Browse Articles

First comprehensive GC–MS profile of Echinops erinaceus with antimicrobial and cytotoxic activities and in-silico model

Abstract TH816: Carbohydrate Quality, Pathway-specific Polygenic Risk Scores, and Risk of Type 2 Diabetes among US Men and Women

Introduction: Carbohydrate quality is associated with type 2 diabetes (T2D) risk, but whether intakes of specific carbohydrates interact with genetic susceptibility remains unclear. Hypothesis: The associations between lower carbohydrate quality and higher T2D risk may be modified by global and pathway-specific polygenic risk scores (PRS). Methods: We analyzed up to 36 years of longitudinal data from 39,540 participants in the Nurses’ Health Studies and Health Professionals Follow-Up Study, free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed every 4 years using validated food frequency questionnaires. We calculated cumulatively averaged alternative Carbohydrate Quality Index (aCQI; based on cereal fiber, whole fruit carbohydrates, glycemic index, sugar from sugar-sweetened beverages [SSB], and whole grain carbohydrates), with a lower score indicating poorer long-term carbohydrate quality. We calculated global and 12 pathway-specific PRS based on 650 genetic variants reflecting distinct T2D mechanisms. Cox regression was used to examine associations between aCQI (and secondarily, its components), PRS, and their interactions with T2D risk. Results: We identified 5,116 incident T2D cases. The global-PRS, and 11 out of 12 pathway-specific PRS (except for bilirubin metabolism) robustly predicted T2D risk. In multivariable analysis, a lower aCQI was associated with higher T2D risk (HR per IQR: 1.20, 95% CI: 1.14-1.26, P <0.001). A significant additive interaction was observed, among participants older than 65 yrs but not younger, between global-PRS and aCQI, with T2D risk (relative excess risk due to interaction =0.21, P int =0.025, Fig. A ). In secondary analysis of aCQI components in those ≥65 yrs, nominally significant interactions were noted between global-PRS with low whole fruit carbohydrates and low whole grain carbohydrates for T2D risk ( P int ≤0.011 ; Fig. A ). Further analysis on pathway-specific PRS suggested potential additive interactions between whole fruit carbohydrates and PRS reflecting proinsulin, hyper insulin, and obesity-mediated insulin resistance pathways, and between sugar from SSB and PRS for obesity-mediated insulin resistance ( P int ≤0.038; Fig. B ). Conclusions: Our data suggest that the association between lower carbohydrate quality and T2D risk may be stronger in older adults with higher genetic risk. Replication studies are needed to examine how specific carbohydrates may interact with genetic risk through specific pathways.

Abstract WE572: Intravascular ultrasound and hemodynamics in stenotic lesions of arteriovenous fistulas or grafts in patients on hemodialysis

Background: Chronic kidney disease (CKD) is a major public health crisis. In the US, one out of seven people has CKD. Of these, over 815,000 people have end-stage kidney disease (ESKD). Approximately 550,000 people undergo hemodialysis treatment in the US. Arteriovenous (AV) vascular accesses, such as arteriovenous fistulas (AVFs) or arteriovenous grafts (AVGs), are required for hemodialysis. Conventional angiography remains the standard diagnostic modality for access dysfunction, but its geometric accuracy is limited. Intravascular ultrasound (IVUS) offers superior lesion detection, yet its accuracy remains uncertain. Using three-dimensional (3D) printed vascular conduits as reference standards, we assessed the accuracy of IVUS versus angiography, hypothesizing that complex conduit geometry, quantified by Gaussian curvature, would exacerbate angiographic error. Methods: Clinically relevant AV access geometries were modeled with computer-aided design (CAD) and fabricated using 3D printing. Lumen diameters were measured by contrast angiography and IVUS, and then compared against CAD dimensions. Conduit geometry was characterized using finite element–based Gaussian curvature mapping. Statistical analyses examined measurement errors, their relationship to geometric complexity and differences across imaging modalities. Results: IVUS demonstrated significantly lower measurement error, particularly in stenotic segments with greater than 50% luminal narrowing. This high-grade stenosis frequently coincided with regions of high positive or negative Gaussian curvature, reflecting the complex geometry of the conduit. In such regions, angiography consistently underestimated lumen diameter, with error magnitude increasing in tortuous segments. IVUS measurements closely approximated CAD ground truth, retaining accuracy even in severe stenosis. For mild stenosis (<50%) and aneurysmal dilatations, both modalities performed comparably. Conclusion: Geometric complexity directly contributes to modality-specific error. Angiography systematically underestimates lumen dimensions in complex, stenotic regions, while IVUS preserves accuracy. These findings establish IVUS as the more reliable modality for evaluating AV access dysfunction and support its integration into routine practice for guiding intervention in AV access stenosis.

