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Efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure
Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
Department of Physiology and Pathophysiology, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
Second Department of Cardiology, Shaanxi Province People's Hospital, Xi'an, China.
Department of Cardiology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China..
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2019 (English)In: Current medical science, ISSN 2096-5230, Vol. 39, no 2, p. 237-242Article in journal (Refereed) Published
Abstract [en]

Few effective treatments for chronic Keshan disease have been available till now. The efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure is inconclusive. This study aimed to determine whether selenium supplementation is associated with a decreased risk of cardiac death in chronic Keshan disease with congestive heart failure by ten years of follow-up. A retrospective long-term follow-up analysis was performed on a monitored cohort consisting of 302 chronic Keshan disease patients with a mean age of 40.8±11.4 years. Of the 302 chronic Keshan disease patients, 170 (56.3%) were given selenium supplementation until the end point of follow-up. Cox proportional hazards regression models were used to identify the independent predictors of cardiac events. Our results showed that during the follow-up, there were 101 deaths of patients with chronic Keshan disease in the selenium supplementation group (101/170, 59.4%) and 98 in non-selenium supplementation group (98/132, 74.2%). Multivariate analyses suggested that selenium supplementation was associated with a decreased risk of cardiac death (HR 0.39, 95% CI 0.28-0.53) after adjustment for baseline age, sex, cigarette smoking, family history of Keshan disease, body mass index (BMI), heart rate, electrocardiogram (ECG) abnormalities, blood pressure, initial cardiothoracic ratio, left ventricular ejection fractions (LVEF) and whole-blood selenium concentration. Our ten-year follow-up analysis indicated that selenium supplementation, specifically combined with the use of angiotensin-converting enzyme inhibitor and beta blocker therapy, improved the survival of patients with chronic Keshan disease with congestive heart failure. BMI, selenium deficiency, male, combined ECG abnormalities, LVEF, and fast heart rate increased the risk of cardiac events.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 39, no 2, p. 237-242
Keywords [en]
Keshan disease, follow-up, selenium supplementation
National Category
Cell and Molecular Biology Cardiac and Cardiovascular Systems Nutrition and Dietetics
Research subject
Biochemistry; Cardiology; Nutrition
Identifiers
URN: urn:nbn:se:umu:diva-158868DOI: 10.1007/s11596-019-2025-3ISI: 000465447300010PubMedID: 31016516OAI: oai:DiVA.org:umu-158868DiVA, id: diva2:1315268
Available from: 2019-05-13 Created: 2019-05-13 Last updated: 2019-05-20Bibliographically approved

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