TY  - JOUR
AB  - BACKGROUND AND AIMS: Observational research has indicated that proton pump inhibitors (PPIs) might increase the long-term risk of cardiovascular events. This study evaluated the evidence from observational studies for an effect of PPI monotherapy on the risk of incident cardiovascular events and cardiovascular mortality. METHODS: The databases MEDLINE, EMBASE, and Scopus were systematically searched up to September 2021. The primary outcome was first cardiovascular event, i.e. first myocardial infarction or first ischaemic stroke. The secondary outcome was cardiovascular mortality. Studies were included following a detailed risk of bias assessment with the ROBINS-I tool. Sensitivity and bias analyses adjusted for potential publication bias, immortal time bias, and unmeasured confounding. RESULTS: We included ten studies with 75,371 first cardiovascular events, as well as seven studies on cardiovascular mortality with 50,329 cardiovascular deaths in total. The pooled hazard ratios (HRs) for PPI use and cardiovascular events were 1.05 with a 95% confidence interval of (0.96; 1.15) before and 0.99 (0.93; 1.04) after adjusting for observational study design bias. The pooled HRs for PPI use and cardiovascular mortality were 1.27 (1.11; 1.44) before and 1.06 (0.96; 1.16) after adjusting for publication bias and observational study design bias. CONCLUSION: It is questionable, whether PPI monotherapy constitutes a cardiovascular risk factor.
AU  - Nolde, M.*
AU  - Ahn, N.*
AU  - Dreischulte, T.*
AU  - Krause, E.*
AU  - Güntner, F.*
AU  - Günter, A.*
AU  - Gerlach, R.*
AU  - Tauscher, M.*
AU  - Amann, U.
AU  - Linseisen, J.
AU  - Meisinger, C.*
AU  - Baumeister, S.E.*
AU  - Rückert-Eheberg, I.M.*
C1  - 66351
C2  - 53144
SP  - 80-89
TI  - Proton pump inhibitors and the risk of cardiovascular events and cardiovascular mortality: A systematic review and meta-analysis of observational studies.
JO  - Eur. J. Intern. Med.
VL  - 106
PY  - 2022
SN  - 0953-6205
ER  - 

TY  - JOUR
AB  - Background: The aim of this study was to examine the predictive value of specific changes in admission ECG on long-term outcome in acute myocardial infarction (AMI). Methods: From 2000 until 2017 all AMI cases (n = 9,689) in the study area of Augsburg, Germany, were prospectively recorded. For this study, all patients with a first-time AMI, who survived the first 28 days, were considered. Median observational time was 6.7 years (IQR: 3.6–10.9). Each case was assigned to one of the following groups according to the admission ECG: ‘ST-segment elevation’, ‘ST-segment depression’, ‘T-wave inversion’, ‘unspecific changes’, ‘normal ECG’ and ‘bundle branch block’ (BBB). Multivariable adjusted COX regression models were calculated to compare long-term all-cause mortality. Results: The final regression model revealed a significantly higher mortality among patients with BBB (HR: 1.52 [1.34–1.73], p-value: < 0.001) and ‘ST-segment depression’ (HR: 1.16 [1.03–1.29], p-value: 0.01252) compared to the STEMI group (reference group). The ‘normal ECG’ group (HR: 0.76 [0.66–0.87], p-value: < 0.001) on the other hand was associated with significantly lower long-term mortality. The ‘T-wave inversion’ group (HR: 1.08 [0.96–1.21]) and the ‘unspecific changes’ group (HR: 1.05 [0.94–1.17]) did not differ significantly from the STEMI group. Conclusion: ST-segment depressions and BBB admission ECGs go along with higher long-term mortality in AMI patients compared to STEMI cases. This should be taken into account by physicians when treating patients with NSTEMIs. Only the complete absence of AMI-related ECG changes predicts a more favorable outcome.
AU  - Schmitz, T.*
AU  - Wein, B.*
AU  - Methe, H.*
AU  - Linseisen, J.
AU  - Heier, M.
AU  - Peters, A.
AU  - Meisinger, C.*
C1  - 64661
C2  - 52401
SP  - 69-76
TI  - Association between admission ECG changes and long-term mortality in patients with an incidental myocardial infarction: Results from the KORA myocardial infarction registry.
JO  - Eur. J. Intern. Med.
VL  - 100
PY  - 2022
SN  - 0953-6205
ER  - 