Abstract WE530: Latinos that Engage in High Occupational Physical Activity are Less Likely to Engage in High Sedentary Activity

Introduction: Foreign-born Latinos engage in higher levels of occupational physical activity (OPA), yet lower levels of leisure-time physical activity, compared with US-born Latinos. However, limited research has examined the association between OPA and sedentary activity among US-born and foreign-born Latinos. The purpose of our study was to examine associations between OPA level and sedentary activity outcomes among US-born and foreign-born Latinos. Hypothesis: We hypothesized that those engaging in higher levels of OPA would be less likely to engage in high sedentary activity. Methods: We used cross-sectional 2013-2018 National Health and Nutrition Examination Survey (NHANES) data on Latinos ≥20 years of age (n=4,275). Participants were asked how many minutes of sedentary behavior they engaged in per week (i.e., time spent sitting, but not including sleep). Based on approximate tertiles of the observed distribution of sedentary activity, time spent in weekly sedentary activity was classified into 3 groups: low (≤1260 minutes); medium (> 1260 to ≤ 2520 minutes); and high (> 2250). OPA was measured based on minutes of moderate-to-vigorous OPA per week, which were categorized into no OPA (0 min/week), medium OPA (<240 min/week), and high OPA (≥240 min/week). Multinomial logistic regression models that accounted for the complex survey design of NHANES were used to estimate the associations between level of OPA with sedentary activity level, stratified by nativity. All models were adjusted for age, sex, and education. Results: In adjusted models among US-born Latinos, compared with those that did not engage in any OPA, individuals that engaged in high OPA levels were significantly less likely to engage in high levels of sedentary activity (Odds Ratio [OR]: 0.36, 95% Confidence Interval [CI]: 0.26-0.51). Among foreign-born Latinos, compared with individuals that reported no OPA, those that engaged in high levels of OPA were also significantly less likely to engage in high levels of sedentary activity (OR: 0.43, 95% CI: 0.31-0.58). Conclusions: In conclusion, these findings suggest that engaging in a high level of OPA may contribute to less sedentary activity among US-born and foreign-born Latinos. Future physical activity promotion efforts should consider the role of various domains of physical activity and sedentary activity in understanding physical activity patterns among US-born and foreign-born Latinos.

An “off-on” CdTe QDs fluorescent nanosensor for detecting apoptosis in osteosarcoma and evaluating chemotherapy response

Abstract MPWE45: Proteomic-Based Biological Aging Clocks Are Associated with Cognitive Aging: The Atherosclerosis Risk in Community Study

Background: Proteomic aging clocks (PACs) reflect multifactorial biological aging and have shown strong associations with dementia risk. However, it remains unclear whether PACs can track cognitive aging trajectories among non-demented people. We examined associations between previously developed PACs and cognitive aging and also tested senescence-specific PACs (SASP-PACs), based on senescence-associated secretory phenotype (SASP) proteins, to assess their relevance compared with non-pathway-specific PACs. Methods: Participants from the Atherosclerosis Risk in Communities (ARIC) cohort, a U.S. population-based study, who remained dementia-free by 2022 were included in this analysis at two time points: midlife (Visit 2, 1990-92; N=3,510; mean age 54 y; 58% female, 17% Black) and late-life (Visit 5, 2011-13; N=3,745; mean age 75 y; 58% female, 17% Black). Non-pathway-specific PACs based on ~5,000 proteins measured by SomaScan were previously developed by training proteins against chronological age using elastic net regression and calculated as weighted sums (midlife: 1,160 and late-life: 613 proteins). SASP-PACs were created using the same method but included only SASP proteins (midlife:110 and late-life:106 proteins). The numbers of overlapping proteins are shown in Figure 1 . Age acceleration (PAA for PACs and SASP-PAA for SASP-PACs) at each life stage was defined as the residual from regressing each PAC on chronological age. Cognitive aging from Visit 5 to 9 (2011–22) was defined as the percentage difference in an individual’s cognitive decline slope from the sample median, estimated using linear mixed models. To account for loss to follow-up, missing cognitive scores were imputed using multilevel joint modeling with predictors and auxiliary variables (e.g., mid-visit cognitive screening test scores). Associations between midlife and late-life PAA/SASP-PAA and cognitive aging were assessed using linear regression, adjusting for demographic and cardiovascular risk factors. Results: Each five-year increase in PAA was associated with a faster rate of cognitive decline relative to the sample median (β [95% CI]; midlife=4.50% [2.73%, 6.26%]; late-life=6.18% [4.35%, 8.01%]). SASP-PAA, despite using fewer proteins, showed comparable results (midlife=3.59% [2.05%, 5.14%]; late-life=5.07% [3.38%, 6.77%]) ( Figure 2 ). Conclusions: PACs show potential to support monitoring of cognitive aging trajectories and early risk stratification for clinical cognitive impairment.

