Burden of kidney failure from atheroembolic disease and association with survival in people receiving dialysis in Australia and New Zealand: a multi-centre registry study

Abstract Background Cardiovascular disease is a leading cause of mortality in kidney failure (KF). Patients with KF from atheroembolic disease are at higher risk of cardiovascular disease than other causes of KF. This study aimed to determine survival on dialysis for patients with KF from atheroembolic disease compared with other causes of KF. Methods All adults (≥ 18 years) with KF initiating dialysis as the first kidney replacement therapy between 1 January 1990 and 31 December 2017 according to the Australia and New Zealand Dialysis and Transplant registry were included. Patients were grouped into either: KF from atheroembolic disease and all other causes of KF. Survival outcomes were assessed by the Kaplan-Meier method and Cox regression analysis adjusted for patient-related characteristics. Results Among 65,266 people on dialysis during the study period, 334 (0.5%) patients had KF from atheroembolic disease. A decreasing annual incidence of KF from atheroembolic disease was observed from 2008 onwards. Individuals with KF from atheroembolic disease demonstrated worse survival on dialysis compared to those with other causes of KF (HR 1.80, 95% confidence interval [CI] 1.61–2.03). The respective one- and five-year survival rates were 77 and 23% for KF from atheroembolic disease and 88 and 47% for other causes of KF. After adjustment for patient characteristics, KF from atheroembolic disease was not associated with increased patient mortality (adjusted HR 0.93 95% CI 0.82–1.05). Conclusions Survival outcomes on dialysis are worse for individuals with KF from atheroembolic disease compared to those with other causes of KF, probably due to patient demographics and higher comorbidity.

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Identification and Analysis of Three Hub Prognostic Genes Related to Osteosarcoma Metastasis

Journal of Oncology ◽

10.1155/2021/6646459 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Jianye Tan ◽

Haofeng Liang ◽

Bingsheng Yang ◽

Shuang Zhu ◽

Guofeng Wu ◽

...

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Survival Rates ◽

Prognostic Biomarkers ◽

Messenger Rnas ◽

Hub Genes ◽

Cox Regression Analysis ◽

Expression Levels ◽

Kaplan Meier ◽

Before And After

Osteosarcoma (OS) often occurs in children and often undergoes metastasis, resulting in lower survival rates. Information on the complexity and pathogenic mechanism of OS is limited, and thus, the development of treatments involving alternative molecular and genetic targets is hampered. We categorized transcriptome data into metastasis and nonmetastasis groups, and 400 differential RNAs (230 messenger RNAs (mRNAs) and 170 long noncoding RNAs (lncRNAs)) were obtained by the edgeR package. Prognostic genes were identified by performing univariate Cox regression analysis and the Kaplan–Meier (KM) survival analysis. We then examined the correlation between the expression level of prognostic lncRNAs and mRNAs. Furthermore, microRNAs (miRNAs) corresponding to the coexpression of lncRNA-mRNA was predicted, which was used to construct a competitive endogenous RNA (ceRNA) regulatory network. Finally, multivariate Cox proportional risk regression analysis was used to identify hub prognostic genes. Three hub prognostic genes (ABCG8, LOXL4, and PDE1B) were identified as potential prognostic biomarkers and therapeutic targets for OS. Furthermore, transcriptions factors (TFs) (DBP, ESX1, FOS, FOXI1, MEF2C, NFE2, and OTX2) and lncRNAs (RP11-357H14.16, RP11-284N8.3, and RP11-629G13.1) that were able to affect the expression levels of genes before and after transcription were found to regulate the prognostic hub genes. In addition, we identified drugs related to the prognostic hub genes, which may have potential clinical applications. Immunohistochemistry (IHC) and quantitative real-time polymerase chain reaction (qRT-PCR) confirmed that the expression levels of ABCG8, LOXL4, and PDE1B coincided with the results of bioinformatics analysis. Moreover, the relationship between the hub prognostic gene expression and patient prognosis was also validated. Our study elucidated the roles of three novel prognostic biomarkers in the pathogenesis of OS as well as presenting a potential clinical treatment for OS.

