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Objectives RA patients have an increased risk for cardiovascular diseases, including atrial fibrillation (AF), but the impact of RA on ischaemic stroke risk in the context of AF remains unknown. We explored whether the risk of ischaemic stroke after diagnosis of AF is further increased among patients with RA compared with non-RA patients. Methods In the nationwide Norwegian Cardio-Rheuma Register, we evaluated cumulative incidence and hazard rate of ischaemic stroke after the first AF diagnosis (2750 individuals with RA and 158 879 without RA between 2010 and 2017) by using a competing risk model with a 3-month delayed entry. Results The 5-year unadjusted cumulative incidence of ischaemic stroke was 7.3% (95% CI: 5.9–8.7%) for patients with RA and 5.0% (95% CI: 4.9–5.2%) for patients without RA. Unadjusted univariate analyses indicated that AF patients with RA had a HR of 1.36 (95% CI: 1.13, 1.62) for ischaemic stroke compared with those without RA. Sex- and age-adjusted HR for ischaemic stroke in RA patients with AF was 1.25 (95% CI: 1.05, 1.50), and the effect size remained unchanged after adjustment for diabetes, hypertension, atherosclerotic cardiovascular disease and oral anticoagulant (OAC) treatment. RA patients were less likely to receive OAC treatment than non-RA patients (adjusted odds ratio 0.88, 95% CI: 0.80, 0.97). Conclusion RA patients diagnosed with AF are at a further increased risk for stroke compared with non-RA patients with AF, and less likely to receive OAC treatment, emphasizing the need to improve stroke prevention in AF patients with RA. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to evaluate the impact of hepatitis C virus (HCV) infection and treatment status on coronavirus disease 2019 (COVID-19)–related hospitalizations in Georgia. Methods We analyzed 2020–2021 Georgian health registry data for COVID-19–positive individuals and categorized the data by HCV infection and treatment status. Logistic regression was used to assess the strengths of the associations. Results Treated individuals with HCV had lower odds of COVID-19–related hospitalization compared to anti-HCV-negative individuals, while untreated HCV-viremic and anti-HCV-positive nonviremic individuals had higher odds. Conclusions HCV treatment prior to COVID-19 infection was associated with lower odds of COVID-19–related hospitalization, highlighting the benefits of HCV management in the context of the pandemic. [ABSTRACT FROM AUTHOR]

Introduction Sodium polystyrene sulphonate (SPS) and calcium polystyrene sulphonate (CPS) are commonly used cation-exchange resins for the treatment and control of hyperkalaemia. However, their use (particularly SPS) has been limited by reports of adverse gastrointestinal (GI) events. The safety of these compounds in patients undergoing dialysis requires larger investigation. Aims To study the occurrence of adverse GI events (occlusion, perforation, thrombosis/ischaemia) in the periods of SPS or CPS exposition versus the periods without exposition in dialysis patients. Methods Dialysis patients were extracted from the French National Registry and merged with the French hospital discharge database (between 2006 and 2017). For our primary analysis, we used patients who had any claim of SPS use (n  = 43 771). Time-varying Cox models, negative binomial regression and pre- versus post-treatment average treatment effects. Results The mean age was 66 ± 15 years, 37% were female and 92% were undergoing haemodialysis. Over a 1-year follow-up, patients on periods with SPS (on-SPS) did not present an increased risk of adverse GI events versus the periods without SPS (off-SPS):  incidence rate (IR) (per 1000 person years) = 7.4 (6.4–8.7) versus 9.5 (8.1–11.0); adjusted hazard ratio (HR) (95% CI) = 0.81 (0.60–1.09), P = 0.17. Patients exposed to SPS did not experience a higher rate of adverse GI events in the year after SPS initiation versus the year before SPS initiation; P-value for parallel trend = 0.87. Patients on-CPS also did not show an increased risk of adverse GI events versus off-CPS: IR (per 1000 py) = 8.6 (5.1–11.9) versus 7.8 (5.1–11.9); adjusted HR (95% CI) = 0.76 (0.31–1.80), P = 0.52. The rates of adverse GI events in the periods on and off exposure were also similar over a follow-up of 5 years. Conclusion Our large, nationwide study shows that the incidence of adverse GI events in patients undergoing dialysis was low and that neither the use of SPS nor CPS was associated with increased GI events risk. [ABSTRACT FROM AUTHOR]

