Evidence map›Paper›PMID 24876350›Full record

ArticleArteriosclerosis, thrombosis, and vascular biology2014

Mediation of cardiovascular risk factor effects through subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis.

Joseph Yeboah, Joseph A Delaney, Robin Nance, Robyn L McClelland, Joseph F Polak, Christopher T Sibley, Alain Bertoni, Gregory L Burke, J Jeffery Carr, David M Herrington

Open access · bronzeAbstract readMulticenter Study

PubMed Full text at PMC Publisher

In one paragraph

Article in Arteriosclerosis, thrombosis, and vascular biology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it

0cells of the map it votes in

9citing papers in PubMed

1.4field-weighted citation impact, top 16% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 19 citations in OpenAlex.

Association between cardiovascular health factors, carotid intima-media thickness and cardiovascular outcomes in primary prevention population for cardiovascular disease.American journal of preventive cardiology · 2026
Article
Urinary Phosphate and Subclinical Atherosclerosis: The AWHS Study.Nutrients · 2024
Article
Subclinical cardiovascular disease and utility of coronary artery calcium score.International journal of cardiology. Heart & vasculature · 2021
Review
Genetic variation implicates plasma angiopoietin-2 in the development of acute kidney injury sub-phenotypes.BMC nephrology · 2020
Article
Pretransplant Cardiac Evaluation Using Novel Technology.Journal of clinical medicine · 2019
Review
Adiposity during adolescence and carotid intima-media thickness in adulthood: Results from the 1993 Pelotas Birth Cohort.Atherosclerosis · 2016
Article
Diabetes and Clinical and Subclinical CVD.Global heart · 2016
Review
Coronary artery calcium scores and cardiovascular risk factors in 31,545 asymptomatic Korean adults.The international journal of cardiovascular imaging · 2016
Article
Hepatic fat content is a determinant of metabolic phenotypes and increased carotid intima-media thickness in obese adults.Scientific reports · 2016
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Joseph YeboahFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.). jyeboah@wakehealth.edu.

Joseph A DelaneyFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Robin NanceFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Robyn L McClellandFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Joseph F PolakFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Christopher T SibleyFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Alain BertoniFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Gregory L BurkeFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

J Jeffery CarrFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

David M HerringtonFrom the Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC (J.Y., D.M.H.); Department of Biostatistics, University of Washington, Seattle, WA (J.A.D., R.N., R.L.M.); Department of Radiology, Tufts Medical Center, Boston, MA (J.F.P.); National Institute of Health, Bethesda, MD (C.T.S.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (A.B., G.L.B.); and Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.J.C.).

Wake Forest University · USTufts Medical Center · USUniversity of Washington · US

Funding

Institute for Clinical and Translational Research (UL1)UL1RR025005 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011

$75.8M

Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015

$26.2M

Longitudinal Changes in Pericardial Adiposity and Subclinical AtherosclerosisR01HL098445 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI CARR, JOHN JEFFREY · 2010 to 2013

$4.6M

Cigarette Smoke and Susceptibility to Influenza InfectionR01HL095163 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JASPERS, ILONA, NOAH, TERRY L · 2009 to 2013

$2.0M

Adjunctive Use of Apyrase to Fibrinolytic TherapyR44HL095169 · NHLBI · APT THERAPEUTICS, INC. · PI CHEN, RIDONG · 2012 to 2013

$1.3M

SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001

$758k

SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000

$694k

SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001

$642k

SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001

$616k

Longitudinal Methods for Cardiovascular Disease ResearchR01HL103729 · NHLBI · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, ROBYN LEAGH · 2011 to 2013

$592k

SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095160 · HC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAAD, MOHAMMED F · 1999 to 2001

$592k

SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095164 · HC · NORTHWESTERN UNIVERSITY · PI LIU, KIANG JOHN · 1999 to 2001

$511k

NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1-TR-000040NCRR NIH HHS UL1 RR025005NCRR NIH HHS UL1-RR-025005NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N01-HC-95159NHLBI NIH HHS N01-HC-95160NHLBI NIH HHS N01-HC-95161NHLBI NIH HHS N01-HC-95162NHLBI NIH HHS N01-HC-95163NHLBI NIH HHS N01-HC-95164NHLBI NIH HHS N01-HC-95165NHLBI NIH HHS N01-HC-95166NHLBI NIH HHS N01-HC-95167NHLBI NIH HHS N01-HC-95168NHLBI NIH HHS N01-HC-95169NHLBI NIH HHS R01 HL098445NHLBI NIH HHS R01HL098445NHLBI NIH HHS R01 HL103729NHLBI NIH HHS R01 HL 103729-01A1

6 · The paper itself

Abstract

objectiveIt is unclear to what extent subclinical cardiovascular disease (CVD) such as coronary artery calcium (CAC), carotid intima-media thickness (CIMT), and brachial flow-mediated dilation (FMD) are mediators of the known associations between traditional cardiovascular risk factors and incident CVD events. We assessed the portion of the effects of risk factors on incident CVD events that are mediated through CAC, CIMT, and FMD. APPROACH AND

resultsSix thousand three hundred fifty-five of 6814 Multi-Ethnic Study of Atherosclerosis participants were included. Nonlinear implementation of structural equation modeling (STATA mediation package) was used to assess whether CAC, CIMT, or FMD are mediators of the association between traditional risk factors and incident CVD event. Mean age was 62 years, with 47% men, 12% diabetics, and 13% current smokers. After a mean follow-up of 7.5 years, there were 539 CVD adjudicated events. CAC showed the highest mediation while FMD showed the least. Age had the highest percent of total effect mediated via CAC for CVD outcomes, whereas current cigarette smoking had the least percent of total effect mediated via CAC (percent [95% confidence interval]: 80.2 [58.8-126.7] versus 10.6 [6.1-38.5], respectively). Body mass index showed the highest percent of total effect mediated via CIMT (17.7 [11.6-38.9]); only a negligible amount of the association between traditional risk factors and CVD was mediated via FMD.

conclusionsMany of the risk factors for incident CVD (other than age, sex, and body mass index) showed a modest level of mediation via CAC, CIMT, and FMD, suggesting that current subclinical CVD markers may not be optimal intermediaries for gauging upstream risk factor modification.

Indexed as

AgedAged, 80 and overAge FactorsAsymptomatic DiseasesAtherosclerosisBody Mass IndexBrachial ArteryCardiovascular DiseasesCarotid Artery DiseasesCarotid Intima-Media ThicknessCoronary AngiographyCoronary Artery DiseaseEthnicityFemaleHumansIncidencecardiovascular eventscarotid intima-media thicknesscoronary artery calcium scoreflow-mediated dilationrisk factors

Identifiers

PMID24876350

DOI10.1161/ATVBAHA.114.303753

PMCPMC4329880

OpenAlexW2530367505

What OpenQuestion holds

Textmetadata

LicenceTDM

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.