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104 results on '"Fowkes, FGR"'

2. Association of Chronic Obstructive Pulmonary Disease with Morbidity and Mortality in Patients with Peripheral Artery Disease: Insights from the EUCLID Trial

Author

Galani J, Mulder H, Rockhold FW, Weissler EH, Baumgartner I, Berger JS, Blomster JI, Fowkes FGR, Hiatt WR, Katona BG, Norgren L, Mahaffey KW, Quint JK, Patel MR, and Jones WS

Subjects
peripheral artery disease, chronic obstructive pulmonary disease, major adverse cardiovascular events, Diseases of the respiratory system, RC705-779
Abstract

Jemi Galani,1 Hillary Mulder,2 Frank W Rockhold,2 E Hope Weissler,2,3 Iris Baumgartner,4 Jeffrey S Berger,5 Juuso I Blomster,6 F Gerry R Fowkes,7 William R Hiatt,8,9 Brian G Katona,10 Lars Norgren,11 Kenneth W Mahaffey,12 Jennifer K Quint,13 Manesh R Patel,1,2 W Schuyler Jones1,2 1Department of Medicine, Duke University Medical Center, Durham, NC, USA; 2Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA; 3Department of Surgery, Division of Vascular Surgery, Duke University Health System, Durham, NC, USA; 4Department of Medicine, Swiss Cardiovascular Center, University of Bern, Bern, Switzerland; 5Departments of Medicine and Surgery, New York University School of Medicine, New York, NY, USA; 6University of Turku, Turku, Finland; 7Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK; 8Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA; 9CPC Clinical Research, Aurora, CO, USA; 10AstraZeneca, Gaithersburg, MD, USA; 11Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 12Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA; 13Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UKCorrespondence: W Schuyler JonesDuke University Medical Center, Box 3330, Durham, NC, 27710, USATel +1 919-668-8917Fax +1 919-668-7026Email schuyler.jones@duke.eduBackground: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of developing lower extremity peripheral artery disease (PAD) and suffering PAD-related morbidity and mortality. However, the effect and burden of COPD on patients with PAD is less well defined. This post hoc analysis from EUCLID aimed to analyze the risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE) in patients with PAD and concomitant COPD compared with those without COPD, and to describe the adverse events specific to patients with COPD.Methods: EUCLID randomized 13,885 patients with symptomatic PAD to monotherapy with either ticagrelor or clopidogrel for the prevention of MACE. In this analysis, MACE, MALE, mortality, and adverse events were compared between groups with and without COPD using unadjusted and adjusted Cox proportional hazards model.Results: Of the 13,883 patients with COPD status available at baseline, 11% (n=1538) had COPD. Patients with COPD had a higher risk of MACE (6.02 vs 4.29 events/100 patient-years; p< 0.001) due to a significantly higher risk of myocardial infarction (MI) (3.55 vs 1.85 events/100 patient-years; p< 0.001) when compared with patients without COPD. These risks persisted after adjustment (MACE: adjusted hazard ratio (aHR) 1.30, 95% confidence interval [CI] 1.11– 1.52; p< 0.001; MI: aHR 1.45, 95% CI 1.18– 1.77; p< 0.001). However, patients with COPD did not have an increased risk of MALE or major bleeding. Patients with COPD were more frequently hospitalized for dyspnea and pneumonia (2.66 vs 0.9 events/100 patient-years; aHR 2.77, 95% CI 2.12– 3.63; p< 0.001) and more frequently discontinued study drug prematurely (19.36 vs 12.54 events/100 patient-years; p< 0.001; aHR 1.34, 95% CI 1.22– 1.47; p< 0.001).Conclusion: In patients with comorbid PAD and COPD, the risks of MACE, respiratory-related adverse events, and premature study drug discontinuation were higher when compared with patients without COPD.Registration: ClinicalTrials.gov: NCT01732822.Keywords: peripheral artery disease, chronic obstructive pulmonary disease, major adverse cardiovascular events

Published
2021

3. Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events

Author

Fowkes, FGR, Murray, GD, Butcher, I, Folsom, AR, Hirsch, AT, Couper, DJ, DeBacker, G, Kornitzer, M, Newman, Sutton-Tyrrell, KC, Cushman, M, Lee, AJ, Price, JF, D'Agostino, RB, Murabito, JM, Norman, PE, Masaki, KH, Bouter, LM, Heine, RJ, Stehouwer, CDA, McDermott, MM, Stoffers, HEJH, Knottnerus, JA, Ogren, M, Hedblad, B, Koenig, W, Meisinger, C, Cauley, JA, Franco, OH, Hunink, MGM, Hofman, A, Witteman, JC, Criqui, MH, Langer, RD, Hiatt, WR, and Hamman, RF

Subjects
Cardiovascular, Prevention, Clinical Research, Heart Disease, Adult, Aged, Aged, 80 and over, Ankle Brachial Index, Cardiovascular Diseases, Europe, Female, Humans, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Prognosis, Reproducibility of Results, Risk Assessment, Risk Factors, Sex Factors, Time Factors, United States, White People, Young Adult, Ankle Brachial Index Collaboration, Ankle brachial index, cardiovascular diseases, risk assessment, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology
Abstract

BackgroundThe ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS.DesignAn analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events.MethodsSubjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events.ResultsIn predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p = 0.050) and 9.6% (95% CI 6.1 to 16.4%, p

Published
2014

4. Peripheral arterial disease (PAD): A challenging manifestation of atherosclerosis

Author

Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Nordanstig, J, Behrendt, C A, Bradbury, A W, de Borst, G J, Fowkes, Fgr, Golledge, J, Gottsater, A, Hinchliffe, R J, Nikol, S, Norgren, L, Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Nordanstig, J, Behrendt, C A, Bradbury, A W, de Borst, G J, Fowkes, Fgr, Golledge, J, Gottsater, A, Hinchliffe, R J, Nikol, S, and Norgren, L

Published
2023

5. The Global Epidemiological Transition in Cardiovascular Diseases: Unrecognised Impact of Endemic Infections on Peripheral Artery Disease

Author

Agius, PA, Cutts, JC, Song, P, Rudan, I, Rudan, D, Aboyans, V, McDermott, MM, Criqui, MH, Fowkes, FGR, Fowkes, FJ, Agius, PA, Cutts, JC, Song, P, Rudan, I, Rudan, D, Aboyans, V, McDermott, MM, Criqui, MH, Fowkes, FGR, and Fowkes, FJ

Abstract

An epidemiological transition in the prevalence of peripheral artery disease (PAD) is taking place especially in low- and middle-income countries (LMICs) where an ageing population and adoption of western lifestyles are associated with an increase in PAD. We discuss the limited evidence which suggests that infection, potentially mediated by inflammation, may be a risk factor for PAD, and show by means of an ecological analysis that country-level prevalence of the major endemic infections of HIV, tuberculosis and malaria are associated with the prevalence of PAD. While further research is required, we propose that scientists and health authorities pay more attention to the interplay between communicable and non-communicable diseases, and we suggest that limiting the occurrence of endemic infections might have some effect on slowing the epidemiological transition in PAD.

Published
2022

6. Global and regional prevalence, burden and risk factors for carotid atherosclerosis: a systematic review and modelling analysis

Author

Song, P, Fang, Z, Wang, H, Cai, Y, Rahimi, K, Zhu, Y, Fowkes, FGR, Fowkes, FJI, and Rudan, I

Subjects
cardiovascular system, cardiovascular diseases, 0605 Microbiology, 1117 Public Health and Health Services
Abstract

Background Estimation of the epidemiological burden of carotid atherosclerosis can serve as a basis for prevention and management of cardiovascular disease. We aimed to provide the first estimation on the prevalence, number of cases, and risk factors for carotid atherosclerosis in the general population globally and regionally. Methods In this systematic review, meta-analysis, and modelling study, we searched PubMed, MEDLINE, Embase, Global Health, and China National Knowledge Infrastructure for articles published from database inception until May 7, 2019, with no language restrictions, for population-based studies that quantified prevalence of carotid atherosclerosis by means of increased carotid intima-media thickness, carotid plaque, and carotid stenosis. Studies were eligible if they included bilaterally scanned carotid arteries using ultrasonography and defined increased carotid intima-media thickness as a thickness of 1·0 mm or more, carotid plaque as a focal carotid intima-media thickness of 1·5 mm or more encroaching into the lumen or at least 0·5 mm or 50% compared with the surrounding carotid intima-media thickness values, and carotid stenosis as 50% or more stenosis. Studies were excluded if the sample was not representative of the general population. We also included studies identified in our previous systematic review and meta-analysis of the prevalence of carotid atherosclerosis in China. We estimated age-specific and sex-specific prevalences of increased carotid intima-media thickness, carotid plaque, and carotid stenosis. We used UN population data to generate the number of people affected in 2000, 2015, and 2020. We did random-effects meta-analyses to assess the effects of risk factors for increased carotid intima-media thickness and carotid plaque. We derived regional numbers of people living with increased carotid intima-media thickness and carotid plaque in 2015 using a risk factors-based model by WHO region. All analyses were done in populations aged 30–79 years due to availability of data. This systematic review and meta-analysis is registered online on PROSPERO, CRD42019134709. Findings We identified 8632 articles through our database search, of which 515 were eligible for full-text review, including 37 articles from our previous study, and 59 articles were eligible for inclusion in our systematic review and meta-analysis. Overall, in people aged 30–79 years in 2020, the global prevalence of increased carotid intima-media thickness is estimated to be 27·6% (95% CI 16·9–41·3), equivalent to 1066·70 million affected people and a percentage change of 57·46% from 2000; of carotid plaque is estimated to be 21·1% (13·2–31·5), equivalent to 815·76 million affected people and a percentage change of 58·97% from 2000; and carotid stenosis is estimated to be 1·5% (1·1–2·1), equivalent to 57·79 million affected people and a percentage change of 59·13% from 2000. The prevalence of increased carotid intima-media thickness, carotid plaque, and carotid stenosis increased consistently with age and was higher in men than in women. Current smoking, diabetes, and hypertension were common risk factors for increased carotid intima-media thickness and carotid plaque. In 2015, the Western Pacific region had the largest share of global cases of increased carotid intima-media thickness (317·62 million [33·36%] of 952·13 million affected people) and carotid plaque (240·77 million [33·20%] of 725·25 million), whereas the African region had the smallest share of cases of increased carotid intima-media thickness (59·08 million [6·21%]) and the Eastern Mediterranean region had the smallest share of carotid plaque cases (44·59 million [6·15%]). Interpretation A substantial global burden of carotid atherosclerosis exists. Effective strategies are needed for primary prevention and management of carotid atherosclerosis. High-quality epidemiological investigations on carotid atherosclerosis are needed to better address the global burden of carotid atherosclerosis at finer levels.

