scholarly journals Legacy effect of statins: 20-year follow up of the West of Scotland Coronary Prevention Study (WOSCOPS)

2017 ◽  
Vol 2016 (4) ◽  
Author(s):  
Mohammed Amin Kashef ◽  
Gregory Giugliano
Keyword(s):  
Myocardial Infarction ◽  
Primary Outcome ◽  
Nonfatal Myocardial Infarction ◽  
Relative Reduction ◽  
Prevention Study ◽  
The West ◽  
Risk Of Death ◽  
Legacy Effect ◽  
Increased Risk ◽  
Scotland Coronary Prevention Study

The West of Scotland Coronary Prevention Study (WOSCOPS) was a randomized, placebo- controlled, primary prevention trial of pravastatin in men aged 45 to 64 (mean age of 55 years) with no history of myocardial infarction at randomization. A total of 6,595 men, with a mean (SD) plasma cholesterol level of 272 (23) mg/dL and mean (SD) low density lipoprotein cholesterol (LDL-C) of 192 (17) mg/dL were randomly assigned to receive pravastatin 40 mg daily or placebo for five years. The primary outcome was a composite of death from coronary heart disease (CHD) and nonfatal myocardial infarction. There was a 31% relative reduction in the primary outcome with pravastatin. There was similar reduction in risk of nonfatal myocardial infarction, death from CHD and death from all cardiovascular causes with no increased risk of death from non-cardiovascular causes nor an increase in incident cancers. 

Impact of Diabetes Mellitus and Insulin Use on Survival After Colorectal Cancer Diagnosis: The Cancer Prevention Study-II Nutrition Cohort

2012 ◽  
Vol 30 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Ahmed N. Dehal ◽  
Christina C. Newton ◽  
Eric J. Jacobs ◽  
Alpa V. Patel ◽  
Susan M. Gapstur ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Cancer Prevention ◽  
Cox Proportional Hazards ◽  
Prevention Study ◽  
Men And Women ◽  
Risk Of Death ◽  
Increased Risk ◽  
Specific Mortality ◽  
Insulin Use

Purpose To examine the association between type 2 diabetes mellitus (T2DM) and survival among patients with colorectal cancer (CRC) and to evaluate whether this association varies by sex, insulin treatment, and durations of T2DM and insulin use. Patients and Methods This study was conducted among 2,278 men and women diagnosed with nonmetastatic colon or rectal cancer between 1992 and 2007 in the Cancer Prevention Study-II Nutrition Cohort, a prospective study of cancer incidence. In 1992 to 1993, participants completed a detailed, self-administrated questionnaire. Vital status and cause of death were ascertained through the end of 2008. Multivariable-adjusted relative risks (RRs) and 95% CIs were estimated using Cox proportional hazards regression. Results Among the 2,278 men and women with nonmetastatic CRC, there were 842 deaths by the end of follow-up (including 377 deaths from CRC and 152 deaths from cardiovascular disease [CVD]). Among men and women combined, compared with patients without T2DM, patients with CRC and T2DM were at higher risk of all-cause mortality (RR, 1.53; 95% CI, 1.28 to 1.83), CRC-specific mortality (RR, 1.29; 95% CI, 0.98 to 1.70), and CVD-specific mortality (RR, 2.16; 95% CI, 1.44 to 3.24), with no apparent differences by sex or durations of T2DM or insulin use. Insulin use, compared with no T2DM, was associated with increased risk of death from all causes (RR, 1.68; 95% CI, 1.22 to 2.31) and CVD (RR, 3.87; 95% CI, 2.12 to 7.08) but not from CRC (RR, 0.58; 95% CI, 0.28 to 1.19). Conclusion Patients with CRC and T2DM have a higher risk of mortality than patients with CRC who do not have T2DM, especially a higher risk of death from CVD.

scholarly journals Patients With LDLR and PCSK9 Gene Variants Experienced Higher Incidence of Cardiovascular Outcomes in Heterozygous Familial Hypercholesterolemia

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Takahito Doi ◽  
Mika Hori ◽  
Mariko Harada‐Shiba ◽  
Yu Kataoka ◽  
Daisuke Onozuka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Primary Outcome ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiovascular Outcomes ◽  
Nonfatal Myocardial Infarction ◽  
Gene Variants ◽  
Low Density ◽  
Gene Variant ◽  
Low Density Lipoprotein Cholesterol

Background Patients with familial hypercholesterolemia who harbored both low‐density lipoprotein receptor ( LDLR ) and PCSK9 (proprotein convertase subtilisin/kexin type 9) gene variants exhibit severe phenotype associated with substantially high levels of low‐density lipoprotein cholesterol. In this study, we investigated the cardiovascular outcomes in patients with both LDLR and PCSK9 gene variants. Methods and Results A total of 232 unrelated patients with LDLR and/or PCSK9 gene variants were stratified as follows: patients with LDLR and PCSK9 ( LDLR/PCSK9 ) gene variants, patients with LDLR gene variant, and patients with PCSK9 gene variant. Clinical demographics and the occurrence of primary outcome (nonfatal myocardial infarction) were compared. The observation period of primary outcome started at the time of birth and ended at the time of the first cardiac event or the last visit. Patients with LDLR/PCSK9 gene variants were identified in 6% of study patients. They had higher levels of low‐density lipoprotein cholesterol ( P =0.04) than those with LDLR gene variants. On multivariate Cox regression model, they experienced a higher incidence of nonfatal myocardial infarction (hazard ratio, 4.62; 95% CI, 1.66–11.0; P =0.003 versus patients with LDLR gene variant). Of note, risk for nonfatal myocardial infarction was greatest in male patients with LDLR/PCSK9 gene variants compared with those with LDLR gene variant (86% versus 24%; P <0.001). Conclusions Patients with LDLR/PCSK9 gene variants were high‐risk genotype associated with atherogenic lipid profiles and worse cardiovascular outcomes. These findings underscore the importance of genetic testing to identify patients with LDLR/PCSK9 gene variants, who require more stringent antiatherosclerotic management.

