scholarly journals Cardiovascular Disease is a Leading Cause of Mortality among TTP Survivors in Clinical Remission

2021 ◽  
Author(s):  
Senthil Sukumar ◽  
Max Alexander Brodsky ◽  
Sarah Hussain ◽  
Lisa R Yanek ◽  
Alison R. Moliterno ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cause Of Death ◽  
Reference Population ◽  
Ohio State University ◽  
State University ◽  
Risk Of Death ◽  
Long Term Follow Up ◽  
The Ohio State University

iTTP survivors experience high rates of adverse health sequelae and increased mortality over long-term follow up. We conducted this multi-center cohort study to evaluate long-term mortality and causes of death in iTTP survivors. Between 2003 and 2020, 222 patients were enrolled in the Ohio State University and Johns Hopkins TTP registries and followed for a median of 4.5 (interquartile range [IQR],75 0.4-11.5) years. Nine patients died during their first iTTP episode and 29 patients died during follow-up. Mortality rate was 1.8 times higher than expected from an age, sex and race adjusted reference population. Cardiovascular disease was a leading primary cause of death (27.6%) tied with relapsed iTTP (27.6%), followed by malignancy (20.7%), infection (13.8%), and other causes (10.3%). Male sex [HR 3.74 (95% CI 1.65-8.48, P=0.002), increasing age [HR 1.04 (95% CI 1.01-1.07), P=0.011] and number of iTTP episodes [HR 1.10 (95% CI 1.01-1.20), P=0.022] were associated with mortality in a model adjusted for African American race [HR 0.70 (95% CI 0.30-1.65), P=0.702], hypertension [HR 0.47 (95% CI 0.20-1.08), P=0.076], CKD [HR 1.46 (95% CI 0.65-3.30, P=0.358] and site [HR 1.46 (95% CI 0.64-3.30), P=0.358]. There was a trend towards shorter survival in patients with lower ADAMTS13 activity during remission (P=0.078). In conclusion, iTTP survivors are at higher risk of death compared with a reference population and cardiovascular disease is a leading cause of death. Our study highlights the need for survivorship care, and investigation focused on cardiovascular disease and early mortality in TTP survivors.

Cardiology Fellowship Education in the Era of High-density Training, Data Tracking, and Quality Measures

2011 ◽  
Vol 9 (2) ◽  
pp. 99
Author(s):  
Alex J Auseon ◽  
Albert J Kolibash ◽  
◽  
Keyword(s):  
Ohio State University ◽  
Training Data ◽  
State University ◽  
Training Requirements ◽  
Healthcare Environment ◽  
Medical Centers ◽  
Work Hour ◽  
The Ohio State University ◽  
Data Tracking

Background:Educating trainees during cardiology fellowship is a process in constant evolution, with program directors regularly adapting to increasing demands and regulations as they strive to prepare graduates for practice in today’s healthcare environment.Methods and Results:In a 10-year follow-up to a previous manuscript regarding fellowship education, we reviewed the literature regarding the most topical issues facing training programs in 2010, describing our approach at The Ohio State University.Conclusion:In the midst of challenges posed by the increasing complexity of training requirements and documentation, work hour restrictions, and the new definitions of quality and safety, we propose methods of curricula revision and collaboration that may serve as an example to other medical centers.

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

scholarly journals Prognostic role of neoplastic markers in Takotsubo syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesco Santoro ◽  
Tecla Zimotti ◽  
Adriana Mallardi ◽  
Alessandra Leopizzi ◽  
Enrica Vitale ◽  
...  
Keyword(s):  
Serum Levels ◽  
Takotsubo Syndrome ◽  
Ca 15.3 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ca 19.9 ◽  
Long Term Follow Up

AbstractTakotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9–14.8, HR = 7.8 95% CI 2.4–25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6–52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

