Short-Term Lifestyle Alteration and All-Cause Mortality: Lessons from COVID-19 Prevention in a Low-Transmission Region

2020 ◽  
Author(s):  
Chengzong Li ◽  
Liang Wang ◽  
Peian Lou ◽  
Ming Chu ◽  
Bing Gu ◽  
...  
Keyword(s):  
Short Term ◽  
Low Transmission ◽  
All Cause Mortality ◽  
Transmission Region

scholarly journals Long-Term and Short-Term Prognostic Value of Circulating Soluble Suppression of Tumorigenicity-2 Concentration in Chronic Heart Failure: A Systematic Review and Meta-Analysis

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Guoqi Dong ◽  
Hao Chen ◽  
Hongru Zhang ◽  
Yihuang Gu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Prognostic Value ◽  
Web Of Science ◽  
Meta Analysis ◽  
Short Term ◽  
Prisma Statement ◽  
All Cause Mortality ◽  
Increasing Risk

<b><i>Introduction:</i></b> Soluble suppression of tumorigenicity-2 (sST2) has been considered as a prognostic factor of cardiovascular disease. However, the prognostic value of sST2 concentration in chronic heart failure remains to be summarized. <b><i>Methods:</i></b> We searched PubMed, Embase, and Web of Science for eligible studies up to January 1, 2020. Data extracted from articles and provided by authors were used in agreement with the PRISMA statement. The endpoints were all-cause mortality (ACM), cardiovascular mortality (CVM)/heart failure-related hospitalization (HFH), and all-cause mortality (ACM)/heart failure-related readmission (HFR). <b><i>Results:</i></b> A total of 11 studies with 5,121 participants were included in this analysis. Higher concentration of sST2 predicted the incidence of long-term ACM (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.02–1.04), long-term ACM/HFR (HR: 1.42, CI: 1.27–1.59), and long-term CVM/HFH (HR: 2.25, CI: 1.82–2.79), regardless of short-term ACM/HFR (HR: 2.31, CI: 0.71–7.49). <b><i>Conclusion:</i></b> Higher sST2 concentration at baseline is associated with increasing risk of long-term ACM, ACM/HFR, and CVM/HFH and can be a tool for the prognosis of chronic heart failure.

scholarly journals Prognostic Value of Systemic Immune-Inflammation Index for Major Adverse Cardiac Events and Mortality in Severe Aortic Stenosis Patients after TAVI

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 588
Author(s):  
Aydin Rodi Tosu ◽  
Muhsin Kalyoncuoglu ◽  
Halil İbrahim Biter ◽  
Sinem Cakal ◽  
Murat Selcuk ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Prognostic Value ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
Auc Value ◽  
Immune Inflammation

Background and objectives: In this study, we aimed to evaluate whether the systemic immune-inflammation index (SII) has a prognostic value for major adverse cardiac events (MACEs), including stroke, re-hospitalization, and short-term all-cause mortality at 6 months, in aortic stenosis (AS) patients who underwent transcatheter aortic valve implantation (TAVI). Materials and Methods: A total of 120 patients who underwent TAVI due to severe AS were retrospectively included in our study. The main outcome of the study was MACEs and short-term all-cause mortality at 6 months. Results: The SII was found to be higher in TAVI patients who developed MACEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the SII (HR: 1.002, 95%CI: 1.001–1.003, p < 0.01) was an independent predictor of MACEs in AS patients after TAVI. The optimal value of the SII for MACEs in AS patients following TAVI was >1.056 with 94% sensitivity and 96% specificity (AUC (the area under the curve): 0.960, p < 0.01). We noted that the AUC value of SII in predicting MACEs was significantly higher than the AUC value of the C-reactive protein (AUC: 0.960 vs. AUC: 0.714, respectively). Conclusions: This is the first study to show that high pre-procedural SII may have a predictive value for MACEs and short-term mortality in AS patients undergoing TAVI.

