Abstract P027: Fasting Glucose And Risk Of Heart Failure

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Hassan Khan ◽  
Setor Kunutsor ◽  
Jussi Kauhanen ◽  
Sudhir Kurl ◽  
Eiran Gorodeski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prospective Studies ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Population Based ◽  
Dose Response Relationship ◽  
Increased Risk ◽  
History Of ◽  
Independent Association

Background: There remains uncertainty regarding the association between fasting glucose (FG) and the risk of heart failure (HF) in individuals without a history of diabetes. Methods and Results: We assessed the association between FG and HF risk in a population-based cohort of 1,740 men aged 42-61 years free from HF or diabetes at baseline. Additionally, we performed a meta-analysis of relevant prospective studies identified from MEDLINE, EMBASE, and Web of Science databases. During a mean follow-up of 20.4 years, 146 participants developed HF (4.1 cases per 1000 person-years). In models adjusted for age, the hazard ratio (HR) for HF per 1 mmol/L increase in FG was 1.34 (95% confidence interval [CI], 1.22, 1.48). This association persisted after adjustment for established HF risk factors (HR 1.27, 95% CI 1.14, 1.42). Compared with FG< 5.6 mmol/L, there was an increased risk amongst those with FG 5.6-6.9 mmol/L (HR 1.24, 95% CI 0.82, 1.88) and ≥ 7.0 mmol/L (HR 3.25, 95% CI 1.50, 7.08). HRs remained consistent across several clinical subgroups. In a meta-analysis of 10 prospective studies (Figure 1) involving a total of 4,213 incident HF cases, the HR for HF per 1 mmol/L increase in FG level was 1.11 (95% CI 1.04, 1.17), consistent with a linear dose-response relationship with evidence of heterogeneity between studies (I2=79%, 63-89%; P<0.001). Conclusions: A positive, continuous, and independent association exists between FG and risk for HF. Further studies are needed to evaluate the causal relevance of these findings.

scholarly journals Prediction of all-cause mortality with malnutrition assessed by controlling nutritional status score in patients with heart failure: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Huiyang Li ◽  
Peng Zhou ◽  
Yikai Zhao ◽  
Huaichun Ni ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Nutritional Status ◽  
Meta Analysis ◽  
Predictive Values ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Conut Score

Abstract Objective: The aim of this meta-analysis was to investigate the association between malnutrition assessed by the controlling nutritional status (CONUT) score and all-cause mortality in patients with heart failure. Design: Systematic review and meta-analysis. Settings: A comprehensively literature search of PubMed and Embase databases was performed until 30 November 2020. Studies reporting the utility of CONUT score in prediction of all-cause mortality among patients with heart failure were eligible. Patients with a CONUT score ≥2 are grouped as malnourished. Predictive values of the CONUT score were summarized by pooling the multivariable-adjusted risk ratios (RR) with 95 % CI for the malnourished v. normal nutritional status or per point CONUT score increase. Participants: Ten studies involving 5196 patients with heart failure. Results: Malnourished patients with heart failure conferred a higher risk of all-cause mortality (RR 1·92; 95 % CI 1·58, 2·34) compared with the normal nutritional status. Subgroup analysis showed the malnourished patients with heart failure had an increased risk of in-hospital mortality (RR 1·78; 95 % CI 1·29, 2·46) and follow-up mortality (RR 2·01; 95 % CI 1·58, 2·57). Moreover, per point increase in CONUT score significantly increased 16% risk of all-cause mortality during the follow-up. Conclusions: Malnutrition defined by the CONUT score is an independent predictor of all-cause mortality in patients with heart failure. Assessment of nutritional status using CONUT score would be helpful for improving risk stratification of heart failure.

