ContextDespite improved understanding of atherothrombosis, cardiovascular prediction algorithms for women have largely relied on traditional risk factorsObjectiveTo develop and validate cardiovascular risk algorithms for women based on a large panel of traditional and novel risk factorsDesign, Setting, and ParticipantsThirty-five factors were assessed among 24 558 initially healthy US women 45 years or older who were followed up for a median of 102 years (through March 2004) for incident cardiovascular events (an adjudicated composite of myocardial infarction, ischemic stroke, coronary revascularization, and cardiovascular death) We used data among a random two thirds (derivation cohort, n = 16 400) to develop new risk algorithms that were then tested to compare observed and predicted outcomes in the remaining one third of women (validation cohort, n = 8158)Main Outcome MeasureMinimization of the Bayes Information Criterion was used in the derivation cohort to develop the best-fitting parsimonious prediction models In the validation cohort, we compared predicted vs actual 10-year cardiovascular event rates when the new algorithms were compared with models based on covariates included in the Adult Treatment Panel III risk scoreResultsIn the derivation cohort, a best-fitting model (model A) and a clinically simplified model (model B, the Reynolds Risk Score) had lower Bayes Information Criterion scores than models based on covariates used in Adult Treatment Panel III In the validation cohort, all measures of fit, discrimination, and calibration were improved when either model A or B was used For example, among participants without diabetes with estimated 10-year risks according to the Adult Treatment Panel III of 5% to less than 10% (n = 603) or 10% to less than 20% (n = 156), model A reclassified 379 (50%) into higher- or lower-risk categories that in each instance more accurately matched actual event rates Similar effects were achieved for clinically simplified model B limited to age, systolic blood pressure, hemoglobin A1c if diabetic, smoking, total and high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and parental history of myocardial infarction before age 60 years Neither new algorithm provided substantive information about women at very low risk based on the published Adult Treatment Panel III scoreConclusionWe developed, validated, and demonstrated highly improved accuracy of 2 clinical algorithms for global cardiovascular risk prediction that reclassified 40% to 50% of women at intermediate risk into higher- or lower-risk categories

https://jamanetwork.com/journals/jama/articlepdf/205528/joc70004_611_619.pdf

Development and Validation of Improved Algorithms for the Assessment of Global Cardiovascular Risk in Women: The Reynolds Risk Score

Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior.

Membrane lipids are essential for biological functions ranging from membrane trafficking to signal transduction. The composition of lipid membranes influences their organization and properties, so it is not surprising that disorders in lipid metabolism and transport have a role in human disease. Significant recent progress has enhanced our understanding of the molecular and cellular basis of lipid-associated disorders such as Tangier disease, Niemann-Pick disease type C and atherosclerosis. These insights have also led to improved understanding of normal physiology.

https://web.iitd.ac.in/~amittal/nature04399.pdf

Role of cholesterol and lipid organization in disease.

This review considers the role of low-dose aspirin for the prevention of atherothrombosis, discussing the molecular mechanism of action of aspirin as well as clinical and epidemiologic studies of aspirin as an antiplatelet agent, with special emphasis on the benefits and risks in different patient populations.

http://departamentos.cardiol.br/DECAGE/esquina/superligado/aspirina.pdf

Low-Dose Aspirin for the Prevention of Atherothrombosis

Periodontal disease has been associated with atherosclerosis, suggesting that bacteria from the oral cavity may contribute to the development of atherosclerosis and cardiovascular disease. Furthermore, the gut microbiota may affect obesity, which is associated with atherosclerosis. Using qPCR, we show that bacterial DNA was present in the atherosclerotic plaque and that the amount of DNA correlated with the amount of leukocytes in the atherosclerotic plaque. To investigate the microbial composition of atherosclerotic plaques and test the hypothesis that the oral or gut microbiota may contribute to atherosclerosis in humans, we used 454 pyrosequencing of 16S rRNA genes to survey the bacterial diversity of atherosclerotic plaque, oral, and gut samples of 15 patients with atherosclerosis, and oral and gut samples of healthy controls. We identified Chryseomonas in all atherosclerotic plaque samples, and Veillonella and Streptococcus in the majority. Interestingly, the combined abundances of Veillonella and Streptococcus in atherosclerotic plaques correlated with their abundance in the oral cavity. Moreover, several additional bacterial phylotypes were common to the atherosclerotic plaque and oral or gut samples within the same individual. Interestingly, several bacterial taxa in the oral cavity and the gut correlated with plasma cholesterol levels. Taken together, our findings suggest that bacteria from the oral cavity, and perhaps even the gut, may correlate with disease markers of atherosclerosis.

https://www.pnas.org/content/pnas/108/Supplement_1/4592.full.pdf

Human oral, gut, and plaque microbiota in patients with atherosclerosis

Inflammation, atherosclerosis, and coronary artery disease.

https://www.internationaljournalofcardiology.com/article/S0167-5273(08)00424-5/pdf

The occurrence of acute myocardial infarction in relation to weather conditions

Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004

Permanent stress may be the trigger of an acute myocardial infarction on the first work-day of the week

The aim of the paper is to give an overview of the epidemiology, treatment pattern and quality, as well as policy issues and disease burden of colorectal cancer (CRC) in Hungary Colorectal cancer is the second most common cause of cancer-related death in both males and females in Hungary The Hungarian Cancer Registry collects data on the epidemiological characteristics of CRC Two pilot programmes (1997/1998 and 2003/2004) were conducted for population-based screening of CRC using both immunological and guaiac faecal occult blood testing (FOBT) The National Health Insurance Fund Administration (NHIFA) spends altogether € 389 million a year on the treatment of CRC It is hoped that the introduction of an accepted and cost-effective screening programme for CRC can reduce the high CRC burden in Hungary

Ildikó Kriszbacher

Papers

Inflammation, atherosclerosis, and coronary artery disease.

The occurrence of acute myocardial infarction in relation to weather conditions

Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004

Permanent stress may be the trigger of an acute myocardial infarction on the first work-day of the week

The disease burden of colorectal cancer in Hungary