المؤلفون: Lutsey, Pamela L., Norby, Faye L., Gottesman, Rebecca F., Mosley, Thomas, MacLehose, Richard F., Punjabi, Naresh M., Shahar, Eyal, Jack, Clifford R., Alonso, Alvaro

مرشدي الرسالة: Univ Arizona

الوصف: Background A growing body of literature has suggested that obstructive sleep apnea (OSA) and habitual short sleep duration are linked to poor cognitive function. Neuroimaging studies may provide insight into this relation. Objective We tested the hypotheses that OSA and habitual short sleep duration, measured at ages 54-73 years, would be associated with adverse brain morphology at ages 67-89 years. Methods Included in this analysis are 312 ARIC study participants who underwent in-home overnight polysomnography in 1996-1998 and brain MRI scans about 15 years later (2012-2013). Sleep apnea was quantified by the apnea-hypopnea index and categorized as moderate/ severe (>= 15.0 events/hour), mild (5.0-14.9 events/hour), or normal (= 8. MRI outcomes included number of infarcts (total, subcortical, and cortical) and white matter hyperintensity (WMH) and Alzheimer's disease signature region volumes. Multivariable adjusted logistic and linear regression models were used. All models incorporated inverse probability weighting, to adjust for potential selection bias. Results At the time of the sleep study participants were 61.7 (SD: 5.0) years old and 54% female; 19% had moderate/severe sleep apnea. MRI imaging took place 14.8 (SD: 1.0) years later, when participants were 76.5 (SD: 5.2) years old. In multivariable models which accounted for body mass index, neither OSA nor abnormal sleep duration were statistically significantly associated with odds of cerebral infarcts, WMH brain volumes or regional brain volumes. Conclusions In this community-based sample, mid-life OSA and habitually short sleep duration were not associated with later-life cerebral markers of vascular dementia and Alzheimer's disease. However, selection bias may have influenced our results and the modest sample size led to relatively imprecise associations.

العلاقة: http://dx.plos.org/10.1371/journal.pone.0158758Test

الإتاحة: http://hdl.handle.net/10150/621324Test
http://arizona.openrepository.com/arizona/handle/10150/621324Test

المؤلفون: Wang, Wendy, Chen, Lin Yee, Walker, Rob F., Alonso, Alvaro, Norby, Faye L., Lakshminarayan, Kamakshi, Lutsey, Pamela L.

المصدر: Pharmacoepidemiology and Drug Safety ; volume 33, issue 4 ; ISSN 1053-8569 1099-1557

الوصف: Purpose Among patients with atrial fibrillation (AF), a nonpharmacologic option (e.g., percutaneous left atrial appendage occlusion [LAAO]) is needed for patients with oral anticoagulant (OAC) contraindications. Among beneficiaries in the Medicare fee‐for‐service coverage 20% sample databases (2015–18) who had AF and an elevated CHA 2 DS 2 ‐VASc score, we assessed the association between percutaneous LAAO versus OAC use and risk of stroke, hospitalized bleeding, and death. Methods Patients undergoing percutaneous LAAO were matched to up to five OAC users by sex, age, date of enrollment, index date, CHA 2 DS 2 ‐VASc score, and HAS‐BLED score. Overall, 17 156 patients with AF (2905 with percutaneous LAAO) were matched (average ± SD 78 ± 6 years, 44% female). Cox proportional hazards model were used. Results Median follow‐up was 10.3 months. After multivariable adjustments, no significant difference for risk of stroke or death was noted when patients with percutaneous LAAO were compared with OAC users (HRs [95% CIs]: 1.14 [0.86–1.52], 0.98 [0.86–1.10]). There was a 2.94‐fold (95% CI: 2.50–3.45) increased risk for hospitalized bleeding for percutaneous LAAO compared with OAC use. Among patients 65 to <78 years old, those undergoing percutaneous LAAO had higher risk of stroke compared with OAC users. No association was present in those ≥78 years. Conclusion In this analysis of real‐world AF patients, percutaneous LAAO versus OAC use was associated with similar risk of death, nonsignificantly elevated risk of stroke, and an elevated risk of bleeding in the post‐procedural period. Overall, these results support results of randomized trials that percutaneous LAAO may be an alternative to OAC use for patients with contraindications.

