AI Article Synopsis
- The study examined the link between ischemic burden measured by vasodilator stress CMR and all-cause mortality in patients with stable ischemic heart disease (SIHD).
- The research involved 6,389 patients and found that a higher ischemic burden was associated with a significant increase in the risk of death over a median follow-up of 5.75 years.
- Revascularization within three months reduced mortality rates, but this protective effect was seen primarily in patients with extensive ischemic burden (more than 5 segments).
Article Abstract
Objectives: This study explored the association of ischemic burden, as measured by vasodilator stress cardiovascular magnetic resonance (CMR), with all-cause mortality and the effect of revascularization on all-cause mortality in patients with stable ischemic heart disease (SIHD).
Background: In patients with SIHD, the association of ischemic burden, derived from vasodilator stress CMR, with all-cause mortality and its role for decision-making is unclear.
Methods: The registry consisted of 6,389 consecutive patients (mean age: 65 ± 12 years; 38% women) who underwent vasodilator stress CMR for known or suspected SIHD. The ischemic burden (at stress first-pass perfusion imaging) was computed (17-segment model). The effect of CMR-related revascularization (within the following 3 months) on all-cause mortality was retrospectively explored using the electronic regional health system registry.
Results: During a 5.75-year median follow-up, 717 (11%) deaths were documented. In multivariable analyses, more extensive ischemic burden (per 1-segment increase) was independently related to all-cause mortality (hazard ratio: 1.04; 95% confidence interval: 1.02 to 1.07; p < 0.001). In 1,032 1:1 matched patients using a limited number of variables (516 revascularized, 516 non-revascularized), revascularization within the following 3 months was associated with less all-cause mortality only in patients with extensive CMR-related ischemia (>5 segments, n = 432; 10% vs. 24%; p = 0.01).
Conclusions: In a large retrospective registry of unselected patients with known or suspected SIHD who underwent vasodilator stress CMR, extensive ischemic burden was related to a higher risk of long-term, all-cause mortality. Revascularization was associated with a protective effect only in the restricted subset of patients with extensive CMR-related ischemia. Further research will be needed to confirm this hypothesis-generating finding.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcmg.2020.02.027 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Overall and late mortality among 24 459 survivors of adolescent and young adult cancer in Alberta, Canada: a population-based cohort study.
Lancet Public Health
January 2025
Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Arthur Child Comprehensive Cancer Centre, Calgary, AB, Canada. Electronic address:
Background: Adolescent and young adult (AYA) cancer survivors are at an increased risk of premature mortality due to their cancer and its treatment. Herein, we aimed to quantify the excess risks of mortality among AYA cancer survivors and identify target populations for intervention.
Methods: The Alberta AYA Cancer Survivor Study is a retrospective, population-based cohort of individuals diagnosed with a first primary neoplasm at age 15-39 years in Alberta, Canada, between 1983 and 2017.
Implications of an Off-Hours Setting in Patients Undergoing Transcatheter Edge-to-Edge Repair for Mitral Regurgitation.
Am Heart J
January 2025
Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address:
Background: - Little is known about mitral transcatheter edge-to-edge repair (TEER) performed outside of usual working hours. We aimed to explore the prevalence, correlates, and outcomes of mitral TEER initiated off-hours, i.e.
View Article and Find Full Text PDFDiminished salivary cortisol response to mental stress predict all-cause mortality in general population.
J Psychosom Res
December 2024
The Second Clinical Medical College, Jinan University, Shenzhen 518020, China; Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China. Electronic address:
Objectives: To characterize individuals with a diminished salivary cortisol response to mental stress, assess its association with all-cause mortality, and quantify the mediating effects of the most relevant and modifiable factors to identify potential target for prevention.
Methods: Data from MIDUS II study with a 16-year follow-up, were used to categorize 1129 participants as responders or non-responders based on the existence of increase in salivary cortisol under mental stress. LASSO-logistics analysis identified the most relevant factors.
Predicting the likelihood of readmission in patients with ischemic stroke: An explainable machine learning approach using common data model data.
Int J Med Inform
December 2024
Department of Health Policy and Management, School of Medicine, Kangwon National University, 510 School of Medicine Building #1 (N414), 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Republic of Korea; Department of Preventive Medicine, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon-si, Gangwon-do 24289, Republic of Korea; Team of Public Medical Policy Development, Gangwon State Research Institute for People's Health, 880 Baksa-ro, Seo-myeon, Chuncheon-si, Gangwon-do 24461, Republic of Korea. Electronic address:
Background: Ischemic stroke affects 15 million people worldwide, causing five million deaths annually. Despite declining mortality rates, stroke incidence and readmission risks remain high, highlighting the need for preventing readmission to improve the quality of life of survivors. This study developed a machine-learning model to predict 90-day stroke readmission using electronic medical records converted to the common data model (CDM) from the Regional Accountable Care Hospital in Gangwon state in South Korea.
View Article and Find Full Text PDFImpact of adjuvant trastuzumab therapy and its discontinuation on cardiac function and mortality in patients with early-stage breast cancer: An analysis based on the Japanese Receipt Claim Database.
Breast
December 2024
Department of Clinical Research and Management, Graduate School of Medicine, University of Ryukyus, Japan; Department of Clinical Pharmacology, Faculty of Medicine, University of the Ryukyus, Japan. Electronic address:
Standard trastuzumab therapy can reduce the risk of early recurrence of HER2-positive breast cancer. However, trastuzumab-induced cardiac dysfunction may force the discontinuation of adjuvant trastuzumab therapy. Incidentally, there are still unclear whether or not trastuzumab treatment should be continued in the setting of reduced cardiac function.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!