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1. Predictive Value of Coronary Artery Calcium Score Categories for Coronary Events Versus Strokes: Impact of Sex and Race: MESA and DHS.

Author

Mehta, Anurag, Pandey, Ambarish, Ayers, Colby R, Khera, Amit, Sperling, Laurence S, Szklo, Moyses S, Gottesman, Rebecca F, Budoff, Mathew J, Blaha, Michael J, Blumenthal, Roger S, Nasir, Khurram, and Joshi, Parag H

Subjects
atherosclerosis, calcium, cardiovascular disease, coronary artery disease, risk, stroke, Clinical Sciences, Cardiovascular System & Hematology
Abstract

BackgroundCoronary artery calcium (CAC) predicts atherosclerotic cardiovascular disease (ASCVD) events, inclusive of coronary heart disease (CHD) and stroke, and is a decision-making aid for primary prevention. The predictive value of CAC categories for CHD and stroke separately and across sex and race groups of an asymptomatic population is unclear.MethodsWhite, Black, and Hispanic participants of MESA (Multi-Ethnic Study of Atherosclerosis) and DHS (Dallas Heart Study) underwent CAC measurement at enrollment and were followed for incident ASCVD events. Ten-year CHD-to-stroke incidence ratios across CAC score categories 0, 1 to 99, and ≥100 were assessed. Associations of CAC with incident CHD and stroke events were evaluated using multivariable-adjusted Cox models and multiplicative interactions of CAC with sex/race were tested.ResultsAmong 7042 participants (mean age, 57 years, 54% women, 36% Black, 23% Hispanic, 49% CAC=0, 19% CAC ≥100), 574 incident ASCVD events (333 CHD and 241 stroke) were observed over 12.3-year follow-up. Ten-year CHD-to-stroke incidence ratio increased significantly across CAC categories in men, women, Whites, Blacks, and Hispanics (all P

Published
2020

2. Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults

Author

Gore, Maria Odette, Ayers, Colby R, Khera, Amit, deFilippi, Christopher R, Wang, Thomas J, Seliger, Stephen L, Nambi, Vijay, Selvin, Elizabeth, Berry, Jarett D, Hundley, W Gregory, Budoff, Matthew, Greenland, Philip, Drazner, Mark H, Ballantyne, Christie M, Levine, Benjamin D, and de Lemos, James A

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Aging, Heart Disease - Coronary Heart Disease, Prevention, Cardiovascular, Heart Disease, Atherosclerosis, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Aged, Aged, 80 and over, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Carotid Intima-Media Thickness, Electrocardiography, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Risk Assessment, Risk Factors, Troponin T, carotid intima-media thickness, coronary artery calcium, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein, N-terminal pro B-type natriuretic peptide, plaque, N‐terminal pro B‐type natriuretic peptide, carotid intima‐media thickness, high‐sensitivity C‐reactive protein, high‐sensitivity cardiac troponin T, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10-year or longer timeframes. Shorter-term CVD risk is also clinically relevant, particularly for high-risk occupations, but is under-investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi-Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16 581). Measurements included N-terminal pro-B-type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high-sensitivity cardiac troponin T (abnormal >5 ng/L); high-sensitivity C-reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima-media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3-year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3-year multivariable-adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2-, 3-, 4.5- and 8-fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non-fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3-year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors.

Published
2020

5. Arrhythmias and Adaptations of the Cardiac Conduction System in Former National Football League Players

Author

Aagaard, Philip, Sharma, Shishir, McNamara, David A, Joshi, Parag, Ayers, Colby R, de Lemos, James A, Lincoln, Andrew E, Baranowski, Bryan, Mandsager, Kyle, Hill, Elizabeth, Castle, Lon, Gentry, James, Lang, Richard, Dunn, Reginald E, Alexander, Kezia, Tucker, Andrew M, and Phelan, Dermot

Subjects
Prevention, Cardiovascular, Heart Disease, Adaptation, Physiological, Adult, African Americans, Aged, Atrial Fibrillation, Cross-Sectional Studies, Football, Heart Conduction System, Humans, Male, Middle Aged, Prevalence, United States, Whites, athlete's heart, atrial fibrillation, conduction disease, National Football League, White People, Black or African American, Cardiorespiratory Medicine and Haematology
Abstract

