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Mo-P1:94 Weight at birth and correlations with cardiovascular risk factors in Brazilian public schools
P1
66
Mon&ty, June 19, 2006: Poster Session Epidemiology of cardiovascular disease
III (ATP III), American Heart Association/American College of Cardiology (AHA/ACC), II European Task Force (II Euro), III European Task Force (III Euro), and Prospective Cardiovascular Munchen Study (PROCAM). L R groups (< 10% 10-yeax coronary risk) was identified for each chart. Prevalence of SA was compared among each estimated L R group. L R patients with SA were recategorized as high risk pts. Results: SA was detected in almost two thirds of L R pts of each group: ATP III 69,5%; AHA/ACC 70,0%; II Euro 68,6%; III Euro 68,4%; P R O C A M 62,3%; p=NS. No significant differences were observed neither in SA prevalence among the estimated L R groups, nor after correction for gender, age and hypertension. SA prevalence was higher in pts with metabolic syndrome: ATP III 84,0%; AHA/ACC 84,8%; II Euro 83,9%; III Euro 83,0%; P R O C A M 85,0%. Conclusions: Including non-invasive SA assessment enables to identify a higher number of pts at risk for cardiovascular events than with commonly used risk charts. Long term observational studies are needed to support the accuracy of this tool.
I Mo-P1:91 I P R E D I C T O R S OF H O S P I T A L I Z A T I O N F O R C A R D I O V A S C U L A R D I S E A S E IN A HYPERCHOLESTEROLEMIC POPULATION C. Saxamin I , P. Deambrosis 1 L. Scalda£erri 2 , E. Kiwanuka 3, G. Terrazzani 1 G. Bader 4 , E Giusti 5, A. Chinellato 1 . 1Pluwmaceutical Sen,ice LHA 9, Trm'iso, Italy: 2I Medicine LHA 9, Trm'iso, Italy: 3Antidiabetic Unit LHA 9, Trm'iso, Italy; 4Outcome Researeh, Pfizer; Roma, Italy." 5pharmacological Dept Universi~, Padova, Italy
Objective: To evaluate the predictors of first admission for cardiovascular disease in hypercholesterolemic patients treated with statins. Design and Setting: A retrospective cohort study of statin utilization, in Local Health Authority (LHA) n 9, Treviso (1994-2003). Methods: Demographic, pharmaceutical and hospitalization data were retrieved from databases of LHA n 9. Cholesterol data were detected at the beginning of treatment and after three months. The clinical complexity of the patient was evaluated trough a proxy-vaxiable consisting in co-prescriptions (antidiabetics, antihypertensive and aspirin). Results: The patients enrolled were 5028. To study the predictors of time to admission, each independent variable (age, gender, compliance, statin, number of co-treatments, and goal achievement) was evaluated by means of log-rank test and those variables resulted associated with time to admission were inserted in a Cox regression model. The risk of first admission increases with age and gender (male vs female). In comparison to simvastatin the risk of first admission decreases with pravastatin atorvastatin and cerivastatin. Patients with polytherapy were more prone to be hospitalized. Seemingly the risk of admission increases with compliance but patients more compliant axe older and have more risk factors. Moreover the Kaplan-Meier analysis considering the cholesterol level induced by statin treatment, indicate that this variable is not significative on CV events. Conclusions: The analysis of administrative database (prescriptions and hospital admissions) seems to indicate that old male patients with polytherapy axe more at risk of first admission in spite of good compliance with statin therapy.
IMo-P1:921
I i
DIABETES AND TRIGLYCERIDES ARE STRONG P R E D I C T O R S OF C O R O N A R Y A R T E R Y R E E V E N T S : A T2-YEAR FOLLOW- UP STUDY
V. Dzenkeviciute, Z. Petrulioniene, S. Kurkutyte. Vilnius UnA,ersity, Medical Facul~, Vilnius, Lithuania This study was performed to analyzed which of the traditional risk factors was associated with reevents of coronary artery disease. We aimed to identify if any variable was predictive. Methods and Results: We collected 206 middle age patients with A M I and performed a prospective 2 year follow-up recording cardiovascular events. The follow-up was completed in 97% (n=201) patients; we did not documented any death whereas clinical events were registered in 22% (n=45) of patients. At univaxiate analysis we found that patients with clinical events had higher prevalence of diabetes (20% vs 12%, p < 0.005), and more elevated TG (44% vs 31%, p < 0.005). Multivariate analysis (logistic regression) confirmed that diabetes (OR 6.7, 95% CI 1.0- 41.3) and TG (OR 0.41, 95% CI 0.17-0.97) were the only variables predictive of clinical events. Conclusion: In this study diabetes and triglycerides had a negative impact on the long-term prognosis in middle age patients with AMI. These risk
factors require spedfic care. The effectiveness of this care will be evaluated during the next follow-up period.
