scholarly journals D-dimer daily continuous tendency predicts the short-term prognosis for COVID-19 independently: A retrospective study from Northeast China

2021 ◽  
pp. 1-9
Author(s):  
Yinting Xing ◽  
Wei Yang ◽  
Yingyu Jin ◽  
Chao Wang ◽  
Xiuru Guan
Keyword(s):  
Cox Regression ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Prognosis Group ◽  
The Difference ◽  
Group B ◽  
The Relationship ◽  
Worse Prognosis ◽  
D Dimer

BACKGROUND AND OBJECTIVE: To study whether D-dimer daily continuous tendency could predict the short-term prognosis of COVID-19. PATIENTS AND METHODES: According to the short-term prognosis, 81 COVID-19 patients were divided into two groups, one of worse prognosis (Group W) and the other of better prognosis (Group B). The slope of D-dimer linear regression during hospitalization (SLOPE) was calculated as an indicator of D-dimer daily continuous tendency. The SLOPE difference between Group W and Group B was compared. The difference between the discharge results and the 3-month follow-up results was also compared. COX regression analysis was used to analyze the relationship between SLOPE and short-term prognosis of COVID-19. RESULTS: There were 16 patients in Group W and 65 patients in Group B. Group W had more critical proportion (p <  0.0001), indicating that the symptoms of its patients were more severe during hospitalization. ARDS, the most visible cause of worse prognosis, accounted for up to 68.75%, and many symptoms merged and resulted in worse prognosis. The D-dimer levels of Group W not only were significantly higher (p <  0.0001), but also showed an increasing trend. In addition, the D-dimer levels at discharge were significantly higher than those at follow-up (p = 0.0261), and the mean difference was as high as 0.7474. SLOPE significantly correlated with the short-term prognosis of COVID-19 independently (RR: 1.687, 95% CI: 1.345–2.116, P <  0.0001). The worst prognosis occurred most likely during the first month after COVID-19 diagnosis. CONCLUSION: Our study found that D-dimer daily continuous tendency independently correlates with worse prognosis and can be used as an independent predictor of the short-term prognosis for COVID-19.

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.

scholarly journals D-Dimer to Fibrinogen Ratio as a Novel Prognostic Marker in Patients After Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2020 ◽  
Vol 26 ◽  
pp. 107602962094858
Author(s):  
Yan Bai ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Xu-Ming Yang ◽  
Qian-Qian Guo ◽  
...  
Keyword(s):  
Cox Regression ◽  
Coronary Intervention ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
Percutaneous Coronary ◽  
The Relationship ◽  
D Dimer

The role of activation of the coagulation and fibrinolysis system in the pathogenesis and prognosis of cardiovascular diseases (CVDs) has drawn wide attention. Recently, the D-dimer to fibrinogen ratio (DFR) is considered as a useful biomarker for the diagnosis and prognosis of ischemic stroke and pulmonary embolism. However, few studies have explored the relationship between DFR and cardiovascular disease. In our study, patients were divided into 2 groups according to DFR value: the lower group (DFR < 0.52, n = 2123) and the higher group (DFR ≥ 0.52, n = 1073). The primary outcome was all-cause mortality (ACM) and cardiac mortality (CM). The average follow-up time was 37.59 ± 22.24 months. We found that there were significant differences between the 2 groups in term of ACM (2.4% vs 6.6%, P < 0.001) and CM (1.5% vs 4.0%, P < 0.001). Kaplan–Meier analyses showed that elevated DFR had higher incidences of ACM (log rank P < 0.001) and CM (log rank P < 0.001). Multivariate Cox regression analyses showed that DFR was an independent predictor of ACM (HR = 1.743, 95%CI: 1.187-2.559 P = 0.005) and CM (HR = 1.695, 95%CI: 1.033-2.781 P = 0.037). This study indicates that DFR is an independent and novel predictor of long-term ACM and CM in post-PCI patients with CAD.

scholarly journals Serum β-2 microglobulin predicts mortality in people with diabetes

2013 ◽  
Vol 169 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Ching-Lung Cheung ◽  
Karen S L Lam ◽  
Bernard M Y Cheung
Keyword(s):  
Cox Regression ◽  
Threshold Model ◽  
Linear Increase ◽  
Diabetic Patients ◽  
Cox Regression Analysis ◽  
Health And Nutrition ◽  
Risk Of Mortality ◽  
The Relationship ◽  
Related Mortality

