scholarly journals Comparing different types of statins for secondary prevention of cardio-cerebrovascular disease from a national cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247419
Author(s):  
Joungyoun Kim ◽  
Hyeong-Seop Kim ◽  
Yun-Jong Bae ◽  
Hyeong-Chul Lee ◽  
Jae-woo Lee ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Cerebrovascular Disease ◽  
National Health ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Different Types ◽  
National Cohort ◽  
Composite Outcomes ◽  
The Difference ◽  
Cox Proportional Hazard Regression

Statins have been recommended for use in atherosclerotic cardio-cerebrovascular disease (CCVD). The purpose of this study was to investigate the efficacy of five different types of statin in the secondary prevention of CCVD in patients. This study retrospectively designed and analyzed data from the National Health Insurance Service-National Health in Korea. Participants aged 40 to 69 years were categorized into five statin groups (atorvastatin, rosuvastatin, pitavastatin, simvastatin, and pravastatin). The primary composite outcome was defined as recurrence of CCVD or all causes of death. Cox proportional hazard regression models were adopted after stepwise adjustments for confounders to investigate the difference in efficacy among the different statins. Of the 755 final participants, 48 patients experienced primary composite outcomes. After adjustments, the hazard ratios (95% confidence intervals) for primary composite outcomes of atorvastatin, pitavastatin, and rosuvastatin groups were 0.956 (0.456–2.005), 1.347 (0.354–5.116), and 0.943 (0.317–2.803), respectively, when compared with the simvastatin group. There were no significant differences between the statins in efficacy for preventing recurrence of CCVD events and/or death in CCVD patients.

scholarly journals Comparing different types of statins for secondary prevention of cardio-cerebrovascular disease from a national cohort study

2020 ◽  
Author(s):  
Joungyoun Kim ◽  
Hyeong-Seop Kim ◽  
Yun-Jong Bae ◽  
Hyeong-Chul Lee ◽  
Jae-woo Lee ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Cerebrovascular Disease ◽  
National Health ◽  
Large Scale ◽  
Simvastatin Group ◽  
Different Types ◽  
National Cohort ◽  
Composite Outcomes ◽  
The Difference ◽  
Cox Proportional Hazard Regression

Abstract Background Statins have been recommended for use in atherosclerotic cardio-cerebrovascular disease (CCVD). The purpose of this study was to investigate the efficacy of five different types of statin in the secondary prevention of CCVD in patients. Methods This study has a retrospective design and utilised data from the Korean National Health Insurance Service-National Health Screening Cohort. Participants aged 40 to 69 years at baseline were categorized into five statin groups (atorvastatin, rosuvastatin, pitavastatin, simvastatin, and pravastatin). The primary composite outcome was defined as recurrence of CCVD or all causes of death. Cox proportional hazard regression models were adopted after stepwise adjustments for confounders to investigate the difference in efficacy among the different statins. Results Of the 755 final study participants (485: atorvastatin, 34: pitavastatin, 8: pravastatin, 96: rosuvastatin, and 132: simvastatin group), 48 patients experienced primary composite outcomes. The median follow-up duration was 12.4 years across all groups. After stepwise adjustments, the hazard ratios (95% confidence intervals) for primary composite outcomes of atorvastatin, pitavastatin, and rosuvastatin groups were 0.956 (0.456–2.005), 1.347 (0.354–5.116), and 0.943 (0.317–2.803), respectively, when compared with the simvastatin group. Conclusions There were no significant differences between the statins in their efficacy for preventing recurrence of CCVD events and/or death in CCVD patients. However, further large-scale clinical trials are required to confirm these results.

scholarly journals Factors Associated With Weight Gain in People Treated With Dolutegravir

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Lucia Taramasso ◽  
Paolo Bonfanti ◽  
Elena Ricci ◽  
Giancarlo Orofino ◽  
Nicola Squillace ◽  
...  
Keyword(s):  
Weight Gain ◽  
Female Gender ◽  
Proportional Hazard ◽  
Cd4 Counts ◽  
Factors Associated ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Tenofovir Alafenamide ◽  
Cox Proportional Hazard Regression

