Risultati per: Caratterizzazione dell'asma in base all'età di insorgenza: uno studio di coorte multi-database

Circulation, Volume 150, Issue Suppl_1, Page A4146424-A4146424, November 12, 2024. The role of genetic ancestry (GA) in hypertensive pregnancy disorders in Latin-American women is poorly understood.Using data from amulti-center case-control study (GenPE) of preeclampsia (PE) in young Colombian women(median age = 19) of predominantly low socioeconomic status (2364 controls and 1811 cases), who identify as Afro-Caribbean (AFR-C), White Hispanic (HISP), Amerindian, and Mixed ethnicity,we evaluated associations between 1) reported ethnicity, and 2) empirically estimated GA, with PE. We performed 3-way admixture mapping using European (EUR), African (AFR) and Amerindian (AMR) ancestry references from the Human Genome Diversity Project using the FLARE software to estimate local and global ancestry in GenPE samples. Statistical significance threshold, for three-way local ancestry analyses, was empirically estimated using STEAM (P = 3.45×10-6).In multivariable logistic regression modelsfor reported ethnicity,AFR-C were 33% more likely to have PE (OR = 1.33; P = 0.02) than HISP women.In models evaluating empirically estimated global GA,AFR was positively associated (OR per 10% increase in ancestry = 1.05; P = 0.002), while AMR (OR = 0.91; P = 0.035) and EUR (OR = 0.95; P = 0.009) were inversely associated with PE. Additionally,adjusting for reported ethnicity in models evaluating global GA and PEchanged estimates only marginally for AFR (OR = 1.04; P = 0.025) and EUR (OR = 0.92; P = 0.009).Evaluation of GA and PE in a subset of women who reported AFR-C ethnicity, showed stronger estimates for all global ancestries: AFR (OR = 1.11; P = 0.013, EUR (OR = 0.82; P = 0.026), and AMR (OR = 0.83; P = 0.01).Association analyses with AFR local GA identified three loci associated with PE.The top locusat chromosome 11, rs2021740 (a smooth muscle enhancer inOTOG1and nearMYOD1), each additional allele of AFR origin associated with 27% increased odds of PE (OR = 1.27; P = 1.13×10-7).The A-allele for this variantis found in greater frequency in AFR reference populations (22%) than in EUR (5%).Subgroup analyses with HELLP syndrome(279 cases and 2364 controls) shows intriguingly opposite findings with increased risk for global AMR and EUR ancestry and decreased risk for AFR ancestry.Using a genetically diverse hispanic population, we showgenetic ancestry is associated with PE independent of reported ethnicityand further demonstrate thepower of admixture mapping to identify a candidate locus for PE.

Circulation, Volume 150, Issue Suppl_1, Page ASu904-ASu904, November 12, 2024. Background:The relationship between base-excess (BE) values, which take into account the time interval from cardiac arrest to blood test, and neurological outcome after out-of-hospital cardiac arrest (OHCA) is not well understood. The purpose of this study was to evaluate the association between BE on arrival at the hospital and neurological outcomes in OHCA patients.Methods:The CRITICAL study, a prospective, multicenter observational study in Osaka, Japan, registered consecutive OHCA patients who were transported to 16 participating critical care centers from 2012 to 2021. We included adult patients aged 18 years with witnessed OHCA whose BE values on hospital arrival was available, and divided patients into quartiles based on BE values of initial blood test on arrival at the hospital: Q1 (BE ≤ −21.1 mmol/L), Q2 (−21.1 < BE ≤ −15.7 mmol/L), Q3 (−15.7 < BE ≤ −10.4 mmol/L), and Q4 (BE > −10.4 mmol/L). The primary outcome was one-month survival with favorable neurological outcome, defined as cerebral performance category scale 1 or 2.Results:A total of 23,854 patients were registered, and 6,066 of them were eligible for analyses. Neurologically favorable outcome was the lowest in the Q1 group (3.2% [49/1,528]), followed by the Q2 (4.7% [70/1,493]), Q3 (9.8% [148/1,515]), and Q4 (23.5% [359/1,530]) group. In the multivariable logistic regression analysis, the adjusted odds ratio of Q1 compared with Q4 for one-month favorable neurological outcome was 0.13 (95% CI 0.090–0.18). The proportion of one-month favorable neurological outcome decreased progressively across decreasing quartiles (p for trend < 0.001). In subgroup analysis, there was an interaction between presence of return of spontaneous circulation (ROSC) before blood test and neurological outcome (p for interaction < 0.001). The neurological outcome worsened as the BE values decreased among those who achieved ROSC before the blood test (p for trend < 0.001), but not in those without ROSC (p for trend = 0.078). There was not a significant interaction between BE values without ROSC before blood test and time from witness to blood test (p for interaction = 0.501).Conclusions:We demonstrated that lower BE values at hospital arrival were associated with worse neurological outcome. The BE values may be one of the effective prognostic indications for neurological outcome, especially in OHCA patients with ROSC before hospital arrival.

