Multistate Models for Survival Analysis of Cardiovascular Disease Process

2016 ◽  
Vol 69 (7) ◽  
pp. 714-715
Author(s):  
Morteza Hajihosseini ◽  
Toba Kazemi ◽  
Javad Faradmal
Keyword(s):  
Cardiovascular Disease ◽  
Survival Analysis ◽  
Disease Process ◽  
Multistate Models

Complications of therapy for ANCA-associated vasculitis

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_3) ◽  
pp. iii74-iii78 ◽  
Author(s):  
Rona Smith
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Course ◽  
Disease Process ◽  
Organ Damage ◽  
Therapeutic Strategies ◽  
Early Mortality ◽  
Treatment Regimens ◽  
Anca Associated Vasculitis ◽  
Monitoring Strategies

Abstract The introduction of immunosuppressive therapies has transformed ANCA-associated vasculitis (AAV) from a largely fatal condition to a chronic relapsing disorder. However, progressive organ damage and disability, both from the disease process itself and from therapies used for treatment, eventually affect the majority of patients. Infection, rather than uncontrolled vasculitis, is the greatest cause of early mortality and remains a major problem thereafter. Increased rates of malignancy and cardiovascular disease are additional important long term sequelae. This review focuses on the complications associated with the immunosuppressive therapies most commonly used to treat ANCA-associated vasculitis, and considers prophylactic and monitoring strategies to minimize these risks. Achieving a balance between immunosuppression to reduce relapse risk and minimizing the adverse effects associated with therapy has become key. The contribution of glucocorticoids to treatment toxicity is increasingly being recognized, and future therapeutic strategies must concentrate on glucocorticoid minimization or sparing strategies. Development of robust predictors of an individual’s future clinical course is needed in order to individually tailor treatment regimens.

Inflammatory cell recruitment in cardiovascular disease: murine models and potential clinical applications

2010 ◽  
Vol 118 (11) ◽  
pp. 641-655 ◽  
Author(s):  
Eileen McNeill ◽  
Keith M. Channon ◽  
David R. Greaves
Keyword(s):  
Cardiovascular Disease ◽  
Atherosclerotic Plaque ◽  
Critical Role ◽  
Disease Process ◽  
Pathological Process ◽  
Plaque Formation ◽  
Murine Models ◽  
Subsequent Transformation ◽  
Inflammatory Monocytes ◽  
Atherosclerotic Plaque Formation

Atherosclerosis is the pathological process that underlies the development of cardiovascular disease, a leading cause of mortality. Atherosclerotic plaque formation is driven by the recruitment of inflammatory monocytes into the artery wall, their differentiation into macrophages and the subsequent transformation of macrophages into cholesterol-laden foam cells. Models of hypercholesterolaemia such as the ApoE (apolipoprotein E)−/− mouse and the application of transgenic technologies have allowed us to undertake a thorough dissection of the cellular and molecular biology of the atherosclerotic disease process. Murine models have emphasized the central role of inflammation in atherogenesis and have been instrumental in the identification of adhesion molecules that support monocyte recruitment, scavenger receptors that facilitate cholesterol uptake by macrophages and other macrophage activation receptors. The study of mice deficient in multiple members of the chemokine family, and their receptors, has shown that chemokines play a critical role in promoting atherosclerotic plaque formation. In the present review, we will discuss novel therapeutic avenues for the treatment of cardiovascular disease that derive directly from our current understanding of atherogenesis gained in experimental animal models.

A global test for competing risks survival analysis

2020 ◽  
Vol 29 (12) ◽  
pp. 3666-3683
Author(s):  
Dominic Edelmann ◽  
Maral Saadati ◽  
Hein Putter ◽  
Jelle Goeman
Keyword(s):  
Survival Analysis ◽  
Likelihood Ratio ◽  
Likelihood Ratio Test ◽  
Competing Risks ◽  
Cox Model ◽  
Wald Test ◽  
Ratio Test ◽  
Type I ◽  
Multistate Models ◽  
Global Test

