The Association of Atherosclerotic Cardiovascular Disease and Statin Use With Inflammation and Treatment Outcomes in Tuberculosis

2021 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Jennie Ruelas Castillo ◽  
Amudha Kumar ◽  
Justin Wei ◽  
Siqing Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Elevated Serum ◽  
University Hospital ◽  
Sputum Smear ◽  
Atherosclerotic Cardiovascular Disease ◽  
All Cause Mortality ◽  
Multivariable Linear Regression Analysis ◽  
Related Mortality ◽  
Statin Use

Abstract Objective: Tuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes.Methods:From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality.Results:Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38-3.00) and ATS patients (aHR 2.79, 95%CI 1.92-4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17-3.24) and ATS (aHR 2.04, 95%CI 1.19-3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (p=0.048) and 25% (p=0.033) of the association all-cause mortality with CAD+AMI- and CAD+AMI+, respectively. ConclusionsIn summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD.

scholarly journals The association of atherosclerotic cardiovascular disease and statin use with inflammation and treatment outcomes in tuberculosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vignesh Chidambaram ◽  
Jennie Ruelas Castillo ◽  
Amudha Kumar ◽  
Justin Wei ◽  
Siqing Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Elevated Serum ◽  
University Hospital ◽  
Sputum Smear ◽  
Atherosclerotic Cardiovascular Disease ◽  
All Cause Mortality ◽  
Multivariable Linear Regression Analysis ◽  
Related Mortality ◽  
Statin Use

AbstractTuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes. From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality. Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38–3.00) and ATS patients (aHR 2.79, 95%CI 1.92–4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17–3.24) and ATS (aHR 2.04, 95%CI 1.19–3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (P = 0.048) and 25% (P = 0.033) of the association all-cause mortality with CAD+AMI− and CAD+AMI+, respectively. In summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD.

Statin Use in Older Adults with Stable Atherosclerotic Cardiovascular Disease

2021 ◽  
Author(s):  
Gabriela Spencer‐Bonilla ◽  
Sukyung Chung ◽  
Ashish Sarraju ◽  
Paul Heidenreich ◽  
Latha Palaniappan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Use

Baseline Lipid Profiles and Statin Use among Patients with Atherosclerotic Cardiovascular Disease

2015 ◽  
Vol 9 (3) ◽  
pp. 441
Author(s):  
Peter P. Toth ◽  
Xuehua Ke ◽  
Zhenxiang Zhao ◽  
Nicole Bonine ◽  
Mark Cziraky ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lipid Profiles ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Use

Abstract 15004: Bariatric Surgery is Associated With Reduced Atherosclerotic Cardiovascular Disease Burden in Obese Patients With Type 2 Diabetes: A Propensity-matched Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Francesca Watson ◽  
Maddalena Ardissino ◽  
Ravi J Amin ◽  
Chanpreet Arhi ◽  
Peter Collins ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Disease Burden ◽  
Atherosclerotic Cardiovascular Disease ◽  
Obese Patients ◽  
Matched Cohort ◽  
All Cause Mortality

