Risk of hospitalization and mortality after breakthrough SARS-CoV-2 infection by vaccine type and previous SARS-CoV-2 infection utilizing medical claims data

Επίπεδα αδιπονεκτίνης στον ορό και τη βρογχοκυψελιδική έκπλυση (BAL) ασθενών με μη μικροκυτταρικό καρκίνο πνεύμονα (NSCLC)

10.12681/eadd/42314 ◽

2017 ◽

Author(s):

Παρασκευή Μπούρα

Keyword(s):

Body Mass Index ◽

Regression Analysis ◽

Confidence Interval ◽

Bronchoalveolar Lavage ◽

Body Mass ◽

Cox Regression ◽

Performance Status ◽

Hazard Ratio ◽

Cox Regression Analysis

Η αδιπονεκτίνη είναι μια από τις κυριότερες αδιποκίνες που παράγονται από τον λιπώδη ιστό. Προηγούμενες μελέτες έδειξαν τη δυνητική χρησιμότητα της αδιπονεκτίνης ορού ως διαγνωστικού ή/και προγνωστικού βιοδείκτη σε διάφορους συμπαγείς όγκους, αλλά τα σχετικά δεδομένα για τον καρκίνο του πνεύμονα, ειδικότερα, είναι ελλιπή. Επιπρόσθετα, η διαγνωστική ή και προγνωστική αξία των επιπέδων αδιπονεκτίνης σε άλλα βιολογικά υγρά -εκτός του περιφερικού αίματος- ασθενών με καρκίνο πνεύμονα ή και με οποιαδήποτε άλλη μορφή καρκίνου, δεν έχει, απ’ όσο γνωρίζουμε, μελετηθεί. Ο πρωταρχικός σκοπός της παρούσας μελέτης ήταν η περαιτέρω διερεύνηση της δυνητικής προγνωστικής αξίας των προθεραπευτικών επιπέδων αδιπονεκτίνης στον ορό και σε δείγματα βρογχοκυψελιδικής έκπλυσης (bronchoalveolar lavage, BAL) ασθενών με μη μικροκυτταρικό καρκίνο πνεύμονα (ΜΜΚΠ) προχωρημένου σταδίου. Στον παρόν ερευνητικό έργο μελετήθηκαν προοπτικά 29 νεοδιαγνωσθέντες ασθενείς με ΜΜΚΠ σταδίου IV. Τα προθεραπευτικά επίπεδα αδιπονεκτίνης ορού και BAL μετρήθηκαν με τη χρήση ανοσοενζυμικής μεθόδου (ELISA), και, ακολούθως, συσχετίσθηκαν με δημογραφικές, κλινικές και παθολογοανατομικές παραμέτρους. Αναλυτικότερα, οι παράμετροι που αξιολογήθηκαν συμπεριελάμβαναν το φύλο, την ηλικία, το Performance Status (PS), το δείκτη μάζας σώματος (Body Mass Index, BMI), την απώλεια βάρους > 10%, καθώς και τον ιστολογικό τύπο, βαθμό διαφοροποίησης (grade) και μέγεθος του πρωτοπαθούς όγκου. Η συσχέτιση των επιπέδων αδιπονεκτίνης και των λοιπών μεταβλητών με τη συνολική επιβίωση των ασθενών αξιολογήθηκε με μονοπαραγοντική και πολυπαραγοντική ανάλυση παλινδρόμησης του Cox (univariate and multivariate Cox regression analysis).Σύμφωνα με τα αποτελέσματα της μελέτης μας, η μέση ηλικία των ασθενών ήταν 65.6 έτη (SD= 10.1 έτη), ενώ η πλειοψηφία ήταν άνδρες (24/29 περιπτώσεις, 82.8%). Ο κυρίαρχος ιστολογικός τύπος ήταν το αδενοκαρκίνωμα (18/29 περιπτώσεις, 62.1%). Η λειτουργική κατάσταση (performance status, PS) των ασθενών ήταν 0 και 1-2 σε 17/29 περιπτώσεις (58.6%) και 12/29 περιπτώσεις (41.4%), αντιστοίχως. Απώλεια βάρους μεγαλύτερη του 10% παρατηρήθηκε σε 10/29 ασθενείς (34.5%). Οι διάμεσες τιμές επιπέδων αδιπονεκτίνης σε ορό και BAL ήταν 17710 ng/ml και 911.5 ng/ml, αντιστοίχως. Δεν παρατηρήθηκαν στατιστικώς σημαντικές συσχετίσεις μεταξύ των επιπέδων αδιπονεκτίνης (τόσο στον ορό όσο και στο BAL) και των κλινικών και παθολογοανατομικών παραμέτρων που αξιολογήθηκαν. Η μονοπαραγοντική ανάλυση παλινδρόμησης του Cox έδειξε ότι τα επίπεδα αδιπονεκτίνης δεν συσχετίζονταν σε στατιστικά σημαντικό βαθμό με την επιβίωση. Ο μόνος προγνωστικός παράγοντας που αναγνωρίστηκε, τόσο στη μονοπαραγοντική όσο και στην πολυπαραγοντική ανάλυση επιβίωσης, ήταν το PS [Hazard ratio (95% Confidence Interval): 2.75 (1.17-6.46), (p=0.02)]Συμπερασματικά, τα αποτελέσματα της προοπτικής μας μελέτης απέτυχαν να αναδείξουν στατιστικά σημαντικά συσχετίσεις των επιπέδων αδιπονεκτίνης (ορού και BAL) με τη συνολική επιβίωση καθώς και με τις δημογραφικές και κλινικοπαθολογοανατομικές παραμέτρους που αξιολογήθηκαν (συμπεριλαμβανομένου του BMI και της απώλειας βάρους), σε ασθενείς με ΜΜΚΠ σταδίου IV, σε συμφωνία με τις περισσότερες προηγούμενες κλινικές παρατηρήσεις.