P1818Descending aortic thoracic diameter: a risk marker for major adverse cardiovascular outcomes in women

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O L Rueda Ochoa ◽  
L R Bons ◽  
S Rohde ◽  
K E L Ghoud ◽  
R Budde ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Increased Risk ◽  
Almost All

Abstract Background Thoracic aortic diameters have been associated with cardiovascular risk factors and atherosclerosis. However, limited evidence regarding the role of thoracic aortic diameters as risk markers for major cardiovascular outcomes among women and men exist. Purpose To evaluate the independent associations between crude and indexed ascending and descending aortic (AA and DA) diameters with major cardiovascular outcomes among women and men and to provide optimal cutoff values associated with increased cardiovascular risk. Methods and results 2178 women and men ≥55 years from the prospective population-based Rotterdam Study underwent multi-detector CT scan of thorax. Crude diameters of the AA and DA were measured and indexed by height, weight, body surface area (BSA) and body mass index (BMI). Incidence of stroke, coronary heart disease (CHD), heart failure (HF), cardiovascular and all-cause mortality were evaluated during 13 years of follow-up. Weight-, BSA-, or BMI-indexed AA diameters showed significant associations with total or cardiovascular mortality in both sexes and height-indexed values showed association with HF in women. Crude AA diameters were associated with stroke in men and HF in women. For DA, crude and almost all indexed diameters showed significant associations with either stroke, HF, cardiovascular or total mortality in women. Only weight-, BSA- and BMI-indexed values were associated with total mortality in men. For crude DA diameter, the risk for stroke increased significantly at the 75th percentile among men while the risks for HF and cardiovascular mortality increased at the 75th and 85th percentiles respectively in women. Conclusions Our study suggests a role for descending thoracic aortic diameter as a marker for increased cardiovascular risk, in particular for stroke, heart failure and cardiovascular mortality among women. The cut points for increased risk for several of cardiovascular outcomes were below the 95th percentile of the distribution of aortic diameters.

scholarly journals Anxiety and new onset of cardiovascular disease: critical review and meta-analysis

2016 ◽  
Vol 208 (3) ◽  
pp. 223-231 ◽  
Author(s):  
Neeltje M. Batelaan ◽  
Adrie Seldenrijk ◽  
Mariska Bot ◽  
Anton J. L. M. van Balkom ◽  
Brenda W. J. H. Penninx
Keyword(s):  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Population Based ◽  
Future Research ◽  
Cvd Prevention ◽  
Traditional Risk Factors ◽  
Independent Association ◽  
New Onset

BackgroundAnxiety has been associated with new-onset cardiovascular disease (CVD), but the quality of this relationship is unclear. Only if anxiety is a causal, independent cardiovascular risk factor might it be a target for CVD prevention.AimsTo determine and examine the independent association and causality between anxiety and incident CVD.MethodPubMed, EMBASE and PsycINFO databases were searched up to October 2013. A review of Hill's criteria for causality and random effects meta-analysis were conducted of prospective, population-based studies examining anxiety and incident CVD in people free from CVD at baseline.ResultsThe meta-analysis comprised 37 papers (n= 1 565 699). The follow-up ranged from 1 to 24 years. Anxiety was associated with a 52% increased incidence of CVD (hazard ratio = 1.52, 95% CI 1.36–1.71). The risk seemed independent of traditional risk factors and depression. The evaluation of Hill's criteria largely argued in favour of causality.ConclusionsAnxiety may be of interest for CVD prevention. Future research should examine biological and behavioural underpinnings of the association in order to identify targets for intervention.

scholarly journals Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hwi Seung Kim ◽  
Jiwoo Lee ◽  
Yun Kyung Cho ◽  
Joong-Yeol Park ◽  
Woo Je Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
National Health ◽  
Population Based ◽  
Metabolic Health ◽  
Metabolically Healthy Obese ◽  
Obesity Status ◽  
Increased Risk ◽  
Metabolically Healthy ◽  
Incident Heart Failure

BackgroundMetabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years.MethodsThe Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first.ResultsThe MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20–1.39], 1.37 [1.22–1.53], and 1.63 [1.50–1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status.ConclusionsMetabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.

scholarly journals Preeclampsia and the risk of chronic kidney disease: a national registry-based cohort study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P M Barrett ◽  
F P McCarthy ◽  
M Evans ◽  
M Kublickas ◽  
I J Perry ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Absolute Risk ◽  
Population Based ◽  
National Registry ◽  
Medical Birth Register ◽  
Increased Risk ◽  
History Of

