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Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer Jan 2019

Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer

Faculty of Health Sciences Publications

Aims Metformin could have benefits on cardiovascular disease and kidney disease progression but is often withheld from individuals with diabetes and chronic kidney disease (CKD) because of a concern that it may increase the risk of lactic acidosis. Materials and methods All‐cause mortality, cardiovascular death, cardiovascular events (death, hospitalization for heart failure, myocardial infarction, stroke or myocardial ischemia), end stage renal disease (ESRD) and the kidney disease composite (ESRD or death) were compared in metformin users and non‐users with diabetes and CKD enrolled in the Trial to Reduce Cardiovascular Events with Aranesp (darbepoeitin‐alfa) Therapy (TREAT) (NCT00093015). Outcomes ...


Mild Cognitive Impairment Impacts Health Outcomes Of Patients With Atrial Fibrillation Undergoing A Disease Management Intervention, Jocasta Ball, Maja-Lisa Loechen, Melinda Carrington, Joshua Wiley, S. Stewart Jan 2018

Mild Cognitive Impairment Impacts Health Outcomes Of Patients With Atrial Fibrillation Undergoing A Disease Management Intervention, Jocasta Ball, Maja-Lisa Loechen, Melinda Carrington, Joshua Wiley, S. Stewart

Faculty of Health Sciences Publications

Objective: Mild cognitive impairment (MCI) is prevalent in atrial fibrillation (AF) and has the potential to contribute to poor outcomes. We investigated the influence of MCI on survival and rehospitalisation in patients with chronic forms of AF undergoing a home-based, AF-specific disease management intervention (home-based intervention (HBI)) or standard management(SM). Methods The Montreal Cognitive Assessment tool was administered at baseline (a score of < 26/30 indicated MCI) in patients with AF randomised to HBI versus SM. Post hoc analyses of mortality and rehospitalisations during a minimum 24-month follow-up were conducted in the overall cohort and in each study group separately. Results Of 260 patients (mean age 72±11, 47% female), 65% demonstrated MCI on screening (34% in SM; 31% in HBI). Overall, the number of days spent alive and outof- hospital during follow-up (P=0.012) and all-cause rehospitalisation were influenced by MCI during follow-up (OR 3.16 (95% CI 1.46 to 6.84)) but MCI did not influence any outcomes in the SM group. However, survival was negatively influenced by MCI in the HBI group (P=0.036); those with MCI in this group were 5.6 times more likely to die during follow-up (OR 5.57 (95% CI 1.10 to 28.1)). Those with MCI in the HBI group also spent less days alive and out-of-hospital than those with no MCI (P=0.022). MCI was also identified as a significant independent correlate of shortest duration of event-free survival (OR 3.48 (95% CI 1.06 to 11.4)), allcause rehospitalisation (OR 3.30 (95% CI 1.25 to 8.69)) and cardiovascular disease (CVD)-related rehospitalisation (OR 2.35 (95% CI 1.12 to 4.91)) in this group. Conclusions The effectiveness of home-based, disease management for patients with chronic forms of AF is negatively affected by comorbid MCI. The benefit of adjunctive support for patients with MCI on CVD-related health outcomes requires further investigation.


Effectiveness Of Programs To Promote Cardiovascular Health Of Indigenous Australians: A Systematic Review, Vainess Mbuzi, Paul Fulbrook, Melanie Jessup Jan 2018

Effectiveness Of Programs To Promote Cardiovascular Health Of Indigenous Australians: A Systematic Review, Vainess Mbuzi, Paul Fulbrook, Melanie Jessup

Faculty of Health Sciences Publications

Background Indigenous Australians carry a greater burden of cardiovascular disease than other Australians. A variety of programs has been implemented with the broad aim of improving Indigenous cardiovascular health, however, relatively few have been evaluated rigorously. In terms of effectiveness, understanding how to best manage cardiovascular disease among this population is an important priority. The review aimed to examine the evidence relating to the effectiveness of cardiovascular programs for Indigenous Australians. Methods PubMed, CINAHL, PsycINFO, Scopus and Web of Science databases were systematically searched for relevant studies, limited to those published in English between 2008 and 2017. All studies that ...


