Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis

J. Mandrioli, L. Ferri, A. Fasano, E. Zucchi, N. Fini, C. Moglia, C. Lunetta, K. Marinou, N. Ticozzi, G. Drago Ferrante, C. Scialo, G. Sorarù, F. Trojsi, A. Conte, Y.M. Falzone, R. Tortelli, M. Russo, V.A. Sansone, G. Mora, V. SilaniP. Volanti, C. Caponnetto, G. Querin, M.R. Monsurrò, M. Sabatelli, A. Chiò, N. Riva, G. Logroscino, S. Messina, A. Calvo

Research output: Contribution to journalArticle

Abstract

Background and purpose: Only a few studies have considered the role of comorbidities in the prognosis of amyotrophic lateral sclerosis (ALS) and have provided conflicting results. Methods: Our multicentre, retrospective study included patients diagnosed from 1 January 2009 to 31 December 2013 in 13 referral centres for ALS located in 10 Italian regions. Neurologists at these centres collected a detailed phenotypic profile and follow-up data until death in an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role in ALS prognosis. Results: A total of 2354 incident cases were collected, with a median survival time from onset to death/tracheostomy of 43 months. According to univariate analysis, together with well-known clinical prognostic factors (age at onset, diagnostic delay, site of onset, phenotype, Revised El Escorial Criteria and body mass index at diagnosis), the presence of dementia, hypertension, heart disease, chronic obstructive pulmonary disease, haematological and psychiatric diseases was associated with worse survival. In multivariate analysis, age at onset, diagnostic delay, phenotypes, body mass index at diagnosis, Revised El Escorial Criteria, dementia, hypertension, heart diseases (atrial fibrillation and heart failure) and haematological diseases (disorders of thrombosis and haemostasis) were independent prognostic factors of survival in ALS. Conclusions: Our large, multicentre study demonstrated that, together with the known clinical factors that are known to be prognostic for ALS survival, hypertension and heart diseases (i.e. atrial fibrillation and heart failure) as well as haematological diseases are independently associated with a shorter survival. Our findings suggest some mechanisms that are possibly involved in disease progression, giving new interesting clues that may be of value for clinical practice and ALS comorbidity management. © 2018 EAN
Original languageEnglish
Pages (from-to)861-868
Number of pages8
JournalEuropean Journal of Neurology
Volume25
Issue number6
DOIs
Publication statusPublished - 2018

Fingerprint

Amyotrophic Lateral Sclerosis
Cardiovascular Diseases
Heart Diseases
Hematologic Diseases
Survival
Comorbidity
Hypertension
Age of Onset
Atrial Fibrillation
Multicenter Studies
Dementia
Body Mass Index
Heart Failure
Phenotype
Tracheostomy
Hemostasis
Chronic Obstructive Pulmonary Disease
Psychiatry
Disease Progression
Thrombosis

Keywords

  • amyotrophic lateral sclerosis
  • anemia
  • anxiety disorder
  • Article
  • body mass
  • cardiomyopathy
  • cardiovascular disease
  • chronic obstructive lung disease
  • comorbidity
  • delayed diagnosis
  • dementia
  • depression
  • drug dependence
  • female
  • follow up
  • gammopathy
  • heart failure
  • human
  • hypertension
  • ischemic heart disease
  • major clinical study
  • male
  • median survival time
  • neurologist
  • obsessive compulsive disorder
  • onset age
  • paroxysmal atrial fibrillation
  • persistent atrial fibrillation
  • phenotype
  • polydipsia
  • priority journal
  • prognosis
  • psychosis
  • retrospective study
  • thrombosis
  • tracheostomy
  • valvular heart disease

Cite this

Mandrioli, J., Ferri, L., Fasano, A., Zucchi, E., Fini, N., Moglia, C., ... Calvo, A. (2018). Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis. European Journal of Neurology, 25(6), 861-868. https://doi.org/10.1111/ene.13620

Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis. / Mandrioli, J.; Ferri, L.; Fasano, A.; Zucchi, E.; Fini, N.; Moglia, C.; Lunetta, C.; Marinou, K.; Ticozzi, N.; Drago Ferrante, G.; Scialo, C.; Sorarù, G.; Trojsi, F.; Conte, A.; Falzone, Y.M.; Tortelli, R.; Russo, M.; Sansone, V.A.; Mora, G.; Silani, V.; Volanti, P.; Caponnetto, C.; Querin, G.; Monsurrò, M.R.; Sabatelli, M.; Chiò, A.; Riva, N.; Logroscino, G.; Messina, S.; Calvo, A.