ObjectiveSerum β-2 microglobulin (B2M) level predicts mortality in chronic kidney disease. Glycation of B2M is cytotoxic and may contribute to the risk of mortality in diabetic patients. Our objective was to evaluate the relationship between B2M and mortality in diabetic patients.MethodsIn this prospective study, 896 participants of the Third National Health and Nutrition Examination Survey with diabetes were included in the analysis. Serum B2M level was used in multivariate Cox regression analysis to predict all-cause and diabetes-related mortality.ResultsDuring a median follow-up of 11.8 years (range 0.1–18.2 years) and 9220.5 person/years, 541 (42.4%) and 207 (16.8%) participants died from all causes and diabetes-related causes respectively. One natural-log unit of B2M was significantly associated with all-cause (hazard ratio (HR)=6.53, 95% CI 2.07–20.6) and diabetes mortality (HR=7.35, 95% CI 1.01–53.38) after multivariable adjustment. Similar results were obtained when B2M was analyzed as tertiles or in the threshold model (T1+T2 vs T3). Examination of regression splines suggests a linear increase in hazard for mortality with increasing B2M levels.ConclusionsSerum B2M level is a novel predictor of all-cause and diabetes-related mortality in people with diabetes regardless of renal function.

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 Prognostic Role of Preoperative D-Dimer, Fibrinogen and Platelet Levels in Patients with Oral Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Yu-jie Liang ◽  
Xue-ying Mei ◽  
Bin Zeng ◽  
Si-en Zhang ◽  
Le Yang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Clinical Stage ◽  
Coagulation Factors ◽  
Cox Regression Analysis ◽  
The Relationship ◽  
D Dimer

Abstract Background: The relationship between cancer and coagulation have been intensively studied in recent years, however, the effects of coagulation factors on oral squamous cell carcinoma (OSCC) had not been reported. This study aimed to investigate the relationship between preoperative D-dimer (DD), fibrinogen (FIB), platelet (PLT) and OSCC, as well as the prognostic value of them. Methods: We retrospectively investigate a total of 202 OSCC patients treated in Guanghua Hospital of Stomatology, Sun Yat-sen University. Baseline demographic and clinicopathological information as well as both preoperative and postoperative DD, FIB and PLT results were collected from each patient if available, all patients were follow-up to disease progression, death or end of study. The correlations between preoperative DD, FIB, PLT and other clinical features, therapeutic effect and PFS were analyzed statistically, postoperative DD and surgical parameters were also analyzed.Results: Preoperative DD were found significantly correlated with T stage, N stage, Clinical stage and relapse of OSCC (P=0.000, 0.001, 0.000 and 0.000, respectively). Univariate and multivariate Cox regression analysis showed that, high preoperative DD independently predict poor prognosis in patients with OSCC (r=2.1, P=0.033). While FIB and PLT showed no prognostic values. Postoperative DD were found significantly correlated with preoperative DD and surgical type, but not the time consuming of surgery (P=0.005, 0.001 and 0.244, respectively). Conclusion: In this study, for the first time, we reported that, preoperative plasma DD was an independent predictor for OSCC stage and patient survival.

scholarly journals Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data

2019 ◽  
Vol 98 (11) ◽  
pp. 2533-2539
Author(s):  
Shreekant Parasuraman ◽  
Jingbo Yu ◽  
Dilan Paranagama ◽  
Sulena Shrestha ◽  
Li Wang ◽  
...  
Keyword(s):  
Polycythemia Vera ◽  
Cox Regression ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Monitoring And Control ◽  
The Difference ◽  
And Control ◽  
The Relationship

Abstract Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.

scholarly journals Increased INR Values Predict Accelerating Deterioration and High Short-Term Mortality Among Patients Hospitalized With Cirrhosis or Advanced Fibrosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Wang ◽  
Fuchen Dong ◽  
Shuning Sun ◽  
Xianbo Wang ◽  
Xin Zheng ◽  
...  
Keyword(s):  
Cox Regression ◽  
Quantitative Relationship ◽  
International Normalized Ratio ◽  
Additive Models ◽  
Chronic Liver ◽  
Advanced Fibrosis ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Starting Point ◽  
The Relationship

