Independent Risk Factor For Incidence Research Articles

Impact of Extraction Time During Donation After Circulatory Death Organ Procurement on Kidney Function After Transplantation in The Netherlands.

In The Netherlands, 60% of deceased-donor kidney offers are after donation after circulatory death. Cold and warm ischemia times are known risk factors for delayed graft function (DGF) and inferior allograft survival. Extraction time is a relatively new ischemia time. During procurement, cooling of the kidneys is suboptimal with ongoing ischemia. However, evidence is lacking on whether extraction time has an impact on DGF if all ischemic periods are included. Between 2012 and 2018, 1524 donation after circulatory death kidneys were procured and transplanted in The Netherlands. Donation and transplantation-related data were obtained from the database of the Dutch Transplant Foundation. The primary outcome parameter was the incidence of DGF. In our cohort, extraction time ranged from 14 to 237 min, with a mean of 62 min (SD 32). In multivariate logistic regression analysis, extraction time was an independent risk factor for incidence of DGF (odds ratio per minute increase 1.008; 95% confidence interval, 1.003-1.013; P = 0.001). The agonal phase, hypoperfusion time, and anastomosis time were not independent risk factors for incidence of DGF. Considering all known ischemic periods during the donation after the circulatory death process, prolonged kidney extraction time increased the risk of DGF after kidney transplantation.

Does locomotive syndrome severity predict future fragility fractures in community-dwelling women with osteoporosis?

We investigated whether the locomotive syndrome (LS) severity affects future fragility fractures in osteoporosis patients. In this retrospective cohort study, 315 women with osteoporosis (mean follow-up period, 2.8 years) were reviewed, of whom 244 were included in the analysis. At baseline, we obtained medical information, bone mineral density of the lumbar spine and femoral neck, and sagittal vertical axis. Additionally, LS risk was assessed using the two-step test, stand-up test, and 25-question geriatric locomotive function scale scores. The LS risk test results were used to classify LS severity, which was rated on a 4-point scale from stage 0 (robust) to 3 (worsening). Cox proportional hazards regression analysis was used to determine the association of the severity with future fragility fracture. Fragility fractures occurred in 37 of 315 participants (11.8%). This study showed that sagittal vertical axis (hazard ratio = 1.014; 95% confidence interval, 1.005-1.023; p value = 0.003) and LS severity (hazard ratio =1.748; 95% confidence interval, 1.133-2.699; p = 0.012) were independent risk factors for incidence of fragility fracture. This study revealed the LS severity to predicted fragility fractures. We suggested that the progression of LS associated with osteoporosis increases the fracture risk.

Outcomes in patients with acute myocardial infarction and a history of illicit drug use

Several reports suggest that illicit drug use may be a major cause of acute myocardial infarction (AMI) independently of smoking habits and associated with a poorer prognosis. The aim of our study was to evaluate the impact of illicit drug use on: – the risk of AMI in France; – its prognosis. This French longitudinal cohort study was based on the administrative hospital-discharge database from the entire population. First, we collected data for all patients admitted in hospital in 2013 with at least 5 years of follow-up to identify potential predictors of AMI. In a second phase, we collected data for all patients admitted with AMI from January 2010 to December 2018. We identified patients with a history of illicit drug use (cannabis, cocaine or opioid). These patients were matched with patients without illicit drug use to assess their prognosis. In France, in 2013, 3381,472 patients were hospitalized with a mean follow-up of 4.7 ± 1.8 years. In multivariable analysis, only cannabis use was significantly associated with a higher risk of AMI (HR 1.320 (95%CI 1.092-1.594), P = 0.004). Between January 2010 and December 2018, we then identified 738,899 AMI patients. Among these patients, 3827 (0.5%) had a known history of illicit drug use. These patients were younger, most often male and had less comorbidities. After 1:1 propensity score matching, during a mean follow-up of 1.9 ± 2.3 years, there was no significant difference between patients without illicit drug use and patients with illicit drug use regarding all-cause death, cardiovascular death, stroke or heart failure. In a large and systematic nationwide analysis, cannabis use was an independent risk factor for incidence of AMI. However, prognosis of illicit drug users presenting with AMI was similar to patients without illicit drug use.