COVID-19 and hematologic diseases: Risk factors and long-term follow-up of CHRONOS19 Registry.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18715-e18715
Author(s):  
Kristina Zakurdaeva ◽  
Olga A. Gavrilina ◽  
Anastasia N. Vasileva ◽  
Sergei Dubov ◽  
Vitaly S. Dubov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Disease Progression ◽  
Primary Endpoint ◽  
Acute Leukemias ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Long Term Follow Up

e18715 Background: Pts with hem diseases are at high risk of COVID-19 severe course and mortality. Emerging data on risk factors and outcomes in this patient population is of great value for developing strategies of medical care. Methods: CHRONOS19 is an ongoing nationwide observational cohort study of adult (≥18 y) pts with hem disease (both malignant and non-malignant) and lab-confirmed or suspected (clinical symptoms and/or CT) COVID-19. Primary objective was to evaluate treatment outcomes. Primary endpoint was 30-day all-cause mortality. Long-term follow-up was performed at 90 and 180 days. Data from 14 centers was collected on a web platform and managed in a deidentified manner. Results: As of data cutoff on January 27, 2021, 575 pts were included in the registry, 486 of them eligible for primary endpoint assessment, n(%): M/F 243(50%)/243(50%), median age 56 [18-90], malignant disease in 452(93%) pts, induction phase/R/R/remission 160(33%)/120(25%)/206(42%). MTA in 93(19%) pts, 158(33%) were transfusion dependent, comorbidities in 278(57%) pts. Complications in 335(69%) pts: pneumonia (67%), CRS (8%), ARDS (7%), sepsis (6%). One-third of pts had severe COVID-19, 25% were admitted to ICU, 20% required mechanical ventilation. All-cause mortality at 30 days – 17%; 80% due to COVID-19 complications. At 90 days, there were 14 new deaths: 6 (43%) due to hem disease progression. Risk factors significantly associated with OS are listed in Tab 1. In multivariate analysis – ICU+mechanical ventilation, HR, 53.3 (29.1-97.8). Acute leukemias were associated with higher risk of death, HR, 2.40 (1.28-4.51), less aggressive diseases (CML, CLL, MM, non-malignant) – with lower risk of death, HR, 0.54 (0.37-0.80). No association between time of COVID-19 diagnosis (Apr-Aug vs. Sep-Jan) and risk of death. COVID-19 affected treatment of hem disease in 65% of pts, 58% experienced treatment delay for a median of 4[1-10] weeks. Relapse rate on Day 30 and 90 – 4%, disease progression on Day 90 detected in 13(7%) pts; 180-day data was not mature at the time of analysis. Several cases of COVID-19 re-infection were described. Conclusions: Thirty-day all-cause mortality in pts with hem disease was higher than in general population with COVID-19. Longer-term follow-up (180 days) for hem disease outcomes and OS will be presented. [Table: see text]

428 The outcome of ICD patients during long-term follow-up: analysis of the cause of death and predictors of survival

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 95-95
Author(s):  
M. Fiek ◽  
B. Zieg ◽  
T. Matis ◽  
A. Hahnefeld ◽  
C.H. Reithmann ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Long Term Follow Up

scholarly journals Using Metabolomics to Classify the Underlying Effects of Multi-Nutrient Supplementation in ADHD Youth

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1351-1351
Author(s):  
Madeline Stern ◽  
Leanna Perez ◽  
Jeanette Johnstone ◽  
Barbara Gracious ◽  
Brenda Leung ◽  
...  
Keyword(s):  
Medical Center ◽  
Ohio State University ◽  
State University ◽  
Adhd Symptoms ◽  
Open Label ◽  
Nutrient Supplementation ◽  
Open Label Phase ◽  
The Ohio State University ◽  
Double Blinded

