High cytomegalovirus serology and subsequent COPD-related mortality: a longitudinal study

BackgroundPositive serology for cytomegalovirus (CMV) has been associated with all-cause mortality risk but its role in COPD mortality is unknown. The objective of the present study was to assess the relationship between CMV serology and COPD mortality.MethodsWe analysed data from 806 participants in the Tucson Epidemiological Study of Airway Obstructive Disease who, at enrolment, were aged 28–70 years and had completed lung function tests. We tested CMV serology in sera from enrolment and defined “high CMV serology” as being in the highest tertile. Vital status, date and cause of death were assessed through death certificates and/or linkage with the National Death Index up to January 2017. The association of CMV serology with all-cause and cause-specific mortality risk was tested in Cox models adjusted for age, sex, level of education, body mass index, smoking status and pack-years.ResultsHigh CMV serology was marginally associated with all-cause mortality (p=0.071) but the effect was inversely dependent on age, with the association being much stronger among participants <55 years than among participants ≥55 years at enrolment (p-value for CMV-by-age interaction <0.001). Compared with low CMV serology, high CMV serology was associated with mortality from COPD among all subjects (adjusted hazard ratio (HR) 2.38, 95% CI 1.11–5.08; p=0.025) and particularly in subjects <55 years old at enrolment (HR 5.40, 95% CI 1.73–16.9; p=0.004). Consistent with these results, high CMV serology also predicted mortality risk among subjects who already had airflow limitation at enrolment (HR 2.10, 95% CI 1.20–3.68; p=0.009).ConclusionsWe report a strong relationship between CMV serology and the risk of dying from COPD, and thus identify a novel risk factor for COPD mortality.

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Mortality risk and causes of death in patients with non-cystic fibrosis bronchiectasis

Respiratory Research ◽

10.1186/s12931-019-1243-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Sooim Sin ◽

Seo Young Yun ◽

Jee Min Kim ◽

Chang Min Park ◽

Jaeyoung Cho ◽

...

Keyword(s):

Lung Cancer ◽

Mortality Risk ◽

Causes Of Death ◽

Smoking Status ◽

Airflow Limitation ◽

Control Group ◽

Mortality Risks ◽

All Cause Mortality ◽

And Control ◽

Related Mortality

Abstract Background All-cause mortality risk and causes of death in bronchiectasis patients have not been fully investigated. The aim of this study was to compare the mortality risk and causes of death between individuals with bronchiectasis and those without bronchiectasis. Methods Patients with or without bronchiectasis determined based on chest computed tomography (CT) at one centre between 2005 and 2016 were enrolled. Among the patients without bronchiectasis, a control group was selected after applying additional exclusion criteria. We compared the mortality risk and causes of death between the bronchiectasis and control groups without lung disease. Subgroup analyses were also performed according to identification of Pseudomonas or non-tuberculous mycobacteria, airflow limitation, and smoking status. Results Of the total 217,702 patients who underwent chest CT, 18,134 bronchiectasis patients and 90,313 non-bronchiectasis patients were included. The all-cause mortality rate in the bronchiectasis group was 1608.8 per 100,000 person-years (95% confidence interval (CI), 1531.5–1690.0), which was higher than that in the control group (133.5 per 100,000 person-years; 95% CI, 124.1–143.8; P < 0.001). The bronchiectasis group had higher all-cause (adjusted hazard ratio (aHR), 1.26; 95% CI, 1.09–1.47), respiratory (aHR, 3.49; 95% CI, 2.21–5.51), and lung cancer-related (aHR, 3.48; 95% CI, 2.33–5.22) mortality risks than the control group. In subgroup analysis, patients with airflow limitation and ever smokers showed higher all-cause mortality risk among bronchiectasis patients. Therefore, we observed significant interrelation between bronchiectasis and smoking, concerning the risks of all-cause mortality (P for multiplicative interaction, 0.030, RERI, 0.432; 95% CI, 0.097–0.769) and lung cancer-related mortality (RERI, 8.68; 95% CI, 1.631–15.736). Conclusion Individuals with bronchiectasis had a higher risk of all-cause, respiratory, and lung cancer-related mortality compared to control group. The risk of all-cause mortality was more prominent in those with airflow limitation and in ever smokers.

