Influence of control selection in nested case-control studies: the example of exposure to antiretroviral treatment (ART) and the risk of myocardial infarction (MI) in the French Hospital Database on HIV (FHDH-ANRS CO4)

2008 ◽  
Vol 17 (5) ◽  
pp. 468-474 ◽  
Author(s):  
M. Guiguet ◽  
M. Mary-Krause ◽  
B. Ename ◽  
D. Costagliola ◽  
S. Grabar
Keyword(s):  
Myocardial Infarction ◽  
Antiretroviral Treatment ◽  
Case Control ◽  
Case Control Studies ◽  
Hospital Database ◽  
Control Selection ◽  
French Hospital ◽  
French Hospital Database ◽  
Nested Case Control

scholarly journals Is the Risk of Myocardial Infarction in People With Human Immunodeficiency Virus (HIV) Associated With Atazanavir or Darunavir? A Nested Case-Control Study Within the French Hospital Database on HIV

2019 ◽  
Vol 221 (4) ◽  
pp. 516-522
Author(s):  
Dominique Costagliola ◽  
Valérie Potard ◽  
Sylvie Lang ◽  
Nathalie de Castro ◽  
Laurent Cotte ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Human Immunodeficiency Virus ◽  
Case Control Study ◽  
Case Control ◽  
Hospital Database ◽  
Immunodeficiency Virus ◽  
French Hospital ◽  
French Hospital Database ◽  
Nested Case Control ◽  
Control Study

Abstract Background The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study has reported an increased risk of cardiovascular diseases in people with human immunodeficiency virus who were exposed to darunavir (DRV) but not to atazanavir (ATV). Our objective was to evaluate associations between ATV or DRV exposures and the risk of myocardial infarction (MI) in a nested case-control study within ANRS-CO4 French Hospital Database on HIV (FHDH). Methods Cases were individuals who had a first validated MI between 2006 and 2012. Up to 5 controls were selected at random with replacement among individuals with no history of MI, followed at the time of MI diagnosis, and matched for age and sex. Conditional logistic regression models were used to adjust for potential confounders (MI risk factors and HIV-related parameters) and for cumulative exposure to each antiretroviral drug (ARV). Results Overall, 408 MI cases and 1250 controls were included: 109 (27%) cases and 288 (23%) controls had been exposed to ATV, and 41 (10%) cases and 107 (9%) controls had been exposed to DRV. There was no significant association between exposure to ATV (adjusted odds ratio [OR] = 1.54; 95% confidence interval [CI], .87–2.73) or DRV (adjusted OR = 0.51; 95% CI, .11–2.32) and the risk of MI. Conclusions In FHDH, exposures to ATV or to DRV were not significantly associated with the risk of MI, adjusting for complete ARV history, contrary to the analysis in DAD.

Incidence of HIV-Related Anal Cancer Remains Increased Despite Long-Term Combined Antiretroviral Treatment: Results From the French Hospital Database on HIV

2012 ◽  
Vol 30 (35) ◽  
pp. 4360-4366 ◽  
Author(s):  
Christophe Piketty ◽  
Hana Selinger-Leneman ◽  
Anne-Marie Bouvier ◽  
Aurelien Belot ◽  
Murielle Mary-Krause ◽  
...  
Keyword(s):  
General Population ◽  
Anal Cancer ◽  
Antiretroviral Treatment ◽  
Hospital Database ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
French Hospital ◽  
French Hospital Database ◽  
Cd4 Cell

Purpose To study recent trends in the incidence of anal cancer in HIV-infected patients receiving long-term combined antiretroviral treatment (cART) compared with the general population. Patients and Methods From the French Hospital Database on HIV, we identified 263 cases of invasive anal squamous cell carcinoma confirmed histologically between 1992 and 2008. We compared incidence rates of anal cancer across four calendar periods: 1992-1996 (pre-cART period), 1997-2000 (early cART period), and 2001-2004 and 2005-2008 (recent cART periods). Standardized incidence ratios (SIRs) were calculated by using general population incidence data from the French Network of Cancer Registries. Results In HIV-infected patients, the hazard ratio (HR) in the cART periods versus the pre-cART period was 2.5 (95% CI, 1.28 to 4.98). No difference was observed across the cART calendar periods (HR, 0.9; 95% CI, 0.6 to 1.3). In 2005-2008, HIV-infected patients compared with the general population had an excess risk of anal cancer, with SIRs of 109.8 (95% CI, 84.6 to 140.3), 49.2 (95% CI, 33.2 to 70.3), and 13.1 (95% CI, 6.8 to 22.8) for men who have sex with men (MSM), other men, and women, respectively. Among patients with CD4 cell counts above 500/μL for at least 2 years, SIRs were 67.5 (95% CI, 41.2 to 104.3) when the CD4 nadir was less than 200/μL for more than 2 years and 24.5 (95% CI, 17.1 to 34.1) when the CD4 nadir was more than 200/μL. Conclusion Relative to that in the general population, the risk of anal cancer in HIV-infected patients is still extremely high, even in patients with high current CD4 cell counts. cART appears to have no preventive effect on anal cancer, particularly in MSM.

