scholarly journals Longitudinal Effects of Serum Calcium and Phosphate Levels and Their Ratio on Incident Ischemic Heart Disease among Korean Adults

Biomolecules ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 103
Author(s):  
Dong Hyuk Jung ◽  
Byoungjin Park ◽  
Yong Jae Lee
Keyword(s):  
Heart Disease ◽  
Calcium Phosphate ◽  
Ischemic Heart Disease ◽  
Serum Calcium ◽  
Large Scale ◽  
Reference Group ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Ischemic Heart ◽  
Health Insurance Data

Serum calcium and phosphate levels are controlled by a regulatory system, but their individual concentration tendencies and interactions may affect long-term vascular health. This study aimed to assess the effects of serum calcium and phosphate levels on incident ischemic heart disease (IHD) in a large-scale community-dwelling Korean cohort. We evaluated 15,259 non-diabetic individuals (median age, 45 years; range, 30–85) without previous IHD or ischemic stroke using the Korean National Health Insurance data. The study population was classified based on the calcium, phosphate, and calcium/phosphate ratios. Using Cox proportional hazards regression models, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD over 50 months after baseline enrolment. The age- and sex-adjusted incidence of IHD gradually increased with serum calcium and phosphate quartiles and decreased with calcium/phosphate ratio quartiles, with an overall crude rate of 2.1% (315/15,259). After setting the lowest calcium, phosphate, and calcium/phosphate ratio quartiles as a reference group, the HRs (95% CIs) of the highest calcium, phosphate, and calcium/phosphate ratio quartiles for IHD were 1.77 (1.15–2.72), 1.73 (1.18–2.55), and 0.58 (0.39–0.87), respectively, after adjusting for potential confounding variables. Serum calcium and phosphate levels were positively associated with IHD incidence, while the serum calcium/phosphate ratio exhibited an inverse relationship. Serum calcium and phosphate homeostasis may merit serious consideration to understand the pathogenesis of coronary atherosclerosis as a risk modifier for IHD.

scholarly journals Relationship Between the Triglyceride-glucose Index and Incident Ischemic Heart Disease Risk: A Prospective Study Using National Health Insurance Data

2020 ◽  
Author(s):  
Byoungjin Park ◽  
Yong-Jae Lee ◽  
Hye Sun Lee ◽  
Dong-Hyuk Jung
Keyword(s):  
Insulin Resistance ◽  
Heart Disease ◽  
Health Insurance ◽  
Ischemic Heart Disease ◽  
National Health Insurance ◽  
National Health ◽  
Ischemic Heart ◽  
Health Insurance Data ◽  
Tyg Index ◽  
Insurance Data

Abstract Background: Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis as well as a lack of health awareness. Until now, the association between early insulin resistance and IHD among nondiabetic adults has been poorly understood. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic adults using National Health Insurance data. Methods: We assessed 16,455 participants (8,426 men and 8,029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review & Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD, using multivariate Cox proportional-hazards regression models, over a 50-month period that followed the baseline survey.Results: During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 1–4 were 1.00, 1.63 (95% CI, 1.06–2.49), 1.88 (95% CI, 1.23–2.87), and 2.35 (95% CI, 1.53–3.61), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, high sensitivity C-reactive protein, and mean arterial blood pressure.Conclusion: A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, a high TyG index may be a useful additional measure in assessing cardiovascular risks for apparently healthy adults in clinical practice.

Long-term nitrate use may be deleterious in ischemic heart disease: A study using the databases from two large-scale postinfarction studies

1999 ◽  
Vol 138 (3) ◽  
pp. 577-585 ◽  
Author(s):  
Yasuyuki Nakamura ◽  
Arthur J Moss ◽  
Mary W. Brown ◽  
Masahiko Kinoshita ◽  
Chuichi Kawai
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Large Scale ◽  
Ischemic Heart

scholarly journals The Incidence of Ischemic Heart Disease and Mortality in People with Subclinical Hypothyroidism: Reanalysis of the Whickham Survey Cohort

