Triglyceride-Glucose Index Associated With the Risk of Cardiovascular Disease: the Kailuan Study

Abstract Purpose: Triglyceride-glucose index (TyG) index, as a marker of insulin resistance, have been associated with risk of cardiovascular disease (CVD) in older adults. Nevertheless, it is unclear to whether TyG index affects risk of CVD and the subtypes of CVD in general Chinese population. Methods: A total of 96541 participants who met the criteria were included from the Kailuan Study. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The study participants were divided into 4 groups (Q1, Q2, Q3 and Q4) by quartiles of the TyG index. Incident of CVD events (myocardial infarction and stroke) during 2006-2017 were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association TyG index with the risk of CVD and the subtypes of CVD by calculating the hazard ratios (HR) and 95% confidence interval (CI).Results: During a median 10.33 years of follow-up, we documented 6421 CVD events including 1493 myocardial infarction events and 5083 stroke events. Multivariate Cox regression analysis showed that compared with the participants in Q1 group, HR (95% CI) for CVD events were for Q2 group 1.12 (95%, 1.03-1.21), Q3 groups 1.28 (95%, 1.18-1.38), and Q4 groups 1.34 (95%, 1.23-1.45). We conducted time-dependent TyG index found compared with Q1 group, HR (95% CI) for CVD events were for Q2 group 1.09(95%, 1.02-1.18), Q3 groups 1.17(95%, 1.09-1.27), and Q4 groups 1.20 (95%, 1.11-1.30). We found similar results in myocardial infarction and stroke.Conclusions: The TyG index is an independent risk factor for CVD. The TyG index may be useful identifying individuals at high risk of developing CVD at an early stage, it can contribution to prevent and control of CVD.

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MicroRNA-146a Serves as a Biomarker for Adverse Prognosis of ST-Segment Elevation Myocardial Infarction

Cardiovascular Therapeutics ◽

10.1155/2021/2923441 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Shengjue Xiao ◽

Tongneng Xue ◽

Qinyuan Pan ◽

Yue Hu ◽

Qi Wu ◽

...

Keyword(s):

Myocardial Infarction ◽

Cox Regression ◽

Control Groups ◽

Hub Genes ◽

Cox Regression Analysis ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Low Levels ◽

And Control

Objective. This study is aimed at exploring the underlying molecular mechanisms of ST-segment elevation myocardial infarction (STEMI) and provides potential clinical prognostic biomarkers for STEMI. Methods. The GSE60993 dataset was downloaded from the GEO database, and the differentially expressed genes (DEGs) between STEMI and control groups were screened. Enrichment analysis of the DEGs was subsequently performed using the DAVID database. A protein–protein interaction network was constructed, and hub genes were identified. The hub genes in patients were then validated by quantitative reverse transcription-PCR. Furthermore, hub gene-miRNA interactions were evaluated using the miRTarBase database. Finally, patient data on classical cardiovascular risk factors were collected, and plasma microRNA-146a (miR-146a) levels were detected. An individualized nomogram was constructed based on multivariate Cox regression analysis. Results. A total of 239 DEGs were identified between the STEMI and control groups. Expression of S100A12 and miR-146a was significantly upregulated in STEMI samples compared with controls. STEMI patients with high levels of miR-146a had a higher risk of major adverse cardiovascular events (MACEs) than those with low levels of miR-146a (log-rank P = 0.034 ). Multivariate Cox regression analysis identified five statistically significant variables, including age, hypertension, diabetes mellitus, white blood cells, and miR-146a. A nomogram was constructed to estimate the likelihood of a MACE at one, two, and three years after STEMI. Conclusion. The incidence of MACEs in STEMI patients expressing high levels of miR-146a was significantly greater than in those expressing low levels. MicroRNA-146a can serve as a biomarker for adverse prognosis of STEMI and might function in its pathogenesis by targeting S100A12, which may exert its role via an inflammatory response. In addition, our study presents a valid and practical model to assess the probability of MACEs within three years of STEMI.

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Nocturia as a Risk Factor for All-Cause and Cardiovascular Disease Mortality

10.21203/rs.3.rs-1055538/v1 ◽

2021 ◽

Author(s):

Shinje Moon ◽

Yoon Jung Kim ◽

Hye Soo Chung ◽

Jae Myung Yu ◽

Il In Park ◽

...

