Differences in Cancer Death Risk Long After ACS Among Selected Urban and Rural Areas in North Italy: The ABC-7a† Study on Heart Disease

BackgroundAn increased risk of cancer death has been demonstrated for patients diagnosed with acute coronary syndrome (ACS). We are investigating possible geographic risk disparities.MethodsThis prospective study included 541 ACS patients who were admitted to hospitals and discharged alive in three provinces of Italy’s Veneto region. The patients were classified as residing in urban or rural areas in each province.ResultsWith 3 exceptions, all patients completed the 22-year follow-up or were followed until death. Urban (46%) and rural (54%) residents shared most of their baseline demographic and clinical characteristics. Pre-existing malignancy was noted in 15 patients, whereas 106 patients developed cancer during the follow-up period, which represented 6232 person-years. No difference in the cancer death risk was found between the urban and rural areas or between southern and northern provinces (hazard ratio [HR] 1.1; 95% confidence interval [CI] 0.7–1.7; p = 0.59 and HR 1.1; 95% CI 0.9–1.4; p = 0.29, respectively) according to the unadjusted Cox regression analysis. Geographic areas, however, showed a strong positive interaction, with risk increasing from the urban to rural areas from southern to northern provinces (HR 1.9; 95% CI 1.1–3.0; p = 0.01). The fully adjusted Cox regression and Fine-Gray competing risk regression models provided similar results. Interestingly, these results persisted, and even strengthened, after exclusion of the 22 patients who developed malignancy and survived to the end of follow-up. We did not observe an urban/rural difference in non-neoplastic death risk or a significant interaction between the geographic areas.ConclusionOur analysis reveals that the cancer death risk among unselected ACS patients in Italy’s Veneto region significantly differs by geography. The northern rural area has the highest risk. These results highlight the importance of implementing a preventive policy based on area-specific knowledge.

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Risk of malignancy long after acute coronary syndrome in selected urban and rural areas and comparison with smoking risk: the ABC-7* study on Heart Disease

Cardio-Oncology ◽

10.1186/s40959-021-00094-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Giuseppe Berton ◽

Heba T. Mahmoud ◽

Rosa Palmieri ◽

Fiorella Cavuto ◽

Rocco Cordiano ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Regression Analysis ◽

Cancer Risk ◽

Rural Areas ◽

Positive Interaction ◽

Cox Regression Analysis ◽

Coronary Syndrome ◽

Urban And Rural Areas ◽

Adjusted Model

Abstract Background Increased cancer risk has been reported in patients with acute coronary syndrome (ACS). Objectives To investigate geographic differences in risk malignancy long after ACS. Methods We enrolled 586 ACS patients admitted to hospitals in three provinces in the Veneto region of Italy in this prospective study. Patient’s residency was classified into three urban and three nearby rural areas. Results All (except for 3) patients completed the follow-up (22 years or death) and 54 % were living in rural areas. Sixteen patients had pre-existing malignancy, and 106 developed the disease during follow-up. Cancer prevalence was 17 % and 24 % (p = 0.05) and incidence of malignancy was 16 and 21/1000 person-years for urban and rural areas, respectively. In unadjusted logistic regression analysis, cancer risk increased from urban to rural areas (odds ratio [OR] 3.4;95 % confidence interval [CI] 1.7–7.1; p = 0.001), with little change from north to south provinces (OR 1.5;95 % CI 1.0-2.2; p = 0.06). Yet, we found a strong positive interaction between urban-rural areas and provinces (OR 2.1;95 % CI 1.2–3.5; p = 0.003). These results kept true in the fully adjusted model. Unadjusted Cox regression analysis revealed increasing hazards ratios (HRs) for malignancy onset from urban to rural areas (HR 3.0;95 % CI 1.5–6.2; p = 0.02), but not among provinces (HR 1.3;95 % CI 1.0–2.0; p = 0.14). Also, we found a strong positive interaction between geographic areas (HR 2.1;95 % CI 1.3–3.5; p = 0.002), even with a fully adjusted model. Conclusions The results in unselected real-world patients demonstrate a significant geographic difference in malignancy risk in ACS patients, with the highest risk in the north-rural area.

