Epidemiology, morbidity and mortality in Behçet’s disease: a cohort study using The Health Improvement Network (THIN)

Rheumatology ◽  
2020 ◽  
Vol 59 (10) ◽  
pp. 2785-2795 ◽  
Author(s):  
Tom Thomas ◽  
Joht Singh Chandan ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
George Gkoutos ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Venous Thrombosis ◽  
Ischaemic Heart Disease ◽  
Thromboembolic Disease ◽  
Age And Gender ◽  
Increased Risk ◽  
And Gender

Abstract Objectives The epidemiology of Behçet’s disease (BD) has not been well characterized in the UK. Evidence on the risk of cardiovascular disease, thromboembolic disease and mortality in patients with BD compared with the general population is scarce. Methods We used a large UK primary care database to investigate the epidemiology of BD. A retrospective matched cohort study was used to assess the following outcomes: risk of cardiovascular, thromboembolic disease and mortality. Controls were selected at a 1:4 ratio (age and gender matched). Cox proportional hazard models were used to derive adjusted hazard ratios (aHR). Results The prevalence of BD was 14.61 (95% CI 13.35–15.88) per 100 000 population in 2017. A total of 1281 patients with BD were compared with 5124 age- and gender-matched controls. There was significantly increased risk of ischaemic heart disease [aHR 3.09 (1.28–7.44)], venous thrombosis [aHR 4.80 (2.42–9.54)] and mortality [aHR 1.40 (1.07–1.84)] in patients with BD compared with corresponding controls. Patients with BD were at higher risk of pulmonary embolism compared with corresponding controls at baseline [adjusted odds ratio 4.64 (2.66–8.09), P < 0.0001]. The majority of patients with pulmonary embolism and a diagnosis of BD had pulmonary embolism preceding the diagnosis of BD, not after (87.5%; n = 28/32). Conclusion BD has a higher prevalence than previously thought. Physicians should be aware of the increased risk of developing ischaemic heart disease, stroke/transient ischaemic attack and deep venous thrombosis in patients with BD at an earlier age compared with the general population. Risk of embolism in patients with BD might vary across the disease course.

scholarly journals Associations between mental illnesses and acute cardiovascular events and cancers in France in 2016

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Lesuffleur ◽  
M Coldefy ◽  
A Rachas ◽  
C Gastaldi-Ménager ◽  
P Tuppin
Keyword(s):  
Heart Failure ◽  
Mental Illness ◽  
Pulmonary Embolism ◽  
General Population ◽  
Cardiovascular Events ◽  
Healthcare Professionals ◽  
Mental Illnesses ◽  
Age And Gender ◽  
Addictive Disorder ◽  
And Gender

Abstract Background People with a mental illness have higher risks of somatic diseases and higher mortality, but this has been poorly documented in France. We studied the associations between mental illnesses and acute cardiovascular events (ACEs) and cancers in the French national health data system (SNDS). Methods We included all health insurance general scheme beneficiaries ≥18 years-of-age in 2016. Mental illnesses (psychotic disorder, neurotic or mood disorder, mental retardation and addictive disorder), ACEs (acute coronary syndrome (ACS), stroke, acute heart failure and pulmonary embolism) and cancers (breast, colorectal, lung and prostate) were identified using algorithms based on long-term disease registry, hospitalization diagnoses and specific drug deliveries. The associations were measured using morbidity ratios standardized by age and gender when appropriate (SMRs). Results ACEs were more frequent in the subjects with a mental illness than in the general population: ACS (SMR: 1.6), stroke (2.3), acute heart failure (1.9), pulmonary embolism (2.4). Similar results were found for each mental illness, except for ACS, which were less frequent in those with a mental retardation (SMR: 0.5) and were not associated with psychotic disorder (SMR: 1.0). Mental illness was also associated with more frequent breast (SMR: 1.3), colorectal (1.3), lung (2.0) and prostate (1.2) cancers, in particular for those with a neurotic or mood disorder (SMRs: 1.3, 1.5, 2.3, 1.2, respectively) and, for lung cancer, those with an addictive disorder (SMR: 2.6). Conclusions Globally, ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender, which could be related to adverse effects of certain psychotropic drugs or behaviours or risk factors related to the mental illness. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness. Key messages ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness.

