Cause Of Death In Cardiovascular Disease Research Articles

Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study.

Stroke is the leading cause of cardiovascular disease death in sub-Saharan Africa and the second leading cause of mortality worldwide. In 2016, 6.23% of all fatalities in Ethiopia were stroke-related. To assess survival status and predictors of mortality among adult stroke patients admitted to Jimma University Medical Center from April 1/2017 to March 31/2022. A retrospective cohort study was conducted on 480 adult stroke patients selected by simple random sampling from patients admitted to the Jimma University Medical Center Stroke Unit from April 1, 2017 to March 31, 2022. Data were extracted from May to June 2022 and entered Epi-data v.3.1 and analyzed by R v.4.2. The Kaplan-Meier curve with Log rank test was used to estimate survival time and to compare survival experience between categories of explanatory variables. The Cox regression model was computed to identify predictors of survival status in stroke patients. Then the 95% CI of the hazard ratio was set with corresponding p-value < 0.05 to declare statistical significance. During 4350 person-days of follow-up; 88 (18.33%) patients died; resulting in an incidence mortality of 20.23 per 1000 person-days, with a median survival time of 38 days. Glasgow coma score <8 on admission (AHR = 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR = 3.96; 95% CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95% CI: 1.23-4.26), and increased intracranial pressure (AHR = 4.27; 95% CI: 2.33, 7.81), were the independent predictors of the time until death. The incidence of stroke mortality was higher at the seven and fourteen days. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and aspiration pneumonia were independent predictors of mortality.

Clinical Profile and Outcomes of Chronic Kidney Disease Patients with Intracerebral Hemorrhage in a Specialized Kidney Center in the Philippines – A Retrospective Study (P14-5.005)

<h3>Objective:</h3> This study describes the clinical profile and outcome of chronic kidney disease patients who develop intracerebral hemorrhage. <h3>Background:</h3> Stroke rates for ESRD patients are markedly higher than for the general population. Stroke is the third leading cause of cardiovascular disease death among persons with end-stage renal disease on dialysis. The risk of hemorrhagic stroke has been reported to be higher than ischemic stroke in hemodialysis patients. The occurrence of intracerebral hemorrhage in chronic kidney disease patients in the Philippines is yet to be systematically described. <h3>Design/Methods:</h3> A retrospective study was done in specialized center for kidney disease. It included all patients in 2017 to 2019 with chronic kidney disease patients who developed acute intracerebral hemorrhage. Other vascular events (subdural hemorrhage and subarachnoid hemorrhage) were excluded. <h3>Results:</h3> There were 88 patients included. The mean age was 49.7±12 years and females outnumber males at 62.5% vs 37.5%. Majority were CKD stage 5 at the time of stroke. Hypertension and diabetes mellitus were the leading causes of CKD identified and were also the co-morbidities seen in most patients. Majority were on hemodialysis. Platelet counts, prothrombin time and activated partial thromboplastin time were within normal range in most patients and only a few patients were taking anticoagulant or antiplatelet prior to the stroke. Intracerebral hemorrhage was most commonly seen in the basal ganglia/putamen, lobar and in the thalamus and most with an ICH score of 0–2. Majority had poor neurologic outcomes with an MRS of 4–5 or even death. <h3>Conclusions:</h3> This study showed that majority patients with CKD who develop intracerebral hemorrhage had poor outcome. This is consistent with studies done in other countries. <b>Disclosure:</b> Dr. Opao has nothing to disclose. Dr. Senga has nothing to disclose. Marc Laurence Fernandez has nothing to disclose.

Heartbeat: an increase in preventable cardiovascular deaths during the COVID-19 pandemic due to avoidance of medical care

Patients with cardiovascular disease (CVD) have an increased mortality risk with COVID-19 infection yet several studies have shown fewer hospital-based CVD diagnoses and procedures during the COVID-19 pandemic. In this...

