Effect of hyperlipidemia in patients with a history of colon cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15603-e15603
Author(s):  
Zahid Tarar ◽  
Muhammad Usman Zafar ◽  
Ghulam Ghous ◽  
Umer Farooq ◽  
Arjan Ahluwalia
Keyword(s):  
Coronary Artery Disease ◽  
Colon Cancer ◽  
Coronary Artery ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Inpatient Mortality ◽  
Peripheral Artery ◽  
History Of ◽  
Artery Disease

e15603 Background: The most common cancer of the digestive system is colorectal cancer. 5-year survival rate of early-stage colon cancer is > 90% whereas it is only 10% for patients with distant metastases. Recent studies have shown that lipids influence a tumor’s metastatic capabilities. High fat diet has also been linked with colon cancer. In this study, we try to understand the effect of hyperlipidemia in patients with a history of colon cancer. Methods: This is a retrospective study examining data from the National Inpatient Sample (NIS) Database of the year 2018. We identified patients with any history of Colon cancer using their specific ICD-10 codes. Additionally, we queried for ICD10 codes for hyperlipidemia. Primary outcome was inpatient mortality. Secondary outcome was hospital length of stay and total charge. Utilizing STATA MP 16.1 we performed multivariate logistic regression analysis. Various comorbidities including previous history of coronary artery disease, peripheral artery disease, stroke, smoking, diabetes, hypertension and chemotherapy were incorporated into the analysis. Additionally, hospital demographics were included in the analysis as well including race, hospital bed size teaching status, location, region, insurance and patient income. Data was considered statistically significant if p-value was < 0.05. Results: The total number of patients included in this study were 34,792. They were all adults age > 18 years. Approximately 49% were females. Mean age was 67 years and average hospital length of stay was 6.5 days. After running multivariable analysis for inpatient mortality, we noted that patients with hyperlipidemia had lower odds of mortality (Odds Ratio (OR) 0.64, 95% Confidence Intervals (CI) 0.56 – 0.73). Higher odds of mortality were seen in patients with coronary artery disease (OR 1.23, 95% CI 1.05 – 1.44). Among racial distributions, Blacks had higher odds of mortality when compared with White (OR 1.3, 95% CI 1.1 – 1.5). Hispanics had lower odds of inpatient mortality compared to Whites (OR 0.8, 95% CI 0.6 – 0.9). The odds of mortality were higher with increasing age (OR 1.025, 95% CI 1.02 – 1.031) and lower among females (0.82, 95% CI 0.73 – 0.91). Among secondary outcomes, hyperlipidemia did not affect the hospital length of stay or cost. Several factors increased the hospital length of stay which included any history of coronary artery disease, peripheral artery disease, or diabetes. In addition, patients admitted over the weekend had a higher length of stay. Conclusions: In this study, we find that hyperlipidemia is associated with lower mortality in patients with colon cancer. This could be possible because patients with hyperlipidemia are on statin therapy. This indirectly could point to a potential benefit of statins in colon cancer. Hyperlipidemia does not affect hospital length of stay or cost.

Effect of acute kidney injury on hospital-based outcomes in patients with multiple myeloma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20006-e20006
Author(s):  
Muhammad Usman Zafar ◽  
Zahid Tarar ◽  
Ghulam Ghous ◽  
Umer Farooq ◽  
Bradley Walter Lash
Keyword(s):  
Heart Failure ◽  
Multiple Myeloma ◽  
Acute Kidney Injury ◽  
Length Of Stay ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Teaching Hospitals ◽  
Inpatient Mortality ◽  
History Of

