Browse Articles

Abstract P1020: Relationship Between CHA ₂ DS ₂ -VASc, Health Literacy, and Atrial Fibrillation Knowledge

Introduction: It is unknown how comorbid diagnoses affect patients’ disease-specific knowledge or how patients’ health literacy or numeracy affects this relationship. In patients with atrial fibrillation (AF), comorbidities can be quantified by the CHA 2 DS 2 -VASc score. We explore the association of AF/stroke knowledge with CHA 2 DS 2 -VASc score, health literacy, and numeracy for usual care participants in the multi-center Randomized Evaluation of Decision Support Interventions for Atrial Fibrillation (RED-AF) trial evaluating decision aids to initiate (initiation cohort) or continue (monitor cohort) oral anticoagulation (OAC) in AF patients. Methods: This study was conducted at six academic medical centers in the United States. Participants were aged ≥18, diagnosed with non-valvular AF, and at risk for stroke (CHA 2 DS 2 -VASc ≥1 for men, ≥2 for women). Patient demographics were obtained via questionnaires after a baseline clinical encounter; knowledge was evaluated by patient responses to 7 questions about OAC and AF. Health literacy was measured by a validated self-reported screening tool; numeracy by a validated subjective numeracy scale; CHA 2 DS 2 -VASc was calculated from medical records. We applied generalized estimating equations for a binomial outcome to jointly relate patient knowledge to CHA 2 DS 2 -VASc score, health literacy and numeracy, controlling for 5 additional patient factors and accounting for clustering by clinician. Results: We report on 306 patients randomized to the usual care group across six participating sites. Average age 68.7 9, 61.6% male, mean CHA 2 DS 2 -VASc 2 1.5. Patient knowledge was independently associated with numeracy (5% higher odds of correct response per 1 unit increase in numeracy, 95% CI 0-10%, p=0.05) and membership in the monitor cohort (40% odds of correct response, 4-89%, p=0.03) but not health literacy or increased stroke risk. Conclusion: In the RED-AF study , although health literacy and increasing stroke risk were not independently associated with patient knowledge about AF, numeracy had a minimal positive association. Those already on OAC had greater disease knowledge than patients newly starting OAC. These results suggest a need to broadly increase patient education regardless of baseline comorbidity burden and degree of health literacy. Future studies should be performed to better understand other factors that drive patient knowledge regarding AF and stroke.

Abstract P1039: Inhibition Of Drug Metabolizing Enzyme Cytochrome P450 2C8 By Acyl-Glucuronide Metabolites Of Gemfibrozil And Clopidogrel.

Human cytochrome P450 (CYP) enzymes are a superfamily of heme-containing oxidoreductases essential in the metabolism of various xenobiotics. CYP2C8 is responsible for the oxidative metabolism of many important drugs including cerivastatin, repaglinide, pioglitazone, enzalutamide, dasabuvir, imatinib, etc. and has generated research interest due to its involvement in drug-drug interactions (DDI). The glucuronide metabolites of the antilipemic drug gemfibrozil and the antiplatelet drug clopidogrel are known as strong inhibitors of CYP2C8 leading to several DDIs. Most of the gemfibrozil dose is primarily metabolized as glucuronide conjugate or gemfibrozil acyl-glucuronide, which is a known mechanism-based inhibitor of CYP2C8 that leads to clinical DDIs with the substrates of CYP2C8. For example, the co-administration of gemfibrozil with the CYP2C8 substrate pioglitazone inhibited the metabolism and increased the concentration of pioglitazone leading to DDIs. In addition, the clopidogrel acyl-glucuronide metabolite is a known strong time-dependent inhibitor of CYP2C8 leading to marked clinical DDIs with the substrates of this enzyme. Patients on clopidogrel and concurrently taking cerivastatin, or the anti-diabetic repaglinide, are at increased risk of rhabdomyolysis. It is not clear how a glucuronide metabolite of these drugs binds in the active site of CYP2C8 and inhibit the enzyme. CYP2C8 enzyme was recombinantly expressed and purified. A biophysical method Surface Plasmon Resonance (SPR) was used to elucidate the binding of the acyl-glucuronide metabolites of gemfibrozil and clopidogrel with CYP2C8. The representative dissociation constant (K D ) of CYP2C8 binding with gemfibrozil acyl-glucuronide was 227.5 ± 38.5 µM, whereas the K D of CYP2C8 binding with clopidogrel acyl-glucuronide was ten-fold lower, in the range of 3 to 25 µM indicative of higher affinity. The purified protein was also used for crystallization with these acyl glucuronides of gemfibrozil and clopidogrel with an aim to determine the three-dimensional structure. Overall, the characterization of CYP2C8 with gemfibrozil acyl-glucuronide and clopidogrel acyl-glucuronide yielded insights into the binding and inhibition of an important drug metabolizing enzyme.