Published
2020

7. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Author

Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, A, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, JR, Catapano, AL, Chugh, S, Cooper, LT, Coresh, J, Criqui, MH, DeCleene, NK, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Sola, J, Fowkes, FGR, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, NJ, Koroshetz, WJ, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Misganaw, AT, Mokdad, AH, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Oliveira, GMM, Otto, CM, Owolabi, MO, Pratt, M, Rajagopalan, S, Reitsma, MB, Ribeiro, ALP, Rigotti, NA, Rodgers, A, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Sundström, J, Timpel, P, Tleyjeh, II, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, A, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, JR, Catapano, AL, Chugh, S, Cooper, LT, Coresh, J, Criqui, MH, DeCleene, NK, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Sola, J, Fowkes, FGR, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, NJ, Koroshetz, WJ, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Misganaw, AT, Mokdad, AH, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Oliveira, GMM, Otto, CM, Owolabi, MO, Pratt, M, Rajagopalan, S, Reitsma, MB, Ribeiro, ALP, Rigotti, NA, Rodgers, A, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Sundström, J, Timpel, P, Tleyjeh, II, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, and Almustanyir, S

Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside

Published
2020

8. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

Author

Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, AZ, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, J, Catapano, AL, Chugh, SS, Cooper, LT, Coresh, J, Criqui, M, DeCleene, N, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Solà, J, Fowkes, G, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Temesgen, AM, Mokdad, A, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, ALP, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundström, J, Timpel, P, Tleyjeh, IM, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Beaton, A, Carapetis, JR, Chugh, S, Criqui, MH, DeCleene, NK, Fernández-Sola, J, Fowkes, FGR, Kassebaum, NJ, Koroshetz, WJ, Misganaw, AT, Mokdad, AH, Oliveira, GMM, Otto, CM, Owolabi, MO, Reitsma, MB, Rigotti, NA, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Tleyjeh, II, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, RM, Amegah, AK, Amini, S, Aminorroaya, A, Amu, H, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, CL, Ansari-Moghaddam, A, Anteneh, ZA, Antonazzo, IC, Antony, B, Anwer, R, Appiah, LT, Arabloo, J, Ärnlöv, J, Artanti, KD, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, AT, Awoke, MA, Ayele, HT, Ayza, MA, Azari, S, B, DB, Baheiraei, N, Baig, AA, Bakhtiari, A, Banach, M, Banik, PC, Baptista, EA, Barboza, MA, Barua, L, Basu, S, Bedi, N, Béjot, Y, Bennett, DA, Bensenor, IM, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, MM, Boloor, A, Brant, LC, Brenner, H, Briko, NI, Butt, ZA, Caetano dos Santos, FL, Cahill, LE, Cahuana-Hurtado, L, Cámera, LA, Campos-Nonato, IR, Cantu-Brito, C, Car, J, Carrero, JJ, Carvalho, F, Castañeda-Orjuela, CA, Catalá-López, F, Cerin, E, Charan, J, Chattu, VK, Chen, S, Chin, KL, Choi, J-YJ, Chu, D-T, Chung, S-C, Cirillo, M, Coffey, S, Conti, S, Costa, VM, Cundiff, DK, Dadras, O, Dagnew, B, Dai, X, Damasceno, AAM, Dandona, L, Dandona, R, Davletov, K, De la Cruz-Góngora, V, De la Hoz, FP, De Neve, J-W, Denova-Gutiérrez, E, Derbew Molla, M, Derseh, BT, Desai, R, Deuschl, G, Dharmaratne, SD, Dhimal, M, Dhungana, RR, Dianatinasab, M, Diaz, D, Djalalinia, S, Dokova, K, Douiri, A, Duncan, BB, Duraes, AR, Eagan, AW, Ebtehaj, S, Eftekhari, A, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, IY, Elhadi, M, El-Jaafary, SI, Esteghamati, S, Etisso, AE, Eyawo, O, Fadhil, I, Faraon, EJA, Faris, PS, Farwati, M, Farzadfar, F, Fernandes, E, Fernandez Prendes, C, Ferrara, P, Filip, I, Fischer, F, Flood, D, Fukumoto, T, Gad, MM, Gaidhane, S, Ganji, M, Garg, J, Gebre, AK, Gebregiorgis, BG, Gebregzabiher, KZ, Gebremeskel, GG, Getacher, L, Obsa, AG, Ghajar, A, Ghashghaee, A, Ghith, N, Giampaoli, S, Gilani, SA, Gill, PS, Gillum, RF, Glushkova, EV, Gnedovskaya, EV, Golechha, M, Gonfa, KB, Goudarzian, AH, Goulart, AC, Guadamuz, JS, Guha, A, Guo, Y, Gupta, R, Hachinski, V, Hafezi-Nejad, N, Haile, TG, Hamadeh, RR, Hamidi, S, Hankey, GJ, Hargono, A, Hartono, RK, Hashemian, M, Hashi, A, Hassan, S, Hassen, HY, Havmoeller, RJ, Hay, SI, Hayat, K, Heidari, G, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Iqbal, U, Irvani, SSN, Shariful Islam, Sheikh, Islam, RM, Iso, H, Iwagami, M, Jain, V, Javaheri, T, Jayapal, SK, Jayaram, S, Jayawardena, R, Jeemon, P, Jha, RP, Jonas, JB, Jonnagaddala, J, Joukar, F, Jozwiak, JJ, Jürisson, M, Kabir, A, Kahlon, T, Kalani, R, Kalhor, R, Kamath, A, Kamel, I, Kandel, H, Kandel, A, Karch, A, Kasa, AS, Katoto, PDMC, Kayode, GA, Khader, YS, Khammarnia, M, Khan, MS, Khan, MN, Khan, M, Khan, EA, Khatab, K, Kibria, GMA, Kim, YJ, Kim, GR, Kimokoti, RW, Kisa, S, Kisa, A, Kivimäki, M, Kolte, D, Koolivand, A, Korshunov, VA, Koulmane Laxminarayana, SL, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kucuk Bicer, B, Kulkarni, V, Kumar, GA, Kumar, N, Kurmi, OP, Kusuma, D, Kwan, GF, La Vecchia, C, Lacey, B, Lallukka, T, Lan, Q, Lasrado, S, Lassi, ZS, Lauriola, P, Lawrence, WR, Laxmaiah, A, LeGrand, KE, Li, M-C, Li, B, Li, S, Lim, SS, Lim, L-L, Lin, H, Lin, Z, Lin, R-T, Liu, X, Lopez, AD, Lorkowski, S, Lotufo, PA, Lugo, A, M, NK, Madotto, F, Mahmoudi, M, Majeed, A, Malekzadeh, R, Malik, AA, Mamun, AA, Manafi, N, Mansournia, MA, Mantovani, LG, Martini, S, Mathur, MR, Mazzaglia, G, Mehata, S, Mehndiratta, MM, Meier, T, Menezes, RG, Meretoja, A, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mirrakhimov, EM, Mirzaei, H, Moazen, B, Moghadaszadeh, M, Mohammad, Y, Mohammad, DK, Mohammed, S, Mohammed, MA, Mokhayeri, Y, Molokhia, M, Montasir, AA, Moradi, G, Moradzadeh, R, Moraga, P, Morawska, L, Moreno Velásquez, I, Morze, J, Mubarik, S, Muruet, W, Musa, KI, Nagarajan, AJ, Nalini, M, Nangia, V, Naqvi, AA, Narasimha Swamy, S, Nascimento, BR, Nayak, VC, Nazari, J, Nazarzadeh, M, Negoi, RI, Neupane Kandel, S, Nguyen, HLT, Nixon, MR, Norrving, B, Noubiap, JJ, Nouthe, BE, Nowak, C, Odukoya, OO, Ogbo, FA, Olagunju, AT, Orru, H, Ortiz, A, Ostroff, SM, Padubidri, JR, Palladino, R, Pana, A, Panda-Jonas, S, Parekh, U, Park, E-C, Parvizi, M, Pashazadeh Kan, F, Patel, UK, Pathak, M, Paudel, R, Pepito, VCF, Perianayagam, A, Perico, N, Pham, HQ, Pilgrim, T, Piradov, MA, Pishgar, F, Podder, V, Polibin, RV, Pourshams, A, Pribadi, DRA, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ur Rahman, MH, Rahman, Muhammad, Rahmani, AM, Rakovac, I, Ram, P, Ramalingam, S, Rana, J, Ranasinghe, P, Rao, SJ, Rathi, P, Rawal, L, Rawasia, WF, Rawassizadeh, R, Remuzzi, G, Renzaho, AMN, Rezapour, A, Riahi, SM, Roberts-Thomson, RL, Roever, L, Rohloff, P, Romoli, M, Roshandel, G, Rwegerera, GM, Saadatagah, S, Saber-Ayad, MM, Sabour, S, Sacco, S, Sadeghi, M, Saeedi Moghaddam, S, Safari, S, Sahebkar, A, Salehi, S, Salimzadeh, H, Samaei, M, Samy, AM, Santos, IS, Santric-Milicevic, MM, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sawhney, M, Saylan, M, Schmidt, MI, Schutte, AE, Senthilkumaran, S, Sepanlou, SG, Sha, F, Shahabi, S, Shahid, I, Shaikh, MA, Shamali, M, Shamsizadeh, M, Shawon, MSR, Sheikh, A, Shigematsu, M, Shin, M-J, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siabani, S, Siddiqi, TJ, Silva, DAS, Singh, JA, Mtech, AS, Skryabin, VY, Skryabina, AA, Soheili, A, Spurlock, EE, Stockfelt, L, Stortecky, S, Stranges, S, Suliankatchi Abdulkader, R, Tadbiri, H, Tadesse, EG, Tadesse, DB, Tajdini, M, Tariqujjaman, M, Teklehaimanot, BF, Temsah, M-H, Tesema, AK, Thakur, B, Thankappan, KR, Thapar, R, Thrift, AG, Timalsina, B, Tonelli, M, Touvier, M, Tovani-Palone, MR, Tripathi, A, Tripathy, JP, Truelsen, TC, Tsegay, GM, Tsegaye, GW, Tsilimparis, N, Tusa, BS, Tyrovolas, S, Umapathi, KK, Unim, B, Unnikrishnan, B, Usman, MS, Vaduganathan, M, Valdez, PR, Vasankari, TJ, Velazquez, DZ, Venketasubramanian, N, Vu, GT, Vujcic, IS, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, RG, Weldemariam, AH, Westerman, R, Winkler, AS, Wiysonge, CS, Wolfe, CDA, Wubishet, BL, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, LL, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, SB, Zaman, MS, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, YMH, Murray, CJL, Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, AZ, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, J, Catapano, AL, Chugh, SS, Cooper, LT, Coresh, J, Criqui, M, DeCleene, N, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Solà, J, Fowkes, G, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Temesgen, AM, Mokdad, A, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, ALP, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundström, J, Timpel, P, Tleyjeh, IM, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Beaton, A, Carapetis, JR, Chugh, S, Criqui, MH, DeCleene, NK, Fernández-Sola, J, Fowkes, FGR, Kassebaum, NJ, Koroshetz, WJ, Misganaw, AT, Mokdad, AH, Oliveira, GMM, Otto, CM, Owolabi, MO, Reitsma, MB, Rigotti, NA, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Tleyjeh, II, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, RM, Amegah, AK, Amini, S, Aminorroaya, A, Amu, H, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, CL, Ansari-Moghaddam, A, Anteneh, ZA, Antonazzo, IC, Antony, B, Anwer, R, Appiah, LT, Arabloo, J, Ärnlöv, J, Artanti, KD, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, AT, Awoke, MA, Ayele, HT, Ayza, MA, Azari, S, B, DB, Baheiraei, N, Baig, AA, Bakhtiari, A, Banach, M, Banik, PC, Baptista, EA, Barboza, MA, Barua, L, Basu, S, Bedi, N, Béjot, Y, Bennett, DA, Bensenor, IM, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, MM, Boloor, A, Brant, LC, Brenner, H, Briko, NI, Butt, ZA, Caetano dos Santos, FL, Cahill, LE, Cahuana-Hurtado, L, Cámera, LA, Campos-Nonato, IR, Cantu-Brito, C, Car, J, Carrero, JJ, Carvalho, F, Castañeda-Orjuela, CA, Catalá-López, F, Cerin, E, Charan, J, Chattu, VK, Chen, S, Chin, KL, Choi, J-YJ, Chu, D-T, Chung, S-C, Cirillo, M, Coffey, S, Conti, S, Costa, VM, Cundiff, DK, Dadras, O, Dagnew, B, Dai, X, Damasceno, AAM, Dandona, L, Dandona, R, Davletov, K, De la Cruz-Góngora, V, De la Hoz, FP, De Neve, J-W, Denova-Gutiérrez, E, Derbew Molla, M, Derseh, BT, Desai, R, Deuschl, G, Dharmaratne, SD, Dhimal, M, Dhungana, RR, Dianatinasab, M, Diaz, D, Djalalinia, S, Dokova, K, Douiri, A, Duncan, BB, Duraes, AR, Eagan, AW, Ebtehaj, S, Eftekhari, A, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, IY, Elhadi, M, El-Jaafary, SI, Esteghamati, S, Etisso, AE, Eyawo, O, Fadhil, I, Faraon, EJA, Faris, PS, Farwati, M, Farzadfar, F, Fernandes, E, Fernandez Prendes, C, Ferrara, P, Filip, I, Fischer, F, Flood, D, Fukumoto, T, Gad, MM, Gaidhane, S, Ganji, M, Garg, J, Gebre, AK, Gebregiorgis, BG, Gebregzabiher, KZ, Gebremeskel, GG, Getacher, L, Obsa, AG, Ghajar, A, Ghashghaee, A, Ghith, N, Giampaoli, S, Gilani, SA, Gill, PS, Gillum, RF, Glushkova, EV, Gnedovskaya, EV, Golechha, M, Gonfa, KB, Goudarzian, AH, Goulart, AC, Guadamuz, JS, Guha, A, Guo, Y, Gupta, R, Hachinski, V, Hafezi-Nejad, N, Haile, TG, Hamadeh, RR, Hamidi, S, Hankey, GJ, Hargono, A, Hartono, RK, Hashemian, M, Hashi, A, Hassan, S, Hassen, HY, Havmoeller, RJ, Hay, SI, Hayat, K, Heidari, G, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Iqbal, U, Irvani, SSN, Shariful Islam, Sheikh, Islam, RM, Iso, H, Iwagami, M, Jain, V, Javaheri, T, Jayapal, SK, Jayaram, S, Jayawardena, R, Jeemon, P, Jha, RP, Jonas, JB, Jonnagaddala, J, Joukar, F, Jozwiak, JJ, Jürisson, M, Kabir, A, Kahlon, T, Kalani, R, Kalhor, R, Kamath, A, Kamel, I, Kandel, H, Kandel, A, Karch, A, Kasa, AS, Katoto, PDMC, Kayode, GA, Khader, YS, Khammarnia, M, Khan, MS, Khan, MN, Khan, M, Khan, EA, Khatab, K, Kibria, GMA, Kim, YJ, Kim, GR, Kimokoti, RW, Kisa, S, Kisa, A, Kivimäki, M, Kolte, D, Koolivand, A, Korshunov, VA, Koulmane Laxminarayana, SL, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kucuk Bicer, B, Kulkarni, V, Kumar, GA, Kumar, N, Kurmi, OP, Kusuma, D, Kwan, GF, La Vecchia, C, Lacey, B, Lallukka, T, Lan, Q, Lasrado, S, Lassi, ZS, Lauriola, P, Lawrence, WR, Laxmaiah, A, LeGrand, KE, Li, M-C, Li, B, Li, S, Lim, SS, Lim, L-L, Lin, H, Lin, Z, Lin, R-T, Liu, X, Lopez, AD, Lorkowski, S, Lotufo, PA, Lugo, A, M, NK, Madotto, F, Mahmoudi, M, Majeed, A, Malekzadeh, R, Malik, AA, Mamun, AA, Manafi, N, Mansournia, MA, Mantovani, LG, Martini, S, Mathur, MR, Mazzaglia, G, Mehata, S, Mehndiratta, MM, Meier, T, Menezes, RG, Meretoja, A, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mirrakhimov, EM, Mirzaei, H, Moazen, B, Moghadaszadeh, M, Mohammad, Y, Mohammad, DK, Mohammed, S, Mohammed, MA, Mokhayeri, Y, Molokhia, M, Montasir, AA, Moradi, G, Moradzadeh, R, Moraga, P, Morawska, L, Moreno Velásquez, I, Morze, J, Mubarik, S, Muruet, W, Musa, KI, Nagarajan, AJ, Nalini, M, Nangia, V, Naqvi, AA, Narasimha Swamy, S, Nascimento, BR, Nayak, VC, Nazari, J, Nazarzadeh, M, Negoi, RI, Neupane Kandel, S, Nguyen, HLT, Nixon, MR, Norrving, B, Noubiap, JJ, Nouthe, BE, Nowak, C, Odukoya, OO, Ogbo, FA, Olagunju, AT, Orru, H, Ortiz, A, Ostroff, SM, Padubidri, JR, Palladino, R, Pana, A, Panda-Jonas, S, Parekh, U, Park, E-C, Parvizi, M, Pashazadeh Kan, F, Patel, UK, Pathak, M, Paudel, R, Pepito, VCF, Perianayagam, A, Perico, N, Pham, HQ, Pilgrim, T, Piradov, MA, Pishgar, F, Podder, V, Polibin, RV, Pourshams, A, Pribadi, DRA, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ur Rahman, MH, Rahman, Muhammad, Rahmani, AM, Rakovac, I, Ram, P, Ramalingam, S, Rana, J, Ranasinghe, P, Rao, SJ, Rathi, P, Rawal, L, Rawasia, WF, Rawassizadeh, R, Remuzzi, G, Renzaho, AMN, Rezapour, A, Riahi, SM, Roberts-Thomson, RL, Roever, L, Rohloff, P, Romoli, M, Roshandel, G, Rwegerera, GM, Saadatagah, S, Saber-Ayad, MM, Sabour, S, Sacco, S, Sadeghi, M, Saeedi Moghaddam, S, Safari, S, Sahebkar, A, Salehi, S, Salimzadeh, H, Samaei, M, Samy, AM, Santos, IS, Santric-Milicevic, MM, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sawhney, M, Saylan, M, Schmidt, MI, Schutte, AE, Senthilkumaran, S, Sepanlou, SG, Sha, F, Shahabi, S, Shahid, I, Shaikh, MA, Shamali, M, Shamsizadeh, M, Shawon, MSR, Sheikh, A, Shigematsu, M, Shin, M-J, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siabani, S, Siddiqi, TJ, Silva, DAS, Singh, JA, Mtech, AS, Skryabin, VY, Skryabina, AA, Soheili, A, Spurlock, EE, Stockfelt, L, Stortecky, S, Stranges, S, Suliankatchi Abdulkader, R, Tadbiri, H, Tadesse, EG, Tadesse, DB, Tajdini, M, Tariqujjaman, M, Teklehaimanot, BF, Temsah, M-H, Tesema, AK, Thakur, B, Thankappan, KR, Thapar, R, Thrift, AG, Timalsina, B, Tonelli, M, Touvier, M, Tovani-Palone, MR, Tripathi, A, Tripathy, JP, Truelsen, TC, Tsegay, GM, Tsegaye, GW, Tsilimparis, N, Tusa, BS, Tyrovolas, S, Umapathi, KK, Unim, B, Unnikrishnan, B, Usman, MS, Vaduganathan, M, Valdez, PR, Vasankari, TJ, Velazquez, DZ, Venketasubramanian, N, Vu, GT, Vujcic, IS, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, RG, Weldemariam, AH, Westerman, R, Winkler, AS, Wiysonge, CS, Wolfe, CDA, Wubishet, BL, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, LL, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, SB, Zaman, MS, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, YMH, and Murray, CJL

Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019.Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside hi

Published
2020

13. Collaborative meta-analysis of prospective studies of plasma fibrinogen and cardiovascular disease

Author

Kostis, JB, Wilson, AC, Folsom, AR, Chambless, L, Wu, K, Benderly, M, Goldbourt, U, Willeit, J, Kiechl, S, Yarnell, JWG, Sweetnam, PM, Elwood, PC, Cushman, M, Psaty, BM, Tybjaerg-Hansen, A, Haverkate, F, de Maat, MPM, Thompson, SG, Fowkes, FGR, Lee, AJ, Smith, FB, Salomaa, V, Rasi, V, Vahtera, E, Jousilahti, P, Pekkanen, J, D'Agostino, R, Kannel, WB, Levy, D, Wilson, PWF, Arocha-Pinango, CL, Rodriguez-Larralde, A, Nagy, E, Mijares, M, Espinosa, R, Roa, E, Ryder, E, Diez-Ewald, MP, Campos, G, Fernandez, V, Torres, E, Marchioli, R, Valagussa, F, Rosengren, A, Wilhelmsen, L, Lappas, G, Eriksson, H, Cremer, P, Nagel, D, Curb, JD, Rodriguez, B, Yano, K, Salonen, JT, Nyyssonen, K, Tuomainen, TP, Hedblad, B, Lind, P, Loewel, H, Hense, HW, Koenig, W, Meade, TW, Cooper, JA, De Stavola, B, Garrow, K, Knottenbelt, C, Miller, GJ, Bauer, KA, Rosenberg, RD, Sato, S, Kitamura, A, Naito, Y, Iso, H, Palosuo, T, Ducimetiere, P, Amouyel, P, Arveiler, D, Evans, AE, Ferrieres, J, Juhan-Vague, I, Schulte, H, Assmann, G, Cantin, B, Lamarche, B, Despres, JP, Dagenais, GR, Tunstall-Pedoe, H, Lowe, GDO, Collins, R, Danesh, J, Dickinson, A, Lewington, S, Memon, A, Thompson, S, Walker, M, Wheeler, J, Ben-Shlomo, Y, Smith, GD, Palmieri, V, Yeh, JL, Rudnicka, A, Brennan, P, Cooper, J, Rodeghiero, F, Tosetto, A, Shepherd, J, Ford, I, Norrie, J, Brunner, E, Shipley, M, Feskens, EJM, Kromhout, D, and Collaboration, FS

Subjects
medicine.medical_specialty, Epidemiology, business.industry, Regression dilution, Confounding, Fibrinogen, Regression analysis, Fibrinogen Measurement, Surgery, Meta-Analysis as Topic, Cardiovascular Diseases, Internal medicine, Meta-analysis, Data Interpretation, Statistical, Medicine, Humans, Prospective Studies, Risk factor, Cooperative Behavior, Cardiology and Cardiovascular Medicine, business, Prospective cohort study, Biomarkers, medicine.drug
Abstract

BACKGROUND: Many long-term studies have reported on associations of plasma fibrinogen concentration with cardiovascular disease, but few have been large enough to provide reliable estimates in different circumstances. Moreover, most published prospective studies have related disease risk only to baseline values of plasma fibrinogen (which can lead to substantial underestimation of any risk relationships) and have corrected only for baseline values of possible confounding factors (which can lead to residual biases). OBJECTIVES: By appropriate combination of data from individual participants from all relevant prospective studies in a systematic 'meta-analysis', with correction for regression dilution, the Fibrinogen Studies Collaboration will aim to characterize more precisely than has previously been possible the strength and shape of the age- and sex-specific associations of plasma fibrinogen with coronary heart disease (and, where data are sufficient, with other vascular diseases). It will also help to determine to what extent such associations are independent of possible confounding factors. METHODS: A central database has been established containing data on plasma fibrinogen, sex and other potential confounding factors, age at baseline fibrinogen measurement, age at event or at last follow-up, major vascular morbidity and cause-specific mortality. Information about any repeat measurements of fibrinogen and potential confounding factors is being sought to allow study-specific correction for regression dilution. The analyses will involve age-specific regression models. Synthesis of the available prospective studies of plasma fibrinogen will yield information on more than 10000 incident cardiovascular deaths and events among the approximately 200000 total participants who have been monitored, on average, for about 10 years.

