Abstract 15837: Particulate Matter 2.5 Exposure Increases Risk of Subsequent Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
John K Maxi ◽  
Matthew Herzog ◽  
Jonathan Entwisle ◽  
Jonathan K Wilt ◽  
Richard V Milani
Keyword(s):  
Myocardial Infarction ◽  
Particulate Matter ◽  
Air Quality ◽  
Conditional Logistic Regression ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Daily Average ◽  
History Of ◽  
Particulate Matter 2.5 ◽  
Southeastern Louisiana

Introduction: Particulate matter 2.5 (PM 2.5 ) are airborne particles small enough to be inhaled into the pulmonary alveoli, and are associated with increased hospitalization rates, morbidity, and mortality. The purpose of this study was to evaluate the levels of PM 2.5 in southeastern Louisiana and describe associated cardiovascular outcomes in patients with a history of myocardial infarction (MI). Methods: Air quality monitoring stations were placed around southeastern Louisiana and were analyzed from March 1 st , 2019 to March 1 st , 2020. Samples were collected every 80 seconds, and values were aggregated at the hourly and daily level. We used conditional logistic regression models to determine the risk of MI. Control observations per patient were created using PM 2.5 exposure on the same day of the week for the two weeks before and after the event. Temperature, pressure, humidity, and their interactions with PM 2.5 were included in the model. Results: The average PM 2.5 exposure for the year was 10.41 ug/m 3 +/- 5.57 ug/m 3 , with a daily low of 1.93 ug/m 3 and a daily high of 31.32 ug/m 3 . Peaks from individual sensors reached PM 2.5 concentrations greater than 100 ug/m 3 . PM 2.5 concentration showed a significant, weakly positive correlation with daily average temperature and a significant, weakly negative correlation with daily average barometric pressure. Among patients (n=263) with history of MI, risk of subsequent MI increased by 24.3% per 10 ug/m 3 increase in PM 2.5 exposure with a lag of three days after exposure. (Figure) No significant risk associated with PM 2.5 exposure was observed at shorter lag times. Conclusion: Although the average PM 2.5 levels in southeastern Louisiana were within the WHO guidelines of air quality, PM 2.5 exposure remained a significant risk factor for MI among a those with previous MI.

scholarly journals Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

2012 ◽  
Vol 4 (2) ◽  
pp. 11 ◽  
Author(s):  
Francesco Corea ◽  
Giorgio Silvestrelli ◽  
Andrea Baccarelli ◽  
Alessandra Giua ◽  
Paolo Previdi ◽  
...  
Keyword(s):  
Air Pollution ◽  
Particulate Matter ◽  
Stroke Unit ◽  
Conditional Logistic Regression ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Lacunar Stroke ◽  
Anterior Circulation ◽  
Stroke Registry ◽  
Particulate Air Pollution

Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006-08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 mm (PM10), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00-1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM10 level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00-1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01-1.07; P<0.05). In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

Abstract 2605: Hypoglycemia Does Not Increase Long-term Mortality Or Morbidity In Diabetic Patients With Myocardial Infarction. A Report From The Digami 2 Trial.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Linda G Mellbin ◽  
Klas Malmberg ◽  
Anders Waldenstrom ◽  
Hans Wedel ◽  
Lars Ryden
Keyword(s):  
Myocardial Infarction ◽  
Blood Glucose ◽  
Negative Impact ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Hazard Ratios

Aims Tight, insulin-based glucose control is recommended to diabetic patients (DM pat) with acute myocardial infarction (AMI). A potential draw-back would be if insulin induced hypoglycaemia (HG) had a negative impact of future prognosis. Methods 1253 pat (mean age 68 years; 67% males) with type 2 DM and suspect AMI were followed for a median of 2.1 years. 947 were randomised to insulin infusion during at least 24 hours while 306 were treated routinely. HG (blood glucose<3.0 mmol/L with or without symptoms) was recorded during hospitalisation. Unadjusted and adjusted (age, sex, smoking, previous MI and heart failure, renal function, duration of DM, coronary interventions, blood glucose at randomisation) Hazard Ratios (HR) and 95% Confidence Intervals (CI) for cardiovascular events (CVE = death, MI or stroke) during follow up were calculated. Results 153 pat (12.2%) experienced HG. During the first 24 hours 111 (11.7%) insulin-treated pat experienced HG (symptomatic 23.4%) compared with 3 (1.0%) pat on routine treatment (symptomatic 33.3%). As outlined in the figure HG was not an independent predictor of subsequent CVE. Conclusion Insulin induced HG was not a significant risk factor for subsequent CVE in AMI-pat with type 2 DM. Hypoglycaemic seem to identify patients at high risk for other reasons.

scholarly journals Younger age of patients with myocardial infarction correlates with higher number of relatives with history of premature atherosclerosis

