scholarly journals Factors affecting time until myocardial infarction in hypertension patients using truncated Cox regression

2019 ◽  
Vol 21 (4) ◽  
pp. 169-174
Author(s):  
Abolfazl Hosseinnataj ◽  
Jamshid Yazdani-Charati ◽  
Hossein Mohsenipouya ◽  
Ali Ghaemian ◽  
Roja Nikaein ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Regression ◽  
The Body ◽  
Survival Times ◽  
Statistical Population ◽  
Factors Affecting ◽  
Akaike Criterion ◽  
Cox's Model ◽  
And Control ◽  
First Time

Background and aims: Hypertension is one of the most common and important risk factors of cardiovascular diseases. This phenomenon, if not cured, causes lots of problems in vital organs of the body like kidneys, brain, eyes, and heart. The aim of the current study was to identify factors which affect the time until myocardial infarction (MI) in hypertension patients using truncated Cox regression. Methods: This study was a population retrospective cohort and its statistical population included patients with hypertension symptoms, who had MI for the first time in Sari. A decision was made based on continuing the study as a nested case and control study because the number of MI incidents was low (7%) in the studied sample. In addition, the Cox’s model and truncated Cox were used for determining the factors affecting the patients’ survival. Results: The median and mean survival times in this sample were equal to 57 and 66.44 months, respectively. Considering time truncation, family history (HR=1.70) and the age at diagnosis (HR=0.99) were statistically significant in the Cox’s model (P< 0.05). Conclusion: Overall, using the Akaike criterion for comparing the survival time without the effect of truncation, the Cox’s model demonstrated better fitness by controlling the truncation effect. These results show the importance of controlling the truncation in those diseases in which it is impossible to distinguish the time of the appearance from the symptoms.

scholarly journals Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Joachim Denner ◽  
Matthias Längin ◽  
Bruno Reichart ◽  
Luise Krüger ◽  
Uwe Fiebig ◽  
...  
Keyword(s):  
Immunosuppressive Regimen ◽  
Complete Loss ◽  
Orthotopic Heart Transplantation ◽  
Survival Times ◽  
Post Transplantation ◽  
Porcine Cytomegalovirus ◽  
And Control ◽  
First Time ◽  
Pai 1

Abstract Xenotransplantation using pig organs has achieved survival times up to 195 days in pig orthotopic heart transplantation into baboons. Here we demonstrate that in addition to an improved immunosuppressive regimen, non-ischaemic preservation with continuous perfusion and control of post-transplantation growth of the transplant, prevention of transmission of the porcine cytomegalovirus (PCMV) plays an important role in achieving long survival times. For the first time we demonstrate that PCMV transmission in orthotopic pig heart xenotransplantation was associated with a reduced survival time of the transplant and increased levels of IL-6 and TNFα were found in the transplanted baboon. Furthermore, high levels of tPA-PAI-1 complexes were found, suggesting a complete loss of the pro-fibrinolytic properties of the endothelial cells. These data show that PCMV has an important impact on transplant survival and call for elimination of PCMV from donor pigs.

Beta-blocker use and acute exacerbations of COPD following myocardial infarction: a Danish nationwide cohort study

Thorax ◽  
2020 ◽  
Vol 75 (11) ◽  
pp. 928-933
Author(s):  
Daniel B Rasmussen ◽  
Uffe Bodtger ◽  
Morten Lamberts ◽  
Christian Torp-Pedersen ◽  
Gunnar Gislason ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Beta Blocker ◽  
Cox Regression ◽  
Beta Blockers ◽  
Severe Disease ◽  
Symptom Burden ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Acute Exacerbations ◽  
First Time

