The Mutual Impact of Smoking and Low Cholesterol on All-Cause, Non-Cardiovascular, and Cardiovascular Mortalities in Males

The aim of the current study was to examine the possible relationship between the mutual effects of smoking and low cholesterol on all-cause, non-cardiovascular, and cardiovascular mortalities in males. This is a prospective cohort study of 30,179 males sampled from the Risk Factors and Life Expectancy (RIFLE) studies in the Italian population. The RIFLE data are from 19 different large-scale studies over a 9.5-year follow-up period. The Cox Proportional Hazard model was applied to analyze the data. The associations are presented as hazard ratios (HRs) with 95% confidence interval (CI). Cholesterol data were reported in categories. There were significant mortality risk mutual associations for never-smokers and those in the low cholesterol category (<160 mg/dl) for all-cause (HR = 3.13, 95% CI [1.69, 5.80]), and non-cardiovascular disease (CVD) (HR = 6.51, 95% CI [2.19, 19.33]) mortality in men with an insignificant risk for CVD mortality (HR = 1.90, 95% CI [0.85, 4.22]). There were significant mortality risk associations of the mutual effects of ex-smokers and low cholesterol for non-CVD in the first to third cholesterol categories (HR = 2.50, 95% CI [1.40, 4.46]; HR = 2.65, 95% CI [1.50, 4.71]; HR = 2.12, 95% CI [1.17, 3.82], respectively), but no significant findings for all-cause and CVD deaths. Furthermore, there were significant mortality risk association of mutual effects of current-smokers and low cholesterol for non-CVD (HR = 1.56, 95% CI [1.11, 2.28]) in the first category of cholesterol level, but insignificant risk associations for all-cause deaths (HR = 1.21, 95% CI [0.89, 1.66]). Interestingly, findings indicate a mutual protective association for current-smokers and low cholesterol (<160 mg/dl) for CVD risk in males (HR = 0.42, 95% CI [0.19, 0.91]). Findings of this study identified significant mortality risk association for mutual effects of never-smokers, ex-smokers, and low cholesterol for non-CVD. However, there is significant protective association for current-smokers and low cholesterol for CVD.

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The relationship between telomere length and mortality risk in non-model vertebrate systems: a meta-analysis

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2016.0447 ◽

2018 ◽

Vol 373 (1741) ◽

pp. 20160447 ◽

Cited By ~ 67

Author(s):

Rachael V. Wilbourn ◽

Joshua P. Moatt ◽

Hannah Froy ◽

Craig A. Walling ◽

Daniel H. Nussey ◽

...

Keyword(s):

Telomere Length ◽

Mortality Risk ◽

Evolutionary Biology ◽

Meta Analysis ◽

Theme Issue ◽

Hazard Ratios ◽

Laboratory Rodents ◽

The Relationship ◽

Risk Association

Telomere length (TL) has become a biomarker of increasing interest within ecology and evolutionary biology, and has been found to predict subsequent survival in some recent avian studies but not others. Here, we undertake the first formal meta-analysis to test whether there is an overall association between TL and subsequent mortality risk in vertebrates other than humans and model laboratory rodents. We identified 27 suitable studies and obtained standardized estimates of the hazard ratio associated with TL from each. We performed a meta-analysis on these estimates and found an overall significant negative association implying that short telomeres are associated with increased mortality risk, which was robust to evident publication bias. While we found that heterogeneity in the hazard ratios was not explained by sex, follow-up period, maximum lifespan or the age group of the study animals, the TL–mortality risk association was stronger in studies using qPCR compared to terminal restriction fragment methodologies. Our results provide support for a consistent association between short telomeres and increased mortality risk in birds, but also highlight the need for more research into non-avian vertebrates and the reasons why different telomere measurement methods may yield different results. This article is part of the theme issue ‘Understanding diversity in telomere dynamics’.

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Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men

International Journal of Epidemiology ◽

10.1093/ije/dyab060 ◽

2021 ◽

Author(s):

Jia Huang Lin ◽

Chi Pang Wen ◽

Chao Qiang Jiang ◽

Jian-Min Yuan ◽

Chien Jen Chen ◽

...

Keyword(s):

Meta Analysis ◽

Nasopharyngeal Cancer ◽

Population Based ◽

Individual Participant Data ◽

Tobacco Control Policies ◽

Hazard Ratios ◽

Smoking Exposure ◽

Drinking Status ◽

Individual Participant ◽

Never Smokers

Abstract Background The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC. Methods We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status. Results During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26). Conclusions This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12–16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.

