scholarly journals Perception of pharmacological prevention and subsequent non-adherence to medication in patients with ischaemic heart disease: a population-based cohort study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054362
Author(s):  
Christina Boesgaard Graversen ◽  
Jan Brink Valentin ◽  
Mogens Lytken Larsen ◽  
Sam Riahi ◽  
Teresa Holmberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Angiotensin Receptor Blockers ◽  
Population Based ◽  
Secondary Outcome ◽  
Adherence To Medication ◽  
Pharmacological Prevention ◽  
Cox Proportional Hazard Regression

ObjectiveA patient-focused approach is advocated to embody risk of non-adherence to medication and subsequent adverse clinical outcomes following ischaemic heart disease (IHD). This study aimed to explore how patient perceived information on pharmacological prevention was associated with subsequent non-adherence to medication (measured by non-initiation, non-implementation and non-persistence) in patients with incident IHD.DesignCohort study.SettingDenmark.ParticipantsRegister-based cohort of 829 patients with incident IHD in 2013.MeasuresPerception covered whether patients’ experienced being adequately informed about their pharmacological prevention. Information on such was obtained from a survey and divided into ‘Well informed’, ‘Moderately informed’ and ‘Poorly informed’. Information on baseline characteristics, and reimbursed prescriptions of medication (antiplatelets, statins, ACE-inhibitors/angiotensin receptor blockers and β-blockers) during follow-up were obtained by linkage to nationwide public registers. Non-initiation and non-implementation of medication, measured as proportion of days covered, were analysed by Poisson regression. Non-persistence to medication, measured as risk of discontinuation, was analysed by multivariable Cox proportional hazard regression.Primary and secondary outcome measuresNon-implementation and non-persistence to medication up to 365 days of follow-up were primary outcomes. Secondary outcomes included non-initiation as well as non-implementation and non-persistence to medication at 180 days of follow-up.ResultsA dose–response association was in general found between perception of pharmacological prevention and risk of non-implementation and non-persistence. For example, the hazard of non-persistence to antiplatelets was 1.18 (95% CI 0.71 to 1.96) times higher for patients reporting 'Moderately informed' and 1.89 (95% CI 1.10 to 3.25) times higher for patients reporting 'Poorly informed', compared with patients reporting 'Well informed of perception of pharmacological prevention' up to 365 days of follow-up.ConclusionLower levels of perception of pharmacological prevention were associated with subsequent non-implementation and non-persistence to medication in patients with incident IHD.

scholarly journals Sex Differences in the Risk of Developing Acute Coronary Syndrome in Patients With Sleep Disorders: A Population-Based Cohort Study

2016 ◽  
Vol 11 (5) ◽  
pp. 1560-1568
Author(s):  
Wei-Sheng Chung ◽  
Hsuan-Hung Lin
Keyword(s):  
Acute Coronary Syndrome ◽  
Sex Differences ◽  
Cohort Study ◽  
Sleep Disorders ◽  
Population Based ◽  
Coronary Syndrome ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Middle Aged Adults

Studies that focus on the relationship between sex and the risk of acute coronary syndrome (ACS) are scant. The current study investigated the effects of sex differences in the risk of developing ACS in patients with sleep disorders (SDs). This longitudinal population-based cohort study evaluated the incidence and risk of ACS development in 40,232 men and 65,519 women newly diagnosed with SDs between 2002 and 2008 from the Longitudinal Health Insurance Database. The follow-up period began from the entry date and ended on the date of an ACS event or December 31, 2010. Univariable and multivariable Cox proportional hazard regression models were conducted to estimate the sex differences in the risk of ACS. Men with SDs exhibited an increased incidence of ACS compared with women with SDs in all age- and comorbidity-specific subgroups. After covariates were adjusted, the men with SDs exhibited a 1.48-fold adjusted hazard ratio (aHR) of ACS compared with the women with SDs (95% confidence interval [CI] = 1.36-1.60). After age group stratification, the men with SDs in the young adult group exhibited the highest risk of subsequent ACS development compared with the women with SDs (aHR = 2.07, 95% CI = 1.69-2.55), followed by those in middle-aged adults (aHR = 1.52, 95% CI = 1.32-1.76) and older adults groups (aHR = 1.24, 95% CI = 1.11-1.39). This study determined that men with SDs, particularly young men, are at a higher risk of subsequent ACS development compared with women with SDs.

