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  1. Article ; Online: Can Observational Data and Target Trial Emulation Inform Cardiovascular Disease Prevention and Management Guidelines?

    Russo, Rienna G / Danaei, Goodarz

    Circulation. Cardiovascular quality and outcomes

    2024  , Page(s) e010979

    Language English
    Publishing date 2024-04-29
    Publishing country United States
    Document type Editorial
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.124.010979
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  2. Article ; Online: Self-Administration of Aspirin After Chest Pain for the Prevention of Premature Cardiovascular Mortality in the United States: A Population-Based Analysis.

    Russo, Rienna G / Wikler, Daniel / Rahimi, Kazem / Danaei, Goodarz

    Journal of the American Heart Association

    2024  , Page(s) e032778

    Abstract: Background: Aspirin, an effective, low-cost pharmaceutical, can significantly reduce mortality if used promptly after acute myocardial infarction (AMI). However, many AMI survivors do not receive aspirin within a few hours of symptom onset. Our aim was ... ...

    Abstract Background: Aspirin, an effective, low-cost pharmaceutical, can significantly reduce mortality if used promptly after acute myocardial infarction (AMI). However, many AMI survivors do not receive aspirin within a few hours of symptom onset. Our aim was to quantify the mortality benefit of self-administering aspirin at chest pain onset, considering the increased risk of bleeding and costs associated with widespread use.
    Methods and results: We developed a population simulation model to determine the impact of self-administering 325 mg aspirin within 4 hours of severe chest pain onset. We created a synthetic cohort of adults ≥ 40 years old experiencing severe chest pain using 2019 US population estimates, AMI incidence, and sensitivity/specificity of chest pain for AMI. The number of annual deaths delayed was estimated using evidence from a large, randomized trial. We also estimated the years of life saved (YOLS), costs, and cost per YOLS. Initiating aspirin within 4 hours of severe chest pain onset delayed 13 016 (95% CI, 11 643-14 574) deaths annually, after accounting for deaths due to bleeding (963; 926-1003). This translated to an estimated 166 309 YOLS (149391-185 505) at the cost of $643 235 (633 944-653 010) per year, leading to a cost-effectiveness ratio of $3.70 (3.32-4.12) per YOLS.
    Conclusions: For <$4 per YOLS, self-administration of aspirin within 4 hours of severe chest pain onset has the potential to save 13 000 lives per year in the US population. Benefits of reducing deaths post-AMI outweighed the risk of bleeding deaths from aspirin 10 times over.
    Language English
    Publishing date 2024-05-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.032778
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  3. Article ; Online: Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study.

    Nilsen, Linn / Sharashova, Ekaterina / Løchen, Maja-Lisa / Danaei, Goodarz / Wilsgaard, Tom

    European journal of preventive cardiology

    2023  Volume 30, Issue 16, Page(s) 1791–1800

    Abstract: Aims: To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors.: Methods and results: We estimated the risk reduction under ... ...

    Abstract Aims: To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors.
    Methods and results: We estimated the risk reduction under hypothetical risk reduction strategies for smoking, physical activity, alcohol intake, body mass index, systolic, and diastolic blood pressure in 14 923 women and men (baseline mean age 45.8 years in women and 47.8 years in men) from the population-based Tromsø Study with a maximum of 22 years of follow-up (1994-2016). The estimated risk of AF under no intervention was 6.15% in women and 13.0% in men. This cumulative risk was reduced by 41% (95% confidence interval 17%, 61%) in women and 14% (-7%, 30%) in men under joint interventions on all risk factors. The most effective intervention was lowering body mass index to ≤ 25 kg/m2, leading to a 16% (4%, 25%) lower risk in women and a 14% (6%, 23%) lower risk in men. We found significant sex-differences in the relative risk reduction by sufficient physical activity, leading to a 7% (-4%, 18%) lower risk in women and an 8% (-2%, -13%) increased risk in men. We found no association between the level of education and differences in risk reduction by any of the interventions.
    Conclusion: The population burden of AF could be reduced by modifying lifestyle risk factors. Namely, these modifications could have prevented 41% of AF cases in women and 14% of AF cases in men in the municipality of Tromsø, Norway during a maximum 22-year follow-up period.
    MeSH term(s) Male ; Humans ; Female ; Middle Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/prevention & control ; Risk Factors ; Smoking/adverse effects ; Alcohol Drinking ; Educational Status ; Incidence
    Language English
    Publishing date 2023-08-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2626011-6
    ISSN 2047-4881 ; 2047-4873
    ISSN (online) 2047-4881
    ISSN 2047-4873
    DOI 10.1093/eurjpc/zwad240
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    Zs.A 4686: Show issues Location:
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  4. Article ; Online: Target trial emulation: applying principles of randomised trials to observational studies.

