Abstract:
BACKGROUND:Diabetes mellitus is recognized as a stroke risk factor in atrial fibrillation (AF). Patients with diabetes with retinopathy have an increased risk for systemic cardiovascular complications, and severe diabetic retinopathy predisposes to ocular bleeding. We hypothesized that patients with diabetes, retinopathy, and AF have increased stroke/thromboembolism (TE) and severe bleeding risks when compared with patients with diabetes and AF who do not have retinopathy or to patients with AF and without diabetes. METHODS:We tested our hypothesis in a large "real-world" cohort of individuals with AF from the Loire Valley Atrial Fibrillation project. RESULTS:Of 8,962 patients with AF in our dataset, 1,409 (16%) had documented diabetes mellitus. Of these, 163 (1.8% of the whole cohort) were patients with diabetic retinopathy. After a follow-up of 31 ± 36 months, when compared with patients without diabetes, the risk of stroke/TE in patients with diabetes with no retinopathy increased 1.3-fold (relative risk [RR], 1.30; 95% CI, 1.07-1.59; P = .01); in patients with diabetes with retinopathy, the risk of stroke/TE was increased 1.58-fold (RR, 1.58; 95% CI, 1.07-2.32; P = .02). There was no significant difference when patients with diabetes with no retinopathy were compared with patients with diabetes with retinopathy (RR, 1.21; 95% CI, 0.80-1.84; P = .37). A similar pattern was seen for mortality and severe bleeding. On multivariate analysis, the presence of diabetic retinopathy did not emerge as an independent predictor for stroke/TE or severe bleeding. CONCLUSIONS:Crude rates of stroke/TE increased in a stepwise fashion when patients without diabetes and with AF were compared with patients with diabetes with no retinopathy and patients with diabetes with retinopathy. However, we have shown for the first time, to our knowledge, that the presence of diabetic retinopathy did not emerge as an independent predictor for stroke/TE or severe bleeding on multivariate analysis.
journal_name
Chestjournal_title
Chestauthors
Lip GYH,Clementy N,Pierre B,Boyer M,Fauchier Ldoi
10.1378/chest.14-2096subject
Has Abstractpub_date
2015-04-01 00:00:00pages
1103-1110issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)38960-1journal_volume
147pub_type
杂志文章相关文献
CHEST文献大全abstract:BACKGROUND:COPD and hypertension both increase the risk of congestive heart failure (CHF). Current clinical trials do not inform the selection of combination antihypertensive therapy among patients with COPD. We performed a comparative effectiveness study to investigate whether choice of dual agent antihypertensive the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-1770
更新日期:2013-05-01 00:00:00
abstract::Substantial experimental evidence supports the idea that the fibroblast may play a significant role in the vascular response to injury, especially under hypoxic conditions. Fibroblasts have the ability to rapidly respond to hypoxic stress and to modulate their function to adapt rapidly to local vascular needs. Fibrobl...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.122.6_suppl.326s
更新日期:2002-12-01 00:00:00
abstract::The disease concept of idiopathic BOOP has emerged from a study of many open lung biopsy cases of diffuse infiltrative lung disease. The histopathologic features of idiopathic BOOP have several components: bronchiolitis obliterans, organizing pneumonia, accumulation of foamy cells in the peripheral air spaces, and int...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.1_supplement.44s
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Our laboratory uses pH paper rather than a blood gas analyzer to measure pleural fluid pH to decrease cost and avoid analyzer malfunction due to viscous fluids. METHODS:To compare these two methods of determining pleural fluid pH, 42 patients undergoing diagnostic or therapeutic thoracentesis had two 1-mL a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.112.5.1291
更新日期:1997-11-05 00:00:00
abstract:STUDY OBJECTIVES:To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the dipyridamole stress test (DSST) in predicting > or = 50% obstruction of an internal mammary artery or new native coronary artery disease (CAD) compared with saphenous vein graft obstru...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.4.1040
更新日期:2004-10-01 00:00:00
abstract::We assessed qualitative and quantitative differences in surfactant lipid composition of bronchoalveolar lavage (BAL) fluid in patients with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii (PC) pneumonia. Five normal volunteers and 27 patients with human immunodeficiency virus (HIV) infection underw...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.6.1730
更新日期:1992-12-01 00:00:00
abstract::The Loyola Open-Heart Registry is a fully operational database that contains detailed data on approximately 9,000 patients who have undergone coronary bypass or cardiac valve replacement from January 1970 to December 1984. We analyzed the registry data using multivariate discriminant analysis to identify and quantitat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.3.394
更新日期:1987-03-01 00:00:00
