scholarly journals Distribution of FFRCT in Single Obstructive Coronary Stenosis and Predictors for Major Adverse Cardiac Events: A Propensity Score Matching Study

2021 ◽  
Author(s):  
Xianglan Jin ◽  
Xiangyu Jin ◽  
Xiaoyun Wu ◽  
Luguang Chen ◽  
Tiegong Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Unstable Angina ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Conservative Group ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Adverse Cardiac Events ◽  
History Of

Abstract Background: Fractional flow reserve derived from computed tomography (FFRCT) has been demonstrated significantly improved identification of lesion-specific ischemia compared with coronary computed tomography angiography (CCTA). It remains unclear the distribution of FFRCT values in obstructive stenosis between patients who received percutaneous coronary intervention (PCI) or not in routine clinical practice, as well as its association with clinical outcome. This study aims to reveal the distribution of FFRCT value in patients with single obstructive coronary artery stenosis, and explored the independent factors for predicting major adverse cardiac events (MACE). Methods: This was a retrospective study of adults with non-ST-segment elevation acute coronary syndrome undergoing FFRCT assessment by using CCTA data from January 1, 2016 to December 31, 2020. Propensity score matching (PSM) method was used to account for patient selection bias. The risk factors for predicting MACE were evaluated by a Cox proportional hazards regression analysis. Results: Overall, 655 patients with single obstructive (³ 50%) stenosis shown on CCTA were enrolled and divided into PCI group (376 cases) and conservative group (279 cases) according to treatment. The PSM cohort analysis demonstrated that the difference in history of unstable angina, CCSC and FFRCT between PCI group (188 cases) and conservative group (315 cases) was statistically significant, with all P values < 0.05, while the median follow-up time between them was no statistically significant (24 months vs 22.5months, P = 0.912). The incidence of MACE in PCI group and conservative group were 14.9% (28/188) and 23.5% (74/315) respectively, P = 0.020. Multivariate analysis of Cox proportional hazards regression revealed that history of unstable angina (adjusted odds ratio (adjOR), 3.165; 95% confidence interval (CI), 2.087-4.800; P < 0.001), FFRCT £ 0.8 (OR, 1.632;95% CI, 1.095-2.431; P = 0.016), and PCI therapy (OR, 0.481; 95% CI, 0.305-0.758) were the independent factors for MACE. Conclusions: History of unstable angina and FFRCT value of £ 0.8 were the independent risk factors for MACE, while PCI therapy was the independent protective factor for MACE.

A prognostic model for predicting overall survival (OS) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) after docetaxel.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5013-5013 ◽  
Author(s):  
Kim N. Chi ◽  
Thian San Kheoh ◽  
Charles J. Ryan ◽  
Arturo Molina ◽  
Joaquim Bellmunt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Poor Prognosis ◽  
Prognostic Model ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Phase Iii ◽  
Clinical Parameters ◽  
Available N ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

5013 Background: COU-AA-301 was a multinational, randomized, controlled, phase III trial comparing AA + prednisone (P) (n = 797) versus placebo + P (n = 398) in mCRPC pts post-docetaxel. Using data from that trial, we developed a prognostic model for predicting OS in pts treated with AA post-chemotherapy, with a focus on readily assessable clinical parameters. Methods: The analyses used data from pts treated with AA in the COU-AA-301 trial for whom relevant baseline data were available (n = 729). Baseline variables were assessed for association with OS through a univariate Cox proportional hazards regression model. High/low values for accepted normal ranges were used for laboratory parameters. The Cox proportional hazards regression was used with a stepwise procedure to identify independent prognostic factors for OS. The model was subject to sensitivity analyses and the C-index was utilized as a measure of model accuracy. Results: The following risk factors were associated with a poor prognosis: ECOG performance status (only pts with scores of ≤ 2 were eligible for this trial) of 2 (HR = 2.19, p < 0.0001), presence of liver metastases (HR = 2.00, p < 0.0001), time from start of initial LHRH agonist therapy to start of AA treatment ≤ 36 months (HR = 1.30, p = 0.0078), low albumin (HR = 1.54, p < 0.0001), high ALP (HR = 1.38, p = 0.0016), and high LDH (HR = 2.31, p < 0.0001). Patients were categorized into 3 risk groups (good prognosis, n = 369; intermediate prognosis, n = 321; poor prognosis, n = 107) based on total number of risk factors and median OS calculated for each group (table). The C-index was 0.74 (95% CI: 0.68, 0.80). Conclusions: This prognostic model uses readily available clinical parameters to conveniently assess risk for mCRPC pts previously treated with docetaxel and initiating treatment with AA + P. If validated, the model will be useful in clinical practice and clinical trials. Clinical trial information: NCT00638690. [Table: see text]