In: European Journal of Neurology, Vol. 25, No. 6, 2018, p. 861-868.

Research output: Contribution to journalArticle

Mandrioli, J, Ferri, L, Fasano, A, Zucchi, E, Fini, N, Moglia, C, Lunetta, C, Marinou, K, Ticozzi, N, Drago Ferrante, G, Scialo, C, Sorarù, G, Trojsi, F, Conte, A, Falzone, YM, Tortelli, R, Russo, M, Sansone, VA, Mora, G, Silani, V, Volanti, P, Caponnetto, C, Querin, G, Monsurrò, MR, Sabatelli, M, Chiò, A, Riva, N, Logroscino, G, Messina, S & Calvo, A 2018, 'Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis', European Journal of Neurology, vol. 25, no. 6, pp. 861-868. https://doi.org/10.1111/ene.13620
Mandrioli, J. ; Ferri, L. ; Fasano, A. ; Zucchi, E. ; Fini, N. ; Moglia, C. ; Lunetta, C. ; Marinou, K. ; Ticozzi, N. ; Drago Ferrante, G. ; Scialo, C. ; Sorarù, G. ; Trojsi, F. ; Conte, A. ; Falzone, Y.M. ; Tortelli, R. ; Russo, M. ; Sansone, V.A. ; Mora, G. ; Silani, V. ; Volanti, P. ; Caponnetto, C. ; Querin, G. ; Monsurrò, M.R. ; Sabatelli, M. ; Chiò, A. ; Riva, N. ; Logroscino, G. ; Messina, S. ; Calvo, A. / Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis. In: European Journal of Neurology. 2018 ; Vol. 25, No. 6. pp. 861-868.
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abstract = "Background and purpose: Only a few studies have considered the role of comorbidities in the prognosis of amyotrophic lateral sclerosis (ALS) and have provided conflicting results. Methods: Our multicentre, retrospective study included patients diagnosed from 1 January 2009 to 31 December 2013 in 13 referral centres for ALS located in 10 Italian regions. Neurologists at these centres collected a detailed phenotypic profile and follow-up data until death in an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role in ALS prognosis. Results: A total of 2354 incident cases were collected, with a median survival time from onset to death/tracheostomy of 43 months. According to univariate analysis, together with well-known clinical prognostic factors (age at onset, diagnostic delay, site of onset, phenotype, Revised El Escorial Criteria and body mass index at diagnosis), the presence of dementia, hypertension, heart disease, chronic obstructive pulmonary disease, haematological and psychiatric diseases was associated with worse survival. In multivariate analysis, age at onset, diagnostic delay, phenotypes, body mass index at diagnosis, Revised El Escorial Criteria, dementia, hypertension, heart diseases (atrial fibrillation and heart failure) and haematological diseases (disorders of thrombosis and haemostasis) were independent prognostic factors of survival in ALS. Conclusions: Our large, multicentre study demonstrated that, together with the known clinical factors that are known to be prognostic for ALS survival, hypertension and heart diseases (i.e. atrial fibrillation and heart failure) as well as haematological diseases are independently associated with a shorter survival. Our findings suggest some mechanisms that are possibly involved in disease progression, giving new interesting clues that may be of value for clinical practice and ALS comorbidity management. {\circledC} 2018 EAN",
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TY - JOUR

T1 - Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis

AU - Mandrioli, J.

AU - Ferri, L.

AU - Fasano, A.

AU - Zucchi, E.

AU - Fini, N.

AU - Moglia, C.

AU - Lunetta, C.

AU - Marinou, K.

AU - Ticozzi, N.

AU - Drago Ferrante, G.

AU - Scialo, C.

AU - Sorarù, G.

AU - Trojsi, F.

AU - Conte, A.

AU - Falzone, Y.M.

AU - Tortelli, R.

AU - Russo, M.

AU - Sansone, V.A.

AU - Mora, G.

AU - Silani, V.

AU - Volanti, P.

AU - Caponnetto, C.

AU - Querin, G.

AU - Monsurrò, M.R.

AU - Sabatelli, M.

AU - Chiò, A.

AU - Riva, N.

AU - Logroscino, G.

AU - Messina, S.