IMo-P1:931
I
A P R O S P E C T I V E S T U D Y OF C H A N G E IN BMI A N D RISK OF C A R D I O V A S C U L A R D I S E A S E IN M E N
T.S. Bowman 1'2 , T. Kurth 2'3 , H.D. Sesso 2"3, J.M. Gaziano 1'2'3 . 1VA Boston Healthcare System, Boston, USA." 2Aging-Brigham and Women's Hospital, Boston, USA." 3Preventive Medicine, Brigham and Women's Hospital, Boston, USA
Background: Though an elevated body mass index (BMI) is an important risk factor for cardiovascualr disease (CVD), there are limited data regarding how long-term changes in BMI affect subsequent risk of CVD. Methods: We used a prospective cohort study design among 13,228 nonsmoking men free of cancer in the Physicians" Health Study. Baseline information on CVD risk factors was collected. BMI (in kg/m 2) was assessed at baseline and at 8 years, from which an 8 year change in BMI was calculated. In addition, World Health Organization (WHO) criteria for BMI (normal, overweight or obese) was used to assess 8 year change in W H O category and risk of CVD. We calculated relative risks (RRs) and 95% confidence intervals for risk of CVD, using both age- and multivariable-adjusted Cox proportional hazard models. Results: A total of 1,372 major vascular events (nonfatal ML nonfatal stroke or CVD death) occurred over a median of 13.5 years. Compared to those with a stable BMI (increase of 0 to 1 unit), participants with any decrease in BMI had an age-adjusted RR of 1.14 (95% CL 0.99-1.29) and multivaxiable RR of 1.03 (95% CL 0.90-1.19). Those with a _> 1 unit increase in BMI had an age-adjusted RR of 1.18 (95% CL 1.02-1.37) and a multivariable RR of 1.08 (95% CL 0.93-1.27). The lowest risk of CVD was among participants with a normal BMI that remained normal. Conclusions: In this cohort of apparently healthy men, an increase in BMI over 8 years was associated with a higher risk of CVD that was attenuated after multivaxiable adjustment. CVD events may be prevented by long-term madntainence of BMI in the normal range. I
I Mo-P1:94 iI W E I G H T AT B I R T H A N D C O R R E L A T I O N S W I T H C A R D I O V A S C U L A R RISK FACTORS IN B R A Z I L I A N PUBLIC SCHOOLS T.L.R. Maxtinez, A. Pereira, L.P. Vieira. Heart Institute - Univ. Sao Paulo/Centro de Extensao Universitaria, Sat Paulo, Brazil
Introduction: Low weight at birth can be a marker of coronary heart disease. Methods: 450 children and adolescents (2-19 years old), from rural areas of Itapetininga (Sfto Paulo, Brazil), were evaluated about the birth at weight and data on regarding lipid profile, glicemic and uric acid levels, blood pressure level, nutritional, social and economic statuts were collected. From all children, 21.33% had a low weight at birth (<2.5kg). The Nutritional status was obtained by anthropometric measures as height and weight; Waterloo classification was used for children under 6 years of age and body mass index (BMI) for those over 6 years. Results: by multivariate analysis, there was no association of low weight at birth and total cholesterol (p=0.31), LDL-cholesterol (p=0.46), HDLcholesterol (p=0.21), triglycerides (p=0.9), glicemia (p=0.7), uric acid (p=0.4), systolic arterial pressure(SAP) (p=0.75), nor diastolic arterial pressure (DAP) (p=0.85). Univariate analysis showed a significant positive correlation between low weight at birth and DAP (p=0.039). There was also a significant correlation between normal weight at birth (>2.5kg) and high caloric nutritional intake (p=0.046). A correlation between low weight at birth and lower social economic conditions was also observed (p=0.030). Conchlsions: Low weight at birth can be associated with more predisposition of occuring of the metabolic syndrome factors clustering, probably due to alterations in insulin sensitivity. WITH IMo-P1:951 DCYE SRLEIBPRI DOEVMA ISAC UINL APATIENTS R INSULT A. Arsovska, A. Popovski. Clinic of Neurology, Clinical Center; Skopje, Makedonija
Aim: to investigate the association of dyslipidemia and vascular risk factors in patients with cerebrovasculax insult (CVI). Methods: We examined 354 patients with CVI -256 (72%) with ischemic and 98 (28%) with hemorrhagic insult, median age 72, 5 years. At admission,
XIV bztentational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006
66
Mon&ty, June 19, 2006: Poster Session Epidemiology of cardiovascular disease
III (ATP III), American Heart Association/American College of Cardiology (AHA/ACC), II European Task Force (II Euro), III European Task Force (III Euro), and Prospective Cardiovascular Munchen Study (PROCAM). L R groups (< 10% 10-yeax coronary risk) was identified for each chart. Prevalence of SA was compared among each estimated L R group. L R patients with SA were recategorized as high risk pts. Results: SA was detected in almost two thirds of L R pts of each group: ATP III 69,5%; AHA/ACC 70,0%; II Euro 68,6%; III Euro 68,4%; P R O C A M 62,3%; p=NS. No significant differences were observed neither in SA prevalence among the estimated L R groups, nor after correction for gender, age and hypertension. SA prevalence was higher in pts with metabolic syndrome: ATP III 84,0%; AHA/ACC 84,8%; II Euro 83,9%; III Euro 83,0%; P R O C A M 85,0%. Conclusions: Including non-invasive SA assessment enables to identify a higher number of pts at risk for cardiovascular events than with commonly used risk charts. Long term observational studies are needed to support the accuracy of this tool.