Clinical Characteristics and Risk Factors of Liver Dysfunction in COVID-19 Patients

ABSTRACTBackground:COVID-19 outbreak has spread around the world. Liver dysfunction (LD) was related with high mortality in COVID-19.Methods:Retrospective, single-center study case series of 425 consecutive hospitalized COVID-19 patients were enrolled. Demographic, clinical, laboratory, and treatment data were collected.Results:A total of 425 patients were included in this study, 145 of whom had LD. The overall mortality rate was 8.9%, while 17.9% in the LD group and 4.3% in the nonliver dysfunction (NLD) group. Age, sex, and hypertension were the independent risk factors of LD. LD was an independent risk factor for incidence of severe illness, acute respiratory distress syndrome, and death. The survival rate of patients in LD group was lower than that in NLD group (P < 0.001). A similar trend was observed by the multivariate regression analysis (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 1.69–7.33; P = 0.001). Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had effect to reduce LD (odds ratio of 0.48 [95% CI, 0.232–0.989; P = 0.045]).Conclusions:LD is one of the main features of hospitalized patients of COVID-19, with a worse prognosis. Patients of COVID-19 with LD on admission should be more cautions.

Gender-Related Difference in D-Dimer Level Predicts In-Hospital Heart Failure after Primary PCI for ST-Segment Elevation Myocardial Infarction.

Aims The prognostic value of plasma D-dimer in patients with coronary artery disease (CAD) remains controversial. The study is aimed at investigating the relationship between plasma D-dimer levels and in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI). Methods STEMI patients who underwent pPCI were enrolled in this study. Venous blood samples were collected from patients on admission before pPCI procedure. The study endpoint was the occurrence of in-hospital HF. The participants were divided into two groups according to plasma D-dimer levels and further compared baseline D-dimer levels between male and female. Logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the relationship of D-dimer and in-hospital HF. Results A total of 778 patients were recruited in the study, of which 539 (69.3%) patients had normal D-dimer levels (≤0.5 mg/L) while 239 (30.7%) had increased D-dimer levels (>0.5 mg/L). The female patients have higher D-dimer levels and higher incident rate of in-hospital HF than that in male patients (p < 0.001). The multivariate logistic regression model revealed that D-dimer was an independent predictor for in-hospital HF in overall population (adjusted odds ratio [OR]: 1.197, 95% CI: 1.003-1.429, and p = 0.046) and female patients (adjusted OR: 1.429, 95% CI: 1.083-1.885, and p = 0.012). Conclusion Increased plasma D-dimer levels were an independent risk factor for incidence of in-hospital HF in STEMI patients who underwent pPCI, especially in female patients, which provides guidance for clinicians in identifying patients at high risk of developing HF and lowering their risk.

The association of megalin and cubilin genetic variants with serum levels of 25-hydroxvitamin D and the incidence of acute coronary syndrome in Egyptians: A case control study

Megalin and cubilin are two receptors that mediate endocytosis of 25-hydroxyvitamin D (25(OH)D) for its final activation by hydroxylation. The aim of the present study was to evaluate the association of polymorphisms in megalin (rs2075252 and rs4668123) and cubilin (rs1801222 and rs12766939) with the circulating serum levels of 25(OH)D and with the early incidence of acute coronary syndrome (ACS) in Egyptians. The study included 328 subjects; 185 ACS patients aged between 27 and 60 years, and 143 healthy age-matched controls. Genotyping of cubilin rs12766939 Single Nucleotide Polymorphism (SNP) was performed using Real-Time Polymerase Chain Reaction (qPCR) and for megalin rs4668123 and rs2075252 and cubilin rs1801222 by Polymerase Chain Reaction- Restriction Fragment Length Polymorphism (PCR-RFLP). 25(OH)D levels were measured by Ultra Performance Liquid Chromatography- Tandem Mass Spectroscopy (UPLC-MS/MS). Results showed that vitamin D deficiency was highly linked to ACS incidence (P < 0.0001). The megalin rs4668123 CC, cubilin rs1801222 GG and cubilin rs12766939 GG + GA genotypes are associated with a higher ACS incidence and can be considered risk factors, according to Chi-squared test (P = 0.0003, 0.0442, 0.013 respectively). Conversely,the megalin rs2075252 SNP was not associated with increased ACS incidence. However, after performing multiple logistic regression analysis, only the megalin rs4668123 SNP was considered an independent ACS risk factor. Furthermore,the megalin rs4668123 CC genotype was associated with lower 25(OH)D levels (P = 0.0018). In conclusion, megalin rs4668123 (CC) was linked to lower 25(OH)D levels and can be considered an independent risk factor for incidence of ACS.