Keyword(s):

Cardiovascular Disease ◽

Mortality Risk ◽

Cox Regression ◽

Baseline Survey ◽

Mortality Data ◽

Cox Regression Analysis ◽

Health And Nutrition ◽

Disease Mortality ◽

Confounding Variables ◽

Cox Proportional Hazard Regression

Abstract This study aimed to evaluate the relationship between nocturia and mortality risk using the National Health and Nutrition Examination Survey database 2005–2010, given that only few studies have investigated nocturia or its association with mortality using this database. Data were obtained from the database, and nocturia was defined based on the symptom questionnaire. We categorized patients into two groups: mild nocturia (2–3 voids/night) and moderate-to severe nocturia (≥4 voids/night). Mortality data were obtained by linking the primary database to death certificate data found in the National Death Index with mortality follow-up up to December 31, 2015. Multiple Cox proportional hazard regression analyses were performed with adjustment for confounding variables at the baseline survey. We included 9,892 adults (4,758 men, 5,134 women) in this study. Nocturia occurred in 3,314 individuals (33.5%). In the multiple Cox regression analysis (results presented as hazard ratio, 95% confidence interval), nocturia was significantly associated with all-cause (1.21, 1.08–1.35, p=0.001) and cardiovascular disease (1.45, 1.13–1.85, p=0.003) mortality. Both mild and moderate-to-severe nocturia were significantly associated with all-cause (1.14, 1.02–1.28, p=0.021 and 1.62, 1.34–1.98, p<0.001, respectively) and cardiovascular disease (1.43, 1.11–1.84, p=0.006 and 1.58, 1.01–2.45, p=0.043, respectively) mortality. Nocturia was significantly associated with mortality in men and women after adjustments for major confounding factors. Moreover, the mortality risk increased with increasing nocturia severity.

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Androgen-deprivation Therapy and the Risk of newly Developed Fractures in Patients with Prostate Cancer: A Nationwide Cohort Study in Korea

10.21203/rs.3.rs-140143/v1 ◽

2021 ◽

Author(s):

Do Kyung Kim ◽

Jong Won Kim ◽

Hye Sun Lee ◽

Ju-Young Park ◽

Hyun Kyu Ahn ◽

...

Keyword(s):

Prostate Cancer ◽

Androgen Deprivation Therapy ◽

Cox Regression ◽

Androgen Deprivation ◽

Proportional Hazard ◽

Cox Regression Analysis ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Increased Risk ◽

Cox Proportional Hazard Regression

Abstract Purpose: We evaluated the risk of osteoporosis and fractures associated with androgen deprivation therapy (ADT) use and duration in men with prostate cancer.Methods: From the nationwide claims database in South Korea, a total of 218,203 men with prostate cancer were identified between 2008 and 2017. To adjust for comorbidities between cohorts, 1:1 propensity score matching was used. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events associated with ADT. Results: In the matched cohort, there were differences in the incidence of newly developed osteoporosis (8.79% in the ADT group vs. 7.08% in the non-ADT group, p < 0.0001) and fractures (8.12% in the ADT group vs. 5.04% in the non-ADT group, p < 0.0001). Age-adjusted Cox regression analysis revealed that the ADT group had a significantly higher risk of osteoporosis (HR, 1.381; 95% CI, 1.305–1.461; p < 0.0001) and fractures (HR, 1.815; 95% CI; 1.703–1.935; p < 0.0001) compared to the non-ADT group. Furthermore, the risk of osteoporosis and fractures increased as the duration of ADT increased.Conclusions: The ADT was associated with an increased risk of osteoporosis and fractures in prostate cancer patients.

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Distinct Triglyceride-Glucose Trajectories are associated with Different Risks of Incident Cardiovascular Disease in Normal-Weight Adults

10.21203/rs.3.rs-649230/v1 ◽

2021 ◽

Author(s):

Anxin Wang ◽

Xue Tian ◽

Yingting Zuo ◽

Shuohua Chen ◽

Xia Meng ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Proportional Hazards ◽

