TY  - JOUR
AB  - AIMS: Deleterious effects Lipoprotein (a) (Lp(a)) might be mitigated by overall cardiovascular (CV) risk reduction. However, data on the relationship between increased Lp(a) and incident coronary heart disease (CHD) according to the distribution of modifiable CV risk factors (CVRF) at baseline are still scarce. We investigated the association between high Lp(a) and incident CHD in the general population, depending on the presence/absence of four major CVRFs (hypertension, diabetes, hypercholesterolemia, smoking) at baseline. METHODS: Overall 66,495 CHD-free individuals from eight European prospective population-based cohorts were included. The cohort was stratified according to CVRF burden at baseline in "0/1 CVRF" (low risk; n= 41,770) and"≥2 CVRFs" (increased risk; n=24,725). Fine and Gray competing risk-adjusted models were calculated for the association between Lp(a) mass (<90th versus ≥90th percentile (pctl.); cut-off 43.2 mg/dL) and future CHD events. RESULTS: During a median follow-up of 9.7 years, 3,467 incident CHD events occurred. Despite being at very low absolute risk based on traditional CVRF, individuals with 0/1CVRF demonstrated a strong association between increased Lp(a) mass (≥90th pctl.) and future CHD events, which was comparable to the association observed among individuals with ≥2 CVRFs. The fully-adjusted sub-distribution Hazard Ratios [sHRs] for elevated Lp(a) were 1.38 (95% CI, 1.12-1.71) versus 1.27 (95% CI, 1.10-1.46) in those having 0/1 versus ≥2 CVRFs at baseline (Pinteraction0.50). CONCLUSION: Among CHD-free subjects, high Lp(a) was related to adverse outcome even in individuals with no or only one CVRF at baseline, thereby generating substantial challenges in mitigating Lp(a)-associated CHD risk in very low risk populations.
AU  - Arnold, N.*
AU  - Goßling, A.*
AU  - Bay, B.*
AU  - Weimann, J.*
AU  - Blaum, C.*
AU  - Brunner, F.J.*
AU  - Ferrario, M.M.*
AU  - Brambilla, P.*
AU  - Cesana, G.*
AU  - Leoni, V.*
AU  - Palmieri, L.*
AU  - Donfrancesco, C.*
AU  - Padró, T.*
AU  - Andersson, J.*
AU  - Jousilahti, P.*
AU  - Ojeda, F.*
AU  - Zeller, T.*
AU  - Linneberg, A.*
AU  - Söderberg, S.*
AU  - Iacoviello, L.*
AU  - Gianfagna, F.*
AU  - Sans, S.*
AU  - Veronesi, G.*
AU  - Thorand, B.
AU  - Peters, A.
AU  - Tunstall-Pedoe, H.*
AU  - Kee, F.*
AU  - Salomaa, V.*
AU  - Schnabel, R.B.*
AU  - Kuulasmaa, K.*
AU  - Blankenberg, S.*
AU  - Waldeyer, C.*
AU  - Koenig, W.*
C1  - 74907
C2  - 57715
CY  - Great Clarendon St, Oxford Ox2 6dp, England
TI  - Lipoprotein (a) and incident coronary heart disease in the community: Impact of traditional cardiovascular risk factors.
JO  - Eur. J. Prev. Cardiol.
PB  - Oxford Univ Press
PY  - 2025
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.
AU  - Koskinas, K.C.*
AU  - Van Craenenbroeck, E.M.*
AU  - Antoniades, C.*
AU  - Blüher, M.
AU  - Gorter, T.M.*
AU  - Hanssen, H.*
AU  - Marx, N.*
AU  - McDonagh, T.A.*
AU  - Mingrone, G.*
AU  - Rosengren, A.*
AU  - Prescott, E.B.*
C1  - 74356
C2  - 57266
SP  - 184-220
TI  - Obesity and cardiovascular disease: An ESC clinical consensus statement.
JO  - Eur. J. Prev. Cardiol.
VL  - 32
IS  - 3
PY  - 2025
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIMS: To estimate and compare the impacts of menu calorie labelling and sugar-sweetened beverage (SSB) taxation on reducing obesity prevalence, cardiovascular disease (CVD) mortality, and equity-related impacts, in Belgium and Germany. METHODS: We used microsimulation models over a 20-year simulation horizon (2022-2041). We modelled the impacts through assumed changes in energy intake due to consumer responses and food industry reformulation. Scenarios of partial (in "large" out-of-home businesses; ≥ 250 employees) and full (in all out-of-home businesses) implementation for menu calorie labelling and different tax rates for SSBs (10%, 20%, 30%) were simulated. RESULTS: Compared to the counterfactual scenario, assuming effects on both consumer and industry behaviour, menu calorie labelling applied to all out-of-home businesses was estimated to reduce obesity prevalence by 3·61 (95% uncertainty interval-UI: [2·78, 4·30]) and 4·28 (95% UI: [3·64, 5·06]) percentage points and prevent 1600 (95% UI: [400, 3800]) and 30000 (95% UI: [10000, 58000]) CVD deaths in Belgium and Germany over 20 years, respectively. The 30% SSB tax was estimated to reduce obesity prevalence by 0·27 (95% UI: [0·17, 0·43]) and 0·27 (95% UI: [0·17, 0·39]) percentage points and postpone 2500 (95% UI: [800, 5200]) and 16000 (95% UI: [7500, 28000]) CVD deaths in Belgium and Germany, respectively. In both countries, SSB taxation had a larger impact on CVD deaths for lower (vs. higher) education groups, whereas calorie labelling prevented more CVD deaths for higher (vs. lower) education groups. CONCLUSIONS: Menu calorie labelling and SSB taxation have substantial impacts on reducing obesity prevalence and preventing CVD deaths in Belgium and Germany. Implementing both policies will be important to tackle obesity and CVD burden.
AU  - Putra, I.G.N.E.*
AU  - O'Flaherty, M.*
AU  - Emmert-Fees, K.M.F.*
AU  - Vasquez, M.S.*
AU  - Evans, R.M.*
AU  - Peters, A.
AU  - Kypridemos, C.*
AU  - Berger, N.*
AU  - Robinson, E.B.*
AU  - Colombet, Z.*
C1  - 74918
C2  - 57717
CY  - Great Clarendon St, Oxford Ox2 6dp, England
TI  - Estimating the health impact of menu calorie labelling policy and sugar-sweetened beverage taxation in two European countries: A microsimulation study.
JO  - Eur. J. Prev. Cardiol.
