Sharon Stein Merkin1, Arun Karlamangla2, David Elashoff3, Tristan Grogan3, Teresa Seeman2. 1. Division of Geriatrics, Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address: smerkin@mednet.ucla.edu. 2. Division of Geriatrics, Geffen School of Medicine at UCLA, Los Angeles, CA. 3. Department of Medicine Statistics Core, Geffen School of Medicine at UCLA, Los Angeles, CA.
Abstract
PURPOSE: Examine the relationship between changes in cardiometabolic risk profiles and subsequent cardiovascular disease (CVD). METHODS: The study sample included 5557 Multi-Ethnic Study of Atherosclerosis participants, recruited in 2000 from six U.S. counties. Standardized scores were calculated for metabolic and cardiovascular components relative to accepted clinical cut points and summed to create an index of cardiometabolic risk. CVD events and/or deaths were assessed after examination 3 (years, 2004-2005) through December 2011. Cox proportional hazards models were used to examine the association between change in the cardiometabolic index (examination 3 minus examination 1) and subsequent cardiovascular outcomes adjusted for demographics, socioeconomic status, medication, and stratified by tertiles of baseline cardiometabolic risk. RESULTS: We found a 31% relative increase in the CVD event rate per SD change in the cardiometabolic index among those in the highest tertile of baseline cardiometabolic risk (Hazard ratio = 1.31, 95% CI = 1.14-1.50); associations were not statistically significant in the lower tertiles of baseline risk. CONCLUSIONS: We found that larger increases in the cardiometabolic index over time were significantly associated with higher risk for subsequent CVD events among those with elevated cardiometabolic risk at baseline. These findings highlight the importance of monitoring temporal changes in risk factor profiles for predicting cardiovascular outcomes.
PURPOSE: Examine the relationship between changes in cardiometabolic risk profiles and subsequent cardiovascular disease (CVD). METHODS: The study sample included 5557 Multi-Ethnic Study of Atherosclerosisparticipants, recruited in 2000 from six U.S. counties. Standardized scores were calculated for metabolic and cardiovascular components relative to accepted clinical cut points and summed to create an index of cardiometabolic risk. CVD events and/or deaths were assessed after examination 3 (years, 2004-2005) through December 2011. Cox proportional hazards models were used to examine the association between change in the cardiometabolic index (examination 3 minus examination 1) and subsequent cardiovascular outcomes adjusted for demographics, socioeconomic status, medication, and stratified by tertiles of baseline cardiometabolic risk. RESULTS: We found a 31% relative increase in the CVD event rate per SD change in the cardiometabolic index among those in the highest tertile of baseline cardiometabolic risk (Hazard ratio = 1.31, 95% CI = 1.14-1.50); associations were not statistically significant in the lower tertiles of baseline risk. CONCLUSIONS: We found that larger increases in the cardiometabolic index over time were significantly associated with higher risk for subsequent CVD events among those with elevated cardiometabolic risk at baseline. These findings highlight the importance of monitoring temporal changes in risk factor profiles for predicting cardiovascular outcomes.
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