الإتاحة: https://doi.org/10.1002/pds.5786Test

المؤلفون: Alkis, Taryn, Luo, Xi, Wall, Katherine, Brody, Jennifer, Bartz, Traci, Chang, Patricia P., Norby, Faye L., Hoogeveen, Ron C., Morrison, Alanna C., Ballantyne, Christie M., Coresh, Josef, Boerwinkle, Eric, Psaty, Bruce M., Shah, Amil M., Yu, Bing

المساهمون: National Heart, Lung, and Blood Institute, National Institutes of Health, National Human Genome Research Institute, National Institute on Aging

المصدر: ESC Heart Failure ; volume 11, issue 2, page 1086-1096 ; ISSN 2055-5822 2055-5822

الوصف: Aims Heart failure (HF) has shared genetic architecture with its risk factors: atrial fibrillation (AF), body mass index (BMI), coronary heart disease (CHD), systolic blood pressure (SBP), and type 2 diabetes (T2D). We aim to assess the association and risk prediction performance of risk‐factor polygenic risk scores (PRSs) for incident HF and its subtypes in bi‐racial populations. Methods and results Five PRSs were constructed for AF, BMI, CHD, SBP, and T2D in White participants of the Atherosclerosis Risk in Communities (ARIC) study. The associations between PRSs and incident HF and its subtypes were assessed using Cox models, and the risk prediction performance of PRSs was assessed using C statistics. Replication was performed in the ARIC study Black and Cardiovascular Health Study (CHS) White participants. In 8624 ARIC study Whites, 1922 (31% cumulative incidence) HF cases developed over 30 years of follow‐up. PRSs of AF, BMI, and CHD were associated with incident HF ( P < 0.001), where PRS AF showed the strongest association [hazard ratio (HR): 1.47, 95% confidence interval (CI): 1.41–1.53]. Only the addition of PRS AF to the ARIC study HF risk equation improved C statistics for 10 year risk prediction from 0.812 to 0.829 (∆ C : 0.017, 95% CI: 0.009–0.026). The PRS AF was associated with both incident HF with reduced ejection fraction (HR: 1.43, 95% CI: 1.27–1.60) and incident HF with preserved ejection fraction (HR: 1.46, 95% CI: 1.33–1.62). The associations between PRS AF and incident HF and its subtypes, as well as the improved risk prediction, were replicated in the ARIC study Blacks and the CHS Whites ( P < 0.050). Protein analyses revealed that N‐terminal pro‐brain natriuretic peptide and other 98 proteins were associated with PRS AF . Conclusions The PRS AF was associated with incident HF and its subtypes and had significant incremental value over an established HF risk prediction equation.

الإتاحة: https://doi.org/10.1002/ehf2.14665Test

المؤلفون: Wang, Wendy, Norby, Faye L, George, Kristen M, Alonso, Alvaro, Mosley, Thomas H, Gottesman, Rebecca F, Meyer, Michelle L, Lutsey, Pamela L

المصدر: Journal of the American Heart Association. 10(9)

مصطلحات موضوعية: Cardiovascular, Brain Disorders, Dementia, Acquired Cognitive Impairment, Atherosclerosis, Aging, Prevention, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Clinical Research, Alzheimer's Disease, Neurodegenerative, Neurosciences, Neurological, Carotid Arteries, Carotid Artery Diseases, Carotid Intima-Media Thickness, Female, Follow-Up Studies, Forecasting, Humans, Incidence, Male, Middle Aged, Plaque, Atherosclerotic, Population Surveillance, Retrospective Studies, United States, Vascular Stiffness, carotid intima‐, media thickness, dementia, epidemiology, risk factors, carotid intima‐media thickness, Cardiorespiratory Medicine and Haematology

