scholarly journals Seasonal variation in mortality secondary to acute myocardial infarction in England and Wales: a secondary data analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e019242 ◽  
Author(s):  
Osakpolor Ogbebor ◽  
Babatunde Odugbemi ◽  
Ravi Maheswaran ◽  
Kavya Patel
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Seasonal Variation ◽  
Negative Binomial ◽  
Secondary Data ◽  
Contributory Factor ◽  
Negative Binomial Regression Model ◽  
Winter Mortality ◽  
England And Wales ◽  
The Relationship

BackgroundAcute myocardial infarction (AMI) is a leading cause of death globally. Increase in AMI mortality during winter has also been identified in existing literature. This has been associated with low outdoor and indoor temperatures and increasing age. The relationship between AMI and other factors such as gender and socioeconomic factors varies from study to study. Influenza epidemics have also been identified as a contributory factor.ObjectiveThis paper aims to illustrate the seasonal trend in mortality due to AMI in England and Wales with emphasis on excess winter mortality (EWM).MethodsMonthly mortality rates per 10 000 population were calculated from data provided by the UK Office for National Statistics (ONS) for 1997–2005. To quantify the seasonal variation in winter, the EWM estimates (EWM, EWM ratio, Excess Winter Mortality Index) for each year were calculated. Negative binomial regression model was used to estimate the relationship between increasing age and EWM.ResultsThe decline in mortality rate for AMI was 6.8% yearly between August 1997 and July 2005. Significant trend for reduction in AMI-associated mortality was observed over the period (p<0.001). This decline was not seen with EWM (p<0.001). 17% excess deaths were observed during winter. This amounted to about 20 000 deaths over the 8-year period. Increasing winter mortality was seen with increasing age for AMI.ConclusionEWM secondary to AMI does occur in England and Wales. Excess winter deaths due to AMI have remained high despite decline in overall mortality. More research is needed to identify the relationship of sex, temperature, acclimatisation, vitamin D and excess winter deaths due to AMI.

scholarly journals The Impacts of Regional Regulatory Policies on the Prevention and Control of Chronic Diseases in China: A Mediation Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1058
Author(s):  
Huihui Huangfu ◽  
Qinwen Yu ◽  
Peiwu Shi ◽  
Qunhong Shen ◽  
Zhaoyang Zhang ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Community Service ◽  
Mediation Analysis ◽  
Prevention And Control ◽  
Negative Binomial ◽  
Mediating Effect ◽  
Negative Binomial Regression Model ◽  
Regulatory Policies ◽  
And Control ◽  
The Relationship

Regional regulatory policies (RPs) are a major factor in the prevention and control of chronic diseases (PCCDs) through the implementation of various measures. This study aimed to explore the impacts of RPs on PCCDs, with a focus on the mediating roles of community service. The soundness of the regulatory mechanism (SORM) was used to measure the soundness of RPs based on 1095 policy documents (updated as of 2015). Coverage provided by community service institutions (CSIs) and community health centres (CHCs) was used to represent community service coverage derived from the China Statistical Yearbook (2015), while the number of chronic diseases (NCDs) was used to measure the effects of PCCDs based on data taken from the 2015 China Health and Retirement Longitudinal Study survey. To assess the relationship between SORM, NCDs and community service, a negative binomial regression model and mediation analysis with bootstrapping were conducted. Results revealed that there was a negative correlation between SORM and NCDs. CSIs had a major effect on the relationship between RPs and PCCDs, while CHCs had a partial mediating effect. RPs can effectively prevent and control chronic diseases. Increased effort should also be aimed at strengthening the roles of CSIs and CHCs.

Abstract 327: Gender Differences In The Association Between Hemoglobin Change After Acute Myocardial Infarction And Outcomes

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Lauren E Thompson ◽  
Frederick A Masoudi ◽  
Kensey L Gosch ◽  
Pamela N Peterson ◽  
Adam C Salisbury ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Similar Magnitude ◽  
Men And Women ◽  
Absolute Change ◽  
Hospitalization Rates ◽  
Lower Baseline ◽  
The Relationship ◽  
Baseline Hemoglobin

Background: Hemoglobin decline following acute myocardial infarction (AMI) is associated with long-term morbidity. Since women have lower baseline hemoglobin levels than men, whether the same absolute change in hemoglobin after AMI similarly affects outcomes in women and men is unknown. Methods: We examined patients discharged after AMI in the TRIUMPH registry between 2005 and 2008 who had admission and discharge hemoglobin levels. We compared the relationship between absolute change in hemoglobin during hospitalization with 6- and 12-month mortality and re-hospitalization by gender after adjusting for clinical variables including admission hemoglobin. Results: Of the 4,243 patients with AMI, 33% (1,400 of 4,243) were women. Women were older, had more co-morbidities, and were less likely to present with STEMI, or receive catheterization. Women had lower admission hemoglobin (12.9 g/dL ± 1.9 vs 14.5 ± 2.0, p= <0.01) and a smaller mean absolute change in hemoglobin during hospitalization (-1.5 g/dL ± 1.8 vs -1.6 ±1.8, p = 0.01) compared to men. The association between hemoglobin declines during hospitalization and mortality and re-hospitalization rates at 6 and 12-months were of a similar magnitude between men and women (all interaction p > 0.05). (Figure 1) Conclusion: Although women with AMI had lower admission hemoglobin values, similar declines in hemoglobin during hospitalization were associated with increases in mortality and re-hospitalization in women and men. These findings suggest that absolute change in hemoglobin is equally important at predicting outcomes in women and men, regardless of admission hemoglobin levels.

Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction

2022 ◽  
Author(s):  
Salman Razvi ◽  
Avais Jabbar ◽  
Arjola Bano ◽  
Lorna Ingoe ◽  
Peter Carey ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Mortality Risk ◽  
Fold Increase ◽  
Lower Serum ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Relationship Of ◽  
The Relationship

Objectives: To study the relationship between serum free T3 (FT3), C-reactive protein (CRP), and all-cause mortality in patients with acute myocardial infarction (AMI). Design: Prospective multicentre longitudinal cohort study. Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST- and non-ST-elevation) patients from the ThyrAMI-1 study. The relationship of FT3 and CRP at baseline with all-cause mortality up to June 2020 was assessed. Mediation analysis was performed to evaluate if CRP mediated the relationship between FT3 and mortality. Results: In 1919 AMI patients [29.2% women, mean (SD) age 64.2 (12.1) years and 48.7% STEMI] followed over a median (inter-quartile range) period of 51 (46 to 58) months, there were 277 (14.4%) deaths. Overall, lower serum FT3 and higher CRP levels were associated with higher risk of mortality. When divided into tertiles based on levels of FT3 and CRP, the group with the lowest FT3 and highest CRP levels had 2.5-fold increase in mortality risk [adjusted hazard ratio (95% confidence interval) of 2.48 (1.82 to 3.16)] compared to the group with the highest FT3 and lowest CRP values. CRP mediated 9.8% (95% confidence interval 6.1 to 15.0%) of the relationship between FT3 and mortality. Conclusions: In AMI patients, lower serum FT3 levels on admission are associated with a higher mortality risk, which is partly mediated by inflammation. Adequately designed trials to explore potential benefits of T3 in AMI patients are required.

Sign in / Sign up

Export Citation Format

Share Document