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CCBE1 is a Prognostic Biomarker and Contributes to Prostate Cancer Cell Progression.

10.21203/rs.3.rs-585903/v1 ◽

2021 ◽

Author(s):

Peizhang Li ◽

Huan Xu ◽

Ming Zhan ◽

Yanbo Chen ◽

Dachao Zheng ◽

...

Keyword(s):

Prostate Cancer ◽

Regression Analysis ◽

Confidence Interval ◽

Cancer Cell ◽

Prostate Cancer Cell ◽

Cox Regression ◽

Hazard Ratio ◽

Cancer Tissue ◽

Cox Regression Analysis ◽

Kaplan Meier

Abstract Subject: Collagen And Calcium Binding EGF Domains 1 (CCBE1) is a coding protein which plays a significant role in extracellular matrix remodeling and migration and is involved in the development of Hennekam syndrome and lymphangiogenesis. Here, we investigate its prognostic value in prostate cancer based on TCGA database and its antioncogenic role in prostate cancer.Methods: Wilcoxon rank sum test, Pearson χ2 test, and logistic regression analysis were utilized to evaluate the correlation between CCBE1 and clinicopathological variables. Kaplan-Meier and Cox regression analysis were used to reveal the relation between CCBE1 and survival rates. The role of CCBE1 in prostate cancer was investigated using CCK-8 assay, EdU assay, and transwell experiments, respectively.Results: Here, we found that CCBE1 expression is down-regulated in prostate cancer tissue dramatically in TCGA database. Furthermore, high CCBE1 expression predicted a good prognosis in patients with prostate cancer. High expression level of CCBE1 in PRAD cohort was prominently correlated with T classification (OR =0.49 for T3&T4 vs T2, P<0.001), Gleason score (OR = 0.42 for8&9&10 vs. 6&7, P<0.001). Kaplan-Meier and Cox regression analysis showed that prostate cancer patients with high CCBE1 expression had a better progression-free interval (hazard ratio [HR]:0.50; 95% confidence interval [CI]: 0.33-0.77; P = 0.002) and overall survival (hazard ratio [HR]:0.38; 95% confidence interval [CI]: 0.15-0.92; P = 0.032). In vitro experiments indicated that overexpressed CCBE1 inhibited prostate cancer cell proliferation, migration, and invasion.Conclusion: CCBE1 plays a pivotal role in the progression of prostate cancer and up-regulated CCBE1 expression inhibits prostate cancer tumorgenicity.

