scholarly journals Risk factors for systemic thromboembolism after left chamber cardiac thrombi --- A retrospective multi-center study

2019 ◽  
Author(s):  
wei zhou ◽  
Shun-yi Shi ◽  
Yuan Ji ◽  
Xin Chen ◽  
Jun Huang ◽  
...  
Keyword(s):  
Medical Records ◽  
Heart Function ◽  
Multivariate Logistic Regression ◽  
Increased Risk ◽  
All Cause Mortality ◽  
History Of ◽  
Multi Center Study ◽  
Relationship Of ◽  
The Relationship

Abstract Background : We aimed to characterize the independent predictors of systemic thromboembolism (ST) after left chamber thrombi. Methods: A retrospective analysis on the medical records of 175 patients diagnosed with left chamber thrombi by transthoracic echocardiography (TTE) at three centers were carried out. Multivariate logistic regression was performed to determine the relationship of each characteristic with ST. Multivariate Cox proportional survival analysis was conducted, with covariate adjustments, to identify predictors of all-cause mortality. Results: During a median 42 months of follow-up (25th–75th percentile: 20–62 months), 24 (13.7%) patients had ST, and 62 (35.4%) died. History of diabetes and thrombus mobility were independent predictors of ST (P = 0.003, P = 0.02, respectively). There was a significant association between abnormal ejection fraction (EF) and all-cause mortality (P = 0.003). Conclusions: The morbidity associated with ST and the increased risk for mortality associated with left chamber cardiac thrombi relates to medical history, thrombus state, and diminished heart function.

Abstract 5108: Microalbuminuria is Associated with Progression of Coronary Atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Andrew P DeFilippis ◽  
Holly J Kramer ◽  
Ronit Katz ◽  
Nathan Wong ◽  
Alain Bertoni ◽  
...  
Keyword(s):  
Lipid Lowering ◽  
Albumin Creatinine Ratio ◽  
Ethnic Study ◽  
Median Increase ◽  
Increased Risk ◽  
History Of ◽  
Relationship Of ◽  
The Relationship ◽  
Progression Of Atherosclerosis

Background: Microalbuminuria (MA) is associated with an increased risk of cardiovascular disease (CVD) but the mechanism by which microalbuminuria imparts this increased risk is not known. In this study we assessed the relationship between MA and the development and progression of atherosclerosis by measuring the incidence of new CAC and the progression of existing CAC in individuals free of clinical CVD. Methods : The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of 6,814 participants free of clinical CVD at entry who underwent assessment of coronary artery calcification (CAC) by computerized tomography at baseline. Overall, 6,775 individuals had data available on urinary albumin creatinine ratio (UACR); 1,109 individuals were excluded for missing data or macroalbuminuria (UACR≥300 mg/g). Incident CAC was defined as detectable CAC at follow-up among those with CAC=0 at baseline, and absolute CAC score change among those with CAC>0 at baseline. Relative risk (RR) regression adjusted for covariates; and multivariable adjusted median regression was employed to assess the independent relationship of MA with CAC incidence and progression. Results : Of the 5,666 subjects (mean age 62±10 years, 48% males), baseline MA was seen in 424 (7%) participants, who were more likely to have CAC compared to those with normal UACR (62% vs. 48%, p<0.0001). During a mean follow-up of 2.4±0.8 years, those with MA were more likely to develop CAC (28% vs. 15%, p<0.0001) and they had a higher absolute median increase in CAC (47 vs. 29 Agatston Units, p<0.0001). After adjustment for age, gender, ethnicity, site, follow-up duration, diabetes, hypertension, smoking, family history of heart attack, total cholesterol, lipid lowering medications and body mass index; MA was associated with incident CAC (RR 1.65; 95%CI 1.41–2.48) among those with CAC=0 at baseline. Among those with CAC>0 at baseline, MA was associated with a median increase in CAC of 7.93 (95%CI 0.38 –15.47) Agatston Units in multivariable adjusted analyses (variables noted above). Conclusion : MA is independently associated with development of incident CAC and progression of CAC in an asymptomatic multi-ethnic population, and may in part explain its associated increased risk of CVD.