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The effect of preloading statins prior to primary reperfusion on in-hospital mortality risk in a contemporary large-scale cohort of patients with ST-elevation myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1464 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Fu ◽

C.X Song ◽

X.D Li ◽

Y.J Yang

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Mortality ◽

Mortality Risk ◽

Large Scale ◽

Reperfusion Therapy ◽

St Elevation Myocardial Infarction ◽

Control Group ◽

Funding Source ◽

St Elevation

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p<0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

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Association with Longevity of Phosphatidylinositol 3-Kinase Regulatory Subunit 1 Gene Variants Stems from Protection against Mortality Risk in Men with Cardiovascular Disease

Gerontology ◽

10.1159/000515390 ◽

2021 ◽

pp. 1-9

Author(s):

Timothy A. Donlon ◽

Randi Chen ◽

Kamal H. Masaki ◽

Bradley J. Willcox ◽

Brian J. Morris

Keyword(s):

Cardiovascular Disease ◽

Life Span ◽

Mortality Risk ◽

Regulatory Subunit ◽

Phosphatidylinositol 3 Kinase ◽

Survival Curves ◽

Genotypic Effect ◽

Hazard Ratios ◽

Phosphatidylinositol 3

Introduction: Genetic variation in the phosphatidylinositol 3-kinase reregulatory subunit 1 gene (PIK3R1) is associated with longevity. Objective: The aim of the study was to determine whether cardiovascular disease (CVD) affects this association. Methods: We performed a longitudinal study of longevity-associated PIK3R1 single-nucleotide polymorphism rs7709243 genotype by CVD status in 3,584 elderly American men of Japanese ancestry. Results: At baseline (1991–1993), 2,254 subjects had CVD and 1,314 did not. The follow-up until Dec 31, 2019 found that overall, men with a CVD had higher mortality than men without a CVD (p = 1.7 × 10−5). However, survival curves of CVD subjects differed according to PIK3R1 genotype. Those with longevity-associated PIK3R1 TT/CC had survival curves similar to those of subjects without a CVD (p = 0.11 for TT/CC, and p = 0.054 for TC), whereas survival curves for CVD subjects with the CT genotype were significantly attenuated compared with survival curves of subjects without a CVD (p = 0.0000012 compared with TT/CC, and p = 0.0000028 compared with TC). Men without CVD showed no association of longevity-associated genotype with life span (p = 0.58). Compared to subjects without any CVD, hazard ratios for mortality risk were 1.26 (95% CI, 1.14–1.39; p = 0.0000043) for CT subject with CVD and 1.07 (95% CI 0.99–1.17; p = 0.097) for CC/TT subjects with CVD. There was no genotypic effect on life span for 1,007 subjects with diabetes and 486 with cancer. Conclusion: Our study provides novel insights into the basis for PIK3R1 as a longevity gene. We suggest that the PIK3R1 longevity genotype attenuates mortality risk in at-risk individuals by protection against cellular stress caused by CVD.

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Plasma Branched-Chain Amino Acids and Incident Cardiovascular Disease in the PREDIMED Trial

Clinical Chemistry ◽

10.1373/clinchem.2015.251710 ◽

2016 ◽

Vol 62 (4) ◽

pp. 582-592 ◽

Cited By ~ 91

Author(s):