Abstract Background An unexpected excess in weight gain has recently been reported in the course of dolutegravir (DTG) treatment. The aim of the present study was to investigate whether weight gain differs among different DTG-containing regimens. Methods Adult naïve and experienced people with HIV (PWH) initiating DTG-based antiretroviral therapy (ART) between July 2014 and December 2019 in the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective cohort were included. We used an adjusted general linear model to compare weight change among backbone groups and a Cox proportional hazard regression model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for weight increases >10% from baseline. Results A total of 713 participants, 25.3% women and 91% Caucasian, were included. Of these, 195 (27.4%) started DTG as their first ART regimen, whereas 518 (72.6%) were ART-experienced. DTG was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75, and tenofovir alafenamide (TAF)/FTC in 59. At 6 and 12 months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. Baseline CD4 <200 cells/mm3 (HR, 1.84; 95% CI, 1.15 to 2.96), being ART-naïve (HR, 2.24; 95% CI, 1.24 to 4.18), and treatment with TDF/FTC+DTG (HR, 1.92; 95% CI, 1.23 to 2.98) or TAF/FTC+DTG (HR, 3.80; 95% CI, 1.75 to 8.23) were associated with weight gain >10% from baseline. Higher weight (HR, 0.97 by 1 kg; 95% CI, 0.96 to 0.99) and female gender (HR, 0.54; 95% CI, 0.33 to 0.88) were protective against weight gain. Conclusions Naïve PWH with lower CD4 counts and those on TAF/FTC or TDF/FTC backbones were at higher risk of weight increase in the course of DTG-based ART.

scholarly journals Low SOX12 Expression Is Correlated With Poor Prognosis in Patients With Gastric Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303381990112
Author(s):  
Kan-kan Yang ◽  
Hui-mian Xu ◽  
Jin-yu Huang ◽  
Yu-xuan Guo ◽  
Zhen-ning Wang
Keyword(s):  
Gastric Cancer ◽  
Tnm Stage ◽  
Gastric Cancer Cells ◽  
Hmg Box ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
The Difference ◽  
Cox Proportional Hazard Regression ◽  
Cancer Tissues ◽  
Clinicopathological Variables

Background: SRY-related HMG box-12, which is associated with the prognosis of cancer, has been frequently described. However, both SRY-related HMG box-12 expression and its relationship with clinicopathological variables and patient survival have not been defined in gastric cancer. The aim of our study was to examine the prognostic value of SRY-related HMG box-12 expression in patients with gastric cancer. Methods: In this study, we determined SRY-related HMG box-12 expression in 79 primary gastric cancer tissues and 79 matched adjacent nontumor tissues by immunohistochemistry and then calculated the survival rate using the Kaplan-Meier method. Cox proportional hazard regression model was used to analyze predictors of gastric cancer. Western blot and quantitative real-time polymerase chain reaction were used to investigate the difference in SRY-related HMG box-12 expression between normal gastric epithelial cells and gastric cancer cells at the protein level and RNA level, respectively. Results: SRY-related HMG box-12 was downregulated in gastric cancer tissues. Low SRY-related HMG box-12 expression was significantly associated not only with lymph node metastasis ( P = .027) and TNM stage ( P = .021) but also with disease-specific survival in patients with gastric cancer. Multivariate analysis demonstrated TNM stage was an independent factor predicting poor survival ( P = .034). Conclusions: Low SRY-related HMG box-12 expression is associated with poor clinical outcomes in gastric cancer.

scholarly journals Dietary Vitamin B6 Intake Associated with a Decreased Risk of Cardiovascular Disease: A Prospective Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1484 ◽  
Author(s):  
Jimin Jeon ◽  
Kyong Park
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin B6 ◽  
Epidemiological Studies ◽  
Dietary Vitamin ◽  
Response Analysis ◽  
Cvd Risk ◽  
Beneficial Effects ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression

Although the biological mechanisms underlying the beneficial effects of vitamin B6 on cardiovascular disease (CVD) have been reported on, epidemiological studies have yielded controversial results, and data on the Korean population are limited. This study examined the association between dietary vitamin B6 intake and CVD incidence in Koreans. A total of 9142 participants of the Korean Genome and Epidemiology Study, aged 40–69 years, who did not have CVD or cancer at the baseline were included in the analysis. Dietary data were assessed using a validated semi-quantitative food frequency questionnaire. CVD incidence was assessed using biennial questionnaires and confirmed through repeated personal interviews. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard regression models. After multivariate adjustment, a higher vitamin B6 intake was significantly associated with a decreased CVD risk in men (HR: 0.44; 95% CI: 0.25–0.78); no such association was observed in women. Dose-response analysis confirmed the presence of inverse linearity between vitamin B6 intake and CVD incidence in men (p for nonlinearity = 0.3). A higher dietary intake level of vitamin B6 was associated with a reduced CVD risk in Korean men. These observations require further verification in other populations.

Effect of air pollution on gout development: a nationwide population-based observational study

QJM ◽  
2020 ◽  
Author(s):  
W -S Hu ◽  
C -L Lin
Keyword(s):  
Air Pollution ◽  
Fine Particulate Matter ◽  
Population Based ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Yearly Average ◽  
Cox Proportional Hazard Regression ◽  
Particulate Matter 2.5 ◽  
Total Hydrocarbons

Summary Objective To investigate the effect of air pollution on gout development. Methods A total of 170318 participants were enrolled. These pollutants were considered: carbon monoxide (CO), fine particulate matter 2.5 (PM2.5), total hydrocarbons (THC) and methane (CH4). The yearly average concentrations were calculated from 2000 to 2011. Univariate and multivariate analyses by Cox proportional hazard regression models were adopted to estimate hazard ratios for gout in the Q2–Q4 concentrations of air pollutants compared with the Q1 concentration. Results In THC, relative to the Q1 concentration, the risk of gout was higher in participants exposed to the Q2–Q4 concentrations [adjusted hazard ratio (aHR), 1.10 with 95% confidence interval (CI), 1.01–1.19 in the Q2 concentration of THC; aHR, 4.20 with 95% CI, 3.93–4.49 in the Q3 concentration of THC; aHR, 5.65 with 95% CI, 5.29–6.04 in the Q4 concentration of THC]. In regard to CH4, when the Q1 concentration was defined as the reference, the risks of gout were increased for participants exposed to the Q2, Q3 and Q4 concentrations (aHR, 1.16 with 95% CI, 1.06–1.26 in the Q2 concentration of CH4; aHR, 2.37 with 95% CI, 2.20–2.55 in the Q3 concentration of CH4; aHR, 8.73 with 95% CI, 8.16–9.34 in the Q4 concentration of CH4). Conclusions Association between air pollution and risk of gout was noted.

scholarly journals Pre-Pubertal Internalizing Symptoms and Timing of Puberty Onset in Girls

2020 ◽  
Author(s):  
Julia A Knight ◽  
Rebecca D Kehm ◽  
Lisa Schwartz ◽  
Caren J Frost ◽  
Wendy K Chung ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Internalizing Symptoms ◽  
Maternal Education ◽  
Pubic Hair ◽  
Breast Development ◽  
Standard Deviation Increase ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
Anxiety Depression