Abstract Objectives Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder commonly diagnosed in childhood. Current pharmaceutical treatment options provide a poor long-term risk: benefit ratio with little knowledge of the long-term effects. A broad-spectrum multi-nutrient formula has shown promise in children, but its effects on nutrient status and the underlying metabolome interactions have not been characterized. Methods Blood samples from medication-free children (n = 74) with ADHD enrolled in a double–blind randomized placebo-controlled multinutrient trial (RCT) were collected at baseline and 8 weeks post-intervention. Following RCT is an 8-week open label phase during which all participants took the active supplement. Symptoms were assessed using the Child and Adolescent Symptom Inventory 5. Double-blinded plasma samples will be analyzed for tyrosine, phenylalanine, tryptophan, magnesium, and zinc. Untargeted LC-MS metabolomics using HILIC chromatography and a high resolution QTof will assess very polar analytes in plasma extracts. Linear modeling will elucidate the influence of treatment, sampling time, and ADHD symptom score on plasma nutrient and plasma metabolite concentration. Results Preliminary findings of the open label phase show a significant improvement in inattention (P = 0.0435), hyperactivity (P = 0.0068), ODD (P = 0.0108) and DMDD (P = 0.0119). We hypothesize that these improvements in ADHD symptoms will be correlated with increased circulating concentrations of tyrosine, phenylalanine, tryptophan, magnesium, zinc, and metabolites involved in neurotransmitter synthesis and/or branched chain amino acid metabolism. Conclusions Preliminary findings indicate improvements of ADHD symptoms of inattention, hyperactivity, ODD and DMDD following 8 weeks of open label multi-nutrient supplementation. Results of the double-blinded phase are expected to mirror those observed in the open label phase, with increases in nutrients in those receiving the multinutrient. Funding Sources The sample analyses were supported by NIH Award Number Grant P30 CA016058, OSU, and OSUCCC. Foundation for the Center of Excellence in Mental Health, Canada; The Ohio State University Department of Human Sciences, College of Education and Human Ecology; The Ohio State University Wexner Medical Center, Clinical Research Center.

Resolution of abnormal cardiac MRI T2 signal following immune suppression for cardiac sarcoidosis

2016 ◽  
Vol 64 (6) ◽  
pp. 1148-1150 ◽  
Author(s):  
Elliott D Crouser ◽  
Emily Ruden ◽  
Mark W Julian ◽  
Subha V Raman
Keyword(s):  
Immune Suppression ◽  
Cardiac Sarcoidosis ◽  
T2 Mapping ◽  
Ohio State University ◽  
State University ◽  
Gadolinium Enhancement ◽  
Cardiac Damage ◽  
The Ohio State University ◽  
Objective Improvement

Cardiac MR (CMR) with late gadolinium enhancement is commonly used to detect cardiac damage in the setting of cardiac sarcoidosis. The addition of T2 mapping to CMR was recently shown to enhance cardiac sarcoidosis detection and correlates with increased cardiac arrhythmia risk. This study was conducted to determine if CMR T2 abnormalities and related arrhythmias are reversible following immune suppression therapy. A retrospective study of subjects with cardiac sarcoidosis with abnormal T2 signal on baseline CMR and a follow-up CMR study at least 4 months later was conducted at The Ohio State University from 2011 to 2015. Immune suppression treated participants had a significant reduction in peak myocardial T2 value (70.0±5.5 vs 59.2±6.1 ms, pretreatment vs post-treatment; p=0.017), and 83% of immune suppression treated subjects had objective improvement in cardiac arrhythmias. Two subjects who had received inadequate immune suppression treatment experienced progression of cardiac sarcoidosis. This report indicates that abnormal CMR T2 signal represents an acute inflammatory manifestation of cardiac sarcoidosis that is potentially reversible with adequate immune suppression therapy.

scholarly journals Multiple major morbidities and increased mortality during long-term follow-up after recovery from thrombotic thrombocytopenic purpura

Blood ◽  
2013 ◽  
Vol 122 (12) ◽  
pp. 2023-2029 ◽  
Author(s):  
Cassandra C. Deford ◽  
Jessica A. Reese ◽  
Lauren H. Schwartz ◽  
Jedidiah J. Perdue ◽  
Johanna A. Kremer Hovinga ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Complete Recovery ◽  
Systemic Lupus ◽  
Thrombocytopenic Purpura ◽  
Risk Of Death ◽  
Chronic Disorder ◽  
Key Points ◽  
Long Term Follow Up

Key Points After recovering from TTP, the prevalence of hypertension, depression, and systemic lupus erythematosus and risk of death are increased. TTP may be a more chronic disorder rather than a disorder of acute episodes and complete recovery.

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