scholarly journals Risk of cardiovascular disease after a diagnosis of common psychiatric disorders: a matched cohort study of disease susceptibility and progression trajectory in the UK Biobank

2021 ◽  
Author(s):  
Xin Han ◽  
Yu Zeng ◽  
Yanan Shang ◽  
Yao Hu ◽  
Can Hou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Psychiatric Disorders ◽  
Temporal Pattern ◽  
Disease Susceptibility ◽  
Matched Cohort ◽  
Uk Biobank ◽  
Psychiatry Disorders

Background: Whether associations between psychiatric disorders and cardiovascular diseases (CVDs) can be modified by disease susceptibility and the temporal pattern of these associated CVDs remain unknown. Methods: We conducted a matched cohort study of UK Biobank including 35,227 patients with common psychiatry disorders (anxiety, depression, and stress-related disorders) between 1997 and 2019, together with 176,135 sex- and birth year- individually matched unexposed individuals.Results: The mean age at the index date was 51.76 years, and 66.0% of participants were females. During a mean follow-up of 11.94 years, we observed an elevated risk of CVD among patients with studied psychiatry disorders, compared with matched unexposed individuals (hazard ratios [HRs]=1.16, 95% confidence interval [CI]: 1.14-1.19), especially during the first six months of follow-up (HR=1.59 [1.42-1.79]). To assess the modification role of disease susceptibility, we stratified analyses by family history of CVD and by CVD PRS, which obtained similar estimates between subgroups with different susceptibilities to CVD. We conducted trajectory analysis to visualize the temporal pattern of CVDs after common psychiatry disorders, identifying primary hypertension, acute myocardial infarction, and stroke as three main intermediate steps leading to further increased risk of other CVDs.Conclusions: The association between common psychiatry disorders and subsequent CVD is not modified by predisposition to CVD. Hypertension, acute myocardial infarction, and stroke are three initial CVDs linking psychiatric disorders to other CVD squeals, highlighting a need of timely intervention on these targets to prevent further CVD squeals among all individuals with common psychiatric disorders.Funding: This work is supported by the National Natural Science Foundation of China (No. 81971262 to HS), 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (No. ZYYC21005 to HS), EU Horizon2020 Research and Innovation Action Grant (847776 to UV and FF).

Long term prognostic impact of gender in patients with stable coronary disease: an analysis of the CICCOR registry, a seventeen years, prospective, monocentric, cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Ruiz Ortiz ◽  
J.J Sanchez Fernandez ◽  
C Ogayar Luque ◽  
E Romo Penas ◽  
M Delgado Ortega ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Cardiovascular Death ◽  
Female Sex ◽  
The Impact ◽  
Overall Mortality

Abstract Purpose Women and men with stable coronary artery disease (sCAD) have different clinical features and management, but 1-year prognosis has been reported to be similar in large observational registries. The objective of the present study was to investigate the impact of female sex in the prognosis of the disease in the very long-term. Methods The CICCOR registry (“Chronic ischaemic heart disease in Cordoba”) is a prospective, monocentric, cohort study. From February 1, 2000 to January 31, 2004, all consecutive patients with sCAD attended at two outpatient cardiology clinics in a city of the south of Spain were included in the study and prospectively followed. Differential clinical features of women and men were described and the impact of female sex in long term prognosis was investigated. Results The study sample included 1268 patients, 337 women (27%) and 931 men (73% male). Women were older than men (70±9 versus 65±11 years, p<0.0005), more likely to have hypertension (72% versus 49%, p<0.0005) and diabetes (45% versus 26%), and less likely to be ex-smoker/active smoker (5%/2% versus 49%/9%, p<0.0005). They had more frequently angina in functional class ≥II (22% versus 17%, p=0.04) and atrial fibrillation (8% versus 5%, p=0.04), but had received less frequently coronary revascularization (32% versus 44%, p<0.0005). Prescription of statins (64% versus 68%, p=0.22), antiplatelets (89% versus 93%, p=0.07) and betablockers (67% versus 63%, p=0.28) at first visit was similar than men, but women received more frequently nitrates (78% versus 64%, p<0.0005), angiotensin-conversing enzyme inhibitors or receptor antagonists (56% versus 47%, p=0.004) and diuretics (41% versus 22%, p<0.0005). After up to 17 years of follow-up (median 11 years, IQR 4–15 years, with a total of 12612 patients-years of observation), probabilities of acute myocardial infarction (12% versus 14%, p=0.55) or stroke (14% versus 12%, p=0.40) at median follow up were similar for women and men. However, the risks of hospital admission for heart failure (22% versus 13%, p<0.0005) or cardiovascular death (35% versus 24%, p<0.0005) were significantly higher for women, with a non-significant trend to higher overall mortality (45% versus 39%, p=0.07). After multivariate adjustment, the risks of most events were similar for women and men (Hazard Ratios [95% confidence intervals]: 0.79 [0.55–1.14], p=0.21 for acute myocardial infarction; 0.89 [0.61–1.29], p=0.54 for stroke; 1.13 [0.82–1.57], p=0.46 for admission for heart failure; and 0.92 [0.73–1.16], p=0.48 for cardiovascular death), with a non-significant trend to lower overall mortality (0.83 [0.67–1.02], p=0.08). Conclusion Although women and men with sCAD presents a different clinical profile, and crude rates of hospital admissions for heart failure and cardiovascular death were higher in women, female sex was not an independent prognostic factor in this observational study with up to 17 years of follow-up. Funding Acknowledgement Type of funding source: None

