The Remnant Cholesterol is associated with CVD incidence: A general population cohort study in Southwest China
Chengxi LiuMi DaiKunming TianShiyu ZhouLei LuoZhiying ZengXuelian YanYing XiaoYiying WangRenli DengXiuhong LeiTao Liu
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Abstract Emerging evidence has indicated that remnant cholesterol (RC) could predict cardiovascular disease (CVD) incidence. Nevertheless, the relationship of RC with CVD risk, especially within the general Chinese population remains scarce. The purpose of the present research was to assess that RC concentrations and CVD outcomes in general Chinese adults are related. The Cox proportional hazard model was established to explore the relationship for RC and the outcomes of CVD and CVD subgroups. A restricted cubic spline (RCS) was utilized to investigate the dose-response connection between RC and the risk of CVD outcomes, and the ROC curve was used to calculate the corresponding cut-off values. Moreover, stratified analysis was carried out to investigate the potential effect modification in the association between RC and CVD outcomes. Significant positive associations were found between e levated categorical RC and increased risk of CVD (HR Q4, 1.80; 95% CI 1.15–2.79; P-trend = 0.008), Atherosclerotic cardiovascular disease (HR Q4, 2.00; 95% CI 1.22–3.27; P-trend = 0.007), Stroke (HR Q4, 1.66; 95% CI 1.02–2.69; P-trend = 0.040), and Ischemic stroke (HR Q4, 1.87, 95% CI 1.08–3.25; P-trend = 0.034), respectively. Our study suggested that the incidence of CVD outcomes increased when RC levels were above 0.75 mmol/L. Importantly, the CVD risks related with RC were more likely to be those aged＞60 years, females, BMI < 24 kg/m 2 , and who with hypertension and unhealthy diet patterns. In conclusion, aberrant high level of RC is associated with elevated CVD risk, and independent of low-density lipoprotein cholesterol (LDL-C). Our data reveal urgent primary prevention for subjects with high RC levels to low incidence of CVD, especially for the elderly, females, and those with hypertension and unhealthy diet patterns.Keywords:
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The objective was to discuss the evolution of the real incidence of breast cancer. Observed incidence as calculated by cancer registries differs from the real incidence because of the artifacts brought by diagnostic procedures and case collection. Age-period-cohort models were applied to nearly 11,200 incident breast cancers collected by the Cancer Registry of Isère from 1983 to 2002 in women aged 30-84. We took into account prior knowledge and assumptions concerning the evolution of real incidence, diagnostic procedures, and collection of cases. In the age group 30-49, no real incidence increase was seen if we assume that diagnostic procedures and collection of cases were not impaired. In women aged 50-69, an increase of real incidence and intensive screening could explain the increase of observed incidence but exact quantifications are difficult. At most, the increase due to screening would reach 50%. In women aged 70-84, no real incidence increase was suspected if we assume that changes in clinical practices and screening led to more breast cancer cases collected.
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Background Although most people with relapsing onset multiple sclerosis (R-MS) eventually transition to secondary progressive multiple sclerosis (SPMS), little is known about disability progression in SPMS. Methods All R-MS patients in the Cardiff MS registry were included. Cox proportional hazards regression was used to examine a) hazard of converting to SPMS and b) hazard of attaining EDSS 6.0 and 8.0 in SPMS. Results 1611 R-MS patients were included. Older age at MS onset (hazard ratio [HR] 1.02, 95%CI 1.01–1.03), male sex (HR 1.71, 95%CI 1.41–2.08), and residual disability after onset (HR 1.38, 95%CI 1.11–1.71) were asso- ciated with increased hazard of SPMS. Male sex (EDSS 6.0 HR 1.41 [1.04–1.90], EDSS 8.0 HR 1.75 [1.14–2.69]) and higher EDSS at SPMS onset (EDSS 6.0 HR 1.31 [1.17–1.46]; EDSS 8.0 HR 1.38 [1.19–1.61]) were associated with increased hazard of reaching disability milestones, while older age at SPMS was associated with a lower hazard of progression (EDSS 6.0 HR 0.94 [0.92–0.96]; EDSS 8.0: HR 0.92 [0.90–0.95]). Conclusions Different factors are associated with hazard of SPMS compared to hazard of disability progres- sion after SPMS onset. These data may be used to plan services, and provide a baseline for comparison for future interventional studies and has relevance for new treatments for SPMS RobertsonNP@cardiff.ac.uk
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Approximately 20,000 stroke events, or three quarters of all stroke events in Sweden are included in Riks-Stroke, the National quality Register for Stroke Care, each year. Results from Riks-Stroke show that women, in comparison with men, are more often living in institutions three months after stroke. Women also less often receive secondary stroke prevention. Oral anticoagulants are the most efficient way to prevent stroke in patients with atrial fibrillation. There are wide variations in the use of oral anticoagulants in stroke patients with atrial fibrillation, not only between hospitals, but also between counties and health care regions. Riks-Stroke verifies that treatment in stroke units improves survival as well as functional outcome after stroke. Still more than one quarter of all stroke patients do not receive care in a stroke unit. Post-stroke fatigue is an unexplored long-term consequence that is frequent even late after stroke. It is also an independent predictor for functional dependence, institutional living and death late after stroke. Stroke care in Sweden has improved dramatically the last decades. However, results from Riks-Stroke indicated that there still are several differences and weaknesses and there are subsequently still room for improvements.
