5 results
Search Results
2. Diabetes and male sex are key risk factor correlates of the extent of coronary artery calcification: A Euro-CCAD study.
- Author
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Nicoll, Rachel, Zhao, Ying, Wiklund, Urban, Diederichsen, Axel, Mickley, Hans, Ovrehus, Kristian, Zamorano, Jose, Gueret, Pascal, Schmermund, Axel, Maffei, Erica, Cademartiri, Filippo, Budoff, Matt, and Henein, Michael
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CORONARY heart disease complications , *AGE distribution , *COMPARATIVE studies , *CORONARY disease , *DIABETIC angiopathies , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *SEX distribution , *EVALUATION research , *SPECIALTY hospitals , *ACQUISITION of data , *DISEASE prevalence , *CROSS-sectional method , *RETROSPECTIVE studies , *SEVERITY of illness index , *CALCINOSIS , *DISEASE complications - Abstract
Background and Aims: Although much has been written about the conventional cardiovascular risk factor correlates of the extent of coronary artery calcification (CAC), few studies have been carried out on symptomatic patients. This paper assesses the potential ability of risk factors to associate with an increasing CAC score.Methods: From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and the USA. All had conventional cardiovascular risk factor assessment and CT scanning for CAC scoring.Results: Among all patients, male sex (OR = 4.85, p<0.001) and diabetes (OR = 2.36, p<0.001) were the most important risk factors of CAC extent, with age, hypertension, dyslipidemia and smoking also showing a relationship. Among patients with CAC, age, diabetes, hypertension and dyslipidemia were associated with an increasing CAC score in males and females, with diabetes being the strongest dichotomous risk factor (p<0.001 for both). These results were echoed in quantile regression, where diabetes was consistently the most important correlate with CAC extent in every quantile in both males and females. To a lesser extent, hypertension and dyslipidemia were also associated in the high CAC quantiles and the low CAC quantiles respectively.Conclusion: In addition to age and male sex in the total population, diabetes is the most important correlate of CAC extent in both sexes. [ABSTRACT FROM AUTHOR]- Published
- 2017
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3. Results From the VISIBILITY Iliac Study: Primary and Cohort Outcomes at 9 Months.
- Author
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Rundback, John H., Peeters, Patrick, George, Jon C., Jaff, Michael R., and Faries, Peter L.
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PERIPHERAL vascular disease treatment ,AMPUTATION ,COMPARATIVE studies ,ILIAC artery ,LIMB salvage ,LONGITUDINAL method ,VASCULAR resistance ,RESEARCH methodology ,MEDICAL cooperation ,PERIPHERAL vascular diseases ,PROGNOSIS ,RESEARCH ,SURGICAL stents ,TIME ,TRANSLUMINAL angioplasty ,EVALUATION research ,STENOSIS ,TREATMENT effectiveness ,SEVERITY of illness index ,ANKLE brachial index ,KAPLAN-Meier estimator ,EQUIPMENT & supplies - Abstract
Purpose: To evaluate the safety and effectiveness of primary stenting of the common (CIA) or external iliac artery (EIA) using the Visi-Pro Balloon-Expandable Peripheral Stent System for treatment of stenotic, restenotic, or occluded lesions.Methods: Between 2011 and 2012, 75 patients (mean age 64.2±8.9 years; 46 men) with Rutherford category 2-4 ischemia and atherosclerotic lesions ≤10 cm in length underwent iliac artery stenting at 17 centers in the United States and Europe. The primary outcome of the study was the major adverse event (MAE) rate at 9 months postprocedure [composite of periprocedural death, in-hospital myocardial infarction, clinically driven target lesion revascularization (CD-TLR), and amputation of the treated limb]. Secondary outcomes included 30-day MAE rate, 9-month primary patency, changes in ankle-brachial index (ABI) and the Walking Impairment Questionnaire at 30 days and 9 months postprocedure, device success, and clinically driven target vessel revascularization (CD-TVR) at 30 days and 9 months. Outcomes in specific patient cohorts (ie, gender, stent location, calcification severity, and lesion grade) were analyzed.Results: Eighty-one stents were implanted in 61 CIA and 15 EIA lesions (41 with moderate/severe calcification). The mean lesion treated length was 29.3±13.9 mm. All devices were successfully deployed. MAE occurred in 3 (4.0%) of 75 subjects at 9 months. Primary patency and freedom from CD-TVR at 9 months were both 95.8%. ABI improved from 0.67±0.14 at baseline to 0.94±0.14 and 0.96±0.16 at 30 days and 9-month follow-up, respectively (p<0.001 for both). There were no differences with respect to any of the analyzed patient characteristics, including gender.Conclusion: Nine-month results of the VISIBILITY Iliac stent study ( ClinicalTrials.gov identifier NCT01402700) demonstrated safety and effectiveness for the treatment of atherosclerotic CIA and EIA lesions with the Visi-Pro stent across all treated cohorts. [ABSTRACT FROM AUTHOR]- Published
- 2017
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4. Cross-cultural validation of Lupus Impact Tracker in five European clinical practice settings.
