Cardiovascular disease and the risk of dementia: a survival analysis using administrative data from Manitoba

2022 ◽  
Author(s):  
Luc Clair ◽  
Hope Anderson ◽  
Christopher Anderson ◽  
Okechukwu Ekuma ◽  
Heather J. Prior
Keyword(s):  
Cardiovascular Disease ◽  
Survival Analysis ◽  
Administrative Data

scholarly journals Risk stratification for 25-year cardiovascular disease incidence in type 1 diabetes: Tree-structured survival analysis of the Pittsburgh Epidemiology of Diabetes Complications study

2016 ◽  
Vol 13 (4) ◽  
pp. 250-259 ◽  
Author(s):  
Rachel G Miller ◽  
Stewart J Anderson ◽  
Tina Costacou ◽  
Akira Sekikawa ◽  
Trevor J Orchard
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Survival Analysis ◽  
Diabetes Complications ◽  
Disease Risk ◽  
Clinical Pathways ◽  
Disease Incidence ◽  
Cardiovascular Disease Risk ◽  
Diabetes Duration

Background: The formal identification of subgroups with varying levels of risk is uncommon in observational studies of cardiovascular disease, although such insight might be useful for clinical management. Methods: Tree-structured survival analysis was utilized to determine whether there are meaningful subgroups at varying levels of cardiovascular disease risk in the Pittsburgh Epidemiology of Diabetes Complications study, a prospective cohort study of childhood-onset (<17 years old) type 1 diabetes. Results: Of the 561 participants free of cardiovascular disease (coronary artery disease, stroke or lower extremity arterial disease) at baseline, 263 (46.9%) had an incident cardiovascular disease event over the 25-year follow-up. Tree-structured survival analysis revealed a range of risk groups, from 24% to 85%, which demonstrate that those with short diabetes duration and elevated non–high-density lipoprotein cholesterol have similar cardiovascular disease risk to those with long diabetes duration and that renal disease is a better discriminator of risk in men than in women. Conclusion: Our findings suggest that subgroups with major cardiovascular disease risk differences exist in this type 1 diabetes cohort. Using tree-structured survival analysis may help to identify these groups and the interrelationships between their associated risk factors. This approach may improve our understanding of various clinical pathways to cardiovascular disease and help target intervention strategies.

Frailty Measurement Using Administrative Data in Older Patients With Cardiovascular Disease

2020 ◽  
Vol 5 (8) ◽  
pp. 967
Author(s):  
Abdulla A. Damluji ◽  
Gary Gerstenblith ◽  
Jodi B. Segal
Keyword(s):  
Cardiovascular Disease ◽  
Administrative Data ◽  
Older Patients

Cardiovascular Disease and Hypertension Risk in Living Kidney Donors: An Analysis of Health Administrative Data in Ontario, Canada

2008 ◽  
Vol 86 (3) ◽  
pp. 399-406 ◽  
Author(s):  
Amit X. Garg ◽  
G V. Ramesh Prasad ◽  
Heather R. Thiessen-Philbrook ◽  
Li Ping ◽  
Magda Melo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Administrative Data ◽  
Kidney Donors ◽  
Health Administrative Data ◽  
Living Kidney Donors ◽  
Hypertension Risk

scholarly journals Differences in the risk of cardiovascular disease for movers and stayers in New Zealand: a survival analysis

2017 ◽  
Vol 63 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Frances Darlington-Pollock ◽  
Nichola Shackleton ◽  
Paul Norman ◽  
Arier C. Lee ◽  
Daniel Exeter
Keyword(s):  
Cardiovascular Disease ◽  
Survival Analysis ◽  
New Zealand

scholarly journals Statins for primary prevention and rhabdomyolysis: A nationwide cohort study in France

2018 ◽  
Vol 26 (5) ◽  
pp. 512-521 ◽  
Author(s):  
Joël Coste ◽  
Cécile Billionnet ◽  
Annie Rudnichi ◽  
Jacques Pouchot ◽  
Rosemary Dray-Spira ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Survival Analysis ◽  
Primary Prevention ◽  
Hazard Ratio ◽  
Lipid Lowering ◽  
Control Analysis ◽  
High Potency ◽  
Time Control ◽  
Overall Risk

Aims The purpose of this study was to investigate the risk of rhabdomyolysis in subjects initiating statin therapy for primary prevention of cardiovascular disease, focusing on the type of statin, dose and time since initiation. Methods and results A nationwide cohort study using French hospital discharge and claims databases was performed, studying subjects from the general population 40–75 years in 2009, with no history of cardiovascular disease and no lipid-lowering drugs during the preceding three-year period, followed for up to seven years. The primary outcome was hospitalization for rhabdomyolysis. Event-free survival analysis and case-time-control analysis were both performed, separately by gender. The cohort included 8,236,667 subjects, 969,460 of whom initiated a lipid-lowering drug for cardiovascular disease primary prevention. During 18,407,391 person-months exposed to statins, 168 events were observed, corresponding to an incidence of rhabdomyolysis of 1.10 per 10,000 person-years (1.54 in men vs 0.81 in women); 10/168 cases were fatal, and 18/168 and 57/168 cases occurred during the first month and first trimester of treatment, respectively. Survival analysis did not reveal any increased overall risk (hazard ratio = 1.02 (0.83–1.25) in men and 0.76 (0.60–0.96) in women). However, exposure to high-potency statins was associated with an increased risk in men (hazard ratio = 1.93 (1.27–2.94)). Rosuvastatin 20 mg (in men and women) and simvastatin 40 mg (in men) were associated with hazard ratios > 5. Case-time-control analyses showed similar patterns of risk. Drug interactions did not appear to significantly contribute to rhabdomyolysis events in this study. Conclusion Although the overall risk of statin-associated rhabdomyolysis in the context of primary prevention was not increased, the first months of treatment and the use of high-potency statins represent at-risk situations, which require appropriate monitoring, especially in men.