Abstract TU186: Plasma Metabolomics and Incident Heart Failure in Patients with Gout

Background: Individuals with gout have an elevated risk of developing heart failure (HF) compared to the general population. Larger HDL particle size associates with a higher HF risk in community-dwelling adults. Small HDL particles exert anti-inflammatory effects that may protect against gout attacks and cardiac dysfunction. Objectives: We sought to identify potentially causal metabolic contributors to the development of HF in patients with gout. Methods: We performed targeted 1 H-NMR metabolomics (Nightingale Health) on plasma samples from 1,454 Mass General Brigham (MGB) Biobank participants with a history of gout and no history of heart failure. The primary outcome was incident HF, ascertained using two ICD billing codes for heart failure. Where available, LVEF was used to categorize HF events as HFpEF (LVEF > 50%) or HFrEF (LVEF < 50%). We used multivariable Cox proportional hazards regression to quantify the associations between a 1-SD difference in metabolite level and the time to incident HF at FDR significance < 0.05. We compared metabolite-HF associations in patients with gout to those observed in a matched cohort. Results: The mean age was 75 ± 11 years, 81% of the patients were male, and 88% were self-reported as White. A total of 280 HF events (20 events per 1,000 person-years; 35 HFrEF and 143 HFpEF) occurred over a median follow-up period of 7 years. Among participants with gout, a higher concentration of extra large HDL particles significantly associated with a higher risk of incident HF (HR [95% CI]: 1.44 [1.17-1.76]). In addition, higher levels of free cholesterol (1.35 [1.12-1.62]), phospholipids (1.33 [1.10-1.61]) and total lipids (1.33 [1.10-1.60]) within each extra large HDL particle significantly associated with higher HF risk in participants with gout ( Figure ), with larger effect sizes for HFrEF than HFpEF. In contrast, higher concentrations of small HDL particles, and higher concentrations of free cholesterol, phospholipids and cholesteryl esters in small HDL particles, associated with lower HF risk in the matched controls only ( Figure ), with similar effect sizes for HFpEF and HFrEF. Conclusions: Extra large HDL particles significantly associate with a higher risk of incident HF in patients with gout. In contrast, small HDL particles associate with a lower risk of incident HF in individuals without gout. The mechanisms underlying these associations warrant further study.

Abstract TH956: Grim Age Acceleration Does Not Improve Risk Prediction of the PREVENT (Predicting Risk of Cardiovascular Disease Events) Base Equation

Introduction: The PREVENT (Predicting Risk of Cardiovascular Disease Events) equations estimate 10-year absolute risks for atherosclerotic CVD (ASCVD), heart failure (HF), and CVD (ASCVD + HF). Of PREVENT inputs, chronological age explains most of the variance in risk estimates. Grim Age acceleration (Grim2AA) is an epigenetic age measure that predicts morbidity and mortality; however, whether it contributes to risk prediction is not known. Hypothesis: Incorporating Grim2AA-adjusted age into PREVENT base equations improves 10-year risk discrimination, calibration, and reclassification. Methods: We analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective, multicenter U.S. cohort. We included participants free of CVD with available clinical and Grim2AA measures in midlife (year 20 visit). Grim2AA-adjusted age (Grim2AA + chronological age) replaced chronological age in PREVENT-CVD, PREVENT-ASCVD, and PREVENT-HF base models. Model performance was assessed using C-statistics and calibration, comparing Grim2AA-adjusted age–based vs. original models. We assessed reclassification using the Partial Likelihood Ratio Test. Results: Among the 2,432 participants included, 42.3% were men and 43.4% were Black, with a mean chronological age of 45.2 ± 3.6 years and a mean Grim2AA of 0.13 ± 5.14 years. During a median follow-up of 17.8 (interquartile range 16.9–18.0) years, 147 ASCVD, 173 CVD, and 42 HF events occurred. In univariate models, predicted risk with original and Grim2AA-adjusted PREVENT measures were each significantly associated with CVD outcomes. Each 1-SD Grim2AA-adjusted PREVENT was associated with ASCVD (1.53 [1.43–1.64]), CVD (1.50 [1.42–1.58]), and HF (1.34 [1.26–1.43]) events. There was no difference in overall predictive utility when Grim2AA-adjusted age was integrated in place of chronological age (C-statistic 0.76 [0.72–0.83] vs 0.76 [0.71–0.82]; Δ<0.01; Figure 1) for PREVENT-CVD. Findings were similar for PREVENT-ASCVD and PREVENT-HF models, with no improvement in calibration or reclassification. Results were similar among the subset of participants with Grim2AA ≥ 2 years. Conclusions: Grim2AA does not improve CVD risk estimation of the PREVENT equations. Further research is needed to determine whether other biological age measures can enhance CVD risk assessment.

Feasibility of modifying the washout water weir on dyna sand filters performance

Abstract Among the available technologies, the dyna-sand filter has gained attention due to its continuous filtration and sand washing mechanism, which provides an advantage in maintaining stable operation. Nevertheless, its performance under variable heights of washout weir with constant solid loads and the optimization of its washing system remain areas that require further study. This study investigates the use of the dyna-sand filter in water treatment facilities, focusing on the alteration of the washout weir to improve efficiency and reduce washout water amount. The study evaluates the filter’s performance under fixed influent total suspended solids (TSS) concentration and constant filtration rate (ROF), aiming to demonstrate the advantages of this alteration in enhancing removal efficiency, operational stability, and water saving through a laboratory-scale pilot. The average washout discharge fell from 0.788 to 0.486 L/min, a 38.3% reduction in washout water amount. As a result, filtered water production rose by nearly 2.2%, indicating more efficient hydraulic operation. These findings confirm that raising the washout weir by 4 cm improved filtration and reduced washout water loss. This, in turn, enhanced system productivity and the quality of washwater produced, assuming a consistent flow rate and solid load.