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Pediatric Patients with Adrenal Neuroblastoma: A SEER Analysis, 2004–2013

The American Surgeon ◽

10.1177/000313482008600232 ◽

2020 ◽

Vol 86 (2) ◽

pp. 127-133

Author(s):

Shengxiang Chen ◽

Wenfeng Tang ◽

Randong Yang ◽

Xiaoxiao Hu ◽

Zhongrong Li

Keyword(s):

Overall Survival ◽

Pediatric Patients ◽

Cox Regression ◽

Demographic Data ◽

Survival Rates ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Survival Difference ◽

Tumor Management ◽

End Results

Adrenal neuroblastoma (NB) is a relatively common malignancy in children. The Surveillance, Epidemiology, and End Results database was used to present demographic data and a survival analysis with the aim of making tumor management better. The Surveillance, Epidemiology, and End Results database was used to search pediatric patients (age £16 years) with NB from 2004 to 2013. The Kaplan-Meier method was used to calculate the overall survival. And, we used Cox regression analysis to determine hazard ratios for prognostic variables. Independent prognostic factors were selected into the nomogram to predict individual's three-, five-, and seven-year overall survival. The study included a total of 1870 pediatric patients with NB in our cohort. Overall, three-, five-, and seven-year survival rates for adrenal NB were 0.777, 0.701, and 0.665, respectively, whereas the rates for nonadrenal NB were 0.891, 0.859, and 0.832, respectively. The multivariate analysis identified age >1 year, no complete resection (CR)/CR, radiation, and regional/distant metastasis as independent predictors of mortality for adrenal NB. Concordance index of the nomogram was 0.665 (95% confidence interval, 0.627–0.703). Pediatric patients with adrenal NB have significantly worse survival than those with nonadrenal NB. Adrenal NB with age <1 year, treated with surgery, no radiation, and localized tumor leads to a better survival. There was no survival difference for patients to receive CR and no CR.

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Lepidic component identifies a subgroup of lung adenocarcinoma with a distinctive prognosis: a multicenter propensity-matched analysis

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920982845 ◽

2020 ◽

Vol 12 ◽

pp. 175883592098284

Author(s):

Erjia Zhu ◽

Chenyang Dai ◽

Huikang Xie ◽

Hang Su ◽

Xuefei Hu ◽

...

Keyword(s):

Multivariate Analysis ◽

Lung Adenocarcinoma ◽

Cox Regression ◽

Survival Rates ◽

Prognostic Impact ◽

Data Set ◽

Cox Regression Analysis ◽

T Stage ◽

Kaplan Meier ◽

T Classification

Background: Our aim was to investigate the prognostic impact of the lepidic component on T stage in patients with lung adenocarcinoma (LUAD). Methods: A retrospective data set including 863 cases of LUAD with lepidic component and 856 cases without lepidic component was used to identify matched lepidic-positive and lepidic-negative cohorts ( n = 376 patients per group) using a propensity-score matching. Primary outcome variables included recurrence-free survival (RFS) and overall survival (OS). Prognostic factors were assessed by Cox regression analysis and Kaplan–Meier estimates. Results: Multivariate analysis revealed that lepidic component presence was an independent prognostic factor for prolonged RFS ( p < 0.001) and OS ( p < 0.001). Furthermore, lepidic ratio (LR) >25% or ⩽25% were confirmed to be independent prolonged survival predictors. No survival differences were observed between patients with LUAD with LR >25% or ⩽25% (RFS p = 0.333; OS p = 0.078). The 5-year OS rates of patients with LUAD with a lepidic component were 90% regardless of the T stage, and these survival rates were significantly better than those of patients with LUAD without a lepidic component in the corresponding T stage. Multivariate analysis confirmed that T stage was associated with survival only in patients with LUAD without a lepidic component. Conclusions: Lepidic component presence identifies a LUAD subgroup with an excellent prognosis independent of the LR, pathological T classification. Considering the lepidic component presence may improve prognostic predictions for patients with LUAD.