Hiv Treatment Is Associated With A Twofold Higher Probability Of Raised Triglycerides: Pooled Analyses In 21 023 Individuals In Sub-Saharan Africa, K. Ekoru, E. H. Young, D. G. Dillon, D. Gurdasani, N. Stehouwer, D. Faurholt-Jepsen, N. S. Levitt, N. J. Crowther, M. Nyirenda, M. A. Njelekela, K. Ramaiya, O. Nyan, O. O. Adewole, K. Anastos, C. Compostella, J. A. Dave, C. M. Fourie, H. Friis, I. M. Kruger, C. T. Longenecker, D. P. Maher, E. Mutimura, C. E. Ndhlovu, G. Praygod, E. W. Pefura Yone, M. Pujades-Rodriguez, N. Range, M. U. Sani, M. Sanusi, A. E. Schutte, K. Sliwa, P. C. Tien, E. H. Vorster, C. Walsh, D. Gareta, F. Mashili, E. Sobngwi, C. Adebamowo, A. Kamali, J. Seeley, L. Smeeth, D. Pillay, A. A. Motala, P. Kaleebu, M. S. Sandhu Jan 2018

Hiv Treatment Is Associated With A Twofold Higher Probability Of Raised Triglycerides: Pooled Analyses In 21 023 Individuals In Sub-Saharan Africa, K. Ekoru, E. H. Young, D. G. Dillon, D. Gurdasani, N. Stehouwer, D. Faurholt-Jepsen, N. S. Levitt, N. J. Crowther, M. Nyirenda, M. A. Njelekela, K. Ramaiya, O. Nyan, O. O. Adewole, K. Anastos, C. Compostella, J. A. Dave, C. M. Fourie, H. Friis, I. M. Kruger, C. T. Longenecker, D. P. Maher, E. Mutimura, C. E. Ndhlovu, G. Praygod, E. W. Pefura Yone, M. Pujades-Rodriguez, N. Range, M. U. Sani, M. Sanusi, A. E. Schutte, K. Sliwa, P. C. Tien, E. H. Vorster, C. Walsh, D. Gareta, F. Mashili, E. Sobngwi, C. Adebamowo, A. Kamali, J. Seeley, L. Smeeth, D. Pillay, A. A. Motala, P. Kaleebu, M. S. Sandhu

Faculty of Health Sciences Publications

Background: Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.

Methods: Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG ( > 2.3 mmol/L) was analysed using regression models.

Findings: Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR ...


Associations Of Context-Specific Sitting Time With Markers Of Cardiometabolic Risk In Australian Adults, Paddy C. Dempsey, Nyssa T. Hadgraft, Elisabeth A. H. Winkler, Bronwyn K. Clark, Mathew P. Buman, Paul A. Gardiner, Neville Owen, Brigid M. Lynch, David W. Dunstan Jan 2018

Associations Of Context-Specific Sitting Time With Markers Of Cardiometabolic Risk In Australian Adults, Paddy C. Dempsey, Nyssa T. Hadgraft, Elisabeth A. H. Winkler, Bronwyn K. Clark, Mathew P. Buman, Paul A. Gardiner, Neville Owen, Brigid M. Lynch, David W. Dunstan

Faculty of Health Sciences Publications

Background: High volumes of sitting time are associated with an elevated risk of type 2 diabetes and cardiovascular disease, and with adverse cardiometabolic risk profiles. However, previous studies have predominately evaluated only total sitting or television (TV) viewing time, limiting inferences about the specific cardiometabolic health impacts of sitting accumulated in different contexts. We examined associations of sitting time in four contexts with cardiometabolic risk biomarkers in Australian adults. Methods: Participants (n = 3429; mean ± SD age 58 ± 10 years) were adults without clinically diagnosed diabetes or cardiovascular disease from the 2011–2012 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multiple ...