Published
2016

15. Lipid-Related Markers and Cardiovascular Disease Prediction

Author

Wolfgang Koenig, Simon G. Thompson, Pei Gao, Alexander M. W. Cargill Thompson, J W Jukema, Khaw K-T., Annika Rosengren, Pierre Ducimetière, Daan Kromhout, Adam S. Butterworth, Ian Ford, David Wormser, Vilmundur Gudnason, Angela M. Wood, W J Howard, Naveed Sattar, Danish Saleheen, Jackie A. Cooper, Stephen Kaptoge, Paul M. Ridker, John Danesh, Dorothea Nagel, Lisa Pennells, Nicholas J. Wareham, Fowkes Fgr., Jussi Kauhanen, Muriel J. Caslake, Albert Hofman, E Di Angelantonio, Altan Onat, Ralph B. D'Agostino, Bruce M. Psaty, John Gallacher, Robert Clarke, Johan Sundström, M. S. Sandhu, Richard F. Gillum, Leon A. Simons, S M Boekholdt, Gerd Assmann, Christie M. Ballantyne, Robert W. Tipping, Jukka T. Salonen, Dullaart Rpf., Gilles R. Dagenais, Elizabeth Barrett-Connor, Susan E. Sutherland, Eric J. Brunner, Chris J. Packard, Agustin Gomez-de-la-Camara, S Kiechl, V. Salomaa, Børge G. Nordestgaard, Edoardo Casiglia, Nadeem Sarwar, Faculteit Medische Wetenschappen/UMCG, Lifestyle Medicine (LM), Epidemiology, ACS - Amsterdam Cardiovascular Sciences, and Cardiology

Subjects
Male, Nutrition and Disease, Apolipoprotein B, Disease, 030204 cardiovascular system & hematology, Bioinformatics, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, prevention, lipoprotein(a), Voeding en Ziekte, Medicine, 030212 general & internal medicine, Myocardial infarction, risk, biology, non-hdl cholesterol, General Medicine, Lipoprotein(a), Middle Aged, myocardial-infarction, 3. Good health, Cardiovascular Diseases, Cardiology, Female, lipids (amino acids, peptides, and proteins), metaanalysis, medicine.medical_specialty, Lipoproteins, Risk Assessment, apolipoprotein-b, ldl cholesterol, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Internal medicine, Humans, Aged, VLAG, business.industry, Cholesterol, Cholesterol, HDL, Cholesterol hdl, medicine.disease, Coronary heart disease, a-i, chemistry, Non hdl cholesterol, biology.protein, coronary-heart-disease, business, Biomarkers
Abstract

Context The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated. Objective To determine whether adding information on apolipoprotein B and apolipoprotein A-I, lipoprotein(a), or lipoprotein-associated phospholipase A(2) to total cholesterol and high-density lipoprotein cholesterol (HDL-C) improves cardiovascular disease (CVD) risk prediction. Design, Setting, and Participants Individual records were available for 165 544 participants without baseline CVD in 37 prospective cohorts (calendar years of recruitment: 1968-2007) with up to 15 126 incident fatal or nonfatal CVD outcomes (10 132 CHD and 4994 stroke outcomes) during a median follow-up of 10.4 years (interquartile range, 7.6-14 years). Main Outcome Measures Discrimination of CVD outcomes and reclassification of participants across predicted 10-year risk categories of low ( = 20%) risk. Results The addition of information on various lipid-related markers to total cholesterol, HDL-C, and other conventional risk factors yielded improvement in the model's discrimination: C-index change, 0.0006 (95% CI, 0.0002-0.0009) for the combination of apolipoprotein B and A-I; 0.0016 (95% CI, 0.0009-0.0023) for lipoprotein(a); and 0.0018 (95% CI, 0.0010-0.0026) for lipoprotein-associated phospholipase A(2) mass. Net reclassification improvements were less than 1% with the addition of each of these markers to risk scores containing conventional risk factors. We estimated that for 100 000 adults aged 40 years or older, 15 436 would be initially classified at intermediate risk using conventional risk factors alone. Additional testing with a combination of apolipoprotein B and A-I would reclassify 1.1%; lipoprotein(a), 4.1%; and lipoprotein-associated phospholipase A(2) mass, 2.7% of people to a 20% or higher predicted CVD risk category and, therefore, in need of statin treatment under Adult Treatment Panel III guidelines. Conclusion In a study of individuals without known CVD, the addition of information on the combination of apolipoprotein B and A-I, lipoprotein(a), or lipoprotein-associated phospholipase A(2) mass to risk scores containing total cholesterol and HDL-C led to slight improvement in CVD prediction. JAMA. 2012; 307(23):2499-2506 www.jama.com

Published
2012

16. Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events

Author

Stoffers, HEJH, Ogren, M, Fowkes, FGR, Cushman, M, Cauley, JA, Price, JF, Kornitzer, M, Murabito, JM, Lee, AJ, Meisinger, C, Hirsch, AT, Witteman, JC, Knottnerus, JA, D'Agostino, RB, McDermott, MM, Heine, RJ, Masaki, KH, Folsom, AR, Hunink, MGM, Sutton-Tyrrell, KC, Stehouwer, CDA, Norman, PE, DeBacker, G, Couper, DJ, Murray, GD, Bouter, LM, Butcher, I, Franco, OH, Newman, AB, Hofman, A, Koenig, W, and Hedblad, B

Subjects
body regions, animal structures, cardiovascular system, cardiovascular diseases, human activities
Abstract

The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS.

Published
2014
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17. Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data

Author

Wensley, F, Gao, P, Burgess, S, Kaptoge, S, Di Angelantonio, E, Shah, T, Engert, JC, Clarke, R, Davey-Smith, G, Nordestgaard, BG, Saleheen, D, Samani, NJ, Sandhu, M, Anand, S, Pepys, MB, Smeeth, L, Whittaker, J, Casas, JP, Thompson, SG, Hingorani, AD, Danesh, J, Eiriksdottir, G, Harris, TB, Launer, LJ, Gudnason, V, Folsom, AR, Andrews, G, Ballantyne, CM, Hall, AS, Braund, PS, Balmforth, AJ, Whincup, PH, Morris, R, Lawlor, DA, Lowe, GDO, Timpson, N, Ebrahim, S, Ben-Shlomo, Y, Tybjaerg-Hansen, A, Zacho, J, Brown, M, Ricketts, SL, Ashford, S, Lange, L, Reiner, A, Cushman, M, Tracy, R, Wu, C, Ge, J, Zou, Y, Sun, A, Hung, J, McQuillan, B, Thompson, P, Beilby, J, Warrington, N, Palmer, LJ, Wanner, C, Drechsler, C, Hoffmann, MM, Fowkes, FGR, Tzoulaki, I, Kumari, M, Miller, M, Marmot, M, Onland-Moret, C, van der Schouw, YT, Boer, JM, Wijmenga, C, Khaw, K-T, Vasan, RS, Schnabel, RB, Yamamoto, JF, Benjamin, EJ, Schunkert, H, Erdmann, J, Koenig, IR, Hengstenberg, C, Chiodini, B, Franzosi, MG, Pietri, S, Gori, F, Rudock, M, Liu, Y, Lohman, K, Humphries, SE, Hamsten, A, Norman, PE, Hankey, GJ, Jamrozik, K, Rimm, EB, Pai, JK, Psaty, BM, Heckbert, SR, Bis, JC, Yusuf, S, Xie, C, Collins, R, Bennett, D, Kooner, J, Chambers, J, Elliott, P, Maerz, W, Kleber, ME, Boehm, BO, Winkelmann, BR, Melander, O, Berglund, G, Koenig, W, Thorand, B, Baumert, J, Peters, A, Manson, J, Cooper, JA, Talmud, PJ, Ladenvall, P, Johansson, L, Jansson, J-H, Hallmans, G, Reilly, MP, Qu, L, Li, M, Rader, DJ, Watkins, H, Hopewell, J, Frossard, P, Sattar, N, Robertson, M, Shepherd, J, Schaefer, E, Hofman, A, Witteman, JCM, Kardys, I, Dehghan, A, de Faire, U, Bennet, A, Gigante, B, Leander, K, Peters, B, Maitland-van der Zee, AH, de Boer, A, Klungel, O, Greenland, P, Dai, J, Liu, S, Brunner, E, Kivimaki, M, O'Reilly, D, Ford, I, Packard, CJ, Dis, CRPCH, CIHDS, CC, CUPID, C, Medical Research Council (MRC), University of Groningen, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Pulmonology, and Coronel Institute of Occupational Health

Subjects
Male, Coronary Disease, Bioinformatics, Gene Frequency, MARKERS, Polymorphism (computer science), Risk Factors, Myocardial infarction, Prospective Studies, Prospective cohort study, General Environmental Science, Genetics, RISK, biology, General Engineering, Mendelian Randomization Analysis, General Medicine, Middle Aged, C-Reactive Protein, 1117 Public Health And Health Services, CARDIOVASCULAR-DISEASE, Meta-analysis, symbols, Female, Life Sciences & Biomedicine, Ischaemic Heart Disease, Polymorphism, Single Nucleotide, Molecular Genetics, symbols.namesake, Medicine, General & Internal, INFLAMMATION, Drugs: Cardiovascular System, General & Internal Medicine, medicine, INSTRUMENTAL VARIABLES, Humans, C Reactive Protein Coronary Heart Disease Genetics Collaboration (CCGC), Allele frequency, METAANALYSIS, POLYMORPHISMS, Science & Technology, business.industry, Research, C-reactive protein, medicine.disease, GENE, MYOCARDIAL-INFARCTION, ATHEROSCLEROSIS, Mendelian inheritance, biology.protein, General Earth and Planetary Sciences, business
Abstract

Objective To use genetic variants as unconfounded proxies of C reactive protein concentration to study its causal role in coronary heart disease. Design Mendelian randomisation meta-analysis of individual participant data from 47 epidemiological studies in 15 countries. Participants 194 418 participants, including 46 557 patients with prevalent or incident coronary heart disease. Information was available on four CRP gene tagging single nucleotide polymorphisms (rs3093077, rs1205, rs1130864, rs1800947), concentration of C reactive protein, and levels of other risk factors. Main outcome measures Risk ratios for coronary heart disease associated with genetically raised C reactive protein versus risk ratios with equivalent differences in C reactive protein concentration itself, adjusted for conventional risk factors and variability in risk factor levels within individuals. Results CRP variants were each associated with up to 30% per allele difference in concentration of C reactive protein (P

Published
2011

18. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis

Author

Fibrinogen Studies Collaboration, Danesh, John, Lewington, Sarah, Thompson, Simon G, Lowe, Gordon DO, Collins, Rory, Kostis, JB, Wilson, AC, Folsom, AR, Wu, K, Benderly, M, Goldbourt, U, Willeit, J, Kiechl, S, Yarnell, JWG, Sweetnam, PM, Elwood, PC, Cushman, M, Psaty, BM, Tracy, RP, Tybjaerg-Hansen, A, Haverkate, F, de Maat, MPM, Fowkes, FGR, Lee, AJ, Smith, FB, Salomaa, V, Harald, K, Rasi, R, Vahtera, E, Jousilahti, P, Pekkanen, J, D'Agostino, R, Kannel, WB, Wilson, PWF, Tofler, G, Arocha-Piñango, CL, Rodriguez-Larralde, A, Nagy, E, Mijares, M, Espinosa, R, Rodriquez-Roa, E, Ryder, E, Diez-Ewald, MP, Campos, G, Fernandez, V, Torres, E, Marchioli, R, Valagussa, F, Rosengren, A, Wilhelmsen, L, Lappas, G, Eriksson, H, Cremer, P, Nagel, D, Curb, JD, Rodriguez, B, Yano, K, Salonen, JT, Nyyssönen, K, Tuomainen, T-P, Hedblad, B, Lind, P, Loewel, H, Koenig, W, Meade, TW, Cooper, JA, De Stavola, B, Knottenbelt, C, Miller, GJ, Bauer, KA, Rosenberg, RD, Sato, S, Kitamura, A, Naito, Y, Palosuo, T, Ducimetiere, P, Amouyel, P, Arveiler, D, Evans, AE, Ferrieres, J, Juhan-Vague, I, Bingham, A, Schulte, H, Assmann, G, Cantin, B, Lamarche, B, Després, J-P, Dagenais, GR, Tunstall-Pedoe, H, Woodward, M, Ben-Shlomo, Y, Davey Smith, G, Palmieri, V, Yeh, JL, Rudnicka, A, Ridker, P, Rodeghiero, F, Tosetto, A, Shepherd, J, Ford, I, Robertson, M, Brunner, E, Shipley, M, Feskens, EJM, Kromhout, D, Dickinson, A, Ireland, B, Juzwishin, K, Kaptoge, S, Lewington, S, Memon, A, Sarwar, N, Walker, M, Wheeler, J, White, I, and Wood, A

Abstract

CONTEXT: Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES: Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION: All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION: Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS: Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS: In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.