- Author
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Schneider, Matthias, Mosca, Marta, Pego-Reigosa, José-Maria, Gunnarsson, Iva, Maurel, Frédérique, Garofano, Anna, Perna, Alessandra, Porcasi, Rolando, and Devilliers, Hervé
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QUALITY of life ,STATISTICAL correlation ,HEALTH surveys ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,SCIENTIFIC observation ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH ,RESEARCH evaluation ,SELF-evaluation ,SYSTEMIC lupus erythematosus ,ACTIVITIES of daily living ,CROSS-sectional method ,SEVERITY of illness index ,RESEARCH methodology evaluation ,PATIENTS' attitudes ,PHYSICIANS' attitudes ,FUNCTIONAL assessment ,DESCRIPTIVE statistics ,DIFFERENTIAL item functioning (Research bias) - Abstract
Objectives. The aim was to evaluate the cross-cultural validity of the Lupus Impact Tracker (LIT) in five European countries and to assess its acceptability and feasibility from the patient and physician perspectives. Methods. A prospective, observational, cross-sectional and multicentre validation study was conducted in clinical settings. Before the visit, patients completed LIT, Short Form 36 (SF-36) and care satisfaction questionnaires. During the visit, physicians assessed disease activity [Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI], organ damage [SLICC/ACR damage index (SDI)] and flare occurrence. Cross-cultural validity was assessed using the Differential Item Functioning method. Results. Five hundred and sixty-nine SLE patients were included by 25 specialists; 91.7% were outpatients and 89.9% female, with mean age 43.5(13.0) years. Disease profile was as follows: 18.3% experienced flares; mean SELENA-SLEDAI score 3.4 (4.5); mean SDI score 0.8 (1.4); and SF-36 mean physical and mental component summary scores: physical component summary 42.8(10.8) and mental component summary 43.0(12.3). Mean LIT score was 34.2(22.3) (median: 32.5), indicating that lupus moderately impacted patients' daily life. A cultural Differential Item Functioning of negligible magnitude was detected across countries (pseudo-R2 difference of 0.01-0.04). Differences were observed between LIT scores and Physician Global Assessment, SELENA-SLEDAI, SDI scores = 0 (P < 0.035) and absence of flares (P = 0.004). The LIT showed a strong association with SF-36 physical and social role functioning, vitality, bodily pain and mental health (P < 0.001). The LIT was well accepted by patients and physicians. It was reliable, with Cronbach a coefficients ranging from 0.89 to 0.92 among countries. Conclusion. The LIT is validated in the five participating European countries. The results show its reliability and cultural invariability across countries. They suggest that LIT can be used in routine clinical practice to evaluate and follow patient-reported outcomes in order to improve patient-physician interaction. [ABSTRACT FROM AUTHOR]
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- 2017
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5. Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study.
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D'Agostino, Maria-Antonietta, Wakefield, Richard J., Berner-Hammer, Hilde, Vittecoq, Olivier, Filippou, Georgios, Balint, Peter, Möller, Ingrid, Iagnocco, Annamaria, Naredo, Esperanza, Østergaard, Mikkel, Boers, Maarten, Gaillez, Corine, Van Holder, Karina, Le Bars, Manuela, and OMERACT-EULAR-Ultrasound Task Force
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DOPPLER ultrasonography ,ANTIRHEUMATIC agents ,COMBINATION drug therapy ,CLINICAL trials ,COMPARATIVE studies ,JOINTS (Anatomy) ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,METHOTREXATE ,RESEARCH ,RHEUMATOID arthritis ,SYNOVITIS ,EVALUATION research ,TREATMENT effectiveness ,PREDICTIVE tests ,SEVERITY of illness index ,DISEASE complications - Abstract
Objectives: To study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX).Methods: In this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology-European League Against Rheumatism (OMERACT-EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT-EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2-5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy.Results: Eighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2-5): -0.7 (95% CIs -1.2 to -0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8.Conclusions: In this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment.Trial Registration Number: NCT00767325. [ABSTRACT FROM AUTHOR]- Published
- 2016
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