Validity of a Multidimensional Psychosocial Screener Based on the ESC Cardiovascular Prevention Guidelines – Evidence from the General and Cardiovascular Patient Population

2021 ◽  
Author(s):  
Sophie Catharina Maria van den Houdt ◽  
Christian Albus ◽  
Christoph Herrmann-Lingen ◽  
Jos Widdershoven ◽  
Nina Kupper
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Cardiovascular Prevention ◽  
Roc Curves ◽  
Coronary Intervention ◽  
Screening Instrument ◽  
Work And Family ◽  
Psychosocial Screening ◽  
Predictive Values ◽  
Type D

Aim. To evaluate the psychometric properties and validity of the updated version of the Dutch multidimensional European Society of Cardiology (ESC) psychosocial screening instrument in patients with heart disease and the general population. Method. 678 participants (Mage = 48.2, SD = 16.8; 46% male) of the Dutch general population and 312 cardiac patients (Mage = 65.9, SD = 9.9; 77% male) who recently received percutaneous coronary intervention completed the ESC Psychosocial screening instrument and validated questionnaires for depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), hostility (CMHS), anger (STAS-T), trauma (SRIP), and chronic work and family stress (ERI, MMQ-6). Results. Confirmatory factor analysis (CFA) confirmed that the eight screened risk factors were best measured as separate entities, rather than as broader indications of distress. Inter-instrument agreement, assessed with the intraclass coefficient (ICC) and the screening accuracy indicators (receiving operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV;NPV]) were good for most screened risk factors. PPV was low in low prevalence risk factors like anxiety and trauma. Conclusion. Overall, the current version of the ESC Psychosocial screening instrument has an acceptable performance in both populations, with a fair to excellent level of agreement with established full questionnaires. Besides a few suggestions for further refinement, the screener may be implemented in primary care and cardiological practice.

Changes of miR-130a and ET-1 and Their Predictive Value for In-Stent Restenosis after Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Hongliang LIU ◽  
Hao QIAN ◽  
Junlin MA ◽  
Qiming DAI ◽  
Mingyue JI
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Predictive Value ◽  
Roc Curves ◽  
Coronary Intervention ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Before And After ◽  
Independent Risk Factors ◽  
Sensitivity Specificity

Background: To explore the changes of miR-130a and endothelin -1 (ET-1) and their predictive value for instent restenosis (ISR) after percutaneous coronary intervention (PCI). Methods: Overall, 253 patients with coronary heart disease (CHD) treated with PCI in Lianshui County People's Hospital, Huaian, China from April 2013 to May 2016 were selected. The changes of miR-130a and ET-1 levels before and after PCI were compared. The predictive value of miR-130a and ET-1 for ISR was analyzed by receiver operating characteristic (ROC) curves, and the correlation between ISR and miR-130a, ET-1 was analyzed by Kaplan-Meier (K-M) curve. The risk factors of ISR in CHD patients were evaluated by logistics regression analysis. Results: The postoperative levels of miR-130a and ET-1 were significantly increased (P<0.05). The levels of miR-130a and ET-1 in peripheral blood of patients with ISR were higher than those in patients without ISR (P<0.05). The ROC curves showed that the area under curve (AUC), sensitivity, specificity and critical value of miR-130a in predicting ISR were respectively 0.912, 92.02%, 73.47%, 1.457 pmol/L, and those of ET-1 were 0.814, 87.63%, 63.27%, 2.245 pmol/L, respectively. The K-M curve showed that the incidence of ISR in patients with high expression of miR-130a or ET-1 was significantly higher than that in patients with low expression (P<0.05). miR-130a and ET-1 were independent risk factors for ISR (P<0.05). Conclusion: MiR-130a and ET-1 have high predictive value for ISR after PCI and are independent risk factors for CHD patients, which are worthy of clinical application.