abstract::The objective was to determine if garnetting and raw cotton dusts differed in botanical composition. Estimates of dust composition were based on the contents of gross trash in cotton raw materials and the potential of each gross trash component to be converted into less than 10 mum particulate by a laboratory abrasion...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.4_supplement.97s
更新日期:1981-04-01 00:00:00
abstract:CONTEXT:Few studies have examined the effect of nicotine replacement therapy (NRT) in COPD patients. STUDY OBJECTIVE:To evaluate the efficacy of nicotine sublingual tablets and two levels of support for smoking cessation in COPD patients. DESIGN:Double-blind, multicenter, placebo-controlled smoking cessation trial. ...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.130.2.334
更新日期:2006-08-01 00:00:00
abstract::Extensive surgery for all of the mechanical complications of ischemic heart disease is feasible with early diagnosis, catheterization, and aggressive medical and surgical therapy. A patient is report who, after recovering from cardiogenic shock, required a coronary bypass, closure of ventricular septal defects, mitral...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.1.85
更新日期:1977-01-01 00:00:00
abstract::The effect on pulmonary fluid balance of adrenergic receptor agonist agents commonly employed in clinical sepsis has not been well characterized. Therefore, we tested the hypothesis that dobutamine would increase pulmonary microvasular fluid flux in experimental sepsis-induced lung injury. To define the effects of thi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.1.180
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia. STUDY OBJECTI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.6.1898
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:During medical procedures with the potential to produce aerosols such as bronchoscopy, intubation, or CPR, health-care workers (HCWs) may be exposed to infectious bioaerosols. This scenario is of particular concern when high consequence pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.07.026
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:In recent years, the population of patients with pulmonary arterial hypertension (PAH) has changed dramatically, including more advanced age at diagnosis. We hypothesized that older patients have a distinct clinical profile with different disease characteristics and response to intervention. METHODS:All pre...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2015.11.008
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Previous meta-analyses of pulmonary arterial hypertension (PAH)-specific therapy for PAH pooled PAH-specific combination therapy and monotherapy. This flaw may threaten the authenticity of their findings. METHODS:PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials that ev...
journal_title:Chest
pub_type: 杂志文章,meta分析
doi:10.1016/j.chest.2016.03.031
更新日期:2016-08-01 00:00:00
abstract::A patient with Ewing's sarcoma of the left scapula received prophylactic radiotherapy to the left lung following wide excision of the tumor. While the left lung remained free of tumor, there was metastatic invasion of the right lung within ten months of the initial diagnosis of the disease. Since Ewing's sarcoma frequ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.3.393
更新日期:1976-09-01 00:00:00
abstract::COPD and OSA are both highly prevalent, which implies that both disorders occurring together (overlap syndrome) is likely to be common based on chance association alone. However, different clinical COPD phenotypes influence the likelihood of coexisting OSA in that the increased lung volumes and low BMI associated with...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2017.04.160
更新日期:2017-12-01 00:00:00
abstract::Transient left ventricular (LV) dysfunction syndrome, or Tako-tsubo syndrome, occurs following intense emotional or physical stress and simulates the clinical presentation of an acute myocardial infarction. We report a case of a 77-year-old man with esophageal adenocarcinoma with local invasion of the central airways ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0790
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:There are no recommendations on how to measure arm exercise capacity in individuals with COPD. The objectives of this study were (1) to synthesize the literature on measures of arm exercise capacity in individuals with COPD, (2) to describe the psychometric properties and the target construct of each measure...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.11-0475
更新日期:2012-01-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to evaluate the effects of nasal continuous positive airway pressure (nCPAP) therapy on sleep and daytime symptoms of bed partners and patients with obstructive sleep apnea (OSA). DESIGN:A cross-sectional questionnaire survey. SETTING:The sleep laboratory of a university teaching hosp...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.5.1261
更新日期:1997-05-01 00:00:00
abstract::Stage IIIA non-small cell lung cancer represents a relatively heterogeneous group of patients with metastatic disease to the ipsilateral mediastinal (N2) lymph nodes and also includes T3N1 patients. Presentations of disease range from apparently resectable tumors with occult microscopic nodal metastases to unresectabl...
