Adverse cardiovascular outcomes and their relationship with risk factors according to the prospective study MERIDIAN-RO
https://doi.org/10.15829/1560-4071-2019-6-42-48
Abstract
Aim. To assess the incidence of adverse outcomes and the role of main risk factors in their development.
Material and methods. Prospective, long-term study was conducted with observation period of 36 months. The sample in the MERIDIAN-RO study was formed from the urban and rural population. It included 1622 people aged 25-64 years. The response to the study was 86,1%. Observation and screening of endpoints continued for 36 months. The endpoints were: all-cause death, ischemic stroke, myocardial infarction, coronary artery revascularization.
Results. When studying the relationship between various risk factors and outcomes, it was found that they had a significant impact on the combined endpoint (all-cause death + nonfatal ischemic stroke + nonfatal myocardial infarction): risk SCORE >5% (odds ratio (OR) 5,80, 95% confidence interval (CI) 2,31-14,58, p=0,0001, Wald — 23,040), excessive alcohol consumption (OR 714, 95% CI 1,41-36,31, p=0,018, Wald — 2,908), arterial hypertension (OR 4,77 95% CI 1,91-11,90, p=0,01, Wald — 9,000), combination of coronary artery disease/myocardial infarction/stroke in history (OR 11,16, 95% CI 3,98-31,31, p=0,0001, Wald — 22,607) and an apolipoprotein B increase more than 180 mg/dL (OR 28,57 95% CI 732-111,42, p=0,0001, Wald — 24,509).
Conclusion. The most significant effect on the combined endpoint (all-cause death + nonfatal myocardial infarction + nonfatal stroke) made: SCORE risk >5%, excessive alcohol consumption, hypertension, combination of coronary artery disease/myocardial infarction/stroke in history and an apolipoprotein B increase more than 180 mg/dL. That should be considered when choosing aims and preventive strategies.
About the Authors
E. V. FilippovRussian Federation
Ryazan.
SPIN - 2809-2781
Researcher ID - O-1490-2016
Competing Interests: Nothing to declare
A. N. Vorobyev
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
N. V. Dobrynina
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
L. A. Zotova
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
E. V. Lygina
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
N. N. Nikulina
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
S. V. Seleznev
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
S. S. Yakushin
Russian Federation
Ryazan.
Competing Interests: Nothing to declare
References
1. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension, European Heart Journal. 2018;39,33:3021-104. doi: 10.1093/eurheartj/ehy339.
2. Vartiainen E. The North Karelia Project: Cardiovascular disease prevention in Finland. Glob Cardiol Sci Pract. 2018 Jun 30;2018 (2):13. doi:10.21542/gcsp.2018.13.
3. Puska P, Vartiainen E, Nissinen A, et al. Background, principals, implementation, and general experiences of the North Karelia Project. Global Heart. 2016;11:173-8. doi:10.1016/j.gheart.2016.04.010.
4. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380 (9859):2224-60. doi:10.1016/S0140-6736(12)61766-8.
5. Bobak M, Murphy M, Rose R, et al. Determinants of Adult Mortality in Russia: Estimates from Sibling Data. Epidemiology. 2003; 14 (5):603-11. doi: 10.1097/01.ede.0000082000.75818.4d.
6. Menon J, Joseph J, Thachil A, et al. Surveillance of noncommunicable diseases by community health workers in Kerala: the epidemiology of noncommunicable diseases in rural areas (ENDIRA) study. Glob Heart. 2014;9 (4):409-17 doi:10.1016/j.gheart.2014.07.003.
7. Global status report on non communicable diseases 2014. WHO. Geneva, 2015. 282 p. ISBN 978-92-4-156485-4.
8. Demographic Yearbook of Russia. 2014: statistical. ed. M. A. Dianova. Rosstat. M., 2014. (In Russ.) Демографический ежегодник России 2014 г.: стат.сб., под ред. М. А. Дианова. Росстат. M., 2014. ISBN 978-5-89476-447-4.
9. Global health maps, 2014. Electron. Dan. Access mode: http://gamapserver.who.int/mapLibrary/Files/Maps/Global_NCD_mortality_CVD_2012.png; date of last update: 21/12/2018. (In Russ.)
10. Pencina MJ, DAgostino RB, Larson MG, et al. Predicting the Thirty-year Risk of Cardiovascular Disease: The Framingham Heart Study.Circulation. 2009;119 (24):3078-84. doi:10.1161/CIRCULATIONAHA.108.816694.
11. Oganov RG, Shalnova SA, Kalinina AM. Prevention of cardiovascular diseases: a guide. M.: GEOTAR-Media, 2009. 216 p. (In Russ.). ISBN 978-5-9704-1110-0.
Review
For citations:
Filippov E.V., Vorobyev A.N., Dobrynina N.V., Zotova L.A., Lygina E.V., Nikulina N.N., Seleznev S.V., Yakushin S.S. Adverse cardiovascular outcomes and their relationship with risk factors according to the prospective study MERIDIAN-RO. Russian Journal of Cardiology. 2019;(6):42-48. (In Russ.) https://doi.org/10.15829/1560-4071-2019-6-42-48