AU - Calvo, A.

N1 - cited By 0

PY - 2018

Y1 - 2018

N2 - Background and purpose: Only a few studies have considered the role of comorbidities in the prognosis of amyotrophic lateral sclerosis (ALS) and have provided conflicting results. Methods: Our multicentre, retrospective study included patients diagnosed from 1 January 2009 to 31 December 2013 in 13 referral centres for ALS located in 10 Italian regions. Neurologists at these centres collected a detailed phenotypic profile and follow-up data until death in an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role in ALS prognosis. Results: A total of 2354 incident cases were collected, with a median survival time from onset to death/tracheostomy of 43 months. According to univariate analysis, together with well-known clinical prognostic factors (age at onset, diagnostic delay, site of onset, phenotype, Revised El Escorial Criteria and body mass index at diagnosis), the presence of dementia, hypertension, heart disease, chronic obstructive pulmonary disease, haematological and psychiatric diseases was associated with worse survival. In multivariate analysis, age at onset, diagnostic delay, phenotypes, body mass index at diagnosis, Revised El Escorial Criteria, dementia, hypertension, heart diseases (atrial fibrillation and heart failure) and haematological diseases (disorders of thrombosis and haemostasis) were independent prognostic factors of survival in ALS. Conclusions: Our large, multicentre study demonstrated that, together with the known clinical factors that are known to be prognostic for ALS survival, hypertension and heart diseases (i.e. atrial fibrillation and heart failure) as well as haematological diseases are independently associated with a shorter survival. Our findings suggest some mechanisms that are possibly involved in disease progression, giving new interesting clues that may be of value for clinical practice and ALS comorbidity management. © 2018 EAN

AB - Background and purpose: Only a few studies have considered the role of comorbidities in the prognosis of amyotrophic lateral sclerosis (ALS) and have provided conflicting results. Methods: Our multicentre, retrospective study included patients diagnosed from 1 January 2009 to 31 December 2013 in 13 referral centres for ALS located in 10 Italian regions. Neurologists at these centres collected a detailed phenotypic profile and follow-up data until death in an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role in ALS prognosis. Results: A total of 2354 incident cases were collected, with a median survival time from onset to death/tracheostomy of 43 months. According to univariate analysis, together with well-known clinical prognostic factors (age at onset, diagnostic delay, site of onset, phenotype, Revised El Escorial Criteria and body mass index at diagnosis), the presence of dementia, hypertension, heart disease, chronic obstructive pulmonary disease, haematological and psychiatric diseases was associated with worse survival. In multivariate analysis, age at onset, diagnostic delay, phenotypes, body mass index at diagnosis, Revised El Escorial Criteria, dementia, hypertension, heart diseases (atrial fibrillation and heart failure) and haematological diseases (disorders of thrombosis and haemostasis) were independent prognostic factors of survival in ALS. Conclusions: Our large, multicentre study demonstrated that, together with the known clinical factors that are known to be prognostic for ALS survival, hypertension and heart diseases (i.e. atrial fibrillation and heart failure) as well as haematological diseases are independently associated with a shorter survival. Our findings suggest some mechanisms that are possibly involved in disease progression, giving new interesting clues that may be of value for clinical practice and ALS comorbidity management. © 2018 EAN

KW - amyotrophic lateral sclerosis

KW - anemia

KW - anxiety disorder

KW - Article

KW - body mass

KW - cardiomyopathy

KW - cardiovascular disease

KW - chronic obstructive lung disease

KW - comorbidity

KW - delayed diagnosis

KW - dementia

KW - depression

KW - drug dependence

KW - female

KW - follow up

KW - gammopathy

KW - heart failure

KW - human

KW - hypertension

KW - ischemic heart disease

KW - major clinical study

KW - male

KW - median survival time

KW - neurologist

KW - obsessive compulsive disorder

KW - onset age

KW - paroxysmal atrial fibrillation

KW - persistent atrial fibrillation

KW - phenotype

KW - polydipsia

KW - priority journal

KW - prognosis

KW - psychosis

KW - retrospective study

KW - thrombosis

KW - tracheostomy

KW - valvular heart disease

U2 - 10.1111/ene.13620

DO - 10.1111/ene.13620

M3 - Article

VL - 25

SP - 861

EP - 868

JO - European Journal of Neurology

JF - European Journal of Neurology

SN - 1351-5101

IS - 6

ER -