PB  - Oxford Univ Press
PY  - 2025
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIM: The study aimed to assess the effectiveness of three clinical diagnostic criteria (Simon Broome, MEDPED, and guideline-derived) in identifying children with familial hypercholesterolemia (FH) compared to genetic testing. The evaluation involved 1337 children with elevated LDL-C levels, focusing on the sensitivity and specificity of these clinical scores in detecting genetically confirmed FH cases. METHODS: Clinical data were gathered by a self-reporting questionnaire. Clinical FH was defined in accordance with the tested FH score. Genetically confirmed heterozygous FH (HeFH) was defined by a (likely) pathogenic variant. RESULTS: Of 1337 children undergoing genetic analysis, 211 showed a pathogenic FH mutation. Applying SB, MP and GL-EAS criteria resulted in 210/1337, 125/1337 and 112/835 children being categorized to have FH clinically. The sensitivity of the clinical scores ranged from 0.44-0.54 with a positive predictive value (PPV) of 0.51-0.79. The specificity was 0.91-0.97 with a negative predictive value (NPV) of 0.89-0.91. Similar results were observed for the three clinical scores regarding sensitivity, specificity, PPV and NPV in subgroup analyses defined by gender, age (<10 years vs ≥10 years), or weight (≥90th BMI-percentile vs <90th BMI-percentile). CONCLUSION: Clinical FH scores offer a high degree of specificity for FH diagnosis in children, but at the expense of low sensitivity. Specifically, half of the mutation-positive children in this study would have been missed for early diagnosis and preventive treatment. Given the widespread availability of affordable genetic testing such analysis should be performed at a lower threshold than that indicated by these clinical scores.
AU  - Schmieder, R.S.*
AU  - Krefting, J.*
AU  - Ates, S.*
AU  - Schlieben, L.D.
AU  - Arens, S.*
AU  - Kordonouri, O.*
AU  - Sander, M.*
AU  - Holdenrieder, S.*
AU  - Mall, V.*
AU  - Meitinger, T.*
AU  - von Scheidt, M.*
AU  - Koenig, W.*
AU  - Leipold, G.*
AU  - Prokisch, H.
AU  - Schunkert, H.*
AU  - Sanin, V.*
C1  - 75106
C2  - 57805
CY  - Great Clarendon St, Oxford Ox2 6dp, England
TI  - Clinical scores fail to sufficiently identify children with Familial Hypercholesterolemia.
JO  - Eur. J. Prev. Cardiol.
PB  - Oxford Univ Press
PY  - 2025
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIMS: We explored the manifestations of individual weight loss (WL) response to long-term lifestyle interventions on cardiometabolic risk. METHODS AND RESULTS: We pooled data from three large long-term lifestyle WL-intervention trials: 24-month DIRECT (ClinicalTrials.gov: NCT00160108; n = 322; 87% adherence), 18-month CENTRAL (ClinicalTrials.gov: NCT01530724; n = 278; 86% adherence), and 18-month DIRECT PLUS (ClinicalTrials.gov: NCT03020186; n = 294; 89% adherence). We analyzed longitudinal changes in cardiometabolic risk markers, including anthropometrics, blood biomarkers, and magnetic-resonance-imaging-assessed fat depots, and measured DNA-methylation, proteomics, and metabolomics. Among trial completers (n = 761, mean age = 50.4 years; 89% men, baseline body-mass-index = 30.1 kg/m2), mean WL was -3.3 kg (-3.5%). We classified participants as Successful-WL (36%) with relative-WL > 5%, WL-Resistant (28%) who did not lose or gained weight, and Moderate-WL (36%) with WL between 0% and 5%. Successful-WL achieved the greatest improvements in multiple health indicators. However, the WL-Resistant also showed some significant improvements, with increased high-density-lipoprotein-cholesterol (HDLc) and decreased leptin and visceral fat (P < 0.05 vs. baseline). Overall, each 1 kg sustained lifestyle-induced WL was associated with improvements in lipid markers and insulin resistance [HDLc (+1.44%), triglycerides (-1.37%), insulin (-2.46%), HOMA-IR (-2.71%), leptin (-2.79%)] and intrahepatic-fat regression (-0.49 absolute-units)] and modest but significant change in systolic and diastolic blood pressures (-0.26% and -0.36%). We identified 12 significant methylation sites that are associated with Successful-WL (FDR < 0.05; AUC = 0.73). CONCLUSION: While only ∼one-third of individuals achieved long-term WL, the Moderate-WL and WL-Resistant individuals could benefit improvements in visceral adiposity and cardiometabolic risk by shifting towards a healthy lifestyle pattern, beyond WL. Site-pecific DNA methylation may predict an individual's likelihood of successful WL. REGISTRATION: NCT00160108, NCT01530724, NCT03020186.
AU  - Yaskolka Meir, A.*
AU  - Tsaban, G.*
AU  - Rinott, E.*
AU  - Zelicha, H.*
AU  - Schwarzfuchs, D.*
AU  - Gepner, Y.*
AU  - Rudich, A.*
AU  - Shelef, I.*
AU  - Blüher, M.
AU  - Stumvoll, M.
AU  - Ceglarek, U.*
AU  - Isermann, B.*
AU  - Klöting, N.
AU  - Keller, M.
AU  - Kovacs, P.*
AU  - Qi, L.*
AU  - Wang, D.D.*
AU  - Liang, L.*
AU  - Hu, F.B.*
AU  - Stampfer, M.J.*
AU  - Shai, I.*
C1  - 74862
C2  - 57641
CY  - Great Clarendon St, Oxford Ox2 6dp, England
TI  - Individual response to lifestyle interventions: A pooled analysis of three long-term weight loss trials.
JO  - Eur. J. Prev. Cardiol.