    Matthews, Anthony A / Danaei, Goodarz / Islam, Nazrul / Kurth, Tobias

    BMJ (Clinical research ed.)

    2022  Volume 378, Page(s) e071108

    MeSH term(s) COVID-19 ; Comparative Effectiveness Research ; Extracorporeal Membrane Oxygenation ; Humans ; Respiratory Distress Syndrome ; Respiratory Insufficiency
    Language English
    Publishing date 2022-08-30
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj-2022-071108
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  5. Article ; Online: Scaling up prenatal nutrition could reduce the global burden of noncommunicable diseases in the next generation: a modeling analysis.

    Blakstad, Mia M / Fawzi, Wafaie W / Castro, Marcia C / Thompson, Andrew / Arabi, Mandana / Danaei, Goodarz

    The American journal of clinical nutrition

    2023  Volume 116, Issue 5, Page(s) 1291–1302

    Abstract: Background: Nutritional conditions during pregnancy may influence the epigenetic development of an individual and consequently their later-life risk of noncommunicable disease (NCD). Improving nutrition for pregnant females may therefore serve the dual ... ...

    Abstract Background: Nutritional conditions during pregnancy may influence the epigenetic development of an individual and consequently their later-life risk of noncommunicable disease (NCD). Improving nutrition for pregnant females may therefore serve the dual purpose of directly improving pregnancy outcomes and preventing NCDs in the next generation.
    Objectives: We estimated the impact of prenatal supplementation with iron and folic acid (IFA), multiple micronutrients (MMS), or calcium at 50%, 75%, or 90% coverage on future NCDs by age and sex in 2015.
    Methods: We used secondary data sources from 132 countries to quantify the cases of diabetes and hypertension and the deaths from selected NCDs that could be averted or delayed by scaling up prenatal micronutrient supplementation.
    Results: Globally, >51,000 NCD deaths, 6 million cases of hypertension, and 3 million cases of diabetes could be prevented per offspring birth cohort if mothers were prenatally supplemented with MMS at 90% coverage. For IFA these numbers would be roughly half. Calcium supplementation at 90% could delay 51,000 deaths per birth cohort. Our model suggests that substantial numbers of NCD deaths and cases of hypertension and diabetes could be prevented in future generations by scaling up micronutrient supplementation for mothers during pregnancy.
    Conclusions: Highlighting the additional benefits of proven nutrition interventions is critical in ensuring adequate and sustained investments, and programmatic integration. As the double burden of disease continues to grow, population-wide efforts to scale up micronutrient supplementation to pregnant females could help prevent both undernutrition and chronic disease.
    MeSH term(s) Pregnancy ; Female ; Humans ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/prevention & control ; Calcium ; Micronutrients ; Prenatal Nutritional Physiological Phenomena ; Folic Acid ; Dietary Supplements ; Vitamins ; Iron
    Chemical Substances Calcium (SY7Q814VUP) ; Micronutrients ; Folic Acid (935E97BOY8) ; Vitamins ; Iron (E1UOL152H7)
    Language English
    Publishing date 2023-02-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.1093/ajcn/nqac214
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  6. Article ; Online: Cardiometabolic and renal phenotypes and transitions in the United States population.

    Lhoste, Victor P F / Zhou, Bin / Mishra, Anu / Bennett, James E / Filippi, Sarah / Asaria, Perviz / Gregg, Edward W / Danaei, Goodarz / Ezzati, Majid

    Nature cardiovascular research

    2024  Volume 3, Issue 1, Page(s) 46–59

    Abstract: Cardiovascular and renal conditions have both shared and distinct determinants. In this study, we applied unsupervised clustering to multiple rounds of the National Health and Nutrition Examination Survey from 1988 to 2018, and identified 10 ... ...