The effect of cardiovascular disease on the association between immune-related adverse events and overall survival.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7059-7059
Author(s):  
Ohad Oren ◽  
Julian R. Molina
Keyword(s):  
Lung Cancer ◽  
Cardiovascular Disease ◽  
Overall Survival ◽  
Survival Analysis ◽  
Adverse Events ◽  
Disease States ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Competing Causes ◽  
The Individual

7059 Background: Preliminary data suggests that immune-related adverse events (irAEs) are associated with lower all-cause mortality, presumably due to improved anti-tumor responses. Investigations of large cohorts are needed to establish better understanding of that association. Methods: We reviewed the Mayo Clinic database for all patients who received an immune checkpoint inhibitor (ICI). The primary outcome was all-cause mortality. Descriptive and uni-variate analyses were generated. Results: Between March, 2010 and July, 2019, 3,326 patients received an ICI. The most common irAEs were colitis (287, 8.6%), pneumonitis (238, 7.2%) and hepatitis (227, 6.9%). A total of 933 (28.1%) patients developed at least 1 irAE and 176 (5.3%) patients experienced 2 or more irAEs. Survival analysis demonstrated an association between the number of irAEs and all-cause mortality (log-rank, P < 0.0001), a relationship which was maintained for the 3 most common cancer types (lung, melanoma, renal) and for the individual ICI agents. In patients with lung cancer, colitis (P = 0.04) but not pneumonitis (P = 0.83) was associated with improved overall survival. No association between irEA and all-cause mortality was demonstrated in patients with history of stroke (log-rank, P = 0.12), peripheral artery disease (PAD) (log-rank, P = 0.68) and obesity (log-rank, P = 0.18). In an analysis of pre-ICI body-mass index (BMI), an association between irAE and lower overall mortality was shown in patients with BMI < 30 (log-rank, P < 0.001) and not in those with higher BMIs (log-rank, P = 0.09). The presence of stroke, PAD and obesity were associated with higher all-cause mortality in a survival analysis (P < 0.001). The irAE-mortality association was not modulated by the presence hypertension (log-rank, P < 0.0001), diabetes mellitus (log-rank, P < 0.0001), or heart failure (log-rank, P = 0.006). Conclusions: The development of any irAE is associated with higher overall survival. The presence of numerous cardiovascular disease states neutralizes that association, likely a result of competing causes of mortality although interaction with immune or inflammatory pathways is possible. In addition, pneumonitis is not associated with better overall survival in patients with lung cancer presumably due to compromise of already-tenuous respiratory status.

scholarly journals Impact of major depression on cardiovascular outcomes for individuals with hypertension: prospective survival analysis in UK Biobank

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e024433 ◽  
Author(s):  
Nicholas Graham ◽  
Joey Ward ◽  
Daniel Mackay ◽  
J P Pell ◽  
Jonathan Cavanagh ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Survival Analysis ◽  
Cardiovascular Outcomes ◽  
Secondary Outcome ◽  
Prior History ◽  
Uk Biobank ◽  
Icd 10 ◽  
First Onset ◽  
History Of

ObjectivesTo assess whether a history of major depressive disorder (MDD) in middle-aged individuals with hypertension influences first-onset cardiovascular disease outcomes.DesignProspective cohort survival analysis using Cox proportional hazards regression with a median follow-up of 63 months (702 902 person-years). Four mutually exclusive groups were compared: hypertension only (n=56 035), MDD only (n=15 098), comorbid hypertension plus MDD (n=12 929) and an unaffected (no hypertension, no MDD) comparison group (n=50 798).SettingUK Biobank.ParticipantsUK Biobank participants without cardiovascular disease aged 39–70 who completed psychiatric questions relating International Classification of Diseases-10 Revision (ICD-10) diagnostic criteria on a touchscreen questionnaire at baseline interview in 2006–2010 (n=134 860).Primary and secondary outcome measuresFirst-onset adverse cardiovascular outcomes leading to hospital admission or death (ICD-10 codes I20–I259, I60–69 and G45–G46), adjusted in a stepwise manner for sociodemographic, health and lifestyle features. Secondary analyses were performed looking specifically at stroke outcomes (ICD-10 codes I60–69 and G45–G46) and in gender-separated models.ResultsRelative to controls, adjusted HRs for adverse cardiovascular outcomes were increased for the hypertension only group (HR 1.36, 95% CI 1.22 to 1.52) and were higher still for the comorbid hypertension plus MDD group (HR 1.66, 95% CI 1.45 to 1.9). HRs for the comorbid hypertension plus MDD group were significantly raised compared with hypertension alone (HR 1.22, 95% CI 1.1 to 1.35). Interaction measured using relative excess risk due to interaction (RERI) and likelihood ratios (LRs) were identified at baseline (RERI 0.563, 95% CI 0.189 to 0.938; LR p=0.0116) but not maintained during the follow-up.LimitationsPossible selection bias in UK Biobank and inability to assess for levels of medication adherence.ConclusionsComorbid hypertension and MDD conferred greater hazard than hypertension alone for adverse cardiovascular outcomes, although evidence of interaction between hypertension and MDD was inconsistent over time. Future cardiovascular risk prediction tools may benefit from the inclusion of questions about prior history of depressive disorders.

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