PB  - Oxford Univ Press
PY  - 2025
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Aims The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals.Methods and results The updated LIFE-CVD (i.e. LIFE-CVD2) models were derived using individual participant data from 44 cohorts in 13 countries (687 135 individuals without established CVD, 30 939 CVD events in median 10.7 years of follow-up). LIFE-CVD2 uses sex-specific functions to estimate the lifetime risk of fatal and non-fatal CVD events with adjustment for the competing risk of non-CVD death and is systematically recalibrated to four distinct European risk regions. The updated models showed good discrimination in external validation among 1 657 707 individuals (61 311 CVD events) from eight additional European cohorts in seven countries, with a pooled C-index of 0.795 (95% confidence interval 0.767-0.822). Predicted and observed CVD event risks were well calibrated in population-wide electronic health records data in the UK (Clinical Practice Research Datalink) and the Netherlands (Extramural LUMC Academic Network). When using LIFE-CVD2 to estimate potential gain in CVD-free life expectancy from preventive therapy, projections varied by risk region reflecting important regional differences in absolute lifetime risk. For example, a 50-year-old smoking woman with a systolic blood pressure (SBP) of 140 mmHg was estimated to gain 0.9 years in the low-risk region vs. 1.6 years in the very high-risk region from lifelong 10 mmHg SBP reduction. The benefit of smoking cessation for this individual ranged from 3.6 years in the low-risk region to 4.8 years in the very high-risk region.Conclusion By taking into account geographical differences in CVD incidence using contemporary representative data sources, the recalibrated LIFE-CVD2 model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making for cardiovascular prevention as recommended by 2021 European guidelines. The study introduces LIFE-CVD2, a new tool that helps predict the risk of heart disease over a person's lifetime, and highlights how where you live in Europe can affect this risk. Using health information from over 687 000 people, LIFE-CVD2 looks at things like blood pressure and whether someone smokes to figure out their chance of having heart problems later in life. Health information from another 1.6 million people in seven different European countries was used to show that it did a good job of predicting who might develop heart disease.Knowing your heart disease risk over your whole life helps doctors give you the best advice to keep your heart healthy. Let us say there is a 50-year-old woman who smokes and has a bit high blood pressure. Right now, she might not look like she is in danger. But with the LIFE-CVD2 tool, doctors can show her how making changes today, like lowering her blood pressure or stopping smoking, could mean many more years without heart problems. These healthy changes can make a big difference over many years.
AU  - Hageman, S.H.J.*
AU  - Kaptoge, S.*
AU  - de Vries, T.*
AU  - Lu, W.*
AU  - Kist, J.M.*
AU  - van Os, H.J.A.*
AU  - Numans, M.E.*
AU  - Laell, K.*
AU  - Bobak, M.*
AU  - Pikhart, H.*
AU  - Kubínová, R.*
AU  - Malyutina, S.*
AU  - Pajak, A.*
AU  - Tamosiunas, A.*
AU  - Erbel, R.*
AU  - Stang, A.*
AU  - Schmidt, B.*
AU  - Schramm, S.*
AU  - Bolton, T.R.*
AU  - Spackman, S.*
AU  - Bakker, S.J.L.*
AU  - Blaha, M.J.*
AU  - Boer, J.M.A.*
AU  - Bonnefond, A.*
AU  - Brenner, H.*
AU  - Brunner, E.J.*
AU  - Cook, N.R.*
AU  - Davidson, K.W.*
AU  - Dennison, E.*
AU  - Donfrancesco, C.*
AU  - Doerr, M.*
AU  - Floyd, J.S.*
AU  - Ford, I.*
AU  - Fu, M.*
AU  - Gansevoort, R.T.*
AU  - Giampaoli, S.*
AU  - Gillum, R.F.*
AU  - Gomez-de-la-Camara, A.*
AU  - Håheim, L.L.*
AU  - Hansson, P.O.*
AU  - Harms, P.*
AU  - Humphries, S.E.*
AU  - Ikram, M.K.*
AU  - Jukema, J.W.*
AU  - Kavousi, M.*
AU  - Kiechl, S.*
AU  - Kucharska-Newton, A.*
AU  - Pablos, D.L.*
AU  - Matsushita, K.*
AU  - Meyer, H.E.*
AU  - Moons, K.G.M.*
AU  - Mortensen, M.B.*
AU  - Muilwijk, M.*
AU  - Nordestgaard, B.G.*
AU  - Packard, C.*
AU  - Pamieri, L.*
AU  - Panagiotakos, D.*
AU  - LIFE-CVD2 Working Group (Peters, A.)
AU  - Potier, L.*
AU  - Providencia, R.*
AU  - Psaty, B.M.*
AU  - Ridker, P.M.*
AU  - Rodriguez, B.*
AU  - Rosengren, A.*
AU  - Sattar, N.*
AU  - Schoettker, B.*
AU  - Schwartz, J.E.*
AU  - Shea, S.*
AU  - Shipley, M.J.*
AU  - Sofat, R.*
AU  - LIFE-CVD2 Working Group (Thorand, B.)
AU  - Verschuren, W.M.M.*
AU  - Voelzke, H.*
AU  - Wareham, N.J.*
AU  - Westbury, L.*
AU  - Willeit, P.*
AU  - Zhou, B.*
AU  - Danesh, J.*
AU  - Visseren, F.L.J.*
AU  - di Angelantonio, E.*
AU  - Pennells, L.*
AU  - Dorresteijn, J.A.N.*
C1  - 71332
C2  - 56045
CY  - Great Clarendon St, Oxford Ox2 6dp, England
TI  - Prediction of individual lifetime cardiovascular risk and potential treatment benefit: development and recalibration of the LIFE-CVD2 model to four European risk regions.
JO  - Eur. J. Prev. Cardiol.
PB  - Oxford Univ Press
PY  - 2024
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIMS: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period. METHODS: The study sample comprised 553818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors (sex, smoking, diabetes, non-HDL [high-density lipoprotein] cholesterol, systolic blood pressure [BP], and body mass index [BMI]) and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. RESULTS: The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the United Kingdom were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (p = 0.043 for overall difference) and those with diabetes had a slightly lower HR in central Europe (p = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol (7% per mmol/L; 95% confidence interval [CI], 3-10%) and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%). CONCLUSION: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.
AU  - Reinikainen, J.*
AU  - Kuulasmaa, K.*
AU  - Oskarsson, V.*
AU  - Amouyel, P.*
AU  - Biasch, K.*
AU  - Brenner, H.*
AU  - De Ponti, R.*
AU  - Donfrancesco, C.*
AU  - Drygas, W.*
AU  - Ferrieres, J.*
AU  - Grassi, G.*
AU  - Grimsgaard, S.*
AU  - Iacoviello, L.*
AU  - Jousilahti, P.*
AU  - Kårhus, L.L.*
AU  - Kee, F.*
AU  - Linneberg, A.*
AU  - Luksiene, D.*
AU  - Mariño, J.*
AU  - Moitry, M.*
AU  - Palmieri, L.*
AU  - Peters, A.
AU  - Piwonska, A.*
AU  - Quarti-Trevano, F.*
AU  - Salomaa, V.*
AU  - Sans, S.*
AU  - Schmidt, C.O.*
AU  - Schöttker, B.*
AU  - Söderberg, S.*
AU  - Tamosiunas, A.*
AU  - Thorand, B.
