Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

Ding, Chaowei; Wang, Runlu; Gong, Xiaowei; Yuan, Yadong

doi:10.1097/md.0000000000035502

Cited by 6 publications

References 45 publications

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Risk Factors of Acute Ischemic Stroke and Mortality Among Adults With Endocardial Fibroelastosis

Warsi,

Ramphul,

Dulay

et al. 2024

The Neurologist

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Objectives: Endocardial fibroelastosis (EFE) is a rare form of restrictive cardiomyopathy associated with high morbidity and mortality. The literature is sparse on information pertaining to risk stratification. Thus, we sought to highlight the risk factors of acute ischemic stroke (AIS) and mortality in adults with EFE. Methods: The National Inpatient Sample (NIS) database was queried from 2001 to 2020 using the International Classification of Diseases 9th Revision (ICD-9) and 10th Revision (ICD-10) codes for adult patients with EFE. Factors associated with AIS and mortality were identified. Results: In all, 18495 cases of EFE fit the inclusion criteria, of which 2370 (12.82%) had AIS. The mean ages for patients with and without AIS were 62.37 and 54.24, respectively. Multivariate regression suggested greater odds of AIS in patients with hypertension (aOR 2.329, P<0.01), dyslipidemia (aOR: 1.566, P<0.01), peripheral vascular disease (PVD) (aOR: 1.736, P<0.01), alcohol abuse (aOR: 1.817, P<0.01), age >60 y (aOR: 1.646, P<0.01), females (vs. males, aOR: 1.238, P<0.01), and smokers (aOR: 1.697, P<0.01). Patients with cirrhosis (aOR: 0.174, P<0.01), CKD (aOR: 0.369, P<0.01), COPD (aOR: 0.402, P<0.01), atrial fibrillation (aOR: 0.542, P<0.01) had lower odds of AIS. 3.1% of EFE patients with AIS died. Diabetes (aOR: 11.665, P<0.01) and COPD (aOR: 3.201, P=0.017) were associated with the greatest odds of all-cause mortality. Dyslipidemia (aOR: 0.387, P=0.010) and females (vs. males, aOR: 0.432, P=0.012) had reduced odds of all-cause mortality. Conclusion: Several risk factors are associated with AIS in EFE, while diabetes, COPD, and being male are associated with mortality in EFE.

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Risk Factors of Acute Ischemic Stroke and Mortality Among Adults With Endocardial Fibroelastosis

Warsi,

Ramphul,

Dulay

et al. 2024

The Neurologist

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Building and validating a predictive model for stroke risk in Chinese community-dwelling patients with chronic obstructive pulmonary disease using machine learning methods

Chen,

Yu,

Yang

et al. 2024

Preprint

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Background: The occurrence of stroke in patients with chronic obstructive pulmonary disease (COPD) can have potentially devastating consequences; however, there is still a lack of predictive models that accurately predict the risk of stroke in community-based COPD patients in China. The aim of this study was to construct a novel predictive model that accurately predicts the predictive model for the risk of stroke in community-based COPD patients by applying a machine learning methodology within the Chinese community. Methods: The clinical data of 809 Community COPD patients were analyzed by using the 2020 China Health and Retirement Longitudinal Study (CHARLS) database. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression were used to analyze predictors. Multiple machine learning (ML) classification models are integrated to analyze and identify the optimal model, and Shapley Additive exPlanations (SHAP) interpretation was developed for personalized risk assessment.Results:The following six variables:Heart_disease,Hyperlipidemia,Hypertension,ADL_score, Cesd_score and Parkinson are predictors of stroke in community-based COPD patients. Logistic classification model was the optimal model, test set area under curve (AUC) (95% confidence interval, CI):0.913 (0.835-0.992), accuracy: 0.823, sensitivity: 0.818, and specificity: 0.823. Conclusions: The model constructed in this study has relatively reliable predictive performance, which helps clinical doctors identify high-risk populations of community COPD patients prone to stroke at an early stage.

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Periodontal disease: A systemic condition

Villoria,

Fischer,

Tinoco

et al. 2024

Periodontology 2000

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For decades, periodontitis has been considered to be a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were each studied separately, and relationships were shown. The associations of periodontitis with morbidities, such as cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, respiratory diseases, have been demonstrated. As most such studies were cross‐sectional in nature, questions about causality cannot be univocally answered. And periodontitis as an independent risk factor for one systemic disease, becomes even more difficult to assess since recently periodontitis has also been associated with multimorbidity. Periodontitis and many systemic diseases share environmental, lifestyle and genetic risk factors, and share immunopathology. Moreover, suffering from one common noncommunicable disease may increase the susceptibility for another such chronic disease; the systemic effects of one condition may be one of various risk factors for another such disease. The overarching effect of any systemic disease is it causing a pro‐inflammatory state in the individual; this has also been shown for periodontitis. Moreover, in periodontitis a prothrombotic state and elevated immunological activity have been shown. As such, when we consider periodontal disease as another systemic disease, it can affect the susceptibility and progression of other systemic diseases, and importantly, vice versa. And with this, it is not surprising that periodontitis is associated with a variety of other noncommunicable diseases. The medical definition of a systemic disease includes diseases that affect different organs and systems. Thus, the aim of this opinion paper is to propose that periodontitis should be considered a systemic disease in its own right and that it affects the individual's systemic condition and wellbeing. The dental and medical profession and researchers alike, should adapt this paradigm shift, advancing periodontal disease out of its isolated anatomical location into the total of chronic noncommunicable diseases, being for some conditions a comorbid disease and, vice versa, comorbidities can affect initiation and progression of periodontal disease.

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Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

Cited by 6 publications

References 45 publications

Risk Factors of Acute Ischemic Stroke and Mortality Among Adults With Endocardial Fibroelastosis

Risk Factors of Acute Ischemic Stroke and Mortality Among Adults With Endocardial Fibroelastosis

Building and validating a predictive model for stroke risk in Chinese community-dwelling patients with chronic obstructive pulmonary disease using machine learning methods

Periodontal disease: A systemic condition

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