scholarly journals Factors affecting the effectiveness of endovascular kidney revascularization in patients with renal arteria stenosis

2020 ◽  
pp. 146-153
Author(s):  
E. V. Frolova ◽  
N. V. Morkovskikh ◽  
E. V. Kamenev ◽  
D. R. Sakhipov ◽  
V. A. Germanov
Keyword(s):  
Arterial Hypertension ◽  
Proportional Hazards ◽  
Correlation Coefficients ◽  
Cox Proportional Hazards ◽  
Factors Affecting ◽  
Multivariate Correlation ◽  
Proportional Hazards Regression ◽  
History Of ◽  
The Difference ◽  
Sequential Regression

The paper analyzes the results of surgical treatment of 109 patients with renal artery stenosis and manifestations of ischemic kidney disease (IBD) in the form of renovascular arterial hypertension. Blood pressure normalization was noted in 97 (89%) patients in the early and in 91 (84%) in the late postoperative periods. A sequential regression and multivariate correlation analysis of the factors of a good outcome of the operation was carried out. It was determined that significant prognostic factors are the presence of microalbuminuria and the duration of the history of arterial hypertension before surgery (correlation coefficients (HR) –0.684 and –0.695 at p = 0.0001). With these factors, the difference between the assessment of cumulative survival without clinical deterioration and the Cox proportional hazards regression model was statistically significant.

PETCO2 gradient: a novel prognostic parameter in cardiopulmonary exercise testing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I.D Poveda Pinedo ◽  
I Marco Clement ◽  
O Gonzalez ◽  
I Ponz ◽  
A.M Iniesta ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Proportional Hazards ◽  
Cardiopulmonary Exercise Testing ◽  
Cox Proportional Hazards ◽  
Prognostic Parameter ◽  
Cardiopulmonary Exercise ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Baseline Characteristics ◽  
The Difference

Abstract Background Previous parameters such as peak VO2, VE/VCO2 slope and OUES have been described to be prognostic in heart failure (HF). The aim of this study was to identify further prognostic factors of cardiopulmonary exercise testing (CPET) in HF patients. Methods A retrospective analysis of HF patients who underwent CPET from January to November 2019 in a single centre was performed. PETCO2 gradient was defined by the difference between final PETCO2 and baseline PETCO2. HF events were defined as decompensated HF requiring hospital admission or IV diuretics, or decompensated HF resulting in death. Results A total of 64 HF patients were assessed by CPET, HF events occurred in 8 (12.5%) patients. Baseline characteristics are shown in table 1. Patients having HF events had a negative PETCO2 gradient while patients not having events showed a positive PETCO2 gradient (−1.5 [IQR −4.8, 2.3] vs 3 [IQR 1, 5] mmHg; p=0.004). A multivariate Cox proportional-hazards regression analysis revealed that PETCO2 gradient was an independent predictor of HF events (HR 0.74, 95% CI [0.61–0.89]; p=0.002). Kaplan-Meier curves showed a significantly higher incidence of HF events in patients having negative gradients, p=0.002 (figure 1). Conclusion PETCO2 gradient was demonstrated to be a prognostic parameter of CPET in HF patients in our study. Patients having negative gradients had worse outcomes by having more HF events. Time to first event, decompensated heart Funding Acknowledgement Type of funding source: None

scholarly journals Pain in Patients With Type 2 Diabetes-Related Polyneuropathy Is Associated With Vascular Events and Mortality

2020 ◽  
Vol 105 (9) ◽  
pp. 3005-3014
Author(s):  
Brittany R Lapin ◽  
Kevin M Pantalone ◽  
Alex Milinovich ◽  
Shannon Morrison ◽  
Andrew Schuster ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Proportional Hazards ◽  
Negative Binomial ◽  
Cox Proportional Hazards ◽  
Vascular Events ◽  
Proportional Hazards Regression ◽  
Increased Risk ◽  
History Of ◽  
Mortality Hazard Ratio