2020 ◽  
Author(s):  
Michał Ambroziak ◽  
Katarzyna Niewczas-Wieprzowska ◽  
Agnieszka Maicka ◽  
Andrzej Budaj
Keyword(s):  
Myocardial Infarction ◽  
Family History ◽  
Young Patients ◽  
Significant Risk ◽  
Control Group ◽  
Premature Coronary Artery Disease ◽  
Premature Atherosclerosis ◽  
Global Issues ◽  
Younger Age ◽  
History Of

Abstract Background. Premature coronary artery disease belongs to the most pressing global issues in a modern cardiology. Family history appears to be one of the most important and significant risk factors in young patients with myocardial infarction (MI). The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients <50 years with myocardial infarction (MI) compared to patients ≥ 50 years with MI and to young healthy people.Methods. The studied group (MI<50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI≥50) with MI aged 50-92 years and 240 healthy people aged 30-49 years.Results. There were statistically significant differences between the MI<50 and MI≥50 and young healthy groups regarding family history of premature MI/ischaemic stroke and percent of patients with of ≥2 relatives affected including parents, children, siblings, siblings of parents and grandparents (10.8%, 2.9%, 3.7%, respectively; p<0.0001). There was a statistically significant negative correlation between the age of the first episode of MI and the number of relatives with a history of premature MI/stroke (r=0.249, p<0.05) within all MI patients. Statistically significant differences between MI<50 and MI≥50 groups as well as young healthy control group were revealed regarding prevalence of smoking, body mass index (BMI), LDL, HDL, triglycerides (TG) and glucose levels.Conclusions. Younger age of patients with myocardial infarction correlates with a higher number of relatives with a history of premature MI/ischemic stroke. Thus, the family history of premature atherosclerosis involving not only the first-, but also the second-degree relatives, seems to be valuable and could be considered in an individual CVD risk evaluation in young people.

scholarly journals ПОРІВНЯЛЬНА ХАРАКТЕРИСТИКА ФАКТОРІВ РИЗИКУ

2012 ◽  
Author(s):  
І. К. Чурпій
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Significant Risk ◽  
Female Gender ◽  
Electrolyte Composition ◽  
Terminal Phase ◽  
Phase Flow ◽  
History Of

<p>To optimize the therapeutic tactics and improve the treatment of peritonitis on the basis of retrospective analysis there are determined the significant risk factors: female gender, age 60 – 90 years, time to hospitalization for more than 48 hours, a history of myocardial infarction, stroke, cardiac arrhythmia, biliary, fecal and fibrinous purulent exudate, the terminal phase flow, operations with resection of the intestine and postoperative complications such as pulmonary embolism, myocardial infarction, pleurisy, early intestinal obstruction. Changes in the electrolyte composition of blood and lower albumin &lt;35 % of high risk prognostic course of peritonitis that requires immediate correction in the pre-and postoperative periods. The combination of three or more risk factors for various systems, creating a negative outlook for further treatment and the patient's life.</p>

Pathology of testicular tumours

2017 ◽  
Author(s):  
John Goepel
Keyword(s):  
Metastatic Disease ◽  
Western Europe ◽  
Primary Tumour ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Malignant Tumour ◽  
Paraaortic Lymph Nodes ◽  
History Of ◽  
Pure Seminoma ◽  
Mixed Histology

Tumours of the testis are uncommon and are usually germ cell tumours. They present most often as a scrotal mass in a young man, and are the most frequent malignant tumour in this age group. The incidence has risen over recent decades and is higher in Western Europe. A history of testicular maldescent is a significant risk factor. About 50% are pure seminoma; the remainder non-seminomas may have a single but more usually a mixed histology. Non-seminomas are all called teratoma in the British system. Metastasis readily occurs to paraaortic lymph nodes or the lungs, and some patients present with advanced metastatic disease. Radical orchidectomy is the usual treatment of the primary tumour, with chemotherapy for metastatic disease. There are other tumours that arise in the testis, which will require a different management strategy. Finally, there are tumours that arise in paratesticular tissue or the spermatic cord.

scholarly journals Nutritional status and childhood wheezing in rural Bangladesh

2013 ◽  
Vol 17 (7) ◽  
pp. 1570-1577 ◽  
Author(s):  
Mohammad Delwer Hossain Hawlader ◽  
Emiko Noguchi ◽  
Shams El Arifeen ◽  
Lars Åke Persson ◽  
Sophie E Moore ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Economic Status ◽  
Significant Risk ◽  
International Study ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rural Bangladesh ◽  
History Of ◽  
Serum Total Ige

