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1. Evaluation of System Modelling Techniques for Waste Identification in Lean Healthcare Applications

Author: Alkaabi M, Simsekler MCE, Jayaraman R, Al Kaf A, Ghalib H, Quraini D, Ellahham S, Tuzcu EM, and Demirli K
Subjects: lean healthcare, value stream map, system modelling techniques, waste identification, kaizen, system approaches, healthcare operations, Public aspects of medicine, RA1-1270
Abstract: Maitha Alkaabi,1 Mecit Can Emre Simsekler,1 Raja Jayaraman,1 Abdulqader Al Kaf,1 Hussam Ghalib,2 Dima Quraini,2 Samer Ellahham,2 E Murat Tuzcu,2 Kudret Demirli3 1Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates; 2Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; 3Department of Mechanical, Industrial and Aerospace Engineering, Concordia University, Montreal, CanadaCorrespondence: Mecit Can Emre SimseklerDepartment of Industrial and Systems Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab EmiratesTel +9712 501 8410Fax +971 2 447 2442Email emre.simsekler@ku.ac.aePurpose: Waste identification plays a vital role in lean healthcare applications. While the value stream map (VSM) is among the most commonly used tools for waste identification, it may be limited to visualize the behaviour of dynamic and complex healthcare systems. To address this limitation, system modelling techniques (SMTs) can be used to provide a comprehensive picture of various system-wide wastes. However, there is a lack of evidence in the current literature about the potential contribution of SMTs for waste identification in healthcare processes.Methods: This study evaluates the usability and utility of six types of SMTs along with the VSM. For the evaluation, interview-based questionnaires were conducted with twelve stakeholders from the outpatient clinic at the Heart and Vascular Institute at Cleveland Clinic Abu Dhabi.Results: VSM was found to be the most useful diagram in waste identification in general. However, some SMTs that represent the system behaviour outperformed the VSM in identifying particular waste types, e.g., communication diagram in identifying over-processing waste and flow diagram in identifying transportation waste.Conclusion: As behavioural SMTs and VSM have unique strengths in identifying particular waste types, the use of multiple diagrams is recommended for a comprehensive waste identification in lean. However, limited resources and time, as well as limited experience of stakeholders with SMTs, may still present obstacles for their potential contribution in lean healthcare applications.Keywords: lean healthcare, value stream map, system modelling techniques, waste identification, kaizen, system approaches, healthcare operations
Published: 2021

2. Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis

Author: Ruiz CE, Hahn RT, Berrebi A, Borer JS, Cutlip DE, Fontana G, Gerosa G, Ibrahim R, Jelnin V, Jilaihawi H, Jolicoeur EM, Kliger C, Kronzon I, Leipsic J, Maisano F, Millan X, Nataf P, O'Gara PT, Pibarot P, Ramee SR, Rihal CS, Rodes-Cabau J, Sorajja P, Suri R, Swain JA, Turi ZG, Tuzcu EM, Weissman NJ, Zamorano JL, Serruys PW, Leon MB, Paravalvular Leak Academic Research C, Ruiz, Ce, Hahn, Rt, Berrebi, A, Borer, J, Cutlip, De, Fontana, G, Gerosa, G, Ibrahim, R, Jelnin, V, Jilaihawi, H, Jolicoeur, Em, Kliger, C, Kronzon, I, Leipsic, J, Maisano, F, Millan, X, Nataf, P, O'Gara, Pt, Pibarot, P, Ramee, Sr, Rihal, C, Rodes-Cabau, J, Sorajja, P, Suri, R, Swain, Ja, Turi, Zg, Tuzcu, Em, Weissman, Nj, Zamorano, Jl, Serruys, Pw, Leon, Mb, and Paravalvular Leak Academic Research, C
Published: 2018

3. Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis: An Expert Statement

Author: Ruiz CE, Hahn RT, Berrebi A, Borer JS, Cutlip DE, Fontana G, Gerosa G, Ibrahim R, Jelnin V, Jilaihawi H, Jolicoeur EM, Kliger C, Kronzon I, Leipsic J, Maisano F, Millan X, Nataf P, O'Gara PT, Pibarot P, Ramee SR, Rihal CS, Rodes-Cabau J, Sorajja P, Suri R, Swain JA, Turi ZG, Tuzcu EM, Weissman NJ, Zamorano JL, Serruys PW, Leon MB, Paravalvular Leak Academic Research C, Ruiz, Ce, Hahn, Rt, Berrebi, A, Borer, J, Cutlip, De, Fontana, G, Gerosa, G, Ibrahim, R, Jelnin, V, Jilaihawi, H, Jolicoeur, Em, Kliger, C, Kronzon, I, Leipsic, J, Maisano, F, Millan, X, Nataf, P, O'Gara, Pt, Pibarot, P, Ramee, Sr, Rihal, C, Rodes-Cabau, J, Sorajja, P, Suri, R, Swain, Ja, Turi, Zg, Tuzcu, Em, Weissman, Nj, Zamorano, Jl, Serruys, Pw, Leon, Mb, and Paravalvular Leak Academic Research, C
Published: 2017

4. The burden of cardiovascular diseases among us states, 1990-2016

Author: Roth, GA, Johnson, CO, Abate, KH, Abd-Allah, F, Ahmed, M, Alam, K, Alam, T, Alvis-Guzman, N, Ansari, H, Ärnlöv, J, Atey, TM, Awasthi, A, Awoke, T, Barac, A, Bärnighausen, T, Bedi, N, Bennett, D, Bensenor, I, Biadgilign, S, Castañeda-Orjuela, C, Catalá-López, F, Davletov, K, Dharmaratne, S, Ding, EL, Dubey, M, Faraon, EJA, Farid, T, Farvid, MS, Feigin, V, Fernandes, J, Frostad, J, Gebru, A, Geleijnse, JM, Gona, PN, Griswold, M, Hailu, GB, Hankey, GJ, Hassen, HY, Havmoeller, R, Hay, S, Heckbert, SR, Irvine, CMS, James, SL, Jara, D, Kasaeian, A, Khan, AR, Khera, S, Khoja, AT, Khubchandani, J, Kim, D, Kolte, D, Lal, D, Larsson, A, Linn, S, Lotufo, PA, Razek, H, Mazidi, M, Meier, T, Mendoza, W, Mensah, GA, Meretoja, A, Mezgebe, HB, Mirrakhimov, E, Mohammed, S, Moran, AE, Nguyen, G, Nguyen, M, Ong, KL, Owolabi, M, Pletcher, M, Pourmalek, F, Purcell, CA, Qorbani, M, Rahman, M, Rai, RK, Ram, U, Reitsma, MB, Renzaho, AMN, Rios-Blancas, MJ, Safiri, S, Salomon, JA, Sartorius, B, Sepanlou, SG, Shaikh, MA, Silva, D, Stranges, S, Tabarés-Seisdedos, R, Atnafu, N, Thakur, JS, Topor-Madry, R, Truelsen, T, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Vasankari, T, Vlassov, V, Vollset, SE, Wakayo, T, Weintraub, R, Wolfe, C, Workicho, A, Xu, G, Yadgir, S, Yano, Y, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaki, MES, Zipkin, B, Afshin, A, Gakidou, E, Lim, SS, Mokdad, AH, Naghavi, M, Vos, T, and Murray, CJL
Subjects: Kardiologi, Nutrition and Disease, Voeding en Ziekte, Life Science, Cardiac and Cardiovascular Systems, VLAG
Abstract: Importance Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. Objective To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. Design, Setting, and Participants Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. Exposures Residing in the United States. Main Outcomes and Measures Cardiovascular disease disability-adjusted life-years (DALYs). Results Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. Conclusions and Relevance Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures.
Published: 2018

5. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Vos, T, Barber, Rm, Bell, B, Bertozzi Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie, E, Liang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu, Ozgoren, A, Abd Allah, F, Abdel, Aziz, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu Raddad, Lj, Abu Rmeileh, Nm, Aburto, Tc, Achoki, T, Ackerman, In, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Khabouri, Al, Alam, Ss, Alasfoor, D, Albittar, Mi, Alegretti, Ma, Aleman, Av, Alemu, Za, Alfonso Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis, Guzman, Ameli, N, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, Vs, Artaman, A, Asghar, Rj, Assadi, R, Atkins, Ls, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker Collo, Sl, Barquera, S, Barregard, L, Barrero, Lh, Basu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene, Tj, Bhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin, Abdulhak, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora, Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown, J, Brugha, Ts, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos, Nonato, Campuzano, Ir, Carapetis, Jc, Carpenter, Do, Caso, V, Castaneda Orjuela, Ca, Catala Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, Ss, Cirillo, Massimo, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper, Lt, Cooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, La, De, Cruz, Gongora, De, V, Vega, La, De, Sf, Leo, D, Del, Pozo, Cruz, Dellavalle, Rp, Deribe, K, Derrett, S, Des, Jarlais, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad, Sm, Fernandes, Jg, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia, Guerra, Geleijnse, Fa, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez, De, Cosio, T, Gosselin, Ra, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi Nejad, N, Hagan, H, Halasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia, Pi, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang, Jj, Huang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang, Y, Jonas, Jb, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, Ds, Kemp, Ah, Kengne, Ap, Khader, Ys, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto, M, Knibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate, Defo, Kucuk, B, Bicer, B, Kuipers, Ej, Kulkarni, Vs, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett, Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez Olmedo, N, Lortet Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay, Mt, Majdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason Jones, Aj, Matzopoulos, Rg, Mayosi, Bm, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt, Te, Mohamed, Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori, R, Moschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, Ks, Naghavi, P, Nahas, Z, Naheed, A, Naidoo, Ks, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni, Fn, Nhung, Nt, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Ih, Oh, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian, Jd, Panelo, Ci, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, Ls, Pellegrini, Ca, Pereira, Dm, Perez Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez Riera, L, Santos, Is, Satpathy, M, Saunders, Je, Sawhney, M, Saylan, Mi, Scarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan Mori, Ee, Shackelford, K, Shaheen, A, Shahraz, S, Shamah, Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, Ds, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, Ss, Speyer, P, Sposato, La, Sreeramareddy, Ct, Stoeckl, H, Stathopoulou, Vk, Steckling, N, Stein, Mb, Stein, Dj, Steiner, Tj, Stewart, A, Stork, E, Stovner, Lj, Stroumpoulis, K, Sturua, L, Sunguya, Bf, Swaroop, M, Sykes, Bl, Tabb, Km, Takahashi, K, Tan, F, Tandon, N, Tanne, D, Tanner, M, Tavakkoli, M, Taylor, Hr, Ao, Te, Temesgen, Am, Ten, Have, M, Tenkorang, Ey, Terkawi, As, Theadom, Am, Thomas, E, Thorne Lyman, Al, Thrift, Ag, Tleyjeh, Im, Tonelli, M, Topouzis, F, Towbin, Ja, Toyoshima, H, Traebert, J, Tran, Bx, Trasande, L, Trillini, M, Truelsen, T, Trujillo, U, Tsilimbaris, M, Tuzcu, Em, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Van, Brakel, Van, Wh, Vijver, De, Van, S, Dingenen, R, Van, Gool, Varakin, Yy, Vasankari, Tj, Vavilala, Ms, Veerman, Lj, Velasquez, Melendez, G, Venketasubramanian, N, Vijayakumar, L, Villalpando, S, Violante, Fs, Vlassov, Vv, Waller, S, Wallin, Mt, Wan, X, Wang, L, Wang, J, Wang, Y, Warouw, Ts, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Werdecker, A, Wessells, Kr, Westerman, R, Wilkinson, Jd, Williams, Hc, Williams, Tn, Woldeyohannes, Sm, Wolfe, Cd, Wong, Jq, Wong, H, Woolf, Ad, Wright, Jl, Wurtz, B, Xu, G, Yang, G, Yano, Y, Yenesew, Ma, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, M, Yu, C, Kim, Ky, Zaki, Mel, Zhang, Y, Zhao, Z, Zhao, Y, Zhu, J, Zonies, D, Zunt, Jr, Salomon, Ja, Murray, C. J., Vos, T, Barber, Rm, Bell, B, Bertozzi-Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie ELiang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi-Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu Ozgoren, A, Abd-Allah, F, Abdel Aziz MI, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu-Raddad, Lj, Abu-Rmeileh, Nm, Aburto, Tc, Achoki TAckerman IN, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Al Khabouri MJ, Alam, S, Alasfoor, D, Albittar, Mi, Alegretti MAAleman AV, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzman NAmeli, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, V, Artaman, A, Asghar, Rj, Assadi, R, Atkins, L, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker-Collo, Sl, Barquera, S, Barregard, L, Barrero LHBasu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene TJBhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin Abdulhak, A, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown JBrugha TS, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos Nonato IR, Campuzano JCCarapetis JR, Carpenter, Do, Caso, V, Castaneda-Orjuela, Ca, Catala-Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed-Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, S, Cirillo, M, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper LTCooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas-Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, De la Cruz-Gongora, V, de la Vega SF, De Leo, D, del Pozo-Cruz, B, Dellavalle, Rp, Deribe, K, Derrett, S, Des Jarlais DC, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz-Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad SMFernandes JG, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia-Guerra FAGeleijnse JM, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez de Cosio TGosselin RA, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi-Nejad, N, Hagan HHalasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia Pi IB, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang JJHuang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang YJonas JB, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, D, Kemp, Ah, Kengne, Ap, Khader, Y, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto MKnibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate Defo, B, Kucuk Bicer, B, Kuipers EJKulkarni VS, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez-Olmedo, N, Lortet-Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay MTMajdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason-Jones, Aj, Matzopoulos RGMayosi BM, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia-Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt TEMohamed Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori RMoschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, K, Naghavi, P, Nahas ZNaheed, A, Naidoo, K, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni FNNhung NT, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian JDPanelo CI, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, L, Pellegrini, Ca, Pereira, Dm, Perez-Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk GVPolinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas-Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez-Riera, L, Santos, I, Satpathy, M, Saunders, Je, Sawhney, M, Saylan MIScarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan-Mori, Ee, Shackelford, K, Shaheen AShahraz, S, Shamah Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, D, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, S, Speyer PSposato LA, Sreeramareddy, Ct, Stoeckl, H, Stathopoulou, Vk, Steckling, N, Stein, Mb, Stein, Dj, Steiner, Tj, Stewart, A, Stork, E, Stovner LJStroumpoulis, K, Sturua, L, Sunguya, Bf, Swaroop, M, Sykes, Bl, Tabb, Km, Takahashi, K, Tan, F, Tandon, N, Tanne, D, Tanner, M, Tavakkoli, M, Taylor, Hr, Te Ao BJ, Temesgen, Am, Ten Have, M, Tenkorang, Ey, Terkawi, A, Theadom, Am, Thomas, E, Thorne-Lyman, Al, Thrift, Ag, Tleyjeh, Im, Tonelli, M, Topouzis, F, Towbin, Ja, Toyoshima, H, Traebert, J, Tran, Bx, Trasande, L, Trillini, M, Truelsen, T, Trujillo, U, Tsilimbaris, M, Tuzcu, Em, Ukwaja KNUndurraga EA, Uzun, Sb, van Brakel WH, van de Vijver, S, Van Dingenen, R, van Gool CH, Varakin, Yy, Vasankari, Tj, Vavilala, M, Veerman LJVelasquez-Melendez, G, Venketasubramanian, N, Vijayakumar, L, Villalpando, S, Violante, F, Vlassov, Vv, Waller, S, Wallin, Mt, Wan, X, Wang, L, Wang, J, Wang, Y, Warouw, T, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Werdecker, A, Wessells, Kr, Westerman, R, Wilkinson, Jd, Williams HCWilliams TN, Woldeyohannes, Sm, Wolfe, Cd, Wong, Jq, Wong, H, Woolf, Ad, Wright, Jl, Wurtz, B, Xu, G, Yang, G, Yano, Y, Yenesew, Ma, Yentur GKYip, P, Yonemoto, N, Yoon, Sj, Younis, M, Yu, C, Kim, Ky, Zaki Mel, S, Zhang, Y, Zhao, Z, Zhao, Y, Zhu, J, Zonies, D, Zunt, Jr, Salomon, Ja, Murray, Cj., Vos, Theo, Barber, Ryan M., Bell, Brad, Bertozzi-Villa, Amelia, Biryukov, Stan, Bolliger, Ian, Charlson, Fiona, Davis, Adrian, Degenhardt, Louisa, Dicker, Daniel, Duan, Leilei, Erskine, Holly, Feigin, Valery L., Ferrari, Alize J., Fitzmaurice, Christina, Fleming, Thoma, Graetz, Nichola, Guinovart, Caterina, Haagsma, Juanita, Hansen, Gillian M., Hanson, Sarah Wulf, Heuton, Kyle R., Higashi, Hideki, Kassebaum, Nichola, Kyu, Hmwe, Laurie, Evan, Liang, Xiofeng, Lofgren, Katherine, Lozano, Rafael, Macintyre, Michael F., Moradi-Lakeh, Maziar, Naghavi, Mohsen, Nguyen, Grant, Odell, Shaun, Ortblad, Katrina, Roberts, David Allen, Roth, Gregory A., Sandar, Logan, Serina, Peter T., Stanaway, Jeffrey D., 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Heredia, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H. Dean, Hossain, Mazeda, Hotez, Peter J., Hoy, Damian G., Hsairi, Mohamed, Hu, Howard, Hu, Guoqing, Huang, John J., Huang, Cheng, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa, Iburg, Kim M., Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H., Jassal, Simerjot K., Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Joseph, Jonathan, Juel, Knud, Kan, Haidong, Karch, Andre, Karimkhani, Chante, Karthikeyan, Ganesan, Katz, Ronit, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre P., Khader, Yousef S., Khalifa, Shams Eldin A.H., Khan, Ejaz A., Khan, Gulfaraz, Khang, Young-Ho, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kimokoti, Ruth W., Kinfu, Yohanne, Kinge, Jonas M., Kissela, Brett M., Kivipelto, Miia, Knibbs, Luke, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kosen, Soewarta, Kramer, Alexander, Kravchenko, Michael, Krishnamurthi, Rita V., Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J., Kulkarni, Veena S., Kumar, Kaushalendra, Kumar, G Anil, Kwan, Gene F., Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi, Larsson, Ander, Lawrynowicz, Alicia E.B., Leasher, Janet L., Lee, Jong-Tae, Leigh, Jame, Leung, Ricky, Levi, Miriam, Li, Bin, Li, Yichong, Li, Yongmei, Liang, Juan, Lim, Stephen, Lin, Hsien-Ho, Lind, Margaret, Lindsay, M Patrice, Lipshultz, Steven E., Liu, Shiwei, Lloyd, Belinda K., Ohno, Summer Lockett, Logroscino, Giancarlo, Looker, Katharine J., Lopez, Alan D., Lopez-Olmedo, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A., Low, Nicola, Lucas, Robyn M., Lunevicius, Raimunda, Lyons, Ronan A., Ma, Jixiang, Ma, Stefan, Mackay, Mark T., Majdan, Marek, Malekzadeh, Reza, Mapoma, Christopher C., Marcenes, Wagner, March, Lyn M., Margono, Chri, Marks, Guy B., Marzan, Melvin B., Masci, Joseph R., Mason-Jones, Amanda J., Matzopoulos, Richard G., Mayosi, Bongani M., Mazorodze, Tasara T., Mcgill, Neil W., Mcgrath, John J., Mckee, Martin, Mclain, Abby, Mcmahon, Brian J., Meaney, Peter A., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A., Meltzer, Michele, Memish, Ziad A., Mensah, George, Meretoja, Atte, Mhimbira, Francis A., Micha, Renata, Miller, Ted R., Mills, Edward J., Mitchell, Philip B., Mock, Charles N., Moffitt, Terrie E., Ibrahim, Norlinah Mohamed, Mohammad, Karzan A., Mokdad, Ali H., Mola, Glen L., Monasta, Lorenzo, Montico, Marcella, Montine, Thomas J., Moore, Ami R., Moran, Andrew E., Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N., Moyer, Madeline, Mozaffarian, Dariush, Mueller, Ulrich O., Mukaigawara, Mitsuru, Murdoch, Michele E., Murray, Joseph, Murthy, Kinnari S., Naghavi, Paria, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, K.M. Venkat, Nash, Deni, Nejjari, Chakib, Neupane, Sudan P., Newman, Lori M., Newton, Charles R., Ng, Marie, Ngalesoni, Frida N., Nhung, Nguyen T., Nisar, Muhammad I., Nolte, Sandra, Norheim, Ole F., Norman, Rosana E., Norrving, Bo, Nyakarahuka, Luke, Oh, In Hwan, Ohkubo, Takayoshi, Omer, Saad B., Opio, John Nelson, Ortiz, Alberto, Pandian, Jeyaraj D., Panelo, Carlo Irwin A., Papachristou, Christina, Park, Eun-Kee, Parry, Charles D., Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pavlin, Boris I., Pearce, Neil, Pedraza, Lilia S., Pellegrini, Carlos A., Pereira, David M., Perez-Ruiz, Fernando P., Perico, Norberto, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B., Petzold, Max, Phillips, Michael R., Phillips, David, Phillips, Bryan, Piel, Frederic B., Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, C.A., Popova, Svetlana, Poulton, Richie G., Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Noela M., Qato, Dima, Quistberg, D.A., Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M., Razavi, Homie, Refaat, Amany, Rehm, Jurgen, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L., Riccio, Patricia M., Richardson, Lee, Richardus, Jan Hendrik, Riederer, Anne M., Robinson, Margot, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Rothenbacher, Dietrich, Roy, Nobhojit, Ruhago, George M., Sabin, Nsanzimana, Sacco, Ralph L., Ksoreide, Kjetil, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Sampson, Uchechukwu, Sanabria, Juan R., Sanchez-Riera, Lidia, Santos, Itamar S., Satpathy, Maheswar, Saunders, James E., Sawhney, Monika, Saylan, Mete I., Scarborough, Peter, Schoettker, Ben, Schneider, Ione J.C., Schwebel, David C., Scott, James G., Seedat, Soraya, Sepanlou, Sadaf G., Serdar, Berrin, Servan-Mori, Edson E., Shackelford, Katya, Shaheen, Amira, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shepard, Donald S., Shi, Peilin, Shibuya, Kenji, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Shrime, Mark G., Sigfusdottir, Inga D., Silberberg, Donald H., Simard, Edgar P., Sindi, Shireen, Singh, Jasvinder A., Singh, Lavanya, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Soshnikov, Sergey S., Speyer, Peter, Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stoeckl, Heidi, Stathopoulou, Vasiliki Kalliopi, Steckling, Nadine, Stein, Murray B., Stein, Dan J., Steiner, Timothy J., Stewart, Andrea, Stork, Eden, Stovner, Lars J., Stroumpoulis, Konstantino, Sturua, Lela, Sunguya, Bruno F., Swaroop, Mamta, Sykes, Bryan L., Tabb, Karen M., Takahashi, Ken, Tan, Feng, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Taylor, Hugh R., Te Ao, Braden J., Temesgen, Awoke Misganaw, Have, Margreet Ten, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Theadom, Alice M., Thomas, Elissa, Thorne-Lyman, Andrew L., Thrift, Amanda G., Tleyjeh, Imad M., Tonelli, Marcello, Topouzis, Foti, Towbin, Jeffrey A., Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X., Trasande, Leonardo, Trillini, Matia, Truelsen, Thoma, Trujillo, Ulise, Tsilimbaris, Miltiadi, Tuzcu, Emin M., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen B., Van Brakel, Wim H., Van De Vijver, Steven, Dingenen, Rita Van, Van Gool, Coen H., Varakin, Yuri Y., Vasankari, Tommi J., Vavilala, Monica S., Veerman, Lennert J., Velasquez-Melendez, Gustavo, Venketasubramanian, Narayanaswamy, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy V., Waller, Stephen, Wallin, Mitchell T., Wan, Xia, Wang, Linhong, Wang, Jianli, Wang, Yanping, Warouw, Tati S., Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Werdecker, Andrea, Wessells, K. Ryan, Westerman, Ronny, Wilkinson, James D., Williams, Hywel C., Williams, Thomas N., Woldeyohannes, Solomon M., Wolfe, Charles D.A., Wong, John Q., Wong, Haidong, Woolf, Anthony D., Wright, Jonathan L., Wurtz, Brittany, Xu, Gelin, Yang, Gonghuan, Yano, Yuichiro, Yenesew, Muluken A., Yentur, Gokalp K., Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Kim, Kim Yun, Zaki, Maysaa El Sayed, Zhang, Yong, Zhao, Zheng, Zhao, Yong, Zhu, Jun, Zonies, David, Zunt, Joseph R., Salomon, Joshua A., Murray, Christopher J.L., Cell biology, Gastroenterology & Hepatology, Epidemiology, Health Technology Assessment (HTA), and Public Health
Subjects: Male, Gerontology, Nutrition and Disease, Epidemiology, years lived with disability, Global burden of disease, acute and chronic diseases, countries, Prevalence, Disease, Global Health, Medical and Health Sciences, Conduct disorder, Otitis-media, Cost of Illness, Residence Characteristics, Voeding en Ziekte, 80 and over, Global health, 2.2 Factors relating to the physical environment, 2.1 Biological and endogenous factors, countries, Aetiology, Child, Aged, 80 and over, Medicine(all), education.field_of_study, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, Incidence, Mortality rate, Incidence (epidemiology), Pain Research, Neglected Diseases, Alcohol dependence, General Medicine, Middle Aged, Global burden of disease, Global Burden of Disease Study 2013 Collaborators, Mental Health, Infectious Diseases, Attention deficit/Hyperactivity disorder, Burden of Illness, Child, Preschool, Acute Disease, Female, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, Adolescent, GBD 2013, Population, acute and chronic diseases, Young Adult, Mental-disorders, Age Distribution, Medicine, General & Internal, Weights, General & Internal Medicine, medicine, Humans, Life Science, Disabled Persons, Sex Distribution, Preschool, education, Developing Countries, VLAG, Aged, Science & Technology, business.industry, Developed Countries, Cutaneous Leishmaniasis, Infant, Newborn, Infant, Health outcomes, Newborn, medicine.disease, Comorbidity, Brain Disorders, years lived with disability, Good Health and Well Being, Disease, injury, incidence, prevalence, YLDs, GBD 2010, Chronic Disease, Wounds and Injuries, business, 2.4 Surveillance and distribution, Iron-deficiency, Demography
Abstract: Summary Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. Funding Bill & Melinda Gates Foundation. Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. Funding Bill & Melinda Gates Foundation.
Published: 2015

6. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016

Author: Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, 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Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V, Jin, Y, John, D, John, O, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, and Murray, CJL
Published: 2017

7. Predictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registry

Author: Ribeiro, HB, Webb, JG, Makkar, RR, Cohen, MG, Kapadia, SR, Kodali, S, Tamburino, C, Barbanti, M, Chakravarty, T, Jilaihawi, H, Paradis, JM, de Brito, FS, Canovas, SJ, Cheema, AN, de Jaegere, Peter, Valle, R, Chiam, PTL, Moreno, R, Pradas, G, Ruel, M, Salgado-Fernandez, J, Sarmento-Leite, R, Toeg, HD, Velianou, JL, Zajarias, A, Babaliaros, V, Cura, F, Dager, AE, Manoharan, G, Lerakis, S, Pichard, AD, Radhakrishnan, S, Perin, MA, Dumont, E, Larose, E, Pasian, SG, Nombela-Franco, L, Urena, M, Tuzcu, EM, Leon, MB, Amat-Santos, IJ, Leipsic, J, Rodes-Cabau, J, and Cardiology
Subjects: Aged, 80 and over, Heart Defects, Congenital, Heart Valve Prosthesis Implantation, Male, Cardiac Catheterization, percutaneous coronary intervention, Heart Valve Diseases, coronary obstruction, Disease Management, coronary occlusion, percutaneous aortic valve replacement, Cohort Studies, Postoperative Complications, Treatment Outcome, Bicuspid Aortic Valve Disease, Predictive Value of Tests, Aortic Valve, Humans, Female, Registries, transcatheter aortic valve implantation, Aged, Retrospective Studies
Abstract: ObjectivesThis study sought to evaluate the main baseline and procedural characteristics, management, and clinical outcomes of patients from a large cohort of patients undergoing transcatheter aortic valve implantation (TAVI) who suffered coronary obstruction (CO).BackgroundVery little data exist on CO following TAVI.MethodsThis multicenter registry included 44 patients who suffered symptomatic CO following TAVI of 6,688 patients (0.66%). Pre-TAVI computed tomography data was available in 28 CO patients and in a control group of 345 patients (comparisons were performed including all patients and a cohort matched 1:1 by age, sex, previous coronary artery bypass graft, transcatheter valve type, and size).ResultsBaseline and procedural variables associated with CO were older age (p < 0.001), female sex (p < 0.001), no previous coronary artery bypass graft (p = 0.043), the use of a balloon-expandable valve (p = 0.023), and previous surgical aortic bioprosthesis (p = 0.045). The left coronary artery was the most commonly involved (88.6%). The mean left coronary artery ostia height and sinus of Valsalva diameters were lower in patients with obstruction than in control subjects (10.6 ± 2.1 mm vs. 13.4 ± 2.1 mm, p < 0.001; 28.1 ± 3.8 mm vs. 31.9 ± 4.1 mm, p < 0.001). Differences between groups remained significant after the case-matched analysis (p < 0.001 for coronary height; p = 0.01 for sinus of Valsalva diameter). Most patients presented with persistent severe hypotension (68.2%) and electrocardiographic changes (56.8%). Percutaneous coronary intervention was attempted in 75% of the cases and was successful in 81.8%. Thirty-day mortality was 40.9%. After a median follow-up of 12 (2 to 18) months, the cumulative mortality rate was 45.5%, and there were no cases of stent thrombosis or reintervention.ConclusionsSymptomatic CO following TAVI was a rare but life-threatening complication that occurred more frequently in women, in patients receiving a balloon-expandable valve, and in those with a previous surgical bioprosthesis. Lower-lying coronary ostium and shallow sinus of Valsalva were associated anatomic factors, and despite successful treatment, acute and late mortality remained very high, highlighting the importance of anticipating and preventing the occurrence of this complication.
Published: 2013

8. Everolimus for the prevention of allograft rejection and vasculopathy in cardiac-transplant recipients

Author: Eisen, Hj, Tuzcu, Em, Dorent, R, Kobashigawa, J, Mancini, D, VALANTINE VON KAEPPLER HA, Starling, Rc, Sorensen, K, Hummel, M, Lind, Jm, Abeywickrama, Kh, Bernhardt, P, Rinaldi, Mauro, and STUDY GROUP, FOR THE RAD B.
Published: 2003

9. Defining allograft vasculopathy using volumetric intravasular ultrasound analysis

Author: Young, JB, Badak, ÖZER, Tuzcu, EM, Crowe, TD, Tsunoda, T, Schoenhagen, P, Yamani, MH, Starling, RC, and Haji, SA
Published: 2002

10. Recent developments in balloon valvuloplasty techniques

Author: Elliott Jm and Tuzcu Em
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Mitral valvuloplasty, medicine.medical_treatment, Pregnancy Complications, Cardiovascular, Balloon, Catheterization, Pregnancy, medicine, Humans, Mitral Valve Stenosis, Adverse effect, Surgical treatment, Child, Aged, business.industry, Infant, Aortic Valve Stenosis, medicine.disease, Balloon valvuloplasty, Prognosis, Surgery, Aortic valvuloplasty, Pulmonary Valve Stenosis, Stenosis, Treatment Outcome, Functional status, Female, Cardiology and Cardiovascular Medicine, business
Abstract: The long-term outcome after mitral valvuloplasty is excellent and compares well with surgical treatment of mitral stenosis. Compared with the double balloon technique, the Inoue method is technically easier and may reduce acute complications without any adverse effect on long-term outcomes. Excellent long-term outcome is also seen after balloon valvuloplasty of aortic stenosis in the young and in pulmonary stenosis at all ages. Finally, although balloon aortic valvuloplasty in the elderly may not change the terrible prognosis of such patients, it does improve functional status and is a useful bridge to surgery in selected patients.
Published: 1995

11. Automated identification of luminal and medial adventitial borders in intravascular ultrasound images of human coronary arteries

Author: Meier, Ds, Cothren, Rm, Tuzcu, Em, Masseroli, Marco, Thomas, Jd, Nissen, Se, and Cornhill, Jf
Published: 1995

12. Everolimus in combination with cyclosporine A in de novo heart transplant recipients: A two-year multicenter study to investigate the prevention of graft rejection and vasculopathy

Author: Lehmkuhl, HB, primary, Hetzer, R, additional, Hummel, M, additional, Haverich, A, additional, Sch�ffer, M, additional, Tuzcu, EM, additional, Ulbricht, B, additional, and Bara, C, additional
Published: 2004
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13. Percutaneous coronary intervention in patients with severe aortic stenosis: implications for transcatheter aortic valve replacement.

