Abstract 16004: The Prognostic Value of Automatically Detected Early Repolarization - A Focus on Hispanics

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Philip Aagaard
Keyword(s):  
African Americans ◽  
Smoking Status ◽  
Prognostic Significance ◽  
Cox Proportional Hazards Model ◽  
Early Repolarization ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Significant Difference ◽  
St Segments

Introduction: Early repolarization (ER) associated with sudden cardiac death is based on the presence of >1mm J-point elevations in inferior and/or lateral leads with horizontal/downsloping ST-segments. Automated ECG readings of early repolarization (AER) obtained in clinical practice, on the other hand, are defined by ST segment elevation (ascending/upsloping ST-segments) in addition to J-point elevation. Nonetheless, such automated readings may cause alarm. Methods: We therefore assessed the prevalence and prognostic significance of AER in 238,456 individuals aged 18-75 years. The study was performed at a tertiary medical center serving a racially diverse urban population with a large proportion of Hispanics (43%). The first recorded ECG of each individual during 2000-2012 was included. Patients with ventricular paced rhythm or acute coronary syndrome at the time of acquisition were excluded from the analysis. All automated ECG interpretations were reviewed for accuracy by a board certified cardiologist. The primary endpoint was death during a median follow up of 8.0±2.6 years. Results: AER was present in 3,450 (1.6%) subjects. The prevalence varied significantly with race: African Americans 2.2%, Caucasians 0.9%, and Hispanics 1.5% (p<0.01), and sex: male 2.4% vs. female 0.6% (p<0.001). In a Cox-proportional Hazards model (Figure 1) controlling for age, smoking status, heart rate, QTc, systolic blood pressure, LDL-cholesterol, BMI, and CAD, there was no significant difference in mortality regardless of race or sex (RR 0.98 (95% CI: 0.89-1.07). This was true even if J-waves were present. Conclusion: The prevalence of AER in Hispanics was intermediate to that of African Americans and Caucasians. This ECG finding was not associated with an increased risk of death, regardless of race or sex, and should not trigger additional diagnostic testing.

Abstract 12714: Early Repolarization With J-Point Elevation Predicts Mortality in the Hispanic Female Population

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eric Shulman ◽  
Philip Aagaard ◽  
Faraj Kargoli ◽  
Steve Lener ◽  
John Fisher ◽  
...  
Keyword(s):  
Cox Proportional Hazards Model ◽  
Hispanic Population ◽  
Early Repolarization ◽  
Female Population ◽  
Risk Of Death ◽  
Increased Risk ◽  
Social Security Death Index ◽  
Significant Difference ◽  
The Impact ◽  
Overall Mortality

Introduction: Early repolarization (ER) is associated with an increased risk of sudden cardiac death (SCD). However, the impact of ER may not be uniform across race and gender. An analysis from the Biracial Atherosclerosis Risk in Communities Study showed that ER was associated with SCD risk in Caucasians and highest in female Caucasians, while a study from Northern California found no association between cardiovascular mortality and ER in African Americans. Although Hispanics are the second largest segment of the population, little is known about the prevalence or prognostic implications of ER in this group. We investigated possible associations between automated ECG ER readings, defined as J-point elevation with ST segment elevation and overall mortality. Methods: ECG and EMR databases from a regional medical center from a largely Hispanic population were interrogated. Inclusion criteria included Hispanic ethnicity, age over 18 from 2000-2011. Outcomes were assessed using a Cox Proportional Hazards model with data from the Social Security Death Index. Results: There were n=34,354 Hispanics of which n=544 (1.6%) had ER. When controlling for age, gender, height/weight, systolic/diastolic BP, PR, QRS, QTc, heart rate, ejection fraction, CAD, CHF, myocardial infarction, DM, and malignancy there was no significant difference in mortality between overall subjects with and without ER (HR: 1.15, 95% CI: 0.89-1.50, p=0.294). However, significant interactions were present between gender and ER. In a multivariate regression model, ER was significantly predictive of overall mortality in females (HR: 1.91, 95% CI: 1.24-2.90, p=0.003), but not in males (HR: 0.88, 95% CI: 0.63-1.23, p=0.456) (Figure 1). Conclusions: ER is not associated with an increased risk of death in the overall Hispanic population; however, there is a higher risk of overall mortality in female population. ER may be more complex than initially suspected, which emphasizes a need for additional research.

scholarly journals The prognostic significance of smoking cessation after acute coronary syndromes: an observational, multicentre study from the Melbourne interventional group registry