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Summary Background and objectives Rates of hospitalization are known to be high in patients with kidney disease. However, ongoing risks of subsequent hospitalization and mortality are uncertain. The primary objective was to evaluate patients with kidney disease for long-term risks of subsequent hospitalization, including admissions resulting in death. Design, setting, participants, & measurements Patients hospitalized in Washington State between April of 2006 and December of 2008 who survived to discharge ( n =676,343) were classified by International Classification of Disease codes into CKD ( n =27,870), dialysis ( n =6131), kidney transplant ( n =1100), and reference ( n =641,242) cohorts. Cox proportional hazard models controlling for age, sex, payer, comorbidity, previous hospitalization, primary diagnosis category, and length of stay were conducted for time to event analyses. Results Compared with the reference cohort, risks for subsequent hospitalization were increased in the CKD (hazard ratio=1.20, 99% confidence interval=1.18–1.23, P <0.001), dialysis (hazard ratio=1.76, 99% confidence interval=1.69–1.83, P <0.001), and kidney transplant (hazard ratio=1.85, 99% confidence interval=1.68–2.03, P <0.001) cohorts, with a mean follow-up time of 29 months. Similarly, risks for fatal hospitalization were increased for patients in the CKD (hazard ratio=1.41, 99% confidence interval=1.34–1.49, P <0.001), dialysis (hazard ratio=3.04, 99% confidence interval=2.78–3.31, P <0.001), and kidney transplant (hazard ratio=2.25, 99% confidence interval=1.67–3.03, P <0.001) cohorts. Risks for hospitalization and fatal hospitalization increased in a graded manner by CKD stage. Conclusions Risks of subsequent hospitalization, including admission resulting in death, among patients with kidney disease were substantially increased in a large statewide population. Patients with kidney disease should be a focus of efforts to reduce hospitalizations and mortality.
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The hazard ratio and median survival time are the routine indicators in survival analysis. We briefly introduced the relationship between hazard ratio and median survival time and the role of proportional hazard assumption. We compared 110 pairs of hazard ratio and median survival time ratio in 58 articles and demonstrated the reasons for the difference by examples. The results showed that the hazard ratio estimated by the Cox regression model is unreasonable and not equivalent to median survival time ratio when the proportional hazard assumption is not met. Therefore, before performing the Cox regression model, the proportional hazard assumption should be tested first. If proportional hazard assumption is met, Cox regression model can be used; if proportional hazard assumption is not met, restricted mean survival times is suggested.风险比（hazard ratio，HR）和中位生存时间是生存分析时的常规分析和报告指标。本文简要介绍了HR和中位生存时间的关系以及比例风险假定在这两者之间的作用，分析了检索出的58篇文献中的110对风险比和中位生存时间比的差异，并通过实例阐明了产生这种差异的原因。结果表明，在不满足比例风险假定时，Cox回归模型计算得到的风险比是不合理的，且与中位生存时间之比不等价。因此，在使用Cox回归模型前，应先进行比例风险假定的检验，只有符合比例风险假定时才能使用该模型；当不符合比例风险假定时，建议使用限制性平均生存时间。.
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OBJECTIVE To investigate the thrombocytopenia purpura incidence of children in Jiangxi province.METHODS All the thrombocytopenia purpura cases younger than 14 years old who fell ill during 2007-2009 and hospitalized in either county and higher classes hospital located in Nanchang,Jingdezhen and Yichun were investigated.RESULTS 549 children of thrombocytopenia purpura were investigated.The average annual incidence was 7.20 /100 000,and the masculine incidence was 8.70/100 000,while the feminine was 5.51/100 000.The incidence of 0-4 age group was the highest and it was 15.75 /100 000.The peak of incidence was on May and October every year.CONCLUSION The thrombocytopenia purpura incidence of children is about 7 /100 000 in Jiangxi province.The masculine incidence is relatively higher;and infant is the peak age group.There is no significant difference between four seasons.
Purpura (gastropod)
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The application of survival analysis on the data of credit motorcycle financing experiencing bad loans after the credit starts early, with sixteen covariates were considered. The model used in survival analysis is the Cox proportional hazard models. Cox models have the assumption that the proportional hazard assumption. Extended Cox models selected to improve cox proportional hazard models when one or more covariates did not meet the assumption of proportional hazards. Extended cox models is an extension of cox models that involve time-dependent variables. Covariates that do not meet the proportional hazards assumption in the Cox models diinteraksikan extended with functions appropriate time, in order to obtain time-dependent covariates. So on the model covariates that are not dependent on time and time dependent covariates. The parameters of these covariates estimated using partial maximum likelihood method. To determine whether the extended Cox model is a suitable model for the data in a particular case, likelihood ratio test was used. The results indicate that extended Cox models with functions time appropriate, provide the best model.Keywords : Credit Risk, Survival Analysis, Cox Proportional Hazard , Extended Cox Model
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