I Mo-P1:91 I P R E D I C T O R S OF H O S P I T A L I Z A T I O N F O R C A R D I O V A S C U L A R D I S E A S E IN A HYPERCHOLESTEROLEMIC POPULATION C. Saxamin I , P. Deambrosis 1 L. Scalda£erri 2 , E. Kiwanuka 3, G. Terrazzani 1 G. Bader 4 , E Giusti 5, A. Chinellato 1 . 1Pluwmaceutical Sen,ice LHA 9, Trm'iso, Italy: 2I Medicine LHA 9, Trm'iso, Italy: 3Antidiabetic Unit LHA 9, Trm'iso, Italy; 4Outcome Researeh, Pfizer; Roma, Italy." 5pharmacological Dept Universi~, Padova, Italy
Objective: To evaluate the predictors of first admission for cardiovascular disease in hypercholesterolemic patients treated with statins. Design and Setting: A retrospective cohort study of statin utilization, in Local Health Authority (LHA) n 9, Treviso (1994-2003). Methods: Demographic, pharmaceutical and hospitalization data were retrieved from databases of LHA n 9. Cholesterol data were detected at the beginning of treatment and after three months. The clinical complexity of the patient was evaluated trough a proxy-vaxiable consisting in co-prescriptions (antidiabetics, antihypertensive and aspirin). Results: The patients enrolled were 5028. To study the predictors of time to admission, each independent variable (age, gender, compliance, statin, number of co-treatments, and goal achievement) was evaluated by means of log-rank test and those variables resulted associated with time to admission were inserted in a Cox regression model. The risk of first admission increases with age and gender (male vs female). In comparison to simvastatin the risk of first admission decreases with pravastatin atorvastatin and cerivastatin. Patients with polytherapy were more prone to be hospitalized. Seemingly the risk of admission increases with compliance but patients more compliant axe older and have more risk factors. Moreover the Kaplan-Meier analysis considering the cholesterol level induced by statin treatment, indicate that this variable is not significative on CV events. Conclusions: The analysis of administrative database (prescriptions and hospital admissions) seems to indicate that old male patients with polytherapy axe more at risk of first admission in spite of good compliance with statin therapy.
IMo-P1:921
I i
DIABETES AND TRIGLYCERIDES ARE STRONG P R E D I C T O R S OF C O R O N A R Y A R T E R Y R E E V E N T S : A T2-YEAR FOLLOW- UP STUDY
V. Dzenkeviciute, Z. Petrulioniene, S. Kurkutyte. Vilnius UnA,ersity, Medical Facul~, Vilnius, Lithuania This study was performed to analyzed which of the traditional risk factors was associated with reevents of coronary artery disease. We aimed to identify if any variable was predictive. Methods and Results: We collected 206 middle age patients with A M I and performed a prospective 2 year follow-up recording cardiovascular events. The follow-up was completed in 97% (n=201) patients; we did not documented any death whereas clinical events were registered in 22% (n=45) of patients. At univaxiate analysis we found that patients with clinical events had higher prevalence of diabetes (20% vs 12%, p < 0.005), and more elevated TG (44% vs 31%, p < 0.005). Multivariate analysis (logistic regression) confirmed that diabetes (OR 6.7, 95% CI 1.0- 41.3) and TG (OR 0.41, 95% CI 0.17-0.97) were the only variables predictive of clinical events. Conclusion: In this study diabetes and triglycerides had a negative impact on the long-term prognosis in middle age patients with AMI. These risk
factors require spedfic care. The effectiveness of this care will be evaluated during the next follow-up period.