e20006 Background: Multiple Myeloma, a cancer of plasma cells, is treatable, but incurable. 5-year survival rate is about 54% depending upon the stage. Studies have suggested that up to 50% of the patients experience acute kidney injury or chronic kidney disease at some point in their disease course. Approximately 3% of the patients will end up on hemodialysis. In this study we utilize the National Inpatient Sample (NIS) to understand the effect of acute kidney injury (AKI) on inpatient mortality in multiple myeloma patients. Methods: This is a retrospective study utilizing the data obtained from the NIS for the year 2018. We queried this NIS database for ICD-10 codes for multiple myeloma or plasmacytoma that had not achieved remission or was in relapse. We also looked at codes for acute kidney injury as secondary diagnosis. Primary outcome was inpatient mortality. Secondary outcomes were hospital length of stay and cost utilization. We then ran multivariate logistic regression analysis in STATA MP 16.1. Various comorbidities were accounted for by adding them into the analysis. These included previous history of coronary artery disease, congestive heart failure, stroke, smoking, hyperlipidemia, stem cell transplant, neutropenia and chemotherapy. Results: The population of multiple myeloma patients under investigation were all adults more than 18 years of age and numbered in 3944 patients. The mean age was 65.71 years. Among these 45% were females. While examining inpatient mortality we see that for patients that had AKI the odds of inpatient mortality are higher (Odds Ratio (OR) 1.75, p = 0.003, 95% Confidence Interval (CI) 1.21 – 2.56). History of Heart Failure (OR 2.28, 95% CI 1.59 – 3.28), and increasing age (OR 1.02, 95% CI 1.01 – 1.04) also appear to contribute towards higher odds of mortality. The effect of other comorbidities was not statistically significant. Among demographical characteristics being of Native American heritage or not belonging to any descriptive race predicted higher odds of mortality. Mean LOS was 11 days. Patients with AKI stayed in the hospital longer by ̃1.4 days (Coef. 1.39, 95% CI 0.41 – 2.37). LOS was higher in patients with a history of heart failure (2.61, 95% CI 0.89 – 4.34 and in those with a history of neutropenia (5.52, 95% CI 4.42 – 6.62). LOS was lower in patients with a history of smoking by 1 day. Age lowered the LOS by a clinically insignificant amount. Teaching hospitals had higher LOS by ̃4 days. The total charge for hospitalizations from AKI is higher by $31019 (95% CI 14444.23 – 47594.37). Other factors incurring higher cost include history of neutropenia, and teaching hospitals. Hospitals in the Midwest had lower cost compared to hospitals in the Northeast. Conclusions: Among patients that present with a principal diagnosis of multiple myeloma, having acute kidney injury, adversely affects inpatient outcomes that include, mortality, hospital length of stay and total hospitalization cost.

Abstract 425: Coronary Artery Disease in Patients with Premature Atherosclerotic Peripheral Artery Disease

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Hamza Rana ◽  
Jeanette S Andrews ◽  
Kimberley J Hansen ◽  
Pavel J Levy
Keyword(s):  
Coronary Artery Disease ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Family History ◽  
Peripheral Artery ◽  
History Of ◽  
Premature Cad ◽  
Artery Disease ◽  
Diabetes Family History ◽  
Diabetes Family