ADP-induced platelet aggregation and platelet reactivity index VASP are good predictive markers for clinical outcomes in non-ST elevation acute coronary syndrome

2007 ◽  
Vol 98 (10) ◽  
pp. 838-843 ◽  
Author(s):  
Corinne Frere ◽  
Thomas Cuisset ◽  
Jacques Quilici ◽  
Laurence Camoin ◽  
Joseph Carvajal ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Platelet Reactivity ◽  
Roc Curves ◽  
Coronary Intervention ◽  
Reactivity Index ◽  
Predictive Values ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
St Elevation ◽  
Ischemic Events

SummaryClopidogrel responsiveness has been proposed to be involved in recurrent ischemic events after stenting for non-ST elevation acute coronary syndromes (NSTE ACS). However, its biological definition is not consensual. We assess the value ofADP-induced platelet aggregation (ADP-Ag) and platelet reactivity indexVASP (PRI VASP) in predicting recurrent ischemic events in patients with NSTE ACS undergoing percutaneous coronary intervention (PCI). We studied 195 consecutive NSTE ACS patients undergoing PCI after a 600 mg loading dose of clopidogrel. ADPAg and PRI VASP were analysed. The primary end-point was recurrent ischemic events within 30 days of PCI. It occurred in 14 patients (7%). Construction of ROC curves to examine the value of predictive models showed that sensitivity and specificity for primary endpoint were 79% and 76%, respectively, for a maximal intensity of ADP-Ag ≥70%, 93% and 50% for PRIVASP> 53%. The positive and negative predictive values were 21% and 98%, respectively, for ADP-Ag ≥70%, 12% and 99% for PRIVASP> 53%. In patients with NSTE ACS undergoing PCI, ADP-Ag and PRI VASP identify low responders to clopidogrel with an increased risk of recurrent ischemic events with respective cut-off values of 70% and 53%.

scholarly journals Risk Factors for Mortality in Patients with Alcoholic Hepatitis and Assessment of Prognostic Models: A Population-Based Study

2015 ◽  
Vol 29 (3) ◽  
pp. 131-138 ◽  
Author(s):  
Jack XQ Pang ◽  
Erin Ross ◽  
Meredith A Borman ◽  
Scott Zimmer ◽  
Gilaad G Kaplan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alcoholic Hepatitis ◽  
Roc Curves ◽  
International Normalized Ratio ◽  
Population Based ◽  
Meld Score ◽  
Prognostic Models ◽  
Stepwise Logistic Regression ◽  
Predictive Values ◽  
Logistic Regression Models

BACKGROUND: Severe alcoholic hepatitis (AH) is associated with a substantial risk for short-term mortality.OBJECTIVES: To identify prognostic factors and validate well-known prognostic models in a Canadian population of patients hospitalized for AH.METHODS: In the present retrospective study, patients hospitalized for AH in Calgary, Alberta, between January 2008 and August 2012 were included. Stepwise logistic regression models identified independent risk factors for 90-day mortality, and the discrimination of prognostic models (Model for End-stage Liver Disease [MELD] and Maddrey discriminant function [DF]) were examined using areas under the ROC curves.RESULTS: A total of 122 patients with AH were hospitalized during the study period; the median age was 49 years (interquartile range [IQR] 42 to 55 years) and 60% were men. Median MELD score and Maddrey DF on admission were 21 (IQR 18 to 24) and 45 (IQR 26 to 62), respectively. Seventy-three percent of patients received corticosteroids and/or pentoxifylline, and the 90-day mortality was 17%. Independent predictors of mortality included older age, female sex, international normalized ratio, MELD score and Maddrey DF (all P<0.05). For discrimination of 90-day mortality, the areas under the ROC curves of the prognostic models (MELD 0.64; Maddrey DF 0.68) were similar (P>0.05). At optimal cut-offs of ≥22 for MELD score and ≥37 for Maddrey DF, both models excluded death with high certainty (negative predictive values 90% and 96%, respectively).CONCLUSIONS: In patients hospitalized for AH, well-known prognostic models can be used to predict 90-day mortality, particularly to identify patients with a low risk for death.