IntroductionPatients with chronic obstructive pulmonary disease (COPD) are undertreated with beta-blockers following myocardial infarction (MI), possibly due to fear for acute exacerbations of COPD (AECOPD). Is beta-blocker use associated with increased risk of AECOPD in patients following first-time MI?MethodsDanish nationwide study of patients with COPD following hospitalisation for MI from 2003 to 2015. Multivariable, time-dependent Cox regression accounting for varying beta-blocker use based on claimed prescriptions during up to 13 years of follow-up.ResultsA total of 10 884 patients with COPD were discharged after first-time MI. The 1-year rate of AECOPD was 35%, and 65% used beta-blockers at 1 year. Beta-blocker use was associated with a lower risk of AECOPD (multivariable-adjusted HR 0.78, 95% CI 0.74–0.83). This association was independent of the type of MI (HR 0.70, 95% CI 0.59–0.83 in ST-elevation MI (STEMI) and HR 0.80, 95% CI 0.75–0.84 in non-STEMI), presence or absence of heart failure (HR 0.82, 95% CI 0.74–0.90 and HR 0.77, 95% CI 0.72–0.82, respectively), beta-blocker dosage and type, as well as exacerbation severity. Results were similar in 1118 patients with full data on COPD severity and symptom burden (median forced expiratory volume in 1 s as percentage of predicted was 46 and majority had moderate dyspnoea), and in 1358 patients with severe COPD and frequent AECOPD with a high 1-year rate of AECOPD of 70%.DiscussionBeta-blocker use was not associated with increased risk of AECOPD following MI. This finding was independent of COPD severity, symptom burden and exacerbation history, and supports the safety of beta-blockers in patients with COPD, including high-risk patients with severe disease.

scholarly journals MicroRNA-146a Serves as a Biomarker for Adverse Prognosis of ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Shengjue Xiao ◽  
Tongneng Xue ◽  
Qinyuan Pan ◽  
Yue Hu ◽  
Qi Wu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Regression ◽  
Control Groups ◽  
Hub Genes ◽  
Cox Regression Analysis ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Low Levels ◽  
And Control

Objective. This study is aimed at exploring the underlying molecular mechanisms of ST-segment elevation myocardial infarction (STEMI) and provides potential clinical prognostic biomarkers for STEMI. Methods. The GSE60993 dataset was downloaded from the GEO database, and the differentially expressed genes (DEGs) between STEMI and control groups were screened. Enrichment analysis of the DEGs was subsequently performed using the DAVID database. A protein–protein interaction network was constructed, and hub genes were identified. The hub genes in patients were then validated by quantitative reverse transcription-PCR. Furthermore, hub gene-miRNA interactions were evaluated using the miRTarBase database. Finally, patient data on classical cardiovascular risk factors were collected, and plasma microRNA-146a (miR-146a) levels were detected. An individualized nomogram was constructed based on multivariate Cox regression analysis. Results. A total of 239 DEGs were identified between the STEMI and control groups. Expression of S100A12 and miR-146a was significantly upregulated in STEMI samples compared with controls. STEMI patients with high levels of miR-146a had a higher risk of major adverse cardiovascular events (MACEs) than those with low levels of miR-146a (log-rank P = 0.034 ). Multivariate Cox regression analysis identified five statistically significant variables, including age, hypertension, diabetes mellitus, white blood cells, and miR-146a. A nomogram was constructed to estimate the likelihood of a MACE at one, two, and three years after STEMI. Conclusion. The incidence of MACEs in STEMI patients expressing high levels of miR-146a was significantly greater than in those expressing low levels. MicroRNA-146a can serve as a biomarker for adverse prognosis of STEMI and might function in its pathogenesis by targeting S100A12, which may exert its role via an inflammatory response. In addition, our study presents a valid and practical model to assess the probability of MACEs within three years of STEMI.