The Charms Pilot Study: A Multi-Method Assessment Of The Feasibility Of A Sexual Counselling Implementation Intervention In Cardiac Rehabilitation In Ireland, Patrick J. Murphy, Chris Noone, Maureen D'Eath, Dympna Casey, Sally Doherty, Tiny Jaarsma, Andrew W. Murphy, Martin O'Donnell, Noeleen Fallon, Paddy Gillespie, Amirhossein Jalali, Jenny Mcsharry, John Newell, Elaine Toomey, Elaine E. Steinke, Molly Byrne Jan 2018

The Charms Pilot Study: A Multi-Method Assessment Of The Feasibility Of A Sexual Counselling Implementation Intervention In Cardiac Rehabilitation In Ireland, Patrick J. Murphy, Chris Noone, Maureen D'Eath, Dympna Casey, Sally Doherty, Tiny Jaarsma, Andrew W. Murphy, Martin O'Donnell, Noeleen Fallon, Paddy Gillespie, Amirhossein Jalali, Jenny Mcsharry, John Newell, Elaine Toomey, Elaine E. Steinke, Molly Byrne

Faculty of Health Sciences Publications

Background: Many people living with cardiovascular disease (CVD) are affected by sexual problems associated with the condition. International guidelines recommend all patients with CVD should receive sexual counselling, yet this is rarely provided by health professionals. The current study piloted the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention, a complex multi-level intervention designed to increase the implementation of sexual counselling guidelines in hospital-based cardiac rehabilitation (CR) in Ireland. Methods: The CHARMS intervention, consisting of awareness training and skills development for staff, and education and support for patients, was implemented in two CR centres. Following a repeated measures design ...


Better Indigenous Risk Stratification For Cardiac Health Study (Birch) Protocol: Rationale And Design Of A Cross-Sectional And Prospective Cohort Study To Identify Novel Cardiovascular Risk Indicators In Aboriginal Australian And Torres Strait Island, Marc G. W. Rémond, Simon Stewart, Melinda J. Carrington, Thomas H. Marwick, Bronwyn A. Kingwell, Peter Meikle, Darren O'Brien, Nathaniel S. Marshall, Graeme P. Maguire Jan 2017

Better Indigenous Risk Stratification For Cardiac Health Study (Birch) Protocol: Rationale And Design Of A Cross-Sectional And Prospective Cohort Study To Identify Novel Cardiovascular Risk Indicators In Aboriginal Australian And Torres Strait Island, Marc G. W. Rémond, Simon Stewart, Melinda J. Carrington, Thomas H. Marwick, Bronwyn A. Kingwell, Peter Meikle, Darren O'Brien, Nathaniel S. Marshall, Graeme P. Maguire

Faculty of Health Sciences Publications

Background: Of the estimated 10–11 year life expectancy gap between Indigenous (Aboriginal and Torres Strait Islander people) and non-Indigenous Australians, approximately one quarter is attributable to cardiovascular disease (CVD). Risk prediction of CVD is imperfect, but particularly limited for Indigenous Australians. The BIRCH (Better Indigenous Risk stratification for Cardiac Health) project aims to identify and assess existing and novel markers of early disease and risk in Indigenous Australians to optimise health outcomes in this disadvantaged population. It further aims to determine whether these markers are relevant in non-Indigenous Australians. Methods/design: BIRCH is a cross-sectional and prospective cohort study ...


International Variation In Outcomes Among People With Cardiovascular Disease Or Cardiovascular Risk Factors And Impaired Glucose Tolerance: Insights From The Navigator Trial, Marilia Harumi Higuchi Dos Santos, Abhinav Sharma, Jie Lena Sun, Karen Pieper, John J.V. Mcmurray, Rury R. Holman, Renato D. Lopes Jan 2017

International Variation In Outcomes Among People With Cardiovascular Disease Or Cardiovascular Risk Factors And Impaired Glucose Tolerance: Insights From The Navigator Trial, Marilia Harumi Higuchi Dos Santos, Abhinav Sharma, Jie Lena Sun, Karen Pieper, John J.V. Mcmurray, Rury R. Holman, Renato D. Lopes

Faculty of Health Sciences Publications

Background-—Regional differences in risk of diabetes mellitus and cardiovascular outcomes in people with impaired glucose tolerance are poorly characterized. Our objective was to evaluate regional variation in risk of new-onset diabetes mellitus, cardiovascular outcomes, and treatment effects in participants from the NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research) trial. Methods and Results-—NAVIGATOR randomized people with impaired glucose tolerance and cardiovascular risk factors or with established cardiovascular disease to valsartan (or placebo) and to nateglinide (or placebo) with a median 5-year follow-up. Data from the 9306 participants were categorized by 5 regions: Asia (n=552); Europe ...


