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Articles by E Lonn
Total Records ( 2 ) for E Lonn
  R Clarke , J Halsey , S Lewington , E Lonn , J Armitage , J. E Manson , K. H Bonaa , J. D Spence , O Nygard , R Jamison , J. M Gaziano , P Guarino , D Bennett , F Mir , R Peto , R Collins and for the B Vitamin Treatment Trialists' Collaboration

Elevated plasma homocysteine levels have been associated with higher risks of cardiovascular disease, but the effects on disease rates of supplementation with folic acid to lower plasma homocysteine levels are uncertain. Individual participant data were obtained for a meta-analysis of 8 large, randomized, placebo-controlled trials of folic acid supplementation involving 37 485 individuals at increased risk of cardiovascular disease. The analyses involved intention-to-treat comparisons of first events during the scheduled treatment period. There were 9326 major vascular events (3990 major coronary events, 1528 strokes, and 5068 revascularizations), 3010 cancers, and 5125 deaths. Folic acid allocation yielded an average 25% reduction in homocysteine levels. During a median follow-up of 5 years, folic acid allocation had no significant effects on vascular outcomes, with rate ratios (95% confidence intervals) of 1.01 (0.97-1.05) for major vascular events, 1.03 (0.97-1.10) for major coronary events, and 0.96 (0.87-1.06) for stroke. Likewise, there were no significant effects on vascular outcomes in any of the subgroups studied or on overall vascular mortality. There was no significant effect on the rate ratios (95% confidence intervals) for overall cancer incidence (1.05 [0.98-1.13]), cancer mortality (1.00 [0.85-1.18]) or all-cause mortality (1.02 [0.97-1.08]) during the whole scheduled treatment period or during the later years of it. Dietary supplementation with folic acid to lower homocysteine levels had no significant effects within 5 years on cardiovascular events or on overall cancer or mortality in the populations studied.

  G Saposnik , D.A Redelmeier , H Lu , E Fuller Thomson , E Lonn and J.G. Ray

Background: New immigrants to North America exhibit lower rates of obesity and hypertension than their native-born counterparts. Whether this is reflected by a lower relative risk of acute myocardial infarction (AMI) is not known.

Objective: To determine the risk of AMI among new immigrants compared to long-term residents, and, among those who develop AMI, their short- and long-term mortality rate.

Design: Population-based, matched, retrospective cohort study.

Setting: Entire province of Ontario, the most populated province in Canada, from 1 April 1995 to 31 March 2007.

Participants: A total of 965 829 new immigrants were matched to 3 272 393 long-term residents by year of birth, sex and geographic location.

Measurements: The main study outcome was hospitalization with a most responsible diagnosis of AMI. Secondary study outcomes among those who sustained an AMI were in-hospital, 30-day and 1-year mortality.

Results: The mean age of the participants at study entry was ~34 years. The incidence rate of AMI was 4.14 per 10 000 person-years among new immigrants and 6.61 per 10 000 person-years among long-term residents. After adjusting for age, income quintile, urban vs. rural residence, history of hypertension, diabetes mellitus and smoking and number of health insurance claims, the hazard ratio for AMI was 0.66 [95% confidence interval (CI): 0.63–0.69].

Conclusion: New immigrants appear to be at lower risk of AMI than long-term residents. This finding does not appear to be explained by the availability of health-care services or income level.

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