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‘Fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103720 ◽

2021 ◽

pp. bjsports-2020-103720

Author(s):

Julian Alcazar ◽

David Navarrete-Villanueva ◽

Asier Mañas ◽

Alba Gómez-Cabello ◽

Raquel Pedrero-Chamizo ◽

...

Keyword(s):

Older Adults ◽

Waist Circumference ◽

Older People ◽

Multicentre Study ◽

Mortality Risk ◽

Muscle Power ◽

Smoking Status ◽

Relative Power ◽

Fat Percentage ◽

All Cause Mortality

ObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (F+P) (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

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Triiodothyronine (T3), inflammation and mortality risk in patients with acute myocardial infarction

European Thyroid Journal ◽

10.1530/etj-21-0085 ◽

2022 ◽

Author(s):

Salman Razvi ◽

Avais Jabbar ◽

Arjola Bano ◽

Lorna Ingoe ◽

Peter Carey ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Confidence Interval ◽

Mortality Risk ◽

Fold Increase ◽

Lower Serum ◽

Reactive Protein ◽

All Cause Mortality ◽

Relationship Of ◽

The Relationship

Objectives: To study the relationship between serum free T3 (FT3), C-reactive protein (CRP), and all-cause mortality in patients with acute myocardial infarction (AMI). Design: Prospective multicentre longitudinal cohort study. Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST- and non-ST-elevation) patients from the ThyrAMI-1 study. The relationship of FT3 and CRP at baseline with all-cause mortality up to June 2020 was assessed. Mediation analysis was performed to evaluate if CRP mediated the relationship between FT3 and mortality. Results: In 1919 AMI patients [29.2% women, mean (SD) age 64.2 (12.1) years and 48.7% STEMI] followed over a median (inter-quartile range) period of 51 (46 to 58) months, there were 277 (14.4%) deaths. Overall, lower serum FT3 and higher CRP levels were associated with higher risk of mortality. When divided into tertiles based on levels of FT3 and CRP, the group with the lowest FT3 and highest CRP levels had 2.5-fold increase in mortality risk [adjusted hazard ratio (95% confidence interval) of 2.48 (1.82 to 3.16)] compared to the group with the highest FT3 and lowest CRP values. CRP mediated 9.8% (95% confidence interval 6.1 to 15.0%) of the relationship between FT3 and mortality. Conclusions: In AMI patients, lower serum FT3 levels on admission are associated with a higher mortality risk, which is partly mediated by inflammation. Adequately designed trials to explore potential benefits of T3 in AMI patients are required.

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Eosinophil count and mortality risk in incident hemodialysis patients

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz296 ◽

2020 ◽

Vol 35 (6) ◽

pp. 1032-1042

Author(s):

Duk-Hee Kang ◽

Yuji Lee ◽

Carola Ellen Kleine ◽

Yong Kyu Lee ◽

Christina Park ◽

...

Keyword(s):

Mortality Risk ◽

Eosinophil Count ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Time Varying ◽