Author: Goel SS, Agarwal S, Tuzcu EM, Ellis SG, Svensson LG, Zaman T, Bajaj N, Joseph L, Patel NS, Aksoy O, Stewart WJ, Griffin BP, and Kapadia SR
Published: 2012
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14. Prosthesis-patient mismatch in the transcatheter aortic valve replacement era.

Author: Tuzcu EM, Ozkan A, and Kapadia SR
Published: 2011

15. Lowering the triglyceride/high-density lipoprotein cholesterol ratio is associated with the beneficial impact of pioglitazone on progression of coronary atherosclerosis in diabetic patients: insights from the PERISCOPE (Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation) study.

Author: Nicholls SJ, Tuzcu EM, Wolski K, Bayturan O, Lavoie A, Uno K, Kupfer S, Perez A, Nesto R, Nissen SE, Nicholls, Stephen J, Tuzcu, E Murat, Wolski, Kathy, Bayturan, Ozgur, Lavoie, Andrea, Uno, Kiyoko, Kupfer, Stuart, Perez, Alfonso, Nesto, Richard, and Nissen, Steven E
Abstract: Objectives: The purpose of this study was to determine the factors associated with the favorable effect of pioglitazone on atheroma progression. Background: Diabetes mellitus is associated with accelerated coronary atheroma progression. Pioglitazone slowed progression compared with glimepiride in this population. Methods: In all, 360 diabetic patients with coronary artery disease were treated with pioglitazone or glimepiride for 18 months in the PERISCOPE (Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation) study. Coronary atheroma progression was evaluated by serial intravascular ultrasound. The relationship between changes in biochemical parameters, percent atheroma volume, and total atheroma volume was investigated. Results: Pioglitazone-treated patients demonstrated greater increases in high-density lipoprotein cholesterol (HDL-C) and reductions in glycated hemoglobin, triglycerides, and C-reactive protein. Significant correlations were observed between changes in percent atheroma volume and triglycerides (r = 0.15, p = 0.04), triglyceride/HDL-C ratio (r = 0.16, p = 0.03), and glycated hemoglobin (r = 0.16, p = 0.03) with pioglitazone, and changes in low-density lipoprotein cholesterol (r = -0.15, p = 0.05), apolipoprotein B (r = -0.16, p = 0.04), and apolipoprotein A-I (r = -0.20, p = 0.01) with glimepiride. Substantial atheroma regression, compared to progression, was associated with greater relative increases in HDL-C (14.2% vs. 7.8%, p = 0.04), relative decreases in triglycerides (-13.3% vs. -1.9%, p = 0.045), triglyceride/HDL-C ratio (-22.5 vs. -9.9%, p = 0.05), and decrease in glycated hemoglobin (-0.6% vs. -0.3%, p = 0.01). Multivariable analysis revealed that pioglitazone-induced effects on triglyceride/HDL-C were associated with changes in percent atheroma volume (p = 0.03) and total atheroma volume (p = 0.02). Conclusions: Favorable effects of pioglitazone on the triglyceride/HDL-C ratio correlated with delayed atheroma progression in diabetic patients. This finding highlights the potential importance of targeting atherogenic dyslipidemia in diabetic patients with coronary artery disease. [ABSTRACT FROM AUTHOR]
Published: 2011
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16. Invasive imaging: Coronary intravascular ultrasound: a closer view.

Author: Tuzcu EM, Bayturan O, Kapadia S, Tuzcu, E Murat, Bayturan, Ozgur, and Kapadia, Samir
Published: 2010
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17. Percutaneous Device Closure of Patent Foramen Ovale for Secondary Stroke Prevention: A Call for Completion of Randomized Clinical Trials: A Science Advisory From the American Heart Association/American Stroke Association and the American College of Cardiology Foundation The American Academy of Neurology affirms the value of this science advisory.

Author: O'Gara PT, Messe SR, Tuzcu EM, Catha G, and Ring JC
Published: 2009
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18. Cholesteryl ester transfer protein inhibition, high-density lipoprotein raising, and progression of coronary atherosclerosis: insights from ILLUSTRATE (Investigation of Lipid Level Management Using Coronary Ultrasound to Assess Reduction of Atherosclerosis by CETP Inhibition and HDL Elevation).

Author: Nicholls SJ, Tuzcu EM, Brennan DM, Tardif JC, Nissen SE, Nicholls, Stephen J, Tuzcu, E Murat, Brennan, Danielle M, Tardif, Jean-Claude, and Nissen, Steven E
Published: 2008
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19. High-density lipoprotein and atheroma monitoring.

Author: Nicholls SJ and Tuzcu EM
Published: 2008
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20. Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: the PERISCOPE randomized controlled trial.

Author: Nissen SE, Nicholls SJ, Wolski K, Nesto R, Kupfer S, Perez A, Jure H, De Larochellière R, Staniloae CS, Mavromatis K, Saw J, Hu B, Lincoff AM, Tuzcu EM, PERISCOPE Investigators, Nissen, Steven E, Nicholls, Stephen J, Wolski, Kathy, Nesto, Richard, and Kupfer, Stuart
Abstract: Context: No antidiabetic regimen has demonstrated the ability to reduce progression of coronary atherosclerosis. Commonly used oral glucose-lowering agents include sulfonylureas, which are insulin secretagogues, and thiazolidinediones, which are insulin sensitizers.Objective: To compare the effects of an insulin sensitizer, pioglitazone, with an insulin secretagogue, glimepiride, on the progression of coronary atherosclerosis in patients with type 2 diabetes.Design, Setting, and Participants: Double-blind, randomized, multicenter trial at 97 academic and community hospitals in North and South America (enrollment August 2003-March 2006) in 543 patients with coronary disease and type 2 diabetes.Interventions: A total of 543 patients underwent coronary intravascular ultrasonography and were randomized to receive glimepiride, 1 to 4 mg, or pioglitazone, 15 to 45 mg, for 18 months with titration to maximum dosage, if tolerated. Atherosclerosis progression was measured by repeat intravascular ultrasonography examination in 360 patients at study completion.Main Outcome Measure: Change in percent atheroma volume (PAV) from baseline to study completion.Results: Least squares mean PAV increased 0.73% (95% CI, 0.33% to 1.12%) with glimepiride and decreased 0.16% (95% CI, -0.57% to 0.25%) with pioglitazone(P = .002). An alternative analysis imputing values for noncompleters based on baseline characteristics showed an increase in PAV of 0.64% (95% CI, 0.23% to 1.05%) for glimepiride and a decrease of 0.06% (-0.47% to 0.35%) for pioglitazone (between-group P = .02). Mean (SD) baseline HbA(1c) levels were 7.4% (1.0%) in both groups and declined during treatment an average 0.55% (95% CI, -0.68% to -0.42%) with pioglitazone and 0.36% (95% CI, -0.48% to -0.24%) with glimepiride (between-group P = .03). In the pioglitazone group, compared with glimepiride, high-density lipoprotein levels increased 5.7 mg/dL (95% CI, 4.4 to 7.0 mg/dL; 16.0%) vs 0.9 mg/dL (95% CI, -0.3 to 2.1 mg/dL; 4.1%), and median triglyceride levels decreased 16.3 mg/dL (95% CI, -27.7 to -11.0 mg/dL; 15.3%) vs an increase of 3.3 mg/dL (95% CI, -10.7 to 11.7 mg/dL; 0.6%) (P < .001 for both comparisons). Median fasting insulin levels decreased with pioglitazone and increased with glimepiride (P < .001). Hypoglycemia was more common in the glimepiride group and edema, fractures, and decreased hemoglobin levels occurred more frequently in the pioglitazone group.Conclusion: In patients with type 2 diabetes and coronary artery disease, treatment with pioglitazone resulted in a significantly lower rate of progression of coronary atherosclerosis compared with glimepiride.Trial Registration: clinicaltrials.gov Identifier: NCT00225277. [ABSTRACT FROM AUTHOR]
Published: 2008
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21. Effect of rimonabant on progression of atherosclerosis in patients with abdominal obesity and coronary artery disease: the STRADIVARIUS randomized controlled trial.

Author: Nissen SE, Nicholls SJ, Wolski K, Rodés-Cabau J, Cannon CP, Deanfield JE, Després JP, Kastelein JJ, Steinhubl SR, Kapadia S, Yasin M, Ruzyllo W, Gaudin C, Job B, Hu B, Bhatt DL, Lincoff AM, Tuzcu EM, STRADIVARIUS Investigators, and Nissen, Steven E
Abstract: Context: Abdominal obesity is associated with metabolic abnormalities and increased risk of atherosclerotic cardiovascular disease. However, no obesity management strategy has demonstrated the ability to slow progression of coronary disease.Objective: To determine whether weight loss and metabolic effects of the selective cannabinoid type 1 receptor antagonist rimonabant reduces progression of coronary disease in patients with abdominal obesity and the metabolic syndrome.Design, Setting, and Patients: Randomized, double-blinded, placebo-controlled, 2-group, parallel-group trial (enrollment December 2004-December 2005) comparing rimonabant with placebo in 839 patients at 112 centers in North America, Europe, and Australia.Interventions: Patients received dietary counseling, were randomized to receive rimonabant (20 mg daily) or matching placebo, and underwent coronary intravascular ultrasonography at baseline (n = 839) and study completion (n = 676).Main Outcome Measures: The primary efficacy parameter was change in percent atheroma volume (PAV); the secondary efficacy parameter was change in normalized total atheroma volume (TAV).Results: In the rimonabant vs placebo groups, PAV (95% confidence interval [CI]) increased 0.25% (-0.04% to 0.54%) vs 0.51% (0.22% to 0.80%) (P = .22), respectively, and TAV decreased 2.2 mm3 (-4.09 to -0.24) vs an increase of 0.88 mm3 (-1.03 to 2.79) (P = .03). In the rimonabant vs placebo groups, imputing results based on baseline characteristics for patients not completing the trial, PAV increased 0.25% (-0.04% to 0.55%) vs 0.57% (0.29% to 0.84%) (P = .13), and TAV decreased 1.95 mm3 (-3.8 to -0.10) vs an increase of 1.19 mm3 (-0.73 to 3.12) (P = .02). Rimonabant-treated patients had a larger reduction in body weight (4.3 kg [-5.1 to -3.5] vs 0.5 kg [-1.3 to 0.3]) and greater decrease in waist circumference (4.5 cm [-5.4 to -3.7] vs 1.0 cm [-1.9 to -0.2]) (P < .001 for both comparisons). In the rimonabant vs placebo groups, high-density lipoprotein cholesterol levels increased 5.8 mg/dL (4.9 to 6.8) (22.4%) vs 1.8 mg/dL (0.9 to 2.7) (6.9%) (P < .001), and median triglyceride levels decreased 24.8 mg/dL (-35.4 to -17.3) (20.5%) vs 8.9 mg/dL (-14.2 to -1.8) (6.2%) (P < .001). Rimonabant-treated patients had greater decreases in high-sensitivity C-reactive protein (1.3 mg/dL [-1.7 to -1.2] [50.3%] vs 0.9 mg/dL [-1.4 to -0.5] [30.9%]) and less increase in glycated hemoglobin levels (0.11% [0.02% to 0.20%] vs 0.40% [0.31% to 0.49%]) (P < .001 for both comparisons). Psychiatric adverse effects were more common in the rimonabant group (43.4% vs 28.4%, P < .001).Conclusions: After 18 months of treatment, the study failed to show an effect for rimonabant on disease progression for the primary end point (PAV) but showed a favorable effect on the secondary end point (TAV). Determining whether rimonabant is useful in management of coronary disease will require additional imaging and outcomes trials, which are currently under way.Trial Registration: clinicaltrials.gov Identifier: NCT00124332. [ABSTRACT FROM AUTHOR]
Published: 2008
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22. Beta-blockers and progression of coronary atherosclerosis: pooled analysis of 4 intravascular ultrasonography trials.

Author: Sipahi I, Tuzcu EM, Wolski KE, Nicholls SJ, Schoenhagen P, Hu B, Balog C, Shishehbor M, Magyar WA, Crowe TD, Kapadia S, Nissen SE, Sipahi, Ilke, Tuzcu, E Murat, Wolski, Katherine E, Nicholls, Stephen J, Schoenhagen, Paul, Hu, Bo, Balog, Craig, and Shishehbor, Mehdi
Abstract: Background: In patients with myocardial infarction, beta-adrenergic blockers reduce recurrent myocardial infarction and total mortality rates. However, whether a direct influence of beta-blockers on coronary atherosclerosis contributes to reduced recurrent myocardial infarction and total mortality rates is not known.Objective: To assess whether beta-blocker therapy is associated with reduced atheroma progression in adults with known coronary artery disease.Design: Post hoc, pooled analysis of individual patient data from 4 intravascular ultrasonography (IVUS) trials.Setting: Four IVUS trials conducted in the United States, Europe, and Australia.Patients: 1515 patients with coronary artery disease.Intervention: The original trials used 3 different statins, a calcium-channel blocker, an angiotensin-converting enzyme inhibitor, or an acyl coenzyme A-cholesterol acyltransferase inhibitor.Measurements: Changes in atheroma volume, as determined by IVUS after adjustment for possible confounders by using linear mixed-effects models, were compared in patients who did and did not receive concomitant beta-blocker treatment.Results: Patients who received beta-blockers (n = 1154) were more likely to have histories of myocardial infarction, angina, and hypertension than were patients who did not receive beta-blockers (n = 361). The estimated annual change in atheroma volume was statistically significantly less in patients who received beta-blockers. This was true for univariate and multivariable analyses that controlled for history of myocardial infarction, angina, and hypertension (mean [+/-SE] atheroma volume, -2.4 +/- 0.5 mm3/y in treated patients vs. -0.4 +/- 0.8 mm3/y in untreated patients; P = 0.034). Accordingly, atheroma volume statistically significantly decreased at follow-up IVUS in patients who received beta-blockers (P < 0.001) and did not change in patients who did not receive beta-blockers (P = 0.86). Additional adjustments for low-density lipoprotein cholesterol level, concomitant medications, and clinical trial did not change the results.Limitations: Patients were not randomly assigned to beta-blocker therapy, and interventions other than beta-blocker therapy could have influenced the changes in atheroma volume. Whether progression rate of atherosclerosis as detected by IVUS predicts cardiovascular outcomes is unknown.Conclusions: The analysis demonstrates that beta-blockers can slow progression of coronary atherosclerosis. The findings provide additional support for the current clinical guidelines advocating long-term use of beta-blockers to treat most forms of coronary artery disease. [ABSTRACT FROM AUTHOR]
Published: 2007
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23. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis.

