The Impact of a Population-based Prevention Program on Cardiovascular Events: Findings from the Heart of New Ulm Project

AbstractThis nationwide population-based cohort study aimed to investigate the impact of systemic anti-inflammatory treatment on the major adverse cardiovascular events (MACE) risk in patients with psoriasis from January 2006 to December 2018, using a database provided by the Korean National Health Insurance Service. Patients were grouped based on the following treatment modalities: biologics, phototherapy, methotrexate, cyclosporine, and mixed conventional systemic agents. Patients who had not received any systemic treatment were assigned to the control cohort. The incidence of MACE per 1000 person-year was 3.5, 9.3, 12.1, 28.4, 39.5, and 14.5 in the biologic, phototherapy, methotrexate, cyclosporine, mixed conventional systemic agents, and control cohorts, respectively. During the 36-month follow-up, the cumulative incidence of MACE in the phototherapy and biologic cohorts remained lower than that of other treatment modalities. Cyclosporine (hazard ratio (HR) = 2.11, 95% confidence interval (CI) = 1.64–2.71) and mixed conventional systemic agents (HR = 2.57, 95% CI = 2.05–3.22) treatments were associated with increased MACE risk. Methotrexate treatment was not associated with MACE. Our finding demonstrates that treatment modalities may affect cardiovascular comorbidities in patients with psoriasis. Thus, an appropriate combination of anti-psoriatic therapies should be considered to manage patients with high cardiovascular risk.IRB approval status: Waiver decision was obtained by the institutional review board, Konkuk University Hospital, Seoul, Republic of Korea (KUH1120107).

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The impact of hip, knee and hand osteoarthritis on the subsequent risk of cardiovascular events and all-cause mortality: a population-based cohort study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2016.01.766 ◽

2016 ◽

Vol 24 ◽

pp. S425

Author(s):

T. Kendzerska ◽

L. King ◽

R. Croxford ◽

I. Stanaitis ◽

A. Wall ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Events ◽

Population Based ◽

Hand Osteoarthritis ◽

All Cause Mortality ◽

The Impact ◽

Subsequent Risk

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P1018LIPID PROFILES AND RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN CKD AND DIABETES: A NATIONWIDE POPULATION-BASED STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1018 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Yeonhee Lee ◽

Sehoon Park ◽

Soojin Lee ◽

Min Woo Kang ◽

SangHyun Park ◽

...

Keyword(s):

Cardiovascular Events ◽

Density Lipoprotein ◽

Population Based ◽

Lipoprotein Cholesterol ◽

Lipid Lowering ◽

Major Adverse Cardiovascular Events ◽

Linear Association ◽

All Cause Mortality ◽

Patients With Diabetes ◽

The Impact

Abstract Background and Aims The association of lipid parameters with cardiovascular outcomes and the impact of kidney function on this association have not been thoroughly evaluated in chronic kidney disease (CKD) patients with diabetes. Method We reviewed the National Health Insurance Database of Korea, containing the data of 10,505,818 subjects who received routine check-ups in 2009. We analyzed the association of lipid profile parameters with major adverse cardiovascular events (MACEs) risk and all-cause mortality in a nationally representative cohort of 51,757 lipid-lowering medication-naïve patients who had CKD and diabetes. Results Advanced CKD patients with eGFR <30 mL/min/1.73 m2 (n=10,775) had lower serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) but higher non-HDL-c levels and triglyceride (TG) to HDL-c ratios. There was a positive linear association between serum LDL-c and MACE risk in both early and advanced CKD patients (P <0.001 for trend). A U-shaped relationship was observed between serum LDL-c and all-cause mortality (the 4th and 8th octile groups; lowest hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.87-1.05 and highest HR 1.14, 95% CI 1.04-1.26, respectively). A similar pattern remained in both early and advanced CKD patients. The TG/HDL-c ratio categories showed a positive linear association for MACE risk in early CKD (P <0.001 for trend), but this correlation disappeared in advanced CKD patients. There was no correlation between the serum TG/HDL-c ratio and all-cause mortality in the study patients. Conclusion The LDL-c level predicted the risk for MACEs and all-cause mortality in both early and advanced CKD patients with diabetes, although the patterns of the association differed from each other. However, the TG/HDL-c ratio categories could not predict the risk for either MACEs or all-cause mortality in advanced CKD patients with diabetes, except that the TG/HDL-c ratio predicted MACE risk in early CKD patients with diabetes.