Cox Proportional Hazards Models ◽

Lower Baseline ◽

All Cause Mortality ◽

Relationship Of ◽

The Relationship

Abstract Background Eosinophils are traditionally known as moderators of allergic reactions; however, they have now emerged as one of the principal immune-regulating cells as well as predictors of vascular disease and mortality in the general population. Although eosinophilia has been demonstrated in hemodialysis (HD) patients, associations of eosinophil count (EOC) and its changes with mortality in HD patients are still unknown. Methods In 107 506 incident HD patients treated by a large dialysis organization during 2007–11, we examined the relationships of baseline and time-varying EOC and its changes (ΔEOC) over the first 3 months with all-cause mortality using Cox proportional hazards models with three levels of hierarchical adjustment. Results Baseline median EOC was 231 (interquartile range 155–339) cells/μL and eosinophilia (>350 cells/μL) was observed in 23.4% of patients. There was a gradual increase in EOC over time after HD initiation with a median ΔEOC of 5.1 (IQR −53–199) cells/μL, which did not parallel the changes in white blood cell count. In fully adjusted models, mortality risk was highest in subjects with lower baseline and time-varying EOC (<100 cells/μL) and was also slightly higher in patients with higher levels (≥550 cells/μL), resulting in a reverse J-shaped relationship. The relationship of ΔEOC with all-cause mortality risk was also a reverse J-shape where both an increase and decrease exhibited a higher mortality risk. Conclusions Both lower and higher EOCs and changes in EOC over the first 3 months after HD initiation were associated with higher all-cause mortality in incident HD patients.

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Circulating angiopoietin-like protein 2 levels and mortality risk in patients receiving maintenance hemodialysis: a prospective cohort study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz236 ◽

2019 ◽

Vol 35 (5) ◽

pp. 854-860 ◽

Cited By ~ 1

Author(s):

Jun Morinaga ◽

Tatsuyuki Kakuma ◽

Hirotaka Fukami ◽

Manabu Hayata ◽

Kohei Uchimura ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Mortality Risk ◽

Prospective Cohort ◽

Premature Aging ◽

Skewed Distribution ◽

Maintenance Hemodialysis ◽

All Cause Mortality ◽

Uremic Patients ◽

The Relationship

Abstract Background Patients undergoing hemodialysis treatment have a poor prognosis, as many develop premature aging. Systemic inflammatory conditions often underlie premature aging phenotypes in uremic patients. We investigated whether angiopoietin-like protein 2 (ANGPTL 2), a factor that accelerates the progression of aging-related and noninfectious inflammatory diseases, was associated with increased mortality risk in hemodialysis patients. Methods We conducted a multicenter prospective cohort study of 412 patients receiving maintenance hemodialysis and evaluated the relationship between circulating ANGPTL2 levels and the risk for all-cause mortality. Circulating ANGPTL2 levels were log-transformed to correct for skewed distribution and analyzed as a continuous variable. Results Of 412 patients, 395 were included for statistical analysis. Time-to-event data analysis showed high circulating ANGPTL2 levels were associated with an increased risk for all-cause mortality after adjustment for age, sex, hemodialysis vintage, nutritional status, metabolic parameters and circulating high-sensitivity C-reactive protein levels {hazard ratio [HR] 2.04 [95% confidence interval (CI) 1.10–3.77]}. High circulating ANGPTL2 levels were also strongly associated with an increased mortality risk, particularly in patients with a relatively benign prognostic profile [HR 3.06 (95% CI 1.86–5.03)]. Furthermore, the relationship between circulating ANGPTL2 levels and mortality risk was particularly strong in patients showing few aging-related phenotypes, such as younger patients [HR 7.99 (95% CI 3.55–18.01)], patients with a short hemodialysis vintage [HR 3.99 (95% CI 2.85–5.58)] and nondiabetic patients [HR 5.15 (95% CI 3.19–8.32)]. Conclusion We conclude that circulating ANGPTL2 levels are positively associated with mortality risk in patients receiving maintenance hemodialysis and that ANGPTL2 could be a unique marker for the progression of premature aging and subsequent mortality risk in uremic patients, except those with significant aging-related phenotypes.

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Cigarette Smoking and All-cause Mortality in Rural Chinese Male Adults:15-year Follow-up of the Anqing Cohort Study

10.21203/rs.3.rs-50083/v1 ◽

2020 ◽

Author(s):

Lijing Ye ◽

Jie Yang ◽

Jingyi Li ◽

Nannan Cheng ◽

Yue Zhang ◽

...