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Risk of Malignancy Long After Acute Coronary Syndrome in Selected Urban and Rural Areas and Comparison With Smoking Risk: The ABC-7* Study on Heart Disease. (*ABC is An Acronym for Adria, Bassano, Conegliano, and Padova Hospitals)

10.21203/rs.3.rs-104460/v1 ◽

2020 ◽

Author(s):

Giuseppe Berton ◽

Heba Talat Mahmoud ◽

Rosa Palmieri ◽

Fiorella Cavuto ◽

Rocco Cordiano ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Regression Analysis ◽

Cancer Risk ◽

Rural Areas ◽

Positive Interaction ◽

Cox Regression Analysis ◽

Coronary Syndrome ◽

Urban And Rural Areas ◽

Adjusted Model

Abstract Background Increased cancer risk has been reported in patients with acute coronary syndrome (ACS). Objectives To investigate geographic differences in risk malignancy long after ACS. Methods We enrolled 586 ACS patients admitted to hospitals in three provinces in the Veneto region of Italy in this prospective study. Patient's residency was classified into three urban and three nearby rural areas. Results All (except for 3) patients completed the follow-up (22 years or death) and 54% were living in rural areas. Sixteen patients had pre-existing malignancy, and 106 developed the disease during follow-up. Cancer prevalence was 17% and 24% (p=0.05) and incidence of malignancy was 16 and 21/1000 person-years for urban and rural areas, respectively. In unadjusted logistic regression analysis, cancer risk increased from urban to rural areas (odds ratio [OR] 3.4;95% confidence interval [CI] 1.7-7.1; p=0.001), with little change from north to south provinces (OR 1.5;95% CI 1.0-2.2; p=0.06). Yet, we found a strong positive interaction between urban-rural areas and provinces (OR 2.1;95% CI 1.2-3.5; p=0.003). These results kept true in the fully adjusted model. Unadjusted Cox regression analysis revealed increasing hazards ratios (HRs) for malignancy onset from urban to rural areas (HR 3.0;95% CI 1.5-6.2; p=0.02), but not among provinces (HR 1.3;95% CI 1.0-2.0; p=0.14). Also, we found a strong positive interaction between geographic areas (HR 2.1;95% CI 1.3-3.5; p=0.002), even with a fully adjusted model. Conclusion The results in unselected real-world patients demonstrate a significant geographic difference in malignancy risk in ACS patients, with the highest risk in the north-rural area.

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The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study

BMC Family Practice ◽

10.1186/s12875-021-01471-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ingmar Schäfer ◽

Heike Hansen ◽

Agata Menzel ◽

Marion Eisele ◽

Daniel Tajdar ◽

...

Keyword(s):

Primary Care ◽

Observational Study ◽

Rural Areas ◽

Longitudinal Observational Study ◽

Multivariable Analyses ◽

Gastrointestinal Complaints ◽

Urban And Rural Areas ◽

Quota Sampling ◽

Primary Care Practices

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.

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Macrophage infiltrates in coronary plaque erosion portend a worse cardiovascular outcome in patients with acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.1250 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R.A Montone ◽

V Vetrugno ◽

M Camilli ◽

M Russo ◽

M.G Del Buono ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Vulnerable Plaque ◽

