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Participation in disease management programs and major adverse cardiac events in patients after acute myocardial infarction: a longitudinal study based on registry data

Fischer, Christian ; Höpner, Jens ; Hartwig, Saskia ; [et al.]

Springer Science and Business Media LLC ; 2021

In: BMC Cardiovascular Disorders Vol. 21, No. 1 ( 2021-12)

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In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)

Abstract: Cardiovascular diseases are still the main cause of death in the western world. However, diminishing mortality rates of acute myocardial infarction (AMI) are motivating the need to investigate the process of secondary prevention after AMI. Besides cardiac rehabilitation, disease management programs (DMPs) are an important component of outpatient care after AMI in Germany. This study aims to analyze outcomes after AMI among those who participated in DMPs and cardiac rehabilitation (CR) in a region with overall increased cardiovascular morbidity and mortality. Methods Based on data from a regional myocardial infarction registry and a 2-year follow-up period, we assessed the occurrence of major adverse cardiac events (MACE) in relation to participation in CR and DMP, risk factors for complications and individual healths well as lifestyle characteristics. Multivariable Cox regression was performed to compare survival time between participants and non-participants until an adverse event occurred. Results Of 1094 observed patients post-AMI, 272 were enrolled in a DMP. An association between DMP participation and lower hazard rates for MACE compared to non-enrollees could not be proven in the crude model (hazard ratio = 0.93; 95% confidence interval = 0.65–1.33). When adjusted for possible confounding variables, these results remained virtually unchanged (1.03; 0.72–1.48). Furthermore, smokers and obese patients showed a distinctly lower chance of DMP enrollment. In contrast, those who participated in CR showed a lower risk for MACE in crude (0.52; 0.41–0.65) and adjusted analysis (0.56; 0.44–0.71). Conclusions Participation in DMP was not associated with a lower risk of MACE, but participation in CR showed beneficial effects. Adjustment only slightly changed effect estimates in both cases, but it is still important to consider potential effects of additional confounding variables.

Type of Medium: Online Resource

ISSN: 1471-2261

URL: Article

DOI: 10.1186/s12872-020-01832-3

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2021

detail.hit.zdb_id: 2059859-2

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Gender differences in the association of individual social class and neighbourhood unemployment rate with prevalent type 2 diabetes mellitus: a cross-sectional study from the DIAB-CORE consortium

Müller, Grit ; Hartwig, Saskia ; Greiser, Karin Halina ; [et al.]

BMJ ; 2013

In: BMJ Open Vol. 3, No. 6 ( 2013-06), p. e002601-

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In: BMJ Open, BMJ, Vol. 3, No. 6 ( 2013-06), p. e002601-

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2013-002601

Language: English

Publisher: BMJ

Publication Date: 2013

detail.hit.zdb_id: 2599832-8

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Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study

Hartwig, Saskia ; Kluttig, Alexander ; Tiller, Daniel ; [et al.]

BMJ ; 2016

In: BMJ Open Vol. 6, No. 1 ( 2016-01), p. e009266-

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In: BMJ Open, BMJ, Vol. 6, No. 1 ( 2016-01), p. e009266-

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2015-009266

Language: English

Publisher: BMJ

Publication Date: 2016

detail.hit.zdb_id: 2599832-8

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Cohort profile: The LoewenKIDS Study – life-course perspective on infections, the microbiome and the development of the immune system in early childhood

Gottschick, Cornelia ; Raupach-Rosin, Heike ; Langer, Susan ; [et al.]

Oxford University Press (OUP) ; 2019

In: International Journal of Epidemiology Vol. 48, No. 4 ( 2019-08-01), p. 1382-1383

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In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 48, No. 4 ( 2019-08-01), p. 1382-1383

Type of Medium: Online Resource

ISSN: 0300-5771 , 1464-3685

URL: Article

DOI: 10.1093/ije/dyz069

RVK:

XF 4100

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2019

detail.hit.zdb_id: 1494592-7

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Anthropometric measures in the German National Cohort—more than weight and height

Fischer, Beate ; Sedlmeier, Anja M. ; Hartwig, Saskia ; [et al.]