    Abstract Cardiovascular and renal conditions have both shared and distinct determinants. In this study, we applied unsupervised clustering to multiple rounds of the National Health and Nutrition Examination Survey from 1988 to 2018, and identified 10 cardiometabolic and renal phenotypes. These included a 'low risk' phenotype; two groups with average risk factor levels but different heights; one group with low body-mass index and high levels of high-density lipoprotein cholesterol; five phenotypes with high levels of one or two related risk factors ('high heart rate', 'high cholesterol', 'high blood pressure', 'severe obesity' and 'severe hyperglycemia'); and one phenotype with low diastolic blood pressure (DBP) and low estimated glomerular filtration rate (eGFR). Prevalence of the 'high blood pressure' and 'high cholesterol' phenotypes decreased over time, contrasted by a rise in the 'severe obesity' and 'low DBP, low eGFR' phenotypes. The cardiometabolic and renal traits of the US population have shifted from phenotypes with high blood pressure and cholesterol toward poor kidney function, hyperglycemia and severe obesity.
    Language English
    Publishing date 2024-02-05
    Publishing country England
    Document type Journal Article
    ISSN 2731-0590
    ISSN (online) 2731-0590
    DOI 10.1038/s44161-023-00391-y
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  7. Article ; Online: Reply to P Phalak et al.

    Soto-Mota, Adrian / Flores-Jurado, Yuscely / Norwitz, Nicholas G / Feldman, David / Pereira, Mark A / Danaei, Goodarz / Ludwig, David S

    The American journal of clinical nutrition

    2024  Volume 119, Issue 4, Page(s) 1092–1093

    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Letter
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.1016/j.ajcnut.2024.02.011
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  8. Article ; Online: Increased low-density lipoprotein cholesterol on a low-carbohydrate diet in adults with normal but not high body weight: A meta-analysis.

    Soto-Mota, Adrian / Flores-Jurado, Yuscely / Norwitz, Nicholas G / Feldman, David / Pereira, Mark A / Danaei, Goodarz / Ludwig, David S

    The American journal of clinical nutrition

    2024  Volume 119, Issue 3, Page(s) 740–747

    Abstract: Background: Low-density lipoprotein (LDL) cholesterol change with consumption of a low-carbohydrate diet (LCD) is highly variable. Identifying the source of this heterogeneity could guide clinical decision-making.: Objectives: To evaluate LDL ... ...

    Abstract Background: Low-density lipoprotein (LDL) cholesterol change with consumption of a low-carbohydrate diet (LCD) is highly variable. Identifying the source of this heterogeneity could guide clinical decision-making.
    Objectives: To evaluate LDL cholesterol change in randomized controlled trials involving LCDs, with a focus on body mass index (BMI) in kg/m
    Methods: Three electronic indexes (Pubmed, EBSCO, and Scielo) were searched for studies between 1 January, 2003 and 20 December, 2022. Two independent reviewers identified randomized controlled trials involving adults consuming <130 g/d carbohydrate and reporting BMI and LDL cholesterol change or equivalent data. Two investigators extracted relevant data, which were validated by other investigators. Data were analyzed using a random-effects model and contrasted with results of pooled individual participant data.
    Results: Forty-one trials with 1379 participants and a mean intervention duration of 19.4 wk were included. In a meta-regression accounting for 51.4% of the observed variability on LCDs, mean baseline BMI had a strong inverse association with LDL cholesterol change [β = -2.5 mg/dL/BMI unit, 95% confidence interval (CI): -3.7, -1.4], whereas saturated fat amount was not significantly associated with LDL cholesterol change. For trials with mean baseline BMI <25, LDL cholesterol increased by 41 mg/dL (95% CI: 19.6, 63.3) on the LCD. By contrast, for trials with a mean of BMI 25-<35, LDL cholesterol did not change, and for trials with a mean BMI ≥35, LDL cholesterol decreased by 7 mg/dL (95% CI: -12.1, -1.3). Using individual participant data, the relationship between BMI and LDL cholesterol change was not observed on higher-carbohydrate diets.
    Conclusions: A substantial increase in LDL cholesterol is likely for individuals with low but not high BMI with consumption of an LCD, findings that may help guide individualized nutritional management of cardiovascular disease risk. As carbohydrate restriction tends to improve other lipid and nonlipid risk factors, the clinical significance of isolated LDL cholesterol elevation in this context warrants investigation. This trial was registered at PROSPERO as CRD42022299278.
    MeSH term(s) Adult ; Humans ; Cholesterol, LDL ; Triglycerides ; Diet, Fat-Restricted ; Cholesterol, HDL ; Overweight ; Diet, Carbohydrate-Restricted ; Cholesterol ; Carbohydrates
    Chemical Substances Cholesterol, LDL ; Triglycerides ; Cholesterol, HDL ; Cholesterol (97C5T2UQ7J) ; Carbohydrates
    Language English
    Publishing date 2024-01-17
    Publishing country United States
    Document type Meta-Analysis ; Journal Article
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.1016/j.ajcnut.2024.01.009
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  9. Article ; Online: Global burden of infection-related cancer revisited.