How Educational Inequalities in Cardiovascular Mortality Evolve While Healthcare Insurance Coverage Grows: Colombia, 1998 to 2015

ObjectivesWe aim to explore how the current increase in Healthcare Insurance Coverage in Colombia potentially affected educational inequalities in cardiovascular disease (CVD) mortality from 1998 to 2015. MethodsThe official death database for the period 1998 to 2015, codified by cause of death for CVD (International Classification of Diseases, Tenth Revision: I00-I99) was analyzed (men = 279 537, women = 292 122). We compared Healthcare Insurance Coverage (HIC) fluctuations with the trends and annual percentage changes (APCs) in CVD age-standardized mortality rates (ASMRs), the rate ratios of the ASMR to educational level, and the Relative Index of Inequality (RII), which was used to measure the educational inequalities. ResultsMortality from CVD is higher in men than in women (ASMR/men = 148.2; 95% CI: 147.6-148.7 vs ASMR/women = 139.4; 95% CI: 138.9-139.9). People with a lower educational level have an increased risk of dying prematurely owing to CVD, the higher inequalities being those for young women (RII = 2.62; 95% CI: 2.60-2.64). Inequalities by educational level (APC of the RII) grew at a rate of 2.5% per year in men and 1.7% in women, despite the steady increase of HIC throughout the period. From 1998 to 2011, there was a significant decrease in mortality rates owing to CVD (APC = −2.4% and APC = −2.1% for men and women, respectively). As of 2011, there was an increase only for men (APC = +3.9%). ConclusionsIn Colombia, educational inequalities could be a cause of the worrying increase in mortality caused by CVD, which affects women more than men, whereas the HIC seem to be ineffective at reducing educational inequalities, and therefore mortality by CVD.

Insufficient and excessive amounts of sleep increase the risk of premature death from cardiovascular and other diseases: The Multiethnic Cohort Study

ObjectiveTo explore an independent association between self-reported sleep duration and cause-specific mortality. MethodsData were obtained from the Multiethnic Cohort Study conducted in Los Angeles and Hawaii. ResultsAmong 61,936 men and 73,749 women with no history of cancer, heart attack or stroke, 19,335 deaths occurred during an average 12.9year follow-up. Shorter (≤5h/day) and longer (≥9h/day) sleepers of both sexes (vs. 7h/day) had an increased risk of all-cause and cardiovascular disease (CVD) mortality, but not of cancer mortality. Multivariable hazard ratios for CVD mortality were 1.13 (95% CI 1.00–1.28) for ≤5h/day and 1.22 (95% CI 1.09–1.35) for ≥9h/day among men; and 1.20 (95% CI 1.05–1.36) for ≤5h/day and 1.29 (95% CI 1.13–1.47) for ≥9h/day among women. This risk pattern was not heterogeneous across specific causes of CVD death among men (Phetero 0.53) or among women (Phetero 0.72). The U-shape association for all-cause and CVD mortality was observed in all five ethnic groups included in the study and by subgroups of age, smoking status, and body mass index. ConclusionInsufficient or excessive amounts of sleep were associated with increased risk of mortality from CVD and other diseases in a multiethnic population.

Cerebrovascular Disease Incidence, Characteristics, and Outcomes in Patients Initiating Dialysis: The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study

Stroke is the third most common cause of cardiovascular disease death in patients on dialysis therapy; however, characteristics of cerebrovascular disease, including clinical subtypes and subsequent consequences, have not been well described. Prospective national cohort study, the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. 1,041 incident dialysis patients treated in 81 clinics enrolled from October 1995 to July 1998, followed up until December 31, 2004. Time from dialysis therapy initiation. Cerebrovascular disease events were defined as nonfatal (hospitalized stroke and carotid endarterectomy) and fatal (stroke death) events after dialysis therapy initiation. Stroke subtypes were classified by using standardized criteria from the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) system. The incidence of cerebrovascular event subtypes was analyzed by using time-to-event analyses accounting for competing risk of death. Clinical outcomes after stroke were abstracted from medical records. 165 participants experienced a cerebrovascular event with an overall incidence of 4.9 events/100 person-years. Ischemic stroke was the most common (76% of all 200 events), with cardioembolism subtype accounting for 28% of the 95 abstracted ischemic events. Median time from onset of symptoms to first stroke evaluation was 8.5 hours (25th and 75th percentiles, 1 and 42), with only 56% of patients successfully escaping death, nursing home, or skilled nursing facility. Relatively small sample size limits power to determine risk factors. Cerebrovascular disease is common in dialysis patients, is identified late, and carries a significant risk of morbidity and mortality. Stroke etiologic subtypes on dialysis therapy are multifactorial, suggesting risk factors may change the longer one has end-stage renal disease. Additional studies are needed to address the poor prognosis through prevention, early identification, and treatment.