Risk factors for cardiovascular event recurrence in the Atherosclerosis Risk in Communities (ARIC) study.
BACKGROUND
Numerous studies have identified risk factors and markers associated with incidence of cardiovascular disease (CVD). However, few studies have examined whether established risk factors, novel blood markers, carotid ultrasonography, or ankle-brachial index can predict recurrent CVD events.


RESULTS
We analyzed the relation of established risk factors and markers of atherosclerosis with the risk of recurrent CVD in 766 participants. Over a mean of 8.7 years of follow-up, 70 women and 243 men had a recurrent CVD event (85.3% coronary heart disease and 23.7% stroke). Adjusting for age and sex, this study found that established risk factors were associated with recurrent CVD events in the anticipated direction. Being in the highest (vs lowest) quartiles of lipoprotein (a), fibrinogen, white blood cells, and creatinine at baseline were associated with 47%, 69%, 65%, and 81%, respectively, greater risk of a CVD event, and being in the highest quartile of albumin was associated with 39% lower risk. Being in the highest (vs lowest) quartile of carotid intima-media thickness (IMT) was associated with a doubling of risk, and having carotid plaque with acoustic shadowing (vs having no plaque) was associated with 83% increased risk of a CVD event. After adjustment for established risk factors, creatinine, albumin, and carotid IMT in the highest quartile (vs lowest quartile) and carotid plaque with acoustic shadowing (vs no plaque) were independently associated with recurrent CVD events.


CONCLUSIONS
Established risk factors, but only a few of novel risk factors and markers, were independent predictors of recurrent CVD events.
Wattanakit
Keattiyoat
K
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minn 55454-1015, USA.
Folsom
Aaron R
AR
Chambless
Lloyd E
LE
Nieto
F Javier
FJ
D050197:Atherosclerosis / Q000097:blood / Q000150:complications*; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D003404:Creatinine / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007958:Leukocyte Count; D017270:Lipoprotein(a) / Q000032:analysis; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D049629:Waist-Hip Ratio
D017270:Lipoprotein(a); D012709:Serum Albumin; D005340:Fibrinogen; D002784:Cholesterol; D003404:Creatinine