Introduction: Obesity is an increasingly prevalent global health issue and has a considerable disease burden, including numerous co-morbidities. Atherosclerotic cardiovascular disease (ASCVD) is one such co-morbidity associated with a high mortality rate and prevalence, especially in patients with obesity and concomitant Type 2 diabetes mellitus (T2DM). Bariatric surgery is an effective intervention for patients with obesity, shown to reduce overall cardiovascular disease risk. However, few studies have quantified the long-term impact of bariatric surgery on ASCVD outcomes in the context of key co-morbidities such as T2DM. Hypothesis: Bariatric surgery will improve long-term ASCVD outcomes in obese patients with T2DM. Methods: A nested, nationwide, propensity-matched cohort study was carried out using the Clinical Practice Research Datalink. The study cohort included 593 patients who underwent bariatric surgery and had no past history of ASCVD. A further 593 patients served as propensity-score matched controls. Patients were followed up for a median time of 47.2 months. The primary composite study endpoint was the incidence of ASCVD defined by a diagnosis of new coronary artery disease (CAD), cerebrovascular disease (CeVD), peripheral arterial disease (PAD), or other miscellaneous atherosclerotic disease. Secondary endpoints included all-cause mortality and the incidence of CAD, CeVD, and PAD individually. Results: Patients who underwent bariatric surgery had significantly lower rates of new ASCVD during follow-up (HR 0.53, CI 0.30-0.95, p=0.032). No significant difference was observed in rates of new CAD (HR 0.69, CI 0.32-1.46, p=0.331), CeVD (HR 0.23, CI 0.00-5.45, p=0.1760) and PAD (HR 0.55, CI 0.21-1.43, p=0.218). The bariatric surgery group also had a lower rate of all-cause mortality (HR 0.36, CI 0.19-0.71, p=0.003) compared to controls. Conclusions: In this study, bariatric surgery was associated with improved ASCVD outcomes, as well as lower all-cause mortality, in patients with obesity and T2DM. These findings support the use of bariatric surgery in treating obesity and reducing the burden of its related comorbidities.

Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project

2020 ◽  
Vol 27 (18) ◽  
pp. 1956-1963 ◽  
Author(s):  
Xinyan Wang ◽  
Fangchao Liu ◽  
Jianxin Li ◽  
Xueli Yang ◽  
Jichun Chen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Incidence ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tea Consumption ◽  
Hazard Ratios ◽  
Disease Mortality ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Regression ◽  
Study Participants

Aims The role of tea consumption in the primary prevention of atherosclerotic cardiovascular disease remains unclear in cohort studies. This prospective cohort study aimed to investigate the associations of tea consumption with the risk of atherosclerotic cardiovascular disease and all-cause mortality. Methods We included 100,902 general Chinese adults from the project of Prediction for ASCVD Risk in China (China-PAR) in 15 provinces across China since 1998. Information on tea consumption was collected through standardized questionnaires. Outcomes were identified by interviewing study participants or their proxies, and checking hospital records and/or death certificates. Cox proportional hazard regression models were used to calculate hazard ratios and their corresponding 95% confidence intervals related to tea consumption. Results During a median follow-up of 7.3 years, 3683 atherosclerotic cardiovascular disease events, 1477 atherosclerotic cardiovascular disease deaths, and 5479 all-cause deaths were recorded. Compared with never or non-habitual tea drinkers, the hazard ratio and 95% confidence interval among habitual tea drinkers was 0.80 (0.75–0.87), 0.78 (0.69–0.88), and 0.85 (0.79–0.90) for atherosclerotic cardiovascular disease incidence, atherosclerotic cardiovascular disease mortality, and all-cause mortality, respectively. Habitual tea drinkers had 1.41 years longer of atherosclerotic cardiovascular disease-free years and 1.26 years longer of life expectancy at the index age of 50 years. The observed inverse associations were strengthened among participants who kept the habit during the follow-up period. Conclusion Tea consumption was associated with reduced risks of atherosclerotic cardiovascular disease and all-cause mortality, especially among those consistent habitual tea drinkers.

scholarly journals Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes

2019 ◽  
Vol 12 (4) ◽  
pp. 530-537
Author(s):  
Talar W Markossian ◽  
Holly J Kramer ◽  
Nicholas J Burge ◽  
Ivan V Pacold ◽  
David J Leehey ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Atherosclerotic Cardiovascular Disease ◽  
Risk Equation ◽  
Diabetes Status ◽  
Increased Risk ◽  
Ascvd Risk ◽  
Risk Equivalent ◽  
Statin Use