Abstract 028: The Role of Low Physical activity in Exacerbating Global Ischemic Heart Disease: A Three-Decade Global Comprehensive Analysis

Introduction: Ischemic heart disease (IHD) remains one of the leading causes of morbidity and mortality worldwide, with physical inactivity identified as a key modifiable risk factor. This is the first ever study estimating the burden of IHD attributable to low physical activity (LPA) including first 2 years of COVID-19 pandemic. Method: Using Standardized GBD 2021 methodology, we estimated deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs) due to IHD attributable to LPA stratified by age, sex, year and location across the 204 Countries and territories from 1990-2021. Non-fatal health outcomes were estimated using cause of death ensemble model (CODEm). Results are shown in absolute counts, unadjusted and age-standardized rate per 100,000. Results: From 1990-2021, the average annual percentage change (AAPC) the absolute death count rose by 2.00%, 1.79% for DALYs, 2.81% for YLDs, and 1.77% for YLLs. The highest increase in APC was observed in deaths among countries with a middle socio-demographic index at 2.06%, followed by DALYs at 1.60%. According to health system grouping levels, the highest death rate in 2021 was observed in countries with advanced health systems at 4.38 per 100,000 (95% UI: 1.8-7.3). Over the last three decades, males continued to show a higher burden compared to females, with APCs in deaths of 1.10% for males versus 0.74% for females, 0.89% for DALYs versus 0.65%, and 0.88% for YLLs versus 0.64%. Conclusion: Deaths due to IHD accounted for 2.58% of all IHD related deaths globally in 2021. Our findings underscore the need for public health strategies that address the complex socio-technological landscape influencing physical activity levels and suggest pathways for integrating more movement into daily life to mitigate the IHD burden. The need for action is urgent if we are to reverse the trends that have placed so many at risk in our increasingly sedentary world.

Utility of UAS-LIDAR for estimating forest structural attributes of the Miombo woodlands in Zambia

The ability to collect precise three-dimensional (3D) forest structural information at a fraction of the cost of airborne light detection and ranging (lidar) makes uncrewed aerial systems-lidar (UAS-lidar) a remote sensing tool with high potential for estimating forest structural attributes for enhanced forest management. The estimation of forest structural data in area-based forest inventories relies on the relationship between field-based estimates of forest structural attributes (FSA) and lidar-derived metrics at plot level, which can be modeled using either parametric or non-parametric regression techniques. In this study, the performance of UAS-lidar metrics was assessed and applied to estimate four FSA (above ground biomass (AGB), basal area (BA), diameter at breast height (DBH), and volume (Vol)) using multiple linear regression (MLR), a parametric technique, at two wet Miombo woodland sites in the Copperbelt province of Zambia. FSA were estimated using site-specific MLR models at the Mwekera and Miengwe sites and compared with FSA estimates from generic MLR models that employed combined data from the two sites. The results revealed that the model fit of site-specific MLR models was marginally better (Adj-R2: AGB =  0.87–0.93; BA =  0.88–0.89; DBH =  0.86–0.96; and Vol =  0.87–0.98 than when using a generic combined data model (AGB =  0.80; BA =  0.81; DBH =  0.85; and Vol =  0.85). However, the rRMSE (2.01 – 20.89%) and rBias (0.01-1.03%) of site specific MLR models and combined data model rRMSE (3.40-16.71%) and rBias (0.55-1.16%) were within the same range, suggesting agreement between the site specific and combined data models. Furthermore, we assessed the applicability of a site-specific model to a different site without using local training data. The results obtained were inferior to both site-specific and combined data models (rRMSE: AGB =  36.29%–37.25%; BA =  52.98–54.52%; DBH =  55.57%–64.59%; and Vol =  26.10%–30.17%). The results obtained from this indicate potential for application in estimating FSA using UAS-lidar data in the Miombo woodlands and are a stepping stone towards sustainable local forest management and attaining international carbon reporting requirements. Further research into the performance of UAS-lidar data in the estimation of FSA under different Miombo vegetation characteristics, such as different age groups, hilly terrain, and dry Miombo, is recommended.

Abstract 010: Peripheral Neuropathy is Detected in More than Half of Very Old Adults

Objectives: Emerging evidence suggests peripheral neuropathy (PN) may be more common in older individuals than previously reported, even in the absence of diabetes. However, most studies define PN by loss of protective sensation alone, a late form of PN. We aimed to quantify the prevalence and risk factors for PN in community-dwelling adults aged 80-100 years using the Michigan Neuropathy Screening Instrument (MNSI), a validated screening tool that includes a questionnaire and physical examination. Methods: We conducted a cross-sectional analysis of participants in the Atherosclerosis Risk in Communities Study (2022–2023) who completed the MNSI. Using age-, sex-, site-adjusted logistic regression, we quantified associations between various risk factors and PN, including education, height, body mass index, Short Physical Performance Battery (SPPB) score, lifestyle habits, and comorbidities. PN was defined by a score > 2 on the physical examination or ≥ 7 on the questionnaire portion of MNSI. Results: Among 993 participants (median age 84 years, 40% male, 18% Black, 30% with diabetes), 44.1% screened positive for PN. Risk factors associated with PN included advanced age (≥ 95 years vs 80-85 years, aOR 2.60), male sex (aOR 1.47), taller height (height quartile 2 and 4 vs quartile 1, aOR 1.69 and 1.54), low physical function score (SPPB 0-6 vs 10-12, aOR 2.12), former alcohol consumption (vs no alcohol drinking history, aOR 1.64), and prevalent cardiovascular disease (aOR 1.47) ( Figure ). Diabetes and prediabetes were not significantly associated with PN based on the MNSI, but diabetes was associated with PN based on monofilament testing for loss of protective sensation (aOR 1.51, 95% CI 1.08-2.13). Conclusions: PN detected by the MNSI is highly prevalent among very old adults, regardless of diabetes status. In contrast, PN in adults with diabetes is associated with loss of protective sensation. Routine screening of older adults using the MNSI may be warranted to facilitate early detection and management.

