Nathan Wong

Nathan Wong
University of California, Irvine | UCI · Department of Medicine

PhD, MPH, FACC, FAHA

About

687
Publications
67,945
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Introduction
Dr. Nathan Wong is a cardiovascular epidemiologist and Professor and Director, Heart Disease Prevention Program, Division of Cardiology at the University of California, Irvine in California, as well as Adjunct Professor of Epidemiology and UCLA and UC Irvine and Radiology and Public Health at UC Irvine. He holds MPH and PhD degrees in epidemiology from Yale University. He is also a fellow of the American College of Cardiology, American Heart Association, National Lipid Association, and American Society for Preventive Cardiology. He is a past president (2010-2012) of the American Society for Preventive Cardiology and is president-elect of the Pacific Lipid Association. He has over 300 publications and has co-edited 6 textbooks.
Additional affiliations
February 1988 - present
University of California, Irvine
Position
  • Professor

Publications

Publications (687)
Article
Full-text available
Background: In last 2 decades, there have been substantial changes in the utilization patterns of antihypertensive medicines following new clinical trials and the introduction of new treatment guidelines. The aim of this study was to analyze utilization and prescribing patterns regarding antihypertensive medicines in the Republic of Srpska, Bosnia...
Article
Background: To estimate the population health impact of treating all US adults eligible for the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) with icosapent ethyl (IPE), we estimated (1) the number of ASCVD events and healthcare costs that could be prevented; and (2) medication costs. Methods: We derived RED...
Article
Full-text available
Objective To explore the population health impact of treating all US adults eligible for the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) with icosapent ethyl (IPE), we estimated (1) the number of ASCVD events and healthcare costs that could be prevented; and (2) medication costs. Methods We derived REDUCE...
Article
Background Breast arterial calcification (BAC), a common incidental finding in mammography, has been shown to be associated with angiographic coronary artery disease and cardiovascular disease (CVD) outcomes. We aimed to (1) examine the association of BAC presence and quantity with hard atherosclerotic CVD (ASCVD) and global CVD; (2) ascertain mode...
Article
Patients with acute coronary syndrome (ACS) have a high risk of subsequent adverse cardiovascular outcomes, particularly within the first 30 days. Although it is well documented that initiation of statin therapy in the setting of ACS improves short- and long-term cardiovascular outcomes, and achievement of lower levels of low density lipoprotein ch...
Article
Background and aims Patients with diabetes mellitus (DM) are at an increased risk of acute coronary syndrome (ACS); however, the factors predicting those at highest risk are not well understood. We identified risk factors in those with DM that best predict high ACS risk based on a multiple endothelial injury biomarker algorithm. Methods We studied...
Article
Full-text available
Aims: Statin intolerance (SI) represents a significant public health problem for which precise estimates of prevalence are needed. Statin intolerance remains an important clinical challenge, and it is associated with an increased risk of cardiovascular events. This meta-analysis estimates the overall prevalence of SI, the prevalence according to d...
Article
Aims Examine temporal changes in the risk of cardiovascular events in people with newly diagnosed type 2 diabetes with and without cardiovascular disease (CVD). Methods 283,600 individuals with newly diagnosed type 2 diabetes and age-, sex-, and CVD-matched controls without diabetes were identified through Danish nationwide registries between 1997...
Article
Asian Americans (AsA), Native Hawaiians, and Pacific Islanders (NHPI) comprise 7.7% of the U.S. population, and AsA have had the fastest growth rate since 2010. Yet the National Institutes of Health (NIH) has invested only 0.17% of its budget on AsA and NHPI research between 1992 and 2018. More than 40 ethnic subgroups are included within AsA and N...
Article
Objective: There are limited data on the extent of evidence-based SGLT2is and GLP1-RAs among real-world cohorts of patients with DM. We examined the use of these therapies and glycemic control among current US adults with DM by risk groups, sex, and ethnicity. Methods In adults ≥ 18 years of age with DM from the NIH Precision Medicine Initiative A...
Article
Objective Data on statin therapy intensity and icosapent ethyl use among adults with diabetes mellitus (DM) are limited. We studied statin intensity and icosapent ethyl use with lipid levels among US adults with DM across risk groups, sex and ethnicity. Methods Among adults ≥18 years of age with DM from the NIH Precision Medicine Initiative All of...