AU  - Tunstall-Pedoe, H.*
AU  - Vanuzzo, D.*
AU  - Veronesi, G.*
AU  - Woodward, M.*
AU  - Lekadir, K.*
AU  - Niiranen, T.*
C1  - 68767
C2  - 54977
CY  - Great Clarendon St, Oxford Ox2 6dp, England
SP  - 569–577
TI  - Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: An analysis of 49 cohorts from 11 European countries.
JO  - Eur. J. Prev. Cardiol.
VL  - 31
PB  - Oxford Univ Press
PY  - 2024
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIMS: The role of biomarkers in predicting cardiovascular outcomes in high-risk individuals is not well established. We aimed to investigate benefits of adding biomarkers to cardiovascular risk assessment in individuals with and without diabetes. METHODS AND RESULTS: We used individual-level data of 95 292 individuals of the European population harmonized in the Biomarker for Cardiovascular Risk Assessment across Europe consortium and investigated the prognostic ability of high-sensitivity cardiac troponin I (hs-cTnI), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP). Cox-regression models were used to determine adjusted hazard ratios of diabetes and log-transformed biomarkers for fatal and non-fatal cardiovascular events. Models were compared using the likelihood ratio test. Stratification by specific biomarker cut-offs was performed for crude time-to-event analysis using Kaplan-Meier plots. Overall, 6090 (6.4%) individuals had diabetes at baseline, median follow-up was 9.9 years. Adjusting for classical risk factors and biomarkers, diabetes [HR 2.11 (95% CI 1.92, 2.32)], and all biomarkers (HR per interquartile range hs-cTnI 1.08 [95% CI 1.04, 1.12]; NT-proBNP 1.44 [95% CI 1.37, 1.53]; hs-CRP 1.27 [95% CI 1.21, 1.33]) were independently associated with cardiovascular events. Specific cut-offs for each biomarker identified a high-risk group of individuals with diabetes losing a median of 15.5 years of life compared to diabetics without elevated biomarkers. Addition of biomarkers to the Cox-model significantly improved the prediction of outcomes (likelihood ratio test for nested models P < 0.001), accompanied by an increase in the c-index (increase to 0.81). CONCLUSION: Biomarkers improve cardiovascular risk prediction in individuals with and without diabetes and facilitate the identification of individuals with diabetes at highest risk for cardiovascular events.
AU  - Haller, P.M.*
AU  - Goßling, A.*
AU  - Magnussen, C.*
AU  - Brenner, H.*
AU  - Schöttker, B.*
AU  - Iacoviello, L.*
AU  - Costanzo, S.*
AU  - Kee, F.*
AU  - Koenig, W.*
AU  - Linneberg, A.*
AU  - Sujana, C.
AU  - Thorand, B.
AU  - Salomaa, V.*
AU  - Niiranen, T.J.*
AU  - Söderberg, S.*
AU  - Völzke, H.*
AU  - Dörr, M.*
AU  - Sans, S.*
AU  - Padró, T.*
AU  - Felix, S.B.*
AU  - Nauck, M.*
AU  - Petersmann, A.*
AU  - Palmieri, L.*
AU  - Donfrancesco, C.*
AU  - De Ponti, R.*
AU  - Veronesi, G.*
AU  - Ferrario, M.M.*
AU  - Kuulasmaa, K.*
AU  - Zeller, T.*
AU  - Ojeda, F.M.*
AU  - Blankenberg, S.*
AU  - Westermann, D.*
C1  - 67682
C2  - 53989
CY  - Great Clarendon St, Oxford Ox2 6dp, England
SP  - 1218-1226
TI  - Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus.
JO  - Eur. J. Prev. Cardiol.
VL  - 30
IS  - 12
PB  - Oxford Univ Press
PY  - 2023
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Aims Percutaneous coronary intervention reduces mortality in acute coronary syndrome patients but the cost-utility of increasing its use in elderly acute coronary syndrome patients is unknown. Methods We assessed the efficiency of increased percutaneous coronary intervention use compared to current practice in patients aged >= 75 years admitted for acute coronary syndrome in France, Germany, Greece, Italy, Portugal and Spain with a semi-Markov state transition model. In-hospital mortality reduction estimates by percutaneous coronary intervention use and costs were derived from the EUROpean Treatment & Reduction of Acute Coronary Syndromes cost analysis EU project (n = 28,600). Risk of recurrence and out-of-hospital all-cause mortality were obtained from the Information System for the Development of Research in Primary Care (SIDIAP) database from North-Eastern Spain (n = 55,564). In-hospital mortality was modelled using stratified propensity score analysis. The 8-year acute coronary syndrome recurrence risk and out-of-hospital mortality were estimated with a multistate survival model. The scenarios analysed were to increase percutaneous coronary intervention use among patients with the highest, moderate and lowest probability of receiving percutaneous coronary intervention based on the propensity score analysis. Results France, Greece and Portugal showed similar total costs/1000 individuals (7.29-11.05 m euro); while in Germany, Italy and Spain, costs were higher (13.53-22.57 m euro). Incremental cost-utility ratios of providing percutaneous coronary intervention to all patients ranged from 2262.8 euro/quality adjusted life year gained for German males to 6324.3 euro/quality adjusted life year gained for Italian females. Increasing percutaneous coronary intervention use was cost-effective at a willingness-to-pay threshold of 10,000 euro/quality adjusted life year gained for all scenarios in the six countries, in males and females. Conclusion Compared to current clinical practice, broadening percutaneous coronary intervention use in elderly acute coronary syndrome patients would be cost-effective across different healthcare systems in Europe, regardless of the selected strategy.
AU  - Forné, C.*
AU  - Subirana, I.*
AU  - Blanch, J.*
AU  - Ferrieres, J.*
AU  - Azevedo, A.*
AU  - Meisinger, C.
AU  - Farmakis, D.*
AU  - Tavazzi, L.*
AU  - Davoli, M.*
AU  - Ramos, R.*
AU  - Brosa, M.*
AU  - Marrugat, J.*
AU  - Dégano, I.R.*
C1  - 59721
C2  - 49022
CY  - 1 Olivers Yard, 55 City Road, London Ec1y 1sp, England
SP  - 408-417
TI  - A cost-utility analysis of increasing percutaneous coronary intervention use in elderly patients with acute coronary syndromes in six European countries.
JO  - Eur. J. Prev. Cardiol.
