Abstract 16096: Neurobiological Resilience Associates With a Reduced Risk of MACE

Introduction:Chronic exposure to socioeconomic and/or environmental stressors associates with greater stress-associated neurobiological activity and a higher rate of major adverse cardiovascular events (MACE). Prior work has shown that the link between stressors and CVD involves upregulation of amygdalar activity (AmygA).Hypothesis:Individuals with decreased AmygA in spite of chronic stress exposure (i.e. neurobiological resilience: NbR) are relatively protected from MACE.Methods:Individuals without CVD or active cancer underwent FDG-PET/CT during which AmygA and arterial inflammation (AI) were quantified using validated methods. Chronic stressors were quantified as chronic noise exposure (using the U.S. Department of Transportation U.S. Road and Aviation Noise Map) and socioeconomic status (as neighborhood median household income or crime rate) at each individual?s home address. Individuals living in locals with higher levels of stressors (i.e., living in areas with highest tertile of noise exposure or crime or lowest tertile for income) were followed for incident MACE within 5 years of imaging. Relationships were evaluated using linear and Cox regression.Results:We identified 166 individuals chronically exposed to socioeconomic or environmental stressors ((age [mean ? SD]: 56 ? 13 ; 37% male). Over a median 4.1 yrs, 12 individuals experienced MACE. Among this group, lower AmygA associated with lower AI (standardized ? [95%CI]: 0.166 [0.035, 0.298], p=0.014) and a lower MACE risk (standardized HR [95%CI]: 0.531 [0.388, 0.837], p=0.005) after multivariable adjustments for CVD risk factors (Table).Conclusions:Among individuals exposed to chronic socioeconomic and environmental stressors, a standard deviation lower AmygA associates with a nearly 50% lower MACE risk. These data suggest that methods to improve neurobiological resilience in the context of chronic stress may decrease atherosclerosis and MACE events.