Article
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States (US) and worldwide. Among South Asians living in the US, ASCVD risk is four-fold higher than the local population. Cardioprotective dietary patterns necessitate replacement of dietary saturated fats with healthier oils such as canola, corn, olive, soyb...
Article
Background: Current US guidelines since 2013 have recommended statin use for high cardiovascular (CV) risk adults including those with atherosclerotic cardiovascular disease (ASCVD), regardless of LDL-C levels. Recent data among US population-representative adults regarding extent of LDL-C control in high CV risk persons are lacking. Methods: We ex...
Article
Objective: The 2018 Multisociety Cholesterol Guideline categorized patients with atherosclerotic cardiovascular disease (ASCVD) according to very high risk status, but there are few reports of recent medication use and risk factor control by risk group. We examined in a current cohort of US adults the extent of ASCVD risk factor control and treatme...
Article
Introduction: Coronary artery calcium (CAC) is a measure of subclinical atherosclerosis and predicts cardiovascular disease (CVD) events. Higher parity, the number of live births, has been shown to relate to CVD. We examined whether parity is associated with progression of CAC as one pathway to CVD. Methods: We studied 2772 women aged 44 to 84 year...
Article
Stroke is the second most common cause of death worldwide. The rates of stroke are increasing in less affluent countries predominantly because of a high prevalence of modifiable risk factors. The Lipid Association of India (LAI) has provided a risk stratification algorithm for patients with ischaemic stroke and recommended low density lipoprotein c...
Article
Background and aims Atherosclerosis is a complex phenomenon manifesting several features typical of chronic inflammation and disorders of lipid metabolism. We assessed association of nuclear magnetic resonance (NMR) lipid variables and inflammatory markers with incident CAC and CAC progression among participants with baseline CAC ≥0. Methods MESA...
Article
Full-text available
Chapter
Cardiovascular diseases (CVDs) including coronary artery disease, stroke, heart failure, peripheral arterial disease, and other CVD manifestations comprise the leading causes of morbidity and mortality worldwide. Key risk factors, including hypertension, cigarette smoking, elevated cholesterol, elevated glucose levels/diabetes, obesity, and physica...
Article
Full-text available
The rationale of this study was to examine the effectiveness of 6-month high-impact step aerobics (SA) or moderate-intensity resistance training exercise (RT) on bone mineral density (BMD) and bone bending strength in sedentary women. Results show that SA enhanced BMD in the heel, lower leg, and lumbar spine 2. Introduction: To determine the effe...
Article
Despite an increase in sensitivity for diagnosing diabetes, there has been a decline in the incidence of diabetes across different countries. This multicountry analysis of high- and middle-income settings involving 22 million diabetes diagnoses shows 19 countries had a declining incidence trend from 2010 with a yearly rate change of -1.1% to -10.8%...
Article
Background: All-cause and cardiovascular disease (CVD) mortality are higher among patients with chronic obstructive pulmonary disease (COPD). We examined the association between American Heart Association's Life's Simple 7 (LS7) metrics and all-cause as well as CVD mortality in patients with COPD. Methods: We examined 1513 US adults with COPD aged...
Article
Background: HeFH is a common inherited disorder that leads to markedly elevated LDL-cholesterol from birth and premature cardiovascular disease. HeFH is frequently underdiagnosed and undertreated. Objective: To compare how well primary care physicians and cardiologists recognize and treat HeFH. Methods: The National Lipid Association surveyed...
Article
Objective: We examined diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent based on diabetes severity and other CVD risk factors. Research design and methods: We pooled 4 US cohorts (ARIC, JHS, MESA, FHS-Offspring) and classified subjects by baseline DM/CVD. CVD risks between DM+/CVD- vs. DM-/CVD+ were examined by diabetes s...
Article
Full-text available
The role of ST2 in stable coronary artery disease (CAD) has not yet been well defined. This study was performed to investigate baseline serum soluble ST2 (sST2) level can predict clinical outcomes in patients with stable CAD. A total of 388 consecutive patients with suspected CAD (65 years and 63.7% male) in stable condition referred for elective i...