    Danaei, Goodarz

    The Lancet. Oncology

    2012  Volume 13, Issue 6, Page(s) 564–565

    MeSH term(s) Bacterial Infections/epidemiology ; Female ; Global Health ; Humans ; Male ; Neoplasms/epidemiology ; Neoplasms/microbiology ; Virus Diseases/epidemiology
    Language English
    Publishing date 2012-06
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(12)70176-6
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  10. Article ; Online: Use of sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists according to the 2019 ESC guidelines and the 2019 ADA/EASD consensus report in a national population of patients with type 2 diabetes.

    Lim, Carl-Emil / Pasternak, Björn / Eliasson, Björn / Danaei, Goodarz / Ueda, Peter

    European journal of preventive cardiology

    2022  Volume 30, Issue 8, Page(s) 634–643

    Abstract: Aims: To assess treatment eligibility for, and received treatment with, sodium-glucose co-transporter 2 inhibitors (SGLT2) and glucagon-like peptide-1 (GLP-1) receptor agonists according to the 2019 the American Diabetes Association (ADA)/European ... ...

    Abstract Aims: To assess treatment eligibility for, and received treatment with, sodium-glucose co-transporter 2 inhibitors (SGLT2) and glucagon-like peptide-1 (GLP-1) receptor agonists according to the 2019 the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) consensus report and the 2019 European Society of Cardiology (ESC) guidelines in a nationwide sample of patients with type 2 diabetes.
    Methods and results: Both sets of guidelines included the treatment indications of heart failure, chronic kidney disease, and atherosclerotic cardiovascular disease while only the 2019 ESC guidelines also recommended treatment based on high or very high cardiovascular risk. The analyses included 435 000 patients with type 2 diabetes identified from the Swedish National Diabetes Register (2020-21). According to the 2019 ESC guidelines, 79.5% were recommended any of the two drugs (SGLT2 inhibitors: 37.2%; SGLT2 inhibitors or GLP-1 receptor agonists: 40.9%; GLP-1 receptor agonists: 1.4%). According to the 2019 ADA/EASD consensus report, 48.8% were recommended any of the two drugs (SGLT2 inhibitors: 37.2%; GLP-1 receptor agonists: 11.6%). Of those who had been recommended any of the two drugs, 33.7% had received the recommended treatment according to the 2019 ESC guidelines and 25.4% according to the 2019 ADA/EASD consensus report.
    Conclusions: In this nationwide study, the proportion of patients with type 2 diabetes who were recommended treatment with an SGLT2 inhibitor or a GLP-1 receptor agonist was approximately 80% according to the 2019 ESC guidelines and around half according to the 2019 ADA/EASD consensus report. Uptake of these recommendations in routine clinical practice was limited.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects ; Glucagon-Like Peptide-1 Receptor/agonists ; Hypoglycemic Agents/adverse effects ; Consensus ; Cardiovascular Diseases/drug therapy ; Cardiology ; Glucose/therapeutic use ; Symporters/therapeutic use ; Sodium/therapeutic use
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors ; Glucagon-Like Peptide-1 Receptor ; Hypoglycemic Agents ; Glucose (IY9XDZ35W2) ; Symporters ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2022-12-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2626011-6
    ISSN 2047-4881 ; 2047-4873
    ISSN (online) 2047-4881
    ISSN 2047-4873
    DOI 10.1093/eurjpc/zwac315
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