scholarly journals Nuts: Natural Pleiotropic Nutraceuticals

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3269
Author(s):  
Emilio Ros ◽  
Annapoorna Singh ◽  
James H. O’Keefe
Keyword(s):  
Health Outcomes ◽  
Peanut Butter ◽  
Composite Endpoint ◽  
Major Adverse Cardiovascular Events ◽  
Tree Nuts ◽  
Positive Effects ◽  
Cardiovascular Prognosis ◽  
High Quality Protein ◽  
All Cause Mortality ◽  
Vascular Physiology

Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to favorably influence metabolic and vascular physiology pathways, ameliorate cardiovascular risk factors and improve cardiovascular prognosis. There is increasing evidence that nuts positively impact myriad other health outcomes as well. Nut consumption is correlated with lower cancer incidence and cancer mortality, and decreased all-cause mortality. Favorable effects on cognitive function and depression have also been reported. Randomized controlled trials consistently show nuts have a cholesterol-lowering effect. Nut consumption also confers modest improvements on glycemic control, blood pressure (BP), endothelial function, and inflammation. Although nuts are energy-dense foods, they do not predispose to obesity, and in fact may even help in weight loss. Tree nuts and peanuts, but not peanut butter, generally produce similar positive effects on outcomes. First level evidence from the PREDIMED trial shows that, in the context of a Mediterranean diet, consumption of 30 g/d of nuts (walnuts, almonds, and hazelnuts) significantly lowered the risk of a composite endpoint of major adverse cardiovascular events (myocardial infarction, stroke, and death from cardiovascular disease) by ≈30% after intervention for 5 y. Impressively, the nut-supplemented diet reduced stroke risk by 45%. As they are rich in salutary bioactive compounds and beneficially impact various health outcomes, nuts can be considered natural pleiotropic nutraceuticals.

scholarly journals The Long-Term Impact of Bariatric Surgery on Development of Atrial Fibrillation and Cardiovascular Events in Obese Patients: An Historical Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongtao Yuan ◽  
Jose R. Medina-Inojosa ◽  
Francisco Lopez-Jimenez ◽  
William R. Miranda ◽  
Maria L. Collazo-Clavell ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Gastric Bypass Surgery ◽  
Composite Endpoint ◽  
Major Adverse Cardiovascular Events ◽  
Historical Cohort ◽  
All Cause Mortality ◽  
Heart Failure Admission ◽  
Long Term Impact ◽  
New Onset

Objective: To determine whether early Roux-en-Y gastric bypass surgery (RYGB) reduces the risk of Major adverse cardiovascular events (MACE) in patients with obesity.Patients and Methods: We conducted a study of patients with class II and III obesity [body mass index (BMI) > 35 kg/m2] from Olmsted County, Minnesota, who underwent obesity clinic consultation between the years 1993–2012, and had either RYGB surgery within 1 year (RYGB-1Y group), or medically managed (No-RYGB group). The composite endpoint of MACE (all-cause mortality, stroke, heart failure admission and acute myocardial infarction) was the primary endpoint, with new-onset AF as the secondary endpoint.Results: Of the 1,009 study patients, 308 had RYGB-1Y and 701 were medically managed (No-RYGB). Overall, the age was 44.0 ± 12.4 (mean ± SD) years; BMI was 45.0 ± 6.8 kg/m2. The RYGB-1Y group had a lower rate of MACE (adjusted hazard ratio (HR), 0.62; 95% CI, 0.44–0.88; P = 0.008) and lower mortality (adjusted HR, 0.51; 95% CI, 0.26–0.96; P = 0.04) than the No-RYGB group. The RYGB-1Y surgery was not associated with lower AF occurrence (HR, 0.66; 95% CI, 0.40–1.10; P = 0.11).Conclusion: An early RYGB approach for BMI reduction was associated with lower rates of MACE.