Normal Weight ◽

Cox Proportional Hazards ◽

Annual Increment ◽

Tyg Index ◽

Stable Pattern ◽

Triglyceride Glucose Index

Abstract BackgroundRisk of cardiovascular disease (CVD) is increased in metabolically obese normal weight adults. However, we have limited knowledge of how to prevent CVD in normal-weight people. The triglyceride-glucose index (TyG index) has been considered as a contributor of CVD, while long-term patterns of the triglyceride-glucose index (TyG index) and their effects on CVD among normal-weight adults are poorly characterized. Therefore, this study aimed to identify TyG index trajectories in normal-weight adults and to determine their association with the risk of incident CVD.MethodsThis prospective cohort study included 40,473 normal-weight participants who were free of stroke and myocardial infarction prior to or in 2012. The TyG index was calculated as ln [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)/2], and the TyG index trajectories during 2006-2012 were identified by latent mixture modeling. Cox proportional hazards models were used to examine the associations between TyG index trajectories and incident CVD.Results We identified five distinct TyG index trajectories according to TyG index range and changing pattern over time: low-stable (n=9,806; mean TyG index 7.84-7.93), moderate-stable (n=22,066; mean TyG index 8.43-8.52), elevated-decreasing (n=1,469; mean TyG index 9.83-8.75), moderate-increasing (n=5,842; mean TyG index 8.98-9.26), and elevated-stable (n=1,290; mean TyG index 9.91-10.07). During 6.74 years of follow-up, we documented 1,577 incident CVD events. Compared with the low-stable pattern, the highest risk of CVD was observed in the elevated-stable pattern (hazard ratio [HR], 2.24; 95% confidence interval [CI]: 1.73-2.90), followed by the moderate-increasing pattern (HR, 1.70; 95% CI, 1.43-2.04), the elevated-decreasing pattern (HR, 1.45; 95% CI, 1.11-1.89), and the moderate-stable pattern (HR, 1.25; 95% CI, 1.08-1.44). Similar results were also observed for stroke and myocardial infarction. Consistently, annual increment of the TyG index during 2006-2012 also predicted future risk of CVD.ConclusionsDistinct TyG index trajectories were significantly associated differently subsequent risk of CVD in normal-weight individuals. These observations suggested that long-term trajectories of TyG index may be useful for predicting CVD among normal-weight adults.

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Androgen-deprivation therapy and the risk of newly developed fractures in patients with prostate cancer: a nationwide cohort study in Korea

Scientific Reports ◽

10.1038/s41598-021-89589-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Do Kyung Kim ◽

Hye Sun Lee ◽

Ju-Young Park ◽

Jong Won Kim ◽

Hyun Kyu Ahn ◽

...

Keyword(s):

Prostate Cancer ◽

Androgen Deprivation Therapy ◽

Cox Regression ◽

Androgen Deprivation ◽

Proportional Hazard ◽

Cox Regression Analysis ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Increased Risk ◽

Cox Proportional Hazard Regression

AbstractWe evaluated the risk of osteoporosis and fractures associated with androgen deprivation therapy (ADT) use and duration in men with prostate cancer. From the nationwide claims database in South Korea, a total of 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 144,670 patients were included in the analysis. To adjust for comorbidities between cohorts, 1:1 propensity score matching was used. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events associated with ADT, after controlling for potential confounding factors. In the matched cohort, there were differences in the incidence of newly developed osteoporosis (8.79% in the ADT group vs. 7.08% in the non-ADT group, p < 0.0001) and fractures (8.12% in the ADT group vs. 5.04% in the non-ADT group, p < 0.0001). Age-adjusted Cox regression analysis revealed that the ADT group had a significantly higher risk of osteoporosis (HR, 1.381; 95% CI, 1.305–1.461; p < 0.0001) and fractures (HR, 1.815; 95% CI, 1.703–1.935; p < 0.0001) compared to the non-ADT group. Furthermore, the risk of osteoporosis and fractures increased as the duration of ADT increased. The ADT was associated with an increased risk of osteoporosis and fractures in prostate cancer patients. Clinicians who administer ADT for patients with prostate cancer should always be mindful of the risk of osteoporosis and fracture, avoid unnecessary ADT, and perform regular bone health check-ups.

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Predicting long-term cardiovascular outcomes of patients with acute myocardial infarction using soluble ST2

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2019-0062 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Mustafa Umut Somuncu ◽

Belma Kalayci ◽

Ahmet Avci ◽

Tunahan Akgun ◽

Huseyin Karakurt ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Cox Regression ◽