TY  - JOUR
AB  - BACKGROUND: Prior studies reported high guideline adherence for secondary prevention medications (SPM) at hospital discharge in patients with acute myocardial infarction (AMI). Less is known about medication use in long-term AMI survivors. METHODS: Of the 2077 registered persons with an AMI between 2000 and 2008 who responded to a postal follow-up survey in 2011, 1311 men and 356 women, aged between 34.4 and 84.9years, reported medication intake 7days prior to the survey. These study participants also had their current health condition and comorbidities assessed. Information regarding index AMI was selected from the population-based MONICA/KORA MI registry. Multivariable logistic regression models were conducted to identify factors associated with SPM use (all 4 drug classes). RESULTS: The median time between index AMI and the follow-up survey was 6.1years (IQR: 3.9). At follow-up, a total of 10,422 medications were reported and polypharmacy was observed in 73.8%. Regarding SPM, the proportion of patients taking antiplatelet agents, beta-blockers, statins, and renin-angiotensin-aldosteron system blockers were 90.9%, 86.7%, 85.4%, and 79.3% respectively. Factors associated with SPM use were hypertension (odds ratio [OR] 1.48, p=0.006), SPM prescription at hospital discharge (OR 2.68, p<0.0001), revascularization therapy at index AMI (OR 2.46, p>0.0001), number of medications taken at follow-up (OR 1.48, p<0.0001), and several comorbidities such as lung disorders (OR 0.17; p<0.0001), depression (OR 0.53, p=0.001), neurological disorders (without stroke) (OR 0.34, p=0.002), and cancer (OR 0.45, p=0.005). CONCLUSION: SPM use several years after AMI was high and associated with treatment at index AMI and patients' comorbidities.
AU  - Amann, U.
AU  - Kirchberger, I.
AU  - Heier, M.
AU  - Thilo, C.*
AU  - Kuch, B.*
AU  - Meisinger, C.
C1  - 51743
C2  - 43456
CY  - Amsterdam
SP  - 62-68
TI  - Medication use in long-term survivors from the MONICA/KORA Myocardial Infarction Registry.
JO  - Eur. J. Intern. Med.
VL  - 47
PB  - Elsevier Science Bv
PY  - 2018
SN  - 0953-6205
ER  - 

TY  - JOUR
AB  - Flatworms of the species Schmidtea mediterranea are immortal-adult animals contain a large pool of pluripotent stem cells that continuously differentiate into all adult cell types. Therefore, single-cell transcriptome profiling of adult animals should reveal mature and progenitor cells. By combining perturbation experiments, gene expression analysis, a computational method that predicts future cell states from transcriptional changes, and a lineage reconstruction method, we placed all major cell types onto a single lineage tree that connects all cells to a single stem cell compartment. We characterized gene expression changes during differentiation and discovered cell types important for regeneration. Our results demonstrate the importance of single-cell transcriptome analysis for mapping and reconstructing fundamental processes of developmental and regenerative biology at high resolution.
AU  - Dinser, L.
AU  - Meisinger, C.
AU  - Amann, U.
AU  - Heier, M.
AU  - Thilo, C.*
AU  - Kuch, B.*
AU  - Peters, A.
AU  - Kirchberger, I.
C1  - 52705
C2  - 44290
CY  - 1200 New York Ave, Nw, Washington, Dc 20005 Usa
SP  - 46-52
TI  - Peripheral arterial disease is associated with higher mortality in patients with incident acute myocardial infarction.
JO  - Eur. J. Intern. Med.
VL  - 51
PB  - Amer Assoc Advancement Science
PY  - 2018
SN  - 0953-6205
ER  - 