Abstract Background Preeclampsia is associated with increased risk of future cardiovascular disease, but evidence for associations with chronic kidney disease (CKD) has been inconsistent to date. We aimed to measure associations between preeclampsia and long-term CKD in a population-based sample of parous women, and to identify whether the risk differs by CKD subtype. Methods Using data from the Swedish Medical Birth Register, singleton live births from 1973-2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Preeclampsia was the main exposure of interest and was treated as a time-dependent variable. The primary outcome was maternal CKD, and this was classified into 5 subtypes: hypertensive, diabetic, glomerular/proteinuric, tubulo-interstitial, other/non-specific CKD. Cox proportional hazard regression models were used for analysis. Women with pre-pregnancy comorbidities were excluded. Results The dataset included 1,924,591 unique women who had 3,726,819 singleton pregnancies. The median follow-up was 20.7 (interquartile range 9.9-30.0) years. Overall, 90,964 women (4.7%) experienced preeclampsia and 18,146 (0.9%) developed CKD. Women who had preeclampsia had higher risk of developing any CKD during follow-up (aHR 1.88, 95% CI 1.79-1.98). The risk differed by CKD subtype, and was higher for hypertensive CKD (aHR 3.76, aHR 3.09-4.57), diabetic CKD (aHR 3.45, 95% CI 2.83-4.21) and glomerular/proteinuric CKD (aHR 2.08, 95% CI 1.90-2.29). Women who had preterm preeclampsia, recurrent preeclampsia, or preeclampsia complicated by pre-pregnancy obesity were also at greater risk of any CKD. Conclusions Women with a history of preeclampsia are at increased risk of long-term CKD. The risk is most marked for hypertensive CKD, diabetic CKD, and glomerular/proteinuric CKD. The absolute risk of CKD related to preeclampsia is substantial, and these women may warrant systematic renal monitoring in the years following delivery. Key messages Preeclampsia is an independent predictor of long-term risk of chronic kidney disease in otherwise healthy parous women. Women with a history of preeclampsia may warrant systematic renal monitoring through additional blood pressure, blood glucose, and proteinuria checks.

scholarly journals DOP43 The risk of extra-intestinal cancer in inflammatory bowel disease (IBD): A systematic review and meta-analysis of population-based cohort studies

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S080-S081
Author(s):  
B Z S Lo ◽  
M Zhao ◽  
I Vind ◽  
J Burisch
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Population Based ◽  
Site Specific ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Stratified Analysis ◽  
Year 2000 ◽  
Overall Risk

Abstract Background Patients with Crohn’s disease (CD) and ulcerative colitis (UC) are at increased risk of developing intestinal cancer compared with the background population. However, less is known about the risk of extra-intestinal cancers (EICs). A previous meta-analysis did not find an increased overall risk of EICs but was limited by the scarcity of available studies and the short length of follow-up in those cohorts. The aim of this study was to conduct a systematic review and meta-analysis of population-based cohorts assessing the risk of EICs in inflammatory bowel disease (IBD) patients. Methods A systematic literature search was carried out. Only population-based studies reporting on the prevalence or incidence of EICs were included. All studies were screened (603), and included studies were quality assessed by two investigators (BL, MZ). Studies eligible for meta-analysis were pooled for events, expected events or events in a control-population, and the length of follow-up in patient-years. A meta-analysis of the overall and site-specific risk of EICs and a stratified analysis of the cohorts (according to whether there were most patients followed before or after the year 2000) were conducted. Results In total, 36 studies were included in the systematic review and 14 studies were included in the meta-analysis. The majority of the studies reporting on the overall risk of EICs in their respective cohort were inconclusive due to lack of power. In the meta-analysis, the overall risk of EICs was found to be increased in both CD (IRR: 1.45 [1.26, 1.67]) and UC (IRR: 1.15 [1.02, 1.31]) patients (Figures 1 and 2). The stratified analysis showed a significant increased risk of EICs among CD patients both before (IRR: 1.58 [1.09, 2.28]) and after (IRR: 1.47 [1.28, 1.69]) the year 2000, while no increased risk was found among UC patients. Assessing site-specific EICs, both CD and UC patients demonstrated an increased risk of skin and hepatobiliary malignancies. Furthermore, CD demonstrated an increased risk of haematological and lung malignancies (Figures 3 and 4). Conclusion In conclusion, this systematic review and meta-analysis demonstrated that IBD patients, both CD and UC patients, are at an increased risk of developing EICs; both overall and at specific sites. The transition of the millennium did not increase the risk of EICs in CD or UC patients. However, more studies with longer follow-up are needed to assess the true risk of EICs posed by IBD.