Springer Science and Business Media LLC ; 2020

In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Vol. 63, No. 3 ( 2020-03), p. 290-300

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In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Springer Science and Business Media LLC, Vol. 63, No. 3 ( 2020-03), p. 290-300

Abstract: High levels of adiposity in the population have a major impact on various diseases, but previous epidemiologic studies have largely been restricted to simple anthropometric measures such as the body mass index (BMI), an imperfect predictor of disease risk. There is a critical need for the use of improved measures of relative weight and body composition in large-scale, population-based research. The current article presents initial descriptive results of body composition and fat distribution based on the midterm baseline dataset of the German National Cohort, which included 101,817 participants who were examined in 18 study centers in Germany between March 2014 and March 2017. The anthropometric measures encompassed body weight, height, waist and hip circumference, bioelectrical impedance analysis (BIA), sonography of abdominal adipose tissue, 3D-body scanning, and magnetic resonance imaging. BMI analyses showed that 46.2% of men and 29.7% of women were overweight and 23.5% of men and 21.2% of women were obese. On average, women in almost all age groups demonstrated more subcutaneous adipose tissue layer thickness than men. The mean values of visceral adipose tissue layer thickness, on the other hand, were higher among men than among women in all age groups and increased continuously across age groups in both sexes. The comprehensive assessment of body composition and fat distribution provides novel future opportunities for detailed epidemiologic analyses of overweight and adiposity in relation to the development of chronic diseases.

Type of Medium: Online Resource

ISSN: 1436-9990 , 1437-1588

URL: Article

DOI: 10.1007/s00103-020-03096-w

Language: German

Publisher: Springer Science and Business Media LLC

Publication Date: 2020

detail.hit.zdb_id: 1470303-8

SSG: 20,1

SSG: 8,1

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Longitudinal change in health-related quality of life in people with prevalent and incident type 2 diabetes compared to diabetes-free controls

Schunk, Michaela ; Reitmeir, Peter ; Rückert-Eheberg, Ina-Maria ; [et al.]

Public Library of Science (PLoS) ; 2017

In: PLOS ONE Vol. 12, No. 5 ( 2017-5-3), p. e0176895-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 12, No. 5 ( 2017-5-3), p. e0176895-

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0176895

DOI: 10.1371/journal.pone.0176895.g001

DOI: 10.1371/journal.pone.0176895.g002

DOI: 10.1371/journal.pone.0176895.t001

DOI: 10.1371/journal.pone.0176895.t002

DOI: 10.1371/journal.pone.0176895.t003

DOI: 10.1371/journal.pone.0176895.s001

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2017

detail.hit.zdb_id: 2267670-3

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Novel genetic associations for blood pressure identified via gene-alcohol interaction in up to 570K individuals across multiple ancestries

Feitosa, Mary F. ; Kraja, Aldi T. ; Chasman, Daniel I. ; [et al.]

Public Library of Science (PLoS) ; 2018

In: PLOS ONE Vol. 13, No. 6 ( 2018-6-18), p. e0198166-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 13, No. 6 ( 2018-6-18), p. e0198166-

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0198166

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Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2018

detail.hit.zdb_id: 2267670-3

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Regional differences in antihyperglycemic medication are not explained by individual socioeconomic status, regional deprivation, and regional health care services. Observational results from the German DIAB-CORE consortium

Bächle, Christina ; Claessen, Heiner ; Maier, Werner ; [et al.]

Public Library of Science (PLoS) ; 2018

In: PLOS ONE Vol. 13, No. 1 ( 2018-1-25), p. e0191559-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 13, No. 1 ( 2018-1-25), p. e0191559-

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0191559

DOI: 10.1371/journal.pone.0191559.g001

DOI: 10.1371/journal.pone.0191559.t001

DOI: 10.1371/journal.pone.0191559.t002

DOI: 10.1371/journal.pone.0191559.t003

DOI: 10.1371/journal.pone.0191559.t004

DOI: 10.1371/journal.pone.0191559.t005

DOI: 10.1371/journal.pone.0191559.t006

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2018

detail.hit.zdb_id: 2267670-3

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A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure

Sung, Yun J. ; Winkler, Thomas W. ; de las Fuentes, Lisa ; [et al.]

