scholarly journals Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

2020 ◽  
Author(s):  
Sung Soo Ahn ◽  
Lucy Eunju Lee ◽  
Jung Yoon Pyo ◽  
Jason Jungsik Song ◽  
Yong-Beom Park ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Survival Rates ◽  
Density Lipoprotein ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Atherogenic Index ◽  
Healthy Controls ◽  
Atherogenic Index Of Plasma ◽  
Free Survival ◽  
Kaplan Meier

Abstract Background: To investigate whether atherogenic index of plasma (AIP) at diagnosis is associated with the occurrence of cerebrovascular accident (CVA) or coronary artery disease (CAD) in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: The medical records of 167 AAV patients on initial diagnosis was reviewed, and 300 healthy controls were included. AIP was calculated using the following equation: AIP = Log (triglyceride [mg/dL] / high-density lipoprotein cholesterol [mg/dL]). AAV patients were divided into two groups according to the AIP cut-off of 0.11. The event of stroke, transient ischemic attack, and cerebral hemorrhage was recorded as CVA, and CAD events consisted of either myocardial infarction and angina pectoris. CVA- and CAD- free survival rate between those with AIP ≥ 0.11 and < 0.11 were compared by the Kaplan-Meier analysis, and Cox hazard analysis was conducted to identify predictors of CVA.Results: The median age of AAV patients were 59.0 years, and 54 (32.3%) patients were male. One-hundred and fifteen (68.9%) patients had AIP < 0.11 and 52 (31.1%) had AIP ≥ 0.11. The mean Birmingham vasculitis activity score in AAV patients with AIP < 0.11 was lower than that seen in patients with AIP ≥ 0.11 (12.0 vs. 14.0, P = 0.041). AAV patients had a significantly higher AIP compared to controls (mean -0.01 vs. -0.10, P < 0.001). During follow-up, the occurrence of CVA and CAD was observed in 16 (9.6%) and 14 (8.4%) patients, respectively. In Kaplan-Meier analysis, AAV patients with AIP ≥ 0.11 had significantly lower CVA-free survival rates than in those with AIP < 0.11 (P = 0.027), whereas there was no difference in CAD according to AIP (P = 0.390). Multivariable Cox analysis indicated that AIP ≥ 0.11 at diagnosis was the sole predictor of CVA (Hazard ratio 3.392, 95% confidence interval 1.076, 10.696, P = 0.037). Conclusions: AIP is significantly higher in AAV patients than in healthy controls, and AIP ≥ 0.11 at diagnosis is a significant predictor of CVA during follow-up. Stringent surveillance should be provided in AAV patients with AIP ≥ 0.11 regarding the occurrence of CVA. Trial registration: Retrospectively registered.

scholarly journals Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

2020 ◽  
Author(s):  
Sung Soo Ahn ◽  
Lucy Eunju Lee ◽  
Jung Yoon Pyo ◽  
Jason Jungsik Song ◽  
Yong-Beom Park ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Survival Rates ◽  
Density Lipoprotein ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Atherogenic Index ◽  
Healthy Controls ◽  
Atherogenic Index Of Plasma ◽  
Free Survival ◽  
Kaplan Meier

Abstract Background: To investigate whether atherogenic index of plasma (AIP) at diagnosis is associated with the occurrence of cerebrovascular accident (CVA) or coronary artery disease (CAD) in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods: The medical records of 167 AAV patients on initial diagnosis was reviewed, and 300 healthy controls were included. AIP was calculated using the following equation: AIP = Log (triglyceride [mg/dL] / high-density lipoprotein cholesterol [mg/dL]). AAV patients were divided into two groups according to the AIP cut-off of 0.11. The event of stroke, transient ischemic attack, and cerebral hemorrhage was recorded as CVA, and CAD events consisted of either myocardial infarction and angina pectoris. CVA- and CAD- free survival rate between those with AIP ≥ 0.11 and < 0.11 were compared by the Kaplan-Meier analysis, and Cox hazard analysis was conducted to identify predictors of CVA. Results: The median age of AAV patients were 59.0 years, and 54 (32.3%) patients were male. One-hundred and fifteen (68.9%) patients had AIP < 0.11 and 52 (31.1%) had AIP ≥ 0.11. The mean Birmingham vasculitis activity score in AAV patients with AIP < 0.11 was lower than that seen in patients with AIP ≥ 0.11 (12.0 vs. 14.0, P = 0.041). AAV patients had a significantly higher AIP compared to controls (mean -0.01 vs. -0.10, P < 0.001). During follow-up, the occurrence of CVA and CAD was observed in 16 (9.6%) and 14 (8.4%) patients, respectively. In Kaplan-Meier analysis, AAV patients with AIP ≥ 0.11 had significantly lower CVA-free survival rates than in those with AIP < 0.11 (P = 0.027), whereas there was no difference in CAD according to AIP (P = 0.390). Multivariable Cox analysis indicated that AIP ≥ 0.11 at diagnosis was the sole predictor of CVA (Hazard ratio 3.392, 95% confidence interval 1.076, 10.696, P = 0.037). Conclusions: AIP is significantly higher in AAV patients than in healthy controls, and AIP ≥ 0.11 at diagnosis is a significant predictor of CVA during follow-up. Stringent surveillance should be provided in AAV patients with AIP ≥ 0.11 regarding the occurrence of CVA.

