TY - JOUR AB - BACKGROUND: Shock index (SI) and modified shock index (mSI) are useful instruments for early risk stratification in acute myocardial infarction (AMI) patients. They are strong predictors for short-term mortality. Nevertheless, the association between SI or mSI and long-term mortality in AMI patients has not yet been sufficiently examined. MATERIAL AND METHODS: For this study, a total of 10,174 patients with AMI was included. All cases were prospectively recorded by the population-based Augsburg Myocardial Infarction Registry from 2000 until 2017. Endpoint was all-cause mortality with a median observational time of 6.5 years [IQR: 3.5-7.4]. Using ROC analysis and calculating Youden-Index, the sample was dichotomized into a low and a high SI and mSI group, respectively. Moreover, multivariable adjusted COX regression models were calculated. All analyses were performed for the total sample as well as for STEMI and NSTEMI cases separately. RESULTS: Optimal cut-off values were 0.580 for SI and 0.852 for mSI (total sample). AUC values were 0.6382 (95% CI: 0.6223-0.6549) for SI and 0.6552 (95% CI: 0.6397-0.6713) for mSI. Fully adjusted COX regression models revealed significantly higher long-term mortality for patients with high SI and high mSI compared to patients with low indices (high SI HR: 1.42 [1.32-1.52], high mSI HR: 1.46 [1.36-1.57]). Furthermore, the predictive ability was slightly better for mSI compared to SI and more reliable in NSTEMI cases compared to STEMI cases (for SI and mSI). CONCLUSION: High SI and mSI are useful tools for early risk stratification including long-term outcome especially in NSTEMI cases, which can help physicians to make decision on therapy. NSTEMI patients with high SI and mSI might especially benefit from immediate invasive therapy.Key messagesShock index and modified shock index are predictors of long-term mortality after acute myocardial infarction.Both indices predict long-term mortality not only for STEMI cases, but even more so for NSTEMI cases. AU - Schmitz, T.* AU - Harmel, E.* AU - Linseisen, J. AU - Kirchberger, I.* AU - Heier, M. AU - Peters, A. AU - Meisinger, C.* C1 - 64737 C2 - 52004 SP - 900-908 TI - Shock index and modified shock index are predictors of long-term mortality not only in STEMI but also in NSTEMI patients. JO - Ann. Med. VL - 54 IS - 1 PY - 2022 SN - 0785-3890 ER - TY - JOUR AB - Aim: This study examines epidemiological trends of acute myocardial infarction (AMI) in Germany from 2004–2015 across different age groups, using data of the population-based KORA myocardial infarction registry. Methods: Annual age-standardised, age-group- and sex-specific mortality and event rates (incident and recurrent) per 100,000 population as well as 28-day case fatality were calculated from all registered cases of AMI and coronary heart disease deaths in 25–74-year-olds from 2004–2015 and 75–84-year-olds from 2009–2015. Average annual percentage changes (AAPC) were calculated by joinpoint regression. Results: Mortality rates declined considerably among the elderly (75–84 years), in men by –6.0% annually, due to declines of case fatality by –3.0% and incidence rate by 3.4% and in women by –10.0%, driven by declines in incidence (–9.1%) and recurrence rate (–4.9%). Significant mortality declines also occurred in males, 65–74 years of age (AAPC –3.8%). Among the age groups 25–54 years and 55–64 years, there was no substantial decline in mortality, event rates or case fatality except for a decline of incidence rate in 55–64-year-old men (AAPC –1.8%). Conclusion: Inhomogeneous AMI trends across age-groups indicate progress in prevention and treatment for the population >64 years, while among <55-year-olds, we found no significant trend in AMI morbidity and mortality.KEY MESSAGES Age standardised AMI mortality continued to decline from 2009 to 2015 in the study region. Declines in AMI mortality were driven by declines in event rates (both incidence and recurrence rates) and case fatality. AMI trends were inconsistent across different age groups with the strongest declines in mortality and event rates among the elderly population (75–84 years of age). AU - Krämer, C. AU - Meisinger, C. AU - Kirchberger, I.* AU - Heier, M. AU - Kuch, B.* AU - Thilo, C.