scholarly journals Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (12) ◽  
pp. 3094-3101
Author(s):  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Sumathy Rangarajan ◽  
Hertzel C. Gerstein ◽  
Ulagamadesan Venkatesan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Mortality ◽  
Mortality Rates ◽  
Study Data ◽  
High Income

scholarly journals Cardiovascular mortality in a Western Asian country: results from the Iran Cohort Consortium

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020303 ◽  
Author(s):  
Noushin Fahimfar ◽  
Davood Khalili ◽  
Sadaf Ghajarieh Sepanlou ◽  
Reza Malekzadeh ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Risk Prediction ◽  
Cardiovascular Mortality ◽  
Rural Women ◽  
Prediction Models ◽  
Asian Country ◽  
Mortality Rates ◽  
Western Asia ◽  
Cvd Mortality

ObjectivesCardiovascular mortality in Western Asia is high and still rising. However, most data documented on risk prediction has been derived from Western countries and few population-based cohort studies have been conducted in this region. The current study aimed to present the process of pooling data and cardiovascular disease (CVD) mortality incidences for four Iranian cohorts.MethodsFrom the Iran Cohort Consortium, the Golestan Cohort Study (GCS), Tehran Lipid and Glucose Study, Isfahan Cohort Study (ICS) and the Shahroud Eye Cohort Study (ShECS) were eligible for the current study since they had appropriate data and follow-up visits. Age-standardised CVD mortality rates were estimated for ages 40–80 and 40–65 years. Cox regression was used to compare mortalities among cohorts. Adjusted marginal rates were calculated using Poisson regression.ResultsOverall, 61 291 participants (34 880 women) aged 40–80 years, free of CVD at baseline, were included. During 504 606 person-years of follow-up, 1981 CVD deaths (885 women) occurred. Age-standardised/sex-standardised premature CVD mortality rates were estimated from 133 per 100 000 person-years (95% CI 81 to 184) in ShECS to 366 (95% CI 342 to 389) in the GCS. Compared with urban women, rural women had higher CVD mortality in the GCS but not in the ICS. The GCS population had a higher risk of CVD mortality, compared with the others, adjusted for conventional CVD risk factors.ConclusionsThe incidence of CVD mortality is high with some differences between urban and rural cohorts in Iran as a Western Asian country. Pooling data facilitates the opportunity to globally evaluate risk prediction models.

scholarly journals Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study

2020 ◽  
Author(s):  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Sumathy Rangarajan ◽  
Hertzel C Gerstein ◽  
Ulagamadesan Venkatesan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Wealth Index ◽  
Mortality Rates ◽  
Study Data ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Urban Rural ◽  
Design And Methods

<b>Objectives: </b>We aimed to compare cardiovascular (CV) events, all-cause and CV mortality rates, among adults with and without diabetes in countries with differing levels of income. <p><b>Research design and methods:<a></a><a> </a></b>Prospective Urban Rural Epidemiological (PURE) enrolled 143,567 adults aged 35 to 70 years from 4 high income countries (HIC), 12 middle income countries (MIC) and 5 low income countries (LIC). The mean follow-up was 9.0±3.0 years. </p> <p><b>Results:</b> Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1000 person years, p<0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1000 person years, p<0.001) and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1000 person years, p<0.001) were considerably higher in LIC compared to MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioural risk factors and treatments [Hazards ratio (95% Confidence Interval): 1.89 (1.58 – 2.27) to 1.78 (1.36 – 2.34)].</p> <p><b>Conclusions: </b>CVD rates, all-cause and CV mortality were markedly higher among those with diabetes in LIC compared to MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society. </p>

scholarly journals Contrasting associations between diabetes and cardiovascular mortality rates in low, middle and high-income countries – Cohort study data from 143,567 individuals in 21 countries – The PURE study

2020 ◽  
Author(s):  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Sumathy Rangarajan ◽  
Hertzel C Gerstein ◽  
Ulagamadesan Venkatesan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Wealth Index ◽  
Mortality Rates ◽  
Study Data ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Urban Rural ◽  
Design And Methods

