Major cardiovascular events
A first heart attack, stroke, or cardiovascular death. The papers count that composite of events, not a blood-pressure reading.
The papers count cardiovascular death, myocardial infarction, stroke, and sometimes a hospital stay for unstable angina, heart failure, or a TIA. All-cause death is every recorded death. Insulin resistance is a blood-and-model score. A blood-pressure reading is not this event count.
Also called MACE, major adverse cardiovascular events, cardiovascular events, CHD events.
Connected relationships
Mendelian randomization · Moderate
Alcohol intake→Major cardiovascular events
Higher Alcohol intake increases Major cardiovascular events.
Holmes 2014 found that a gene variant that cuts weekly drinking by 17 percent also cut the odds of coronary heart disease by 10 percent in 261,991 European adults (odds ratio 0.90, 0.84 to 0.96). Millwood 2019 found genetically predicted drinking raised stroke in Chinese men and left heart attack unmoved.
Randomized trial · Moderate
GLP-1 receptor agonist→Major cardiovascular events
Higher GLP-1 receptor agonist decreases Major cardiovascular events.
In 17,604 adults with overweight or obesity, established heart disease, and no diabetes, weekly semaglutide 2.4 mg cut a first heart attack, stroke, or cardiovascular death by 20 percent versus placebo (Lincoff 2023). Liraglutide did the same in type 2 diabetes (Marso 2016). Oral semaglutide was not worse for that same count (Husain 2019).
Meta-analysis · Low
Nighttime transportation noise→Major cardiovascular events
Higher Nighttime transportation noise increases Major cardiovascular events.
In a 2023 dose-response meta-analysis of 23 cohort papers and 18.5 million adults, mostly in Europe, each extra 10 dB of modelled road-traffic noise (as Lden) sat with a 2 percent higher risk of incident cardiovascular disease (RR 1.020, 1.006 to 1.035). Nobody randomized the street.
Randomized trial · Contested
Omega-3 supplementation→Major cardiovascular events
Higher Omega-3 supplementation moves Major cardiovascular events only in some conditions. Read the mechanism.
Assigned 4 g a day of icosapent ethyl cut a five-part ischemic composite in 8179 statin-treated adults with high triglycerides (Bhatt 2019, hazard ratio 0.75); the same dose of mixed EPA plus DHA carboxylic acids did not in 13,078 similar adults (Nicholls 2020, 0.99), and about 400 mg of EPA-DHA in margarine did not after a heart attack (Kromhout 2010).
Randomized trial · Moderate
Obstructive sleep apnea→Major cardiovascular events
A rise in Obstructive sleep apnea does not identify a change in Major cardiovascular events.
McEvoy 2016 found that CPAP plus usual care did not change the risk of a composite cardiovascular event versus usual care alone among 2717 adults with moderate-to-severe obstructive sleep apnea and established coronary or cerebrovascular disease (hazard ratio 1.10, 95% CI 0.91 to 1.32).
Randomized trial · Contested
Coenzyme Q10→Major cardiovascular events
Higher Coenzyme Q10 decreases Major cardiovascular events.
Mortensen 2015 found that 100 mg of coenzyme Q10 three times a day for two years halved a first major heart-failure event versus placebo in 420 people (15 percent versus 26 percent; hazard ratio 0.50). Morisco 1994 had already cut hospitalizations for worsening failure in 641 people on 2 mg per kg a day.
Randomized trial · Moderate
Testosterone→Major cardiovascular events
A rise in Testosterone does not identify a change in Major cardiovascular events.
Lincoff 2023 found that daily testosterone gel was noninferior to placebo for a first major cardiac event among 5198 men aged 45 to 80 with hypogonadism and preexisting or high-risk cardiovascular disease (hazard ratio 0.96, 95% CI 0.78 to 1.17).
Sources
- MV Holmes et al. (2014). Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data.
- IY Millwood et al. (2019). Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China.
- SC Larsson et al. (2021). Alcohol Consumption and Cardiovascular Disease: A Mendelian Randomization Study.
- DB Rosoff et al. (2021). Evaluating the relationship between alcohol consumption, tobacco use, and cardiovascular disease: A multivariable Mendelian randomization study.
- J Lankester et al. (2021). Alcohol use and cardiometabolic risk in the UK Biobank: A Mendelian randomization study.
- AM Lincoff et al. (2023). Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.
- SP Marso et al. (2016). Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes.
- M Husain et al. (2019). Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.
- X Fu et al. (2023). Long-Term Exposure to Traffic Noise and Risk of Incident Cardiovascular Diseases: a Systematic Review and Dose-Response Meta-Analysis.
- G Hao et al. (2022). Associations of road traffic noise with cardiovascular diseases and mortality: Longitudinal results from UK Biobank and meta-analysis.
- W Babisch et al. (2008). Road traffic noise and cardiovascular risk.
- DL Bhatt et al. (2019). Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia.
- SJ Nicholls et al. (2021). Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial.
- D Kromhout et al. (2010). n-3 fatty acids and cardiovascular events after myocardial infarction.
- RD McEvoy et al. (2016). CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.
- Y Peker et al. (2017). Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Nonsleepy Obstructive Sleep Apnea. The RICCADSA Randomized Controlled Trial.