An attempt to explain the bidirectional association between ischaemic heart disease, stroke and depression: a cohort and meta-analytic approach

2019 ◽  
Vol 217 (2) ◽  
pp. 434-441 ◽  
Author(s):  
Marie Kim Wium-Andersen ◽  
Ida Kim Wium-Andersen ◽  
Eva Irene Bosano Prescott ◽  
Kim Overvad ◽  
Martin Balslev Jørgensen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Antidepressant Medication ◽  
Population Based ◽  
Men And Women ◽  
Bidirectional Association ◽  
National Patient ◽  
Cox Proportional Hazard Regression ◽  
Shared Risk

BackgroundDepression and cardiovascular diseases (CVDs) are common diseases and associated in a bidirectional manner.AimsTo examine whether a bidirectional association between CVD and depression could be explained by shared risk factors, misclassification of disease measures or non-response.MethodA total of 10 population-based cohorts including 93 076 men and women (mean age 54.4 years, s.d. = 9.2) and an additional 10 510 men (mean age 51.2 years, s.d. = 0.3) were followed for subsequent depression, ischaemic heart disease (IHD) and stroke in the Danish National Patient Registry from health examinations between 1982 and 2015 and until end of follow-up in 2017–2018. Exposures were physicians’ diagnoses of IHD, stroke, depression or self-reported chest pain, depression, use of antidepressant medication and the Major Depression Inventory at the time of study entry in the Metropolit study. Associations were analysed using Cox proportional hazard regression with disease as time-dependent variables.ResultsIHD and stroke were associated with subsequent depression (hazard ratio (HR) for IHD: 1.79, 95% CI 1.43–2.23 and HR for stroke: 2.62, 95% CI 2.09–3.29) and the associations were present in both men and women. Adjustment for the shared risk factors socioeconomic status, lifestyle, body mass index, statin use and serum lipids did not change the risk estimates. Furthermore, depression was associated with higher risk of subsequent IHD (HR = 1.63, 95% CI 1.36–1.95) and stroke (HR = 1.94, 95% CI 1.63–2.30). The associations were also present when the analyses were based on self-reported disease measures or restricted to include non-responders.ConclusionsThe bidirectional association between CVD and depression was not explained by shared risk factors, misclassification or non-response.

scholarly journals Bowel movement frequency and risks of major vascular and non-vascular diseases: a population-based cohort study among Chinese adults

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031028
Author(s):  
Songchun Yang ◽  
Canqing Yu ◽  
Yu Guo ◽  
Zheng Bian ◽  
Mengyu Fan ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Heart Disease ◽  
Bowel Movement ◽  
Vascular Diseases ◽  
Population Based ◽  
Secondary Outcome ◽  
Chronic Obstructive ◽  
Movement Frequency ◽  
Bowel Movement Frequency

ObjectiveThe application of bowel movement frequency (BMF) in primary care is limited by the lack of solid evidence about the associations of BMF with health outcomes apart from Parkinson’s disease and colorectal cancer. We examined the prospective associations of BMF with major vascular and non-vascular diseases outside the digestive system.DesignPopulation-based prospective cohort study.SettingThe China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008.Participants487 198 participants aged 30 to 79 years without cancer, heart disease or stroke at baseline were included and followed up for a median of 10 years. The usual BMF was self-reported once at baseline.Primary and secondary outcome measuresIncident events of predefined major vascular and non-vascular diseases.ResultsIn multivariable-adjusted analyses, participants having bowel movements ‘more than once a day’ had higher risks of ischaemic heart disease (IHD), heart failure, chronic obstructive pulmonary disease, type 2 diabetes mellitus and chronic kidney disease (CKD) when compared with the reference group (‘once a day’). The respective HRs (95% CIs) were 1.12 (1.09 to 1.16), 1.33 (1.22 to 1.46), 1.28 (1.22 to 1.36), 1.20 (1.15 to 1.26) and 1.15 (1.07 to 1.24). The lowest BMF (‘less than three times a week’) was also associated with higher risks of IHD, major coronary events, ischaemic stroke and CKD. The respective HRs were 1.07 (1.02 to 1.12), 1.22 (1.10 to 1.36), 1.11 (1.05 to 1.16) and 1.20 (1.07 to 1.35).ConclusionBMF was associated with future risks of multiple vascular and non-vascular diseases. The integration of BMF assessment and health counselling into primary care should be considered.