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Elevated CDK5R1 predicts worse prognosis in hepatocellular carcinoma based on TCGA data

Bioscience Reports ◽

10.1042/bsr20203594 ◽

2020 ◽

Author(s):

Zhili Zeng ◽

Zebiao Cao ◽

Enxin Zhang ◽

Haifu Huang ◽

Ying Tang

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Hazard Ratio ◽

Gene Set Enrichment Analysis ◽

High Expression ◽

Rapid Progression ◽

Raw Data ◽

Cox Regression Analysis ◽

Free Interval

Background: Hepatocellular carcinoma (HCC) is a malignant tumor with rapid progression, high recurrence rate and poor prognosis. The objective of our investigation was to explore the prognostic value of CDK5R1 in HCC. Methods: The raw data of HCC raw data were downloaded from The Cancer Genome Atlas (TCGA) database. The Wilcoxon signed-rank test, Kruskal-Wallis test and logistic regression were applied to investigate the relevance between the CDK5R1 expression and clinicopathologic characteristics in HCC. Kaplan-Meier and Cox regression analysis were employed to examine the association between clinicopathologic features and survival. Gene set enrichment analysis (GSEA) was applied to annotate the biological function of CDK5R1. Results: CDK5R1 was highly expressed in HCC tissues. The high expression of CDK5R1 in HCC tissues was significantly associated with tumor status (P=0.00), new tumor event (P=0.00), clinical stage (P=0.00), topography (P=0.00). Elevated CDK5R1 had significant correlation with worse overall survival (OS) (P=7.414e−04), disease-specific survival (DSS) (P=5.642e−04), disease-free interval (DFI) (P=1.785e−05), and progression-free interval (PFI) (P=2.512e−06). Besides, univariate and multivariate Cox regression analysis uncovered that increased CDK5R1 can independently predict adverse OS (P=0.037, hazard ratio [HR]=1.7 (95% CI [1.0-2.7])), DFI (P=0.007, hazard ratio [HR]=3.0 (95% CI [1.4-6.7])), PFI (P=0.007, hazard ratio [HR]=2.8 (95% CI [1.3-5.9])). GSEA disclosed that notch signaling pathway and non-small cell lung cancer were prominently enriched in CDK5R1 high expression phenotype. Conclusions: Increased CDK5R1 may act as a promising independent prognostic factor of poor survival in HCC.

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Incidence and predictors of headache relief after endovascular treatment in patients with unruptured intracranial aneurysms

Interventional Neuroradiology ◽

10.1177/1591019916666503 ◽

2016 ◽

Vol 23 (1) ◽

pp. 18-27 ◽

Cited By ~ 5

Author(s):

Wenjun Ji ◽

Aihua Liu ◽

Xinjian Yang ◽

Youxiang Li ◽

Chuhan Jiang ◽

...

Keyword(s):

Regression Analysis ◽

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Cox Regression ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Cox Regression Analysis ◽

Unruptured Intracranial Aneurysms ◽

Headache Relief

Objective Patients with unruptured intracranial aneurysms often present with headaches. We retrospectively determined the incidence of headache relief in patients with unruptured intracranial aneurysms after endovascular treatment, with the main goals of preventing aneurysmal haemorrhage and identifying factors associated with headache relief in a cohort study. Methods From a cohort of patients with unruptured intracranial aneurysms who were treated with endovascular coiling and admitted between January 2012 and December 2014, we included 123 patients who had headaches and underwent regular follow-up. The severity of headache was assessed by a quantitative 11-point headache scale for all patients before and after the endovascular treatment. Headache relief was defined as a decrease in the headache score. We determined the incidence and predictors of headache relief using Kaplan–Meier curves and Cox regression analysis. Results Of the 123 patients with a mean follow-up of 14.1 months (range 1–39 months), 69 had headache relief. The overall cumulative incidence of headache relief was 62.3% (95% confidence interval (CI) 54.2%, 69.4%). On multivariate Cox regression analysis, the side of headache ipsilateral to the aneurysm (adjusted hazard ratio 0.540; 95% CI 0.408, 0.715; P < 0.001) and aneurysm size (adjusted hazard ratio 1.753; 95% CI 1.074, 2.863; P = 0.025) were significant predictors of headache relief. Conclusions Endovascular treatment relieved preoperative headaches for most patients with unruptured intracranial aneurysms. The side of headache ipsilateral to the aneurysm and aneurysm size >10 mm were significant predictors of headache relief.