Exploring Risk Factors with Ventilator Associated Pneumonia among Infants in Intensive Care Units

AbstractBackground: Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring more than 48 hours after child is intubated and ventilated mechanically; VAP is the second most common hospital-acquired infection in pediatric Intensive Care Units, which linked to increased morbidity, mortality, lengths of stay in the hospital and intensive care unit with high costs.Aim of Study: The current study aimed to explore the risk factors of VAP among infants in Intensive Care Units.Subjects and Methods: A descriptive exploratory design was used to achieve the current study.Setting: The current study conducted at Pediatric Intensive Care Units at Pediatric University Hospital and Specialized Pediatric Hospital which affiliated to Cairo University Hos-pitals.Sample: A convenience sample of 54 mechanically ven-tilated infants for more than 48 hours enrolled in the study.Tools: The required data was collected by using risk factors assessment sheet and standardized observational checklists which consist of three parts: General infection control measures, nasogastric tube feeding and endotracheal tube suctioning.Results: The current study results revealed that, more than half of infants were less than 6 months of age, nearly two-thirds are males, and near to three quarters of infants developed VAP. Prior antibiotic use, sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs, coma, inadequate general infection control measures, inadequate endotracheal tube suctioning technique, supine position, inadequate nasogastric tube feeding technique, presence of nasogastric tube and oral route of endotracheal tube were statistically significant risk factors associated with VAP. More than half of VAP infants died during period of hospitalization.Conclusion: Prior antibiotic use was the only independent risk factor for incidence of VAP; and sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs were the major risk factors of VAP among infants in pediatric Intensive Care Units.Recommendations: Inservice training program should be conducted for pediatric intensive care nurses about prevention of VAP among infants. Also, similar studies should be con-ducted on large sample and different settings.

Risk factors for paclitaxel-induced peripheral neuropathy in patients with breast cancer

BackgroundPaclitaxel induced peripheral neuropathy (PIPN) is a major debilitating side effect of paclitaxel in patients with breast cancer with no fully known mechanisms. The aim of the study was to find out the possible risk factors for PIPN.MethodsEligible patients with node positive breast cancer undergoing chemotherapy with paclitaxel were assessed. They belonged to an initial randomized controlled trial in which the effectiveness of omega-3 fatty acids in preventing and reducing severity of PIPN was evaluated (protocol ID: NCT01049295). Reduced total neuropathy score (r-TNS) was used for measuring PIPN. All analyses were performed adjusting for intervention effect. The association between age, BMI, BSA, pathological grade, molecular biomarkers and PIPN was evaluated.ResultsFifty-seven patients with breast cancer were investigated. Age was significantly associated with risk of PIPN (RR:1.50, P value = .024). Body mass index and BSA had significant association with severity of PIPN (B:1.28, P = .025; and B: 3.88, P = .010 respectively). Also, BSA showed a significant association with the risk of PIPN (RR: 2.28, P = .035; B: 3.88, P = .035). Incidence and severity of PIPN were much more pronounced in progesterone receptor positive (PR+) patients (RR:1.88, P = .015 and B:1.54, P = .012). Multivariate analysis showed that age and the status of PR+ were independent risk factor for incidence and the status of PR+ was the only independent risk factor for severity of PIPN.ConclusionAge, BSA and the status of PR+, should be considered as the risk factors for PIPN before commencement of chemotherapy with paclitaxel in patients with breast cancer. Older patients, those with greater BSA and PR+ patients may need closer follow up and more medical attention due to greater incidence and severity of PIPN.

