885 results on '"Vaduganathan, M."'
Search Results
2. High-sensitivity troponin-T concentrations and long-term risk of death in patients with acute pulmonary embolism
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Pareek, M, primary, Rosberg, V, additional, Kristensen, A M D, additional, Afzal, M, additional, Byrne, C, additional, Biering-Sorensen, T, additional, Vaduganathan, M, additional, Bhatt, D L, additional, Lofgren, B, additional, Sorensen, R, additional, Torp-Pedersen, C, additional, and Kragholm, K H, additional
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- 2023
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3. Heart failure medical therapy and outcomes in patients undergoing transcatheter mitral valve repair for secondary mitral regurgitation: a TVT Registry analysis across 449 US centers
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Varshney, A S, primary, Shah, M, additional, Vemulapalli, S, additional, Kosinski, A, additional, Bhatt, A S, additional, Sandhu, A T, additional, Hirji, S, additional, Defilippis, E M, additional, Shah, P B, additional, Fiuzat, M, additional, Ogara, P T, additional, Bhatt, D L, additional, Kaneko, T, additional, Givertz, M M, additional, and Vaduganathan, M, additional
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- 2023
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4. Serial high-sensitivity troponin-I and long-term risk of myocardial infarction and coronary revascularization in subjects with suspected acute coronary syndrome
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Pareek, M, primary, Frangeskos, J, additional, Kristensen, A M D, additional, Vaduganathan, M, additional, Byrne, C, additional, Biering-Sorensen, T, additional, Fosbol, E, additional, Kober, L, additional, Gislason, G H, additional, Torp-Pedersen, C, additional, Bhatt, D L, additional, and Kragholm, K H, additional
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- 2023
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5. Effect of dapagliflozin in patients with heart failure with mildly reduced or preserved ejection fraction treated with beta-blockers: the DELIVER trial
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Peikert, A, primary, Bart, B A, additional, Vardeny, O, additional, Vaduganathan, M, additional, Claggett, B L, additional, Desai, A S, additional, Jhund, P S, additional, Kosiborod, M N, additional, Lam, C S P, additional, Martinez, F A, additional, De Boer, R A, additional, Hernandez, A F, additional, Shah, S J, additional, Mc Murray, J J V, additional, and Solomon, S D, additional
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- 2023
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6. Effects of dapagliflozin in heart failure with preserved ejection fraction and chronic obstructive pulmonary disease: an analysis of the DELIVER trial
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Butt, J, primary, Lu, H, additional, Kondo, T, additional, Bachus, E, additional, De Boer, R A, additional, Hernandez, A, additional, Inzucchi, S, additional, Jhund, P S, additional, Kosiborod, M, additional, Lam, C, additional, Martinez, F, additional, Shah, S J, additional, Vaduganathan, M, additional, Solomon, S D, additional, and Mcmurray, J J V, additional
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- 2023
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7. Clinical and echocardiographic characteristics and cardiovascular outcomes according to diabetes status in a large general population sample
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Lassen, M C H, primary, Skaarup, K G, additional, Johansen, N D, additional, Vaduganathan, M, additional, Qasim, A, additional, Jensen, G B, additional, Schnohr, P, additional, Jensen, M T, additional, Mogelvang, R, additional, and Biering-Sorensen, T, additional
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- 2023
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8. Effect of dapagliflozin on outpatient worsening heart failure in patients with mildly reduced or preserved ejection fraction: the DELIVER trial
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Chatur, S, primary, Vaduganathan, M, additional, Claggett, B L, additional, Desai, A S, additional, Docherty, K F, additional, Jhund, P S, additional, De Boer, R A, additional, Hernandez, A F, additional, Inzucchi, S E, additional, Kosiborod, M N, additional, Lam, C S P, additional, Martinez, F A, additional, Shah, S J, additional, Mcmurray, J V, additional, and Solomon, S D, additional
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- 2023
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9. Influence of background therapy on efficacy of dapagliflozin in patients with heart failure and improved ejection fraction
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Pabon Porras, M A, primary, Clagget, B L, additional, Chatur, S, additional, Bhatt, A S, additional, Vaduganathan, M, additional, Fang, J, additional, Desai, A, additional, Jhund, P, additional, Martinez, F, additional, De Boer, R, additional, Kosiborod, M, additional, Lam, C, additional, Mcmurray, J, additional, Solomon, S, additional, and Vaderny, O, additional
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- 2023
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10. Effect of dapagliflozin in patients in Asia with heart failure with mildly reduced or preserved ejection fraction: insights from DELIVER
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Wang, X, primary, Lam, C S P, additional, Claggett, B, additional, Miao, M, additional, Shah, S J, additional, Jhund, P S, additional, Desai, A S, additional, Chiang, C, additional, Pham, V N, additional, Han, Y, additional, Kitakaze, M, additional, Langkilde, A M, additional, Mcmurray, J J V, additional, Solomon, S D, additional, and Vaduganathan, M, additional
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- 2023
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11. High-sensitivity troponin-i and risk of heart failure in individuals with suspected acute coronary syndrome
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Byrne, C, primary, Vaduganathan, M, additional, Biering-Sorensen, T, additional, Kristensen, A M D, additional, Omar, M, additional, Bhatt, D L, additional, Schou, M, additional, Kober, L, additional, Gislason, G, additional, Torp-Pedersen, C, additional, Kragholm, K, additional, and Pareek, M, additional
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- 2023
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12. Echocardiographic characterization of patients with supranormal ejection fraction: pooled core laboratory analysis of the TOPCAT and PARAGON-HF trials
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Wang, X, primary, Chatur, S, additional, Lu, H, additional, Claggett, B, additional, Skali, H, additional, Vaduganathan, M, additional, Minamisawa, M, additional, Inciardi, R M, additional, Shah, A M, additional, Packer, M, additional, Pitt, B, additional, Rouleau, J, additional, Pfeffer, M A, additional, Mcmurray, J J V, additional, and Solomon, S D, additional
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- 2023
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13. Angiotensin–neprilysin inhibition and renal outcomes across the spectrum of ejection fraction in heart failure
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Mc Causland, F, Lefkowitz, M, Claggett, B, Packer, M, Senni, M, Gori, M, Jhund, P, Mcgrath, M, Rouleau, J, Shi, V, Swedberg, K, Vaduganathan, M, Zannad, F, Pfeffer, M, Zile, M, Mcmurray, J, Solomon, S, Mc Causland F. R., Lefkowitz M. P., Claggett B., Packer M., Senni M., Gori M., Jhund P. S., McGrath M. M., Rouleau J. L., Shi V., Swedberg K., Vaduganathan M., Zannad F., Pfeffer M. A., Zile M., McMurray J. J. V., Solomon S. D., Mc Causland, F, Lefkowitz, M, Claggett, B, Packer, M, Senni, M, Gori, M, Jhund, P, Mcgrath, M, Rouleau, J, Shi, V, Swedberg, K, Vaduganathan, M, Zannad, F, Pfeffer, M, Zile, M, Mcmurray, J, Solomon, S, Mc Causland F. R., Lefkowitz M. P., Claggett B., Packer M., Senni M., Gori M., Jhund P. S., McGrath M. M., Rouleau J. L., Shi V., Swedberg K., Vaduganathan M., Zannad F., Pfeffer M. A., Zile M., McMurray J. J. V., and Solomon S. D.
- Abstract
Aims: Patients with heart failure are at higher risk of progression to end-stage renal disease (ESRD), regardless of ejection fraction (EF). We assessed the renal effects of angiotensin–neprilysin inhibition in a pooled analysis of 13 195 patients with heart failure with reduced and preserved EF. Methods and results: We combined data from PARADIGM-HF (EF ≤40%; n = 8399) and PARAGON-HF (EF ≥45%; n = 4796) in a pre-specified pooled analysis. We assessed the effect of treatment (sacubitril/valsartan vs. enalapril or valsartan) on a composite of either ≥50% reduction in estimated glomerular filtration rate (eGFR), ESRD, or death from renal causes, in addition to changes in eGFR slope. We assessed whether baseline renal function or EF modified the effect of therapy on renal outcomes. At randomization, eGFR was 68 ± 20 ml/min/1.73 m2 in PARADIGM-HF and 63 ± 19 ml/min/1.73 m2 in PARAGON-HF. The composite renal outcome occurred in 70 of 6594 patients (1.1%) in the sacubitril/valsartan group and in 123 of 6601 patients (1.9%) in the valsartan or enalapril group (hazard ratio 0.56, 95% confidence interval [CI] 0.42–0.75; p < 0.001). The mean eGFR change was −1.8 (95% CI −1.9 to −1.7) ml/min/1.73 m2/year for the sacubitril/valsartan group, compared with −2.4 (95% CI −2.5 to −2.2) ml/min/1.73 m2/year for the valsartan or enalapril group. The treatment effect on the composite renal endpoint was not modified by categories of baseline eGFR (p-interaction = 0.64), but was most pronounced in those with baseline EF between 30% and 60% (p-interaction = 0.001). Conclusions: In patients with heart failure, sacubitril/valsartan reduced the risk of serious adverse renal outcomes and slowed decline in eGFR, compared with valsartan or enalapril, independent of baseline renal function.
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- 2022
14. Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support-Free Days in Patients Hospitalized With COVID-19: A Randomized Clinical Trial.
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Lawler, P.R., Derde, L.P.G., Veerdonk, F.L. van de, McVerry, B.J., Huang, D.T., Berry, L.R., Lorenzi, E., Kimmenade, R.R.J. van, Gommans, F., Vaduganathan, M., Leaf, D.E., Baron, R.M., Kim, E.Y., Frankfurter, C., Epelman, S., Kwan, Y., Grieve, R., O'Neill, S., Sadique, Z., Puskarich, M., Marshall, J.C., Higgins, A.M., Mouncey, P.R., Rowan, K.M., Al-Beidh, F., Annane, D., Arabi, Y.M., Au, C., Beane, A., Bentum-Puijk, W. van, Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Burrell, A., Buzgau, A., Buxton, M., Cecconi, M., Cheng, A.C., Cove, M., Detry, M.A., Estcourt, L.J., Ezekowitz, J., Fitzgerald, M., Gattas, D., Godoy, L.C., Goossens, H., Haniffa, R., Harrison, D.A., Hills, T., Horvat, C.M., Ichihara, N., Lamontagne, F., Linstrum, K.M., McAuley, D.F., McGlothlin, A., McGuinness, S.P., McQuilten, Z., Murthy, S., Nichol, A.D., Owen, D.R.J., Parke, R.L., Parker, J.C., Pollock, K.M., Reyes, L.F., Saito, H., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Singh, V., Turgeon, A.F., Turner, A.M., Zarychanski, R., Green, C., Lewis, R.J., Angus, D.C., Berry, S., Gordon, A.C., McArthur, C.J., Webb, S.A., Lawler, P.R., Derde, L.P.G., Veerdonk, F.L. van de, McVerry, B.J., Huang, D.T., Berry, L.R., Lorenzi, E., Kimmenade, R.R.J. van, Gommans, F., Vaduganathan, M., Leaf, D.E., Baron, R.M., Kim, E.Y., Frankfurter, C., Epelman, S., Kwan, Y., Grieve, R., O'Neill, S., Sadique, Z., Puskarich, M., Marshall, J.C., Higgins, A.M., Mouncey, P.R., Rowan, K.M., Al-Beidh, F., Annane, D., Arabi, Y.M., Au, C., Beane, A., Bentum-Puijk, W. van, Bonten, M.J.M., Bradbury, C.A., Brunkhorst, F.M., Burrell, A., Buzgau, A., Buxton, M., Cecconi, M., Cheng, A.C., Cove, M., Detry, M.A., Estcourt, L.J., Ezekowitz, J., Fitzgerald, M., Gattas, D., Godoy, L.C., Goossens, H., Haniffa, R., Harrison, D.A., Hills, T., Horvat, C.M., Ichihara, N., Lamontagne, F., Linstrum, K.M., McAuley, D.F., McGlothlin, A., McGuinness, S.P., McQuilten, Z., Murthy, S., Nichol, A.D., Owen, D.R.J., Parke, R.L., Parker, J.C., Pollock, K.M., Reyes, L.F., Saito, H., Santos, M.S., Saunders, C.T., Seymour, C.W., Shankar-Hari, M., Singh, V., Turgeon, A.F., Turner, A.M., Zarychanski, R., Green, C., Lewis, R.J., Angus, D.C., Berry, S., Gordon, A.C., McArthur, C.J., and Webb, S.A.
- Abstract
Item does not contain fulltext, IMPORTANCE: Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. OBJECTIVE: To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS: In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non-critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS: Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES: The primary outcome was organ support-free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS: On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support-free days among critically ill patients was 10 (-1 to 16) in the ACE inhibitor group (n = 231), 8 (-1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support-free days compared with control were 94.9% and 95.4%, respectively. Hospital surv
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- 2023
15. Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support–free days in patients hospitalized with COVID-19
- Author
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Writing Committee for the REMAP-CAP Investigators, Lawler, PR, Derde, LPG, Van de Veerdonk, FL, McVerry, BJ, Huang, DT, Berry, LR, Lorenzi, E, Van Kimmenade, R, Gommans, F, Vaduganathan, M, Leaf, DE, Baron, RM, Kim, EY, Frankfurter, C, Epelman, S, Kwan, Y, Grieve, R, O'Neill, S, Sadique, Z, Puskarich, M, Marshall, JC, Higgins, AM, Mouncey, PR, Rowan, KM, Al-Beidh, F, Annane, D, Arabi, YM, Au, C, Beane, A, Van Bentum-Puijk, W, Bonten, MJM, Bradbury, CA, Brunkhorst, FM, Burrell, A, Buzgau, A, Buxton, M, Cecconi, M, Cheng, AC, Cove, M, Detry, MA, Estcourt, LJ, Ezekowitz, J, Fitzgerald, M, Gattas, D, Godoy, LC, Goossens, H, Haniffa, R, Harrison, DA, Hills, T, Horvat, CM, Ichihara, N, Lamontagne, F, Linstrum, KM, McAuley, DF, McGlothlin, A, McGuinness, SP, McQuilten, Z, Murthy, S, Nichol, AD, Owen, DRJ, Parke, RL, Parker, JC, Pollock, KM, Reyes, LF, Saito, H, Santos, MS, Saunders, CT, Seymour, CW, Shankar-Hari, M, Singh, V, Turgeon, AF, Turner, AM, Zarychanski, R, Green, C, Lewis, RJ, Angus, DC, Berry, S, Gordon, AC, McArthur, CJ, and Webb, SA
- Abstract
IMPORTANCE: Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. OBJECTIVE: To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS: In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non-critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS: Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES: The primary outcome was organ support-free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS: On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support-free days among critically ill patients was 10 (-1 to 16) in the ACE inhibitor group (n = 231), 8 (-1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support-free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE: In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02735707.