Circulation, Volume 150, Issue Suppl_1, Page A4134396-A4134396, November 12, 2024. Backgrounds:Ischemic heart disease (IHD) remains a leading cause of mortality globally and has a high prevalence in the United States, necessitating an understanding of long-term trends to inform interventions. This study examines IHD-related mortality trends among US adults from 1999 to 2020, considering demographic and geographic disparities.Aim:This study aimed to evaluate patterns and geographical variations in mortality associated with IHD among adults in the United States.Methods:Death certificates from the CDC WONDER database spanning from 1999 to 2020 were analyzed to investigate mortality related to IHD among adults aged 35 years and above. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated, stratified by year, sex, race/ethnicity, and geographic region.Results:Ischemic Heart Disease (IHD) caused 12,756,359 deaths among U.S. adults aged 35 and above from 1999 to 2020. Annual trends in age-adjusted mortality rates (AAMRs) showed a decline from 48.7 in 1999 to 28.9 in 2020, with notable fluctuations. Men consistently had higher AAMRs than women. NH Black or African American individuals exhibited the highest AAMRs. Geographically, significant disparities existed among states and regions, with the Northeast having the highest mortality. Nonmetropolitan areas consistently had higher AAMRs compared to metropolitan areas, showing varying trends over the study period.Conclusion:Fluctuations in mortality trends among IHD patients were observed over the study duration, revealing significant disparities across demographic and geographic parameters. Targeted interventions are imperative to alleviate the burden of IHD and mitigate mortality rates in the United States.