scholarly journals Plasma Leptin and the Risk of Cardiovascular Disease in the West of Scotland Coronary Prevention Study (WOSCOPS)

Circulation ◽  
2001 ◽  
Vol 104 (25) ◽  
pp. 3052-3056 ◽  
Author(s):  
A. Michael Wallace ◽  
Alex D. McMahon ◽  
Chris J. Packard ◽  
Anne Kelly ◽  
James Shepherd ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Prevention Study ◽  
The West ◽  
Scotland Coronary Prevention Study ◽  
Plasma Leptin

D-dimer and the incidence of heart failure and mortality after acute myocardial infarction

Heart ◽  
2020 ◽  
pp. heartjnl-2020-316880 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Shanjie Wang ◽  
Jinxin Liu ◽  
Yini Wang ◽  
Hengxuan Cai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Risk Of Death ◽  
Increased Risk ◽  
Clinical Covariates ◽  
All Cause Mortality ◽  
D Dimer

ObjectiveD-dimer might serve as a marker of thrombogenesis and a hypercoagulable state following plaque rupture. Few studies explore the association between baseline D-dimer levels and the incidence of heart failure (HF), all-cause mortality in an acute myocardial infarction (AMI) population. We aimed to explore this association.MethodsWe enrolled 4504 consecutive patients with AMI with complete data in a prospective cohort study and explored the association of plasma D-dimer levels on admission and the incidence of HF, all-cause mortality.ResultsOver a median follow-up of 1 year, 1112 (24.7%) patients developed in-hospital HF, 542 (16.7%) patients developed HF after hospitalisation and 233 (7.1%) patients died. After full adjustments for other relevant clinical covariates, patients with D-dimer values in quartile 3 (Q3) had 1.51 times (95% CI 1.12 to 2.04) and in Q4 had 1.49 times (95% CI 1.09 to 2.04) as high as the risk of HF after hospitalisation compared with patients in Q1. Patients with D-dimer values in Q4 had more than a twofold (HR 2.34; 95% CI 1.33 to 4.13) increased risk of death compared with patients in Q1 (p<0.001). But there was no association between D-dimer levels and in-hospital HF in the adjusted models.ConclusionsD-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.

Risk Factors for Myocardial Infarction and Stroke Among Sepsis Survivors: A Competing Risks Analysis

2019 ◽  
Vol 35 (1) ◽  
pp. 34-41
Author(s):  
Yueh-Che Hsieh ◽  
Po-Yang Tsou ◽  
Yu-Hsun Wang ◽  
Christin Chih-Ting Chao ◽  
Wan-Chien Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Hospital Discharge ◽  
Preventive Measures ◽  
Risk Model ◽  
Cerebrovascular Diseases ◽  
Competing Risk ◽  
Research Database ◽  
Risk Of Death ◽  
Increased Risk

Objectives: Predictors for post-sepsis myocardial infarction (MI) and stroke are yet to be identified due to the competing risk of death. Methods: This study included all hospitalized patients with sepsis from National Health Insurance Research Database of Taiwan between 2000 and 2011. The primary outcome was the first occurrence of MI and stroke requiring hospitalization within 180 days following hospital discharge from the index sepsis episode. The association between predictors and post-sepsis MI and stroke were analyzed using cumulative incidence competing risk model that controlled for the competing risk of death. Results: Among 42 316 patients with sepsis, 1012 (2.4%) patients developed MI and stroke within 180 days of hospital discharge. The leading 5 predictors for post-sepsis MI and stroke are prior cerebrovascular diseases (hazard ratio [HR]: 2.02, 95% confidence interval [CI]: 1.74-2.32), intra-abdominal infection (HR: 1.94, 95% CI: 1.71-2.20), previous MI (HR: 1.81, 95% CI: 1.53-2.15), lower respiratory tract infection (HR: 1.62, 95% CI: 1.43-1.85), and septic encephalopathy (HR: 1.61, 95% CI: 1.26-2.06). Conclusions: Baseline comorbidities and sources of infection were associated with an increased risk of post-sepsis MI and stroke. The identified risk factors may help physicians select a group of patients with sepsis who may benefit from preventive measures, antiplatelet treatment, and other preventive measures for post-sepsis MI and stroke.

scholarly journals Low Toenail Chromium Concentration and Increased Risk of Nonfatal Myocardial Infarction

2005 ◽  
Vol 162 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Eliseo Guallar ◽  
F. Javier Jiménez ◽  
Pieter van 't Veer ◽  
Peter Bode ◽  
Rudolph A. Riemersma ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chromium Concentration ◽  
Nonfatal Myocardial Infarction ◽  
Increased Risk
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