Abstract 13029: Sonothrombolysis Improves Left Atrial Pressure and Volume in Patients With ST Elevation Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hsu Po Chiang ◽  
Miguel Aguiar ◽  
Bruno Tavares ◽  
Wilson Mathias ◽  
Bruno C Borges ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Atrial ◽  
Therapy Group ◽  
Left Ventricular ◽  
The Body ◽  
Control Group ◽  
Mechanical Index ◽  
Control Groups ◽  
St Elevation ◽  
And Control

Introduction: Preclinical studies in ST elevation myocardial infarction (STEMI) indicate that high mechanical index impulses guided with transthoracic diagnostic ultrasound associated with intravenously administered microbubbles results in the dissolution of the thrombus (sonothrombolysis), improving coronary microcirculation and epicardial coronary recanalization rate. Hypothesis: Left atrial (LA) echocardiographic parameters are compromised in STEMI and can be accurately measured by two-dimensional echocardiography. To study the effect of sonotrombolysis on the LA pressure and volume we propose our study. Methods: A total of 100 patients were randomized, 50 for the control group and 50 for the therapy group. Echocardiographic analysis of LA pressure and volume were performed immediately before and after percutaneous coronary intervention (PCI), 72 hours, 1 month and 6 months of follow-up. LA pressure was classified in normal or elevated, depending on the grade of left ventricular diastolic disfunction (DD): normal diastolic function and DD grade 1 have normal LA pressure, and DD grades 2 and 3 have elevated LA pressure, according to the American and European guideline. LA volume was evaluated by Simpson method and indexed to the body surface area. Results: The LA pressure and volume had lower values in the therapy group after 6 months of PCI. The comparison of LA pressure between the therapy and control groups respectively was: before PCI (72% vs. 70% normal; 28% vs. 30% elevated; p=0.826), after PCI (68% vs. 65% normal; 32% vs. 35% elevated; p=0.777), 72 hours (75% vs. 62% normal; 25% vs. 38% elevated; p=0.147), 1 month (68% vs. 52% normal; 32% vs. 48% elevated; p=0.123) and 6 months (84% vs. 64% normal; 16% vs. 36% elevated; p=0.035). The comparison of LA volumes between the therapy and control groups respectively was: before PCI (19.0±6.2 vs. 22.4±9.8 ml/m 2 ; p=0.061), after PCI (22.8±7.9 vs. 24.4±12.1 ml/m 2 ; p=0.469), 72 hours (25.9±8.5 vs. 26.4±12.7 ml/m 2 ; p=0.815), 1 month (27.2±8.3 vs. 29.1±13.1 ml/m 2 ; p=0.410) and 6 months (26.7±7.5 vs. 33.1±14.9 ml/m 2 ; p=0.013). Conclusions: The use of sonothrombolysis as adjuvant therapy in STEMI patients results in better values of LA pressure and volume, demonstrating the benefit of using this new therapy.

scholarly journals Impact of pre-admission depression on mortality following myocardial infarction

2017 ◽  
Vol 210 (5) ◽  
pp. 356-361 ◽  
Author(s):  
Jens Sundbøll ◽  
Morten Schmidt ◽  
Kasper Adelborg ◽  
Lars Pedersen ◽  
Hans Erik Bøtker ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Regression ◽  
Population Based ◽  
Prognostic Impact ◽  
Depression Diagnosis ◽  
All Cause Mortality ◽  
History Of ◽  
Rate Ratios ◽  
First Time ◽  
History Of Depression

BackgroundThe prognostic impact of previous depression on myocardial infarction survival remains poorly understood.AimsTo examine the association between depression and all-cause mortality following myocardial infarction.MethodUsing Danish medical registries, we conducted a nationwide population-based cohort study. We included all patients with first-time myocardial infarction (1995–2014) and identified previous depression as either a depression diagnosis or use of antidepressants. We used Cox regression to compute adjusted mortality rate ratios (aMRRs) with 95% confidence intervals.ResultsWe identified 170 771 patients with first-time myocardial infarction. Patients with myocardial infarction and a previous depression diagnosis had higher 19-year mortality risks (87% v. 78%). The overall aMRR was 1.11 (95% CI 1.07–1.15) increasing to 1.22 (95% CI 1.17–1.27) when including use of antidepressants in the depression definition.ConclusionsA history of depression was associated with a moderately increased all-cause mortality following myocardial infarction.

