scholarly journals Chronic obstructive pulmonary disease and the risk of 12 cardiovascular diseases: a population-based study using UK primary care data

Thorax ◽  
2018 ◽  
Vol 73 (9) ◽  
pp. 877-879 ◽  
Author(s):  
Ann D Morgan ◽  
Kieran J Rothnie ◽  
Krishnan Bhaskaran ◽  
Liam Smeeth ◽  
Jennifer K Quint
Keyword(s):  
Cardiovascular Diseases ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Chronic Obstructive ◽  
Population Based Study ◽  
Obstructive Pulmonary Disease ◽  
Arterial Circulation ◽  
Relative Risks ◽  
Cohort Study Design

Risks for cardiovascular diseases (CVDs) other than myocardial infarction and stroke in the general COPD population are not well quantified. We used a matched cohort study design and Cox regression to estimate relative risks for 12 separate CVDs in a large population-based cohort of patients with COPD over a 12-year period. Associations between COPD and individual CVDs were heterogeneous, with the highest relative risks observed for heart failure and diseases of the arterial circulation (in excess of 2.5 for those aged 64–75 years). Relative risks declined with increasing age but for most CVD outcomes remained unchanged over the study period.

scholarly journals Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2753 ◽  
Author(s):  
Chi-Kuei Hsu ◽  
Chih-Cheng Lai ◽  
Kun Wang ◽  
Likwang Chen
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
Reflux Disease ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Esophageal Reflux

This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD) in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05). A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]). The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012). In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

Impact of putative chemopreventative agents on prostate cancer diagnosis.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 40-40
Author(s):  
Hanan Goldberg ◽  
Faizan Moshin ◽  
Zachary William Abraham Klaassen ◽  
Thenappan Chandrasekar ◽  
Christopher Wallis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cox Regression ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cumulative Exposure ◽  
Population Based Study ◽  
Diagnosis Rate ◽  
The Impact

40 Background: Prostate cancer (PC) is the most common non-cutaneous cancer in Canadian men and the third most common cause of cancer death in Canada. Several studies have shown that use of commonly prescribed medications, including those used for diabetes and hypercholesterolemia, is associated with improved survival in various malignancies, including PC. There has not been any large population-based study, examining the effects of these and other commonly prescribed medications, on the rate of PC diagnosis, over a 20 years follow-up period. Methods: A retrospective population-based study using data from the institute of clinical evaluative sciences, including all male patients aged 65 and above in Ontario who have had a negative first prostate biopsy between 1994 and 2016. We assessed the impact of commonly prescribed medications on PC diagnosis. The medications included Statins (hydrophilic and hydrophobic), diabetes drugs (metformin, insulins, sulfonylureas, and thizolidinedions), proton pump inhibitors, 5 alpha reductase inhibitors, and alpha blockers. Time dependent Cox regression proportional hazards models were performed determine predictors of PC diagnosis. Medication exposure was time varying and modeled as “ever” vs. “never” use or as cumulative exposure for 6 months of usage. A priori variables included in the model included age, ADG comorbidity score, rurality index, index year, and all medications. Results: A total of 51,415 men were analyzed over a mean (SD) follow-up time of 8.06 (5.44) years. Overall, 10,466 patients (20.4%) were diagnosed with PC, 16,726 (32.5%) had died, and 1,460 (2.8%) patients died of PC. On multivariable analysis increasing age and rurality index were associated with higher PC diagnosis rate, while a more recent index year, and usage of hydrophilic statins was associated with a lower diagnosis rate in both “ever” vs. “never” and cumulative models (HR 0.832, 95% CI 0.732-0.946, p = 0.005, HR 0.973 95% CI 0.951-0.995, p = 0.016, respectively). Conclusions: Hydrophilic statins are associated with a clinically significant lower PC diagnosis. To our knowledge this is the first study demonstrating a clear advantage of one group of statins (hydrophilic) over another (hydrophobic) in PC prevention.

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