Abstract Purpose Type 2 diabetes–related polyneuropathy (DPN) is associated with increased vascular events and mortality, but determinants and outcomes of pain in DPN are poorly understood. We sought to examine the effect of neuropathic pain on vascular events and mortality in patients without DPN, DPN with pain (DPN + P), and DPN without pain (DPN-P). Methods A retrospective cohort study was conducted within a large health system of adult patients with type 2 diabetes from January 1, 2009 through December 31, 2016. Using an electronic algorithm, patients were classified as no DPN, DPN + P, or DPN-P. Primary outcomes included number of vascular events and time to mortality. Independent associations with DPN + P were evaluated using multivariable negative binomial and Cox proportional hazards regression models, adjusting for demographics, socioeconomic characteristics, and comorbidities. Results Of 43 945 patients with type 2 diabetes (age 64.6 ± 14.0 years; 52.1% female), 13 910 (31.7%) had DPN: 9104 DPN + P (65.4%) vs 4806 DPN-P (34.6%). Vascular events occurred in 4538 (15.1%) of no DPN patients, 2401 (26.4%) DPN + P, and 1006 (20.9%) DPN-P. After adjustment, DPN + P remained a significant predictor of number of vascular events (incidence rate ratio [IRR] = 1.55, 95% CI, 1.29-1.85), whereas no DPN was protective (IRR = 0.70, 95% CI, 0.60-0.82), as compared to DPN-P. Compared to DPN-P, DPN + P was also a significant predictor of mortality (hazard ratio = 1.42, 95% CI, 1.25-1.61). Conclusions Our study found a significant association between pain in DPN and an increased risk of vascular events and mortality. This observation warrants longitudinal study of the risk factors and natural history of pain in DPN.

scholarly journals The impact of preoperative use of calcium channel blockers on outcomes of patients undergoing esophagectomy: a propensity score-matched cohort study

2020 ◽  
Author(s):  
Qihua Lin ◽  
Tianhua Zhang ◽  
Zhijie Wu ◽  
Huiting Li ◽  
Junjie Yu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Scores ◽  
Proportional Hazards ◽  
Perioperative Complications ◽  
Cox Proportional Hazards ◽  
Perioperative Outcomes ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Proportional Hazards Regression ◽  
History Of

Abstract BACKGROUND In this study, we compared the effects of using preoperative CCBs on perioperative outcomes, cancer recurrence and overall survival in patients undergoing esophagectomy. METHODS A retrospective cohort study was performed on patients who underwent esophagectomy at the Sun Yat-Sen University Cancer Center (n=2415, 2009-2013). Univariate and multivariate logistic regression analyses were performed to assess the perioperative outcomes, while recurrence-free survival and overall survival were assessed using Kaplan-Meier survival estimates and compared using a multivariate Cox proportional hazards regression, adjusted with propensity scores. RESULTS There were 162 patients in the CCB group and 1110 patients in the non-CCB group and the total incidence of perioperative complications was 45.7% in the CCB group and 42.5% in the non-CCB group. The differences in total perioperative complications and other perioperative outcomes were not significantly different between the two groups (P>0.05). The mortality rate was not significantly different between the two groups after matching (38.1% vs 31.6%, P=0.233). The difference in recurrence rate between the two groups was not statistically significant after matching (43.2% vs 32.9%, P = 0.061). Overall survival was shorter in patients with preoperative CCB use than in patients without CCB use (hazards ratio: 1.517, 95% confidence intervals (CI): 1.036-2.220, P=0.030). The multivariate Cox proportional hazards regression adjusted with propensity scores found that a history of smoking cigarettes, clinical stage III at diagnosis, preoperative CCB use, preoperative diuretics use, operation type and postoperative chemotherapy affected the overall survival of patients after esophagectomy. Recurrence-free survival was similar between the CCB and non-CCB groups (HR: 1.425, 95%CI: 0.989-2.053, P=0.054). A history of chronic lung disease, hypertension, and preoperative use of beta-blockers affected the recurrence-free survival of patients after esophagectomy. CONCLUSION Preoperative CCBs use was associated with shorter overall survival but did not affect recurrence-free survival or the postoperative complications for patients undergoing esophagectomy.

Abstract P044: Ten-Year Blood Pressure Trajectories and Long-Term Risk of Cardiovascular Mortality: The Minnesota Business and Professional Men Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Susanne M Tielemans ◽  
Johanna M Geleijnse ◽  
Hendriek C Boshuizen ◽  
Sabita S Soedamah-Muthu ◽  
Alessandro Menotti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Added Value ◽  
Time To Death ◽  
History Of ◽  
The Difference ◽  
Single Baseline ◽  
Cvd Mortality