Incidence and risk factors for stroke following percutaneous coronary intervention

2020 ◽  
Vol 15 (8) ◽  
pp. 909-922
Author(s):  
Luke P Dawson ◽  
Justin A Cole ◽  
Terase F Lancefield ◽  
Andrew E Ajani ◽  
Nick Andrianopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
General Population ◽  
Coronary Intervention ◽  
Population Based ◽  
Stroke Incidence ◽  
Female Sex ◽  
Previous Stroke ◽  
Percutaneous Coronary

Background Stroke rates and risk factors may change as percutaneous coronary intervention practice evolves and no data are available comparing stroke incidence after percutaneous coronary intervention to the general population. Aims This study aimed to identify the incidence and risk factors for inpatient and subsequent stroke following percutaneous coronary intervention with comparison to age-matched controls. Methods Data were prospectively collected from 22,618 patients undergoing percutaneous coronary intervention in the Melbourne Interventional Group registry (2005–2015). The cohort was compared to the North-East Melbourne Stroke Incidence Study population-based cohort (1997–1999) and predefined variables assessed for association with inpatient or outpatient stroke. Results Inpatient stroke occurred in 0.33% (65.3% ischemic, 28.0% haemorrhagic, and 6.7% cause unknown), while outpatient stroke occurred in 0.55%. Inpatient and outpatient stroke were associated with higher rates of in-hospital major adverse cardiovascular outcomes ( p < 0.0001) and mortality ( p < 0.0001), as well as 12-month mortality ( p < 0.0001). Factors independently associated with inpatient stroke were renal impairment, ST-elevation myocardial infarction, previous stroke, left ventricular ejection fraction 30–45%, and female sex, while those associated with outpatient stroke were previous stroke, chronic lung disease, previous myocardial infarction, rheumatoid arthritis, female sex, and older age. Compared to the age-standardized population-based cohort, stroke rates in the 12 months following discharge were higher for percutaneous coronary intervention patients <65 years old, but lower for percutaneous coronary intervention patients ≥65 years old. Conclusions Risk of inpatient stroke following percutaneous coronary intervention appears to be largely associated with clinical status at presentation, while outpatient stroke relates more to age and chronic disease. Compared to the general population, outpatient stroke rates following percutaneous coronary intervention are higher for younger, but not older, patients.

Psychosocial Screening Instrument for physical Trauma patients

2019 ◽  
Author(s):  
Maria Karabatzakis ◽  
Brenda Leontine Den Oudsten ◽  
Taco Gosens ◽  
Jolanda De Vries
Keyword(s):  
Screening Instrument ◽  
Trauma Patients ◽  
Psychosocial Screening ◽  
Physical Trauma

Predisposing Factors, Demographics, Angiographic Features, and the Possible Role of Inflammation in Coronary Perforations—A 10-year Single-center Experience

2011 ◽  
Vol 9 (2) ◽  
pp. 87 ◽  
Author(s):  
Preeti Chandra ◽  
Saurav Chatterjee ◽  
Nishant Koradia ◽  
Deepak Thekkoott ◽  
Bilal Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Predisposing Factors ◽  
Covered Stents ◽  
Optimal Management ◽  
Balloon Inflation ◽  
Catheterization Laboratory ◽  
Cell Counts

Background:Coronary perforation during percutaneous coronary intervention is a rare but dreaded complication. The risk factors, optimal management, and outcome remain obscure.Objectives:To determine the predisposing factors, optimal management, and preventive strategies. We retrospectively looked at coronary perforations at our catheterization laboratory over the last 10 years. We reviewed patient charts and reports. Two independent operators, in a blinded approach, reviewed all procedural cineangiograms. Data were analyzed by simple statistical methodology.Results:Nine patients were treated conservatively and six patients were treated with prolonged balloon inflation. Six patients were treated with polytetrafluoroethylene (PTFE)-covered stents. One patient required emergency coronary artery bypass graft. No deaths were reported. Subjects with perforations also had a significantly higher total white blood cell count (means 12,134 versus 6,155, 95 % confidence interval [CI], p< 0.0001, n=22), total absolute neutrophil count (means 74.2 % versus 57.1 %, 95 % CI, p<0.0001, n=22), and neutrophil:lymphocyte ratio (means 3.65 versus 1.50, 95% CI, p<0.0001, n=22).Conclusions:Coronary perforations are rare but potentially fatal events. Hypertension, small vessel diameter, high balloon:artery ratio, use of hydrophilic wires, and presence of myocardial bridging appear to be possible risk factors. Most perforations can be treated conservatively or with prolonged balloon inflation using perfusion balloons. Use of PTFE-covered stents could be a life-saving measure in cases of large perforations. Subjects with perforations also had greater systemic inflammation as indicated by elevated white cell counts.