High Serum ◽

Major Adverse Cardiovascular Events ◽

Lower Systolic Blood Pressure ◽

Cox Regression Analysis ◽

Killip Class ◽

Target Vessel Revascularization

AbstractBackgroundThe increase in soluble suppression of tumorigenicity 2 (sST2) both in the diagnosis and prognosis of heart failure is well established; however, existing data regarding sST2 values as the prognostic marker after myocardial infarction (MI) are limited and have been conflicting. This study aimed to assess the clinical significance of sST2 in predicting 1-year adverse cardiovascular (CV) events in MI patients.Materials and methodsIn this prospective study, 380 MI patients were included. Participants were grouped into low sST2 (n = 264, mean age: 60.0 ± 12.1 years) and high sST2 groups (n = 116, mean age: 60.5 ± 11.6 years), and all study populations were followed up for major adverse cardiovascular events (MACE) which are composed of CV mortality, target vessel revascularization (TVR), non-fatal reinfarction, stroke and heart failure.ResultsDuring a 12-month follow-up, 68 (17.8%) patients had MACE. CV mortality and heart failure were significantly higher in the high sST2 group compared to the low sST2 group (15.5% vs. 4.9%, p = 0.001 and 8.6% vs. 3.4% p = 0.032, respectively). Multivariate Cox regression analysis concluded that high serum sST2 independently predicted 1-year CV mortality [hazard ratio (HR) 2.263, 95% confidence interval (CI) 1.124–4.557, p = 0.022)]. Besides, older age, Killip class >1, left anterior descending (LAD) as the culprit artery and lower systolic blood pressure were the other independent risk factors for 1-year CV mortality.ConclusionsHigh sST2 levels are an important predictor of MACE, including CV mortality and heart failure in a 1-year follow-up period in MI patients.

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Individuals with familial hypercholesterolemia have increased risk of re-hospitalization after acute myocardial infarction compared with controls

European Heart Journal ◽

10.1093/ehjci/ehaa946.2962 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Svendsen ◽

H.W Krogh ◽

J Igland ◽

G.S Tell ◽

L.J Mundal ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Familial Hypercholesterolemia ◽

Cox Regression ◽

Public Institution ◽

University Hospital ◽

Funding Source ◽

Hazard Ratios ◽

Increased Risk ◽

University Of Oslo

Abstract Background and aim We have previously reported that individuals with familial hypercholesterolemia (FH) have a two-fold increased risk of acute myocardial infarction (AMI) compared with the general population. The consequences of having an AMI on re-hospitalization and mortality are however less known. The aim of the present study was to compare the risk of re-hospitalization with AMI and CHD and risk of mortality after incident (first) AMI-hospitalization between persons with and without FH (controls). Methods The original study population comprised 5691 persons diagnosed with FH during 1992–2014 and 119511 age and sex matched controls randomly selected from the general Norwegian population. We identified 221 individuals with FH and 1947 controls with an incident AMI registered in the Norwegian Patient Registry (NPR) or the Cardiovascular Disease in Norway Project during 2001–2017. Persons with incident AMI were followed until December 31st 2017 for re-hospitalization with AMI or coronary heart disease (CHD) registered in the NPR, and for mortality through linkage to the Norwegian Cause of Death Registry. Risk of re-hospitalization was compared with sub-hazard ratios (SHR) from competing risk regression with death as competing event, and mortality was compared using hazard ratios (HR) from Cox regression. All models were adjusted for age. Results Risk of re-hospitalization was 2-fold increased both for AMI [SHR=2.53 (95% CI: 1.88–3.41)] and CHD [SHR=1.82 (95% CI: 1.44–2.28)]. However, persons with FH did not have increased 28-day mortality following an incident AMI (HR=1.05 (95% CI: 0.62–1.78), but the longer-term (>28 days) mortality after first AMI was increased in FH [HR=1.45 (95% CI: 1.07–1.95]. Conclusion This study yields the important finding that persons with FH have increased risk of re-hospitalization of both AMI and CHD after incident AMI. These findings call for more intensive follow-up of individuals with FH after an AMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): University of Oslo and Oslo University Hospital

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Lymphadenectomy in Early-Stage Intermediate-/High-Risk Endometrioid Endometrial Cancer: Clinical Characteristics and Outcomes in an Australian Cohort

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001039 ◽

2017 ◽

Vol 27 (7) ◽

pp. 1379-1386 ◽

Cited By ~ 1

Author(s):