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Outcomes of Patients With Advanced Gastrointestinal Cancer in Relationship to Opioid Use: Findings From Eight Clinical Trials

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2019.7382 ◽

2020 ◽

Vol 18 (5) ◽

pp. 575-581

Author(s):

Omar Abdel-Rahman ◽

Hatim Karachiwala ◽

Jacob C. Easaw

Keyword(s):

Clinical Trials ◽

Regression Analysis ◽

Cox Regression ◽

Survival Outcomes ◽

Disease Entity ◽

Gastrointestinal Cancers ◽

Opioid Use ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

The Impact

Background: This study assessed the patterns of opioid use among patients with advanced gastrointestinal cancers who were included in 8 clinical trials and evaluated the impact of opioid use on survival outcomes of included patients. Methods: Deidentified datasets from 8 clinical trials evaluating first-line systemic treatment of advanced gastrointestinal cancers were accessed from the Project Data Sphere platform (ClinicalTrial.gov identifiers: NCT01124786, NCT00844649, NCT00290966, NCT00678535, NCT00699374, NCT00272051, NCT00305188, and NCT00384176). These trials evaluated patients with pancreatic carcinoma, gastric carcinoma, hepatocellular carcinoma (HCC), and colorectal carcinoma. Multivariable logistic regression analysis was used to evaluate factors predicting the use of opioids. Kaplan-Meier survival estimates were used to compare survival outcomes in each disease entity among patients who did or did not receive opioid treatment. Multivariable Cox regression analysis was then used to further assess the impact of opioid use on survival outcomes in each disease entity. Results: A total of 3,441 participants were included in the current analysis. The following factors predicted a higher probability of opioid use within logistic regression analysis: younger age at diagnosis (odds ratio [OR], 0.990; 95% CI, 0.984–0.997; P=.004), nonwhite race (OR for white vs nonwhite, 0.749; 95% CI, 0.600–0.933; P=.010), higher ECOG score (OR for 1 vs 0, 1.751; 95% CI, 1.490–2.058; P<.001), and pancreatic primary site (OR for colorectal vs pancreatic, 0.241; 95% CI, 0.198–0.295; P<.001). Use of opioids was consistently associated with worse overall survival (OS) in Kaplan-Meier survival estimates of each disease entity (P=.008 for pancreatic cancer; P<.001 for gastric cancer, HCC, and colorectal cancer). In multivariable Cox regression analysis, opioid use was associated with worse OS among patients with pancreatic cancer (hazard ratio [HR], 1.245; 95% CI, 1.063–1.459; P=.007), gastric cancer (HR, 1.725; 95% CI, 1.403–2.122; P<.001), HCC (HR, 1.841; 95% CI, 1.480–2.290; P<.001), and colorectal cancer (HR, 1.651; 95% CI, 1.380–1.975; P<.001). Conclusions: Study findings suggest that opioid use is consistently associated with worse OS among patients with different gastrointestinal cancers. Further studies are needed to understand the underlying mechanisms of this observation and its potential implications.

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Reoperation for recurrent glioblastomas: What to expect?

Surgical Neurology International ◽

10.25259/sni_538_2020 ◽

2021 ◽

Vol 12 ◽

pp. 42

Author(s):

Iuri Santana Neville ◽

Alexandra Gomes dos Santos ◽

Cesar Cimonari Almeida ◽

Leonardo Bilich Abaurre ◽

Samia Yasin Wayhs ◽

...

Keyword(s):

Cox Regression ◽

Karnofsky Performance Status ◽

Performance Status ◽

Survival Rates ◽

Weibull Model ◽

University Hospital ◽

Current Standard ◽

Weibull Regression ◽

Cox Regression Analysis ◽

Kaplan Meier

Background: The current standard treatment for glioblastoma (GBM) is maximal safe surgical resection followed by radiation and chemotherapy. Unfortunately, the disease will invariably recur even with the best treatment. Although the literature suggests some advantages in reoperating patients harboring GBM, controversy remains. Here, we asked whether reoperation is an efficacious treatment strategy for GBM, and under which circumstances, it confers a better prognosis. Methods: We retrospectively reviewed 286 consecutive cases of newly diagnosed GBM in a single university hospital from 2008 to 2015. We evaluated clinical and epidemiological parameters possibly influencing overall survival (OS) by multivariate Cox regression analysis. OS was calculated using the Kaplan–Meier method in patients submitted to one or two surgical procedures. Finally, the survival curves were fitted with the Weibull model, and survival rates at 6, 12, and 24 months were estimated. Results: The reoperated group survived significantly longer (n = 63, OS = 20.0 ± 2.3 vs. 11.4 ± 1.0 months, P < 0.0001). Second, the multivariate analysis revealed an association between survival and number of surgeries, initial Karnofsky Performance Status, and age (all P < 0.001). Survival estimates according to the Weibull regression model revealed higher survival probabilities for reoperation compared with one operation at 6 months (83.74 ± 3.42 vs. 63.56 ± 3.59, respectively), 12 months (64.00 ± 4.85 vs. 37.53 ± 3.52), and 24 months (32.53 ± 4.78 vs. 12.02 ± 2.36). Conclusion: Our data support the indication of reoperation for GBM, especially for younger patients with good functional status. Under these circumstances, survival can be doubled at 12 and 24 months.