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016874 ◽  
Author(s):  
Matias B Yudi ◽  
Omar Farouque ◽  
Nick Andrianopoulos ◽  
Andrew E Ajani ◽  
Katie Kalten ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Secondary Prevention ◽  
Proportional Hazards Model ◽  
Smoking Status ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Coronary Syndrome ◽  
Interventional Group ◽  
Persistent Smoking

ObjectiveWe aim to ascertain the prognostic significance of persistent smoking and smoking cessation after an acute coronary syndrome (ACS) in the era of percutaneous coronary intervention (PCI) and optimal secondary prevention pharmacotherapy.MethodsConsecutive patients from the Melbourne Interventional Group registry (2005–2013) who were alive at 30 days post-ACS presentation were included in our observational cohort study. Patients were divided into four categories based on their smoking status: non-smoker; ex-smoker (quit >1 month before ACS); recent quitter (smoker at presentation but quit by 30 days) and persistent smoker (smoker at presentation and at 30 days). The primary endpoint was survival ascertained through the Australian National Death Index linkage. A Cox-proportional hazards model was used to estimate the adjusted HR and 95% CI for survival.ResultsOf the 9375 patients included, 2728 (29.1%) never smoked, 3712 (39.6%) were ex-smokers, 1612 (17.2%) were recent quitters and 1323 (14.1%) were persistent smokers. Cox-proportional hazard modelling revealed, compared with those who had never smoked, that persistent smoking (HR 1.78, 95% CI 1.36 to 2.32, p<0.001) was an independent predictor of increased hazard (mean follow-up 3.9±2.2 years) while being a recent quitter (HR 1.27, 95% CI 0.96 to 1.68, p=0.10) or an ex-smoker (HR 1.03, 95% CI 0.87 to 1.22, p=0.72) were not.ConclusionsIn a contemporary cohort of patients with ACS, those who continued to smoke had an 80% risk of lower survival while those who quit had comparable survival to lifelong non-smokers. This underscores the importance of smoking cessation in secondary prevention despite the improvement in management of ACS with PCI and pharmacotherapy.

P6588Impact of age and sex on the long-term prognosis associated with early repolarization in the general population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A K Holkeri ◽  
A Eranti ◽  
M A Haukilahti ◽  
T Kerola ◽  
T V Kentta ◽  
...  
Keyword(s):  
General Population ◽  
Prognostic Significance ◽  
Cox Proportional Hazards Model ◽  
Future Research ◽  
Age Group ◽  
Early Repolarization ◽  
Increased Risk ◽  
Male Subjects ◽  
Age And Sex ◽  
Female Subjects

Abstract Background Early repolarization (ER) in the electrocardiogram (ECG) has been associated with increased sudden cardiac death (SCD) risk in the general population. However, controversy remains about the risk associated with ER in different population subgroups. Purpose We evaluated whether age and sex affect the prognostic significance of ER in general population subjects. Methods The study population consisted of Finnish general population subjects aged over 30 years participating in the Mini-Finland Health Survey in 1978–80. Subjects underwent extensive baseline health examinations including a resting 12-lead ECG and were followed for 24±10 years. After excluding ECGs with QRS duration >110ms, the presence of ER (J-point elevation ≥0.1 mV in ≥2 inferior/lateral leads) was assessed from the remaining 6,631 subjects. The association between ER and SCD risk was analysed in subgroups according to age (<50 years or ≥50 years) and sex by using the Cox proportional hazards model. Effect modification of ER by age group and by sex was tested using the Wald test. Results ER was present in 250 (15.7%) of the 1,592 male subjects aged <50 years, 117 (6.8%) of the 1,713 female subjects aged <50 years, 182 (13.4%) of the 1,362 male subjects aged ≥50 years, and 244 (12.4%) of the 1,964 female subjects aged ≥50 years. There was a significant interaction between age group and ER (p=0.011). Among subjects aged <50 years, ER was associated with SCD risk after adjusting for age, sex, blood pressure, body mass index, serum cholesterol, coronary artery disease, diabetes, and active smoking (hazard ratio [HR] 1.79; 95% confidence interval [CI] 1.09–2.92; p=0.021), whereas in subjects aged ≥50 years ER was not associated with increased risk of SCD. Particularly female subjects aged <50 years with ER had a high risk of SCD (HR 4.85; 95% CI 1.65–14.29; p=0.004) in the multivariate analysis, whereas among <50-year-old male subjects ER was not associated with SCD (p=0.024 for interaction between sex and ER). Conclusion Our results suggest that among adults <50 years old, and especially among <50-year-old women, ER is associated with increased SCD risk, whereas among older subjects ER is not associated with SCD. Future research should focus on identifying the factors accounting for the difference between the age groups and to improve the risk stratification in the younger female patient populations with ER. Acknowledgement/Funding Aarne Koskelo foundation and Paavo Ilmari Ahvenainen Foundation

scholarly journals The effectiveness of clopidogrel in the prevention of thrombotic complications in patients with acute coronary syndrome and genetic factors