AbstractObjectiveTo investigate the association between current childhood nutritional status and current wheezing among pre-school children in rural Bangladesh.DesignCross-sectional study.SettingMatlab region, rural Bangladesh.SubjectsChildren (n 912) aged 4·5 years. Anthropometric measurements of the mothers and their children were taken during a 1-year period from December 2007 to November 2008. Current wheezing was identified using the International Study of Asthma and Allergies in Childhood questionnaire. Serum total IgE was measured by human IgE quantitative ELISA. IgE specific antibody to dust mites (Dermatophagoides pteronyssinus) was measured by the CAP-FEIA system (Phadia AB, Uppsala, Sweden).ResultsWheezing at 4·5 years old was significantly associated with stunting (OR = 1·58; 95 % CI 1·13, 2·22) and underweight (OR = 1·39; 95 % CI 1·00, 1·94). The association with stunting remained significant after adjustment for sex, birth weight, birth length, gestational age at birth, mother's parity, maternal BMI, family history of asthma, socio-economic status, season of birth and intervention trial arm (OR = 1·74; 95 % CI 1·19, 2·56).ConclusionsStunting was a significant risk factor for wheezing among rural Bangladeshi children. Further studies will be required to confirm the relationship between nutritional status and allergic illnesses in developing countries.

Risk Factors for Silent Cerebral Infarcts in a Pediatric Sickle Cell Anemia (SCA) Cohort

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2487-2487 ◽  
Author(s):  
Francoise Bernaudin ◽  
Suzanne Verlhac ◽  
Annie Kamdem ◽  
Cécile Arnaud ◽  
Lena Coïc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Logistic Regression Analysis ◽  
G6pd Deficiency ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
History Of ◽  
Independent Risk Factors

Abstract Background Silent infarcts are associated with impaired cognitive functioning and have been shown to be predictors of stroke (Miller ST J Pediatr 2001). Until now, reported risk factors for silent infarcts were low pain event rate, history of seizures, high leukocyte count and Sen bS haplotype (Kinney TR Pediatrics 1999). Here, we seek to define the prevalence and risk factors of silent infarcts in the Créteil SCA pediatric cohort comprising patients assessed at least yearly by transcranial doppler (TCD) since 1992, and by MRI/MRA. Methods This study retrospectively analyzed data from the Créteil cohort stroke-free SS/Sb0 children (280; 134 F, 146 M), according to institutional review board. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities (&lt; 170 cm/sec) and normal MRA on TP, although TP was re-initiated in case of abnormal velocities recurrence. Patients with “conditional” velocities (170–199 cm/sec) were assessed by TCD 4 times yearly. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF, LDH levels; MCV; SpO2) were obtained a minimum of 3 months away from a transfusion, one month from a painful episode, after 12 months of age, before the first TCD, and always before therapy intensification. Results. Patients were followed for a total of 2139 patient-years. Alpha-Thal was present in 114/254 patients (45%) and 27/241 (11.2%) had G6PD deficiency. Beta genotype, available in 240 patients, was BaBa in 102 (42.5%), BeBe in 54 (22.5%), SeSe in 19 (7.9%) and “other” in 65 (27.1%); TCD was abnormal in 52 of 280 patients (18.6%). MRA showed stenoses in 30 of 226 evaluated patients (13.3%) while MRI demonstrated presence of silent infarcts in 81/280 patients (28.9%). Abnormal TCD (p&lt;0.001), G6PD deficiency (p=0.008), high LDH (p=0.03), and low Hb (p=0.026) were significant risk factors for stenoses by univariate analysis while multivariate analysis retained only abnormal TCD as a significant risk factor for stenoses ([OR= 10.6, 95% CI (4.6–24.4)]; p&lt;0.001). Univariate logistic regression analysis showed that the risk of silent infarcts was not related to alpha-Thal, beta genotype, abnormal TCD, WBC, PMN, platelets, reticulocyte counts, MCV, LDH level, HbF %, pain or ACS rates but was significantly associated with stenoses detected by MRA (p&lt;0.001), gender (male; p=0.04), G6PD deficiency (p=0.05), low Hb (p=0.016) and Hct (p=0.012). Multivariate logistic regression analysis showed that gender ([OR= 2.1, 95% CI (1.03–4.27)]; p=0.042), low Hb ([OR= 1.4, 95% CI (1.0–1.1)]; p=0.05) and stenoses ([OR= 4.8, 95% CI (1.88–12.28)]; p=0.001) were all significant independent risk factors for silent infarcts. The presence of stenoses was the only significant risk factor for silent infarcts in patients with a history of abnormal TCD ([OR= 5.9, 95% CI (1.6–21.7)]; p=0.008). Conclusion We recently showed that G6PD deficiency, absence of alpha-Thal, and hemolysis are independent significant risk factors for abnormal TCD in stroke-free SCA patients (Bernaudin et al, Blood, 2008, in press). Here, we report that an abnormal TCD is the most significant risk factor for stenoses and, expanding previous studies, we demonstrate that stenoses, low Hb and gender are significant independent risk factors for silent infarcts.

