However, Cheng et al. to I09, I11, I20 to I51), and the secondary endpoint was all-cause mortality. Statistical methods Continuous variables are presented as meansSDs, and categorical variables are presented as numbers and percentages. Baseline characteristics were compared among the groups using one-way analysis of variance for continuous variables and the Chi-square test for categorical variables. Cardiac death and all-cause mortality were calculated, and the difference was compared between groups with a Chi-square test. Cox proportional hazard regression analysis was used to evaluate the association between different PA groups for endpoint events. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to show the impact. Associations were investigated with stratification according to baseline age. Model 1 was adjusted for age and gender. Model 2 was further adjusted for primary prevention, NYHA class, CRTD implantation, LVEF, LVEDD, -blockers, and aldosterone antagonists. Model 3 was adjusted for factors in Model 2 and potential mediators on the causal pathway including BMI, ischemic sodium 4-pentynoate cardiomyopathy, hypertension, AF, diabetes, and prior myocardial infarction. In addition, a restricted cubic spline was used to assess the dose-response association between PA and the risk of endpoints. Four knots were placed at the 5th, 35th, 65th, and 95th percentiles of PA. To specify the PA range for achieving optimal benefits as a target value that can be practicable in clinical practice, we determined the amount Rabbit Polyclonal to Ezrin of PA required when the risk was halved, and 8.04% PA (lower tertile point) was used as the reference (HR?=?1.0). A value of valueangiotensin-converting enzyme inhibitors, angiotensin receptor blockers, Body Mass Index, cardiac resynchronization therapy and implantable cardioverter-defibrillator, left ventricular end-diastolic dimension, left ventricular ejection fraction, New York Heart Association class Significant differences among the three groups were detected for male gender ( em P /em ?=?0.026), age at implantation ( em P /em ? ?0.001), NYHA class ( em P /em ? ?0.001), LVEF ( em P /em ? ?0.001), ischemic cardiomyopathy ( em P /em ? ?0.001), hypertension ( em P /em ?=?0.047), diabetes ( em P /em ?=?0.005), stroke ( em P /em ?=?0.044), prior myocardial infarction ( em P /em ? ?0.001), and use of aldosterone antagonists ( em P /em ? ?0.001) and loop-diuretics ( em P /em ? ?0.001). No significant differences were found regarding other baseline characteristics (Table ?(Table11). Clinical outcomes The mean follow-up time was 59.7??22.4?months. A total of 90 cardiac deaths (10.9%) and 191 all-cause mortality events (23.2%) occurred. The percentage of cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1C3, em P /em ? ?0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1C3, em P /em ? ?0.001) events decreased according to baseline PA tertiles. A total of 462 patients were aged 60?years or older (56.2%). Compared to patients younger than 60?years, older patients had sodium 4-pentynoate a lower average PA level (9.6% vs 12.8%, em P /em ? ?0.001) but higher rates of cardiac death (13.2% vs 8.1%, em P /em ?=?0.024) and all-cause mortality (28.4% vs 16.7%, em P /em ? ?0.001) events (Fig.?1). Open in a separate window Fig. 1 Cardiac death and all-cause mortality events percentage in younger and older groups PA and cardiac death Multivariate Cox sodium 4-pentynoate regression analyses showed that a higher level of PA was inversely associated with cardiac death (HR 0.40, 95% CI: 0.25C0.66, tertile 2 vs tertile 1; HR 0.25, 95% CI: 0.14C0.45, tertile 3 vs tertile 1; em P /em trend? ?0.001). The results remained statistically significant after adjustment for confounders including age, gender, primary prevention, NYHA class, CRTD implantation, LVEF, LVEDD, -blocker use, and aldosterone antagonist use (Model 2). After additional adjustment of potential mediators, including BMI, ischemic cardiomyopathy, hypertension, AF, diabetes, and prior myocardial infarction, the results were similar (Model 3). The results from Model 2 and Model 3 were consistent, and as obesity and comorbidities are very common and related to clinical diagnosis and treatment decisions for ICD patients, in the present sodium 4-pentynoate study, findings from Model 3 were used as the main results (Table?2). Table 2 Cardiac death outcomes and multivariate cox regression analyses thead th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ No. of events /th th rowspan=”1″ colspan=”1″ No. of participants /th th rowspan=”1″ colspan=”1″ Model 1 /th th rowspan=”1″ colspan=”1″ sodium 4-pentynoate Model 2 /th th rowspan=”1″ colspan=”1″ Model 3 /th th rowspan=”1″ colspan=”1″ em P /em trend /th /thead Tertile 151274Ref.Ref.Ref. ?0.001Tertile 2242740.40 (0.25C0.66)0.42 (0.26C0.69)0.41 (0.25C0.68)Tertile 3152740.25 (0.14C0.45)0.26 (0.14C0.48)0.28 (0.15C0.51)Age, years?? ?60??Tertile 11076Ref.Ref.Ref.0.127??Tertile 2111210.57 (0.24C1.35)0.76 (0.31C1.85)0.82 (0.33C2.04)??Tertile 381630.29 (0.11C0.74)0.39 (0.15C1.06)0.47 (0.17C1.26)???60??Tertile 141198Ref.Ref.Ref. ?0.001??Tertile 2131530.35 (0.19C0.65)0.34 (0.18C0.65)0.34 (0.18C0.64)??Tertile 371110.25 (0.11C0.57)0.24 (0.11C0.55)0.25 (0.11C0.57) Open in a separate window Model 1 adjusted for age and gender; Model 2 further adjusted for Model 1 puls primary prevention, NYHA, CRT-D, LVEF, LVEDD, -blockers, and aldosterone antagonists; Model 3 adjusted factors in Model 2 and potential mediators on the causal pathway including BMI, ischemic cardiomyopathy, hypertension, AF,.