Pathobiological Determinants of Atherosclerosis in Youth, PDAY
In 1983, Robert Wissler of the University of Chicago recruited a group of pathologists and scientists to participate in a multi-center cooperative project which became known as the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. The purpose of this study was to improve knowledge of the natural history of atherosclerosis in childhood and young adulthood and to determine its association with risk factors for adult coronary heart disease.
The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study began in 1985 (NIH HL33476) as a nationwide cooperative project involving 15 medical centers. The PDAY Research Group collected arteries, blood, tissue, and data from more than 3000 young persons who died between 15 and 34 years of age of external causes (accidents, homicides, suicides). A common protocol was followed for collecting risk factor data and coronary arteries and aortas from approximately 1,000 autopsies per year for three years. Specimens were collected and preserved in a standardized way at each collection center. Data management and statistical analysis were conducted at the University of Texas in San Antonio. The unit at Louisiana State University was composed of three central laboratories: the lipid biochemistry center; the coronary heart disease risk factor center; and a gross morphology center. The morphometry central laboratory was located at Ohio State University. Administration and coordination were directed from the University of Chicago and the University of Illinois. In addition to serving as collection centers, many of the centers carried out individual research projects. In 1992, the project continued (NIH HL45720) with a subset of the original institutions and investigators as the Risk Factors in Early Atherogenesis (RFEHA), to increase the number of study cases, in particular, the number of women. RFEHA added 1,400 new specimens to the 1,800 cases already collected in PDAY to achieve over 3,000 total specimens. Emphasis was placed on female cases and those that provided the best opportunity to study transition lesions between fatty streaks and fibrous plaques. Both projects used the same protocols and the combined results and resources of both projects are referred to as PDAY.
The PDAY study has shown that the Coronary Heart disease (CHD) risk factors (gender, age, serum lipoprotein concentrations, smoking, hypertension, obesity, and hyperglycemia) are associated with both the early and advanced lesions of atherosclerosis in adolescence and young adulthood, decades before the occurrence of CHD. The PDAY Study also developed risk scores, which provided weighted summaries of the effects of the individual risk factors, to predict the presence of advanced lesions in the coronary arteries and abdominal aortas of adolescents and young adults. These risk scores had discrimination similar to that obtained for prediction of CHD events in the Framingham study. Though based on observational data, the PDAY study has provided strong justification for efforts to control CHD risk factors in youth.
In 1998, after completion of the two PDAY grant supported investigations, the National Heart, Lung, and Blood Institute (NHLBI) designated the LSUHSC Department of Pathology as the institution to centralize and manage the tissues, materials, and data from 13 years of research in the PDAY projects. For this purpose the NHLBI awarded HL60808 to the LSUHSC Department of Pathology with Dr Jack P. Strong as principal investigator to support the PDAY Cardiovascular Specimen and Data Library. The LSUHSC PDAY investigators have assembled this autopsy material (principally of aorta and coronary artery, but with other tissues including liver, serum, and adipose tissue) from over 3,000 Black and white males and females. These specimens were from autopsies on individuals ages 15 to 34 who died of accidental or traumatic causes. The grant for the Cardiovascular Specimen and Data Library has been renewed through July 2009. Despite devastating losses of some research materials in New Orleans from the aftermath of Hurricane Katrina in August 2005, much of the PDAY Cardiovascular Specimen and Data Library was retained. The specimens and data in the PDAY Specimen and Data Library (the PDAY Archive) are available for research by investigators in the United States of America and abroad. See the “Materials we offer” link for details to gain access to these valuable materials from human subjects with quantitative data on atherosclerotic lesions in their coronary arteries and aortas.