scholarly journals Relative Contributions of Bone Density, Bone Turnover, and Clinical Risk Factors to Long-Term Fracture Prediction

2003 ◽  
Vol 18 (2) ◽  
pp. 312-318 ◽  
Author(s):  
L Joseph Melton ◽  
Cynthia S Crowson ◽  
W Michael O'Fallon ◽  
Heinz W Wahner ◽  
B Lawrence Riggs
Keyword(s):  
Risk Factors ◽  
Bone Density ◽  
Bone Turnover ◽  
Fracture Prediction ◽  
Clinical Risk Factors ◽  
Clinical Risk

Long-Term Follow-Up of Patients With Isolated Side Branch Coronary Artery Disease

Angiology ◽  
2021 ◽  
pp. 000331972110280
Author(s):  
Sukru Arslan ◽  
Ahmet Yildiz ◽  
Okay Abaci ◽  
Urfan Jafarov ◽  
Servet Batit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vessel Diameter ◽  
Side Branch ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Artery Disease

The data with respect to stable coronary artery disease (SCAD) are mainly confined to main vessel disease. However, there is a lack of information and long-term outcomes regarding isolated side branch disease. This study aimed to evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch coronary artery disease (CAD). A total of 437 patients with isolated side branch SCAD were included. After a median follow-up of 38 months, the overall MACCE and all-cause mortality rates were 14.6% and 5.9%, respectively. Among angiographic features, 68.2% of patients had diagonal artery and 82.2% had ostial lesions. In 28.8% of patients, the vessel diameter was ≥2.75 mm. According to the American College of Cardiology lesion classification, 84.2% of patients had either class B or C lesions. Age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels were independent predictors of MACCE. On the other hand, side branch location, vessel diameter, and lesion complexity did not affect outcomes. Clinical risk factors seem to have a greater impact on MACCE rather than lesion morphology. Therefore, the treatment of clinical risk factors is of paramount importance in these patients.

scholarly journals WHO absolute fracture risk models (FRAX): Do clinical risk factors improve fracture prediction in older women without osteoporosis?

2011 ◽  
Vol 26 (8) ◽  
pp. 1774-1782 ◽  
Author(s):  
Teresa A Hillier ◽  
Jane A Cauley ◽  
Joanne H Rizzo ◽  
Kathryn L Pedula ◽  
Kristine E Ensrud ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Older Women ◽  
Fracture Prediction ◽  
Clinical Risk Factors ◽  
Risk Models ◽  
Clinical Risk

scholarly journals Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: the Atherosclerosis Risk in Communities (ARIC) study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Erick A. Perez-Alday ◽  
Aron Bender ◽  
David German ◽  
Srini V. Mukundan ◽  
Christopher Hamilton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Predictive Accuracy ◽  
Clinical Risk Factors ◽  
Short Term ◽  
Clinical Risk ◽  
Atherosclerosis Risk

Abstract Background The risk of sudden cardiac death (SCD) is known to be dynamic. However, the accuracy of a dynamic SCD prediction is unknown. We aimed to measure the dynamic predictive accuracy of ECG biomarkers of SCD and competing non-sudden cardiac death (non-SCD). Methods Atherosclerosis Risk In Community study participants with analyzable ECGs in sinus rhythm were included (n = 15,716; 55% female, 73% white, age 54.2 ± 5.8 y). ECGs of 5 follow-up visits were analyzed. Global electrical heterogeneity and traditional ECG metrics (heart rate, QRS, QTc) were measured. Adjudicated SCD was the primary outcome; non-SCD was the competing outcome. Time-dependent area under the receiver operating characteristic curve (ROC(t) AUC) analysis was performed to assess the prediction accuracy of a continuous biomarker in a period of 3,6,9 months, and 1,2,3,5,10, and 15 years using a survival analysis framework. Reclassification improvement as compared to clinical risk factors (age, sex, race, diabetes, hypertension, coronary heart disease, stroke) was measured. Results Over a median 24.4 y follow-up, there were 577 SCDs (incidence 1.76 (95%CI 1.63–1.91)/1000 person-years), and 829 non-SCDs [2.55 (95%CI 2.37–2.71)]. No ECG biomarkers predicted SCD within 3 months after ECG recording. Within 6 months, spatial ventricular gradient (SVG) elevation predicted SCD (AUC 0.706; 95%CI 0.526–0.886), but not a non-SCD (AUC 0.527; 95%CI 0.303–0.75). SVG elevation more accurately predicted SCD if the ECG was recorded 6 months before SCD (AUC 0.706; 95%CI 0.526–0.886) than 2 years before SCD (AUC 0.608; 95%CI 0.515–0.701). Within the first 3 months after ECG recording, only SVG azimuth improved reclassification of the risk beyond clinical risk factors: 18% of SCD events were reclassified from low or intermediate risk to a high-risk category. QRS-T angle was the strongest long-term predictor of SCD (AUC 0.710; 95%CI 0.668–0.753 for ECG recorded within 10 years before SCD). Conclusion Short-term and long-term predictive accuracy of ECG biomarkers of SCD differed, reflecting differences in transient vs. persistent SCD substrates. The dynamic predictive accuracy of ECG biomarkers should be considered for competing SCD risk scores. The distinction between markers predicting short-term and long-term events may represent the difference between markers heralding SCD (triggers or transient substrates) versus markers identifying persistent substrate.

