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Allen J Taylor

Publications and source records attributed to Allen J Taylor.

57 records · Page 4Linked to original sources
PubMedDate not supplied

beta-Blocker use in long-term dialysis patients: association with hospitalized heart failure and mortality.

BACKGROUND: beta-Blockers have been shown to be beneficial in the treatment and prevention of heart failure (HF) in the general population, but they have not been assessed for their association with nonfatal HF in a nationally representative population of long-term dialysis patients. METHODS: We conducted a retrospective cohort study of 2550 patients enrolled in the US Renal Data System (USRDS) Wave 2 who were Medicare eligible at the start of the study. Analysis was stratified by the presence or absence of a known diagnosis of HF, and patients followed up until December 31, 2000. Cox regression analysis, including propensity scores, was used to model adjusted hazard ratios for beta-blocker use (assessed separately by cardioselective activity and lipid solubility) with time to the first Medicare institutional claim for HF, cardiovascular-related death, or death from any cause. RESULTS: In patients without a previous history of HF, beta-blocker use was significantly associated with a lower adjusted risk of HF (adjusted hazard ratio, 0.69; 95% confidence interval, 0.52-0.91; P=.008), with a similar reduction in risk of cardiac-related and all-cause death. beta-Blocker use had no statistically significant associations with outcomes in patients with previous HF. CONCLUSIONS: In dialysis patients without a previous documented history of HF, beta-blocker use was associated with a lower risk of new HF, cardiovascular death, and death from any cause. No such associations were seen for dialysis patients with a previous history of HF. These results are hypothesis generating only and should be confirmed in randomized trials.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Relationship between depression and C-reactive protein in a screening population.

BACKGROUND: Both depression and C-reactive protein (CRP) are markers of increased risk for cardiovascular events. This study examined the relationship between CRP and depression in a cohort of participants undergoing a periodic physical to assess potential for interaction as either mediation or confounding of effect on cardiovascular risk. METHODS: We conducted a cross-sectional study of a cohort of 696 consenting, active duty US Army personnel undergoing a periodic physical. We measured depression using the Patient Health Questionnaire-9, the depression module of the self-administered version of the Primary Care Evaluation of Mental Disorders (PRIME-MD). We used a highly sensitive assay to measure CRP. RESULTS: The mean age in the cohort was 44 years (SD +/- 3; 82% male). The mean CRP level was 1.7 mg/l (range, 0.3-9.9; SD +/- 1.6 mg/l). Depression scores ranged from 0 to 26 with a mean of 2 (SD +/- 3). Depression scores correlated with prevalences of major depressive disorder and of any depressive disorder of 3.3% and 15%, respectively. Depression scores correlated positively with CRP levels (r = 0.085; p =.028), as did other variables known to be associated with CRP: body mass index (BMI; r = 0.36), insulin levels (r = 0.22), mean arterial pressure (r = 0.21), triglycerides (r = 0.18), exercise (r = -0.12), female sex (r = 0.097), current smoking status (r = 0.08), and high density lipoprotein (r = -0.09). After controlling only for BMI, the relationship between depression and CRP lost statistical significance among women (adjusted r = 0.08; p =.37), among men (adjusted r = -0.11; p =.8), and overall (adjusted r = 0.047; p =.219). CONCLUSION: Depressive symptoms are only weakly correlated with CRP. However, after adjusting for BMI, we found no significant relationship between CRP and depression. The relationship between depression and clinical coronary disease is unlikely to be explained through direct effects on CRP levels, but may be mediated by BMI.

Adult↗