Abstract P3009: Biomarkers and Risk of Cognitive Impairment in Atrial Fibrillation: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort

Introduction: Atrial fibrillation (AF) is highly prevalent, and its health effects outside of stroke are under intense study. AF increases dementia risk, but underlying mechanisms are unknown. Stroke or cerebrovascular pathophysiology, possibly attenuated with anticoagulation, may be contributory. Hypotheses: We assessed two hypotheses: (1) that higher levels of 9 circulating biomarkers (see Figure) would be associated with greater risk of incident cognitive impairment (ICI) in REGARDS participants with AF, and (2) that associations would be attenuated after adjusting for oral anticoagulant use. Methods: REGARDS enrolled 30,239 persons > 45 years old in 2003-07. AF was defined by self-report or ECG. ICI was defined during follow-up by robust cognitive norms based on the Montreal Cognitive Assessment and Six-Item Screener. Biomarkers were measured at baseline in participants with AF and no prior stroke. HRs of time to ICI by biomarkers were calculated by Cox proportional hazards models, with covariates shown in the Figure. Interaction testing by baseline oral anticoagulant use was also performed. Results: Among 2,261 participants with baseline AF, mean follow-up was 10.6 years (mean age 66.5 years, 51% women, 28.7% Black), and there were 149 ICI cases (7%). Higher NT-proBNP, FVIII, and GDF15 were each associated with ICI (Figure), with the largest association for FVIII (HR adj 2.41 per SD higher FVIII). Added adjustment for anticoagulant use did not attenuate associations, but the association of GDF15 was lower among those on anticoagulation (HR 1.0, 95% CI 0.4-2.6 compared to HR 1.8, 95% CI 1.1-3.0 without anticoagulation; p interaction 0.07). Conclusion: Higher NT-proBNP, FVIII, and GDF15 were associated with ICI in this biracial cohort with AF. Risk associated with GDF15, an inflammation marker, might be reduced with anticoagulation, but further study is needed.

Abstract P1053: Impact of Adversity and Birth Outcomes on the Prevalence of Heart-Related Conditions in Children

Background: Adverse childhood experiences (ACEs), social determinants of health, and adverse birth outcomes significantly impact children's well-being. Stress, psychological distress, and adverse birth outcomes contribute to various health issues, including heart-related conditions. This study explores the relationship between these factors and heart health in children to inform interventions and policies. Methods: Data from the National Survey of Children’s Health (NSCH) from 2016 to 2019 were analyzed. The NSCH provides comprehensive data on children's health. US households were randomly contacted by mail, and one child from each eligible household was selected. The overall weighted response rates ranged from 37.4% to 43.1%, with 131,774 children aged 0 to 17 years included. Key variables included bullying, emotional support from family, peers, and healthcare providers, parental divorce, birth weight, preterm birth, and heart conditions. Logistic regression analysis evaluated the relationship between these factors and heart-related conditions, controlling for confounders. Results: The prevalence of heart-related conditions was 2.40%. Bullying was reported by 4.15% of children as definitely true, 18.87% as somewhat true, and 76.98% as not true. Emotional support from family was reported by 89.44%, from peers by 12.65%, and from healthcare providers by 28.70%. Parental divorce was experienced by 22.43% of children. Very low birth weight was reported in 1.18%, low birth weight in 6.50%, and preterm birth in 10.83% of the sample. Logistic regression showed bullied children were 1.93 times more likely to have a heart condition. Emotional support from healthcare providers was associated with a 1.34 times higher likelihood of heart conditions. Low birth weight and preterm birth were associated with higher likelihoods of heart conditions (OR: 1.50 and 1.54, respectively). Emotional support from family, peers, and parental divorce were insignificant predictors. Conclusion: Adverse experiences such as bullying and adverse birth outcomes significantly increase the likelihood of heart-related conditions in children. Emotional support from healthcare providers also plays a crucial role. Interventions targeting bullying, enhancing emotional support, and addressing risks associated with adverse birth outcomes can mitigate long-term health impacts. Early intervention strategies are essential to improve children's health outcomes and prevent long-term cardiovascular issues.

