Diabetes in Ontario

Hux, Janet E.; Ivis, Frank J.; Flintoft, Virginia; Bica, Adina

doi:10.2337/diacare.25.3.512

Cited by 1,123 publications

(931 citation statements)

References 20 publications

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“…The authors linked the CorHealth Ontario registry (date and type of cardiac procedures, comorbidities, EF, and angiographic data) with the Canadian Institute for Health Information's Discharge Abstract Database (comorbidities and hospital admissions) and Same Day Surgery database (comorbidities), Ontario Health Insurance Plan database (physician service claims), Registered Persons Database (ascertainment of vital statistics), and Canadian census. Although lacking in physiologic and laboratory measures, these administrative databases have been validated for many outcomes, exposures, and comorbidities 18, 19, 20, 21…”

Section: Methodsmentioning

confidence: 99%

“…Comorbidities were identified from the CorHealth Ontario registry and supplemented with data from the Discharge Abstract Database, the Same Day Surgery database, and the Ontario Health Insurance Plan database using International Classification of Diseases, Tenth Revision, Canada ( ICD‐10‐CA ) codes32 within 5 years before CABG using validated algorithms 18, 20, 33, 34, 35. We estimated socioeconomic status on the basis of patients’ neighborhood median income in the Canadian census and determined their residence (rural versus urban) using Statistics Canada definitions 36.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Tran

Dupuis

et al. 2018

JAHA

104

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BackgroundFrailty is increasing in prevalence and poses a formidable challenge for clinicians. The cardiac surgery literature consists primarily of small single‐center studies with limited follow‐up, and the epidemiological features of frailty remain to be elucidated in long‐term follow‐up.Methods and ResultsWe conducted a population‐based, retrospective, cohort study in Ontario, Canada, between 2008 and 2015. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups frailty indicator (a multidimensional instrument validated for research using administrative data). The primary outcome was mortality. Mortality rates were calculated using the Kaplan‐Meier method. The hazard of death was assessed using a multivariable Cox proportional hazard model. Of 40 083 patients, 8803 (22%) were frail. At 4±2 years of follow‐up, age‐ and sex‐standardized mortality rate per 1000 person‐years was higher in frail (33; 95% confidence interval, 29–36) compared with nonfrail (22; 95% confidence interval, 19–24) patients. Frailty was associated with an increased risk of long‐term mortality (adjusted hazard ratio, 1.20; 95% confidence interval, 1.12–1.28) and greater differences in the survival of patients between 40 and 74 years of age than in those who were ≥85 years old.ConclusionsFrailty was present in a large proportion of patients undergoing coronary artery bypass grafting and was independently associated with long‐term mortality. The adjusted risk of frailty‐related death was inversely proportional to age. Our findings highlight the need for more comprehensive preoperative risk stratification models to assist with optimal selection of operative candidates. In addition, we identified the <75 years age group as a potential target for comprehensive preoperative optimization programs, such as cardiac prehabilitation, nutritional augmentation, and psychosocial support.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Tran

Dupuis

et al. 2018

JAHA

104

View full text Add to dashboard Cite

show abstract

“…These data were then linked to the Canadian Institute for Health Information's Discharge Abstract Database (DAD; comorbidities and hospital admissions) and Same Day Surgery (SDS) database (comorbidities), Ontario Health Insurance Plan (OHIP) database (physician service claims), Registered Persons Database (RPDB; ascertainment of vital statistics), and Canadian census. While lacking physiologic and laboratory measures, these administrative databases have been validated for many outcomes, exposures, and comorbidities 15, 16, 17, 18…”

Section: Methodsmentioning

confidence: 99%

“…Comorbidities were identified from the CorHealth Ontario registry and supplemented with data from DAD, SDS, and OHIP using International Classification of Diseases––10th Revision (ICD‐10) codes19 within 5 years before CABG and using validated algorithms (eg, chronic obstructive pulmonary disease [COPD], asthma, hypertension, diabetes mellitus) 15, 17, 20, 21. We estimated socioeconomic status based on patients’ neighborhood median income in the Canadian census and determined their residence (rural versus urban) using Statistics Canada definitions 22.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Sun

