Noteworthy Cardiology Posters from TMIOA's 19th Annual WCIRDC

For the past 19 years, The Metabolic Institute of America’s World Congress on Insulin Resistance, Diabetes, and Cardiovascular Disease (WCIRDC) has been a hub for the latest research and clinically impactful data for clinicians treating patients with diabetes and cardiovascular disease.

This year, highlights from the 3-day meeting, which was held both in-person in Los Angeles, California and virtually, included more than 16 sessions, discussions around special populations, the release of new multispecialty guidelines from a DCRMI Task Force, and oral and poster presentations. To celebrate the annual meeting, Endocrinology Network staff and advisory board members have put together a list of 6 noteworthy posters related to cardiovascular disease presented at WCIRDC.

Title: Adolescence Arterial Stiffness Precedes Elevated Blood Pressure in Young Adulthood: The ALSPAC Birth Cohort
Lead Investigator: Andrew Agbaje, MD, MPH, University of Eastern Finland
Summary: With an interest in assessing how carotid-femoral pulse wave velocity (cfPWV) might influence systolic and diastolic blood pressure from adolescence through adulthood among patients from the Avon Longitudinal Study of Parents and Children. Using a cohort of 3862 with data related to cfPWV, body composition, and blood pressure, investigators conducted cross-lagged structural equation models and adjusted for baseline covariates such as age, sex, LDL-C, HDL-C, TG, hs-CRP, fasting blood glucose, fasting insulin concentration, heart rate, moderate to vigorous physical activity, smoking status, family history, total fat mass, and lean mass to assess associations between cfPWV and BP at ages 17.7 and 24.5 years. Results of the study suggested the prevalence of elevated systolic blood pressure at 17.7 and 24.5 years was 26% and 33%, respectively. Results indicated cfPWV at 17.7 years was directly associated with systolic BP at 24.5 years (Regression coefficient 12 mmHg [standard error 3.76]; P=.002), but systolic BP at 17.7 years was not associated with cfPWV at 24.5 years (0.00 [0.00]; P=.168). Investigators noted baseline cfPWV was directly associated with follow-up diastolic blood pressure but not vice-versa.

Title: Metabolic Complications of Highly Active Antiretroviral Therapy in Adult HIV-Infected Patients with Heart Failure: A 7-year Prospective Cohort Study
Lead Investigator: Kevin Sheng-Kai Ma, DDS
Summary: With an interest in determining whether patients with HIV and heart failure using highly active antiretroviral therapy (HAART) were at a greater risk of metabolic syndrome and CV complications than patients with HIV without heart failure. With this in mind, investigators designed a prospective cohort study with 5 years of follow-up that included 172 patients recruited from the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study. Results of the study indicated HAART was effective for patients with or without heart failure, with a similar PVL of HIV (R=.001; P=.69) and CD4 count for patients with heart failure (R=-.06; P=.48). Further analysis suggested HAART was not associated with increased risk of cardiovascular disease among patients with heart failure, with results indicated comparable D:A:D (R) (R=.002; P=.97) and D:A:D (F) (R=.04; P=.62) scores between the groups. Results did suggest patients with heart failure had a greater risk of higher risk of T2DM (R=.24; P=.01), increased total cholesterol (R=.23; P=.006) compared to baseline. Additionally, results indicated patients with heart failure presented with a significantly greater risk of increased LDL-D (R=.18; P=.04) and increased uric acid (R=.35; P=.004).