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Cisplatin-Based versus Carboplatin-Based Chemotherapy for Extra-Pulmonary Neuroendocrine Carcinomas; A Real-World Study.

Neuroendocrinology ◽

10.1159/000520193 ◽

2021 ◽

Author(s):

Omar Abdel-Rahman ◽

Sheryl L. Koski

Keyword(s):

Overall Survival ◽

Regression Analysis ◽

Cox Regression ◽

Survival Outcomes ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Platinum Agent ◽

Extra Pulmonary ◽

The Impact ◽

Neuroendocrine Carcinomas

Objective: To assess the survival differences between cisplatin/etoposide versus carboplatin/etoposide chemotherapy regimens in the management of extra-pulmonary neuroendocrine carcinomas (NECs). Methods: Administrative cancer care databases in the province of Alberta, Canada were reviewed, and patients with extra-pulmonary NECs (including those with small cell and large cell neuroendocrine carcinomas) who were treated with either cisplatin/ etoposide or carboplatin/ etoposide, 2004-2019, were reviewed. Kaplan-Meier survival estimates were used to compare the survival outcomes according to the type of platinum agent, and multivariable Cox regression analysis was used to assess the impact of the type of platinum agent on overall survival outcomes. Results: A total of 263 eligible patients were included in this analysis. These include 176 patients who received cisplatin/ etoposide and 87 patients who received carboplatin/etoposide. Using Kaplan-Meier survival estimates, patients treated with cisplatin have better overall survival compared to patients treated with carboplatin (P=0.005). Multivariable Cox regression analysis suggested that the following factors were associated with worse overall survival: higher Charlson comorbidity index (HR: 1.17; 95% CI: 1.05-1.30), gastrointestinal primary site (HR: 1.55; 95% CI: 1.12-2.14), stage IV disease (HR: 1.75; 95% CI: 1.28-2.38) and use of carboplatin (HR: 1.40; 95% CI: 1.02-1.92). Conclusions: The current study suggested that cisplatin/etoposide might be associated with better overall survival compared to carboplatin/etoposide among patients with extra-pulmonary NECs. It is unclear if this is related to differences in inherent responsiveness to the two platinum agents, or due to differences in comorbidity burden between the two treatment groups.

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Survival outcomes for multiple myeloma over three decades: A Surveillance, Epidemiology, and End Results (SEER) analysis

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.8019 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 8019-8019 ◽

Cited By ~ 10

Author(s):

I. Jawed ◽

C. M. Lee ◽

J. D. Tward ◽

O. K. Macdonald ◽

D. Martincic ◽

...

Keyword(s):

