Journal of Internal Medicine最新文献

{"title":"Depression and risk of stroke and mortality after percutaneous coronary intervention: A nationwide population study","authors":"Dae Young Cheon,&nbsp;Yong-Moon Park,&nbsp;Myung Soo Park,&nbsp;Jae Hyuk Choi,&nbsp;Mi-Sun Oh,&nbsp;Seongwoo Han,&nbsp;Kyung-Ho Yu,&nbsp;Byung-Chul Lee,&nbsp;Kyungdo Han,&nbsp;Minwoo Lee","doi":"10.1111/joim.20018","DOIUrl":"10.1111/joim.20018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited evidence exists on the role of depression in the risk of developing stroke and other cardiovascular outcomes in patients who have undergone percutaneous coronary interventions (PCI). We investigated this relationship with data from the Korean National Health Insurance Service database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our nationwide retrospective cohort study included 164,198 patients who had undergone PCI between 2010 and 2017. Depression was defined with the ICD-10 codes recorded prior to the PCI. The primary outcome was a new-onset stroke following the PCI. Secondary outcomes included PCI with myocardial infarction (MI), revascularization (PCI or coronary artery bypass grafting), and all-cause mortality. A multivariable Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI), adjusting for potential confounders, including sociodemographic and lifestyle factors, comorbidities, and MI at the index PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 5.0 years, acute stroke occurred in 5.7% of patients with pre-existing depression (17.4% of the study population), compared to 3.5% of those without depression. Depression was associated with a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20–1.35). Additionally, depression was linked with a 25% elevated risk of all-cause death (aHR 1.25, 95% CI, 1.21–1.29) and an 8% increased risk of revascularization (aHR 1.08, 95% CI 1.04–1.11). The associations with the risk of stroke and all-cause mortality were stronger in patients under 65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that pre-existing depression may increase the risk of stroke and all-cause mortality following PCI, particularly in patients under 65 years. Additionally, depression was significantly associated with an increased need for revascularization. This underscores the potential benefits of managing depression to reduce stroke risk and overall cardiovascular outcomes following PCI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 6","pages":"468-480"},"PeriodicalIF":9.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium and frailty in older adults: Clinical overlap and biological underpinnings","authors":"Giuseppe Bellelli,&nbsp;Federico Triolo,&nbsp;Maria Cristina Ferrara,&nbsp;Stacie G. Deiner,&nbsp;Alessandro Morandi,&nbsp;Matteo Cesari,&nbsp;Daniel Davis,&nbsp;Alessandra Marengoni,&nbsp;Marco Inzitari,&nbsp;Leiv Otto Watne,&nbsp;Kenneth Rockwood,&nbsp;Davide Liborio Vetrano","doi":"10.1111/joim.20014","DOIUrl":"10.1111/joim.20014","url":null,"abstract":"<p>Frailty and delirium are two common geriatric syndromes sharing several clinical characteristics, risk factors, and negative outcomes. Understanding their interdependency is crucial to identify shared mechanisms and implement initiatives to reduce the associated burden. This literature review summarizes scientific evidence on the complex interplay between frailty and delirium; clinical, epidemiological, and pathophysiological commonalities; and current knowledge gaps. We conducted a PubMed systematic search in June 2023, which yielded 118 eligible articles out of 991. The synthesis of the results—carried out by content experts—highlights overlapping risk factors, clinical phenotypes, and outcomes and explores the influence of one syndrome on the onset of the other. Common pathophysiological mechanisms identified include inflammation, neurodegeneration, metabolic insufficiency, and vascular burden. The review suggests that frailty is a risk factor for delirium, with some support for delirium associated with accelerated frailty. The proposed unifying framework supports the integration and measurement of both constructs in research and clinical practice, identifying the geroscience approach as a potential avenue to develop strategies for both conditions. In conclusion, we suggest that frailty and delirium might be alternative—sometimes coexisting—manifestations of accelerated biological aging. Clinically, the concepts addressed in this review can help approach older adults with either frailty or delirium from a different perspective. From a research standpoint, longitudinal studies are needed to explore the hypothesis that specific pathways within the biology of aging may underlie the clinical manifestations of frailty and delirium. Such research will pave the way for future understanding of other geriatric syndromes as well.