scholarly journals Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of 15 000 Swedish men and women born 1915-29

BMJ ◽  
1998 ◽  
Vol 317 (7153) ◽  
pp. 241-245 ◽  
Author(s):  
D. A Leon ◽  
H. O Lithell ◽  
D. Vagero ◽  
I. Koupilova ◽  
R. Mohsen ◽  
...  
Keyword(s):  
Growth Rate ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Fetal Growth ◽  
Men And Women ◽  
Risk Of Death ◽  
Increased Risk

scholarly journals Cardiovascular disease in women with breast cancer – a nationwide cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Jakobsen ◽  
Christophe Kolodziejczyk ◽  
Morten Sall Jensen ◽  
Peter Bo Poulsen ◽  
Humma Khan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Pulmonary Embolism ◽  
Cohort Study ◽  
Heart Disease ◽  
Index Date ◽  
Hospital Records ◽  
Pulmonary Heart Disease ◽  
Increased Risk

Abstract Background There is increasing concern about cardiovascular disease (CVD) after breast cancer (BC). The aim of this study was to estimate the prevalence of different types of CVD in women diagnosed with BC compared to cancer-free controls as well as the incidence of CVD after BC diagnosis. Methods We performed a cohort study based on data from national registries covering the entire Danish population. We followed 16,505 cancer-naïve BC patients diagnosed from 2003 to 2007 5 years before and up to 10 years after BC diagnosis compared to 165,042 cancer-free controls. Results We found that 15.6% of BC patients were registered with at least one CVD diagnosis in hospital records before BC diagnosis. Overall, BC patients and controls were similar with regard to CVD comorbidity before BC diagnosis. After BC diagnosis, the incidence of all CVD diagnoses combined was significantly higher in BC patients than controls up to approximately 6 years after the index date (BC diagnosis). After 10 years, 28% of both BC patients and controls (without any CVD diagnosis up to 5 years before the index date) had at least one CVD diagnosis according to hospital records. However, the incidence of heart failure, thrombophlebitis/thrombosis and pulmonary heart disease including pulmonary embolism remained higher in BC patients than controls during the entire 10-year follow-up period. After 10 years, 2.7% of BC patients compared to 2.5% of controls were diagnosed with heart failure, 2.7% of BC patients compared to 1.5% of controls were diagnosed with thrombophlebitis/thrombosis, and 1.5% of BC patients compared to 1.0% of controls were diagnosed with pulmonary heart disease according to hospital records. Furthermore, we found that the risk of heart failure and thrombophlebitis/thrombosis was higher after chemotherapy. Conclusions Focus on CVD in BC patients is important to ensure optimum treatment with regard to BC as well as possible CVD. Strategies to minimise and manage the increased risk of heart failure, thrombophlebitis/thrombosis and pulmonary heart disease including pulmonary embolism in BC patients are especially important.

Abstract P186: Circulating Desphospho-uncarboxylated Matrix Gla Protein and the Risk of Coronary Heart Disease and Stroke

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Geertje W Dalmeijer ◽  
Yvonne T van der Schouw ◽  
Elke J Magdeleyns ◽  
Cees Vermeer ◽  
W. Monique M Verschuren ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Vitamin K ◽  
Stroke Risk ◽  
Matrix Gla Protein ◽  
Chd Risk ◽  
Increased Risk ◽  
Incident Cases