Abstract Background Both reduced glomerular filtration rate and increased urine albumin excretion, markers of chronic kidney disease (CKD), are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). However, CKD is not recognized as an ASCVD risk equivalent by most lipid guidelines. Statin medications, especially when combined with ezetimibe, significantly reduce ASCVD risk in patients with nondialysis-dependent CKD. Unless physicians recognize the heightened ASCVD risk in this population, statins may not be prescribed in the absence of clinical cardiovascular disease or diabetes, a recognized ASCVD risk equivalent. We examined statin use in adults with nondialysis-dependent CKD and examined whether the use differed in the presence of clinical ASCVD and diabetes. Methods This study ascertained statin use from pharmacy dispensing records during fiscal years 2012 and 2013 from the US Department of Veterans Affairs Healthcare System. The study included 581 344 veterans aged ≥50 years with nondialysis-dependent CKD Stages 3–5 with no history of kidney transplantation or dialysis. The 10-year predicted ASCVD risk was calculated with the pooled risk equation. Results Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously over 2 years (2012–13). Statin use in 2012 was 76.2 and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P < 0.001). The 10-year predicted ASCVD risk was ≥7.5% in 95.1% of veterans with CKD, regardless of diabetes status. Conclusions Statin use is low in veterans with nondialysis-dependent CKD in the absence of ASCVD or diabetes despite high-predicted ASCVD risk. Future studies should examine other populations.

Associations Among Daily Fish Intake, Monocyte/HDL-C Ratio, and Lifestyle in Japanese Males Aged >50: Risk Stratification of Atherosclerotic Cardiovascular Disease

2021 ◽  
Author(s):  
Shigemasa Tani ◽  
Wataru Atsumi ◽  
Kazuhiro Imatake ◽  
Yasuyuki Suzuki ◽  
Tsukasa Yagi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Stratification ◽  
Inflammatory Marker ◽  
Health Planning ◽  
Smoking Habit ◽  
Fish Intake ◽  
University Hospital ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lifestyle Behaviors ◽  
Clinical Trial Registration

Abstract Background: The monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) may be a novel inflammatory marker of the developing atherosclerotic cardiovascular disease (ASCVD). We investigated the relationship between the average number of days of fish intake per week and the MHR and lifestyle behaviors and to explore the validity of stratifying the risk of ASCVD using the combination of MHR and the serum HDL-C level.Methods: This cross-sectional study was conducted in a population of 2485 males aged over 50 years at the Health Planning Center of Nihon University Hospital between April 2018 and March 2019.Results: The average frequency of fish intake was 2.32 ± 1.31 per week. Multiple stepwise regression analysis identified increased weekly fish frequency intake as an independent determinant of a decreased MHR (β = -0.072, p < 0.0001). Healthier lifestyle behaviors were also significantly associated with decreased MHR. As the fish intake frequency increased, the proportion of subjects with the cigarette smoking habit decreased (p = 0.014), that of subjects with aerobic exercise habit increased (p < 0.0001), and that of subjects with alcohol drinking habit increased (p < 0.0001). A risk stratification or ASCVD by combining the HDL-C level and fish intake frequency with the MHR could be developed, indicating that even with similar HDL-C levels, higher HMR and fish frequency are associated with higher risk ASCVD. Conclusion: A high fish intake frequency may be associated with healthier lifestyle behaviors as well as a lower MHR, and may thus represent a component of a healthy lifestyle associated with a lower risk of ASCVD in Japanese males aged over 50 years. These associations may be related to being the preventive effect of fish intake on ASCVD.Clinical Trial Registration: UMIN (http://www.umin.ac.jp/) Study ID: UMIN 000041368 registered 10/08/2020

scholarly journals Impact of incident diabetes on atherosclerotic cardiovascular disease according to statin use history among postmenopausal women

2016 ◽  
Vol 31 (8) ◽  
pp. 747-761 ◽  
Author(s):  
Yunsheng Ma ◽  
Gioia M. Persuitte ◽  
Christopher Andrews ◽  
Kathleen M. Hovey ◽  
Michael J. LaMonte ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Incident Diabetes ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Use
Sign in / Sign up

Export Citation Format

Share Document