Breast cancer risk in hyperprolactinemia: a population-based cohort study and meta-analysis of the literature

2015 ◽  
Vol 173 (2) ◽  
pp. 269-273 ◽  
Author(s):  
O M Dekkers ◽  
V Ehrenstein ◽  
M Bengtsen ◽  
D Kormendine Farkas ◽  
A M Pereira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Meta Analysis ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Combining Data ◽  
First Time ◽  
Time Diagnosis

ObjectiveTo enhance the precision of the risk estimate for breast cancer in hyperprolactinemia patients by collecting more data and pooling our results with available data from former studies in a meta-analysis.DesignPopulation-based cohort study and meta-analysis of the literature.MethodsUsing nationwide registries, we identified all patients with a first-time diagnosis of hyperprolactinemia during 1994–2012 including those with a new breast cancer diagnoses after the start of follow-up. We calculated standardised incidence ratios (SIRs) as a measure of relative risk (RR) using national cancer incidence rates. We performed a meta-analysis, combining data from our study with data in the existing literature.ResultsWe identified 2457 patients with hyperprolactinemia and 20 breast cancer cases during 19 411 person-years of follow-up, yielding a SIR of 0.99 (95% CI 0.60–1.52). Data from two additional cohort studies were retrieved and analyzed. When the three risk estimates were pooled, the combined RR was 1.04 (95% CI 0.75–1.43).ConclusionsWe found no increased risk of breast cancer among patients with hyperprolactinemia.

Tobacco smoking and the risk of heart failure: A systematic review and meta-analysis of prospective studies

2018 ◽  
Vol 26 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Dagfinn Aune ◽  
Sabrina Schlesinger ◽  
Teresa Norat ◽  
Elio Riboli
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Smoking Cessation ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
Quitting Smoking ◽  
Former Smokers ◽  
Never Smokers

Background We conducted a systematic review and meta-analysis to clarify the association between smoking and the risk of developing heart failure. Methods PubMed and Embase databases were searched up to 24 July 2018. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of heart failure associated with smoking. Summary RRs and 95% CIs were estimated using a random effects model. Results Twenty-six studies were included. The summary RR was 1.75 (95% CI: 1.54–1.99, I2 = 81%, n = 10) for current smokers, 1.16 (95% CI: 1.08–1.24, I2 = 51%, n = 9) for former smokers, and 1.44 (1.34–1.55, I2 = 83%, n = 10) for ever smokers compared with never smokers. The summary RR was 1.41 (95% CI: 1.01–1.96, I2 = 82%, n = 2) per 10 cigarettes per day, 1.11 (95% CI: 1.04–1.18, I2 = 70%, n = 3) and 1.08 (95% CI: 1.02–1.14, I2 = 34%, n = 2) per 10 pack-years among ever smokers and former smokers, respectively, and 0.79 (95% CI: 0.63–1.00, I2 = 96%, n = 2) per 10 years since quitting smoking. The association between smoking cessation and heart failure reached significance at 15 years of smoking cessation, and at 30 years the summary RR was 0.72 (95% CI: 0.57–0.90), only slightly higher than the summary RR for never smokers (0.64 (95% CI: 0.57–0.72)) when compared with current smokers. Conclusion Smoking is associated with increased risk of heart failure, but the risk decreases with increasing duration since smoking cessation. Any further studies should investigate the association between number of cigarettes per day, duration, pack-years and time since quitting smoking and risk of heart failure.

scholarly journals Association between coffee consumption and risk of bladder cancer in a meta-analysis of 16 prospective studies