scholarly journals Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

2020 ◽  
Author(s):  
Sung Soo Ahn ◽  
Lucy Eunju Lee ◽  
Jung Yoon Pyo ◽  
Jason Jungsik Song ◽  
Yong-Beom Park ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cerebrovascular Accident ◽  
Multivariable Analysis ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Immunosuppressive Drug ◽  
Atherogenic Index ◽  
Atherogenic Index Of Plasma ◽  
And Gender

Abstract Background: We investigated whether the atherogenic index of plasma (AIP) at diagnosis can predict cerebrovascular accident (CVA) and cardiovascular disease during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: The medical records of 167 immunosuppressive drug-naïve AAV patients and those of 300 age- and gender-matched controls were retrospectively reviewed. AIP was calculated using the following equation: AIP = Log (triglyceride (mmol/L) / high-density-cholesterol (mmol/L)). AAV patients were divided into two groups according to their AIP, AAV patients with AIP < 0.11 (N=115) and AAV patients with AIP ≥ 0.11 (N=52). Results: The median age and body mass index of AAV patients were 59.0 years and 22.1 kg/m2, respectively. The median calculated AIP of patients was 0.01 and AAV patients with AIP < 0.11 exhibited a lower Birmingham vasculitis activity score than those with AIP ≥ 0.11 but it was not significant (P = 0.064). AAV patients had a significantly lower body mass index than controls, nevertheless, AAV patients had a significantly higher AIP than controls (0.01 vs. -0.12). Sixteen patients were diagnosed with CVA, and AAV patients with AIP ≥ 0.11 had a significantly lower CVA-free survival rate than those with AIP < 0.11. Multivariable analysis indicated that AIP ≥ 0.11 at diagnosis was significantly associated with CVA during follow-up. Conclusions: AIP was significantly higher in AAV patients than in controls. Furthermore, AIP at diagnosis could predict CVA occurrence during follow-up in AAV patients.

scholarly journals Risk Factor Analysis of Intravesical Recurrence After Laparoscopic Nephroureterectomy for Upper Tract Urothelial Carcinoma

2021 ◽  
Author(s):  
Masato Yanagi ◽  
Tsutomu Hamasaki ◽  
JunJun Akatsuka ◽  
Yuki Endo ◽  
Hayato Takeda ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Survival Rates ◽  
Urine Cytology ◽  
Rank Test ◽  
Free Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Positive Urine ◽  
Laparoscopic Nephroureterectomy

Abstract Background: One of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after laparoscopic nephroureterectomy (LNU) for UTUC.Methods: Clinicopathological and surgical information were collected from the medical records of 73 patients treated with LNU for non-metastatic UTUC, without a history of or concomitant bladder cancer. The association between IVR after LNU and clinicopathological and surgery-related factors, including preoperative urine cytology and pneumoperitoneum time, was analyzed using Cox proportional hazards regression models and the Kaplan–Meier method with log-rank test.Results: During the median follow-up time of 39.1 months, 18 (24.7%) patients had subsequent IVR after LNU. The 3- and 5-year IVR-free survival rates were 76.5% and 74.3%, respectively. In the multivariate Cox regression analysis, positive preoperative urine cytology (hazard ratio [HR]: 3.55; 95% confidence interval [CI]: 1.326–11.327; p=0.011) and prolonged pneumoperitoneum time of ≥ 210 min (HR: 3.40; 95% CI: 1.271–10.692; p=0.014) were independent prognostic factors for IVR-free survival. In patients with positive urine cytology, the Kaplan–Meier method with log-rank test revealed that the 3-year and 5-years IVR free survival rates were 46.3% and 39.7%, respectively, in patients with a prolonged pneumoperitoneum time of ≥ 210 min, which was significantly lower than that in their counterparts (76% and 76%, respectively, p=0.041).Conclusions: In UTUC patients with positive urine cytology, the occurrence of IVR is highly probable when the pneumoperitoneum time of LNU is prolonged (≥ 210 min). Strict follow-up after LNU is highly recommended for these patients.