scholarly journals Oral tolerance as antigen-specific immunotherapy

2021 ◽  
Author(s):  
Natália Pinheiro-Rosa ◽  
Lícia Torres ◽  
Mariana de Almeida Oliveira ◽  
Marcos Felipe Andrade de Oliveira ◽  
Mauro Andrade de Freitas Guimaraes ◽  
...  
Keyword(s):  
Oral Tolerance ◽  
Inflammatory Diseases ◽  
Tolerance Induction ◽  
Allergic Diseases ◽  
Oral Route ◽  
Oral Immunotherapy ◽  
The Body ◽  
Factors Affecting ◽  
Oral Tolerance Induction ◽  
And Control

Abstract Oral tolerance is a physiological phenomenon described more than a century ago as a suppressive immune response to antigens that gain access to the body by the oral route. It is a robust and long-lasting event with local and systemic effects in which the generation of mucosally-induced regulatory T cells (iTreg) play an essential role. The idea of using oral tolerance to inhibit autoimmune and allergic diseases by oral administration of target antigens was an important development that was successfully tested in 1980’s. Since then, several studies have shown that feeding specific antigens can be used to prevent and control chronic inflammatory diseases in both animal models and clinically. Therefore, oral tolerance can be classified as an antigen-specific form of oral immunotherapy (OIT). In the light of novel findings on mechanisms, sites of induction and factors affecting oral tolerance, this review will focus on specific characteristics of oral tolerance induction and how they impact in its therapeutic application.

scholarly journals Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival

2020 ◽  
Author(s):  
Joachim Denner ◽  
Matthias Längin ◽  
Bruno Reichart ◽  
Luise Krüger ◽  
Uwe Fiebig ◽  
...  
Keyword(s):  
Immunosuppressive Regimen ◽  
Complete Loss ◽  
Orthotopic Heart Transplantation ◽  
Survival Times ◽  
Post Transplantation ◽  
Porcine Cytomegalovirus ◽  
And Control ◽  
First Time ◽  
Pai 1

Xenotransplantation using pig organs has achieved survival times of more than 195 days in pig orthotopic heart transplantation into baboons. Here we demonstrate that in addition to an improved immunosuppressive regimen, non-ischaemic preservation with continuous perfusion and control of post-transplantation growth of the transplant, prevention of transmission of the porcine cytomegalovirus (PCMV) plays an important role in achieving long survival times. For the first time we demonstrate that PCMV transmission in orthotopic pig heart xenotransplantation was associated with a reduced survival time of the transplant and increased levels of IL-6 and TNFα were found in the transplanted baboon. Furthermore, high levels of tPA-PAI-1 complexes were found, suggesting a complete loss of the pro-fibrinolytic properties of the endothelial cells. These data show that PCMV has an important impact on transplant survival and call for elimination of PCMV from donor pigs.

scholarly journals Triglyceride-Glucose Index Associated With the Risk of Cardiovascular Disease: the Kailuan Study

2021 ◽  
Author(s):  
Qian LIU ◽  
Haozhe CUI ◽  
Yihan MA ◽  
Xu HAN ◽  
Zhiwei CAO ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Tyg Index ◽  
Hazard Ratios ◽  
Triglyceride Glucose Index ◽  
Cox Proportional Hazard Regression ◽  
And Control