Background and Objective: An increase in the international normalized ratio (INR) is associated with increased mortality in patients with cirrhosis and other chronic liver diseases, while little is known about the quantitative relationship. This study aimed to investigate the quantitative relationship between the INR and short-term prognosis among patients hospitalized with cirrhosis or advanced fibrosis and to evaluate the role of the INR as a risk factor for short-term liver transplant (LT)-free mortality in these patients.Patients and Methods: This study prospectively analyzed multicenter cohorts established by the Chinese Acute-on-Chronic Liver Failure (CATCH-LIFE) study. Cox regression was used to describe the relationship between the INR and independent risk factors for short-term LT-free mortality. Forest plots were used in the subgroup analysis. Generalized additive models (GAMs) and splines were used to illustrate the quantitative curve relationship between the INR and the outcome and inflection point on the curve.Results: A total of 2,567 patients with cirrhosis and 924 patients with advanced fibrosis were included in the study. The 90-day LT-free mortality of patients with cirrhosis and advanced fibrosis was 16.7% (428/2,567) and 7.5% (69/924), respectively. In the multivariable Cox regression analysis, the increase in the INR was independently associated with the risk of 90-day LT-free mortality both in patients with cirrhosis (HR, 1.06; 95% CI, 1.04–1.07, p &lt; 0.001) and in patients with advanced fibrosis (HR, 1.09; 95% CI, 1.06–1.12, p &lt; 0.001). An INR of 1.6/1.7 was found to be the starting point of coagulation dysfunction with a rapid increase in mortality in patients with cirrhosis or in patients with advanced fibrosis, respectively. A 28-day LT-free mortality of 15% was associated with an INR value of 2.1 in both cirrhosis and advanced fibrosis patients.Conclusions: This study was the first to quantitatively describe the relationship between the INR and short-term LT-free mortality in patients with cirrhosis or advanced fibrosis. The starting points of INR indicating the rapid increase in mortality and the unified cutoff value of coagulation failure in cirrhosis and advanced fibrosis, will help clinicians accurately recognize early disease deterioration.

scholarly journals Arterial lactate levels and their prognostic value in patients undergoing pulmonary thromboendarterectomy

2021 ◽  
Vol 2 (2) ◽  
pp. 123-129
Author(s):  
Cristhian Felipe Ramirez Ramos ◽  
Clara Inés Saldarriaga-Giraldo ◽  
Manuela Yepes-Calderón ◽  
Gustavo Adolfo Castilla-Agudelo ◽  
Mateo Aránzazu Uribe ◽  
...  
Keyword(s):  
Cox Regression ◽  
Rapid Change ◽  
Area Under The Curve ◽  
Pulmonary Thromboendarterectomy ◽  
Arterial Lactate ◽  
Cox Regression Analysis ◽  
The People ◽  
Lactate Levels ◽  
The Relationship

Objective.  Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods. Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results. Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regression of COX, no relationship with mortality was found. The area under the curve shows regular performance on both day 1 and day 2 in predicting mortality outcomes. Conclusions. The behavior of the lactate in patients undergoing pulmonary thromboendarterectomy shows a rapid change during the first hours after the procedure. No role was found as a predictor of mortality neither in-hospital nor in follow-up.

P6601Low miR-19b-1-5p expression in ACS patients is related to aspirin resistance and major adverse cardio-cerebrovascular event (MACCE)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Singh ◽  
M W J Ronde ◽  
E E Creemers ◽  
M Y Chan ◽  
T S Hwee ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Cox Regression ◽  
Aspirin Resistance ◽  
Buffy Coat ◽  
Cerebrovascular Event ◽  
Cox Regression Analysis ◽  
Coronary Syndrome ◽  
Suitable Marker ◽  
The Relationship

Abstract Aim Despite aspirin therapy, acute coronary syndrome (ACS) patients are at risk of developing re-events owing to the aspirin resistance. This study sought to explore the possibility of utilizing miR-19b-1-5p as a suitable biomarker for aspirin resistance and future major adverse cardio-cerebrovascular (MACCE) events in the ACS patients. Methods Buffy coat from ACS (n=945) patients was used to measure the miR-19b-1-5p expression by RT-qPCR and Platelets function was determined by Multiplate® aggregometry testing. Furthermore, MACCE was collected over a mean follow-up time of 1.01±0.43 years. Linear regression concerning the relationship between miR-19b-1-5p expression and Multiplate® data and cox regression concerning MACCE were used for the analysis, to be able to adjust for confounding. Results Low miR-19b-1-5p expression was found to be related to aspirin resistance as could be observed from sustained platelet aggregation in the presence of aspirin (-Log-miR-19b-1-5p, (B (95% CI); 41.51 (5.09–77.93); p<0.05), even after adjusting for several confounders. The Cox regression analysis, showed that with lower miR-19b-1-5p expression, was independently associated to a higher risk of MACCE (-Log-miR-19b-1-5p, (HR (95% CI); 2.41 (1.51–3.84); p<0.05). Furthermore, both a sustained platelet aggregation on aspirin and lower miR-19b-1-5p expression, were related to an increased leukocyte count (B (95% CI); 3.85 (0.95–6.75) for platelet aggregation and 1.44 (0.41–2.46), for -Log-miR-19b-1-5p; p<0.05). Conclusions Lower miR-19b-1-5p expression was found to be associated with sustained platelet aggregation on aspirin, an increased leucocyte count and the risk of MACCE in ACS patients. Therefore, miR-19b-1-5p could be a suitable marker for aspirin resistance and might predict future MACCE in ACS patients.

