scholarly journals Mortality in a Cohort of Men Expressing the Glucose-6-Phosphate Dehydrogenase Deficiency

Blood ◽  
1998 ◽  
Vol 91 (2) ◽  
pp. 706-709
Author(s):  
Pierluigi Cocco ◽  
Pierfelice Todde ◽  
Susanna Fornera ◽  
Maria Bonaria Manca ◽  
Pierina Manca ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Hodgkin’S Lymphoma ◽  
Ischemic Heart ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Glucose 6 Phosphate Dehydrogenase

The objective of this study was to test the hypothesis of a lower mortality from cancer and cardiovascular diseases among men expressing glucose-6-phosphate dehydrogenase (G6PD) deficiency. We designed a mortality study based on death certificates from January 1, 1982 through December 31, 1992 in a cohort of G6PD-deficient men. Cohort members were 1,756 men, identified as expressing the G6PD-deficient phenotype during a 1981 population screening of the G6PD polymorphism. The setting was the island of Sardinia, Italy. Outcome measures were cause-specific standardized mortality ratios (SMRs), which were computed as 100 times the observed/expected ratio, with the general Sardinian male population as the reference. Deaths from all causes were significantly less than expected due to decreased SMRs for ischemic heart disease (SMR, 28; 95% confidence interval [CI], 10 to 62), cerebrovascular disease (SMR, 22; 95% CI, 6 to 55), and liver cirrhosis (SMR, 12; 95% CI, 0 to 66), which explained 95.6% of the deficit in total mortality. All cancer mortality was close to the expectation, with a significant increase in the SMR for non-Hodgkin's lymphoma (SMR, 545; 95% CI, 147 to 1,395). A decrease in mortality from cardiovascular diseases was one of the study hypotheses, based on an earlier human report and experimental evidence. However, selection bias is also a likely explanation. Further analytic studies are warranted to confirm whether subjects expressing the G6PD-deficient phenotype are protected against ischemic heart disease and cerebrovascular disease. This cohort study is consistent with more recent case-control studies in rejecting the hypothesis of a decreased cancer risk among G6PD-deficient subjects. The observed increase in mortality from non-Hodgkin's lymphoma and decrease in mortality from liver cirrhosis were not previously reported.

scholarly journals Mortality in a Cohort of Men Expressing the Glucose-6-Phosphate Dehydrogenase Deficiency

Blood ◽  
1998 ◽  
Vol 91 (2) ◽  
pp. 706-709 ◽  
Author(s):  
Pierluigi Cocco ◽  
Pierfelice Todde ◽  
Susanna Fornera ◽  
Maria Bonaria Manca ◽  
Pierina Manca ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Hodgkin’S Lymphoma ◽  
Ischemic Heart ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract The objective of this study was to test the hypothesis of a lower mortality from cancer and cardiovascular diseases among men expressing glucose-6-phosphate dehydrogenase (G6PD) deficiency. We designed a mortality study based on death certificates from January 1, 1982 through December 31, 1992 in a cohort of G6PD-deficient men. Cohort members were 1,756 men, identified as expressing the G6PD-deficient phenotype during a 1981 population screening of the G6PD polymorphism. The setting was the island of Sardinia, Italy. Outcome measures were cause-specific standardized mortality ratios (SMRs), which were computed as 100 times the observed/expected ratio, with the general Sardinian male population as the reference. Deaths from all causes were significantly less than expected due to decreased SMRs for ischemic heart disease (SMR, 28; 95% confidence interval [CI], 10 to 62), cerebrovascular disease (SMR, 22; 95% CI, 6 to 55), and liver cirrhosis (SMR, 12; 95% CI, 0 to 66), which explained 95.6% of the deficit in total mortality. All cancer mortality was close to the expectation, with a significant increase in the SMR for non-Hodgkin's lymphoma (SMR, 545; 95% CI, 147 to 1,395). A decrease in mortality from cardiovascular diseases was one of the study hypotheses, based on an earlier human report and experimental evidence. However, selection bias is also a likely explanation. Further analytic studies are warranted to confirm whether subjects expressing the G6PD-deficient phenotype are protected against ischemic heart disease and cerebrovascular disease. This cohort study is consistent with more recent case-control studies in rejecting the hypothesis of a decreased cancer risk among G6PD-deficient subjects. The observed increase in mortality from non-Hodgkin's lymphoma and decrease in mortality from liver cirrhosis were not previously reported.