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Glycemic Control and Risk of Sepsis and Subsequent Mortality in Type 2 Diabetes

10.2337/figshare.16775743 ◽

2021 ◽

Author(s):

Anca Balintescu ◽

Marcus Lind ◽

Mikael Andersson Franko ◽

Anders Oldner ◽

Maria Cronhjort ◽

...

Keyword(s):

Type 2 Diabetes ◽

Regression Analysis ◽

Cox Regression ◽

Cubic Spline ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Increased Risk

Objective To investigate the nature of the relationship between HbA1c and sepsis among individuals with type 2 diabetes and to assess the association of sepsis and all-cause mortality in such patients. Research design and methods We included 502,871 individuals with type 2 diabetes recorded in the Swedish National Diabetes Register and used multivariable Cox regression and restricted cubic spline analyses to assess the association between time-updated HbA1c values and sepsis occurrence between January 1, 2005 and December 31, 2015. The association between sepsis and death was examined using multivariable Cox regression analysis. Result Overall, 14,534 (2.9%) patients developed sepsis during the study period. On multivariable Cox regression analysis, compared with an HbA1c of 48-52 mmol/mol (6.5-6.9%), the adjusted hazard ratio for sepsis was 1.15 (95% CI 1.07-1.24) for HbA1c <43 mmol/mol (6.1%); 0.93 (0.87-0.99) for HbA1c 53-62 mmol/mol (7.0-7.8%); 1.05 (0.97-1.13) for HbA1c 63-72 mmol/mol (7.9-8.7%); 1.14 (1.04-1.25) for HbA1c 73-82 mmol/mol (8.8-9.7%); and 1.52 (1.37-1.68) for HbA1c >82 mmol/mol (9.7%). In the cubic spline model, a reduction of the adjusted risk was observed within the lower HbA1c range until 53 mmol/mol (7.0%), with a hazard ratio of 0.78 (0.73-0.82) per standard deviation, and increased thereafter (P for non-linearity <0.001). As compared to patients without sepsis, the adjusted hazard ratio for death among patients with sepsis was 4.16 (4.03-4.30). Conclusions In a nationwide cohort of individuals with type 2 diabetes, we found a U-shaped association between HbA1c and sepsis and a four-fold increased risk of death among those developing sepsis.

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Ring Sideroblasts and SF3B1 Mutations in Myelodysplastic Syndromes (MDS): Are They Two Faces of the Same Coin? a Study on Behalf of the MDS Clinical Research Consortium (MDS CRC)

Blood ◽

10.1182/blood.v128.22.4321.4321 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4321-4321

Author(s):

Rami S. Komrokji ◽

John Barnard ◽

David P Steensma ◽

Amy E. DeZern ◽

Gail J. Roboz ◽

...

Keyword(s):