Clinical Significance of MYCN Amplification and Ploidy in Favorable-Stage Neuroblastoma: A Report From the Children's Oncology Group

2008 ◽  
Vol 26 (6) ◽  
pp. 913-918 ◽  
Author(s):  
Jennifer Schneiderman ◽  
Wendy B. London ◽  
Garrett M. Brodeur ◽  
Robert P. Castleberry ◽  
A. Thomas Look ◽  
...  
Keyword(s):  
Tumor Cell ◽  
Clinical Significance ◽  
Survival Rates ◽  
Mycn Amplification ◽  
Oncology Group ◽  
Free Survival ◽  
Kaplan Meier ◽  
Stage Disease ◽  
Pediatric Oncology Group

Purpose MYCN amplification is rarely detected in patients with favorable-stage neuroblastoma (NB). To determine the clinical significance of MYCN amplification in children with favorable-stage NB, we performed a retrospective review of data from the Pediatric Oncology Group (POG) biology study 9047. Patients and Methods MYCN status, tumor cell ploidy, treatment, and outcome of patients with stage A, B, or Ds NB, enrolled on POG 9047 between 1990 and 1999 were analyzed. Event-free survival (EFS) and overall (OS) survival rates were analyzed using the Kaplan-Meier method. Results Of the 1,667 patients enrolled on POG 9047, 643 had favorable-stage disease. Of these, follow-up data were available on 568 (34%) with stage A, B, or Ds disease and normal MYCN copy number, and 32 (1.9%) patients with MYCN-amplified, stage A, B, or Ds tumors. Within the cohort lacking MYCN amplification, the 7-year EFS and OS rates (± SE) were 91% ± 1% and 96% ± 1%, respectively. Patients with MYCN amplification had significantly worse EFS and OS (50% ± 9% and 59% ± 9%, respectively, P < .0001). Within the cohort of children with MYCN amplification, the 7-year EFS and OS rates were 80% ± 10% and 87% ± 9%, respectively for patients with hyperdiploid tumors and 25% ± 11% and 38% ± 12% for patients with diploid/hypodiploid NBs (P = .0063 and P = .0074, respectively). Conclusion Tumor cell ploidy may be a clinically useful factor for prognostication and treatment stratification in children with MYCN-amplified, favorable-stage NB tumors.

Sinonasal mucosal melanoma: retrospective survival study of 25 patients

2011 ◽  
Vol 126 (2) ◽  
pp. 147-151 ◽  
Author(s):  
C Vandenhende ◽  
X Leroy ◽  
D Chevalier ◽  
G Mortuaire
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Cancer Control ◽  
Tumour Stage ◽  
Rank Tests ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free ◽  
Tumour Node

AbstractObjective:To determine potential prognostic factors for survival in patients with mucosal malignant melanoma of the sinonasal tract.Methods:Patients managed between 1991 and 2008 were assessed retrospectively. The seventh edition Union for International Cancer Control (7th UICC) tumour-node-metastasis classification was used for tumour staging. Kaplan–Meier and log rank tests were used for survival analysis.Results:Twenty-five patients were studied (six were tumour stage three, eight tumour stage four(a) and 11 tumour stage four(b)). Surgery was performed on 23 patients (92 per cent). Fifteen received post-operative radiotherapy. Mean follow up was 31.3 months (range, two to 99 months). Three-year disease-free survival was improved in patients with stage four tumour arising from the nasal fossa, versus other sites, and in those with stage four tumour treated with surgery plus adjuvant radiotherapy, versus other treatments.Conclusion:Patients with melanoma of the nasal cavity have very poor survival rates. Treatment is still based on adequate surgical resection with safe margins. In this study, post-operative radiotherapy improved local control only for stage four tumours.