Abstract TU162: Association Between Perceived Risk of Hypertension and Healthcare Utilization among Black Adults with Elevated Blood Pressure or Untreated Stage 1 Hypertension: Findings from the RESTORE Network

Introduction: Perceived risk of hypertension may influence health behaviors, but data are limited among Black adults, a population with a high prevalence of hypertension and low preventive healthcare engagement. We examined associations between perceived hypertension risk and healthcare use in Black adults with elevated blood pressure (BP) or untreated stage 1 hypertension. Methods: Data were from two community-based trials in the AHA Health Equity Research Network on Hypertension Prevention (RESTORE), the EPIPHANY (Equity in Prevention and Progression of Hypertension by Addressing Barriers to Nutrition and Physical Activity) trial, which included Black adults from rural Alabama, and CLIP (Community-to-Clinic Linkage Implementation Program in Barbershops), which included Black men from New York City. All participants had systolic BP 120-139 mmHg and/or diastolic BP 80-89 mmHg. Perceived hypertension risk was assessed by asking participants what they thought their chances of developing hypertension were “below average”, “average”, or “above average” compared to adults of the same age and sex. Healthcare use outcomes were having: 1) a usual place of care and 2) a recent healthcare visit (in the last 12 months). We estimated prevalence ratios for associations between perceived risk and healthcare use, overall and by site and sex. Results: The analysis included 761 participants (mean age 39.5 years, 30.0% women). Overall, 51.9% reported a “below average” hypertension risk ( Figure 1 ). A higher proportion of participants with perceived “below average” risk than with higher perceived risk was insured and reported having a high school education or less ( Table 1 ). In EPIPHANY participants, perceived risk was not associated with healthcare use. Among CLIP participants, those with “average” or “above average” risk were more likely to have a usual place of care than those with “below average” risk but were less likely to have had a recent healthcare visit ( Table 2 ). Conclusion: In the current study of Black adults with elevated BP or stage 1 hypertension, over half of participants perceived themselves to be at a “below average” risk for hypertension. Associations between perceived risk and healthcare use differed by site. Higher perceived hypertension risk among urban Black men was associated with having a usual place of care but with lower likelihood of having a recent healthcare visit, underscoring the need to convert risk awareness into ongoing preventive care.

Abstract 67: Objectively Measured vs. Self-Reported Physical Activity and Coronary Artery Calcification: The Atherosclerosis Risk in Communities Study

Introduction: Coronary artery calcification (CAC) is a marker of subclinical atherosclerosis with important implications for cardiovascular risk assessment. Despite established cardiovascular benefits of physical activity, its relationship with CAC remains unclear. Hypothesis: The CAC Agatston score has an inverse association with both objectively measured and self-reported physical activity. Methods: We analyzed data from 1,449 participants in the Atherosclerosis Risk in Communities (ARIC) study to investigate the cross-sectional association of objective and self-reported physical activity at visit 6 (2016-17) with Agatston scores from cardiac CT at visit 7 (2018-19). Objective physical activity was measured using an accelerometer embedded in the Zio® XT ECG monitor, which provided continuous monitoring for up to 14 days. Self-reported activity in the past year was assessed via modified Baecke Questionnaire. Multivariable linear regression and logistic regression were used for analysis. Results: Objective and self-reported physical activity assessments were obtained at a median (IQR) age of 78 (75-81) years; 60.4% were females, and 23.1% were Black. The Spearman correlation coefficient between objectively measured and self-reported average daily hours of moderate-to-vigorous physical activity (MVPA) was 0.40. Cardiac CT scan was performed at a median (IQR) of 1.7 (1.5-2.0) years thereafter. Overall, the Agatston score was 0 in 10.1% and was > 400 in 39.1% of the participants. We observed a significant J-shaped association between objectively measured MVPA and Agatston score ( Figure 1 ). The estimated mean Agatston score was highest at 64 (at 0 hours/day of MVPA) and reached its nadir of 30 at 0.74 hours/day of MVPA. Beyond 0.74 hours/day of MVPA, the estimated mean Agatston score showed a slight upward trend. Similarly, among participants with detectable CAC (Agatston score > 0), 0.80 hours/day of MVPA corresponded to the lowest marginal predicted probability (17%) of severe CAC (Agatston score > 400) ( Figure 2 ). In contrast, there was no significant association between self-reported MVPA and Agatston scores. Conclusions: Objectively measured physical activity demonstrated a J-shaped relationship with CAC, with the lowest Agatston score observed at approximately 45 minutes daily of MVPA. Self-reported activity may inadequately capture this association, highlighting the importance of objective assessment in cardiovascular risk evaluation.