Regression Analysis ◽

Myelodysplastic Syndromes ◽

Research Funding ◽

Somatic Mutations ◽

Cox Regression ◽

Hazard Ratio ◽

Free Survival ◽

Cox Regression Analysis ◽

Mutational Status ◽

Hazard Ratios

Abstract Introduction Recurrent somatic mutations in SF3B1, a gene encoding a spliceosome component, have been identified in patients (pts) with myelodysplastic syndromes (MDS). SF3B1 mutations (MT) are more commonly detected in pts with ring sideroblast (RS) morphology and are associated with favorable outcome. The proposed 2016 World Health Organization (WHO) MDS classification categorizes pts with >5% RS and SF3B1 MT as MDS with RS, in contrast to prior WHO classifications which required ≥15% RS regardless of genotype. In this study, we explored the prognostic value of RS and SF3B1 MT and assessed the validity of the new proposal. Methods We identified 471 pts with MDS and known SF3B1 mutational status from MDS CRC institutions. RS were assessed as present or absent (RS +/-) based on bone marrow aspirate reports (n=157); in cases where quantitative data on RS% were available (n=41), pts were grouped in the 5-15% RS group or > 15% RS group. Survival was calculated from time of diagnosis. Cox regression analysis was used to estimate hazard ratios for overall survival (OS) and AML free survival (AFS), which was defined as time to death or AML transformation, respectively. Chi-squared and Wilcoxon tests were used to test for differences in categorical and continuous distributions, respectively. Results: Among 471 pts with known SF3B1 mutational status, 76 (16%) had MT. Pts with MT had lower-risk International Prognostic Scoring System (IPSS) scores compared to SF3B1 wild-type (WT; 79% vs 57%, p < .001). Among pts with MT, 50% had RS + compared to 19% RS + in the WT group (p < .001). MT were independently associated with better OS (HR 0.48, p= .001) and longer AFS (HR 0.5, p <.005) after adjusting for age and IPSS. We compared outcomes of four groups: WT/RS-, MT/RS-, WT/RS+, and MT/ RS +. Adjusting for age and IPSS, pts with MT/RS + had the best outcome, with hazard ratios for AFS of 4.2 for WT/RS- vs. MT/RS+ (p =.018), 4.1 for MT/RS- vs. MT/RS+ (p =.045), and 5.1 for WT/RS+ vs. MT/RS+ (p= .01). We compared 7 pts with 5-15% RS to 22 pts with >15% RS. Among patients with RS 5-15%, 4/7 pts (57%) were classified as MDS with excess blasts compared to 24% for those RS >15% (p=.09). Pts with 5-15% RS were more likely to be thrombocytopenic (5/7, 71%) compared to >15% RS (29%, p=.04). One patient (14%) with 5-15% RS had MT compared to 12 (55%) pts with > 15% RS, p= .06. In Cox regression analysis using the RS 5-15% group as the reference, the hazard ratio for RS > 15% for AFS was 0.26 (p = .034) and the hazard ratio for MT for AFS was 0.08 (p= .002). Conclusions SF3B1 somatic mutations in MDS are commonly associated with RS, better OS and longer AML-free survival. Patients with RS and MT had a significantly better outcome than those with either isolated RS or MT, or neither. These data support incorporation of SF3B1 mutation status into the WHO classification regardless of RS percent, though with differentiation for those with RS and MT. Disclosures Komrokji: Novartis: Consultancy, Speakers Bureau; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Consultancy; Boehringer-Ingelheim: Research Funding. Roboz:Cellectis: Research Funding; Agios, Amgen, Amphivena, Astex, AstraZeneca, Boehringer Ingelheim, Celator, Celgene, Genoptix, Janssen, Juno, MEI Pharma, MedImmune, Novartis, Onconova, Pfizer, Roche/Genentech, Sunesis, Teva: Consultancy.

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Serum FLC Levels at Presentation Have Independent Prognostic Significance in CLL and Levels Above 50mg/L Identify Patients with Progressive Disease.

Blood ◽

10.1182/blood.v114.22.2355.2355 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2355-2355 ◽

Cited By ~ 1

Author(s):

Guy Pratt ◽

Stephen Harding ◽

Chris Fegan ◽

Chris J Pepper ◽

David Oscier ◽

...

Keyword(s):