Keyword(s):

Mortality Risk ◽

Smoking Status ◽

Familial Aggregation ◽

Rural China ◽

Significant Risk ◽

Risk Of Death ◽

All Cause Mortality ◽

Former Smokers ◽

Disease Study

Abstract Background — According to the Global Burden of Disease Study 2017, smoking is one of the leading four risk factors contributing to deaths in China. We aimed to evaluate the associations of smoking with all-cause mortality in a Chinese rural population.Methods—Male participants over age 45 (n=5,367) from a large familial aggregation study in rural China, were included in the current analyses. A total of 528 former smokers and 3849 current smokers accounted for 10% and 71.7% of the cohort, respectively. Generalized Estimating Equations were used to evaluate the association between baseline smoking status and mortality, adjusting for pertinent covariates. Results—There were 579 recorded deaths during the 15-year follow-up. Current smokers (odds ratio [OR],1.60; 95% CI,1.23-2.08) had higher all-cause mortality risks than nonsmokers. Relative to nonsmokers, current smokers of more than 40 pack-years ([OR],1.85; 95% CI,1.33-2.56) had a higher all-cause mortality risk. Compared to nonsmokers, current smokers who started smoking before age 20 ([OR],1.91; 95% CI,1.43-2.54) had a higher all-cause mortality risk, and former smokers in the lower pack-year group who quit after age 41 (median) ([OR],3.19; 95% CI,1.83-5.56) also had a higher risk of death after adjustment. Furthermore, former smokers who were also former drinkers had the highest significant risk of mortality than people who never smoke and drink.(P for interaction = 0.034).Conclusions—This study provides evidence that current smokers or former smokers have higher mortality risk than nonsmokers and would benefit from cessation at a younger age.

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Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

10.21203/rs.3.rs-122536/v1 ◽

2020 ◽

Author(s):

Kun He ◽

Wenli Zhang ◽

Xueqi Hu ◽

Hao Zhao ◽

Bingxin Guo ◽

...

Keyword(s):

Older Adults ◽

Mortality Risk ◽

Cox Regression ◽

Cohort Analysis ◽

Relative Effect ◽

Long Term Conditions ◽

Cox Models ◽

Chinese Older Adults ◽

All Cause Mortality ◽

The Impact

Abstract Background: Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the combination of multimorbidity and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/combination) and all-cause mortality in Chinese older adults. Methods: We conducted a population-based study of 50,100 Chinese participants. Cox regression models were used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results: The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted Cox models, the hazard rations (HRs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.10 (1.01-1.20), 1.21 (1.10-1.33), and 1.46 (1.27-1.67), respectively (Ptrend <0.001). In the LTCs ≥ 2 category, the combination of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥ 75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years.Conclusions: The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly combinations.

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The Effect of Smoking on the Relationship between Alcohol Consumption and All-Cause Mortality in Canadian Women

Contemporary Drug Problems ◽

10.1177/009145090503200303 ◽

2005 ◽

Vol 32 (3) ◽

pp. 373-386

Author(s):

Jürgen Rehm ◽

Bo Zhang ◽

Susan Bondy ◽

Mary Jane Ashley ◽

Joanna Cohen ◽

...

Keyword(s):

Alcohol Consumption ◽

Protective Effect ◽

Lower Risk ◽

Smoking Status ◽

Moderate Drinking ◽

Risk Of Mortality ◽

Heavy Drinkers ◽

All Cause Mortality ◽

The Relationship ◽

Effect Of Light

The protective effect of light to moderate drinking on all-cause mortality in general is well established, but there have been questions on its generalizability to women and non-smokers. The present study addresses these questions with a large cohort of Canadian middle-aged women. The key findings indicate that light to moderate drinkers have a markedly lower risk of mortality compared with current abstainers and that this effect is independent of smoking status. Part of this effect may be due to ex-drinkers who are part of the current abstainers group. Heavy drinkers have a higher mortality risk than light to moderate drinkers.