Objective: Premature atherosclerotic peripheral artery disease (PAD) is being diagnosed with increasing frequency. Little is known about concomitant coronary artery disease (CAD) in patients with premature PAD. This study examines prevalence, associated clinical characteristics, and predictors of concomitant CAD in young PAD patients. Methods: We studied patients with severe atherosclerotic PAD <55 years of age (mean 49.36±6.45 yrs) treated at a single academic Vascular center between 1998 and 2010. Data was collected at the time of initial evaluation. CAD was defined by documented acute coronary syndrome; and/or prior coronary revascularizations. Associations with concomitant CAD were evaluated univariately using chi-square tests for categorical characteristics or t-tests for continuous characteristics, and using multivariable logistic regression. Results: Total of 561 patients (46% female, 20% Black) were analyzed. Mean age at diagnosis was 46.64±6.86 years. Risk factors included smoking (97%), hyperlipidemia (67%), hypertension (64%), family history of premature CAD (47%), and diabetes (25%). Aortoiliac disease was present in 77% of patients; 36% were disabled. Overall, 174 (31%) patients had clinical CAD. Patients with premature CAD were less likely to be Blacks (p=0.004), had greater frequency of hypertension, hyperlipidemia, diabetes, family history of premature CAD, polyvascular disease (i.e. cerebral vascular disease [CeVD]) (p<.001 for each), renovascular disease (p=.016) and mesenteric disease (p=.012). Multivariable logistic regression modeling showed higher odds of concomitant CAD for patients with hyperlipidemia (OR 4.71; 95 CI 2.82-7.85; p<.0001), diabetes (OR 2.11; 95% CI 1.28-3.47; p<0.01), family history of premature CAD OR 2.00; 95% CI 1.27-3.14;p<0.01) CeVD (OR 2.15; 95% CI 1.34-3.48;p<0.01), mesenteric vascular disease (OR 2.70;95% CI 1.19-6.14; p=.02). One pack year in smoking increase had 1.01 times odds of concomitant CAD (95% CI 1.001-1.018; p=.02). Conclusions: Clinical CAD was prevalent in 1/3 of patients with premature PAD, and those with premature CAD were less likely to be Black. Among patients with premature PAD, higher odds of concomitant clinical CAD were associated with presence of hyperlipidemia, diabetes, family history of premature CAD, polyvascular disease.

scholarly journals Promising Effects of Atorvastatin on Outcomes of Patients with Severe COVID-19, A Retrospective Cohort Study

2021 ◽  
Author(s):  
Mohmmad Haji Aghajani ◽  
Omid Moradi ◽  
Hamed Azhdari Tehrani ◽  
Hossein Amini ◽  
Elham Pourheidar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Retrospective Cohort ◽  
Invasive Mechanical Ventilation ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Artery Disease

Purpose: Considering the anti-inflammatory effect of atorvastatin and the role of medical comorbidities such as hypertension and coronary artery disease on prognosis of the COVID-19 patients, we aimed to assess the effect of atorvastatin add-on therapy on mortality due to COVID-19. Methods: We conducted a retrospective cohort study, including patients who were hospitalized with confirmed diagnosis of severe COVID-19. Baseline characteristics and related clinical data of patients were recorded. Clinical outcomes consist of in hospital mortality, need for invasive mechanical ventilation and hospital length of stay. COX regression analysis models were used to assess the association of independent factors to outcomes. Results: Atorvastatin was administered for 421 out of 991 patients. The mean age was 61.640±17.003 years. Older age, higher prevalence of hypertension and coronary artery disease reported in patients who received atorvastatin. These patients had shorter hospital length of stay (P=0.001). Based on COX proportional hazard model, in hospital use of atorvastatin was associated to decrease in mortality (HR=0.679, P=0.005) and lower need for invasive mechanical ventilation (HR=0.602, P=0.014). Conclusions: Atorvastatin add-on therapy in patient with severe COVID-19 was associated with lower in hospital mortality and reduced the risk of need for invasive mechanical ventilation which support to continue the prescription of the medication.

scholarly journals Impact of Coronary CT angiography in combination with CAD-RADS on the management of coronary artery disease patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Andre ◽  
S Seitz ◽  
P Fortner ◽  
R Sokiranski ◽  
F Gueckel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Ct Angiography ◽  
Patient Management ◽  
Male Gender ◽  
Coronary Ct ◽  
History Of ◽  
Artery Disease ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Siemens Healthineers Introduction Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management. Purpose Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity. Methods CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis. Results The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p &lt; 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF. Conclusions CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models. CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)

scholarly journals The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

2020 ◽  
Author(s):  
Han-Young Jin ◽  
Jonathan R. Weir-McCall ◽  
Jonathon A. Leipsic ◽  
Jang-Won Son ◽  
Stephanie L. Sellers ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Natural History ◽  
Coronary Calcification ◽  
History Of ◽  
Artery Disease ◽  
The Relationship
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