486 Clinical composite endpoint classification of REVIVE II corresponds to all-cause mortality risk

2007 ◽  
Vol 6 (1) ◽  
pp. 106-107
Author(s):  
J TEERLINK ◽  
L DELGADOHERRERA ◽  
R THAKKAR ◽  
B HUANG ◽  
R PADLEY
Keyword(s):  
Mortality Risk ◽  
Composite Endpoint ◽  
All Cause Mortality

scholarly journals Systolic blood pressure and outcome in patients admitted with acute heart failure: a pooled analysis from 4 randomized clinical trials

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
J Grand ◽  
K Miger ◽  
A Sajadieh ◽  
L Kober ◽  
C Torp-Pedersen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Composite Endpoint ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Term Outcome ◽  
Ventricular Ejection Fraction ◽  
Long Term Outcome ◽  
All Cause Mortality ◽  
Short And Long Term

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Background In acute heart failure (AHF), low systolic blood pressure (SBP) has been associated with poor outcome. Less is known of the risk related to normal versus elevated SBP and interaction with left ventricular ejection fraction. Purpose The aim of the present study was to assess the association between baseline SBP and short- and long-term outcome in a large cohort of AHF-patients. Methods A pooled cohort of four randomized controlled trials investigating the vasodilator serelaxin versus placebo in patients admitted with AHF and an SBP from 125 to 180 mmHg. Endpoints were 180-day all-cause mortality and a short-term composite endpoint (worsening heart failure, all-cause mortality or hospital readmission for HF through Day 14). Left ventricular ejection fraction (LVEF) was categorized into HFrEF (<40%) and HFpEF (= >40%). Multivariable Cox regression was used and adjusted for age, sex, baseline body mass index, HFrEF, serum estimated glomerular filtration rate, allocated treatment (placebo/serelaxin), diabetes mellitus, ischemic heart disease, and atrial fibrillation/flutter. Measurements and Main Results A total of 10.533 patients with a mean age of 73 (±12) years and median SBP of 140 (130-150) mmHg were included within mean 8.2 hours from admission. LVEF was assessed in 8493 (81%), and of these, 4294 (51%) had HFrEF. Increasing SBP as a continuous variable was inversely associated with 180-day mortality (HRadjusted: 0.93 [0.88-0.98], p = 0.004 per 10 mmHg increase) and with the composite endpoint (HRadjusted: 0.90 [0.85-0.95], p < 0.0001 per 10 mmHg increase). A significant interaction was observed regarding LVEF, revealing that SBP was not associated with mortality in patients with HFpEF  (HRadjusted: 1.01 [0.94-1.09], p = 0.83 per 10 mmHg increase), but SBP was associated with increased mortality in HFrEF (HRadjusted: 0.80 [0.73-0.88], p < 0.001 per 10 mmHg increase) (Figure). Conclusions Elevated SBP is independently associated with favorable short- and long-term outcome in AHF-patients. The association between SBP and mortality was, however, not present in patients with preserved LVEF. Abstract Figure. Survival plots by SBP and LVEF

scholarly journals Comparative effectiveness of bisoprolol and carvedilol among patients receiving maintenance hemodialysis

2021 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Jia-Sin Liu ◽  
Yi-Chun Tsai ◽  
Mei-Chuan Kuo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Cox Model ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Risk Of Death ◽  
Relative Safety ◽  
Dialysis Vintage ◽  
All Cause Mortality

Abstract Background Despite widespread use, there is no trial evidence to inform β-blocker’s (BB) relative safety and efficacy among patients undergoing hemodialysis (HD). We herein compare health outcomes associated with carvedilol or bisoprolol use, the most commonly prescribed BBs in these patients. Methods We created a cohort study of 9305 HD patients who initiated bisoprolol and 11 171 HD patients who initiated carvedilol treatment between 2004 and 2011. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs) between carvedilol and bisoprolol users during a 2-year follow-up. Results Bisoprolol initiators were younger, had shorter dialysis vintage, were women, had common comorbidities of hypertension and hyperlipidemia and were receiving statins and antiplatelets, but they had less heart failure and digoxin prescriptions than carvedilol initiators. During our observations, 1555 deaths and 5167 MACEs were recorded. In the multivariable-adjusted Cox model, bisoprolol initiation was associated with a lower all-cause mortality {hazard ratio [HR] 0.66 [95% confidence interval (CI) 0.60–0.73]} compared with carvedilol initiation. After accounting for the competing risk of death, bisoprolol use (versus carvedilol) was associated with a lower risk of MACEs [HR 0.85 (95% CI 0.80–0.91)] and attributed to a lower risk of heart failure [HR 0.83 (95% CI 0.77–0.91)] and ischemic stroke [HR 0.84 (95% CI 0.72–0.97)], but not to differences in the risk of acute myocardial infarction [HR 1.03 (95% CI 0.93–1.15)]. Results were confirmed in propensity score matching analyses, stratified analyses and analyses that considered prescribed dosages or censored patients discontinuing or switching BBs. Conclusions Relative to carvedilol, bisoprolol initiation by HD patients was associated with a lower 2-year risk of death and MACEs, mainly attributed to lower heart failure and ischemic stroke risk.