الوصف: Background Increased carotid intima-media thickness, interadventitial diameter, presence of carotid plaque, and lower distensibility are predictors for cardiovascular disease. These indices likely relate to cerebrovascular disease, and thus may constitute a form of vascular contributions to dementia and Alzheimer disease-related dementia. Therefore, we assessed the relationship of carotid measurements and arterial stiffness with incident dementia in the ARIC (Atherosclerosis Risk in Communities) study. Methods and Results A total of 12 459 ARIC participants with carotid arterial ultrasounds in 1990 to 1992 were followed through 2017 for dementia. Dementia cases were identified using in-person and phone cognitive status assessments, hospitalization discharge codes, and death certificate codes. Cox proportional hazards models were used to estimate the hazard ratios (HRs) for incident dementia. Participants were aged 57±6 at baseline, 57% were women, and 23% were Black individuals. Over a median follow-up time of 24 years, 2224 dementia events were ascertained. After multivariable adjustments, the highest quintile of carotid intima-media thickness and interadventitial diameter in midlife was associated with increased risk of dementia (HR [95% CIs], 1.25 [1.08-1.45]; and 1.22 [1.04-1.43], respectively) compared with its respective lowest quintile. Presence of carotid plaque did not have a significant association with dementia (HR [95% CI], 1.06 [0.97-1.15]). Higher distensibility was associated with lower risk of dementia (HR [95% CI] highest versus lowest quintile, 0.76 [0.63-0.91]). Conclusions Greater carotid intima-media thickness, interadventitial diameter, and lower carotid distensibility are associated with an increased risk of incident dementia. These findings suggest that both atherosclerosis and carotid stiffness may be implicated in dementia risk.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/83m0w2hfTest

المؤلفون: George, Kristen M, Folsom, Aaron R, Norby, Faye L, Lutsey, Pamela L

المصدر: Journal of Geriatric Psychiatry and Neurology. 33(1)

مصطلحات موضوعية: Medical Microbiology, Biomedical and Clinical Sciences, Aging, Infectious Diseases, Sexually Transmitted Infections, Prevention, Cardiovascular, Atherosclerosis, Mind and Body, Infection, Cognitive Dysfunction, Cohort Studies, Female, Humans, Infections, Longitudinal Studies, Male, Middle Aged, Risk Factors, cognitive decline, cohort study, infection, Clinical Sciences, Neurosciences, Geriatrics, Clinical sciences, Biological psychology

الوصف: Infections of herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), Helicobacter pylori, and Chlamydia pneumoniae may play a role in cognitive decline via systemic inflammation. We hypothesized that Atherosclerosis Risk in Communities study participants who were seropositive in midlife for antibodies to HSV-1, CMV, H pylori, or C pneumoniae would have an accelerated rate of cognitive decline over 20 years. Atherosclerosis Risk in Communities performed a case-cohort study involving a stratified random sample of participants tested for serum immunoglobulin G antibodies to the pathogens of interest. We conducted a longitudinal study using this cohort. Cognitive change was measured using Z scores from the Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF) Tests administered at visits 2 (1990-1992), 4 (1996-1998), and 5 (2011-2013). Linear regression models with generalized estimating equations and inverse probability of attrition weights were used to evaluate associations between infection and cognitive performance. Four hundred twenty-six participants were analyzed, of which 3% were seronegative for all 4 infections, 14% seropositive for one, 33% and 34% seropositive for 2 and 3, respectively, and 16% seropositive for all infections. At baseline, test scores were significantly lower for participants seropositive for H pylori and C pneumoniae. After baseline covariate adjustment, the rate of decline in DWR, DSS, WF, and global Z scores did not differ significantly by infection status for any of the 4 infections. There was also no significant association between the number of infections for which participants were seropositive and cognitive decline. Our study provides no evidence supporting a longitudinal relationship between seropositivity and cognitive decline.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/28f697fqTest

المؤلفون: Walker, Rob F., Zakai, Neil A., Mason, Susan M., MacLehose, Richard F., Norby, Faye L., Evensen, Line Holtet, Alonso, Alvaro, Lutsey, Pamela L.