Introduction: We characterised 10[[Unable to Display Character: ‑]]year trajectories of annual blood pressure (BP) measurements and studied the added value on long-term cardiovascular disease (CVD) mortality in comparison to a single baseline BP measurement. Methods: This study is based on data from 266 men, aged 45 to 55 years, who participated in the Minnesota Business and Professional Men Study. BP was measured annually between 1947[[Unable to Display Character: ‑]]1957, a time when only very high levels of BP were treated. Men who did not die before 1957 and did not have a history of myocardial infarction or stroke were included. We identified BP trajectories by means of finite mixture group-based trajectory modelling (PROC TRAJ in SAS). For each individual, time to death was defined as the difference in years between 1957 and year of death (the last man died in 2002). Cox proportional hazards analysis was used to examine BP trajectories in relation to CVD mortality. Results: All 266 men died and 142 (53.4%) from CVD, with mean (± sd) time to death 21±10 years. We identified four systolic BP trajectories with baseline mean systolic BP levels ranging from 112 (SBP1) to 165 (SBP4) mmHg. This difference of 53 mmHg in baseline systolic BP level was associated with a hazard ratio (HR) of 2.4 (95% CI: 1.5-3.8) for CVD mortality. From age 45 to 65, mean systolic BP levels of the four trajectories (Figure 1A) increased from 0.4 to 2.1 mmHg/year for SBP1 to SBP4. For systolic BP trajectories, the HR of CVD mortality increased from 1.6 (SBP2) to 4.2 (SBP4), compared to men in SBP1 (Figure 1A). A similar pattern was observed for diastolic BP (Figure 1B). Conclusion: In this population of middle[[Unable to Display Character: ‑]]aged US men, the increase in BP was strongest in those with the highest BP levels. Trajectories of BP predicted CVD mortality much better than a single BP measurement.

Risk of non-infectious uveitis or myasthenia gravis in patients on checkpoint inhibitors in a large healthcare claims database

2020 ◽  
pp. bjophthalmol-2020-317060 ◽  
Author(s):  
Tian Xia ◽  
Alexander J Brucker ◽  
Brendan McGeehan ◽  
Brian L VanderBeek
Keyword(s):  
Multivariate Analysis ◽  
Myasthenia Gravis ◽  
Index Date ◽  
Proportional Hazards ◽  
Checkpoint Inhibitors ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Increased Risk ◽  
History Of ◽  
Infectious Uveitis

AimTo determine if checkpoint inhibitors (CPIs) confer an increased risk of non-infectious uveitis or myasthenia gravis (MG) compared to patients on non-checkpoint inhibitor (N-CPI) chemotherapy.MethodsA retrospective cohort study was performed comparing patients in a large commercial and Medicare advantage database exposed to CPI compared to N-CPI. All patients who initiated a CPI (ipilimumab, pembrolizumab, nivolumab, atezolizumab, avelumab, cemiplimab and durvalumab) were eligible. Date of earliest CPI in the exposure group and N-CPI chemotherapy in the comparator group was considered the index date. Exclusion occurred in both cohorts for any history of uveitis or MG diagnosis and having <1 year in the insurance plan prior to the index date, and <6 months in plan following the index date. Every exposed patient was matched up to 1:10 based on demographics and index year to patients on N-CPI chemotherapy. Multivariate Cox proportional hazards regression modelling was performed.ResultsFor evaluation of incidence of non-infectious uveitis, 26 (0.3%) of 8678 patients on CPI and 123 (0.2%) of 76 153 N-CPI comparators were found to have non-infectious uveitis. After multivariate analysis, CPIs showed an increased hazard for uveitis compared to N-CPI (HR=2.09; 95% CI 1.36 to 3.22, p=0.001). For the MG analysis, 11 (0.1%) of 9210 patients developed MG in the CPI group and 36 (0.04%) of 80 620 comparators. The CPI cohort had a higher hazard of developing MG (HR=2.60; 95% CI 1.34 to 5.07, p=0.005) compared to controls in multivariate analysis.ConclusionsExposure to CPI confers a higher risk for non-infectious uveitis and MG compared to N-CPI chemotherapy.

scholarly journals Distribution of FFRCT in Single Obstructive Coronary Stenosis and Predictors for Major Adverse Cardiac Events: A Propensity Score Matching Study

2021 ◽  
Author(s):  
Xianglan Jin ◽  
Xiangyu Jin ◽  
Xiaoyun Wu ◽  
Luguang Chen ◽  
Tiegong Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Unstable Angina ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Conservative Group ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Adverse Cardiac Events ◽  
History Of