scholarly journals Prognostic Nomogram for Penile Cancer, an Analysis Based on SEER Database

2020 ◽  
Author(s):  
Yong-Bo Chen ◽  
Liang Gao ◽  
Liang-You Tang ◽  
Jiang Guo ◽  
Yu-Chang Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Penile Cancer ◽  
Proportional Hazards ◽  
Characteristic Curve ◽  
Cox Proportional Hazards ◽  
Seer Database ◽  
Survival Status ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Development Group

Abstract Background: We aimed to establish a prognostic nomogram for Penile Cancer (PC) patients based on the Surveillance, Epidemiology, and End Results Program (SEER) database.Methods: Data of 1694 patients between 2010 and 2015 were downloaded and extracted from the SEER database. Then, they were randomly divided into the development group (70%) and the verification group (30%). Following, the univariate and multivariate Cox proportional hazards regression was respectively used to explore the possible risk factors of PC. Factors which significantly related to the overall survival (OS) were used to establish the nomogram. Further, the concordance index (C-index), receiver operating characteristic curve (ROC) and calibration curve were used to assess the nomogram, respectively. An internal validation was carried out to test the accuracy and effectiveness of nomogram. Finally, the Kaplan-Meier calculation was used to predict the further survival status of these patients.Results: Multivariate Cox proportional hazards regression demonstrated that the independent prognostic risk factors associated with PC were age, stage T, N and M, and grade, with a moderate c-index of 0.732 [95% confidence interval (CI), 0.706-0.757] in development group and 0.743 (95% CI, 0.703-0.782) in verification group. Meanwhile, the areas under the ROC (AUC) of 3-year and 5-year survival were 0.739 and 0.727, respectively. The survival calibration curves of 3-year and 5-year brought out a high consistency. Conclusion: Our study obtained a satisfactory nomogram to reveal the survival of PC patients, which could be helpful for clinicians to assess the situation of PC patients and to implement the further treatment.

scholarly journals Prognostic nomogram for penile cancer, an analysis based on SEER database

2020 ◽  
Author(s):  
Yon-Bo Chen ◽  
Liang Gao ◽  
Liang-You Tang ◽  
Jiang Guo ◽  
Yu-Chang Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Penile Cancer ◽  
Proportional Hazards ◽  
Characteristic Curve ◽  
Cox Proportional Hazards ◽  
Seer Database ◽  
Survival Status ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Development Group

Abstract BackgroundWe aimed to establish a prognostic nomogram for Penile Cancer (PC) patients based on the Surveillance, Epidemiology, and End Results Program (SEER) database.MethodsData of 1694 patients between 2010 and 2015 were downloaded and extracted from the SEER database. Then, they were randomly divided into the development group (70%) and the verification group (30%). Following, the univariate and multivariate Cox proportional hazards regression was respectively used to explore the possible risk factors of PC. Factors which significantly related to the overall survival (OS) were used to establish the nomogram. Further, the concordance index (C-index), receiver operating characteristic curve (ROC) and calibration curve were used to assess the nomogram, respectively. An internal validation was carried out to test the accuracy and effectiveness of nomogram. Finally, the Kaplan-Meier calculation was used to predict the further survival status of these patients.ResultsMultivariate Cox proportional hazards regression demonstrated that the independent prognostic risk factors associated with PC were age, stage T, N and M, and grade, with a moderate c-index of 0.732 [95% confidence interval (CI), 0.706-0.757] in development group and 0.743 (95% CI, 0.703-0.782) in verification group. Meanwhile, the areas under the ROC (AUC) of 3-year and 5-year survival were 0.739 and 0.727, respectively. The survival calibration curves of 3-year and 5-year brought out a high consistency. ConclusionOur study obtained a satisfactory nomogram to reveal the survival of PC patients, which could be helpful for clinicians to assess the situation of PC patients and to implement the further treatment.