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Abstract 13370: The Relationship Between Longitudinal Changes in Left Ventricular Ejection Fraction and Survival From 57,823 Patients in a Large Regional Health System

Circulation ◽

10.1161/circ.142.suppl_3.13370 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Linyuan Jing ◽

Samuel Fielden ◽

Gregory J Wehner ◽

Joseph Leader ◽

Christopher M Haggerty ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Linear Relationship ◽

Mortality Risk ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

All Cause Mortality ◽

Non Linear ◽

The Relationship

Introduction: An intriguing U-shape relationship between left ventricular ejection fraction (LVEF) and survival has recently been reported, with LVEFs of 60-65% associated with the lowest mortality risk. In heart failure, LVEF recovery has been linked to improved outcomes; however, the relationship between changes in LVEF (ΔLVEF) and survival in a general clinical population has not been studied. We hypothesized that ΔLVEF would have a non-linear relationship with all-cause mortality. Methods: A total of 194,599 echocardiograms from 57,823 patients with physician-reported LVEF were identified from Geisinger health records, along with dates of death or last living encounter, age, sex, smoking status, height, weight, and active diagnoses. ΔLVEF for a given echocardiogram was calculated for 136,776 studies as the difference between the most recent previous and current LVEF. Cox Proportional Hazards Regression was used to relate interaction between ΔLVEF and current LVEF to all-cause mortality while adjusting for confounders. Results: Death occurred in 15,419 patients who underwent 39,562 (29%) echocardiograms. Median follow up duration was 3.6 years (IQR, 1.3-7.2), and median time between tests was 1.0 year (IQR, 0.2-2.3). The interaction between LVEF and ΔLVEF ( P < 0.001) demonstrated that a stable LVEF of 60-65% was associated with the best survival (Figure). A decreased LVEF was universally associated with increased mortality, while LVEFs that had increased showed non-linear interactions. In general, an LVEF of 35-55% that had increased from the previous test was associated with a similar or slightly lower mortality than the same LVEF that was unchanged or had decreased, while an LVEF >55% that had increased was associated with an increase in mortality risk compared to those with a stable LVEF. Conclusions: Changes in LVEF have a non-linear relationship with all-cause mortality. In general, a constant, stable LVEF associates with the lowest risk of mortality.

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Self-reported visual impairment, physical activity and all-cause mortality: The HUNT Study

Scandinavian Journal of Public Health ◽

10.1177/1403494816680795 ◽

2016 ◽

Vol 45 (1) ◽

pp. 33-41 ◽

Cited By ~ 4

Author(s):

Audun Brunes ◽

W. Dana Flanders ◽

Liv Berit Augestad

Keyword(s):

Physical Activity ◽

Visual Impairment ◽

Mortality Risk ◽

Cox Regression ◽

Age Groups ◽

Health Study ◽

Cox Models ◽

Hazard Ratios ◽

All Cause Mortality ◽

Hunt Study

Aims: To examine the associations of self-reported visual impairment and physical activity (PA) with all-cause mortality. Methods: This prospective cohort study included 65,236 Norwegians aged ⩾20 years who had participated in the Nord-Trøndelag Health Study (HUNT2, 1995−1997). Of these participants, 11,074 (17.0%) had self-reported visual impairment (SRVI). The participants’ data were linked to Norway’s Cause of Death Registry and followed throughout 2012. Hazard ratios and 95% confidence intervals (CI) were assessed using Cox regression analyses with age as the time-scale. The Cox models were fitted for restricted age groups (<60, 60−84, ⩾85 years). Results: After a mean follow-up of 14.5 years, 13,549 deaths were identified. Compared with adults with self-reported no visual impairment, the multivariable hazard ratios among adults with SRVI were 2.47 (95% CI 1.94–3.13) in those aged <60 years, 1.22 (95% CI 1.13–1.33) in those aged 60–84 years and 1.05 (95% CI 0.96–1.15) in those aged ⩾85 years. The strength of the associations remained similar or stronger after additionally controlling for PA. When examining the joint associations, the all-cause mortality risk of SRVI was higher for those who reported no PA than for those who reported weekly hours of PA. We found a large, positive departure from additivity in adults aged <60 years, whereas the departure from additivity was small for the other age groups. Conclusions: Adults with SRVI reporting no PA were associated with an increased all-cause mortality risk. The associations attenuated with age.

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