Cycling May Lower Mortality Risk in People Who Have Diabetes

Abstract Aims To identify variables predicting ejection fraction (EF) recovery and characterize prognosis of heart failure (HF) patients with EF recovery (HFrecEF). Methods and results Retrospective study of adults referred for ≥2 echocardiograms separated by ≥6 months between 2008 and 2016 at the two largest echocardiography centres in Alberta who also had physician-assigned diagnosis of HF. Of 10 641 patients, 3124 had heart failure reduced ejection fraction (HFrEF) (EF ≤ 40%) at baseline: while mean EF declined from 30.2% on initial echocardiogram to 28.6% on the second echocardiogram in those patients with persistent HFrEF (defined by <10% improvement in EF), it improved from 26.1% to 46.4% in the 1174 patients (37.6%) with HFrecEF (defined by EF absolute improvement ≥10%). On multivariate analysis, female sex [adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) 1.40–1.96], younger age (aOR per decade 1.16, 95% CI 1.09–1.23), atrial fibrillation (aOR 2.00, 95% CI 1.68–2.38), cancer (aOR 1.52, 95% CI 1.03–2.26), hypertension (aOR 1.38, 95% CI 1.18–1.62), lower baseline ejection fraction (aOR per 1% decrease 1.07 (1.06–1.08), and using hydralazine (aOR 1.69, 95% CI 1.19–2.40) were associated with EF improvements ≥10%. HFrecEF patients demonstrated lower rates per 1000 patient years of mortality (106 vs. 164, adjusted hazard ratio, aHR 0.70 [0.62–0.79]), all-cause hospitalizations (300 vs. 428, aHR 0.87 [0.79–0.95]), all-cause emergency room (ER) visits (569 vs. 799, aHR 0.88 [0.81–0.95]), and cardiac transplantation or left ventricular assist device implantation (2 vs. 10, aHR 0.21 [0.10–0.45]) compared to patients with persistent HFrEF. Females with HFrEF exhibited lower mortality risk (aHR 0.94 [0.88–0.99]) than males after adjusting for age, time between echocardiograms, clinical comorbidities, medications, and whether their EF improved or not during follow-up. Conclusion HFrecEF patients tended to be younger, female, and were more likely to have hypertension, atrial fibrillation, or cancer. HFrecEF patients have a substantially better prognosis compared to those with persistent HFrEF, even after multivariable adjustment, and female patients exhibit lower mortality risk than men within each subgroup (HFrecEF and persistent HFrEF) even after multivariable adjustment.

Download Full-text

DOES INCREASED CAREGIVER LIFE SATISFACTION EXPLAIN SPOUSAL CAREGIVERS’ LOWER MORTALITY RISK?: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY

The Gerontologist ◽

10.1093/geront/gnv241.04 ◽

2015 ◽

Vol 55 (Suppl_2) ◽

pp. 523-524

Keyword(s):

Life Satisfaction ◽

Mortality Risk ◽

Spousal Caregivers ◽

Lower Mortality ◽

Health And Retirement Study ◽

Retirement Study ◽

Lower Mortality Risk

Download Full-text

Healthy eating and lower mortality risk in a large cohort of cardiac patients who received state-of-the-art drug treatment

American Journal of Clinical Nutrition ◽

10.3945/ajcn.115.112276 ◽

2015 ◽

Vol 102 (6) ◽

pp. 1527-1533 ◽

Cited By ~ 7

Author(s):

Femke PC Sijtsma ◽

Sabita S Soedamah-Muthu ◽

Janette de Goede ◽

Linda M Oude Griep ◽

Johanna M Geleijnse ◽

...