Circulation, Volume 150, Issue Suppl_1, Page A4139942-A4139942, November 12, 2024. Background:Thromboembolic events in atrial fibrillation (AF) patients represent a significant health concern among older adults in the United States. This study investigates trends and demographic disparities in mortality rates due to thromboembolic events in AF patients aged 65 and older from 1999 to 2020.Methods:Utilizing the CDC WONDER database from 1999-2020, this retrospective analysis focused on ICD code I48 for AF and related stroke codes (I26, I63, I74, and I82). Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions.Results:Between 1999 and 2020, thromboembolic events in AF accounted for 422,525 deaths among adults aged 65+ in the U.S., primarily occurring in medical facilities (45.0%). The overall AAMR for thromboembolic events in AF-related deaths increased from 47.3 in 1999 to 49.1 in 2020, with an AAPC of -0.15 (95% CI: -0.37 to 0.07, p = 0.169). A significant decline occurred from 1999 to 2006 (APC: -1.45; 95% CI: -3.22 to -0.63, p < 0.000001), followed by a mild rise from 2006 to 2020 (APC: 0.50; 95% CI: 0.25 to 0.88, p = 0.013). Older women exhibited higher AAMRs compared to older men (women: 46.4; men: 43.5). Among racial/ethnic groups, White patients had the highest AAMRs (48.7), followed by Black population (33.5), American Indians (30.1), Asians (28.8), and Hispanics (27.3). All racial groups saw significant increases in AAMRs except Asian population, who experienced a slight decrease. The highest AAPC was observed in Blacks (1.46; 95% CI: 0.94 to 1.84, p < 0.000001). AAMRs varied by state, ranging from 29.2 in Nevada to 83.9 in Vermont. The Western region had the highest average AAMR (52.0). Nonmetropolitan areas had higher AAMRs than metropolitan areas (51.6 vs. 44.4).Conclusion:This analysis reveals stable yet slightly increasing mortality rates for thromboembolic events in AF among older adults in the U.S. over the past two decades, highlighting ongoing public health concerns. Addressing disparities and improving healthcare access for vulnerable populations are crucial to reducing these mortality rates and improving health outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4146295-A4146295, November 12, 2024. Background:Previous studies have highlighted the impact of sex differences on the outcomes of patients admitted for ST-elevation myocardial infarction (STEMI). However, there is limited evidence as to whether there is a difference in the outcomes between females and male STEMI patients who have a concomitant diagnosis of chronic kidney disease (CKD) and end-stage renal disease (ESRD).Research Question:Does sex affect the outcomes for STEMI patients with concomitant CKD and ESRD?Methods:This is a retrospective population-based cohort study that uses the National Inpatient Sample database. CKD patients in the United States hospitalized for STEMI were identified using the International Classification of Diseases, Ninth and Tenth Revision (ICD-9 and 10) codes. Inclusion criteria were adult patients who were hospitalized from 2012 to 2020. A subset of patients with ESRD were also identified. Multivariate regression analysis was performed, with the model adjusted for age and comorbidities. The primary outcome of interest was in-hospital mortality. Secondary outcomes evaluated included ischemic stroke, major bleeding complications, pressor requirement, permanent pacemaker implantation, percutaneous coronary intervention, coronary artery bypass grafting, surgery, pericardiocentesis, mechanical circulatory support, and mechanical ventilation.Results:A total of 1,283,255 STEMI patients without CKD, 158,715 STEMI patients with CKD, and 22,690 STEMI patients with ESRD were identified and analyzed. Among patients with STEMI and CKD, females demonstrated higher in-hospital mortality compared to male counterparts (16.7% vs 12.7%, aOR=1.13, 95% CI: 1.05-1.21, p

Circulation, Volume 150, Issue Suppl_1, Page A4142110-A4142110, November 12, 2024. Background:Coronary artery calcium (CAC) scans contain more actionable information than the Agatston CAC score. We have previously shown in the Multi-Ethnic Study of Atherosclerosis (MESA) that AI-enabled left atrial (LA) volumetry in CAC scans (AI-CAC) enabled prediction of atrial fibrillation (AF) as early as one year. Furthermore, we have recently shown adding AI-CAC LA volumetry to CHA2DS2-VASc risk score improved stroke prediction in MESA. In this study we evaluated the performance of AI-CAC LA volumetry versus LA measured by human experts using cardiac magnetic resonance imaging (CMRI) for predicting AF and stroke, and compared them with CHARGE-AF risk score, Agatston score, and NT-proBNP.Methods:We used 15-year outcomes data from 3552 asymptomatic individuals (52.2% women, age 61.7±10.2 years) who underwent both CAC scans and CMRI in the MESA baseline examination. We have applied the AutoChamberTM(HeartLung.AI, Houston, TX) component of AI-CAC to 3552 CAC scans. CMRI LA volume was previously measured by human experts. Data on NT-proBNP, CHARGE-AF risk score and the Agatston score were obtained from MESA. Discrimination was assessed using the time-dependent area under the curve (AUC).Results:Over 15 years follow-up, 562 cases of AF and 140 cases of stroke accrued. The AUC for 15-yearAF predictionby AI-CAC LA volume (0.801) was comparable to CMRI LA volume (0.797) and significantly higher than Agatston CAC Score (0.687) and NT-proBNP (0.704). Similarly, the AUC for 15-yearstrokepredictionfor AI-CAC volumetry (0.761) was comparable to CMRI volumetry (0.751) and significantly higher than NT-proBNP (0.631) and Agatston CAC Score (0.646). AI-CAC LA volume outperformed CHARGE AF over 1-3 years for incident AF (p