- Published
- 2023
16. Long-term (180-day) outcomes in critically ill patients with COVID-19 in the REMAP-CAP randomized clinical trial
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Florescu, S, Stanciu, D, Zaharia, M, Kosa, A, Codreanu, D, Kidwai, A, Masood, S, Kaye, C, Coutts, A, MacKay, L, Summers, C, Polgarova, P, Farahi, N, Fox, E, McWilliam, S, Hawcutt, D, Rad, L, O’Malley, L, Whitbread, J, Jones, D, Dore, R, Saunderson, P, Kelsall, O, Cowley, N, Wild, L, Thrush, J, Wood, H, Austin, K, Bélteczki, J, Magyar, I, Fazekas, Á, Kovács, S, Szőke, V, Donnelly, A, Kelly, M, Smyth, N, O’Kane, S, McClintock, D, Warnock, M, Campbell, R, McCallion, E, Azaiz, A, Charron, C, Godement, M, Geri, G, Vieillard-Baron, A, Johnson, P, McKenna, S, Hanley, J, Currie, A, Allen, B, McGoldrick, C, McMaster, M, Mani, A, Mathew, M, Kandeepan, R, Vignesh, C, TV, B, Ramakrishnan, N, James, A, Elvira, E, Jayakumar, D, Pratheema, R, Babu, S, Ebenezer, R, Krishnaoorthy, S, Ranganathan, L, Ganesan, M, Shree, M, Guilder, E, Butler, M, Cowdrey, K-A, Robertson, M, Ali, F, McMahon, E, Duffy, E, Chen, Y, Simmonds, C, McConnochie, R, O’Connor, C, El-Khawas, K, Richardson, A, Hill, D, Commons, R, Abdelkharim, H, Saxena, M, Muteithia, M, Dobell-Brown, K, Jha, R, Kalogirou, M, Ellis, C, Krishnamurthy, V, O’Connor, A, Thurairatnam, S, Mukherjee, D, Kaliappan, A, Vertue, M, Nicholson, A, Riches, J, Maloney, G, Kittridge, L, Solesbury, A, Ramos, A, Collins, D, Brickell, K, Reid, L, Smyth, M, Breen, P, Spain, S, Curley, G, McEvoy, N, Geoghegan, P, Clarke, J, Silversides, J, McGuigan, P, Ward, K, O’Neill, A, Finn, S, Wright, C, Green, J, Collins, É, Knott, C, Smith, J, Boschert, C, Slieker, K, Ewalds, E, Sanders, A, Wittenberg, W, Geurts, H, Poojara, L, Sara, T, Nand, K, Reeve, B, Dechert, W, Phillips, B, Oritz-Ruiz de Gordoa, L, Affleck, J, Shaikh, A, Murray, A, Ramanan, M, Frakking, T, Pinnell, J, Robinson, M, Gledhill, L, Wood, T, Sanghavi, R, Bhonagiri, D, Ford, M, Parikh, HG, Avard, B, Nourse, M, McDonald, B, Edmunds, N, Hoiting, O, Peters, M, Rengers, E, Evers, M, Prinssen, A, Morgan, M, Cole, J, Hill, H, Davies, M, Williams, A, Thomas, E, Davies, R, Wise, M, Grimm, P, Soukup, J, Wetzold, R, Löbel, M, Starke, L, Lellouche, F, Lizotte, P, Declerq, P, Antoine, M, Stephanie, G, Jean-Pierre, E, François, B, Marion, B, Philippe, R, Pourcine, F, Monchi, M, Luis, D, Mercier, R, Sagnier, A, Verrier, N, Caplin, C, Richecoeu, J, Combaux, D, Siami, S, Aparicio, C, Vautier, S, Jeblaoui, A, Lemaire-Brunel, D, D'Aragon, F, Carbonneau, E, Leblond, J, Plantefeve, G, Leparco, C, Contou, D, Fartoukh, M, Courtin, L, Labbe, V, Voiriot, G, Salhi, S, Chassé, M, Carrier, F, Boumahni, D, Benettaib, F, Ghamraoui, A, Sement, A, Gachet, A, Hanisch, A, Haffiane, A, Boivin, A-H, Barreau, A, Guerineau, E, Poupblanc, S, Egreteau, P, Lefevre, M, Bocher, S, Le Loup, G, Le Guen, L, Carn, V, Bertel, M, Antcliffe, D, Templeton, M, Rojo, R, Coghlan, P, Smee, J, Barker, G, Finn, A, Kreb, G, Hoff, U, Hinrichs, C, Nee, J, Mackay, E, Cort, J, Whileman, A, Spencer, T, Spittle, N, Beavis, S, Padmakumar, A, Dale, K, Hawes, J, Moakes, E, Gascoyne, R, Pritchard, K, Stevenson, L, Cooke, J, Nemeth-Roszpopa, K, Gauli, B, Bastola, S, Muller, G, Nay, M-A, Kamel, T, Benzekri, D, Jacquier, S, Runge, I, Mathonnet, A, Barbier, F, Bretagnol, A, Carter, J, Van Der Heyden, K, Mehrtens, J, Morris, A, Morgan, S, Burke, T, Mercier, E, Chartier, D, Salmon, C, Dequin, P-F, Garot, D, Bellemare, D, Cloutier, È, Daher, R, Costerousse, O, Boulanger, M-C, Couillard-Chénard, É, Lauzier, F, Francoeur, C, Francois, B, Gay, A, Anne-Laure, F, Ramali, M, HC, O, Ghosh, A, Osagie, R, Arachchige, M, Hartley, M, Cheung, W, Wong, H, Seigne, P, Eustace, J, O'Callaghan, A-M, O'Brien, F, Bamford, P, Reid, A, Cawley, K, Faulkner, M, Pickering, C, Raj, A, Tsinaslanidis, G, Khade, R, Agha, G, Sekiwala, R, Smith, T, Brewer, C, Gregory, J, Limb, J, Cowton, A, O’Brien, J, Postlethwaite, K, Malakouti, S, Music, E, Ricketts, D, King, A, Clermont, G, Bart, R, Mayr, F, Schoenling, A, Andreae, M, Shetty, V, Brant, E, Malley, B, Donadee, C, Sackrowitz, R, Weissman, A, Yealy, D, Barton, D, Talia, N, Nikitas, N, Wells, C, Lankester, L, McMillan, H, Van den Oever, H, Kruisdijk-Gerritsen, A, Haidar, G, Bain, W, Barbash, I, Fitzpatrick, M, Franz, C, Kitsios, G, Moghbeli, K, Rosborough, B, Shah, F, Suber, T, Pulletz, M, Williams, P, Birch, J, Wiseman, S, Horton, S, Alegria, A, Turki, S, Elsefi, T, Crisp, N, Allen, L, Truman, N, Smith, M, Chukkambotla, S, Goddard, W, Duberley, S, Khan, M, Kazi, A, Simpson, J, Duke, G, Chan, P, Carter, B, Hunter, S, Voigt, I, Schueler, R, Blank, E, Hüning, V, Steffen, M, Goralski, P, Litton, E, Regli, A, Pellicano, S, Palermo, A, Eroglu, E, Bihari, S, Laver, RD, Jin, X, Brown, J, McIntyre, J, French, C, Bates, S, Towns, M, Yang, Y, McGain, F, McCullagh, I, Cairns, T, Hanson, H, Patel, B, Clement, I, Evetts, G, Touma, O, Holland, S, Hodge, C, Taylor, H, Alderman, M, Barnes, N, Da Rocha, J, Smith, C, Brooks, N, Weerasinghe, T, Sinclair, J-A, Abusamra, Y, Doherty, R, Cudlipp, J, Singh, R, Yu, H, Daebis, A, Ng, C, Kendrick, S, Saran, A, Makky, A, Greener, D, Rowe-Leete, L, 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T, Young, I, Burrell, A, Ferguson, N, Hodgson, C, Orford, N, Phua, J, Baron, R, Epelman, S, Frankfurter, C, Gommans, F, Kim, E, Leaf, D, Vaduganathan, M, Van Kimmenade, R, Sanil, A, Van Beurden, M, Effelaar, E, Schotsman, J, Boyd, C, Harland, C, Shearer, A, Wren, J, Attanayaka, U, Darshana, S, Ishani, P, Udayanga, I, Higgins, AM, Berry, LR, Lorenzi, E, Murthy, S, McQuilten, Z, Mouncey, PR, Al-Beidh, F, Annane, D, Arabi, YM, Beane, A, Van Bentum-Puijk, W, Bhimani, Z, Bonten, MJM, Bradbury, CA, Brunkhorst, FM, Buzgau, A, Buxton, M, Charles, WN, Cove, M, Detry, MA, Estcourt, LJ, Fagbodun, EO, Fitzgerald, M, Girard, TD, Goligher, EC, Goossens, H, Haniffa, R, Hills, T, Horvat, CM, Huang, DT, Ichihara, N, Lamontagne, F, Marshall, JC, McAuley, DF, McGlothlin, A, McGuinness, SP, McVerry, BJ, Neal, MD, Nichol, AD, Parke, RL, Parker, JC, Parry-Billings, K, Peters, SEC, Reyes, LF, Rowan, KM, Saito, H, Santos, MS, Saunders, CT, Serpa-Neto, A, Seymour, CW, Shankar-Hari, M, Stronach, LM, Turgeon, AF, Turner, AM, Van de Veerdonk, FL, Zarychanski, R, Green, C, Lewis, RJ, Angus, DC, McArthur, CJ, Berry, S, Derde, LPG, Gordon, AC, Webb, SA, Lawler, PR, Comm REMAP-CAP Investigators, Apollo - University of Cambridge Repository, Intensive Care Medicine, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Raymond Poincaré [Garches], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pittsburgh Foundation, PF, Amgen, Health Research Board, HRB: CTN 2014-012, Horizon 2020 Framework Programme, H2020: 101003589, Translational Breast Cancer Research Consortium, TBCRC, Canadian Institutes of Health Research, IRSC: 158584, Heart and Stroke Foundation of Canada, HSF, National Institute for Health and Care Research, NIHR, European Commission, EC, National Health and Medical Research Council, NHMRC: 1101719, APP194811, CS-2016-16-011, GNT2008447, RP-2015-06-18, Office of Health and Medical Research, OHMR, Health Research Council of New Zealand, HRC: 16/631, Eisai, Ministère des Affaires Sociales et de la Santé: PHRC-20-0147, Université Pierre et Marie Curie, UPMC, NIHR Imperial Biomedical Research Centre, BRC, Minderoo Foundation, Funding/Support : The Platform for European Preparedness Against (Re-) emerging Epidemics (PREPARE) consortium by the European Union, FP7-HEALTH-2013-INNOVATION-1 (#602525), the Rapid European COVID-19 Emergency Research response (RECOVER) consortium by the European Union’s Horizon 2020 research and innovation programme (#101003589), the Australian National Health and Medical Research Council (#APP1101719), the Australian Medical Research Future Fund (#APP2002132), the Health Research Council of New Zealand (#16/631), the Canadian Institutes of Health Research Strategy for Patient-Oriented Research Innovative Clinical Trials Program Grant (#158584) and the Canadian Institute of Health Research COVID-19 Rapid Research Funding (#447335), the UK National Institute for Health Research (NIHR) and the NIHR Imperial Biomedical Research Centre, the Health Research Board of Ireland (CTN 2014-012), the UPMC Learning While Doing Program, the Translational Breast Cancer Research Consortium, the French Ministry of Health (PHRC-20-0147), the Wellcome Trust Innovations Project (215522), the Minderoo Foundation, the EU Programme Emergency Support Instrument, the NHS Blood and Transplant Research and Development Programme, the Translational Breast Cancer Research Consortium, the NSW Office of Health and Medical Research, Amgen, Eisai, and the Pittsburgh Foundation. Dr Higgins is funded by an NHMRC Emerging Leadership Fellowship (GNT2008447). Dr McQuilten is funded by an NHMRC Emerging Leadership Fellowship (APP194811). Dr Gordon is funded by an NIHR Research Professorship (RP-2015-06-18) and Dr Shankar-Hari by an NIHR Clinician Scientist Fellowship (CS-2016-16-011). Dr Turgeon is the Chairholder of the Canada Research Chair in Critical Care Neurology and Trauma. Dr Lawler is supported by a career award from the Heart and Stroke Foundation of Canada., and European Project: 602525,EC:FP7:HEALTH,FP7-HEALTH-2013-INNOVATION-1,PREPARE(2014)
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Adult ,Male ,corticosteroid ,[SDV]Life Sciences [q-bio] ,Critical Illness ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,antiplatelet ,Lopinavir ,Adaptive platform trial randomized controlled trial intensive care, pneumonia COVID-19 antiplatelet immunoglobulin antiviral corticosteroid immune modulation anticoagulation ,All institutes and research themes of the Radboud University Medical Center ,Adrenal Cortex Hormones ,Humans ,anticoagulation ,intensive care, pneumonia ,COVID-19 Serotherapy ,Original Investigation ,Medicine(all) ,immune modulation ,Ritonavir ,SARS-CoV-2 ,COVID-19 ,Anticoagulants ,Bayes Theorem ,General Medicine ,Middle Aged ,antiviral ,Receptors, Interleukin-6 ,Adaptive platform trial ,randomized controlled trial ,Female ,Human medicine ,immunoglobulin ,Follow-Up Studies ,Hydroxychloroquine - Abstract
ImportanceThe longer-term effects of therapies for the treatment of critically ill patients with COVID-19 are unknown.ObjectiveTo determine the effect of multiple interventions for critically ill adults with COVID-19 on longer-term outcomes.Design, Setting, and ParticipantsPrespecified secondary analysis of an ongoing adaptive platform trial (REMAP-CAP) testing interventions within multiple therapeutic domains in which 4869 critically ill adult patients with COVID-19 were enrolled between March 9, 2020, and June 22, 2021, from 197 sites in 14 countries. The final 180-day follow-up was completed on March 2, 2022.InterventionsPatients were randomized to receive 1 or more interventions within 6 treatment domains: immune modulators (n = 2274), convalescent plasma (n = 2011), antiplatelet therapy (n = 1557), anticoagulation (n = 1033), antivirals (n = 726), and corticosteroids (n = 401).Main Outcomes and MeasuresThe main outcome was survival through day 180, analyzed using a bayesian piecewise exponential model. A hazard ratio (HR) less than 1 represented improved survival (superiority), while an HR greater than 1 represented worsened survival (harm); futility was represented by a relative improvement less than 20% in outcome, shown by an HR greater than 0.83.ResultsAmong 4869 randomized patients (mean age, 59.3 years; 1537 [32.1%] women), 4107 (84.3%) had known vital status and 2590 (63.1%) were alive at day 180. IL-6 receptor antagonists had a greater than 99.9% probability of improving 6-month survival (adjusted HR, 0.74 [95% credible interval {CrI}, 0.61-0.90]) and antiplatelet agents had a 95% probability of improving 6-month survival (adjusted HR, 0.85 [95% CrI, 0.71-1.03]) compared with the control, while the probability of trial-defined statistical futility (HR >0.83) was high for therapeutic anticoagulation (99.9%; HR, 1.13 [95% CrI, 0.93-1.42]), convalescent plasma (99.2%; HR, 0.99 [95% CrI, 0.86-1.14]), and lopinavir-ritonavir (96.6%; HR, 1.06 [95% CrI, 0.82-1.38]) and the probabilities of harm from hydroxychloroquine (96.9%; HR, 1.51 [95% CrI, 0.98-2.29]) and the combination of lopinavir-ritonavir and hydroxychloroquine (96.8%; HR, 1.61 [95% CrI, 0.97-2.67]) were high. The corticosteroid domain was stopped early prior to reaching a predefined statistical trigger; there was a 57.1% to 61.6% probability of improving 6-month survival across varying hydrocortisone dosing strategies.Conclusions and RelevanceAmong critically ill patients with COVID-19 randomized to receive 1 or more therapeutic interventions, treatment with an IL-6 receptor antagonist had a greater than 99.9% probability of improved 180-day mortality compared with patients randomized to the control, and treatment with an antiplatelet had a 95.0% probability of improved 180-day mortality compared with patients randomized to the control. Overall, when considered with previously reported short-term results, the findings indicate that initial in-hospital treatment effects were consistent for most therapies through 6 months.
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- 2023
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17. In patients with type 2 diabetes chronic kidney disease is a modifiable cardiovascular risk factor
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Agarwal, R, primary, Pitt, B, additional, Rossing, P, additional, Anker, S D, additional, Filippatos, G, additional, Ruilope, L M, additional, Kovesdy, C P, additional, Tuttle, K, additional, Vaduganathan, M, additional, Wanner, C, additional, Bansilal, S, additional, Gebel, M, additional, Joseph, A, additional, Lawatscheck, R, additional, and Bakris, G, additional
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- 2022
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18. Association of baseline and longitudinal changes in cardiometabolic health with risk of heart failure among adults with type 2 diabetes: an analysis from the Look AHEAD trial
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Pandey, A P, primary, Patel, K V P, additional, Khan, M S K, additional, Bahnson, J L B, additional, Garcia, K R G, additional, Clark, J M C, additional, Balasubramanyam, A B, additional, Bertoni, A G B, additional, Vaduganathan, M V, additional, Farkouh, M E F, additional, Januzzi Jr, J L J, additional, Verma, S V, additional, and Espeland, M E, additional
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- 2022
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19. Prognostic implications of NYHA class and NT-proBNP levels in mild heart failure: a PARADIGM-HF analysis
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Rohde, L E, primary, Zimerman, A, additional, Claggett, B, additional, Packer, M, additional, Desai, A S, additional, Zile, M, additional, Rouleau, J, additional, Swedberg, K, additional, Lefkowitz, M, additional, Shi, V, additional, McMurray, J, additional, Vaduganathan, M, additional, and Solomon, S D, additional
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- 2022
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20. Serial high-sensitivity troponin T concentrations and long-term outcomes in patients with suspected acute coronary syndrome
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Pareek, M, primary, Kragholm, K H, additional, Vaduganathan, M, additional, Pallisgaard, J L, additional, Byrne, C, additional, Kristensen, A M D, additional, Biering-Sorensen, T, additional, Lee, C J, additional, Bonde, A N, additional, Maeng, M, additional, Fosbol, E L, additional, Kober, L, additional, Gislason, G H, additional, Bhatt, D L, additional, and Torp-Pedersen, C, additional
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- 2022
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21. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study