Background Habitual high-intensity endurance exercise is associated with increased atrial fibrillation (AF) risk and impaired cardiac conduction. It is unknown whether these observations extend to prior strength-type sports exposure. The primary aim of this study was to compare AF prevalence in former National Football League (NFL) athletes to population-based controls. The secondary aim was to characterize other conduction system parameters. Methods and Results This cross-sectional study compared former NFL athletes (n=460, age 56±12 years, black 47%) with population-based controls of similar age and racial composition from the cardiovascular cohort Dallas Heart Study-2 (n=925, age 54±9 years, black 53%). AF was present in 28 individuals (n=23 [5%] in the NFL group; n=5 [0.5%] in the control group). After controlling for other cardiovascular risk factors in multivariable regression analysis, former NFL participation remained associated with a 5.7 (95% CI: 2.1-15.9, P

Published
2019

6. Longitudinal Trends in Cardiovascular Risk Factor Profiles and Complications Among Patients Hospitalized for COVID-19 Infection: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry

Author

Hall, Eric J., Ayers, Colby R., Kolkailah, Ahmed A., Rutan, Christine, Walchok, Jason, Williams, Joseph H., IV, Wang, Tracy Y., Rodriguez, Fatima, Bradley, Steven M., Stevens, Laura, Hall, Jennifer L., Mallya, Pratheek, Roth, Gregory A., Morrow, David A., Elkind, Mitchell S.V., Das, Sandeep R., and de Lemos, James A.

Published
2023
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9. Multimodality Strategy for Cardiovascular Risk Assessment

Author

de Lemos, James A, Ayers, Colby R, Levine, Benjamin D, deFilippi, Christopher R, Wang, Thomas J, Hundley, W Gregory, Berry, Jarett D, Seliger, Stephen L, McGuire, Darren K, Ouyang, Pamela, Drazner, Mark H, Budoff, Matthew, Greenland, Philip, Ballantyne, Christie M, and Khera, Amit

Subjects
Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Heart Disease - Coronary Heart Disease, Cardiovascular, Patient Safety, Aging, Prevention, Heart Disease, Atherosclerosis, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Adult, Aged, Biomarkers, Cardiovascular Diseases, Cohort Studies, Combined Modality Therapy, Electrocardiography, Ethnicity, Female, Follow-Up Studies, Humans, Male, Middle Aged, Population Surveillance, Prospective Studies, Risk Assessment, Texas, biomarker, C-reactive protein, coronary calcium, NT-proBNP, risk prediction, troponin T, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise
Abstract

BackgroundCurrent strategies for cardiovascular disease (CVD) risk assessment among adults without known CVD are limited by suboptimal performance and a narrow focus on only atherosclerotic CVD (ASCVD). We hypothesized that a strategy combining promising biomarkers across multiple different testing modalities would improve global and atherosclerotic CVD risk assessment among individuals without known CVD.MethodsWe included participants from MESA (Multi-Ethnic Study of Atherosclerosis) (n=6621) and the Dallas Heart Study (n=2202) who were free from CVD and underwent measurement of left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein. Associations of test results with the global composite CVD outcome (CVD death, myocardial infarction, stroke, coronary or peripheral revascularization, incident heart failure, or atrial fibrillation) and ASCVD (fatal or nonfatal myocardial infarction or stroke) were assessed over >10 years of follow-up. Multivariable analyses for the primary global CVD end point adjusted for traditional risk factors plus statin use and creatinine (base model).ResultsEach test result was independently associated with global composite CVD events in MESA after adjustment for the components of the base model and the other test results (P

Published
2017

13. Prevalence of Antiphospholipid Antibodies and Association With Incident Cardiovascular Events

Author

Zuo, Yu, primary, Navaz, Sherwin, additional, Liang, Wenying, additional, Li, Chun, additional, Ayers, Colby R., additional, Rysenga, Christine E., additional, Harbaugh, Alyssa, additional, Norman, Gary L., additional, Solow, E. Blair, additional, Bermas, Bonnie, additional, Akinmolayemi, Oludamilola, additional, Rohatgi, Anand, additional, Karp, David R., additional, Knight, Jason S., additional, and de Lemos, James A., additional

Published
2023
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22. Cardiometabolic Health Outcomes Associated With Discordant Visceral and Liver Fat Phenotypes: Insights From the Dallas Heart Study and UK Biobank

Author

Tejani, Sanaa, McCoy, Cody, Ayers, Colby R., Powell-Wiley, Tiffany M., Després, Jean-Pierre, Linge, Jennifer, Dahlqvist Leinhard, Olof, Petersson, Mikael, Borga, Magnus, Neeland, Ian J., Tejani, Sanaa, McCoy, Cody, Ayers, Colby R., Powell-Wiley, Tiffany M., Després, Jean-Pierre, Linge, Jennifer, Dahlqvist Leinhard, Olof, Petersson, Mikael, Borga, Magnus, and Neeland, Ian J.

