scholarly journals Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as a risk factor for mortality in peruvian adults with chronic kidney disease.

2021 ◽  
Author(s):  
Gianfranco Umeres-Francia1 ◽  
María Rojas-Fernández ◽  
Percy Herrera Añazco ◽  
Vicente Benites-Zapata
Keyword(s):  
Risk Factor ◽  
Cox Regression ◽  
Outcome Variable ◽  
Lymphocyte Ratio ◽  
Hazard Ratios ◽  
Ckd Stage ◽  
All Cause Mortality ◽  
The Relationship ◽  
Crude Analysis

Objective: To assess the association between NLR and PLR with all-cause mortality in Peruvian patients with CKD Methods: We conducted a retrospective cohort study in adults with CKD in stages 1 to 5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cut-off point of 3.5 and 232.5; respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95%CI). Results: We analyzed 343 participants with a median follow-up time of 2.45 years (2.08-3.08). The frequency of deaths was 17.5% (n=60). In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR=2.01; 95% CI:1.11-3.66) and (HR=2.58; 95% CI:1.31-5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, CKD stage, albumin and hemoglobin, the high NLR and PLR remained as an independent risk factor for all-cause mortality, (HR=2.10; 95% CI:1.11-3.95) and (HR=2.71; 95% CI:1.28-5.72). Conclusion: Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.

Association between selenium intake, diabetes, and mortality in adults: findings from National Health and Nutrition Examination Survey (NHANES) 2003-2014

2021 ◽  
pp. 1-24
Author(s):  
Bushra Hoque ◽  
Zumin Shi
Keyword(s):  
National Health ◽  
Cox Regression ◽  
Inverse Association ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Hazard Ratios ◽  
The Us ◽  
All Cause Mortality ◽  
Cvd Mortality

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.

Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Health Study ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Cardiology ◽  
2017 ◽  
Vol 138 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Xili Lu ◽  
Wei Wang ◽  
Ling Zhu ◽  
Yilu Wang ◽  
Kai Sun ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cox Regression Analysis ◽  
Fragmented Qrs ◽  
All Cause Mortality ◽  
The Relationship ◽  
Cvd Mortality

Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.

Abstract 16212: Warranty Period of Zero Coronary Artery Calcium Score in Asymptomatic Korean Individuals

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ji-hyun Lee ◽  
Dong-hee Han ◽  
Bríain ó Hartaigh ◽  
Heidi Gransar ◽  
Su-Yeon Choi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Calcium Score ◽  
Cardiac Risk ◽  
Low Risk ◽  
Warranty Period ◽  
Hazard Ratios

Introduction: Zero coronary artery calcium (CAC) is a reliable predictor of absent atherosclerosis and serves as a useful adjunct for identifying those at low risk. Despite this, the “warranty period” that displays the protective value associated with the absence of CAC towards experiencing a cardiovascular event among Asians is not well established. Hypothesis: To examine whether the absence of CAC displays a more favorable warranty period for all-cause death compared with the presence of CAC in a Korean cohort. Methods: A total of 48,215 asymptomatic Koreans (mean age: 54±8.8 years; 25% women) were enrolled and stratified by the absence or presence of CAC. Time to exceeding 1% of cumulative all-cause death was estimated in order to identify low-risk individuals. Hazard ratios (HR) with 95% confidence intervals (95% CI) for all-cause death were estimated according to prespecified cardiac risk factors and the presence of CAC. Results: In total, 30,605 (63.5%) individuals presented with a zero CAC. Across a median follow-up of 4.4 years (Interquartile range: 2.7-6.6 years), 415 (0.9%) individuals experienced the endpoint of all-cause death. For those with a zero CAC, the time to exceeding 1% risk was found to be 9 years, indicating a substantially longer warranty period compared with participants with a CAC>0 (e.g., 5 year warranty period). The time to exceeding 1% risk tended to decline for individuals on the background of increasing CAC scores. For each of the other prespecified risk factor groups, a zero CAC provided a longer cumulative event free period than in the presence of any CAC. Cox regression analyses also revealed that the absence of CAC was independently associated with a lower risk of all-cause death in each of the respective risk factor groups when compared with CAC>0. Conclusions: In a large cohort of asymptomatic Korean individuals, the absence of CAC evokes a strong protective effect against all-cause death as demonstrated by a longer warranty period.