Clinical Trials in Thrombosis: Secondary Prevention of Myocardial Infarction

1976 ◽  
Vol 35 (01) ◽  
pp. 049-056 ◽  
Author(s):  
Christian R Klimt ◽  
P. H Doub ◽  
Nancy H Doub
Keyword(s):  
Myocardial Infarction ◽  
Secondary Prevention ◽  
Case Control ◽  
Therapeutic Effects ◽  
Case Control Studies ◽  
Definitive Answer ◽  
Inhibition Of Platelet Aggregation ◽  
Prospective Trials

SummaryNumerous in vivo and in vitro experiments, investigating the inhibition of platelet aggregation and the prevention of experimentally-induced thrombosis, suggest that anti-platelet drugs, such as aspirin or the combination of aspirin and dipyridamole or sulfinpyrazone, may be effective anti-thrombotic agents in man. Since 1971, seven randomized prospective trials and two case-control studies have been referenced in the literature or are currently being conducted, which evaluate the effects of aspirin, sulfinpyrazone, or dipyridamole in combination with aspirin in the secondary prevention of myocardial infarction. A critical review of these trials indicates a range of evidence from no difference to a favorable trend that antiplatelet drugs may serve as anti-thrombotic agents in man. To date, a definitive answer concerning the therapeutic effects of these drugs in the secondary prevention of coronary heart disease is not available.

scholarly journals A systematic assessment of the association between frequently prescribed medicines and the risk of common cancers: a series of nested case-control studies

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
R. D. McDowell ◽  
C. Hughes ◽  
P. Murchie ◽  
C. Cardwell
Keyword(s):  
Cancer Risk ◽  
Conditional Logistic Regression ◽  
Exposure Dose ◽  
Case Control ◽  
Case Control Studies ◽  
Systematic Assessment ◽  
Exposure Response ◽  
Prescribed Medicines ◽  
Nested Case Control ◽  
Novel Associations

Abstract Background Studies systematically screening medications have successfully identified prescription medicines associated with cancer risk. However, adjustment for confounding factors in these studies has been limited. We therefore investigated the association between frequently prescribed medicines and the risk of common cancers adjusting for a range of confounders. Methods A series of nested case-control studies were undertaken using the Primary Care Clinical Informatics Unit Research (PCCIUR) database containing general practice (GP) records from Scotland. Cancer cases at 22 cancer sites, diagnosed between 1999 and 2011, were identified from GP records and matched with up to five controls (based on age, gender, GP practice and date of registration). Odds ratios (OR) and 95% confidence intervals (CI) comparing any versus no prescriptions for each of the most commonly prescribed medicines, identified from prescription records, were calculated using conditional logistic regression, adjusting for comorbidities. Additional analyses adjusted for smoking use. An association was considered a signal based upon the magnitude of its adjusted OR, p-value and evidence of an exposure-response relationship. Supplementary analyses were undertaken comparing 6 or more prescriptions versus less than 6 for each medicine. Results Overall, 62,109 cases and 276,580 controls were included in the analyses and a total of 5622 medication-cancer associations were studied across the 22 cancer sites. After adjusting for comorbidities 2060 medicine-cancer associations for any prescription had adjusted ORs greater than 1.25 (or less than 0.8), 214 had a corresponding p-value less than or equal to 0.01 and 118 had evidence of an exposure-dose relationship hence meeting the criteria for a signal. Seventy-seven signals were identified after additionally adjusting for smoking. Based upon an exposure of 6 or more prescriptions, there were 118 signals after adjusting for comorbidities and 82 after additionally adjusting for smoking. Conclusions In this study a number of novel associations between medicine and cancer were identified which require further clinical and epidemiological investigation. The majority of medicines were not associated with an altered cancer risk and many identified signals reflected known associations between medicine and cancer.

scholarly journals OP0234 RISK OF ACUTE MYOCARDIAL INFARCTION AMONG NEW USERS OF CHONDROITIN SULPHATE: A NESTED CASE-CONTROL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 144.1-144
Author(s):  
R. Mazzucchelli ◽  
S. Rodriguez-Martin ◽  
A. García-Vadillo ◽  
M. Gil ◽  
A. Rodríguez-Miguel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Case Control Study ◽  
Chondroitin Sulphate ◽  
Case Control ◽  
Nested Case Control ◽  
Incident Cases ◽  
Control Study