Abstract TH854: Digital Twins Powered by Generative Artificial Intelligence Support Long-Term Evaluation of Obesity and Cardiometabolic Outcomes

Introduction: Obesity and cardiometabolic diseases are leading contributors to global morbidity and mortality. Their interdependent progression is not well captured by existing models, which often rely on oversimplified assumptions and lack the flexibility to evaluate diverse populations. Hypothesis: We assessed the hypothesis that a generative AI digital twin model could accurately simulate long-term, multivariate trajectories of obesity and cardiometabolic comorbidities, enabling evaluation of intervention effects across subgroups and clinical benefits associated with sustained weight loss. Methods: The Dynamic Evaluation of Cardiometabolic and Obesity DiseasE (DECODE) model was developed using a Conditional Restricted Boltzmann Machine (CRBM) architecture. Training data included adult patients (≥18 years) from a U.S. electronic health record database (2007–2024, Dandelion Health) and a U.S. commercial claims database (2016–2023). Inputs comprised >100 static and longitudinal variables (e.g., demographics, body mass index [BMI], comorbidities, medications). Validation compared observed versus synthetic distributions, variances, and correlation structures in a held-out cohort (≥10,000 patients) using Pearson correlations and Intersection over Union (IoU). Subgroup validation examined performance by baseline type 2 diabetes, age ≥65 years, BMI ≥40, sex, race, and GLP-1RA prescription. Simulations estimated the 5- and 10-year effects of sustained 10% weight loss on cardiometabolic outcomes (including heart failure and atrial fibrillation) and bariatric surgery. Results: The trained DECODE model achieved high validity and concordance with observed data distributions, variances, and correlation structures (ρ≥0.94; overall and subgroup-specific IoUs ranged 0.88-0.99 and 0.78-0.99, respectively). Sustained 10% weight loss was associated with notable reductions in the 5- and 10- year cumulative incidence (5-year risk ratio [RR]; 10-year RR) of heart failure (0.83; 0.74) and bariatric surgery (0.83; 0.88). The association with atrial fibrillation was minimal (0.98; 0.96). Conclusions: DECODE provides a dynamic, high-resolution framework for simulating obesity and cardiometabolic disease progression across diverse populations. Generative AI digital twins enable rigorous evaluation of long-term interventions, with simulations demonstrating significant reductions in cardiometabolic risk at both 5 and 10 years following sustained weight loss.

A non-randomised controlled study of the missing link person-centred care transition support intervention after stroke or TIA

Abstract The transition from hospital to home after stroke or transient ischaemic attack (TIA) is a vulnerable phase marked by gaps in coordination, communication and patient preparedness. This study evaluated the effectiveness of a multicomponent care transition support on perceived quality of care transition (QCT) amongst people with stroke or TIA one week post-discharge. This non-randomised controlled study was conducted in three Swedish hospitals. Adult people with stroke or TIA discharged to home and referred for home-based neurorehabilitation were eligible. Data were collected during hospitalisation and at a blinded one-week follow-up. Primary outcome was perceived QCT, assessed with the Care Transition Measure. Secondary outcomes included health literacy, medication adherence and perception of received care. In total, 163 participants completed follow-up. The intervention group reported higher perceived QCT than controls ( p  = 0.002), which remained significant after adjustments (β = 6.34; 95% CI 0.56–12.12; p  = 0.03). The intervention group reported greater confidence in managing health and better understanding of medications. Health literacy was higher in the intervention group, with no between-group differences in medication adherence or perception of received care. A multicomponent care transition support intervention may improve perceived QCT early after discharge in people with stroke or TIA.

Abstract TU227: Annual Change in High-Sensitivity Cardiac Troponin T and Risk of Cardiovascular Disease and Mortality: The Atherosclerosis Risk in Communities (ARIC) Study

Background: Measurable concentrations of high-sensitivity cardiac troponins (hs-cTn; hs-cTnT and hs-cTnI) reflect subclinical myocardial damage, define stage B heart failure (HF) when persistently high, and are prognostic of cardiovascular disease (CVD). A recent consensus report recommended annual hs-cTn testing among persons with diabetes to inform treatment and promote early HF detection. However, data supporting annual testing in the general population are sparse. Methods: We evaluated 6,411 Black and White adults who attended ARIC visits 2 (V2; 1990 – 92) and 4 (V4; 1996 – 98) and were free of CVD. Hs-cTnT change over the approximate 6-year interval was annualized and modeled in absolute ([V4 hs-cTnT – V2 hs-cTnT]/years between visits) and percent scales ([[V4 hs-cTnT/V2 hs-cTnT] (1/years between visits) – 1] * 100). Hs-cTnT concentrations < 3 ng/L were imputed as 1.5 ng/L. Using Cox regression, we evaluated the associations of annualized hs-cTnT change (modeled linearly and using restricted cubic splines) with incident HF hospitalization or death, adjudicated coronary heart disease (CHD), and all-cause mortality after V4. Results: The mean age was 63 years (51% women, 22% Black adults). On average, participants experienced an annual 0.4 ng/L increase (9% relative increase) in hs-cTnT. Over 28 years of follow-up, there were 1,744 HF events, 1,303 CHD events, and 4,236 deaths. After adjustment for demographic and CVD risk factors, a 0.5 ng/L annual increase in hs-cTnT was associated with significantly greater risk of HF (HR 1.04, 95% CI: 1.03, 1.05), CHD (HR 1.03, 95% CI: 1.02, 1.05), and death (HR 1.03, 95% CI: 1.02, 1.04). When modeled flexibly using restricted cubic splines, annualized percent change in hs-cTnT was robustly associated with risk of HF, CHD, and death in a dose-response fashion ( Figure ). Conclusion: One-year increases in hs-cTnT were associated with increased risk of HF, CHD, and death, suggesting that annual hs-cTnT changes are clinically relevant. Routine hs-cTnT screening in the general middle-aged population may be useful for identifying persons at high risk for developing CVD.