Circulation, Volume 150, Issue Suppl_1, Page A4147077-A4147077, November 12, 2024. Background:Tricuspid regurgitation (TR) worsens heart failure symptoms and perpetuates right ventricular failure (RVF). Given the limited efficacy of medicines and high risk of surgical mortality, percutaneous therapeutic options are gaining importance. The TRILUMINATE study reported an 86% reduction in TR severity and 4% mortality rate using Triclip G4 tricuspid transcatheter edge-to-edge repair (T-TEER) system with improvement in health status. Triclip subsequently gained FDA approval for TR on April 2, 2024.Objective:To evaluate reported device and patient related adverse events during early experience with Triclip system for T-TEER.Methods:The events reported for Triclip since it gained FDA approval were extracted from the FDA MAUDE database. Previously published reports, duplicates and events before FDA approval were excluded. Grades of TR at baseline and after T-TEER associated with single leaflet device attachment (SLDA) were compared using Wilcoxon rank sum test.Results:After excluding 14 reports, 45 were included, dating from 04/02/24 to 05/31/24. Of these, 31 (67.4%) featured patient complications, with SLDA being the most frequent (n=24, 53%).(Figure-1) Cause of SLDA was reported in 8 reports.(Figure-2) SLDA led to regression of TR to pre-procedure levels in 10 patients and Polymorphic VT in one patient. Other patient issues included damage to leaflets (n=7, 15.6%) which necessitated surgery in one case and prompted consideration of the same in another. There were 4 reports of clip entrapment in the chordae. Device-related issues included 3 cases of leaks in the steerable guide catheter affecting its ability to hold the column, knotting on the lock line, difficulties with positioning the second clip above the valve, clip reopening beyond the expected 5°, clip opening while locked but staying closed post-deployment, delays in clip delivery, and challengers in guiding catheter positioning. No acute deaths were reported in the MAUDE database within 2 months of device approval.Conclusion:Our research findings summarize the reported adverse events during the early period following FDA approval of Triclip G4 T-TEER system. This provides valuable insights into common failure modes and complications, offering guidance on their optimal utilization. Multiple adverse events can be noted soon after approval of the Triclip, underscoring the importance of good initial training and proctoring.

Circulation, Volume 150, Issue Suppl_1, Page A4148026-A4148026, November 12, 2024. Introduction:Multi-venous compression syndromes pose diagnostic and management dilemmas due to uncertainties in both etiology and clinical course. Clinical thresholds for surgical intervention are unclear, and systemic symptoms beyond the anatomic sites of compression are common, including exertional dyspnea, intermittent tachycardia, and fatigue. We hypothesize that multi-venous compression syndromes may represent a manifestation of autonomic dysfunction with impaired venous return to the right heart (preload failure physiology).Methods:Consecutive patients presenting to the Vascular Medicine clinic, Vascular Surgery clinic, or the vascular ultrasound laboratory at Brigham and Women’s Hospital from November 1, 2021 to May 1, 2024 with evidence of multi-vein compressions were retrospectively included in this cohort. Venous compressions evaluated were thoracic outlet syndrome, popliteal entrapment, left common iliac vein compression, and left renal vein compression. Data were analyzed from autonomic function testing and invasive cardiopulmonary exercise testing (iCPET) performed for clinical indications.Results:A total of 16 patients presented with imaging-confirmed multi-vein compressions. The average (standard deviation) number of compressed sites were 4 (2). Eleven patients (69%) had clinical symptoms of dysautonomia. Five patients (31%) underwent autonomic function testing; all had an abnormal result, most commonly manifesting as reduced orthostatic cerebral blood flow velocity. Seven patients (44%) underwent iCPET; the average right atrial pressure at peak upright exercise was abnormally low at 1 mmHg (1.5 mmHg) with a range of 0-4 mmHg. Four out of 7 patients had accompanying peak oxygen consumption less than 80% of predicted. Seven patients (44%) underwent surgery for at least one compression; the most common procedure was left common iliac vein stenting. Two patients with dysautonomia underwent venous decompression and reported no significant change in overall symptoms. Nine patients with dysautonomia were managed conservatively with medical therapy (salt/water repletion, oral pyridostigmine, beta blocker, midodrine, and/or compression garments). Eight of these patients reported improved functional status after at least 6 months.Conclusions:Patients with multi-vein compressions are enriched for autonomic dysfunction and preload failure. Medical therapy can improve overall functional status without requiring surgical intervention.