Cardiac Death ◽

Cox Regression ◽

Plaque Rupture ◽

Culprit Lesion ◽

Coronary Syndrome ◽

Fibrous Cap ◽

Plaque Erosion

Abstract Background Plaque erosion (PE) is responsible for at least one-third of acute coronary syndrome (ACS). Inflammatory activation is considered a key mechanism of plaque instability in patients with plaque rupture through the release of metalloproteinases and the inhibition of collagen synthesis that in turns lead to fibrous cap degradation. However, the clinical relevance of macrophage infiltration has never been investigated in patients with PE. Purpose In our study, we aimed at assessing the presence of optical coherence tomography (OCT)-defined macrophage infiltrates (MØI) at the culprit site in ACS patients with PE, evaluating their clinical and OCT correlates, along with their prognostic value. Methods ACS patients undergoing OCT imaging and presenting PE as culprit lesion were retrospectively selected. Presence of MØI at culprit site and in non-culprit segments along the culprit vessel was assessed. The incidence of major adverse cardiac events (MACEs), defined as the composite of cardiac death, recurrent myocardial infarction and target vessel revascularization (TVR), was assessed [follow-up median (interquartile range, IQR) time 2.5 (2.03–2.58) years]. Results We included 153 patients [median age (IQR) 64 (53–75) years, 99 (64.7%) males]. Fifty-one (33.3%) patients presented PE with MØI and 102 (66.7%) PE without MØI. Patients having PE with MØI compared with PE patients without MØI had more vulnerable plaque features both at culprit site and at non-culprit segments. In particular, culprit lesion analysis demonstrated that patients with PE with MØI had a significantly thinner fibrous cap [median (IQR) 100 (60–120) μm vs. 160 (95–190) μm, p<0.001], higher prevalence of thrombus [41 (80.4%) vs. 64 (62.7%), p=0.028], lipid plaque [39 (76.5%) vs. 50 (49.0%), p<0.001], TCFA [20 (39.2%) vs. 14 (13.7%), p=0.001], and a higher maximum lipid arc [median [IQR] 250.0° (177.5°-290.0°) vs. 190.0° (150.0°-260.0°), p=0.018) at the culprit lesion compared with PE without MØI. MACEs were significantly more frequent in PE with MØI patients compared with PE without MØI [11 (21.6%) vs. 6 (5.9%), p=0.008], mainly driven by a higher risk of cardiac death and TVR. At multivariable Cox regression model, PE with MØI [HR=2.95, 95% CI (1.09–8.02), p=0.034] was an independent predictor of MACEs. Conclusion Our study demonstrates that among ACS patients with PE the presence of MØI at culprit lesion is associated with a more aggressive phenotype of coronary atherosclerosis with more vulnerable plaque features, along with a worse prognosis at a long-term follow-up. These findings are of the utmost importance in the era of precision medicine because clearly show that macrophage infiltrates may identify patients with a higher cardiovascular risk requiring more aggressive secondary prevention therapies and a closer clinical follow-up. Prognosis Funding Acknowledgement Type of funding source: None

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Association of Derived Neutrophil-To-Lymphocyte Ratio With Prognosis of Coronary Heart Disease After PCI

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.705862 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gang-Qiong Liu ◽

Wen-Jing Zhang ◽

Jia-Hong Shangguan ◽

Xiao-Dan Zhu ◽

Wei Wang ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cox Regression ◽

Univariate Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Major Adverse Cardiovascular Events ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

The Third

Aims: The present study aimed to investigate the prognostic role of derived neutrophil-to-lymphocyte ratio (dNLR) in patients with coronary heart disease (CHD) after PCI.Methods: A total of 3,561 post-PCI patients with CHD were retrospectively enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The patients (3,462) were divided into three groups according to dNLR tertiles: the first tertile (dNLR < 1.36; n = 1,139), second tertile (1.36 ≥ dNLR < 1.96; n = 1,166), and third tertile(dNLR ≥ 1.96; n = 1,157). The mean follow-up time was 37.59 ± 22.24 months. The primary endpoint was defined as mortality (including all-cause death and cardiac death), and the secondary endpoint was major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).Results: There were 2,644 patients with acute coronary syndrome (ACS) and 838 patients with chronic coronary syndrome (CCS) in the present study. In the total population, the all-cause mortality (ACM) and cardiac mortality (CM) incidence was significantly higher in the third tertile than in the first tertile [hazard risk (HR) = 1.8 (95% CI: 1.2–2.8), p = 0.006 and HR = 2.1 (95% CI: 1.23–3.8), p = 0.009, respectively]. Multivariate Cox regression analyses suggested that compared with the patients in the first tertile than those in the third tertile, the risk of ACM was increased 1.763 times (HR = 1.763, 95% CI: 1.133–2.743, p = 0.012), and the risk of CM was increased 1.763 times (HR = 1.961, 95% CI: 1.083–3.550, p = 0.026) in the higher dNLR group during the long-term follow-up. In both ACS patients and CCS patients, there were significant differences among the three groups in the incidence of ACM in univariate analysis. We also found that the incidence of CM was significantly different among the three groups in CCS patients in both univariate analysis (HR = 3.541, 95% CI: 1.154–10.863, p = 0.027) and multivariate analysis (HR = 3.136, 95% CI: 1.015–9.690, p = 0.047).Conclusion: The present study suggested that dNLR is an independent and novel predictor of mortality in CHD patients who underwent PCI.