Title: The Effect of Diabetes Mellitus and Revascularization Status on Cardiorespiratory Fitness in Multivessel Acute Coronary Syndrome Patients
Lead Investigator: Hye-Su Yin, Keimyung University Dongsan Hospital
Summary: Investigators sought to assess how diabetes mellitus and revascularization status may impact cardiorespiratory fitness among patients with multivessel ACS to fill an apparent knowledge gap. To do so, investigators assessed a cohort of 82 patients who underwent PCI between December 2016-December 2020 who completed a cardiopulmonary exercise test (CPET)—these patients were categorized according to presence of diabetes mellitus and further analyzed according to revascularization status. The primary outcome of interest was cardiorespiratory fitness, which was defined as peak oxygen uptake at 1-year CPET, and the secondary outcome of interest was MACE. Results indicated cardiorespiratory fitness was superior in patients with complete revascularization compared to the patients with incomplete revascularization (25.9±3.7 vs. 22.8±4.0 ml/min/kg, P=.029). This was consistent in patients without diabetes (26.1±4.2 vs 23.7±4.0 ml/min/kg, P=.036), but the apparent effect of complete revascularization was diminished among patients with diabetes (25.2±2.3 vs 24.0±4.4 ml/min/kg, P=.506). No significant differences were observed for MACE at a median follow-up of 703 days.

Title: Association Between Hypertension and Severity of NAFLD among Adults with Obesity
Lead Investigator: Diego Chambergo-Michilot, MS6, Clínica Avendaño
Summary: With CVD playing a major role in risk of mortality among patients with nonalcoholic fatty liver disease, investigators sought to evaluate associations between hypertension and NAFLD severity through a cross-sectional analysis of data from adults with obesity who attended a Peruvian bariatric center from 2017-2020. A total of 234 participants were identified for inclusion—the prevalence of hypertension was 19.2% and the prevalence of severe NAFLD was 46.2%. In adjusted analyses, prevalence of hypertension was significantly greater in the severe NAFLD group than among those with non-severe NAFLD (adjusted prevalence ratio [aPR]=1.33; 95% CI, 1.03-1.74). After stratification by metabolic syndrome and adjustment for confounders, results indicate the association became significant only in the non-metabolic syndrome group (aPR=1.80; 95% CI, 1.05-3.11).

Title: Association of Endocan Level and Obesity with the Development of Cardiovascular Events
Lead Investigator: Botagoz Baidildina, Karaganda Medical University
Summary: Baidildina and a team from Karaganda Medical University sought to assess whether endocan levels could help predict risk of future cardiovascular events among patients with obesity. To do so, investigators designed the current study as a prospective population-based cohort study of 223 patients with no history of cardiovascular events followed for 48 months with a primary composite end point of myocardial infarction, invasively treated stable/unstable ischemic heart disease, stroke, or all-cause mortality. The cohort had a mean age of 51.8 years and contained 177 women. Overall, 35 of the 223 patients experienced a primary end point event. Results of the investigators’ analysis demonstrated significant differences between the groups in BMI (P=.014), WC (P=.038), endocan (P=.017), and age (P=.001), but no significant differences were observed for cholesterol (P=.55), glucose (P=.13), gender (P=.72). In a binary regression analysis, results indicated both endocan (HR, 2.5 [95% CI, 1.14–5.76]; P.02) and obesity (HR, 4.2 [95% CI, 1.3–13.4], P=.01) persisted as significant predictors of experiencing an outcome event.

Title: Metabolic Syndrome as a Risk Factor for Peripheral Artery Disease: A Systematic Review and Meta-Analysis
Lead Investigator: Jared Fernandez-Morales, Peruvian Union University
Summary: To fill an apparent knowledge gap related to associations of metabolic syndrome with PAD, investigators designed a systematic review of data from within the PubMed, Web of Science, Scopus, and Embase databases from inception through March 2021. Searching for cohort studies assessing risk of PAD in patients with and without metabolic syndrome, 1007 studies were identified for possible inclusion. Of these, 7 studies with a population of 43,824 participants were included in final analyses. Upon analysis, results indicated all studies using relative risk demonstrated an association between metabolic syndrome and development of PAD, with the exception of 1 study (RR, 1.31 [95% CI, 1.03-1.59]; I2=15.6%). A meta-analysis of 2 studies presenting adjusted RR sand using the JIS classification for metabolic syndrome pointed to an association between metabolic syndrome and development of PAD (RR, 1.31 [95% CI, 1.03-1.59]; I2=15.6%). Investigators noted no evidence was found detailing an association between both variables in studies that used hazard ratios, with the exception of a single study.