Standard tests for the Cox model, such as the likelihood ratio test or the Wald test, do not perform well in situations, where the number of covariates is substantially higher than the number of observed events. This issue is perpetuated in competing risks settings, where the number of observed occurrences for each event type is usually rather small. Yet, appropriate testing methodology for competing risks survival analysis with few events per variable is missing. In this article, we show how to extend the global test for survival by Goeman et al. to competing risks and multistate models[Per journal style, abstracts should not have reference citations. Therefore, can you kindly delete this reference citation.]. Conducting detailed simulation studies, we show that both for type I error control and for power, the novel test outperforms the likelihood ratio test and the Wald test based on the cause-specific hazards model in settings where the number of events is small compared to the number of covariates. The benefit of the global tests for competing risks survival analysis and multistate models is further demonstrated in real data examples of cancer patients from the European Society for Blood and Marrow Transplantation.

scholarly journals Impact of Health Status and Lifestyle Modifications on Vascular Structure and Function in Children and Adolescents

2015 ◽  
Vol 11 (4) ◽  
pp. 330-343
Author(s):  
Donald R. Dengel ◽  
Justin R. Ryder
Keyword(s):  
Cardiovascular Disease ◽  
Children And Adolescents ◽  
Vascular System ◽  
Disease Process ◽  
Structure And Function ◽  
Vascular Structure ◽  
Lifestyle Modifications ◽  
Genetic Abnormalities ◽  
And Function ◽  
Reliable Methods

Until recently cardiovascular disease is often thought of as a disease that manifests itself during middle age. Researchers and clinicians have begun to realize that the initial signs of cardiovascular disease begin early on in childhood with changes present in both vascular structure and function. This increased recognition has resulted in considerable effort to develop accurate and reliable methods to measure as well as track changes in vascular structure and function applicable to study this process in children and adolescents. Certain genetic abnormalities and chronic diseases, which present or emerge in childhood often result in meaningful changes to vascular structure and function, which aid in our understanding of the vascular disease process. In this review, we will discuss different methods of assessing vascular structure and function, the diseases in childhood associated with decrements and maladaptive changes in the vascular system, and whether modification of lifestyle (ie, weight loss, dietary and/or exercise changes) can affect vascular structure and function in children.

scholarly journals Risk stratification for 25-year cardiovascular disease incidence in type 1 diabetes: Tree-structured survival analysis of the Pittsburgh Epidemiology of Diabetes Complications study

2016 ◽  
Vol 13 (4) ◽  
pp. 250-259 ◽  
Author(s):  
Rachel G Miller ◽  
Stewart J Anderson ◽  
Tina Costacou ◽  
Akira Sekikawa ◽  
Trevor J Orchard
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Survival Analysis ◽  
Diabetes Complications ◽  
Disease Risk ◽  
Clinical Pathways ◽  
Disease Incidence ◽  
Cardiovascular Disease Risk ◽  
Diabetes Duration

Background: The formal identification of subgroups with varying levels of risk is uncommon in observational studies of cardiovascular disease, although such insight might be useful for clinical management. Methods: Tree-structured survival analysis was utilized to determine whether there are meaningful subgroups at varying levels of cardiovascular disease risk in the Pittsburgh Epidemiology of Diabetes Complications study, a prospective cohort study of childhood-onset (<17 years old) type 1 diabetes. Results: Of the 561 participants free of cardiovascular disease (coronary artery disease, stroke or lower extremity arterial disease) at baseline, 263 (46.9%) had an incident cardiovascular disease event over the 25-year follow-up. Tree-structured survival analysis revealed a range of risk groups, from 24% to 85%, which demonstrate that those with short diabetes duration and elevated non–high-density lipoprotein cholesterol have similar cardiovascular disease risk to those with long diabetes duration and that renal disease is a better discriminator of risk in men than in women. Conclusion: Our findings suggest that subgroups with major cardiovascular disease risk differences exist in this type 1 diabetes cohort. Using tree-structured survival analysis may help to identify these groups and the interrelationships between their associated risk factors. This approach may improve our understanding of various clinical pathways to cardiovascular disease and help target intervention strategies.