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The Potential Impact of Systemic Anti-Inflammatory Therapies on Major Adverse Cardiovascular Events: A Korean Nationwide Cohort Study

10.21203/rs.3.rs-115540/v1 ◽

2020 ◽

Author(s):

Joo Ran Hong ◽

Hojin Jeong ◽

Hyeongsu Kim ◽

Hyun Suk Yang ◽

Ji Youn Hong ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Events ◽

Population Based ◽

Treatment Modalities ◽

Major Adverse Cardiovascular Events ◽

Cardiovascular Comorbidities ◽

Anti Inflammatory ◽

And Control ◽

The Impact ◽

Systemic Agents

Abstract This nationwide population-based cohort study aimed to investigate the impact of systemic anti-inflammatory treatment on the major adverse cardiovascular events (MACE) risk in patients with psoriasis from January 2006 to December 2018, using a database provided by the Korean National Health Insurance Service. Patients were grouped based on the following treatment modalities: biologics, phototherapy, methotrexate, cyclosporine, and mixed conventional systemic agents. Patients who had not received any systemic treatment were assigned to the control cohort. The incidence of MACE per 1,000 person-year was 3.5, 9.3, 12.1, 28.4, 39.5, and 14.5 in the biologic, phototherapy, methotrexate, cyclosporine, mixed conventional systemic agents, and control cohorts, respectively. During the 36-month follow-up, the cumulative incidence of MACE in the phototherapy and biologic cohorts remained lower than that of other treatment modalities. Cyclosporine (hazard ratio (HR) = 2.11, 95% confidence interval (CI) = 1.64–2.71) and mixed conventional systemic agents (HR = 2.57, 95% CI = 2.05–3.22) treatments were associated with increased MACE risk. Methotrexate treatment was not associated with MACE. Our finding demonstrates that treatment modalities may affect cardiovascular comorbidities in patients with psoriasis. Thus, an appropriate combination of anti-psoriatic therapies should be considered to manage patients with high cardiovascular risk.

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Impact of rheumatoid arthritis on major cardiovascular events in patients with and without coronary artery disease

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-217154 ◽

2020 ◽

Vol 79 (9) ◽

pp. 1182-1188 ◽

Cited By ~ 1

Author(s):

Brian Bridal Løgstrup ◽

Kevin Kris Warnakula Olesen ◽

Dzenan Masic ◽

Christine Gyldenkerne ◽

Pernille Gro Thrane ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiovascular Events ◽

Treatment Strategies ◽

Population Based ◽

Major Adverse Cardiovascular Events ◽

All Cause Mortality ◽

Artery Disease ◽

The Impact

IntroductionRheumatoid arthritis (RA) is a risk factor for cardiovascular disease. The clinical consequences of coincident RA and coronary artery disease (CAD) are unknown.ObjectiveWe aimed to estimate the impact of RA on the risk of adverse cardiovascular events in patients with and without CAD.MethodsA population-based cohort of patients registered in the Western Denmark Heart Registry, who underwent coronary angiography (CAG) between 2003 and 2016, was stratified according to the presence of RA and CAD. Endpoints were myocardial infarction (MI), major adverse cardiovascular events (MACE; MI, ischaemic stroke and cardiac death) and all-cause mortality.ResultsA total of 125 331 patients were included (RA: n=1732). Median follow-up was 5.2 years. Using patients with neither RA nor CAD as reference (cumulative MI incidence 2.7%), the 10-year risk of MI was increased for patients with RA alone (3.8%; adjusted incidence rate ratio (IRRadj) 1.63, 95% CI 1.04 to 2.54), for patients with CAD alone (9.9%; IRRadj 3.35, 95% CI 3.10 to 3.62), and highest for patients with both RA and CAD (12.2%; IRRadj 4.53, 95% CI 3.66 to 5.59). Similar associations were observed for MACE an all-cause mortality.ConclusionsIn patients undergoing CAG, RA is significantly associated with the 10-year risk of MI, MACE and all-cause mortality regardless of the presence of CAD. However, patients with RA and CAD carry the largest risk, while the additive risk of RA in patients without CAD is minor. Among patients with RA, risk stratification by presence or absence of documented CAD may allow for screening and personalised treatment strategies

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