Risk of anticoagulation therapy in surgical intensive care unit patients predicted by thromboelastograph

To explore the correlation between thromboelastography (TEG) parameters and the risk of venous thromboembolism (VTE) and bleeding in patients receiving anticoagulant therapy in surgical intensive care unit (SICU). 205 patients received low molecular weight heparin (LMWH) anticoagulant therapy admitted to SICU of Tianjin Hospital from December 2016 to December 2017 were consecutively enrolled. TEG detection was performed in all patients at 1 day after anticoagulation therapy, and coagulation reaction time (R value), blood clot generation time (K value), blood clot generation rate (α angle) and maximum width value (MA value) were recorded. At the same time, the traditional coagulation function test was carried out, and prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimer levels were also recorded. The incidence of deep venous thrombosis (DVT), pulmonary embolism (PE) and bleeding during hospitalization were observed. Multivariate Logistic regression analysis was used to analyze the risk factors for VTE and bleeding in patients receiving anticoagulant therapy. Of 205 patients, during the anticoagulant treatment, 14 patients developed DVT, and 4 patients with PE (2 of them were combined with DVT) with an incidence of 7.8% (16/205). There were 2 patients suffering from cerebral hemorrhage, 2 patients with gastric bleeding, and 1 patient with intra-tracheal hemorrhage with an incidence of 2.4% (5/205). Compared with the patients without VTE or bleeding, the R value of TEG in patients with VTE was significantly lowered (minutes: 4.6±2.2 vs. 7.4±1.4, P < 0.01), which was significantly increased in patients with hemorrhagic complications (minutes: 12.1±1.1 vs. 7.4±1.4, P < 0.01). There was no significant difference in the K value, α angle, MA value of TEG, or PT, APTT, D-dimer between the patients with and without VTE or bleeding. Multivariate Logistic regression analysis revealed that the R value of TEG was independent risk factor for incidence of VTE and hemorrhagic complication in SICU patients who receiving anticoagulation therapy [VTE: β = 0.386, odds ratio (OR) = 1.096, 95% confidence interval (95%CI) = 1.021-2.361, P = 0.006; hemorrhagic complication: β = -1.213, OR = 1.051, 95%CI = 1.017-3.458, P = 0.045]. The R value of TEG is associated with the occurrence of VTE and hemorrhagic complications in patients receiving anticoagulant therapy in SICU.

Analysis of Status and Risk Factors for Macrovascular Complications in Type 2 Diabetes Mellitus

The status and risk factors for atherosclerosis (AS) were investigated and the sensitivity and accuracy of existing examine methods of AS were evaluated in patients with diabetes mellitus(T2DM). Ninety nine patients who diagnosed with the WHO 1999 criteria for T2DM were enrolled in this study, which were divided into atherosclerotic group(group A) and non-atherosclerosis group(group B). The clinical characteristics, including fasting plasma glucose(FPG), postprandial plasma glucose(PPG), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), glycosylated hemoglobin A1c(HbAlc) and early examination methods of AS, including carotid intima-media thickness(CIMT), ankle brachial index(ABI) and pulse wave velocity (PWV) were recorded. The t-test, χ2 test or linear regression model were used for retrospective analyses then showed that the prevalence rate of carotid plaque was 29.3%( 29/99), there is no difference between the distribution of age and gender in the group with or without plaque (χ2 = 0.044, P>0.05; t = 0.850, P>0.05). It also demonstrated that systolic blood pressure(SBP), diastolic blood pressure (DBP), LDL-C, CIMT, history of smoke were significantly higher in plaques group than that of without plaques ( P＜0.05). Logistic analysis showed that LDL-C and CIMT were independent risk factors for incidence of cervical atheromatous plaques in type 2 diabetic patients (P＜0.05). The risk of AS has increased by 1.7 times by every unit of LDL-C, as well as increased by 13.8 times by every unit of CIMT. CIMT and PWV, but not ABI, are valuable for AS diagnosing. According to sensitivity and specificity, the best diagnostic value for CIMT is 0.9mm and for PWV is 1560.As a result, LDL-C and CIMT are independent risk factors for AS. Early intervention and controlling of risks factors will have clinical value for prevention and treatment of macrovascular diseases in T2DM. The corresponding cut-off points 1560 of PWV is better than 1400 for diagnosis of AS in this hospital.