Cancer screening prevalence and preference among hospitalized women with and without diabetes mellitus

Objective To determine the prevalence of nonadherence to breast cancer and colorectal cancer screening, associated risk factors, and screening preference among hospitalized women with and without diabetes aged 50–75 years who were cancer-free at baseline. Methods A prospective study compared women with and without diabetes who were cancer-free (except for skin cancer) at baseline and between 50 and 75 years of age, admitted to the general medical service at an academic center were approached for study participation from December 1, 2014, to May 31, 2017. The study evaluated breast and colorectal cancer screening nonadherence prevalence, preference for screening locale, sociodemographic and clinical variables associated with nonadherence using multivariable logistic regression model. Results Of 510 women, 39% had a prior diagnosis of diabetes mellitus, and 36% were African American. Women with diabetes were more likely to have obesity, reliance on assistive devices for ambulation, inability to work (have a disability), and a greater average number of comorbidities compared to women without diabetes. Women with or without diabetes were equally nonadherent with BRC (28% vs 36%, p = 0.6) and CRC (25% vs 28%, p = 0.51) screening guidelines. After adjustment for sociodemographic and clinical risk factors, only high risk for CRC (OR = 3.20, 95%CI; 1.03–9.91) was an independent risk factor associated with nonadherence to BRC among hospitalized women with diabetes. Whereas after similar adjustment, age younger than 60 years (OR = 2.91, 95%CI; 1.15–7.35) and current or prior smoking (OR = 2.80, 95%CI; 1.14–6.86) were associated with nonadherence to CRC among women with diabetes. 46% of women with diabetes expressed a preference for in-hospital screening for BRC, while 45% expressed a similar preference for CRC. Conclusion Hospitalizations may offer additional screening opportunities as almost half of the women with diabetes preferred undergoing breast and colorectal cancer screening during a hospital stay.

Abstract P1085: Heart Failure Incidence Among Disaggregated Asian American, Native Hawaiian, and Pacific Islander Subgroups: Insights from the PANACHE Study

Background: Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) persons comprise ~10% of the U.S. population—24 million people—yet a significant gap exists in contemporary data on incident heart failure (HF). Methods: We identified adults ≥30 years without cardiovascular disease (CVD) within Kaiser Permanente Northern California and Hawaii from 2012-2022. Incident HF was defined as a hospitalization, >3 clinic visits, or death due to HF, based on validated diagnostic codes and death certificates. We reported age-sex-adjusted incidence per 1,000 person-years by AANHPI subgroup with [95% confidence intervals] and calculated adjusted hazard ratios for incident HF in each subgroup compared to non-Hispanic Whites. Results: Among 2,653,007 million adults without CVD, mean age was 49±15 years and 53% were women. CVD risk factor prevalence was high, including hypertension (22%), dyslipidemia (26%), diabetes (7%), and overweight/obesity (56%). The cohort's self-reported racial/ethnic breakdown and rates of incident HF were: 6.8% Chinese (2.64 [2.55-2.73]), 7.3% Filipino (5.07 [4.93-5.22]), 2.4% Native Hawaiian/other Pacific Islander (8.75 [8.31-9.21]), 1.7% Japanese (3.07 [2.91-3.24]), 0.8% Korean (2.44 [2.15-2.74]), 3.5% South Asian (5.46 [5.1-5.84]), 1.9% Vietnamese (3.05 [2.74-3.37]), 1.0% other Southeast Asian (4.71 [4.1-5.36]), and 74.5% Non-Hispanic White (4.52 [4.49-4.56]). Adjusting for age, sex, and CVD risk factors, Chinese, Filipino, Japanese, Korean, and Vietnamese adults had lower risk of incident HF, while Native Hawaiian/other Pacific Islander and South Asian adults had higher risk compared to non-Hispanic White adults ( Figure ). Conclusions: Most AANHPI subgroups had lower adjusted risk of incident HF compared to non-Hispanic White adults, with Native Hawaiian/Pacific Islander and South Asian adults being notable exceptions. Our findings underscore the importance of disaggregating race and ethnicity to better understand risk profiles and mediators of incident HF.

Abstract P3006: Glycemia and Lipids Profiles Levels, Awareness and Control in the Adult Population: the Italian Health Examination Survey 2023-2024 - CUORE Project

Introduction: WHO recommends monitoring glycemic and lipid profiles in the population to control and prevent NCDs. The target for glycemic/diabetes is to halt the rise within 2025 (2010 as baseline). The Italian Ministry of Health (MoH) has strengthened prevention/health promotion and supported their periodic assessment through national health examination surveys (HESs), technically and financially supported by the Ministry of Health - National Centre for Disease Prevention and Control, and conducted within the CUORE Project. Hypothesis: The aim to monitor the achievement of the glycemia/diabetes WHO target and lipids profiles distribution in the Italian general population. Methods: In 2023 a new HES started including the assessment of fasting serum glycemia, total and HDL cholesterolemia and triglyceridemia. Up to now, data from random samples of residents in 12 Regions (of 20 regions) distributed in North, Centre and South of Italy and aged 35-74 years are available (1192 men, 1200 women). Glycemia and lipids profiles were assayed by a central lab. Elevated glycemia/diabetes (DM): glycemia ≥126 mg/dl and/or on medication. Elevated total cholesterol/hypercholesterolemia (HChol): total cholesterol ≥240 mg/dl and/or on medication. Results: Glycemia mean level was 97 mg/dl (95%CI: 96-98) in men and 91 mg/dl (90-92) in women; DM resulted 9% (6-12) and 7% (4-10) respectively. Among those with DM, about 2 in 10 men and 1 in 10 women were unaware; about 1 and 4 of 10 were aware but not on medication, respectively. Total cholesterol mean level was 194 mg/dl (192-196) in men and 203 (201-205) in women; HChol resulted 24% (18-31) and 29% (22-36) respectively. Mean level of HDL cholesterol was 49 mg/dl (49-50) in men and 60 mg/dl (59-61) in women; mean level of triglycerides was 116 mg/dl (112-120) and 93 mg/dl (91-96) respectively. Among those with HChol (men 25% - 21-30%; women 30% - 24-35%), about 2 in 10 men and 2 in 10 women were unaware; about 2 of 10 were aware but not on medication. Conclusions: Compared to 2008, these preliminary data showed a significant decrease of glycemia, total cholesterol and triglycerides mean values both in men and women, as well as of DM and HChol prevalence, but improvements on their awareness and control are still necessary.