Keyword(s):

Drug Treatment ◽

Healthy Eating ◽

Mortality Risk ◽

State Of The Art ◽

Large Cohort ◽

Cardiac Patients ◽

Lower Mortality ◽

Lower Mortality Risk

Download Full-text

Clinical Decision Analysis as a Means of Technology Assessment: The Effectiveness of Intraoperative Cholangiography

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300008035 ◽

1992 ◽

Vol 8 (1) ◽

pp. 185-197 ◽

Cited By ~ 2

Author(s):

Thomas E. Scott ◽

Itzhak Jacoby

Keyword(s):

Decision Analysis ◽

Mortality Risk ◽

Technology Assessment ◽

Common Duct ◽

Cost Effective ◽

Clinical Decision ◽

Intraoperative Cholangiography ◽

Lower Mortality ◽

Effective Option ◽

Lower Mortality Risk

AbstractThree strategies for timely detection of common duct stones are examined by decision analysis: the use of intraoperative cholangiography (IOC) in ALL, NONE, or in SOME of the cases that are selected by the estimated probability of a common duct stone. Selective use of IOC is the most cost-effective option and offers a slightly lower mortality risk.

Download Full-text

1095 Gastroenterologist Care is Associated With Lower Mortality Risk in Hospitalized Ulcerative Colitis Patients

Gastroenterology ◽

10.1016/s0016-5085(12)60738-0 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-197 ◽

Cited By ~ 1

Author(s):

Sanjay K. Murthy ◽

A. Hillary Steinhart ◽

Jill M. Tinmouth ◽

Peter C. Austin ◽

Geoffrey C. Nguyen

Keyword(s):

Ulcerative Colitis ◽

Mortality Risk ◽

Lower Mortality ◽

Lower Mortality Risk

Download Full-text

Personality Pathways to Mortality: Interleukin-6 Links Conscientiousness to Mortality Risk

10.31234/osf.io/b42ya ◽

2020 ◽

Author(s):

Páraic S O'Súilleabháin ◽

Nick Turiano ◽

Denis Gerstorf ◽

Martina Luchetti ◽

stephen gallagher ◽

...

Keyword(s):

Mortality Risk ◽

Interleukin 6 ◽

The United States ◽

Lower Mortality ◽

Reactive Protein ◽

Age Related ◽

Physiological Pathways ◽

Adjusted Model ◽

Lower Mortality Risk

Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35 – 86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.

Download Full-text

Association of Sedentary and Active Bout Frequency With Mortality in Older Men Using Accelerometry

Innovation in Aging ◽

10.1093/geroni/igab046.3462 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 969-970

Author(s):

Lauren Roe ◽

Stephanie Harrison ◽

Kyle Moored ◽

Kristine Ensrud ◽

Katie Stone ◽

...

Keyword(s):

Mortality Risk ◽

Sedentary Time ◽

Osteoporotic Fractures ◽

Older Men ◽

Transition Frequency ◽

Lower Mortality ◽

Cox Proportional Hazard ◽

Mortality Models ◽

Cox Proportional Hazard Models ◽

Lower Mortality Risk

Abstract Background Time spent sedentary increases with age and has several negative health consequences. We sought to examine associations between daily sedentary and active bout frequency with all-cause mortality. Methods Data are from 2,918 men in the Osteoporotic Fractures in Men (MrOS) study (mean age at Visit 3±SD: 79.0±5.1 years) with valid activity monitor data (5.1±0.3 days worn>90%) at Year 7 visit (Visit 3, 2007-2009). Sedentary and active bout frequencies are defined as the daily transition frequency from a sedentary bout lasting 5+ minutes to activity of any intensity, and the transition frequency from an active bout lasting 5+ minutes to sedentary. Deaths were centrally adjudicated using death certificates. Cox proportional hazard models were used to examine associations between quartiles of sedentary (Q1 referent, <13.6 bouts/day) or active (Q1 referent, <5 bouts/day) bout frequency and mortality. Models were repeated, stratifying by median daily total time spent sedentary and active. Results After 9.4±3.7 years of follow-up, 1,487 (51.0%) men died. Men averaged 16.9±5.1 and 8.2±4.2 sedentary and active bouts/day, respectively. After full covariate adjustment, each quartile reflecting a higher sedentary (Q4 vs Q1 HR: 0.68, 95%CI: 0.58-0.81, p-trend<0.001) and active bout (Q4 vs Q1 HR: 0.57, 95%CI: 0.48-0.68, p-trend<0.001) frequency was associated with lower mortality risk. There was no evidence that effects differed by total sedentary time (p-interaction for sedentary bout frequency and total sedentary time>0.05). Conclusions More frequent, prolonged sedentary and active bouts are associated with a lower mortality risk in older men and is not moderated by total sedentary time.