Comparison of Self-Expanding RDV Perceval S versus TAVI ACURATE neo/TF

2021 ◽  
Author(s):  
Victor Mauri ◽  
Stephen Gerfer ◽  
Elmar Kuhn ◽  
Matti Adam ◽  
Kaveh Eghbalzadeh ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Implantation Rate ◽  
Paravalvular Leak ◽  
Short Term ◽  
Cerebrovascular Events ◽  
Transcatheter Heart Valve ◽  
All Cause Mortality ◽  
Rapid Deployment

Abstract Background Rapid deployment aortic valve replacement (RDAVR) and transcatheter aortic valve implantation (TAVI) have emerged as increasingly used alternatives to conventional aortic valve replacement to treat patients at higher surgical risk. Therefore, in this single-center study, we retrospectively compared clinical outcomes and hemodynamic performance of two self-expanding biological prostheses, the sutureless and rapid deployment valve (RDV) Perceval-S (PER) and the transcatheter heart valve (THV) ACURATE neo/TF (NEO) in a 1:1 propensity-score-matching (PSM) patient cohort. Methods A total of 332 consecutive patients with symptomatic aortic valve stenosis underwent either singular RDAVR with PER (119) or TAVI with NEO (213) at our institutions between 2012 and 2017. To compare the unequal patient groups, a 1:1 PSM for preoperative data and comorbidities was conducted. Afterward, 59 patient pairs were compared with regard to relevant hemodynamic parameter, relevant paravalvular leak (PVL), permanent postoperative pacemaker (PPM) implantation rate, and clinical postoperative outcomes. Results Postoperative clinical short-term outcomes presented with slightly higher rates for 30-day all-cause mortality (PER = 5.1% vs. NEO = 1.7%, p = 0.619) and major adverse cardiocerebral event in PER due to cerebrovascular events (transient ischemic attack [TIA]-PER = 3.4% vs. TIA-NEO = 1.7%, p = 0.496 and Stroke-PER = 1.7% vs. Stroke-NEO = 0.0%, p = 1). Moreover, we show comparable PPM rates (PER = 10.2% vs. NEO = 8.5%, p = 0.752). However, higher numbers of PVL (mild—PER = 0.0% vs. NEO = 55.9%, p = 0.001; moderate or higher—PER = 0.0% vs. NEO = 6.8%, p = 0.119) after TAVI with NEO were observed. Conclusion Both self-expanding bioprostheses, the RDV-PER and THV-NEO provide a feasible option in elderly and patients with elevated perioperative risk. However, the discussed PER collective showed more postoperative short-term complications with regard to 30-day all-cause mortality and cerebrovascular events, whereas the NEO showed higher rates of PVL.

EP.WE.14Prognostic significance of metabolic syndrome in patients undergoing carotid artery revascularisation: A systematic review and meta-analysis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Long Term Outcomes ◽  
Short Term ◽  
All Cause Mortality ◽  
Major Adverse Events

Abstract Aims to evaluate prognostic significance of metabolic syndrome (MetS) in patients undergoing carotid artery revascularisation. Methods A systematic review and meta-analysis was performed in compliance with PRISMA standards to evaluate prognostic significance of MetS in patients undergoing carotid endarterectomy or carotid stenting. Short-term (&lt;30 days) postoperative outcomes (all-cause mortality, stroke or transient ischaemic attack (TIA), myocardial infarction, major adverse events) and long-term outcomes (restenosis, all-cause mortality, stroke or TIA, myocardial infarction, major adverse events) were considered as outcomes of interest. Random effects modelling was applied for the analyses. Results Analysis of 3721 patients from five cohort studies showed no difference between the MetS and no MetS groups in terms of the following short-term outcomes: all-cause mortality (OR: 1.67,P=0.32), stroke or TIA (OR: 2.44,P=0.06), myocardial infarction (OR: 1.01,P=0.96), major adverse events (OR: 1.23, P = 0.66). In terms of long-term outcomes, MetS was associated with higher risk of restenosis (OR: 1.75,P=0.02), myocardial infarction (OR: 2.12,P=0.04), and major adverse events (OR: 1.30, P = 0.009) but there was no difference between the two groups in terms of all-cause mortality (OR: 1.11, P = 0.25), and stroke or TIA (OR: 1.24, P = 0.33). The quality and certainty of the available evidence were judged to be moderate. Conclusions The best available evidence suggest that although MetS may not affect the short-term postoperative morbidity and mortality outcomes in patients undergoing carotid revascularisation, it may result in higher risks of restenosis, myocardial infarction and major adverse events in the long-term. Evidence from large prospective cohort studies are required for more robust conclusions.