Rhonda Farrell ◽

Suzanne C. Dixon ◽

Jonathan Carter ◽

Penny M. Webb

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

High Risk ◽

Adjuvant Treatment ◽

Cox Regression ◽

Early Stage ◽

Cox Regression Analysis ◽

Cancer Study ◽

Stage Ib ◽

Australian Cohort

ObjectiveThe role of lymphadenectomy (LND) in early-stage endometrial cancer (EC) remains controversial. Previous studies have included low-risk patients and nonendometrioid histologies for which LND may not be beneficial, whereas long-term morbidity after LND is unclear. In a large Australian cohort of women with clinical early-stage intermediate-/high-risk endometrioid EC, we analyzed the association of LND with clinicopathological characteristics, adjuvant treatment, survival, patterns of disease recurrence, and morbidity.Materials and MethodsFrom a larger prospective study (Australian National Endometrial Cancer Study), we analyzed data from 328 women with stage IA grade 3 (n = 63), stage IB grade 1 to 3 (n = 160), stage II grade 1 to 3 (n = 71), and stage IIIC1/2 grade 1 to 3 (n = 31/3) endometrioid EC. Overall survival (OS) was estimated using Kaplan-Meier methods. The association of LND with OS was assessed using Cox regression analysis adjusted for age, stage, grade, and adjuvant treatment. The association with risk of recurrent disease was analyzed using logistic regression adjusted for age, stage, and grade. Morbidity data were analyzed using χ2 tests.ResultsMedian follow-up was 45.8 months. Overall survival at 3 years was 93%. Lymphadenectomy was performed in 217 women (66%), 16% of this group having positive nodes. Median node count was 12. There were no significant differences in OS between LND and no LND groups, or by number of nodes removed. After excluding stage IB grade 1/2 tumors, there was no association between LND and OS among a “high-risk” group of 190 women with a positive node rate of 24%. However, a similar cohort (n = 71) of serous EC in the Australian National Endometrial Cancer Study had improved survival after LND. Women who underwent LND had significantly higher rates of critical events (5% vs 0%, P = 0.02) and lymphoedema (23% vs 4%, P < 0.0001).ConclusionsIn this cohort with early-stage intermediate-/high-risk endometrioid EC, LND did not improve survival but was associated with significantly increased morbidity.

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Efficacy and toxicity hypofractionated radiotherapy for centrally located non-small cell lung cancer

Journal of Radiotherapy in Practice ◽

10.1017/s1460396921000376 ◽

2021 ◽

pp. 1-4

Author(s):

Tanzeel Janjua ◽

Fei Sun ◽

Katy Clarke ◽

Pete Dickinson ◽

Kevin Franks ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Cox Regression ◽

Early Stage ◽

Performance Status ◽

Small Cell ◽

Small Cell Lung ◽

Early Stage Lung Cancer ◽

Cox Regression Analysis

Abstract Aim: Centrally located early-stage non-small cell lung cancer in patients who are unfit for surgery are treated with fractionated radiotherapy. We present the outcomes of a moderately hypofractionated accelerated dose regimen of 50 Gy in 15 fractions from a single centre in the UK. Materials and methods: Electronic case notes and radiotherapy records of lung cancer patients treated between January 2014 and December 2016 were retrospectively reviewed. Adult Comorbidity Evaluation-27 score was used to evaluate comorbidities. Mean lung doses and percentage of lung receiving more than 20 Gy were calculated for all patients. Survival outcomes were estimated using Kaplan–Meier curves. Results: Fifty-three patients were included in the study; the median follow-up was 20.2 months. 87% of patients had stage I disease. There was no 30-day post-treatment mortality. Ninety-day mortality rate after radiotherapy was 3.8%. Grade 2 pneumonitis was seen in five patients while no grade 3 or 4 pneumonitis was observed. The median progression-free survival (PFS) and overall survival (OS) were 18.5 months and 28.2 months, respectively. The estimated 1 and 2 years PFS were 62.3% and 41.3%, respectively, and OS were 77.4% and 56.6%, respectively. Worsening performance status was associated with worse survival on cox regression analysis. Disease relapsed in 36% of patients. 7.5% of patients with relapsed disease had infield recurrence. Findings: 50 Gy in 15 fractions radiotherapy for central early-stage lung cancer is a feasible choice that requires further randomised trials.

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RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF EARLY COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION AFTER CARDIO-INTERVENTION TREATMENT

Wiadomości Lekarskie ◽

10.36740/wlek202006132 ◽

2020 ◽

Vol 73 (6) ◽

pp. 1245-1251

Author(s):

Iryna A. Holovanova ◽

Grygori A. Oksak ◽

Iryna M. Tkachenko ◽

Maxim V. Khorosh ◽

Mariia M. Tovstiak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cox Regression ◽

Risk Indicators ◽

Interventional Treatment ◽

Early Complications ◽

Cox Regression Analysis ◽

Intervention Treatment

The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators. Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient’s transportation time by ambulance. Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender – in 35%; the age over of 70 – by 50%; the timely arrival of an emergency medical team – by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI. Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.

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