Abstract Stressful environments have been associated with earlier menarche. We hypothesized that anxiety, and possibly other internalizing symptoms, are also associated with earlier puberty in girls. The LEGACY Girls Study (2011-2016) includes 1040 girls aged 6 to 13 years at recruitment with growth and development assessed every 6 months. Pre-pubertal maternal reports of daughter’s internalizing symptoms were available for breast onset (N=447), pubic hair onset (N=456), and menarche (N=681). Using Cox Proportional Hazard Regression, we estimated prospective hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between one standard deviation of the percentiles of pre-pubertal anxiety, depression, and somatization symptoms and the timing of each pubertal outcome. Multivariable models included age, race/ethnicity, study center, maternal education, body mass index percentile, and breast cancer family history. Additional models included maternal self-reported anxiety. One standard deviation increase of maternally-reported anxiety in girls at baseline was associated with earlier subsequent onset of breast (HR 1.22, 95% CI 1.09-1.36) and pubic hair (HR 1.15, 95% CI 1.01-1.30) development, but not menarche (HR 0.94, 95% CI 0.83-1.07). The association of anxiety with earlier breast development persisted after adjustment for maternal anxiety. Increased anxiety in young girls may indicate risk for earlier pubertal onset.

The Impact of Long Working Hours on Cognitive Function: A Follow-Up Study with Gender Stratification

2021 ◽  
Vol 80 (2) ◽  
pp. 727-734
Author(s):  
Seunghyun Lee ◽  
Joon Yul Choi ◽  
Wanhyung Lee
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Working Hours ◽  
Gender Stratification ◽  
Long Working Hours ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
The Impact ◽  
The Relationship

Background: Recent studies have shown that long working hours can have adverse consequences on health and possibly trigger biological processes that mediate the relationship between long working hours and cognitive decline. Objective: To investigate whether long working hours and the overall duration such exposure is associated with a decline in cognitive function. Methods: Data obtained during the Korean Longitudinal Study on Aging (n = 2,518) during the period 2006–2018 were used to explore the relationship between long working hours and cognitive decline. Korean version of the Mini-Mental State Examination (K-MMSE) scores were used to evaluate cognitive function. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), which were used to evaluate declines in K-MMSE scores over the 12-year study period. Results: Overall HR (95% CI) for a decline in cognitive function in long working hours group was 1.13 (0.73–1.17). When categorized by sex, women with long working hours had an HR (95% CI) of 1.50 (1.05–2.22), K-MMSE scores decreased significantly after working long hours for 5 years (p < 0.01). Conclusion: The study furthers understanding of the effects of long working hours on cognitive decline among female workers. Further research is required to determine the effects of long working hours on cognitive functions.

scholarly journals Oncotype DX recurrence score implications for disparities in chemotherapy and breast cancer mortality in Georgia

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Lindsay J. Collin ◽  
Ming Yan ◽  
Renjian Jiang ◽  
Kevin C. Ward ◽  
Brittany Crawford ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Breast Cancer Mortality ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
To Receive

Abstract Among women diagnosed with stage I–IIIa, node-negative, hormone receptor (HR)-positive breast cancer (BC), Oncotype DX recurrence scores (ODX RS) inform chemotherapy treatment decisions. Differences in recurrence scores or testing may contribute to racial disparities in BC mortality among women with HR+ tumors. We identified 12,081 non-Hispanic White (NHW) and non-Hispanic Black (NHB) BC patients in Georgia (2010–2014), eligible to receive an ODX RS. Logistic regression was used to estimate the odds of chemotherapy receipt by race and ODX RS. Cox proportional hazard regression was used to calculate the hazard ratios (HRs) comparing BC mortality rates by race and recurrence score. Receipt of Oncotype testing was consistent between NHB and NHW women. Receipt of chemotherapy was generally comparable within strata of ODX RS—although NHB women with low scores were slightly more likely to receive chemotherapy (OR = 1.16, 95% CI 0.77, 1.75), and NHB women with high scores less likely to receive chemotherapy (OR = 0.77, 95% CI 0.48, 1.24), than NHW counterparts. NHB women with a low recurrence score had the largest hazard of BC mortality (HR = 2.47 95% CI 1.22, 4.99) compared to NHW women. Our data suggest that additional tumor heterogeneity, or other downstream treatment factors, not captured by ODX, may be drivers of racial disparities in HR+ BC.

scholarly journals Metformin use and risk of gastric adenocarcinoma in a Swedish population-based cohort study