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"382-398"},"PeriodicalIF":9.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Clinical predictors of donor antibody titre and correlation with recipient antibody response in a COVID-19 convalescent plasma clinical trial”","authors":"","doi":"10.1111/joim.20011","DOIUrl":"10.1111/joim.20011","url":null,"abstract":"<p>Madariaga MLL, Guthmiller JJ, Schrantz S, Jansen MO, Christenson C, Kumar M, Prochaska M, Wool G, Durkin-Celauro A, Oh WH, Trockman L, Vigneswaran J, Keskey R, Shaw DG, Dugan H, Zheng N-Y, Cobb M, Utset H, Wang J, Stovicek O, Bethel C, Matushek S, Giurcanu M, Beavis KG, di Sabato D, Meltzer D, Ferguson MK, Kress JP, Shanmugarajah K, Matthews JB, Fung JF, Wilson PC, Alverdy JC, Donington JS (University of Chicago, Chicago, USA). Clinical predictors of donor antibody titre and correlation with recipient antibody response in a COVID-19 convalescent plasma clinical trial (Original). <i>J Intern Med</i>., 2021;289:559–573. https://doi.org/10.1111/joim.13185</p><p>In the author byline, one of the author names was incorrect and should have been corrected from Christensen C. to Christenson C.</p><p>The online version of the article has been updated.</p><p>We apologize for this error.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"456"},"PeriodicalIF":9.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alpha-1 antitrypsin deficiency associated with increased risks of skin cancer, leukemia, and hepatic cancer: A nationwide cohort study","authors":"Nanna J. Korsbæk,&nbsp;Eskild M. Landt,&nbsp;Sarah C. W. Marott,&nbsp;Børge G. Nordestgaard,&nbsp;Gabrielle R. Vinding,&nbsp;Gregor B. E. Jemec,&nbsp;Morten Dahl","doi":"10.1111/joim.20016","DOIUrl":"10.1111/joim.20016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>α₁-Antitrypsin deficiency is characterized by elevated elastase activity and excessive elastin degradation, which may impact cancer development and progression. We tested the hypothesis that individuals with α₁-antitrypsin deficiency have increased susceptibility to cancer in the Danish population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a nationwide nested study, we identified 2702 individuals with α₁-antitrypsin deficiency and 26,750 control subjects without α₁-antitrypsin deficiency matched on age, sex, and municipality. We recorded admissions due to cancer as outcomes during a median follow-up of 62 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals with α₁-antitrypsin deficiency versus control subjects had an increased hazard of skin cancer (2.18, 95%CI: 1.81–2.63), leukemia (1.76, 1.12–2.79), liver cancer (3.91, 2.23–6.85), and cancer overall (1.25, 1.13–1.38). Corresponding hazard ratios when the entire Danish population was used as control group were 3.02 (2.55–3.58), 1.83 (1.19–2.81), 4.46 (2.74–7.28), and 1.45 (1.31–1.59). When the analysis was stratified according to comorbidities, the hazard for skin cancer was higher in those with chronic obstructive pulmonary disease (COPD) (3.59, 2.60–4.95) and skin disease (2.93, 2.19–3.92) but remained elevated in those without any of these diseases. Hazards for skin cancer in individuals with α₁-antitrypsin deficiency were similar when stratified by liver cirrhosis and ischemic heart disease (<i>p</i>s for interaction: ≥0.76). Hazards for liver cancer in individuals with α₁-antitrypsin deficiency versus control subjects were similar when stratified according to liver cirrhosis, COPD, skin disease, and ischemic heart disease (<i>p</i>s for interaction: ≥0.13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Individuals with α₁-antitrypsin deficiency have increased risks of skin cancer, leukemia, and liver cancer in the Danish population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 6","pages":"460-467"},"PeriodicalIF":9.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam: Anders Ekbom (1947‒2024)","authors":"","doi":"10.1111/joim.20013","DOIUrl":"10.1111/joim.20013","url":null,"abstract":"&lt;p&gt;&lt;/p&gt;&lt;p&gt;On July 29, our long-time friend, colleague and Editor of the &lt;i&gt;Journal of Internal Medicine&lt;/i&gt; (JIM) passed away at the age of 76 years, following a long struggle with cancer. Anders Ekbom was a committed and highly appreciated member of the JIM team for more than 19 years and continued his important work until his very last days. Although not unexpected, our loss of the joy of having him among us has left us with a feeling of profound grief, but the abundance of positive and inspiring memories collected over all the years will help us to carry on.