TY  - JOUR
AB  - BACKGROUND: Data on the association between handgrip strength and multimorbidity (MMB) are missing. AIM: The purpose of this study was to examine if handgrip strength is related to MMB in a large population-based sample of older persons. METHODS: The cross-sectional analysis was based on 1079 older people (aged 65-94years), who participated in the KORA-Age study in the Augsburg region, southern Germany. Participants underwent an interview and extensive examinations, including anthropometric measurements, registration of chronic diseases, determination of health-related behaviors (smoking, alcohol intake and physical activity), collection of blood samples, and muscle strength measurement using hand-grip dynamometry. RESULTS: In men, handgrip strength correlated strongly with the number of co-existing diseases (r=-0.176, p<0.001), and the same pattern was observed for women (r=-0.287, p<0.001). Among women, handgrip strength in the lower tertile compared to the upper tertile was significantly associated with an increased odds of having MMB (OR: 2.57, 95% CI: 1.30-5.07, p=0.007) after controlling for age, BMI, education, alcohol intake, smoking habits, medications number, inflammatory markers, telomere length and levels of physical activity. Contrary, no significant association between handgrip strength and MMB was found among men (OR: 1.32, 95% CI: 0.73-2.40, p=0.362) after multivariable adjustment. CONCLUSION: Lower levels of handgrip strength are associated with a higher odd of MMB among older women even after adjusting for traditional and novel confounders. Increasing the levels of muscular strength in older women seems to be important in order to reduce the risk for the co-occurrence of multiple chronic diseases.
AU  - Volaklis, K.A.*
AU  - Halle, M.*
AU  - Thorand, B.
AU  - Peters, A.
AU  - Ladwig, K.-H.
AU  - Schulz, H.
AU  - Koenig, W.*
AU  - Meisinger, C.
C1  - 48465
C2  - 41160
CY  - Amsterdam
SP  - 35-40
TI  - Handgrip strength is inversely and independently associated with multimorbidity among older women: Results from the KORA-Age study.
JO  - Eur. J. Intern. Med.
VL  - 31
PB  - Elsevier Science Bv
PY  - 2016
SN  - 0953-6205
ER  - 

TY  - JOUR
AB  - Muscular strength, an important component of physical fitness, has an independent role in the prevention of chronic diseases whereas muscular weakness is strongly related to functional limitations and physical disability. Our purpose was to investigate the role of muscular strength as a predictor of mortality in health and disease. We conducted a systematic search in EMBASE and MEDLINE (1980-2014) looking for the association between muscular strength and mortality risk (all-cause and cause-specific mortality). Selected publications included 23 papers (15 epidemiological and 8 clinical studies). Muscular strength was inversely and independently associated with all-cause mortality even after adjusting for several confounders including the levels of physical activity or even cardiorespiratory fitness. The same pattern was observed for cardiovascular mortality; however more research is needed due to the few available data. The existed studies failed to show that low muscular strength is predictive of cancer mortality. Furthermore, a strong and inverse association of muscular strength with all-cause mortality has also been confirmed in several clinical populations such as cardiovascular disease, peripheral artery disease, cancer, renal failure, chronic obstructive pulmonary disease, rheumatoid arthritis and patients with critical illness. However, future studies are needed to further establish the current evidence and to explore the exact independent mechanisms of muscular strength in relation to mortality. Muscular strength as a modifiable risk factor would be of great interest from a public health perspective.
AU  - Volaklis, K.A.*
AU  - Halle, M.R.*
AU  - Meisinger, C.
C1  - 44548
C2  - 36922
CY  - Amsterdam
SP  - 303-310
TI  - Muscular strength as a strong predictor of mortality: A narrative review.
JO  - Eur. J. Intern. Med.
VL  - 26
IS  - 5
PB  - Elsevier Science Bv
PY  - 2015
SN  - 0953-6205
ER  -