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Roth, G, Mensah, G, Johnson, C, Addolorato, G, Ammirati, E, Baddour, L, Barengo, N, Beaton, A, Benjamin, E, Benziger, C, Bonny, A, Brauer, M, Brodmann, M, Cahill, T, Carapetis, J, Catapano, A, Chugh, S, Cooper, L, Coresh, J, Criqui, M, Decleene, N, Eagle, K, Emmons-Bell, S, Feigin, V, Fernandez-Sola, J, Fowkes, G, Gakidou, E, Grundy, S, He, F, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, H, Mirijello, A, Temesgen, A, Mokdad, A, Moran, A, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, A, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundstrom, J, Timpel, P, Tleyjeh, I, Valgimigli, M, Vos, T, Whelton, P, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Fowkes, F, Misganaw, A, Oliveira, G, Sliwa, K, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, W, Abu-Gharbieh, E, Abushouk, A, Acharya, D, Adair, T, Adebayo, O, Ademi, Z, Advani, S, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, M, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, C, Alahdab, F, Al-Eyadhy, A, Alhabib, K, Alif, S, Alipour, V, Aljunid, S, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, R, Amegah, A, Amini, S, Aminorroaya, A, Amu, H, Amugsi, D, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, C, Ansari-Moghaddam, A, Anteneh, Z, Antonazzo, I, Antony, B, Anwer, R, Appiah, L, Arabloo, J, Arnlov, J, Artanti, K, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, A, Awoke, M, Ayele, H, Ayza, M, Azari, S, B, D, Baheiraei, N, Baig, A, Bakhtiari, A, Banach, M, Banik, P, Baptista, E, Barboza, M, Barua, L, Basu, S, Bedi, N, Bejot, Y, Bennett, D, Bensenor, I, Berman, A, Bezabih, Y, Bhagavathula, A, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, M, Boloor, A, Brant, L, Brenner, H, Briko, N, Butt, Z, Caetano dos Santos, F, Cahill, L, Cahuana-Hurtado, L, Camera, L, Campos-Nonato, I, Cantu-Brito, 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A., Mensah G. A., Johnson C. O., Addolorato G., Ammirati E., Baddour L. M., Barengo N. C., Beaton A. Z., Benjamin E. J., Benziger C. P., Bonny A., Brauer M., Brodmann M., Cahill T. J., Carapetis J., Catapano A. L., Chugh S. S., Cooper L. T., Coresh J., Criqui M., DeCleene N., Eagle K. A., Emmons-Bell S., Feigin V. L., Fernandez-Sola J., Fowkes G., Gakidou E., Grundy S. M., He F. J., Howard G., Hu F., Inker L., Karthikeyan G., Kassebaum N., Koroshetz W., Lavie C., Lloyd-Jones D., Lu H. S., Mirijello A., Temesgen A. M., Mokdad A., Moran A. E., Muntner P., Narula J., Neal B., Ntsekhe M., Moraes de Oliveira G., Otto C., Owolabi M., Pratt M., Rajagopalan S., Reitsma M., Ribeiro A. L. P., Rigotti N., Rodgers A., Sable C., Shakil S., Sliwa-Hahnle K., Stark B., Sundstrom J., Timpel P., Tleyjeh I. M., Valgimigli M., Vos T., Whelton P. K., Yacoub M., Zuhlke L., Murray C., Fuster V., Beaton A., Carapetis J. R., Chugh S., Criqui M. H., DeCleene N. K., Fowkes F. G. R., Kassebaum N. J., Koroshetz W. J., Misganaw A. T., Mokdad A. H., Oliveira G. M. M., Otto C. M., Owolabi M. O., Reitsma M. B., Rigotti N. A., Sable C. A., Shakil S. S., Sliwa K., Stark B. A., Tleyjeh I. I., Zuhlke L. J., Abbasi-Kangevari M., Abdi A., Abedi A., Aboyans V., Abrha W. A., Abu-Gharbieh E., Abushouk A. I., Acharya D., Adair T., Adebayo O. M., Ademi Z., Advani S. M., Afshari K., Afshin A., Agarwal G., Agasthi P., Ahmad S., Ahmadi S., Ahmed M. B., Aji B., Akalu Y., Akande-Sholabi W., Aklilu A., Akunna C. J., Alahdab F., Al-Eyadhy A., Alhabib K. F., Alif S. M., Alipour V., Aljunid S. M., Alla F., Almasi-Hashiani A., Almustanyir S., Al-Raddadi R. M., Amegah A. K., Amini S., Aminorroaya A., Amu H., Amugsi D. A., Ancuceanu R., Anderlini D., Andrei T., Andrei C. L., Ansari-Moghaddam A., Anteneh Z. A., Antonazzo I. C., Antony B., Anwer R., Appiah L. T., Arabloo J., Arnlov J., Artanti K. D., Ataro Z., Ausloos M., Avila-Burgos L., Awan A. T., Awoke M. A., Ayele H. T., Ayza M. A., Azari S., B D. B., Baheiraei N., Baig A. A., Bakhtiari A., Banach M., Banik P. C., Baptista E. A., Barboza M. A., Barua L., Basu S., Bedi N., Bejot Y., Bennett D. A., Bensenor I. M., Berman A. E., Bezabih Y. M., Bhagavathula A. S., Bhaskar S., Bhattacharyya K., Bijani A., Bikbov B., Birhanu M. M., Boloor A., Brant L. C., Brenner H., Briko N. I., Butt Z. A., Caetano dos Santos F. L., Cahill L. E., Cahuana-Hurtado L., Camera L. A., Campos-Nonato I. R., Cantu-Brito C., Car J., Carrero J. J., Carvalho F., Castaneda-Orjuela C. A., Catala-Lopez F., Cerin E., Charan J., Chattu V. K., Chen S., Chin K. L., Choi J. -Y. J., Chu D. -T., Chung S. -C., Cirillo M., Coffey S., Conti S., Costa V. M., Cundiff D. K., Dadras O., Dagnew B., Dai X., Damasceno A. A. M., Dandona L., Dandona R., Davletov K., De la Cruz-Gongora V., De la Hoz F. P., De Neve J. -W., Denova-Gutierrez E., Derbew Molla M., Derseh B. T., Desai R., Deuschl G., Dharmaratne S. D., Dhimal M., Dhungana R. R., Dianatinasab M., Diaz D., Djalalinia S., Dokova K., Douiri A., Duncan B. B., Duraes A. R., Eagan A. W., Ebtehaj S., Eftekhari A., Eftekharzadeh S., Ekholuenetale M., El Nahas N., Elgendy I. Y., Elhadi M., El-Jaafary S. I., Esteghamati S., Etisso A. E., Eyawo O., Fadhil I., Faraon E. J. A., Faris P. S., Farwati M., Farzadfar F., Fernandes E., Fernandez Prendes C., Ferrara P., Filip I., Fischer F., Flood D., Fukumoto T., Gad M. M., Gaidhane S., Ganji M., Garg J., Gebre A. K., Gebregiorgis B. G., Gebregzabiher K. Z., Gebremeskel G. G., Getacher L., Obsa A. G., Ghajar A., Ghashghaee A., Ghith N., Giampaoli S., Gilani S. A., Gill P. S., Gillum R. F., Glushkova E. V., Gnedovskaya E. V., Golechha M., Gonfa K. B., Goudarzian A. H., Goulart A. C., Guadamuz J. S., Guha A., Guo Y., Gupta R., Hachinski V., Hafezi-Nejad N., Haile T. G., Hamadeh R. R., Hamidi S., Hankey G. J., Hargono A., Hartono R. K., Hashemian M., Hashi A., Hassan S., Hassen H. Y., Havmoeller R. J., Hay S. I., Hayat K., Heidari G., Herteliu C., Holla R., Hosseini M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Househ M., Huang J., Humayun A., Iavicoli I., Ibeneme C. U., Ibitoye S. E., Ilesanmi O. S., Ilic I. M., Ilic M. D., Iqbal U., Irvani S. S. N., Islam S. M. S., Islam R. M., Iso H., Iwagami M., Jain V., Javaheri T., Jayapal S. K., Jayaram S., Jayawardena R., Jeemon P., Jha R. P., Jonas J. B., Jonnagaddala J., Joukar F., Jozwiak J. J., Jurisson M., Kabir A., Kahlon T., Kalani R., Kalhor R., Kamath A., Kamel I., Kandel H., Kandel A., Karch A., Kasa A. S., Katoto P. D. M. C., Kayode G. A., Khader Y. S., Khammarnia M., Khan M. S., Khan M. N., Khan M., Khan E. A., Khatab K., Kibria G. M. A., Kim Y. J., Kim G. R., Kimokoti R. W., Kisa S., Kisa A., Kivimaki M., Kolte D., Koolivand A., Korshunov V. A., Koulmane Laxminarayana S. L., Koyanagi A., Krishan K., Krishnamoorthy V., Kuate Defo B., Kucuk Bicer B., Kulkarni V., Kumar G. A., Kumar N., Kurmi O. P., Kusuma D., Kwan G. F., La Vecchia C., Lacey B., Lallukka T., Lan Q., Lasrado S., Lassi Z. S., Lauriola P., Lawrence W. R., Laxmaiah A., LeGrand K. E., Li M. -C., Li B., Li S., Lim S. S., Lim L. -L., Lin H., Lin Z., Lin R. -T., Liu X., Lopez A. D., Lorkowski S., Lotufo P. A., Lugo A., M N. K., Madotto F., Mahmoudi M., Majeed A., Malekzadeh R., Malik A. A., Mamun A. A., Manafi N., Mansournia M. A., Mantovani L. G., Martini S., Mathur M. R., Mazzaglia G., Mehata S., Mehndiratta M. M., Meier T., Menezes R. G., Meretoja A., Mestrovic T., Miazgowski B., Miazgowski T., Michalek I. M., Miller T. R., Mirrakhimov E. M., Mirzaei H., Moazen B., Moghadaszadeh M., Mohammad Y., Mohammad D. K., Mohammed S., Mohammed M. A., Mokhayeri Y., Molokhia M., Montasir A. A., Moradi G., Moradzadeh R., Moraga P., Morawska L., Moreno Velasquez I., Morze J., Mubarik S., Muruet W., Musa K. I., Nagarajan A. J., Nalini M., Nangia V., Naqvi A. A., Narasimha Swamy S., Nascimento B. R., Nayak V. C., Nazari J., Nazarzadeh M., Negoi R. 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M., Sabour S., Sacco S., Sadeghi M., Saeedi Moghaddam S., Safari S., Sahebkar A., Salehi S., Salimzadeh H., Samaei M., Samy A. M., Santos I. S., Santric-Milicevic M. M., Sarrafzadegan N., Sarveazad A., Sathish T., Sawhney M., Saylan M., Schmidt M. I., Schutte A. E., Senthilkumaran S., Sepanlou S. G., Sha F., Shahabi S., Shahid I., Shaikh M. A., Shamali M., Shamsizadeh M., Shawon M. S. R., Sheikh A., Shigematsu M., Shin M. -J., Shin J. I., Shiri R., Shiue I., Shuval K., Siabani S., Siddiqi T. J., Silva D. A. S., Singh J. A., Mtech A. S., Skryabin V. Y., Skryabina A. A., Soheili A., Spurlock E. E., Stockfelt L., Stortecky S., Stranges S., Suliankatchi Abdulkader R., Tadbiri H., Tadesse E. G., Tadesse D. B., Tajdini M., Tariqujjaman M., Teklehaimanot B. F., Temsah M. -H., Tesema A. K., Thakur B., Thankappan K. R., Thapar R., Thrift A. G., Timalsina B., Tonelli M., Touvier M., Tovani-Palone M. R., Tripathi A., Tripathy J. P., Truelsen T. C., Tsegay G. M., Tsegaye G. W., Tsilimparis N., Tusa B. S., Tyrovolas S., Umapathi K. K., Unim B., Unnikrishnan B., Usman M. S., Vaduganathan M., Valdez P. R., Vasankari T. J., Velazquez D. Z., Venketasubramanian N., Vu G. T., Vujcic I. S., Waheed Y., Wang Y., Wang F., Wei J., Weintraub R. G., Weldemariam A. H., Westerman R., Winkler A. S., Wiysonge C. S., Wolfe C. D. A., Wubishet B. L., Xu G., Yadollahpour A., Yamagishi K., Yan L. L., Yandrapalli S., Yano Y., Yatsuya H., Yeheyis T. Y., Yeshaw Y., Yilgwan C. S., Yonemoto N., Yu C., Yusefzadeh H., Zachariah G., Zaman S. B., Zaman M. S., Zamanian M., Zand R., Zandifar A., Zarghi A., Zastrozhin M. S., Zastrozhina A., Zhang Z. -J., Zhang Y., Zhang W., Zhong C., Zou Z., Zuniga Y. M. H., Murray C. J. 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I, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, R, Weldemariam, A, Westerman, R, Winkler, A, Wiysonge, C, Wolfe, C, Wubishet, B, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, L, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, T, Yeshaw, Y, Yilgwan, C, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, S, Zaman, M, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, M, Zastrozhina, A, Zhang, Z, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, Y, Roth G. A., Mensah G. A., Johnson C. O., Addolorato G., Ammirati E., Baddour L. M., Barengo N. C., Beaton A. Z., Benjamin E. J., Benziger C. P., Bonny A., Brauer M., Brodmann M., Cahill T. J., Carapetis J., Catapano A. L., Chugh S. S., Cooper L. T., Coresh J., Criqui M., DeCleene N., Eagle K. A., Emmons-Bell S., Feigin V. L., Fernandez-Sola J., Fowkes G., Gakidou E., Grundy S. M., He F. J., Howard G., Hu F., Inker L., Karthikeyan G., Kassebaum N., Koroshetz W., Lavie C., Lloyd-Jones D., Lu H. S., Mirijello A., Temesgen A. M., Mokdad A., Moran A. E., Muntner P., Narula J., Neal B., Ntsekhe M., Moraes de Oliveira G., Otto C., Owolabi M., Pratt M., Rajagopalan S., Reitsma M., Ribeiro A. L. P., Rigotti N., Rodgers A., Sable C., Shakil S., Sliwa-Hahnle K., Stark B., Sundstrom J., Timpel P., Tleyjeh I. M., Valgimigli M., Vos T., Whelton P. K., Yacoub M., Zuhlke L., Murray C., Fuster V., Beaton A., Carapetis J. R., Chugh S., Criqui M. H., DeCleene N. K., Fowkes F. G. R., Kassebaum N. J., Koroshetz W. J., Misganaw A. T., Mokdad A. H., Oliveira G. M. M., Otto C. M., Owolabi M. O., Reitsma M. B., Rigotti N. A., Sable C. A., Shakil S. S., Sliwa K., Stark B. A., Tleyjeh I. I., Zuhlke L. J., Abbasi-Kangevari M., Abdi A., Abedi A., Aboyans V., Abrha W. A., Abu-Gharbieh E., Abushouk A. I., Acharya D., Adair T., Adebayo O. M., Ademi Z., Advani S. M., Afshari K., Afshin A., Agarwal G., Agasthi P., Ahmad S., Ahmadi S., Ahmed M. B., Aji B., Akalu Y., Akande-Sholabi W., Aklilu A., Akunna C. J., Alahdab F., Al-Eyadhy A., Alhabib K. F., Alif S. M., Alipour V., Aljunid S. M., Alla F., Almasi-Hashiani A., Almustanyir S., Al-Raddadi R. M., Amegah A. K., Amini S., Aminorroaya A., Amu H., Amugsi D. A., Ancuceanu R., Anderlini D., Andrei T., Andrei C. L., Ansari-Moghaddam A., Anteneh Z. A., Antonazzo I. C., Antony B., Anwer R., Appiah L. T., Arabloo J., Arnlov J., Artanti K. D., Ataro Z., Ausloos M., Avila-Burgos L., Awan A. T., Awoke M. A., Ayele H. T., Ayza M. A., Azari S., B D. B., Baheiraei N., Baig A. A., Bakhtiari A., Banach M., Banik P. C., Baptista E. A., Barboza M. A., Barua L., Basu S., Bedi N., Bejot Y., Bennett D. A., Bensenor I. M., Berman A. E., Bezabih Y. M., Bhagavathula A. S., Bhaskar S., Bhattacharyya K., Bijani A., Bikbov B., Birhanu M. M., Boloor A., Brant L. C., Brenner H., Briko N. I., Butt Z. A., Caetano dos Santos F. L., Cahill L. E., Cahuana-Hurtado L., Camera L. A., Campos-Nonato I. R., Cantu-Brito C., Car J., Carrero J. J., Carvalho F., Castaneda-Orjuela C. A., Catala-Lopez F., Cerin E., Charan J., Chattu V. K., Chen S., Chin K. L., Choi J. -Y. J., Chu D. -T., Chung S. -C., Cirillo M., Coffey S., Conti S., Costa V. M., Cundiff D. K., Dadras O., Dagnew B., Dai X., Damasceno A. A. M., Dandona L., Dandona R., Davletov K., De la Cruz-Gongora V., De la Hoz F. P., De Neve J. -W., Denova-Gutierrez E., Derbew Molla M., Derseh B. T., Desai R., Deuschl G., Dharmaratne S. D., Dhimal M., Dhungana R. R., Dianatinasab M., Diaz D., Djalalinia S., Dokova K., Douiri A., Duncan B. B., Duraes A. R., Eagan A. W., Ebtehaj S., Eftekhari A., Eftekharzadeh S., Ekholuenetale M., El Nahas N., Elgendy I. Y., Elhadi M., El-Jaafary S. I., Esteghamati S., Etisso A. E., Eyawo O., Fadhil I., Faraon E. J. A., Faris P. S., Farwati M., Farzadfar F., Fernandes E., Fernandez Prendes C., Ferrara P., Filip I., Fischer F., Flood D., Fukumoto T., Gad M. M., Gaidhane S., Ganji M., Garg J., Gebre A. K., Gebregiorgis B. G., Gebregzabiher K. Z., Gebremeskel G. G., Getacher L., Obsa A. G., Ghajar A., Ghashghaee A., Ghith N., Giampaoli S., Gilani S. A., Gill P. S., Gillum R. F., Glushkova E. V., Gnedovskaya E. V., Golechha M., Gonfa K. B., Goudarzian A. H., Goulart A. C., Guadamuz J. S., Guha A., Guo Y., Gupta R., Hachinski V., Hafezi-Nejad N., Haile T. G., Hamadeh R. R., Hamidi S., Hankey G. J., Hargono A., Hartono R. K., Hashemian M., Hashi A., Hassan S., Hassen H. Y., Havmoeller R. J., Hay S. I., Hayat K., Heidari G., Herteliu C., Holla R., Hosseini M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Househ M., Huang J., Humayun A., Iavicoli I., Ibeneme C. U., Ibitoye S. E., Ilesanmi O. S., Ilic I. M., Ilic M. D., Iqbal U., Irvani S. S. N., Islam S. M. S., Islam R. M., Iso H., Iwagami M., Jain V., Javaheri T., Jayapal S. K., Jayaram S., Jayawardena R., Jeemon P., Jha R. P., Jonas J. B., Jonnagaddala J., Joukar F., Jozwiak J. J., Jurisson M., Kabir A., Kahlon T., Kalani R., Kalhor R., Kamath A., Kamel I., Kandel H., Kandel A., Karch A., Kasa A. S., Katoto P. D. M. C., Kayode G. A., Khader Y. S., Khammarnia M., Khan M. S., Khan M. N., Khan M., Khan E. A., Khatab K., Kibria G. M. A., Kim Y. J., Kim G. R., Kimokoti R. W., Kisa S., Kisa A., Kivimaki M., Kolte D., Koolivand A., Korshunov V. A., Koulmane Laxminarayana S. L., Koyanagi A., Krishan K., Krishnamoorthy V., Kuate Defo B., Kucuk Bicer B., Kulkarni V., Kumar G. A., Kumar N., Kurmi O. P., Kusuma D., Kwan G. F., La Vecchia C., Lacey B., Lallukka T., Lan Q., Lasrado S., Lassi Z. S., Lauriola P., Lawrence W. R., Laxmaiah A., LeGrand K. E., Li M. -C., Li B., Li S., Lim S. S., Lim L. -L., Lin H., Lin Z., Lin R. -T., Liu X., Lopez A. D., Lorkowski S., Lotufo P. A., Lugo A., M N. K., Madotto F., Mahmoudi M., Majeed A., Malekzadeh R., Malik A. A., Mamun A. A., Manafi N., Mansournia M. A., Mantovani L. G., Martini S., Mathur M. R., Mazzaglia G., Mehata S., Mehndiratta M. M., Meier T., Menezes R. G., Meretoja A., Mestrovic T., Miazgowski B., Miazgowski T., Michalek I. M., Miller T. R., Mirrakhimov E. M., Mirzaei H., Moazen B., Moghadaszadeh M., Mohammad Y., Mohammad D. K., Mohammed S., Mohammed M. A., Mokhayeri Y., Molokhia M., Montasir A. A., Moradi G., Moradzadeh R., Moraga P., Morawska L., Moreno Velasquez I., Morze J., Mubarik S., Muruet W., Musa K. I., Nagarajan A. J., Nalini M., Nangia V., Naqvi A. A., Narasimha Swamy S., Nascimento B. R., Nayak V. C., Nazari J., Nazarzadeh M., Negoi R. I., Neupane Kandel S., Nguyen H. L. T., Nixon M. R., Norrving B., Noubiap J. J., Nouthe B. E., Nowak C., Odukoya O. O., Ogbo F. A., Olagunju A. T., Orru H., Ortiz A., Ostroff S. M., Padubidri J. R., Palladino R., Pana A., Panda-Jonas S., Parekh U., Park E. -C., Parvizi M., Pashazadeh Kan F., Patel U. K., Pathak M., Paudel R., Pepito V. C. F., Perianayagam A., Perico N., Pham H. Q., Pilgrim T., Piradov M. A., Pishgar F., Podder V., Polibin R. V., Pourshams A., Pribadi D. R. A., Rabiee N., Rabiee M., Radfar A., Rafiei A., Rahim F., Rahimi-Movaghar V., Ur Rahman M. H., Rahman M. A., Rahmani A. M., Rakovac I., Ram P., Ramalingam S., Rana J., Ranasinghe P., Rao S. J., Rathi P., Rawal L., Rawasia W. F., Rawassizadeh R., Remuzzi G., Renzaho A. M. N., Rezapour A., Riahi S. M., Roberts-Thomson R. L., Roever L., Rohloff P., Romoli M., Roshandel G., Rwegerera G. M., Saadatagah S., Saber-Ayad M. M., Sabour S., Sacco S., Sadeghi M., Saeedi Moghaddam S., Safari S., Sahebkar A., Salehi S., Salimzadeh H., Samaei M., Samy A. M., Santos I. S., Santric-Milicevic M. M., Sarrafzadegan N., Sarveazad A., Sathish T., Sawhney M., Saylan M., Schmidt M. I., Schutte A. E., Senthilkumaran S., Sepanlou S. G., Sha F., Shahabi S., Shahid I., Shaikh M. A., Shamali M., Shamsizadeh M., Shawon M. S. R., Sheikh A., Shigematsu M., Shin M. -J., Shin J. I., Shiri R., Shiue I., Shuval K., Siabani S., Siddiqi T. J., Silva D. A. S., Singh J. A., Mtech A. S., Skryabin V. Y., Skryabina A. A., Soheili A., Spurlock E. E., Stockfelt L., Stortecky S., Stranges S., Suliankatchi Abdulkader R., Tadbiri H., Tadesse E. G., Tadesse D. B., Tajdini M., Tariqujjaman M., Teklehaimanot B. F., Temsah M. -H., Tesema A. K., Thakur B., Thankappan K. R., Thapar R., Thrift A. G., Timalsina B., Tonelli M., Touvier M., Tovani-Palone M. R., Tripathi A., Tripathy J. P., Truelsen T. C., Tsegay G. M., Tsegaye G. W., Tsilimparis N., Tusa B. S., Tyrovolas S., Umapathi K. K., Unim B., Unnikrishnan B., Usman M. S., Vaduganathan M., Valdez P. R., Vasankari T. J., Velazquez D. Z., Venketasubramanian N., Vu G. T., Vujcic I. S., Waheed Y., Wang Y., Wang F., Wei J., Weintraub R. G., Weldemariam A. H., Westerman R., Winkler A. S., Wiysonge C. S., Wolfe C. D. A., Wubishet B. L., Xu G., Yadollahpour A., Yamagishi K., Yan L. L., Yandrapalli S., Yano Y., Yatsuya H., Yeheyis T. Y., Yeshaw Y., Yilgwan C. S., Yonemoto N., Yu C., Yusefzadeh H., Zachariah G., Zaman S. B., Zaman M. S., Zamanian M., Zand R., Zandifar A., Zarghi A., Zastrozhin M. S., Zastrozhina A., Zhang Z. -J., Zhang Y., Zhang W., Zhong C., Zou Z., Zuniga Y. M. H., and Murray C. J. L.