Cancer in agricultural populations

2020 ◽  
pp. 837-837
Author(s):  
K. . Togawa
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Cohort Studies ◽  
Health Effects ◽  
Cancer Incidence ◽  
Lower Prevalence ◽  
International Consortium ◽  
Adverse Health Effects ◽  
Specific Cancer ◽  
Cancer Types

Agricultural workers can be exposed to a wide variety of agents (e.g. pesticides), some of which may have adverse health effects, such as cancer. To study the health effects of agricultural exposures, an international consortium of agricultural cohort studies, AGRICOH, was established. The present analysis compared cancer incidence between the AGRICOH cohorts and the general population and found lower overall cancer incidence in the AGRICOH cohorts, with some variation across cohorts for specific cancer types. The observed lower cancer incidence may be due to healthy worker bias or lower prevalence of risk factors in the agricultural populations. Further analysis is underway.

Risk factors of coronary microvascular obstruction (Preprint)

2020 ◽  
Author(s):  
Yong Li ◽  
Shuzheng Lyu
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Logistic Regression ◽  
Microvascular Obstruction ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Neutrophil Percentage ◽  
Percutaneous Coronary ◽  
St Elevation

BACKGROUND Coronary microvascular obstruction /no-reflow(CMVO/NR) is a predictor of long-term mortality in survivors of ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PPCI). OBJECTIVE To identify risk factors of CMVO/NR. METHODS Totally 2384 STEMI patients treated with PPCI were divided into two groups according to thrombolysis in myocardial infarction(TIMI) flow grade:CMVO/NR group(246cases,TIMI 0-2 grade) and control group(2138 cases,TIMI 3 grade). We used univariable and multivariable logistic regression to identify risk factors of CMVO/NR. RESULTS A frequency of CMVO/NR was 10.3%(246/2384). Logistic regression analysis showed that the differences between the two groups in age(unadjusted odds ratios [OR] 1.032; 95% CI, 1.02 to 1.045; adjusted OR 1.032; 95% CI, 1.02 to 1.046 ; P <0.001), periprocedural bradycardia (unadjusted OR 2.357 ; 95% CI, 1.752 to 3.171; adjusted OR1.818; 95% CI, 1.338 to 2.471 ; P <0.001),using thrombus aspirationdevices during operation (unadjusted OR 2.489 ; 95% CI, 1.815 to 3.414; adjusted OR1.835; 95% CI, 1.291 to 2.606 ; P =0.001),neutrophil percentage (unadjusted OR 1.028 ; 95% CI, 1.014 to 1.042; adjusted OR1.022; 95% CI, 1.008 to 1.036 ; P =0.002) , and completely block of culprit vessel (unadjusted OR 2.626; 95% CI, 1.85 to 3.728; adjusted-OR 1.656;95% CI, 1.119 to 2.45; P =0.012) were statistically significant ( P <0. 05). The area under the receiver operating characteristic curve was 0.6896 . CONCLUSIONS Age , periprocedural bradycardia, using thrombus aspirationdevices during operation, neutrophil percentage ,and completely block of culprit vessel may be independent risk factors for predicting CMVO/NR. We registered this study with WHO International Clinical Trials Registry Platform (ICTRP) (registration number: ChiCTR1900023213; registered date: 16 May 2019).http://www.chictr.org.cn/edit.aspx?pid=39057&htm=4. Key Words: Coronary disease ST elevation myocardial infarction No-reflow phenomenon Percutaneous coronary intervention

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