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Contributions of the Framingham Heart Study to the Epidemiology of Coronary Heart Disease.

ABSTRACT: Since its launch in 1948, the Framingham Heart Study has proved critical to shaping and enhancing our understanding of the history and root causes of coronary heart disease (CHD). A modern prototype for population-based studies, the Framingham Heart Study garnered widespread recognition in its early years for identifying risk factors for CHD and stroke and formulating CHD risk scores. Although the study remains iconic for its robust design and successes in uncovering risk factors for CHD, it has undergone transformations during the past 2 decades. The 21st century ushered in a new era in "molecular epidemiology" centered on cutting-edge genetic and "-omics technologies." Framingham Heart Study investigators embraced these opportunities by pioneering genome-wide association studies at the population level and examining CHD through the lens of genetic variation, gene expression, and microRNA signatures. The Framingham Heart Study continues to evolve as it seeks to pinpoint new causes of disease with the hope of advancing personalized approaches to the treatment and prevention of CHD.

SUBMITTER: Chen G

PROVIDER: S-EPMC9316391 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Contributions of the Framingham Heart Study to the Epidemiology of Coronary Heart Disease.

Chen George G Levy Daniel D

JAMA cardiology 20161001 7

Since its launch in 1948, the Framingham Heart Study has proved critical to shaping and enhancing our understanding of the history and root causes of coronary heart disease (CHD). A modern prototype for population-based studies, the Framingham Heart Study garnered widespread recognition in its early years for identifying risk factors for CHD and stroke and formulating CHD risk scores. Although the study remains iconic for its robust design and successes in uncovering risk factors for CHD, it has ...[more]

PMID: 27464224

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Project description:PurposeTo extract radiomic features from coronary artery calcium (CAC) on CT images and to determine whether this approach could improve the ability to identify individuals at risk for a composite endpoint of clinical events.Materials and methodsParticipants from the Offspring and Third Generation cohorts of the community-based Framingham Heart Study underwent noncontrast cardiac CT (2002-2005) and were followed for more than a median of 9.1 years for composite major events. A total of 624 participants with CAC Agatston score (AS) of greater than 0 and good or excellent CT image quality were included for manual CAC segmentation and extraction of a predefined set of radiomic features reflecting intensity, shape, and texture. In a discovery cohort (n = 318), machine learning was used to select the 20 most informative and nonredundant CAC radiomic features, classify features predicting events, and define a radiomic-based score (RS). Performance of the RS was tested independently for the prediction of events in a validation cohort (n = 306).ResultsThe RS had a median value of 0.08 (interquartile range, 0.007-0.71) and a weak and modest correlation with Framingham risk score (FRS) (r = 0.2) and AS (r = 0.39), respectively. The continuous RS unadjusted, adjusted for age and sex, FRS, AS, and FRS plus AS were significantly associated with events (hazard ratio [HR] = 2.2, P < .001; HR = 1.8, P = .002; HR = 2.0, P < .001; HR = 1.7, P = .02; and HR = 1.8, P = .01, respectively). In participants with AS of less than 300, RS association with events remained significant when unadjusted and adjusted for age and sex, FRS, AS, and FRS plus AS (HR = 2.4, 2.8, 2.8, 2.3, and 2.6; P < .001, respectively). In the same subgroup of participants, adding the RS to AS resulted in a significant improvement in the discriminatory ability for events as compared with the AS (area under the receiver operating curve: 0.80 vs 0.68, respectively; P = .03).ConclusionA radiomic-based score, including the complex properties of CAC, may constitute an imaging biomarker to be further developed to identify individuals at risk for major adverse cardiovascular events in a community-based cohort. Supplemental material is available for this article. © RSNA, 2020.

Project description:The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2-4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden.The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the epidemiology of cardiovascular disease, it has evolved over the years with staggering expanded breadth and depth that have far greater implications in the study of the epidemiology of a wide spectrum of human diseases. The FHS welcomes research collaborations using existing or new collection of data. Detailed information regarding the procedures for research application submission and review are available at [http://www.framinghamheartstudy.org/researchers/index.php].

Dataset Information

Contributions of the Framingham Heart Study to the Epidemiology of Coronary Heart Disease.

Publications

Contributions of the Framingham Heart Study to the Epidemiology of Coronary Heart Disease.

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