Published
2005

19. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Author

Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basanez, M-G, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabe, E, Bhalla, K, Bhandari, B, Bikbov, B, Bin Abdulhak, A, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, SA, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, GR, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, AT-A, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, de Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Dharmaratne, SD, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fevre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gosselin, R, Grainger, R, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Halasa, YA, Hall, W, Haring, D, Maria Haro, J, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, J-P, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Ma, J, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Elena Medina-Mora, M, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, A-C, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Perez Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leon, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JRA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, van der Werf, MJ, van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, P-H, Zaidi, AKM, Zheng, Z-J, Zonies, D, Lopez, AD, Murray, CJL, Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basanez, M-G, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabe, E, Bhalla, K, Bhandari, B, Bikbov, B, Bin Abdulhak, A, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, SA, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, GR, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, AT-A, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, de Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Dharmaratne, SD, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fevre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gosselin, R, Grainger, R, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Halasa, YA, Hall, W, Haring, D, Maria Haro, J, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, J-P, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Ma, J, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Elena Medina-Mora, M, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, A-C, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Perez Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leon, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JRA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, van der Werf, MJ, van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, P-H, Zaidi, AKM, Zheng, Z-J, Zonies, D, Lopez, AD, and Murray, CJL

Abstract

BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly cor

Published
2012

20. Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk

Author

Ehret, GB, Munroe, PB, Rice, KM, Bochud, M, Johnson, AD, Chasman, DI, Smith, AV, Tobin, MD, Verwoert, GC, Hwang, S-J, Pihur, V, Vollenweider, P, O'Reilly, PF, Amin, N, Bragg-Gresham, JL, Teumer, A, Glazer, NL, Launer, L, Zhao, JH, Aulchenko, Y, Heath, S, Sober, S, Parsa, A, Luan, J, Arora, P, Dehghan, A, Zhang, F, Lucas, G, Hicks, AA, Jackson, AU, Peden, JF, Tanaka, T, Wild, SH, Rudan, I, Igl, W, Milaneschi, Y, Parker, AN, Fava, C, Chambers, JC, Fox, ER, Kumari, M, Go, MJ, van der Harst, P, Kao, WHL, Sjogren, M, Vinay, DG, Alexander, M, Tabara, Y, Shaw-Hawkins, S, Whincup, PH, Liu, Y, Shi, G, Kuusisto, J, Tayo, B, Seielstad, M, Sim, X, Khanh-Dung, HN, Lehtimaki, T, Matullo, G, Wu, Y, Gaunt, TR, Onland-Moret, NC, Cooper, MN, Platou, CGP, Org, E, Hardy, R, Dahgam, S, Palmen, J, Vitart, V, Braund, PS, Kuznetsova, T, Uiterwaal, CSPM, Adeyemo, A, Palmas, W, Campbell, H, Ludwig, B, Tomaszewski, M, Tzoulaki, I, Palmer, ND, Aspelund, T, Garcia, M, Chang, Y-PC, O'Connell, JR, Steinle, NI, Grobbee, DE, Arking, DE, Kardia, SL, Morrison, AC, Hernandez, D, Najjar, S, McArdle, WL, Hadley, D, Brown, MJ, Connell, JM, Hingorani, AD, Day, INM, Lawlor, DA, Beilby, JP, Lawrence, RW, Clarke, R, Hopewell, JC, Ongen, H, Dreisbach, AW, Li, Y, Young, JH, Bis, JC, Kahonen, M, Viikari, J, Adair, LS, Lee, NR, Chen, M-H, Olden, M, Pattaro, C, Bolton, JAH, Koettgen, A, Bergmann, S, Mooser, V, Chaturvedi, N, Frayling, TM, Islam, M, Jafar, TH, Erdmann, J, Kulkarni, SR, Bornstein, SR, Graessler, J, Groop, L, Voight, BF, Kettunen, J, Howard, P, Taylor, A, Guarrera, S, Ricceri, F, Emilsson, V, Plump, A, Barroso, IS, Khaw, K-T, Weder, AB, Hunt, SC, Sun, YV, Bergman, RN, Collins, FS, Bonnycastle, LL, Scott, LJ, Stringham, HM, Peltonen, L, Perola, M, Vartiainen, E, Brand, S-M, Staessen, JA, Wang, TJ, Burton, PR, Artigas, MS, Dong, Y, Snieder, H, Wang, X, Zhu, H, Lohman, KK, Rudock, ME, Heckbert, SR, Smith, NL, Wiggins, KL, Doumatey, A, Shriner, D, Veldre, G, Viigimaa, M, Kinra, S, Prabhakaran, D, Tripathy, V, Langefeld, CD, Rosengren, A, Thelle, DS, Corsi, AM, Singleton, A, Forrester, T, Hilton, G, McKenzie, CA, Salako, T, Iwai, N, Kita, Y, Ogihara, T, Ohkubo, T, Okamura, T, Ueshima, H, Umemura, S, Eyheramendy, S, Meitinger, T, Wichmann, H-E, Cho, YS, Kim, H-L, Lee, J-Y, Scott, J, Sehmi, JS, Zhang, W, Hedblad, B, Nilsson, P, Smith, GD, Wong, A, Narisu, N, Stancakova, A, Raffel, LJ, Yao, J, Kathiresan, S, O'Donnell, CJ, Schwartz, SM, Ikram, MA, Longstreth, WT, Mosley, TH, Seshadri, S, Shrine, NRG, Wain, LV, Morken, MA, Swift, AJ, Laitinen, J, Prokopenko, I, Zitting, P, Cooper, JA, Humphries, SE, Danesh, J, Rasheed, A, Goel, A, Hamsten, A, Watkins, H, Bakker, SJL, van Gilst, WH, Janipalli, CS, Mani, KR, Yajnik, CS, Hofman, A, Mattace-Raso, FUS, Oostra, BA, Demirkan, A, Isaacs, A, Rivadeneira, F, Lakatta, EG, Orru, M, Scuteri, A, Ala-Korpela, M, Kangas, AJ, Lyytikainen, L-P, Soininen, P, Tukiainen, T, Wurtz, P, Ong, RT-H, Doerr, M, Kroemer, HK, Voelker, U, Voelzke, H, Galan, P, Hercberg, S, Lathrop, M, Zelenika, D, Deloukas, P, Mangino, M, Spector, TD, Zhai, G, Meschia, JF, Nalls, MA, Sharma, P, Terzic, J, Kumar, MVK, Denniff, M, Zukowska-Szczechowska, E, Wagenknecht, LE, Fowkes, FGR, Charchar, FJ, Schwarz, PEH, Hayward, C, Guo, X, Rotimi, C, Bots, ML, Brand, E, Samani, NJ, Polasek, O, Talmud, PJ, Nyberg, F, Kuh, D, Laan, M, Hveem, K, Palmer, LJ, van der Schouw, YT, Casas, JP, Mohlke, KL, Vineis, P, Raitakari, O, Ganesh, SK, Wong, TY, Tai, ES, Cooper, RS, Laakso, M, Rao, DC, Harris, TB, Morris, RW, Dominiczak, AF, Kivimaki, M, Marmot, MG, Miki, T, Saleheen, D, Chandak, GR, Coresh, J, Navis, G, Salomaa, V, Han, B-G, Zhu, X, Kooner, JS, Melander, O, Ridker, PM, Bandinelli, S, Gyllensten, UB, Wright, AF, Wilson, JF, Ferrucci, L, Farrall, M, Tuomilehto, J, Pramstaller, PP, Elosua, R, Soranzo, N, Sijbrands, EJG, Altshuler, D, Loos, RJF, Shuldiner, AR, Gieger, C, Meneton, P, Uitterlinden, AG, Wareham, NJ, Gudnason, V, Rotter, JI, Rettig, R, Uda, M, Strachan, DP, Witteman, JCM, Hartikainen, A-L, Beckmann, JS, Boerwinkle, E, Vasan, RS, Boehnke, M, Larson, MG, Jarvelin, M-R, Psaty, BM, Abecasis, GR, Chakravarti, A, Elliott, P, van Duijn, CM, Newton-Cheh, C, Levy, D, Caulfield, MJ, Johnson, T, Ehret, GB, Munroe, PB, Rice, KM, Bochud, M, Johnson, AD, Chasman, DI, Smith, AV, Tobin, MD, Verwoert, GC, Hwang, S-J, Pihur, V, Vollenweider, P, O'Reilly, PF, Amin, N, Bragg-Gresham, JL, Teumer, A, Glazer, NL, Launer, L, Zhao, JH, Aulchenko, Y, Heath, S, Sober, S, Parsa, A, Luan, J, Arora, P, Dehghan, A, Zhang, F, Lucas, G, Hicks, AA, Jackson, AU, Peden, JF, Tanaka, T, Wild, SH, Rudan, I, Igl, W, Milaneschi, Y, Parker, AN, Fava, C, Chambers, JC, Fox, ER, Kumari, M, Go, MJ, van der Harst, P, Kao, WHL, Sjogren, M, Vinay, DG, Alexander, M, Tabara, Y, Shaw-Hawkins, S, Whincup, PH, Liu, Y, Shi, G, Kuusisto, J, Tayo, B, Seielstad, M, Sim, X, Khanh-Dung, HN, Lehtimaki, T, Matullo, G, Wu, Y, Gaunt, TR, Onland-Moret, NC, Cooper, MN, Platou, CGP, Org, E, Hardy, R, Dahgam, S, Palmen, J, Vitart, V, Braund, PS, Kuznetsova, T, Uiterwaal, CSPM, Adeyemo, A, Palmas, W, Campbell, H, Ludwig, B, Tomaszewski, M, Tzoulaki, I, Palmer, ND, Aspelund, T, Garcia, M, Chang, Y-PC, O'Connell, JR, Steinle, NI, Grobbee, DE, Arking, DE, Kardia, SL, Morrison, AC, Hernandez, D, Najjar, S, McArdle, WL, Hadley, D, Brown, MJ, Connell, JM, Hingorani, AD, Day, INM, Lawlor, DA, Beilby, JP, Lawrence, RW, Clarke, R, Hopewell, JC, Ongen, H, Dreisbach, AW, Li, Y, Young, JH, Bis, JC, Kahonen, M, Viikari, J, Adair, LS, Lee, NR, Chen, M-H, Olden, M, Pattaro, C, Bolton, JAH, Koettgen, A, Bergmann, S, Mooser, V, Chaturvedi, N, Frayling, TM, Islam, M, Jafar, TH, Erdmann, J, Kulkarni, SR, Bornstein, SR, Graessler, J, Groop, L, Voight, BF, Kettunen, J, Howard, P, Taylor, A, Guarrera, S, Ricceri, F, Emilsson, V, Plump, A, Barroso, IS, Khaw, K-T, Weder, AB, Hunt, SC, Sun, YV, Bergman, RN, Collins, FS, Bonnycastle, LL, Scott, LJ, Stringham, HM, Peltonen, L, Perola, M, Vartiainen, E, Brand, S-M, Staessen, JA, Wang, TJ, Burton, PR, Artigas, MS, Dong, Y, Snieder, H, Wang, X, Zhu, H, Lohman, KK, Rudock, ME, Heckbert, SR, Smith, NL, Wiggins, KL, Doumatey, A, Shriner, D, Veldre, G, Viigimaa, M, Kinra, S, Prabhakaran, D, Tripathy, V, Langefeld, CD, Rosengren, A, Thelle, DS, Corsi, AM, Singleton, A, Forrester, T, Hilton, G, McKenzie, CA, Salako, T, Iwai, N, Kita, Y, Ogihara, T, Ohkubo, T, Okamura, T, Ueshima, H, Umemura, S, Eyheramendy, S, Meitinger, T, Wichmann, H-E, Cho, YS, Kim, H-L, Lee, J-Y, Scott, J, Sehmi, JS, Zhang, W, Hedblad, B, Nilsson, P, Smith, GD, Wong, A, Narisu, N, Stancakova, A, Raffel, LJ, Yao, J, Kathiresan, S, O'Donnell, CJ, Schwartz, SM, Ikram, MA, Longstreth, WT, Mosley, TH, Seshadri, S, Shrine, NRG, Wain, LV, Morken, MA, Swift, AJ, Laitinen, J, Prokopenko, I, Zitting, P, Cooper, JA, Humphries, SE, Danesh, J, Rasheed, A, Goel, A, Hamsten, A, Watkins, H, Bakker, SJL, van Gilst, WH, Janipalli, CS, Mani, KR, Yajnik, CS, Hofman, A, Mattace-Raso, FUS, Oostra, BA, Demirkan, A, Isaacs, A, Rivadeneira, F, Lakatta, EG, Orru, M, Scuteri, A, Ala-Korpela, M, Kangas, AJ, Lyytikainen, L-P, Soininen, P, Tukiainen, T, Wurtz, P, Ong, RT-H, Doerr, M, Kroemer, HK, Voelker, U, Voelzke, H, Galan, P, Hercberg, S, Lathrop, M, Zelenika, D, Deloukas, P, Mangino, M, Spector, TD, Zhai, G, Meschia, JF, Nalls, MA, Sharma, P, Terzic, J, Kumar, MVK, Denniff, M, Zukowska-Szczechowska, E, Wagenknecht, LE, Fowkes, FGR, Charchar, FJ, Schwarz, PEH, Hayward, C, Guo, X, Rotimi, C, Bots, ML, Brand, E, Samani, NJ, Polasek, O, Talmud, PJ, Nyberg, F, Kuh, D, Laan, M, Hveem, K, Palmer, LJ, van der Schouw, YT, Casas, JP, Mohlke, KL, Vineis, P, Raitakari, O, Ganesh, SK, Wong, TY, Tai, ES, Cooper, RS, Laakso, M, Rao, DC, Harris, TB, Morris, RW, Dominiczak, AF, Kivimaki, M, Marmot, MG, Miki, T, Saleheen, D, Chandak, GR, Coresh, J, Navis, G, Salomaa, V, Han, B-G, Zhu, X, Kooner, JS, Melander, O, Ridker, PM, Bandinelli, S, Gyllensten, UB, Wright, AF, Wilson, JF, Ferrucci, L, Farrall, M, Tuomilehto, J, Pramstaller, PP, Elosua, R, Soranzo, N, Sijbrands, EJG, Altshuler, D, Loos, RJF, Shuldiner, AR, Gieger, C, Meneton, P, Uitterlinden, AG, Wareham, NJ, Gudnason, V, Rotter, JI, Rettig, R, Uda, M, Strachan, DP, Witteman, JCM, Hartikainen, A-L, Beckmann, JS, Boerwinkle, E, Vasan, RS, Boehnke, M, Larson, MG, Jarvelin, M-R, Psaty, BM, Abecasis, GR, Chakravarti, A, Elliott, P, van Duijn, CM, Newton-Cheh, C, Levy, D, Caulfield, MJ, and Johnson, T