الوصف: Background - The risk of pregnancy-related mortality in the United States has nearly doubled since 1990, with venous thromboembolism (VTE) accounting for approximately 10% of these deaths. Objectives - The objective of this study was to assess whether preexisting autoimmune disease is a risk factor for postpartum VTE. Methods - Using the MarketScan Commercial and Medicare Supplemental administrative databases, a retrospective cohort study analyzed whether postpartum persons with autoimmune disease had a higher risk of postpartum VTE incidence than postpartum persons without autoimmune disease. Using International Classification of Diseases codes, we identified 757,303 individuals of childbearing age who had a valid delivery date with at least 12 weeks of follow-up. Results - Individuals were, on average, 30.7 years old (SD, 5.4), and 3.7% (N = 27,997 of 757,303) of them had evidence of preexisting autoimmune disease. In covariate-adjusted models, postpartum persons with preexisting autoimmune disease had higher rates of postpartum VTE than postpartum persons without autoimmune disease (hazard ratio [HR], 1.33; 95% CI, 1.07-1.64). When analyzed by individual autoimmune disease, those with systemic lupus erythematosus (HR, 2.49; 95% CI, 1.47-4.21) and Crohn’s disease (HR, 2.49; 95% CI, 1.34-4.64) were at an elevated risk of postpartum VTE compared with those without autoimmune disease. Conclusion - Autoimmune disease was associated with a higher rate of postpartum VTE, with evidence that the association was most pronounced among individuals with systemic lupus erythematosus and Crohn’s disease. These findings suggest that postpartum persons of childbearing age with autoimmune disease may require more monitoring and prophylactic care after delivery to prevent potentially fatal VTE events.

العلاقة: Research and Practice in Thrombosis and Haemostasis (RPTH); Walker, Zakai, Mason, MacLehose, Norby, Evensen, Alonso, Lutsey. Autoimmune disease and risk of postpartum venous thromboembolism. Research and Practice in Thrombosis and Haemostasis (RPTH). 2023;7(2); FRIDAID 2159377; https://hdl.handle.net/10037/29942Test

الإتاحة: https://doi.org/10.1016/j.rpth.2023.100091Test
https://hdl.handle.net/10037/29942Test

المؤلفون: Reyes, Jorge L., Norby, Faye L., Ji, Yuekai, Wang, Wendy, Parikh, Romil, Zhang, Michael J., Oldenburg, Niki C., Lutsey, Pamela L., Jack, Clifford R., Johansen, Michelle, Gottesman, Rebecca F., Coresh, Josef, Mosley, Thomas, Soliman, Elsayed Z., Alonso, Alvaro, Chen, Lin Yee

المساهمون: National Heart, Lung, and Blood Institute

المصدر: Pacing and Clinical Electrophysiology ; volume 46, issue 8, page 951-959 ; ISSN 0147-8389 1540-8159