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 40 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Liping Xiong ◽  
Li Fan ◽  
Qingdong Xu ◽  
Qian Zhou ◽  
Huiyan Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
All Cause Mortality ◽  
History Of ◽  
The Relationship

Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

scholarly journals Hypertension Burden and the Risk of New-Onset Atrial Fibrillation

Hypertension ◽  
2021 ◽  
Vol 77 (3) ◽  
pp. 919-928
Author(s):  
So-Ryoung Lee ◽  
Chan Soon Park ◽  
Eue-Keun Choi ◽  
Hyo-Jeong Ahn ◽  
Kyung-Do Han ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Total Study Population ◽  
Increased Risk ◽  
Burden Scale ◽  
History Of ◽  
Study Population ◽  
Korean National Health Insurance ◽  
Stage 1 ◽  
The Relationship

The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.

scholarly journals A study of herpes zoster particularly in its relationship to chickenpox

1949 ◽  
Vol 47 (3) ◽  
pp. 253-262 ◽  
Author(s):  
H. E. Seiler
Keyword(s):  
Herpes Zoster ◽  
Sex Differentiation ◽  
Motor Paralysis ◽  
Recurrent Herpes ◽  
History Of ◽  
The One ◽  
Two Peaks ◽  
Relationship Of ◽  
The Relationship

The results of a field survey of herpes zoster over a period of 18 months are described and the difficulties of such a survey mentioned.A total of 246 patients with herpes zoster, only 16% of whom had attended hospital, is reported. It is calculated that the yearly incidence in the population was approximately 2 per 1000.Full investigation and ‘follow up’ was undertaken in 184 cases. These are classified according to the site of the zoster—the dorsal, supra-orbital and cervical regions being affected in almost 90%, the dorsal region alone accounting for 53·3%.Herpes generalisatus occurred in 7, or 38%, of the cases, recurrent herpes zoster in 6, or 3·3%, while there was one case of motor paralysis affecting lower limb.The majority of patients were apparently well at the onset of the zoster, but 27 had some associated disease; 5 gave a history of trauma prior to the onset and 2 were related to pregnancy.The seasonal and geographical distribution is given and, while the numbers are too small for statistical analysis, the disease in 1947 showed two peaks of higher incidence, the one in May and the other in October. Crowding or density of population did not appear to be important, and the disease occurred sporadically rather than in epidemic form.There was a higher proportion of female cases, but when related to the population as a whole no sex differentiation was observed. Of the patients 60% were over 45 years of age.There was no evidence that housing conditions or occupation were of aetiological significance or that the disease was more common among any particular section of the community.Eleven patients had been associated with other cases of herpes zoster before developing the disease, while 3 gave a suggestive history of prior contact with chickenpox.A condition indistinguishable from chickenpox occurred among the contacts of 10 patients, 12 individuals being affected, and there was one instance of concurrent herpes zoster and chickenpox. Other infections such as mumps, measles and rubella, while as common in association with the onset of herpes zoster, were not so frequently found as the chickenpox condition amongst contacts of the disease.The results of the survey as regards the relationship of chickenpox and herpes zoster are discussed. It is considered that the evidence does not favour a significant association with chickenpox prior to the onset of herpes zoster, but that the facts are consistent with the view that a condition indistinguishable from chickenpox may follow contact with herpes zoster. It is suggested, however, that this may be a generalized manifestation of the virus of zoster rather than true chickenpox.

The Relationship of Drug Abuse to Unexplained Sudden Death

2008 ◽  
Vol 132 (12) ◽  
pp. 1903-1906
Author(s):  
Amy C. Gruszecki ◽  
Gerald McGwin, Jr ◽  
C. Andrew Robinson, Jr ◽  
Gregory G. Davis
Keyword(s):  
Drug Abuse ◽  
Cause Of Death ◽  
Control Group ◽  
Manner Of Death ◽  
Increased Risk ◽  
History Of ◽  
Matched Case ◽  
Relationship Of ◽  
The Relationship ◽  
Control Study

Abstract Context.—Forensic pathologists regularly investigate the deaths of individuals with a history of drug abuse. Autopsy, including toxicology testing, reveals no cause for death in a subset of this cohort. Objective.—To determine whether deaths with an undetermined cause and manner of death are associated with a history of drug abuse. Design.—Retrospective matched case-control study of 52 decedents whose cause of death remained undetermined following autopsy, matched 1:2 to a control group of living patients admitted for cholecystectomy according to age and date of death or procedure. Results.—Individuals whose cause of death was undetermined were 5.3 times (95% confidence interval, 1.9– 14.5) more likely to have a history of drug abuse than were patients with cholecystitis. Conclusions.—Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicologic finding at autopsy to account for death.

scholarly journals Hydatid Cyst of the Adrenal Gland: A Clinical Study of Six Cases