Abstract

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure (GUCY1A3-GUCY1B3, NPR3-C5orf23, ADM, FURIN-FES, GOSR2, GNAS-EDN3); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention.

Published
2011

22. Consensus Conference on Sclerotherapy

Author

Ancona, E, Baccaglini, U, Baggio, Elda, Burnand, Kg, Fchleir, Cornu Thenard, A, Einarsson, E, Fowkes, Fgr, Garde, C, Grondin, L, Hoerdegen, K, Lipari, Giovanni, Maleti, O, Norgren, L, Parpex, P, Partsch, H, Perrin, M, Schadec, Mk, Scurr, Jh, Spreafico, G, Staelens, I, and Vin, F.

Subjects
Sclerotherapy, consensus document, varicose veins
Published
1995

23. Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb ischaemia due to infrainguinal disease. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial

Author

Bradbury, AW, primary, Adam, DJ, additional, Bell, J, additional, Forbes, JF, additional, Fowkes, FGR, additional, Gillespie, I, additional, Raab, G, additional, and Ruckley, CV, additional

Published
2010
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25. Investigation of factors which might indicate susceptibility to particulate air pollution

Author

Prescott, Gordon, Lee, Robert, Cohen, Geoffrey, Elton, Robert, Lee, Amanda Jane, Fowkes, FGR, Agius, Raymond, Prescott, Gordon, Lee, Robert, Cohen, Geoffrey, Elton, Robert, Lee, Amanda Jane, Fowkes, FGR, and Agius, Raymond

Abstract

OBJECTIVES To determine whether previous symptoms or recognised risk factors of cardiovascular ill health, are associated with an increased likelihood of adverse health effects related to particulate air pollution. METHODS Cardiovascular event rates were studied relative to urban concentrations of particulate air pollution and baseline risk factors. The Edinburgh artery study consisted of a cohort of 1592 subjects aged 55–74 and was followed up to the end of March 1998 for a median of 10 years resulting in about 5 million person-days of observation. Baseline measurements included plasma fibrinogen and blood and plasma viscosity. A nested case-control approach was used to investigate a possible interaction between effects of these selected baseline risk factors and particulate air pollution, on subsequent event rates. RESULTS During the follow up period there were 343 fatal and non-fatal myocardial infarctions or strokes. Trends in adverse cardiovascular outcomes related to pollution were identified among subjects belonging to the highest baseline quintile of plasma fibrinogen. Evidence for interactions between concentrations of particulate pollution and fibrinogen was not established at conventional levels of significance. CONCLUSIONS People with high concentrations of plasma fibrinogen might be more susceptible to adverse cardiovascular effects of particulate air pollution, but limitations of power mean that evidence relating to such an interaction is not conclusive. A range of cardiopulmonary risk factors warrant investigation in relation to possible susceptibility to air pollution.

Published
2000

27. Urban air pollution and cardiopulmonary ill health

Author

Prescott, Gordon, Cohen, Geoffrey, Elton, Robert, Fowkes, FGR, Agius, Raymond, Prescott, Gordon, Cohen, Geoffrey, Elton, Robert, Fowkes, FGR, and Agius, Raymond

Abstract

OBJECTIVES: To examine possible associations between daily concentrations of urban air pollutants and hospital emergency admissions and mortality due to cardiac and pulmonary disease. METHODS: A time series study was conducted in the City of Edinburgh, which has a population of about 450,000. Poisson log linear regression models were used to investigate the relation of the daily event rate with daily air pollution concentrations of sulphur dioxide (SO2) and black smoke from 1981 to 1995, and of nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter (PM10) from 1992 to 1995. Adjustments were made for seasonal and weekday variation, daily temperature, and wind speed. RESULTS: The most significant findings were positive associations over the period 1981-95 between black smoke as a mean of the previous three days and daily all cause mortality in people aged > or = 65, and respiratory mortality also in this age group (3.9% increase in mortality for a 10 micrograms/m3 increment in black smoke). For hospital emergency admissions between 1992 and 1995 the two most significant findings (p < 0.05) were for cardiovascular admissions of people aged > or = 65 which showed a positive association with PM10 as a mean of the 3 previous days, and a negative association with O3 as a mean of the previous three days. Analyses of outcomes based on linkage with previous cardiorespiratory emergency admissions did not show substantially different results. CONCLUSION: These data suggest that in the City of Edinburgh, after correction for confounders, there was a small but significant association between concentrations of black smoke and respiratory mortality in the older age group, probably attributable to higher pollution levels in the early part of the study period. There were also generally weak and variable associations between day to day changes in concentrations of urban air pollutants at a single central point and emergency hospital admission rates from cardi

Published
1998

36. Hemostatic factors, inflammatory markers, and progressive peripheral atherosclerosis: the Edinburgh Artery Study.

Author

Tzoulaki I, Murray GD, Price JF, Smith FB, Lee AJ, Rumley A, Lowe GDO, and Fowkes FGR

Abstract

The interplay between inflammatory and hemostatic mechanisms may play a crucial role in the development and progression of atherosclerosis. The authors evaluated the separate and joint associations of hemostatic and inflammatory variables on peripheral atherosclerotic progression in the Edinburgh Artery Study, a population cohort study of 1,592 men and women aged 55-74 years that started in 1987. Levels of fibrinogen, fibrin D-dimer, von Willebrand factor, tissue plasminogen activator antigen, factor VII, prothrombin fragment 1 + 2, urinary fibrinopeptide A, C-reactive protein, and interleukin-6 were measured at baseline. Arm and ankle blood pressures were measured, and atherosclerotic progression was assessed by computing ankle brachial index (ABI) at baseline (1,582 participants) and after 12 years of follow-up (813 participants). Fibrinogen (p = 0.05) and D-dimer (p < or = 0.05) were significantly associated with ABI change independently of baseline ABI and cardiovascular disease risk factors. However, these associations were no longer significant when analyses were adjusted for either C-reactive protein or interleukin-6. Moreover, subjects with higher levels of both D-dimer and interleukin-6 at baseline had the greatest ABI decline. In conclusion, fibrinogen and D-dimer, but not other hemostatic factors, were associated with progressive peripheral atherosclerosis. Since D-dimer and fibrinogen are acute phase reactants, these data support the hypothesis that inflammation is more related to atherosclerosis than is hypercoagulation. [ABSTRACT FROM AUTHOR]

Published
2006
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39. Hostility, cigarette smoking and alcohol consumption in the general population.

