Cause-specific mortality and years of life lost in patients with different manifestations of vascular disease

Rob C.M. Kruijsdijk, Yolanda van der Graaf, Hendrik Koffijberg, Gert Jan de Borst, Hendrik M. Nathoe, L. Jaap Kappelle, Frank L.J. Visseren

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Abstract

Design The design was a prospective cohort study. Methods A total of 5911 patients with stable coronary artery disease, cerebrovascular disease, peripheral artery disease (PAD), abdominal aortic aneurysm or polyvascular disease were followed-up for mortality. Cause-specific standardised mortality ratios (SMRs) and YLL, compared to the Dutch population, were estimated. Determinants for cause-specific mortality were evaluated using competing risks models. Results During a median follow-up of 6.0 years (interquartile range (IQR): 3.1–9.2), 958 (16.2%) patients died. All-cause mortality was increased compared to the general population (SMR: 1.26, 95% confidence interval (CI): 1.18–1.34). Patients with PAD and polyvascular disease were at highest risk, especially for ischaemic heart disease (SMR: 2.52, 95% CI: 1.70–3.60 and SMR: 3.97, 95% CI: 3.18–4.90, respectively). Patients with PAD were at increased risk of dying from cancer (SMR: 1.67, 95% CI: 1.25–2.17). On average, patients with vascular disease of ≥50 years died 7.8 years younger than the general population, with 80% of the excess YLL attributable to cardiovascular disease. In middle-aged patients the excess YLL were about 10 years, of which 24% were lost due to cancer. Important determinants for mortality were male gender, smoking, physical inactivity, renal insufficiency and polyvascular disease. Conclusions Patients with manifest vascular disease are at increased risk of both cardiovascular and cancer mortality, particularly patients with PAD or polyvascular disease. On average, patients with vascular disease of ≥50 years die 7.8 years younger than the general population.
Original languageEnglish
Pages (from-to)160-169
JournalEuropean journal of preventive cardiology
Volume23
Issue number2
DOIs
Publication statusPublished - 2016

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Vascular Diseases
Mortality
Peripheral Arterial Disease
Confidence Intervals
Population
Cerebrovascular Disorders
Neoplasms
Abdominal Aortic Aneurysm
Renal Insufficiency
Myocardial Ischemia
Coronary Artery Disease
Cohort Studies
Cardiovascular Diseases
Smoking
Prospective Studies

Keywords

  • METIS-320527
  • IR-98484

Cite this

Kruijsdijk, R. C. M., van der Graaf, Y., Koffijberg, H., de Borst, G. J., Nathoe, H. M., Kappelle, L. J., & Visseren, F. L. J. (2016). Cause-specific mortality and years of life lost in patients with different manifestations of vascular disease. European journal of preventive cardiology, 23(2), 160-169. https://doi.org/10.1177/2047487314566998
Kruijsdijk, Rob C.M. ; van der Graaf, Yolanda ; Koffijberg, Hendrik ; de Borst, Gert Jan ; Nathoe, Hendrik M. ; Kappelle, L. Jaap ; Visseren, Frank L.J. / Cause-specific mortality and years of life lost in patients with different manifestations of vascular disease. In: European journal of preventive cardiology. 2016 ; Vol. 23, No. 2. pp. 160-169.
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abstract = "Design The design was a prospective cohort study. Methods A total of 5911 patients with stable coronary artery disease, cerebrovascular disease, peripheral artery disease (PAD), abdominal aortic aneurysm or polyvascular disease were followed-up for mortality. Cause-specific standardised mortality ratios (SMRs) and YLL, compared to the Dutch population, were estimated. Determinants for cause-specific mortality were evaluated using competing risks models. Results During a median follow-up of 6.0 years (interquartile range (IQR): 3.1–9.2), 958 (16.2{\%}) patients died. All-cause mortality was increased compared to the general population (SMR: 1.26, 95{\%} confidence interval (CI): 1.18–1.34). Patients with PAD and polyvascular disease were at highest risk, especially for ischaemic heart disease (SMR: 2.52, 95{\%} CI: 1.70–3.60 and SMR: 3.97, 95{\%} CI: 3.18–4.90, respectively). Patients with PAD were at increased risk of dying from cancer (SMR: 1.67, 95{\%} CI: 1.25–2.17). On average, patients with vascular disease of ≥50 years died 7.8 years younger than the general population, with 80{\%} of the excess YLL attributable to cardiovascular disease. In middle-aged patients the excess YLL were about 10 years, of which 24{\%} were lost due to cancer. Important determinants for mortality were male gender, smoking, physical inactivity, renal insufficiency and polyvascular disease. Conclusions Patients with manifest vascular disease are at increased risk of both cardiovascular and cancer mortality, particularly patients with PAD or polyvascular disease. On average, patients with vascular disease of ≥50 years die 7.8 years younger than the general population.",
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Cause-specific mortality and years of life lost in patients with different manifestations of vascular disease. / Kruijsdijk, Rob C.M.; van der Graaf, Yolanda; Koffijberg, Hendrik; de Borst, Gert Jan; Nathoe, Hendrik M.; Kappelle, L. Jaap; Visseren, Frank L.J.