Abstract 14301: Effects of Septal Reduction Therapy on Acute Cardiovascular Events and All-cause Mortality in Patients With Obstructive Hypertrophic Cardiomyopathy: Propensity Score-matched Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sae Morita ◽  
Yanling Zhao ◽  
Kohei Hasegawa ◽  
Muredach P Reilly ◽  
Mathew S Maurer ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Propensity Score ◽  
New York State ◽  
Control Group ◽  
Short Term ◽  
Alcohol Septal Ablation ◽  
Septal Myectomy ◽  
All Cause Mortality ◽  
Obstructive Hypertrophic Cardiomyopathy ◽  
Matched Study

Introduction: Septal reduction therapy (SRT) - i.e., septal myectomy and alcohol septal ablation - has been used to treat medically-refractory obstructive hypertrophic cardiomyopathy (HOCM) for a few decades. However, the effects of SRT on the risk of acute cardiovascular (CV) events and all-cause mortality are largely unknown. Hypothesis: SRT is associated with a long-term decrease in acute CV events and a short-term increase in all-cause mortality in patients with HOCM. Methods: We performed a propensity score (PS)-matched study using all-payer databases that capture all hospitalizations and outpatient visits in New York State. We identified patients with HOCM who underwent SRT between January 1, 2007 and December 31, 2014 (i.e., the SRT group) and those who have never had SRT but had at least one hospitalization for HOCM during the same period (i.e., the control group). We performed 1:1 PS matching using age, sex, race/ethnicity, source of payment, season and year of starting event follow-up (i.e., the day of SRT or the index hospitalization), and Elixhauser comorbidity measures. The primary outcomes were (1) acute CV event (i.e., emergency department visit or unplanned hospitalization for CV disease) during 1-360 days and 361-720 days and (2) 7-, 15-, 30-, 180-, and 360-day all-cause mortality. We compared the risk of the outcome event using logistic regression models. Results: The analytic cohort consisted of 690 patients with HOCM (i.e., 345 PS-matched pairs). The SRT group had a lower risk of acute CV event during 361-720 days (OR 0.44; 95% CI, 0.20-0.97; P=0.04) but a higher risk of 7-day mortality (11 vs. 2 in the control group; P=0.03). The SRT group had a non-significant trend towards lower all-cause mortality in longer terms ( Figure ). Conclusion: In this population-based PS-matched study of patients with HOCM, SRT was associated with a reduced risk of acute CV events in the second post-procedure year at the sacrifice of a short-term increase in all-cause mortality.

scholarly journals Health Impact Assessment of PM2.5 attributable mortality from the September 2020 Washington State Wildfire Smoke Episode

2020 ◽  
Author(s):  
Yisi Liu ◽  
Elena Austin ◽  
Jianbang Xiang ◽  
Tim Gould ◽  
Tim Larson ◽  
...  
Keyword(s):  
Pacific Northwest ◽  
Excess Mortality ◽  
Health Impact Assessment ◽  
Health Impact ◽  
Attributable Mortality ◽  
Short Term ◽  
Wildfire Smoke ◽  
The Pacific ◽  
All Cause Mortality ◽  
Short Term Mortality

