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Incidence of 12 common cardiovascular diseases and subsequent mortality risk in the general population

Prugger, Christof; Perier, Marie-Cécile; Gonzalez-Izquierdo, Arturo; Hemingway, Harry; Denaxas, Spiros; Empana, Jean-Philippe; (2023) Incidence of 12 common cardiovascular diseases and subsequent mortality risk in the general population. European Journal of Preventive Cardiology , Article zwad192. 10.1093/eurjpc/zwad192. (In press).

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Abstract

BACKGROUND: Incident events of cardiovascular diseases (CVD) are heterogenous and may results in different mortality risks. Such evidence may help inform patient and physician decisions in CVD prevention and risk factor management. AIM: To determine the extent to which incident events of common CVD show heterogeneous associations with subsequent mortality risk in the general population. METHODS: Based on England-wide linked electronic health records, we established a cohort of 1,310,518 people ≥30 years of age initially free of CVD and followed up for non-fatal events of 12 common CVD and cause-specific mortality. The 12 CVD were considered as time-varying exposures in Cox's proportional hazards models to estimate hazard rate ratios (HRR) with 95% confidence intervals (CI). RESULTS: Over the median follow-up of 4.2 years (2010-2016), 81,516 non-fatal CVD, 10,906 cardiovascular deaths, and 40,843 non-cardiovascular deaths occurred. All 12 CVD were associated with increased risk of cardiovascular mortality, with HRR (95% CI) ranging from 1.67 (1.47-1.89) for stable angina to 7.85 (6.62-9.31) for haemorrhagic stroke. All 12 CVD were also associated with increased non-cardiovascular and all-cause mortality risk but to a lesser extent: HRR (95% CI) ranged from 1.10 (1.00-1.22) to 4.55 (4.03-5.13) and from 1.24 (1.13-1.35) to 4.92 (4.44-5.46) for transient ischaemic attack and sudden cardiac arrest, respectively. CONCLUSIONS: Incident events of 12 common CVD show significant adverse and markedly differential associations with subsequent cardiovascular, non-cardiovascular, and all-cause mortality risk in the general population.

Type: Article
Title: Incidence of 12 common cardiovascular diseases and subsequent mortality risk in the general population
Location: England
DOI: 10.1093/eurjpc/zwad192
Publisher version: https://doi.org/10.1093/eurjpc/zwad192
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Coronary heart disease, epidemiology, incidence, prevention, stroke, survival analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/10171993
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