Elsevier BV ; 2018

In: The American Journal of Human Genetics Vol. 102, No. 3 ( 2018-03), p. 375-400

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In: The American Journal of Human Genetics, Elsevier BV, Vol. 102, No. 3 ( 2018-03), p. 375-400

Type of Medium: Online Resource

ISSN: 0002-9297

URL: Article

DOI: 10.1016/j.ajhg.2018.01.015

RVK:

XA 10000

Language: English

Publisher: Elsevier BV

Publication Date: 2018

detail.hit.zdb_id: 1473813-2

SSG: 12

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Onchocerca volvulus-specific antibody and cellular responses in onchocerciasis patients treated annually with ivermectin for 30 years and exposed to parasite transmission in central Togo

Johanns, Saskia I. ; Gantin, Richard G. ; Wangala, Bawoubadi ; [et al.]

Public Library of Science (PLoS) ; 2022

In: PLOS Neglected Tropical Diseases Vol. 16, No. 5 ( 2022-5-3), p. e0010340-

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In: PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 16, No. 5 ( 2022-5-3), p. e0010340-

Abstract: Annual mass drug administrations (MDA) of ivermectin will strongly reduce Onchocerca volvulus microfilariae (mf) in the skin and in the onchocerciasis patients’ eyes. Ivermectin treatment will also affect the expression of immunity in patients, such that activated immune defenses may help control and contribute to clearance of mf of O . volvulus . Longitudinal surveys are a prerequisite to determining the impact of ivermectin on the status of anti-parasite immunity, notably in risk zones where parasite transmission and active O . volvulus infections persist. Methodology/Principal findings Onchocerciasis patients were treated annually with ivermectin and their Onchocerca volvulus antigen (OvAg) specific IgG and cellular responses were investigated before and at 30 years post initial ivermectin treatment (30yPT). Repeated annual ivermectin treatments eliminated persisting O . volvulus microfilariae (mf) from the skin of patients and abrogated patent infections. The OvAg-specific IgG1 and IgG4 responses were diminished at 30yPT to the levels observed in endemic controls. Prior to starting ivermectin treatment, OvAg-induced cellular productions of IL-10, IFN-γ, CCL13, CCL17 and CCL18 were low in patients, and at 30yPT, cellular cytokine and chemokine responses increased to the levels observed in endemic controls. In contrast, mitogen(PHA)- induced IL-10, IFN-γ, CCL17 and CCL18 cellular production was diminished. This divergent response profile thus revealed increased parasite antigen-specific but reduced polyclonal cellular responsiveness in patients. The transmission of O . volvulus continued at the patients’ location in the Mô river basin in central Togo 2018 and 2019 when 0.58% and 0.45%, respectively, of Simulium damnosum s . l . vector blackflies carried O . volvulus infections. Conclusions/Significance Repeated annual ivermectin treatment of onchocerciasis patients durably inhibited their patent O . volvulus infections despite ongoing low-level parasite transmission in the study area. Repeated MDA with ivermectin affects the expression of immunity in patients. O . volvulus parasite-specific antibody levels diminished to levels seen in infection-free endemic controls. With low antibody levels, antibody-dependent cellular cytotoxic responses against tissue-dwelling O . volvulus larvae will weaken. O . volvulus antigen inducible cytokine and chemokine production increased in treated mf-negative patients, while their innate responsiveness to mitogen declined. Such lower innate responsiveness in elderly patients could contribute to reduced adaptive immune responses to parasite infections and vaccines. On the other hand, increased specific cellular chemokine responses in mf-negative onchocerciasis patients could reflect effector cell activation against tissue invasive larval stages of O . volvulus . The annual Simulium damnosum s.l. biting rate observed in the Mô river basin was similar to levels prior to initiation of MDA with ivermectin, and the positive rtPCR results reported here confirm ongoing O . volvulus transmission.

Type of Medium: Online Resource

ISSN: 1935-2735

URL: Article

DOI: 10.1371/journal.pntd.0010340

DOI: 10.1371/journal.pntd.0010340.g001

DOI: 10.1371/journal.pntd.0010340.g002

DOI: 10.1371/journal.pntd.0010340.g003

DOI: 10.1371/journal.pntd.0010340.g004

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DOI: 10.1371/journal.pntd.0010340.t003

DOI: 10.1371/journal.pntd.0010340.t004

DOI: 10.1371/journal.pntd.0010340.t005

DOI: 10.1371/journal.pntd.0010340.t006

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2022

detail.hit.zdb_id: 2429704-5

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