scholarly journals Metformin use and risk of gastric adenocarcinoma in a Swedish population-based cohort study

2019 ◽  
Vol 121 (10) ◽  
pp. 877-882 ◽  
Author(s):  
Jiaojiao Zheng ◽  
Shao-Hua Xie ◽  
Giola Santoni ◽  
Jesper Lagergren
Keyword(s):  
Cohort Study ◽  
Gastric Adenocarcinoma ◽  
Population Based ◽  
Matched Cohort ◽  
Swedish Population ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
Treatment Use

Abstract Background Whether or not the use of metformin decreases the risk of gastric adenocarcinoma is unclear. Methods This was a population-based cohort study in 2005–2015. Associations between metformin use and gastric non-cardia and cardia adenocarcinomas were examined within two cohorts; a diabetes cohort of participants using anti-diabetes medications, and a matched cohort of common-medication users, where metformin non-users were frequency matched (10:1) with metformin users for sex and age. Multivariable Cox proportional hazard regression analyses provided hazard ratios (HR) and 95% confidence intervals (CI), adjusting for sex, age, calendar year, comorbidity, Helicobacter pylori eradication treatment, use of non-steroidal anti-inflammatory drugs or aspirin and use of statins. Results During the follow-up for a median of 5.8 years, 892 (0.1%) participants in the diabetes cohort and 6395 (0.1%) participants in the matched cohort of common-medication users developed gastric adenocarcinoma. Metformin users had no significantly decreased risk of gastric non-cardia adenocarcinoma (diabetes cohort: HR 0.93, 95% CI 0.78–1.12; matched cohort: HR 1.30, 95% CI 1.18–1.42) or cardia adenocarcinoma (diabetes cohort: HR 1.49, 95% CI 1.09–2.02; matched cohort: HR 1.58, 95% CI 1.38–1.81) compared with non-users in both cohorts. Conclusions This cohort study with <10 years of follow-up suggests metformin use may not prevent gastric adenocarcinoma.

scholarly journals Association of nephrolithiasis with the risk of cardiovascular diseases: a longitudinal follow-up study using a national health screening cohort

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040034
Author(s):  
So Young Kim ◽  
Woo Jin Bang ◽  
Chanyang Min ◽  
Hyo Geun Choi
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
National Health ◽  
Proportional Hazards Model ◽  
Health Screening ◽  
Cox Proportional Hazards Model ◽  
Secondary Outcome ◽  
Follow Up Study ◽  
Age And Sex

ObjectivesThe aim of this study was to explore the associations of stroke and ischaemic heart disease in patients with nephrolithiasis.DesignA longitudinal follow-up study.SettingData from the Korean National Health Insurance Service–Health Screening Cohort (2002–2013) were retrieved to identify the occurrence of nephrolithiasis.Participants and interventionsIn total, 19 103 patients with nephrolithiasis were matched at a 1:4 ratio with control participants for age, sex, income and region of residence.Primary and secondary outcome measuresThe occurrence of stroke and ischaemic heart disease was analysed in both patients with nephrolithiasis and control participants. The primary outcome was HRs of stroke and ischaemic heart disease in a stratified Cox proportional hazards model. Smoking, alcohol consumption, obesity and Charlson Comorbidity Index were adjusted for as covariates. Subgroup analyses according to age and sex were also performed.ResultsEight per cent (1615/19 103) of patients with nephrolithiasis and 7.2% (5476/76 412) of control participants had stroke. Nine per cent (1879/19 103) of patients with nephrolithiasis and 7.7% (5895/76 412) of control participants had ischaemic heart disease. Patients with nephrolithiasis had risks of stroke and ischaemic heart disease that were 1.18 times (95% CI=1.11 to 1.24) and 1.24 times (95% CI=1.18 to 1.31) those of the control participants, respectively. The age and sex subgroups showed consistent results.ConclusionsNephrolithiasis was associated with increased risks of stroke and ischaemic heart disease.

scholarly journals Mortality Risk in People with Type 2 Diabetes: A Large Prospective PopulationBased Cohort Study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study)

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Collier A ◽  
Hair M ◽  
Cameron L ◽  
Ghosh S ◽  
Boyle J ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Cohort Study ◽  
Heart Disease ◽  
Smoking Status ◽  
Economic Status ◽  
Population Based ◽  
Socio Economic Status