Abstract Background: Fractional flow reserve derived from computed tomography (FFRCT) has been demonstrated significantly improved identification of lesion-specific ischemia compared with coronary computed tomography angiography (CCTA). It remains unclear the distribution of FFRCT values in obstructive stenosis between patients who received percutaneous coronary intervention (PCI) or not in routine clinical practice, as well as its association with clinical outcome. This study aims to reveal the distribution of FFRCT value in patients with single obstructive coronary artery stenosis, and explored the independent factors for predicting major adverse cardiac events (MACE). Methods: This was a retrospective study of adults with non-ST-segment elevation acute coronary syndrome undergoing FFRCT assessment by using CCTA data from January 1, 2016 to December 31, 2020. Propensity score matching (PSM) method was used to account for patient selection bias. The risk factors for predicting MACE were evaluated by a Cox proportional hazards regression analysis. Results: Overall, 655 patients with single obstructive (³ 50%) stenosis shown on CCTA were enrolled and divided into PCI group (376 cases) and conservative group (279 cases) according to treatment. The PSM cohort analysis demonstrated that the difference in history of unstable angina, CCSC and FFRCT between PCI group (188 cases) and conservative group (315 cases) was statistically significant, with all P values < 0.05, while the median follow-up time between them was no statistically significant (24 months vs 22.5months, P = 0.912). The incidence of MACE in PCI group and conservative group were 14.9% (28/188) and 23.5% (74/315) respectively, P = 0.020. Multivariate analysis of Cox proportional hazards regression revealed that history of unstable angina (adjusted odds ratio (adjOR), 3.165; 95% confidence interval (CI), 2.087-4.800; P < 0.001), FFRCT £ 0.8 (OR, 1.632;95% CI, 1.095-2.431; P = 0.016), and PCI therapy (OR, 0.481; 95% CI, 0.305-0.758) were the independent factors for MACE. Conclusions: History of unstable angina and FFRCT value of £ 0.8 were the independent risk factors for MACE, while PCI therapy was the independent protective factor for MACE.

scholarly journals DOP59 Evaluation of the efficacy of tofacitinib as maintenance therapy in patients with Ulcerative Colitis stratified by OCTAVE Sustain baseline endoscopic subscore

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S094-S095
Author(s):  
S D Lee ◽  
J R Allegretti ◽  
F Steinwurz ◽  
S B Connelly ◽  
N Lawendy ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Logistic Regression ◽  
Treatment Effect ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Phase 3 ◽  
Loss Of Response ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
The Difference

Abstract Background Tofacitinib is an oral, small molecule JAK inhibitor for the treatment of ulcerative colitis (UC). Efficacy and safety of tofacitinib in patients (pts) with UC were evaluated in two 8-week, Phase 3 induction studies (OCTAVE Induction 1&2), a 52-week, Phase 3 maintenance study (OCTAVE Sustain), and an open-label, long-term extension study. Here, we evaluate tofacitinib efficacy in OCTAVE Sustain (NCT01458574) by baseline Mayo endoscopic subscore (ES). Methods Pts with an OCTAVE Sustain baseline ES of 0 or 1 were included. Proportion of pts achieving efficacy endpoints at Week 52 of OCTAVE Sustain (responders from OCTAVE Induction 1&2; tofacitinib 5 or 10 mg twice daily [BID] or placebo [PBO]) was evaluated in relation to OCTAVE Sustain baseline ES. Using logistic regression, the difference in treatment effect (tofacitinib vs PBO) between baseline ES (0 vs 1) for each efficacy endpoint was assessed. Cox proportional hazards regression was used to model the difference in treatment effect between baseline ES (0 vs 1) for time to treatment failure and loss of response. Results At Week 52 of OCTAVE Sustain, a numerically higher proportion of pts with a baseline ES of 0 achieved remission and endoscopic improvement vs pts with a baseline ES of 1, regardless of tofacitinib dose (Table). Logistic regression analyses showed a larger treatment effect of tofacitinib 5 mg BID at Week 52 in pts with a baseline ES of 0 vs 1 (p=0.0306) for clinical response (Table). Treatment effect of tofacitinib 10 mg BID was not significantly different between baseline ES 0 vs 1 for any endpoint (Table). In tofacitinib 5 mg BID-treated pts, Cox proportional hazards regression showed difference in risk vs PBO to be larger in pts with a baseline ES of 0 vs 1 for treatment failure (p=0.0231) and loss of response (p=0.0209); corresponding differences for 10 mg BID-treated pts were not significant (p=0.9239 and p=0.9613, respectively). Conclusion In general, at Week 52 of OCTAVE Sustain, a higher proportion of tofacitinib-treated pts achieved endpoints with a baseline ES of 0 vs 1. Based on proportions, the treatment effect of tofacitinib 5 mg BID was more evident in pts with a baseline ES of 0 vs 1. This difference in treatment effect related to baseline ES was not observed with tofacitinib 10 mg BID. Baseline ES may be an important factor in predicting outcomes, and suggests that aiming for a deeper remission after induction may allow successful maintenance with tofacitinib 5 mg BID. These analyses were post hoc and limited by the small sample sizes.

