Impact of Pre-diabetes alone or in combination with Hypertension, Dyslipidemia, or both on Major Adverse Cardiovascular Events

2019 ◽  
Author(s):  
Nahid Hashemi Madani ◽  
Faramarz Ismail-Beigi ◽  
Hossein Poustchi ◽  
Mahdi Nalini ◽  
Sadaf G. Sepanlou ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Fasting Glucose ◽  
Population Based ◽  
Major Adverse Cardiovascular Events ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Cox Proportional Hazard ◽  
Normal Fasting Glucose ◽  
Cox Proportional Hazard Models

Abstract Background Whether pre-diabetes in the absence of hypertension (HTN) or dyslipidemia (DLP) is a risk factor for occurrence of major adverse cardiovascular events (MACE) is not fully established. We investigated the effect of impaired fasting glucose (IFG) alone and in combination with HTN, DLP or both on subsequent occurrence of MACE as well as individual MACE components. Methods This longitudinal population-based study included 9,831 inhabitants of Northeastern Iran. The participants were free of any cardiovascular disease at baseline and were followed yearly from 2010 to 2017. Cox proportional hazard models were fitted to measure the hazard of IFG alone or in combination with HTN and DLP on occurrence of MACE as the primary endpoint. Results 297 MACE were recorded during 6.2±0.1 years follow up. IFG alone compared to normal fasting glucose (NFG) was not associated with increased in occurrence of MACE (HR, 1.05; 95% CI, 0.59-1.86; p, 0.8). However, combination of IFG and HTN (HR, 2.75; 95% CI, 1.93-3.90; p, 0.001) or HTN + DLP (HR, 2.85; 95% CI, 1.79-4.54; p, 0.001) significantly increased the hazard of MACE. In contrast, IFG with DLP at baseline did not increase the hazard of MACE compared to normoglycemic- normolipemic individuals (p,0.2). The results also indicated IFG with HTN, DLP, or HTN+DLP were associated with significant higher HRs for some individual components of MACE. Conclusion IFG, per se, does not appear to increase hazard of MACE. However, IFG with HTN or HTN + DLP conferred a significant hazard for MACE in an incremental manner.

scholarly journals Impaired Fasting Glucose alone or in combination with Hypertension, Dyslipidemia, or both AND Major Adverse Cardiovascular Events among patients without previous cardiovascular disease.

2019 ◽  
Author(s):  
Nahid Hashemi Madani ◽  
Faramarz Ismail-Beigi ◽  
Hossein Poustchi ◽  
Mahdi Nalini ◽  
Sadaf G. Sepanlou ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Impaired Fasting Glucose ◽  
Cardiovascular Events ◽  
Fasting Glucose ◽  
Population Based ◽  
Major Adverse Cardiovascular Events ◽  
Cox Proportional Hazard ◽  
Normal Fasting Glucose ◽  
Cox Proportional Hazard Models

Abstract Background Whether pre-diabetes in the absence of hypertension (HTN) or dyslipidemia (DLP) is a risk factor for occurrence of major adverse cardiovascular events (MACE) is not fully established. We investigated the effect of impaired fasting glucose (IFG) alone and in combination with HTN, DLP or both on subsequent occurrence of MACE as well as individual MACE components. Methods This longitudinal population-based study included 9,831 inhabitants of Northeastern Iran. The participants were free of any cardiovascular disease at baseline and were followed yearly from 2010 to 2017. Cox proportional hazard models were fitted to measure the hazard of IFG alone or in combination with HTN and DLP on occurrence of MACE as the primary endpoint. Results 297 MACE were recorded during 6.2±0.1 years follow up. IFG alone compared to normal fasting glucose (NFG) was not associated with increased in occurrence of MACE (HR, 1.05; 95% CI, 0.59-1.86; p, 0.8). However, combination of IFG and HTN (HR, 2.75; 95% CI, 1.93-3.90; p, 0.001) or HTN + DLP (HR, 2.85; 95% CI, 1.79-4.54; p, 0.001) significantly increased the hazard of MACE. In contrast, IFG with DLP at baseline did not increase the hazard of MACE compared to normoglycemic- normolipemic individuals (p,0.2). The results also indicated IFG with HTN, DLP, or HTN+DLP were associated with significant higher HRs for some individual components of MACE. Conclusion IFG, per se, does not appear to increase hazard of MACE. However, IFG with HTN or HTN + DLP conferred a significant hazard for MACE in an incremental manner.

