scholarly journals Increased percentage of Atrial Pace Ventricular Pace was associated with increased cardiovascular morality in patients with a DDD pacemaker

2020 ◽  
Author(s):  
Wen-Hsien Lee ◽  
Chee-Siong Lee ◽  
Wei-Chung Tsai ◽  
Feng-Hsien Lin ◽  
Wan-Ling Tsai ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Old Age ◽  
Cardiovascular Mortality ◽  
Multivariable Analysis ◽  
Total Mortality ◽  
Permanent Pacemaker ◽  
Ventricular Pace ◽  
Atrial Pace ◽  
Ventricular Pacing

Abstract Background Compared to single-chamber pacing system, dual chamber atrioventricular pacing system (DDD) was associated with reduced mortality and hospitalization for heart failure. High percentage of right ventricular pacing was reported to be associated with high cardiovascular events. However, another meta-analysis study showed ventricular pacing reduction modalities did not improve adverse clinical outcomes. Hence, the relationship between the pacing percentage and clinical outcomes is necessary to be further studied. Methods The present study was designed to evaluate the association of total and cardiovascular mortality with the percentages of atrial sense ventricular sense (ASVS), atrial sense ventricular pace (ASVP), atrial pace ventricular sense (APVS), and atrial pace ventricular pace (APVP) in patients with a DDD pacemaker. Study subjects were selected from patients arranged for permanent pacemaker follow-up at our special clinic. 177 patients with a DDD pacemaker were included. We collected their pacemaker follow-up data at their first visit for pacemaker follow-up after permanent pacemaker implantation. Results Among the 177 subjects, the mean follow-up to mortality was 2.44 ± 1.03 years. There were 22 and 10 patients documented as total and cardiovascular mortality. In the Cox proportional hazards regression analysis, old age (P = 0.030) and low hemoglobin (P = 0.007) were the predictors of increased total mortality and increased creatinine (P = 0.023) and high percentage of APVP (hazard ratio [HR], 1.030; 95% confidence interval [CI], 1.012–1.049; P = 0.001) were the predictors of increased cardiovascular mortality after multivariable analysis. Conclusion In patients with a DDD pacemaker, old age and low hemoglobin were associated with increased total mortality and high creatinene and high percentage of APVP were associated with increased cardiovascular mortality after multivariable analysis. Hence, reduction in unnecessary atrial and ventricular pacing in patients with a DDD pacemaker might be useful in improving cardiovascular prognosis.

P1136Is there a negative impact of permanent pacemaker implantation in long-term outcomes after transcatheter aortic valve implantation?

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T J Carvalho Mendonca ◽  
L Patricio ◽  
M Oliveira ◽  
I Rodrigues ◽  
G Portugal ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Permanent Pacemaker ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Introduction Transcatheter aortic valve implantation (TAVI) is an established treatment in patients (P) with aortic stenosis. Despite the continuous developments of this procedure, high-grade conduction disturbances requiring permanent pacemaker (PPM) implantation is still a major and common complication of TAVI. Furthermore, long-term chronic right ventricular pacing has been associated with negative effects on ventricular function and heart failure (HF). Aim   to evaluate the long-term impact of PPM after TAVI focusing on mortality and HF hospitalization. Methods  We retrospectively examined P who underwent TAVI with a self-expanding valve from 2009 to 2018 at our institution. All P had pre-procedural clinical evaluation, including ECG, cardiac computed tomographic angiography and transthoracic echocardiography. P with previous PPM were excluded. Results  265P (57% male, mean age 81.4 years, 20% with left ventricular ejection fraction <40%) were analysed. Mean STS score and mean Euroscore II were 6.33% and 7.07%, respectively. Mean transvalvular gradient was 52.78 mmHg and mean aortic valve area 0.67 cm2. Forty-seven P (17%) underwent PPM implantation during the first 30 days after TAVI. P requiring PPM had higher prevalence of diabetes mellitus, chronic renal disease, atrial fibrillation and right bundle branch block. During a mean follow-up of 20.3 months, post-TAVI PPM was associated with similar mortality rate (29.8% vs. 25.6%, HR 1.28, 95% CI 0.72-2.29, p = 0.42) and similar cardiovascular mortality (9.8% vs. 6.4%, HR 0.72, 95% CI 0.21-2.4, p = 0.59) compared to P without PPM. There were no significant differences in HF hospitalization (4.9% vs. 2.4%, p = 0.47). Kaplan-Meier curves of total mortality and cardiovascular mortality according to the need for PPM post-TAVI were similar.  Conclusions  In P submitted to TAVI, PPM implantation is a relatively common finding, not associated with higher risk of total mortality, cardiovascular mortality or HF hospitalization in a long-term follow-up.