Abstract

Objective: To evaluate the cardiometabolic outcomes associated with discordant visceral adipose tissue (VAT) and liver fat (LF) phenotypes in 2 cohorts. Patients and Methods: Participants in the Dallas Heart Study underwent baseline imaging from January 1, 2000, through December 31, 2002, and were followed for incident cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) through 2013. Associations between VAT-LF groups (low-low, high-low, low-high, and high-high) and outcomes were assessed using multivariable- adjusted regression and were replicated in the independent UK Biobank. Results: The Dallas Heart Study included 2064 participants (mean SD age, 449 years; 54% female; 47% black). High VATehigh LF and high VATelow LF were associated with prevalent atheroscle- rosis, whereas low VATehigh LF was not. Of 1731 participants without CVD/T2DM, 128 (7.4%) developed CVD and 95 (5.5%) T2DM over a median of 12 years. High VATehigh LF and high VATelow LF were associated with increased risk of CVD (hazard ratios [HRs], 2.0 [95% CI, 1.3 to 3.2] and 2.4 [95% CI, 1.4 to 4.1], respectively) and T2DM (odds ratios [ORs], 7.8 [95% CI, 3.8 to 15.8] and 3.3 [95% CI, 1.4 to 7.8], respectively), whereas low VATehigh LF was associated with T2DM (OR, 2.7 [95% CI, 1.1 to 6.7]). In the UK Biobank (N1⁄422,354; April 2014-May 2020), only high VATelow LF remained associated with CVD after multivariable adjustment for age and body mass index (HR, 1.5 [95% CI, 1.2 to 1.9]). Conclusion: Although VAT and LF are each associated with cardiometabolic risk, these observations demonstrate the importance of separating their cardiometabolic implications when there is presence or absence of either or both in an individual., Funding: National Institute of Diabetes and Digestive and Kidney Diseases [K23 DK106520]; National Center for Advancing Translational Sciences [UL1TR001105]; Swedish Research Council [VR-2019-04751]

Published
2022
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25. Cardiometabolic Health Outcomes Associated With Discordant Visceral and Liver Fat Phenotypes: Insights From the Dallas Heart Study and UK Biobank

Author

Tejani, Sanaa, primary, McCoy, Cody, additional, Ayers, Colby R., additional, Powell-Wiley, Tiffany M., additional, Després, Jean-Pierre, additional, Linge, Jennifer, additional, Leinhard, Olof Dahlqvist, additional, Petersson, Mikael, additional, Borga, Magnus, additional, and Neeland, Ian J., additional

Published
2022
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30. Identifying Discordance of Right- and Left-Ventricular Filling Pressures in Patients with Heart Failure by the Clinical Examination

Author

Pham, David, primary, Drazner, Mark H., additional, Ayers, Colby R., additional, Grodin, Justin L., additional, Hardin, Elizabeth A., additional, Garg, Sonia, additional, Mammen, Pradeep P.A., additional, Amin, Alpesh, additional, Araj, Faris G., additional, Morlend, Robert M., additional, and Thibodeau, Jennifer T., additional

Published
2021
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40. Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index

Author

Khera, Rohan, primary, Pandey, Ambarish, additional, Ayers, Colby R., additional, Carnethon, Mercedes R., additional, Greenland, Philip, additional, Ndumele, Chiadi E, additional, Nambi, Vijay, additional, Seliger, Stephen L., additional, Chaves, Paulo H. M., additional, Safford, Monika M., additional, Cushman, Mary, additional, Xanthakis, Vanessa, additional, Vasan, Ramachandran S., additional, Mentz, Robert J., additional, Correa, Adolfo, additional, Lloyd-Jones, Donald M., additional, Berry, Jarett D., additional, de Lemos, James A., additional, and Neeland, Ian J., additional

Published
2020
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41. Associations Between High-Density Lipoprotein Particles and Ischemic Events by Vascular Domain, Sex, and Ethnicity

Author

Singh, Kavisha, primary, Chandra, Alvin, additional, Sperry, Thomas, additional, Joshi, Parag H., additional, Khera, Amit, additional, Virani, Salim S., additional, Ballantyne, Christie M., additional, Otvos, James D., additional, Dullaart, Robin P.F., additional, Gruppen, Eke G., additional, Connelly, Margery A., additional, Ayers, Colby R., additional, and Rohatgi, Anand, additional

Published
2020
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