scholarly journals Clinical implication of metabolic syndrome in nonobese patients with antineutrophil cytoplasmic antibody-associated vasculitis

2020 ◽  
Author(s):  
Soo Bin [email protected] ◽  
Hyeok Chan Kwon ◽  
Jung Yoon Pyo ◽  
Mi Il Kang ◽  
Jason Jungsik Song ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Age And Gender ◽  
Free Survival ◽  
Anca Associated Vasculitis ◽  
Hazards Model ◽  
Kaplan Meier ◽  
And Gender ◽  
Nonobese Patients

Abstract Objective: We investigated the prevalence of metabolic syndrome (MetS) in all or nonobese patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and compared it with age- and gender-matched controls. Also, we assessed the effect of variables at diagnosis on the risk of cardiovascular disease (CVD) in all or nonobese AAV patients. Methods: In this study, 173 AAV patients and 344 controls were included and MetS was defined by the National Cholesterol Education Program Adults Treatment Panel III criteria. The obesity based on BMI was defined as BMI ≥ 25 kg/m 2 . The follow-up duration was defined as the period from diagnosis to the last visit or to each poor outcome occurrence. Results: The median age of AAV patients was 58.7 years and 57 patients were men. The prevalence of MetS was 50.9% in all AAV patients and 46.5% in nonobese AAV patients, which were significantly higher than 37.8% in all controls and 28.2% in nonobese controls. In the Kaplan-Meier survival analysis, Mets at diagnosis significantly reduced the cumulative CVD-free survival rate in both all and nonobese AAV patients. In the multivariable Cox hazards model analysis, CVD during follow-up was significantly associated with both BVAS (HR 1.159) and MetS at diagnosis (HR 9.036) in nonobese AAV patients. Conclusions: The prevalence of MetS at diagnosis in all or nonobese AAV patients was significantly higher than those in all or nonobese controls. Furthermore, both BVAS and MetS at diagnosis increased the risk of CVD in nonobese AAV patients.

scholarly journals Clinical implication of metabolic syndrome in nonobese patients with antineutrophil cytoplasmic antibody-associated vasculitis

2021 ◽  
Author(s):  
Soo Bin Lee ◽  
Hyeok Chan Kwon ◽  
Jung Yoon Pyo ◽  
Mi Il Kang ◽  
Jason Jungsik Song ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Age And Gender ◽  
Free Survival ◽  
Anca Associated Vasculitis ◽  
Hazards Model ◽  
Kaplan Meier ◽  
And Gender ◽  
Nonobese Patients

Abstract Objective: We investigated the prevalence of metabolic syndrome (MetS) in all or nonobese patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and compared it with age- and gender-matched controls. Also, we assessed the effect of variables at diagnosis on the risk of cardiovascular disease (CVD) in all or nonobese AAV patients. Methods: In this study, 173 AAV patients and 344 controls were included and MetS was defined by the National Cholesterol Education Program Adults Treatment Panel III criteria. The obesity based on body mass index (BMI) was defined as BMI ≥ 25 kg/m2. The follow-up duration was defined as the period from diagnosis to the last visit or to each poor outcome occurrence.Results: The median age of AAV patients was 58.7 years and 57 patients were men. The prevalence of MetS was 50.9% in all AAV patients and 46.5% in nonobese AAV patients, which were significantly higher than 37.8% in all controls and 28.2% in nonobese controls. In the Kaplan-Meier survival analysis, Mets at diagnosis significantly reduced the cumulative CVD-free survival rate in both all and nonobese AAV patients. In the multivariable Cox hazards model analysis, CVD during follow-up was significantly associated with both BVAS (HR 1.159) and MetS at diagnosis (HR 9.036) in nonobese AAV patients.Conclusions: The prevalence of MetS at diagnosis in all or nonobese AAV patients was significantly higher than those in all or nonobese controls. Furthermore, both BVAS and MetS at diagnosis increased the risk of CVD in nonobese AAV patients.

scholarly journals Atherogenic index of plasma is an independent predictor of ultrasound-proven nonalcoholic fatty liver disease among non-obese populations