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Risk factors and features of stroke among young persons in urban and rural areas of the Tambov Region

Medicine and Physical Education: Science and Practice ◽

10.20310/2658-7688-2021-3-1(9)-45-52 ◽

2021 ◽

pp. 45-52

Author(s):

Ekaterina B. Zvonareva ◽

Lubov I. Grigorova

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Cerebral Circulation ◽

Young Patients ◽

Clinical Hospital ◽

Regional Features ◽

Urban And Rural Areas ◽

Concomitant Factors ◽

Causes And Risk Factors

Since 2011 according to the national project “Health” the Regional Vascular Center has been operating on the basis of the Tambov Regional Clinical Hospital. This is a ward for patients with acute cerebral circulation disorder. Since 2017 there has been an increase in patients due to an increase in the number of attached population to Tambov Regional Clinical Hospital and, accordingly, unfortunately, the mortality rate from acute cerebral circulation disorder has been increasing. Between 2016 and 2020, a study was conducted based on the follow-up of young patients with hemorrhagic and ischemic stroke. In the study we emphasized the research of regional features of the structure, causes, and risk factors of stroke in persons in the city of Tambov and the districts of the Tambov Region. We verified pathogenetic subtypes of stroke among young patients. We identified and considered main and concomitant factors determining stroke outcome, degree of neurological deficiency, and disabled patients. We identified the leading causes of stroke in persons, the main of which were: arterial hypertension, cardiac pathology, atherosclerosis.

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INTREPID II: protocol for a multistudy programme of research on untreated psychosis in India, Nigeria and Trinidad

BMJ Open ◽

10.1136/bmjopen-2020-039004 ◽

2020 ◽

Vol 10 (6) ◽

pp. e039004

Author(s):

Tessa Roberts ◽

Oye Gureje ◽

Rangaswamy Thara ◽

Gerard Hutchinson ◽

Alex Cohen ◽

...

Keyword(s):

Rural Areas ◽

Help Seeking ◽

Psychotic Disorders ◽

Global South ◽

Ethical Review ◽

Target Populations ◽

Key Stakeholders ◽

Pilot Work ◽

Urban And Rural Areas

IntroductionThere are few robust and directly comparable studies of the epidemiology of psychotic disorders in the Global South. INTREPID II is designed to investigate variations in untreated psychotic disorders in the Global South in (1) incidence and presentation (2) 2-year course and outcome, (3) help-seeking and impact, and (4) physical health.MethodsINTREPID II is a programme of research incorporating incidence, case–control and cohort studies of psychoses in contiguous urban and rural areas in India, Nigeria and Trinidad. In each country, the target samples are 240 untreated cases with a psychotic disorder, 240 age-matched, sex-matched and neighbourhood-matched controls, and 240 relatives or caregivers. Participants will be followed, in the first instance, for 2 years. In each setting, we have developed and are employing comprehensive case-finding methods to ensure cohorts are representative of the target populations. Using methods developed during pilot work, extensive data are being collected at baseline and 2-year follow-up across several domains: clinical, social, help-seeking and impact, and biological.Ethics and disseminationInformed consent is sought, and participants are free to withdraw from the study at any time. Participants are referred to mental health services if not already in contact with these and emergency treatment arranged where necessary. All data collected are confidential, except when a participant presents a serious risk to either themselves or others. This programme has been approved by ethical review boards at all participating centres. Findings will be disseminated through international conferences, publications in international journals, and through local events for key stakeholders.