VL  - 28
IS  - 4
PB  - Sage Publications Ltd
PY  - 2021
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Background: Although work stress and impaired sleep are established risk factors for cardiovascular disease (CVD) among healthy individuals, their impact on hypertensive workers is largely unknown. Design: Prospective cohort study design. Methods: Hypertensive workers (N = 1959), derived from the population-based MONICA/KORA study in Southern Germany, who were free of any cardiovascular disease and diabetes were interviewed at baseline for work stress (high demand plus low control) and impaired sleep (difficulties falling asleep and/or maintaining sleep). Hazard ratios and 95% confidence intervals (CIs) were estimated by multivariate Cox proportional hazards models with adjustment for relevant covariates. Results: During a mean follow-up of 17.8 years covering 34,900 person-years, 134 fatal CVD and 73 coronary heart disease (CHD) events were observed. In comparison to participants with low work stress and non-impaired sleep, participants with work stress (hazard ratio (HR) 1.56, 95% CI 0.81-2.98), or impaired sleep (HR 1.76, 95% CI 0.96-3.22) had an increased risk of CVD, while participants with both work stress and impaired sleep had the highest risk of CVD mortality (HR 2.94, 95% CI 1.18-7.33). Participants with both risk conditions had an absolute CVD mortality risk of 7.13 cases per 1000 person-years in comparison to 3.05 cases per 1000-person years in the reference group. Similar risk patterns were found for CHD mortality. Conclusions: Our findings add a new piece of evidence that work stress together with impaired sleep increase risk of coronary and cardiovascular mortality in hypertensive workers.
AU  - Li, J.*
AU  - Atasoy, S.
AU  - Fang, X.
AU  - Angerer, P.*
AU  - Ladwig, K.-H.
C1  - 55952
C2  - 46711
CY  - Great Clarendon St, Oxford Ox2 6dp, England
SP  - 220-226
TI  - Combined effect of work stress and impaired sleep on coronary and cardiovascular mortality in hypertensive workers: The MONICA/KORA cohort study.
JO  - Eur. J. Prev. Cardiol.
VL  - 28
IS  - 2
PB  - Oxford Univ Press
PY  - 2021
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Background Challenging clinical practice guidelines that recommend serum potassium concentration between 4.0-5.0 mEq/L or ≥4.5 mEq/L in patients with acute myocardial infarction, recent studies found increased mortality risks in patients with a serum potassium concentration of ≥4.5 mEq/L. Studies investigating consequences of hypokalemia after acute myocardial infarction revealed conflicting results. Therefore, the aim of this systematic review and meta-analysis was to combine evidence from previous studies on the association of serum potassium concentration with both short and long-term mortality as well as the occurrence of ventricular arrhythmias. Design Systematic review and meta-analysis. Methods A structured search of MEDLINE and EMBASE databases yielded 23 articles published between 1990 and January 2017 that met the inclusion criteria. Study selection, data extraction and quality assessment were carried out by three reviewers. Random effects models were used to pool estimates across the included studies and sensitivity analyses were performed when possible. Results Twelve studies were included in the meta-analysis. Both pooled results from six studies investigating short-term mortality and from five studies examining long-term mortality revealed significantly increased risks in patients with serum potassium concentrations of <3.5 mEq/L, 4.5-<5.0 mEq/L and ≥5.0 mEq/L after acute myocardial infarction. In addition, a serum potassium concentration of <3.5 mEq/L was significantly associated with the occurrence of ventricular arrhythmias. Conclusions Mortality, both short and long term, and the occurrence of ventricular arrhythmias in patients with acute myocardial infarction seem to be negatively associated with hypokalemic serum potassium concentration. There is evidence for adverse consequences of serum potassium concentrations of ≥4.5 mEq/L. Due to the heterogeneity among existing studies, further research is necessary to confirm the need to change clinical practice guidelines.
AU  - Colombo, M.
AU  - Kirchberger, I.
AU  - Amann, U.
AU  - Dinser, L.
AU  - Meisinger, C.
C1  - 53543
C2  - 44612
SP  - 576-595
TI  - Association of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis.
JO  - Eur. J. Prev. Cardiol.
VL  - 25
IS  - 6
PY  - 2018
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Aims Darapladib, a potent inhibitor of lipoprotein-associated phospholipase A2 (Lp-PLA2), has not reduced risk of cardiovascular disease outcomes in recent randomized trials. We aimed to test whether Lp-PLA2 enzyme activity is causally relevant to coronary heart disease. Methods In 72,657 patients with coronary heart disease and 110,218 controls in 23 epidemiological studies, we genotyped five functional variants: four rare loss-of-function mutations (c.109+2T > C (rs142974898), Arg82His (rs144983904), Val279Phe (rs76863441), Gln287Ter (rs140020965)) and one common modest-impact variant (Val379Ala (rs1051931)) in PLA2G7, the gene encoding Lp-PLA2. We supplemented de-novo genotyping with information on a further 45,823 coronary heart disease patients and 88,680 controls in publicly available databases and other previous studies. We conducted a systematic review of randomized trials to compare effects of darapladib treatment on soluble Lp-PLA2 activity, conventional cardiovascular risk factors, and coronary heart disease risk with corresponding effects of Lp-PLA2-lowering alleles. Results Lp-PLA2 activity was decreased by 64% ( p = 2.4 × 10-25) with carriage of any of the four loss-of-function variants, by 45% ( p < 10-300) for every allele inherited at Val279Phe, and by 2.7% ( p = 1.9 × 10-12) for every allele inherited at Val379Ala. Darapladib 160 mg once-daily reduced Lp-PLA2 activity by 65% ( p < 10-300). Causal risk ratios for coronary heart disease per 65% lower Lp-PLA2 activity were: 0.95 (0.88-1.03) with Val279Phe; 0.92 (0.74-1.16) with carriage of any loss-of-function variant; 1.01 (0.68-1.51) with Val379Ala; and 0.95 (0.89-1.02) with darapladib treatment. Conclusions In a large-scale human genetic study, none of a series of Lp-PLA2-lowering alleles was related to coronary heart disease risk, suggesting that Lp-PLA2 is unlikely to be a causal risk factor.
AU  - Gregson, J.M.*
AU  - Freitag, D.F.*
AU  - Surendran, P.*
AU  - Stitziel, N.O.*
AU  - Chowdhury, R.*
AU  - Burgess, S.*
AU  - Kaptoge, S.*
AU  - Gao, P.*
AU  - Staley, J.R.*
AU  - Willeit, P.*
AU  - Nielsen, S.F.*
AU  - Caslake, M.*
AU  - Trompet, S.*
AU  - Polfus, L.M.*
AU  - Kuulasmaa, K.*
AU  - Kontto, J.*
AU  - Perola, M.*
AU  - Blankenberg, S.*
AU  - Veronesi, G.*
AU  - Gianfagna, F.*
AU  - Männistö, S.*
AU  - Kimura, A.*
AU  - Lin, H.*
AU  - Reilly, D.F.*
AU  - Gorski, M.*
AU  - Mijatovic, V.*
AU  - Munroe, P.B.*
AU  - Ehret, G.B.*
AU  - Thompson, A.*
AU  - Uria-Nickelsen, M.*
AU  - Malarstig, A.*
AU  - Dehghan, A.*
AU  - Vogt, T.F.*
AU  - Sasaoka, T.*
AU  - Takeuchi, F.*
AU  - Kato, N.*
AU  - Yamada, Y.*
AU  - Kee, F.*
AU  - Müller-Nurasyid, M.