- Abstract
Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside
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- 2020
22. Greater event rates in high-risk patients with a history of heart disease: from the Systolic Blood Pressure Intervention Trial (SPRINT)
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Pareek, M., Byrne, C., Mikkelsen, A. D., Kristensen, A. M. Dyrvig, Vaduganathan, M., Biering-Sorensen, T., Kragholm, K. H., Mortensen, M. B., Singh, A., Olsen, M. H., and Bhatt, D. L.
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Cardiology and Cardiovascular Medicine - Abstract
Background The Systolic Blood Pressure Intervention Trial (SPRINT) found that intensive versus standard blood pressure (BP) control reduced cardiovascular (CV) morbidity and mortality in patients at high CV risk. Effects were consistent among patients with and without prevalent CV disease. However, it is unknown whether the benefits and risks of intensive BP control are affected by the specific type of heart disease. Purpose To assess the risks of incident CV events and safety events in patients with individual types of heart disease, and to assess if the presence of heart disease modified the effect of intensive versus standard BP control. Methods SPRINT was a randomized, controlled trial comprising 9,361 individuals ≥50 years of age at high CV risk, without diabetes, and with a systolic BP 130–180 mmHg. Participants were randomized to intensive or standard BP control. The primary efficacy endpoint was the composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from CV causes. The primary safety endpoint was the composite of serious adverse events. We assessed event risk in patients with self-reported heart disease versus those without and further assessed the safety and efficacy of intensive BP control, including relevant interactions, in these individuals, using multivariable Cox proportional-hazards regression. Results Of 9361 participants, 326 (3.5%) reported a history of congestive heart failure, 760 (8.1%) of myocardial infarction, 1206 (12.9%) of angina, and 1830 (19.6%) of atrial fibrillation, atrial flutter, or irregular heartbeat. The prevalence of these conditions did not significantly differ between patients randomized to intensive versus standard BP control (P>0.05 for all). At median 3.2 years (range 0–4.8 years), congestive heart failure (adjusted hazard ratio [aHR], 1.94, 95% confidence interval [CI], 1.45–2.61; P Conclusions In SPRINT, a history of any type of heart disease was associated with a greater risk for both efficacy and safety events. Patients with angina did not appear to derive benefit from intensive BP control. Funding Acknowledgement Type of funding sources: None. Figure 1
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- 2021
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23. Multi-marker biomarker panel, adverse cardiovascular and kidney outcomes, and response to canagliflozin in the CANVAS Program
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Vaduganathan, M, Sattar, N, Xu, J, Butler, J, Mahaffey, KW, Neal, B, Shaw, W, Rosenthal, N, Pfeifer, M, Hansen, MK, and Januzzi, JL
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Science & Technology ,Cardiac & Cardiovascular Systems ,Cardiovascular System & Hematology ,Cardiovascular System & Cardiology ,Life Sciences & Biomedicine ,1102 Cardiorespiratory Medicine and Haematology - Abstract
Background/Introduction: Circulating biomarkers reflecting different mechanistic pathways may identify patients most likely to benefit from sodium glucose co-transporter 2 (SGLT2) inhibitors. Purpose: To determine if 3 biomarkers (high sensitivity cardiac troponin T [hs-cTnT], soluble ST2 [sST2], and insulin-like growth factor binding protein 7 [IGFBP7]) have prognostic implications or modify treatment response to canagliflozin in the CANVAS trial. Methods: Among 3,040 participants in the CANVAS trial with available biomarker data, we created a multi-marker panel assigning 1 point for each abnormally elevated level of hs-cTnT, sST2, and IGFBP7. We assessed its association with risk of cardiac and kidney outcomes, and whether each biomarker alone or as a multi-marker panel modified the treatment response to canagliflozin. Incremental discrimination was tested by comparing C-statistics of a base clinical model plus each individual biomarker (or multi-marker panel) vs. the base clinical model alone (age, eGFR, body mass index, systolic blood pressure, HbA1c, duration of diabetes, urine albumin:creatinine ratio, history of HF, and diuretic use). Results: Among placebo-treated participants, 38% had elevated levels of hs-cTnT ≥14 pg/mL, 7% had sST2 >35 ng/mL, and 49% had IGFBP7 >96.5ng/mL. Overall, 1,102 (36%), 1,051 (35%), 819 (27%), and 68 (2%) had 0, 1, 2, and 3 elevated biomarkers. Increasing numbers of elevated biomarkers independently predicted each cardiac and kidney outcome in a graded fashion and improved risk discrimination compared with clinical variables alone (C-statistic improvement by +0.04 to +0.06) (Figure). Canagliflozin reduced heart failure and kidney events regardless of baseline biomarker concentrations, however patients with elevated hs-cTnT appeared to derive greater relative benefit for major adverse cardiovascular events (MACE) compared with those with lower values (hazard ratio [HR] 0.77; 95% confidence interval [CI] 0.61-0.97 vs. HR 1.10; 95% CI 0.83-1.44; Pinteraction=0.05). Similarly, patients with elevated IGFBP7 >96.5 ng/mL (HR 0.81; 95% CI 0.64-1.01) appeared to derive greater relative treatment effects for stroke compared with patients with normal IGFBP7 ≤96.5 ng/mL (HR 1.03; 95% CI 0.78-1.36; Pinteraction=0.05). Participants with an increasing number of abnormal circulating biomarkers appeared to have greatest relative reductions in MACE from canagliflozin treatment: 0 abnormal biomarkers (HR 0.94; 95% CI 0.63-1.39), 1 abnormal biomarker (HR 1.36; 95% CI 0.96-1.92), 2 abnormal biomarkers (HR 0.62; 95% CI 0.46-0.83), and 3 abnormal biomarkers (HR 0.44; 95% CI 0.19-1.01); Pinteraction trend=0.009. Conclusions: Circulating markers of myocardial injury and remodeling are frequently abnormal in patients with type 2 diabetes at high cardiovascular risk and may identify patients who may derive greater benefit from SGLT2 inhibitors.
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- 2021
24. Serum protein signatures detect early radiographic osteoarthritis
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Ling, S.M., Patel, D.D., Garnero, P., Zhan, M., Vaduganathan, M., Muller, D., Taub, D., Bathon, J.M., Hochberg, M., Abernethy, D.R., Metter, E.J., and Ferrucci, L.
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- 2009
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25. Marital status, cardiovascular events, and intensive blood pressure lowering among men and women in the Systolic Blood Pressure Intervention Trial
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Pareek, M, primary, Byrne, C, additional, Mikkelsen, A D, additional, Dyrvig Kristensen, A M, additional, Vaduganathan, M, additional, Biering-Sorensen, T, additional, Kragholm, K H, additional, Mortensen, M B, additional, Singh, A, additional, Olsen, M H, additional, and Bhatt, D L, additional
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- 2021
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26. Greater event rates in high-risk patients with a history of heart disease: from the Systolic Blood Pressure Intervention Trial (SPRINT)
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Pareek, M, primary, Byrne, C, additional, Mikkelsen, A D, additional, Dyrvig Kristensen, A M, additional, Vaduganathan, M, additional, Biering-Sorensen, T, additional, Kragholm, K H, additional, Mortensen, M B, additional, Singh, A, additional, Olsen, M H, additional, and Bhatt, D L, additional
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- 2021
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27. Prognostic significance of polyvascular disease in patients admitted with acute decompensated heart failure: the ARIC Study Community Surveillance
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Chunawala, Z, primary, Qamar, A, additional, Arora, S, additional, Pandey, A, additional, Fudim, M, additional, Vaduganathan, M, additional, Mentz, R, additional, and Caughey, M, additional
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- 2021
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28. Primary health insurance and cardiovascular outcomes in the systolic blood pressure intervention trial
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Byrne, C, primary, Pareek, M, additional, Vaduganathan, M, additional, Mikkelsen, A D, additional, Kristensen, A M D, additional, Biering-Sorensen, T, additional, Kragholm, K H, additional, Mortensen, M B, additional, Singh, A, additional, Olsen, M H, additional, and Bhatt, D L, additional
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- 2021
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29. Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure
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Solomon, S, Vaduganathan, M, L Claggett, B, Packer, M, Zile, M, Swedberg, K, Rouleau, J, A Pfeffer, M, Desai, A, Lund, L, Kober, L, Anand, I, Sweitzer, N, Linssen, G, Merkely, B, Luis Arango, J, Vinereanu, D, Chen, C, Senni, M, Sibulo, A, Boytsov, S, Shi, V, Rizkala, A, Lefkowitz, M, Mcmurray, J, Solomon SD, Vaduganathan M, L Claggett B, Packer M, Zile M, Swedberg K, Rouleau J, A Pfeffer M, Desai A, Lund LH, Kober L, Anand I, Sweitzer N, Linssen G, Merkely B, Luis Arango J, Vinereanu D, Chen CH, Senni M, Sibulo A, Boytsov S, Shi V, Rizkala A, Lefkowitz M, McMurray JJV, Solomon, S, Vaduganathan, M, L Claggett, B, Packer, M, Zile, M, Swedberg, K, Rouleau, J, A Pfeffer, M, Desai, A, Lund, L, Kober, L, Anand, I, Sweitzer, N, Linssen, G, Merkely, B, Luis Arango, J, Vinereanu, D, Chen, C, Senni, M, Sibulo, A, Boytsov, S, Shi, V, Rizkala, A, Lefkowitz, M, Mcmurray, J, Solomon SD, Vaduganathan M, L Claggett B, Packer M, Zile M, Swedberg K, Rouleau J, A Pfeffer M, Desai A, Lund LH, Kober L, Anand I, Sweitzer N, Linssen G, Merkely B, Luis Arango J, Vinereanu D, Chen CH, Senni M, Sibulo A, Boytsov S, Shi V, Rizkala A, Lefkowitz M, and McMurray JJV
- Abstract
Background: While disease-modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF (>40%). Sacubitril/valsartan has been compared with a renin-angiotensin-aldosterone-system inhibitor alone in 2 similarly designed clinical trials of patients with reduced and preserved LVEF, permitting examination of its effects across the full spectrum of LVEF. Methods: We combined data from PARADIGM-HF (LVEF eligibility≤40%; n=8399) and PARAGON-HF (LVEF eligibility≥45%; n=4796) in a prespecified pooled analysis. We divided randomized patients into LVEF categories: ≤22.5% (n=1269), >22.5% to 32.5% (n=3987), >32.5% to 42.5% (n=3143), > 42.5% to 52.5% (n=1427), > 52.5% to 62.5% (n=2166), and >62.5% (n=1202). We assessed time to first cardiovascular death and HF hospitalization, its components, and total heart failure hospitlizations, all-cause mortality, and noncardiovascular mortality. Incidence rates and treatment effects were examined across categories of LVEF. Results: Among 13 195 randomized patients, we observed lower rates of cardiovascular death and HF hospitalization, but similar rates of noncardiovascular death, among patients in the highest versus the lowest groups. Overall sacubitril/valsartan was superior to renin-angiotensin-aldosterone-system inhibition for first cardiovascular death or heart failure hospitalization (Hazard Ratio [HR] 0.84 [95% CI, 0.78-0.90]), cardiovascular death (HR 0.84 [95% CI, 0.76-0.92]), heart failure hospitalization (HR 0.84 [95% CI, 0.77-0.91]), and all-cause mortality (HR 0.88 [95% CI, 0.81-0.96]). The effect of sacubitril/valsartan was modified by LVEF (treatment-by-continuous LVEF interaction P=0.02), and benefit appeared to be present for individuals with EF primarily below the normal range, although the treatment benefit for cardiovascular death diminished at a lower ejection fraction. We observed effect mod
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- 2019
30. Empagliflozin facilitates sustained insulin dose reductions in patients with type 2 diabetes and cardiovascular disease: the EMPA-REG OUTCOME trial
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Vaduganathan, M, additional, Sattar, N, additional, Fitchett, D, additional, George, JT, additional, Ofstad, AP, additional, Verma, S, additional, Mattheus, M, additional, Wanner, C, additional, Inzucchi, SE, additional, Zinman, B, additional, and Butler, J, additional
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- 2021
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31. Race, Temporary Mechanical Circulatory Support, and Clinical Outcomes after the 2018 US Adult Heart Allocation System Policy Change
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Okoh, A.K., primary, Mehra, M.R., additional, Tayal, R., additional, Drakos, S.G., additional, Machado, S., additional, Yin, M.G., additional, Lee, L.Y., additional, Shah, K.S., additional, Russo, M.J., additional, Vaduganathan, M., additional, and Stehlik, J., additional
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- 2021
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32. Impact of Sex on Access to Donor Organs and Clinical Outcomes in the New 2018 US Adult Heart Allocation System - OPTN/UNOS Analysis
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Okoh, A.K., primary, Mehra, M.R., additional, Tayal, R., additional, Drakos, S.G., additional, Machado, S., additional, Yin, M.G., additional, Lee, L.Y., additional, Shah, K., additional, Russo, M.J., additional, Vaduganathan, M., additional, and Stehlik, J., additional
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- 2021
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33. Baseline and on-treatment serum potassium and mortality in high risk patients: the Systolic Blood Pressure Intervention Trial (SPRINT)
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Byrne, C, primary, Pareek, M, additional, Biering-Soerensen, T, additional, Vaduganathan, M, additional, Krogager, M.L, additional, Kragholm, K.H, additional, McCullough, M, additional, Desai, N.R, additional, Olsen, M.H, additional, and Bhatt, D.L, additional
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34. Baseline and on-treatment serum bicarbonate, intensive blood pressure lowering, and mortality: the Systolic Blood Pressure Intervention Trial (SPRINT)
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Pareek, M, primary, Byrne, C, additional, Vaduganathan, M, additional, Biering-Sorensen, T, additional, Krogager, M.L, additional, Kragholm, K.H, additional, McCullough, M, additional, Desai, N.R, additional, Olsen, M.H, additional, and Bhatt, D.L, additional
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- 2020
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35. Application of a Medicare claims-based model predicting left ventricular ejection fraction subtype to investigate the epidemiology of heart failure in the US Medicare program
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Desai, R.J, primary, Mahesri, M, additional, Chin, K, additional, Lahoz, R, additional, Studer, R, additional, Vaduganathan, M, additional, and Patorno, E, additional
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- 2020
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- View/download PDF
36. Intensive versus standard blood pressure control and vascular procedures: insights from the Systolic Blood Pressure Intervention Trial
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Byrne, C, primary, Pareek, M, additional, Rujic, D, additional, Krogager, M.L, additional, Kragholm, K.H, additional, Biering-Soerensen, T, additional, Vaduganathan, M, additional, Olesen, T.B, additional, Olsen, M.H, additional, and Bhatt, D.L, additional
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37. Erratum: 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 (The Lancet (2018) 392(10159) (1736–1788)(S0140673618322037)(10.1016/S0140-6736(18)32203-7))
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Roth G. 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- Abstract
GBD 2017 Causes of Death Collaborators. 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. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article.