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Mortality among persons experiencing musculoskeletal pain: a prospective study among Danish men and women

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03620-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Teresa Holmberg ◽

Michael Davidsen ◽

Lau Caspar Thygesen ◽

Mikala Josefine Krøll ◽

Janne Schurmann Tolstrup

Keyword(s):

Pain Intensity ◽

Cox Regression ◽

Widespread Pain ◽

Men And Women ◽

Respiratory Mortality ◽

Discriminatory Accuracy ◽

Increased Risk ◽

A Prospective Study ◽

Risk Of Cancer

Abstract Background Musculoskeletal (MSK) pain affects many people worldwide and has a great impact on general health and quality of life. However, the relationship between MSK pain and mortality is not clear. This study aimed to investigate all-cause and cause-specific mortality in relation to self-reported MSK pain within the last 14 days, including spread of pain and pain intensity. Methods This prospective cohort study included a representative cohort of 4806 men and women aged 16+ years, who participated in a Danish MSK survey 1990–1991. The survey comprised questions on MSK pain, including spread of pain and pain intensity. These data were linked with the Danish Register of Causes of Death to obtain information on cause of death. Mean follow-up was 19.1 years. Cox regression analyses were performed with adjustment for potential confounders. Results In the study population (mean age 44.5 years; 47.9% men), 41.0% had experienced MSK pain within the last 14 days and 1372 persons died during follow-up. For both sexes, increased all-cause mortality with higher spread and intensity of MSK pain was observed; a high risk was observed especially for men with strong pain (HR = 1.66; 95% CI:1.09–2.53) and women with widespread pain (HR = 1.49; 95% CI:1.16–1.92). MSK pain within last 14 days yielded c-statistics of 0.544 and 0.887 with age added. Moreover, persons with strong MSK pain had an increased cardiovascular mortality, persons with moderate pain and pain in two areas had an increased risk of cancer mortality, and persons with widespread pain had an increased risk of respiratory mortality. Conclusions Overall, persons experiencing MSK pain had a higher risk of mortality. The increased mortality was not accounted for by potential confounders. However, when evaluating these results, it is important to take the possibility of unmeasured confounders into account as we had no information on e.g. BMI etc. Significance The present study provides new insights into the long-term consequences of MSK pain. However, the discriminatory accuracy of MSK pain was low, which indicates that this information cannot stand alone when predicting mortality risk.

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AKTIVITAS DAN KONSEKUENSI DISPERSI RADIOAKTIF UNTUK DAERAH KOTA DAN PEDESAAN

Jurnal Pengembangan Energi Nuklir ◽

10.17146/jpen.2015.17.2.2603 ◽

2015 ◽

Vol 17 (2) ◽

pp. 79 ◽

Cited By ~ 1

Author(s):

Pande Made Udiyani ◽

Sri Kuntjoro ◽

Jupiter Sitorus Pane

Keyword(s):