Article
Full-text available
Heterozygous familial hypercholesterolemia (HeFH) creates elevated low-density lipoprotein cholesterol (LDL-C), causing premature atherosclerotic cardiovascular disease (ASCVD). Guidelines recommend cascade screening relatives and starting statin therapy at 8-10 years old, but adherence to these recommendations is low. Our purpose was to measure se...
Article
Aims We examined cardiovascular outcomes associated with initiation of GLP-1RA versus SGLT-2i treatment in a real-world setting among patients with type 2 diabetes. Methods and Results This Danish nationwide registry-based cohort study included patients with type 2 diabetes with a first ever prescription of either GLP-1RA or SGLT-2i from 2013 thro...
Article
Background: Individuals with no history of coronary artery disease can develop acute coronary syndrome (ACS), often in the absence of major risk factors including low-density lipoprotein cholesterol (LDL-C). We identified risk factors and biomarkers that can help identify those at discordantly high risk of ACS with normal LDL-C using a novel valid...
Article
Full-text available
Heterozygous familial hypercholesterolemia (HeFH) results in significant elevations in LDL-C and premature atherosclerotic cardiovascular disease (ASCVD). Current guidelines recommend add-on proprotein subtilisin/kexin type 9 inhibitor (PCSK9i) therapy for additional LDL-C lowering beyond statins. Data are sparse, however, regarding treatment patte...
Article
Inflammation is a marker of arterial disease stemming from cholesterol-dependent to -independent molecular mechanisms. In recent years, the role of inflammation in atherogenesis has been underpinned by pharmacological approaches targeting systemic inflammation that have led to a significant reduction in cardiovascular disease (CVD) risk. Although t...
Article
Background Obesity is associated with an increased risk of heart failure (HF); however, how metabolic weight groups relate to HF risk, especially in postmenopausal women, has not been demonstrated. Methods We included 19 412 postmenopausal women ages 50 to 79 without cardiovascular disease from the Women’s Health Initiative. Normal weight was defi...
Preprint
Full-text available
The role of ST2 in stable coronary artery disease (CAD) has not yet been well defined. This study was performed to investigate baseline serum soluble ST2 (sST2) level can predict clinical outcomes in patients with stable CAD. A total of 388 consecutive patients with suspected CAD (65 years and 63.7% male) in stable condition referred for elective i...
Article
Full-text available
Background: We sought to evaluate the association of metabolic syndrome (MetS) and computed tomography (CT)-derived cardiometabolic biomarkers (non-alcoholic fatty liver disease [NAFLD] and epicardial adipose tissue [EAT] measures) with long-term risk of major adverse cardiovascular events (MACE) in asymptomatic individuals. Methods: This was a...
Article
Full-text available
Aims THEMIS (NCT01991795) demonstrated cardioprotective benefits of ticagrelor plus acetylsalicylic acid (ASA) compared with placebo plus ASA in patients with type 2 diabetes (T2D), stable coronary artery disease (CAD) and no history of myocardial infarction (MI) or stroke. To complement these findings, we assessed clinical outcomes and healthcare...
Article
The relation between elevated lipoprotein(a) and total atherosclerotic cardiovascular disease (ASCVD) residual risk in persons with known cardiovascular disease on statin therapy is not well-established. We examined first and total recurrent ASCVD event risk in statin-treated adults with prior ASCVD. We studied 3,359 adults (mean age 63.6 years, 85...
Chapter
Nearly 500 million adults worldwide currently have diabetes, a number expected to increase to 700 million over the next 25 years, largely fueled by the obesity epidemic and unhealthy lifestyles. Atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease, stroke, heart failure, and peripheral arterial disease, is among the most...
Book
This second edition provides an updated review on the current guidelines and practice standards for the clinical management of cardiovascular risk factors and prevention of cardiovascular diseases. Endorsed by the American Society for Preventive Cardiology, this practical textbook includes concise descriptions of major and newer risk factors, bioma...
Article
Full-text available
PurposeThe Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial showed the cardiovascular disease (CVD) benefits of liraglutide therapy among patients with type 2 diabetes mellitus (T2DM). We applied this trial to US adults with T2DM in terms of eligibility and preventable CVD events.Methods We incl...