- Published
- 2018
38. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- Author
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D., Gething P. W., Gezae K. E., Ghadami M. R., Ghadiri K., Ghasemi-Kasman M., Ghimire M., Ghoshal A. G., Gill P. S., Gill T. K., Ginawi I. A., Giussani G., Gnedovskaya E. V., Goldberg E. M., Goli S., Gomez-Dantes H., Gona P. N., Gopalani S. V., Gorman T. M., Goulart A. C., Goulart B. N. G., Grada A., Grosso G., Gugnani H. C., Guillemin F., Guo Y., Gupta P. C., Gupta R., Gupta T., Gutierrez R. A., Gyawali B., Haagsma J. A., Hachinski V., Hafezi-Nejad N., Bidgoli H. H., Hagos T. B., Hailegiyorgis T. T., Haj-Mirzaian A., Hamadeh R. R., Hamidi S., Handal A. J., Hankey G. J., Hao Y., Harb H. L., Harikrishnan S., Haririan H., Haro J. M., Hassankhani H., Hassen H. Y., Havmoeller R., Hay R. J., Hay S. I., Hedayatizadeh-Omran A., Heibati B., Hendrie D., Henok A., Heredia-Pi I., Herteliu C., Heydarpour F., Heydarpour P., Hibstu D. T., Hoek H. W., Hoffman H. J., Hole M. K., Rad E. H., Hoogar P., Hosgood H. D., Hosseini S. M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Hotez P. J., Hoy D. G., Hsairi M., Htet A. S., Huang J. J., Iburg K. M., Ikeda C. T., Ilesanmi O. S., Irvani S. S. N., Irvine C. M. S., Islam S. M. S., Islami F., Jacobsen K. H., Jahangiry L., Jahanmehr N., Jain S. K., Jakovljevic M., James S. L., Jayatilleke A. U., Jeemon P., Jha R. P., Jha V., Ji J. S., Johnson C. O., Jonas J. B., Jonnagaddala J., Shushtari Z. J., Joshi A., Jozwiak J. J., Jungari S. B., Jurisson M., Kabir Z., Kadel R., Kahsay A., Kalani R., Kanchan T., Kar C., Karami M., Karami Matin B., Karch A., Karema C., Karimi N., Karimi S. M., Kasaeian A., Kassa D. H., Kassa G. M., Kassa T. D., Kassebaum N. J., Katikireddi S. V., Kaul A., Kawakami N., Kazemi Z., Kazemi Karyani A., Keighobadi M. M., Keiyoro P. N., Kemmer L., Kemp G. R., Kengne A. P., Keren A., Khader Y. S., Khafaei B., Khafaie M. A., Khajavi A., Khalid N., Khalil I. A., Khan E. A., Khan M. S., Khan M. A., Khang Y. -H., Khater M. M., Khazaei M., Khoja A. T., Khosravi A., Khosravi M. H., Kiadaliri A. A., Kidanemariam Z. T., Kiirithio D. N., Kim C. -I., Kim D., Kim Y. -E., Kim Y. J., Kimokoti R. W., Kinfu Y., Kisa A., Kissimova-Skarbek K., Knudsen A. K. S., Kocarnik J. M., Kochhar S., Kokubo Y., Kolola T., Kopec J. A., Kosen S., Kotsakis G. A., Koul P. A., Koyanagi A., Krishan K., Krishnaswami S., Krohn K. J., Defo B. K., Bicer B. K., Kumar G. A., Kumar M., Kuzin I., Lad D. P., Lad S. D., Lafranconi A., Lalloo R., Lallukka T., Lami F. H., Lang J. J., Langan S. M., Lansingh V. C., Latifi A., Lau K. M. -M., Lazarus J. V., Leasher J. L., Ledesma J. R., Lee P. H., Leigh J., Leili M., Leshargie C. T., Leung J., Levi M., Lewycka S., Li S., Li Y., Liang X., Liao Y., Liben M. L., Lim L. -L., Lim S. S., Limenih M. A., Linn S., Liu S., Looker K. J., Lopez A. D., Lorkowski S., Lotufo P. A., Lozano R., Lucas T. C. D., Lunevicius R., Lyons R. A., Ma S., Macarayan E. R. K., Mackay M. T., Maddison E. R., Madotto F., Maghavani D. P., Mai H. T., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malta D. C., Mamun A. A., Manda A. -L., Manguerra H., Mansournia M. A., Mantilla Herrera A. M., Mantovani L. G., Maravilla J. C., Marcenes W., Marks A., Martins-Melo F. R., Martopullo I., Marz W., Marzan M. B., Massano J., Massenburg B. B., Mathur M. R., Maulik P. K., Mazidi M., McAlinden C., McGrath J. J., McKee M., McMahon B. J., Mehata S., Mehrotra R., Mehta K. M., Mehta V., Mejia-Rodriguez F., Mekonen T., Melese A., Melku M., Memiah P. T. N., Memish Z. A., Mendoza W., Mengistu G., Mensah G. A., Mereta S. T., Meretoja A., Meretoja T. J., Mestrovic T., Miazgowski B., Miazgowski T., Millear A. I., Miller T. R., Mini G. K., Mirarefin M., Mirica A., Mirrakhimov E. M., Misganaw A. T., Mitchell P. B., Mitiku H., Moazen B., Mohajer B., Mohammad K. A., Mohammadi M., Mohammadifard N., Mohammadnia-Afrouzi M., Mohammed M. A., Mohammed S., Mohebi F., Mokdad A. H., Molokhia M., Monasta L., Montanez J. C., Moosazadeh M., Moradi G., Moradi M., Moradi-Lakeh M., Moradinazar M., Moraga P., Morawska L., Velasquez I. M., Morgado-Da-Costa J., Morrison S. D., Moschos M. M., Mousavi S. M., Mruts K. B., Muche A. A., Muchie K. F., Mueller U. O., Muhammed O. S., Mukhopadhyay S., Muller K., Mumford J. E., Murthy G. V. S., Musa K. I., Mustafa G., Nabhan A. F., Nagata C., Nagel G., Naghavi M., Naheed A., Nahvijou A., Naik G., Najafi F., Nam H. S., Nangia V., Nansseu J. R., Neamati N., Negoi I., Negoi R. I., Neupane S., Newton C. R. J., Ngunjiri J. W., Nguyen A. Q., Nguyen G., Nguyen H. T., Nguyen H. L. T., Nguyen L. H., Nguyen M., Nguyen N. B., Nguyen S. H., Nichols E., Ningrum D. N. A., Nixon M. R., Nomura S., Noroozi M., Norrving B., Noubiap J. J., Nouri H. R., Shiadeh M. N., Nowroozi M. R., Nsoesie E. O., Nyasulu P. S., Odell C. M., Ofori-Asenso R., Ogbo F. A., Oh I. -H., Oladimeji O., Olagunju A. T., Olagunju T. O., Olivares P. R., Olsen H. E., Olusanya B. O., Olusanya J. O., Ong K. L., Ong S. K., Oren E., Ortiz A., Ota E., Otstavnov S. S., Overland S., Owolabi M. O., Mahesh P. 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R., Roever L., Ronfani L., Roshandel G., Rostami A., Roth G. A., Rothenbacher D., Rubagotti E., Sachdev P. S., Sadat N., Sadeghi E., Saeedi Moghaddam S., Safari H., Safari Y., Safari-Faramani R., Safdarian M., Safi S., Safiri S., Sagar R., Sahebkar A., Sahraian M. A., Sajadi H. S., Salam N., Salama J. S., Salamati P., Saleem Z., Salimi Y., Salimzadeh H., Salomon J. A., Salvi S. S., Salz I., Samy A. M., Sanabria J., Sanchez-Nino M. D., Santomauro D. F., Santos I. S., Santos J. V., Santric Milicevic M. M., Sao Jose B. P., Sardana M., Sarker A. R., Sarmiento-Suarez R., Sarrafzadegan N., Sartorius B., Sarvi S., Sathian B., Satpathy M., Sawant A. R., Sawhney M., Saxena S., Schaeffner E., Schmidt M. I., Schneider I. J. C., Schutte A. E., Schwebel D. C., Schwendicke F., Scott J. G., Sekerija M., Sepanlou S. G., Servan-Mori E., Seyedmousavi S., Shabaninejad H., Shafieesabet A., Shahbazi M., Shaheen A. A., Shaikh M. A., Shams-Beyranvand M., Shamsi M., Sharafi H., Sharafi K., Sharif M., Sharif-Alhoseini M., Sharma J., Sharma R., She J., Sheikh A., Shi P., Shibuya K., Shiferaw M. S., Shigematsu M., Shiri R., Shirkoohi R., Shiue I., Shokoohinia Y., Shokraneh F., Shoman H., Shrime M. G., Si S., Siabani S., Sibai A. M., Siddiqi T. J., Sigfusdottir I. D., Sigurvinsdottir R., Silva D. A. S., Silva J. P., Silveira D. G. A., Singam N. S. V., Singh J. A., Singh N. P., Singh V., Sinha D. N., Skiadaresi E., Skirbekk V., Sliwa K., Smith D. L., Smith M., Filho A. M. S., Sobaih B. H., Sobhani S., Soofi M., Sorensen R. J. D., Soyiri I. N., Sposato L. A., Sreeramareddy C. T., Srinivasan V., Stanaway J. D., Starodubov V. I., Stein D. J., Steiner C., Steiner T. J., Stokes M. A., Stovner L. J., Subart M. L., Sudaryanto A., Sufiyan M. B., Sulo G., Sunguya B. F., Sur P. J., Sykes B. L., Sylaja P. N., Sylte D. O., Szoeke C. E. I., Tabares-Seisdedos R., Tabuchi T., Tadakamadla S. K., Tandon N., Tassew S. 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C., Wilner L. B., Wilson S., Winkler A. S., Wiyeh A. B., Wiysonge C. S., Wolfe C. D. A., Woolf A. D., Wyper G. M. A., Xavier D., Xu G., Yadgir S., Yahyazadeh Jabbari S. H., Yamada T., Yan L. L., Yano Y., Yaseri M., Yasin Y. J., Yeshaneh A., Yimer E. M., Yip P., Yisma E., Yonemoto N., Yoon S. -J., Yotebieng M., Younis M. Z., Yousefifard M., Yu C., Zadnik V., Zaidi Z., Zaman S. B., Zamani M., Zandian H., Zar H. J., Zenebe Z. M., Zipkin B., Zhou M., Zodpey S., Zucker I., Zuhlke L. J., and Murray C. J. L.
- Abstract
Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased
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- 2018
39. Efficacy and safety of SGLT2 inhibitors in heart failure: systematic review and meta-analysis
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Butler, J. Usman, M.S. Khan, M.S. Greene, S.J. Friede, T. Vaduganathan, M. Filippatos, G. Coats, A.J.S. Anker, S.D.
- Abstract
Aims: We sought to conduct a meta-analysis regarding the safety and efficacy of sodium-glucose co-transporter 2 (SGLT2) inhibitors in patients with heart failure (HF). Methods and results: MEDLINE, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were searched from their inception to November 2020 for placebo-controlled randomized controlled trials of SGLT2 inhibitors. Randomized controlled trials were selected if they reported at least one of the prespecified outcomes in patients with HF. Hazard ratios (HRs) or risk ratios and their corresponding 95% confidence intervals were pooled using a random-effects model. A total of seven trials including 16 820 HF patients (N = 8884 in the SGLT2 inhibitor arms; N = 7936 in the placebo arms) were included. In the overall HF cohort, SGLT2 inhibitors compared with placebo significantly reduced the risk of the composite endpoint of first HF hospitalization or cardiovascular death [HR: 0.77 (0.72–0.83); P
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- 2020
40. ESC/ESH guideline-recommended age categories and intensive blood pressure management in high-risk adults: insights from SPRINT
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Pareek, M, Biering-Sorensen, T, Vaduganathan, M, Byrne, C, Qamar, A, Pandey, A, Olesen, T B, Olsen, M H, and Bhatt, D L
- Abstract
The 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for arterial hypertension propose different intensities of blood pressure (BP) lowering in patients \lt;65 years, 65–79 years, and ≥80 years of age. However, it is unclear whether intensive BP management is well-tolerated and modifies risk uniformly across this age spectrum.To assess the relationship between age, treatment response to intensive BP lowering, and cardiovascular (CV) outcomes.SPRINT was a randomized, controlled trial in which 9,361 individuals ≥50 years of age, at high CV risk but without diabetes who had a systolic BP (SBP) 130–180 mmHg, were randomized to intensive (target SBP \lt;120mmHg) or standard antihypertensive treatment (target SBP \lt;140mmHg). The primary efficacy endpoint was the composite of acute coronary syndromes, stroke, heart failure, or death from CV causes. The primary safety endpoint was the composite of serious adverse events (SAE). We examined the prognostic implications of age, using Cox proportional-hazards regression models adjusted for demographic, clinical, and laboratory variables. Whether a linear association was present between age and clinical endpoints was evaluated using restricted cubic splines. We further explored the effects of intensive BP lowering across the age spectrum using interaction analyses.Age was noted for all individuals, and 3,805 (41\, 4,390 (47\, and 1,166 (12\ were \lt;65 years, 65–79 years, and ≥80 years, respectively. Mean age was similar between the two study groups (intensive group 67.9 years vs. standard group 67.9 years; P=0.94). Median follow-up was 3.3 years (range 0–4.8), with 562 primary efficacy events (6\ and 3,529 primary safety events (38\ recorded during the study period. Age was linearly associated with the risk of stroke (test for overall trend, P\lt;0.001) and non-linearly associated with the risk of primary efficacy events, death from CV causes, death from any cause, heart failure, and SAE (test for non-linearity, P\lt;0.05; test for overall trend, P\lt;0.001). Age remained significantly associated with all tested endpoints after multivariable adjustment (P\lt;0.001). Furthermore, the risk of primary events increased over guideline-recommended age-categories (65–79 years vs. \lt;65 years; adj. HR 1.65, 95\.34–2.04; P\lt;0.001 and ≥80 years vs. 65–79 years; adj. HR 1.92, 95\.54–2.40; P\lt;0.001), as did the risk of SAE (P\lt;0.001). The safety and efficacy of intensive BP lowering was not modified by age whether tested continuously or categorically (P\gt;0.05). The Figure shows similar treatment effects (hazard ratios) across the spectrum of age. P-values are for the interaction between age and treatment effect for each endpoint.Figure 1In SPRINT, higher age was associated with a greater risk of both CV events and SAE. However, intensive BP lowering appeared to be associated with similar risks and benefits across the age spectrum.