الوصف: Background Recent evidence indicates that abnormal P‐wave parameters (PWPs)—ECG markers of atrial myopathy—are associated with incident dementia, independent of atrial fibrillation (AF) and clinical ischemic stroke. However, the mechanisms remain unclear and may include subclinical vascular brain injury. Hence, we evaluated the association of abnormal PWPs with brain MRI correlates of vascular brain injury in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC‐NCS). Methods ARIC‐NCS participants who underwent 3T brain MRI scans in 2011–2013 were included. PWPs were measured from standard 12‐lead ECGs. Brain MRI outcomes included cortical infarcts, lacunar infarcts, cerebral microhemorrhages, brain volumes, and white matter disease (WMD) volume. We used weighted multivariable logistic and linear regression to evaluate the associations of abnormal PWPs with brain MRI outcomes. Results Among 1715 participants (mean age, 76.1 years; 61% women; 29% Black), 797 (46%) had ≥1 abnormal PWP. After multivariable adjustment, including adjusting for prevalent AF, abnormal P‐wave terminal force in lead V1 (aPTFV1) and prolonged P‐wave duration (PPWD) were associated with increased odds of both cortical (OR 1.41; 95% CI, 1.14 to 1.74 and OR 1.30; 95% CI, 1.04 to 1.63, respectively) and lacunar infarcts (OR 1.36; 95% CI, 1.15 to 1.63 and OR 1.37; 95% CI, 1.15 to 1.65, respectively). Advanced interatrial block (aIAB) was associated with higher odds of subcortical microhemorrhage (OR 2.04; 95% CI, 1.36 to 3.06). Other than a significant association between aPTFV1 with lower parietal lobe volume, there were no other significant associations with brain or WMD volume. Conclusion In this exploratory analysis of a US community‐based cohort, ECG surrogates of atrial myopathy are associated with a higher prevalence of brain infarcts and microhemorrhage, suggesting subclinical vascular brain injury as a possible mechanism underlying the association of atrial myopathy with dementia.

الإتاحة: https://doi.org/10.1111/pace.14687Test

المؤلفون: Zhang, Michael J., Ji, Yuekai, Wang, Wendy, Norby, Faye L., Parikh, Romil, Eaton, Anne A., Inciardi, Riccardo M., Alonso, Alvaro, Soliman, Elsayed Z., Mosley, Thomas H., Johansen, Michelle C., Gottesman, Rebecca F., Shah, Amil M., Solomon, Scott D., Chen, Lin Yee

المصدر: JACC: Advances ; volume 2, issue 5, page 100408 ; ISSN 2772-963X

الإتاحة: https://doi.org/10.1016/j.jacadv.2023.100408Test
https://api.elsevier.com/content/article/PII:S2772963X23002508?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772963X23002508?httpAccept=text/plainTest

المؤلفون: Reinier, Kyndaron, Dizon, Bernadine, Chugh, Harpriya, Bhanji, Ziana, Seifer, Madison, Sargsyan, Arayik, Uy-Evanado, Audrey, Norby, Faye L, Nakamura, Kotoka, Hadduck, Katy, Shepherd, Daniel, Grogan, Tristan, Elashoff, David, Jui, Jonathan, Salvucci, Angelo, Chugh, Sumeet S

المساهمون: National Institutes of Health, National Heart, Lung, and Blood Institute

المصدر: The Lancet Digital Health ; volume 5, issue 11, page e763-e773 ; ISSN 2589-7500

مصطلحات موضوعية: Health Information Management, Decision Sciences (miscellaneous), Health Informatics, Medicine (miscellaneous)

الإتاحة: https://doi.org/10.1016/s2589-7500Test(23)00147-4
https://api.elsevier.com/content/article/PII:S2589750023001474?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2589750023001474?httpAccept=text/plainTest

المؤلفون: Chugh, Harpriya S., Sargsyan, Arayik, Nakamura, Kotoka, Uy-Evanado, Audrey, Dizon, Bernadine, Norby, Faye L., Young, Christopher, Hadduck, Katy, Jui, Jonathan, Shepherd, Daniel, Salvucci, Angelo, Chugh, Sumeet S., Reinier, Kyndaron

المساهمون: National Institutes of Health, National Heart, Lung, and Blood Institute

المصدر: Heart Rhythm ; volume 20, issue 7, page 947-955 ; ISSN 1547-5271

الإتاحة: https://doi.org/10.1016/j.hrthm.2023.03.025Test
https://api.elsevier.com/content/article/PII:S1547527123003272?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1547527123003272?httpAccept=text/plainTest