AbstractMajor wildfires that started in the summer of 2020 along the west coast of the U.S. have made PM2.5 concentrations in cities in this region rank among the highest in the world. Regions of Washington were impacted by active wildfires in the state, and by aged wood smoke transported from fires in Oregon and California. This study aims to assess the population health impact of increased PM2.5 concentrations attributable to the wildfire. Average daily PM2.5 concentrations for each county before and during the 2020 Washington wildfire episode were obtained from the Washington Department of Ecology. Utilizing previously established associations of short-term mortality for PM2.5, we estimated excess mortality for Washington attributable to the increased PM2.5 levels. On average, PM2.5 concentrations increased 91.7 μg/m3 during the wildfire episode. Each week of wildfire smoke exposures was estimated to result in 87.6 (95% CI: 70.9, 103.1) cases of increased all-cause mortality, 19.1 (95% CI: 10.0, 28.2) increased cardiovascular disease deaths, and 9.4 (95% CI: 5.1, 13.5) increased respiratory disease deaths. Because wildfire smoke episodes are likely to continue impacting the Pacific Northwest in future years, continued preparedness and mitigations to reduce exposures to wildfire smoke are necessary to avoid this excess health burden.

Abstract 16401: Duration of Dual Antiplatelet Therapy in Coronary Heart Disease: A 60,000-patient Meta-analysis of Randomised Controlled Trials

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Anda Bularga ◽  
Mohammed Meah ◽  
Dimitrios Doudesis ◽  
Anoop S Shah ◽  
Nicholas L Mills ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Major Bleeding ◽  
Randomised Controlled Trials ◽  
Dual Antiplatelet Therapy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Short Term ◽  
All Cause Mortality ◽  
Standard Duration ◽  
Randomised Controlled

Introduction: Dual antiplatelet therapy (DAPT) is the cornerstone of pharmacological treatment for patients with acute coronary syndrome (ACS) and in those undergoing percutaneous coronary intervention for stable coronary disease. Despite widespread use, the optimal duration of DAPT remains uncertain. We present an updated meta-analysis comparing outcomes in short-term DAPT (≤ 6 months) versus long-term DAPT (≥ 12 months). Methods: Four major databases were searched for randomised controlled trials of interest. The primary outcome was all-cause mortality. Secondary safety outcomes included any bleeding and major bleeding. Efficacy outcomes included cardiovascular death, myocardial infarction, stent thrombosis, coronary revascularization and thrombotic stroke. Further subgroup analysis stratified by index presentation and a sensitivity analysis to evaluate shorter duration DAPT (≤3 months) was performed. Results: Nineteen randomised controlled trials were included (n=60,879) of which 8 compared shorter duration DAPT (≤3 months) with standard duration (12 months) (n=38,036). Short-term DAPT was associated with an apparent modest increase in myocardial infarction (risk ratio [RR] 1.09; 95% confidence interval [CI], 0.98-1.22) with a major reduction in bleeding (RR 0.68; 95% CI, 0.55-0.83) for major bleeding and (RR 0.66; 95% CI, 0.56-0.77 for any bleeding) and an overall apparent reduction in all-cause mortality (RR 0.90; 95% CI 0.81-1.01). These associations persisted when comparing shorter duration DAPT to standard duration. Subgroup analysis of patients with stable disease or ACS identified no significant heterogenicity in efficacy, safety or mortality outcomes. Conclusion: In the largest meta-analysis to date comparing duration of DAPT, we show that short (≤ 6 months) and shorter (≤ 3 months) DAPT is associated with continuing trends for small reductions in all-cause mortality irrespective of index presentation.