Abstract MP11: Association of fixed dose combination therapy use with blood pressure control and cardiovascular outcomes in the Systolic Blood Pressure Reduction Intervention (SPRINT) Trial: A post-hoc analysis

Background: The seminal SPRINT trial demonstrated that intensive blood pressure (BP) control is associated with lower risk of adverse cardiovascular (CV) outcomes. However, BP control among individuals with hypertension in the US remains suboptimal. Fixed-dose combination (FDC) therapies are commonly used in clinical practice as a strategy to improve adherence to BP-lowering therapies. Whether use of FDC agents can facilitate greater intensive BP control and lower risk of adverse CV outcomes is not known. Methods: We performed a post-hoc analysis of SPRINT including 8623 participants with available drug therapy data. FDC use was defined by use of at least one combination agent. The association between FDC use and rate of change in BP in the acute (≤6 months) follow-up of the trial was assessed by linear mixed-effect model with repeated measures (LMMRM) including a FDC*time interaction term with adjustment for potential confounders. Difference in adjusted estimated marginal means for follow-up BP achieved at different timepoints between the FDC vs. non-FDC groups was also compared using LMMRM. Finally, multivariable Cox proportional hazards models were constructed to evaluate the association of FDC use with risk of composite CV events (non-fatal MI, CV death, and HF event). Results: Among 8623 participants analyzed, 9.3% (N=803) were prescribed FDC at baseline with greater rate of use in the intensive BP control vs. usual care group (5.79[5.61 to 5.97] vs. 3.90[3.75 to 4.06] per 100 person-months; p-diff<0.001). Among those with FDC use, the most commonly used formulations were lisinopril/HCTZ (11.3%) and triamterene/HCTZ (9.1%). In the overall cohort, FDC use was associated with more rapid BP reduction in the first 6 months (mean monthly change in systolic BP FDC vs. non-FDC [95% CI]: -1.94[-1.65 to -1.22] mmHg vs. -1.33[-1.27 to -1.40] mmHg; p-diff<0.001) with comparable difference across treatment arms. On long-term follow-up, participants using FDCs achieved significantly lower systolic BP at each timepoint. The risk of the composite CV events was not different among those with vs. without FDC use during the trial after adjusting for potential confounders (HR[95%CI]: 0.81[0.49 to 1.34]). Conclusions: Among SPRINT participants, use of FDC therapies was associated with more rapid acute BP control and lower BP during long-term follow-up. These observations suggest that FDC therapies may facilitate faster and more sustained achievement of intensive BP control.

Spatial distribution characteristics and influencing factors of milk tea stores in Wuhan based on sDNA and OPGD models

Milk tea stores have rapidly expanded in Wuhan due to residents’ increased consumption demand. Therefore, studying the spatial distribution and influencing factors of stores is important for optimizing their layout and promoting economic development. Using milk-tea store data from Amap City’s Point of Interest function and road network data from Baidu HeatMap, we analyzed the spatial distribution characteristics of stores within the third ring road of Wuhan City using ArcGIS. We then examined the influencing factors by combining spatial design network analysis, optimal parameters-based geographical detection, and location-based service big data. Our results revealed the following: (1) The spatial distribution of stores was concentrated in areas with high closeness and betweenness centrality, forming a multi-core “northwest–southeast” distribution pattern with significant spatial positive correlation. (2) The stores’ spatial pattern was influenced by the road network betweenness and the presence of office buildings, shopping malls, shopping centers, and tourism resources. The road network betweenness had the greatest impact on the stores’ spatial distribution, while the kernel density of betweenness presented a “one major and multiple sub-core” structure consistent with that of the stores’ spatial distribution. The kernel density of closeness and betweenness regulated the formation of the stores’ core area and multiple sub-core areas, respectively, and both factors governed the stores’ spatial distribution, which was characterized by a “widely-scattered and sporadically-clustered” pattern. (3) The stores’ distribution was closely associated with the spatial and dynamic population distribution at different times of the day. By demonstrating the big data for the spatial distribution and driving factors of milk tea stores at the urban regional scale, we fill the research gap on the spatial distribution of milk tea stores at the meso-scale. Our results offer insights into the future urban planning of milk tea stores amid the current milk tea craze.