* AU - Linseisen, J. AU - Amann, U. C1 - 63565 C2 - 51590 CY - 2-4 Park Square, Milton Park, Abingdon Or14 4rn, Oxon, England SP - 2142-2152 TI - Epidemiological trends in mortality, event rates and case fatality of acute myocardial infarction from 2004 to 2015: Results from the KORA MI registry. JO - Ann. Med. VL - 53 IS - 1 PB - Taylor & Francis Ltd PY - 2021 SN - 0785-3890 ER - TY - JOUR AB - Objective. The American Diabetes Association (ADA) has recently recommended HbA1c for diagnosing diabetes as an alternative to glucose-based criteria. We compared the new HbA1c-based criteria for diagnosis of diabetes and prediabetes with the glucose-based criteria. Research design and methods. In the population-based German KORA surveys (S4/F4) 1,764 non-diabetic participants aged 31-60 years and 896 participants aged 61-75 years underwent measurements of HbA1c, fasting plasma glucose (FPG), and 2-h glucose. Results. Only 20% of all subjects diagnosed with diabetes by glucose or HbA1c criteria had diabetes by both criteria; for prediabetes, the corresponding figure was 23%. Using HbA1c >= 6.5%, the prevalence of diabetes was strongly reduced compared to the glucose criteria (0.7% instead of 2.3% in the middle-aged, 2.9% instead of 7.9% in the older subjects). Only 32.0% (middle-aged) and 43.2% (older group) of isolated impaired glucose tolerance (i-IGT) cases were detected by the HbA1c criterion (5.7% <= HbA1c < 6.5%). Conclusion. By glucose and the new HbA1c diabetes criteria, different subjects are diagnosed with type 2 diabetes in middle-aged as well as older subjects. The new HbA1c criterion lacks sensitivity for impaired glucose tolerance. AU - Rathmann, W.* AU - Kowall, B.* AU - Tamayo, T.* AU - Giani, G.* AU - Holle, R. AU - Thorand, B. AU - Heier, M. AU - Huth, C. AU - Meisinger, C. C1 - 7977 C2 - 29960 SP - 170-177 TI - Hemoglobin A1c and glucose criteria identify different subjects as having type 2 diabetes in middle-aged and older populations: The KORA S4/F4 study. JO - Ann. Med. VL - 44 IS - 2 PB - Informa Healthcare PY - 2012 SN - 0785-3890 ER - TY - JOUR AB - Introduction. Although the prevalence of celiac disease (CD) has been extensively investigated in recent years, an accurate estimate of CD frequency in the European population is still lacking. The aims of this study were: 1) to establish accurately the prevalence of CD in a large sample of the European population (Finland, Germany, Italy, and UK), including both children and adults; and 2) to investigate whether the prevalence of CD significantly varies between different areas of the European continent. Materials and methods. Samples were drawn from the four populations. All 29,212 participants were tested for CD by tissue transglutaminase (tTG) antibody test. Positive and border-line findings were further tested for serum endomysial antibodies (EMA). All serological determinations were centrally performed. Small-bowel biopsies were recommended to autoantibody-positive individuals. Previously diagnosed cases were identified. Results. The overall CD prevalence (previously diagnosed plus anti-tTG and EMA positives) was 1.0% (95% CI 0.9-1.1). In subjects aged 30-64 years CD prevalence was 2.4% in Finland (2.0-2.8), 0.3% in Germany (0.1-0.4), and 0.7% in Italy (0.4-1.0). Sixty-eight percent of antibody-positive individuals showed small-bowel mucosal changes typical for CD (Marsh II/III lesion). Conclusions. CD is common in Europe. CD prevalence shows large unexplained differences in adult age across different European countries. AU - Mustalahti, K.* AU - Catassi, C.* AU - Reunanen, A.* AU - Fabiani, E.* AU - Heier, M. AU - McMillan, S.* AU - Murray, L.* AU - Metzger, M.-H. AU - Gasparin, M.* AU - Bravi, E.* AU - Mäki, M.* C1 - 5490 C2 - 27998 CY - New York SP - 587-595 TI - The prevalence of celiac disease in Europe: Results of a centralized, international mass screening project. JO - Ann. Med. VL - 42 IS - 8 PB - Informa Healthcare PY - 2010 SN - 0785-3890 ER - TY - JOUR AB - Background. Several studies have investigated associations between the -174GC single nucleotide polymorphism (rs1800795) of the IL6 gene and phenotypes related to type 2 diabetes mellitus (T2DM) but presented inconsistent results. Aims. This joint analysis aimed to clarify whether IL6 -174GC was associated with glucose and circulating interleukin-6 concentrations as well as body mass index (BMI). Methods. Individual-level data from all studies of the IL6-T2DM consortium on Caucasian subjects with available BMI were collected. As study-specific estimates did not show heterogeneity (P0.1), they were combined by using the inverse-variance fixed-effect model. Results. The main analysis included 9440, 7398, 24,117, or 5659 non-diabetic and manifest T2DM subjects for fasting glucose, 2-hour glucose, BMI, or circulating interleukin-6 levels, respectively. IL6 -174 C-allele carriers had significantly lower fasting glucose (-0.091 mmol/L, P=0.014). There was no evidence for association between IL6 -174GC and BMI or interleukin-6 levels, except in some subgroups. Conclusions. Our data suggest that C-allele carriers of the IL6 -174GC polymorphism have lower fasting glucose levels on average, which substantiates previous findings of decreased T2DM risk of these subjects. AU - Huth, C. AU - Illig, T. AU - Herder, C.