Risk analysis of carotid stent from a population-based database in Taiwan

Cheng, Chun-An; Chien, Wu-Chien; Hsu, Chien Yeh; Lin, Hon-Yi; Chiu, Hung Wen

doi:10.1097/md.0000000000004747

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…Primary position. NR Cheng et al (2016) [ 44 ] Taiwan National Health Research Insurance database from 2004 to 2015 AMI, ischemic stroke, hemorrhagic stroke, all cause death AMI: 410; ischemic stroke: 434–437; hemorrhagic stroke: 430–432 (ICD-9). NR NR Chuang et al (2016) [ 45 ] Taiwan National Health Research Insurance database from 1996 to 2011 ACS, ischemic stroke, hemorrhagic stroke ACS: 410, 411; ischemic stroke: 433–438; hemorrhagic stroke: 430–432 (ICD-9).…”

Section: Resultsmentioning

confidence: 99%

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Bosco

Hsueh

McConeghy

et al. 2021

BMC Med Res Methodol

234

113

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Background Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data. Methods We identified peer-reviewed articles published in MEDLINE and EMBASE between January 1, 2010 to October 9, 2020. Studies utilizing administrative data to assess the MACE composite outcome using International Classification of Diseases 9th or 10th Revision diagnosis codes were included. Reviews, abstracts, and studies not providing outcome code definitions were excluded. Data extracted included data source, timeframe, MACE components, code definitions, code positions, and outcome validation. Results A total of 920 articles were screened, 412 were retained for full-text review, and 58 were included. Only 8.6% (n = 5/58) matched the traditional three-point MACE RCT definition of acute myocardial infarction (AMI), stroke, or cardiovascular death. None matched four-point (+unstable angina) or five-point MACE (+unstable angina and heart failure). The most common MACE components were: AMI and stroke, 15.5% (n = 9/58); AMI, stroke, and all-cause death, 13.8% (n = 8/58); and AMI, stroke and cardiovascular death 8.6% (n = 5/58). Further, 67% (n = 39/58) did not validate outcomes or cite validation studies. Additionally, 70.7% (n = 41/58) did not report code positions of endpoints, 20.7% (n = 12/58) used the primary position, and 8.6% (n = 5/58) used any position. Conclusions Components of MACE endpoints and diagnostic codes used varied widely across observational studies. Variability in the MACE definitions used and information reported across observational studies prohibit the comparison, replication, and aggregation of findings. Studies should transparently report the administrative codes used and code positions, as well as utilize validated outcome definitions when possible.

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Section: Resultsmentioning

confidence: 99%

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Bosco

Hsueh

McConeghy

et al. 2021

BMC Med Res Methodol

234

113

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show abstract

“…Although external validation is an essential step in prediction model development, only 4 of the 30 included models had been externally validated in an independent patient population before; 2 were externally validated in the same article in which their development was described (Alcocer 2013 and Cheng 2016), 16 , 17 and the other 2 had each been validated twice in independent validation studies (Rothwell 1999 and Tu 2003). 18 – 21 Our findings are similar to the findings of these previous studies, except that the discriminative performance of the Tu 2003 and Cheng 2016 models was slightly better in the previous external validations.…”

Section: Discussionmentioning

confidence: 99%

Prediction Models for Clinical Outcome After a Carotid Revascularization Procedure

Volkers

Algra

Kappelle³

et al. 2018

Stroke

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“…Additionally, it was indicated that the risk of plaque was significantly greater in people with increased systolic blood pressure (SBP) variability (every 10 mmHg increase) and diastolic blood pressure (DBP) variability (1,24,25). Pulse pressure (PP) variability (every 10 mmHg increase) raises the risk of carotid plaque for both community-based subjects and stroke patients (26,27).…”

Section: Blood Pressurementioning

confidence: 99%

Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review

Ji¹,

Leng²,

Dong³

et al. 2019

Ann. Transl. Med.

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Background: Carotid atherosclerosis is a major cause of stroke, but the conclusion about risk factors for carotid atherosclerosis is still controversial. The aim of our present meta-analysis and systematic review was to explore the modifiable risk factors for carotid atherosclerosis. Methods:We searched PubMed from January 1962 to October 2018 to include longitudinal and crosssectional studies. The results were pooled using random effects model. Heterogeneity was measured by I 2 statistic and publication bias was assessed by funnel plots.Results: A total of 14,700 articles were screened, of which 76 with 27 factors were eligible. Our metaanalysis of cross-sectional studies indicated nine factors (hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, hypertriglyceridemia, diabetes, and higher low density lipoprotein) were significantly associated with the presence of carotid plaque, among which four (hyperlipidemia, hyperhomocysteinemia, hypertension, and hyperuricemia) could elevate the risk of atherosclerosis by at least 50%; and one factor (hypertension) was associated with increased carotid intimamedia thickness. In the systematic review, another five factors [negative emotion, socioeconomic strain, alcohol, air pollution, and obstructive sleep apnea syndrome (OSAS)] were also related to the presence of atherosclerosis. The cross-sectional associations with most of the above 14 factors were further confirmed by longitudinal studies. Among them, the managements of 4 factors (hypertension, hyperlipidemia, diabetes and OSAS) were indicated to prevent carotid atherosclerosis by cohort studies.Conclusions: Effective interventions targeting pre-existing disease, negative emotion, lifestyle and diet may reduce the risk of carotid atherosclerosis. Further good-quality prospective studies are needed to confirm these findings.

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Risk analysis of carotid stent from a population-based database in Taiwan

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 23 publications

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Prediction Models for Clinical Outcome After a Carotid Revascularization Procedure

Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review

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