scholarly journals Dietary Intake of Marine Polyunsaturated n-3 Fatty Acids and Risk of Recurrent Venous Thromboembolism

2019 ◽  
Vol 119 (12) ◽  
pp. 2053-2063 ◽  
Author(s):  
Trond Isaksen ◽  
Line H. Evensen ◽  
Sigrid K. Brækkan ◽  
John-Bjarne Hansen
Keyword(s):  
Fatty Acids ◽  
Venous Thromboembolism ◽  
Dietary Intake ◽  
Cox Regression ◽  
Risk Of Recurrence ◽  
Vein Thrombosis ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Recurrent Vte

Abstract Background Limited knowledge exists on the association between intake of long-chained n-3 polyunsaturated fatty acids (n-3 PUFAs) and risk of recurrence and all-cause mortality in patients with venous thromboembolism (VTE). Objectives This article investigates whether intake of marine n-3 PUFAs was associated with risk of recurrence and mortality in patients with incident VTE. Methods A total of 595 patients with incident VTE and available data on n-3 PUFA intake were derived from the Tromsø Study surveys 4 (1994–1995) and 6 (2007–2008). Weekly intake of n-3 PUFAs was categorized as low, medium, and high based on tertiles. Recurrent VTEs and all-cause mortality were registered up to December 31, 2016. Hazard ratios (HRs) were calculated using Cox regression models with the low intake category as reference. Results There were 98 recurrent VTEs and 227 deaths during follow-up. Overall, we found no association between intake of n-3 PUFAs and risk of recurrent VTE. However, inverse associations were found for high intakes in patients with unprovoked VTE (HR 0.45, 95% confidence interval [CI]: 0.20–1.01), cancer-free patients (HR 0.51, 95% CI: 0.27–0.95), and deep vein thrombosis (DVT) patients (HR 0.49, 95% CI: 0.24–0.97). The inverse associations were more evident when follow-up was restricted to the time after discontinuation of anticoagulant therapy. No association was observed between intake of n-3 PUFAs and mortality after incident VTE. Conclusion A high dietary intake of marine n-3 PUFAs was associated with lower risk of recurrent VTE after unprovoked index events, DVT, and in cancer-free patients.

Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients

2019 ◽  
Vol 96 (1133) ◽  
pp. 128-133
Author(s):  
Yu-Qing Huang ◽  
Jia-Yi Huang ◽  
Lin Liu ◽  
Chao-Lei Chen ◽  
Yu-Ling Yu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Elderly Patients ◽  
Ischaemic Stroke ◽  
Cox Regression ◽  
Interaction Analysis ◽  
Interactive Effect ◽  
Cox Regression Analysis ◽  
Elderly Hypertensive ◽  
The Relationship

BackgroundAlthough hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.ObjectivesThe present study attempted to explore the relationship between triglyceride and first ischaemic stroke in a Chinese community elderly patients with hypertension.Methods and resultsThis was a retrospective cohort study. We enrolled 3249 consecutive elderly patients with hypertension from a community in China between January 2010 and December 2011. Patients were divided into four groups based on the quartiles of triglyceride. Multivariate Cox regression analysis, subgroup and interaction test were performed to evaluate the relationship between triglyceride and first ischaemic stroke. There were a total of 3249 participants including 1455 male and 1794 female, with a mean age of 71.36±7.18 years. At an average follow-up of 5.5 years, 205 patients were identified to have first ischaemic stroke. After adjustment for potential confounders, using the lowest quartiles of triglyceride as the reference, multivariable HR (95% CI) for first ischaemic stroke increased in parallel with the quartiles of triglyceride (HRs were 1.56 (95% CI 1.07 to 2.51), 1.74 (95% CI 1.07 to 2.84) and 1.85 (95% CI 1.05 to 2.89)) from the second to the fourth quartiles, respectively (p=0.002 for trend). Subgroup and interaction analysis showed that there was no interactive effect on triglyceride and first ischaemic stroke.ConclusionTriglyceride was an independent risk factor for first ischaemic stroke among Chinese elderly patients with hypertension.

