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Track 4 - Prevention and Treatment of CVD
Session Type
Track 4 - Prevention and Treatment of CVD
Room
Hall 4
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Session Ticket
Pre-Recorded
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Introduction

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:00 - 10:03

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Refinement of risk prediction by imaging

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:03 - 10:17

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gut microbiota composition and functional relevance in subclinical carotid atherosclerosis

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:17 - 10:27

Abstract

Background and Aims

Gut Microbiota (GM) alterations in composition associate with cardiovascular disease (CVD) via multiple cellular and immune-inflammatory networks. We performed GM analysis in a cohort of the general population, to relate intestinal bacterial landscape and functionality to Subclinical Carotid Atherosclerosis (SCA).

Methods

GM composition of 345 subjects from an epidemiological study at low CVD SCORE risk was assessed by fecal genomic DNA extraction and 16S rRNA gene sequencing. In a representative subset 23 subject free from SCA and in 23 subjects with advanced SCA, a further GM analysis by whole metagenomic shotgun sequencing (WMSS) predicted cellular and metabolic pathways expressed in each bacterial strain.

Results

GM was correlated with CVD risk and circulating inflammatory markers. We highlighted different GM landscape in individuals with or without SCA (p=0.016). Reduction of Bacteroides and significant increase of pro-inflammatory genera Escherichia, Coriobacteriaceae and Streptococcus was observed, while reduction of anti-inflammatory Roseburia, Bifidobacterium, Faecalibacterium in subjects with SCA was outlined.

WMSS added higher abundance of further pro-inflammatory Dorea, Granulicatella, Klebsiella and Citrobacter strains associated to advanced SCA. The functional metagenomic data analysis revealed specific metabolic pathways upregulated with SCA (metabolism of sugars and arginine on top) and those with absence of SCA (purines synthesis and starch degradation).

Conclusions

We provided new and specific signatures of GM dysbiosis marking SCA in a general population at low CVD risk. The metagenomic functional analysis identified bacterial strains responsible of the metabolic and functional dysbiosis associated with SCA.

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Serum Ceramides and Type 2 Diabetes are Mutually Independent Predictors of Cardiovascular Events in Patients with Peripheral Artery Disease

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:27 - 10:37

Abstract

Background and Aims

Ceramides are enriched in atherosclerotic plaques, and a set of circulating ceramides including Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:1), and Cer(d18:1/24:0) has recently emerged as predictors of cardiovascular outcomes in coronary artery disease patients. However, their power to predict cardiovascular events in patients with peripheral artery disease (PAD) is unknown and is addressed in the present study.

Methods

We measured the serum concentrations of the above mentioned ceramides in a cohort of 380 patients with sonographically proven PAD, of whom 107 had type 2 diabetes (T2DM).

Results

ceramides t2dm.jpgProspectively, we recorded 221 cardiovascular events over a mean follow-up time of 6.3±2.3 years. Cardiovascular event risk was higher in T2DM patients than in those who did not have diabetes (69 vs. 52%, p=0.001). The ceramides Cer(18:1/16:0) and Cer(18:1/24:1) and the respective ratios Cer(18:1/16:0) / Cer(18:1/24:0) and Cer(18:1/24:1) / Cer(18:1/24:0) were significant predictors of cardiovascular events both univariately and after multivariate adjustment including the presence of T2DM (figure). Conversely, T2DM predicted cardiovascular events independently from the investigated ceramides (adjusted HR 1.76 [1.31-2.35], p<0.001).

Conclusions

We conclude that the investigated ceramides and T2DM are mutually independent predictors of cardiovascular events in PAD patients.

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Residual cholesterol as prognostic predictor associates with different glucose metabolism status in patients with coronary artery disease

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:37 - 10:47
Presenter

Abstract

Background and Aims

Previous studies have demonstrated that residual cholesterol (RC), including triglyceride-rich lipoprotein-cholesterol (TRL-C) and remnant-like lipoprotein particles-cholesterol (RLP-C), are an emerging risk factor for coronary artery disease (CAD). The aim of the present cohort study is to examine the effects of RC on major cardiovascular events (MACEs) in patients with stable coronary artery disease (CAD) and different glucose metabolism status.

Methods

In this multicenter study, we consecutively enrolled 4,355 patients from October 2011 to March 2017. Patients were categorized according to status of glucose metabolism (diabetes mellitus [DM], pre-DM, normal glucose regulation [NGR]) levels and further classified into 9 groups by RC levels. Participants were followed for MACEs (myocardial infarction, stroke, revascularization and cardiac death) for up to 8 years. Cox proportional hazards model was used to calculate hazard ratios with 95% confidence intervals.

Results

During follow-up period, 543 (12.5%) events occurred. TRL and RLP-C was significant predictors of risk for MACEs after adjustment for potential confounder. No significant difference in occurrence of CVEs was observed between NGR and pre-DM groups (p>0.05). When patients were categorized by both status of glucose metabolism and RC levels, highest levels of RLP-C, calculated and measured TRL-C were significant and independent predictors of developing MACEs in pre-DM (HR: 2.3, 1.7, 1.8, p<0.05) and DM (HR: 2.1, 1.7, 1.8, p<0.05).

figure.jpg

Conclusions

Our findings for the first time, indicated that RC levels were the independent risk factors for CVEs in CAD patients in DM and Pre-DM status, suggesting that RC may help further stratify CAD patients with mild impaired glucose metabolism.

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Impact of vascular risk factors on 10-year absolute risk of dementia – risk charts for targeted prevention

Session Type
Track 4 - Prevention and Treatment of CVD
Date
07.10.2020, Wednesday
Session Time
10:00 - 11:17
Lecture Time
10:47 - 10:57

Abstract

Background and Aims

Dementia is the largest global challenge for health and social care in the 21st century. A third of all dementia may be preventable due to vascular risk factors. Intensive multi-domain intervention trials targeting primarily vascular risk factors show improved cognitive function in people at risk. Such interventions will however be expensive to implement generally and will represent unrealistic economic tasks for most societies. Therefore, a risk score identifying high-risk individuals is warranted.

Methods

In 61,664 individuals from two prospective cohorts of the Danish general population, we generated 10-year absolute risk scores for all-cause dementia and Alzheimer’s disease from genetics and vascular risk factors, to enable identification of high-risk individuals who are anticipated to benefit the most from targeted, preventive intervention.

Results

In both sexes, 10-year absolute risk of all-cause dementia and Alzheimer’s disease increased with increasing age, number of APOE ɛ4 alleles, and number of GWAS risk alleles. 10-year absolute risk of all-cause dementia for women with APOE ɛ44 genotype and 22-31 GWAS risk alleles was 3%, 13%, 30%, and 44% in 50-59, 60-69, 70-79, and 80-100 year-olds, respectively. Corresponding values for men were 2%, 11%, 26%, and 39%. 10-year absolute risks increased further in individuals with diabetes, hypertension and low education.

Conclusions

10-year absolute risk of all-cause dementia and Alzheimer’s disease increased with age, APOE ɛ4 alleles, GWAS risk alleles, diabetes, hypertension, and low education. 10-year absolute risk charts for dementia will facilitate identification of high-risk individuals, who most likely will benefit the most from an early intervention of vascular risk factors.

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