2019 ◽  
Vol 121 (10) ◽  
pp. 877-882 ◽  
Author(s):  
Jiaojiao Zheng ◽  
Shao-Hua Xie ◽  
Giola Santoni ◽  
Jesper Lagergren
Keyword(s):  
Cohort Study ◽  
Gastric Adenocarcinoma ◽  
Population Based ◽  
Matched Cohort ◽  
Swedish Population ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
Treatment Use

Abstract Background Whether or not the use of metformin decreases the risk of gastric adenocarcinoma is unclear. Methods This was a population-based cohort study in 2005–2015. Associations between metformin use and gastric non-cardia and cardia adenocarcinomas were examined within two cohorts; a diabetes cohort of participants using anti-diabetes medications, and a matched cohort of common-medication users, where metformin non-users were frequency matched (10:1) with metformin users for sex and age. Multivariable Cox proportional hazard regression analyses provided hazard ratios (HR) and 95% confidence intervals (CI), adjusting for sex, age, calendar year, comorbidity, Helicobacter pylori eradication treatment, use of non-steroidal anti-inflammatory drugs or aspirin and use of statins. Results During the follow-up for a median of 5.8 years, 892 (0.1%) participants in the diabetes cohort and 6395 (0.1%) participants in the matched cohort of common-medication users developed gastric adenocarcinoma. Metformin users had no significantly decreased risk of gastric non-cardia adenocarcinoma (diabetes cohort: HR 0.93, 95% CI 0.78–1.12; matched cohort: HR 1.30, 95% CI 1.18–1.42) or cardia adenocarcinoma (diabetes cohort: HR 1.49, 95% CI 1.09–2.02; matched cohort: HR 1.58, 95% CI 1.38–1.81) compared with non-users in both cohorts. Conclusions This cohort study with <10 years of follow-up suggests metformin use may not prevent gastric adenocarcinoma.

scholarly journals IL-6 and Other Biomarkers associated with Poor Prognosis in a Cohort of Hospitalized Patients with COVID-19 in Madrid

2021 ◽  
Vol 16 ◽  
pp. 117727192110133
Author(s):  
Encarnación Donoso-Navarro ◽  
Ignacio Arribas Gómez ◽  
Francisco A Bernabeu-Andreu
Keyword(s):  
Lymphocyte Count ◽  
Univariate Analysis ◽  
Fatal Outcome ◽  
Hospitalized Patients ◽  
Blood Concentrations ◽  
Cox Proportional Hazard ◽  
Lower Blood ◽  
The Difference ◽  
Cox Proportional Hazard Regression ◽  
Relationship Of

Objectives: There are several published works on the prognostic value of biomarkers in relation to the severity or fatal outcome of coronavirus disease 2019 (COVID-19). In Spain, the second European country in incidence of the disease at the time of data collection, there are few studies that include both laboratory parameters and clinical parameters. Our aim is to study the relationship of a wide series of biomarkers with admission to intensive care and death in a hospital in the Autonomous Community of Madrid (Spain), with special attention to IL-6 due to its role in the systemic inflammatory response associated with a worse prognosis of the disease. Methods: Data were collected from 546 hospitalized patients with COVID-19. All of them had IL-6 results, in addition to other biochemical and haematological parameters. The difference of the medians for the selected parameters between the groups (ICU vs non-ICU, dead vs survivors) was studied using a Mann-Whitney analysis. The independent variables that predicted death were studied using a Cox proportional hazard regression model. Results: Higher age and blood concentrations of ALT, creatinine, CK, cTnI, LDH, NT-proBNP, CRP, IL-6, leucocyte count and D-dimer together with lower blood concentrations of albumin and lymphocyte count were associated with mortality in univariate analysis. Age, LDH, IL-6 and lymphocyte count remained associated with death in multivariate analysis. Conclusions: Age, LDH, IL-6 and lymphocyte count, as independent predictors of death, could be used to establish more aggressive therapies in COVID-19 patients.

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