfusion defect (PD) on SPECT.</p

Incremental prognostic value of cardiac CT findings for adverse cardiac event.

<p>Incremental prognostic value of cardiac CT findings for adverse cardiac event.</p

Univariate and multivariate analysis of factors associated with adverse cardiac event.

<p>Univariate and multivariate analysis of factors associated with adverse cardiac event.</p

Baseline clinical and imaging characteristics.

<p>Baseline clinical and imaging characteristics.</p

The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes

<div><p>Background</p><p>Gestational hypertensive diseases (GHD) and gestational diabetes mellitus (GDM) increase the risk of cardiovascular disease (CVD) later in life. However, the association between gestational medical diseases and familial history of CVD has not been investigated to date. In the present study, we examined the association between familial history of CVD and GHD or GDM via reliable questionnaires in a large cohort of registered nurses.</p><p>Methods</p><p>The Korean Nurses’ Survey was conducted through a web-based computer-assisted self-interview, which was developed through consultation with cardiologists, gynecologists, and statisticians. We enrolled a total of 9,989 female registered nurses who reliably answered the questionnaires including family history of premature CVD (FHpCVD), hypertension (FHH), and diabetes mellitus (FHDM) based on their medical knowledge. Either multivariable logistic regression analysis or generalized estimation equation was used to clarify the effect of positive family histories on GHD and GDM in subjects or at each repeated pregnancy in an individual.</p><p>Results</p><p>In this survey, 3,695 subjects had at least 1 pregnancy and 8,783 cumulative pregnancies. Among them, 247 interviewees (6.3%) experienced GHD and 120 (3.1%) experienced GDM. In a multivariable analysis adjusted for age, obstetric, and gynecologic variables, age at the first pregnancy over 35 years (adjusted OR 1.61, 95% CI 1.02–2.43) and FHpCVD (adjusted OR 1.60, 95% CI 1.16–2.22) were risk factors for GHD in individuals, whereas FHH was not. FHDM and history of infertility therapy were risk factors for GDM in individuals (adjusted OR 2.68, 95% CI 1.86–3.86; 1.84, 95% CI 1.05–3.23, respectively). In any repeated pregnancies in an individual, age at the current pregnancy and at the first pregnancy, and FHpCVD were risk factors for GHD, while age at the current pregnancy, history of infertility therapy, and FHDM were risk factors for GDM.</p><p>Conclusions</p><p>The FHpCVD and FHDM are significantly associated with GHD and GDM, respectively. Meticulous family histories should be obtained, and women with family histories of these conditions should be carefully monitored during pregnancy.</p></div

Baseline characteristics of the study population.

<p>Baseline characteristics of the study population.</p