What Factors Should Be Considered to Improve Outcome of Mechanical Mitral Valve Replacement in Children?

2021 ◽  
Vol 12 (3) ◽  
pp. 367-374
Author(s):  
Mohamed F. Elsisy ◽  
Joseph A. Dearani ◽  
Elena Ashikhmina ◽  
Prasad Krishnan ◽  
Jason H. Anderson ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Multivariable Analysis ◽  
Permanent Pacemaker ◽  
Early Mortality ◽  
Prosthetic Valve Thrombosis ◽  
Valve Size ◽  
Valve Thrombosis

Objective: To identify risk factors for pediatric mechanical mitral valve replacement (mMVR) to improve management in this challenging population. Methods: From 1993 to 2019, 93 children underwent 119 mMVR operations (median age, 8.8 years [interquartile range [IQR]: 2.1-13.3], 54.6% females) at our institution. Twenty-six (21.8%) patients underwent mMVR at ≤2 years and 93 (78.2%) patients underwent mMVR at >2 years. Median follow-up duration was 7.6 years [IQR: 3.2-12.4]. Results: Early mortality was 9.7%, but decreased with time and was 0% in the most recent era (13.9% from 1993 to 2000, 7.3% from 2001 to 2010, 0% from 2011 to 2019, P = .04). It was higher in patients ≤2 years compared to patients >2 years (26.9% vs 2.2%, P < .01). On multivariable analysis for mitral valve reoperation, valve size <23 mm was significant with a hazard ratio of 5.38 (4.87-19.47, P = .01);. Perioperative stroke occurred in 1% and permanent pacemaker was necessary in 12%. Freedom from mitral valve reoperation was higher in patients >2 years and those with a prosthesis ≥23 mm. Median time to reoperation was 7 years (IQR: 4.5-9.1) in patients >2 years and 3.5 years (IQR: 0.6-7.1) in patients ≤2 years ( P = .0511), but was similar between prosthesis sizes ( P = .6). During follow-up period (median 7.6 years [IQR: 3.2-12.4], stroke occurred in 10%, prosthetic valve thrombosis requiring reoperation in 4%, endocarditis in 3%, and bleeding in 1%. Conclusion: Early and late outcomes of mMVR in children are improved when performed at age >2 years and with prosthesis size ≥23 mm. These factors should be considered in the timing of mMVR.

P1818Descending aortic thoracic diameter: a risk marker for major adverse cardiovascular outcomes in women

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O L Rueda Ochoa ◽  
L R Bons ◽  
S Rohde ◽  
K E L Ghoud ◽  
R Budde ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Increased Risk ◽  
Almost All

Abstract Background Thoracic aortic diameters have been associated with cardiovascular risk factors and atherosclerosis. However, limited evidence regarding the role of thoracic aortic diameters as risk markers for major cardiovascular outcomes among women and men exist. Purpose To evaluate the independent associations between crude and indexed ascending and descending aortic (AA and DA) diameters with major cardiovascular outcomes among women and men and to provide optimal cutoff values associated with increased cardiovascular risk. Methods and results 2178 women and men ≥55 years from the prospective population-based Rotterdam Study underwent multi-detector CT scan of thorax. Crude diameters of the AA and DA were measured and indexed by height, weight, body surface area (BSA) and body mass index (BMI). Incidence of stroke, coronary heart disease (CHD), heart failure (HF), cardiovascular and all-cause mortality were evaluated during 13 years of follow-up. Weight-, BSA-, or BMI-indexed AA diameters showed significant associations with total or cardiovascular mortality in both sexes and height-indexed values showed association with HF in women. Crude AA diameters were associated with stroke in men and HF in women. For DA, crude and almost all indexed diameters showed significant associations with either stroke, HF, cardiovascular or total mortality in women. Only weight-, BSA- and BMI-indexed values were associated with total mortality in men. For crude DA diameter, the risk for stroke increased significantly at the 75th percentile among men while the risks for HF and cardiovascular mortality increased at the 75th and 85th percentiles respectively in women. Conclusions Our study suggests a role for descending thoracic aortic diameter as a marker for increased cardiovascular risk, in particular for stroke, heart failure and cardiovascular mortality among women. The cut points for increased risk for several of cardiovascular outcomes were below the 95th percentile of the distribution of aortic diameters.