Author

Whiteman MC, Fowkes FGR, Deary IJ, and Lee AJ

Abstract

Hostility has been associated with coronary heart disease, and hostility may affect coronary risk through its influence on risk factors such as cigarette smoking and alcohol consumption. The objective of this study was to determine relationships between hostile personality, cigarette smoking and alcohol consumption in the general population. The Edinburgh Artery Study comprises a cross-sectional survey of 1592 men and women aged 55-74 years sampled from age-sex registers of 10 general practices throughout the city. The Bedford-Foulds Personality Deviance Questionnaire was used to elicit extrapunitiveness (including hostile thoughts), dominance (including hostile acts) and intropunitiveness. Social class, age and deprivation score were controlled for in multivariate analyses. The hostile thoughts scale emerged as a significant independent predictor of alcohol consumption in men and women (P < 0.01), and the models accounted for 4-9% of the variance in alcohol consumption. Hostile acts were independently predictive of smoking in men (P 0.001). with the model accounting for 5% of the variance in smoking. Hostile thoughts were independently predictive of smoking in women (P < 0.001), and the model accounted for 4% of the variance in their smoking. We conclude that hostility may affect coronary risk through its influence on lifestyle-related coronary risk factors, although in future further elucidation of hostility type and standard measurement of hostility are necessary. (C) 1997 Elsevier Science Ltd [ABSTRACT FROM AUTHOR]

Published
1997
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40. Dietary nutrients and plasma n-3, n-6, saturated and monounsaturated fatty acids.

Author

Leng GC, Horrobin DF, Smith FB, Ells K, Morse-Fisher N, and Fowkes FGR

Abstract

The aim of this study was to determine the relationship between dietary nutrients and plasma fatty acids in a cross-sectional survey of the general population. A sample of 306 men and women aged 55-74 years (half of whom had clinical evidence of arterial disease) completed a food frequency questionnaire and had a blood sample taken for the estimation of plasma fatty acid concentrations. Several dietary nutrients were found to correlate with the plasma fatty acids. Dietary saturated fat was positively correlated with plasma oleic acid, but inversely related to the n-6 fatty acids. Dietary linoleic acid (LA) and a-tocopherol were positively correlated with plasma LA and its metabolites, but inversely associated with palmitic and oleic acids, and with a-linolenic (ALA) and eicosapentaenoic acids (EPAs). Vitamin C showed positive correlations with LA and its metabolites, but negative associations with oleic acid. Beta-Carotene was inversely associated with oleic acid, and positively associated with LA. Alcohol intake was positively associated with plasma arachidonic acid (M), docosahexaenoic acid (DHA) and EPAs which are protective against atherosclerosis. Both dietary vegetable and cereal fibre showed negative correlations with oleic acid and positive associations with LA, but only vegetable fibre was associated with M, EPAs and DHA. These findings therefore demonstrate that several dietary nutrients known to be associated with less cardiovascular disease are correlated with higher levels of polyunsaturated fatty acids, which may therefore be acting as mediators in the prevention of vascular disease. [ABSTRACT FROM AUTHOR]

Published
1997
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43. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, Gm, Carnahan, E, Stevens, Ga, Cowan, Mj, Farzadfar, F, Lin, Jk, Finucane, Mm, Rao, M, Khang, Yh, Riley, Lm, Mozaffarian, D, Lim, Ss, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, Na, Rahim, Hf, Addo, J, Aekplakorn, W, Afifi, Mm, Agabiti Rosei, E, Salinas, Ca, Agyemang, C, Ali, Mk, Ali, Mm, Al Nsour, M, Al Nuaim AR, Ambady, R, Di Angelantonio, E, Aro, P, Azizi, F, Babu, Bv, Bahalim, An, Barbagallo, Cm, Barbieri, Ma, Barceló, A, Barreto, Sm, Barros, H, Bautista, Le, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, Enzo, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León AC, Campos, H, Cappuccio, Fp, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, Cj, Chaouki, N, Chatterji, S, Chen, Cj, Chen, Z, Choi, Js, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Corsi, Am, Costanza, Mc, Craig, Cl, Dankner, Rs, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, Gh, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, Ch, Fan, Jg, Ferreccio, C, Fezeu, L, Firmo, Jo, Florez, Hj, Fornés, Ns, Fowkes, Fg, Franceschini, G, Frisk, F, Fuchs, Fd, Fuller, El, Getz, L, Giampaoli, S, Gómez, Lf, Gomez Zumaquero JM, Graff Iversen, S, Grant, Jf, Carvajal, Rg, Gulliford, Mc, Gupta, R, Gupta, Pc, Gureje, O, Gutierrez, Hr, Hansen, Tw, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, Wh, Herrera, Vm, Ho, S, Holdsworth, M, Frisman, Gh, Hopman, Wm, Hussain, A, Husseini, A, Ibrahim, Mm, Ikeda, N, Jacobsen, Bk, Jaddou, Hy, Jafar, Th, Janghorbani, M, Jasienska, G, Joffres, Mr, Jonas, Jb, Kadiki, Oa, Kalter Leibovici, O, Kamadjeu, Rm, Kaptoge, S, Karalis, I, Kastarinen, Mj, Katz, J, Keinan Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, Kw, Kiyohara, Y, Kobayashi, J, Krause, Mp, Kubínová, R, Kurjata, P, Kusuma, Ys, Lam, Th, Langhammer, A, Lawes, Cm, Le, C, Lee, J, Lévy Marchal, C, Lewington, S, Li, Y, Lim, To, Lin, X, Lin, Cc, Lin, Hh, Lind, L, Lissner, L, Liu, X, Lopez Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, Dr, Maggi, S, Magliano, Dj, Makdisse, M, Mancia, G, Mannami, T, Marques Vidal, P, Mbanya, Jc, McFarlane Anderson, N, Miccoli, R, Miettola, J, Minh, Hv, Miquel, Jf, Miranda, Jj, Mohamed, Mk, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, Wf, Morales, Dd, Morgan, K, Muiesan, Lm, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, Ka, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, Sw, Ohkubo, T, Olivieri, Oliviero, Önal, Ae, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, Wh, Panagiotakos, Db, Panza, F, Park, Y, Passos, Vm, Pednekar, Ms, Pelizzari, Pm, Peres, Ma, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, Ot, Ramos, Lr, Rampal, S, Rampal, L, Rasmussen, F, Reddy, Kk, Redon, J, Revilla, L, Reyes García, V, Roaeid, Rb, Robinson, Ca, Rodriguez 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Subjects
Male, Settore MED/09 - Medicina Interna, kidney disease, Endocrinology, Diabetes and Metabolism, humanos, coste de las enfermedades, Disease, Global Health, Cohort Studies, Endocrinology, Cost of Illness, cardiovascular disease, Health Transition, Risk Factors, transición sanitaria, estudios prospectivos, Renal Insufficiency, Chronic -- complications -- epidemiology -- mortality, evaluación de riesgos, Renal Insufficiency, Prospective Studies, Chronic, estudios de cohortes, Metabolic Syndrome, education.field_of_study, diabetes, Mortality rate, Age Factors, Cardiovascular Diseases, Diabetes Complications, Female, Health Surveys, Humans, Metabolic Syndrome X, Renal Insufficiency, Chronic, Risk Assessment, Sex Factors, Spatio-Temporal Analysis, Internal Medicine, Cardiovascular Diseases -- complications -- epidemiology -- mortality, Cardiovascular disease,Diabetes Mellitus, chronic kidney disease, Diabetes Complications -- epidemiology -- mortality, Sciences bio-médicales et agricoles, Diabetes and Metabolism, encuestas de salud, análisis temporoespacial, Risk assessment, complicaciones de la diabetes, insuficiencia renal, medicine.medical_specialty, Cardiovascular disease, diabetes mortality, Population, enfermedades cardiovasculares, Metabolic Syndrome X -- complications -- epidemiology -- mortality, Article, chronic kidney disease, mortality, Internal medicine, Environmental health, Diabetes mellitus, medicine, factores de riesgo, Risk factor, education, business.industry, medicine.disease, Relative risk, Cardiovascular Diseases/complications, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Diabetes Complications/epidemiology, Diabetes Complications/mortality, Metabolic Syndrome X/complications, Metabolic Syndrome X/epidemiology, Metabolic Syndrome X/mortality, Renal Insufficiency, Chronic/complications, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/mortality, business, Kidney disease
Abstract

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010., 0, info:eu-repo/semantics/published

Published
2014

44. Inflammation and haemostasis in the development and progression of peripheral atherosclerotic disease

Author

Tzoulaki, Ioanna, Fowkes, FGR, and Murray, GD

Subjects
Peripheral arterial disease, Medicine
Abstract

Peripheral arterial disease (PAD) defines atherosclerotic disease of the arteries to the legs. PAD begins early in life and remains asymptomatic over long periods. The ankle brachial index (ABI) is an important diagnostic test which can identify asymptomatic individuals and serve as a good marker of the underlying peripheral and systemic atherosclerosis. Recent advances in vascular biology proposed a role of inflammatory and haemostatic mechanisms in atherosclerotic disease. Although inflammatory and haemostatic markers have been associated with coronary atherosclerosis in large scale epidemiological studies their role in PAD development is not well established and for many markers unknown. Also, their relationship with the progression of early asymptomatic disease has not been studied before. The aim of this thesis was to examine 12 markers of inflammation and haemostasis in relation to peripheral atherosclerotic progression and incident PAD. The Edinburgh Artery Study was used for this analysis. This is a population based cohort study of 1,592 men and women recruited in 1987. ABI was measured at baseline and at two follow up examinations which were conducted after 5 and after 12 years. Also, subjects were followed up for cardiovascular events for 17 years. Conventional cardiovascular risk factors, C-reactive protein (CRP), interleukin-6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), E-selectin, fibrinogen, D-dimer, tissue plasminogen activator (t-PA), vonWillebrand factor (vWF), factor VII, fibrinopeptide A (FpA) and prothrombin fragments 1+2 (F1+2) were measured at baseline. Valid ABI measurements were available for 1,582 subjects at baseline, for 1,081 subjects at the 5 year follow up and for 816 subjects at the 12 year follow up. The population showed a progression in atherosclerotic disease assessed by the mean ABI decline over time. The mean change in ABI was -0.04 (0.18) after 5 years and -0.06 (0.19) after 12 years. From inflammatory markers, CRP (p

Published
2007

45. The Global Epidemiological Transition in Cardiovascular Diseases: Unrecognised Impact of Endemic Infections on Peripheral Artery Disease.

Author

Agius PA, Cutts JC, Song P, Rudan I, Rudan D, Aboyans V, McDermott MM, Criqui MH, Fowkes FGR, and Fowkes FJI

Subjects
Humans, Prevalence, Risk Factors, Cardiovascular Diseases epidemiology, Noncommunicable Diseases, Peripheral Arterial Disease epidemiology, Peripheral Arterial Disease etiology
Abstract

An epidemiological transition in the prevalence of peripheral artery disease (PAD) is taking place especially in low- and middle-income countries (LMICs) where an ageing population and adoption of western lifestyles are associated with an increase in PAD. We discuss the limited evidence which suggests that infection, potentially mediated by inflammation, may be a risk factor for PAD, and show by means of an ecological analysis that country-level prevalence of the major endemic infections of HIV, tuberculosis and malaria are associated with the prevalence of PAD. While further research is required, we propose that scientists and health authorities pay more attention to the interplay between communicable and non-communicable diseases, and we suggest that limiting the occurrence of endemic infections might have some effect on slowing the epidemiological transition in PAD., (© 2022. The Author(s).)

Published
2022
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46. Understanding Study Drug Discontinuation Through EUCLID.