Abstract Purpose: Triglyceride-glucose index (TyG) index, as a marker of insulin resistance, have been associated with risk of cardiovascular disease (CVD) in older adults. Nevertheless, it is unclear to whether TyG index affects risk of CVD and the subtypes of CVD in general Chinese population. Methods: A total of 96541 participants who met the criteria were included from the Kailuan Study. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The study participants were divided into 4 groups (Q1, Q2, Q3 and Q4) by quartiles of the TyG index. Incident of CVD events (myocardial infarction and stroke) during 2006-2017 were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association TyG index with the risk of CVD and the subtypes of CVD by calculating the hazard ratios (HR) and 95% confidence interval (CI).Results: During a median 10.33 years of follow-up, we documented 6421 CVD events including 1493 myocardial infarction events and 5083 stroke events. Multivariate Cox regression analysis showed that compared with the participants in Q1 group, HR (95% CI) for CVD events were for Q2 group 1.12 (95%, 1.03-1.21), Q3 groups 1.28 (95%, 1.18-1.38), and Q4 groups 1.34 (95%, 1.23-1.45). We conducted time-dependent TyG index found compared with Q1 group, HR (95% CI) for CVD events were for Q2 group 1.09(95%, 1.02-1.18), Q3 groups 1.17(95%, 1.09-1.27), and Q4 groups 1.20 (95%, 1.11-1.30). We found similar results in myocardial infarction and stroke.Conclusions: The TyG index is an independent risk factor for CVD. The TyG index may be useful identifying individuals at high risk of developing CVD at an early stage, it can contribution to prevent and control of CVD.

Research on the Construction of Three Levels of Customization Model Based on Human Engineering

2010 ◽  
Vol 37-38 ◽  
pp. 1088-1091
Author(s):  
Wei Jin An ◽  
Wen Ming Yang
Keyword(s):  
The Body ◽  
Individual Factors ◽  
Human Engineering ◽  
Characteristic Parameters ◽  
Factors Affecting ◽  
Model Based ◽  
Design Case ◽  
Increasing Demand ◽  
And Control ◽  
Mathematical Relationships

In order to satisfy increasing demand for personalized products, through analysis characteristic parameters of individual factors such as the various parts of the body size, body weight, body surface area, factors affecting the performance of the machine and their mathematical relationships, three levels of customization model based on human engineering by using mechanics and control theory was established to help designers to design personalized products, best meet customer's all aspects of demand. Finally, three levels of customization model was applied to Man-machine system (human-bicycle system for the design case) to show application of the model.

scholarly journals One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks

2021 ◽  
Author(s):  
Alireza Amirzadegan ◽  
Seyed-Ali Sadre-Bafghi ◽  
Saeed Ghodsi ◽  
Hamidreza Soleimani ◽  
Mehrnaz Mohebi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Cox Regression ◽  
Coronary Intervention ◽  
The Body ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Artery Ectasia ◽  
Timi Flow ◽  
Percutaneous Coronary

Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty. Methods: We conducted a retrospective cohort study on 385 patients, including 87 subjects with CAE, who underwent percutaneous coronary intervention (PCI). Major adverse cardiovascular events (MACE) were considered to consist of mortality, nonfatal myocardial infarction (MI), repeated revascularization, and stroke. Results: The mean age of the participants was 57.31±6.70 years. Multivariate regression analysis revealed that patients with diabetes, ST-segment–elevation MI at presentation, and high thrombus grades were more likely to have suboptimal postPCI thrombolysis in myocardial infarction (TIMI) flow. However, CAE was not a predictor of a decreased TIMI flow (OR: 1.46, 95% CI: 0.78–8.32; P=0.391). The Cox-regression model showed that CAE, the body mass index, and a family history of MI were risk factors for MACE, while short lesion lengths (<20 vs >20 mm) had an inverse relationship. The adjusted hazard ratio (HR) for the prediction of MACE in the presence of CAE was 1.65 (95% CI: 1.08–4.78; P=0.391). All-cause mortality (HR: 1.69, 95% CI: 0.12–3.81; P=0.830) and nonfatal MI (HR: 1.03, 95% CI: 0.72–4.21; P=0.341) occurred similarly in the CAE and non-CAE groups. Conversely, CAE increased urgent repeat revascularization (HR: 2.40; 95% CI: 1.13–5.86; P=0.013) Conclusion: Although CAE had no substantial short-term prognostic effects on post-PCI TIMI flow, considerable concerns regarding adverse outcomes emerged during our extended follow-up. Stringent follow-ups of these patients should be underscored due to the high likelihood of urgent revascularization.

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