4070Clinical impact of mitral regurgitation before or following transcatheter aortic valve replacement in patients with aortic stenosis: a nationwide multivariable analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Fauchier ◽  
A Bernard ◽  
A Bisson ◽  
T Lacour ◽  
J Herbert ◽  
...  
Keyword(s):  
Transcatheter Aortic Valve Replacement ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Total Mortality ◽  
Transcatheter Aortic Valve ◽  
Mortality Hazard ◽  
History Of ◽  
The Impact ◽  
Mortality Hazard Ratio

Abstract Patients undergoing transcatheter aortic valve replacement (TAVR) may have concomitant mitral regurgitation (MR). The impact of MR at baseline or after TAVR on subsequent prognosis remains to be more precisely determined. We analysed the impact of MR before or after TAVR on prognosis in the systematic analysis of patients treated with TAVR at a nationwide level. Methods Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients with aortic stenosis treated with transfemoral TAVR in France between 2008 and 2018. Cox regression was used for the analysis of predictors of events during follow-up. Results A total of 47,872 patients with transfemoral TAVR were included in the analysis (mean age 83±7 years). Moderate/severe MR was present at baseline (MRb) in 9.5% of the patients. Few patients (1.6%) revealed moderate/severe MR post-TAVR (MRpt). Mean follow-up was 1.31±1.61 years. MRb was associated with an increased cardiovascular mortality (Hazard ratio 1.29, 95% CI 1.20–1.39) and total mortality (Hazard ratio 1.15, 95% CI 1.10–1.21). However, MRb was not an independent predictor in multivariable analysis, neither for cardiovascular mortality (adjusted HR 1.06, 95% CI 0.98–1.14) nor for total mortality (adjusted HR 1.01, 95% CI 0.96–1.07). MRpt was not a predictor of cardiovascular or total mortality. Older age, male sex, history of pulmonary edema/cardiogenic shock, atrial fibrillation, myocardial infarction, diabetes, renal failure, liver disease, pulmonary disease, previous cancer and anemia at baseline independently predicted mortality during follow-up. All of them (but history of cancer) were also independent predictor of cardiovascular death. Conclusion Baseline MR was associated with increased cardiovascular and totality mortality following TAVR but was not an independent predictor of any of them. By contrast, several other predictors of cardiovascular and total mortality were identified. This suggests that MR should not be directly considered to establish the strategy for TAVR decision or for avoiding TAVR-related futility.

Cholesteryl Ester Transfer Protein in Patients with Rheumatoid Arthritis

2013 ◽  
Vol 40 (7) ◽  
pp. 1040-1047 ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Miguel A. González-Gay ◽  
José A. García-Dopico ◽  
Federico Díaz-González
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Risk ◽  
Cholesteryl Ester ◽  
Cholesteryl Ester Transfer Protein ◽  
Cardiovascular Mortality ◽  
Multivariable Analysis ◽  
Risk Function ◽  
Total Mortality ◽  
Transfer Protein ◽  
Score Risk