scholarly journals Elevation of Neurodegenerative Serum Biomarkers among Hospitalized COVID-19 Patients

2021 ◽  
Author(s):  
Jennifer A. Frontera ◽  
Allal Boutajangout ◽  
Arjun V. Masurkar ◽  
Rebecca A. Betensky ◽  
Yulin Ge ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Neurological Complications ◽  
Cox Proportional Hazards ◽  
Serum Biomarkers ◽  
Hospital Death ◽  
Regression Analyses ◽  
Total Tau ◽  
Proportional Hazards Regression ◽  
Age Related ◽  
History Of

ABSTRACTINTRODUCTIONOlder adults hospitalized with COVID-19 are susceptible to neurological complications, particularly encephalopathy, which may reflect age-related neurodegenerative processes.METHODSSerum total tau, ptau-181, GFAP, NFL, UCHL1, and amyloid-beta(Aβ-40,42) were measured in hospitalized COVID-19 patients without a history of dementia, and compared among patients with or without encephalopathy, in-hospital death versus survival, and discharge home versus other dispositions using multivariable Cox proportional hazards regression analyses.RESULTSAmong 251 patients, admission serum ptau-181 and UCHL1 were significantly elevated in patients with encephalopathy (both P<0.05) and total tau, GFAP, and NFL were significantly lower in those discharged home(all P<0.05). These markers correlated significantly with severity of COVID illness. NFL, GFAP and UCH-L1 were significantly higher in hospitalized COVID patients than in non-COVID controls with mild cognitive impairment or Alzheimer’s disease(AD).DISCUSSIONAge-related neurodegenerative biomarkers were elevated to levels observed in AD and associated with encephalopathy and worse outcomes among hospitalized COVID-19 patients.

scholarly journals Prognostic value of MRI-measured tumor thickness in patients with tongue squamous cell carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ki-Sun Park ◽  
Yangsean Choi ◽  
Jiwoong Kim ◽  
Kook-Jin Ahn ◽  
Bum-soo Kim ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Value ◽  
Proportional Hazards ◽  
Correlation Coefficients ◽  
Cox Proportional Hazards ◽  
Tumor Thickness ◽  
Tongue Squamous Cell Carcinoma ◽  
Depth Of Invasion

AbstractThis study aimed to assess the prognostic value of MRI-measured tumor thickness (MRI-TT) in patients with tongue squamous cell carcinoma (SCC). This single-center retrospective cohort study included 133 pathologically confirmed tongue SCC patients between January 2009 and October 2019. MRI measurements of tongue SCC were based on axial and coronal T2-weighted (T2WI) and contrast-enhanced T1-weighted (CE-T1WI) images. Two radiologists independently measured MRI-TT. Intraclass correlation coefficients (ICC) were calculated for inter-rater agreements. Spearman’s rank correlation between MRI-TT and pathologic depth of invasion (pDOI) was assessed. Cox proportional hazards analyses on recurrence-free (RFS) and overall survival (OS) were performed for MRI-TT and pDOI. Kaplan–Meier survival curves were plotted with log-rank tests. The intra- and inter-rater agreements of MRI-TT were excellent (ICC: 0.829–0.897, all P < 0.001). The correlation between MRI-TT and pDOI was good (Spearman’s correlation coefficients: 0.72–0.76, P < 0.001). MRI-TT were significantly greater than pDOI in all axial and coronal T2WI and CE-T1WI (P < 0.001). In multivariate Cox proportional hazards analysis, MRI-TT measured on axial CE-T1WI yielded a significant prognostic value for OS (hazards ratio 2.77; P = 0.034). MRI-TT demonstrated excellent intra- and inter-rater agreements as well as high correlation with pDOI. MRI-TT may serve as a prognostic predictor in patients with tongue SCC.

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