scholarly journals Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038829
Author(s):  
Ross McQueenie ◽  
Barbara I Nicholl ◽  
Bhautesh D Jani ◽  
Jordan Canning ◽  
Sara Macdonald ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Uk Biobank ◽  
Long Term Conditions ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Clinical Records

ObjectiveTo investigate how the type and number of long-term conditions (LTCs) impact on all-cause mortality and major adverse cardiovascular events (MACE) in people with rheumatoid arthritis (RA).DesignPopulation-based longitudinal cohort study.SettingUK Biobank.ParticipantsUK Biobank participants (n=502 533) aged between 37 and 73 years old.Primary outcome measuresPrimary outcome measures were risk of all-cause mortality and MACE.MethodsWe examined the relationship between LTC count and individual comorbid LTCs (n=42) on adverse clinical outcomes in participants with self-reported RA (n=5658). Risk of all-cause mortality and MACE were compared using Cox’s proportional hazard models adjusted for lifestyle factors (smoking, alcohol intake, physical activity), demographic factors (sex, age, socioeconomic status) and rheumatoid factor.Results75.7% of participants with RA had multimorbidity and these individuals were at increased risk of all-cause mortality and MACE. RA and >4 LTCs showed a threefold increased risk of all-cause mortality (HR 3.30, 95% CI 2.61 to 4.16), and MACE (HR 3.45, 95% CI 2.66 to 4.49) compared with those without LTCs. Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in participants with RA compared with those without RA or LTCs: twofold increased risk of all-cause mortality (HR 2.20, 95% CI 1.55 to 3.12) and threefold increased risk of MACE (HR 3.17, 95% CI 2.27 to 4.64). These findings remained in a subset (n=3683) with RA diagnosis validated from clinical records or medication reports.ConclusionThose with RA and other LTCs, particularly comorbid osteoporosis, are at increased risk of adverse outcomes, although the role of corticosteroids could not be evaluated in this study. These results are clinically relevant for the monitoring and management of RA across the healthcare system, and future clinical guidelines for RA should acknowledge the importance of multimorbidity.

4181Prognosis of patients with mid-range left ventricular ejection fraction treated with PCI: insight from the global leaders study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Chichareon ◽  
R Modolo ◽  
N Kogame ◽  
M Tomaniak ◽  
E Teiger ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Stent Thrombosis ◽  
Composite Endpoint ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality

Abstract Background Heart failure with mid-range ejection fraction (left ventricular ejection fraction between 40 to 49%) was introduced in the 2016 European Society of Cardiology guidelines for heart failure. The prognosis of the mid-range of left ventricular ejection fraction (LVEF) was less well assessed in patients treated with percutaneous coronary intervention (PCI). Purpose We aimed to assess the 2-year outcomes of patients with mid-range ejection fraction (LVEF between 40 to 49%) after PCI compared with reduced LVEF (<40%) and preserved LVEF (≥50) in the GLOBAL LEADERS study. Methods The GLOBAL LEADERS study was a multicenter, randomized trial comparing the efficacy and safety of two antiplatelet strategies in all-comers patients undergoing PCI with biolimus-A9 eluting stent. Patients with available information of LVEF were eligible in the present analysis. Patients were classified according to their LVEF into three groups; preserved (LVEF ≥50), mid-range (LVEF 40–49%) and reduced (LVEF <40%) left ventricular ejection fraction. Clinical outcomes at 2 years after PCI were compared among three groups in the multivariable Cox regression analysis. The primary outcome of present study was all-cause mortality at 2 years after PCI. The secondary outcomes were patient-oriented composite endpoint (POCE). Individual components of the composite endpoint, definite or probable stent thrombosis and bleeding academic research consortium (BARC) type 3 or 5 were also reported. Results Out of 15968 patients included in the GLOBAL LEADERS study, information of LVEF was available in 15008 patients (93.99%); 12,128 patients (80.81%) were in the group of preserved LVEF, 1,737 patients (11.57%) were in the mid-range LVEF group and 1,143 patients (7.62%) were in the reduced LVEF group. The risk of all-cause mortality and POCE at 2 years were significantly different among the three groups. In an adjusted model, compared with the group of preserved LVEF, the hazard ratio for the all-cause mortality at 2 years rose from 1.89 (95% CI, 1.46–2.45) to 3.72 (95% CI, 2.95–4.70) in the group of mid-range and reduced LVEF respectively. Similar rises were observed for the POCE at 2 years from 1.27 (95% CI, 1.11–1.44) in the group of mid-range LVEF to 1.63 (95% CI, 1.42–1.87) in the group of reduced LVEF. The risk of stroke, myocardial infarction, and definite or probable stent thrombosis in patients with mid-range LVEF was not different from patients with reduced LVEF (see figure). A similar risk of revascularization was observed among the three groups. Outcomes among three LVEF categories Conclusion Patients with mid-range LVEF undergoing PCI had a different prognosis from patients with reduced LVEF and preserved LVEF in term of survival and composite ischemic endpoints at 2 years.