Objective.To investigate how cholesteryl ester transfer protein (CETP), one of the enzymes involved in the reverse cholesterol transfer, is expressed in patients with rheumatoid arthritis (RA) and its potential relationship with both dyslipidemia and the risk of cardiovascular mortality observed in these patients.Methods.Plasma CETP concentrations and CETP activity were measured in 101 patients with RA and 115 sex- and age-matched controls. A multivariable analysis adjusted for standard cardiovascular risk factors, including high-density lipoprotein cholesterol, was performed to evaluate the influence of CETP on dyslipidemia and cardiovascular mortality risk, as assessed by the Systematic Coronary Risk Evaluation (SCORE) risk function.Results.Patients with RA showed lower CETP activity [beta coefficient = −10.82 (95% CI −19.56 to 2.07) pmol/3 h; p = 0.02] and an inferior CETP mass [β = −0.85 (95% CI −1.64 to 0.05)μg/ml; p = 0.03] versus controls. Divided into those taking and those not taking glucocorticoids, patients taking glucocorticoids revealed lower CETP activity and mass [β = −8.98 (95% CI −14.55 to 3.41) pmol/3 h; p = 0.00, for CETP activity; and β = −0.77 (95% CI −1.46 to 0.08)μg/ml; p = 0.03, for CETP mass]. Patients with RA not taking glucocorticoids showed no differences versus controls in either CETP activity or mass. Both current prednisone intake [β = −16.14 (95% CI −24.87 to 7.41) pmol/3 h; p = 0.00] and average daily prednisone intake during the last 3 months [β = −0.36 (95% CI −0.54 to 0.18)μg/ml; p = 0.01] were strongly and inversely correlated with CETP activity and mass, respectively. CETP activity showed an inverse trend compared to SCORE risk, demonstrating that lower levels were effective predictors of total mortality when a higher SCORE risk was found [β = −4.7 (95% CI −9.3 to 0.02) pmol/3 h; p = 0.04] in patients with RA.Conclusion.CETP is downregulated in patients with RA who are taking glucocorticoids. Low CETP activity is associated with an increased level of cardiovascular risk in patients with RA.

scholarly journals Renal function and outcomes in atrial fibrillation patients after catheter ablation

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241449
Author(s):  
Tetsuma Kawaji ◽  
Satoshi Shizuta ◽  
Takanori Aizawa ◽  
Shintaro Yamagami ◽  
Yasuaki Takeji ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Renal Function ◽  
Catheter Ablation ◽  
Clinical Outcomes ◽  
Cox Model ◽  
Strong Predictor ◽  
Multivariable Analysis ◽  
Heart Failure Hospitalization

Background Atrial fibrillation (AF) and renal failure coexist and interact. However, scarce data about association between renal function and clinical outcomes in patients undergoing catheter ablation for AF are available. We sought to evaluate long-term renal function and clinical outcomes after AF ablation. Methods We enrolled 791 non-dialysis patients undergoing catheter ablation for AF, and evaluated the incidence of worsening renal function (WRF) after the procedure, defined as >30% decline in estimate glomerular filtration rate. Results Mean follow-up duration was 5.1±2.5 years. Five hundreds and twenty-six patients (66.5%) were free from recurrent atrial arrhythmias without any antiarrhythmic drugs at the time of final follow-up. Cumulative incidence of WRF was 13.2% at 5-year after procedure, which was significantly higher in patients with recurrent AF compared to those without (21.6% versus 8.7%, P<0.001). In the multivariable analysis, recurrent AF was an independent risk factor for WRF (adjusted hazard ratio [HR] 1.89, 95% confidence interval 1.27–2.81, P = 0.002), along with congestive heart failure, diabetes, and eGFR <60 ml/min/1.73m2 at baseline. Patients with WRF had significantly higher 5-year incidences of all-cause death, cardiovascular death, heart failure hospitalization, ischemic stroke, and major bleeding compared to those without WRF. After adjustment of baseline differences in the multivariate Cox model, the excessive risks of WRF for all-cause death and heart failure hospitalization remained significant (adjusted HR 3.46, P = 0.002; adjusted HR 3.67, P<0.001). Conclusions In AF patients undergoing catheter ablation for AF, arrhythmia recurrence was associated with WRF during follow-up, which was a strong predictor of adverse clinical outcomes.

Clinical and Echocardiographic Outcomes After Aortic Valve Repair Surgery

2019 ◽  
Vol 14 (3) ◽  
pp. 209-217 ◽  
Author(s):  
Eilon Ram ◽  
Boris Orlov ◽  
Ami Shinfeld ◽  
Alexander Kogan ◽  
Leonid Sternik ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Clinical Outcomes ◽  
Multivariable Analysis ◽  
Aortic Insufficiency ◽  
Aortic Valve Repair ◽  
Pericardial Patch ◽  
Valve Repair ◽  
Significant Independent Predictor ◽  
Autologous Pericardial Patch