Environmental Conditions ◽

Rural Areas ◽

Urban Areas ◽

Life Time ◽

Total Risk ◽

Design Basis ◽

Air Dispersion ◽

Design Basis Accident ◽

Urban And Rural Areas ◽

Risk Of Cancer

ABSTRAKAKTIVITAS DAN KONSEKUENSI DISPERSI RADIOAKTIF UNTUK DAERAH KOTA DAN PEDESAAN. Konsekuensi karena lepasan kontaminan radioaktif oleh manusia dipengaruhi oleh banyak faktor seperti besarnya aktivitas kontaminan yang tersebar dan kondisi lingkungan. Kondisi lingkungan meliputi kondisi meteorologi, kontur tapak, dan pathway kontaminan ke manusia. Tujuan penelitian ini adalah analisis aktivitas dan konsekuensi radionuklida waktu paruh panjang akibat kecelakaan di daerah perkotaan dan pedesaan. Tujuan khusus adalah menghitung aktivitas dispersi udara dan deposisi permukaan, prediksi laju dosis dan risiko yang ditimbulkan untuk daerah perkotaan dan pedesaan sebagai fungsi lokasi. Metode yang digunakan adalah simulasi estimasi konsekuensi dari dispersi produk fisi di atmosfer akibat kecelakaan terpostulasi Beyond Design Basis Accident, BDBA. Perhitungan dilakukan untuk lepasan radioaktif akibat kecelakaan PWR 1000 MWe yang disimulasikan untuk area pedesaan dan perkotaan Tapak Bojanegara-Serang. Hasil analisis aktivitas dispersi udara dan deposisi permukaan untuk area pedesaan (rural) lebih tinggi dibandingkan areal perkotaan (urban). Penerimaan dosis untuk area pedesaan lebih tinggi dibandingkan dengan penerimaaan dosis area perkotaan. Dosis invidu efektif maksimum untuk area pedesaan (rural) adalah 9,24x10-2 Sv dan daerah perkotaan (urban) adalah 5,14x10-2 Sv. Risiko total terkena kanker untuk masyarakat yang berdomisili di area perkotaan lebih tinggi dibandingkan area pedesaan. Kata kunci: aktivitas, konsekuensi, dispersi, perkotaan, pedesaan ABSTRACTTHE ACTIVITIES AND RADIOACTIVE DISPERSION CONSEQUENCES FOR URBAN AND RURAL AREA. The consequences of radioactive releases of contaminants by humans is influenced by many factors such as the amount of activity that spread contaminants and environmental conditions. Environmental conditions include meteorological conditions, the contours of the site and contaminant pathways to humans. The purpose of this research is the analysis of the consequences of radionuclide activity and long half-life time due to accidents in urban and rural areas. The specific objective is to calculate the activity of the air dispersion and surface deposition, dose rate predictions and the risks posed to urban and rural areas as a function of the location. The estimates method used is simulation of the consequences on fission products dispersion in the atmosphere due to the postulated accident Beyond Design Basis Accident, BDBA. The calculation is performed for radioactive releases from accidents in 1000 MWe PWR simulated for rural and urban areas on Bojanegara-Serang site. Results of the analysis are that the activity of air dispersion and deposition surface at rural areas higher than urban areas. The Acceptance dose is higher for rural areas compared with urban areas. The maximum effective individual dose for rural areas is 9.24x10-2 Sv and urban areas is 5.14x10-2 Sv. The total risk of cancer for people who live in urban areas is higher than rural areas. Keywords: activity, consequence, dispersion, urban, rural

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Impact of Metabolic Syndrome on the Development of Cardiovascular Disease among Kazakhs in Remote Rural Areas of Xinjiang, China: A Cohort Study

10.21203/rs.3.rs-34700/v1 ◽

2020 ◽

Author(s):

Wenwen Yang ◽

Shuxia Guo ◽

Haixia Wang ◽

Yu Li ◽

Xianghui Zhang ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Rural Areas ◽

Cox Regression ◽

Baseline Survey ◽

Minority Populations ◽

Cox Regression Analysis ◽

Independent Risk Factors

Abstract Background: Metabolic syndrome (MS) could promote the development of cardiovascular disease(CVD). The aim of this study was to examine the association of MS and its components with CVD among Kazakhs in Xinjiang. Methods: According to the geographical distribution of the minority populations in Xinjiang, we selected the representative prefecture (Yili). A total of 2,644 participants completed the baseline survey between April 2010 and December 2012. The follow-up survey was conducted from April 2016 to December 2016. Only 2,286 out of 2,644 participants were followed-up on, with a follow-up rate of 86.46%. Cox regression was used to evaluate the association of each component and the number of combinations of MS components on the development of CVD. Results: Multivariate Cox regression analysis showed that blood pressure (BP), waist circumference (WC), and triglycerides (TG) were independently associated with CVD. Participants with 1–5 MS components had an increased hazard ratio for developing CVD, from 1.82 to 8.59 (trend P<0.001), compared with those without any MS components. This trend persisted after adjusting for other general risk factors. The risk of developing CVD increased when TG and WC coexisted, or when TG/WC and BP coexisted. However, no significant interactions were found between BP , WC , and TG. Conclusions: BP , WC, and TG were independent risk factors for CVD in Kazakhs. In clinical practice, a more informative assessment may be obtained by taking into account the number of MS components.

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