Author: Nicholls SJ, Tuzcu EM, Sipahi I, Grasso AW, Schoenhagen P, Hu T, Wolski K, Crowe T, Desai MY, Hazen SL, Kapadia SR, Nissen SE, Nicholls, Stephen J, Tuzcu, E Murat, Sipahi, Ilke, Grasso, Adam W, Schoenhagen, Paul, Hu, Tingfei, Wolski, Kathy, and Crowe, Tim
Abstract: Context: Statins reduce low-density lipoprotein cholesterol (LDL-C) levels and slow progression of coronary atherosclerosis. However, no data exist describing the relationship between statin-induced changes in high-density lipoprotein cholesterol (HDL-C) and disease progression.Objective: To investigate the relationship between changes in LDL-C and HDL-C levels and atheroma burden.Design, Setting, and Patients: Post-hoc analysis combining raw data from 4 prospective randomized trials (performed in the United States, North America, Europe, and Australia between 1999 and 2005), in which 1455 patients with angiographic coronary disease underwent serial intravascular ultrasonography while receiving statin treatment for 18 months or for 24 months. Ultrasound analysis was performed in the same core laboratory for all of the studies.Main Outcome Measure: Relationship between changes in lipoprotein levels and coronary artery atheroma volume.Results: During statin therapy, mean (SD) LDL-C levels were reduced from 124.0 (38.3) mg/dL (3.2 [0.99] mmol/L) to 87.5 (28.8) mg/dL (2.3 [0.75] mmol/L) (a 23.5% decrease; P<.001), and HDL-C levels increased from 42.5 (11.0) mg/dL (1.1 [0.28] mmol/L) to 45.1 (11.4) mg/dL (1.2 [0.29] mmol/L) (a 7.5% increase; P<.001). The ratio of LDL-C to HDL-C was reduced from a mean (SD) of 3.0 (1.1) to 2.1 (0.9) (a 26.7% decrease; P<.001). These changes were accompanied by a mean (SD) increase in percent atheroma volume from 39.7% (9.8%) to 40.1% (9.7%) (a 0.5% [3.9%] increase; P = .001) and a mean (SD) decrease in total atheroma volume of 2.4 (23.6) mm3 (P<.001). In univariate analysis, mean levels and treatment-mediated changes in LDL-C, total cholesterol, non-HDL cholesterol, apolipoprotein B, and ratio of apolipoprotein B to apolipoprotein A-I were significantly correlated with the rate of atherosclerotic progression, whereas treatment-mediated changes in HDL-C were inversely correlated with atheroma progression. In multivariate analysis, mean levels of LDL-C (beta coefficient, 0.11 [95% confidence interval, 0.07-0.15]) and increases in HDL-C (beta coefficient, -0.26 [95% confidence interval, -0.41 to -0.10]) remained independent predictors of atheroma regression. Substantial atheroma regression (> or =5% reduction in atheroma volume) was observed in patients with levels of LDL-C less than the mean (87.5 mg/dL) during treatment and percentage increases of HDL-C greater than the mean (7.5%; P<.001). No significant differences were found with regard to clinical events.Conclusions: Statin therapy is associated with regression of coronary atherosclerosis when LDL-C is substantially reduced and HDL-C is increased by more than 7.5%. These findings suggest that statin benefits are derived from both reductions in atherogenic lipoprotein levels and increases in HDL-C, although it remains to be determined whether the atherosclerotic regression associated with these changes in lipid levels will translate to meaningful reductions in clinical events and improved clinical outcomes. [ABSTRACT FROM AUTHOR]
Published: 2007
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24. Contrast enhancement of coronary atherosclerotic plaque: a high-resolution, multidetector-row computed tomography study of pressure-perfused, human ex-vivo coronary arteries.

Author: Halliburton SS, Schoenhagen P, Nair A, Stillman A, Lieber M, Tuzcu EM, Vince DG, White RD, Halliburton, Sandra S, Schoenhagen, Paul, Nair, Anuja, Stillman, Arthur, Lieber, Michael, Murat Tuzcu, E, Geoffrey Vince, D, and White, Richard D
Published: 2006
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25. Determinants of arterial wall remodeling during lipid-lowering therapy: serial intravascular ultrasound observations from the Reversal of Atherosclerosis with Aggressive Lipid Lowering Therapy (REVERSAL) trial.

Author: Schoenhagen P, Tuzcu EM, Apperson-Hansen C, Wang C, Wolski K, Lin S, Sipahi I, Nicholls SJ, Magyar WA, Loyd A, Churchill T, Crowe T, Nissen SE, Schoenhagen, Paul, Tuzcu, E Murat, Apperson-Hansen, Carolyn, Wang, Chaohui, Wolski, Kathy, Lin, Songhua, and Sipahi, Ilke
Published: 2006

26. Effect of ACAT inhibition on the progression of coronary atherosclerosis.

Author: Nissen SE, Tuzcu EM, Brewer HB, Sipahi I, Nicholls SJ, Ganz P, Schoenhagen P, Waters DD, Pepine CJ, Crowe TD, Davidson MH, Deanfield JE, Wisniewski LM, Hanyok JJ, Kassalow LM, Acyl-coenzyme A:cholesterol Acyltransferase Intravascular Atherosclerosis Treatment Evaluation Investigators, Nissen, Steven E, Tuzcu, E Murat, Brewer, H Bryan, and Sipahi, Ilke
Abstract: Background: The enzyme acyl-coenzyme A:cholesterol acyltransferase (ACAT) esterifies cholesterol in a variety of tissues. In some animal models, ACAT inhibitors have antiatherosclerotic effects. Methods: We performed intravascular ultrasonography in 408 patients with angiographically documented coronary disease. All patients received usual care for secondary prevention, including statins, if indicated. Patients were randomly assigned to receive the ACAT inhibitor pactimibe (100 mg per day) or matching placebo. Ultrasonography was repeated after 18 months to measure the progression of atherosclerosis. Results: The primary efficacy variable analyzing the progression of atherosclerosis--the change in percent atheroma volume--was similar in the pactimibe and placebo groups (0.69 percent and 0.59 percent, respectively; P=0.77). However, both secondary efficacy variables assessed by means of intravascular ultrasonography showed unfavorable effects of pactimibe treatment. As compared with baseline values, the normalized total atheroma volume showed significant regression in the placebo group (-5.6 mm3, P=0.001) but not in the pactimibe group (-1.3 mm3, P=0.39; P=0.03 for the comparison between groups). The atheroma volume in the most diseased 10-mm subsegment regressed by 3.2 mm3 in the placebo group, as compared with a decrease of 1.3 mm3 in the pactimibe group (P=0.01). The combined incidence of adverse cardiovascular outcomes was similar in the two groups (P=0.53). Conclusions: For patients with coronary disease, treatment with an ACAT inhibitor did not improve the primary efficacy variable (percent atheroma volume) and adversely affected two major secondary efficacy measures assessed by intravascular ultrasonography. ACAT inhibition is not an effective strategy for limiting atherosclerosis and may promote atherogenesis. (ClinicalTrials.gov number, NCT00268515.). [ABSTRACT FROM AUTHOR]
Published: 2006

27. Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease.

Author: Nissen SE, Tuzcu EM, Schoenhagen P, Crowe T, Sasiela WJ, Tsai J, Orazem J, Magorien RD, O'Shaughnessy C, Ganz P, Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) Investigators, Nissen, Steven E, Tuzcu, E Murat, Schoenhagen, Paul, Crowe, Tim, Sasiela, William J, Tsai, John, Orazem, John, Magorien, Raymond D, and O'Shaughnessy, Charles
Abstract: Background: Recent trials have demonstrated better outcomes with intensive than with moderate statin treatment. Intensive treatment produced greater reductions in both low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP), suggesting a relationship between these two biomarkers and disease progression.Methods: We performed intravascular ultrasonography in 502 patients with angiographically documented coronary disease. Patients were randomly assigned to receive moderate treatment (40 mg of pravastatin orally per day) or intensive treatment (80 mg of atorvastatin orally per day). Ultrasonography was repeated after 18 months to measure the progression of atherosclerosis. Lipoprotein and CRP levels were measured at baseline and follow-up.Results: In the group as a whole, the mean LDL cholesterol level was reduced from 150.2 mg per deciliter (3.88 mmol per liter) at baseline to 94.5 mg per deciliter (2.44 mmol per liter) at 18 months (P<0.001), and the geometric mean CRP level decreased from 2.9 to 2.3 mg per liter (P<0.001). The correlation between the reduction in LDL cholesterol levels and that in CRP levels was weak but significant in the group as a whole (r=0.13, P=0.005), but not in either treatment group alone. In univariate analyses, the percent change in the levels of LDL cholesterol, CRP, apolipoprotein B-100, and non-high-density lipoprotein cholesterol were related to the rate of progression of atherosclerosis. After adjustment for the reduction in these lipid levels, the decrease in CRP levels was independently and significantly correlated with the rate of progression. Patients with reductions in both LDL cholesterol and CRP that were greater than the median had significantly slower rates of progression than patients with reductions in both biomarkers that were less than the median (P=0.001).Conclusions: For patients with coronary artery disease, the reduced rate of progression of atherosclerosis associated with intensive statin treatment, as compared with moderate statin treatment, is significantly related to greater reductions in the levels of both atherogenic lipoproteins and CRP. [ABSTRACT FROM AUTHOR]
Published: 2005

28. Atherosclerosis imaging: intravascular ultrasound.

Author: Tuzcu EM and Schoenhagen P
Abstract: Most acute coronary syndromes result from the rupture or erosion of high-risk plaques. Clinical imaging studies have shown that atherosclerotic plaque formation and rupture are widespread processes that are often asymptomatic. The rationale for atherosclerosis imaging is the in-vivo identification of high-risk lesions, which may subsequently lead to prevention of future cardiovascular events. Although intravascular ultrasound (IVUS) imaging studies demonstrated that echolucent appearance of the plaque and expansive (positive) remodelling are associated with unstable clinical presentation, these characteristics were not adequate for accurate plaque characterisation. Recent technical developments in ultrasound equipment and analytical methods, utilising several characteristics of the digitised ultrasound signal with radiofrequency analysis and elastography, promise accurate tissue characterisation. Other imaging modalities, including optical coherence tomography, also contribute to a more precise characterisation of the composition of atherosclerotic plaques. A non-imaging approach is the focal assessment of temperature differences using sensitive intravascular thermography catheters, presumably reflecting focal inflammatory changes of vulnerable lesions. Although the histological characteristics of the atheroma are critically important in the sequence of events leading to acute coronary syndromes, the clinical relevance of identifying these characteristics is not yet clear.There is increasing evidence that identifying and treating individual culprit lesions may not be enough to prevent the ischaemic cardiac events in most patients, because the acute coronary syndrome is not a disease of a single site or a few discrete segments, but rather a systemic disease that involves the entire coronary tree. In addition to detection and quantitation of early coronary atherosclerosis and disease activity, accurate and reproducible methods could help to identify high-risk patients and allow serial monitoring during various therapeutic interventions. Serial IVUS imaging makes it possible to visualise the vessel wall that harbours the atheroma at different time points. Typically, serial IVUS allows the assessment of the percentage change in atheroma volume, with considerable statistical power to detect small changes. Using this methodology, aggressive lipid lowering by a high-dose statin agent has been shown to stop the progression of atherosclerosis, and a new mutant high-density lipoprotein complex was found to be effective in regressing atheroma burden.Although intravascular ultrasound is very accurate for quantification of atheroma burden, widespread application and accurate and reproducible non-invasive imaging modalities are needed for large-scale risk assessment algorithms. Cardiovascular computed tomography is at the forefront of the non-invasive imaging modalities. Future prospective imaging studies will be necessary to identify focal or systemic characteristics of high-risk lesions and to demonstrate the relationship between plaque burden, biochemical markers and clinical events. [ABSTRACT FROM AUTHOR]
Published: 2004
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29. Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound.

Author: Schoenhagen P, Tuzcu EM, Stillman AE, Moliterno DJ, Halliburton SS, Kuzmiak SA, Kasper JM, Magyar WA, Lieber ML, Nissen SE, White RD, Schoenhagen, Paul, Tuzcu, E Murat, Stillman, Arthur E, Moliterno, David J, Halliburton, Sandra S, Kuzmiak, Stacie A, Kasper, Jane M, Magyar, William A, and Lieber, Michael L
Published: 2003
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30. Everolimus for the prevention of allograft rejection and vasculopathy in cardiac-transplant recipients.

Author: Eisen HJ, Tuzcu EM, Dorent R, Kobashigawa J, Mancini D, Valentine-von Kaeppler HA, Starling RC, Sørensen K, Hummel M, Lind JM, Abeywickrama KH, Bernhardt P, and RAD B253 Study Group
Published: 2003

31. Ebstein's anomaly: natural and unnatural history

Author: Robert W. Stewart, Freidoon Ghazi, Farmer D, Richard Sterba, Douglas S. Moodie, Carl C. Gill, Tuzcu Em, and Andrea Kovacs
Subjects: Adult, Male, medicine.medical_specialty, Fourth heart sound, Adolescent, Accessory pathway, Sudden death, Death, Sudden, Risk Factors, Ebstein's anomaly, medicine, Humans, cardiovascular diseases, Child, Third heart sound, business.industry, Infant, General Medicine, Middle Aged, Right bundle branch block, medicine.disease, Surgery, Ebstein Anomaly, Natural history, Child, Preschool, cardiovascular system, Female, Supraventricular tachycardia, medicine.symptom, business
Abstract: Clinical features and natural history were analyzed in 30 patients with Ebstein's anomaly (mean age 26 years, range 1.5-58 years, 53% females). The main presenting symptoms were dyspnea and fatigue (83%). At presentation, there were six patients (20%) in New York Heart Association Functional Class (NYHAFC) I, nine (30%) in NYHA-FC II, and 15 (50%) in NYHA-FC III or IV; 12 patients (40%) were cyanotic. Common auscultatory findings were widely split second heart sound in 21 (70%), third heart sound in 14 (47%), fourth heart sound in 16 (53%), and a systolic murmur in 22 (73%). Right bundle branch block was present in 21 (70%), documented supraventricular tachycardia in seven (23%), and Wolff-Parkinson-White syndrome in three (10%). Catheterization was performed in 93% without complications. Fourteen patients were treated surgically (12 [86%] in NYHA-FC III or IV, 10 [71%] with associated anomalies); tricuspid valve replacement was performed in eight, atrial septal defect repair in two, accessory pathway ablation in two, right atrial plication in one, and automatic cardioverter defibrillator implantation in one. Surgical treatment improved 10 patients from NYHA-FC III or IV to NYHA-FC I or II. Death occurred in nine patients (five treated surgically and four medically); four of these deaths were sudden. In the eight patients who had tricuspid valve replacement, there were one operative and two late deaths. The authors conclude that surgical therapy with tricuspid valve replacement improves the clinical status of patients who are severely ill. Risk of sudden death remains an important problem in patients with Ebstein's anomaly regardless of severity of the disease and mode of treatment.
Published: 1989

32. Valve in valve: another milestone for transcatheter valve therapy.

Author: Tuzcu EM, Kapadia SR, and Svensson LG
Published: 2012
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33. 'SOURCE' of Enthusiasm for Transcatheter Aortic Valve Implantation.

Author: Tuzcu EM, Kapadia SR, and Svensson LG
Published: 2010
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34. Multimodality quantitative imaging of aortic root for transcatheter aortic valve implantation: more complex than it appears.

Author: Tuzcu EM, Kapadia SR, and Schoenhagen P
Published: 2010
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35. Statins targeting inflammation by lowering low-density lipoprotein?

Author: Tuzcu EM and Nicholls SJ
Published: 2007

36. Intra-aortic balloon-pump rupture and entrapment

Author: Brodell Gk, Conrad Simpfendorfer, Steven J Weiss, and Tuzcu Em
Subjects: medicine.medical_specialty, Intra-Aortic Balloon Pumping, Vascular disease, business.industry, medicine.medical_treatment, General Medicine, Middle Aged, medicine.disease, Balloon, Surgery, Entrapment, medicine, Humans, Equipment Failure, Female, Complication, business, Intra-aortic balloon pump
Abstract: The authors report a case of intra-aortic balloon rupture and entrapment in a patient with extensive vascular disease. The balloon was subsequently removed percutaneously. A review of the diagnosis and management of this unusual complication is presented.
Published: 1989

37. President's Page: Valvular Heart Disease: The Convergence of Interventional and Surgical Approaches.

Author: Nissen SE and Tuzcu EM
Published: 2006
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38. Intravascular ultrasound in cardiovascular medicine.

Author: Nicholls SJ, Tuzcu EM, Sipahi I, Schoenhagen P, Nissen SE, Nicholls, Stephen J, Tuzcu, E Murat, Sipahi, Ilke, Schoenhagen, Paul, and Nissen, Steven E
Published: 2006

39. Markov model for selection of aortic valve replacement versus transcatheter aortic valve implantation (without replacement) in high-risk patients.