Abstract 325: Readmission among Hospitalized Patients with Non-Valvular Atrial Fibrillation

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Karen E Smoyer-Tomic ◽  
Kimberly Siu ◽  
Barbara Johnson ◽  
David R Walker ◽  
Stephen Sander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Readmission Rate ◽  
Ischemic Heart ◽  
Index Admission ◽  
Readmission Rates ◽  
Diagnosis Codes

Background: An important goal of healthcare reform is reducing the need for hospital readmissions. This study examined readmission rates, reasons for readmissions, and risk factors associated with readmissions in non-valvular atrial fibrillation (NVAF) patients, which may facilitate identification of potential gaps in care. Methods: Patients with AF hospitalizations in any diagnostic position in 2004-2009 were extracted from a large, national commercial and Medicare supplemental administrative claims database. Patients with valvular or transient causes of AF, under the age of 18 years, pregnant, or dead at discharge were excluded from the study. All patients had at least 30 days follow up from the index hospitalization discharge date. Readmission rate within 30 days of discharge date was calculated. Reasons for readmission were reported by ICD-9 diagnosis codes in the primary position. ICD-9 diagnosis codes were grouped into common acute conditions (e.g., ischemic heart disease, cerebrovascular disease) and reported. Logistic regression analyses were conducted to identify risk factors for readmission, controlling for patients’ demographic and clinical characteristics. Results: A total of 6439 patients met the study criteria. The overall 30-day readmission rate was 18.0%. Readmission rates for patients with AF as primary or secondary diagnosis in index admissions were 11.8% and 20.3%, respectively (p<0.001). Readmissions on average occurred 9.7 (SD 9.0) days from index admission discharge, with a mean readmission length of stay (LOS) of 7.4 (SD 8.0) days. The 4 most common grouped diagnoses for readmissions were AF (ICD-9 code 427.31, 10.2% of all readmissions), ischemic heart disease (IHD; 410.xx - 414.xx, 7.2%), heart failure (HF; 428.xx, 7.1%), and cerebrovascular disease (CVD; 430.xx - 438.xx, 6.0%). Longer LOS in the index admission, higher Charlson comorbidity index, and emergency room admission for the index admission all significantly increased the likelihood of having a readmission (p<0.001 in all cases). Patients discharged to home from index admission, patients with AF as primary diagnosis in index admissions, and patients living in the South region were less likely to be readmitted (p<0.01 in all cases). Conclusions: Almost one fifth of patients with NVAF were readmitted within 30 days of discharge. AF, IHD, HF, and CVD were the most common reasons for readmission. Identification of risk factors for readmission may assist healthcare providers in targeting good clinical practice aimed at improving quality of care and reducing the need for readmissions.

Potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease

Amino Acids ◽  
2016 ◽  
Vol 48 (8) ◽  
pp. 1955-1967 ◽  
Author(s):  
Maurizio Balestrino ◽  
Matteo Sarocchi ◽  
Enrico Adriano ◽  
Paolo Spallarossa
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Ischemic Heart

HOMOARGININE LEVEL AND METHIONINE-HOMOCYSTEINE BALANCE IN PATIENTS WITH ISCHEMIC HEART DISEASE

2019 ◽  
Vol 64 (9) ◽  
pp. 516-524
Author(s):  
A. A. Zhloba ◽  
T. F. Subbotina ◽  
N. S. Molchan ◽  
Yu. S. Polushin
Keyword(s):  
Amino Acids ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischemic Heart Disease ◽  
Statistical Significance ◽  
Artery Bypass ◽  
Prognostic Significance ◽  
Ischemic Heart ◽  
Impaired Metabolism ◽  
Total Homocysteine

The level of homoarginine (hArg) in terms of prognostic significance may exceed the natriuretic peptides and other well-known markers according to the latest data about the progression of cardiovascular diseases. The lack of data on the association of hArg levels with levels of other metabolites makes it difficult to understand its role in the pathogenesis of cardiovascular diseases. Relationships of hArg and other amino acids, including methionine (Met) and total homocysteine (tHcy), and their ratio in patients with ischemic heart disease were evaluated. The study included 74 patients with coronary heart disease (57 men and 17 women) aged 62 (57 - 67) years before coronary artery bypass surgery and 27 healthy people of similar age. In patients, the level of hArg was almost 2 times lower (p <0.05) than in healthy individuals and rates lower than 1.4 μM were in half of them. The statistically significant decrease (p = 0.0025) of the Met/tHcy ratio corresponded to a decrease in the level of hArg. This ratio did not correlate with glucose level or body mass index. Less statistical significance of hArg correlation with levels of Met or tHcy separately was observed. In the subgroup of patients with hAarg level above 2.1 μM, a lower incidence of myocardial infarction was noted. Thus, a low hArg level is associated with impaired metabolism of sulfur-containing amino acids involved in transmethylation reactions, in patients with ischemic heart disease. The Met/tHcy ratio, closely correlating with the level of hArg, apparently reveals a link between the reactions of creatine formation and transmethylation, highlighting a cohort of patients with the most profound and dangerous changes in tissue metabolism.