&lt;/p&gt;&lt;p&gt;When first meeting Anders in person, it was easy to mistake him for a retired colonel of the British Army, and this first impression was strengthened by his keen interest in (particularly military) history. In fact, following secondary school, Anders had been trained as an officer in the Royal Swedish Engineering Corps. With his renaissance persona, he then studied various topics, including theology, law and economics at the University of Lund, before almost completing an education to work as a civil engineer. Fortunately, for our field of science, he switched to medical school at Lund and later Uppsala, receiving his MD title in 1978. He then embarked on a very successful career as a gastrointestinal surgeon, obtaining his board certification in 1984. Like several Swedish surgeons wanting to deepen their academic insights, he became interested in epidemiological research, and he defended his PhD thesis in 1990. In 1997, he moved to the Karolinska Institutet, where he rapidly established an excellent research group, being appointed as a full professor of epidemiology in 1999. Among his most important work during his long and highly productive career are numerous studies on colorectal cancer in inflammatory bowel disease, stressing the role of hereditary factors, and the influence of inflammation in carcinogenesis, including its role in the development of lymphoma in diseases such as rheumatoid arthritis. Much of this research has been translated to important clinical guidelines. From early on, he had a vast international network and served as adjunct professor of epidemiology at Harvard. His role in promoting the training of physician-scientists by creating and developing clinical research infrastructures in collaborations between university hospitals and medical faculties cannot be overestimated. He has fostered many senior clinical researchers, not least by keeping a positive attitude and stressing the concept that science is serious business but also must be a joyful experience.&lt;/p&gt;&lt;p&gt;Anders’ unique personality, his ability to continuously question concepts and ideas in a critical way, and his (somewhat unusual) capability to distinguish between opinions and their proposers—often by application of his great sense of humor—contributed greatly to his success. His abilities as a problem-solver and a promoter of teamwork have been of great use both to the Karolinska Institutet and the","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"457-458"},"PeriodicalIF":9.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting factor XIIa for therapeutic interference with hereditary angioedema","authors":"Danny M. Cohn,&nbsp;Thomas Renné","doi":"10.1111/joim.20008","DOIUrl":"https://doi.org/10.1111/joim.20008","url":null,"abstract":"<p>Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent attacks of swelling. Local vasodilation and vascular leakage are stimulated by the vasoactive peptide bradykinin, which is excessively produced due to dysregulation of the activated factor XII (FXIIa)-driven kallikrein–kinin system. There is a need for novel treatments for HAE that provide greater efficacy, improved quality of life, minimal adverse effects, and reduced treatment burden over current first-line therapies. FXIIa is emerging as an attractive therapeutic target for interference with HAE attacks. In this review, we draw on preclinical, experimental animal, and in vitro studies, providing an overview on targeting FXIIa as the basis for pharmacologic interference in HAE. We highlight that there is a range of FXIIa inhibitors in development for different therapeutic areas. Of these, garadacimab, an FXIIa-targeted inhibitory monoclonal antibody, is the most advanced and has shown potential as a novel long-term prophylactic treatment for patients with HAE in clinical trials. The evidence from these trials is summarized and discussed, and we propose areas for future research where targeting FXIIa may have therapeutic potential beyond HAE.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 4","pages":"311-326"},"PeriodicalIF":9.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tadalafil use is associated with a lower incidence of Type 2 diabetes in men with benign prostatic hyperplasia: A population-based cohort study","authors":"Atsushi Takayama,&nbsp;Satomi Yoshida,&nbsp;Koji Kawakami","doi":"10.1111/joim.20012","DOIUrl":"10.1111/joim.20012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tadalafil, commonly prescribed for benign prostatic hyperplasia (BPH), may benefit patients with Type 2 diabetes mellitus (T2DM) for glycemic markers and complications. However, the association between the long-term use of tadalafil and the incidence of T2DM has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We emulated a target trial of tadalafil use (5 mg/day) and the risk of T2DM using a population-based claims database in Japan. Patients who initiated tadalafil or alpha-blockers for BPH and had no history of diabetes diagnosis, no dispensing of glucose-lowering drugs, and no