Abstract TH863: Assessing Differences in Hypertension Prevalence and Incidence by Sexual Orientation: Analysis using Electronic Health Records from an Illinois Health System

Background: The weathering hypothesis proposes that sexual minorities would have earlier onset of chronic disease like hypertension (HTN) due to chronic stress and discrimination. This hypothesis has not been fully studied as most prior work focused on prevalence analysis. Using electronic health records from a large health system in Illinois, we compared prevalence and incidence of HTN by sexual orientation. Methods: We used data from people 30-60 years old with sexual orientation data and no evidence of HIV at the time of reporting sexual orientation (index date). We then identified prevalent (before or on index date) and incident (≥1 day after index date) HTN cases using diagnosis codes, medications, and outpatient blood pressure (≥140/90 mmHg). We performed 1:4 propensity score matching of bisexual (bi) and gay/lesbian to straight adults (covariates: age, legal sex, race&ethnicity, prior year utilization, year of first visit). We used logistic regression to calculate HTN prevalence ratios and Cox proportional hazards models to calculate hazard ratios. Subgroup analysis by legal sex (male/female) and age group (incidence only) was also performed. Results: The 157,334 eligible individuals (1.95% bi, 5.34% gay/lesbian) had crude HTN prevalences of bi-8.4%, gay/lesbian-11.2% and straight–10.2% (Image 1). Matching led to covariate balance. Compared to straight controls, bi (PR: 1.25, 95%CI: 1.15, 1.36) and gay/lesbian adults (PR: 1.22, 95%CI: 1.17, 1.26) had significantly higher HTN prevalence with slightly lower age at diagnosis. The prevalence remained higher in subgroup analyses by sex and using the ≥130/80 mmHg threshold (Images 2&3). Survival analysis showed bi adults had higher HTN risk (HR: 1.24, 95% CI: 1.07, 1.44) than straight controls with bi adults having lower mean diagnosis age. Stratified analyses show higher risk in males only. Sensitivity analysis with the ≥130/80 mmHg threshold showed significantly higher risk in bi adults, but subgroup analysis by sex only had significant results for females. No significant difference in HTN risk between gay/lesbian and straight controls were noted. Incident analysis by age showed higher risk in younger subgroups. (Images 2&3). Conclusion: Consistent with weathering, we found higher HTN prevalence in sexual minority adults and higher incident HTN risk in bisexual compared to matched straight adults. Confirmation with data from other health systems and community-based cohorts is needed.

Abstract TH901: Geographic Disparities in Transcatheter Aortic Valve Replacement (TAVR) Outcomes at Shasta Regional Medical Center: Assessing the Impact of Rural Residence, Comorbidities, and Access to Care.

Intro: Transcatheter Aortic Valve Replacement (TAVR) is the standard of care for patients with symptomatic aortic stenosis and high surgery risk. However, access to TAVR varies and rural populations often face barriers due to limited access to cardiologists, travel burden, geographic isolation, and financial constraints. Understanding comorbidity trends helps contextualize geographic disparities among rural populations. Shasta Regional Medical Center (SRMC) serves as the closest resource for advanced cardiac procedures for Northern California north of Redding, and is why we assessed the most prevalent comorbidities, impact of rural residence, and comorbidity burden among patients receiving TAVR at SRMC. Methods: A retrospective analysis was conducted on TAVR procedures performed at SRMC from 2020-2024. Aggregate data were analyzed for comorbities including diabetes, hypertension (HTN), prior myocardial infarcion (pMI), heart failure (HF), prior percutaneous intervention (pPCI), conduction defects, and cerebrovascular accidents (CVA). Rural-Urban Commuting Area (RUCA) codes and Zip Code Tabulation Areas (ZCTA) were used to classify residence as Urban (≤3), Micropolitan (>3,≤6), or Rural (>6). Chi-square tests evaluated differences in comorbidity prevalence and NYHA functional class among groups, and t-tests assessed comorbidity burden. Institutional Review Board approval and a wavier of consent was obtained. Results: A total of 430 TAVR procedures were analyzed. HTN, diabetes, and pPCI were the most prevalent comorbidities (84.6%, 27.2%, and 20.5%, respectively). Annual trend anaylsis showed significant variation in pMI (p=0.0129) and recent HF (p<0.0001). Rural analysis (n=388) included 288 Urban, 31 Micropolitan, and 69 Rural patients. No statistically significant differences were observed in comorbidity prevalence or comorbidity burden between groups (p=0.50). However, NYHA class distribution differed significantly, with Rural and Micropolitan patients presenting in more advanced stages compared to Urban counterparts (p=0.038 and p=0.001, respectively). Conclusions: Although comorbidity burden and prevalence were similar across geographic groups, Rural and Micropolitan patients presented in more advanced NYHA class than their Urban counterparts. These findings may indicate delays in cardiac care, referral processes, or symptom reporting, and further support the need for improved outreach and referral optimization for rural populations.