Incidence and risk factors of deep venous thrombosis of lower extremity in patients with pelvic or ac-etabular fracture

Objective To investigate the incidence and risk factors of deep venous thrombosis (DVT) of lower extremity in patients with pelvic or acetabular fracture. Methods From August 2015 to December 2016, 110 patients with pelvic or acetabular fracture were treated in our hospital. They were 76 males and 34 females with a mean age of 44.2 years (range, from 16 to 76 years). There were 48 pelvic fractures, including 12 anterior and posterior compression, 16 lateral compression and 20 vertical shear ones by the Young-Burgess classification; there were 62 acetabular fractures, including 26 simple and 36 complex ones by the Letournel-Judet classification. The incidence of lower extremity DVT was detected preoperatively and postoperatively using ultrasound detection. The factors associated with the incidence of DVT were analyzed statistically. The risk factors were screened by single factor logistic regression analysis; the major independent risk factors were determined by multi-factor logistic regression analysis. P< 0.05 was considered as statisti-cally significant. Results DVT occurred in 32 patients (29.09%), including 21 cases (19.09%) of proximal thrombosis and 3 cases of combined pulmonary embolism. The incidence of DVT in patients with acetabular fracture was significantly higher than in those with pelvic fracture (P 60 years, combined injuries and interval of >2 weeks from injury to surgery were independent risk factors for incidence of DVT (P< 0.05). Conclusions The risk of lower extremity DVT is high in patients with pelvic or acetabular fracture in spite of active prophylaxis, especially the risk of proximal thrombosis. Age of >60 years, combined injuries and interval of >2 weeks from injury to surgery may be the independent risk factors for incidence of DVT. Key words: Pelvis; Acetabulum; Fractures, bone; Venous thrombosis; Risk factors

Correlation of Meniscal and Articular Cartilage Injuries in Children and Adolescents With Timing of Anterior Cruciate Ligament Reconstruction

Background: In pediatric patients, anterior cruciate ligament (ACL) reconstruction is controversial; however, delaying surgery until skeletal maturity is complete may increase the risk of secondary meniscal and articular cartilage injury. Purpose: To assess the risk of meniscal and chondral injuries with delay of ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Records were reviewed in patients younger than 17 years (median age, 14 years) who had ACL reconstruction. Patients were consecutively enrolled and assigned to 1 of 3 surgical groups based on timing of surgery: acute (<6 weeks after surgery), subacute (6-12 weeks), or chronic (>3 months). The type and grade of meniscal injuries was documented according to the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine (ISAKOS) meniscal classification criteria. International Cartilage Repair Society (ICRS) criteria were used to document location and grade of chondral injuries. Associations between patient characteristics and meniscal injury were tested using rank sum and chi-square tests. Regression analyses were conducted to model incidence and severity of lateral and medial meniscal tears. There were 130 patients who had 135 ACL reconstructions between the years of 2000 and 2012. Results: Sixty-two ACL injuries were treated acutely, 37 were subacute, and 36 were chronic. Meniscal injuries (n = 112) included 70 lateral and 42 medial tears. Time to surgery had bivariate association with lateral and medial meniscal tears (P = .016 and .007, respectively). Independent risk factors for incidence of lateral meniscal tears were younger age (P = .028) and return to sports activities before surgery (P = .007). Patients with 1 episode of instability had 3-fold higher odds of higher grade lateral meniscal tear (95% CI, 1.30-7.60). Compared with acute reconstruction, subacute and chronic reconstruction patients had 1.45 and 2.82 times higher odds, respectively, of lateral meniscal tear severity (P = .12). Independent risk factors for incidence of medial meniscal tears were female sex (P = .03), older age (P = .01), and any episode of instability (P = .01). Adjusted odds ratio for medial meniscal tear was 4.7 for an instability episode (vs no episode; P = .01). Adjusted odds ratio for increased severity of medial meniscal tears included any instability episode, 5.6 (P < .01); playing sports before reconstruction, 15.2 (P < .01); and time to surgery greater than 3 months, 4.3 (P = .046). Seventeen patients had 23 chondral injuries. The risk factors for chondral injury included increased time to surgery (P = .005) and any instability episode (P = .001). For increased grade of chondral injury, risk factors were time to surgery (P ≤ .001) and any instability episode (P = .003). Conclusion: Delayed ACL reconstruction increased the risks of secondary meniscal and chondral injuries in this population of pediatric patients.