Abstract P2089: Heavy coffee consumption is associated with borderline high risk of coronary heart disease - a meta-analysis

Background: Coffee's global popularity arises from its stimulating effects on the central nervous system, taste, and aroma, making it one of the most widely consumed beverages. Numerous studies have explored the potential link between coffee consumption and diseases, particularly coronary heart disease (CHD), yet this association remains debatable. Purpose: This study aims to assess the risks and benefits of coffee consumption concerning CHD, compared to individuals who do not drink coffee. Methods: An umbrella meta-analysis incorporating existing meta-analyses was conducted. A systematic search was performed on the PubMed database from 2006 to 2023 using the PRISMA protocol. MeSH terms "coffee consumption," "coronary artery disease," and "myocardial infarction" were used. The study included 3.28 million participants from cohort studies across four prospective meta-analyses. Additionally, subgroup analysis based on varying levels of coffee intake (very-heavy, moderate, and light) was performed. Analysis was conducted using RevMan to derive a summarised risk ratio (RR) of CHD/MI associated with coffee consumption and a 95% Confidence Interval. Risk bias was incorporated using RoBANS integrated with RevMan. Sensitivity analysis was conducted by excluding one study at a time to derive Heterogeneity Index (I 2 ) scores. Forest plots were generated, with statistical significance set at p<0.05. Results: The study comprised four meta-analyses meeting the inclusion criteria, incorporating 80 studies involving 3.28 million individuals worldwide. Compared to non-coffee drinkers, coffee consumers had a summarized risk ratio of 1.08 (95%CI: 1.01-1.14, I2: 76%, p<0.00001). Subgroup analysis, with one study omitted, revealed that very-heavy coffee drinkers had a risk ratio of 1.14 (0.99-1.29, 73%, p<0.00001), moderate coffee drinkers had a risk ratio of 1.02 (0.89-1.14, 77%, p<0.00001), and light coffee drinkers had a risk ratio of 1.00 (0.94-1.06, 0%, p<0.00001). Conclusion: Based on our umbrella meta-analysis, very-heavy coffee consumption is associated with a borderline increased risk of CHD. However, no significant difference was found between moderate and light coffee drinkers regarding CHD risk.

Abstract P3049: Metabolic Measures and Incident Cardiovascular Disease and Mortality: A Pooled Analysis of Multi-ethnic NHLBI Cohorts

Background: The added roles of metabolic measures in health outcomes in racial/ethnic groups in the US remain poorly understood. Pooling data from multi-ethnic cohorts can improve the power to conduct detailed assessment of health outcomes across different racial/ethnic groups. Objectives: We examined associations of metabolic measures (fasting plasma glucose, log-fasting insulin, log-HOMA-β, log-HOMA-IR and triglyceride glucose index [TGI]) with incident cardiovascular disease (CVD) and mortality in the US and examined the differences in strength of associations across racial/ethnic groups. Methods: We pooled individual-participants' data of 23,896 individuals (mean age 49.1years, 45.3% men) from 5 NHLBI cohorts (ARIC, CARDIA, CHS, JHS and MESA) without CVD or diabetes at baseline. Associations between metabolic measures and incident CVD were determined using Fine and Gray models adjusted for confounders. Results: Over a median period of 19 years (13.9-30.9), there were 4800 first-ever incident CVD and 7976 deaths. All metabolic measures showed positive log-linear association with incident CVD (aHR (95% CI) per SD: FPG 1.10 [1.06-1.15]; log-fasting insulin [1.18; 1.13-1.23]; logHOMA-β [1.15; 1.10-1.20]; logHOMA-IR [1.19; 1.14-1.24]; TGI [1.24; 1.19-1.29]) and all-cause mortality (aHR (95% CI) per SD: FPG 1.10 [1.07-1.13]; log-fasting insulin [1.14; 1.11-1.18]; logHOMA-β [1.11; 1.08-1.15]; logHOMA-IR [1.15; 1.11-1.19]; TGI [1.13; 1.09-1.16]). Associations with incident CVD were comparable across racial/ethnic groups. However, associations of each of FPG, log-fasting insulin and logHOMA-IR with incident mortality was stronger in Whites than other racial/ethnic groups. Adjustment for blood pressure, lipids, serum creatinine and adiposity did not explain the racial/ethnic differences in associations of these measures with mortality (FPG X 2 =7.6, p- Interaction=0.05); log-fasting insulin X 2 =8.8, p- Interaction=0.03) and logHOMA-IR X 2 =10.6, p- Interaction=0.01). Conclusion: There is need for further studies to investigate the putative biological mechanisms underlying the observed ethnic differences in association of metabolic measures with mortality in the US.