IMo-P1:931
I
A P R O S P E C T I V E S T U D Y OF C H A N G E IN BMI A N D RISK OF C A R D I O V A S C U L A R D I S E A S E IN M E N
T.S. Bowman 1'2 , T. Kurth 2'3 , H.D. Sesso 2"3, J.M. Gaziano 1'2'3 . 1VA Boston Healthcare System, Boston, USA." 2Aging-Brigham and Women's Hospital, Boston, USA." 3Preventive Medicine, Brigham and Women's Hospital, Boston, USA
Background: Though an elevated body mass index (BMI) is an important risk factor for cardiovascualr disease (CVD), there are limited data regarding how long-term changes in BMI affect subsequent risk of CVD. Methods: We used a prospective cohort study design among 13,228 nonsmoking men free of cancer in the Physicians" Health Study. Baseline information on CVD risk factors was collected. BMI (in kg/m 2) was assessed at baseline and at 8 years, from which an 8 year change in BMI was calculated. In addition, World Health Organization (WHO) criteria for BMI (normal, overweight or obese) was used to assess 8 year change in W H O category and risk of CVD. We calculated relative risks (RRs) and 95% confidence intervals for risk of CVD, using both age- and multivariable-adjusted Cox proportional hazard models. Results: A total of 1,372 major vascular events (nonfatal ML nonfatal stroke or CVD death) occurred over a median of 13.5 years. Compared to those with a stable BMI (increase of 0 to 1 unit), participants with any decrease in BMI had an age-adjusted RR of 1.14 (95% CL 0.99-1.29) and multivaxiable RR of 1.03 (95% CL 0.90-1.19). Those with a _> 1 unit increase in BMI had an age-adjusted RR of 1.18 (95% CL 1.02-1.37) and a multivariable RR of 1.08 (95% CL 0.93-1.27). The lowest risk of CVD was among participants with a normal BMI that remained normal. Conclusions: In this cohort of apparently healthy men, an increase in BMI over 8 years was associated with a higher risk of CVD that was attenuated after multivaxiable adjustment. CVD events may be prevented by long-term madntainence of BMI in the normal range. I
I Mo-P1:94 iI W E I G H T AT B I R T H A N D C O R R E L A T I O N S W I T H C A R D I O V A S C U L A R RISK FACTORS IN B R A Z I L I A N PUBLIC SCHOOLS T.L.R. Maxtinez, A. Pereira, L.P. Vieira. Heart Institute - Univ. Sao Paulo/Centro de Extensao Universitaria, Sat Paulo, Brazil
Introduction: Low weight at birth can be a marker of coronary heart disease. Methods: 450 children and adolescents (2-19 years old), from rural areas of Itapetininga (Sfto Paulo, Brazil), were evaluated about the birth at weight and data on regarding lipid profile, glicemic and uric acid levels, blood pressure level, nutritional, social and economic statuts were collected. From all children, 21.33% had a low weight at birth (<2.5kg). The Nutritional status was obtained by anthropometric measures as height and weight; Waterloo classification was used for children under 6 years of age and body mass index (BMI) for those over 6 years. Results: by multivariate analysis, there was no association of low weight at birth and total cholesterol (p=0.31), LDL-cholesterol (p=0.46), HDLcholesterol (p=0.21), triglycerides (p=0.9), glicemia (p=0.7), uric acid (p=0.4), systolic arterial pressure(SAP) (p=0.75), nor diastolic arterial pressure (DAP) (p=0.85). Univariate analysis showed a significant positive correlation between low weight at birth and DAP (p=0.039). There was also a significant correlation between normal weight at birth (>2.5kg) and high caloric nutritional intake (p=0.046). A correlation between low weight at birth and lower social economic conditions was also observed (p=0.030). Conchlsions: Low weight at birth can be associated with more predisposition of occuring of the metabolic syndrome factors clustering, probably due to alterations in insulin sensitivity. WITH IMo-P1:951 DCYE SRLEIBPRI DOEVMA ISAC UINL APATIENTS R INSULT A. Arsovska, A. Popovski. Clinic of Neurology, Clinical Center; Skopje, Makedonija
Aim: to investigate the association of dyslipidemia and vascular risk factors in patients with cerebrovasculax insult (CVI). Methods: We examined 354 patients with CVI -256 (72%) with ischemic and 98 (28%) with hemorrhagic insult, median age 72, 5 years. At admission,
XIV bztentational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006