scholarly journals Replacement of potatoes with other vegetables and risk of myocardial infarction in the Danish Diet, Cancer and Health cohort

2021 ◽  
pp. 1-21
Author(s):  
Anne Mette L. Würtz ◽  
Mette D. Hansen ◽  
Anne Tjønneland ◽  
Eric B. Rimm ◽  
Erik B. Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Similar Pattern ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Heterogeneous Group ◽  
Dietary Guidelines ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Root Vegetables

ABSTRACT Intake of vegetables is recommended for the prevention of myocardial infarction (MI). However, vegetables make up a heterogeneous group, and subgroups of vegetables may be differentially associated with MI. The aim of this study was to examine replacement of potatoes with other vegetables or subgroups of other vegetables and the risk of MI. Substitutions between subgroups of other vegetables and risk of MI were also investigated. We followed 29,142 women and 26,029 men aged 50-64 years in the Danish Diet, Cancer and Health cohort. Diet was assessed at baseline by using a detailed validated FFQ. Hazards ratios (HR) with 95% CI for the incidence of MI were calculated using Cox proportional hazards regression. During 13.6 years of follow-up, 656 female and 1,694 male cases were identified. Among women, the adjusted HR for MI was 1.02 (95% CI: 0.93, 1.13) per 500 g/week replacement of potatoes with other vegetables. For vegetable subgroups, the HR was 0.93 (95% CI: 0.77, 1.13) for replacement of potatoes with fruiting vegetables and 0.91 (95% CI: 0.77, 1.07) for replacement of potatoes with other root vegetables. A higher intake of cabbage replacing other vegetable subgroups was associated with a statistically non-significant higher risk of MI. A similar pattern of associations was found when intake was expressed in kcal/week. Among men, the pattern of associations was overall found to be similar to that for women. This study supports food-based dietary guidelines recommending to consume a variety of vegetables from all subgroups.

scholarly journals Clinical impact of regression from sustained to paroxysmal atrial fibrillation: the Fushimi AF registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Fujino ◽  
H Ogawa ◽  
S Ikeda ◽  
K Doi ◽  
Y Hamatani ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Clinical Impact ◽  
Cox Proportional Hazards Model ◽  
Cardiac Events ◽  
Hazards Model ◽  
Adverse Cardiac Events

Abstract Background Atrial fibrillation (AF) commonly progresses from paroxysmal type to sustained type in the natural course of the disease, and we previously demonstrated that the progression of AF was associated with increased risk of clinical adverse events. There are some patients, though less frequently, who regress from sustained to paroxysmal AF, but the clinical impact of the regression of AF remains unknown. Purpose We sought to investigate whether regression from sustained to paroxysmal AF is associated with better clinical outcomes. Methods Using the dataset of the Fushimi AF Registry, patients who were diagnosed as sustained (persistent or permanent) AF at baseline were studied. Conversion of sustained AF to paroxysmal AF during follow-up was defined as regression of AF. Major adverse cardiac events (MACE) were defined as the composite of cardiac death, stroke, and hospitalization for heart failure (HF). Event rates were compared between the patients with and without regression of AF. In patients with sustained AF at baseline, predictors of MACE were identified using Cox proportional hazards model. Results Among 2,253 patients who were diagnosed as sustained AF at baseline, regression of AF was observed in 9.0% (202/2,253, 2.0 per 100 patient-years) during a median follow-up of 4.0 years. Of these, 24.3% (49/202, 4.6 per 100 patient-years) of the patients finally recurred to sustained AF during follow-up. The proportion of asymptomatic patients was lower in patients with regression of AF than those without (with vs without regression; 49.0% vs 69.5%, p&lt;0.01). The percentage of beta-blocker use at baseline was similar between the two groups (37.2% vs 33.8%, p=0.34). The prevalence of patients who underwent catheter ablation or electrical cardioversion during follow-up was higher in patients with regression of AF (catheter ablation: 15.8% vs 5.5%; p&lt;0.01, cardioversion: 4.0% vs 1.4%; p&lt;0.01, respectively). The rate of MACE was significantly lower in patients with regression of AF as compared with patients who maintained sustained AF (3.7 vs 6.2 per 100 patient-years, log-rank p&lt;0.01). Figure shows the Kaplan-Meier curves for MACE, cardiac death, hospitalization for heart failure, and stroke. In patients with sustained AF at baseline, multivariable Cox proportional hazards model demonstrated that regression of AF was an independent predictor of lower MACE (adjusted hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.28 to 0.88, p=0.02), stroke (HR: 0.51, 95% CI: 0.30 to 0.88, p=0.02), and hospitalization for HF (HR: 0.50, 95% CI: 0.29 to 0.85, p=0.01). Conclusion Regression from sustained to paroxysmal AF was associated with a lower incidence of adverse cardiac events. Funding Acknowledgement Type of funding source: None