Comparison of incidence and pattern of interstitial lung disease (ILD) during erlotinib and gefitinib treatment in Japanese pts with NSCLC

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19056-e19056
Author(s):  
K. Hotta ◽  
K. Kiura ◽  
N. Takigawa ◽  
H. Yoshioka ◽  
S. Harita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Toxicity Data ◽  
Factors Affecting ◽  
History Of ◽  
Gefitinib Treatment ◽  
Clinical Records ◽  
Erlotinib Therapy ◽  
Significant Factors

e19056 Background: Erlotinib was approved in Dec 2007 in Japan, and incidence and pattern of ILD during its therapy for Japanese pts with NSCLC has not still been determined, although we had previously reported the frequency of ILD through the gefitinib treatment [PASCO2004, #7063]. In this study, we intended to elucidate this issue in pts receiving erlotinib therapy. Methods: We reviewed the clinical records of 159 pts who had initiated erlotinib therapy last year (cohort A), and of 330 pts receiving gefitinib between 2000 and 2003 (cohort B) for comparing the incidence and pattern of ILD during the both TKI treatments. Toxicity data during the first months after the initiation of TKIs were obtained. Results: The demographics of 489 pts were as follows; M:63%, Ad:75%, and PS 0–1:69%. None of pts in the cohort B received erlotinib therapy before the gefitinib treatment, whereas 66 of the 159 cohort A pts (42%) were given gefitinib before the erlotinib therapy. In 23% and 28% of the pts in the cohorts A and B, erlotinib and gefitinb treatments were discontinued within 1 month after the initiation of TKI therapy, respectively. Two pts (1.3%) developed ILD in the cohort A during the first month of erlotinib treatment, while 8 ILD-events (2.4%) were observed in the gefitinib therapy (cohort B) during the same treatment period. Both 2 pts who developed ILD during the erlotinib therapy had not had a history of prior gefitinib treatment. The toxicity grades of ILD were as follows: grades 1 and 2 in 1 each (cohort A) and grades 3, 4 and 5 in 1, 1 and 6 pts, respectively (cohort B). Statistically significant factors affecting the occurrence of ILD by multivariate analysis were presence of prior pulmonary fibrosis (OR=37.3, p<0.01) and poor PS (OR=6.4, p=0.02), but type of TKIs was not a significant risk factor for ILD. Conclusions: In this setting, the type of TKIs did not affect the incidence of ILD although its incidence after the initiation of erlotinib was somewhat low as compared with that during gefitinib therapy. In addition, the grade of ILD was less severe in the cohort A. These might be partly due to a patient selection based on the recent awareness of Japanese physicians regarding the risk factors for ILD events who learned it through the gefitinib treatment. No significant financial relationships to disclose.

Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture

2000 ◽  
Vol 93 (3) ◽  
pp. 379-387 ◽  
Author(s):  
Seppo Juvela ◽  
Matti Porras ◽  
Kristiina Poussa
Keyword(s):  
Risk Factors ◽  
Smoking Status ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Aneurysm Rupture ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Fine Print

Object. The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed.Methods. One hundred forty-two patients with 181 unruptured aneurysms were followed from the 1950s until death or the occurrence of subarachnoid hemorrhage or until the years 1997 to 1998. The annual and cumulative incidence of aneurysm rupture as well as several potential risk factors predictive of rupture were studied using life-table analyses and Cox's proportional hazards regression models including time-dependent covariates.The median follow-up time was 19.7 years (range 0.8–38.9 years). During 2575 person-years of follow up, there were 33 first-time episodes of hemorrhage from previously unruptured aneurysms, for an average annual incidence of 1.3%. In 17 patients, hemorrhage led to death. The cumulative rate of bleeding was 10.5% at 10 years, 23% at 20 years, and 30.3% at 30 years after diagnosis. The diameter of the unruptured aneurysm (relative risk [RR] 1.11 per mm in diameter, 95% confidence interval [CI] 1–1.23, p = 0.05) and patient age at diagnosis inversely (RR 0.97 per year, 95% CI 0.93–1, p = 0.05) were significant independent predictors for a subsequent aneurysm rupture after adjustment for sex, hypertension, and aneurysm group. Active smoking status at the time of diagnosis was a significant risk factor for aneurysm rupture (RR 1.46, 95% CI 1.04–2.06, p = 0.033) after adjustment for size of the aneurysm, patient age, sex, presence of hypertension, and aneurysm group. Active smoking status as a time-dependent covariate was an even more significant risk factor for aneurysm rupture (adjusted RR 3.04, 95% CI 1.21–7.66, p = 0.02).Conclusions. Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.

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