OP0069 Concomitant Methotrexate Affect the Incidence of Large Joint Replacement Surgery in the Rheumatoid Arthritis Patients Treated with Etanercept

BackgroundEULAR recommends that all biologics DMARDs should be used preferentially in combination with methotrexate (MTX) in rheumatoid arthritis (RA) patients. The TEMPO study and the JESMR study showed that combination...

GW24-e2455 Analysis of risk factors for patients with essential hypertension combining coronary heart disease

Objectives1) To investigate the characteristics of blood pressure and its relationship with the incidence of cardiovascular event in patients with essential hypertension (EH) combining coronary heart disease (CHD);2) To identify...

SAT0013 Risk Factors for Progression of Large Joint Destruction in Patients with Rheumatoid Arthritis Based on Incident Rate of Joint Surgery During Treatment with Biologics

BackgroundEvolving pharmacologic treatment in rheumatoid arthritis (RA), including methotrexate (MTX) and biologics, has helped to prevent progression of joint destruction. It is still unclear whether current treatment strategies prevent progression...

Uric acid is an independent risk factor for carotid atherosclerosis in a Japanese elderly population without metabolic syndrome

BackgroundCarotid intima-media thickness (IMT) is an useful surrogate marker of cardiovascular disease. Associations between uric acid (UA), metabolic syndrome (MetS) and carotid IMT have been reported, but findings regarding the relationship have been inconsistent.MethodsA total of 1,579 Japanese elderly subjects aged ≥65 years {663 men aged, 78 ± 8 (mean ± standard deviation) years and 916 women aged 79 ± 8 years} were divided into 4 groups according to UA quartiles. We first investigated the association between UA concentrations and confounding factors including MetS; then, we assessed whether there is an independent association of UA with carotid IMT and atherosclerosis in participants subdivided according to gender and MetS status.ResultsCarotid IMT was significantly increased according to the quartiles of UA in both genders without MetS and women with MetS. Multivariate logistic regression analysis showed that odds ratio (OR) {95% confidence interval (CI)} in men for carotid atherosclerosis was significantly increased in the third (OR, 1.75; 95% CI, 1.02-3.02), and fourth quartiles (OR, 2.01; 95% CI, 1.12-3.60) of UA compared with that in the first quartile of UA, and the OR in women was significantly increased in the fourth quartile (OR, 2.10; 95% CI, 1.30-3.39). Similarly, the ORs were significantly associated with increasing quartiles of UA in both genders without MetS, but not necessarily increased in those with MetS.ConclusionsUA was found to be an independent risk factor for incidence of carotid atherosclerosis in both genders without MetS.