Author

Weissler EH, Mulder H, Rockhold FW, Baumgartner I, Norgren L, Blomster J, Katona BG, Fowkes FGR, Mahaffey K, Bonaca M, Patel MR, and Jones WS

Abstract

Introduction: Disparities in the care and outcomes of peripheral artery disease (PAD) have been well-established. In part this is due to disparities in enrollment of PAD trial cohorts. However, less attention has been paid to non-random protocol non-adherence after enrollment, which may lead to inaccurate estimates of treatment effects and reduce generalizability of study results. We aimed to ascertain characteristics associated with premature study drug discontinuation in a PAD cohort., Methods: Using data from EUCLID (Examining Use of Ticagrelor in Peripheral Artery Disease), factors associated with study drug discontinuation were assessed using univariable and multivariable Cox proportional hazards models with time to study drug discontinuation as the outcome of interest. Relationships between study drug discontinuation and major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, ischemic stroke), major adverse limb events (MALE; acute limb ischemia, major amputation, and lower extremity revascularization), and all-cause hospitalization were assessed., Results: Of 13,842 eligible EUCLID participants, 3,886 (28.1%) prematurely and permanently discontinued study drug over a maximum follow-up of 42 months (annualized rate of 13.2 discontinuations per 100 patient-years). In a multivariable model, premature study drug discontinuation was associated with older age (aHR 1.16, 95%CI 1.14-1.19), eligibility based on prior lower extremity revascularization rather than ABI/TBI criteria (aHR 1.14, 95%CI 1.06-1.23), CLI status (aHR 1.23, 95%CI 1.06-1.42), COPD (aHR 1.36, 95%CI 1.24-1.49), and geographic region. In a multivariable analysis, study drug discontinuation was significantly associated with MACE (aHR 3.27, 95%CI 2.90-3.67, p < 0.001), MALE (aHR 1.84, 95%CI 1.63-2.07, p < 0.001), and all-cause hospitalization (aHR 2.37, 95%CI 2.21-2.54) following study drug discontinuation., Conclusions: This analysis of EUCLID demonstrates that premature, permanent discontinuation of study drug is relatively common in more than a quarter of PAD patients, is unevenly distributed based on geography and other baseline characteristics, and is associated with worse outcomes in a clinical trial context. Study teams leading future PAD trials may want to address the possibility of study drug discontinuation prospectively, as a proactive approach may help investigators to maintain study cohort diversity and representativeness without sacrificing power and precision., Competing Interests: EUCLID was funded by AstraZeneca; AstraZeneca did not fund the analysis in this manuscript, design the analysis, or draft the manuscript, but did approve the manuscript. BK was employed by AstraZeneca. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Weissler, Mulder, Rockhold, Baumgartner, Norgren, Blomster, Katona, Fowkes, Mahaffey, Bonaca, Patel and Jones.)

Published
2022
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47. Total Cardiovascular and Limb Events and the Impact of Polyvascular Disease in Chronic Symptomatic Peripheral Artery Disease.

Author

Szarek M, Hess C, Patel MR, Jones WS, Berger JS, Baumgartner I, Katona B, Mahaffey KW, Norgren L, Blomster J, Rockhold FW, Hsia J, Fowkes FGR, and Bonaca MP

Subjects
Clopidogrel therapeutic use, Humans, Lower Extremity blood supply, Ticagrelor therapeutic use, Treatment Outcome, Peripheral Arterial Disease complications, Peripheral Arterial Disease drug therapy, Peripheral Arterial Disease epidemiology, Platelet Aggregation Inhibitors therapeutic use
Abstract

Background Peripheral artery disease (PAD) is associated with heightened risk for major adverse cardiovascular and limb events, but data on the burden of risk for total (first and potentially subsequent) events, and the association with polyvascular disease, are limited. This post hoc analysis of the EUCLID (Examining Use of Ticagrelor in Peripheral Artery Disease) trial evaluated total cardiovascular and limb events among patients with symptomatic PAD, overall and by number of symptomatic vascular territories. Methods and Results In the EUCLID trial, patients with symptomatic PAD (lower extremity revascularization >30 days before randomization or ankle-brachial index ≤0.80) were randomized to treatment with ticagrelor or clopidogrel. Relative effects on total events (cardiovascular death; nonfatal myocardial infarction and ischemic stroke; acute limb ischemia, unstable angina, and transient ischemic attack requiring hospitalization; coronary, carotid, and peripheral revascularization procedures; and amputation for symptomatic PAD) were summarized by hazard ratios (HRs), whereas absolute risks were estimated by incidence rates and mean cumulative functions. Among 13 885 randomized patients, 7600 total cardiovascular and limb events occurred during a median 2.7 years of follow-up, translating to 60.0 and 62.5 events per 100 patients through 3 years for the ticagrelor and clopidogrel groups, respectively (HR, 0.96; 95% CI, 0.89-1.03; P =0.27). Among 1393 patients with disease in 3 vascular territories, event accrual rates through 3 years for the ticagrelor and clopidogrel groups were 87.3 and 97.7 events per 100 patients, respectively. Absolute risk reductions for ticagrelor relative to clopidogrel at 3 years were -0.2, 6.7, and 10.3 events per 100 patients for 1, 2, and 3 affected vascular territories, respectively ( P interaction =0.09). Conclusions Patients with symptomatic PAD have nearly double the number of total events than first events, with rates reflecting the number of affected vascular territories. These findings highlight the clinical relevance of quantifying disease burden in terms of total events and the need for long-term preventive treatments in high-risk patient populations. Registration URL: https://clinicaltrials.gov/; Unique identifier: NCT01732822.

Published
2022
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48. World regional differences in outcomes for patients with peripheral artery disease: Insights from the EUCLID trial.

Author

Norgren L, North R, Baumgartner I, Berger JS, Blomster JI, Hiatt WR, Jones WS, Katona BG, Mahaffey KW, Mulder H, Patel MR, Rockhold FW, and Fowkes FGR

Subjects
Clopidogrel therapeutic use, Humans, Internationality, Ischemia drug therapy, Ischemic Stroke epidemiology, Myocardial Infarction epidemiology, Ticagrelor therapeutic use, Treatment Outcome, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease drug therapy, Peripheral Arterial Disease epidemiology
Abstract

Regional variations exist in the epidemiology of peripheral artery disease (PAD), in comorbidities, use of secondary prevention, and outcomes. Large studies of these variations in worldwide populations are rare. The EUCLID (Examining Use of tiCagreLor In peripheral artery Disease) trial included 13,885 patients with PAD from four geographical regions (Central/South America, Europe, Asia, North America) and compared monotherapy with ticagrelor and clopidogrel. Inclusion criteria were either an ankle-brachial index < 0.80 or a prior revascularization. The primary efficacy endpoint was time to first occurrence of any event in the composite of cardiovascular death, myocardial infarction, or ischemic stroke and did not differ between the study arms. This post hoc analysis of EUCLID confirmed that regional differences occurred in the inclusion criteria with more prior revascularization in North America (73.9%) and Asia (72.5%) compared with Central/South America (34.0%) and Europe (51.6%). The characteristics of patients also differed. Prior amputation at baseline was most frequent in Central/South America (6.3%) compared with other regions (1.6-2.8%). A history of stroke was most common in Asia, coronary heart disease in North America, and diabetes in Central/South America compared with other regions. The incidence of outcomes in patients with PAD varied by region. North America had the highest rate of the primary combined endpoint (5.97 events/100 patient-years). Corresponding rates were 4.80, 3.95, and 3.87 for Asia, Europe, and Central/South America, respectively. Hospitalization for acute limb ischemia (events/100 patient-years) was most frequent in Europe (0.75) and North America (0.74) compared with Asia (0.60) and Central/South America (0.33). Adjustment for inclusion criteria and relevant PAD characteristics did not have a major impact on these regional differences. Further adjustment for concomitant disease, risk factors, and preventive medication modified the regional differences only marginally. In conclusion, substantial regional differences were found in cardiovascular and limb outcomes in patients with PAD and were not explained by variation in the category of included patients, concomitant disease, risk factors, and prevention. Such differences, which may be due to variation in other factors such as background population rates or clinical care, need to be considered when designing and interpreting large international studies ( ClinicalTrials.gov Identifier: NCT01732822 ).

Published
2022
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49. Etiology and outcomes of amputation in patients with peripheral artery disease in the EUCLID trial.

Author

Govsyeyev N, Nehler MR, Low Wang CC, Kavanagh S, Hiatt WR, Long C, Jones WS, Fowkes FGR, Berger JS, Baumgartner I, Patel MR, Goodney PP, Beckman JA, Katona BG, Mahaffey KW, Blomster J, Norgren L, and Bonaca MP

Subjects
Aged, Female, Follow-Up Studies, Global Health, Humans, Incidence, Male, Prospective Studies, Survival Rate trends, Amputation, Surgical adverse effects, Diabetes Mellitus epidemiology, Lower Extremity blood supply, Peripheral Arterial Disease surgery, Postoperative Complications epidemiology
Abstract

Objective: Amputation remains a frequent and feared outcome in patients with peripheral artery disease (PAD). Although typically characterized as major or minor on the extent of tissue loss, the etiologies and outcomes after amputation by extent are not well-understood. In addition, emerging data suggest that the drivers and outcomes of amputation in patients with PAD may differ in those with and without diabetes mellitus (DM)., Methods: The EUCLID trial randomized 13,885 patients with symptomatic PAD, including 5345 with concomitant diabetes, to ticagrelor or clopidogrel and followed them for long-term outcomes. Amputations were prospectively reported by trial investigators. Their primary and contributing drivers were adjudicated using safety data, including infection, ischemia, or multifactorial etiologies. Outcomes following major and minor amputations were analyzed, including recurrent amputation, major adverse limb events, adverse cardiovascular events, and mortality. Multivariable logistic regression models were used to identify independent predictors of minor amputations. Analyses were performed overall and stratified by the presence or absence of DM at baseline., Results: Of the patients randomized, 398 (2.9%) underwent at least one lower extremity nontraumatic amputation, for a total of 511 amputations (255 major and 256 minor) over a median of 30 months. A history of minor amputation was the strongest independent predictor for a subsequent minor amputation (odds ratio, 7.29; 95% confidence interval, 5.17-10.30; P < .001) followed by comorbid DM (odds ratio, 4.60; 95% confidence interval, 3.16-6.69; P < .001). Compared with patients who had a major amputation, those with a minor amputation had similar rates of subsequent major amputation (12.2% vs 13.6%), major adverse limb events (15.1% vs 14.9%), and major adverse cardiovascular events (17.6% vs 16.3%). Ischemia alone was the primary driver of amputation (51%), followed by infection alone (27%), and multifactorial etiologies (22%); however, infection was the most frequent driver in those with DM (58%) but not in those without DM (15%)., Conclusions: Outcomes after amputation remain poor regardless of whether they are categorized as major or minor. The pattern of amputation drivers in PAD differs by history of DM, with infection being the dominant etiology in those with DM and ischemia in those without DM. Greater focus is needed on the prognostic importance of minor amputation and of the multifactorial etiologies of amputation in PAD. Nomenclature with anatomical description of amputations and eliminating terms "major" or "minor" would seem appropriate., (Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2022
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50. Ankle-Brachial Index for Risk Stratification in Patients With Symptomatic Peripheral Artery Disease With and Without Prior Lower Extremity Revascularization: Observations From the EUCLID Trial.

Author

Hiatt WR, Hess CN, Bonaca MP, Kavanagh S, Patel MR, Baumgartner I, Berger JS, Blomster JI, Jones WS, Katona BG, Mahaffey KW, Norgren L, Rockhold FW, and Fowkes FGR

Subjects
Ankle Brachial Index, Humans, Lower Extremity, Platelet Aggregation Inhibitors, Risk Assessment, Ticagrelor, Peripheral Arterial Disease diagnosis
Abstract

[Figure: see text].

Published
2021
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