* AU - Gieger, C. AU - Grallert, H. AU - Vollmert, C. AU - Rathmann, W.* AU - Hamid, Y.H.* AU - Pedersen, O.* AU - Hansen, T.* AU - Thorand, B. AU - Meisinger, C. AU - Döring, A. AU - Klopp, N. AU - Gohlke, H. AU - Lieb, W.* AU - Hengstenberg, C.* AU - Lyssenko, V.* AU - Groop, L.* AU - Ireland, H.* AU - Stephens, J.W.* AU - Wernstedt Asterholm, I.* AU - Jansson, J.-O.* AU - Boeing, H.* AU - Möhlig, M.* AU - Stringham, H.M.* AU - Boehnke, M.* AU - Tuomilehto, J.* AU - Fernandez-Real, J.-M.* AU - Lopez-Bermejo, A.* AU - Gallart, L.* AU - Vendrell, J.* AU - Humphries, S.E.* AU - Kronenberg, F.* AU - Wichmann, H.-E. AU - Heid, I.M. C1 - 983 C2 - 26190 SP - 128-138 TI - Joint analysis of individual participants' data from 17 studies on the association of the IL6 variant -174G>C with circulating glucose levels, interleukin-6 levels, and body mass index. JO - Ann. Med. VL - 41 IS - 2 PB - Informa Healthcare PY - 2009 SN - 0785-3890 ER - TY - JOUR AB - BACKGROUND AND AIM. To measure in ̄ammatory markers in postmenopausal women on different forms of hormone in postmenopausal women on different forms of hormone replacement therapy (HRT). replacement therapy (HRT). METHOD. C-reactive protein (CRP), ®brinogen, plasma METHOD. C-reactive protein (CRP), ®brinogen, plasma viscosity (PV), albumin and white blood cell (WBC) count viscosity (PV), albumin and white blood cell (WBC) count were determined in 749 postmenopausal women. were determined in 749 postmenopausal women. RESULTS. CRP concentration was signi®cantly higher in RESULTS. CRP concentration was signi®cantly higher in women on estrogen monotherapy (difference of the median women on estrogen monotherapy (difference of the median (d) 0.96 (d) 0.96 mg/l, mg/l, P P = = 0.013), compared to those without HRT, 0.013), compared to those without HRT, but there was no difference in women on combined HRT. but there was no difference in women on combined HRT. Fibrinogen concentration was signi®cantly lower in women Fibrinogen concentration was signi®cantly lower in women on estrogen monotherapy (d 0.25 on estrogen monotherapy (d 0.25 g/l, g/l, P P = = 0.004) and 0.004) and combined HRT (d 0.4 combined HRT (d 0.4 g/l, g/l, P P < < 0.001), compared to women 0.001), compared to women without HRT. Similarly, PV was signi®cantly lower in women without HRT. Similarly, PV was signi®cantly lower in women on estrogen monotherapy (d 0.017 on estrogen monotherapy (d 0.017 mPa mPa ⋅ ⋅ s, s, P P = = 0.007) and 0.007) and women on combined HRT (d 0.039 women on combined HRT (d 0.039 mPa mPa ⋅ ⋅ s, s, P P < < 0.001), 0.001), compared to those without HRT. No differences were found compared to those without HRT. No differences were found for WBC count and the negative acute phase marker for WBC count and the negative acute phase marker albumin in the various treatment groups. In contrast to albumin in the various treatment groups. In contrast to oral estrogen administration, levels o fCRP, ®brinogen and oral estrogen administration, levels o fCRP, ®brinogen and PV in women on transdermal estrogen therapy did not differ PV in women on transdermal estrogen therapy did not differ from the no-HRT group. There was no association between from the no-HRT group. There was no association between these markers o fin ̄ammation and plasma estrogen levels. these markers o fin ̄ammation and plasma estrogen levels. CONCLUSION. Oral estrogen monotherapy was associated CONCLUSION. Oral estrogen monotherapy was associated with highest concentrations o fCRP. In contrast, other with highest concentrations o fCRP. In contrast, other markers o fin ̄ammation were either similar or lower in the markers o fin ̄ammation were either similar or lower in the oral HRT group, compared to the group o fwomen without oral HRT group, compared to the group o fwomen without HRT, suggesting that higher CRP concentrations re ̄ect HRT, suggesting that higher CRP concentrations re ̄ect estrogen effects on CRP expression rather than a systemic estrogen effects on CRP expression rather than a systemic pro-in ̄ammatory effect. pro-in ̄ammatory ef AU - Fröhlich, M.* AU - Mühlberger, N. AU - Hanke, H.* AU - Imhof, A.* AU - Döring, A. AU - Pepys, M.P.* AU - Koenig, W.* C1 - 10365 C2 - 21552 SP - 353-361 TI - Markers of inflammation in woman on different hormone replacement therapies. JO - Ann. Med. VL - 35 PY - 2003 SN - 0785-3890 ER -