Regression Analysis ◽

Binding Site ◽

Progressive Disease ◽

Cox Regression ◽

Hazard Ratio ◽

Cox Regression Analysis ◽

Site Group ◽

Mutational Status ◽

Time To First Treatment ◽

Abnormal Ratio

Abstract Abstract 2355 Poster Board II-332 An abnormal serum FLC ratio at presentation has been shown to be prognostic in chronic lymphocytic leukaemia (Pratt et al, 2009). Here we further analyse a retrospective cohort of 259 CLL patients (Stage: A, 209; B 23, C, 21; Male: Female ratio 1.6:1, mean age 75: Range 29-98). The levels of FLC and B2M were assessed using nephelometric immunoassays (The Binding Site, Birmingham UK) on the Siemens Dade Behring BN‘II analyser. Previously recorded measurements for biological and clinical markers (age, sex, CD38, Zap70, and VH mutational status) were used to produce Kaplan Meier Survival Curves and in Cox Regression analysis. We have identified that a cut-off above 50mg/L (in the context of an abnormal ratio to exclude renal effects) identifies a cohort of patients with progressive disease and a significantly poorer outcome. A total of 38 out of the 259 patients had serum FLC > 50mg/L. CLL patients with serum FLC >50mg/L had the following characteristics Stage A/B/C (26/5/5 + 2 unknown), Mutated vs Unmutated (19 vs 13, 6 unknown), Zap70 pos vs neg (19 vs 16, 3 unknown), CD38 pos vs neg (13 vs 23, 2 unknown) and 32 out of the 38 patients have progressed to treatment. Median time to first treatment for the CLL cohort with >50mg/L serum FLC was 83 months compared to 241 months for the CLL patients with normal FLC (p=9.8×10−6). Median overall survival was also significantly shorter for patients with an abnormal ratio and >50mg/L serum FLC (p=7.6 × 10−7). Cox regression analysis on the above population gave stage (Hazard ratio 3.9 p=<0.001), Zap 70 (Hazard ratio 1.9, p=0.001) and abnormal ratio with production above 50mg/L (Hazard ratio 1.9 p=0.009) as the only independent prognostic variables. Importantly >50mg/L FLC production is independent of both Zap70 and Vh mutational status as an indicator of time to first treatment. This study shows that in an unselected population of CLL patients serum FLC >50mg/L can independently identify a group of CLL patients with progressive disease and a poorer outlook. Disclosures: Harding: The Binding Site Group Ltd: Employment. Bradwell:The Binding Site Group Ltd:. Mead:Binding Site UK Ltd: Employment.

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Glycemic Control and Risk of Sepsis and Subsequent Mortality in Type 2 Diabetes

10.2337/figshare.16775743.v1 ◽

2021 ◽

Author(s):

Anca Balintescu ◽

Marcus Lind ◽

Mikael Andersson Franko ◽

Anders Oldner ◽

Maria Cronhjort ◽

...

Keyword(s):

Type 2 Diabetes ◽

Regression Analysis ◽

Cox Regression ◽

Cubic Spline ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Increased Risk

Objective To investigate the nature of the relationship between HbA1c and sepsis among individuals with type 2 diabetes and to assess the association of sepsis and all-cause mortality in such patients. Research design and methods We included 502,871 individuals with type 2 diabetes recorded in the Swedish National Diabetes Register and used multivariable Cox regression and restricted cubic spline analyses to assess the association between time-updated HbA1c values and sepsis occurrence between January 1, 2005 and December 31, 2015. The association between sepsis and death was examined using multivariable Cox regression analysis. Result Overall, 14,534 (2.9%) patients developed sepsis during the study period. On multivariable Cox regression analysis, compared with an HbA1c of 48-52 mmol/mol (6.5-6.9%), the adjusted hazard ratio for sepsis was 1.15 (95% CI 1.07-1.24) for HbA1c <43 mmol/mol (6.1%); 0.93 (0.87-0.99) for HbA1c 53-62 mmol/mol (7.0-7.8%); 1.05 (0.97-1.13) for HbA1c 63-72 mmol/mol (7.9-8.7%); 1.14 (1.04-1.25) for HbA1c 73-82 mmol/mol (8.8-9.7%); and 1.52 (1.37-1.68) for HbA1c >82 mmol/mol (9.7%). In the cubic spline model, a reduction of the adjusted risk was observed within the lower HbA1c range until 53 mmol/mol (7.0%), with a hazard ratio of 0.78 (0.73-0.82) per standard deviation, and increased thereafter (P for non-linearity <0.001). As compared to patients without sepsis, the adjusted hazard ratio for death among patients with sepsis was 4.16 (4.03-4.30). Conclusions In a nationwide cohort of individuals with type 2 diabetes, we found a U-shaped association between HbA1c and sepsis and a four-fold increased risk of death among those developing sepsis.