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhi-Wei Dai ◽  
Ke-Dan Cai ◽  
Fu-Rong Li ◽  
Xian-Bo Wu ◽  
Guo-Chong Chen
Keyword(s):  
Bladder Cancer ◽  
Prospective Studies ◽  
Smoking Status ◽  
Meta Analysis ◽  
Coffee Consumption ◽  
Final Analysis ◽  
Current Evidence ◽  
Increased Risk ◽  
Independent Association ◽  
Summary Relative Risk

Abstract Background Current evidence remains equivocal as to whether and how consumption of coffee may be associated with risk of bladder cancer, and potential influence of confounding by smoking on this association is yet to be elucidated. We conducted an updated meta-analysis of prospective studies to address these issues. Methods Relevant studies were identified by searching PubMed and EMBASE databases from inception to April 2019. A random-effects model was used to estimate summary relative risk (RR) with corresponding 95% confidence interval (CI) of bladder cancer associated with coffee consumption. Results The final analysis included 16 prospective studies comprising 2,122,816 participants and 11,848 bladder cancer cases. Overall, coffee consumption was not associated with risk of bladder cancer (RR high-vs-low = 1.07, 95% CI: 0.96–1.20). The lack of association persisted in the strata defined by sex or participants’ smoking status. Meta-regression analyses identified the number cases (Pdifference = 0.06) and the degree of adjustment for smoking (Pdifference = 0.04) as potential sources of heterogeneity. There was an increased risk of bladder cancer related to higher coffee consumption among studies with fewer cases (RR high-vs-low = 1.38, 95% CI: 1.05–1.81) and among those with poorer adjustment for smoking (RR high-vs-low = 1.48, 95% CI: 1.14–1.93). Results were similar in the dose-response analyses (RR 1 cup/d = 1.01, 95% CI: 0.98–1.03). Conclusion Best evidence available to date does not support an independent association between coffee consumption and bladder cancer risk. Some direct associations observed in individual studies may be a result of residual confounding by smoking.

Estrogen Replacement Therapy (ERT) Is Not Associated with an Increased Risk of Leukemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1063-1063
Author(s):  
Julie A. Ross ◽  
Penny J. Sinner ◽  
Cindy K. Blair ◽  
James R. Cerhan ◽  
Aaron R. Folsom
Keyword(s):  
Myeloid Leukemia ◽  
Population Based ◽  
Health Study ◽  
Appreciable Effect ◽  
Cancer Risk Factors ◽  
Increased Risk ◽  
History Of ◽  
Post Menopausal ◽  
Iowa Women's Health Study

Abstract Recent studies have reported an increased risk of breast, endometrial, ovarian, and gall bladder cancer associated with ERT. One proposed mechanism by which ERT increases risk is through the binding of estrogen to receptors at the tissue site. Estrogen receptors are also present on certain hematopoietic cells as well as on myeloid leukemia cells. Further, downregulation of the estrogen receptor through DNA methylation has been associated with increased acute myeloid leukemia (AML) survival. We evaluated whether ERT is associated with an increased risk of leukemia, particularly AML, in the Iowa Women’s Health Study. A cohort of 37,172 post-menopausal Iowa women ages 55 to 69 years with no history of prior cancer was linked annually to the population-based state cancer registry through 2001. In addition to other self-reported cancer risk factors, participants were asked about current and former use of ERT in 1986 and on four subsequent follow-up questionnaires. A total of 201 cases of leukemia were identified over 16 years of follow-up including 64 AMLs and 87 chronic lymphocytic leukemias (CLLs). Compared to never users of ERT at study baseline, current [multivariate relative risk (RR), 1.09; 95% Confidence Interval (CI) 0.70–1.72) and former users (RR=0.81, 95% CI=0.58–1.14) were at no increased risk of developing leukemia. For AML, current users also had no increased risk (RR=0.86, 95% CI=0.39–1.92) and there was a suggestion that former users had a slight decreased risk (RR=0.68, 95% CI=0.38–1.22). For CLL, all results were around unity. Duration of ERT or time-dependent use had no appreciable effect on the RRs. We conclude that ERT use is unlikely to be a risk factor for leukemia, including AML. Supported by NCI R01 CA39741.

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