2006 ◽  
Vol 6 ◽  
pp. 2420-2425 ◽  
Author(s):  
Ali Horchani ◽  
Yassine Nouira ◽  
Kais Nouira ◽  
Haikel Bedioui ◽  
Emna Menif ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Hydatid Cyst ◽  
Ct Scan ◽  
Preoperative Diagnosis ◽  
Laparoscopic Approach ◽  
Lumbar Pain ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

Hydatid cyst of the adrenal gland (HCAG) is an exceptional occurrence. We report our experience of six cases of HCAG and discuss the diagnosis and treatment of this hydatid localization. We retrospectively reviewed and analyzed the clinical files of six patients admitted to our institution from January 1990 to December 2000 for HCAG. Patients varied in age from 24—59 years. They were five males and one female. One patient had a history of pulmonary hydatidosis treated surgically 10 years previously. Five patients presented with lumbar pain and one patient had bouts of hypertension, headache, and palpitation. Physical examination was normal except in one patient who was hypertensive. Preoperative diagnosis was highly suggested by ultrasonography. CT scan performed in all cases clearly showed the relationship of the cyst with adjacent organs. Serology tests were positive in two cases. One patient had elevated urine VMA and was operated on with the diagnosis of cystic phaeochromocytoma. All six patients were operated on and had either an adrenalectomy (two cases) or partial pericystectomy (four cases). In one case, partial pericystectomy was conducted through a retroperitoneal laparoscopic approach. The hydatid nature of the cyst was confirmed pathologically. All patients had a smooth postoperative course with no cystic recurrence on follow-up. The diagnosis of HCAG is based mainly on ultrasonography and CT scan. Surgery with either partial or total excision of the cyst, with or without preservation of the adrenal gland, is the treatment of choice.

scholarly journals A reassessment of the relationship between depression and all-cause mortality in 3,604,005 participants from 293 studies

2017 ◽  
Author(s):  
Eiko I Fried ◽  
Beyon Miloyan
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Total Sample ◽  
Mental Condition ◽  
Analysis Methodology ◽  
All Cause Mortality ◽  
Model Adjustment ◽  
Relationship Of ◽  
The Relationship

The objective of this study is to explain inconsistencies in the relationship between depression and all-cause mortality by performing a reassessment of the included studies of previous systematic reviews. We assessed study-level methodological variables with a focus on sample size and follow-up period, measurement and classification of depression, and model adjustment. We included the constituent studies of fifteen systematic reviews on depression and mortality, yielding 488 articles after the removal of duplicates. 333 studies were extracted, 40 of which used data that overlapped with other included studies. We included 313 estimates from 293 articles in the meta-analysis with a total sample of 3,604,005 participants and over 417,901 deaths. We identified a pronounced publication bias favoring large, positive associations in imprecise studies. Several factors moderated the relationship between depression and mortality. Most importantly, the 16 estimates adjusting for at least one comorbid mental condition (Pooled Effect: 1.08; 95% CI: 0.98-1.18), and the fraction of 8 of those estimates also adjusting for health variables (e.g., smoking, alcohol use, or physical inactivity; Pooled Effect: 1.04; 95% CI: 0.87-1.21), reported considerably smaller associations than the 204 unadjusted estimates (Pooled Effect: 1.32; 95% CI: 1.28-1.36). The sizable relationship of depression and mortality reported in previous systematic reviews is largely based on low-quality studies; controlling for important covariates attenuates the association considerably. Higher quality studies are needed based on large community samples, extensive follow-up, adjustment for health behaviors and mental disorders, and time-to-event outcomes based on survival analysis methodology.

scholarly journals SO048CREATININE INDEX AND IT'S ASSOCIATION WITH MORTALITY AND HOSPITALISATION AMONG INCIDENT HAEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nandakumar Mooppil ◽  
Seema Aithal ◽  
Tripti Singh ◽  
Rajiva Ibakkanavar
Keyword(s):  
Serum Creatinine ◽  
Lean Body Mass ◽  
Body Mass ◽  
Negative Binomial ◽  
Laboratory Data ◽  
Exposure Period ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Relationship