2012 ◽  
Vol 93 (2) ◽  
pp. 294-297
Author(s):  
A S Galyavich ◽  
D D Valeeva
Keyword(s):  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Antiplatelet Drug ◽  
C3435t Polymorphism ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
P Glycoprotein ◽  
Cyp2c19 Polymorphism ◽  
Increased Risk

This review article presents the current views on genotyping during administration of clopidogrel - an antiplatelet drug from the class of thienopyridines, for patients with acute coronary syndrome. Highlighted were the data on genetic disorders affecting the absorption and metabolism of clopidogrel. The gene ABCB1 (MDR1) encodes the intestinal transporter P-glycoprotein. The variability of this gene may affect the bioavailability of clopidogrel. However, data on the relationship between C3435T polymorphism of ABCB1 gene and the expression of P-glycoprotein still remain controversial. Differences in the effects of C3435T may reflect the differences in the frequency of ABCB1 polymorphism among ethnic groups and the complex of effects of different polymorphisms in the same gene within a haplotype, or confounding factors of the environment. The most important role in the metabolism of clopidogrel is played by cytochrome P-450 (iso-enzyme CYP2C19). Several large studies have confirmed the prognostic significance of CYP2C19 polymorphism in patients receiving clopidogrel. In a recent meta-analysis of nine pharmacogenetic studies of clopidogrel, which included 9685 patients with acute coronary syndrome, revealed was a significant association between the homozygous and heterozygous alleles with reduced CYP2C19 function and an increased risk of death due to cardiovascular disease, myocardial infarction or stroke. Two large randomized studies of CYP2C19 genotyping did not reveal any relationship between its variants and the occurrence of cardiovascular events in patients with acute coronary syndrome or atrial fibrillation. Thus, in genetic studies of the antiplatelet effectiveness of clopidogrel, there are many uncertainties; domestic data on this subject is extremely scarce.

scholarly journals Is There an Interplay between Immune Checkpoint Inhibitors, Thromboprophylactic Treatments and Thromboembolic Events? Mechanisms and Impact in Non-Small Cell Lung Cancer Patients

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 67
Author(s):  
Federico Nichetti ◽  
Francesca Ligorio ◽  
Emma Zattarin ◽  
Diego Signorelli ◽  
Arsela Prelaj ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Smoking Status ◽  
Prognostic Significance ◽  
Antiplatelet Drugs ◽  
Thromboembolic Events ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

PD-1 pathway blockade has been shown to promote proatherogenic T-cell responses and destabilization of atherosclerotic plaques. Moreover, preclinical evidence suggests a potential synergy of antiplatelet drugs with immune checkpoint inhibitors (ICIs). We conducted an analysis within a prospective observational protocol (APOLLO study) to investigate the rates, predictors, and prognostic significance of thromboembolic events (TE) and thromboprophylaxis in patients with advanced NSCLC treated with ICIs. Among 217 patients treated between April 2014 and September 2018, 13.8% developed TE events. Current smoking status (HR 3.61 (95% CI 1.52–8.60), p = 0.004) and high (>50%) PD-L1 (HR 2.55 (95% CI 1.05–6.19), p = 0.038) resulted in being independent TE predictors. An increased risk of death following a diagnosis of TE (HR 2.93; 95% CI 1.59–5.42; p = 0.0006) was observed. Patients receiving antiplatelet treatment experienced longer progression-free survival (PFS) (6.4 vs. 3.4 months, HR 0.67 (95% CI 0.48–0.92), p = 0.015) and a trend toward better OS (11.2 vs. 9.6 months, HR 0.78 (95% CI 0.55–1.09), p = 0.14), which were not confirmed in a multivariate model. No impact of anticoagulant treatment on patients’ outcomes was observed. NSCLC patients treated with ICIs bear a consistent risk for thrombotic complications, with a detrimental effect on survival. The impact of antiplatelet drugs on ICIs efficacy deserves further investigation in prospective trials.