Objective To assess early and late clinical outcomes in patients who underwent aortic valve repair surgery for aortic valve insufficiency, and to investigate predictors for recurrence. Methods Of 151 consecutive patients who underwent aortic valve repair surgery for varying degrees of aortic insufficiency (AI) in our department between 2004 and 2018, 60 (40%) underwent aortic root replacement, 71 (47%) aortic cusp plication, 31 (20%) subcommissural annuloplasty, 29 (19%) circular annuloplasty, and 28 (18%) autologous pericardial patch augmentation. Results One patient died in the hospital (0.7%). Mean clinical and echocardiographic follow-up was 62±43 months (range 1 to 159) and 50 ± 40 months (range 1 to 158), respectively. The overall survival rate was 99.3% at 1 year and 98% at 5 years of follow-up. Seventeen patients (11.3%) had recurrent severe AI, and all of them underwent reoperation with a mean duration to reoperation of 35 ± 39 months. Risk factors for the development of recurrent significant AI (≥3) or reoperation, by univariable analysis, were unicuspid or bicuspid aortic valve (AV) ( P = 0.018), the use of subcommissural annuloplasty ( P = 0.010), the need for cusp repair ( P = 0.001), and the use of pericardial patch augmentation ( P < 0.001). By multivariable analysis only the use of pericardial patch augmentation emerged as a significant independent predictor for the development of recurrent significant AI (≥3) or reoperation ( P = 0.020). Conclusion AV repair can be performed with low morbidity and mortality, with good early and late clinical outcomes. However, in our experience there was a significant rate of recurrent AI especially in patients who underwent cusp augmentation using glutaraldehyde-treated autologous pericardial patch.

scholarly journals Impact of Plasma Potassium Normalization on Short‐Term Mortality in Patients With Hypertension and Hyperkalemia

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Maria Lukács Krogager ◽  
Peter Søgaard ◽  
Christian Torp‐Pedersen ◽  
Henrik Bøggild ◽  
Gunnar Gislason ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Reference Group ◽  
Multivariable Analysis ◽  
Plasma Potassium ◽  
Cardiovascular Death ◽  
Risk Of Death ◽  
Increased Risk ◽  
Short Term Mortality

Background Hyperkalemia can be harmful, but the effect of correcting hyperkalemia is sparsely studied. We used nationwide data to examine hyperkalemia follow‐up in patients with hypertension. Methods and Results We identified 7620 patients with hypertension, who had the first plasma potassium measurement ≥4.7 mmol/L (hyperkalemia) within 100 days of combination antihypertensive therapy initiation. A second potassium was measured 6 to 100 days after the episode of hyperkalemia. All‐cause mortality within 90 days of the second potassium measurement was assessed using Cox regression. Mortality was examined for 8 predefined potassium intervals derived from the second measurement: 2.2 to 2.9 mmol/L (n=37), 3.0 to 3.4 mmol/L (n=184), 3.5 to 3.7 mmol/L (n=325), 3.8 to 4.0 mmol/L (n=791), 4.1 to 4.6 mmol/L (n=3533, reference), 4.7 to 5.0 mmol/L (n=1786), 5.1 to 5.5 mmol/L (n=720), and 5.6 to 7.8 mmol/L (n=244). Ninety‐day mortality in the 8 strata was 37.8%, 21.2%, 14.5%, 9.6%, 6.3%, 6.2%, 10.0%, and 16.4%, respectively. The multivariable analysis showed that patients with concentrations >5.5 mmol/L after an episode of hyperkalemia had increased mortality risk compared with the reference (hazard ratio [HR], 2.27; 95% CI, 1.60–3.20; P <0.001). Potassium intervals 3.5 to 3.7 mmol/L and 3.8 to 4.0 mmol/L were also associated with increased risk of death (HR, 1.71; 95% CI, 1.23–2.37; P <0.001; HR, 1.36; 95% CI, 1.04–1.76; P <0.001, respectively) compared with the reference group. We observed a trend toward increased risk of death within the interval 5.1 to 5.5 mmol/L (HR, 1.29; 95% CI, 0.98–1.69). Potassium concentrations <4.1 mmol/L and >5.0 mmol/L were associated with increased risk of cardiovascular death. Conclusions Overcorrection of hyperkalemia to levels <4.1 mmol/L was frequent and associated with increased all‐cause and cardiovascular mortality. Potassium concentrations >5.5 mmol/L were also associated with an increased all‐cause and cardiovascular mortality.