Download Full-text

Low Dose Hydroxychloroquine is Associated with Lower Mortality in COVID-19: A Meta-Analysis of 27 Studies and 44,684 Patients

10.21203/rs.3.rs-107101/v1 ◽

2020 ◽

Author(s):

Augusto Di Castelnuovo ◽

Simona Costanzo ◽

Antonio Cassone ◽

Roberto Cauda ◽

Giovanni de Gaetano ◽

...

Keyword(s):

Risk Ratio ◽

Mortality Risk ◽

Low Dose ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Total Mortality ◽

Lower Mortality ◽

Daily Dose ◽

Meta Analyses ◽

Lower Mortality Risk

Abstract Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19, but its association with mortality is not well characterized. We conducted two meta-analyses to evaluate the association between HCQ (with or without azithromycin (AZM)) and total mortality in COVID-19 patients.Methods: Articles were retrieved until November 10th, 2020 by searching in seven databases. Data were combined using the general variance-based method.Results: A total of 27 articles were found (N=44,684 patients, including N=7,803 from 5 randomized clinical trials (RCTs)). Overall, the use of HCQ was associated with 22% lower mortality risk (pooled risk ratio: 0.78, 95%CI: 0.67 to 0.91; I2=80%, random effects). This association was found reversed when pooling only RCTs (16.7% of the overall weight; pooled risk ratio: 1.11, 0.99 to 1.24) or studies in which daily dose >400 mg or total dose >4,400 mg were used (pooled risk ratio: 1.10, 95%CI: 0.99 to 1.23 in both cases). Overall, HCQ+AZM (10 studies) was also associated with 28% lower mortality risk, but uncertainty was large (95%CI: 0.48 to 1.08; P=0.11). Use of HCQ was not associated with severe adverse events.Conclusions: HCQ use was not associated with mortality reduction in COVID-19 patients when 5 RCTs only were evaluated, while a 9% to 33% reduced mortality was observed when observational studies were also included. The association was mainly apparent in studies that used lower doses of HCQ. These findings can help disentangling the debate on HCQ use in COVID-19.

Download Full-text

Quality of Life and mortality in the general population: a systematic review and meta-analysis

10.21203/rs.2.22428/v3 ◽

2020 ◽

Author(s):

Aung Zaw Zaw Phyo ◽

Rosanne Freak-Poli ◽

Heather Craig ◽

Danijela Gasevic ◽

Nigel Stocks ◽

...

Keyword(s):

Quality Of Life ◽

General Population ◽

Mortality Risk ◽

Population Characteristics ◽

Lower Mortality ◽

Physical Component Score ◽

Component Score ◽

Meta Analyses ◽

Lower Mortality Risk

Abstract Background: Quality of life (QoL) is multi-dimensional concept of an individual’ general well-being status in relation to their value, environment, cultural and social context in which they live. This study aimed to quantitatively synthesise available evidence on the association between QoL and mortality in the general population. Methods: An electronic search was conducted using three bibliographic databases, MEDLINE, EMBASE and PsycINFO. Inclusion criteria were studies that assessed QoL using standardized tools and examined mortality risk in a non-patient population. Qualitative data synthesis and meta-analyses using a random-effects model were performed. Results: Of 4,184 articles identified, 47 were eligible for inclusion, involving approximately 1,200,000 participants. Studies were highly heterogeneous in terms of QoL measures, population characteristics and data analysis. In total, 43 studies (91.5%) reported that better QoL was associated with lower mortality risk. The results of four meta-analyses indicated that higher health-related QoL (HRQoL) is associated with lower mortality risk, which was consistent for overall HRQoL (HR 0.633, 95% CI: 0.514 to 0.780), physical function (HR 0.987, 95% CI: 0.982 to 0.992), physical component score (OR 0.950, 95% CI: 0.935 to 0.965), and mental component score (OR 0.980, 95% CI: 0.969 to 0.992). Conclusion: These findings provide evidence that better QoL/HRQoL was associated with lower mortality risk. The utility of these measures in predicting mortality risk indicates that they should be considered further as potential screening tools in general clinical practice, beyond the traditional objective measures such as body mass index and the results of laboratory tests.

Download Full-text