scholarly journals Meditation: Evidence Map of Systematic Reviews

2021 ◽  
Vol 9 ◽  
Author(s):  
Caio Fábio Schlechta Portella ◽  
Ricardo Ghelman ◽  
Veronica Abdala ◽  
Mariana Cabral Schveitzer ◽  
Rui Ferreira Afonso
Keyword(s):  
Health Outcomes ◽  
Systematic Reviews ◽  
Well Being ◽  
Complementary Therapy ◽  
Evidence Map ◽  
Confidence Levels ◽  
Positive Effects ◽  
Key Word ◽  
Meta Analyses

Study Basis: This evidence map presents a summary of studies that addressed the effects of meditation on various clinical and health conditions. Meditation is a contemplative practice that has been used for the promotion of health, and the treatment of different conditions.Method: The study is based on the search of four electronic databases for the period 1994-November 2019 and includes systematic reviews, meta-analyses, meta-syntheses, and integrative reviews. 3iE evidence gap map was the methodology of choice, and AMSTAR 2 was used for the analyses. Tableau was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects.Results: This map encompasses 191 studies, with Mindfulness being the key word that retrieved the highest number of results. Several meditation techniques were evaluated in different contexts, and the confidence levels of 22 studies were high, 84 were moderate, and 82 were low. Two 2 meta-syntheses and 1 integrative review were also included. Most of the studies reported positive effects and a beneficial potential of the practice of meditation. Health outcomes were divided into five groups out of which mental health and vitality, and well-being and quality of life stood out with the largest number of studies.Conclusions: Meditation has been applied in different areas. This Evidence Map intends to be an easy visual tool to access valuable evidence-based information on this complementary therapy for patients, health professionals, and managers.

scholarly journals Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review

2022 ◽  
Vol 11 (2) ◽  
pp. 328
Author(s):  
Nuria Marín-Jiménez ◽  
Carolina Cruz-León ◽  
Alejandro Perez-Bey ◽  
Julio Conde-Caveda ◽  
Alberto Grao-Cruces ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Predictive Validity ◽  
Systematic Reviews ◽  
Gait Speed ◽  
Meta Analysis ◽  
Motor Fitness ◽  
All Cause Mortality ◽  
Impaired Balance ◽  
Over 40 Years

Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.

scholarly journals Left ventricular remodelling pattern and prognostic relevance in patients with STEMI treated with primary percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Chimed ◽  
P Van Der Bijl ◽  
R Lustosa ◽  
J.M Montero ◽  
N.A Marsan ◽  
...  
Keyword(s):  
Systolic Function ◽  
Composite Endpoint ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Chi Square ◽  
Group 4 ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2