AU  - Ferrieres, J.*
AU  - Arveiler, D.*
AU  - Amouyel, P.*
AU  - Salomaa, V.*
AU  - Boerwinkle, E.*
AU  - Thompson, S.G.*
AU  - Ford, I.*
AU  - Jukema, J.W.*
AU  - Sattar, N.*
AU  - Packard, C.J.*
AU  - Al Shafi Majumder, A.*
AU  - Alam, D.S.*
AU  - Deloukas, P.*
AU  - Schunkert, H.*
AU  - Samani, N.J.*
AU  - Kathiresan, S.*
AU  - Nørdestgaard, B.G.*
AU  - Saleheen, D.*
AU  - Howson, J.M.M.*
AU  - di Angelantonio, E.*
AU  - Butterworth, A.S.*
AU  - Danesh, J.*
C1  - 50592
C2  - 42404
SP  - 492-504
TI  - Genetic invalidation of Lp-PLA2 as a therapeutic target: Large-scale study of five functional Lp-PLA2-lowering alleles.
JO  - Eur. J. Prev. Cardiol.
VL  - 24
IS  - 5
PY  - 2017
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - BACKGROUND: Previous studies have indicated that patients with acute myocardial infarction (AMI) who have a history of peripheral arterial disease (PAD) have different characteristics and poorer outcomes than patients without PAD. However, data on short-term mortality are conflicting and it is unclear whether patients with PAD have a different scope of AMI symptoms or differences in pre-hospital delay time (PHDT) compared with patients without PAD. The objective of this study was to determine the associations between a history of PAD and presenting AMI symptoms, PHDT and 28-day case fatality in a population-based sample of patients with AMI. DESIGN: This was an observational study. METHODS: Information on history of PAD was obtained from the patients' medical records and their AMI symptoms were assessed by interviews with patients. Multivariable logistic regression models were used to determine the association of PAD with AMI symptoms and 28-day case fatality. A multivariable linear regression model was developed to examine the relations between PAD and PHDT. RESULTS: From the 5848 patients with AMI included in this study, 9.8% had a history of PAD. Patients with PAD were significantly less likely to report chest symptoms (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.41-0.66) or pain in the upper left extremity (OR 0.67, 95% CI 0.54-0.84) than patients without PAD. PAD was significantly related with longer PHDT in patients <69 years of age (p = 0.0117) and men (p = 0.0104). A significantly higher 28-day case fatality (OR 2.09, 95% CI 1.47-2.96) was found in patients with PAD compared with patients without PAD. CONCLUSIONS: Patients with PAD should receive comprehensive education on the possibility of atypical AMI symptoms and the need to call emergency medical services immediately.
AU  - Kirchberger, I.
AU  - Amann, U.
AU  - Heier, M.
AU  - Kuch, B.*
AU  - Thilo, C.*
AU  - Peters, A.
AU  - Meisinger, C.
C1  - 49858
C2  - 40996
CY  - London
SP  - 265-273
TI  - Presenting symptoms, pre-hospital delay time and 28-day case fatality in patients with peripheral arterial disease and acute myocardial infarction from the MONICA/KORA Myocardial Infarction Registry.
JO  - Eur. J. Prev. Cardiol.
VL  - 24
IS  - 3
PB  - Sage Publications Ltd
PY  - 2017
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - The combined effect of social status and risk factors on the absolute risk of cardiovascular disease has been insufficiently investigated, but results provide guidance on who could benefit most through prevention. Methods We followed 77,918 cardiovascular disease-free individuals aged 35-74 years at baseline, from 38 cohorts covering Nordic and Baltic countries, the UK and Central Europe, for a median of 12 years. Using Fine-Gray models in a competing-risks framework we estimated the effect of the interaction of education with smoking, blood pressure and body weight on the cumulative risk of incident acute coronary heart disease and stroke. Results Compared with more educated smokers, the less educated had an added increase in absolute risk of cardiovascular disease of 3.1% (95% confidence interval + 0.1%, +6.2%) in men and of 1.5% (-1.9%, +5.0%) in women, consistent across smoking categories. Conversely, the interaction was negative for overweight: -2.6% (95% CI: -5.6%, +0.3%) and obese: -3.6% (-7.6%, +0.4%) men, suggesting that the more educated would benefit more from the same reduction in body weight. A weaker interaction was observed for body weight in women, and for blood pressure in both genders. Less educated men and women with a cluster of two or more risk factors had an added cardiovascular disease risk of 3.6% (+0.1%, +7.0%) and of 2.6% (-0.5%, +5.6%), respectively, compared with their more educated counterparts. Conclusions Socially disadvantaged subjects have more to gain from lifestyle and blood pressure modification, hopefully reducing both their risk and also social inequality in disease.
AU  - Veronesi, G.*
AU  - Tunstall-Pedoe, H.*
AU  - Ferrario, M.M.*
AU  - Kee, F.*
AU  - Kuulasmaa, K.*
AU  - Chambless, L.E.*
AU  - Amouyel, P.*
AU  - Arveiler, D.*
AU  - Bobak, M.*
AU  - Ferrieres, J.*
AU  - Giampaoli, S.*
AU  - Jørgensen, T.*
AU  - Peters, A.
AU  - Salomaa, V.*
AU  - Söderberg, S.*
AU  - Tamosiunas, A.*
AU  - Cesana, G.*
C1  - 50490
C2  - 42320
SP  - 437-445
TI  - Combined effect of educational status and cardiovascular risk factors on the incidence of coronary heart disease and stroke in European cohorts: Implications for prevention.
JO  - Eur. J. Prev. Cardiol.
