Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

Background Improvement in exercise capacity is a main goal of cardiac rehabilitation but the effects are often lost at long-term follow-up and thus also the benefits on prognosis. We assessed whether improvement in VO2peak during a cardiac rehabilitation programme predicts long-term prognosis. Methods and results We performed a retrospective analysis of 1561 cardiac patients completing cardiac rehabilitation in 2011–2017 in Copenhagen. Mean age was 63.6 (11) years, 74% were male and 84% had coronary artery disease, 6% chronic heart failure and 10% heart valve replacement. The association between baseline VO2peak and improvement after cardiac rehabilitation and being readmitted for cardiovascular disease and/or all-cause mortality was assessed with three different analyses: Cox regression for the combined outcome, for all-cause mortality and a multi-state model. During a median follow-up of 2.3 years, 167 readmissions for cardiovascular disease and 77 deaths occurred. In adjusted Cox regression there was a non-linear decreasing risk of the combined outcome with higher baseline VO2peak and with improvement of VO2peak after cardiac rehabilitation. A similar linear association was seen for all-cause mortality. Applying the multi-state model, baseline VO2peak and change in VO2peak were associated with risk of a cardiovascular disease readmission and with all-cause mortality but not with mortality in those having an intermediate readmission for cardiovascular disease. Conclusion VO2peak as well as change in VO2peak were highly predictive of future risk of readmissions for cardiovascular disease and all-cause mortality. The predictive value did not extend beyond the next admission for a cardiovascular event.

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Contrasting associations of insulin resistance with diabetes, cardiovascular disease and all-cause mortality in the elderly: PROSPER long-term follow-up

Diabetologia ◽

10.1007/s00125-014-3383-9 ◽

2014 ◽

Vol 57 (12) ◽

pp. 2513-2520 ◽

Cited By ~ 12

Author(s):

Paul Welsh ◽

David Preiss ◽

Suzanne M. Lloyd ◽

Anton J. de Craen ◽

J. Wouter Jukema ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

The Elderly ◽

All Cause Mortality ◽

Long Term Follow Up

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Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure

Journal of Telemedicine and Telecare ◽

10.1177/1357633x18774632 ◽

2018 ◽

Vol 25 (5) ◽

pp. 286-293 ◽

Cited By ~ 6

Author(s):

Ines Frederix ◽

Lien Vanderlinden ◽

Anne-Sophie Verboven ◽

Maria Welten ◽

Donna Wouters ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Healthcare Costs ◽

Follow Up Study ◽

All Cause Mortality ◽

Long Term Follow Up ◽

Heart Failure Readmissions ◽

Time Point

Aims The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t0); 142 CHF patients (65% male; age: 76 ± 10 years; EF: 36 ± 15%) were alive and entered the follow-up study (time point: t1) with a final evaluation at 79 months (time point: t2). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t1 – t2). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group ( p = 0.04). Healthcare costs did not differ significantly between the TM (€ 9140 ± 10580) and UC group (€ 12495 ± 22433) ( p = 0.87). Discussion An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: https://clinicaltrials.gov/ct2/show/NCT03171038 ).

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Mortality in acromegaly: a 20-year follow-up study

Endocrine Related Cancer ◽

10.1530/erc-16-0106 ◽

2016 ◽

Vol 23 (6) ◽

pp. 469-480 ◽

Cited By ~ 46

Author(s):

Elina Ritvonen ◽

Eliisa Löyttyniemi ◽

Pia Jaatinen ◽

Tapani Ebeling ◽

Leena Moilanen ◽

...

Keyword(s):

Causes Of Death ◽

Age And Gender ◽

Follow Up Study ◽

All Cause Mortality ◽

Long Term Follow Up ◽

Standardized Mortality Ratios ◽

And Gender ◽

Causes Of Deaths

Objective It is unclear whether mortality still is increased in acromegaly and whether there are gender-related differences. We dynamically assessed outcome during long-term follow-up in our nationwide cohort. Patients and methods We studied standardized mortality ratios (SMRs) relative to the general population and causes of death in acromegaly (n=333) compared with age- and gender-matched controls (n=4995). Results During 20 (0–33) years follow-up, 113 (34%) patients (n=333, 52% women) and 1334 (27%) controls (n=4995) died (P=0.004). SMR (1.9, 95% CI: 1.53–2.34, P<0.001) and all-cause mortality (OR 1.6, 95% CI: 1.2–2.2, P<0.001) were increased in acromegaly. Overall distribution of causes of death (P<0.001) differed between patients and controls but not cardiovascular (34% vs 33%) or cancer deaths (27% vs 27%). In acromegaly, but not in controls, causes of deaths shifted from 44% cardiovascular and 28% cancer deaths during the first decade, to 23% cardiovascular and 35% cancer deaths during the next two decades. In acromegaly, cancer deaths were mostly attributed to pancreatic adenocarcinoma (n=5), breast (n=4), lung (n=3) and colon (n=3) carcinoma. In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, P<0.001) and death (67 vs 76 years, P=0.0015). Compared with controls, women (36% vs 25%, P<0.01), but not men (31% vs 28%, P=0.44), had increased mortality. Conclusions In acromegaly, men are younger at diagnosis and death than women. Compared with controls, mortality is increased during 20 years of follow-up, especially in women. Causes of deaths shift from predominantly cardiovascular to cancer deaths.

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