Eddeen

2018

JAHA

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BackgroundHeart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting.Methods and ResultsWe conducted a retrospective cohort study in Ontario, Canada, between October 1, 2008, and March 31, 2015, using Cardiac Care Network and Canadian Institute of Health Information data. HF is captured through a validated population‐based database of all Ontarians with physician‐diagnosed HF. We defined pEF as ejection fraction ≥50% and rEF as ejection fraction <50%. The primary outcome was all‐cause mortality. Analyses were stratified by sex. Mortality rates were calculated using Kaplan–Meier method. The relative hazard of death was assessed using multivariable Cox proportional hazard models. Of 40 083 patients (20.6% women), 55.5% had pEF without HF, 25.7% had rEF without HF, 6.9% had HFpEF, and 12.0% had HFrEF. Age‐standardized HFpEF mortality rates at 4±2 years of follow‐up were similar in women and men. HFrEF standardized HFpEF mortality rates were higher in women than men.ConclusionsWe found a higher prevalence and poorer prognosis of HFpEF in women. A history of HF was a more important prognosticator than ejection fraction. Preoperative screening and extended postoperative follow‐up should be focused on women and men with HF rather than on rEF alone.

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“…We obtained hospitalization data from the Canadian Institute for Health Information (CIHI) Discharge Abstract Database, which contains detailed clinical information regarding all hospital admissions, and data on emergency department visits from the CIHI National Ambulatory Care Reporting System. We identified patients with hypertension, diabetes and congestive heart failure using validated disease‐specific databases 24, 25, 26. Demographic and mortality data were obtained from the Ontario Health Insurance Plan Registered Persons Database, a registry of all Ontario residents with publically‐funded health insurance, and physicians’ services were identified using OHIP physician claims data.…”

Section: Methodsmentioning

confidence: 99%

A population‐based study of the drug interaction between clopidogrel and angiotensin converting enzyme inhibitors

Cressman

Macdonald

Fernandes

et al. 2015

Brit J Clinical Pharma

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AimsClopidogrel and angiotensin converting enzyme (ACE) inhibitors are commonly co‐prescribed drugs. Clopidogrel inhibits carboxylesterase 1 (CES1), the enzyme responsible for converting prodrug ACE inhibitors (such as ramipril and perindopril) to their active metabolites. The clinical implications of this potential drug interaction are unknown. The clinical consequences of the potential drug interaction between clopidogrel and prodrug ACE inhibitors were examined.MethodsWe conducted a nested case–control study of Ontarians aged 66 years and older treated with clopidogrel between September 1 2003 and March 31 2013 following acute myocardial infarction. Cases were subjects who died or were hospitalized for reinfarction or heart failure in the subsequent year, and each was matched with up to four controls. The primary outcome was a composite of reinfarction, heart failure or death. The primary analysis examined whether use of the prodrug ACE inhibitors ramipril or perindopril was more common among cases than use of lisinopril, an active ACE inhibitor.ResultsAmong 45 918 patients treated with clopidogrel following myocardial infarction, we identified 4203 cases and 14 964 controls. After adjustment, we found no association between the composite outcome and use of perindopril (adjusted odds ratio (aOR) 0.94, 95% confidence interval (CI) 0.76, 1.16) or ramipril (aOR 0.97, 95% CI 0.80, 1.18), relative to lisinopril. Secondary analyses of each element of the composite outcome yielded similar findings.ConclusionsFollowing myocardial infarction, use of clopidogrel with ACE inhibitors activated by CES1 is not associated with an increased risk of adverse cardiovascular outcomes relative to lisinopril. These findings suggest that the recently described drug interaction between clopidogrel and prodrug ACE inhibitors is of little clinical relevance.

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Diabetes in Ontario

Cited by 1,123 publications

References 20 publications

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

A population‐based study of the drug interaction between clopidogrel and angiotensin converting enzyme inhibitors

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