Development and Validation of a Prognostic Nomogram Model for Recurrence of Non-Muscle Invasive Bladder Cancer

2021 ◽  
Author(s):  
Sanhe Liu ◽  
Yongzhi Li ◽  
Diansheng Cui ◽  
Yuexia Jiao ◽  
Liqun Duan ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Risk Stratification ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Muscle Invasive Bladder Cancer ◽  
Clinicopathologic Characteristics ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Muscle Invasive

Abstract BackgroundDifferent recurrence probability of non-muscle invasive bladder cancer (NMIBC) requests different adjuvant treatments and follow-up strategies. However, there is no simple, intuitive, and generally accepted clinical recurrence predictive model available for NMIBC. This study aims to construct a predictive model for the recurrence of NMIBC based on demographics and clinicopathologic characteristics from two independent centers. MethodsDemographics and clinicopathologic characteristics of 511 patients with NMIBC were retrospectively collected. Recurrence free survival (RFS) was estimated using the Kaplan-Meier method and log-rank tests. Univariate Cox proportional hazards regression analysis was used to screen variables associated with RFS, and a multivariate Cox proportional hazards regression model with a stepwise procedure was used to identify those factors of significance. A final nomogram model was built using the multivariable Cox method. The performance of the nomogram model was evaluated with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed with bootstrap resampling. X-tile software was used for risk stratification calculated by the nomogram model. ResultsIndependent prognostic factors including tumor stage, recurrence status, and European Association of Urology (EAU) risk stratification group were introduced to the nomogram model. The model showed acceptable calibration and discrimination (area under the receiver operating characteristic [ROC] curve was 0.85; the consistency index [C-index] was 0.79 [95% CI: 0.76 to 0.82]), which was superior to the EAU risk stratification group alone. The decision curve also proved well clinical usefulness. Moreover, all populations could be stratified into three distinct risk groups by the nomogram model. ConclusionsWe established and validated a novel nomogram model that can provide individual prediction of RFS for patients with NMIBC. This intuitively prognostic nomogram model may help clinicians in postoperative treatment and follow-up decision-making.

Antibiotic and acid-suppression medications during early childhood are associated with obesity

Gut ◽  
2018 ◽  
Vol 68 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Christopher M Stark ◽  
Apryl Susi ◽  
Jill Emerick ◽  
Cade M Nylund
Keyword(s):  
Early Childhood ◽  
Department Of Defense ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Event Analysis ◽  
Early Exposure ◽  
Single Event ◽  
Inclusion Criteria ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

ObjectiveGut microbiota alterations are associated with obesity. Early exposure to medications, including acid suppressants and antibiotics, can alter gut biota and may increase the likelihood of developing obesity. We investigated the association of antibiotic, histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) prescriptions during early childhood with a diagnosis of obesity.DesignWe performed a cohort study of US Department of Defense TRICARE beneficiaries born from October 2006 to September 2013. Exposures were defined as having any dispensed prescription for antibiotic, H2RA or PPI medications in the first 2 years of life. A single event analysis of obesity was performed using Cox proportional hazards regression.Results333 353 children met inclusion criteria, with 241 502 (72.4%) children prescribed an antibiotic, 39 488 (11.8%) an H2RA and 11 089 (3.3%) a PPI. Antibiotic prescriptions were associated with obesity (HR 1.26; 95% CI 1.23 to 1.28). This association persisted regardless of antibiotic class and strengthened with each additional class of antibiotic prescribed. H2RA and PPI prescriptions were also associated with obesity, with a stronger association for each 30-day supply prescribed. The HR increased commensurately with exposure to each additional medication group prescribed.ConclusionsAntibiotics, acid suppressants and the combination of multiple medications in the first 2 years of life are associated with a diagnosis of childhood obesity. Microbiota-altering medications administered in early childhood may influence weight gain.