Author: Gada H, Kapadia SR, Tuzcu EM, Svensson LG, and Marwick TH
Published: 2012

40. Percutaneous device closure of patent foramen ovale for secondary stroke prevention: a call for completion of randomized clinical trials. A science advisory from the American Heart Association/American Stroke Association and the American College of Cardiology Foundation.

Author: O'Gara PT, Messe SR, Tuzcu EM, Catha G, Ring JC, and American Heart Association
Published: 2009
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41. The editor's roundtable: intravascular ultrasonic imaging of the coronary arteries.

Author: Friedewald VE, Marso SP, Tuzcu EM, Weissman NJ, Roberts WC, Friedewald, Vincent E, Marso, Steven P, Tuzcu, E Murat, Weissman, Neil J, and Roberts, William C
Published: 2007
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42. Pilot candidate gene analysis of patients ≥ 60 years old with aortic stenosis involving a tricuspid aortic valve.

Author: Ellis SG, Dushman-Ellis S, Luke MM, Murugesan G, Kottke-Marchant K, Ellis GM, Griffin B, Tuzcu EM, Hazen S, Ellis, Stephen G, Dushman-Ellis, Sandra, Luke, May M, Murugesan, Gurunathan, Kottke-Marchant, Kandice, Ellis, Gary M, Griffin, Brian, Tuzcu, E Murat, and Hazen, Stanley
Abstract: The potential genetic basis of aortic stenosis in older people is poorly understood. A total of 265 patients with aortic stenosis involving tricuspid aortic valves and 961 controls were genotyped for ≤660 candidate single nucleotide polymorphisms (SNPs). After dividing the patients and controls into training and validation sets, we tested the correlation of the SNPs with the age-adjusted aortic valve area, determined by echocardiography or cardiac catheterization. A bootstrapped global p value of ≤0.005 was considered evidence of a possible significant correlation. The cases were aged 73 ± 7 years, and 72.7% were men. The median aortic valve area was 1.0 cm(2) (interquartile range 0.7 to 1.5). The controls were aged 69 ± 6 years, and 69.8% were men. The minor allele frequency was 21% ± 15% (37% <0.20). Three SNPs met the criteria for significant correlation (rs2276288 [MYO7A], p = 0.001; rs5194 [AGTR1], p = 0.004; rs207 307 [ELN], p = 0.005). Another 2 SNPs reached borderline significance (p ≤0.008). In conclusion, we report 3 SNPs to be associated with aortic stenosis involving tricuspid aortic valves in older subjects. Given the concerns regarding the problem of multiple statistical testing, validation studies are required to further assess these correlations. [ABSTRACT FROM AUTHOR]
Published: 2012
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43. Transcatheter versus surgical aortic-valve replacement in high-risk patients.

Author: Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Williams M, Dewey T, Kapadia S, Babaliaros V, Thourani VH, Corso P, Pichard AD, Bavaria JE, Herrmann HC, and Akin JJ
Published: 2011
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44. Effect of torcetrapib on the progression of coronary atherosclerosis.

Author: Nissen SE, Tardif J, Nicholls SJ, Revkin JH, Shear CL, Duggan WT, Ruzyllo W, Bachinsky WB, Lasala GP, Tuzcu EM, ILLUSTRATE (Investigation of Lipid Level Management Using Coronary Ultrasound to Assess Reduction of Atherosclerosis by CETP Inhibition and HDL Elevation) Investigators, Nissen, Steven E, Tardif, Jean-Claude, Nicholls, Stephen J, Revkin, James H, Shear, Charles L, Duggan, William T, Ruzyllo, Witold, Bachinsky, William B, and Lasala, Gabriel P
Abstract: Background: Levels of high-density lipoprotein (HDL) cholesterol are inversely related to cardiovascular risk. Torcetrapib, a cholesteryl ester transfer protein (CETP) inhibitor, increases HDL cholesterol levels, but the functional effects associated with this mechanism remain uncertain. Methods: A total of 1188 patients with coronary disease underwent intravascular ultrasonography. After treatment with atorvastatin to reduce levels of low-density lipoprotein (LDL) cholesterol to less than 100 mg per deciliter (2.59 mmol per liter), patients were randomly assigned to receive either atorvastatin monotherapy or atorvastatin plus 60 mg of torcetrapib daily. After 24 months, disease progression was measured by repeated intravascular ultrasonography in 910 patients (77%). Results: After 24 months, as compared with atorvastatin monotherapy, the effect of torcetrapib-atorvastatin therapy was an approximate 61% relative increase in HDL cholesterol and a 20% relative decrease in LDL cholesterol, reaching a ratio of LDL cholesterol to HDL cholesterol of less than 1.0. Torcetrapib was also associated with an increase in systolic blood pressure of 4.6 mm Hg. The percent atheroma volume (the primary efficacy measure) increased by 0.19% in the atorvastatin-only group and by 0.12% in the torcetrapib-atorvastatin group (P=0.72). A secondary measure, the change in normalized atheroma volume, showed a small favorable effect for torcetrapib (P=0.02), but there was no significant difference in the change in atheroma volume for the most diseased vessel segment. Conclusions: The CETP inhibitor torcetrapib was associated with a substantial increase in HDL cholesterol and decrease in LDL cholesterol. It was also associated with an increase in blood pressure, and there was no significant decrease in the progression of coronary atherosclerosis. The lack of efficacy may be related to the mechanism of action of this drug class or to molecule-specific adverse effects. (ClinicalTrials.gov number, NCT00134173 [ClinicalTrials.gov].). [ABSTRACT FROM AUTHOR]
Published: 2007

45. Repeated intravascular ultrasound imaging in cardiac transplant recipients does not accelerate transplant coronary artery disease.

Author: Ramasubbu K, Schoenhagen P, Balghith MA, Brechtken J, Ziada KM, Kapadia SR, Hobbs RE, Rincon G, Nissen SE, Tuzcu EM, Ramasubbu, Kumudha, Schoenhagen, Paul, Balghith, Mohammed A, Brechtken, Johannes, Ziada, Khaled M, Kapadia, Samir R, Hobbs, Robert E, Rincon, Gustavo, Nissen, Steven E, and Tuzcu, E Murat
Abstract: Objectives: This study was designed to examine the impact of repeated intravascular ultrasound (IVUS) examinations on transplant coronary artery disease (CAD).Background: Serial IVUS is the most accurate method for early detection and surveillance of transplant CAD. However, the long-term safety of serial IVUS exams is not well described. Accordingly, we examined the impact of repeated IVUS examinations on transplant CAD.Methods: We examined 226 transplant recipients who underwent one or more IVUS examinations and coronary angiography at least one year after the last IVUS exam. The coronary angiograms were analyzed using quantitative coronary angiography. Vessel diameters, frequency, and severity of stenoses in IVUS-imaged and nonimaged coronary arteries were compared. In a subgroup analysis of 31 patients, angiographic lumen diameters were measured at baseline (within eight weeks of transplantation) and during follow-up (after two, three, or four IVUS studies).Results: In the 226 patients, 548 coronary arteries were previously imaged by IVUS and 130 arteries were not imaged by IVUS. On subsequent angiograms, stenoses were observed in 16.2% (21/130) of nonimaged arteries and 19.5% (107/548) of imaged arteries (p = 0.38). The arterial diameters of nonimaged and imaged arteries were not significantly different (p = 0.07), regardless of the number of IVUS exams and duration of follow-up. Subgroup analysis revealed a significant decrease in vessel lumen diameter over time in nonimaged as well as imaged arteries. The magnitude of the diameter decrease was not significantly different between the two groups.Conclusions: Repeated IVUS examinations following heart transplantation do not result in angiographically evident acceleration of transplant CAD. Therefore, serial IVUS imaging is a safe method for the detection and surveillance of transplant CAD. [ABSTRACT FROM AUTHOR]
Published: 2003
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46. Nitroprusside in critically ill patients with left ventricular dysfunction and aortic stenosis.

Author: Khot UN, Novaro GM, Popovic ZB, Mills RM, Thomas JD, Tuzcu EM, Hammer D, Nissen SE, and Francis GS
Published: 2003

47. Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomy.

Author: Sitges M, Shiota T, Lever HM, Qin JX, Bauer F, Drinko JK, Agler DA, Martin MG, Greenberg NL, Smedira NG, Lytle BW, Tuzcu EM, Garcia MJ, Thomas JD, Sitges, Marta, Shiota, Takahiro, Lever, Harry M, Qin, Jian Xin, Bauer, Fabrice, and Drinko, Jeannie K
Abstract: Both percutaneous transcoronary alcohol septal reduction (ASR) and surgical myectomy are effective treatments to relieve left ventricular (LV) outflow tract obstruction in obstructive hypertrophic cardiomyopathy (HC). LV diastolic function was assessed by echocardiography in 57 patients with obstructive HC at baseline and 5 +/- 4 months after ASR (n = 37) or surgical myectomy (n = 20). LV outflow tract pressure gradient decreased from 65 +/- 40 to 23 +/- 21 mm Hg (p <0.01) after treatment. The ratio of the early-to-late peak diastolic LV inflow velocities, and the ratio of the early peak diastolic LV inflow velocity to the lateral mitral annulus early diastolic velocity determined by tissue Doppler imaging significantly decreased after the procedures (1.6 +/- 1.7 vs 1.0 +/- 0.7 and 15 +/- 8 vs 11 +/- 5, respectively), whereas LV inflow propagation velocity significantly increased (60 +/- 24 vs 71 +/- 36 cm/s). Left atrial size decreased from 29 +/- 7 to 25 +/- 6 cm(2) (p <0.05). Patients had a significant improvement in New York Heart Association functional class and in exercise performance. When comparing ASR with myectomy, no difference was found in the degree of change in any parameter of diastolic function. Thus, diastolic function indexes obtained by echocardiography changed after septal reduction interventions in patients with obstructive HC; this change was similar to that after surgical myectomy and ASR. [ABSTRACT FROM AUTHOR]
Published: 2003
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48. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author: Lozano, Rafael, Fullman, Nancy, Abate, Degu, Abay, Solomon M, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Nebiyu Dereje, Abebe, Zegeye, Abejie, Ayenew Negesse, Abera, Semaw F, Abil, Olifan Zewdie, Aboyans, Victor, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen Me, Abyu, Gebre Y, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshari, Mahdi, Afshin, Ashkan, Agarwal, Gina, Aghayan, Sargis Aghasi, Agius, Dominic, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Ahmed, Sayem, Akalu, Temesgen Yihunie, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Tahiya, Albujeer, Ammar, Alebel, Animut, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Alhabib, Samia, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine A, Almasi, Ali, Al-Maskari, Fatma, Al-Mekhlafi, Hesham M, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amenu, Kebede, Amini, Erfan, Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansari, Hossein, Ansariadi, Ansariadi, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Appiah, Lambert Tetteh, Aremu, Olatunde, Areri, Habtamu Abera, Ärnlöv, Johan, Arora, Monika, Aryal, Krishna K, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Asghar, Rana Jawad, Assadi, Reza, Ataro, Zerihun, Atique, Suleman, Atre, Sachin R, Atteraya, Madhu Sudhan, Ausloos, Marcel, Avila-Burgos, Leticia, Avokpaho, Euripide F G A, Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayele, Henok Tadesse, Ayele, Yohanes, Ayer, Rakesh, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter S, Azzopardi-Muscat, Natasha, Babalola, Tesleem Kayode, Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Banach, Maciej, Banerjee, Amitava, Banoub, Joseph Adel Mattar, Banstola, Amrit, Barac, Aleksandra, Barboza, Miguel A, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Barthelemy, Celine M, Bassat, Quique, Basu, Arindam, Basu, Sanjay, Battista, Robert J, Baune, Bernhard T, Baynes, Habtamu Wondifraw, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Belachew, Abate Bekele, Belay, Aregawi Gebreyesus, Belay, Saba Abraham, Belay, Yihalem Abebe, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Berhe, Abadi Kidanemariam, Berman, Adam E, Bernabe, Eduardo, Bernstein, Robert S, Bertolacci, Gregory J, Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhansali, Anil, Bhattarai, Suraj, Bhaumik, Soumyadeep, Bhutta, Zulfiqar A, Biadgo, Belete, Biehl, Molly H, Bijani, Ali, Bikbov, Boris, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Birlik, Sait Mentes, Birungi, Charles, Bisanzio, Donal, Biswas, Tuhin, Bitew, Helen, Bizuneh, Hailemichael, Bjertness, Espen, Bobasa, Eshetu Mulisa, Boufous, Soufiane, Bourne, Rupert, Bozorgmehr, Kayvan, Bragazzi, Nicola Luigi, Brainin, Michael, Brant, Luisa C, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul Svitil, Britton, Gabrielle, Brugha, Traolach, Bukhman, Gene, Busse, Reinhard, Butt, Zahid A, Cahuana-Hurtado, Lucero, Callender, Charlton SKH, Campos-Nonato, Ismael R, Campuzano Rincon, Julio Cesar, Cano, Jorge, Car, Josip, Car, Mate, Cárdenas, Rosario, Carrero, Juan J, Carter, Austin, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Causey, Kate, Çavlin, Alanur, Cercy, Kelly M, Cerin, Ester, Chaiah, Yazan, Chalek, Julian, Chang, Hsing-Yi, Chang, Jung-Chen, Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chaturvedi, Pankaj, Chiang, Peggy Pei-Chia, Chin, Ken Lee, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal, Choi, Jee-Young J, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J, Chung, Sheng-Chia, Cicuttini, Flavia M, Ciobanu, Liliana G, Cirillo, Massimo, Claro, Rafael M, Claßen, Thomas Khaled Dwayne, Cohen, Aaron J, Collado-Mateo, Daniel, Cooper, Cyrus, Cooper, Leslie Trumbull, Cornaby, Leslie, Cortinovis, Monica, Costa, Megan, Cousin, Ewerton, Cromwell, Elizabeth A, Crowe, Christopher Stephen, Cunningham, Matthew, Daba, Alemneh Kabeta, Dadi, Abel Fekadu, Dandona, Lalit, Dandona, Rakhi, Dang, Anh Kim, Dargan, Paul I, Daryani, Ahmad, Das, Siddharth K, Das Gupta, Rajat, das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davis, Adrian C, Davitoiu, Dragos Virgil, Davletov, Kairat, Dayama, Anand, de Courten, Barbora, De Leo, Diego, De Neve, Jan-Walter, De Steur, Hans, Degefa, Meaza Girma, Degenhardt, Louisa, Degfie, Tizta Tilahun, Deiparine, Selina, Dellavalle, Robert P, Demoz, Gebre Teklemariam, Demtsu, Balem, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Dessie, Getenet Ayalew, Dey, Subhojit, Dharmaratne, Samath D, Dhimal, Meghnath, Dicker, Daniel, Dinberu, Mesfin Tadese, Ding, Eric L, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Douwes-Schultz, Dirk, Driscoll, Tim Robert, Duan, Leilei, Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B, Duraes, Andre R, Ebrahimpour, Soheil, Edvardsson, David, El Bcheraoui, Charbel, Eldrenkamp, Erika, El-Khatib, Ziad, Elyazar, Iqbal RF, Enayati, Ahmadali, Endries, Aman Yesuf, Eshrati, Babak, Eskandarieh, Sharareh, Esteghamati, Alireza, Esteghamati, Sadaf, Estep, Kara, Fakhar, Mahdi, Fakhim, Hamed, Fanzo, Jessica, Faramarzi, Mahbobeh, Fareed, Mohammad, Farhadi, Farzaneh, Farid, Talha A, Farinha, Carla Sofia e Sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Farzaei, Mohammad Hosein, Farzam, Hossein, Fazaeli, Ali Akbar, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fekadu, Wubalem, Feldman, Rachel, Fentahun, Netsanet, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, Joao C, Feyissa, Garumma Tolu, Fijabi, Daniel Obadare, Filip, Irina, Finegold, Samuel, Finger, Jonas David, Fischer, Florian, Fitzmaurice, Christina, Flor, Luisa Sorio, Foigt, Nataliya A, Foreman, Kyle J, Frank, Tahvi D, Franklin, Richard Charles, Fukumoto, Takeshi, Fukutaki, Kai, Fuller, John E, Fürst, Thomas, Furtado, João M, Gakidou, Emmanuela, Gallus, Silvano, Gankpe, Fortune Gbetoho, Gansevoort, Ron T, Garcia, Ana Cristina, Garcia-Basteiro, Alberto L, Garcia-Gordillo, Miguel A, Gardner, William M, Gebre, Abadi Kahsu, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremichael, Bereket, Gebremichael, Teklu Gebrehiwo, Gelano, Tilayie Feto, Geleijnse, Johanna M, Geramo, Yilma Chisha Dea, Getachew, Sefonias, Gething, Peter W, Gezae, Kebede Embaye, Ghadami, Mohammad Rasoul, Ghadimi, Reza, Ghadiri, Keyghobad, Ghasemi-Kasman, Maryam, Ghiasvand, Hesam, Ghimire, Mamata, Ghoshal, Aloke Gopal, Giampaoli, Simona, Gill, Paramjit Singh, Gill, Tiffany K, Giussani, Giorgia, Gnedovskaya, Elena V, Goldberg, Ellen M, Goli, Srinivas, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gorman, Taren M, Goto, Atsushi, Goulart, Alessandra C, Goulart, Bárbara Niegia Garcia, Grada, Ayman, Griswold, Max G, Grosso, Giuseppe, Gugnani, Harish Chander C, Guillemin, Francis, Guimaraes, Andre Luiz Sena, Guo, Yuming, Gupta, Prakash C, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Ha, Giang Hai, Haagsma, Juanita A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Haghparast Bidgoli, Hassan, Hagos, Tekleberhan B, Haile, Michael Tamene, Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hamadeh, Randah R, Hamidi, Samer, Hankey, Graeme J, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haririan, Hamidreza, Haro, Josep Maria, Hasan, Mehedi, Hassankhani, Hadi, Hassen, Hamid Yimam, Havmoeller, Rasmus, Hawley, Caitlin N, Hay, Simon I, He, Yihua, Hedayatizadeh-Omran, Akbar, Hegazy, Mohamed I, Heibati, Behzad, Heidari, Behnam, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Heredia-Pi, Ileana, Herteliu, Claudiu, Heydarpour, Behzad, Heydarpour, Fatemeh, Heydarpour, Sousan, Hibstu, Desalegn T, Híjar, Martha, Hoek, Hans W, Hoffman, Daniel J, Hole, Michael K, Homaie Rad, Enayatollah, Hoogar, Praveen, Horita, Nobuyuki, Hosgood, H Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Hsiao, Thomas, Hu, Guoqing, Huang, John J, Hughes, Caitlyn, Huynh, Chantal K, Igumbor, Ehimario U, Ikeda, Chad Thomas, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Ivers, Rebecca Q, Izadi, Neda, Jacobsen, Kathryn H, Jahangiry, Leila, Jahanmehr, Nader, Jain, Sudhir Kumar, Jakovljevic, Mihajlo, Jalu, Moti Tolera, Jamal, Amr A, James, Spencer L, Jassal, Simerjot K, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Johnson, Catherine O, Johnson, Sarah C, Jonas, Jost B, Jonnagaddala, Jitendra, Jorjoran Shushtari, Zahra, Joshi, Ankur, Jozwiak, Jacek Jerzy, Jungari, Suresh Banayya, Jürisson, Mikk, K, Madhanraj, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kahssay, Molla, Kalani, Rizwan, Kapil, Umesh, Karami, Manoochehr, Karami Matin, Behzad, Karanikolos, Marina, Karimi, Narges, Karimi, Seyed M, Karimi-Sari, Hamidreza, Kasaeian, Amir, Kassa, Dessalegn H, Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassa, Zemenu Yohannes, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazemi, Zhila, Karyani, Ali Kazemi, Kazi, Dhruv Satish, KC, Prakash, Kebede, Seifu, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Grant Rodgers, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khafaei, Behzad, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young-Ho, Khanna, Tripti, Khater, Mona M, Khatony, Alireza, Khazaeipour, Zahra, Khazaie, Habibolah, Khoja, Abdullah T, Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Khubchandani, Jagdish, Kiadaliri, Aliasghar A, Kiarie, Helen W, Kibret, Getiye D, Kiirithio, Daniel N, Kim, Daniel, Kim, Jun Y, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinra, Sanjay, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kissoon, Niranjan, Kivimäki, Mika, Kocarnik, Jonathan M, Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A, Kosek, Margaret N, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael A, Krishan, Kewal, Krohn, Kristopher J, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kudom, Andreas A, Kulikoff, Xie Rachel, Kumar, G Anil, Kumar, Manasi, Kumar, Pushpendra, Kutz, Michael J, Kyu, Hmwe Hmwe, Lachat, Carl, Lad, Deepesh P, Lad, Sheetal D, Lafranconi, Alessandra, Lagat, Abraham K, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lami, Faris Hasan, Lamichhane, Prabhat, Lan, Qing, Lang, Justin J, Lansingh, Van C, Lansky, Sonia, Larson, Heidi J, Larsson, Anders O, Laryea, Dennis Odai, Lassi, Zohra S, Latifi, Arman, Lau, Kathryn Mei-Ming, Laxmaiah, Avula, Lazarus, Jeffrey V, Leasher, Janet L, Lebedev, Georgy, Ledesma, Jorge R, Lee, James B, Lee, Paul H, Leever, Andrew T, Leigh, James, Leinsalu, Mall, Leshargie, Cheru Tesema, Leung, Janni, Lewycka, Sonia, Li, Shanshan, Li, Xiaohong, Li, Yichong, Liang, Juan, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Lee-Ling, Limenih, Miteku Andualem, Linn, Shai, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lucchesi, Lydia R, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Mackay, Mark T, Maddison, Emilie R, Madotto, Fabiana, Maghavani, Dhaval P, Magis-Rodriguez, Carlos, Mahotra, Narayan Bahadur, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mamun, Abdullah A, Manda, Ana-Laura, Mandarano-Filho, Luiz Garcia, Mangalam, Srikanth, Manguerra, Helena, Mansournia, Mohammad Ali, Mapoma, Chabila Christopher, Maravilla, Joemer C, Marcenes, Wagner, Marks, Ashley, Martin, Randall V, Martins, Sheila C O, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, Mashamba-Thompson, Tivani Phosa, 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Subjects: GENDER-DIFFERENCES, SUICIDE, Medicine (all), Burden of Disease Study 2017, SDG, CONSUMPTION, 11 Medical And Health Sciences, GBD, Sustainable Development Goals, PREVENTION, ALCOHOL-USE, CARDIOVASCULAR-DISEASE, SMOKING PREVALENCE, General & Internal Medicine, factors risk, Medicine and Health Sciences, Human medicine, CESSATION, PERSPECTIVE, TRANSITION
Abstract: Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health -related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related S DG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2.5th percentile and 100 as the 97.5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59.4 (IQR 35.4-67.3), ranging from a low of 11.6 (95% uncertainty interval 9.6-14.0) to a high of 84.9 (83.1-86.7). SDG index values in countries assessed at the subnational level varied substantially particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attaimnent by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation The GBD study offers a unique, robust platform for monitoring the health -related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health -related SDG indicators, NCDs, NCD-related risks, and violence -related indicators will require a concerted shift away from what might have driven past gains curative interventions in the case of NCDs towards multisectoral, prevention -oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the S DGs. What is clear is that our actions or inaction today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Published: 2018

49. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Roth, Gregory A., Collaborotors, G. B. 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Des, Dessie, Getenet Ayalew, Dey, Subhojit, Dhannaratne, Samath D., Dicker, Daniel, Dinberu, Mesfin Tadese, Ding, Eric L., Dirac, M. Ashworth, Djalalinia, Shirin, Dokova, Klara, Ter Doku, David, Donnelly, Christl A., Dorsey, E. Ray, Doshi, Pratik P., Douwes-Schultz, Dirk, Doyle, Kerrie E., Driscoll, Tim R., Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B., Duraes, Andre R., Ebrahimi, Hedyeh, Ebrahimpour, Soheil, Edessa, Dumessa, Edvardsson, David, Eggen, Anne Elise, El Bcheraoui, Charbel, Zaki, Maysaa El Sayed, El-Khatib, Ziad, Elkout, Hajer, Eltinsel, Christian Lycke, Endres, Matthias, Endries, Aman Yesuf, Er, Benjamin, Erskine, Holly E., Eshrati, Babak, Eskandarieh, Sharareh, Esmaeili, Reza, Esteghamati, Alireza, Fakhar, Mahdi, Fakhim, Hamed, Faramarzi, Mahbobeh, Fareed, Mohammad, Farhadi, Farzaneh, Faninha, Carla Sofia E. Sa, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Farzaei, Mohammad Hosein, Feign, Valery L., Feigl, Andrea B., Fentahun, Netsanet, Eereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, Joao C., Ferrari, Alice J., Feyissa, Garumma Tolu, Filip, Irina, Finegold, Samuel, Fischer, Florian, Eitzmaurice, Christina, Foigt, Nataliya A., Foreman, Kyle J., Fornari, Carla, Frank, Tahvi D., Fukumoto, Takeshi, Fuller, John E., Fullman, Nancy, Furst, Thomas, Furtado, Joao M., Futran, Neal D., Gallus, Silvano, Garcia-Basteiro, Alberto L., Garcia-Gordillo, Miguel A., Gardner, William M., Gebre, Abadi Kahsu, Gebrehiwol, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremichael, Bereket, Gebremichael, Teklu Gebrehiwo, Gelano, Tilayie Feto, Geleijinse, Johanna M., Genova-Maleras, Ricard, Geramo, Yilma Chisha Dea, Gething, Peter W., Gezae, Kebede Embaye, Ghadami, Mohammad Rasoul, Ghadimi, Reza, Falavarjani, Khalil Ghasemi, Ghasemi-Kasman, Maryam, Ghimire, Mamata, Gibney, Katherine B., Gill, Paramjit Singh, Gill, Tiffany K., Gillum, Richard F., Ginawi, Ibrahim Abdelmageed, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goldberg, Ellen M., Goli, Srinivas, Gomez-Dantes, Hector, Gona, Philimon N., Gopalani, Sameer Vali, Gorman, Taren M., Goto, Atsushi, Goulart, Alessandra C., Gnedovskaya, Elena V., Grada, Aymara, Grosso, Giuseppe, Gugnani, Hanish Chander, Guimaraes, Andre Luiz Sena, Gun, Nailing, Gupta, Prakash C., Gupta, Rahid, Gupta, Rajenv, Gupta, Tanush, Gutierrez, Reyna Alma, Gyawali, Bishal, Haagsma, Juanita A., Hafezi-Nejad, Nima, Hagos, Tekleberhan B., Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hamadeh, Randall R., Hamidi, Sinner, Handal, Meads J., Hankey, Graeme J., Harb, Hilda L., Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Hasan, Mehedi, Hassankhani, Hadi, Hassen, Hamid, Havmoeller, Rasmus, Hay, Roderick J., Hay, Simon I., He, Yihua, Hedayatizadeh-Omran, Akbar, Hegazy, Mohamed I., Heibati, Behzad, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Henry, Nathaniel J., Herteliu, Claudiu, Heydarpour, Fatemeh, Heydarpour, Pouria, Heydarpour, Sousan, Hibstu, Desalegn Tsegaw, Hoek, Hans W., Hole, Michael K., Red, Enayatollah Homaie, Hoogar, Praveen, Hosgood, H. Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hotez, Peter J., Hoy, Damian C., Hsiao, Thomas, Hu, Guoqing, Huang, John J., Husseini, Abdullatif, Hussen, Mohammedaman Mama, Hutfless, Susan, Idrisov, Bulat, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, Nazrul, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Jacobsen, Kathryn H., Jahangiry, Leila, Jahanmehr, Nader, Jain, Sudhir Kumar, Jakovlievic, Mihajlo, Jalu, Moti Tolera, James, Spencer L., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jenkins, Kathy J., Jha, Ravi Prakash, Jha, Vivekanand, Johnson, Catherine O., Johnson, Sarah C., Jonas, Jost B., Joshi, Ankur, Jozwiak, Jacek Jerzy, Jungari, Suresh Banayya, Jurisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kalani, Rizwan, Karami, Manoochehr, Matin, Behzad Karami, Karch, Andre, Karema, Corine, Karimi-Sari, Hamidreza, Kasaeian, Amir, Kassa, Dessalegn H., Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassebaum, Nicholas J., Katikireddi, Srinivasa Vittal, Kaul, Anil, Kazemi, Zhila, Karyani, Ali Kazemi, Kazi, Dhruv Satish, Kefale, Adane Teshome, Keiyoro, Peter Njenga, Kemp, Grant Rodgers, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khafaei, Behzad, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A., Khan, Ejaz Ahmad, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young-Ho, Khater, Mona M., Khoja, Abdullah T., Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Khubchandani, Jagdish, Kiadaliri, Aliasghar A., Kibret, Getiye D., Kidanemariam, Zelalem Teklemariam, Kiirithio, Daniel N., Kim, Daniel, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimaki, Mika, Knudsen, Ann Kristin Skrindo, Kocarnik, Jonathan M., Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A., Koul, Parvaiz A., Koyanagi, Ai, Kravchenko, Michael A., Krishan, Kewal, Defo, Barthelemy Kuate, Bicer, Burcu Kinuk, Kumar, G. Anil, Kumar, Manasi, Kumar, Pushpendra, Kutz, Michael J., Kuzin, Igor, Kyu, Hmwe Hmwe, Lad, Deepesh P., Lad, Sheetal D., Lafranconi, Alessandra, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lam, Jennifer O., Lami, Faris Hasan, Van Lansingh, C., Lansky, Sonia, Larson, Heidi J., Latifi, Amman, Lau, Kathryn Mei-Ming, Lazarus, Jeffrey V., Lebedev, Georgy, Lee, Paul H., Leigh, James, Leili, Mostafa, Leshargie, Cheru Tesema, Li, Shanshan, Li, Yichong, Liang, Juan, Lim, Lee-Ling, Lim, Stephen S., Limenih, Miteku Andualem, Linn, Shai, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Lansdale, Chris, Lopez, Alan D., Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Lunevicius, Raimundas, Ma, Stefan, Macarayan, Erlyn Rachelle King, Mackay, Mark T., MacLachlan, Jennifer H., Maddison, Emilie R., Nadotto, Fabiana, Abd El Razek, Hassan Magdy, Abd El Razek, Muhammed Magdy, Maghavani, Dhaval P., Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Manda, Ana-Laura, Mandarano-Filho, Luiz Garcia, Manguerra, Helena, Mansournia, Mohammad Ali, Mapoma, Chabila Christopher, Marami, Dadi, Maravilla, Joemer C., Marcenes, Wagner, Marczak, Laurie, Marks, Ashley, Marks, Guy B., Martinez, Gabriel, Martins-Melo, Francisco Rogerlandio, Martopullo, Ira, Marz, Winfried, Marron, Melvin B., Masci, Joseph R., Lylassenburg, Benjamin Ballard, Mathur, Manu Raj, Mathur, Prashant, Matzopoulos, Richard, Maulik, Pallab K., Mazidi, Mohsen, McAlinden, Cohn, McGrath, John J., McKee, Martin, McMahon, Brian J., Mehata, Suiiesh, Mehndiratta, Man Mohan, Mehrotra, Ravi, Mehta, Kala M., Mehta, Varshil, Mekonnen, Tefera C., Melese, Addisu, Melku, Mulugeta, Memiah, Peter T. N., Memish, Ziad A., Mendoza, Walter, Mengistu, Desalegn Tadese, Mengistu, Getnet, Mensah, George A., Mereta, Seid Tiku, Meretoja, Atte, Meretoja, Tuomo J., Meshovic, Tbmislav, Mezgebe, Haftay Berhane, Miazgowski, Bartosz, Miazgowski, Tomasz, Millear, Anoushka I., Miller, Ted R., Katherine, Molly, Petrie, Miller, Mini, G. K., Mirabi, Parvaneh, Mirarefin, Mojde, Mirica, Andreea, Mirrakhimov, Erkin M., Misganaw, Awoke Temesgen, Mitiku, Habtamu, Moazen, Babak, Mohammad, Karzan Abdulmuhsin, Mohammad, Moslem, Mohammadifard, Noushin, Mohammed, A. Mohammed, Mohammed, Shafiu, Mohan, Viswanathan, Mokdad, Ali H., Molokhia, Mariam, Monasta, Lorenzo, Moradi, Ghobad, Moradi-Lakeh, Maziar, Moradinazar, Mehdi, Moraga, Paula, Morawska, Lidia, Velasquez, Ilais Moreno, Morgado-Da-Costa, Joana, Morrison, Shane Douglas, Moschos, Marilita M., Mouodi, Simin, Mousavi, Seyyed Meysam, Muchie, Kindie Eentahun, Mueller, Ulrich Otto, Mukhopadhyay, Satinath, Muller, Kate, Mumford, John Everett, Musa, Jonah, Musa, Kamand Imran, Mustafa, Ghulam, Muthupandian, Saravanan, Nachega, Jean B., Nagel, Gabriele, Naheed, Aliya, Nahvijou, Azin, Naik, Gunidatta, Nair, Sanjeev, Najafi, Farid, Naldi, Luigi, Nam, Hae Sung, Nangia, Vinay, Nansseu, Jobert Richie, Nascirnento, Bruno Ramos, Natarajan, Gopalakrishnan, Nearnati, Nahid, Negoi, Ionut, Negoi, Ruxcandra Irina, Nettpane, Subas, Newton, Charles R. J., Ngalesoni, Frida N., Ngunjiri, Josephine W., Anh Quynh Nguyen, Nguyen, Grant, Ha Thu Nguyen, Luong Thanh Nguyen, Long Hoang Nguyen, Nguyen, Minh, Trang Huyen Nguyen, Nichols, Emma, Ningnun, Dina Nur Anggraini, Nirayo, Yirga Legesse, Nixon, Molly R., Nolutshungu, Nomonde, Nomura, Shhhei, Norhelin, Ole F., Noroozi, Mehdi, Norrving, Bo, Noubiap, Jean Jacques, Nouri, Hamid Reza, Shiadeh, Malihe Nourollahpour, Nowroozi, Mohammad Reza, Nyasulu, Peter S., Odell, Christopher M., Ofori-Asenso, Richard, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olagunju, Andrew T., Olivares, Pedro R., Olsen, Helen Elizabeth, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin L., Ong, Sok King Sk, Oren, Eyal, Orpana, Heather M., Ortiz, Alberto, Ortiz, Justin R., Otstavnov, Stanislav S., Overland, Simon, Owolabi, Mayowa Ojo, Ozdemir, Raziye, Mahesh, P. A., Pacella, Rosana, Pakhale, Smita, Pakhare, Abhijit P., Pakpour, Amir H., Pana, Adrian, Panda-Jonas, Songhomitra, Pandian, Jeyaraj Durai, Parisi, Andrea, Park, Eun-Kee, Parry, Charles D. H., Parsian, Hadi, Patel, Shanti, Pati, Sanghamitra, Patton, George C., Paturi, Vishnupriya Rao, Paulson, Katherine R., Pereira, Alexandre, Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael R., Piel, Frederic B., Pigott, David M., Pillay, Julian David, Pirsaheb, Meghdad, Pishgar, Farhad, Polinder, Suzanne, Postma, Maarten J., Pourshams, Akram, Poustchi, Hossein, Pujar, Ashwini, Prakash, Swayam, Prasad, Narayan, Purcell, Caroline A., Qorbani, Mostafa, Quintana, Hedley, Quistberg, D. Alex, Rade, Kirankumar Waman, Radfah, Amir, Rafay, Anwar, Rafiei, Alireza, Rahim, Fakher, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Ranabhat, Chhabi Lal, Ranjan, Prabhat, Rao, Puja C., Rawaf, David Laith, Rawaf, Salman, Razo-Garcia, Christian, Reddy, K. Srinath, Reiner, Robert C., Reitsma, Marissa B., Remuzzi, Giuseppe, Renzaho, Andre M. N., Resnikoff, Serge, Rezaei, Satar, Rezaeian, Shahab, Rezai, Mohammad Sadegh, Riahi, Seyed Mohammad, Ribeiro, Antonio Luiz P., Rios-Blancas, Maria Jesus, Roba, Kedir Teji, Roberts, Nicholas L. S., Robinson, Stephen R., Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Sachdev, Perminder S., Saddik, Basema, Sadeghi, Ehsan, Safari, Hosein, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Salam, Nasir, Salama, Joseph S., Salamati, Payman, De Saldanha, Raphael Freitas, Saleem, Zikria, Salimi, Yahya, Salvi, Sundeep Santosh, Salz, Inbal, Sambala, Evanson Zondani, Samy, Abdatiah M., Sanabria, Juan, Sanchez-Nino, Maria Dolores, Santomauro, Damian Francesco, Santos, Itamar S., Santos, Joao Vasco, Milicevic, Milena M. Santric, Jose, Bruno Piassi Sao, Sarker, Abdur Razzaque, Sarmiento-Suarez, Rodrigo, Sarrafzadegan, Nizal, Sartorius, Benn, Sarvi, Shahabeddin, Sathian, Brijesh, Satpathy, Maheswar, Sawant, Arundhati R., Sawhney, Monika, Saxena, Sonia, Sayyah, Mehdi, Schaeffher, Elke, Schmidt, Maria Ines, Schneider, Ione J. C., Schottker, Ben, Schutte, Aletta Elisabeth, Schwebel, David C., Schwendicke, Falk, Scott, James G., Sekerija, Mario, Sepanlou, Sadaf G., Servan-Mori, Edson, Seyedmousavi, Seyedmojtaba, Shabaninejad, Hosein, Shackelford, Katya Anne, Shafieesabet, Azadeh, Shahbazi, Mehdi, Shaheen, Amira A., Shaikh, Masood Ali, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Shamsizadeh, Morteza, Sharafi, Kiomars, Sharif, Mehdi, Sharif-Alhoseini, Mandi, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shi, Peilin, Shiferaw, Mekonnen Sisav, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, Shokraneh, Farhad, Shrine, Mark G., Si, Si, Siabani, Soraya, Siddiqi, Tariq J., Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silberberg, Donald H., Silva, Diego Augusto Santos, Silva, Joao Pedro, Da Silva, Natacha Torres, Silveira, Dayane Bride Alves, Singh, Jasvinder A., Singh, Narinder Pal, Singh, Prashant Kumar, Singh, Virendra, Sinha, Dhirendra Narain, Sliwa, Karen, Smith, Mari, Sobaih, Badr Hasan, Sobhani, Soheila, Solangwi, Eugene, Soneji, Samir S., Soofi, Moslem, Sorensen, Reed J. D., Soriano, Joan B., Soyiri, Ireneous N., Sposato, Luciano A., Sreeramareddy, Chandrashekhar F., Srinivasan, Vinay, Stanaway, Jeffrey D., Starodubov, Vladimir I., Stathopoulou, Vasiliki, Stein, Dan J., Steiner, Caitlyn, Stewart, Leo G., Stokes, Mark A., Subart, Michelle L., Sudaryanto, Agus, Sufiyan, Mu'awiyyah Babale, Sur, Patrick John, Sutradhar, Ipsita, Sykes, Bryan L., Sylaja, P. N., Sylte, Dillon O., Szoeke, Cassandra E. I., Tabares-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Takahashi, Ken, Tandon, Nikhil, Tassew, Segen Gebremeskel, Taveira, Nuno, Tehrani-Banihashemi, Arash, Tekalign, Tigist Gashaw, Tekle, Merhawi Gebremedhin, Temsah, Mohamad-Hani, Temsah, Omar, Terkawi, Abdullah Sulieman, Teshale, Manaye Yihune, Tesserna, Belay, Tessema, Gizachew Assefa, Thankappan, Kavumpurathu Raman, Thirinavukkarasu, Sathish, Thomas, Nihal, Thrift, Amanda G., Thurston, George D., Tilahun, Binyam, To, Quyen G., Tobe-Gai, Ruoyan, Tonellli, Marcello, Topor-Madry, Roman, Torre, Anna E., Tortajada-Cirbes, Miguel, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Bach Xuan Tran, Khah Bao Tran, Tripathi, Suryakant, Troeger, Christopher E., Truelsen, Thomas Clement, Nu Thi Truong, Tsadik, Afewerki Gebremeskel, Tsoi, Derrick, Car, Lorainne Tudor, Tuzcu, E. 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Reiner, Rc, Reitsma, Mb, Renzaho, Amn, Riahi, Sm, Ribeiro, Alp, Rios-Blancas, Mj, Roba, Kt, Roberts, Nl, Robinson, Sr, Sahraian, Ma, Saldanha, Rf, Sambala, Ez, Samy, Am, Sanchez-Niño, Md, Santomauro, Df, Santos, Jv, Milicevic, Mm, Sao Jose, Bp, Sarker, Ar, Sarmiento-Suárez, R, Sawant, Ar, Schmidt, Mi, Schneider, Ijc, Schöttker, B, Schutte, Ae, Schwebel, Dc, Scott, Jg, Sepanlou, Sg, Serván-Mori, E, Shackelford, Ka, Shaheen, Aa, Shaikh, Ma, Shrime, Mg, Siddiqi, Tj, Sigfusdottir, Id, Silberberg, Dh, Silva, Da, Silva, Jp, Silva, Ntd, Silveira, Dga, Singh, Ja, Singh, Np, Singh, Pk, Sinha, Dn, Sobaih, Bh, Sorensen, Rjd, Soriano, Jb, Soyiri, In, Sposato, La, Sreeramareddy, Ct, Stanaway, Jd, Starodubov, Vi, Stein, Dj, Stewart, Lg, Stokes, Ma, Subart, Ml, Sufiyan, Mb, Sur, Pj, Sykes, Bl, Sylaja, Pn, Sylte, Do, Szoeke, Cei, Tabarés-Seisdedos, R, Tadakamadla, Sk, Tassew, Sg, Tekalign, Tg, Tekle, Mg, Temsah, Mh, Teshale, My, Tessema, Ga, Thankappan, Kr, Thrift, Ag, Thurston, Gd, To, Qg, Torre, Ae, Tortajada-Girbés, M, Tovani-Palone, Mr, Tran, Bx, Tran, Kb, Troeger, Ce, Truelsen, Tc, Truong, Nt, Tsadik, Ag, Tuzcu, Em, Ukwaja, Kn, Undurraga, Ea, Updike, Rl, Uthman, Oa, Uzun, Sb, Valdez, Pr, Vasankari, Tj, Vladimirov, Sk, Vollset, Se, Wagner, Gr, Wallin, Mt, Walson, Jl, Wang, Yp, Wassie, Mm, Weintraub, Rg, Weldegwergs, Kg, Werkneh, Aa, West, Te, Whiteford, Ha, Wilner, Lb, Wolfe, Cda, Wu, Yc, Wyper, Gma, Yahyazadeh Jabbari, Sh, Yan, Ll, Yasin, Yj, Yentür, Gk, Yimer, Em, Yirsaw, Bd, Yoon, Sj, Younis, Mz, Zaman, Sb, Zeleke, Aj, Zenebe, Zm, Zhang, Al, Zuhlke, Lj, and Murray, Cjl.
Subjects: Adult, Male, Adolescent, national age-sex-specific mortality, UNITED-STATES, Global Health, Socioeconomic Factor, Global Burden of Disease, GBD, causes of death, Young Adult, Age Distribution, Life Expectancy, General & Internal Medicine, Cause of Death, PUBLIC-HEALTH PROBLEM, mortality, 282 causes global burden of disease, Sex Distribution, Child, Aged, Aged, 80 and over, BARRIERS, DEMENTIA, Medicine (all), Infant, Newborn, Infant, 11 Medical And Health Sciences, Middle Aged, TRENDS, PREVENTION, PREVALENCE, ALZHEIMERS-DISEASE, INDIVIDUALS, 3121 General medicine, internal medicine and other clinical medicine, Child, Preschool, REGISTRATION, Female, Human medicine, Human
Abstract: Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.
Published: 2018

50. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Stanaway, Jeffrey D., Afshin, Ashkan, Gakidou, Emmanuela, Lim, Stephen S., Abate, Degu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Molla, Abebe, Zegeye, Abera, Semaw F., Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A., Adane, Akilew Awoke, Adebayo, Oladimeji M., Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Ademi, Zanfina, Adetokunboh, Olatunji O., Adib, Mina G., Admasie, Amha, Adsuar, Jose C., Afanvi, Kossivi Agbelenko, Afarideh, Mohsen, Agarwal, Gina, Aggarwal, Anju, Aghayan, Sargis Aghasi, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akbari, Mohammad Esmaeil, Akinyemiju, Tomi, Akseer, Nadia, Al-Aly, Ziyad, Al-Eyadhy, Ayman, Al-Mekhlafi, Hesham M., Alahdab, Fares, Alam, Khurshid, Alam, Samiah, Alam, Tahiya, Alashi, Alaa, Alavian, Seyed Moayed, Alene, Kefyalew Addis, Ali, Komal, Ali, Syed Mustafa, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T., Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A., Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansha, Mustafa Geleto, Antó, Josep M., Antonio, Carl Abelardo T., Anwari, Palwasha, Appiah, Lambert Tetteh, Appiah, Seth Christopher Yaw, Arabloo, Jalal, Aremu, Olatunde, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna K., Asayesh, Hamid, Ataro, Zerihun, Ausloos, Marcel, Avokpaho, Euripide F.G.A., Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayer, Rakesh, Ayuk, Tambe B., Azzopardi, Peter S., Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Ball, Kylie, Ballew, Shoshana H., Banach, Maciej, Banoub, Joseph Adel Mattar, Barac, Aleksandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H., Basu, Sanjay, Baune, Bernhard T., Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Bekru, Eyasu Tamru, Belay, Ezra, Belay, Yihalem Abebe, Bell, Michelle L., Bello, Aminu K., Bennett, Derrick A., Bensenor, Isabela M., Bergeron, Gilles, Berhane, Adugnaw, Bernabe, Eduardo, Bernstein, Robert S., Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhattarai, Suraj, Bhutta, Zulfiqar A., Biadgo, Belete, Bijani, Ali, Bikbov, Boris, Bilano, Ver, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Blacker, Brigette F., Bleyer, Archie, Borschmann, Rohan, Bou-Orm, Ibrahim R., Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J., Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J.K., Brenner, Hermann, Briko, Andrey Nikolaevich, Britton, Gabrielle, Brugha, Traolach, Buchbinder, Rachelle, Burnett, Richard T., Busse, Reinhard, Butt, Zahid A., Cahill, Leah E., Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael R., Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J., Carvalho, Félix, Castañeda-Orjuela, Carlos A., Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cercy, Kelly M., Cerin, Ester, Chaiah, Yazan, Chang, Hsing Yi, Chang, Jung Chen, Chang, Kai Lan, Charlson, Fiona J., Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chee, Miao Li, Cheng, Ching Yu, Chew, Adrienne, Chiang, Peggy Pei Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chitheer, Abdulaal, Choi, Jee Young J., Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J., Chung, Sheng Chia, Cicuttini, Flavia M., Cirillo, Massimo, Cohen, Aaron J., Collado-Mateo, Daniel, Cooper, Cyrus, Cooper, Owen R., Coresh, Josef, Cornaby, Leslie, Cortesi, Paolo Angelo, Cortinovis, Monica, Costa, Megan, Cousin, Ewerton, Criqui, Michael H., Cromwell, Elizabeth A., Cundiff, David K., Daba, Alemneh Kabeta, Dachew, Berihun Assefa, Dadi, Abel Fekadu, Damasceno, Albertino Antonio Moura, Dandona, Lalit, Dandona, Rakhi, Darby, Sarah C., Dargan, Paul I., Daryani, Ahmad, Das Gupta, Rajat, Das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davitoiu, Dragos Virgil, Davletov, Kairat, De la Cruz-Góngora, Vanessa, De La Hoz, Fernando Pio, De Leo, Diego, De Neve, Jan Walter, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P., Demoz, Gebre Teklemariam, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Deshpande, Aniruddha, Des Jarlais, Don C., Dessie, Getenet Ayalew, Deveber, Gabrielle Aline, Dey, Subhojit, Dharmaratne, Samath Dhamminda, Dhimal, Meghnath, Dinberu, Mesfin Tadese, Ding, Eric L., Diro, Helen Derara, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Doyle, Kerrie E., Driscoll, Tim R., Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B., Duraes, Andre R., Ebert, Natalie, Ebrahimi, Hedyeh, Ebrahimpour, Soheil, Edvardsson, David, Effiong, Andem, Eggen, Anne Elise, El Bcheraoui, Charbel, El-Khatib, Ziad, Elyazar, Iqbal Rf, Enayati, Ahmadali, Endries, Aman Yesuf, Er, Benjamin, Erskine, Holly E., Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Fakhim, Hamed, Faramarzi, Mahbobeh, Fareed, Mohammad, Farid, Talha A., Farinha, Carla Sofia E.sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S., Farzaei, Mohammad Hosein, Fatima, Batool, Fay, Kairsten A., Fazaeli, Ali Akbar, Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed Mohammad, Fernandes, Eduarda, Fernandes, Joao C., Ferrara, Giannina, Ferrari, Alize J., Ferreira, Manuela L., Filip, Irina, Finger, Jonas David, Fischer, Florian, Foigt, Nataliya A., Foreman, Kyle J., Fukumoto, Takeshi, Fullman, Nancy, Fürst, Thomas, Furtado, João M., Futran, Neal D., Gall, Seana, 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Tr, Miller-Petrie, Mk, Mini, Gk, Mirrakhimov, Em, Misganaw, At, Mohammad, Ka, Mokdad, Ah, Morrison, Sd, Moschos, Mm, Mousavi, Sm, Mruts, Kb, Muche, Aa, Muchie, Kf, Mueller, Uo, Musa, Ki, Nabhan, Af, Nansseu, Jr, Nascimento, Br, Negoi, Ri, Newton, Crj, Ngunjiri, Jw, Nguyen, Aq, Nguyen, Ht, Nguyen, Hlt, Nguyen, Nb, Ningrum, Dna, Nirayo, Yl, Nixon, Mr, Norheim, Of, Noubiap, Jj, Nouri, Hr, Nowroozi, Mr, Nsoesie, Eo, Obermeyer, Cm, Odell, Cm, Ogbo, Fa, Oh, Ih, Olagunju, At, Olagunju, To, Olivares, Pr, Olsen, He, Olusanya, Bo, Olusanya, Jo, Ong, Kl, Ong, Sk, Orpana, Hm, Owolabi, Mo, Pakhare, Ap, Pakpour, Ah, Park, Ek, Parry, Cdh, Patil, St, Patton, Gc, Paulson, Kr, Paz Ballesteros, Wc, Pereira, Dm, Pham, Hq, Phillips, Mr, Pillay, Jd, Piradov, Ma, Polkinghorne, Kr, Postma, Mj, Purcell, Ca, Purwar, Mb, Rahman, Mhu, Rahman, Ma, Rai, Rk, Raju, Sb, Ranabhat, Cl, Rath, Gk, Rawaf, Dl, Rehm, Cd, Reiner RC, Jr, Reitsma, Mb, Renzaho, Amn, Reynales-Shigematsu, Lm, Ribeiro, Alp, Rivera, Ja, Roba, Kt, Roth, Ga, Sahraian, Ma, Salomon, Ja, Salvi, Dd, Samy, Am, Sanchez-Niño, Md, Sánchez-Pimienta, Tg, Santomauro, Df, Santos, Jv, Santric Milicevic, Mm, Sao Jose, Bp, Sarker, Ar, Sawant, Ar, Schmidt, Mi, Schneider, Ijc, Schutte, Ae, Schwebel, Dc, Scott, Jg, Sepanlou, Sg, Serre, Ml, Shaheen, Aa, Shaikh, Ma, Shin, Mj, Shrime, Mg, Sibai, Am, Siddiqi, Tj, Sigfusdottir, Id, Silva, Da, Silva, Jp, Silveira, Dga, Singh, Ja, Singh, Np, Sinha, Dn, Smith, Dl, Sobaih, Bh, Sorensen, Rjd, Soriano, Jb, Soyiri, In, Sposato, La, Sreeramareddy, Ct, Starodubov, Vi, Stein, Dj, Stein, Mb, Stokes, Ma, Subart, Ml, Sufiyan, Mb, Sunguya, Bf, Sur, Pj, Sykes, Bl, Szoeke, Cei, Tadakamadla, Sk, Tassew, Sg, Tekalign, Tg, Tekelemedhin, Sw, Tekle, Mg, Temsah, Mh, Thankappan, Kr, Thomas, Hj, Thomas, Ml, Thurston, Gd, To, Qg, Torre, Ae, Tovani-Palone, Mr, Towbin, Ja, Tran, Bx, Tran, Kb, Truelsen, Tc, Truong, Nt, Tsadik, Ag, Tuzcu, Em, Tymeson, Hd, Ukwaja, Kn, Updike, Rl, Uthman, Oa, Valdez, Pr, Vasankari, Tj, Vladimirov, Sk, Vollset, Se, Vu, Gt, Waller, Sg, Walson, Jl, Wang, Yp, Weintraub, Rg, Werkneh, Aa, West, Jj, Whiteford, Ha, Wiyeh, Ab, Wolfe, Cda, Wong, Ty, Yahyazadeh Jabbari, Sh, Yan, Ll, Yasin, Yj, Yimer, Em, Yoon, Sj, Younis, Mz, Zaman, Sb, Zhang, Al, Zimsen, Srm, Murray, Cjl., Stanaway, Jeffrey D, Afshin, Ashkan, Gakidou, Emmanuela, Lim, Stephen S, Abate, Degu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Molla, Abebe, Zegeye, Abera, Semaw F, Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A, Adane, Akilew Awoke, Adebayo, Oladimeji M, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Ademi, Zanfina, Adetokunboh, Olatunji O, Adib, Mina G, Admasie, Amha, Adsuar, Jose C, Afanvi, Kossivi Agbelenko, Afarideh, Mohsen, Agarwal, Gina, Aggarwal, Anju, Aghayan, Sargis Aghasi, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akbari, Mohammad Esmaeil, Akinyemiju, Tomi, Akseer, Nadia, Al-Aly, Ziyad, Al-Eyadhy, Ayman, Al-Mekhlafi, Hesham M, Alahdab, Fare, Alam, Khurshid, Alam, Samiah, Alam, Tahiya, Alashi, Alaa, Alavian, Seyed Moayed, Alene, Kefyalew Addi, Ali, Komal, Ali, Syed Mustafa, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, Françoi, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansha, Mustafa Geleto, Antó, Josep M, Antonio, Carl Abelardo T, Anwari, Palwasha, Appiah, Lambert Tetteh, Appiah, Seth Christopher Yaw, Arabloo, Jalal, Aremu, Olatunde, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna K, Asayesh, Hamid, Ataro, Zerihun, Ausloos, Marcel, Avokpaho, Euripide F G A, Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayer, Rakesh, Ayuk, Tambe B, Azzopardi, Peter S, Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Ball, Kylie, Ballew, Shoshana H, Banach, Maciej, Banoub, Joseph Adel Mattar, Barac, Aleksandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Basu, Sanjay, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Bekru, Eyasu Tamru, Belay, Ezra, Belay, Yihalem Abebe, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Bergeron, Gille, Berhane, Adugnaw, Bernabe, Eduardo, Bernstein, Robert S, Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhattarai, Suraj, Bhutta, Zulfiqar A, Biadgo, Belete, Bijani, Ali, Bikbov, Bori, Bilano, Ver, Bililign, Nigu, Bin Sayeed, Muhammad Shahdaat, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Blacker, Brigette F, Bleyer, Archie, Borschmann, Rohan, Bou-Orm, Ibrahim R, Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brenner, Hermann, Briko, Andrey Nikolaevich, Britton, Gabrielle, Brugha, Traolach, Buchbinder, Rachelle, Burnett, Richard T, Busse, Reinhard, Butt, Zahid A, Cahill, Leah E, Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael R, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cercy, Kelly M, Cerin, Ester, Chaiah, Yazan, Chang, Hsing-Yi, Chang, Jung-Chen, Chang, Kai-Lan, Charlson, Fiona J, Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chee, Miao Li, Cheng, Ching-Yu, Chew, Adrienne, Chiang, Peggy Pei-Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chitheer, Abdulaal, Choi, Jee-Young J, 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Hsiao, Thoma, Hu, Guoqing, Hu, Howard, Huang, John J, Hussen, Mamusha Aman, Huynh, Chantal K, Iburg, Kim Moesgaard, Ikeda, Nayu, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Jackson, Maria D, Jacobsen, Kathryn H, Jahangiry, Leila, Jahanmehr, Nader, Jain, Sudhir Kumar, Jakovljevic, Mihajlo, James, Spencer L, Jassal, Simerjot K, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Jonas, Jost B, Jonnagaddala, Jitendra, Jorjoran Shushtari, Zahra, Joshi, Ankur, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Zubair, Kahsay, Amaha, Kalani, Rizwan, Kanchan, Tanuj, Kant, Surya, Kar, Chittaranjan, Karami, Manoochehr, Karami Matin, Behzad, Karch, André, Karema, Corine, Karimi, Narge, Karimi, Seyed M, Kasaeian, Amir, Kassa, Dessalegn H, Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kaul, Anil, 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N, Resnikoff, Serge, Reynales-Shigematsu, Luz Myriam, Rezaei, Satar, Ribeiro, Antonio Luiz P, Rivera, Juan A, Roba, Kedir Teji, Rodríguez-Ramírez, Sonia, Roever, Leonardo, Román, Yesenia, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Rushton, Lesley, Sabanayagam, Charumathi, Sachdev, Perminder S, Saddik, Basema, Sadeghi, Ehsan, Saeedi Moghaddam, Sahar, Safari, Hosein, Safari, Yahya, Safari-Faramani, Roya, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salam, Nasir, Salamati, Payman, Saleem, Zikria, Salimi, Yahya, Salimzadeh, Hamideh, Salomon, Joshua A, Salvi, Devashri Digvijay, Salz, Inbal, Samy, Abdallah M, Sanabria, Juan, Sanchez-Niño, Maria Dolore, Sánchez-Pimienta, Tania G, Sanders, Taren, Sang, Yingying, Santomauro, Damian Francesco, Santos, Itamar S, Santos, João Vasco, Santric Milicevic, Milena M, Sao Jose, Bruno Piassi, Sardana, Mayank, Sarker, Abdur Razzaque, Sarmiento-Suárez, Rodrigo, Sarrafzadegan, Nizal, Sartorius, Benn, Sarvi, Shahabeddin, Sathian, Brijesh, Satpathy, Maheswar, Sawant, Arundhati R, Sawhney, Monika, Saylan, Mete, Sayyah, Mehdi, Schaeffner, Elke, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Scott, James G, Seedat, Soraya, Sekerija, Mario, Sepanlou, Sadaf G, Serre, Marc L, Serván-Mori, Edson, Seyedmousavi, Seyedmojtaba, Shabaninejad, Hosein, Shaddick, Gavin, Shafieesabet, Azadeh, Shahbazi, Mehdi, Shaheen, Amira A, Shaikh, Masood Ali, Shamah Levy, Teresa, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Sharafi, Heidar, Sharafi, Kiomar, Sharif, Mehdi, Sharif-Alhoseini, Mahdi, Sharifi, Hamid, Sharma, Jayendra, Sharma, Meenakshi, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shi, Peilin, Shibuya, Kenji, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, Shokraneh, Farhad, Shoman, Haitham, Shrime, Mark G, Shupler, Matthew S, Si, Si, Siabani, Soraya, Sibai, Abla Mehio, Siddiqi, Tariq J, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Silva, João Pedro, Silveira, Dayane Gabriele Alve, Singh, Jasvinder A, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Skirbekk, Vegard, Smith, David L, Smith, Mari, Sobaih, Badr Hasan, Sobhani, Soheila, Somayaji, Ranjani, Soofi, Moslem, Sorensen, Reed J D, Soriano, Joan B, Soyiri, Ireneous N, Spinelli, Angela, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Starodubov, Vladimir I, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stevanovic, Goran, Stockfelt, Leo, Stokes, Mark A, Sturua, Lela, Subart, Michelle L, Sudaryanto, Agu, Sufiyan, Mu'awiyyah Babale, Sulo, Gerhard, Sunguya, Bruno F, Sur, Patrick John, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Takahashi, Ken, Tandon, Nikhil, Tassew, Segen Gebremeskel, Tavakkoli, Mohammad, Taveira, Nuno, Tehrani-Banihashemi, Arash, Tekalign, Tigist Gashaw, Tekelemedhin, Shishay Wahdey, Tekle, Merhawi Gebremedhin, Temesgen, Habtamu, Temsah, Mohamad-Hani, Temsah, Omar, Terkawi, Abdullah Sulieman, Tessema, Belay, Teweldemedhin, Mebrahtu, Thankappan, Kavumpurathu Raman, Theis, Andrew, Thirunavukkarasu, Sathish, Thomas, Hannah J, Thomas, Matthew Lloyd, Thomas, Nihal, Thurston, George D, Tilahun, Binyam, Tillmann, Taavi, To, Quyen G, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Torre, Anna E, Tortajada-Girbés, Miguel, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Towbin, Jeffrey A, Tran, Bach Xuan, Tran, Khanh Bao, Truelsen, Thomas Clement, Truong, Nu Thi, Tsadik, Afewerki Gebremeskel, Tudor Car, Lorainne, Tuzcu, E Murat, Tymeson, Hayley D, Tyrovolas, Stefano, Ukwaja, Kingsley N, Ullah, Irfan, Updike, Rachel L, Usman, Muhammad Shariq, Uthman, Olalekan A, Vaduganathan, Muthiah, Vaezi, Afsane, Valdez, Pascual R, Van Donkelaar, Aaron, Varavikova, Elena, Varughese, Santosh, Vasankari, Tommi Juhani, Venkateswaran, Vidhya, Venketasubramanian, Narayanaswamy, Villafaina, Santo, Violante, Francesco S, Vladimirov, Sergey Konstantinovitch, Vlassov, Vasily, Vollset, Stein Emil, Vos, Theo, Vosoughi, Kia, Vu, Giang Thu, Vujcic, Isidora S, Wagnew, Fasil Shiferaw, Waheed, Yasir, Waller, Stephen G, Walson, Judd L, Wang, Yafeng, Wang, Yanping, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weldegebreal, Fitsum, Werdecker, Andrea, Werkneh, Adhena Ayaliew, West, J Jason, Westerman, Ronny, Whiteford, Harvey A, Widecka, Justyna, Wijeratne, Tissa, Winkler, Andrea Sylvia, Wiyeh, Alison B, Wiysonge, Charles Shey, Wolfe, Charles D A, Wong, Tien Yin, Wu, Shouling, Xavier, Deni, Xu, Gelin, Yadgir, Simon, Yadollahpour, Ali, Yahyazadeh Jabbari, Seyed Hossein, Yamada, Tomohide, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yasin, Yasin Jemal, Yeshaneh, Alex, Yimer, Ebrahim M, Yip, Paul, Yisma, Engida, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yousefifard, Mahmoud, Yu, Chuanhua, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zavala-Arciniega, Lui, Zhang, Anthony Lin, Zhang, Hao, Zhang, Kai, Zhou, Maigeng, Zimsen, Stephanie R M, Zodpey, Sanjay, and Murray, Christopher J L
Subjects: Science & Technology, GBD, risks, risk factors, comparative risk assesment, Dalys, Medicine (all), CHOLESTEROL, BLOOD-PRESSURE, 11 Medical And Health Sciences, ILLNESS, TRENDS, humanities, Medicine, General & Internal, TOBACCO CONTROL, General & Internal Medicine, parasitic diseases, Medicine and Health Sciences, CARDIOVASCULAR-DISEASES, TRIAL, Human medicine, Life Sciences & Biomedicine, METAANALYSIS
Abstract: Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk– outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Lancet 2018; 392: 1923–94 *Collaborators listed at the end of the paper Correspondence to: Prof Christopher J L Murray, Institute for Health Metrics and Evalution, Seattle, WA 98121, USA cjlm@uw.edu Global Health Metrics 1924 www.thelancet.com Vol 392 November 10, 2018 Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning.
Published: 2018

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