Background: Matrix Gla protein (MGP) is a vitamin K dependent protein and a potent inhibitor of vascular calcification. Desphospho-uncarboxylated MGP (dp-ucMGP) is a marker for vitamin K status with high dp-ucMGP concentration reflecting a low vitamin K status. High dp-ucMGP concentrations are thought to be associated with an increased risk of cardiovascular disease, but this has never been investigated in the general population. Objective: This study aimed to investigate the association of dp-ucMGP with incident coronary heart disease (CHD) or stroke in the general population. Design and Methods: A prospective case-cohort study with a representative baseline sample of 1406 participants and 1154 and 380 incident cases of CHD and stroke, respectively, was nested within the EPIC-NL study. Dp-ucMGP concentrations were measured by ELISA technique in baseline plasma samples. The incidence of fatal and non-fatal CHD and stroke was obtained by linkage to national registers. Cox proportional hazard models adapted for the case-cohort design were used to calculate hazard ratios (HRs) per standard deviation (SD) and per quartile of circulating dp-ucMGP levels, adjusted for cardiovascular risk factors. Results: This case-cohort study had an average follow-up of 11.5 years. Circulating dp-ucMGP levels were not associated with CHD risk with a HR per SD of 1.00 (95% CI: 0.93-1.07) and a HR Q4 vs Q1 of 0.94 (95% CI: 0.79-1.13) after multivariate adjustment. Circulating dp-ucMGP was not associated with stroke risk with a HR per SD of 0.98 (95% CI: 0.90-1.08) and a HR Q4 vs Q1 of 1.09 (95% CI: 0.78-1.51). Conclusion: This study does not support the hypothesis that high dp-ucMGP levels, reflecting a poor vitamin K status, are associated with increased CHD or stroke risk.

Long-term transportation noise exposure and incidence of ischaemic heart disease and stroke: a cohort study

2019 ◽  
pp. oemed-2018-105333 ◽  
Author(s):  
Andrei Pyko ◽  
Niklas Andersson ◽  
Charlotta Eriksson ◽  
Ulf de Faire ◽  
Tomas Lind ◽  
...  
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Noise Exposure ◽  
Road Traffic ◽  
Cox Proportional Hazards ◽  
Aircraft Noise ◽  
Transportation Noise ◽  
Increased Risk

BackgroundThere is limited evidence from longitudinal studies on transportation noise from different sources and development of ischaemic heart disease (IHD) and stroke.ObjectivesThis cohort study assessed associations between exposure to noise from road traffic, railway or aircraft and incidence of IHD and stroke.MethodsIn a cohort of 20 012 individuals from Stockholm County, we estimated long-term residential exposure to road traffic, railway and aircraft noise. National Patient and Cause-of-Death Registers were used to identify IHD and stroke events. Information on risk factors was obtained from questionnaires and registers. Adjusted HR for cardiovascular outcomes related to source-specific noise exposure were computed using Cox proportional hazards regression.ResultsNo clear or consistent associations were observed between transportation noise and incidence of IHD or stroke. However, noise exposure from road traffic and aircraft was related to IHD incidence in women, with HR of 1.11 (95% CI 1.00 to 1.22) and 1.25 (95% CI 1.09 to 1.44) per 10 dB Lden, respectively. For both sexes taken together, we observed a particularly high risk of IHD in those exposed to all three transportation noise sources at≥45 dB Lden, with a HR of 1.57 (95% CI 1.06 to 2.32), and a similar tendency for stroke (HR 1.42; 95% CI 0.87 to 2.32).ConclusionNo overall associations were observed between transportation noise exposure and incidence of IHD or stroke. However, there appeared to be an increased risk of IHD in women exposed to road traffic or aircraft noise as well as in those exposed to multiple sources of transportation noise.

scholarly journals Renal hyperfiltration is independently associated with increased all-cause mortality in individuals with type 2 diabetes: a prospective cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e001481
Author(s):  
Giuseppe Penno ◽  
Emanuela Orsi ◽  
Anna Solini ◽  
Enzo Bonora ◽  
Cecilia Fondelli ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Prospective Cohort ◽  
Age And Gender ◽  
Death Rates ◽  
Risk Of Death ◽  
Renal Hyperfiltration ◽  
Increased Risk ◽  
And Gender