BP in Young Adults with CKD and Associations with Cardiovascular Events and Decline in Kidney Function

2021 ◽  
pp. ASN.2020081156
Author(s):  
Alexander J. Kula ◽  
David K. Prince ◽  
Joseph T. Flynn ◽  
Nisha Bansal
Keyword(s):  
Heart Failure ◽  
Young Adults ◽  
Cardiovascular Events ◽  
Treatment Strategies ◽  
Proportional Hazard ◽  
Ckd Progression ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
The Relationship

BackgroundBP is an important modifiable risk factor for cardiovascular events and CKD progression in middle-aged or older adults with CKD. However, studies describing the relationship between BP with outcomes in young adults with CKD are limited.MethodsIn an observational study, we focused on 317 young adults (aged 21–40 years) with mild to moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. Exposures included baseline systolic BP evaluated continuously (per 10 mm Hg increase) and in categories (<120, 120–129, and ≥130 mm Hg). Primary outcomes included cardiovascular events (heart failure, myocardial infarction, stroke, or all-cause death) and CKD progression (50% decline of eGFR or ESKD). We used Cox proportional hazard models to test associations between baseline systolic BP with cardiovascular events and CKD progression.ResultsCardiovascular events occurred in 52 participants and 161 had CKD progression during median follow-up times of 11.3 years and 4.1 years, respectively. Among those with baseline systolic BP ≥130 mm Hg, 3%/yr developed heart failure, 20%/yr had CKD progression, and 2%/yr died. In fully adjusted models, baseline systolic BP ≥130 mm Hg (versus systolic BP<120 mm Hg) was significantly associated with cardiovascular events or death (hazard ratio [HR], 2.13; 95% confidence interval [95% CI], 1.05 to 4.32) and CKD progression (HR, 1.68; 95% CI, 1.10 to 2.58).ConclusionsAmong young adults with CKD, higher systolic BP is significantly associated with a greater risk of cardiovascular events and CKD progression. Trials of BP management are needed to test targets and treatment strategies specifically in young adults with CKD.

scholarly journals Pediatric Ischemic Stroke and Epilepsy: A Nationwide Cohort Study

Stroke ◽  
2021 ◽  
Author(s):  
Heléne E.K. Sundelin ◽  
Torbjörn Tomson ◽  
Johan Zelano ◽  
Jonas Söderling ◽  
Peter Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Population Based ◽  
Proportional Hazard ◽  
Future Planning ◽  
Population Based Study ◽  
First Degree Relatives ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

Background and Purpose: The risk of epilepsy after stroke has not been thoroughly explored in pediatric ischemic stroke. We examined the risk of epilepsy in children with ischemic stroke as well as in their first-degree relatives. Methods: In Swedish National Registers, we identified 1220 children <18 years with pediatric ischemic stroke diagnosed 1969 to 2016, alive 7 days after stroke and with no prior epilepsy. We used 12 155 age- and sex-matched individuals as comparators. All first-degree relatives to index individuals and comparators were also identified. The risk of epilepsy was estimated in children with ischemic stroke and in their first-degree relatives using Cox proportional hazard regression model. Results: Through this nationwide population-based study, 219 (18.0%) children with ischemic stroke and 91 (0.7%) comparators were diagnosed with epilepsy during follow-up corresponding to a 27.8-fold increased risk of future epilepsy (95% CI, 21.5–36.0). The risk of epilepsy was still elevated after 20 years (hazard ratio [HR], 7.9 [95% CI, 3.3–19.0]), although the highest HR was seen in the first 6 months (HR, 119.4 [95% CI, 48.0–297.4]). The overall incidence rate of epilepsy was 27.0 per 100 000 person-years (95% CI, 21.1–32.8) after ischemic stroke diagnosed ≤day 28 after birth (perinatal) and 11.6 per 100 000 person-years (95% CI, 9.6–13.5) after ischemic stroke diagnosed ≥day 29 after birth (childhood). Siblings and parents, but not offspring, to children with ischemic stroke were at increased risk of epilepsy (siblings: HR, 1.64 [95% CI, 1.08–2.48] and parents: HR, 1.41 [95% CI, 1.01–1.98]). Conclusions: The risk of epilepsy after ischemic stroke in children is increased, especially after perinatal ischemic stroke. The risk of epilepsy was highest during the first 6 months but remained elevated even 20 years after stroke which should be taken into account in future planning for children affected by stroke.

scholarly journals The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study

2012 ◽  
Vol 19 (3) ◽  
pp. 381-387 ◽  
Author(s):  
Sunil Amin ◽  
Richard R P Warner ◽  
Steven H Itzkowitz ◽  
Michelle Kang Kim
Keyword(s):  
Small Bowel ◽  
Population Based ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Before And After ◽  
Cox Proportional Hazard Models ◽  
Small Intestinal