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- 2019
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41. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019
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Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, AZ, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, J, Catapano, AL, Chugh, SS, Cooper, LT, Coresh, J, Criqui, M, DeCleene, N, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Solà, J, Fowkes, G, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Temesgen, AM, Mokdad, A, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, ALP, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundström, J, Timpel, P, Tleyjeh, IM, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Beaton, A, Carapetis, JR, Chugh, S, Criqui, MH, DeCleene, NK, Fernández-Sola, J, Fowkes, FGR, Kassebaum, NJ, Koroshetz, WJ, Misganaw, AT, Mokdad, AH, Oliveira, GMM, Otto, CM, Owolabi, MO, Reitsma, MB, Rigotti, NA, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Tleyjeh, II, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, RM, Amegah, AK, Amini, S, Aminorroaya, A, Amu, H, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, CL, Ansari-Moghaddam, A, Anteneh, ZA, Antonazzo, IC, Antony, B, Anwer, R, Appiah, LT, Arabloo, J, Ärnlöv, J, Artanti, KD, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, AT, Awoke, MA, Ayele, HT, Ayza, MA, Azari, S, B, DB, Baheiraei, N, Baig, AA, Bakhtiari, A, Banach, M, Banik, PC, Baptista, EA, Barboza, MA, Barua, L, Basu, S, Bedi, N, Béjot, Y, Bennett, DA, Bensenor, IM, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, MM, Boloor, A, Brant, LC, Brenner, H, Briko, NI, Butt, ZA, Caetano dos Santos, FL, Cahill, LE, Cahuana-Hurtado, L, Cámera, LA, Campos-Nonato, IR, Cantu-Brito, C, Car, J, Carrero, JJ, Carvalho, F, Castañeda-Orjuela, CA, Catalá-López, F, Cerin, E, Charan, J, Chattu, VK, Chen, S, Chin, KL, Choi, J-YJ, Chu, D-T, Chung, S-C, Cirillo, M, Coffey, S, Conti, S, Costa, VM, Cundiff, DK, Dadras, O, Dagnew, B, Dai, X, Damasceno, AAM, Dandona, L, Dandona, R, Davletov, K, De la Cruz-Góngora, V, De la Hoz, FP, De Neve, J-W, Denova-Gutiérrez, E, Derbew Molla, M, Derseh, BT, Desai, R, Deuschl, G, Dharmaratne, SD, Dhimal, M, Dhungana, RR, Dianatinasab, M, Diaz, D, Djalalinia, S, Dokova, K, Douiri, A, Duncan, BB, Duraes, AR, Eagan, AW, Ebtehaj, S, Eftekhari, A, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, IY, Elhadi, M, El-Jaafary, SI, Esteghamati, S, 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Etisso, AE, Eyawo, O, Fadhil, I, Faraon, EJA, Faris, PS, Farwati, M, Farzadfar, F, Fernandes, E, Fernandez Prendes, C, Ferrara, P, Filip, I, Fischer, F, Flood, D, Fukumoto, T, Gad, MM, Gaidhane, S, Ganji, M, Garg, J, Gebre, AK, Gebregiorgis, BG, Gebregzabiher, KZ, Gebremeskel, GG, Getacher, L, Obsa, AG, Ghajar, A, Ghashghaee, A, Ghith, N, Giampaoli, S, Gilani, SA, Gill, PS, Gillum, RF, Glushkova, EV, Gnedovskaya, EV, Golechha, M, Gonfa, KB, Goudarzian, AH, Goulart, AC, Guadamuz, JS, Guha, A, Guo, Y, Gupta, R, Hachinski, V, Hafezi-Nejad, N, Haile, TG, Hamadeh, RR, Hamidi, S, Hankey, GJ, Hargono, A, Hartono, RK, Hashemian, M, Hashi, A, Hassan, S, Hassen, HY, Havmoeller, RJ, Hay, SI, Hayat, K, Heidari, G, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Iqbal, U, Irvani, SSN, Shariful Islam, Sheikh, Islam, RM, Iso, H, Iwagami, M, Jain, V, Javaheri, T, 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Stranges, S, Suliankatchi Abdulkader, R, Tadbiri, H, Tadesse, EG, Tadesse, DB, Tajdini, M, Tariqujjaman, M, Teklehaimanot, BF, Temsah, M-H, Tesema, AK, Thakur, B, Thankappan, KR, Thapar, R, Thrift, AG, Timalsina, B, Tonelli, M, Touvier, M, Tovani-Palone, MR, Tripathi, A, Tripathy, JP, Truelsen, TC, Tsegay, GM, Tsegaye, GW, Tsilimparis, N, Tusa, BS, Tyrovolas, S, Umapathi, KK, Unim, B, Unnikrishnan, B, Usman, MS, Vaduganathan, M, Valdez, PR, Vasankari, TJ, Velazquez, DZ, Venketasubramanian, N, Vu, GT, Vujcic, IS, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, RG, Weldemariam, AH, Westerman, R, Winkler, AS, Wiysonge, CS, Wolfe, CDA, Wubishet, BL, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, LL, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, SB, Zaman, MS, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, YMH, and Murray, CJL
- Abstract
Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019.Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside hi
- Published
- 2020
42. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
- Author
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Kyu, Hh, Abate, D, Abate, Kh, Abay, Sm, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, Rs, Abebe, M, Abebe, Z, Abil, Oz, Aboyans, V, Abrham, Ar, Abu-Raddad, Lj, Abu-Rmeileh, Nme, Accrombessi, Mmk, Acharya, D, Acharya, P, Ackerman, In, Adamu, Aa, Adebayo, Om, Adekanmbi, V, Ademi, Z, Adetokunboh, Oo, Adib, Mg, Adsuar, Jc, Afanvi, Ka, Afarideh, M, Afshin, A, Agarwal, G, Agesa, Km, Aggarwal, R, Aghayan, Sa, Agrawal, A, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, Mb, Ahmed, S, Aichour, An, Aichour, I, Aichour, Mte, Akinyemiju, T, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Mekhlafi, Hm, Al-Raddadi, Rm, Alahdab, F, Alam, K, Alam, T, Alashi, A, Alavian, Sm, Alene, Ka, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, Sm, Alkerwi, A, Alla, F, Allebeck, P, Alonso, J, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Aminde, Ln, Amini, E, Amiresmaili, M, Ammar, W, Amoako, Ya, Anber, Nh, Andrei, Cl, Androudi, S, Animut, Md, Anjomshoa, M, Ansha, Mg, Antonio, Cat, Anwari, P, Arabloo, J, Aremu, O, Ärnlöv, J, Arora, A, Arora, M, Artaman, A, Aryal, Kk, Asayesh, H, Ataro, Z, Ausloos, M, Avila-Burgos, L, Avokpaho, Efga, Awasthi, A, Ayala, Quintanilla, Ayer, R, Azzopardi, Ps, Babazadeh, A, Badali, H, Balakrishnan, K, Bali, Ag, Banach, M, Banoub, Jam, Barac, A, Barboza, Ma, Barker-Collo, Sl, Bärnighausen, Tw, Barquera, S, Barrero, Lh, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Behzadifar, M, Bekele, Bb, Bekru, Et, Belachew, Ab, Belay, Ya, Bell, Ml, Bello, Ak, Bennett, Da, Bensenor, Im, Berhane, A, Bernabe, E, Bernstein, Rs, Beuran, M, Beyranvand, T, Bhala, N, Bhatt, S, Bhaumik, S, Bhutta, Za, Biadgo, B, Biehl, Mh, Bijani, A, Bikbov, B, Bilano, V, Bililign, N, Bin, Sayeed, Bisanzio, D, Bjørge, T, Bleyer, A, Bobasa, Em, Bou-Orm, Ir, Boufous, S, Bourne, R, Brady, Oj, Brant, Lc, Brayne, C, Brazinova, A, Breitborde, Njk, Brenner, H, Briant, Ps, Briko, An, Britton, G, Brugha, T, Buchbinder, R, Busse, R, Butt, Za, Cahuana-Hurtado, L, Campuzano, Rincon, Cano, J, Cárdenas, R, Carrero, Jj, Carter, A, Carvalho, F, Castañeda-Orjuela, Ca, Castillo, Rivas, J, Castro, F, Catalá-López, F, Cercy, Km, Cerin, E, Chaiah, Y, Chang, Jc, Charlson, Fj, Chattu, Vk, Chiang, Pp, Chitheer, A, Choi, Jj, Christensen, H, Christopher, Dj, Chung, Sc, Cicuttini, Fm, Cirillo, Massimo, Collado-Mateo, D, Cooper, C, Cortesi, Pa, Cortinovis, M, Cousin, E, Criqui, Mh, Cromwell, Ea, Cross, M, Crump, Ja, Daba, Ak, Dachew, Ba, Dadi, Af, Dandona, L, Dandona, R, Dargan, Pi, Daryani, A, Das, Gupta, Das, R, Neves, J, Dasa, Tt, Davitoiu, Dv, De, La, Hoz, Fp, Leo, De, D, De, Neve, Jw, Steur, De, H, Degefa, Mg, Degenhardt, L, Deiparine, S, Demoz, Gt, Denova-Gutiérrez, E, Deribe, K, Dervenis, N, Des, Jarlais, Dey, S, Dharmaratne, Sd, Dhimal, M, Dinberu, Mt, Dirac, Ma, Djalalinia, S, Doan, L, Dokova, K, Doku, Dt, Dorsey, Er, Doyle, Ke, Driscoll, Tr, Dubey, M, Dubljanin, E, Duken, Ee, Duncan, Bb, Duraes, Ar, Ebrahimi, H, Ebrahimpour, S, Echko, Mm, Edessa, D, Edvardsson, D, Effiong, A, Eggen, Ae, Ehrlich, Jr, Bcheraoui, El, C, El-Khatib, Z, Elyazar, Irf, Enayati, A, Endalifer, Ml, Endries, Ay, Er, B, Erskine, He, Eskandarieh, S, Esteghamati, A, Esteghamati, S, Fakhim, H, Faramarzi, M, Fareed, M, Farhadi, F, Farid, Ta, Farinha, Cses, Farioli, A, Faro, A, Farzadfar, F, Fazaeli, Aa, Feigin, Vl, Fentahun, N, Fereshtehnejad, Sm, Fernandes, E, Fernandes, Jc, Ferrari, Aj, Ferreira, Ml, Filip, I, Fischer, F, Fitzmaurice, C, Foigt, Na, Foreman, Kj, Frank, Td, Fukumoto, T, Fullman, N, Fürst, T, Furtado, Jm, Gakidou, E, Gall, S, Gallus, S, Ganji, M, Garcia-Basteiro, Al, Gardner, Wm, Gebre, Ak, Gebremedhin, At, Gebremichael, Tg, Gelano, Tf, Geleijnse, Jm, Genova-Maleras, R, Geramo, Ycd, Gething, Pw, Gezae, Ke, Ghadami, Mr, Ghadiri, K, Ghasemi-Kasman, M, Ghimire, M, Ghoshal, Ag, Gill, Ps, Gill, Tk, Ginawi, Ia, Giussani, G, Gnedovskaya, Ev, Goldberg, Em, Goli, S, Gómez-Dantés, H, Gona, Pn, Gopalani, Sv, Gorman, Tm, Goulart, Ac, Goulart, Bng, Grada, A, Grosso, G, Gugnani, Hc, Guillemin, F, Guo, Y, Gupta, Pc, Gupta, R, Gupta, T, Gutiérrez, Ra, Gyawali, B, Haagsma, Ja, Hachinski, V, Hafezi-Nejad, N, Haghparast, Bidgoli, Hagos, Tb, Hailegiyorgis, Tt, Haj-Mirzaian, A, Hamadeh, Rr, Hamidi, S, Handal, Aj, Hankey, Gj, Hao, Y, Harb, Hl, Harikrishnan, S, Haririan, H, Haro, Jm, Hassankhani, H, Hassen, Hy, Havmoeller, R, Hay, Rj, Hay, Si, Hedayatizadeh-Omran, A, Heibati, B, Hendrie, D, Henok, A, Heredia-Pi, I, Herteliu, C, Heydarpour, F, Heydarpour, P, Hibstu, Dt, Hoek, Hw, Hoffman, Hj, Hole, Mk, Homaie, Rad, E, Hoogar, P, Hosgood, Hd, Hosseini, Sm, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Hotez, Pj, Hoy, Dg, Hsairi, M, Htet, As, Huang, Jj, Iburg, Km, Ikeda, Ct, Ilesanmi, Os, Irvani, Ssn, Irvine, Cms, Islam, Sms, Islami, F, Jacobsen, Kh, Jahangiry, L, Jahanmehr, N, Jain, Sk, Jakovljevic, M, James, Sl, Jayatilleke, Au, Jeemon, P, Jha, Rp, Jha, V, Js, Ji, Johnson, Co, Jonas, Jb, Jonnagaddala, J, Jorjoran, Shushtari, Z, Joshi, A, Jozwiak, Jj, Jungari, Sb, Jürisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalani, R, Kanchan, T, Kar, C, Karami, M, Karami, Matin, B, Karch, A, Karema, C, Karimi, N, Karimi, Sm, Kasaeian, A, Kassa, Dh, Kassa, Gm, Kassa, Td, Kassebaum, Nj, Katikireddi, Sv, Kaul, A, Kawakami, N, Kazemi, Z, Karyani, Ak, Keighobadi, Mm, Keiyoro, Pn, Kemmer, L, Kemp, Gr, Kengne, Ap, Keren, A, Khader, Ys, Khafaei, B, Khafaie, Ma, Khajavi, A, Khalid, N, Khalil, Ia, Khan, Ea, Khan, Ms, Khan, Ma, Khang, Yh, Khater, Mm, Khazaei, M, Khoja, At, Khosravi, A, Khosravi, Mh, Kiadaliri, Aa, Kidanemariam, Zt, Kiirithio, Dn, Kim, Ci, Kim, D, Kim, Ye, Kim, Yj, Kimokoti, Rw, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Knudsen, Aks, Kocarnik, Jm, Kochhar, S, Kokubo, Y, Kolola, T, Kopec, Ja, Kosen, S, Kotsakis, Ga, Koul, Pa, Koyanagi, A, Krishan, K, Krishnaswami, S, Krohn, Kj, Kuate, Defo, Kucuk, B, Bicer, B, Kumar, Ga, Kumar, M, Kuzin, I, Lad, Dp, Lad, Sd, Lafranconi, A, Lalloo, R, Lallukka, T, Lami, Fh, Lang, Jj, Langan, Sm, Lansingh, Vc, Latifi, A, Lau, Km, Lazarus, Jv, Leasher, Jl, Ledesma, Jr, Lee, Ph, Leigh, J, Leili, M, Leshargie, Ct, Leung, J, Levi, M, Lewycka, S, Li, S, Li, Y, Liang, X, Liao, Y, Liben, Ml, Lim, Ll, Lim, Ss, Limenih, Ma, Linn, S, Liu, S, Looker, Kj, Lopez, Ad, Lorkowski, S, Lotufo, Pa, Lozano, R, Lucas, Tcd, Lunevicius, R, Lyons, Ra, Ma, S, Macarayan, Erk, Mackay, Mt, Maddison, Er, Madotto, F, Maghavani, Dp, Mai, Ht, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malta, Dc, Mamun, Aa, Manda, Al, Manguerra, H, Mansournia, Ma, Mantilla, Herrera, Mantovani, Lg, Maravilla, Jc, Marcenes, W, Marks, A, Martins-Melo, Fr, Martopullo, I, März, W, Marzan, Mb, Massano, J, Massenburg, Bb, Mathur, Mr, Maulik, Pk, Mazidi, M, Mcalinden, C, Mcgrath, Jj, Mckee, M, Mcmahon, Bj, Mehata, S, Mehrotra, R, Mehta, Km, Mehta, V, Mejia-Rodriguez, F, Mekonen, T, Melese, A, Melku, M, Memiah, Ptn, Memish, Za, Mendoza, W, Mengistu, G, Mensah, Ga, Mereta, St, Meretoja, A, Meretoja, Tj, Mestrovic, T, Miazgowski, B, Miazgowski, T, Millear, Ai, Miller, Tr, Mini, Gk, Mirarefin, M, Mirica, A, Mirrakhimov, Em, Misganaw, At, Mitchell, Pb, Mitiku, H, Moazen, B, Mohajer, B, Mohammad, Ka, Mohammadi, M, Mohammadifard, N, Mohammadnia-Afrouzi, M, Mohammed, Ma, Mohammed, S, Mohebi, F, Mokdad, Ah, Molokhia, M, Monasta, L, Montañez, Jc, Moosazadeh, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradinazar, M, Moraga, P, Morawska, L, Moreno, Velásquez, I, Morgado-Da-Costa, J, Morrison, Sd, Moschos, Mm, Mousavi, Sm, Mruts, Kb, Muche, Aa, Muchie, Kf, Mueller, Uo, Muhammed, Os, Mukhopadhyay, S, Muller, K, Mumford, Je, Murthy, Gvs, Musa, Ki, Mustafa, G, Nabhan, Af, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Nahvijou, A, Naik, G, Najafi, F, Nam, Hs, Nangia, V, Nansseu, Jr, Neamati, N, Negoi, I, Negoi, Ri, Neupane, S, Newton, Crj, Ngunjiri, Jw, Nguyen, Aq, Nguyen, G, Nguyen, Ht, Nguyen, Hlt, Nguyen, Lh, Nguyen, M, Nguyen, Nb, Nguyen, Sh, Nichols, E, Ningrum, Dna, Nixon, Mr, Nomura, S, Noroozi, M, Norrving, B, Noubiap, Jj, Nouri, Hr, Shiadeh, Mn, Nowroozi, Mr, Nsoesie, Eo, Nyasulu, Ps, Odell, Cm, Ofori-Asenso, R, Ogbo, Fa, Ih, Oh, Oladimeji, O, Olagunju, At, Olagunju, To, Olivares, Pr, Olsen, He, Olusanya, Bo, Olusanya, Jo, Ong, Kl, Ong, Sk, Oren, E, Ortiz, A, Ota, E, Otstavnov, Ss, Øverland, S, Owolabi, Mo, P, A, M, Pacella, R, Pakhare, Ap, Pakpour, Ah, Pana, A, Panda-Jonas, S, Park, Ek, Park, J, Parry, Cdh, Parsian, H, Pasdar, Y, Patel, S, Patil, St, Patle, A, Patton, Gc, Paturi, Vr, Paudel, D, Paulson, Kr, Pearce, N, Pereira, A, Pereira, Dm, Perico, N, Pesudovs, K, Petzold, M, Pham, Hq, Phillips, Mr, Pigott, Dm, Pillay, Jd, Piradov, Ma, Pirsaheb, M, Pishgar, F, Plana-Ripoll, O, Polinder, S, Popova, S, Postma, Mj, Pourshams, A, Poustchi, H, Prabhakaran, D, Prakash, S, Prakash, V, Prasad, N, Purcell, Ca, Qorbani, M, Quistberg, Da, Radfar, A, Rafay, A, Rafiei, A, Rahim, F, Rahimi, K, Rahimi, Z, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, Mhu, Rahman, Ma, Rahman, Su, Rai, Rk, Rajati, F, Ranjan, P, Rao, Pc, Rasella, D, Rawaf, Dl, Rawaf, S, Reddy, Ks, Reiner, Rc, Reitsma, Mb, Remuzzi, G, Renzaho, Amn, Resnikoff, S, Rezaei, S, Rezai, Ms, Ribeiro, Alp, Roberts, Nls, Robinson, Sr, Roever, L, Ronfani, L, Roshandel, G, Rostami, A, Roth, Ga, Rothenbacher, D, Rubagotti, E, Sachdev, Ps, Sadat, N, Sadeghi, E, Saeedi, Moghaddam, S, Safari, H, Safari, Y, Safari-Faramani, R, Safdarian, M, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sahraian, Ma, Sajadi, Hs, Salam, N, Salama, Js, Salamati, P, Saleem, Z, Salimi, Y, Salimzadeh, H, Salomon, Ja, Salvi, Ss, Salz, I, Samy, Am, Sanabria, J, Sanchez-Niño, Md, Santomauro, Df, Santos, Is, Santos, Jv, Santric, Milicevic, Sao, Mm, Jose, Bp, Sardana, M, Sarker, Ar, Sarmiento-Suárez, R, Sarrafzadegan, N, Sartorius, B, Sarvi, S, Sathian, B, Satpathy, M, Sawant, Ar, Sawhney, M, Saxena, S, Schaeffner, E, Schmidt, Mi, Schneider, Ijc, Schutte, Ae, Schwebel, Dc, Schwendicke, F, Scott, Jg, Sekerija, M, Sepanlou, Sg, Serván-Mori, E, Seyedmousavi, S, Shabaninejad, H, Shafieesabet, A, Shahbazi, M, Shaheen, Aa, Shaikh, Ma, Shams-Beyranvand, M, Shamsi, M, Sharafi, H, Sharafi, K, Sharif, M, Sharif-Alhoseini, M, Sharma, J, Sharma, R, She, J, Sheikh, A, Shi, P, Shibuya, K, Shiferaw, Ms, Shigematsu, M, Shiri, R, Shirkoohi, R, Shiue, I, Shokoohinia, Y, Shokraneh, F, Shoman, H, Shrime, Mg, Si, S, Siabani, S, Sibai, Am, Siddiqi, Tj, Sigfusdottir, Id, Sigurvinsdottir, R, Silva, Das, Silva, Jp, Silveira, Dga, Singam, Nsv, Singh, Ja, Singh, Np, Singh, V, Sinha, Dn, Skiadaresi, E, Skirbekk, V, Sliwa, K, Smith, Dl, Smith, M, Soares, Filho, Sobaih, Bh, Sobhani, S, Soofi, M, Sorensen, Rjd, Soyiri, In, Sposato, La, Sreeramareddy, Ct, Srinivasan, V, Stanaway, Jd, Starodubov, Vi, Stein, Dj, Steiner, C, Steiner, Tj, Stokes, Ma, Stovner, Lj, Subart, Ml, Sudaryanto, A, Sufiyan, Mb, Sulo, G, Sunguya, Bf, Sur, Pj, Sykes, Bl, Sylaja, Pn, Sylte, Do, Szoeke, Cei, Tabarés-Seisdedos, R, Tabuchi, T, Tadakamadla, Sk, Tandon, N, Tassew, Sg, Tavakkoli, M, Taveira, N, Taylor, Hr, Tehrani-Banihashemi, A, Tekalign, Tg, Tekelemedhin, Sw, Tekle, Mg, Temsah, Mh, Temsah, O, Terkawi, As, Tessema, B, Teweldemedhin, M, Thankappan, Kr, Theis, A, Thirunavukkarasu, S, Thomas, N, Tilahun, B, Qg, To, Tonelli, M, Topor-Madry, R, Torre, Ae, Tortajada-Girbés, M, Touvier, M, Tovani-Palone, Mr, Towbin, Ja, Tran, Bx, Tran, Kb, Troeger, Ce, Tsadik, Ag, Tsoi, D, Tudor, Car, L, Tyrovolas, S, Ukwaja, Kn, Ullah, I, Undurraga, Ea, Updike, Rl, Usman, Ms, Uthman, Oa, Vaduganathan, M, Vaezi, A, Valdez, Pr, Varavikova, E, Varughese, S, Vasankari, Tj, Venketasubramanian, N, Villafaina, S, Violante, Fs, Vladimirov, Sk, Vlassov, V, Vollset, Se, Vos, T, Vosoughi, K, Vujcic, Is, Wagnew, Fs, Waheed, Y, Wang, Y, Wang, Yp, Weiderpass, E, Weintraub, Rg, Weiss, Dj, Weldegebreal, F, Weldegwergs, Kg, Werdecker, A, West, Te, Westerman, R, Whiteford, Ha, Widecka, J, Wijeratne, T, Williams, Hc, Wilner, Lb, Wilson, S, Winkler, As, Wiyeh, Ab, Wiysonge, Cs, Wolfe, Cda, Woolf, Ad, Wyper, Gma, Xavier, D, Xu, G, Yadgir, S, Yahyazadeh, Jabbari, Yamada, T, Yan, Ll, Yano, Y, Yaseri, M, Yasin, Yj, Yeshaneh, A, Yimer, Em, Yip, P, Yisma, E, Yonemoto, N, Yoon, Sj, Yotebieng, M, Younis, Mz, Yousefifard, M, Yu, C, Zadnik, V, Zaidi, Z, Zaman, Sb, Zamani, M, Zandian, H, Zar, Hj, Zenebe, Zm, Zhou, M, Zipkin, B, Zodpey, S, Zucker, I, Zuhlke, Lj, Murray, Cjl., GBD 