Abstract P1173: Opportunities for Intervention: Mental Health and Cardiovascular Health Literacy in Women – Insights from the Research Goes Red Initiative

Introduction: Cardiovascular health literacy (CVHL) is vital for managing cardiovascular risk. However, poor mental health can be a barrier, and there's a gap in understanding how mental health impacts CVHL in women. Hypothesis: We hypothesized that mental health has an association with cardiovascular health literacy. We further hypothesized that this would vary by younger age. Methods: We conducted a cross-sectional study using data from the Research Goes Red registry and SAFE HEART study. Women aged ≥18 completed questionnaires on cardiovascular health literacy (CVHL) and mental health. CVHL was assessed using a validated tool, with scores ranging 0-100. It included knowledge of CVD risk factors, exercise, diet, and therapeutic interventions. Psychological health risk was measured using the Perceived Stress Scale (PSS-4; score 1-16), Generalized Anxiety Disorder scale (GAD-2; score 1-6), and Patient Health Questionnaire (PHQ-2; score 0-6) for assessing depression. Stepwise linear regression models evaluated associations between mental health and CVHL. Final adjusted models employed spline terms for PHQ-2 (scores 1, 2, 3), GAD-2 (scores 1, 2, 3), and PSS-4 (scores 4, 8, 12). Results: A total of 677 women were included in the analysis. Mean age 40.07 (SD15.30), 29.08% Black, and 64.1% employed. Our analysis revealed complex associations between mental health measures and cardiovascular health literacy (CVHL). Perceived stress (PSS-4) showed a non-linear relationship with CVHL (β=-2.64, 7.28, -5.72 for scores 4, 8, ≥12 respectively; all p<0.05). Depression (PHQ-2) demonstrated a significant negative association at score 1 in the crude model (β=-6.51, 95% CI: -10.69, -2.34), which attenuated after adjustment. Anxiety (GAD-2) showed a significant positive association at scores ≥3 in the crude model (β=6.94, 95% CI: 2.06, 11.83), also attenuating after adjustment. Age ≥50 was consistently associated with higher CVHL scores across all models (β range: 10.49-13.3; all p<0.001). Physical activity <150 minutes/week showed a positive association (β=4.76, p<0.05), but interacted negatively with BMI ≥25 (β=-7.12, p<0.05). Financial strain was negatively associated with CVHL (β=-6.41, 95% CI: -9.16 to -3.67, p<0.001). Conclusion: Mental health and CVHL show complex relationships, older age consistently predicting higher CVHL. Financial strain negatively impacts CVHL, highlighting the need for targeted interventions addressing both psychological and socioeconomic factors.

Correction: “When I talk about it, my eyes light up!” Impacts of a national laboratory internship on community college student success

Abstract P2136: Prognostic Value of the Six-Minute Walk Test in Patients with Hypertrophic Cardiomyopathy

Background: The six-minute walk test (6MWT) is a simpler, safer, and more cost-effective measure of functional capacity than cardiopulmonary exercise testing (CPET) and can be used for risk stratification of several cardiovascular diseases. However, there are no data on the prognostic value of the 6MWT in hypertrophic cardiomyopathy (HCM). Objective: To investigate the prognostic value of the 6MWT in HCM and determine whether it can be used as an alternative to CPET. Methods: A total of 534 patients with HCM were prospectively recruited to undergo both 6MWT and CPET. The endpoint of this study was major adverse cardiovascular events (MACE, a composite of cardiovascular death, heart failure, aborted sudden cardiac death, and stroke). The associations of the 6MWT with MACE were investigated using survival analyses, and the ability of 6MWT and CPET parameters to predict MACE were compared. Results: Four hundred and ninety-six patients with HCM who had complete follow-up data available were included. The mean age was 46.8 years, and 69.1% were male. The 6MWT distance correlated significantly with peak VO 2 on CPET (r=0.328, P<0.001). Thirty-eight patients had MACE during a median follow-up of 2.7 years. A shorter 6MWT distance was independently associated with a higher risk of MACE (per 100-m decrease, hazard ratio 1.755, P=0.003) after adjusting for covariables. The association between peak VO 2 and MACE was also determined (per 1 mL/min/kg decrease, hazard ratio 1.102, P=0.044). The ability of the 6MWT distance to predict MACE was not significantly different from that of peak VO 2 (C-statistic, 0.643 vs 0.616). The optimal cutoff value of the 6MWT distance was identified as 423 m. Addition of the 6MWT distance (as a dichotomous variable) to the adjusted Cox model with clinical and demographic covariables significantly improved the ability of the model to predict MACE (C-statistic, 0.791 vs. 0.731, P=0.038), while addition of peak VO 2 did not improve the prediction performance of the model (C-statistic, 0.754 vs. 0.731, P=0.346). Conclusions: Poor performance on the 6MWT was an independent risk factor for MACE in patients with HCM. The 6MWT distance provided additional prognostic discrimination beyond conventional covariables when compared with peak VO 2 . These findings suggest that the 6MWT not only serves as an alternative to CPET but has greater clinical value, highlighting the importance of routine 6MWT to assess functional capacity in patients with HCM.

