Dataset Information

Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis.

ABSTRACT: BACKGROUND:Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the extent to which these associations are explained by established cardiovascular risk factors. METHODS:We used data from EPIC-CVD, a case-cohort study, which includes data from 23 centres from 10 European countries. We included only women, of whom 10 880 comprise the randomly selected sub-cohort, supplemented with 4522 cases outside the sub-cohort. We conducted Prentice-weighted Cox proportional hazards regressions with age as the underlying time scale, stratified by country and adjusted for relevant confounders. RESULTS:After confounder and intermediate adjustment, post-menopausal women were not at higher CHD risk compared with pre-menopausal women. Among post-menopausal women, earlier menopause was linearly associated with higher CHD risk [HRconfounder and intermediate adjusted per-year decrease = 1.02, 95% confidence interval (CI) = 1.01-1.03, p = 0.001]. Women with a surgical menopause were at higher risk of CHD compared with those with natural menopause (HRconfounder-adjusted = 1.25, 95% CI = 1.10-1.42, p < 0.001), but this attenuated after additional adjustment for age at menopause and intermediates (HR = 1.12, 95% CI = 0.96-1.29, p = 0.15). A proportion of the association was explained by cardiovascular risk factors. CONCLUSIONS:Earlier and surgical menopause were associated with higher CHD risk. These associations could partially be explained by differences in conventional cardiovascular risk factors. These women might benefit from close monitoring of cardiovascular risk factors and disease.

SUBMITTER: Dam V

PROVIDER: S-EPMC6693816 | biostudies-other | 2019 Feb

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis.

Dam Veerle V van der Schouw Yvonne T YT Onland-Moret N Charlotte NC Groenwold Rolf H H RHH Peters Sanne A E SAE Burgess Stephen S Wood Angela M AM Chirlaque Maria-Dolores MD Moons Karel G M KGM Oliver-Williams Clare C Schuit Ewoud E Tikk Kaja K Weiderpass Elisabete E Holm Marianne M Tjønneland Anne A Kühn Tilman T Fortner Renée T RT Trichopoulou Antonia A Karakatsani Anna A La Vecchia Carlo C Ferrari Pietro P Gunter Marc M Masala Giovanna G Sieri Sabina S Tumino Rosario R Panico Salvatore S Boer Jolanda M A JMA Verschuren W M Monique WMM Salamanca-Fernández Elena E Arriola Larraitz L Moreno-Iribas Conchi C Engström Gunnar G Melander Olle O Nordendahl Maria M Wennberg Patrik P Key Timothy J TJ Colorado-Yohar Sandra S Matullo Giuseppe G Overvad Kim K Clavel-Chapelon Francoise F Boeing Heiner H Quiros J Ramon JR di Angelantonio Emanuele E Langenberg Claudia C Sweeting Michael J MJ Riboli Elio E Wareham Nicholas J NJ Danesh John J Butterworth Adam A

International journal of epidemiology 20190801 4

<h4>Background</h4>Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the extent to which these associations are explained by established cardiovascular risk factors.<h4>Methods</h4>We used data ...[more]

PMID: 30796459

Similar Datasets

Project description:Comparison of patients with coronary heart disease and controls in genome-wide association studies has revealed several single nucleotide polymorphisms (SNPs) associated with coronary heart disease. We aimed to establish the external validity of these findings and to obtain more precise risk estimates using a prospective cohort design.We tested 13 recently discovered SNPs for association with coronary heart disease in a case-control design including participants differing from those in the discovery samples (3829 participants with prevalent coronary heart disease and 48,897 controls free of the disease) and a prospective cohort design including 30,725 participants free of cardiovascular disease from Finland and Sweden. We modelled the 13 SNPs as a multilocus genetic risk score and used Cox proportional hazards models to estimate the association of genetic risk score with incident coronary heart disease. For case-control analyses we analysed associations between individual SNPs and quintiles of genetic risk score using logistic regression.In prospective cohort analyses, 1264 participants had a first coronary heart disease event during a median 10·7 years' follow-up (IQR 6·7-13·6). Genetic risk score was associated with a first coronary heart disease event. When compared with the bottom quintile of genetic risk score, participants in the top quintile were at 1·66-times increased risk of coronary heart disease in a model adjusting for traditional risk factors (95% CI 1·35-2·04, p value for linear trend=7·3×10(-10)). Adjustment for family history did not change these estimates. Genetic risk score did not improve C index over traditional risk factors and family history (p=0·19), nor did it have a significant effect on net reclassification improvement (2·2%, p=0·18); however, it did have a small effect on integrated discrimination index (0·004, p=0·0006). Results of the case-control analyses were similar to those of the prospective cohort analyses.Using a genetic risk score based on 13 SNPs associated with coronary heart disease, we can identify the 20% of individuals of European ancestry who are at roughly 70% increased risk of a first coronary heart disease event. The potential clinical use of this panel of SNPs remains to be defined.The Wellcome Trust; Academy of Finland Center of Excellence for Complex Disease Genetics; US National Institutes of Health; the Donovan Family Foundation.

Dataset Information

Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis.

Publications

Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets