REFERRAL FOR PHARMACOLOGIC TESTING, A MARKER OF POOR EXERCISE CAPACITY, CONFERS A HIGHER RISK OF SHORT AND LONG TERM MORTALITY THAN MOST TRADITIONAL CARDIAC RISK FACTORS EXCEPT AGE

Abstract Background: Previous data show a high incidence of major lower extremity amputations (LEA) in Austria. Moreover, recent data on the epidemiology of major LEA are sparse in the Country. This study estimated the incidence and mortality rates of major LEA and assessed risk factors of post major LEA mortality in individuals with diabetes.Methods: A retrospective cohort analysis of 507,180 individuals with diabetes enrolled in the Austrian Health Insurance between 2014 and 2017 was performed. Crude and age-standardized rates of major LEA (hip, femur, knee, lower leg) were estimated by extracting their procedure codes from the database. Short- (30-day, 90-day) and long-term (1-year, 5-year) all-cause cumulative mortality after major LEA was estimated from the date of amputation till the date of death. Poisson regression was performed to compare rates by characteristics and assess the annual trend. The Cox-regression was performed to identify significant risk factors of all-cause mortality after major LEA.Results: A total of 2,165 individuals with diabetes underwent major LEA between 2014 and 2017. The mean age was amputees was 73.0 ±11.3 years, 62.7% were males, and 87.3% had a peripheral vascular disease (PVD). The overall age-standardized rate was 6.44 per 100,000 population. The rate increased with age (p<0.001) and was higher (p<0.001) in males (9.38) than females (5.66). The rate was 5.71 in 2014, 6.86 in 2015, 6.71 in 2016, and 6.66 in 2017, with an insignificant annual change of 3% (p=0.825). The cumulative 30-day mortality was 13.5%, 90-day was 22.0%, 1-year was 34.4%, and 5-year was 66.7%. Age, male sex, above-knee amputation, Charlson index, and heart failure were significantly associated with both short- and long-term mortality. Cancer, dementia, heart failure, PVD, and renal disease were only associated with long-term mortality.Conclusions: The rate of major LEA remained stable between 2014 and 2017 in Austria. Short and long-term mortality rates were considerably high after major LEA. Old age, male sex, above-knee amputations, heart failure, and Charlson Index were significant predictors of both short- and long-term mortality, whereas, comorbidities such as cancer, dementia, PVD, and renal disease were significant predictors of long-term mortality only.

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P70: Gastric bypass provides long-term improvement in cardiac risk factors

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2008.03.131 ◽

2008 ◽

Vol 4 (3) ◽

pp. 339

Author(s):

Gavitt Woodard ◽

John Downey ◽

Joseph Peraza ◽

John Morton

Keyword(s):

Risk Factors ◽

Gastric Bypass ◽

Cardiac Risk ◽

Cardiac Risk Factors

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The Incidence of Acute Kidney Injury Following Lung Transplantation Performed on Cardiopulmonary Bypass; Risk Factors, Effect on Short and Long-Term Mortality

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2019.01.1068 ◽

2019 ◽

Vol 38 (4) ◽

pp. S419 ◽

Cited By ~ 1

Author(s):

C. Carlheim ◽

A.M. Holm ◽

J.F. Bugge

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Cardiopulmonary Bypass ◽

Lung Transplantation ◽

Kidney Injury ◽

Short And Long Term ◽

Long Term Mortality

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Long-term irreversible trastuzumab-induced cardiotoxicity for metastatic breast cancer in a patient without cardiac risk factors

Oxford Medical Case Reports ◽

10.1093/omcr/omx038 ◽

2017 ◽

Vol 2017 (7) ◽

Cited By ~ 4

Author(s):

Satoru Tanaka ◽

Ayana Ikari ◽

Toshikatsu Nitta ◽

Tetsuya Horiuchi

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Metastatic Breast Cancer ◽

Metastatic Breast ◽

Cardiac Risk ◽

Cardiac Risk Factors

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Cardiovascular Disease as a Long-Term Complication of Treatment for Testicular Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2003.04.173 ◽