scholarly journals Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive L-thyroxine therapy for differentiated thyroid carcinoma

2005 ◽  
Vol 153 (1) ◽  
pp. 23-29 ◽  
Author(s):  
A Caroline Heijckmann ◽  
Maya S P Huijberts ◽  
Piet Geusens ◽  
Jolanda de Vries ◽  
Paul P C A Menheere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Vertebral Fracture ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Clinical Risk Factors ◽  
Type I ◽  
Mineral Density ◽  
Clinical Risk

Objective: Untreated hyperthyroidism and treatment with high doses of thyroid hormone are associated with osteoporosis. However, their effect on bone turnover, their contribution to bone mineral density (BMD) in the context of other clinical risk factors for osteoporosis and the prevalence of vertebral fractures is not well documented. Design: Cross-sectional study. Methods: We studied 59 patients receiving L-thyroxine suppressive therapy for differentiated thyroid carcinoma (DTC). BMD of the hip was measured by dual X-ray absorptiometry (DXA) and lateral DXA pictures of the lumbar and thoracic vertebrae were performed. Bone resorption was measured by C-telopeptides of type I collagen (ICTP) and bone formation by procollagen type I N-propeptide (PINP). Clinical risk factors for osteoporosis were evaluated using a questionnaire. Results: Z-scores of BMD were similar as the NHANES (National Health and Nutrition Examination Survey) III reference group in women and men, also after long-term (>10 years) suppression therapy. Patients in the lowest and highest quartile of BMD showed significant differences in the presence of clinical risk factors. ICTP levels were significantly higher than in age-matched controls, PINP levels were not different. We found four patients with a prevalent vertebral fracture. Conclusions: We conclude that patients with well-differentiated thyroid carcinoma are not at increased risk of developing low bone mass nor have a higher prevalence of vertebral fracture at least when treated with relatively low doses of l-thyroxine.

Clinical Risk Factors for Orthostatic Hypotension: Results Among Elderly Fallers in Long-Term Care

2016 ◽  
Vol 16 (3) ◽  
pp. e143-e147 ◽  
Author(s):  
Deanna Gray-Miceli ◽  
Sarah J. Ratcliffe ◽  
Arwin Thomasson ◽  
Patricia Quigley ◽  
Kang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Orthostatic Hypotension ◽  
Long Term Care ◽  
Clinical Risk Factors ◽  
Term Care ◽  
Clinical Risk

scholarly journals Association of Cardiovascular Disease and Long-Term Exposure to Fine Particulate Matter (PM2.5) in the Southeastern United States

Atmosphere ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 947
Author(s):  
R. Burciaga Valdez ◽  
Mohammad Z. Al-Hamdan ◽  
Mohammad Tabatabai ◽  
Darryl B. Hood ◽  
Wansoo Im ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Particulate Matter ◽  
Health Effects ◽  
Fine Particulate Matter ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Fine Particulate ◽  
Ambient Levels

There is a well-documented association between ambient fine particulate matter air pollution (PM2.5) and cardiovascular disease (CVD) morbidity and mortality. Exposure to PM2.5 can cause premature death and harmful and chronic health effects such as heart attack, diabetes, and stroke. The Environmental Protection Agency sets annual PM2.5 standards to reduce these negative health effects. Currently above an annual average level of 12.0 µg/m is considered unhealthy. Methods. We examined the association of long-term exposure to PM2.5 and CVD in a cohort of 44,610 individuals who resided in 12 states recruited into the Southern Community Cohort Study (SCCS). The SCCS was designed to recruit Black and White participants who received care from Federally Qualified Health Centers; hence, they represent vulnerable individuals from low-income families across this vast region. This study tests whether SCCS participants who lived in locations exposed to elevated ambient levels of PM2.5 concentrations were more likely to report a history of CVD at enrollment (2002–2009). Remotely sensed satellite data integrated with ground monitoring data provide an assessment of the average annual PM2.5 in urban and rural locations where the SCCS participants resided. We used multilevel logistic regression to estimate the associations between self-reported CVD and exposure to elevated ambient levels of PM2.5. Results. We found a 13.4 percent increase in the odds of reported CVD with exposure to unhealthy levels of PM2.5 exposure at enrollment. The SCCS participants with medical histories of hypertension, hypercholesterolemia, and smoking had, overall, 385 percent higher odds of reported CVD than those without these clinical risk factors. Additionally, Black participants were more likely to live in locations with higher ambient PM2.5 concentrations and report high levels of clinical risk factors, thus, they may be at a greater future risk of CVD. Conclusions: In the SCCS participants, we found a strong relation between exposures to high ambient levels of PM2.5 and self-reported CVD at enrollment.

scholarly journals Clinical risk factors, bone density and fall history in the prediction of incident fracture among men and women

Bone ◽  
2013 ◽  
Vol 52 (2) ◽  
pp. 541-547 ◽  
Author(s):  
M.H. Edwards ◽  
K. Jameson ◽  
H. Denison ◽  
N.C. Harvey ◽  
A. Aihie Sayer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Density ◽  
Clinical Risk Factors ◽  
Men And Women ◽  
Clinical Risk ◽  
Incident Fracture
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