ForamJ – A tool for the reproducible, semi-automated analysis of foraminifera micro computed tomography datasets

Abstract The application of micro-computed tomography (µCT) to foraminiferal test analysis has opened new avenues for high-resolution, non-destructive 3D characterisation of internal and external morphological features. However, existing workflows are typically limited by low throughput, manual segmentation, and reliance on proprietary software, constraining dataset reproducibility and scalability. Here we present ForamJ, an open-source ImageJ plugin developed specifically for the semi-automated, reproducible analysis of foraminiferal µCT datasets. ForamJ streamlines key stages of image processing, including test segmentation, homogenous infill removal, chamber isolation, and morphological quantification, with outputs tailored to established micropaleontological metrics while providing a significant decrease in processing time versus existing methods. These include both calcite volume and chamber volumes, test surface area, inner and outer wall thickness and chamber centroids - parameters directly relevant to taxonomy, taphonomy, paleoecology, and biomineralisation processes. The plugin supports both single-sample and batch-processing workflows, enabling high-throughput analysis. Two use cases are presented: (1) the assessment of species-specific morphological variability in ancient cosmopolitan benthic foraminifera genus Cibicidoides spp. and (2) quantification of trends in between multiple species of modern planktonic foraminifera. Validation against manual segmentation of benthic foraminifera performed in commercial software ORS Dragonfly demonstrates ForamJ’s analytical fidelity, with a 1.30% difference in calcite volume between ForamJ and manually annotated tests, with a 0.9981% (± 0.001) segmentation accuracy and 0.97 (± 0.008) dice score with a median processing speed of 154 seconds per sample. By embedding foraminifera-specific metrics into an accessible, reproducible, and extensible framework, ForamJ provides a lightweight, dedicated digital toolset for advancing µCT-based test analysis in foraminiferal research.

Abstract TU269: Cross-Sectional Associations of Sleep with Atrial Cardiopathy in Adults with Overweight or Obesity

Background: Sleep disturbances are prevalent among individuals with excess adiposity and may contribute to atrial abnormalities. However, the relationship between sleep and atrial cardiopathy remains unexplored. We hypothesized that poor sleep quality and shorter sleep duration would be associated with prevalent atrial cardiopathy in adults with overweight or obesity. Methods: This cross-sectional analysis included participants from the Long-term Effectiveness of the Anti-Obesity medication Phentermine (LEAP) trial with sleep and electrocardiogram (ECG) data at baseline. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Global scores were used to categorize individuals as having poor (>5) or good (≤5) quality sleep; self-reported sleep duration was categorized as short (<7 h/night) or sufficient (≥7 h/night). Atrial cardiopathy (present vs. absent) was defined from ECG as P-wave terminal force in lead V1 >4000 , P-wave duration >120 ms, P-wave axis (<0 ° or <75 °), or presence of premature atrial contractions. Multivariable logistic regression models examined the associations of sleep quality and duration with atrial cardiopathy, adjusting for sociodemographics and cardiometabolic risk factors. Effect modification by body mass index (BMI) was also evaluated. Results: Among 851 participants (mean age 49±12 years, 72% female, 60.5% white, mean BMI 35.7±4.3 kg/m2),209 participants (24.6%) met criteria for atrial cardiopathy. Poor sleep quality was reported in 452 (53%) of participants. In multivariable-adjusted models, neither poor sleep quality or short sleep duration was associated with atrial cardiopathy ((ORs with 95% confidence interval: 0.85, (0.61-1.2) and 1.13, (0.81-1.58)), respectively. The associations of sleep disturbance (poor quality, short duration) with atrial cardiopathy were similar across BMI strata defined by median BMI, with no significant effect modification observed (all interaction p-values >0.8). Conclusions: In adults with overweight and obesity, our results revealed that poor sleep quality and short sleep duration were not associated with atrial cardiopathy. It is possible that both sleep quality and atrial remodeling have already been altered in this patient population. Future studies including individuals without overweight or obesity may help clarify whether sleep disturbances are independently associated with atrial cardiopathy.