Small-intestinal carcinoids (SIC) are the most common small-bowel malignancies. We sought to determine the risk of developing SIC before and after other primary malignancies (PM) and the prognosis of patients with SIC, with and without another PM. We used the Surveillance, Epidemiology, and End Results database to identify patients diagnosed with SICs between 1973 and 2007. Multiple primary-standardized incidence ratios were calculated as an approximation of relative risk (RR) to explore the association of SICs with metachronous malignancies. Survival analysis was performed using Kaplan–Meier methods and Cox proportional-hazard models. Among 8331 patients with SICs, 2424 (29%) had another PM at some time. The most common sites were prostate (26.2%), breast (14.3%), colon (9.1%), lung/bronchus (6.3%), and bladder (5.3%). Overall, 67% of patients had a PM diagnosed before SIC (pre-SIC), 33% after SIC (post-SIC), and 8% had a PM both before and after SIC. Among the pre-SIC group, the risk of future SIC was increased after cancers of the small bowel (RR 11.86 (95% CI: 6.13–20.72)), esophagus (4.05 (1.10–10.36)), colon (1.39 (1.05–1.81)), kidney (1.93 (1.12–3.09)), prostate (1.38 (1.17–1.62)), and leukemia (2.15 (1.18–3.61)). Among the post-SIC group, there was an increased risk of future PM of the small bowel (8.78 (4.54–15.34)), liver (2.49 (1.08–4.91)), prostate (1.25 (1.0–1.53)), and thyroid (2.73 (1.10–5.62)). Compared to patients with only SIC, those with a PM pre-SIC had worse mean survival (57.9 vs 40.9 months, HR 1.55 (1.42–1.69), P<0.001). In conclusion, almost one-third of patients with SICs have an associated metachronous primary tumor. When these primaries occur prior to (but not after) the SIC diagnosis, the prognosis is worse than with an initial SIC. The type of malignancies associated with SICs may guide future screening efforts.

scholarly journals Association of Tooth Scaling with Acute Myocardial Infarction and Analysis of the Corresponding Medical Expenditure: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7613
Author(s):  
Yi-Wei Kao ◽  
Ben-Chang Shia ◽  
Huei-Chen Chiang ◽  
Mingchih Chen ◽  
Szu-Yuan Wu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Periodontal Diseases ◽  
Population Based ◽  
Medical Expenditure ◽  
Control Group ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Scaling Group

Accumulating evidence has shown a significant correlation between periodontal diseases and systemic diseases. In this study, we investigated the association between the frequency of tooth scaling and acute myocardial infarction (AMI). Here, a group of 7164 participants who underwent tooth scaling was compared with another group of 7164 participants without tooth scaling through propensity score matching to assess AMI risk by Cox’s proportional hazard regression. The results show that the hazard ratio of AMI from the tooth scaling group was 0.543 (0.441, 0.670) and the average expenses of AMI in the follow up period was USD 265.76, while the average expenses of AMI in follow up period for control group was USD 292.47. The tooth scaling group was further divided into two subgroups, namely A and B, to check the influence of tooth scaling frequency on AMI risk. We observed that (1) the incidence rate of AMI in the group without any tooth scaling was 3.5%, which is significantly higher than the incidence of 1.9% in the group with tooth scaling; (2) the tooth scaling group had lower total medical expenditures than those of the other group because of the high medical expenditure associated with AMI; and (3) participants who underwent tooth scaling had a lower AMI risk than those who never underwent tooth scaling had. Therefore, the results of this study demonstrate the importance of preventive medicine.

scholarly journals Plasma Lutein, a Nutritional Biomarker for Development of Advanced Age-Related Macular Degeneration: The Alienor Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2047
Author(s):  
Bénédicte M. J. Merle ◽  
Audrey Cougnard-Grégoire ◽  
Jean-François Korobelnik ◽  
Wolfgang Schalch ◽  
Stéphane Etheve ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
High Performance ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Cox Proportional Hazard Models ◽  
Adjusted Model ◽  
Reduced Risk