scholarly journals Body mass index mortality paradox in chronic kidney disease patients with suspected cardiac chest pain.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Jamie Michael O'Driscoll ◽  
Adrian Slee ◽  
Rajan Sharma
Keyword(s):  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Risk Factor ◽  
Kidney Disease ◽  
Body Mass ◽  
All Cause Mortality ◽  
The Relationship

Background: Chronic kidney disease (CKD) is a silent clinical condition associated with adverse comorbidity and high cardiovascular disease (CVD) risk. An inverse relationship with body mass index (BMI) and mortality has been demonstrated in hemodialysis patients. However, it is unclear if this risk-factor paradox is evident in non-dialysis CKD patients. The aims of this study were to explore the relationship between, nutritional status, markers of inflammation, autonomic and cardiac function with BMI. Longitudinal follow-up explored the relationship between BMI and all-cause mortality. Methods: 211-consecutive CKD patients referred for dobutamine stress echocardiography to detect or exclude myocardial ischemia were recruited. BMI, albumin, C-reactive protein (CRP) and haemoglobin (Hb) were recorded as markers of nutritional and inflammatory status. Left ventricular ejection fraction (LVEF) and heart rate variability (HRV) as an indicator of cardiac function was recorded. All subjects were followed prospectively until November 2014 and study end-point was all-cause mortality. Results: BMI was inversely associated with CKD status. After covariate adjustment, this association remained. During a mean follow-up period of 3.3±0.9 years there were 35 deaths (17%). BMI was inversely associated with all-cause mortality (HR 0.81, 95% CI 0.71-0.9). Other important independent predictors of mortality were heart rate variability (HR 0.98, 95% CI 0.97-0.99), myocardial ischemia (HR 1.37, 95% CI 1.17-1.81), and albumin (HR 0.86, 95% CI 0.81-0.92). Conclusions: The presence of a body mass index paradox exists in non-dialysis CKD patients. This risk-factor paradox was an independent predictor of all-cause mortality and may have significant clinical implications relevant to screening, assessment and treatment and requires further study.

scholarly journals Blood pressure, frailty status, and all-cause mortality in elderly hypertensives; The Nambu Cohort Study

2021 ◽  
Author(s):  
Taku Inoue ◽  
Mitsuteru Matsuoka ◽  
Tetsuji Shinjo ◽  
Masahiro Tamashiro ◽  
Kageyuki Oba ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Frailty Status ◽  
Frail Patients ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Using Data ◽  
The Relationship ◽  
Elderly Hypertensives

AbstractAntihypertensive therapy is pivotal for reducing cardiovascular events. The 2019 Guidelines for the Management of Hypertension set a target blood pressure (BP) of <140/90 mmHg for persons older than 75 years of age. Optimal BP levels for older persons with frailty, however, are controversial because evidence for the relationship between BP level and prognosis by frailty status is limited. Here, we evaluated the relationship between systolic BP and frailty status with all-cause mortality in ambulatory older hypertensive patients using data from the Nambu Cohort study. A total of 535 patients (age 78 [70–84] years, 51% men, 37% with frailty) were prospectively followed for a mean duration of 41 (34–43) months. During the follow-up period, 49 patients died. Mortality rates stratified by systolic BP and frailty status were lowest in patients with systolic BP < 140 mmHg and non-frailty, followed by those with systolic BP ≥ 140 mmHg and non-frailty. Patients with frailty had the highest mortality regardless of the BP level. The adjusted hazard ratios (95% confidence intervals) of each category for all-cause mortality were as follows: ≥140 mmHg/Non-frailty 3.19 (1.12–11.40), <140 mmHg/Frailty 4.72 (1.67–16.90), and ≥140 mmHg/Frailty 3.56 (1.16–13.40) compared with <140 mmHg/Non-frailty as a reference. These results indicated that frail patients have a poor prognosis regardless of their BP levels. Non-frail patients, however, with systolic BP levels <140 mmHg had a better prognosis. Frailty may be a marker to differentiate patients who are likely to gain benefit from antihypertensive medication among older hypertensives.