Abstract 161: Presence of Vaccination Antibodies and Cardiovascular Mortality: Insights From NHANES III and Continuous NHANES

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Neeraj Shah ◽  
Nileshkumar J Patel ◽  
Peeyush Grover ◽  
Ankit Chothani ◽  
Kathan Mehta ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Cardiovascular Mortality ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Cardiac Risk ◽  
Nhanes Iii ◽  
Vaccination History ◽  
Nationally Representative ◽  
Artery Disease

Background: Prior studies have investigated the effect of influenza vaccination on cardiovascular mortality (CVM). The influence of vaccinations other than influenza and CVM has not been investigated before. Methods: The public dataset of National Health and Nutrition Examination Survey III (NHANES III) between the years 1988-1994 and continuous NHANES from 1999-2004 was used for this analysis. From NHANES III, we included patients >18 years old with available data on positive antibody against measles, mumps, rubella, diphtheria, pertussis or tetanus. From continuous NHANES, we included patients >18 years with available titers and vaccination history on hepatitis A, hepatitis B and pneumococcus. Protective titers were analyzed as per standardized cut offs. The primary outcome was CVM per National Death Index. Traditional cardiac risk factors along with CRP and social class (insurance, income and education level) were adjusted for in the multivariable analysis. Results: There were 1,848 (9.7%) cardiovascular deaths with a mean follow up of 13 years for NHANES III. There were 366 (2.3%) cardiovascular deaths with a mean follow up of 4.7 years for continuous NHANES. Multivariable analysis from NHANES III and continuous NHANES did not show any influence of individual seroprotective titers of routine vaccinations on CV mortality. In the multivariable model, significant predictors of mortality were age (p<0.01) male sex (p<0.01), CRP (p<0.01), hypertension (p<0.01), smoking (p<0.01), congestive heart failure (p<0.01), diabetes mellitus (p<0.01) & history of coronary artery disease equivalent (p<0.01). Combined effect of vaccinations was studied by combining the vaccination titers of measles, rubella, diphtheria and tetanus, however, it did not show any protective effect of 3 or more positive vaccination titers (odds ratio=0.94, p=0.6) or all 4 positive vaccination titers (odds ratio=0.93, p=0.6) compared to 2 or less positive vaccination titers as the referent group. Conclusion: Our observational study in a large database suggests that presence of non-influenza vaccination antibodies is not associated with decreased cardiovascular mortality in a nationally representative cohort.

scholarly journals Intake of starch and sugars and total and cause-specific mortality in a Japanese community: the Takayama Study

2019 ◽  
Vol 122 (07) ◽  
pp. 820-828 ◽  
Author(s):  
Chisato Nagata ◽  
Keiko Wada ◽  
Michiyo Yamakawa ◽  
Kie Konishi ◽  
Yuko Goto ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Mortality Data ◽  
High Intake ◽  
Free Sugars ◽  
Baseline Mortality ◽  
Specific Mortality ◽  
Self Administered Questionnaire

AbstractStudies on the intake of different types of carbohydrates and long-term mortality are sparse. We examined the association of starch, total and each type of sugar and free sugars with the risk of total and cause-specific mortality in a cohort of the general population in Japan. Study subjects were 29 079 residents from the Takayama Study, Japan, who responded to a self-administered questionnaire in 1992. Diet was assessed by a validated FFQ at the baseline. Mortality was ascertained during 16 years of follow-up. We noted 2901 deaths (974 cancer related and 775 cardiovascular related) in men and 2438 death (646 cancer related and 903 cardiovascular related) in women. In men, intake of starch was inversely associated with total mortality after controlling for covariates (hazard ratio (HR) for the highest quartile v. lowest quartile: 0·71; 95 % CI 0·60, 0·84; Ptrend &lt; 0·001). Intakes of total sugars, glucose, fructose, sucrose, maltose and free and naturally occurring sugars were significantly positively associated with total mortality in men (HR for the highest v. lowest quartile of total sugar: 1·27; 95 % CI 1·12, 1·45; Ptrend &lt; 0·0001). Similar relations were observed for cardiovascular mortality and non-cancer, non-cardiovascular mortality in men. In women, there was no significant association between any type of carbohydrates and mortality except that intake of free sugars was significantly positively associated with total and non-cancer, non-cardiovascular mortality. Data suggest that the high intake of starch reduces mortality, whereas the high intake of sugars, including glucose, fructose and sucrose, increases mortality in Japanese men.

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