2003 ◽

Vol 21 (8) ◽

pp. 1513-1523 ◽

Cited By ~ 392

Author(s):

R.A. Huddart ◽

A. Norman ◽

M. Shahidi ◽

A. Horwich ◽

D. Coward ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Testicular Cancer ◽

Cardiac Risk ◽

Mortality Data ◽

Resident Male ◽

Cardiac Risk Factors ◽

Long Term Survivors

Purpose: To assess the risk of cardiovascular morbidity and cardiac risk factors in long-term survivors of testicular cancer according to treatment received. Patients and Methods: All resident male patients registered in the United Kingdom between 1982 and 1992 attending for follow-up were eligible for recruitment. Patients completed a current health questionnaire and underwent clinical review, along with hematologic, biochemical, and hormonal profiles. For patients not under routine review, follow-up information was sought from their general practitioner and mortality data were sought from the Office of National Statistics. Descriptive analysis was performed on all variables and comparisons were made among patients treated by orchidectomy and follow-up only, chemotherapy alone (C), radiotherapy alone (RT), and radiotherapy and chemotherapy (C/RT). Results: Data on cardiovascular events were available on 992 patients. After a median follow-up of 10.2 years, 68 events had been reported, including 18 deaths. After adjusting for age, increased risk for cardiac events was seen after C (relative risk [RR] = 2.59; 95% confidence interval [CI], 1.15 to 5.84; P = .022), RT (RR = 2.40; 95% CI, 1.04 to 5.45; P = .036), and C/RT (RR = 2.78; 95% CI, 1.09 to 7.07; P = .032). There were no significant differences in cardiac risk factors. On multivariate analysis, age, treatment group, free thyroxine, protein, and magnesium levels were associated with cardiovascular disease. Conclusion: In long-term survivors of testicular cancer, we observed a two-fold or greater risk of developing cardiovascular disease. This was not due to increases in cardiac risk factors, which suggests a direct or indirect treatment effect. These data support the continued research into the minimization of treatment in good-prognosis testicular cancer.

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Long-term risk factor management after inpatient cardiac rehabilitation by means of a structured post-care programme

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1177/1741826711398837 ◽

2011 ◽

Vol 18 (6) ◽

pp. 843-849 ◽

Cited By ~ 5

Author(s):

Birgit M Harb ◽

Manfred Wonisch ◽

Dieter Brandt ◽

Rudolf Müller

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiac Rehabilitation ◽

Ldl Cholesterol ◽

Cardiac Risk ◽

Rehabilitation Programme ◽

Cardiac Risk Factors ◽

Secondary Prevention Programme ◽

One Year

Background: Initiation of a long-term improvement of cardiac risk factors is one of the major aims of a cardiac rehabilitation/secondary prevention programme. Methods and participants: The Health Guide collected data in terms of cardiac risk factors: blood pressure, resting pulse, total cholesterol, LDL cholesterol, body weight, physical activity and number of cigarettes at admission and discharge after a stationary rehabilitation programme and every 3 months. After 12 months the Health Guides were returned. In the prospective study 2664 patients (71.8% men, age: MV = 62.94 years, SD = 9.96; 28% women, MV = 67.59 years, SD = 9.53) with coronary heart disease (CHD) were included. Results: All cardiac risk factors documented by the Health Guide improved during the cardiac rehabilitation programme. After one year, risk factors were significantly lower than at admission, apart from total cholesterol. The individual goal in terms of body weight and LDL cholesterol was partially achieved after the rehabilitation programme and maintained after one year. In the investigation years, 2004–2007, the cholesterol and blood pressure were significantly lower than in the years 2000–2003. Conclusion: The use of a Health Guide resulted in an improved long-term effect of a cardiac rehabilitation/secondary prevention programme. It is a simple and cheap intervention and can help in the guidance of the patients.

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