scholarly journals Novel Biomarkers in Cardiovascular Disease: A Review

2010 ◽  
Vol 2 (3) ◽  
pp. 66 ◽  
Author(s):  
Anna Meiliana ◽  
Andi Wijaya
Keyword(s):  
Cardiovascular Disease ◽  
Risk Stratification ◽  
Medical Profession ◽  
Clinical Care ◽  
Disease Process ◽  
Cardiac Biomarkers ◽  
Coronary Syndrome ◽  
Monitoring Tools ◽  
Novel Biomarkers ◽  
Protein Components

BACKGROUND: The investigation of novel circulating serum and plasma biomarkers in patients with cardiovascular disease has been accelerating at a remarkable pace. New markers or tests are often presented too early to the medical profession, potentially leading to overuse and, thus, extra burden and costs to patients, the healthcare industry, and the economy. The challenge for clinicians and medical researchers is how to optimally apply existing and new markers/tests.CONTENT: Biomarkers are biological parameters that can be objectively measured and quantified as indicators of normal biologic processes, pathogenic processes, or responses to a therapeutic intervention. Typically thought of as disease process screening, diagnosing, or monitoring tools, biomarkers may also be used to determine disease susceptibility and eligibility for specific therapies. Cardiac biomarkers are protein components of cell structures that are released into circulation when myocardial injury occurs. They play a pivotal role in the diagnosis, risk stratification, and treatment of patients with chest pain and suspected acute coronary syndrome (ACS) as well as those with acute exacerbations of heart failure.SUMMARY: Active investigation has brought forward an increasingly large number of novel candidate markers but few have withstood the test of time and become integrated into contemporary clinical care because of their readily apparent diagnostic, prognostic, and/or therapeutic utility. With regard to the more novel biomarkers, careful thought is needed with regard to the appropriate target populations for discovery and validation, as well as the criteria used to sort out the contenders from the pretenders.KEYWORDS: biomarker, cardiovascular disease, atherosclerosis, acute myocardial infarction, heart failure, risk stratification, diagnosis, prognosis

Heart disease and anaesthesia

2017 ◽  
Author(s):  
Stefan De Hert ◽  
Patrick Wouters
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Interventional Procedure ◽  
Disease Process ◽  
Volume Overload ◽  
Heart Rhythm ◽  
Interventional Cardiology ◽  
Cardiac Complications ◽  
Perioperative Morbidity

Cardiovascular disease is a leading cause of mortality. Hypertension is one of the major risk factors for cardiovascular disease. Classically, hypertension is subdivided according to the aetiology into primary and secondary hypertension. Ischaemic heart disease constitutes a major concern for perioperative morbidity and mortality. Therefore important efforts are directed towards the identification of the patient at risk for perioperative cardiac complications and towards optimization of the cardiac status before intervention. Cardiac rhythm disturbances fall into two general classes: bradyarrhythmias and tachyarrhythmias. While single isolated extra or skipped heart beats are usually harmless, serious heart rhythm disturbances are caused by an underlying heart disease. Valvular heart disease refers to any disease process involving any valve of the heart. Valvular heart disease may be as a result of a stenosis or an insufficiency of the valve, or both. It is characterized by pressure or volume overload to the atria and the ventricles (or both). It is this overload that will be responsible for the symptomatology of the disease. As a result of significant advances in prenatal diagnosis, cardiac surgery, interventional cardiology, and perioperative medicine, about 90% of infants with congenital heart disease are currently expected to reach adulthood. Management of these patients requires insight into (1) the primary cardiac lesion, (2) the type of cardiac surgical or interventional procedure(s) performed, (3) the presence of residual defects or sequelae, (4) the current physical status (i.e. balanced vs unbalanced), (5) the effects of surgery or pregnancy on their pathophysiological condition, and (6) the presence of comorbidity.

Cardiovascular disease and the risk of dementia: a survival analysis using administrative data from Manitoba

2022 ◽  
Author(s):  
Luc Clair ◽  
Hope Anderson ◽  
Christopher Anderson ◽  
Okechukwu Ekuma ◽  
Heather J. Prior
Keyword(s):  
Cardiovascular Disease ◽  
Survival Analysis ◽  
Administrative Data
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