Circulation, Volume 150, Issue Suppl_1, Page A4140940-A4140940, November 12, 2024. Background:The 4th Universal Definition of Myocardial Injury (UDMI) recognizes several categories of myocardial injury, including acute myocardial infarction (MI) which is further sub-classified into five types. However, data on these different types of myocardial injury and their risk factors is limited.Methods:In the MESA study of 6814 participants, 15905 clinical events were identified over the first 14 years, 4079 of which meet MESA criteria for physician adjudication for a possible cardiovascular event. Herein, we developed a standardized data format and a REDCap tool with an interactive robust logic algorithm to re-adjudicate all 4079 cases for the presence and classification of all 9 types of myocardial injury as defined by the 4thUDMI. Adjudication process as shown inFigure 1. The prevalence of myocardial injury types was evaluated using descriptive statistics, and adjudicator agreement was assessed using Cohen’s kappa (κ) statistics and percent agreement.Results:Out of 4079 events, adjudication is completed on 2282, of which 15% classified into subtypes of myocardial injury. Adjudication was achieved for 91% of the events in phase 1, 7% in phase 2, 2% in phase 3. The overall agreement between two adjudicators for the presence of myocardial injury was 91% (κ: 0.67), but the agreement for the specific subtype was 53% (κ: 0.38). The most common events were Type 1 MI (N= 114), followed by Type 2 MI (N= 95), and Acute non-ischemic myocardial injury (N= 85) (Figure 2). Compared to the original MESA adjudication for the presence of MI, 97% (N= 72) of probable MI and 8% (N= 174) of no MI were reclassified into five and six types of myocardial injury events respectively.Conclusion:This study highlights the complexities in identifying subtypes of myocardial injury based on current definition. This study provides a novel dataset to explore diverse correlations with these myocardial injury subtypes.

Circulation, Volume 150, Issue Suppl_1, Page A4141585-A4141585, November 12, 2024. Introduction/Background:Despite increasing awareness of lipoprotein(a) [Lp(a)] as an independent, genetically determined, causal risk driver of atherosclerotic cardiovascular disease (ASCVD), Lp(a) screening occurs infrequently, and nationwide, comprehensive data characterizing the risk of elevated Lp(a) are lacking.Aims:To evaluate the association of Lp(a) level with cardiovascular disease (CVD) events in individuals with and without pre-existing ASCVD using real-world data from the Family Heart DatabaseTM.Methods:Observational, retrospective cohort study using longitudinal data in over 324 million individuals from 2012-2021. Selection criteria included individuals ≥18 years with ≥1 Lp(a) test measured in nmol/L during May 1, 2013 to December 31, 2020, and ≥1 medical claim pre- and post-index date (date of earliest Lp[a] test). Lp(a) levels were categorized by percentile (80th). Elevated Lp(a) was defined as >80thpercentile ( >140 nmol/L). Multivariable Cox Proportional Hazards model analyses compared a group with Lp(a)

Circulation, Volume 150, Issue Suppl_1, Page A4146291-A4146291, November 12, 2024. Background:Circulatory diseases represent the primary cause of mortality in the US. Comprehending trends and potential disparities in the prevalence of circulatory conditions, such as angina pectoris (AP), myocardial infarction (MI), hypertension (HTN), and coronary heart disease (CHD), is essential for forming public health strategies.Aim:To investigate trends in the prevalence of circulatory conditions, including AP, MI, HTN, and CHD among US adults from 2019 to 2022.Methods:Prevalence percentages for all available circulatory diseases from the Centers for Disease Control and Prevention’s National Health Interview Survey (NHIS) database were retrieved for patients aged >18 years from 2019 to 2022. Annual Percentage Changes (APCs) along with their respective 95% CIs were calculated using regression analysis with Join point. The data was stratified by year, gender, age, race, nativity, veteran status, social vulnerability, employment status, metropolitan statistical area (MSA) status and census region.Results:Between 2019 and 2022, HTN was steadily the most prevalent, staying relatively constant at 27.0% (95% CI: 26.4, 27.7) in 2019 and 27.2% (95% CI: 26.5, 27.8) in 2022. Males consistently had higher prevalence than females with significant increases noted from 2019 to 2022 (APC: 1.0234). Black or African American had the highest prevalence (34.4% in 2022). The South (30.1% in 2022) and the West (22.5% in 2022) had respectively the highest and lowest rates. The second highest prevalence was seen in CHD increasing from 4.6% (95% CI: 4.3, 4.9) in 2019 to 4.9 (95% CI: 4.7, 5.2) in 2020. Males consistently exhibited a higher prevalence than females, with both genders showing significant increases in recent years (Male APC: 3.1448) (Female APC: 2.0165). For MI, a slight decrease was noted from 3.1% (95% CI:2.9, 3.4) in 2019 to 3.0% (95% CI:2.7, 3.2) in 2022. White individuals exhibited the highest prevalence (3.3% in 2022). AP had the lowest overall prevalence staying relatively consistent (1.7% in 2019 and 1.6% in 2022) (Figure 1).Conclusion:Significant trends (Figure 2) in most common circulatory diseases have been identified. Targeted interventions are imperative, particularly for high-risk demographics such as males, older adults, veterans, and unemployed individuals.