Tracking Restoration Of Park And Urban Street Settings In Coronary Artery Disease Patients, Regina Grazuleviciene, Jone Vencloviene, Raimondas Kubilius, Vytautas Grizas, Asta Danileviciute, Audrius Dedele, Sandra Andrusaityte, Astra Vitkauskiene, Rasa Steponaviciute, Mark J. Nieuwenhuijsen Jan 2016

Tracking Restoration Of Park And Urban Street Settings In Coronary Artery Disease Patients, Regina Grazuleviciene, Jone Vencloviene, Raimondas Kubilius, Vytautas Grizas, Asta Danileviciute, Audrius Dedele, Sandra Andrusaityte, Astra Vitkauskiene, Rasa Steponaviciute, Mark J. Nieuwenhuijsen

Faculty of Health Sciences Publications

The physiological effects of natural and urban environments on the cardiovascular system of coronary artery disease (CAD) patients are not fully understood. This controlled field study examines the effects of restorative walking in a park vs. in an urban street environment on CAD patients’ stress parameters and cardiac function. Methods: Twenty stable CAD patients were randomly allocated to 7 days controlled walking in a city park or in an urban street environment group. The relationship between different environmental exposures and health effects was analyzed using Wilcoxon signed-rank test and exact Mann-Whitney U test. Results: The mean reduction in cortisol levels ...


Challenges In Personalised Management Of Chronic Diseases-Heart Failure As Prominent Example To Advance The Care Process, Hans Peter Brunner-La, Lutz Fleischhacker, Olga Golubnitschaja, Frank Heemskerk, Thomas Helms, Thom Hoedemakers, Sandra Huygen Allianses, Tiny Jaarsma, Judita Kinkorova, Jan Ramaekers, Peter Ruff, Ivana Schnur, Emilio Vanoli, Jose Verdu, Bettina Zippel-Schultz Jan 2016

Challenges In Personalised Management Of Chronic Diseases-Heart Failure As Prominent Example To Advance The Care Process, Hans Peter Brunner-La, Lutz Fleischhacker, Olga Golubnitschaja, Frank Heemskerk, Thomas Helms, Thom Hoedemakers, Sandra Huygen Allianses, Tiny Jaarsma, Judita Kinkorova, Jan Ramaekers, Peter Ruff, Ivana Schnur, Emilio Vanoli, Jose Verdu, Bettina Zippel-Schultz

Faculty of Health Sciences Publications

Chronic diseases are the leading causes of morbidity and mortality in Europe, accounting for more than 2/3 of all death causes and 75 % of the healthcare costs. Heart failure is one of the most prominent, prevalent and complex chronic conditions and is accompanied with multiple other chronic diseases. The current approach to care has important shortcomings with respect to diagnosis, treatment and care processes. A critical aspect of this situation is that interaction between stakeholders is limited and chronic diseases are usually addressed in isolation. Health care in Western countries requires an innovative approach to address chronic diseases to ...


Clinically Significant Novel Biomarkers For Prediction Of First Ever Myocardial Infarction: The Tromsø Study, Tom Wilsgaard, Ellisiv Bøgeberg Mathiesen, Anil Patwardhan, Michael W. Rowe, Henrik Schirmer, Maja-Lisa Løchen, Julie Sudduth-Klinger, Sarah Hamren, Kaare Harald Bønaa, Inger Njølstad Jan 2015

Clinically Significant Novel Biomarkers For Prediction Of First Ever Myocardial Infarction: The Tromsø Study, Tom Wilsgaard, Ellisiv Bøgeberg Mathiesen, Anil Patwardhan, Michael W. Rowe, Henrik Schirmer, Maja-Lisa Løchen, Julie Sudduth-Klinger, Sarah Hamren, Kaare Harald Bønaa, Inger Njølstad

Faculty of Health Sciences Publications

Background: Identification of individuals with high risk for first-ever myocardial infarction ( MI ) can be improved. The objectives of the study were to survey multiple protein biomarkers for association with the 10-year risk of incident MI and identify a clinically significant risk model that adds information to current common risk models. Methods and Results: We used an immunoassay platform that uses a sensitive, sample-efficient molecular counting technology to measure 51 proteins in samples from the fourth survey ( 1994 ) in the Tromsø Study, a longitudinal study of men and women in Tromsø, Norway. A case control design was used with 419 first-ever ...


Red Cell Distribution Width Is Associated With Incident Myocardial Infarction In A General Population: The Tromsø Study, Tove Skjelbakken, Jostein Lappegard, Trygve S. Ellingsen, Elizabeth Barret-Connor, Jan Brox, Maja-Lisa Løchen, Inger Njølstad, Tom Wilsgaard, Ellisiv B. Mathiesen, Sigrid K. Braekkan, John-Bjarne Hansen Jan 2014

Red Cell Distribution Width Is Associated With Incident Myocardial Infarction In A General Population: The Tromsø Study, Tove Skjelbakken, Jostein Lappegard, Trygve S. Ellingsen, Elizabeth Barret-Connor, Jan Brox, Maja-Lisa Løchen, Inger Njølstad, Tom Wilsgaard, Ellisiv B. Mathiesen, Sigrid K. Braekkan, John-Bjarne Hansen

Faculty of Health Sciences Publications

Background: Red cell distribution width (RDW), a measure of the variability in size of circulating erythrocytes, is associated with mortality and adverse outcome in selected populations with cardiovascular disease. It is scarcely known whether RDW is associated with incident myocardial infarction (MI). We aimed to investigate whether RDW was associated with risk of first-ever MI in a large cohort study with participants recruited from a general population. Methods and Results: Baseline characteristics, including RDW, were collected for 25 612 participants in the Tromsø Study in 1994–1995. Incident MI during follow-up was registered from inclusion through December 31, 2010. Cox ...


Ethnic Difference In The Prevalence Of Angina Pectoris In Sami And Non-Sami Populations: The Saminor Study, Bent-Martin Eliassen, S Graff-Iversen, Marita Melhus, Maja-Lisa Loechen, Ann Ragnhild Broderstad Jan 2014

Ethnic Difference In The Prevalence Of Angina Pectoris In Sami And Non-Sami Populations: The Saminor Study, Bent-Martin Eliassen, S Graff-Iversen, Marita Melhus, Maja-Lisa Loechen, Ann Ragnhild Broderstad

Faculty of Health Sciences Publications

Objective. To assess the population burden of angina pectoris symptoms (APS), self-reported angina and a combination of these, and explore potential ethnic disparity in their patterns. If differences in APS were found between Sami and non-Sami populations, we aimed at evaluating the role of established cardiovascular risk factors as mediating factors. Design. Cross-sectional population-based study. Methods. A health survey was conducted in 2003 2004 in areas with Sami and non-Sami populations (SAMINOR). The response rate was 60.9%. The total number for the subsequent analysis was 15,206 men and women aged 36 79 years (born 1925 1968). Information concerning ...


Baseline Characteristics In The Aliskiren Trial In Type 2 Diabetes Using Cardio-Renal Endpoints (Altitude), Hans Henrik Parving, Barry M. Brenner, John J.V. Mcmurray, Dick De Zeeuw, Steven M. Haffner, Scott D. Solomon, Nish Chaturvedi, Frederik Persson, Maria Nicolaides, Alexia Richard, Zhihua Xiang, Juergen Armbrecht, Marc A. Pfeffer Jan 2012

Baseline Characteristics In The Aliskiren Trial In Type 2 Diabetes Using Cardio-Renal Endpoints (Altitude), Hans Henrik Parving, Barry M. Brenner, John J.V. Mcmurray, Dick De Zeeuw, Steven M. Haffner, Scott D. Solomon, Nish Chaturvedi, Frederik Persson, Maria Nicolaides, Alexia Richard, Zhihua Xiang, Juergen Armbrecht, Marc A. Pfeffer

Faculty of Health Sciences Publications

Introduction: Patients with type 2 diabetes are at enhanced risk for macro- and microvascular complications. Albuminuria and/or reduced kidney function further enhances the vascular risk. We initiated the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE). Aliskiren, a novel direct renin inhibitor, which lowers plasma renin activity, may thereby provide greater cardio-renal protection compared with angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) alone. Materials and methods: ALTITUDE is a randomized, double-blind, placebo-controlled study in high risk type 2 diabetic patients receiving aliskiren 300 mg once daily or placebo added to recommended cardio-renal protective treatment ...