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Disability progression in relapse-free multiple sclerosis patients on fingolimod versus interferon-beta/glatiramer acetate

Multiple Sclerosis Journal ◽

10.1177/1352458520918489 ◽

2020 ◽

pp. 135245852091848

Author(s):

Viktor von Wyl ◽

Pascal Benkert ◽

André Moser ◽

Johannes Lorscheider ◽

Bernhard Décard ◽

...

Keyword(s):

Multiple Sclerosis ◽

Regression Analysis ◽

Confidence Interval ◽

Glatiramer Acetate ◽

Interferon Beta ◽

Cox Regression ◽

Hazard Ratio ◽

Disability Progression ◽

Cox Regression Analysis ◽

Multiple Sclerosis Patients

Background: Disability progression independent of relapses (PIRA) has been described as a frequent phenomenon in relapsing-remitting multiple sclerosis (RRMS). Objective: To compare the occurrence of disability progression in relapse-free RRMS patients on interferon-beta/glatiramer acetate (IFN/GA) versus fingolimod. Methods: This study is based on data from the Swiss association for joint tasks of health insurers. Time to relapse and 12-month confirmed disability progression were compared between treatment groups using multivariable Cox regression analysis with confounder adjustment. Inverse-probability weighting was applied to correct for the bias that patients on fingolimod have a higher chance to remain relapse-free than patients on IFN/GA. Results: We included 1640 patients (64% IFN/GA, 36% fingolimod, median total follow-up time = 4–5 years). Disease-modifying treatment (DMT) groups were well balanced with regard to potential confounders. Disability progression was observed in 155 patients (8.8%) on IFN/GA and 51 (7.6%) on fingolimod, of which 44 and 23 were relapse-free during the initial DMT, respectively. Adjusted standard regression analysis on all patients indicated that those on fingolimod experience less frequently disability progression compared with IFN/GA (hazard ratio = 0.53 (95% confidence interval = 0.37–0.76)). After bias correction, this was also true for patients without relapses (hazard ratio=0.56 (95% confidence interval = 0.32–0.98). Conclusion: Our analysis indicates that fingolimod is superior to IFN/GA in preventing disability progression in both relapsing and relapse-free, young, newly diagnosed RRMS patients.

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Serum Chemerin as a Novel Prognostic Indicator in Chronic Heart Failure

Journal of the American Heart Association ◽

10.1161/jaha.119.012091 ◽

2019 ◽

Vol 8 (15) ◽

Cited By ~ 3

Author(s):

Xiang Zhou ◽

Yifei Tao ◽

Yuqi Chen ◽

Weiting Xu ◽

Zhiyuan Qian ◽

...

Keyword(s):

Heart Failure ◽

Regression Analysis ◽

Chronic Heart Failure ◽

Cox Regression ◽

Prognostic Indicator ◽

Hazard Ratio ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Cox Regression Analysis ◽

Adverse Cardiac Events

Background It has been documented that circulating chemerin is associated with inflammation, metabolic syndrome, and coronary artery disease. The present study was aimed to evaluate the prognostic value of serum chemerin in patients with chronic heart failure. Methods and Results We included 834 patients with chronic heart failure in a prospective cohort study and investigated the association between serum chemerin and clinical outcomes using multivariate Cox regression analysis. Patients with higher chemerin levels tended to be older and women and were more likely to experience hypertension, diabetes mellitus, and hyperlipemia. Cox regression analysis showed that chemerin was a significant predictor of major adverse cardiac events (hazard ratio, 1.83; 95% CI, 1.31–2.96) after adjustment for conventional risk factors. Net reclassification and integrated discrimination improvements for major adverse cardiac events were markedly improved by addition of chemerin to the reference model. In addition, chemerin was an independent predictor of all‐cause mortality (hazard ratio, 1.67; 95% CI, 1.21–2.73) after multivariable adjustment. Furthermore, the Kaplan–Meier survival analysis revealed that chemerin was a prognostic indicator of major adverse cardiac events in patients with chronic heart failure and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels above and below the median. Conclusions Our study suggests that chemerin is a novel serum marker for predicting major adverse cardiac events in patients with chronic heart failure.

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