<b>Objectives: </b>We aimed to compare cardiovascular (CV) events, all-cause and CV mortality rates, among adults with and without diabetes in countries with differing levels of income. <p><b>Research design and methods:<a></a><a> </a></b>Prospective Urban Rural Epidemiological (PURE) enrolled 143,567 adults aged 35 to 70 years from 4 high income countries (HIC), 12 middle income countries (MIC) and 5 low income countries (LIC). The mean follow-up was 9.0±3.0 years. </p> <p><b>Results:</b> Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1000 person years, p<0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1000 person years, p<0.001) and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1000 person years, p<0.001) were considerably higher in LIC compared to MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioural risk factors and treatments [Hazards ratio (95% Confidence Interval): 1.89 (1.58 – 2.27) to 1.78 (1.36 – 2.34)].</p> <p><b>Conclusions: </b>CVD rates, all-cause and CV mortality were markedly higher among those with diabetes in LIC compared to MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society. </p>

scholarly journals Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study

2020 ◽  
Author(s):  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Sumathy Rangarajan ◽  
Hertzel C Gerstein ◽  
Ulagamadesan Venkatesan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Wealth Index ◽  
Mortality Rates ◽  
Study Data ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Urban Rural ◽  
Design And Methods

<b>Objectives: </b>We aimed to compare cardiovascular (CV) events, all-cause and CV mortality rates, among adults with and without diabetes in countries with differing levels of income. <p><b>Research design and methods:<a></a><a> </a></b>Prospective Urban Rural Epidemiological (PURE) enrolled 143,567 adults aged 35 to 70 years from 4 high income countries (HIC), 12 middle income countries (MIC) and 5 low income countries (LIC). The mean follow-up was 9.0±3.0 years. </p> <p><b>Results:</b> Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1000 person years, p<0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1000 person years, p<0.001) and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1000 person years, p<0.001) were considerably higher in LIC compared to MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioural risk factors and treatments [Hazards ratio (95% Confidence Interval): 1.89 (1.58 – 2.27) to 1.78 (1.36 – 2.34)].</p> <p><b>Conclusions: </b>CVD rates, all-cause and CV mortality were markedly higher among those with diabetes in LIC compared to MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society. </p>

1603-P: Changes in Age- and Gender-Specific All-Cause Mortality Rates and Ratios in People with T2DM in Hungary between 2001-2016: A Nationwide Cohort Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1603-P
Author(s):  
GYORGY JERMENDY ◽  
ZOLTAN KISS ◽  
GYÖRGY ROKSZIN ◽  
IBOLYA FÁBIÁN ◽  
ISTVAN WITTMANN ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rates ◽  
Age And Gender ◽  
All Cause Mortality ◽  
And Gender ◽  
Gender Specific

scholarly journals Attributable mortality of vancomycin resistance in ampicillin-resistant Enterococcus faecium bacteremia in Denmark and the Netherlands: A matched cohort study

2021 ◽  
pp. 1-9
Author(s):  
Wouter C. Rottier ◽  
Mette Pinholt ◽  
Akke K. van der Bij ◽  
Magnus Arpi ◽  
Sybrandus N. Blank ◽  
...  
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Antibiotic Therapy ◽  
Enterococcus Faecium ◽  
Mortality Rates ◽  
Vancomycin Resistance ◽  
Attributable Mortality ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
The Impact

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

scholarly journals Arterial stiffness and progression of cerebral white matter hyperintensities in patients with type 2 diabetes and matched controls: a 5-year cohort study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Kristian L. Funck ◽  
Esben Laugesen ◽  
Pernille Høyem ◽  
Brian Stausbøl-Grøn ◽  
Won Y. Kim ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
White Matter ◽  
Arterial Stiffness ◽  
White Matter Hyperintensities ◽  
Cerebrovascular Diseases ◽  
Study Data ◽  
Cerebral White Matter ◽  
Intracranial Volume

Abstract Background Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. Methods In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59  ±  10 years and patients had a median (range) diabetes duration of 1.8 (0.8–3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). Results Patients with T2DM had a higher PWV than controls (8.8  ±  2.2 vs. 7.9  ±  1.4 m/s, p  <  0.01). WMH progression were similar in the two groups (p  =  0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1–32%], p  <  0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p  <  0.05). We found no interaction between diabetes and PWV on cWMH progression. Conclusions PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.

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