Background: This study investigated the effects of age, gender, socio-economic status, smoking status, hypertension, ischaemic heart disease, Body Mass Index (BMI), Glycaemic control (HbA1c) and dyslipidaemia in type 2 diabetes in a population-based analysis.

scholarly journals Incidence and predictors of kyphotic deformity following resection of cervical intradural tumors in adults: a population-based cohort study

2020 ◽  
Vol 162 (11) ◽  
pp. 2905-2913
Author(s):  
Charles Tatter ◽  
Alexander Fletcher-Sandersjöö ◽  
Oscar Persson ◽  
Gustav Burström ◽  
Per Grane ◽  
...  
Keyword(s):  
Cohort Study ◽  
Tumor Resection ◽  
Population Based ◽  
Magnetic Resonance Images ◽  
Secondary Outcome ◽  
Posterior Fixation ◽  
Intradural Tumor ◽  
Common Diagnosis ◽  
The Mean

Abstract Background The first line of treatment for most cervical intradural tumors is surgical resection through laminotomy or laminectomy. This may cause a loss of posterior pulling force leading to kyphosis, which is associated with decreased functional outcome. However, the incidence and predictors of kyphosis in these patients are poorly understood. Object To assess the incidence of posterior fixation (PF), as well as predictors of radiological kyphosis, following resection of cervical intradural tumors in adults. Methods A population-based cohort study was conducted on adult patients who underwent intradural tumor resection via cervical laminectomy with or without laminoplasty between 2005 and 2017. Primary outcome was kyphosis requiring PF. Secondary outcome was radiological kyphotic increase, measured by the change in the C2–C7 Cobb angle between pre- and postoperative magnetic resonance images. Results Eighty-four patients were included. Twenty-four percent of the tumors were intramedullary, and the most common diagnosis was meningioma. The mean laminectomy range was 2.4 levels, and laminoplasty was performed in 40% of cases. No prophylactic PF was performed. During a mean follow-up of 4.4 years, two patients (2.4%) required delayed PF. The mean radiological kyphotic increase after surgery was 3.0°, which was significantly associated with laminectomy of C2 and C3. Of these, C3 laminectomy demonstrated independent risk association. Conclusions There was a low incidence of delayed PF following cervical intradural tumor resection, supporting the practice of not performing prophylactic PF. Kyphotic increase was associated with C2 and C3 laminectomy, which could help identify at-risk patients were targeted follow-up is indicated.

scholarly journals Keloid risk in patients with atopic dermatitis: a nationwide retrospective cohort study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022865 ◽  
Author(s):  
Ying-Yi Lu ◽  
Chun-Ching Lu ◽  
Wei-Wen Yu ◽  
Li Zhang ◽  
Qing-Rui Wang ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Secondary Outcome ◽  
Severe Atopic Dermatitis ◽  
Secondary Outcome Measure ◽  
Research Database ◽  
Cox Proportional Hazard Regression

ObjectiveThe pathogenesis of keloid is largely unknown. Because keloid and atopic dermatitis have overlapping pathophysiological mechanisms, we aimed to evaluate keloid risk in patients with atopic dermatitis.Study designPopulation-based retrospective cohort study.SettingThe Taiwan National Health Insurance Research Database was used to analyse data for people who had been diagnosed with atopic dermatitis.ParticipantsWe identified 8371 patients with newly diagnosed atopic dermatitis during 1996–2010. An additional 33 484 controls without atopic dermatitis were randomly identified and frequency matched at a one-to-four ratio.Primary and secondary outcome measureThe association between atopic dermatitis and keloid risk was estimated using Cox proportional hazard regression models.ResultsAfter adjustment for covariates, the atopic dermatitis patients have a 3.19-fold greater risk of developing keloid compared with the non-atopic dermatitis group (3.19vs1.07 per 1000 person-years, respectively). During the study period, 163 patients with atopic dermatitis and 532 patients without atopic dermatitis developed keloid. Notably, keloid risk increased with severity of atopic dermatitis, particularly in patients with moderate to severe atopic dermatitis.ConclusionsOur results indicate that patients with atopic dermatitis had a higher than normal risk of developing keloid and suggest that atopic dermatitis may be an independent risk factor for keloid.

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