2017 DALYs & HALE Coll, Kyu, Hh, Abate, D, Abate, Kh, Abay, Sm, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, R, Abebe, M, Abebe, Z, Abil, Oz, Aboyans, V, Abrham, Ar, Abu-Raddad, Lj, Abu-Rmeileh, Nme, Accrombessi, Mmk, Acharya, D, Acharya, P, Ackerman, In, Adamu, Aa, Adebayo, Om, Adekanmbi, V, Ademi, Z, Adetokunboh, Oo, Adib, Mg, Adsuar, Jc, Afanvi, Ka, Afarideh, M, Afshin, A, Agarwal, G, Agesa, Km, Aggarwal, R, Aghayan, Sa, Agrawal, A, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, Mb, Ahmed, S, Aichour, An, Aichour, I, Aichour, Mte, Akinyemiju, T, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Mekhlafi, Hm, Al-Raddadi, Rm, Alahdab, F, Alam, K, Alam, T, Alashi, A, Alavian, Sm, Alene, Ka, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, Sm, Alkerwi, A, Alla, F, Allebeck, P, Alonso, J, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Aminde, Ln, Amini, E, Amiresmaili, M, Ammar, W, Amoako, Ya, Anber, Nh, Andrei, Cl, Androudi, S, Animut, Md, Anjomshoa, M, Ansha, Mg, Antonio, Cat, Anwari, P, Arabloo, J, Aremu, O, Ärnlöv, J, Arora, A, Arora, M, Artaman, A, Aryal, Kk, Asayesh, H, Ataro, Z, Ausloos, M, Avila-Burgos, L, Avokpaho, Efga, Awasthi, A, Ayala Quintanilla, Bp, Ayer, R, Azzopardi, P, Babazadeh, A, Badali, H, Balakrishnan, K, Bali, Ag, Banach, M, Banoub, Jam, Barac, A, Barboza, Ma, Barker-Collo, Sl, Bärnighausen, Tw, Barquera, S, Barrero, Lh, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Behzadifar, M, Bekele, Bb, Bekru, Et, Belachew, Ab, Belay, Ya, Bell, Ml, Bello, Ak, Bennett, Da, Bensenor, Im, Berhane, A, Bernabe, E, Bernstein, R, Beuran, M, Beyranvand, T, Bhala, N, Bhatt, S, Bhaumik, 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Alve, Singam, Narayana Sarma Venkata, Singh, Jasvinder A, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Skirbekk, Vegard, Sliwa, Karen, Smith, David L, Smith, Mari, Soares Filho, Adauto Martin, Sobaih, Badr Hasan, Sobhani, Soheila, Soofi, Moslem, Sorensen, Reed J D, Soyiri, Ireneous N, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Starodubov, Vladimir I, Stein, Dan J, Steiner, Caitlyn, Steiner, Timothy J, Stokes, Mark A, Stovner, Lars Jacob, Subart, Michelle L, Sudaryanto, Agu, Sufiyan, Mu'awiyyah Babale, Sulo, Gerhard, Sunguya, Bruno F, Sur, Patrick John, Sykes, Bryan L, Sylaja, P.N., Sylte, Dillon O, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Tandon, Nikhil, Tassew, Segen Gebremeskel, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tehrani-Banihashemi, Arash, Tekalign, Tigist Gashaw, Tekelemedhin, Shishay Wahdey, Tekle, Merhawi Gebremedhin, Temsah, Mohamad-Hani, Temsah, Omar, Terkawi, Abdullah Sulieman, Tessema, Belay, Teweldemedhin, Mebrahtu, Thankappan, Kavumpurathu Raman, Theis, Andrew, Thirunavukkarasu, Sathish, Thomas, Nihal, Tilahun, Binyam, To, Quyen G, 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, Troeger, Christopher E, Tsadik, Afewerki Gebremeskel, Tsoi, Derrick, Tudor Car, Lorainne, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Ullah, Irfan, Undurraga, Eduardo A, Updike, Rachel L, Usman, Muhammad Shariq, Uthman, Olalekan A, Vaduganathan, Muthiah, Vaezi, Afsane, Valdez, Pascual R, Varavikova, Elena, Varughese, Santosh, Vasankari, Tommi Juhani, Venketasubramanian, Narayanaswamy, Villafaina, Santo, Violante, Francesco S, Vladimirov, Sergey Konstantinovitch, Vlassov, Vasily, Vollset, Stein Emil, Vos, Theo, Vosoughi, Kia, Vujcic, Isidora S, Wagnew, Fasil Shiferaw, Waheed, Yasir, Wang, Yafeng, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Weldegebreal, Fitsum, Weldegwergs, Kidu Gidey, Werdecker, Andrea, West, T Eoin, Westerman, Ronny, Whiteford, Harvey A, Widecka, Justyna, Wijeratne, Tissa, Williams, Hywel C, Wilner, Lauren B, Wilson, Shadrach, Winkler, Andrea Sylvia, Wiyeh, Alison B, Wiysonge, Charles Shey, Wolfe, Charles D A, Woolf, Anthony D, Wyper, Grant M A, Xavier, Deni, Xu, Gelin, Yadgir, Simon, 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, Zadnik, Vesna, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zandian, Hamed, Zar, Heather J, Zenebe, Zerihun Menlkalew, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zucker, Inbar, Zuhlke, Liesl Joanna, and Murray, Christopher J L
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Male ,Health Status ,health statu ,HALE ,mortality rate ,communicable disease ,DALYs ,Global Burden of Disease ,Risk Factors ,Prevalence ,Medicine and Health Sciences ,Singapore ,OUTCOMES ,disability-adjusted life year ,international cooperation ,Medicine (all) ,11 Medical And Health Sciences ,Central African Republic ,newborn disease ,IRON-DEFICIENCY ,AIDS ,priority journal ,Bahrain ,disease severity ,Female ,Quality-Adjusted Life Years ,cerebrovascular accident ,Ukraine ,Life Sciences & Biomedicine ,INTERVENTIONS ,Slovakia ,DISORDERS ,Burundi ,WEIGHTS ,GBD 2017 DALYs and HALE Collaborators ,Communicable Diseases ,Article ,STYLE ,Medicine, General & Internal ,Life Expectancy ,General & Internal Medicine ,Humans ,Disabled Persons ,human ,Healthy Lifestyle ,HALE, DALYs, global burden of disease ,Mortality ,Aged ,Science & Technology ,Mortality, Premature ,HIV ,ischemic heart disease ,major clinical study ,PREVENTION ,non communicable disease ,GBD, disability-adjusted life-years ,age ,sex factor ,Socioeconomic Factors ,Algeria ,Federation of Bosnia and Herzegovina ,lower respiratory tract infection ,Wounds and Injuries ,GENDER ,Human medicine ,trend study ,chronic obstructive lung disease - Abstract
Background How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7.4 years (95% uncertainty interval 74-7.8), from 65.6 years (65.3-65- 8) in 1990 to 73.0 years (72.7-73.3) in 2017. The increase in years of life varied from 5.1 years (5.0-5.3) in high SDI countries to 12.0 years (11.3-12.8) in low SDI countries. Of the additional years of life expected at birth, 26.3% (20.1-33.1) were expected to be spent in poor health in high SDI countries compared with 11.7% (8.8-15.1) in low-middle SDI countries. HALE at birth increased by 6.3 years (5.9-6.7), from 57.0 years (54.6-59.1) in 1990 to 63.3 years (60.5-65.7) in 2017. The increase varied from 3.8 years (3.4-4.1) in high SDI countries to 10.5 years (9.8-11.2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1.0 year (0.4-1.7) in Saint Vincent and the Grenadines (62.4 years [59.9-64.7] in 1990 to 63.5 years [60.9-65.8] in 2017) to 23.7 years (21.9-25.6) in Eritrea (30.7 years [28.9-32.2] in 1990 to 54.4 years [51.5-57.1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1.4 years (0.6-2.3) in Algeria to 11.9 years (10.9-12.9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75.8 years [72.4-78.7]) and males (72.6 years [69 " 8-75.0]) and the lowest estimates were in Central African Republic (47.0 years [43.7-50.2] for females and 42.8 years [40.1-45.6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41.3% (38.8-43.5) for communicable diseases and by 49"8% (47.9-51.6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40.1% (36.8-43.0), although age-standardised DALY rates decreased by 18.1% (16.0-20.2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low S DI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.
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- 2018
43. Pre-discharge and early post-discharge troponin elevation among patients hospitalized for heart failure with reduced ejection fraction: Findings from the ASTRONAUT trial
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Greene SJ, Butler J, Fonarow GC, Subacius HP, Ambrosy AP, Vaduganathan M, Triggiani M, Solomon SD, Lewis EF, Maggioni AP, Böhm M, Chioncel O, Nodari S, Senni M, Zannad F, Gheorghiade M, ASTRONAUT Investigators and Coordinators, Greene, S, Butler, J, Fonarow, G, Subacius, H, Ambrosy, A, Vaduganathan, M, Triggiani, M, Solomon, S, Lewis, E, Maggioni, A, Böhm, M, Chioncel, O, Nodari, S, Senni, M, Zannad, F, Gheorghiade, M, and ASTRONAUT Investigators and, C
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Male ,medicine.medical_specialty ,Time Factors ,Population ,Heart failure ,Outcomes ,030204 cardiovascular system & hematology ,Hospitalization ,Post-discharge ,Troponin ,Cardiology and Cardiovascular Medicine ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Interquartile range ,Cause of Death ,Internal medicine ,Troponin I ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,education ,Aged ,Outcome ,education.field_of_study ,Ejection fraction ,biology ,business.industry ,Hazard ratio ,Stroke Volume ,Middle Aged ,Prognosis ,medicine.disease ,Patient Discharge ,United States ,Europe ,Survival Rate ,biology.protein ,Cardiology ,Female ,business ,Biomarkers ,Follow-Up Studies - Abstract
Aims: Troponin levels are commonly elevated among patients hospitalized for heart failure (HF), but the prevalence and prognostic significance of early post-discharge troponin elevation are unclear. This study sought to describe the frequency and prognostic value of pre-discharge and post-discharge troponin elevation, including persistent troponin elevation from the inpatient to outpatient settings. Methods and results: The ASTRONAUT trial (NCT00894387; http://www.clinicaltrials.gov) enrolled hospitalized HF patients with ejection fraction ≤40% and measured troponin I prior to discharge (i.e. study baseline) and at 1-month follow-up in a core laboratory (elevation defined as >0.04 ng/mL). This analysis included 1469 (91.0%) patients with pre-discharge troponin data. Overall, 41.5% and 29.9% of patients had elevated pre-discharge [median: 0.09 ng/mL; interquartile range (IQR): 0.06–0.19 ng/mL] and 1-month (median: 0.09 ng/mL; IQR: 0.06–0.15 ng/mL) troponin levels, respectively. Among patients with pre-discharge troponin elevation, 60.4% had persistent elevation at 1 month. After adjustment, pre-discharge troponin elevation was not associated with 12-month clinical outcomes. In contrast, 1-month troponin elevation was independently predictive of increased all-cause mortality [hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.18–2.13] and cardiovascular mortality or HF hospitalization (HR 1.28, 95% CI 1.03–1.58) at 12 months. Associations between 1-month troponin elevation and outcomes were similar among patients with newly elevated (i.e. normal pre-discharge) and persistently elevated levels (interaction P ≥ 0.16). The prognostic value of 1-month troponin elevation for 12-month mortality was driven by a pronounced association among patients with coronary artery disease (interaction P = 0.009). Conclusions: In this hospitalized HF population, troponin I elevation was common during index hospitalization and at 1-month follow-up. Elevated troponin I level at 1 month, but not pre-discharge, was independently predictive of increased clinical events at 12 months. Early post-discharge troponin I measurement may offer a practical means of risk stratification and should be investigated as a therapeutic target.
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- 2018
44. Neprilysin inhibition in heart failure: mechanisms and substrates beyond modulating natriuretic peptides
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D'Elia, E, Iacovoni, A, Vaduganathan, M, Lorini, F, Perlini, S, Senni, M, D'Elia E, Iacovoni A, Vaduganathan M, Lorini F, Perlini S, Senni M., D'Elia, E, Iacovoni, A, Vaduganathan, M, Lorini, F, Perlini, S, Senni, M, D'Elia E, Iacovoni A, Vaduganathan M, Lorini F, Perlini S, and Senni M.
- Abstract
The autonomic nervous system, the renin–angiotensin–aldosterone system, and the natriuretic peptide system represent critical regulatory pathways in heart failure and as such have been the major targets of pharmacological development. The introduction and approval of angiotensin receptor neprilysin inhibitors (ARNi) have broadened the available drug treatments of patients with chronic heart failure with reduced ejection fraction. Neprilysin catalyses the degradation of a number of vasodilator peptides, including the natriuretic peptides, bradykinin, substance P, and adrenomedullin, as well as vasoconstrictor peptides, including endothelin-1 and angiotensin I and II. We review the multiple, potentially competing, substrates for neprilysin inhibition, and the resultant composite clinical effects of ARNi therapy. A mechanistic understanding of this novel therapeutic class may provide important insights into the expected on-target and off-target effects when this agent is more widely prescribed.
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- 2017
45. Pre-discharge and early post-discharge troponin elevation among patients hospitalized for heart failure with reduced ejection fraction: findings from the ASTRONAUT trial
- Author
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Greene, S, Butler, J, Fonarow, G, Subacius, H, Ambrosy, A, Vaduganathan, M, Triggiani, M, Solomon, S, Lewis, E, Maggioni, A, Böhm, M, Chioncel, O, Nodari, S, Senni, M, Zannad, F, Gheorghiade, M, ASTRONAUT Investigators and, C, Greene SJ, Butler J, Fonarow GC, Subacius HP, Ambrosy AP, Vaduganathan M, Triggiani M, Solomon SD, Lewis EF, Maggioni AP, Böhm M, Chioncel O, Nodari S, Senni M, Zannad F, Gheorghiade M, ASTRONAUT Investigators and Coordinators, Greene, S, Butler, J, Fonarow, G, Subacius, H, Ambrosy, A, Vaduganathan, M, Triggiani, M, Solomon, S, Lewis, E, Maggioni, A, Böhm, M, Chioncel, O, Nodari, S, Senni, M, Zannad, F, Gheorghiade, M, ASTRONAUT Investigators and, C, Greene SJ, Butler J, Fonarow GC, Subacius HP, Ambrosy AP, Vaduganathan M, Triggiani M, Solomon SD, Lewis EF, Maggioni AP, Böhm M, Chioncel O, Nodari S, Senni M, Zannad F, Gheorghiade M, and ASTRONAUT Investigators and Coordinators
- Abstract
Aims: Troponin levels are commonly elevated among patients hospitalized for heart failure (HF), but the prevalence and prognostic significance of early post-discharge troponin elevation are unclear. This study sought to describe the frequency and prognostic value of pre-discharge and post-discharge troponin elevation, including persistent troponin elevation from the inpatient to outpatient settings. Methods and results: The ASTRONAUT trial (NCT00894387; http://www.clinicaltrials.gov) enrolled hospitalized HF patients with ejection fraction ≤40% and measured troponin I prior to discharge (i.e. study baseline) and at 1-month follow-up in a core laboratory (elevation defined as >0.04 ng/mL). This analysis included 1469 (91.0%) patients with pre-discharge troponin data. Overall, 41.5% and 29.9% of patients had elevated pre-discharge [median: 0.09 ng/mL; interquartile range (IQR): 0.06–0.19 ng/mL] and 1-month (median: 0.09 ng/mL; IQR: 0.06–0.15 ng/mL) troponin levels, respectively. Among patients with pre-discharge troponin elevation, 60.4% had persistent elevation at 1 month. After adjustment, pre-discharge troponin elevation was not associated with 12-month clinical outcomes. In contrast, 1-month troponin elevation was independently predictive of increased all-cause mortality [hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.18–2.13] and cardiovascular mortality or HF hospitalization (HR 1.28, 95% CI 1.03–1.58) at 12 months. Associations between 1-month troponin elevation and outcomes were similar among patients with newly elevated (i.e. normal pre-discharge) and persistently elevated levels (interaction P ≥ 0.16). The prognostic value of 1-month troponin elevation for 12-month mortality was driven by a pronounced association among patients with coronary artery disease (interaction P = 0.009). Conclusions: In this hospitalized HF population, troponin I elevation was common during index hospitalization and at 1-month follow-up. Elevated troponin I level at 1 mo
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- 2017
46. Mode of Death in Heart Failure With Preserved Ejection Fraction
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Vaduganathan, M, Patel, R, Michel, A, Shah, S, Senni, M, Gheorghiade, M, Butler, J, Vaduganathan M, Patel RB, Michel A, Shah SJ, Senni M, Gheorghiade M, Butler J, Vaduganathan, M, Patel, R, Michel, A, Shah, S, Senni, M, Gheorghiade, M, Butler, J, Vaduganathan M, Patel RB, Michel A, Shah SJ, Senni M, Gheorghiade M, and Butler J
- Abstract
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF. Although sudden death accounted for ∼25% to 30% of deaths in trials, its definition is nonspecific; it is unclear what proportion represents arrhythmic deaths. Moving forward, reporting and definitions of modes of death must be standardized and tailored to the HFpEF population. Broad-scale systematic autopsies and long-term rhythm monitoring may clarify the underlying pathology and mechanisms driving mortal events. There is an unmet need for a longitudinal multicenter, global registry of patients with HFpEF to map its natural history.