VL  - 24
IS  - 4
PY  - 2017
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - AIMS: Previous studies have provided inconsistent results about the cardiovascular risks for participants with metabolically healthy obesity (MHO). These uncertainties might partly reflect the lack of a uniform definition of MHO. We conducted a systematic review and meta-analysis to examine whether there is a suitable approach that identifies obese participants who are not at an increased risk of cardiovascular events compared with healthy normal-weight participants. METHODS AND RESULTS: Twenty-two prospective studies were eligible for the meta-analysis. Using random-effect models, pooled relative risks (RRs) were calculated for the combined effects of obesity with the presence or absence of metabolic syndrome, insulin resistance, hypertension, diabetes, hyperlipidaemia and any of these metabolic factors. Participants with MHO defined by the absence of metabolic syndrome were at increased risk for cardiovascular events compared with healthy normal-weight participants (pooled RR 1.45, 95% confidence interval (CI) 1.20-1.70), but had lower risks than unhealthy normal-weight (RR 2.07, 95% CI 1.62-2.65) and obese (RR 2.31, 95% CI 1.99-2.69) participants. The risk associated with participants who had MHO was particularly high over the long term. Similar risk estimates were observed when MHO was defined by other approaches. CONCLUSIONS: None of the approaches clearly identified an obese subgroup not at increased risk of cardiovascular events compared with normal-weight healthy participants. A benign obese phenotype might be defined by strict definitions, but insufficient studies exist to support this. More research is needed to better define MHO.
AU  - Eckel, N.*
AU  - Meidtner, K.*
AU  - Kalle-Uhlmann, T.*
AU  - Stefan, N.
AU  - Schulze, M.B.*
C1  - 47589
C2  - 40684
CY  - London
SP  - 956-966
TI  - Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis.
JO  - Eur. J. Prev. Cardiol.
VL  - 23
IS  - 9
PB  - Sage Publications Ltd
PY  - 2016
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - BACKGROUND: It is unknown whether the symptoms of first and recurrent acute myocardial infarction (AMI) are similar in the same person. This study examined the frequency of symptom mismatch, which factors are associated with a symptom mismatch and how symptom mismatch is related to 28-day case fatality. DESIGN: Observational study. METHODS: The sample consisted of 1282 persons with a first and recurrent AMI, recruited from a population-based AMI registry, 1985-2011. Occurrence of 11 symptoms was recorded in first and recurrent AMI using standardized patient interview. Logistic regression modelling adjusted for demographic and clinical variables was applied. RESULTS: Mismatch was highest for dyspnoea (40.6%) and lowest for chest symptoms (10.4%). Compared with women, men were less likely to have a mismatch of pain between the shoulder blades (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.43-0.79), pain in the throat/jaw (OR 0.67, 95% CI 0.50-0.91), nausea (OR 0.62, 95% CI 0.47-0.82), vomiting (OR 0.50, 95% CI 0.36-0.71), or fear of death (OR 0.71, 95% CI 0.53-0.94), or to have three or more mismatching symptoms (OR 0.60, 95% CI 0.45-0.79). Persons with diabetes were more likely to have a mismatch in chest symptoms, whereas persons with hyperlipidaemia or persons who received any revascularization therapy at first infarction were significantly less likely to have a mismatch of chest symptoms. Twenty-eight-day case fatality significantly increased with the number of mismatching symptoms (OR 1.14, 95% CI 1.02-1.28). CONCLUSIONS: Patients with AMI may benefit from information about the possibility that a recurrent infarction may be associated with different symptoms.
AU  - Kirchberger, I.
AU  - Heier, M.
AU  - Golüke, H.
AU  - Kuch, B.*
AU  - von Scheidt, W.*
AU  - Peters, A.
AU  - Meisinger, C.
C1  - 44920
C2  - 37115
CY  - London
SP  - 377-384
TI  - Mismatch of presenting symptoms at first and recurrent acute myocardial infarction. From the MONICA/KORA Myocardial Infarction Registry.
JO  - Eur. J. Prev. Cardiol.
VL  - 23
IS  - 4
PB  - Sage Publications Ltd
PY  - 2016
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - BACKGROUND: Hyponatremia is associated with an increased risk of mortality in patients with heart failure and in acute ST-segment elevation myocardial infarction (STEMI). The aim was to assess the impact of hyponatremia on admission on long-term mortality of patients with first ever STEMI or non-STEMI (NSTEMI). DESIGN: This was a longitudinal observation study METHODS: The study population consisted of 3558 patients, aged 25-74 years, with an incident acute myocardial infarction (AMI) in the years 2000-2008 who survived for at least 28 days. All consecutive patients were registered through the Cooperative Health Research in the Region of Augsburg (KORA) Myocardial Infarction Registry. Serum sodium levels were obtained on admission. The association with long-term-mortality was examined using Cox regression models. RESULTS: Hyponatraemia, defined as a sodium level less than 136 mmol/l, was present in 658 (18.5%) patients on admission. During a median follow-up period of six years (interquartile range (IQR) 4.0-8.2 years), 526 patients (14.8%) died. Hyponatraemia was significantly associated with long-term mortality by an 83% higher risk in the age- and sex-adjusted analysis. After further adjustment for reduced left ventricular ejection fraction (LVEF), glomerular filtration rate, haemoglobin, hypertension, hyperlipidaemia, any recanalization therapy, diabetes, medication with diuretics and angiotensin-converting enzyme (ACE) inhibitor/angiotensin-receptor blocker before admission and other parameters hyponatraemia remained a strong predictor for higher long-term mortality (hazard ratio 1.61; 95% confidence interval 1.32-1.97). CONCLUSIONS: Patients with incident AMI and hyponatraemia on admission showed a significantly higher risk of long-term mortality than patients without. This strong predictive value was independent of a number of prognostic factors, including diabetes, glomerular filtration rate or reduced LVEF.
AU  - Burkhardt, K.*
AU  - Kirchberger, I.
AU  - Heier, M.
AU  - Zirngibl, A.
AU  - Kling, E.*
AU  - von Scheidt, W.*
AU  - Kuch, B.*
AU  - Meisinger, C.
C1  - 42749
C2  - 35319
SP  - 1419-1426
TI  - Hyponatraemia on admission to hospital is associated with increased long-term risk of mortality in survivors of myocardial infarction.
JO  - Eur. J. Prev. Cardiol.