Miguel Ruiz-Canela ◽

Estefania Toledo ◽

Clary B Clish ◽

Adela Hruby ◽

Liming Liang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Amino Acids ◽

Cardiovascular Death ◽

Branched Chain Amino Acids ◽

Control Group ◽

Cvd Risk ◽

Hazard Ratios ◽

Increased Risk ◽

Branched Chain

Abstract BACKGROUND The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean diet (MedDiet) intervention may counteract this effect. METHODS We developed a case-cohort study within the Prevención con Dieta Mediterránea (PREDIMED), with 226 incident CVD cases and 744 noncases. We used LC-MS/MS to measure plasma BCAAs (leucine, isoleucine, and valine), both at baseline and after 1 year of follow-up. The primary outcome was a composite of incident stroke, myocardial infarction, or cardiovascular death. RESULTS After adjustment for potential confounders, baseline leucine and isoleucine concentrations were associated with higher CVD risk: the hazard ratios (HRs) for the highest vs lowest quartile were 1.70 (95% CI, 1.05–2.76) and 2.09 (1.27–3.44), respectively. Stronger associations were found for stroke. For both CVD and stroke, we found higher HRs across successive quartiles of BCAAs in the control group than in the MedDiet groups. With stroke as the outcome, a significant interaction (P = 0.009) between baseline BCAA score and intervention with MedDiet was observed. No significant effect of the intervention on 1-year changes in BCAAs or any association between 1-year changes in BCAAs and CVD were observed. CONCLUSIONS Higher concentrations of baseline BCAAs were associated with increased risk of CVD, especially stroke, in a high cardiovascular risk population. A Mediterranean-style diet had a negligible effect on 1-year changes in BCAAs, but it may counteract the harmful effects of BCAAs on stroke.

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Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

Blood Purification ◽

10.1159/000430903 ◽

2015 ◽

Vol 40 (1) ◽

pp. 53-58 ◽

Cited By ~ 1

Author(s):

Camiel L.M. de Roij van Zuijdewijn ◽

Menso J. Nubé ◽

Piet M. ter Wee ◽

Peter J. Blankestijn ◽

Renée Lévesque ◽

...

Keyword(s):

Confidence Intervals ◽

Mortality Risk ◽

Survival Benefit ◽

Regression Models ◽

Cox Regression ◽

Treatment Time ◽

High Volume ◽

P Values ◽

Hazard Ratios

Background/Aims: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time. Methods: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable. Results: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap. Conclusion: The survival benefit of high-volume HDF over HD is independent of treatment time.

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Association between Socioeconomic Status (SES) and Mortality Risk of Gastroenteropancreatic–Neuroendocrine Tumors (GEP–NETs): A Large-Scale Population Study

SSRN Electronic Journal ◽

10.2139/ssrn.4005190 ◽

2022 ◽

Author(s):

You Zeng ◽

Haohui Yu ◽

Queran Lin ◽

Pengpeng Ye ◽

Junrun Zhang ◽

...

Keyword(s):

Socioeconomic Status ◽

Neuroendocrine Tumors ◽

Population Study ◽

Mortality Risk ◽

Large Scale ◽

Gastroenteropancreatic Neuroendocrine Tumors ◽

Scale Population

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Abstract 3481: A Prospective Comparison of NMR-Measured LDL Particle Number, Apolipoprotein B100, and Standard Lipids with Incident CHD in 27,673 Initially Healthy Women

Circulation ◽

10.1161/circ.116.suppl_16.ii_787-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Samia Mora ◽

James Otvos ◽

Julie E Buring ◽

Nader Rifai ◽

Paul M Ridker

Keyword(s):

Prospective Cohort ◽

Large Scale ◽

Particle Number ◽

Proton Nuclear Magnetic Resonance ◽

Resonance Spectroscopy ◽

Healthy Women ◽

Prospective Comparison ◽

Chd Risk ◽

Hazard Ratios ◽

Apolipoprotein B100

Background While ATP-III recommends measurement of total and HDL cholesterol (HDL-C) as part of coronary risk assessment, measurement of LDL particle number (LDL-P) is not currently recommended. Methods and Results In a prospective cohort of 27,673 initially healthy women, baseline LDL-P was measured by proton nuclear magnetic resonance spectroscopy, apolipoprotein B100 (ApoB) was measured using an immunoturbidimetric assay, and standard lipids were directly measured. LDL-P correlated with LDL cholesterol (LDL-C; r=0.62), ApoB (0.84), non HDL-C (0.74), and total:HDL-C ratio (0.80). During a mean follow-up of 11 years, 668 incident coronary heart disease (CHD) events occurred. Using the lowest quintile as the reference, and adjusting for age, smoking, blood pressure, diabetes, menopause, hormone use, and body mass index, the association of LDL-P with CHD was stronger than LDL-C (Table ), and comparable in magnitude to ApoB, non HDL-C and total:HDL-C ratio. In a subgroup analysis of women with LDL-C<100 mg/dL, elevations in LDL-P, ApoB, non HDL-C, or total:HDL-C ratio were all separately associated with higher CHD risk (P<0.001 for all). Both LDL-P and ApoB remained associated with CHD after additionally adjusting for total cholesterol, HDL-C, and triglycerides (hazard ratios for top vs bottom quintile: 2.03 [95% CI 1.27–3.24] for LDL-P, and 3.08 [95% CI 1.92– 4.93] for ApoB) overall, and similarly in women with LDL-C<100 mg/dL (2.77 [95%CI 1.05–7.29] for LDL-P and 2.62 [95%CI 0.97–7.05] for ApoB). Conclusions In this large-scale prospective cohort, elevations in NMR-measured LDL particle number were significantly associated with incident CHD, with a magnitude of risk not substantially different from ApoB, non HDL-C, or total:HDL-C ratio. Among women with LDL-C <100mg/dL, elevations in LDL-P, ApoB, non HDL-C, and total:HDL-C ratio all carried higher CHD risk. Risk Factor-Adjusted Hazard Ratios for Incident CHD