2010 ◽  
Vol 95 (4) ◽  
pp. 1734-1740 ◽  
Author(s):  
Salman Razvi ◽  
Jola U. Weaver ◽  
Mark P. Vanderpump ◽  
Simon H. S. Pearce
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Subclinical Hypothyroidism ◽  
Subsequent Treatment ◽  
Hazard Ratio ◽  
Community Dwelling ◽  
Ischemic Heart ◽  
Vascular Events ◽  
Thyroid Autoantibody

Abstract Context: The Whickham Survey evaluated vascular events over 20 yr in community-dwelling subjects stratified by thyroid function and thyroid autoantibody status. No association between ischemic heart disease (IHD) and a composite autoimmune thyroid disease group, comprising individuals with subclinical hypothyroidism (SCH), with positive thyroid antibodies or those using levothyroxine, was found. This result appears to be at odds with the findings of other cohort studies. Objective: The objective of the study was to evaluate incident IHD and mortality in participants in relation to their thyroid status. Outcomes, Design, and Participants: Data were reanalyzed assessing incident IHD events and mortality during 20 yr of follow-up in individuals with endogenous SCH (n = 97; TSH 6.0–15 mIU/liter) vs. the euthyroid group (n = 2279), who were IHD free at baseline. Results: Incident IHD was significantly higher in the SCH group [adjusted hazard ratio 1.76 (95% confidence interval 1.15–2.71); P = 0.01]. IHD mortality was also increased in the SCH group [hazard ratio of 1.79 (1.02–3.56); P = 0.05]. These findings lost their significance when subsequent treatment with levothyroxine was excluded from the regression model. There was no difference in all-cause mortality between the groups. Conclusion: In the Whickham Survey, there is an association between incident IHD events and IHD-related mortality with SCH over the 20 yr of follow-up. Furthermore, subsequent treatment of SCH with levothyroxine appears to attenuate IHD-related morbidity and mortality, and this may explain why some other longitudinal studies of SCH have not shown such an association; properly designed controlled trials of treatment of SCH are required to answer this question definitively.

scholarly journals Longitudinal Effect of Hemoglobin Concentration With Incident Ischemic Heart Disease According to Hepatic Steatosis Status Among Koreans

2021 ◽  
Vol 8 ◽  
Author(s):  
Dong Hyuk Jung ◽  
Yong Jae Lee ◽  
Byoungjin Park
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Hepatic Steatosis ◽  
Reference Group ◽  
Ischemic Heart ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: An increased hemoglobin (Hb) level may have detrimental effects on hepatic steatosis (HS) as well as cardiovascular disease (CVD). We investigated Hb's effect on incident ischemic heart disease (IHD) risk in the context of hepatic steatosis (HS).Methods: We assessed 17,521 non-diabetic participants and retrospectively screened for IHD using the Korea National Health Insurance data. High Hb was defined as Hb levels ≥16.3 g/dL in men and 13.9 g/dL in women (>75th percentile). The participants were divided into five groups: reference (group 1), mild HS only (group 2), mild HS and high Hb (group 3), severe HS only (group 4), and severe HS and high Hb (group 5). We assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazards regression models over 50 months from the baseline survey.Results: During the follow-up period, 330 (1.9%) participants developed IHD (310 angina pectoris and 20 myocardial infarction). Compared with the reference group (group 1), the HRs for IHD were 1.04 (95% CI, 0.75–1.46) in group 2, 1.14 (95% CI, 0.70–1.85) in group 3, 1.58 (95% CI, 1.08–2.32) in group 4, and 1.79 (95% CI, 1.15–2.80) in group 5, after adjusting for IHD risk factors.Conclusions: We found the combined effect of HS and Hb levels on the incidence of IHD.

scholarly journals Phenotypic Disease Network Analysis to Identify Comorbidity Patterns in Hospitalized Patients with Ischemic Heart Disease Using Large-Scale Administrative Data

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 80
Author(s):  
Dejia Zhou ◽  
Liya Wang ◽  
Shuhan Ding ◽  
Minghui Shen ◽  
Hang Qiu
Keyword(s):  
Heart Disease ◽  
Network Analysis ◽  
Ischemic Heart Disease ◽  
Administrative Data ◽  
Large Scale ◽  
Integrated Management ◽  
Cerebrovascular Diseases ◽  
Hospitalized Patients ◽  
Ischemic Heart ◽  
Healthcare Database