Circulation, Volume 150, Issue Suppl_1, Page A4140981-A4140981, November 12, 2024. Introduction/Background:Patients with hematological malignancies are at a higher risk of developing atrial fibrillation. Additionally, it can predispose to an increased risk of bleeding limiting anticoagulation for stroke prevention. LAAO has been successfully utilized among patients with atrial fibrillation and contraindication to anticoagulation.Research Question:What are the outcomes and in-hospital complications of left atrial appendage occlusion (LAAO) among patients with atrial fibrillation and hematological malignancy?Methods:The National Inpatient Sample (NIS) was analyzed from 2015-2020 to identify admissions for LAAO among patients with and without a hematological malignancy. Baseline characteristics were compared between the two groups and multivariate logistic regression was used to analyze hospitalization outcomes.Results:We identified 89,920 weighted admissions for LAAO procedures of which 1,665 patients (1.85%) had a hematological malignancy. In the adjusted analysis, the odds of MACCE (aOR 1.86, 95% CI 1.10-3.14, p 0.0205), cardiogenic shock (aOR 3.76, 95% CI 1.95-7.24, p

Circulation, Volume 150, Issue Suppl_1, Page A4142806-A4142806, November 12, 2024. Background:Digital education for outpatient atrial fibrillation (AF) patients is gradually increasing. However, research on digital education for patients with atrial fibrillation catheter ablation (AFCA) is limited.Objective:Our aim is to develop a new multi-stage education model based on digital animation and to evaluate its effect on quality of life and negative mood in AFCA patients.Methods:This randomized, controlled clinical trial included 208 AF patients who underwent catheter ablation in the Department of Cardiology at Renmin Hospital of Wuhan University between January 2022 and August 2023. Patients were randomly assigned to the digital animation intervention group (n=104) and the usual care group (n=104). The primary outcome was the difference in the Quality of Life in patients with Atrial Fibrillation (AF-Qol-18) scores at 3 months. Secondary outcomes included differences in Medication Adherence Report Scale (MARS-5) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score at 3 months.Results:The main outcome of the study is the change in quality of life at 3 months after discharge from AFCA, secondary outcomes of the study were improvements in patients’ anxiety, depression, and medication adherence. In the digital animation intervention group, the AF-Qol-18 score increased from 38.02 (SD 6.52) to 47.77 (SD 5.74), the MARS-5 score increased from 17.04 (SD 3.03) to 20.13 (SD 2.12), the SAS score decreased from 52.82 (SD 8.08) to 45.39 (SD 6.13), and the SDS score decreased from 54.12 (SD 6.13) to 45.47 (SD 5.94). In the usual care group, the AF-Qol-18 score increased from 36.97 (SD 7.00) to 45.31 (SD 5.71), the MARS-5 score increased from 17.14 (SD 3.01) to 18.47 (SD 2.79), the SAS score decreased from 51.83 (SD 7.74) to 47.31 (SD 5.87), and the SDS score decreased from 52.78 (SD 5.21) to 45.37 (SD 6.18).Conclusions:This educational model effectively improves postoperative anxiety, depression, medication adherence, and quality of life in patients at 3 months post-discharge.