United States ◽

Multiple Myeloma ◽

Cox Regression ◽

Patient Characteristics ◽

The United States ◽

Survival Outcomes ◽

Cox Regression Analysis ◽

Black Race ◽

Younger Age ◽

End Results

8019 Background: There is limited data regarding survival outcomes for multiple myeloma in the literature. The purpose of this study was to analyze how patient characteristics and decade of treatment affect overall survival (OS) and cause-specific survival (CSS) for patients within a large United States (US) population database. Methods: Data were obtained from the Surveillance, Epidemiology, and End Results Program (SEER) of the US National Cancer Institute for the years 1973–2003. Patient characteristics (gender, race, age) and year of diagnosis were analyzed by multivariate Cox regression analysis for both OS and CSS endpoints. Results: 40,538 patients were included in the analysis. The mean age at diagnosis was 68.3 (median 69) years. Mean survival for the entire cohort was 41 (median 24) months. Females had better OS than males, hazard ratio (HR) 0.91 (CI 0.89–0.93, P = 0.0001), and CSS, HR 0.96 (CI 0.93–0.98, P = 0.004). There were no significant differences in OS between white and black race (P = 0.34), but black race was associated with improved CSS, HR 0.89 (CI 0.86–0.93, P = 0.0001). Younger age (age <40, 41–60, 61–70, and 71–80) was associated with improved OS and CSS (all P = 0.0001). Early treatment decade (1973–1985) was associated with diminished OS and CSS on multivariate analysis with HR 1.11 (CI 1.08–1.14, P = 0.0001) and HR 1.12 (CI 1.08–1.16, P = 0.001), respectively. Conclusions: This is the largest reported population analysis of survival outcomes for multiple myeloma. It covers three decades of care in the United States. This study reveals that improved OS and CSS are associated with younger age, female gender, and recent decade of treatment. We believe that survival improvement in recent treatment decades may be due to advances in supportive care and/or earlier diagnosis as the standard treatment for myeloma did not significantly change during this time period. Follow up studies may show dramatic improvements in survival outcomes due to modern myeloma therapies in this decade. No significant financial relationships to disclose. [Table: see text]

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Real-world outcomes among patients (pts) treated with gemcitabine (GEM)-based therapy post-FOLFIRINOX (FFOX) failure in advanced pancreatic cancer (APC).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.303 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 303-303

Author(s):

Erica S Tsang ◽

Jennifer L. Spratlin ◽

Winson Y. Cheung ◽

Christina Kim ◽

Shiying Kong ◽

...

Keyword(s):

Cox Regression ◽

Advanced Pancreatic Cancer ◽

Population Based ◽

Rank Test ◽

Survival Outcomes ◽

Test Results ◽

Publicly Funded ◽

Cox Regression Analysis ◽

Treatment Regimens ◽

Kaplan Meier

303 Background: Limited evidence exists for the selection of chemotherapy in APC after first-line (1stL) FFOX. Gemcitabine/nab-paclitaxel (GEMNAB) is publicly funded for second-line (2ndL) use in the provinces of Alberta (AB) and Manitoba (MB), but is not covered in British Columbia (BC). We compared population-based outcomes by region to examine the utility of 2ndL GEMNAB versus GEM alone. Methods: We identified pts treated with 1stL FFOX between 2013-2015 across BC, AB, and MB. Baseline characteristics and treatment regimens were compared between AB/MB and BC. Survival outcomes were assessed by the Kaplan-Meier, and compared with log-rank test. Results: 370 pts treated with 1stL FFOX were identified (145 AB/MB, 225 BC), with a median age of 61y, 42% female, and 68% with metastatic disease (similar in both groups). Receipt of 2ndL therapy was 49% AB/MB vs 44% BC ( p = 0.35), and time from diagnosis to 2ndL therapy measured 7.6 mos AB/MB versus 9.4 mos BC ( p = 0.1). The distribution of 2ndL gemcitabine use was: 72% GEMNAB, 23% GEM in AB/MB versus 27% GEMNAB, 66% GEM in BC ( p < 0.001). Median overall survival (OS) from diagnosis was similar: 12.4 mos in AB/MB versus 10.9 mos in BC ( p = 0.75). On Cox regression analysis, region was not significant. A secondary survival analysis by 2ndL regimen demonstrated a median OS of 18.0 mos with GEMNAB versus 14.3 mos GEM ( p < 0.01). Conclusions: In our population-based comparison of APC pts treated with 1stL FFOX, survival outcomes were comparable regardless of publicly funded access to 2ndL GEMNAB versus GEM. OS by regimen favored 2ndL GEMNAB, but patient selection may be largely responsible for this difference. Randomized trials are needed to demonstrate the benefit of GEMNAB post-FFOX in APC.

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The relationship between miR-219-5p Gene Polymorphisms and the prognosis of colorectal cancer

10.21203/rs.3.rs-30253/v1 ◽

2020 ◽

Author(s):

Yang Yan ◽

Xiaohui Du ◽

Shaoyou Xia ◽

Songyan Li ◽

Da Teng ◽

...

