scholarly journals P867Yield of targeted AF screening in a high-risk cohort with chronic kidney disease, diabetes mellitus and cardiovascular disease

EP Europace ◽  
2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i163-i163
Author(s):  
P Sobocinski-Doliwa ◽  
J M Corander ◽  
M Rosenqvist ◽  
J Spaak
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
High Risk Cohort

scholarly journals Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
High Risk ◽  
Kidney Disease ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

scholarly journals Prescribing Trend of Antirheumatic Drugs in Taiwan and Risk of Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Nationwide Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Chien-Ying Lee ◽  
Chih-Jaan Tai ◽  
Ya-Fang Tsai ◽  
Yu-Hsiang Kuan ◽  
Chiu-Hsiang Lee ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Control Group ◽  
Research Database ◽  
Antirheumatic Drugs ◽  
Prescribing Trend

We aimed to investigate the prescribing trend of antirheumatic drugs and assess the risk of cardiovascular disease in patients with rheumatoid arthritis in Taiwan. This study was a retrospective cohort study, conducted based on the Taiwan National Health Insurance Research Database. The study subjects were 15,366 new rheumatoid arthritis patients from 2003 to 2010. To avoid selection bias, we applied propensity score matching to obtain general patients, as the control group. Cox proportional hazard model was used to evaluate the risk of cardiovascular disease in rheumatoid arthritis patients. The most common prescriptions of rheumatoid arthritis were nonsteroidal anti-inflammatory drugs. After controlling for related variables, rheumatoid arthritis patients had a higher risk of cardiovascular disease than general patients (adjusted hazard ratio [aHR] = 1.31; 95% confidence interval [CI]: 1.23-1.39). Age was the most significantly associated risk factor with the cardiovascular disease. Other observed risk factors for cardiovascular disease included hypertension (aHR = 1.57, 95% CI: 1.48-1.65), diabetes mellitus (aHR = 1.47, 95% CI: 1.38-1.57), and chronic kidney disease (aHR = 1.48, 95% CI: 1.31-1.66). Patients with rheumatoid arthritis indeed had a higher risk of incident cardiovascular diseases. Besides, age, hypertension, diabetes mellitus, and chronic kidney disease were also associated with a higher risk of cardiovascular disease.

scholarly journals Markers of endothelial damage in patients with chronic kidney disease on hemodialysis

2017 ◽  
Vol 312 (4) ◽  
pp. F673-F681 ◽  
Author(s):  
Andrés Carmona ◽  
Maria L. Agüera ◽  
Carlos Luna-Ruiz ◽  
Paula Buendía ◽  
Laura Calleros ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Prognostic Markers ◽  
Plasma Concentrations ◽  
Endothelial Damage ◽  
Inflammatory State ◽  
Monocyte Subpopulations ◽  
Elisa Data

Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD142+/CD16+, CD14+/CD162+) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD162+ and CD142+/CD16+), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.

scholarly journals The Impact of Pharmacist-delivered Motivational Interviewing on Chronic Kidney Disease Identification and Management in Patients with Diabetes Mellitus and Low Socioeconomic Status

2019 ◽  
Vol 10 (4) ◽  
pp. 8
Author(s):  
Keri Lillian DePatis ◽  
Catherine Harrington
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Motivational Interviewing ◽  
Urinary Albumin ◽  
Secondary Outcome ◽  
High Risk Patients ◽  
Patients With Diabetes ◽  
Risk Patients

Purpose: Chronic kidney disease (CKD) is a common complication among patients with diabetes mellitus; however, noncompliance with the recommended annual screening is common. Increased screening among high-risk patients is important to identify the early stages CKD, potentially resulting in earlier treatment, slower progression, fewer complications, and decreased healthcare expenditures. Motivational interviewing (MI) has previously been shown to be effective for various behaviors, such as smoking cessation and cholesterol level control. The objective of this study is to evaluate the effectiveness of pharmacist-delivered MI compared to typical education (TE) methods in increasing CKD screening and subsequent angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) initiation in high-risk patient populations. Methods: Pharmacists screened diabetic patients within their chronic disease management clinic to identify patients that are at high-risk for CKD, indicated by a score of 4 or greater on the validated SCORED screening tool. High-risk patients were randomized to one of four groups to receive either one or two face-to-face education sessions from a pharmacist or student pharmacist using either MI or TE methods. Patients were then given the option to have their urine tested with a dipstick to detect albumin and creatinine, provided at no cost. The primary outcome was to determine the rate of urinary albumin testing, and the secondary outcome was to determine the rate of ACE-I or ARB initiation in patients found to have albuminuria. Results: There were no significant differences in the rates of urinary albumin screening (87% in TE vs. 100% in MI, P = 0.4828) or subsequent ACE-I/ARB initiation (100% in TE and 50% in MI, P = 1.000) between education groups. Of the high-risk patients who underwent urinary albumin screening, 54% (n=15) were found to have proteinuria Conclusions: While it appears that MI does not impact patient acceptance rates of microalbuminuria screening and ACE-I/ARB initiation, this study demonstrates the feasibility of pharmacist-delivered microalbuminuria screening in patients at high-risk for CKD in the outpatient setting.   Article Type: Practice-Based Research

scholarly journals Immunometabolic Dysregulation at the Intersection of Obesity and COVID-19

2021 ◽  
Vol 12 ◽  
Author(s):  
Collins N. Khwatenge ◽  
Marquette Pate ◽  
Laura C. Miller ◽  
Yongming Sang
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Immune Responses ◽  
Metabolic Disorders ◽  
Acute Infection ◽  
Meta Analyses ◽  
Metabolic Comorbidities ◽  
Interdisciplinary Intervention

Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.

scholarly journals Intravenous neurotropic vitamin b injection in chronic kidney disease patients on dialysis: patient’s perspective

2020 ◽  
Vol 11 (SPL4) ◽  
Author(s):  
Rizaldy Taslim Pinzon ◽  
Radian Adhiputra Antonius
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Daily Activity ◽  
Treatment Quality ◽  
Vitamin B ◽  
Dialysis Patients ◽  
Risk Of Mortality ◽  
Intravenous Vitamin

Chronic kidney disease is characterized by a decrease in glomerular filtration rate and lasts over 3 months. Meanwhile, patient perspectives include patient compliance in treatment and care programs. Vitamin B combination plays a role in reducing the risk of mortality for cardiovascular disease. This study aims in measuring perspective on patients with chronic kidney disease undergoing hemodialysis to intravenous vitamin B injection. This is a cohort retrospective study of patients on dialysis that were injected with intravenous vitamin B two times a week after dialysis. The subjects studied were chronic kidney disease patients who underwent hemodialysis at Bethesda Hospital Yogyakarta and Panti Rapih Hospital Yogyakarta, Indonesia. This study involved 58 patients, comprising 38 male (65.5%) and 20 females (34.5%). Total 41 patients (70.7%) with age under 60 years. The most common comorbidities were hypertension (86.2%), diabetes mellitus (25.9%), and cardiovascular disease (20.7%). Patients' perspectives on improvement of fatigue symptoms are higher in patients with hypertension comorbidity (88.9%), sleep quality higher in diabetes mellitus comorbidity (80%), daily activity higher in patients with other comorbidity (84.6%) and mood higher in other comorbidity (88.9%). Overall, most of the patients were satisfied with the treatment (98.3%), satisfied that it reduced fatigue (96.6%), said no side effects appeared (91.4%), were confident in the treatment (94.8%), considered it resulted in greater benefit than costs (84.5%). Patients' perspectives in the treatment of intravenous vitamin B combination injections for chronic dialysis patients have satisfactory treatment quality.

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