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- 2017
47. Erratum: 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 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))
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Stanaway, J.D. Afshin, A. Gakidou, E. Lim, S.S. Abate, D. Abate, K.H. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdollahpour, I. Abdulkader, R.S. Abebe, M. Abebe, Z. Abera, S.F. Abil, O.Z. Abraha, H.N. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M.E. Accrombessi, M.M.K. Acharya, D. Acharya, P. Adamu, A.A. Adane, A.A. Adebayo, O.M. Adedoyin, R.A. Adekanmbi, V. Ademi, Z. Adetokunboh, O.O. Adib, M.G. Admasie, A. Adsuar, J.C. Afanvi, K.A. Afarideh, M. Agarwal, G. Aggarwal, A. Aghayan, S.A. Agrawal, A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmadieh, H. Ahmed, M.B. Aichour, A.N. Aichour, I. Aichour, M.T.E. Akbari, M.E. Akinyemiju, T. Akseer, N. Al-Aly, Z. Al-Eyadhy, A. Al-Mekhlafi, H.M. Alahdab, F. Alam, K. Alam, S. Alam, T. Alashi, A. Alavian, S.M. Alene, K.A. Ali, K. Ali, S.M. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Ammar, W. Anber, N.H. Anderson, J.A. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Ansha, M.G. Antó, J.M. Antonio, C.A.T. Anwari, P. Appiah, L.T. Appiah, S.C.Y. Arabloo, J. Aremu, O. Ärnlöv, J. Artaman, A. Aryal, K.K. Asayesh, H. Ataro, Z. Ausloos, M. Avokpaho, E.F.G.A. Awasthi, A. Ayala Quintanilla, B.P. Ayer, R. Ayuk, T.B. Azzopardi, P.S. Babazadeh, A. Badali, H. Badawi, A. Balakrishnan, K. Bali, A.G. Ball, K. Ballew, S.H. Banach, M. Banoub, J.A.M. Barac, A. Barker-Collo, S.L. Bärnighausen, T.W. Barrero, L.H. Basu, S. Baune, B.T. Bazargan-Hejazi, S. Bedi, N. Beghi, E. Behzadifar, M. Behzadifar, M. Béjot, Y. Bekele, B.B. Bekru, E.T. Belay, E. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Bergeron, G. Berhane, A. Bernabe, E. Bernstein, R.S. Beuran, M. Beyranvand, T. Bhala, N. Bhalla, A. Bhattarai, S. Bhutta, Z.A. Biadgo, B. Bijani, A. Bikbov, B. Bilano, V. Bililign, N. Bin Sayeed, M.S. Bisanzio, D. Biswas, T. Bjørge, T. Blacker, B.F. Bleyer, A. Borschmann, R. Bou-Orm, I.R. Boufous, S. Bourne, R. Brady, O.J. Brauer, M. Brazinova, A. Breitborde, N.J.K. Brenner, H. Briko, A.N. Britton, G. Brugha, T. Buchbinder, R. Burnett, R.T. Busse, R. Butt, Z.A. Cahill, L.E. Cahuana-Hurtado, L. Campos-Nonato, I.R. Cárdenas, R. Carreras, G. Carrero, J.J. Carvalho, F. Castañeda-Orjuela, C.A. Castillo Rivas, J. Castro, F. Catalá-López, F. Causey, K. Cercy, K.M. Cerin, E. Chaiah, Y. Chang, H.-Y. Chang, J.-C. Chang, K.-L. Charlson, F.J. Chattopadhyay, A. Chattu, V.K. Chee, M.L. Cheng, C.-Y. Chew, A. Chiang, P.P.-C. Chimed-Ochir, O. Chin, K.L. Chitheer, A. Choi, J.-Y.J. Chowdhury, R. Christensen, H. Christopher, D.J. Chung, S.-C. Cicuttini, F.M. Cirillo, M. Cohen, A.J. Collado-Mateo, D. Cooper, C. Cooper, O.R. Coresh, J. Cornaby, L. Cortesi, P.A. Cortinovis, M. Costa, M. Cousin, E. Criqui, M.H. Cromwell, E.A. Cundiff, D.K. Daba, A.K. Dachew, B.A. Dadi, A.F. Damasceno, A.A.M. Dandona, L. Dandona, R. Darby, S.C. Dargan, P.I. Daryani, A. Das Gupta, R. Das Neves, J. Dasa, T.T. Dash, A.P. Davitoiu, D.V. Davletov, K. De la Cruz-Góngora, V. De La Hoz, F.P. De Leo, D. De Neve, J.-W. Degenhardt, L. Deiparine, S. Dellavalle, R.P. Demoz, G.T. Denova-Gutiérrez, E. Deribe, K. Dervenis, N. Deshpande, A. Des Jarlais, D.C. Dessie, G.A. Deveber, G.A. Dey, S. Dharmaratne, S.D. Dhimal, M. Dinberu, M.T. Ding, E.L. Diro, H.D. Djalalinia, S. Do, H.P. Dokova, K. Doku, D.T. Doyle, K.E. Driscoll, T.R. Dubey, M. Dubljanin, E. Duken, E.E. Duncan, B.B. Duraes, A.R. Ebert, N. Ebrahimi, H. Ebrahimpour, S. Edvardsson, D. Effiong, A. Eggen, A.E. El Bcheraoui, C. El-Khatib, Z. Elyazar, I.R. Enayati, A. Endries, A.Y. Er, B. Erskine, H.E. Eskandarieh, S. Esteghamati, A. Estep, K. Fakhim, H. Faramarzi, M. Fareed, M. Farid, T.A. Sá Farinha, C.S.E. Farioli, A. Faro, A. Farvid, M.S. Farzaei, M.H. Fatima, B. Fay, K.A. Fazaeli, A.A. Feigin, V.L. Feigl, A.B. Fereshtehnejad, S.-M. Fernandes, E. Fernandes, J.C. Ferrara, G. Ferrari, A.J. Ferreira, M.L. Filip, I. Finger, J.D. Fischer, F. Foigt, N.A. Foreman, K.J. Fukumoto, T. Fullman, N. Fürst, T. Furtado, J.M. Futran, N.D. Gall, S. Gallus, S. Gamkrelidze, A. Ganji, M. Garcia-Basteiro, A.L. Gardner, W.M. Gebre, A.K. Gebremedhin, A.T. Gebremichael, T.G. Gelano, T.F. Geleijnse, J.M. Geramo, Y.C.D. Gething, P.W. Gezae, K.E. Ghadimi, R. Ghadiri, K. Ghasemi Falavarjani, K.G. Ghasemi-Kasman, M. Ghimire, M. Ghosh, R. Ghoshal, A.G. Giampaoli, S. Gill, P.S. Gill, T.K. Gillum, R.F. Ginawi, I.A. Giussani, G. Gnedovskaya, E.V. Godwin, W.W. Goli, S. Gómez-Dantés, H. Gona, P.N. Gopalani, S.V. Goulart, A.C. Grada, A. Grams, M.E. Grosso, G. Gugnani, H.C. Guo, Y. Gupta, R. Gupta, R. Gupta, T. Gutiérrez, R.A. Gutiérrez-Torres, D.S. Haagsma, J.A. Habtewold, T.D. Hachinski, V. Hafezi-Nejad, N. Hagos, T.B. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Handal, A.J. Hankey, G.J. Hao, Y. Harb, H.L. Harikrishnan, S. Haro, J.M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hawley, C.N. Hay, S.I. Hedayatizadeh-Omran, A. 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Mohebi, F. Mokdad, A.H. Molokhia, M. Momeniha, F. Monasta, L. Moodley, Y. Moradi, G. Moradi-Lakeh, M. Moradinazar, M. Moraga, P. Morawska, L. Morgado-Da-Costa, J. Morrison, S.D. Moschos, M.M. Mouodi, S. Mousavi, S.M. Mozaffarian, D. Mruts, K.B. Muche, A.A. Muchie, K.F. Mueller, U.O. Muhammed, O.S. Mukhopadhyay, S. Muller, K. Musa, K.I. Mustafa, G. Nabhan, A.F. Naghavi, M. Naheed, A. Nahvijou, A. Naik, G. Naik, N. Najafi, F. Nangia, V. Nansseu, J.R. Nascimento, B.R. Neal, B. Neamati, N. Negoi, I. Negoi, R.I. Neupane, S. Newton, C.R.J. Ngunjiri, J.W. Nguyen, A.Q. Nguyen, G. Nguyen, H.T. Nguyen, H.L.T. Nguyen, H.T. Nguyen, M. Nguyen, N.B. Nichols, E. Nie, J. Ningrum, D.N.A. Nirayo, Y.L. Nishi, N. Nixon, M.R. Nojomi, M. Nomura, S. Norheim, O.F. Noroozi, M. Norrving, B. Noubiap, J.J. Nouri, H.R. Nourollahpour Shiadeh, M. Nowroozi, M.R. Nsoesie, E.O. Nyasulu, P.S. Obermeyer, C.M. Odell, C.M. Ofori-Asenso, R. Ogbo, F.A. Oh, I.-H. Oladimeji, O. Olagunju, A.T. Olagunju, T.O. Olivares, P.R. Olsen, H.E. Olusanya, B.O. Olusanya, J.O. Ong, K.L. Ong, S.K. Oren, E. Orpana, H.M. Ortiz, A. Ota, E. Otstavnov, S.S. Øverland, S. Owolabi, M.O. Mahesh, P.A. Pacella, R. Pakhare, A.P. Pakpour, A.H. Pana, A. Panda-Jonas, S. Park, E.-K. Parry, C.D.H. Parsian, H. Patel, S. Pati, S. Patil, S.T. Patle, A. Patton, G.C. Paudel, D. Paulson, K.R. Paz Ballesteros, W.C. Pearce, N. Pereira, A. Pereira, D.M. Perico, N. Pesudovs, K. Petzold, M. Pham, H.Q. Phillips, M.R. Pillay, J.D. Piradov, M.A. Pirsaheb, M. Pischon, T. Pishgar, F. Plana-Ripoll, O. Plass, D. Polinder, S. Polkinghorne, K.R. Postma, M.J. Poulton, R. Pourshams, A. Poustchi, H. Prabhakaran, D. Prakash, S. Prasad, N. Purcell, C.A. Purwar, M.B. Qorbani, M. Radfar, A. Rafay, A. Rafiei, A. Rahim, F. Rahimi, Z. Rahimi-Movaghar, A. Rahimi-Movaghar, V. Rahman, M. Rahman, M.H.U. Rahman, M.A. Rai, R.K. Rajati, F. Rajsic, S. Raju, S.B. Ram, U. Ranabhat, C.L. Ranjan, P. Rath, G.K. Rawaf, D.L. Rawaf, S. Reddy, K.S. Rehm, C.D. Rehm, J. Reiner, R.C. Reitsma, M.B. Remuzzi, G. Renzaho, A.M.N. Resnikoff, S. Reynales-Shigematsu, L.M. Rezaei, S. Ribeiro, A.L.P. Rivera, J.A. Roba, K.T. Rodríguez-Ramírez, S. Roever, L. Román, Y. Ronfani, L. Roshandel, G. Rostami, A. Roth, G.A. Rothenbacher, D. Roy, A. Rubagotti, E. Rushton, L. Sabanayagam, C. Sachdev, P.S. Saddik, B. Sadeghi, E. Saeedi Moghaddam, S. Safari, H. Safari, Y. Safari-Faramani, R. Safdarian, M. Safi, S. Safiri, S. Sagar, R. Sahebkar, A. Sahraian, M.A. Sajadi, H.S. Salam, N. Salamati, P. Saleem, Z. Salimi, Y. Salimzadeh, H. Salomon, J.A. Salvi, D.D. Salz, I. Samy, A.M. Sanabria, J. Sanchez-Niño, M.D. Sánchez-Pimienta, T.G. Sanders, T. Sang, Y. Santomauro, D.F. Santos, I.S. Santos, J.V. Santric Milicevic, M.M. Sao Jose, B.P. Sardana, M. Sarker, A.R. Sarmiento-Suárez, R. Sarrafzadegan, N. Sartorius, B. Sarvi, S. Sathian, B. Satpathy, M. Sawant, A.R. Sawhney, M. Saylan, M. Sayyah, M. Schaeffner, E. Schmidt, M.I. Schneider, I.J.C. Schöttker, B. Schutte, A.E. Schwebel, D.C. Schwendicke, F. Scott, J.G. Seedat, S. Sekerija, M. Sepanlou, S.G. Serre, M.L. Serván-Mori, E. Seyedmousavi, S. Shabaninejad, H. Shaddick, G. Shafieesabet, A. Shahbazi, M. Shaheen, A.A. Shaikh, M.A. Shamah Levy, T. Shams-Beyranvand, M. Shamsi, M. Sharafi, H. Sharafi, K. Sharif, M. Sharif-Alhoseini, M. Sharifi, H. Sharma, J. Sharma, M. Sharma, R. She, J. Sheikh, A. Shi, P. Shibuya, K. Shiferaw, M.S. Shigematsu, M. Shin, M.-J. Shiri, R. Shirkoohi, R. Shiue, I. Shokraneh, F. Shoman, H. Shrime, M.G. Shupler, M.S. Si, S. Siabani, S. Sibai, A.M. Siddiqi, T.J. Sigfusdottir, I.D. Sigurvinsdottir, R. Silva, D.A.S. Silva, J.P. Silveira, D.G.A. Singh, J.A. Singh, N.P. Singh, V. Sinha, D.N. Skiadaresi, E. Skirbekk, V. Smith, D.L. Smith, M. Sobaih, B.H. Sobhani, S. Somayaji, R. Soofi, M. Sorensen, R.J.D. Soriano, J.B. Soyiri, I.N. Spinelli, A. Sposato, L.A. Sreeramareddy, C.T. Srinivasan, V. Starodubov, V.I. Steckling, N. Stein, D.J. Stein, M.B. Stevanovic, G. Stockfelt, L. Stokes, M.A. Sturua, L. Subart, M.L. Sudaryanto, A. Sufiyan, M.B. Sulo, G. Sunguya, B.F. Sur, P.J. Sykes, B.L. Szoeke, C.E.I. Tabarés-Seisdedos, R. Tabuchi, T. Tadakamadla, S.K. Takahashi, K. Tandon, N. Tassew, S.G. Tavakkoli, M. Taveira, N. Tehrani-Banihashemi, A. Tekalign, T.G. Tekelemedhin, S.W. Tekle, M.G. Temesgen, H. Temsah, M.-H. Temsah, O. Terkawi, A.S. Tessema, B. Teweldemedhin, M. Thankappan, K.R. Theis, A. Thirunavukkarasu, S. Thomas, H.J. Thomas, M.L. Thomas, N. Thurston, G.D. Tilahun, B. Tillmann, T. To, Q.G. Tobollik, M. Tonelli, M. Topor-Madry, R. Torre, A.E. Tortajada-Girbés, M. Touvier, M. Tovani-Palone, M.R. Towbin, J.A. Tran, B.X. Tran, K.B. Truelsen, T.C. Truong, N.T. Tsadik, A.G. Tudor Car, L. Tuzcu, E.M. Tymeson, H.D. Tyrovolas, S. Ukwaja, K.N. Ullah, I. Updike, R.L. Usman, M.S. Uthman, O.A. Vaduganathan, M. Vaezi, A. Valdez, P.R. Van Donkelaar, A. Varavikova, E. Varughese, S. Vasankari, T.J. Venkateswaran, V. Venketasubramanian, N. Villafaina, S. Violante, F.S. Vladimirov, S.K. Vlassov, V. Vollset, S.E. Vos, T. Vosoughi, K. Vu, G.T. Vujcic, I.S. Wagnew, F.S. Waheed, Y. Waller, S.G. Walson, J.L. Wang, Y. Wang, Y. Wang, Y.-P. Weiderpass, E. Weintraub, R.H. Weldegebreal, F. Werdecker, A. Werkneh, A.A. West, J.J. Westerman, R. Whiteford, H.A. Widecka, J. Wijeratne, T. Winkler, A.S. Wiyeh, A.B. Wiysonge, C.S. Wolfe, C.D.A. Wong, T.Y. Wu, S. Xavier, D. Xu, G. Yadgir, S. Yadollahpour, A. Yahyazadeh Jabbari, S.H. Yamada, T. Yan, L.L. Yano, Y. Yaseri, M. Yasin, Y.J. Yeshaneh, A. Yimer, E.M. Yip, P. Yisma, E. Yonemoto, N. Yoon, S.-J. Yotebieng, M. Younis, M.Z. Yousefifard, M. Yu, C. Zaidi, Z. Zaman, S.B. Zamani, M. Zavala-Arciniega, L. Zhang, A.L. Zhang, H. Zhang, K. Zhou, M. Zimsen, S.R.M. Zodpey, S. Murray, C.J.L. GBD 2017 Risk Factor Collaborators
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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. 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. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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48. Medication dosing for heart failure with reduced ejection fraction — opportunities and challenges
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Marti, C.N. Fonarow, G.C. Anker, S.D. Yancy, C. Vaduganathan, M. Greene, S.J. Ahmed, A. Januzzi, J.L. Gheorghiade, M. Filippatos, G. Butler, J.
- Abstract
Multiple drug classes have shown incremental benefits in heart failure with reduced ejection fraction. Most of these trials were designed to achieve specific doses of the investigational agent. Clinical practice guidelines recommend using the same target dosing of therapies, as tolerated. However, with the increasing number of available therapies, clinicians face the challenge of simultaneously using several drugs, achieving target doses, and managing side effects that are often overlapping. Blood pressure, renal function, hyperkalaemia, and other factors may impede achieving target doses of all medications, leaving clinicians with dilemmas as to how to sequence and dose these various classes of drugs. The guideline-directed eligibility for certain drugs and devices requires stability on maximally tolerated doses of background therapies. However, significant variability exists in dosing achieved in clinical practice. We discuss the existing background data regarding the doses of heart failure medications in clinical trials and in practice, and provide recommendations on how to navigate this complex therapeutic decision-making. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology
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- 2019
49. Body mass index and intensive blood pressure management in high-risk adults: insights from the systolic blood pressure intervention trial SPRINT)
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Pareek, M., Vaduganathan, M., Biering-Sorensen, T., Oxlund, C. S., Rasmussen, B. S., Olsen, M. H., and Bhatt, D. L.
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- 2018
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50. 4877Renal function and intensive blood pressure lowering in high-risk adults without diabetes: insights from the Systolic Blood Pressure Intervention Trial (SPRINT)
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Pareek, M, primary, Kristensen, A M D, additional, Vaduganathan, M, additional, Biering-Sorensen, T, additional, Byrne, C, additional, Almarzooq, Z, additional, Olesen, T B, additional, Olsen, M H, additional, and Bhatt, D L, additional
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- 2019
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