Keyword(s):

Colorectal Cancer ◽

Regression Analysis ◽

Prognostic Value ◽

Cox Regression ◽

Malignant Tumors ◽

Survival Rates ◽

Tnm Staging ◽

Cox Regression Analysis ◽

Normal Tissues ◽

Kaplan Meier

Abstract Background Colorectal cancer (CRC) is one of the most common malignant tumors, its morbidity and mortality are increasing year by year, it is a serious threat to people's health. Some studies have reported that miR-219-5p acts as a tumor suppressor in some malignant tumors. So the purpose of this study was to investigate the prognostic value of miR-219-5p expression in CRC patients. Methods QRT-PCR was used to detect the expression levels of miR-219-5p in CRC tissues and corresponding normal tissues (P < 0.001). The prognostic value of miR-219-5p in CRC was analyzed by Kaplan-Meier and Cox regression analysis. Results The results indicated that the expression of miR-219-5p was significantly lower in CRC tissues, and its expression was closely correlated with tumor differentiation, TNM staging and lymph node metastasis (all P < 0.05). Moreover, Kaplan Meier survival analysis showed that the patients with low expression of miR-219-5p had worse overall survival rates (P < 0.05). Cox regression analysis further demonstrated that miR-219-5p expression was an independent prognostic factor for survival time in CRC patients (P = 0.018, HR = 2.026 and 95%CI: 1.127–3.643). Conclusions All the results suggest that miR-219-5p expression can be used as a potential prognostic biomarker for CRC patients.

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P2514Pupillary area predicts all-cause mortality in patients with cardiovascular disease

European Heart Journal ◽

10.1093/eurheartj/ehz748.0843 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Nozaki ◽

K Kamiya ◽

N Hamazaki ◽

R Matsuzawa ◽

T Ichikawa ◽

...

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Cox Regression ◽

Independent Predictor ◽

Area Measurement ◽

Rank Tests ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

All Cause Mortality

Abstract Background Autonomic dysfunction is among the most important pathophysiological factors involved in the high mortality rate associated with cardiovascular disease (CVD). Autonomic function is generally evaluated by heart rate variability, which is obtained by Holter electrocardiography. However, the measurement of heart rate variability requires continuous electrocardiographic monitoring for 24 h, which is time consuming and not always feasible. The pupillary area is controlled by the autonomic nervous system; however, limited data are available regarding the utility of the pupillary area for predicting prognosis in patients with CVD. Purpose We aimed to investigate whether pupillary area can be used as a novel prognostic marker in patients with CVD. Methods We retrospectively reviewed 1342 consecutive Japanese patients hospitalized for CVD. The study was performed in accordance with the tenets of the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of our University Hospital. The pupillary area measurement was performed on both eyes at least 7 days after hospitalization for CVD using a portable videopupillography system (Iriscorder Dual C10641; Hamamatsu Photonics, Hamamatsu, Japan) consisting of a goggle-shaped measurement portion with a charge-coupled device camera and a control portion with a video monitor and microcomputer with software for data analysis. After securing the goggles on the patient's face and fully covering the patient's eyes, a 5-minute period was allowed for dark adaptation. All patients were tested once between 09:00 and 12:00 h. The primary outcome of this study was all-cause mortality, and the endpoint time was calculated as the number of days from the date of pupillary area measurement up to three years. We performed the Kaplan–Meier and log-rank tests and multivariable Cox regression analysis to evaluate the prognostic predictive capability of the pupillary area. Results The study population had a mean age of 65±13 years, and 69.4% of the patients were male. The median of the pupillary area was 18.5 mm2 (interquartile range: 13.3–23.4 mm2). Over a median follow-up period of 1.9 years (interquartile range: 1.0–3.0 years), a total of 114 deaths occurred in the patient population. The Kaplan–Meier and log-rank tests revealed that all-cause mortality was significantly higher in the small pupillary area group than in the large pupillary area group (P<0.0001, Figure). Furthermore, Cox regression analysis indicated that the pupillary area was an independent predictor of mortality (Hazard ratio: 0.96; 95% confidence interval: 0.93–0.98; P=0.006) even after adjusting for several preexisting prognostic factors. Kaplan-Meire Curve Conclusion The pupillary area can be an independent predictor of prognosis in patients with CVD, and our observations suggest that the assessment of the pupillary area can be useful as a new noninvasive prognostic predictor in patients with CVD.

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