Abstract P1158: Agreement of Non-Invasive Devices that Measure Pulse Wave Velocity: VaSera vs VICORDER

Background: Adequately assessing subclinical cardiovascular disease (CVD) risk is crucial to mitigate CVD globally. A functional and structural measure of subclinical CVD risk, arterial stiffness is commonly measured as pulse wave velocity (PWV). However, PWV is typically estimated using non-invasive devices that use different techniques and body segments for measurement, leading to concerns when comparing PWV from different devices. Two PWV measures that estimate central arterial stiffness include a heart-to-thigh PWV (htPWV) and carotid-femoral PWV (cfPWV). It is essential to determine the agreement between different devices, particularly those used in large population-based cohorts, because these cohort studies are key to understanding subclinical CVD risk factors. Methods: We compared PWV measurements between the VaSera (htPWV) and VICORDER (cfPWV) devices in generally healthy adults (18-84 years) during two separate visits. We recruited 60 participants, of which 58 had PWV data for both devices. At each visit, three measurements were taken with the VaSera at a supine posture and three at 25 degrees for the VICORDER. The closest two observations were averaged for each device, and average observations from both visits were used for analysis. Agreement was assessed via the intraclass correlation coefficient (ICC) from a two-level mixed effects model adjusted for visit, side, and device, and Bland-Altman plots. Results: The ICC between the VaSera and VICORDER was 0.83 [95% confidence interval: 0.76, 0.89]. On average, VaSera values were 2.27 [-4.17, -0.36] m/s lower than VICORDER values. Conclusion: There was good agreement between measures of PWV on the VaSera and VICORDER devices. However, VaSera measurements were consistently lower than VICORDER values. The good agreement between devices suggests that each devices is accurately classifying high vs. low arterial stiffness, but the large differences in values between devices suggests PWV measured by the devices would not be interchangeable/comparable.

Abstract P2068: Prevalence of blood pressure control among adults with hypertrophic cardiomyopathy and hypertension

Introduction: Hypertension (HTN) occurs in ~50% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac disorder. Most individuals with HCM (~70%) have left ventricular outflow tract obstruction, precluding use of first- or second line anti-hypertensive agents. Little is known about the prevalence of blood pressure (BP) control among adults with HCM and HTN. Objectives: We sought to describe the prevalence of BP control among adults with HCM and HTN in a large clinical cohort. Methods: Data for this cross-sectional analysis was extracted from electronic health records of adults diagnosed with HCM (ICD codes I42.1/I42.2) who are treated for HTN and receive care in a large health system in New York. We conducted Wilcoxon-rank sum and Pearson chi-squared tests to compare demographic and clinical characteristics, and receipt of HCM specialty care (vs. not) between adults with and without controlled BP. Uncontrolled BP was defined as use of antihypertensive agents and systolic BP≥140 mmHg or diastolic BP ≥ 90mmHg. Results: Of 4,054 adults with HCM, 2,401 (59%) had HTN, 44% women, 69% Non-Hispanic (NH) white, 13% NH Black, 6.3% Hispanic/Latine. Adults with HCM and HTN were older, mean ± standard deviation, 69±15 vs 63±20 years, had higher body mass index (BMI), 28±7 vs 27±8, p<0.001, and higher systolic and diastolic BP, 131/76 ±19/12 vs 128/75±20/11 mmHg, compared to those with HCM only. A higher proportion of adults with HCM and HTN were seen in a specialized HCM program, 50% vs 38%, p<0.001, compared to adults with HCM only. Among adults with HCM and HTN, 824 (34%) had uncontrolled BP. Participants with uncontrolled BP were more likely to be older, 70±14 vs 68±16 years, p<0.001, have a higher BMI, 29±9 vs 28±8, p>0.001, and have co-morbid diabetes, 11% vs 8%, p<0.001, compared to participants with controlled BP. BP control did not significantly differ between women and men. There was a higher proportion of NH Black and Hispanic/Latine participants among those with uncontrolled BP, compared to participants with controlled BP, 16% vs 11%, and 7.4% vs 5.7%, respectively, p<0.001. Forty-seven % of participants with uncontrolled BP received HCM specialty care vs 51% of those with controlled BP, but the difference was not statistically significant. Conclusions: Over a third of adults with HCM and HTN had uncontrolled BP in this cohort. Findings highlight the need for focused strategies to improve BP control among this population.

The study on the adsorption characteristics of anthracite under different temperature and pressure conditions

The study of the adsorption characteristics of coal is of great significance to gas prevention and CO2 geological storage. To explore the adsorption mechanism of coal, this study focuses on columnar anthracite. Adsorption tests on coal rock under a range of physical field conditions were conducted using the volumetric method. The adsorption characteristics of anthracite for CO2, CH4, and N2 gases under different conditions were investigated using Grand Canonical Monte Carlo (GCMC) and Molecular Dynamics (MD) methods. The results showed that the adsorption capacities of anthracite for these three gases are in the order of CO2 > CH4 > N2, and that the adsorption capacity increases with increasing gas injection pressure. The CO2/CH4/N2 gas molecule adsorption capacity of the anthracite macromolecular structure model decreases with increasing temperature. The increase in temperature has the greatest influence on the CO2 absorption capacity, followed by the CH4 and N2 adsorption capacities. The research offers a theoretical basis for the control of coal mine gas and the geological storage of CO2.