MO500A NEW INDEX BASED ON THE DIFFERENCE BETWEEN CREATININE-BASED EGFR AND CYSTATIN-C EGFR ASSOCIATES WITH THE PHYSICAL COMPONENT OF THE SF-36 AND PREDICTS CARDIOVASCULAR EVENTS AND PROGRESION TO KIDNEY FAILURE IN CKD

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Francesca Mallamaci ◽  
Graziella D'Arrigo ◽  
Carmela Marino ◽  
Patrizia Pizzini ◽  
Giovanni Luigi Tripepi ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Physical Component Summary ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Cardiovascular Health Study ◽  
Study Cohort ◽  
Sf 36 ◽  
The Difference ◽  
The Relationship

Abstract Background and Aims Analyses in a large clinical trial in hypertensive patients (SPRINT) and in the Cardiovascular Health study cohort coherently showed that the difference between the GFR as estimated by serum cystatin and creatine (eGFRDiff) associates with frailty and predicts a lower risks for adverse outcomes including frailty, falls, cardiovascular events and mortality. Whether eGFRdiff in CKD patients associates with frailty metrics like the physical component summary (PCS) of the SF-36 and cardiovascular (CV) and kidney outcomes has not been studied. Method In a cohort of 757 with stages 2-5 CKD we tested the relationship between eGFRDiff with PCS (n=582) and in the whole cohort investigated the relationship between the same indicator with the incidence rate of two combined endpoint: non fatal CV events/death and renal events (dialysis/transplantation/eGFR reduction &gt;30%)/death over a median follow up of 35.6 months (inter-quartile range 21.3-36.2months). Results The eGFRDiff was strongly related to PCS (rho=0.25, P&lt;0.001) and physical functioning (rho=0.26, P&lt;0.001) emerged as the strongest correlate of eGFRDiff among PCS sub-domains. At baseline, eGFRDiff had a median value of 7.0 ml/min/1.73m2 (interquartile range: 2.2-13.0 ml/min/1.73m2) and h P=0.001), serum phosphate (β=-0.11, P=0.003), and BMI (β=-0.08, P=0.043) had an independent relationship with the eGFRDiff. During follow-up, 118 patients had fatal (n=29) and non fatal (n=89) CV events and 13 died of causes other than CV. Overall, 131 patients had the combined endpoint of non fatal CV event/death. Furthermore, 246 patients had renal outcomes and 276 patients had the combined end-point renal events/death. On univariate Cox regression analyses, 1 unit increase in eGFRdiff associated with a 3% reduction of the HR of non fatal CV events/death (hazard ratio: 0.965, 95% CI: 0.951-0.978, P&lt;0.001) and a 2% reduction of the HR of renal events/death ( 0.979, 95% CI: 0.969-0.990, P&lt;0.001). Data adjustment for potential confounders (age, gender, smoking, diabetes, cardiovascular comorbidities, antihypertensive therapy, BMI, systolic BP, haemoglobin, albumin total cholesterol, 24h urinary protein, phosphate, and C-reactive protein) did not materially modify the eGFRdiff- non fatal CV events-death (HR: 0.958, 95% CI: 0.939-0.977, P&lt;0.001) as well as the eGFRdiff- renal events-death (HR: 0.984, 95% CI: 0.971-0.997, P=0.014). Conclusion The eGFRDiff, a new biomarker of frailty, associates with the Physical Component summary of SF36 and predicts cardiovascular events, progression to kidney failure and death independently of other risk factors in CKD patients. Considering eGFRDiff as a marker of patients’ functional status may be helpful to nephrologists as an indicator of poor prognosis.

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