Is opium addiction a risk factor for deep vein thrombosis? A case–control study

The objective of the present study was to investigate the association between opioid addiction and deep vein thrombosis (DVT) and whether opioid addiction is a risk factor of DVT. This case-control study was conducted in Kerman, Iran in 2008. The cases were selected among the patients hospitalized because of DVT. The controls were recruited from the same hospital from internal wards. Opioid addiction was investigated by physician's interview based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Logistic regression modeling was carried out for statistical analysis. The crude odds ratio (OR) of opioid addiction for DVT was 4.25 (95% confidence interval = 2.6-6.9). However, multivariate logistic regression analysis revealed that opioid addiction was not an independent risk factor for DVT, OR 0.56 (0.1-3). The method of opioid usage--oral or inhaled and injected--OR 6.3 (1.41-28.3) and previous surgery in the last 3 months before the study, OR 3.1 (1.36-7), were significant independent risk factors for incidence of DVT. Opioid addiction per se was not a risk factor for DVT, whereas the method of its use especially injection was found to be independent risk factor for DVT. Our results suggested the prophylactic treatment of anticoagulant for intravenous drug abuser is considerable.

Carotid Intima-Media Thickness, Systemic Inflammation, and Incidence of Heart Failure Hospitalizations

This study explored the relationships between carotid intima-media thickness (IMT), plasma levels of C-reactive protein (CRP), and incidence of heart failure hospitalizations. Men and women from the general population (n=4691), without history of myocardial infarction or stroke, were examined. Incidence of hospitalizations attributable to heart failure was studied over a mean follow-up of 13 years. A total of 75 subjects were hospitalized with a primary diagnosis of heart failure. Adjusted for risk factors, the hazards ratios (95% CI) were 1.00, 0.98 (0.36 to 2.7), 1.9 (0.80 to 4.6), and 2.7 (1.1 to 6.2), respectively, for the 1st, 2nd, 3rd, and 4th quartiles of IMT (P for trend=0.003). The HR associated with CRP levels >or=3 mg/L (versus <1 mg/L) was 2.0 (95% CI: 1.06 to 3.9) after adjustments for risk factors. There was a significant interaction between IMT and CRP on heart failure incidence (P=0.028). Subjects with CRP >or=3 mg/L and IMT in the 4th quartile had an adjusted HR of 3.7 (1.9 to 7.1) compared to those with CRP <3 mg/L and IMT in quartile 1 to 3. High IMT and high CRP are both independent risk factors for incidence of heart failure requiring hospitalization. The joint exposure to both risk factors substantially increases the risk.

Association of serum uric acid and lipid with carotid atherosclerosis in hypertension patients

Objective The aim of the present study was to determine the associations between uric acid,lipid and carotid atherosclerosis in the hypertension patients.Methods Eighty participants with essential hypertension were enrolled to undergo by uhrasonography to calculate intima-media thickness (IMT) and carotid artery plaques,each participants were detected UA,serum lipids.Results Multiple regression analysis revealed the UA,TG,LDLC was significantly independently associated with IMT (P＜0.01) in non-plaques participants.UA,LDL-C in the group of carotid atherosclerotic were significantly higer than the group of the normal I MT.Condusion UA,TG,LDL-C were found to be an independent risk factor for incidence of carotid atherosclerosis. Key words: Hypertension; Atherosclerosis; Uric acid ; Carotid artery ; Dyslipidemias

Six‐year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African‐Americans

To report the 6-year incidence of, and risk factors for, lower extremity arterial disease (LEAD) in African-Americans with Type 1 diabetes mellitus. African-Americans (n = 483) with Type 1 diabetes were re-examined 6 years after an original visit. At both visits, patients underwent a structured clinical interview which included history of amputation or leg angioplasty because of poor circulation in lower extremities; ocular examination; masked grading of seven stereoscopic fundus photographs; and blood pressure measurements. Biological tests included blood and urine assays. Of the 483 patients who had a 6-year follow-up, 457 had no LEAD at the baseline examination. Of these 457 patients, 26 (5.7%) developed LEAD over the 6-year follow-up. Six-year incidence of LEAD was significantly associated with baseline older age (P = 0.0002) and longer duration of diabetes (P < 0.0001). Multiple logistic regression analysis showed that baseline longer duration of diabetes, male gender, higher systolic blood pressure, retinopathy severity, and presence of foot ulcers were significant and independent risk factors for incidence of LEAD. Blood pressure control and prevention and treatment of foot ulcers may be helpful in reducing the morbidity associated with LEAD in African-Americans with Type 1 diabetes.