Lutein and zeaxanthin may lower the risk of age-related macular degeneration (AMD). We evaluated the associations of plasma lutein and zeaxanthin with the incidence of advanced AMD in the Alienor study (Antioxydants Lipides Essentiels Nutrition et Maladies Oculaires). Alienor study is a prospective population-based cohort of 963 residents of Bordeaux, France, who were 73 years or older at baseline (2006–2008). The present study included 609 participants with complete ophthalmologic and plasma carotenoids data. Examinations were performed every two years over an eight-year period (2006 to 2017). Plasma lutein and zeaxanthin were determined at baseline from fasting blood samples using high-performance liquid chromatography. Cox proportional hazard models were used to assess associations between plasma lutein, zeaxanthin, and their (total cholesterol (TC) + triglycerides (TG)) ratios with AMD. Among the 609 included participants, 54 developed advanced incident AMD during a median follow-up time of 7.6 years (range 0.7 to 10.4). Participants with higher plasma lutein had a reduced risk for incident advanced AMD in the fully adjusted model (HR = 0.63 per 1-SD increase (95% CI, 0.41–0.97), p = 0.03). A similar association was observed using the lutein/(TC + TG) ratio (HR = 0.59 (95% CI, 0.39–0.90), p = 0.01). No associations were evidenced for other carotenoids. Higher plasma lutein was associated with a 37% reduced risk of incident advanced AMD.

scholarly journals Potato consumption and risk of pancreatic cancer in the HELGA cohort

2018 ◽  
Vol 119 (12) ◽  
pp. 1408-1415
Author(s):  
Lene A. Åsli ◽  
Tonje Braaten ◽  
Anja Olsen ◽  
Anne Tjønneland ◽  
Kim Overvad ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Registries ◽  
Glycaemic Index ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
The Mean ◽  
Potato Consumption ◽  
Adjusted Model

AbstractPotatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22,Pfor trend0·030) when comparing the highestv.the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72,Pfor trend0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84,Pfor trend0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

scholarly journals Farming tasks and the development of rheumatoid arthritis in the agricultural health study

2019 ◽  
pp. oemed-2018-105361 ◽  
Author(s):  
Christine G Parks ◽  
Armando Meyer ◽  
Laura E Beane Freeman ◽  
Jonathan Hofmann ◽  
Dale P Sandler
Keyword(s):  
Rheumatoid Arthritis ◽  
Self Report ◽  
Health Study ◽  
Proportional Hazard ◽  
Agricultural Health ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
Agricultural Health Study

ObjectivesFarming has been associated with rheumatoid arthritis (RA). Some studies have evaluated the effects of pesticides, but other agricultural exposures may also affect immune response.MethodsWe investigated non-pesticide agricultural exposures in relation to RA in licensed pesticide applicators (n=27 175, mostly male farmers) and their spouses (n=22 231) in the Agricultural Health Study (AHS) cohort (1993–1997) who completed at least one follow-up survey through 2015. Incident RA cases (n=229 applicators and 249 spouses) were identified based on self-report confirmed by use of disease-modifying antirheumatic drugs or medical records. Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) were estimated by Cox proportional hazard models adjusting for applicator status, state, smoking, education and specific pesticide use, allowing estimates to vary by median age when hazards assumptions were not met.ResultsOverall, RA was associated with regularly applying chemical fertilisers (HR=1.50; 95% CI 1.11 to 2.02), using non-gasoline solvents (HR=1.40; 95% CI 1.09 to 1.80), and painting (HR=1.26; 95% CI 1.00 to 1.59). In older applicators (>62 years), RA was associated with driving combines (HR=2.46; 95% CI 1.05 to 5.78) and milking cows (HR=2.56; 95% CI 1.01 to 6.53). In younger participants (≤62 years), RA was inversely associated with raising animals as well as crops (HR=0.68; 95% CI 0.51 to 0.89 vs crops only). Associations with specific crops varied by age: some (eg, hay) were inversely associated with RA in younger participants, while others (eg, alfalfa) were associated with RA in older participants.ConclusionThese findings suggest several agricultural tasks and exposures may contribute to development of RA.

scholarly journals Major Adverse Cardiovascular Events in Treated Periodontitis: A Population-Based Follow-Up Study from Taiwan

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0130807 ◽  
Author(s):  
Shing-Hsien Chou ◽  
Ying-Chang Tung ◽  
Yu-Sheng Lin ◽  
Lung-Sheng Wu ◽  
Chia-Pin Lin ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Population Based ◽  
Major Adverse Cardiovascular Events ◽  
Follow Up Study

Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors

2014 ◽  
Vol 32 (6) ◽  
pp. 564-570 ◽  
Author(s):  
Lawson Eng ◽  
Jie Su ◽  
Xin Qiu ◽  
Prakruthi R. Palepu ◽  
Henrique Hon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Survivors ◽  
Second Hand Smoke ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Peer Smoking ◽  
After Cancer

Purpose Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated with cessation rates in lung cancer survivors. Patients and Methods Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting. Results In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio [aOR], 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes. Conclusion SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.

Sign in / Sign up

Export Citation Format

Share Document