5 research outputs found
Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study
Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality
Unmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator: A systematic review and meta-analysis
Background: Use of implantable cardioverter defibrillators is increasingly common. As patients approach the end of life, it is appropriate to deactivate the shock function. Aim: To assess the prevalence of implantable cardioverter defibrillator reprogramming to deactivate the shock function at the end of life and the prevalence of advance directives among this population. Design: Following a previously established protocol available in PROSPERO, we performed a narrative synthesis of our findings and used the logit transforma
Application of artificial neural networks for transistor open‐circuit fault diagnosis in three‐phase rectifiers
Phenotypes Determined by Cluster Analysis and Their Survival in the Prospective European Scleroderma Trials and Research Cohort of Patients With Systemic Sclerosis
Objective Systemic sclerosis (SSc) is a heterogeneous connective tissue
disease that is typically subdivided into limited cutaneous SSc (lcSSc)
and diffuse cutaneous SSc (dcSSc) depending on the extent of skin
involvement. This subclassification may not capture the entire
variability of clinical phenotypes. The European Scleroderma Trials and
Research (EUSTAR) database includes data on a prospective cohort of SSc
patients from 122 European referral centers. This study was undertaken
to perform a cluster analysis of EUSTAR data to distinguish and
characterize homogeneous phenotypes without any a priori assumptions,
and to examine survival among the clusters obtained. Methods A total of
11,318 patients were registered in the EUSTAR database, and 6,927 were
included in the study. Twenty-four clinical and serologic variables were
used for clustering. Results Clustering analyses provided a first
delineation of 2 clusters showing moderate stability. In an exploratory
attempt, we further characterized 6 homogeneous groups that differed
with regard to their clinical features, autoantibody profile, and
mortality. Some groups resembled usual dcSSc or lcSSc prototypes, but
others exhibited unique features, such as a majority of lcSSc patients
with a high rate of visceral damage and antitopoisomerase antibodies.
Prognosis varied among groups and the presence of organ damage markedly
impacted survival regardless of cutaneous involvement. Conclusion Our
findings suggest that restricting subsets of SSc patients to only those
based on cutaneous involvement may not capture the complete
heterogeneity of the disease. Organ damage and antibody profile should
be taken into consideration when individuating homogeneous groups of
patients with a distinct prognosis
Phenotypes determined by cluster analysis and their survival in the prospective european scleroderma trials and research cohort of patients with systemic sclerosis
Systemic sclerosis (SSc) is a heterogeneous connective tissue disease that is typically subdivided into limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) depending on the extent of skin involvement. This subclassification may not capture the entire variability of clinical phenotypes. The European Scleroderma Trials and Research (EUSTAR) database includes data on a prospective cohort of SSc patients from 122 European referral centers. This study was undertaken to perform a cluster analysis of EUSTAR data to distinguish and characterize homogeneous phenotypes without any a priori assumptions, and to examine survival among the clusters obtained