history of hemoglobin A1c levels of ≥6.5% (47–48 mmol/mol) were included. The primary outcome was the incidence of T2DM. Pooled logistic regression was used to estimate adjusted risk ratios (RRs) and 5-year cumulative incidence differences (CIDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 5180 participants initiated tadalafil treatment and were compared with 20,049 patients who initiated alpha-blockers. The median follow-up time for each arm was 27.2 months (interquartile range [IQR], 12.0–47.9) in tadalafil users and 31.3 months (IQR, 13.7–57.2) in alpha-blocker users. The incidence rates of T2DM in tadalafil and alpha-blocker users were 5.4 (95% confidence interval [CI], 4.0–7.2) and 8.8 (95% CI, 7.8–9.8) per 1000-person years, respectively. Initiation of tadalafil was associated with a reduced risk of T2DM (RR, 0.47; 95% CI, 0.39–0.62; 5-year CID, −0.031; 95% CI, −0.040 to −0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence of T2DM was lower in men with BPH treated with tadalafil than in those treated with alpha-blockers. Thus, tadalafil may be more beneficial than alpha-blockers in preventing T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"422-434"},"PeriodicalIF":9.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: Adherence to guideline-recommended care of late-onset hypertension in females versus males: A population-based cohort study","authors":"Ann Bugeja,&nbsp;Gregory L. Hundemer,&nbsp;Daniel I. McIsaac","doi":"10.1111/joim.20010","DOIUrl":"10.1111/joim.20010","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We thank Dr. Huang et al. for their thoughtful response to our published manuscript [&lt;span&gt;1, 2&lt;/span&gt;]. Their first concern addresses our interpretation of the adjusted hazard ratio (aHR 0.98 [95% CI 0.96, 0.99]) for antihypertensive medication prescription by sex. Although statistically significant, its clinical significance remains uncertain, though we acknowledge its relevance at the population level in the discussion section of our manuscript. To explore potential effect modifiers, we tested a priori interactions between sex and several plausible variables—age, diabetes status, era of hypertension diagnosis, and preexisting cardiovascular disease—by incorporating these multiplicative terms into our model. We then reported aHRs of each stratum from stratified analyses for those variables that were statistically significant on the multiplicative scale. However, we did not report measures of relative excess due to interaction [&lt;span&gt;3&lt;/span&gt;]. It is certainly possible that other covariates may have been effect modifiers of the association between sex and prescription of antihypertensive medication.&lt;/p&gt;&lt;p&gt;Second, misclassification bias is a recognized issue in observational studies utilizing administrative data. Nonetheless, the case definition for hypertension used in our study has been validated, showing a sensitivity of 75%, specificity of 94%, positive predictive value of 81%, and negative predictive value of 92%, as detailed in our methods section [&lt;span&gt;4&lt;/span&gt;]. As the authors correctly note, administrative data do not capture nuances related to gender and patient preferences that can influence hypertension treatment, which may introduce residual confounding [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Third, although the aHR for the prescription of guideline-recommended antihypertensive medication is statistically significant (aHR 0.995, 95% CI [0.994, 0.997]), determining its clinical significance is challenging. We acknowledge that this effect may be clinically relevant at the population level, as discussed in our manuscript. Evaluating antihypertensive medication prescriptions over time, alongside data on actual blood pressure management and drug intolerance, would offer additional insights beyond our current findings.&lt;/p&gt;&lt;p&gt;Lastly, we aimed to address the observation that better cardiovascular outcomes in females compared to males do not appear to be linked to the completion of hypertension-related investigations or the prescription of antihypertensive medication [&lt;span&gt;6&lt;/span&gt;]. We proposed that females might benefit more from antihypertensive treatment compared to males, but we recognize that we cannot draw definitive conclusions due to limitations such as insufficient data on treatment adherence, gender-specific issues, and potential residual confounding. More detailed data would enhance our study and support the development of targeted implementation strategies for older populations.&lt;/p&gt;&lt;p&gt;The authors declare no conflicts of i","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"454-455"},"PeriodicalIF":9.