Background:There is some evidence from epidemiological studies suggesting that CS and glucosamine could play a role in cardiovascular disease (CVD) prevention (1-4).Studies to date have included prevalent users, therefore a bias that overestimates protection cannot be excluded.Objectives:To test the hypothesis that chondroitin sulphate (CS) or glucosamine reduce the risk of acute myocardial infarction (AMI).Methods:Case-control study nested in a primary cohort composed of patients aged 40 to 99 years, with at least one year of follow-up in the BIFAP database during the 2002-2015 study period. From this cohort of patients, we identified incident cases of AMI and randomly selected five controls per case, matched by exact age, gender, and index date. Adjusted odds ratios (AOR) and their corresponding 95% confidence interval (CI)) were calculated through a conditional logistic regression. Only new users of CS or glucosamine were considered.Results:A total of 23,585 incident cases of AMI and 117,405 controls were included. The mean age was 67.0 (SD 13.4) years and 71.75% were male, in both groups. 558 (2.37%) cases and 3,082 (2.62%) controls used or had used CS. The current use of CS was associated with a lower risk of AMI (AOR 0.57; 95%CI: 0.46–0.72) and disappeared after discontinuation (recent and past users). The reduced risk among current users was observed in both short-term (<365 days AOR 0.58; 95%CI: 0.45-0.75) and long-term users (>364 days AOR 0.56; 95%CI 0.36-0.87), in both sexes (men, AOR=0.52; 95%CI:0.38-0.70; women, AOR=0.65; 95%CI: 0.46-0.91), in individuals over or under 70 years of age (AOR=0.54; 95%CI:0.38-0.77, and AOR=0.61; 95%CI:0.45-0.82, respectively) and in individuals at intermediate (AOR=0.65; 95%CI:0.48-0.91) and high cardiovascular risk (AOR=0.48;95%CI:0.27-0.83), but not in those at low risk (AOR=1.11; 95%CI:0.48-2.56). In contrast, the current use of glucosamine was not associated with either increased or decreased risk of AMI (AOR= 0.86; CI95% 0.66-1.08)Conclusion:Our results support a cardioprotective effect of CS, while no effect was observed with glucosamine. The highest protection was found among subgroups at higher cardiovascular risk.References:[1]Ma H, Li X, Sun D, Zhou T, Ley SH, Gustat J, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019;365(Journal Article):l1628.[2]de Abajo FJ, Gil MJ, Garcia Poza P, Bryant V, Oliva B, Timoner J, et al. Risk of nonfatal acute myocardial infarction associated with non-steroidal antiinflammatory drugs, non-narcotic analgesics and other drugs used in osteoarthritis: a nested case-control study. PharmacoepidemiolDrug Saf. 2014;23(11):1128–38.[3]Li Z-H, Gao X, Chung VC, Zhong W-F, Fu Q, Lv Y-B, et al. Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study. Ann Rheum Dis. 2020 Apr 6;annrheumdis-2020-217176.[4]King DE, Xiang J. Glucosamine/Chondroitin and Mortality in a US NHANES Cohort. J Am Board Fam Med. 2020 Dec;33(6):842–7.Disclosure of Interests:Ramón Mazzucchelli Speakers bureau: UCB, Lilly, Grant/research support from: Pfizer, Roche, Amgen, Sara Rodriguez-Martin: None declared, Alberto García-Vadillo: None declared, Miguel Gil: None declared, Antonio Rodríguez-Miguel: None declared, Diana Barreira-Hernández: None declared, Alberto García-Lledó: None declared, Francisco de Abajo: None declared

scholarly journals Relation of therapies for ankylosing spondylitis and psoriatic arthritis to risk of myocardial infarction: a nested case control study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Rachael Stovall ◽  
Christine Peloquin ◽  
David Felson ◽  
Tuhina Neogi ◽  
Maureen Dubreuil
Keyword(s):  
Myocardial Infarction ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Case Control Study ◽  
Tumor Necrosis Factor Inhibitor ◽  
The United States ◽  
Case Control ◽  
Geographical Regions ◽  
Nested Case Control ◽  
Control Study

Abstract Background Risk of myocardial infarction (MI) is elevated in ankylosing spondylitis and psoriatic arthritis (AS/PsA) compared to the general population. We evaluated the risk of MI related to the use of tumor necrosis factor inhibitor (TNFi) and other therapies in AS/PsA. Methods We conducted a nested case-control study using 1994–2018 data from OptumLabs® Data Warehouse, which includes de-identified medical and pharmacy claims, laboratory results, and enrollment records for commercial and Medicare Advantage enrollees. The database contains longitudinal health information on enrollees and patients, representing a diverse mixture of ages, ethnicities and geographical regions across the United States. Assessing AS/PsA separately, MI cases were matched to 4 controls by sex, age, diagnosis year and insurance type. We evaluated treatment within 6 months prior to MI including NSAIDs (AS referent), disease-modifying anti-rheumatic drug (DMARDs; PsA referent) and TNFi alone or in combinations. We evaluated the relation of treatment categories to MI risk using conditional logistical regression adjusting for confounders. Results Among 26,648 AS subjects, there were 237 MI cases and 894 matched controls. Among 43,734 PsA subjects, there were 404 cases and 1596 controls. In AS, relative to NSAID use, the adjusted odds ratio (aOR) for MI among TNFi only users was 0.85 (95% CI 0.39–1.85) and for DMARD only users was 1.04 (95% CI 0.65–1.68). In PsA, relative to DMARD use, the aOR among TNFi only was 1.09 (95% CI 0.74–1.60). Combination therapies also had no effect. Conclusions Among AS/PsA, no combination of therapies appeared to be protective or harmful with regards to MI. Future studies should capture more AS and PsA patients and include longer term follow up to further investigate this question.

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