Effect of ticagrelor monotherapy on mortality after percutaneous coronary intervention: a systematic review and meta-analysis of randomized trials including 26 143 patients

2020 ◽  
Author(s):  
Sung-Jin Hong ◽  
Chul-Min Ahn ◽  
Jung-Sun Kim ◽  
Byeong-Keuk Kim ◽  
Young-Guk Ko ◽  
...  
Keyword(s):  
Conventional Therapy ◽  
Randomized Trials ◽  
Therapy Group ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Short Term ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Conventional Therapy Group ◽  
Type 3

Abstract Aims Optimal timing and strategy of antiplatelet monotherapy after dual-antiplatelet therapy (DAPT) consisting of aspirin and P2Y12 inhibitor for patients who underwent percutaneous coronary intervention (PCI) is still being debated. The aim of this study was to evaluate the effect of ticagrelor monotherapy after short-term DAPT after PCI on mortality. Methods and results A systematic review and meta-analysis was performed using PubMed to search for ticagrelor monotherapy after short-term DAPT comparing conventional DAPT in patients who underwent PCI. Three randomized trials encompassing 26 143 patients [ticagrelor monotherapy after 1–3 months of DAPT (n = 13 062) vs. conventional therapy (n = 13 081)] were included. The efficacy endpoint of all-cause mortality was significantly lower with the ticagrelor monotherapy group vs. the conventional therapy group [risk ratio (RR) = 0.80, 95% confidence interval (CI) 0.65–0.98; P = 0.03; I2 = 0%; number needed to treat for benefit (NNTB) = 320]. The safety endpoint of Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding was also significantly lower with the ticagrelor monotherapy group vs. the conventional therapy group (RR = 0.67, 95% CI 0.49–0.92; P = 0.01; I2 = 65%; NNTB = 156). There were no significant differences in ischaemic stroke, acute myocardial infarction, and stent thrombosis. The favourable effects of the ticagrelor monotherapy vs. the conventional therapy on all-cause mortality and BARC type 3 or 5 bleeding were consistent in the subset of patients presenting acute coronary syndromes (n = 15 157). Conclusion Ticagrelor monotherapy after short-term DAPT of 1–3 months was associated with decreased all-cause mortality and BARC type 3 or 5 bleeding not offset by increase of cardiac death, ischaemic stroke, acute myocardial infarction, and stent thrombosis.

scholarly journals Patient Age and Survival After Surgery for Esophageal Cancer

2020 ◽  
Vol 28 (1) ◽  
pp. 159-166 ◽  
Author(s):  
Jesper Lagergren ◽  
Matteo Bottai ◽  
Giola Santoni
Keyword(s):  
Esophageal Cancer ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Flexible Parametric Model ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Abstract Background Esophagectomy for esophageal cancer is associated with a substantial risk of life-threatening complications and a limited long-term survival. This study aimed to clarify the controversial questions of how age influences short-term and long-term survival. Methods This population-based cohort study included almost all patients who underwent curatively intended esophagectomy for esophageal cancer in Sweden in 1987–2010, with follow-up through 2016. The exposure was age, analyzed both as a continuous and categorical variable. The probability of mortality was computed using a novel flexible parametric model approach. The reported probabilities are proper measures of the risk of dying, and the related odds ratios (OR) are therefore more suitable measures of association than hazard ratios. The outcomes were 90-day all-cause mortality, 5-year all-cause mortality, and 5-year disease-specific mortality. A novel flexible parametric model was used to derive the instantaneous probability of dying and the related OR along with 95% confidence intervals (CIs), adjusted for sex, education, comorbidity, tumor histology, pathological tumor stage, and resection margin status. Results Among 1737 included patients, the median age was 65.6 years. When analyzed as a continuous variable, older age was associated with slightly higher odds of 90-day all-cause mortality (OR 1.05, 95% CI 1.02–1.07), 5-year all-cause mortality (OR 1.02, 95% CI 1.01–1.03), and 5-year disease-specific mortality (OR 1.01, 95% CI 1.01–1.02). Compared with patients aged < 70 years, those aged 70–74 years had no increased risk of any mortality outcome, while patients aged ≥ 75 years had higher odds of 90-day mortality (OR 2.85, 95% CI 1.68–4.84), 5-year all-cause mortality (OR 1.56, 95% CI 1.27–1.92), and 5-year disease-specific mortality (OR 1.38, 95% CI 1.09–1.76). Conclusions Patient age 75 years or older at esophagectomy for esophageal cancer appears to be an independent risk factor for higher short-term mortality and lower long-term survival.

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