journal_title:Chest
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1378/chest.123.1_suppl.202s
更新日期:2003-01-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the role of oropharyngeal and cutaneous commensal microorganisms (OCCs) as a cause of ventilator-associated pneumonia (VAP). DESIGN:Retrospective analysis of the medical and microbiological records. SETTING:One medical-surgical ICU. PATIENTS:All VAP episodes recorded during a 10-year p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.4.1389
更新日期:2002-10-01 00:00:00
abstract::The severity of pulmonary hypertension was evaluated by right cardiac catheterization in 89 patients with stable chronic obstructive pulmonary disease, both at rest and during maximum treadmill exercise. Thirty-one patients were found to have pulmonary hypertension at rest, defined as a mean pulmonary arterial pressur...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.2.185
更新日期:1986-08-01 00:00:00
abstract::We report an individual with limb-girdle muscular dystrophy who has devised a way to assist her respiration by using her hands braced against the tray of her wheelchair. Utilizing this method, she was able to increase her tidal volume (VT) and lower her respiratory rate compared to unassisted spontaneous breathing, th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.3.949
更新日期:2003-03-01 00:00:00
abstract::Important alterations in respiratory function have been observed after open cholecystectomy. These include a decrease in the abdominal tidal volume, forced vital capacity, and forced expiratory volume at 1 s. Laparoscopic cholecystectomy is a new procedure allowing removal of the gallbladder without a subcostal or mid...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.4.1173
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Much controversy persists regarding the place of statin drugs in the treatment of patients with COPD. This systematic review and meta-analysis sought to determine the clinical efficacy of statin therapy in COPD. METHODS:We searched MEDLINE, EMBASE, the Cochrane Database, and PubMed for relevant clinical stu...
journal_title:Chest
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.chest.2017.08.015
更新日期:2017-12-01 00:00:00
abstract::A study to assess the effect of the long-term use of triamcinolone acetonide (TA) on adrenal function was conducted with 143 male and female patients with asthma who were randomly assigned to receive 800, 1200, or 1,600 micrograms of TA daily for six months. Adrenal function was assessed prior to treatment and after t...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.101.5.1250
更新日期:1992-05-01 00:00:00
abstract::We studied six patients with type A botulism to determine the degree of initial respiratory compromise and to quantitate the time course and extent of recovery of the ventilatory and upper airway muscles and exercise performance. The VM weakness was identified in all patients early after botulism. Upper airway muscle ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.3.620
更新日期:1990-09-01 00:00:00
abstract::Sepsis is among the most common reasons for admission to ICUs throughout the world, and it is believed to be the third most common cause of death in the United States. The pathogenetic mechanism and physiologic changes associated with sepsis are exceedingly complex, but our understanding is evolving rapidly. The major...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.13-2104
更新日期:2014-06-01 00:00:00
abstract::Retractions of the lower ribcage (chest wall distortion [CWD]) during inspiration are frequently observed with moderate to severe respiratory disease in the infant. Laryngotracheobronchitis (LTB) results in a reversible partial airway obstruction with severe CWD. We wished to measure the motion of the chest wall durin...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.6.1842
更新日期:1993-06-01 00:00:00