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Relationship between Cardiovascular Disease Risk and Neck Circumference Shown in the Systematic Coronary Risk Estimation (SCORE) Risk Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010763 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10763

Author(s):

Serkan Asil ◽

Ender Murat ◽

Hatice Taşkan ◽

Veysel Özgür Barış ◽

Suat Görmel ◽

...

Keyword(s):

Mortality Risk ◽

Cardiovascular Mortality ◽

Risk Model ◽

Disease Risk ◽

Neck Circumference ◽

Anthropometric Measurements ◽

Cvd Risk ◽

Cardiovascular Mortality Risk ◽

Very High ◽

Score Risk

Introduction: The most important way to reduce CVD-related mortality is to apply appropriate treatment according to the risk status of the patients. For this purpose, the SCORE risk model is used in Europe. In addition to these risk models, some anthropometric measurements are known to be associated with CVD risk and risk factors. Objectives: This study aimed to investigate the association of these anthropometric measurements, especially neck circumference (NC), with the SCORE risk chart. Methods: This was planned as a cross-sectional study. The study population were classified according to their SCORE risk values. The relationship of NC and other anthropometric measurements with the total cardiovascular risk indicated by the SCORE risk was investigated. Results: A total of 232 patients were included in the study. The patients participating in the study were analysed in four groups according to the SCORE ten-year total cardiovascular mortality risk. As a result, the NC was statistically significantly lower among the SCORE low and moderate risk group than all other SCORE risk groups (low-high and very high 36(3)–38(4) (IQR) p: 0.026, 36(3)–39(4) (IQR) p < 0.001, 36(3)–40(4) (IQR) p < 0.001), (moderate-high and very high 38(4) vs. 39(4) (IQR) p: 0.02, 38(4) vs. 40(4) (IQR) p < 0.001, 39(4) vs. 40(4) (IQR) p > 0.05). NC was found to have the strongest correlation with SCORE than the other anthropometric measurements. Conclusions: Neck circumference correlates strongly with the SCORE risk model which shows the ten-year cardiovascular mortality risk and can be used in clinical practice to predict CVD risk.

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Relative water content consistently predicts drought mortality risk in seedling populations with different morphology, physiology, and times to death

10.1101/2020.12.08.416917 ◽

2020 ◽

Author(s):

Gerard Sapes ◽

Anna Sala

Keyword(s):

Water Content ◽

Real Time ◽

Pinus Ponderosa ◽

Mortality Risk ◽

Relative Water Content ◽

Large Scale ◽

Water Status ◽

Physiological Indicators ◽

Relative Water ◽

Global Impacts

AbstractPredicted increases in forest drought mortality highlight the need for predictors of incipient drought-induced mortality (DIM) risk that enable proactive large-scale management. Such predictors should be consistent across plants with varying morphology and physiology. Because of their integrative nature, indicators of water status are promising candidates for real time monitoring of DIM, particularly if they standardize morphological differences among plants. We assessed the extent to which differences in morphology and physiology between Pinus ponderosa populations influence time to mortality and the predictive power of key indicators of DIM risk. Time to incipient mortality differed between populations but occurred at the same relative water content (RWC) and water potential (WP). RWC and WP were more accurate predictors of drought mortality risk than other physiological indicators, including non-structural carbohydrate (NSC) content and percent loss of conductivity (PLC). These results highlight that variables related to water status capture critical thresholds during DIM and the associated dehydration processes. Both WP and RWC are promising candidates for large-scale assessments of DIM risk. RWC is of special interest because it allows comparisons across different morphologies and can be remotely sensed. Our results offer promise for real time landscape-level monitoring of DIM and its global impacts.

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