Ischemic heart disease (IHD) exhibits elevated comorbidity. However, few studies have systematically analyzed the comorbid status of IHD patients with respect to the entire spectrum of chronic diseases. This study applied network analysis to provide a complete picture of physical and mental comorbidities in hospitalized patients with IHD using large-scale administrative data. Hospital discharge records from a provincial healthcare database of IHD inpatients (n = 1,035,338) and one-to-one matched controls were included in this retrospective analysis. We constructed the phenotypic disease networks in IHD and control patients and further assessed differences in comorbidity patterns. The community detection method was applied to cluster diagnoses within the comorbidity network. Age- and sex-specific patterns of IHD comorbidities were also analyzed. IHD inpatients showed 50% larger comorbid burden when compared to controls. The IHD comorbidity network consisted of 1941 significant associations between 71 chronic conditions. Notably, the more densely connected comorbidities in IHD patients were not within the highly prevalent ones but the rarely prevalent ones. Two highly interlinked communities were detected in the IHD comorbidity network, where one included hypertension with heart and multi-organ failures, and another included cerebrovascular diseases, cerebrovascular risk factors and anxiety. Males exhibited higher comorbid burden than females, and thus more complex comorbidity relationships were found in males. Sex-specific disease pairs were detected, e.g., 106 and 30 disease pairs separately dominated in males and females. Aging accounts for the majority of comorbid burden, and the complexity of the comorbidity network increased with age. The network-based approach improves our understanding of IHD-related comorbidities and enhances the integrated management of patients with IHD.

Comparative Effectiveness of CABG versus PCI in Patients with Ischemic Heart Disease: insights from SWEDEHEART Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Redfors ◽  
S Volz ◽  
O Angeras ◽  
D Ioanes ◽  
J Odenstedt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sensitivity Analysis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Ischemic Heart ◽  
Funding Source ◽  
Left Main

Abstract Background Several studies have compared CABG to PCI as revascularization treatment in patients with ischemic heart disease (IHD). However, it remains unclear which revascularization strategy carries survival benefits in the long-term. Methods We used data from the SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) registry for all hospital admissions at 13 cardiac care centers within Västra Götaland County in Sweden (∼20% of all SWEDEHEART data). The database contains >1000 clinical variables documenting the entire process of acute coronary hospital care. All patients hospitalized for stable angina or NSTE-ACS during the period 2000–2018 were included in the analysis. We used a propensity score-adjusted Cox proportional-hazards regression with hospitals as random-effect variables. We adjusted for patients' demographics, socio-economic status, traditional risk factors, comorbidities, the severity of coronary artery disease, left ventricular function, calendar year and medication at discharge. For sensitivity analysis, we used the instrumental variable estimator for the Cox proportional-hazards model (with treating hospital as a treatment-preference instrument) to simultaneously deal with the problems of unmeasured confounding and censoring of the outcome. The primary outcome was all-cause mortality. Results In total, 11,896 patients were included in the study. Of these, 3,129 (26.3%) were women. 20.4% had diabetes and 10.4% had a previous myocardial infarction. The mean age was 66.7±10.7, and 42.9% were >70 years old. 61.5% had three-vessel and/or left main disease. Median follow-up time was 5.7 years (range 1 day-18.2 years). Revascularization therapy after coronary angiography was PCI in 9449 (79.4%) and CABG in 2,447 (20.6%) patients. CABG patients were more likely to have diabetes, left main/multivessel disease and heart failure. The number of revascularized patients with PCI increased by 6.4% per calendar year (P<0.001). There were 2,481 (20.9%) deaths. CABG was associated with a lower risk of death compared to PCI (HR 0.81; 95% CI 0.69–0.95; P=0.011. We found no evidence for treatment heterogeneity between the revascularization strategy and age, gender, diabetes, heart failure and indication for revascularization (all P-interaction >0.05). Results from the sensitivity analysis support the conclusions from the primary model. Conclusions In hospitalized patients due to IHD, revascularization with CABG was associated with superior long-term survival compared to PCI. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Heart and Lung Foundation, ALF Västra Götaland, Swedish Scientific Council

scholarly journals Incidence of Heart Failure among Diabetic Patients with Ischemic Heart Disease: A Cohort Study