scholarly journals Alcohol intake, tobacco smoking, and esophageal adenocarcinoma survival: a molecular pathology epidemiology cohort study

2019 ◽  
Vol 31 (1) ◽  
pp. 1-11
Author(s):  
R. Stephen McCain ◽  
Damian T. McManus ◽  
Stephen McQuaid ◽  
Jacqueline A. James ◽  
Manuel Salto-Tellez ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Cigarette Smoking ◽  
Esophageal Adenocarcinoma ◽  
Alcohol Intake ◽  
Smoking Status ◽  
Glut 1 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Significant Difference ◽  
Risk Of Cancer

Abstract Purpose To investigate the association between cigarette smoking, alcohol consumption, and esophageal adenocarcinoma survival, including stratified analysis by selected prognostic biomarkers. Methods A population-representative sample of 130 esophageal adenocarcinoma patients (n = 130) treated at the Northern Ireland Cancer Centre between 2004 and 2012. Cox proportional hazards models were applied to evaluate associations between smoking status, alcohol intake, and survival. Secondary analyses investigated these associations across categories of p53, HER2, CD8, and GLUT-1 biomarker expression. Results In esophageal adenocarcinoma patients, there was a significantly increased risk of cancer-specific mortality in ever, compared to never, alcohol drinkers in unadjusted (HR 1.96 95% CI 1.13–3.38) but not adjusted (HR 1.70 95% CI 0.95–3.04) analysis. This increased risk of death observed for alcohol consumers was more evident in patients with normal p53 expression, GLUT-1 positive or CD-8 positive tumors. There were no significant associations between survival and smoking status in esophageal adenocarcinoma patients. Conclusions In esophageal adenocarcinoma patients, cigarette smoking or alcohol consumption was not associated with a significant difference in survival in comparison with never smokers and never drinkers in fully adjusted analysis. However, in some biomarker-selected subgroups, ever-alcohol consumption was associated with a worsened survival in comparison with never drinkers. Larger studies are needed to investigate these findings, as these lifestyle habits may not only be linked to cancer risk but also cancer survival.

scholarly journals Effect of PCSK9 E670G and R46L Polymorphisms on Major Adverse Cardio-Cerebrovascular Events in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Anwar Santoso ◽  
Yulianto Yulianto ◽  
Hendra Simarmata ◽  
Abhirama Nofandra Putra ◽  
Erlin Listiyaningsih
Keyword(s):  
Myocardial Infarction ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Cerebrovascular Events ◽  
St Segment ◽  
Significant Difference

AbstractMajor adverse cardio-cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) are still high, although there have been advances in pharmacology and interventional procedures. Proprotein convertase subtilisin/Kexin type 9 (PCSK9) is a serine protease regulating lipid metabolism associated with inflammation in acute coronary syndrome. The MACCE is possibly related to polymorphisms in PCSK9. A prospective cohort observational study was designed to confirm the association between polymorphism of E670G and R46L in the PCSK9 gene with MACCE in STEMI. The Cox proportional hazards model and Spearman correlation were utilized in the study. The Genotyping of PCSK9 and ELISA was assayed.Sixty-five of 423 STEMI patients experienced MACCE in 6 months. The E670G polymorphism in PCSK9 was associated with MACCE (hazard ratio = 45.40; 95% confidence interval: 5.30–390.30; p = 0.00). There was a significant difference of PCSK9 plasma levels in patients with previous statin consumption (310 [220–1,220] pg/mL) versus those free of any statins (280 [190–1,520] pg/mL) (p = 0.001).E670G polymorphism of PCSK9 was associated with MACCE in STEMI within a 6-month follow-up. The plasma PCSK9 level was higher in statin users.

Stage at presentation and oncologic outcomes for agent orange exposed and non-exposed United States veterans diagnosed with prostate cancer.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 259-259
Author(s):  
Alexander Tward ◽  
Jonathan David Tward
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Cox Regression ◽  
Smoking Status ◽  
Initial Therapy ◽  
Agent Orange ◽  
Oncologic Outcomes ◽  
Free Survival ◽  
Risk Of Death ◽  
Increased Risk