Circulation, Volume 150, Issue Suppl_1, Page A4146535-A4146535, November 12, 2024. Introduction:Cardiovascular(CV) disease is one of the leading cause of death in females in USA out of which 44% suffer. According to the latest CDC guidelines, 13.4 % are suffering from the infertility.It includes the most common conditions including endometriosis, poly cystic ovarian syndrome. Studies shows a mutlitude of factors including genetic abnormalities, hormonal imbalances like chronic anovulation or increased androgens predispose the women to subsequent health conditions.Literature review suggests that long term cv risks are less understood in the infertile women.Aim:The aim of the study is to identify the CV outcomes including coronary heart disease(CAD) , acute coronary syndrome(ACS), and heart failure in women with underlying infertility condition.Methods:The NIS 2020 was queried for the female adult population (age >18 years) with a primary or secondary diagnosis of infertility. Prevalence of CV risk factors were compared between females with and without infertility problem. The association of cardiac diagnoses including CAD, ACS and was analysed. Multivariate regression analysis was performed taking all-cause mortality as a primary outcome.Results:A total of 3870 adult patients with a primary or secondary diagnosis of infertility were identified and the mean age was 36 years.In adult population without infertility condition, patients with an underlying infertility were found to have an increased association with DM (48.16%vs 23.11%; P

Circulation, Volume 150, Issue Suppl_1, Page A4146540-A4146540, November 12, 2024. Background:Myocarditis is an inflammatory disease of the myocardium associated with numerous adverse outcomes such as arrhythmias, heart failure, cardiac arrest as well as death. Clinical characteristics and mortality outcome data in myocarditis specific to Asian patients is limited.Research Question:To evaluate characteristics and mortality outcome amongst a multi-ethnic cohort of Asian patients diagnosed with myocarditis.Methods:This retrospective, single-center cohort study involved consecutive patients diagnosed with myocarditis between 2010 and 2021 in a tertiary academic center. Patient respective clinical profile, diagnostic results and outcomes were detailed. Categorical variables were compared between mortality groups using the chi-squared test, and continuous variables with t-tests or Mann-Whitney U tests.Results:A total of 203 patients (mean age 41.8, 40.9% female) diagnosed with myocarditis were included in the study. The prevalence of fulminant myocarditis, acute non-fulminant myocarditis and chronic inflammatory cardiomyopathy in this cohort was 31%, 67.2% and 5.5% respectively. Over a mean follow up period of 4.7 years (SD 3.5), the all-cause mortality was 17.7% (36 patients) (p=

Circulation, Volume 150, Issue Suppl_1, Page A4146494-A4146494, November 12, 2024. Background:Distribution patterns for visceral (VAT), abdominal subcutaneous (ASAT), and gluteofemoral (GFAT) adipose tissue are strongly associated with cardiovascular disease. Circulating metabolites and proteins are dynamic indicators of biological processes and reflect metabolic health. It is not yet clear how these analytes are associated with adiposity distribution patterns.Aims:To determine the multi-omic profiles of adiposity distribution and their associated metabolomic and proteomic measurements.Methods:MRI-derived volumes of VAT, ASAT, and GFAT adjusted for BMI were available for 40,032 UK Biobank participants. Circulating metabolites and proteins were measured using the Nightingale Health NMR biomarker platform and Olink platform, respectively. We used linear regression models to assess the association between each analyte and VAT, ASAT, and GFAT. Models were adjusted for sex, age at MRI, MRI batch, and time between enrollment and MRI. Functional protein pathway enrichment was performed using the DAVID annotation tool.Results:Among 40,032 UK Biobank participants with adiposity volumes, 22,630 (56.5%) and 5023 (12.5%) had 168 metabolomic and 2910 proteomic measurements, respectively. In the metabolomic subset, the mean (SD) age was 55.7 (7.5) years, 10,992 (48.6%) were male, and all self-reported as white. In the proteomic subset, the mean (SD) age was 54.9 (7.8) years, 2417 (48.1%) were male, and all self-reported as white. Multi-variable linear regression revealed 39, 139, and 146 significant metabolite associations (P