scholarly journals The Role of Sense of Coherence in the Outcomes of Acute Myocardial Infarction Survivors; a Two-year Cohort Study

2021 ◽  
Author(s):  
Hamiodreza Roohafza ◽  
Ramin Heidari ◽  
Ali Safaei ◽  
Gholamreza Masoumi ◽  
Azam Soleimani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Medical History ◽  
Sense Of Coherence ◽  
Demographic Data ◽  
Large Population ◽  
Health Anxiety ◽  
Cardiac Events

Abstract Background: Survivors of acute myocardial infarction(AMI) struggle with stressful consequences. Sense of coherence(SOC) seems to be associated with a person's capacity to face life incidents. The current study aims to evaluate SOC's correlation with the major adverse cardiac events(MACE) among the AMI survivors. The study was designed and reported following the STROBE guidelines and checklist.Methods: This study was part of the ST-elevated myocardial infarction cohort study in Isfahan(SEMI-CI) conducted on 724 AMI survivors followed for two years. The patients' demographic, medical history and follow-up manifestations were recruited. The 13-item SOC questionnaire was utilized and the Diagnostic Criteria for Psychosomatic Research(DCPR) questionnaire for psychosomatic disorders evaluation, including health anxiety, illness denial, irritable mood, and demoralization. MACE was defined as non-fatal MI, non-fatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Results: Logistic regression assessments showed that the SOC level was an independent predictor for the development of MACE(OR:0.67; 95%CI:0.40-0.85). This finding was confirmed by the controlling factors, including demographic data(OR:0.60; 95%CI:0.35-0.79), demographic factors and medical history(OR:0.62; 95%CI:0.36-0.86), the previous ones plus clinical follow-up assessments(OR:0.59; 95%CI:0.33-0.79), and all the evaluations plus psychosomatic factors(OR:0.76; 95%CI:0.42-0.92). Similar outcomes were achieved using SOC scores.Conclusion: Based on this study, SOC was an independent MACE predictor in a large population of AMI patients through a 2-year-follow-up period.

scholarly journals In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039096
Author(s):  
Natsuko Kanazawa ◽  
Hiroaki Iijima ◽  
Kiyohide Fushimi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Coronary Intervention ◽  
Cardiac Mortality ◽  
Percutaneous Coronary ◽  
All Cause Mortality

ObjectivesTo verify the associations between participation in an in-hospital cardiac rehabilitation (CR) programme and clinical outcomes among patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).DesignA retrospective cohort study using the Japanese administrative claims database.SettingJapanese acute-care hospitals.ParticipantsPatients aged ≥18 years who underwent PCI due to AMI and survived to discharge.Primary and secondary outcome measureThe primary outcomes were revascularisation, all-cause readmission and cardiac readmission (median follow-up period: 324 days, 236 days and 263 days, respectively). The secondary outcomes were all-cause mortality and cardiac mortality (median follow-up period: both were 460 days).ResultThe data of 13 697 patients were extracted from the database, and 65.4% of them participated in an in-hospital CR. The risks of revascularisation, all-cause readmission and cardiac readmission among CR participants were compared with those of non-participants using two statistical techniques: matched-pair analysis based on propensity score and a 30-day landmark analysis. The results of those analysis were consistent and showed that the CR participants had lower risk of revascularisation (adjusted HR: 0.74; 95% CI: 0.65 to 0.84), all-cause readmission (HR: 0.81; 95% CI: 0.74 to 0.88) and cardiac readmission (HR: 0.77; 95% CI: 0.70 to 0.85). However, all-cause mortality and cardiac mortality were not associated with participation in the CR.ConclusionsIt was suggested that in-hospital CR participation may reduce the risk of revascularisation, all-cause readmission and cardiac readmission among patients with AMI after PCI. In-hospital CR may expand the potential benefits of CR in addition to outpatient CR.

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