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Article
Current risk stratification strategies do not fully explain cardiovascular disease (CVD) risk. We aimed to evaluate the association of low-density lipoprotein (LDL-P) and high-density lipoprotein (HDL-P) particles with progression of coronary artery calcium and carotid wall injury. All participants in the Multi-Ethnic Study Atherosclerosis (MESA) w...
Article
Background: Individuals with no history of coronary artery disease can develop acute coronary syndrome (ACS), often in the absence of major risk factors including low-density lipoprotein cholesterol (LDL-C). We identified risk factors and biomarkers that can help identify those at discordantly high risk of ACS who have normal LDL-C using a novel co...
Article
Introduction: South Asians (SA) have increased atherosclerotic cardiovascular disease (ASCVD) risk and SA ethnicity is considered a “risk-enhancing factor” in the latest prevention guidelines. Diabetes mellitus (DM) is common in SA, but it is not known how pre-DM or DM may contribute to subclinical atherosclerosis in SA compared to other ethnic gro...
Article
Background: Atherosclerotic cardiovascular disease (ASCVD) risk prediction in persons with type 2 diabetes (T2DM) using existing calculators is imprecise. We aimed to develop a machine-learning (ML) model for prediction of ASCVD events in adults with T2DM. Methods: We utilized subjects with T2DM from the Action to Control Cardiovascular Risk in Dia...
Article
Introduction: Coronary artery calcium (CAC) is a measure of subclinical atherosclerosis and predicts cardiovascular disease (CVD) events. Greater parity, or number of live births, has been shown to relate to CVD. We examined whether the relation of parity to CVD events may depend on the presence and extent of subclinical atherosclerosis measured by...
Article
Background: It is not well quantified if diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent depends on DM severity and other CVD risk factors. Methods: We pooled 4 US community-based cohorts (ARIC, JHS, MESA, FHS Offspring) and classified subjects by baseline DM/CVD status. DM+/CVD- was further classified by DM duration, HbA1c...
Article
Background: Liver fibrosis is a complication of non-alcoholic fatty liver disease (NAFLD) and is associated with increased atherosclerotic cardiovascular disease (ASCVD) risk. Whether this risk may be enhanced in persons with pre-diabetes (pre-DM) or diabetes (DM), however, is not established. We examined the association of liver fibrosis with esti...
Article
Aim In statin-treated persons with atherosclerotic cardiovascular disease (ASCVD) the further ASCVD risk that diabetes mellitus (DM) adds is not well-quantified. We examined this residual risk for initial and total recurrent ASCVD events. Methods We studied 3271 patients with ASCVD on statin therapy in the AIM-HIGH clinical trial cohort. Cox regre...
Article
Full-text available
L ifestyle modification plays an enormously important role in the reduction of risk of MI and stroke, two major cardiovascular killers globally. Lifestyle modification is the cornerstone o f A S C V D p r e v e n t i o n. L i f e s t y l e modification includes attention to diet, physical activity, alcohol consumption, tobacco usage and stress mana...
Article
Background and aims We sought to assess the performance of a comprehensive machine learning (ML) risk score integrating circulating biomarkers and computed tomography (CT) measures for the long-term prediction of hard cardiac events in asymptomatic subjects. Methods We studied 1069 subjects (age 58.2 ± 8.2 years, 54.0% males) from the prospective...
Article
Full-text available
Use an assay for Lp(a) measurement that is unaffected by the isoform size. 2. Lp(a) multiples the risk of other ASCVD risk factors like high LDL-C, low HDL-C, systemic hypertension, diabetes and hyperhomocysteinemia. With only PCSK9 inhibitors being available as effective pharmacotherapy at present, other risk factors must be treated optimally to c...
Article
Full-text available
Objectives The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies. Background Individuals with MetS or T2D have a heterogeneously increased risk of a...
Article
Despite statin therapy, many patients with atherosclerotic cardiovascular disease (ASCVD) still suffer from ASCVD events. Predictors of residual ASCVD risk are not well-delineated. We aimed to develop an ASCVD risk prediction model for patients with prior ASCVD on statin use. We utilized statin-treated patients with ASCVD from the AIM-HIGH trial co...
Article
Full-text available