Background: Physical activity is important to reduce mortality, morbidity and risk factors in patients with coronary heart disease. This report evaluates to what extent patients are still physically active following an exercise-based cardiac rehabilitation programme 12–14 months post-myocardial infarction and factors predicting why not. Methods: Data from the National Quality Registry Swedeheart with post-myocardial infarction patients (n=368) admitted from July 2012 to November 2014 were collected with outcomes of physical activity after 12–14 months. Baseline data included demographics, clinical variables, participation in exercise programmes, prescribed physical activity, health-related quality of life and self-reported health (EQ-5D-3L/EQ-VAS). A direct binary logistic regression analysis was used to identify indicators of low physical activity. Results: Physical activity frequency per week (PA/week) was low, i.e. zero to three times, in older patients over 64 years (P=0.00) and in those having problems with pain/discomfort (138 PA/week vs. 195) (P=0.01), problems with mobility (60 PA/week vs.273) (P=0.04) and anxiety/depression (128 PA/week vs. 205) (P=0.04). Conclusion: Indicators predicting low physical activity can be used targeting improved post-myocardial infarction care outlining person-centred rehabilitation programmes and specialist nursing-led programmes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Coronary artery bypass grafting using saphenous vein grafts (SVGs) in addition to the left internal mammary artery (IMA) graft is vitiated by poor long-term patency of the vein grafts. Hypothetically, the increased use of arterial grafts could confer even better outcomes. Our goal was to evaluate results after coronary artery bypass grafting in Sweden, where arterial grafts were used as a second conduit. METHODS: Within the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) registry, we identified patients who had coronary artery bypass grafting from 2001 to 2015 using the IMA and the SVG, the radial artery (RA) or the additional IMA [bilateral IMA (BIMA)] as a second conduit. Deaths, postoperative incidence of coronary angiography and need for reintervention were recorded, and multivariable adjusted hazard ratios were calculated for different types of grafts. RESULTS: The study population comprised 46 343 cases of IMA + SVG, 1036 cases of IMA + RA and 862 cases of BIMA. The mean followup time (SD) was 9.3 (4.2) years for IMA + SVG, 10.7 (4.1) years for IMA + RA grafts and 5.5 (5.0) years for the BIMA graft. The adjusted hazard ratio for death was (95% confidence interval) 1.01 (0.89-1.14) for IMA + RA and 0.87 (0.72-1.06) for BIMA grafts compared with IMA + SVG. The adjusted hazard ratio for the first angiographic examination was (95% confidence interval) 0.96 (0.84-1.10) for IMA + RA and 1.13 (0.95-1.35) for BIMA grafts. The adjusted hazard ratio for the need for reintervention was (95% confidence interval) 0.91 (0.75-1.09) for IMA + RA and 1.26 (1.00-1.58) for BIMA grafts. CONCLUSIONS: Patients who had arterial grafts as second conduits did not demonstrate a better outcome in any of the studied endpoints. Radial artery grafts seem to be preferable to BIMA grafts as an alternative to an SVG. [ABSTRACT FROM AUTHOR]

Background: The Swedish Palliative Registry is a nationwide quality registry aimed at facilitating improvement in end-of-life care. The goal is for the registry to list and report quality indicators related to care during the last week of life in all cases expected death in Sweden. Aim: To examine the quality of care during the last week of life as reported to the registry for patients with heart disease compared to those with cancer. Method: A retrospective registry study. Results: Patients dying of heart disease compared to those dying from cancer had more shortness of breath, fewer drugs prescribed as needed against the usual symptoms and often died alone. Furthermore, they and their close relatives received less information about the imminence of death and bereavement follow-up was less common. The healthcare personnel were less aware of the heart disease patients' symptoms and less often knew about where they wished to die. Conclusion: Great differences were found in registered end-of-life care suggesting that the care given to patients with heart disease and cancer was unequal even after adjustment for age, sex and setting at the time of death. If our observational findings are confirmed in future studies there is obviously a need for new models for end-of-life management in order to facilitate the provision of equal care to dying patients regardless of diagnosis. [ABSTRACT FROM AUTHOR]

Background Nonmelanoma skin cancer (NMSC) is a growing public health problem among Caucasians, thus mortality data that may provide insight into the clinical course and foster our understanding of NMSC are important. Objectives We examined total and cause-specific mortality among patients with NMSC registered in the Danish Cancer Registry from 1978 to 2001. Methods A total of 82 837 patients with basal cell carcinoma (BCC) and 13 453 patients with squamous cell carcinoma (SCC) were followed through the National Death Registry for specific causes of death. Standardized mortality ratios (SMRs) were computed based on mortality rates in the general population. Results Among patients with BCC, we found a slightly reduced total mortality [SMR 0·97, 95% confidence interval (CI) 0·96–0·98] with decreased SMRs seen for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD) and diabetes mellitus. The SMR for suicide was increased. Among patients with SCC, we found an increased total mortality (SMR 1·30, 95% CI 1·26–1·33) due primarily to excess deaths from cancers, COPD, CVD and infectious diseases. Conclusions We found markedly different mortality patterns among patients with BCC and those with SCC, suggesting important differences in the clinical course of these patients. [ABSTRACT FROM AUTHOR]

Background One critical aspect for improvement of health care delivery to the population is a continuous monitoring of results. In this context, an increasing number of clinical cancer registries has been implemented in Germany since 2013. Main aspects of these registries include quality control, assessment of clinical outcome, support of epidemiological registries and potential implementation into clinical follow up. The ADT (Cooperation of German Cancer Centres e.V.) aims to merge data from local cancer registries into one nation-wide registry. In this context, we were able to analyse for the first time data of > 100.000 patients with malignant diseases of the stomach and esophagus. Methods Data from all local cancer registries in Germany were requested in the context of the National German Cancer Conference 2018 hosted by the German Cancer Society (DKG). After preparation of data, analysis included demographic and treatment aspects, and esophageal/gastric/GOJ cancers were analysed separately. Results From 2000–2016, 101.559 patients with cancers of the esophagus and stomach have been reported, representing approximately one quarter of the expected cancer cases in this time frame in Germany. Data quality and completeness improved over time. Incidences of esophageal and GOJ cancers increased, whereas incidence of gastric cancer decreased. Median age differed between entities with highest respectively lowest age in gastric/esophageal cancer. Further, median age increased in all three tumor types in the study period. Treatment pattern changed over time with a distinct increase of the use of neoadjuvant therapy in all cancer types. Percentage of curative intended surgery increased over time, reaching roughly 60% in gastric cancer, about 50% in GOJ and esophageal adenocarcinoma, and slightly less then 25% in esophageal squamous cell carcinoma. Finally, analysis of tumor stage dependent treatment confirmed higher rates of curative intended surgical treatment in early tumor stages, and an increased use of neoadjuvant treatment or chemo/radiotherapy approaches in higher tumor stages. Conclusion Combined Clinical Cancer Registries provide the unique opportunity to assess clinical relevant data of a large population based cohort of patients for purposes such as quality control and outcome measurement. Further, subgroup analyses can provide valid information on clinically relevant questions such as outcome/quality of different treatments. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]