VL  - 22
IS  - 11
PY  - 2015
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - BACKGROUND: Older patients with acute myocardial infarction (MI) are often lacking optimal support to continue rehabilitation after discharge from hospital. The objective of the study was to examine whether a home-based case management programme led by nurses can improve atherogenic risk factors, physical functioning, and mental health in the first year following discharge. METHODS: The KORINNA study is a randomized two-armed parallel group trial including 329 patients (aged 65-92 years) from the Augsburg Hospital in southern Germany. The intervention consisted of an individualized follow-up programme with a duration of 1 year, including home visits and telephone calls. The control group received usual care. Secondary outcome measures included clinical parameters (blood pressure, lipid parameters), functional status measures, cognitive status, depressive symptoms, and nutrition risk. RESULTS: At 1-year follow up, patients in the intervention group (n = 116) had significantly better low-density lipoprotein cholesterol levels (-8.4 mg/dl, 95% CI -16.4 to -0.4), hand grip strength (+2.53 kg, 95% CI 0.56 to 4.50), and SCREEN-II nutrition risk scores (+2.03, 95% CI 0.58 to 3.48) than patients in the control group (n = 136). The intervention group also had better mean scores with regard to self-reported disability, activities in daily living, and mental health, but differences were not always significant and meaningful. CONCLUSIONS: The results of the KORINNA study indicate that nurse-based case management can improve blood lipid levels, functional status, and nutrition risk of aged patients with MI.  
AU  - Hunger, M.
AU  - Kirchberger, I.
AU  - Holle, R.
AU  - Seidl, H.
AU  - Kuch, B.*
AU  - Wende, R.*
AU  - Meisinger, C.
C1  - 30581
C2  - 33716
CY  - London
SP  - 442-450
TI  - Does nurse-based case management for aged myocardial infarction patients improve risk factors, physical functioning and mental health? The KORINNA trial.
JO  - Eur. J. Prev. Cardiol.
VL  - 22
IS  - 4
PB  - Sage Publications Ltd
PY  - 2015
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Background: The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS. Design: An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events. Methods: Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS+ABI, were fitted for the primary outcome of major coronary events.
AU  - Fowkes, F.G.R.*
AU  - Murray, G.D.*
AU  - Butcher, I.*
AU  - Folsom, A.R.*
AU  - Hirsch, A.T.*
AU  - Couper, D.J.*
AU  - Debacker, G.*
AU  - Kornitzer, M.*
AU  - Newman, A.B.*
AU  - Sutton-Tyrrell, K.C.*
AU  - Cushman, M.*
AU  - Lee, A.J.*
AU  - Price, J.F.*
AU  - D'Agostino, R.B.*
AU  - Murabito, J.M.*
AU  - Norman, P.E.*
AU  - Masaki, K.H.*
AU  - Bouter, L.M.*
AU  - Heine, R.J.*
AU  - Stehouwer, C.D.A.*
AU  - McDermott, M.M.*
AU  - Stoffers, H.E.J.H.*
AU  - Knottnerus, J.A.*
AU  - Ogren, M.*
AU  - Hedblad, B.*
AU  - Koenig, W.*
AU  - Meisinger, C.
AU  - Cauley, J.A.*
AU  - Franco, O.H.*
AU  - Hunink, M.G.M.*
AU  - Hofman, A.*
AU  - Witteman, J.C.*
AU  - Criqui, M.H.*
AU  - Langer, R.D.*
AU  - Hiatt, W.R.*
AU  - Hamman, R.F.*
C1  - 31040
C2  - 34115
SP  - 310-320
TI  - Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events.
JO  - Eur. J. Prev. Cardiol.
VL  - 21
IS  - 3
PY  - 2014
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Background: Prior studies have reported an association between traffic-related air pollution in urban areas and exacerbation of cardiovascular disease. We assess here whether time spent in different modes of transportation can trigger the onset of acute myocardial infarction (AMI).Design: We performed a case-crossover study. We interviewed consecutive cases of AMI in the KORA Myocardial Infarction Registry in Augsburg, Southern Germany between February 1999 and December 2003 eliciting data on potential triggers in the four days preceding myocardial infarction onset.Results: A total of 1459 cases with known date and time of AMI symptom onset, who had survived 24 hours after the onset, completed the registry's standard interview on potential triggers of AMI. An association between exposure to traffic and AMI onset 1 hour later was observed (odds ratio: 3.2; 95% confidence interval [CI]: 2.7-3.9, p < 0.001). Using a car was the most common source of traffic exposure; nevertheless, times spent in public transport or on a bicycle were similarly associated with AMI onset 1 hour later. While the highest risk for AMI onset was within 1 hour of exposure to traffic, the elevated risk persisted for up to 6 hours. Women, patients aged 65 years or older, patients not part of the workforce, and those with a history of angina or diabetes exhibited the largest associations between times spent in traffic and AMI onset 1 hour later.Conclusion: The data suggest that transient exposure to traffic regardless of the means of transportation may increase the risk of AMI transiently.
AU  - Peters, A.
AU  - von Klot, S.
AU  - Mittleman, M.A.*
AU  - Meisinger, C.
AU  - Hörmann, A.
AU  - Kuch, B.*
AU  - Wichmann, H.-E.
C1  - 11188
C2  - 30542
SP  - 750-758
TI  - Triggering of acute myocardial infarction by different means of transportation.
JO  - Eur. J. Prev. Cardiol.
VL  - 20
IS  - 5
PB  - SAGE Publications
PY  - 2013
SN  - 2047-4873
ER  - 

TY  - JOUR
AB  - Aims: The potential influence of lunar phases on the occurrence of myocardial infarction is still controversial. The purpose of the present study was to investigate the association of the lunar cycle on the occurrence of fatal and non-fatal myocardial infarction based on a myocardial infarction registry. Methods and results: We studied 15,985 patients consecutively hospitalised with an acute myocardial infarction (AMI) between 1 January 1985 and 31 December 2007 with a known date of symptom onset who were recruited from a population-based myocardial infarction registry. The exact hour of AMI onset was known for 9813 events. Poisson regression analysis was performed to examine the relation between the lunar cycle and the occurrence of AMI. There was no association between new moon, full moon, waning moon and waxing moon and the occurrence of AMI. However, we observed that the three days after a new moon may be significantly protective for the occurrence of AMI, rate ratio (RR) 0.94 (95% CI 0.91-0.98), and the day before a new moon had a slightly negative effect (RR 1.06, 95% CI 1.00-1.12). Stratified analysis did not reveal any susceptible subgroups. Conclusion: The moon phases did not show any apparent association with AMI occurrence. However, there might be a 'cardioprotective' time three days after a new moon.
AU  - Wende, R.*
AU  - von Klot, S.
AU  - Kirchberger, I.
AU  - Kuch, B.*
AU  - von Scheidt, W.*
AU  - Peters, A.
AU  - Meisinger, C.
C1  - 24873
C2  - 31739
SP  - 268-274
TI  - The influence of lunar phases on the occurrence of myocardial infarction: Fact or myth? The MONICA/KORA myocardial infarction registry.
JO  - Eur. J. Prev. Cardiol.
VL  - 20
IS  - 2
PB  - Sage Publications Ltd.
PY  - 2013
SN  - 2047-4873
ER  -