259 Background: Exposure of Vietnam War Veterans to the defoliant Agent Orange (AO) has been linked to increased tumor stage of Veterans diagnosed with prostate cancer. However, information on the effect of exposure to treatment outcomes is lacking. The goal of this study was to evaluate oncologic outcomes in Veterans based on AO exposure history, accounting for known prognostic covariates not previously studied. Methods: United States military Veterans diagnosed with prostate adenocarcinoma born between the years 1930-1956 were identified from a large professionally curated institutional database. Evaluable patients had to have known AO exposure status, age, NCCN risk group, Charlson comorbidity score, smoking status, and whether initial therapy was surgical, radiation, or systemic. Risk of death, metastasis, and progression stratified by the type of initial therapy received was analyzed using Cox regression. Results: There were 70 AO exposed and 561 non-exposed Veterans identified, with a median follow-up of 10.0 years. AO exposure Veterans (AOeV) were significantly younger (64.0 versus 65.7 years, p=0.013) at diagnosis and presented at more advanced stages (e.g. Stage 4: 14.3% versus 2.5%) than non-exposed Veterans (non-AOeV). There was no difference for overall survival (HR=0.86, p=0.576, metastasis-free survival (HR=1.5, p=0.212), or progression-free survival (HR=0.67, p 0.060) between AOeV versus non-AOeV in analyses stratified by treatment received accounting for other prognostic covariates. Cigarette smoking was associated with a 2- 3-fold increased risk of death over those who quit or never smoked. Conclusions: Although AOeV do present at younger age and higher clinical stages than non-AOeV, the oncologic outcomes after accounting for treatments received and other prognostic covariates are similar. The implication is that AOeV are more likely to be recommended multimodality or systemic therapies at presentation.

Abstract 14873: Is There Difference in Clinical Outcomes Following Percutaneous Coronary Intervention (PCI) for Acute Coronary Syndrome (ACS) between Hospitals With and Without Onsite Cardiac Surgery Backup?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tomonori Akasaka ◽  
Seiji Hokimoto ◽  
Noriaki Tabata ◽  
Kenji Sakamoto ◽  
Kenichi Tsujita ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Bleeding Complications ◽  
Hospital Death ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
The Impact

Background: Based on 2011 ACCF/AHA/SCAI PCI guideline, it is recommended that PCI should be performed at hospital with onsite cardiac surgery. But, recent data suggests that there is no significant difference in clinical outcomes following primary or elective PCI between hospitals with and without onsite cardiac surgery. The proportion of PCI centers without onsite cardiac surgery comprises approximately more than half of all PCI centers in Japan. We examined the impact of with or without onsite cardiac surgery on clinical outcomes following PCI to ACS. Methods: From Aug 2008 to March 2011, subjects (n=2288) were enrolled from the Kumamoto Intervention Conference Study (KICS), which is a multicenter registry, and enrolling consecutive patients undergoing PCI in 15 centers in Japan. Patients were assigned to two groups treated in hospitals with (n=1954) or without (n=334) onsite cardiac surgery. Clinical events were followed up for 12 months. Primary endpoint was in-hospital death, cardiovascular death, myocardial infarction, and stroke. And we monitored other events those were non-cardiovascular deaths, bleeding complications, revascularizations, and emergent CABG. Results: There was no overall significant difference in primary endpoint between hospitals with and without onsite cardiac surgery (9.6%vs9.5%; P=0.737). There was also no significant difference when events in primary endpoint were considered separately. In other events, only revascularization was more frequently seen in hospitals with onsite cardiac surgery (22.1%vs12.9%; P<0.001). Kaplan-Meier analysis for primary endpoint showed that there was no significant difference between two groups (Log Rank P=0.943). By cox proportional hazards model analysis for primary endpoint, without onsite cardiac surgery was not a predictive factor for primary endpoint (HR 0.969, 95%CI 0.704-1.333; P=0.845). We performed propensity score matching analysis to correct for the disparate patient numbers between two groups, and there was also no significant difference for primary endpoint (6.9% vs 8.0%; P=0.544). Conclusions: There is no significant difference in clinical outcomes following PCI for ACS between hospitals with and without onsite cardiac surgery backup in Japan.

scholarly journals Tuberculosis Mortality by Occupation in South Africa, 2011–2015

2018 ◽  
Vol 15 (12) ◽  
pp. 2756 ◽  
Author(s):  
Tahira Kootbodien ◽  
Kerry Wilson ◽  
Nonhlanhla Tlotleng ◽  
Vusi Ntlebi ◽  
Felix Made ◽  
...  
Keyword(s):  
South Africa ◽  
Smoking Status ◽  
Direct Method ◽  
Multivariate Logistic Regression Analysis ◽  
World Health ◽  
Health Concern ◽  
Mortality Data ◽  
Middle Income ◽  
Risk Of Death ◽  
Increased Risk

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.

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