scholarly journals 751Investigation of the obesity paradox in kidney cancer: mystifying association or myth?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Alicia Heath ◽  
Joanna Clasen ◽  
Elio Riboli ◽  
Ghislaine Scelo ◽  
David Muller
Keyword(s):  
Kidney Cancer ◽  
Cox Regression ◽  
Obesity Paradox ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
All Cause Mortality ◽  
Using Data ◽  
Restricted Cubic Splines

Abstract Background An “obesity paradox” has been reported in kidney cancer, whereby obesity is a risk factor, yet appears to be associated with better survival. To evaluate this paradox, we investigated the association between pre-diagnostic adiposity and renal cell carcinoma (RCC) incidence and mortality. Methods Using data from 363,521 men and women in the European Prospective Investigation into Cancer and Nutrition (EPIC), Cox regression models yielded confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for RCC incidence and mortality in relation to BMI modelled continuously and using restricted cubic splines. RCC-specific and all-cause mortality were evaluated among cases. Results During a mean follow-up of 14.9 years, 936 incident RCC cases were identified, 383 of whom died (278 due to RCC). Each 5 kg/m2 increment in BMI was associated with 27% and 46% higher RCC incidence and mortality (HRs=1.27, 95% CI 1.18-1.37 and 1.46, 95% CI 1.28-1.66, respectively). Comparing a BMI of 35 with 22 kg/m2, HRs for RCC incidence and mortality were 1.88 (95% CI 1.54-2.30) and 2.37 (95% CI 1.68-3.35), respectively. Among RCC cases, HRs per 5 kg/m2 increment in BMI were 1.22 (95% CI 1.07-1.41) for RCC-specific mortality and 1.18 (95% CI 1.04-1.34) for all-cause mortality. Similar, positive linear associations were evident for waist circumference and waist-to-hip ratio. Conclusions Obesity was associated with increased RCC incidence and mortality, and worse prognosis among cases. Key messages The kidney cancer-obesity paradox does not appear to be real. Higher adiposity is associated with an increased risk of incident and fatal RCC.

Masticatory Capacity and Mortality: The Preventive and Clinical Investigation Center (IPC) Cohort Study

2019 ◽  
Vol 99 (2) ◽  
pp. 152-158 ◽  
Author(s):  
C. Darnaud ◽  
F. Thomas ◽  
N. Danchin ◽  
P. Boutouyrie ◽  
P. Bouchard
Keyword(s):  
Cancer Mortality ◽  
Cox Regression ◽  
Clinical Investigation ◽  
Missing Teeth ◽  
Masticatory Efficiency ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Adjusted Model

Poor oral health (OH) has been associated with mortality, but the association between OH components and mortality remains imprecise. The present observational study aimed to investigate if there is an association between oral masticatory efficiency and cardiovascular (CV) mortality in a large French subject cohort. The study was based on a cohort of 85,830 subjects aged between 16 and 94 y at recruitment. The follow-up extended from 2001 to 2014 and the mean follow-up was 8.06 ± 2.73 y. The number of deaths totaled 1,670. Full-mouth examinations were performed. Dental plaque, dental calculus, gingival inflammation, missing teeth, and masticatory units were recorded. Masticatory units represent the number of natural or prosthetic opposing premolars and molar pairs and can be considered an accurate indicator for masticatory efficiency. Causes of death were ascertained from death certificates. Cox regression analyses were used to calculate hazard ratios (HRs). In the fully adjusted model, the number of masticatory units <5 is associated with an HR of 1.72 (95% confidence interval [CI], 1.54 to 1.91) for all-cause mortality, HR of 1.41 (95% CI, 1.01 to 1.99) for CV mortality, HR of 1.76 (95% CI, 1.44 to 2.15) for cancer mortality, and HR of 1.85 (95% CI, 1.55 to 2.20) for non-CV and noncancer mortality. Significant statistical associations with the other oral variables were also found for all-cause mortality, cancer mortality, and non-CV and noncancer mortality in the adjusted models. Our study indicates that after full adjustment, all oral parameters are associated with all-cause, cancer, and non-CV and noncancer mortality. However, the low number of masticatory units is associated with an increased risk of CV mortality. We highlight the association of masticatory units and CV mortality.

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