scholarly journals Identification of Arp2/3 Complex Subunits as Prognostic Biomarkers for Hepatocellular Carcinoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Shenglan Huang ◽  
Dan Li ◽  
LingLing Zhuang ◽  
Liying Sun ◽  
Jianbing Wu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mrna Expression ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Gene Set Enrichment Analysis ◽  
Prognostic Biomarkers ◽  
Migration And Invasion ◽  
Regression Analyses ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

The actin-related protein 2/3 complex (Arp2/3) is a major actin nucleator that has been widely reported and plays an important role in promoting the migration and invasion of various cancers. However, the expression patterns and prognostic values of Arp2/3 subunits in hepatocellular carcinoma (HCC) remain unclear. In this study, The Cancer Genome Atlas (TCGA) and UCSC Xena databases were used to obtain mRNA expression and the corresponding clinical information, respectively. The differential expression and Arp2/3 subunits in HCC were analyzed using the “limma” package of R 4.0.4 software. The prognostic value of each subunit was evaluated using Kaplan–Meier survival analysis and Cox proportional hazards regression analyses. The results revealed that mRNA expression of Arp2/3 members (ACTR2, ACTR3, ARPC1A, APRC1B, ARPC2, ARPC3, ARPC4, ARPC5, and ARPC5L) was upregulated in HCC. Higher expression of Arp2/3 members was significantly correlated with worse overall survival (OS) and shorter progression-free survival (PFS) in HCC patients. Cox proportional hazards regression analyses demonstrated that ACTR3, ARPC2, and ARPC5 were independent prognostic biomarkers of survival in patients with HCC. The relation between tumor immunocyte infiltration and the prognostic subunits was determined using the TIMER 2.0 platform and the GEPIA database. Gene set enrichment analysis (GSEA) was performed to explore the potential mechanisms of prognostic subunits in the carcinogenesis of HCC. The results revealed that ACTR3, ARPC2, and ARPC5 were significantly positively correlated with the infiltration of immune cells in HCC. The GSEA results indicated that ACTR3, ARPC2, and ARPC5 are involved in multiple cancer-related pathways that promote the development of HCC. In brief, various analyses indicated that Arp2/3 complex subunits were significantly upregulated and predicted worse survival in HCC, and they found that ACTR3, ARPC2, and ARPC5 could be used as independent predictors of survival and might be applied as promising molecular targets for diagnosis and therapy of HCC in the future.

Active monitoring of 12760 clozapine recipients in the UK and Ireland

1999 ◽  
Vol 175 (6) ◽  
pp. 576-580 ◽  
Author(s):  
Janet Munro ◽  
Desmond O'Sullivan ◽  
Christopher Andrews ◽  
Alejandro Arana ◽  
Ann Mortimer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Treatment Resistant ◽  
Active Monitoring ◽  
Case Register ◽  
Proportional Hazards Regression ◽  
Age Related ◽  
The Uk ◽  
To Receive

BackgroundPeople prescribed clozapine for treatment-resistant schizophrenia have mandatory haematological monitoring through a case register for identifying reversible neutropenia.AimsTo quantify risk factors for agranulocytosis in subjects receiving clozapine.MethodData from 12 760 subjects registered to receive clozapine from January 1990 to April 1997 were analysed. Risk factors for agranulocytosis were quantified using a Cox proportional-hazards regression analysis.ResultsThe risk for agranulocytosis in Asian subjects was 2.4 times that in Caucasians (P=0.03). There was an age-related increase in risk of 53% per decade (P=0.0001).ConclusionsThe case register yielded valuable information for guiding research into the causes of the haematological reactions.

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