Abstract Background and Aims Studies have suggested that higher lean body mass (LBM) is associated with increased longevity among haemodialysis (HD) patients. It has been shown that creatinine index is a surrogate marker of lean body mass and can be estimated using a simplified equation based on age, gender, serum creatinine and KT/V(sp). The present study was conducted to investigate the association between estimated creatinine index and all-cause mortality in a large racially diverse cohort of incident HD patients. We also examined the relationship between creatinine index and hospitalisation incidence in this cohort. Method Incident patients (aged≥18 years) between January, 2010 and December, 2018 who survived six months of HD were included in this retrospective observational study. Baseline demographic data was collected at study commencement, followed by clinical and laboratory data during the 6 month exposure period. Patients were followed from the index date (last day of exposure period) until first of the following – death, withdrawal or end of study (June 30, 2019). The exposure of interest was Creatinine Index (CI) estimated using a simplified formula (Canaud et al 2014) based on patient demographics (age and gender), pre-dialysis serum creatinine and KT/V(sp). Patients were stratified into 4 groups based on CI quartiles - Q1(&lt;=17.48), Q2(17.49-18.91), Q3(18.92-20.54) and Q4(20.55+). Primary outcome was all-cause mortality during the overall follow-up. Adjusted hazard ratios were estimated using a Cox regression model for association between CI quartiles and mortality. Negative binomial regression models were used to assess the relationship between CI quartiles and hospitalisation. Results A total of 3172 incident HD patients (mean age 60.4±11.5 years, 56.2% male, 57.4% Chinese and 70.4% with diabetes as cause of ESRD) were included in the study. During the median follow-up of 2.8 (1.4-4.7) years, 755 (23.8%) patients died. The mean creatinine index for entire cohort was 19.1±2.3 mg/kg/day. The patients in the lowest CI quartile (Q1) were older, females, had higher incidence of diabetes and comorbidity but lower levels of albumin, haemoglobin, BMI and SGA scores compared to higher quartiles (p&lt;0.001). Following multivariate analysis the adjusted hazard of death were as follows - Q4 (aHR-1, reference), Q1 (aHR-2.14, 95%CI 1.56-2.94), Q2 (aHR-1.58, 95%CI 1.21-2.05), Q3 (aHR-1.33, 95%CI 1.05-1.68), p&lt;0.001. Patients in the lowest quartile of CI (Q1) had 64% higher incidence of hospitalisation (IRR 1.64, 95%CI 1.36–1.98, p&lt;0.001) compared with patients in Q4 (IRR-1, reference). Conclusion Creatinine index derived from a simplified equation is useful in predicting mortality and hospitalisation among Southeast Asian incident HD patients. Low CI was associated with increased risk of all-cause mortality and hospitalisation in our cohort. The present study is limited by the lack of data on residual renal function which might confound the results.

Abstract 15126: Cardiorespiratory Fitness and Atrial Fibrillation: A Population-based Follow-up Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Danesh K Kella ◽  
Jari Laukkanen ◽  
Michael S Lloyd ◽  
Sudhir Kuir ◽  
Rainer Rauramaa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiorespiratory Fitness ◽  
Disease Status ◽  
Population Based ◽  
History Of ◽  
Disease Study ◽  
Relationship Of ◽  
The Relationship ◽  
Fourth Quartile

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and has a complex association with exercise capacity. The relationship of atrial fibrillation with cardiorespiratory fitness (CRF) has not been previously investigated. Methods: Cardiorespiratory fitness, as assessed by maximal oxygen uptake (VO2max), was measured at baseline in 1,950 middle-aged men (mean 52.6 ± 5.1 years) from the Kuopio Ischaemic Heart Disease Study (KIHD). Results: During an average follow-up of 19.5 years, there were 305 incident AF cases (annual AF rate of 65.1/1000 person-years, 95% CI: 58.2 to 72.8). Overall a non-linear association was observed between CRF and incident atrial fibrillation. Rate of incident AF varied from 11.5 (95% CI: 9.4-14.0) for the first quartile of CRF, to 9.1 (95% CI: 7.4-11.2) for second quartile, 5.7 (95% CI: 4.4-7.4) for third quartile and 6.3 (95% CI: 5.0-8.0) for the fourth quartile respectively, Figure 1. Usual levels of CRF were non-linearly associated with AF risk, Figure 2. Age-adjusted HR comparing top versus bottom fourth of usual CRF levels was 0.67(95% CI: 0.48-0.95), which attenuated to 0.98 (95% CI: 0.66-1.43) upon further adjustment for several risk factors. These findings were comparable across age, body mass index, history of smoking, diabetes and cardiovascular disease status at baseline. Conclusions: Improved fitness as indicated by higher levels of CRF is protective of atrial fibrillation within an optimal range, beyond which the risk of atrial fibrillation rises again. Our findings are congruent with emerging data on the complex relationship between physical fitness and incident AF.

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