Longevity and Diet in Okinawa, Japan: The Past, Present and Future

2003 ◽  
Vol 15 (1_suppl) ◽  
pp. S3-S9 ◽  
Author(s):  
S Miyagi ◽  
N Iwama ◽  
T Kawabata ◽  
K Hasegawa
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Daily Intake ◽  
National Average ◽  
Ischemic Heart ◽  
Meat Intake ◽  
The Past ◽  
Life Expectancy At Birth ◽  
Okinawa Prefecture

Japan has the longest life expectancy at birth (LEB) in the world. Okinawa, Japan's poorest prefecture, previously had the highest longevity indices in the country. However, the latest LEB for men in Okinawa is no higher than the national average. The purpose of this study is to examine why the longevity indices in Okinawa were once the highest in Japan, and to examine the reasons for their recent decline. In 1990, in Okinawa, the age-adjusted death rates (ADR) of the three leading causes of death were lower than their national averages. By 2000, the standard mortality ratios (SMR, Japan=100) of heart disease and cerebrovascular disease for both sexes in Okinawa had increased, compared to their 1990 levels. Both of the ADR of ischemic heart disease and the ADR of cerebrovascular disease for men increased to 45.5 and 63.5 in 2000, up from 42.9 and 59.1 in 1990, respectively, and the SMR of ischemic heart disease for men in Okinawa reached 101 in 2000. Consequently, the national ranking of Okinawa prefecture for LEB of men has dropped. As of 1988, in Okinawa, daily intake of meat and daily intake of pulses were both approximately 90 grams, which is about 20% and 30% higher than the national average, respectively. Also, as of 1988, daily intake of green and yellow vegetables in Okinawa was about 50% higher than the national average. However, by 1998, daily meat intake and fat energy ratio had surpassed 100 grams and 30%, respectively, and daily intake of pulses and green and yellow vegetables had declined to the level of the national average. Recently, young Japanese, particularly young men in Okinawa, have shown a tendency to avoid the traditional dishes of stewed meat and champuru.

Doxorubicin, Cardiac Risk Factors, and Cardiac Toxicity in Elderly Patients With Diffuse B-Cell Non-Hodgkin's Lymphoma

2008 ◽  
Vol 26 (19) ◽  
pp. 3159-3165 ◽  
Author(s):  
Dawn L. Hershman ◽  
Russell B. McBride ◽  
Andrew Eisenberger ◽  
Wei Yann Tsai ◽  
Victor R. Grann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Elderly Patients ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cardiac Risk ◽  
Hodgkin's Lymphoma ◽  
Cardiac Risk Factors ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Purpose Anthracycline-based chemotherapy, which improves survival for patients with non-Hodgkin's lymphoma, is often withheld from elderly patients because of its cardiotoxicity. We studied the cardiac effects of doxorubicin in a population-based sample of older patients with diffuse large B-cell lymphoma (DLBCL). Patients and Methods Among patients age ≥ 65 years diagnosed with DLBCL from 1991 to 2002 in the Surveillance, Epidemiology, and End Results–Medicare database, we developed logistic regression models of the associations of doxorubicin with demographic, clinical, and cardiac variables. We then developed Cox proportional hazards models of the association between doxorubicin and subsequent congestive heart failure (CHF), taking predictors of CHF into account. Results Of 9,438 patients with DLBCL, 3,164 (42%) received doxorubicin-based chemotherapy. Any doxorubicin use was associated with a 29% increase in risk of CHF (95% CI, 1.02 to 1.62); CHF risk increased with number of doxorubicin claims, increasing age, prior heart disease, comorbidities, diabetes, and hypertension; hypertension intensified the effect of doxorubicin on risk of CHF (hazard ratio = 1.8; P < .01). In the 8 years after diagnosis, the adjusted CHF-free survival rate was 74% in doxorubicin-treated patients versus 79% in patients not treated with doxorubicin. Conclusion Among patients receiving chemotherapy for DLBCL, those with prior heart disease were less likely than others to be treated with doxorubicin, and those who received doxorubicin were more likely than others to develop CHF. Various cardiac risk factors increased CHF risk, but only hypertension was synergistic with doxorubicin. Doxorubicin has dramatically improved survival of DLBCL patients; nonetheless, some subgroups may benefit from efforts to reduce doxorubicin-related CHF risk.

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