In: European journal of preventive cardiology, Vol. 23, No. 2, 2016, p. 160-169.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cause-specific mortality and years of life lost in patients with different manifestations of vascular disease

AU - Kruijsdijk, Rob C.M.

AU - van der Graaf, Yolanda

AU - Koffijberg, Hendrik

AU - de Borst, Gert Jan

AU - Nathoe, Hendrik M.

AU - Kappelle, L. Jaap

AU - Visseren, Frank L.J.

PY - 2016

Y1 - 2016

N2 - Design The design was a prospective cohort study. Methods A total of 5911 patients with stable coronary artery disease, cerebrovascular disease, peripheral artery disease (PAD), abdominal aortic aneurysm or polyvascular disease were followed-up for mortality. Cause-specific standardised mortality ratios (SMRs) and YLL, compared to the Dutch population, were estimated. Determinants for cause-specific mortality were evaluated using competing risks models. Results During a median follow-up of 6.0 years (interquartile range (IQR): 3.1–9.2), 958 (16.2%) patients died. All-cause mortality was increased compared to the general population (SMR: 1.26, 95% confidence interval (CI): 1.18–1.34). Patients with PAD and polyvascular disease were at highest risk, especially for ischaemic heart disease (SMR: 2.52, 95% CI: 1.70–3.60 and SMR: 3.97, 95% CI: 3.18–4.90, respectively). Patients with PAD were at increased risk of dying from cancer (SMR: 1.67, 95% CI: 1.25–2.17). On average, patients with vascular disease of ≥50 years died 7.8 years younger than the general population, with 80% of the excess YLL attributable to cardiovascular disease. In middle-aged patients the excess YLL were about 10 years, of which 24% were lost due to cancer. Important determinants for mortality were male gender, smoking, physical inactivity, renal insufficiency and polyvascular disease. Conclusions Patients with manifest vascular disease are at increased risk of both cardiovascular and cancer mortality, particularly patients with PAD or polyvascular disease. On average, patients with vascular disease of ≥50 years die 7.8 years younger than the general population.

AB - Design The design was a prospective cohort study. Methods A total of 5911 patients with stable coronary artery disease, cerebrovascular disease, peripheral artery disease (PAD), abdominal aortic aneurysm or polyvascular disease were followed-up for mortality. Cause-specific standardised mortality ratios (SMRs) and YLL, compared to the Dutch population, were estimated. Determinants for cause-specific mortality were evaluated using competing risks models. Results During a median follow-up of 6.0 years (interquartile range (IQR): 3.1–9.2), 958 (16.2%) patients died. All-cause mortality was increased compared to the general population (SMR: 1.26, 95% confidence interval (CI): 1.18–1.34). Patients with PAD and polyvascular disease were at highest risk, especially for ischaemic heart disease (SMR: 2.52, 95% CI: 1.70–3.60 and SMR: 3.97, 95% CI: 3.18–4.90, respectively). Patients with PAD were at increased risk of dying from cancer (SMR: 1.67, 95% CI: 1.25–2.17). On average, patients with vascular disease of ≥50 years died 7.8 years younger than the general population, with 80% of the excess YLL attributable to cardiovascular disease. In middle-aged patients the excess YLL were about 10 years, of which 24% were lost due to cancer. Important determinants for mortality were male gender, smoking, physical inactivity, renal insufficiency and polyvascular disease. Conclusions Patients with manifest vascular disease are at increased risk of both cardiovascular and cancer mortality, particularly patients with PAD or polyvascular disease. On average, patients with vascular disease of ≥50 years die 7.8 years younger than the general population.

KW - METIS-320527

KW - IR-98484

U2 - 10.1177/2047487314566998

DO - 10.1177/2047487314566998

M3 - Article

VL - 23

SP - 160

EP - 169

JO - European journal of preventive cardiology

JF - European journal of preventive cardiology

SN - 2047-4873

IS - 2

ER -