2019 ◽  
Author(s):  
Senbeta Guteta Abdissa ◽  
Wakgari Deressa ◽  
Amit Shah
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Addis Ababa ◽  
Cox Proportional Hazards ◽  
Ischemic Heart ◽  
Diabetic Patients

Abstract Background In population studies of heart failure (HF), diabetes was shown to be an independent risk factor but the evidence regarding Diabetes Mellitus (DM) having incremental effect in incidence of HF in patients with ischemic heart disease (IHD) is scarce. Our study aimed to assess the incidence of HF in diabetic IHD patients compared to non-diabetic IHD patients. Methods A retrospective cohort study was conducted among 306 patients with IHD followed-up at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The IHD patients who did not have HF at baseline were followed for 24 months beginning from November 30, 2015. We assessed the incidence of HF in patients with diabetic IHD versus the non-diabetic IHD. Cox proportional hazards models were used to assess the association between diabetic IHD and HF after controlling for important covariates. Results Mean age was 56.8 years and male patients accounted for 69%. Prevalence of DM was 31.4% (n=96). During the 24 months follow-up period, 196 (64.1%) had incident HF. Predictors of incident HF were female sex [COR 2.2(1.3-3.8), p=0.006], DM [COR 1.8 (1.1-3.0), p = .04], older age [t (304) = 2.5, p = 0.01, two tailed], bigger left atrial size [t (196) = 2.9, p = 0.005, two-tailed], and lower hemoglobin [t (232) = - 2.3, p = 0.02, two-tailed]. On multivariate Cox regression, DM was significantly associated with incident HF [Hazard Ratio = 2.04, 95% CI: 1.32-3.14, p = 0.001]. Furthermore, when the patients were stratified by hypertension (HTN), DM was associated with worse prognosis, the strongest association being in those with co-existing DM and HTN [HR = 2.57,95% CI =1.66-3.98, p<0.0001] followed by the presence of DM without HTN [HR 2.27, 95% CI = 1.38-3.71, p=0.001]. Conclusion DM is the strongest predictor of incident HF in patients with IHD. It is worse when DM is combined with HTN.

scholarly journals The Association between Sarcoidosis and Ischemic Heart Disease—A Healthcare Analysis of a Large Israeli Population

2021 ◽  
Vol 10 (21) ◽  
pp. 5067
Author(s):  
Tal Gonen ◽  
Daphna Katz-Talmor ◽  
Howard Amital ◽  
Doron Comaneshter ◽  
Arnon D. Cohen ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Ischemic Heart ◽  
Rank Test ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Long Term Follow Up

(1) Background: Inflammation plays a pivotal role in atherosclerosis, and the association between chronic inflammatory states and ischemic heart disease (IHD) has been shown in several rheumatic diseases. Persistent inflammation might also be a risk factor for IHD in sarcoidosis patients. (2) Methods: Demographic and clinical data of 3750 sarcoidosis patients and 18,139 age- and sex-matched controls were retrieved from the database of Clalit Health Services, Israel’s largest healthcare organization. Variables associated with IHD were assessed by a logistic regression model. To assess for variables that were related to increased risk of all-cause mortality, the Cox proportional hazards method was used, and a log-rank test was performed for survival analysis. (3) Results: Both groups were composed of 64% females with a median age of 56 years. An association between sarcoidosis and IHD was demonstrated by a multivariate analysis (adjusted odds ratio (OR) 1.5; 95% confidence interval (CI) 1.36–1.66). Long-term follow-up revealed increased mortality among sarcoidosis patients: 561 (15%) deaths compared to 1636 (9%) deaths among controls (p < 0.001). Survival analysis demonstrated that sarcoidosis patients were also at increased risk for all-cause mortality compared to controls (multivariate model, adjusted HR 1.93; 95% CI 1.76–2.13).

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