IntroductionIn addition to favoring renal disease progression, renal ‘hyperfiltration’ has been associated with an increased risk of death, though it is unclear whether and how excess mortality is related to increased renal function. We investigated whether renal hyperfiltration is an independent predictor of death in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian multicenter study.Research design and methodsThis observational, prospective cohort study enrolled 15 773 patients with type 2 diabetes consecutively attending 19 Italian diabetes clinics in 2006–2008. Serum creatinine, albuminuria, cardiovascular risk factors, and complications/comorbidities were assessed at baseline. Vital status on 31 October 2015 was retrieved for 15 656 patients (99.26%). Patients were stratified (A) by absolute estimated glomerular filtration rate (eGFR) values in eGFR deciles or Kidney Disease: Improving Global Outcomes (KDIGO) categories and (B) based on age-corrected thresholds or age and gender-specific 95th and 5th percentiles in hyperfiltration, hypofiltration, and normofiltration groups.ResultsThe highest eGFR decile/category and the hyperfiltration group included (partly) different individuals with similar clinical features. Age and gender-adjusted death rates were significantly higher in deciles 1, 9, and 10 (≥103.9, 50.9–62.7, and <50.9 mL/min/1.73 m2, respectively) versus the reference decile 3 (92.9–97.5 mL/min/1.73 m2). Mortality risk, adjusted for multiple confounders, was also increased in deciles 1 (HR 1.461 (95% CI 1.175 to 1.818), p=0.001), 9 (1.312 (95% CI 1.107 to 1.555), p=0.002), and 10 (1.976 (95% CI 1.673 to 2.333), p<0.0001) versus decile 3. Similar results were obtained by stratifying patients by KDIGO categories. Death rates and adjusted mortality risks were significantly higher in hyperfiltering and particularly hypofiltering versus normofiltering individuals.ConclusionsIn type 2 diabetes, both high-normal eGFR and hyperfiltration are associated with an increased risk of death from any cause, independent of confounders that may directly impact on mortality and/or affect GFR estimation. Further studies are required to clarify the nature of this relationship.Trial registration numberNCT00715481.

scholarly journals Vertebral fracture as risk factors for self-harm: A retrospective cohort study

2020 ◽  
Author(s):  
James Prior ◽  
Fay Crawford-Manning ◽  
Rebecca Whittle ◽  
Alyshah Abdul-Sultan ◽  
Carolyn Chew-Graham ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Age And Gender ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Self Harm ◽  
And Gender

Abstract BackgroundThe prevention of self-harm is an international public health priority, It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures Methods Retrospective cohort study using data from the Clinical Practice Research Datalink. Patients with vertebral fracture were identified and matched to patients without fracture by age and gender. Incident self-harm was defined by medical record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by age and gender. ResultsThe number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), mean age was 74 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6).Greatest risk of self-harm was found in those with vertebral fractures who were younger (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). ConclusionsPrimary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Younger, male patients appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

Increased risk of coronary heart disease among patients with idiopathic inflammatory myositis: a nationwide population study in Taiwan

Rheumatology ◽  
2019 ◽  
Vol 58 (11) ◽  
pp. 1935-1941 ◽  
Author(s):  
Meng-Yu Weng ◽  
Edward Chia-Cheng Lai ◽  
Yea-Huei Kao Yang
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Health Insurance ◽  
Cardiovascular Risk ◽  
General Population ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Idiopathic Myositis

Abstract Objective To evaluate the risk of incident coronary heart disease (CHD) among patients with DM and PM in a general population context. Methods We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database containing records covering the years from 2000 to 2010. DM and PM were confined for the purposes of this study to those aged ⩾18 years who were eligible for the Taiwan catastrophic illness certificate. The diagnoses, CHD outcomes and cardiovascular risk factors were identified from electronic claims data. We conducted two cohort analyses: CHD and DM, and CHD and PM, excluding for each analysis individuals with CHD already identified at baseline. Data for the comparison group was obtained from the Longitudinal Health Insurance database, comprising 1 million persons randomly sampled from the total beneficiaries during 2000. We estimated hazard ratios comparing myositis with comparison cohorts, adjusting for potential cardiovascular risk factors. Results A total of 1145 patients with idiopathic myositis were identified, along with 732 723 control patients aged ⩾18 years. The incidence rates of CHD were 15.1 in DM and 30.1 in PM per 1000 person-years, vs 8.4 and 10.5 per 1000 person-years in the comparison cohort. The adjusted hazard ratios for CHD in patients with idiopathic myositis were 2.21 (95% CI 1.64, 2.99) for DM and 3.73 (95% CI 2.83, 4.90) for PM. Conclusion Results of this general population-based cohort study suggest that DM and PM are associated with an increased risk of CHD.

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