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes risk reduction diet and risk of liver cancer and chronic liver disease mortality: A prospective cohort study","authors":"Yun Chen,&nbsp;Longgang Zhao,&nbsp;Su Yon Jung,&nbsp;Margaret S. Pichardo,&nbsp;Melissa Lopez-Pentecost,&nbsp;Thomas E. Rohan,&nbsp;Nazmus Saquib,&nbsp;Yangbo Sun,&nbsp;Fred K. Tabung,&nbsp;Tongzhang Zheng,&nbsp;Jean Wactawski-Wende,&nbsp;JoAnn E. Manson,&nbsp;Marian L Neuhouser,&nbsp;Xuehong Zhang","doi":"10.1111/joim.20007","DOIUrl":"10.1111/joim.20007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to prospectively evaluate the association between a diabetes risk reduction diet (DRRD) score and the risk of liver cancer development and chronic liver disease-specific mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 98,786 postmenopausal women from the Women's Health Initiative-Observational Study and the usual diet arm of the Diet Modification trial. The DRRD score was derived from eight factors: high intakes of dietary fiber, coffee, nuts, polyunsaturated fatty acids, low intakes of red and processed meat, foods with high glycemic index, sugar-sweetened beverages (SSBs), and <i>trans</i> fat based on a validated Food-Frequency Questionnaire administered at baseline (1993–1998). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for liver cancer incidence and chronic liver disease mortality were estimated using Cox proportional hazards regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and conclusion</h3>\u0000 \u0000 <p>After a median follow-up of 22.0 years, 216 incident liver cancer cases and 153 chronic liver disease deaths were confirmed. A higher DRRD score was significantly associated with a reduced risk of developing liver cancer (HR_{Tertile 3 vs. Tertile 1} = 0.69; 95% CI: 0.49–0.97; <i>P</i>_trend = 0.03) and chronic liver disease mortality (HR_{T3 vs. T1} = 0.54; 95% CI: 0.35–0.82; <i>P</i>_trend = 0.003). We further found inverse associations with dietary fiber and coffee, and positive associations with dietary glycemic index, SSBs, and <i>trans</i> fat. A higher DRRD score was associated with reduced risk of developing liver cancer and chronic liver disease mortality among postmenopausal women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 5","pages":"410-421"},"PeriodicalIF":9.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apixaban, edoxaban and rivaroxaban but not dabigatran are associated with higher mortality compared to vitamin-K antagonists: A retrospective German claims data analysis","authors":"Christiane Engelbertz,&nbsp;Ursula Marschall,&nbsp;Jannik Feld,&nbsp;Lena Makowski,&nbsp;Stefan A. Lange,&nbsp;Eva Freisinger,&nbsp;Joachim Gerß,&nbsp;Günter Breithardt,&nbsp;Andreas Faldum,&nbsp;Holger Reinecke,&nbsp;Jeanette Köppe","doi":"10.1111/joim.20006","DOIUrl":"10.1111/joim.20006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vitamin-K antagonists (VKAs) have widely been replaced by non-VKA oral anticoagulants (NOACs). This includes Austria, Germany and Switzerland, where as VKA, instead of warfarin, the much longer-acting phenprocoumon is used, which was not compared to NOACs in clinical trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using administrative data from a large German health insurance, we included all anticoagulation-naïve patients with a first prescription of a NOAC or VKA between 2012 and 2020. We analysed overall survival, major adverse cardiac and cerebrovascular events, major thromboembolic events and major bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 570,137 patients were included (apixaban: 26.9%, dabigatran: 4.6%, edoxaban: 8.8%, rivaroxaban: 39.1% and VKA: 20.7% of these 99.4% phenprocoumon). In the primary analysis using a 1:1 propensity score matching-cohort (PSM-cohort), a significantly higher overall mortality was found for apixaban, edoxaban and rivaroxaban (all <i>p </i>&lt; 0.001) but not for dabigatran (<i>p</i> = 0.13) compared to VKA. In this PSM-cohort, 5-year mortality was 22.7% for apixaban versus 12.7% for VKA, 19.5% for edoxaban versus 11.4% for VKA, 16.0% for rivaroxaban versus 12.3% for VKA (all <i>p</i> &lt; 0.001) and 13.0% for dabigatran versus 12.8% for VKA (<i>p</i> = 0.06). The observed effect was confirmed in sensitivity analyses using un-weighted and three different weighted Fine–Gray regression models on the basis of the entire cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large real-world analysis, apixaban, edoxaban and rivaroxaban, but not dabigatran, were associated with worse survival compared to VKA. These findings, consistent with a few other studies including phenprocoumon, cast profound doubts on the unreflected, general use of NOACs. Randomized trials should assess whether phenprocoumon might actually be superior to NOACs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"296 4","pages":"362-376"},"PeriodicalIF":9.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}