Abstract Background Left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) is a complex pathological process which has been associated with long-term cardiovascular adverse events. The current definition of LV remodelling is usually based on the change in LV end-diastolic volume (LVEDV). An increase in LVEDV, however, may also be considered an adaptive response to maintain effective LV ejection fraction (LVEF) in LV remodelling. Purpose To reclassify post-infarct LV remodelling according to the change in LVEDV and LVEF from baseline and to determine the prognostic relevance of integrated LV remodelling and systolic function groups. Methods A total of 1859 patients with STEMI who received primary percutaneous coronary intervention (PCI) and guideline-directed medical treatment, were retrospectively evaluated. Four LV remodelling subgroups were identified, based on the change in LVEDV and LVEF from baseline to 6 months post-infarct. ≥20% increase in LVEDV, compared to baseline, was defined as LV dilatation, while any increase or decrease in LVEF compared to baseline was used to categorise remodelling further according to systolic function. Study endpoints were all-cause mortality and the composite of all-cause mortality and heart failure (HF) hospitalisation. Results The mean age of the study population was 60±11 years and the majority were men (76.4%). 402 patients showed LVEDV≥20% and LVEF increase (Group 1), 952 patients LVEDV≤20% and LVEF increase (Group 2), 325 patients LVEDV≤20% and LVEF decrease (Group 3) and 180 patients LVEDV≥20% and LVEF decrease (Group 4). During a median follow-up of 89 (IQR 64; 113) months, all-cause mortality occurred in 256 patients (13.8%), HF hospitalisation in 40 patients (2.2%) and the composite endpoint in 279 patients (15.0%). All-cause mortality was significantly higher in Group 4 (21.7%, chi-square p=0.002) compared to other groups (15.4% in Group, 12.9% in Group 2 and 9.8% in Group 3). The composite endpoint was also significantly more frequent in Group 4 (25.6%, chi-square p&lt;0.001) compared with the other groups (16.2% in Group 1, 13.8% in Group 2 and 11.4% in Group 3). Mean survival time (Figure 1A) and event-free survival time for the composite endpoint (Figure 1B) were significantly lower in Group 4 (122 months 95% CI 115–128, p=0.004 and 117 months 95% CI 110–124, p&lt;0.001, respectively) compared to other groups. Conclusion Patients with LVEDV≥20% and a LVEF decrease at 6 months after STEMI experienced all-cause mortality and the composite endpoint of all-cause mortality and HF hospitalisation more frequently compared to other LV remodelling groups. Patients with an increase in LVEDV and a decrease in LVEF 6 months after STEMI, may benefit from careful surveillance and preventative strategies. KM comparison for study endpoints. Funding Acknowledgement Type of funding source: None

scholarly journals Morbidity and Mortality Reduction Associated with Polysomnography Testing in Idiopathic Pulmonary Fibrosis: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Nicholas T Vozoris ◽  
Andrew S Wilton ◽  
Peter C Austin ◽  
Tetyana Kendzerska ◽  
Clodagh M Ryan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Health Outcomes ◽  
Index Date ◽  
Population Based ◽  
Sleep Breathing Disorders ◽  
Breathing Disorders ◽  
All Cause Mortality ◽  
Important Health

Abstract Background: It is not well-known if diagnosing and treating sleep breathing disorders among individuals with idiopathic pulmonary fibrosis (IPF) improves health outcomes. We evaluated the association between receipt of laboratory-based polysomnography (which is the first step in the diagnosis and treatment of sleep breathing disorders in Ontario, Canada) and respiratory-related hospitalization and all-cause mortality among individuals with IPF.Methods: We used a retrospective, population-based, cohort study design, analyzing health administrative data from Ontario, Canada, from 2007-2019. Individuals with IPF were identified using an algorithm based on health administrative codes previously developed by IPF experts. Propensity score matching was used to account for potential differences in 41 relevant covariates between individuals that underwent polysomnography (exposed) and individuals that did not undergo polysomnography (controls), in order minimize potential confounding. Respiratory-related hospitalization and all-cause mortality were evaluated up to 12 months after the index date. Results: Out of 5044 individuals with IPF identified, 201 (4.0%) received polysomnography, and 189 (94.0%) were matched to an equal number of controls. Compared to controls, exposed individuals had significantly reduced rates of respiratory-related hospitalization (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.24-0.75), p=0.003) and all-cause mortality (HR 0.49, 95% CI 0.30-0.80), p=0.004). Significantly reduced rate of respiratory-related hospitalization (but not all-cause mortality) was also observed among those with >=1 respiratory-related hospitalization (HR 0.38, 95% CI 0.15-0.99) and systemic corticosteroid receipt (HR 0.37, 95% CI 0.19-0.94) in the year prior to the index date, which reflect sicker subgroups of persons. Conclusions: Undergoing polysomnography was associated with significantly improved clinically-important health outcomes among individuals with IPF, highlighting the potential importance of incorporating this testing in IPF disease management.

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