2021 ◽  
Author(s):  
Hua-Jun Ye ◽  
Xu-Yan Chen ◽  
XiXi He
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Independent Predictor ◽  
Density Lipoprotein ◽  
Atherogenic Index ◽  
Alcoholic Fatty Liver ◽  
Atherogenic Index Of Plasma ◽  
Nonalcoholic Fatty Liver

Abstract Background & AimsEvidence regarding the association between atherogenic index of plasma (AIP) and the risk of non-alcoholic fatty liver disease (NAFLD) in non-obese populations is limited. Our study aimed to investigate whether AIP predicts NAFLD in non-obese Chinese populations.MethodsThe present study was a population-based longitudinal study, including 16 173 non-obese participants who underwent health examinations in a tertiary hospital from January 2010 to December 2014. The primary outcome was developing NAFLD during the follow-up period. AIP was calculated as Log (Triglycerides/ high-density lipoprotein cholesterol).ResultsThe mean age of the included participants was 43.2 ± 15.0 years old, and about 52.5% of them were male. During the follow-up period, 2 322 of 16 173 (14.3%) participants developed NAFLD. In the fully-adjusted model, for every one standard deviation increased in AIP levels, the incidence of NAFLD increased by 52% (1.52, 95%CI 1.43, 1.60). The optimal cut-off point of AIP for incident NAFLD was 0.00 (receiver operator characteristic 0.76 [95% CI 0.75–0.77], sensitivity 0.68, specificity 0.72). Individuals with AIP values in the positive range had two-fold increased odds of developing NALFD compared with those with values in the negative range. After propensity score matching, for every one-SD increased in AIP levels, the incidence of NAFLD increased by 34% (HR 1.34, 95%CI 1.27, 1.41).ConclusionAIP is an independent predictor of incident NAFLD among Chinese non-obese populations.

Phase I Study of Fludarabine Plus Cyclophosphamide in Patients With Previously Untreated Low-Grade Lymphoma: Results and and Long-Term Follow-Up—A Report From the Eastern Cooperative Oncology Group

2000 ◽  
Vol 18 (5) ◽  
pp. 987-987 ◽  
Author(s):  
Howard S. Hochster ◽  
Martin M. Oken ◽  
Jane N. Winter ◽  
Leo I. Gordon ◽  
Bruce G. Raphael ◽  
...  
Keyword(s):  
Phase Ii ◽  
Bone Marrow Involvement ◽  
Survival Rates ◽  
Eastern Cooperative Oncology Group ◽  
Disease Free Survival ◽  
Low Grade ◽  
Survival Times ◽  
Free Survival ◽  
Disease Free

PURPOSE: To determine the toxicity and recommended phase II doses of the combination of fludarabine plus cyclophosphamide in chemotherapy-naive patients with low-grade lymphoma. PATIENTS AND METHODS: Previously untreated patients with low-grade lymphoma were entered onto dosing cohorts of four patients each. The cyclophosphamide dose, given on day 1, was increased from 600 to 1,000 mg/m2. Fludarabine 20 mg/m2 was administered on days 1 through 5. The first eight patients were treated every 21 days; later patients were treated every 28 days. Prophylactic antibiotics were required. RESULTS: Prolonged cytopenia and pulmonary toxicity each occurred in three of eight patients treated every 3 weeks. The 19 patients treated every 28 days, who were given granulocyte colony-stimulating factor as indicated, did not have undue nonhematologic toxicity. Dose-limiting toxicity was hematologic. At the recommended phase II/III dose (cyclophosphamide 1,000 mg/m2), grade 4 neutropenia was observed in 17% of all cycles and 31% of first cycles. Grade 3 or 4 thrombocytopenia was seen in only 1% of all cycles. The median number of cycles per patient was six (range, two to 11) for all patients enrolled. The response rate was 100% of 27 patients entered; 89% achieved a complete and 11% a partial response. Nineteen of 22 patients with bone marrow involvement had clearing of the marrow. Median duration of follow-up was more than 5 years; median overall and disease-free survival times have not been reached. Kaplan-Meier estimated 5-year overall survival and disease-free survival rates were 66% and 53%, respectively. CONCLUSION: The recommended dosing for this combination in patients with previously untreated low-grade lymphoma is cyclophosphamide 1,000 mg/m2 day 1 and fludarabine 20 mg/m2 days 1 through 5. The regimen has a high level of activity, with prolonged complete remissions providing 5-year overall and disease-free survival rates as high as those reported for other therapeutic approaches in untreated patients.

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