Abstract TH833: Patient characteristics associated with 90-day referral to a home-based cardiac rehabilitation program in Kaiser Permanente Southern California

Background: Cardiac rehabilitation (CR) is a guideline-recommended exercise and lifestyle management program to support individuals recovering from a cardiovascular event or procedure. It is effective in reducing subsequent morbidity and mortality among high-risk patients. Given the historic under-referral to CR, we aimed to identify patient factors associated with referral to an 8-week home-based CR (HBCR) program within Kaiser Permanente Southern California (KPSC). Methods: We identified 44,468 KPSC adults ≥18 years of age with an HBCR-eligible event or procedure between 1/1/2021 and 9/30/2024; the first event per patient was selected. We identified all HBCR referrals occurring within 90 days of the event or procedure date. Using Poisson regression with a robust error variance, we calculated multivariable-adjusted prevalence ratios (PR) for the association of baseline sociodemographic and clinical characteristics with 90-day referral to HBCR. Results: Overall, 13,164 individuals (29.6%) had a HBCR referral within 90 days of the qualifying event. A higher proportion of adults having vs not having a 90-day referral were male (71.4% vs 59.5%), Asian/Pacific Islander ([API];13.3% vs 10.8%), and had a myocardial infarction (MI) as their qualifying event (52.7% vs 35.6%); all p-values were <0.001. After multivariable adjustment, those having a higher likelihood of referral were older (PR 1.44, 95% CI 1.25-1.66; PR 1.56, 95% CI 1.36, 1.80; PR 1.22, 95% CI 1.05, 1.42 for ages 35-54, 55-75, and ≥75 vs 18-34 years, respectively) and Hispanic and Asian/Pacific Islander compared to white (PR 1.05, 95% CI 1.02-1.08 and PR 1.06, 95% CI 1.02, 1.10, respectively). Those having a lower likelihood of referral were female (PR 0.83, 95% CI 0.81, 0.86), non-Hispanic black compared to white (PR 0.93, 95% CI 0.89, 0.98), those with Medicaid or Medicare insurance (PR 0.91, 95% CI 0.85, 0.97 and PR 0.88, 95% CI 0.86, 0.91, respectively), those needing an interpreter (PR 0.94, 95% CI 0.90, 0.99), and patients having any hospitalizations (PR 0.87, 95% CI 0.84, 0.90), emergency department visits (PR 0.93, 95% CI 0.90, 0.95), or home health visits (PR 0.75, 95% CI 0.71, 0.79) in the year prior to their event. ( Table ) Conclusion: Approximately 30% of eligible patients were referred to HBCR within 90-days leaving much room for improvement. Focusing on patient populations at high risk of non-referral and understanding provider barriers to referrals are important to improve uptake.

Abstract TU120: MS#1072 Association of chronic kidney disease with COVID-19 disease severity in the Hispanics/Latinos: the HCHS/SOL study

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality. Disparities in COVID-19 severity by Hispanic/Latino ethnicity and comorbidities are known, but differences within Hispanic/Latino populations with different chronic kidney disease (CKD) stages are not well-studied. Objective: Conduct longitudinal analysis of CKD with incident COVID-19 infection and related hospitalization or death in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: CKD at HCHS/SOL Visit 2 (2014-2017) was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m 2 or urine albumin to creatinine ratio (ACR) ≥30 mg/g. CKD stages were defined as Stage 1) (G1) eGFR ≥90 and ACR ≥30, 2) (G2) eGFR 60-89 and ACR ≥30, 3) (G3) eGFR 30-59, 4) (G4) eGFR 15-29, and 5) (G5) eGFR ≤15. A composite COVID-19 outcome between 2020-2023 was defined as adjudicated COVID-19 infection, positive SARS-CoV-2 test, positive immunoglobulin G serology, or COVID-related hospitalization or death. Severe COVID-19 was defined as COVID-related hospitalization or death. Odds ratios (OR) were estimated from logistic regression accounting for age, sex, center, Hispanic background, diabetes, hypertension, cardiovascular disease, and the HCHS/SOL’s complex sampling design. Results: At Visit 2, the mean (standard error) age was 47.6 (0.3) years, and 46% were male. Out of 9673 Hispanic/Latinos, 1188 (12%) had prevalent CKD, including 52% G1, 21% G2, 22% G3, 3% G4, and 1% G5. Overall, 18.9% of those with CKD had evidence of COVID-19, compared to 25.0% of non-CKD participants (p = 0.001). Hispanic/Latinos with CKD had a greater percentage of severe COVID-19 (3.2% versus 2.0%; p=0.01). G1 and G5 had the highest percentage of COVID-19 (21.5%) and severe COVID-19 (6.0%), respectively. CKD was not associated with the composite COVID-19 variable (OR 0.80, 95% confidence interval (CI) 0.63, 1.02) or severe COVID-19 (OR 1.04, 95% CI 0.63, 1.72) in adjusted models. Conclusions: CKD was not associated with COVID-19 severity in Hispanics/Latinos, possibly due to older age and more healthcare utilization.